Development and validation of nomograms for predicting stroke recurrence after firstepisode ischemic stroke.
10.12122/j.issn.1673-4254.2022.01.16
- Author:
Jin LIU
1
;
Yan Ling YANG
1
;
Ke YAN
1
;
Cai Rong ZHU
1
;
Min JIANG
1
Author Information
1. Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China.
- Publication Type:Journal Article
- Keywords:
Cox proportional hazards regression model;
nomogram;
recurrence of ischemic stroke
- MeSH:
Aged;
Humans;
Ischemic Stroke;
Middle Aged;
Nomograms;
Prognosis;
Proportional Hazards Models;
Retrospective Studies;
Risk Factors;
Stroke
- From:
Journal of Southern Medical University
2022;42(1):130-136
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To explore the risk factors for recurrence in first-episode ischemic stroke survivors and establish a model for predicting stroke recurrence using a nomogram.
METHODS:We collected the data from a total of 821 first-episode ischemic stroke survivors admitted in the Department of Neurology, West China Hospital, Sichuan University from January, 2010 to December, 2018. R software was used for random sampling of the patients, and 70% of the patients were included in the training set to establish the prediction model and 30% were included in the validation set. Cox proportional risk regression model was used to analyze the factors affecting stroke recurrence, and R software rms package was used to construct the histogram and establish the visual prediction model. C-index and calibration curve were used to evaluate the performance of the model for predicting stroke occurrence.
RESULTS:Among the 821 survivors, the recurrence rate was 16.81% at 3 years and 19.98% at 5 years. Multivariate analysis of the training set by Cox regression model showed that an age over 65 years (HR= 2.596, P=0.024), an age of 45-64 years (HR=2.510, P=0.006), a mRS score beyond 3 (HR=2.284, P=0.004) and a history of coronary heart disease (HR=1.353, P=0.034) were all risk factors for stroke recurrence. The C-indexes of the nomogram for the 3-and 5-year relapse prediction model were 0.640 and 0.671, respectively.
CONCLUSION:Age, mRS score and peripheral vascular disease are the factors affecting stroke recurrence in first-episode ischemic stroke survivors, and the nomogram has a high discrimination and predictive power for predicting ischemic stroke recurrence.
