Construction and Validation of a Nomogram Model for Predicting Symptomatic Intracranial Hemorrhage after Intravenous Thrombolysis in Acute Ischemic Stroke
JIA Guangjie
Department of Neurology, Qixian People's Hospital, Qixian Henan 475200
Abstract：【Objective】To construct and validate a nomogram model based on clinical data to predict symptomatic intracranial hemorrhage (sICH) following intravenous thrombolysis in patients with acute ischemic stroke (AIS).【Methods】 A total of 213 AIS patients who received intravenous thrombolysis were randomly divided into a training set and a validation set in a 7∶3 ratio using stratified sampling. Multivariate logistic regression analysis was used to identify independent predictors of sICH, which were then used to build a nomogram model. The model was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).【Results】 The training set included 149 AIS patients, among whom 25 cases (16.78%) developed sICH. Multivariate logistic regression analysis identified age, baseline National Institutes of Health Stroke Scale (NIHSS) score, onset-to-treatment time (OTT), neutrophil-to-lymphocyte ratio (NLR), and hyperdense middle cerebral artery sign (HMCAS) as independent predictors of sICH (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of the nomogram model was 0.972 in the training set and 0.940 in the validation set, indicating good discrimination. The calibration curve demonstrated good agreement between predicted and observed sICH risk (P=0.196). DCA indicated that the nomogram had good clinical utility.【Conclusion】 Age, NIHSS score, OTT, NLR, and HMCAS are independent predictors of sICH after intravenous thrombolysis in AIS patients. The developed nomogram model can effectively predict the risk of sICH.
贾广杰. 列线图构建急性缺血性脑卒中静脉溶栓后症状性颅内出血的模型及验证[J]. 医学临床研究, 2025, 42(6): 989-992.
JIA Guangjie. Construction and Validation of a Nomogram Model for Predicting Symptomatic Intracranial Hemorrhage after Intravenous Thrombolysis in Acute Ischemic Stroke. JOURNAL OF CLINICAL RESEARCH, 2025, 42(6): 989-992.
2025, Vol. 42 
