A Nomogram for Predicting Stroke Recurrence Among Young Adults. Issue 6 (June 2020)

• Record Type: Journal Article
• Authors: Yuan, Kang; Chen, Jingjing; Xu, Pengfei; Zhang, Xiaohao; Gong, Xiuqun; Wu, Min; Xie, Yi; Wang, Huaiming; Xu, Gelin; Liu, Xinfeng
• Is Part Of: Stroke. Volume 51:Issue 6(2020)
• Publication Date: 2020-06
• Subjects: atherosclerosis -- calibration -- hypertension -- nomograms -- young adult; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.120.029740
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : Background and Purpose—: This study aimed to develop and validate a nomogram for predicting the risk of stroke recurrence among young adults after ischemic stroke. Methods—: Patients aged between 18 and 49 years with first-ever ischemic stroke were selected from the Nanjing Stroke Registry Program. A stepwise Cox proportional hazards regression model was employed to develop the best-fit nomogram. The discrimination and calibration in the training and validation cohorts were used to evaluate the nomogram. All patients were classified into low-, intermediate-, and high-risk groups based on the risk scores generated from the nomogram. Results—: A total of 604 patients were enrolled in this study. Hypertension (hazard ratio [HR], 2.038 [95% CI, 1.504–3.942]; P =0.034), diabetes mellitus (HR, 3.224 [95% CI, 1.848–5.624]; P <0.001), smoking status (current smokers versus nonsmokers; HR, 2.491 [95% CI, 1.304–4.759]; P =0.006), and stroke cause (small-vessel occlusion versus large-artery atherosclerosis; HR, 0.325 [95% CI, 0.109–0.976]; P =0.045) were associated with recurrent stroke. Educational years (>12 versus 0–6; HR, 0.070 [95% CI, 0.015–0.319]; P =0.001) were inversely correlated with recurrent stroke. The nomogram was composed of these factors, and successfully stratified patients into low-, intermediate-, and high-risk groups ( P <0.001). Conclusions—: The nomogram composed of hypertension, diabetes mellitus, smoking status, stroke cause, and education years may predict the risk of stroke recurrence among young adults after ischemic stroke. Abstract : Supplemental Digital Content is available in the text.