A novel score to predict progression in anterior circulation single subcortical infarction patients

Abstract

Abstract Objective Progressive infarction (PI) has a negative effect on functional prognosis. Our study aimed to develop and validate a risk score for predicting PI in patients with anterior circulation single subcortical infarction (ACSSI). Methods Between January 2020 and October 2022, we retrospectively enrolled 638 eligible patients with ACSSI. Two‐thirds of the eligible patients were randomly allocated to the training cohort (n = 425). Another resampling sample was formed through the bootstrap method and was used as the validation group (n = 425). Multivariate logistic regression analysis was used to identify the independent factors associated with PI. Each factor was then point assigned based on β‐coefficient and a risk scoring system was developed. This scoring system was internally validated through 1000‐bootstrap resamplings. The C‐statistic and Hosmer‐Lemeshow test were used to assess model discrimination and calibration. Results PI occurred in 121 patients, accounting for 19.0% of the total patients. A 7‐point NTS score system based on the initial NIHSS score, triglyceride‐glucose index, and the number of infarct slices on axial diffusion‐weighted imaging was developed. The NTS score showed good discrimination and calibration in the training cohort (C‐statistic = 0.686; p value of Hosmer–Lemeshow test = 0.797) and validation cohort (C‐statistic = 0.681; p value of Hosmer–Lemeshow test = 0.451). The three risk levels for predicting PI in the training and validation cohorts based on NTS score were as follows: low (0–2, 9.6% vs. 9.3%), intermediate (3–5, 28.2% vs. 26.7%), and high risk (6–7, 60.2% vs. 57.4%). Interpretation The NTS score is a valid and convenient risk score for predicting PI in ACSSI patients.