4.6 Article

Prognostic nomogram for patients with minor stroke and transient ischaemic attack

Journal

POSTGRADUATE MEDICAL JOURNAL
Volume 97, Issue 1152, Pages 644-649

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/postgradmedj-2020-137680

Keywords

Neurology; Stroke

Funding

  1. Science and Technology Research and Development Fund of Shenzhen [KJYY20180703165202011]
  2. Shenzhen Science and Technology Plan Project [JCYJ2017081 81 63505 850]

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This study aimed to develop and validate a prognostic nomogram for patients with minor stroke and TIA, which demonstrated favorable predictive accuracy. The nomogram has the potential to impact clinical decision-making.
Background Ischaemic stroke and transient ischaemic attack (TIA) share a common cause. We aim to develop and validate a concise prognostic nomogram for patients with minor stroke and TIA. Methods A total of 994 patients with minor stroke and TIA were included. They were split into a derivation (n=746) and validation (n=248) cohort. The modified Rankin Scale (mRS) scores 3 months after onset were used to assess the prognosis as unfavourable outcome (mRS >= 2) or favourable outcome (mRS<2). Result The final model included seven independent predictors: gender, age, baseline National Institute of Health Stroke Scale (NIHSS), hypertension, diabetes mellitus, white blood cell and serum uric acid. The Harrell's concordance index (C-index) of the nomogram for predicting the outcome was 0.775 (95% CI 0.735 to 0.814), which was confirmed by the validation cohort (C-index=0.787 (95% CI 0.722 to 0.853)). The calibration curve showed that the nomogram-based predictions were consistent with actual observation in both derivation cohort and validation cohort. Conclusion The proposed nomogram showed favourable predictive accuracy for minor stroke and TIA. This has the potential to contribute to clinical decision-making.

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