Nomogram prediction model for short-term disease outcomes of mechanical thrombectomy in patients with anterior circulation large vessel occlusion acute ischemic stroke

PEI Gaoyou; LEI Qinyu; HUANG Wenhao; XU Liguo; LI Zhendong; YANG Xiaopeng; FENG Guangsen

doi:10.3639/j.issn.1671-2897.2025.04.014

Abstract：Objective To analyze the influencing factors of short-term disease outcomes of mechanical thrombectomy(MT)in patients with anterior circulation large vessel occlusion acute ischemic stroke(LVO-AIS)and to construct a nomogram prediction model.Methods A total of 212 patients with anterior circulation LVO-AIS who underwent MT in the Second Affiliated Hospital of Zhengzhou University from March 2022 to January 2025 were included.They were followed up for 3 months and divided into poor outcome group(n=47)and good outcome group(n=165)based on different disease outcomes.The influencing factors of short-term disease outcomes of MT in patients with anterior circulation LVO-AIS were explored by multivariate Logistic stepwise regression.A nomogram prediction model for short-term disease outcomes of MT in patients with anterior circulation LVO-AIS was constructed,and its predictive value was evaluated by the receiver operating characteristic(ROC)curve.Results The proportion of patients aged≥60 years,with a history of hypertension,poor collateral circulation,postoperative modified Thrombolysis in Cerebral Infarction(mTICI)grade 0-2a,postoperative hemorrhagic transformation,and core infarction volume in the poor outcome group was higher than that in the good outcome group,and the National Institutes of Health stroke scale(NIHSS)at admission,puncture-to-reperfusion time,neutrophil count(NE)and neutrophil-lymphocyte ratio(NLR)in the poor outcome group were higher compared with good outcome group,while the lymphocyte count(LYM)was lower than that in the good outcome group(P<0.05).Multivariate analysis showed that high NIHSS score at admission(OR=1.982,95%CI:1.409-2.787),large core infarction volume(OR=2.337,95%CI:1.589-3.439),poor collateral circulation(OR=2.550,95%CI:1.696-3.833),postoperative hemorrhagic transformation(OR=2.846,95%CI:1.846-4.389),and high NLR(OR=2.059,95%CI:1.469-2.884)were risk factors for poor short-term disease outcomes of MT in patients with anterior circulation LVO-AIS(P<0.05).The consistency index(C-index)of the nomogram model was 0.892(95%CI:0.841-0.943);the original curve was close to the ideal curve.The area under the curve(AUC)(95%CI)of the nomogram model for predicting short-term disease outcomes of MT in patients with anterior circulation LVO-AIS was 0.903(0.852-0.954),with a specificity of 87.59%and a sensitivity of 91.03%.Conclusion The influencing factors of short-term disease outcomes of MT in patients with anterior circulation LVO-AIS include NIHSS score at admission,core infarction volume,collateral circulation,postoperative hemorrhagic transformation,and NLR.The nomogram model based on these factors has high application value in predicting short-term disease outcomes.