Can a Novel NAFO Nomogram Improve Prediction of the Neurological Function at Discharge in Acut Ischemic Stroke Patients with Mechanical Thrombectomy? A Chinese Multicenter Cohort Study

Abstract

Listen

Translate article

Purpose: We aimed to develop a nomogram for individualized prediction of neurological impairment for acute ischemic stroke (AIS) patients with mechanical thrombectomy (MT). Methods: We conducted a multicenter prospective study in Chinese AIS patients with MT from January 2014 to December 2018. The clinical outcome was the neurological impairment at discharge. The nomogram was generated by multivariate logistic regression analysis for predicting the probability of neurological impairment using a forward stepwise method that included age, NIHSS (National Institutes of Health Stroke Scale) score on admission, fasting blood glucose (FBG), creatinine, clinical and demographic characteristics as pre-established variables. We assessed the discriminative performance by using the area under the receiver-operating characteristic curve (AUC-ROC) and calibration of neurological impairment prediction model by using the Hosmer-Lemeshow test. Results: The study included 238 patients, NIHSS score on admission (OR: 1.148, p < 0.0001), Age (OR: 1.028, p = 0.031), FBG (OR: 1.147, p = 0.025) and OTT (OR: 1.002, p=0.013) remained independent predictors of neurological impairment to develop the NAFO nomogram in Chinese AIS patients with MT. The AUC-ROC value of the NAFO nomogram was 0.792 (95% CI: 0.733 – 0.851) in the cohort. Calibration was good (p = 0.459 for the Hosmer-Lemeshow test). Conclusions: The NAFO nomogram is the first nomogram developed and validated in Chinese AIS patients with MT and it may be used to predict the neurological impairment for these patients.