摘要
Abstract
Objective To explore the risk factors for post-acute cerebral infarction(ACI)seizures and to develop and validate a clinical prediction model based on the Fine-Gray competing risk model.Methods A retrospective cohort study was conducted including 580 ACI patients admitted between January 2021 and March 2024,with a follow-up period of 1 month.Multivariate analysis was performed using the Fine-Gray competing risk model,with seizure as the event of interest.A nomogram prediction model was developed based on the identified independent risk factors,and model performance was evaluated using the C-index and calibration curve.Results Among the 580 patients,61(10.52%)developed seizures.Results of the multivariate analysis using the Fine-Gray competing risk model showed that cortical infarction(s HR=1.34,95%CI:1.07-1.68),hemorrhagic transformation(s HR=1.38,95%CI:1.11-1.72),high pre-thrombolysis National Institutes of Health stroke scale(NIHSS)score(s HR=1.37,95%CI:1.14-1.66),cardioembolic type(s HR=1.37,95%CI:1.06-1.78),and carotid circulation involvement(s HR=1.35,95%CI:1.09-1.66)were independent risk factors(all P<0.05).The C-index of the prediction model was 0.82(95%CI:0.79-0.86),and the calibration curve showed high consistency between predicted probabilities and actual risks.Conclusions Based on the competing risk model analysis,cortical infarction,hemorrhagic transformation,high pre-thrombolysis NIHSS score,TOAST classification of cardioembolic type,and carotid circulation involvement are independent risk factors for post-ACI seizures.The nomogram developed on the above factors can quantitatively predict the risk of post-ACI seizures with good predictive performance.关键词
竞争风险模型/急性脑梗死/癫痫/预测Key words
Competing risk model/Acute cerebral infarction/Seizures/Prediction分类
医药卫生
