Construction and validation of a clinical predictive model for early neurological deterioration in patients with mild acute ischemic stroke
10.19845/j.cnki.zfysjjbzz.2025.0064
- VernacularTitle:轻型急性缺血性脑卒中早期神经功能恶化临床预测模型构建与验证
- Author:
Weilai LI
1
;
Weihong WU
1
;
Ying JI
2
Author Information
1. 遵化坤桐医院神经内科，河北 遵化 064200
2. 中国人民解放军联勤保障部队第981医院神经内科，河北 承德 067000
- Publication Type:Journal Article
- Keywords:
Acute ischemic stroke;
Mild acute ischemic stroke;
Early neurological deterioration;
Nomogram
- MeSH:
Nomograms
- From:
Journal of Apoplexy and Nervous Diseases
2025;42(4):321-327
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors for early neurological deterioration in mild acute ischemic stroke，to construct a clinical predictive model，and to perform internal validation of this model. Methods A retrospective analysis was performed for 739 patients with mild acute ischemic stroke who were admitted to Department of Neurology，Kuntong Hospital of Zunhua，from October 2020 to December 2023，and they were randomly divided into a training set with 534 patients （72.3%） and a validation set with 205 patients （27.7%） at a ratio of 7∶3. Univariate and multivariate logistic regression analyses were performed for the training set to determine the risk factors for early neurological deterioration in mild acute ischemic stroke. A clinical predictive model was constructed，and internal validation was performed in terms of discriminatory ability，calibration，and clinical decision making. A nomogram was plotted. Results The multivariate logistic regression analysis showed that female sex （OR=1.87，95% CI 1.14~3.09，P=0.014），time window ≤6 hours （OR=3.10，95%CI 1.56~6.19，P=0.001），a baseline NIHSS score of 2 points （OR=3.72，95%CI 1.30~10.61，P=0.014），a baseline NIHSS score of 3 points （OR=4.24，95%CI 1.45~12.35，P=0.008），a TOAST classification of large artery atherosclerosis （OR=3.88，95%CI 2.20~6.83，P<0.001），and the responsible arteries of the basilar artery，the middle cerebral artery，and the internal carotid artery （OR=8.39，95%CI 2.28~30.85，P=0.001； OR=6.22，95%CI 1.78~21.71，P=0.004； OR=5.38，95%CI 1.15~25.13，P=0.032） were independent risk factors for early neurological deterioration in mild acute ischemic stroke. The clinical predictive model constructed showed a moderate discriminatory ability （AUC>0.7），good calibration （P>0.05） in the Hosmer-Lemeshow goodness-of-fit test），and good clinical benefits in both the training set and the validation set. Conclusion This clinical predictive model can effectively predict the onset of early neurological deterioration in mild acute ischemic stroke and guide clinicians to make decisions，and therefore，it holds promise for clinical application.
- Full text:2025071613595102169轻型急性缺血性脑卒中早期神经功能恶化临床预测模型构建与验证.pdf
