Development and validation of a nomogram model for prediction of stroke-associated pneumonia associated with intracerebral hemorrhage

BMC Geriatrics

Research

Huiqin Xu¹  Yuchen Xu¹  Ying Wang²  Yuting Chen²  Roumeng Chen²  Xinshi Wang³  Jinyang Xia⁴  Han Zheng⁴  Yifan Cai⁴  Jiajun Xu⁴ 

[1] Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China;Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China;Graduate school, Wenzhou Medical University, Wenzhou, Zhejiang, China;Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China;Key Laboratory of Alzheimer’s Disease of Zhejiang Province, Institute of Aging, Wenzhou Medical University, Wenzhou, Zhejiang, China;Department of Geriatrics, Geriatric Medical Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China;First Clinical School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China;

关键词: Intracranial hemorrhage;    Stroke-associated pneumonia;    Predictors;    Nomogram;    Validation;   

DOI  :  10.1186/s12877-023-04310-5

 received in 2023-06-08, accepted in 2023-09-12,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundWe aimed to establish risk factors for stroke-associated pneumonia (SAP) following intracerebral hemorrhage (ICH) and develop an efficient and convenient model to predict SAP in patients with ICH.MethodsOur study involved 1333 patients consecutively diagnosed with ICH and admitted to the Neurology Department of the First Affiliated Hospital of Wenzhou Medical University. The 1333 patients were randomly divided (3:1) into the derivation cohort (n = 1000) and validation Cohort (n = 333). Variables were screened from demographics, lifestyle-related factors, comorbidities, clinical symptoms, neuroimaging features, and laboratory tests. In the derivation cohort, we developed a prediction model with multivariable logistic regression analysis. In the validation cohort, we assessed the model performance and compared it to previously reported models. The area under the receiver operating characteristic curve (AUROC), GiViTI calibration belt, net reclassification index (NRI), integrated discrimination index (IDI) and decision curve analysis (DCA) were used to assess the prediction ability and the clinical decision-making ability.ResultsThe incidence of SAP was 19.9% and 19.8% in the derivation (n = 1000) and validation (n = 333) cohorts, respectively. We developed a nomogram prediction model including age (Odds Ratio [OR] 1.037, 95% confidence interval [CI] 1.020–1.054), male sex (OR 1.824, 95% CI 1.206–2.757), multilobar involvement (OR 1.851, 95% CI 1.160–2.954), extension into ventricles (OR 2.164, 95% CI 1.456–3.215), dysphagia (OR 3.626, 95% CI 2.297–5.725), disturbance of consciousness (OR 2.113, 95% CI 1.327–3.362) and total muscle strength of the worse side (OR 0.93, 95% CI 0.876–0.987). Compared with previous models, our model was well calibrated and showed significantly higher AUROC, better reclassification ability (improved NRI and IDI) and a positive net benefit for predicted probability thresholds between 10% and 73% in DCA.ConclusionsWe developed a simple, valid, and clinically useful model to predict SAP following ICH, with better predictive performance than previous models. It might be a promising tool to assess the individual risk of developing SAP for patients with ICH and optimize decision-making.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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