Zhang et al reported a nomogram for predicting early neurological improvement (ENI) following endovascular thrombectomy for ischemic stroke. The authors are from Nanjing Medical University, Shanghai University of Traditional Chinese Medicine and affiliated hospitals in China.
Patient selection: endovascular thrombectomy in a patient with ischemic stroke
Outcome: favorable at 3 months (modified Ranking scale 0 to 2). A reduction in the NIHSS by >= 6 points was the optimal definition of early neurological improvement (ENI).
Parameters:
(1) age in years
(2) blood glucose in mmol/L
(3) recanalization
(4) symptomatic intracranial hemorrhage (sICH)
(5) ASPECTS score, from 2 to 10
points for age =
= 118.56 - (1.078 * (age))
points for ASPECTS score =
= (12.5 * (ASPECTS)) - 25
|
Parameter
|
Finding
|
Points
|
|
blood glucose
|
< 5.9 mmol/L
|
32.1
|
|
|
5.9 to 6.7 mmol/L
|
21.4
|
|
|
6.8 to 8.5 mmol/L
|
10.7
|
|
|
> 8.5 mmol/L
|
0
|
|
recanalization
|
no
|
0
|
|
|
yes
|
57.5
|
|
sICH
|
no
|
95.9
|
|
|
yes
|
0
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 382.5
value of X =
= (0.02677 * (score)) - 7.815
probability of early neurological improvement =
= 1 / (1 + EXP((-10 * X))
Performance:
• The area under the ROC curve is 0.80.
