列线图风险预测模型评估未溶栓治疗的出血转化和脑梗死再发风险

目的建立列线图风险预测模型评估未溶栓治疗的出血转化和脑梗死再发风险。方法回顾性分析未给予溶栓治疗的脑梗死病人118例,单因素回归分析得到发生出血转化(HT)的危险因素,多因素回归Logistic分析出独立危险因素,同时利用R软件构建未溶栓治疗的出血转化和脑梗死再发风险的列线图预测模型。结果年龄(OR=4.084,95%CI:1.583~8.746)、高血压(OR=6.056,95%CI:2.065~17.762)、房颤(OR=3.347,95%CI:1.239~9.041)、NIHSS评分(OR=2.754,95%CI:1.226~6.187)、低密度脂蛋白(OR=2.659,95%CI:1.040~6.799)、大面积脑梗死(OR=5.652,95%CI:1.622~19.698)是未溶栓治疗患者发生出血转化和脑梗死再发的独立危险因素,以此6个独立危险因素构建列线图预测风险模型,并验证该模型的精确度,预测结果和实际值基本相同,C-index为0.850(95%CI:0.832~0.878),表明风险预测模型准确度较高。结论年龄、高血压、房颤、NIHSS评分、低密度脂蛋白、大面积脑梗死是未溶栓治疗患者发生出血转化和脑梗死再发的独立危险因素,本研究建立的风险预测模型准确度高,对于提高未溶栓治疗的患者发生出血转化和脑梗死的诊治有一定的指导价值。

Nomographic risk prediction model to assess the risk of hemorrhagic transformation and cerebral infarction recurrence without thrombolytic therapy

Objective To establish a nomogram risk prediction model to evaluate the risk of hemorrhagic transformation and cerebral infarction recurrence without thrombolytic therapy.Methods Totally 118 patients with cerebral infarction who did not receive thrombolytic therapy were retrospectively analyzed.The risk factors of hemorrhagic transformation(HT)were obtained by univariate regression analysis.Independent risk factors were identified by multivariate logistic regression analysis.At the same time,the risk model of hemorrhagic transformation and recurrence risk of cerebral infarction without thrombolytic therapy was established by R software analysis.Results Age(OR=4.084,95%CI:1.583-8.746),hypertension(OR=6.056,95%CI:2.065-17.762),atrial fibrillation(OR=3.347,95%CI:1.239-9.041),NIHSS score(OR=2.754,95%CI:1.226-6.187),low-density lipoprotein(OR=2.659,95%CI:1.040-6.799),large-area cerebral infarction(OR=5.652,95%CI:2.622~19.698)were independent risk factors for hemorrhagic transformation and recurrence of cerebral infarction in patients without thrombolytic therapy.Based on these six independent risk factors,a nomogram prediction risk model was established and the accuracy of the model was verified.The prediction results were basically the same as the actual value,and the c-index was 0.850(95%CI:0.832-0.878),indicating that the accuracy of the risk prediction model was relatively high High.Conclusion Age,hypertension,atrial fibrillation,NIHSS score,low-density lipoprotein and massive cerebral infarction are independent risk factors for hemorrhagic transformation and recurrence of cerebral infarction in patients without thrombolytic therapy.The risk prediction model established in this study has high accuracy,so as to improve the diagnosis and treatment of hemorrhagic transformation and cerebral infarction in patients without thrombolytic therapy.