AUTHOR=Jiang Yi , Xie Chunhui , Zhang Guanghui , Liu Mengqian , Xu Yiwen , Zhong Wen , Ge Zhonglin , Tao Zhonghai , Qian Mingyue , Gong Chen , Shen Xiaozhu 

TITLE=Establishment of a dynamic nomogram including thyroid function for predicting the prognosis of acute ischemic stroke with standardized treatment

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1139446

DOI=10.3389/fneur.2023.1139446

ISSN=1664-2295

ABSTRACT=Purpose: Many patients with acute ischemic stroke (AIS) cannot undergo thrombolysis or thrombectomy because they have missed the time-window or do not meet the treatment criteria. In addition, there is a lack of a available tool to predict the prognosis of patients with standardized treatment. The aim of this study was to develop a dynamic nomogram to predict the 3-month poor outcomes in patients with AIS. 
Methods: This was a retrospective multicenter study. We collected the clinical data of patients with AIS who underwent standardized treatment at the First People's Hospital of Lianyungang between October 1, 2019 and December 31, 2021 and at the Second People's Hospital of Lianyungang between January 1, 2022 and July 17, 2022. Baseline demographic, clinical, and laboratory information of patients were recorded. The outcome was 3-month modified Rankin Scale (mRS) score. Least absolute shrinkage and selection operator regression were used to select the optimal predictive factors. Multiple logistic regression was performed to establish the nomogram. Decision curve analysis (DCA) was applied to assess the clinical benefit of the nomogram. The calibration and discrimination property of the nomogram were validated by calibration plots and concordance index. 
Results: A total of 823 eligible patients were enrolled. The final model included gender (OR 0.555; 95% CI, 0.378-0.813), systolic blood pressure (SBP; OR 1.006; 95% CI, 0.996-1.016), free triiodothyronine (FT3; OR 0.841; 95% CI, 0.629-1.124), National Institutes of Health stroke scale (NIHSS; OR 18.074; 95% CI, 12.264-27.054), Trial of Org 10172 in Acute Stroke Treatment (TOAST; Cardioembolic (OR 0.736; 95% CI, 0.396-1.36); Other subtypes (OR 0.398; 95% CI, 0.257-0.609). The nomogram showed good calibration and discrimination ( C-index, 0.858; 95% CI, 0.830-0.886). DCA confirmed the clinical usefulness of the model. The dynamic nomogram can be obtained at the website: predict model (90-day prognosis of AIS patients). 
Conclusion: We established a dynamic nomogram based on gender, SBP, FT3, NIHSS and TOAST, which availably calculated the probability of 90-day poor prognosis in AIS patients with standardized treatment.