A New Nomogram for Predicting the Risk of Intracranial Hemorrhage in Acute Ischemic Stroke Patients After Intravenous Thrombolysis

Ze-An Weng; Ze-An Weng; Xiao-Xiong Huang; Xiao-Xiong Huang; Xiao-Xiong Huang; Die Deng; Die Deng; Zhen-Guo Yang; Zhen-Guo Yang; Shu-Yuan Li; Shu-Yuan Li; Jian-Kun Zang; Jian-Kun Zang; Yu-Feng Li; Yu-Feng Li; Yan-Fang Liu; Yan-Fang Liu; You-Sheng Wu; You-Sheng Wu; Tian-Yuan Zhang; Tian-Yuan Zhang; Xuan-Lin Su; Xuan-Lin Su; Dan Lu; Dan Lu; An-Ding Xu; An-Ding Xu

doi:10.3389/fneur.2022.774654

Frontiers in Neurology (Mar 2022)

A New Nomogram for Predicting the Risk of Intracranial Hemorrhage in Acute Ischemic Stroke Patients After Intravenous Thrombolysis

Ze-An Weng,
Ze-An Weng,
Xiao-Xiong Huang,
Xiao-Xiong Huang,
Xiao-Xiong Huang,
Die Deng,
Die Deng,
Zhen-Guo Yang,
Zhen-Guo Yang,
Shu-Yuan Li,
Shu-Yuan Li,
Jian-Kun Zang,
Jian-Kun Zang,
Yu-Feng Li,
Yu-Feng Li,
Yan-Fang Liu,
Yan-Fang Liu,
You-Sheng Wu,
You-Sheng Wu,
Tian-Yuan Zhang,
Tian-Yuan Zhang,
Xuan-Lin Su,
Xuan-Lin Su,
Dan Lu,
Dan Lu,
An-Ding Xu,
An-Ding Xu

Affiliations

Ze-An Weng: Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Ze-An Weng: Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Xiao-Xiong Huang: Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Xiao-Xiong Huang: Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Xiao-Xiong Huang: Department of Neurology and Stroke Center, The Central Hospital of Shaoyang, Shaoyang, China
Die Deng: Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Die Deng: Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Zhen-Guo Yang: Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Zhen-Guo Yang: Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Shu-Yuan Li: Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Shu-Yuan Li: Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Jian-Kun Zang: Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Jian-Kun Zang: Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Yu-Feng Li: Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Yu-Feng Li: Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Yan-Fang Liu: Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Yan-Fang Liu: Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
You-Sheng Wu: Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
You-Sheng Wu: Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Tian-Yuan Zhang: Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Tian-Yuan Zhang: Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Xuan-Lin Su: Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Xuan-Lin Su: Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Dan Lu: Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Dan Lu: Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
An-Ding Xu: Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
An-Ding Xu: Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China

DOI: https://doi.org/10.3389/fneur.2022.774654
Journal volume & issue: Vol. 13

Abstract

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BackgroundWe aimed to develop and validate a new nomogram for predicting the risk of intracranial hemorrhage (ICH) in patients with acute ischemic stroke (AIS) after intravenous thrombolysis (IVT).MethodsA retrospective study enrolled 553 patients with AIS treated with IVT. The patients were randomly divided into two cohorts: the training set (70%, n = 387) and the testing set (30%, n = 166). The factors in the predictive nomogram were filtered using multivariable logistic regression analysis. The performance of the nomogram was assessed based on the area under the receiver operating characteristic curve (AUC-ROC), calibration plots, and decision curve analysis (DCA).ResultsAfter multivariable logistic regression analysis, certain factors, such as smoking, National Institutes of Health of Stroke Scale (NIHSS) score, blood urea nitrogen-to-creatinine ratio (BUN/Cr), and neutrophil-to-lymphocyte ratio (NLR), were found to be independent predictors of ICH and were used to construct a nomogram. The AUC-ROC values of the nomogram were 0.887 (95% CI: 0.842–0.933) and 0.776 (95% CI: 0.681–0.872) in the training and testing sets, respectively. The AUC-ROC of the nomogram was higher than that of the Multicenter Stroke Survey (MSS), Glucose, Race, Age, Sex, Systolic blood Pressure, and Severity of stroke (GRASPS), and stroke prognostication using age and NIH Stroke Scale-100 positive index (SPAN-100) scores for predicting ICH in both the training and testing sets (p < 0.05). The calibration plot demonstrated good agreement in both the training and testing sets. DCA indicated that the nomogram was clinically useful.ConclusionsThe new nomogram, which included smoking, NIHSS, BUN/Cr, and NLR as variables, had the potential for predicting the risk of ICH in patients with AIS after IVT.

Published in Frontiers in Neurology

ISSN: 1664-2295 (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system
Website: https://www.frontiersin.org/journals/neurology/

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