摘要
Abstract
Objective To explore the influencing factors of ischemic stroke recurrence after neurointerventional surgery,and to construct a nomogram prediction model,to provide evidence-based basis for clinical precise risk stratification and individualized intervention strategy formulation.Methods A total of 152 patients with ischemic stroke who underwent nerve intervention were followed up regularly for more than 1 years.The patients were divided into recurrence group and non-recurrence group according to whether they relapsed.The differences in clinical data between the two groups were compared.Logistic regression analysis was used to screen out the influencing factors of ischemic stroke recurrence,and a nomogram prediction model was constructed and verified internally.Results There were significant differences in the ratio of hypertension,the degree of cerebral vascular stenosis and vascular recanalization between the recurrent group and the non-recurrent group(all P<0.05).Binary Logistic regression analysis showed that hypertension and severe cerebral vascular stenosis were independent risk factors for recurrence of ischemic stroke(all P<0.05),and vascular recanalization was a protective factor for recurrence of ischemic stroke(P<0.05).Hypertension,degree of cerebral vascular stenosis,vascular recanalization,and nomogram risk prediction models could predict the recurrence of ischemic stroke after neurointervention,the area under the curve was 0.676(95%CI:0.575-0.778),0.711(95%CI:0.600-0.822),0.662(95%CI:0.550-0.774),and 0.850(95%CI:0.784-0.916),respectively.When the cut-off value was taken,the sensitivity was 0.579,0.876,0.581 and 0.774 respectively,and the specificity was 0.774,0.516,0.744 and 0.760 respectively.Bootstrap method(B=1 000)was used to verify the prediction model of ischemic stroke recurrence after neurointervention.The results showed that the prediction curve was close to the ideal state after bias correction,and the C-index reached 0.657,indicating that the model had strong predictive ability.In addition,the decision curve of the model showed that the net income was always positive and better than the two invalid reference lines in the range of 0.00 to 0.80 threshold probability.Conclusions Hypertension and severe cerebral vascular stenosis are independent risk factors for recurrence of ischemic stroke,and vascular recanalization is a protective factor for recurrence of ischemic stroke.The risk prediction model based on these three factors has high predictive ability and practical value,which is helpful to evaluate the risk of recurrence of ischemic stroke and improve the prognosis of patients.关键词
神经介入术/缺血性脑卒中复发/影响因素/预测模型Key words
neurointerventional surgery/recurrent ischemic stroke/influencing factors/prediction model分类
医药卫生
