A Novel Nomogram for Predicting Poor 6-Month Function in Patients With Acute Ischemic Stroke Receiving Thrombolysis

Patients with acute ischemic stroke (AIS) receiving thrombolysis with good function at discharge are usually ignored. Their functional deterioration after discharge not only compromises the effectiveness of thrombolytic therapy but also reduces their long-term quality of life, which is not conducive to the advancement of medical healthcare and continuing care.

The aims of this study were to explore the risk factors for poor 6-month function in patients with AIS receiving thrombolysis with good function at discharge and construct a novel nomogram model.

This case-control study retrospectively analyzed the medical data of 149 patients with AIS receiving thrombolysis with good function at discharge from January 2017 to June 2019. Patients were divided into a poor function group (<3 points) and a good function group (≥3 points) according to their modified Rankin Scale scores at 6 months. Logistic regression was used to identify risk factors for poor 6-month function. A novel nomogram prediction model for poor 6-month function was constructed, and its prediction performance and concordance were evaluated.

Of 149 patients, 21 (14%) had poor 6-month function and 128 (86%) had good 6-month function. Multivariate regression analysis showed that physical inactivity, neutrophil count, cerebral small vessel disease score, and hospitalization days were independent risk factors for poor 6-month function. A regression model was established according to the multivariate analysis, and the area under the curve was 0.9363. The accuracy was 71.99%, the sensitivity was 78.83%, and the specificity was 70.26%. A nomogram model was constructed, and its concordance index was 0.836 after internal validation.

The novel nomogram model facilitates risk prediction of poor 6-month function in patients with AIS receiving thrombolysis with good function at discharge and is helpful for making discharge plans.