INNOVATIVE nomogram models are providing healthcare professionals with powerful tools for predicting early neurological deterioration (END) and 90-day prognosis outcomes in patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis. A study developed these models based on a retrospective analysis of AIS patients, aiming to enhance individualized treatment strategies.
The research was conducted using two separate cohorts. The derivation cohort, comprising 298 patients with AIS treated between January 2021 and March 2024, helped identify key predictors of END and poor prognosis. Early neurological deterioration, defined as an NIHSS increase of ≥2 points within 24 hours, was observed in nearly 24% of patients, with those experiencing END at significantly greater risk of poor 90-day outcomes. Key risk factors for END included a lower initial NIHSS score, delayed door-to-needle time, reduced ASPECTS score, and incomplete Willis artery. Meanwhile, poor 90-day outcomes were linked to higher initial NIHSS scores, elevated glucose levels, nonlacunar infarctions, and a history of hypertension.
The models were created using multivariate logistic regression and showed strong accuracy, with an area under the curve (AUC) of 0.740 for END prediction and 0.859 for 90-day prognosis in the derivation cohort. In a validation cohort of 94 patients, the models maintained their predictive power, with AUC values of 0.716 and 0.795, respectively.
These nomogram models offer healthcare professionals a reliable, easy-to-use tool to assess stroke patients’ risk of adverse outcomes, facilitating more informed decision-making in treatment plans. As healthcare continues to embrace personalized medicine, such innovations in forecasting are crucial in improving patient care and outcomes.
Reference:
Wei L et al. Accurate forecasting in acute ischemic stroke: innovative nomogram models for early neurological deterioration and 90-day prognosis outcomes following intravenous thrombolysis. Eur J Med Res. 2025;30(1):671.
