Risk factors for secondary infection in patients with acute ischemic stroke undergoing intravenous thrombolysis and construction of a nomogram model
10.19845/j.cnki.zfysjjbzz.2024.0174
- VernacularTitle:静脉溶栓急性缺血性脑卒中继发感染的风险因素和列线图模型构建
- Author:
Xiaoxi LI
1
;
Xiaodi YAN
;
Peng XIA
Author Information
1. 南京医科大学鼓楼临床医学院急诊科,江苏 南京 210008
- Keywords:
Ischemic stroke;
Intravenous thrombolysis;
Infection;
LASSO regression;
Nomogram
- From:
Journal of Apoplexy and Nervous Diseases
2024;41(10):916-922
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors for secondary infection in patients with acute ischemic stroke(AIS)undergoing intravenous thrombolysis,and to construct a nomogram model.Methods A retrospective analysis was performed for the clinical data of 391 patients with AIS who underwent intravenous thrombolysis in Nanjing Drum Tower Hospital retrospectively from December 2016 to December 2021,and according to the presence of absence of secondary in-fection,they were divided into infection group with 75 patients and non-infection group with 316 patients.Results Age[odds ratio(OR)=1.049,95%confidence interval(CI)1.017-1.082],history of renal insufficiency(OR=3.76,95%CI 1.382-9.966),history of antihypertensive drugs(OR=0.298,95%CI 0.144-0.562),hemorrhagic transforma-tion after thrombolysis(OR=2.851,95%CI 1.05-7.36),white blood cell count(WBC)on admission(OR=1.17,95%CI 1.045-1.313),prothrombin time(PT)on admission(OR=1.585,95%CI 1.206-2.167),and dysphagia(OR=8.309,95%CI 4.091-17.269)were independent risk factors for secondary infection.The nomogram predictive model based on these risk factors had an area under the ROC curve of 0.867 and a cutoff value of 0.180,suggesting that the model had good discriminatory ability and calibration.According to the cutoff value of the nomogram,the patients were di-vided into high-risk and low-risk groups based on the risk of secondary infection,and the low-risk group had a significantly higher cumulative survival rate than the high-risk group(P<0.000 1).Conclusion Age,history of renal insufficiency,his-tory of antihypertensive drugs,hemorrhagic transformation after thrombolysis,WBC on admission,PT on admission,and dysphagia on admission are risk factors for secondary infection in AIS patients after intravenous thrombolysis,and the nomo-gram predictive model constructed based on the above risk factors has a good value in predicting secondary infection and 90-day survival.
