Early function decline after ischemic stroke can be predicted by a nomogram based on age, use of thrombolysis, RDW and NIHSS score at admission

Turcato, Gianni; Cervellin, Gianfranco; Cappellari, Manuel; Bonora, Antonio; Zannoni, M; Bovi, Paolo; Ricci, Giorgio; Lippi, Giuseppe

doi:10.1007/s11239-016-1456-y

Cited by 36 publications

(40 citation statements)

References 25 publications

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“…Moreover, our study also demonstrated that NHISS on admission and age are stronger, significant and independent predictors of 3-month unfavorable outcome in ischemic stroke patients. As previously reported [2,[13][14][15][27][28][29], NIHSS score constitutes a strong independent predictor of poor outcome in patients with ischemic stroke, and age contribute to a long-term mortality and unfavorable outcome, this could be due to the fact that old age is associated with one or more cardiovascular disease such as coronary artery disease, high blood pressure, high cholesterol, atrial fibrillation, heart failure, peripheral artery disease, and cerebral amyloid angiopathy.…”

Section: Discussionmentioning

confidence: 71%

“…To the best of our knowledge, there have only been 3 scholarly works carried out on nomograms for individualized prediction of the probability of unfavorable outcome of ischemic stroke in Caucasians (Italian) [13][14][15]. The START nomogram was designed to predict outcome after intravenous thrombolysis for stroke [14], and another nomogram model was developed in a study including 344 patients who started oral anticoagulants 1-7 days after atrial fibrillation-related stroke onset [13].…”

Section: Introductionmentioning

confidence: 99%

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A COACHS Nomogram to Predict the Probability of Three-Month Unfavorable Outcome after Acute Ischemic Stroke in Chinese Patients

et al. 2019

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Background: Accurate prognostication of unfavorable outcome made at the early onset of stroke is important to both the clinician and the patient management. This study was aimed to develop a nomogram based on the integration of parameters to predict the probability of 3-month unfavorable functional outcome in Chinese acute ischemic stroke patients. Methods: We retrospectively collected patients who underwent acute ischemic stroke at Stroke Center of the Nanjing First Hospital (China) between May 2013 and May 2018. After exclusion, the study population includes 1,025 patients for nomogram development. The main outcome measure was 3-month unfavorable outcome (modified Rankin Scale > 2). Multivariable logistic regression analysis was used to develop the predicting model, and stepwise logistic regression with the Akaike information criterion was utilized to find best-fit nomogram model. We incorporated the creatinine, fast blood glucose, age, previous cerebral hemorrhage, previous valvular heart disease, and NHISS score (COACHS), and these factors were presented with a nomogram. We assessed the discriminative performance by using the area under curve (AUC) of receiver-operating characteristic (ROC) and calibration of risk prediction model by using the Hosmer-Lemeshow test. Results: Multivariate analysis of the 1,025 patients for logistic regression helped identify the independent factors as National Institutes of Health Stroke Scale score on admission, age, previous valvular heart disease, fasting blood glucose, creatinine, and previous cerebral hemorrhage, which were included in the COACHS nomogram. The AUC-ROC of nomogram was 0.799. Calibration was good (p = 0.1376 for the Hosmer-Lemeshow test). Conclusions: The COACHS nomogram may be used to predict unfavorable outcome at 3 months after acute ischemic stroke in Chinese population. It may be also a reliable tool that is effective in its clinical utilization to risk-stratify acute stroke patients.

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

A COACHS Nomogram to Predict the Probability of Three-Month Unfavorable Outcome after Acute Ischemic Stroke in Chinese Patients

et al. 2019

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“…Although no systematic studies on the correlation between these routine clinical indicators and ischemic stroke have been performed either in China or abroad, a few reports have been published that evaluated the relationship between routine blood tests and stroke. Recent reports have been published on the relationship between the neutrophil/lymphocyte ratio (Xue et al, 2017;Zhang et al, 2011), red blood cell distribution width and stroke prognosis at home and abroad (Kim et al, 2012a;Turcato et al, 2017b). In 2017, Turcato et al (2017a) found that determination of red blood cell distribution width could provide guidance on the risk of cardiovascular and cerebrovascular diseases.…”

Section: Discussionmentioning

confidence: 99%

Comparison of routine hematological indicators of liver and kidney function, blood count and lipid profile in healthy people and stroke patients

Cui

Wei

Xiao

et al. 2020

PeerJ

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Background and methods Stroke has become a major public health problem worldwide. In this article, we carried out statistical analysis, correlation analysis and principal component analysis (PCA) to evaluate the clinical value of routine hematological indicators in early diagnosis of ischemic stroke using R language. Results For the full blood count comparisons, stroke patients had obvious differences in the distribution width of red blood cells (RDW-CV), average distribution width of red blood cells (RDW-SD), mean hemoglobin concentrations, platelet large cell ratio, mean platelet volume and lymphocytes. Patients with ischemic stroke also exhibited different degrees of abnormalities in liver function test. With respect to renal function, stroke patients had obvious changes in uric acid and urea levels. Finally, when comparing the lipid profile, triglyceride concentrations were increased and high-density lipoprotein cholesterol concentrations were reduced in stroke patients. In addition, correlation analysis among these clinical indicators indicated that there were both common characteristics and differences between patients and health controls. Furthermore, the results of PCA indicated that these clinical indicators could distinguish patients from the healthy controls. Conclusion Conventional hematological clinical indicators, such as liver function, renal function, full blood count and lipid concentration profiles highly correlated with the occurrence of ischemic stroke. Therefore, the detection and analyzation of these clinical indicators are of great significance for the prediction of ischemic stroke.

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“…Emerging evidence suggests that, besides red blood cell abnormalities, many human disorders may be frequently associated with high RDW. It has been linked to ischemic cerebrovascular disease and to poorer outcome after ischemic stroke [33]. Higher values of RDW have also recently shown to be associated with increased mortality of ESRD patients [34, 35].…”

Section: Discussionmentioning

confidence: 99%

Low Cerebral Oxygenation Is Associated with Cognitive Impairment in Chronic Hemodialysis Patients

Kovářová¹,

Valeriánová²,

Kmentova³

et al. 2018

Nephron

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Background/Aims: High rates of cognitive impairment (CI) are an alarming problem in patients undergoing chronic hemodialysis (HD). Its pathophysiology remains unclear and there are indications that brain ischemia might be one of the key causes. Cerebral tissue oxygenation, as measured by near-infrared spectroscopy, is known to be decreased in HD patients. However, it is unknown whether CI is associated or not associated with lower cerebral oxygenation in these patients. The primary aim of our study was to probe this possible association. Our secondary aim was to assess other factors possibly related to cerebral ischemia and CI. Methods: Thirty-nine patients treated by chronic HD were included in this cross-sectional study. All measurements were performed before the initiation of an HD session. The Montreal Cognitive Assessment (MoCA) was administered according to published recommendations. Regional saturation of oxygen (rSO2) of the left frontal lobe was measured using the INVOS 5100C device. Basic medical history and laboratory data were recorded, and handgrip strength was analyzed. We used the unpaired t test to compare the rSO2 and other variables between cognitively normal patients (MoCA score ≥26) and those who displayed CI (MoCA score <26). Multiple linear regression analysis was used to adjust for principal confounders. Results: Cognitively impaired patients had lower brain rSO2 values compared to cognitively normal patients (48 ± 9 vs. 57 ± 10%, p = 0.01). Among other variables, higher red cell distribution width (15.8 ± 1.9 vs. 13.8 ± 1.6%, p = 0.01) and lower hand grip strength (49.2 ± 23.3 vs. 99.3 ± 31.4 lbs, p < 0.001) also displayed a significant association with CI. The relation between rSO2 and MoCA score was significant after adjustment for age and gender (p = 0.007). Conclusion: Decreased brain oxygenation is associated with weaker cognitive performance in patients undergoing chronic HD. Further understanding the causes of cerebral ischemia in HD patients could lead to the prevention of cognitive decline in this population.

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Early function decline after ischemic stroke can be predicted by a nomogram based on age, use of thrombolysis, RDW and NIHSS score at admission

Cited by 36 publications

References 25 publications

A COACHS Nomogram to Predict the Probability of Three-Month Unfavorable Outcome after Acute Ischemic Stroke in Chinese Patients

A COACHS Nomogram to Predict the Probability of Three-Month Unfavorable Outcome after Acute Ischemic Stroke in Chinese Patients

Comparison of routine hematological indicators of liver and kidney function, blood count and lipid profile in healthy people and stroke patients

Low Cerebral Oxygenation Is Associated with Cognitive Impairment in Chronic Hemodialysis Patients

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