Nomogram to Predict Cognitive Dysfunction After a Minor Ischemic Stroke in Hospitalized-Population.
Nomogram to Predict Cognitive Dysfunction After a Minor Ischemic Stroke in Hospitalized-Population.
复制标题
列线图预测住院人群轻微缺血性中风后的认知功能障碍
DOI：
10.3389/fnagi.2021.637363
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发表时间：
2021
影响因子：
4.8
通讯作者：
Liu X
中科院分区：
文献类型：
--
作者：
Gong L;Wang H;Zhu X;Dong Q;Yu Q;Mao B;Meng L;Zhao Y;Liu X
目前还没有一个简单的评分系统来预测轻微缺血性卒中后认知功能障碍的风险。我们的目的是开发和外部验证诺模图预测中风后认知功能障碍（PSCI）的概率在住院人群中轻微中风。此外，还研究了氧化三甲胺（TMAO）与PSCI的缔合作用。我们前瞻性地对2017年6月至2018年2月期间在卒中中心收集的数据进行了一项开发队列研究，并在2018年6月至2019年2月期间进行了一项外部验证队列研究。主要结局是认知障碍，定义为轻微卒中发作后6 - 12个月蒙特利尔认知评估（莫卡）评分<22分。基于多变量logistic模型，生成诺模图模型。在入院时使用液相色谱串联质谱法评估血浆TMAO水平。共有228名参与者完成了生成诺模图的随访数据。经多因素Logistic回归分析，年龄、女性、Fazekas评分、文化程度、颅内动脉粥样硬化性狭窄（ICAS）、糖化血红蛋白（HbA 1c）、皮质梗死等7个变量仍是PSCI的独立预测因子。模型的受试者工作特征曲线下面积（AUC-ROC）为0.829，C指数为0.810，验证队列模型的AUC-ROC为0.812。有认知功能障碍的患者血浆TMAO水平高于无认知功能障碍的患者（中位数4.56 vs. 3.22 μmol/L; p ≤ 0.001）。总之，该评分系统是第一个在卒中中心队列中开发和验证的列线图，用于个体化预测轻微卒中后的认知障碍。入院时较高的血浆TMAO水平提示PSCI的潜在标志物。
An easily scoring system to predict the risk of cognitive impairment after minor ischemic stroke has not been available. We aimed to develop and externally validate a nomogram for predicting the probability of post-stroke cognitive impairment (PSCI) among hospitalized population with minor stroke. Moreover, the association of Trimethylamine N-oxide (TMAO) with PSCI is also investigated. We prospectively conducted a developed cohort on collected data in stroke center from June 2017 to February 2018, as well as an external validation cohort between June 2018 and February 2019. The main outcome is cognitive impairment defined as <22 Montreal Cognition Assessment (MoCA) score points 6 – 12 months following a minor stroke onset. Based on multivariate logistic models, the nomogram model was generated. Plasma TMAO levels were assessed at admission using liquid chromatography tandem mass spectrometry. A total of 228 participants completed the follow-up data for generating the nomogram. After multivariate logistic regression, seven variables remained independent predictors of PSCI to compose the nomogram included age, female, Fazekas score, educational level, number of intracranial atherosclerotic stenosis (ICAS), HbA1c, and cortical infarction. The area under the receiver-operating characteristic (AUC-ROC) curve of model was 0.829, C index was good (0.810), and the AUC-ROC of the model applied in validation cohort was 0.812. Plasma TMAO levels were higher in patients with cognitive impairment than in them without cognitive dysfunction (median 4.56 vs. 3.22 μmol/L; p ≤ 0.001). In conclusion, this scoring system is the first nomogram developed and validated in a stroke center cohort for individualized prediction of cognitive impairment after minor stroke. Higher plasma TMAO level at admission suggests a potential marker of PSCI.
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影响因子：
4.6
作者：
Chander RJ;Lam BYK;Lin X;Ng AYT;Wong APL;Mok VCT;Kandiah N
通讯作者：
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影响因子：
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44.1
作者：
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