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BMC Neurology
Published in: BMC Neurology 1/2019

Open Access 01-12-2019 | Stroke | Research article

A nomogram for predicting the in-hospital mortality after large hemispheric infarction

Authors: Wenzhe Sun, Guo Li, Ziqiang Liu, Jinfeng Miao, Zhaoxia Yang, Qiao Zhou, Run Liu, Suiqiang Zhu, Zhou Zhu

Published in: BMC Neurology | Issue 1/2019

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Abstract

Background

Large hemispheric infarction (LHI) is a severe form of stroke with high mortality and disability rates. The purpose of this study was to explore predictive indicators of the in-hospital mortality of LHI patients treated conservatively without decompressive hemicraniectomy.

Method

We performed a retrospective study of 187 consecutive patients with LHI between January 1, 2016 to May 31, 2019. The receiver operating curves were preformed to evaluate predictive performance of demographics factors, biomarkers and radiologic characteristics. Significant prognostic factors were combined to build a nomogram to predict the risk of in-hospital death of individual patients.

Result

One hundred fifty-eight patients with LHI were finally enrolled, 58 of which died. Through multivariate logistic regression analysis, we identified that independent prognostic factors for in-hospital death were age (adjusted odds ratio [aOR] = 1.066; 95% confidence interval [CI], 1.025–1.108; P = 0.001), midline shift (MLS, aOR = 1.330, 95% CI, 1.177–1.503; P <  0.001), and neutrophil-to-lymphocyte ratio (NLR, aOR = 3.319, 95% CI, 1.542–7.144; P = 0.002). NLR may serve as a better predictor than white blood count (WBC) and neutrophil counts. Lastly, we used all of the clinical characteristics to establish a nomogram for predicting the prognosis, area under the curve (AUC) of this nomogram was 0.858 (95% CI, 0.794–0.908).

Conclusion

This study shows that age, MLS, and admission NLR value are independent predictors of in-hospital mortality in patients with LHI. Moreover, nomogram, serve as a precise and convenient tool for the prognosis of LHI patients.
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Metadata
Title
A nomogram for predicting the in-hospital mortality after large hemispheric infarction
Authors
Wenzhe Sun
Guo Li
Ziqiang Liu
Jinfeng Miao
Zhaoxia Yang
Qiao Zhou
Run Liu
Suiqiang Zhu
Zhou Zhu
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Stroke
Published in
BMC Neurology / Issue 1/2019
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-019-1571-4

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