A prediction model of hemorrhage transformation in AIS patients after thrombolysis based on routine laboratory data
10.3969/j.issn.1009-0126.2025.01.019
- VernacularTitle:基于实验室常规检验数据建立急性缺血性脑卒中患者溶栓后出血转化预测模型
- Author:
Hua YANG
1
;
Yuewen DONG
1
;
Xiaoxia ZHANG
1
Author Information
1. 054000 邢台市中心医院检验科
- Publication Type:Journal Article
- Keywords:
ischemic stroke;
tissue plasminogen activator;
proportional hazards models
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2025;27(1):84-88
- CountryChina
- Language:Chinese
-
Abstract:
Objective To develop a model for visualizing the risk of hemorrhagic transformation(HT)in acute ischemic stroke(AIS)patients after alteplase thrombolysis based on routine labo-ratory data.Methods A total of 252 AIS patients receiving alteplase thrombolysis in our hospital from January 2021 to January 2024 were enrolled,and then divided into HT group and non-HT group according to developing HT or not within 24 h after thrombolysis.The influencing factors for HT in AIS patients after alteplase thrombolysis were analyzed,and then a model of visualizing the risk was conducted and its predictive performance was verified.Results HT occurred in 52 out of 252 AIS patients(20.63％).The HT group had significantly higher ratio of hypertension,higher NIHSS score at admission,elevated neutrophil count,and increased D-dimer(D-D)and to-tal bilirubin(TBIL)levels,whereas lower uric acid(UA)and serum potassium levels when com-pared with the non-HT group(P＜0.05,P＜0.01).Multivariate logistic regression analysis identi-fied neutrophils,D-D,and TBIL as independent risk factors for HT(OR=2.753,95％CI:1.399-5.417,P=0.003;OR=1.987,95％CI:1.322-2.986,P=0.001;OR=2.121,95％CI:1.392-3.230,P=0.000),while UA and serum potassium were protective factors(OR=0.417,95％CI:0.202-0.860,P=0.027;OR=0.160,95％CI:0.028-0.911,P=0.039).The AUC value of the constructed model in predicting HT in AIS patients after alteplase thrombolysis was 0.920(95％CI:0.880-0.950),with a sensitivity of 96.15％and a specificity of 80.50％.Hosmer-Lemeshow test(x2=1.888,P=0.169)confirmed the model had good fit,and Bootstrap internal validation yielded a C-index of 0.921.Conclusion Neutrophils,D-D,and TBIL are risk factors,while UA and serum potassium are protective factors for HT in AIS patients following alteplase thrombolysis.Our developed model of risk visualization demonstrates robust predictive performance.
