Risk prediction model for poor prognosis after intravenous thrombolysis among ischemic stroke patients aged ≥ 80 years and analysis of follow-up
Abstract To develop and validate practical prediction tools to estimate poor outcomes in patients ≥ 80 years old with acute ischemic stroke after intravenous alteplase thrombolysis, aiding clinical decision-making.To explore the longest benefit window after thrombolysis in the elderly. 1: A retrospe...
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41598-024-84912-0 |
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| author | Ying Wang Dongwei Liu Mokhtar Aldhabi Zuolei Chen Le Feng Huanmin Gao Lin Yin |
| author_facet | Ying Wang Dongwei Liu Mokhtar Aldhabi Zuolei Chen Le Feng Huanmin Gao Lin Yin |
| author_sort | Ying Wang |
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| description | Abstract To develop and validate practical prediction tools to estimate poor outcomes in patients ≥ 80 years old with acute ischemic stroke after intravenous alteplase thrombolysis, aiding clinical decision-making.To explore the longest benefit window after thrombolysis in the elderly. 1: A retrospectively analysis was conducted on acute stroke patients who underwent intravenous thrombolysis. Patients aged ≥ 80 years were compared to those aged 60–79 years, with a focus on the incidence of symptomatic intracranial hemorrhage, mortality, and poor functional outcome (modified Rankin Score ≥ 2 at 90 days post-thrombolysis). R software was utilized to develop a clinical prediction model and perform internal validation. 2: Ninety days, 180 days, and one year were designated as follow-up time points for all patients. 1.Patients aged ≥ 80 years had higher 90-day poor outcome and mortality (P < 0.001).However, there was no significant difference in symptomatic intracranial hemorrhage between the two groups (P > 0.05).Baseline NIHSS score (OR, 1.15; 95% CI,1.07–1.23; P < 0.001) and admission blood glucose (OR, 1.36; 95% CI,1.11–1.74; P = 0.007) were identified as independent predictors of poor prognosis at 90 days.The area of the prediction model under the receiver operator characteristic curve was 0.77. An online prognostic calculator was developed.2.There was no further improvement in mRS Score in the elderly group after 180days (P < 0.05). (1)The prediction model can estimate the poor outcome of patients aged ≥ 80 years with acute ischemic stroke after intravenous alteplase thrombolysis.The predictors are readily derived at admission.The prediction calculator( https://80ivtr.shinyapps.io/dynnomapp/ ) can be used as a popular tool for physicians. (2)The total duration of benefit after intravenous thrombolysis for patients aged ≥ 80 years is 180 days, while it is at least 1 year for patients between 60 and 79 years. |
| format | Article |
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| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-be65cd541d0c43cebbc851e092b6699c2025-01-12T12:19:41ZengNature PortfolioScientific Reports2045-23222025-01-0115111310.1038/s41598-024-84912-0Risk prediction model for poor prognosis after intravenous thrombolysis among ischemic stroke patients aged ≥ 80 years and analysis of follow-upYing Wang0Dongwei Liu1Mokhtar Aldhabi2Zuolei Chen3Le Feng4Huanmin Gao5Lin Yin6Department of Neurology, The Second Hospital of Dalian Medical UniversityThe West Coast New Area People’s Hospital of QingdaoThe Affiliated Hospital of Qingdao Binhai UniversityThe Affiliated Hospital of Qingdao Binhai UniversityPKUCare Zibo HospitalThe Affiliated Hospital of Qingdao Binhai UniversityDepartment of Neurology, The Second Hospital of Dalian Medical UniversityAbstract To develop and validate practical prediction tools to estimate poor outcomes in patients ≥ 80 years old with acute ischemic stroke after intravenous alteplase thrombolysis, aiding clinical decision-making.To explore the longest benefit window after thrombolysis in the elderly. 1: A retrospectively analysis was conducted on acute stroke patients who underwent intravenous thrombolysis. Patients aged ≥ 80 years were compared to those aged 60–79 years, with a focus on the incidence of symptomatic intracranial hemorrhage, mortality, and poor functional outcome (modified Rankin Score ≥ 2 at 90 days post-thrombolysis). R software was utilized to develop a clinical prediction model and perform internal validation. 2: Ninety days, 180 days, and one year were designated as follow-up time points for all patients. 1.Patients aged ≥ 80 years had higher 90-day poor outcome and mortality (P < 0.001).However, there was no significant difference in symptomatic intracranial hemorrhage between the two groups (P > 0.05).Baseline NIHSS score (OR, 1.15; 95% CI,1.07–1.23; P < 0.001) and admission blood glucose (OR, 1.36; 95% CI,1.11–1.74; P = 0.007) were identified as independent predictors of poor prognosis at 90 days.The area of the prediction model under the receiver operator characteristic curve was 0.77. An online prognostic calculator was developed.2.There was no further improvement in mRS Score in the elderly group after 180days (P < 0.05). (1)The prediction model can estimate the poor outcome of patients aged ≥ 80 years with acute ischemic stroke after intravenous alteplase thrombolysis.The predictors are readily derived at admission.The prediction calculator( https://80ivtr.shinyapps.io/dynnomapp/ ) can be used as a popular tool for physicians. (2)The total duration of benefit after intravenous thrombolysis for patients aged ≥ 80 years is 180 days, while it is at least 1 year for patients between 60 and 79 years.https://doi.org/10.1038/s41598-024-84912-0Ischemic strokeIntravenous thrombolysisPrediction modelsAged ≥ 80 yearsFollow-up |
| spellingShingle | Ying Wang Dongwei Liu Mokhtar Aldhabi Zuolei Chen Le Feng Huanmin Gao Lin Yin Risk prediction model for poor prognosis after intravenous thrombolysis among ischemic stroke patients aged ≥ 80 years and analysis of follow-up Scientific Reports Ischemic stroke Intravenous thrombolysis Prediction models Aged ≥ 80 years Follow-up |
| title | Risk prediction model for poor prognosis after intravenous thrombolysis among ischemic stroke patients aged ≥ 80 years and analysis of follow-up |
| title_full | Risk prediction model for poor prognosis after intravenous thrombolysis among ischemic stroke patients aged ≥ 80 years and analysis of follow-up |
| title_fullStr | Risk prediction model for poor prognosis after intravenous thrombolysis among ischemic stroke patients aged ≥ 80 years and analysis of follow-up |
| title_full_unstemmed | Risk prediction model for poor prognosis after intravenous thrombolysis among ischemic stroke patients aged ≥ 80 years and analysis of follow-up |
| title_short | Risk prediction model for poor prognosis after intravenous thrombolysis among ischemic stroke patients aged ≥ 80 years and analysis of follow-up |
| title_sort | risk prediction model for poor prognosis after intravenous thrombolysis among ischemic stroke patients aged ≥ 80 years and analysis of follow up |
| topic | Ischemic stroke Intravenous thrombolysis Prediction models Aged ≥ 80 years Follow-up |
| url | https://doi.org/10.1038/s41598-024-84912-0 |
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