Construction and validation of a nomogram model for hemorrhagic transformation in acute cerebral infarction after intravenous thrombolysis
CAO Shuxian
ZHAI Lijing
YIN Yu
HAN Yue
WANG Li
LI Yang
Abstract：Objective To construct and validate a nomogram model of the influencing factors of hemorrhagic transformation(HT)in acute cerebral infarction(ACI)after intravenous thrombolysis(IVT).Methods A retrospective analysis was performed on the clinical data of 114 patients with ACI who underwent IVT in 904th Hospital of Wuxi Joint Logistics Support Force from January 2021 to December 2024.According to presence or absence of HT,they were divided into HT group(n=25)and non-HT group(n=89).The influencing factors of HT in ACI patients after IVT were analyzed by univariate and multivariate logistic regression analysis,and a nomogram model was constructed based on these factors,and its predictive value was evaluated by Hosmer-Lemeshow goodness of fit test and receiver operating characteristic(ROC)curve.Results The interval from onset to thrombolysis,score of National Institutes of Health stroke scale(NIHSS)at admission,neutrophil-to-lymphocyte count ratio(NLR),level of total bilirubin(TBIL),proportions of massive cerebral infarction(MCI)and severe overall burden of cerebral small vessel disease(CSVD)in HT group were higher than those in non-HT group,while levels of blood urea nitrogen(BUN)and blood potassium,prognostic nutritional index(PNI)and dosage of thrombolytic drug were lower than those in non-HT group(P<0.05).Multivariate logistic regression analysis showed that increased TBIL,decreased blood potassium,decreased PNI and severe overall burden of CSVD were risk factors of HT in ACI patients after IVT(P<0.05).Results of the nomogram model constructed on the above four factors showed that Hosmer-Lemeshow goodness of fit test was χ2=0.392,P=1.000.The predicted probability was relatively closer to the actual probability,and its area under the curve(AUC),sensitivity and specificity were 0.972(95%CI:0.945-0.998),88.00%and 94.38%respectively.Conclusions The influencing factors of HT include TBIL,blood potassium,PNI and overall burden of CSVD in ACI patients after IVT,and the nomogram model constructed on these factors has a high predictive value in HT.
Keywords：acute cerebral infarctionintravenous thrombolysishemorrhagic transformationinfluencing factornomogram model
Publication Date：2025-12-28
Online Publishing Date：2025-12-02(First online date of this platform, not the publication date of the document)
Pages：6( 34-39 )