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Nomogram to Predict Mortality of Endovascular Thrombectomy for Ischemic Stroke Despite Successful Recanalization

BACKGROUND: The trajectory of ischemic stroke patients attributable to large vessel occlusion is fundamentally altered by endovascular thrombectomy. This study aimed to develop a nomogram for predicting 3‐month mortality risk in patients with ischemic stroke attributed to artery occlusion in anterio...

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Autores principales: Zhang, Xiaohao, Yuan, Kang, Wang, Huaiming, Gong, Pengyu, Jiang, Teng, Xie, Yi, Sheng, Lei, Liu, Dezhi, Liu, Xinfeng, Xu, Gelin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033899/
https://www.ncbi.nlm.nih.gov/pubmed/31973604
http://dx.doi.org/10.1161/JAHA.119.014899
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author Zhang, Xiaohao
Yuan, Kang
Wang, Huaiming
Gong, Pengyu
Jiang, Teng
Xie, Yi
Sheng, Lei
Liu, Dezhi
Liu, Xinfeng
Xu, Gelin
author_facet Zhang, Xiaohao
Yuan, Kang
Wang, Huaiming
Gong, Pengyu
Jiang, Teng
Xie, Yi
Sheng, Lei
Liu, Dezhi
Liu, Xinfeng
Xu, Gelin
author_sort Zhang, Xiaohao
collection PubMed
description BACKGROUND: The trajectory of ischemic stroke patients attributable to large vessel occlusion is fundamentally altered by endovascular thrombectomy. This study aimed to develop a nomogram for predicting 3‐month mortality risk in patients with ischemic stroke attributed to artery occlusion in anterior circulation who received successful endovascular thrombectomy treatment. METHODS AND RESULTS: Patients with successful endovascular thrombectomy (modified Thrombolysis in Cerebral Infarction IIb or III) were enrolled from a multicenter registry as the training cohort. Step‐wise logistic regression with Akaike information criterion was utilized to establish the best‐fit nomogram. The discriminative value of the nomogram was tested by concordance index. An additional 224 patients from 2 comprehensive stroke centers were prospectively recruited as the test cohort for validating the new nomogram. Altogether, 417 patients were enrolled in the training cohort. Age (odds ratio [OR], 1.07; 95% CI, 1.03−1.10), poor pretreatment collateral status (OR, 2.13; 95% CI, 1.18−3.85), baseline blood glucose level (OR, 1.12; 95% CI, 1.04−1.21), symptomatic intracranial hemorrhage (OR, 9.51; 95% CI, 4.54−19.92), and baseline National Institutes of Health Stroke Scale score (OR, 1.08; 95% CI, 1.03−1.12) were associated with mortality and were incorporated in the nomogram. The c‐index of the nomogram was 0.835 (95% CI, 0.785–0.885) in the training cohort and 0.758 (95% CI, 0.667–0.849) in the test cohort. CONCLUSIONS: The nomogram, composed of age, pretreatment collateral status, baseline blood glucose level, symptomatic intracranial hemorrhage, and baseline National Institutes of Health Stroke Scale score, may predict risk of mortality in patients with ischemic stroke and treated successfully with endovascular thrombectomy.
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spelling pubmed-70338992020-02-27 Nomogram to Predict Mortality of Endovascular Thrombectomy for Ischemic Stroke Despite Successful Recanalization Zhang, Xiaohao Yuan, Kang Wang, Huaiming Gong, Pengyu Jiang, Teng Xie, Yi Sheng, Lei Liu, Dezhi Liu, Xinfeng Xu, Gelin J Am Heart Assoc Original Research BACKGROUND: The trajectory of ischemic stroke patients attributable to large vessel occlusion is fundamentally altered by endovascular thrombectomy. This study aimed to develop a nomogram for predicting 3‐month mortality risk in patients with ischemic stroke attributed to artery occlusion in anterior circulation who received successful endovascular thrombectomy treatment. METHODS AND RESULTS: Patients with successful endovascular thrombectomy (modified Thrombolysis in Cerebral Infarction IIb or III) were enrolled from a multicenter registry as the training cohort. Step‐wise logistic regression with Akaike information criterion was utilized to establish the best‐fit nomogram. The discriminative value of the nomogram was tested by concordance index. An additional 224 patients from 2 comprehensive stroke centers were prospectively recruited as the test cohort for validating the new nomogram. Altogether, 417 patients were enrolled in the training cohort. Age (odds ratio [OR], 1.07; 95% CI, 1.03−1.10), poor pretreatment collateral status (OR, 2.13; 95% CI, 1.18−3.85), baseline blood glucose level (OR, 1.12; 95% CI, 1.04−1.21), symptomatic intracranial hemorrhage (OR, 9.51; 95% CI, 4.54−19.92), and baseline National Institutes of Health Stroke Scale score (OR, 1.08; 95% CI, 1.03−1.12) were associated with mortality and were incorporated in the nomogram. The c‐index of the nomogram was 0.835 (95% CI, 0.785–0.885) in the training cohort and 0.758 (95% CI, 0.667–0.849) in the test cohort. CONCLUSIONS: The nomogram, composed of age, pretreatment collateral status, baseline blood glucose level, symptomatic intracranial hemorrhage, and baseline National Institutes of Health Stroke Scale score, may predict risk of mortality in patients with ischemic stroke and treated successfully with endovascular thrombectomy. John Wiley and Sons Inc. 2020-01-24 /pmc/articles/PMC7033899/ /pubmed/31973604 http://dx.doi.org/10.1161/JAHA.119.014899 Text en © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Zhang, Xiaohao
Yuan, Kang
Wang, Huaiming
Gong, Pengyu
Jiang, Teng
Xie, Yi
Sheng, Lei
Liu, Dezhi
Liu, Xinfeng
Xu, Gelin
Nomogram to Predict Mortality of Endovascular Thrombectomy for Ischemic Stroke Despite Successful Recanalization
title Nomogram to Predict Mortality of Endovascular Thrombectomy for Ischemic Stroke Despite Successful Recanalization
title_full Nomogram to Predict Mortality of Endovascular Thrombectomy for Ischemic Stroke Despite Successful Recanalization
title_fullStr Nomogram to Predict Mortality of Endovascular Thrombectomy for Ischemic Stroke Despite Successful Recanalization
title_full_unstemmed Nomogram to Predict Mortality of Endovascular Thrombectomy for Ischemic Stroke Despite Successful Recanalization
title_short Nomogram to Predict Mortality of Endovascular Thrombectomy for Ischemic Stroke Despite Successful Recanalization
title_sort nomogram to predict mortality of endovascular thrombectomy for ischemic stroke despite successful recanalization
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033899/
https://www.ncbi.nlm.nih.gov/pubmed/31973604
http://dx.doi.org/10.1161/JAHA.119.014899
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