A NAC nomogram to predict the probability of three-month unfavorable outcome in Chinese acute ischemic stroke patients treated with mechanical thrombectomy.

BACKGROUND AND PURPOSE: Mechanical thrombectomy (MT) is a standard care for most acute ischemic stroke (AIS) patients. For AIS patients underwent MT, predicting the patients at high risk of unfavorable outcome and adjusting therapeutic strategies accordingly can greatly improve patient outcomes. We aimed to develop and validate a nomogram for individualized prediction of Chinese AIS patients underwent MT. METHODS: We conducted a multicenter prospective study including 238 AIS patients who underwent MT from January 2014 to December 2018. The main outcome measure was three-month unfavorable outcome (modified Rankin Scale 3-6). A nomogram was generated based on multivariate logistic model. We assessed the discriminative performance by using the area under the receiver-operating characteristic curve and calibration of risk prediction model by using the Hosmer-Lemeshow test. RESULTS: In NAC nomogram, NIHSS (National Institutes of Health Stroke Scale) score on admission (OR: 1.193, p < 0.0001), Age (OR: 1.025, p = 0.037) and Creatinine (OR: 1.028, p < 0.0001) remained independent predictors of 3-month unfavorable outcome in Chinese AIS patients treated with MT. The NAC nomogram exhibited an area under the curve of 0.816 for predicting functional impairment. Calibration was good (p = 0.560 for the Hosmer-Lemeshow test). CONCLUSIONS: The NAC nomogram is the first nomogram developed and validated in Chinese AIS patients treated with MT and it may be used to predict 3 months unfavorable outcome for these patients.

Profile and 1-Year Outcome of Ischemic Stroke in East China: Nanjing First Hospital Stroke Registry.

BACKGROUND: The profile and 1-year outcome after acute ischemic stroke (AIS) in Nanjing, China, is uncertain. This study aimed to investigate the profile and outcome after 1-year follow-up of AIS in East China. METHODS: In a prospective cohort study, 2168 patients with AIS were recruited consecutively. The primary outcome was death or dependency defined as a modified Rankin Scale score of 3-6 at 12 months. Plausible risk factors of death or dependency, such as demographics, risk factors of cardiovascular diseases, clinical features, laboratory results, and complications after a stroke, were selected from available variables to perform multivariable logistic regression analyses. RESULTS: Eight hundred thirty-seven (38.6%) patients died or suffered from dependency. Multivariate logistic regression analysis showed that age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.03-1.05), history of diabetes mellitus (OR, 1.50; 95% CI, 1.10-2.04), prior stroke (OR, 2.08; 95% CI, 1.51-2.87), National Institutes of Health Stroke Scale (NIHSS) score (OR, 23.06; 95% CI, 14.24-37.34), estimated glomerular filtration rate (OR, 1.65; 95% CI, 1.02-2.66), pulmonary infection (OR, 2.98; 95% CI, 2.17-4.09), and gastrointestinal bleeding (OR, 7.81; 95% CI, 2.76-22.09) were significantly and independently associated with higher rates of mortality or disability (all P values < .05). Male gender (P values < .001) was the only factor associated with lower mortality or disability. CONCLUSIONS: The main dominating predictors for death or dependency were older age, female gender, diabetes mellitus, prior stroke, NIHSS score, estimated glomerular filtration rate, pulmonary infection, and gastrointestinal bleeding.