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Prognostic nomogram for patients with minor stroke and transient ischaemic attack
Zhihao Lei1, Shuanglin Li2, Hongye Feng1
1Department of Neurology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
Postgraduate Medical Journal
|September 12, 2020
Summary
A new prognostic nomogram accurately predicts outcomes for patients with minor stroke and transient ischaemic attack (TIA). This tool aids clinical decision-making for these common cerebrovascular events.
Area of Science:
- Neurology
- Clinical Medicine
- Public Health
Background:
- Ischaemic stroke and transient ischaemic attack (TIA) share common etiological factors.
- Accurate prognosis is crucial for managing patients with minor stroke and TIA.
- Existing prognostic tools may lack conciseness or broad applicability.
Purpose of the Study:
- To develop and validate a concise prognostic nomogram for patients experiencing minor stroke or TIA.
- To identify key predictors of short-term outcomes in this patient population.
Main Methods:
- A cohort of 994 patients with minor stroke and TIA was divided into derivation (n=746) and validation (n=248) groups.
- The modified Rankin Scale (mRS) at 3 months post-onset was used to define favourable (mRS<2) versus unfavourable (mRS≥2) outcomes.
- A multivariable logistic regression model was employed to identify independent predictors.
Main Results:
- Seven independent predictors were identified: gender, age, baseline NIHSS, hypertension, diabetes mellitus, white blood cell count, and serum uric acid.
- The nomogram demonstrated good predictive accuracy with a Harrell's concordance index (C-index) of 0.775 in the derivation cohort and 0.787 in the validation cohort.
- Calibration curves confirmed consistency between predicted and observed outcomes in both cohorts.
Conclusions:
- The developed nomogram exhibits favorable predictive accuracy for outcomes in minor stroke and TIA patients.
- This tool has the potential to assist clinicians in making informed treatment and management decisions.
- Further validation in diverse populations may enhance its clinical utility.
