Journal of Hebei Medical University ›› 2025, Vol. 46 ›› Issue (6): 662-667.doi: 10.3969/j.issn.1007-3205.2025.06.007

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Establishment and validation of a prediction model for early neurological deterioration in middle-aged and elderly patients withacute ischaemic stroke: a single-centre retrospective study

  

  1. 1.Department of Neurology, the First Hospital of Harbin Medical University, Heilongjiang Province, 
    Harbin 150001, China； 2.Department of Critical Care Unit, the First Hospital of Harbin Medical 
    University, Heilongjiang Province, Harbin 150001, China； 3.Department of Nephrology, 
    the First Hospital of Harbin Medical University, Heilongjiang 
    Province, Harbin 150001, China

  • Online:2025-06-25 Published:2025-07-04

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Abstract: Objective To initially establish a prediction model for the occurrence of early neurological deterioration (END) in middle-aged and elderly patients with acute ischemic stroke (AIS) based on single-centre clinical data, and to validate its performance. 
Methods The clinical data of 318 AIS patients treated in the First Hospital of Harbin Medical University from January 2020 to December 2023 were retrospectively collected and divided into the END group (n=80, 25.16%) and the non-END group (n=238,74.84%) according to the occurrence of END within 7 d of thrombolysis. The risk factors of END were screened using binary logistic regression, and a prediction model was established based on the results of logistic regression.Finally, the performance of the model in identifying END was evaluated using the receiver operating characteristic (ROC) curve, and the evaluation indexes were AUC, accuracy, sensitivity, and specificity. 
Results Multivariate logistic regression analysis showed that age (OR=1.247, 95%CI: 1.030-1.510), National Institute of Health stroke scale(NIHSS) score (OR=1.872, 95%CI: 1.325-2.645), hypersensitive C-reactive protein(hs-CRP) (OR=1.430, 95%CI: 1.091-1.876), hyperglycaemia (OR=1.372, 95%CI: 1.109-1.697), and fibrinogen to albumin ratio (FAR) (OR=1.537, 95%CI: 1.184-1.996) were the independent risk factors for the development of END in middle-aged and elderly AIS patients. An END prediction model was established based on the five parameters screened by logistic regression analysis, and the are under the curve (AUC) of the model for predicting the occurrence of END in middle-aged and elderly AIS patients was 0.879 (95%CI: 0.831-0.927), with an accuracy of 82.71%, a sensitivity of 78.75%, and a specificity of 84.03%, as validated by the ROC curve. 
Conclusion Age, NIHSS score, hs-CRP, blood glucose, and FAR are independent risk factors for END in middle-aged and elderly patients with AIS, and the model established accordingly has good predictive value for END. 


Key words: ischemic stroke, early neurological deterioration, middle-aged and elderly