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A nomogram predictive model for long-term survival in spontaneous intracerebral hemorrhage patients without cerebral herniation at admission

Stratification of spontaneous intracerebral hemorrhage (sICH) patients without cerebral herniation at admission, to determine the subgroups may be suffered from poor outcomes or benefit from surgery, is important for following treatment decision. The aim of this study was to establish and verify a d...

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Autores principales: Lin, Fuxin, He, Qiu, Zhuo, Lingyun, Zhao, Mingpei, Ye, Gengzhao, Gao, Zhuyu, Huang, Wei, Cai, Lveming, Wang, Fangyu, Shangguan, Huangcheng, Fang, Wenhua, Lin, Yuanxiang, Wang, Dengliang, Kang, Dezhi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9946945/
https://www.ncbi.nlm.nih.gov/pubmed/36813798
http://dx.doi.org/10.1038/s41598-022-26176-0
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author Lin, Fuxin
He, Qiu
Zhuo, Lingyun
Zhao, Mingpei
Ye, Gengzhao
Gao, Zhuyu
Huang, Wei
Cai, Lveming
Wang, Fangyu
Shangguan, Huangcheng
Fang, Wenhua
Lin, Yuanxiang
Wang, Dengliang
Kang, Dezhi
author_facet Lin, Fuxin
He, Qiu
Zhuo, Lingyun
Zhao, Mingpei
Ye, Gengzhao
Gao, Zhuyu
Huang, Wei
Cai, Lveming
Wang, Fangyu
Shangguan, Huangcheng
Fang, Wenhua
Lin, Yuanxiang
Wang, Dengliang
Kang, Dezhi
author_sort Lin, Fuxin
collection PubMed
description Stratification of spontaneous intracerebral hemorrhage (sICH) patients without cerebral herniation at admission, to determine the subgroups may be suffered from poor outcomes or benefit from surgery, is important for following treatment decision. The aim of this study was to establish and verify a de novo nomogram predictive model for long-term survival in sICH patients without cerebral herniation at admission. This study recruited sICH patients from our prospectively maintained ICH patient database (RIS-MIS-ICH, ClinicalTrials.gov Identifier: NCT03862729) between January 2015 and October 2019. All eligible patients were randomly classified into a training cohort and a validation cohort according to the ratio of 7:3. The baseline variables and long-term survival outcomes were collected. And the long-term survival information of all the enrolled sICH patients, including the occurrence of death and overall survival. Follow-up time was defined as the time from the onset to death of the patient or the last clinical visit. The nomogram predictive model was established based on the independent risk factors at admission for long-term survival after hemorrhage. The concordance index (C-index) and ROC curve were used to evaluate the accuracy of the predictive model. Discrimination and calibration were used to validate the nomogram in both the training cohort and the validation cohort. A total of 692 eligible sICH patients were enrolled. During the average follow-up time of 41.77 ± 0.85 months, a total of 178 (25.7%) patients died. The Cox Proportional Hazard Models showed that age (HR 1.055, 95% CI 1.038–1.071, P < 0.001), Glasgow Coma Scale (GCS) at admission (HR 2.496, 95% CI 2.014–3.093, P < 0.001) and hydrocephalus caused by intraventricular hemorrhage (IVH) (HR 1.955, 95% CI 1.362–2.806, P < 0.001) were independent risk factors. The C index of the admission model was 0.76 and 0.78 in the training cohort and validation cohort, respectively. In the ROC analysis, the AUC was 0.80 (95% CI 0.75–0.85) in the training cohort and was 0.80 (95% CI 0.72–0.88) in the validation cohort. SICH patients with admission nomogram scores greater than 87.75 were at high risk of short survival time. For sICH patients without cerebral herniation at admission, our de novo nomogram model based on age, GCS and hydrocephalus on CT may be useful to stratify the long-term survival outcomes and provide suggestions for treatment decision-making.
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spelling pubmed-99469452023-02-24 A nomogram predictive model for long-term survival in spontaneous intracerebral hemorrhage patients without cerebral herniation at admission Lin, Fuxin He, Qiu Zhuo, Lingyun Zhao, Mingpei Ye, Gengzhao Gao, Zhuyu Huang, Wei Cai, Lveming Wang, Fangyu Shangguan, Huangcheng Fang, Wenhua Lin, Yuanxiang Wang, Dengliang Kang, Dezhi Sci Rep Article Stratification of spontaneous intracerebral hemorrhage (sICH) patients without cerebral herniation at admission, to determine the subgroups may be suffered from poor outcomes or benefit from surgery, is important for following treatment decision. The aim of this study was to establish and verify a de novo nomogram predictive model for long-term survival in sICH patients without cerebral herniation at admission. This study recruited sICH patients from our prospectively maintained ICH patient database (RIS-MIS-ICH, ClinicalTrials.gov Identifier: NCT03862729) between January 2015 and October 2019. All eligible patients were randomly classified into a training cohort and a validation cohort according to the ratio of 7:3. The baseline variables and long-term survival outcomes were collected. And the long-term survival information of all the enrolled sICH patients, including the occurrence of death and overall survival. Follow-up time was defined as the time from the onset to death of the patient or the last clinical visit. The nomogram predictive model was established based on the independent risk factors at admission for long-term survival after hemorrhage. The concordance index (C-index) and ROC curve were used to evaluate the accuracy of the predictive model. Discrimination and calibration were used to validate the nomogram in both the training cohort and the validation cohort. A total of 692 eligible sICH patients were enrolled. During the average follow-up time of 41.77 ± 0.85 months, a total of 178 (25.7%) patients died. The Cox Proportional Hazard Models showed that age (HR 1.055, 95% CI 1.038–1.071, P < 0.001), Glasgow Coma Scale (GCS) at admission (HR 2.496, 95% CI 2.014–3.093, P < 0.001) and hydrocephalus caused by intraventricular hemorrhage (IVH) (HR 1.955, 95% CI 1.362–2.806, P < 0.001) were independent risk factors. The C index of the admission model was 0.76 and 0.78 in the training cohort and validation cohort, respectively. In the ROC analysis, the AUC was 0.80 (95% CI 0.75–0.85) in the training cohort and was 0.80 (95% CI 0.72–0.88) in the validation cohort. SICH patients with admission nomogram scores greater than 87.75 were at high risk of short survival time. For sICH patients without cerebral herniation at admission, our de novo nomogram model based on age, GCS and hydrocephalus on CT may be useful to stratify the long-term survival outcomes and provide suggestions for treatment decision-making. Nature Publishing Group UK 2023-02-22 /pmc/articles/PMC9946945/ /pubmed/36813798 http://dx.doi.org/10.1038/s41598-022-26176-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Lin, Fuxin
He, Qiu
Zhuo, Lingyun
Zhao, Mingpei
Ye, Gengzhao
Gao, Zhuyu
Huang, Wei
Cai, Lveming
Wang, Fangyu
Shangguan, Huangcheng
Fang, Wenhua
Lin, Yuanxiang
Wang, Dengliang
Kang, Dezhi
A nomogram predictive model for long-term survival in spontaneous intracerebral hemorrhage patients without cerebral herniation at admission
title A nomogram predictive model for long-term survival in spontaneous intracerebral hemorrhage patients without cerebral herniation at admission
title_full A nomogram predictive model for long-term survival in spontaneous intracerebral hemorrhage patients without cerebral herniation at admission
title_fullStr A nomogram predictive model for long-term survival in spontaneous intracerebral hemorrhage patients without cerebral herniation at admission
title_full_unstemmed A nomogram predictive model for long-term survival in spontaneous intracerebral hemorrhage patients without cerebral herniation at admission
title_short A nomogram predictive model for long-term survival in spontaneous intracerebral hemorrhage patients without cerebral herniation at admission
title_sort nomogram predictive model for long-term survival in spontaneous intracerebral hemorrhage patients without cerebral herniation at admission
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9946945/
https://www.ncbi.nlm.nih.gov/pubmed/36813798
http://dx.doi.org/10.1038/s41598-022-26176-0
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