The systemic inflammation score is a prognostic factor for patients with ischemic stroke who have not undergone intravenous thrombolysis or endovascular thrombectomy therapy
The systemic inflammation score (SIS) has been utilised as a representative biomarker for evaluating nutritional and inflammation status. However, the predictive value of SIS has not been reported in patients with acute ischemic stroke (AIS). We aimed to evaluate whether SIS is associated with progn...
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| Veröffentlicht in: | Clinical neurology and neurosurgery 2024-04, Vol.239, p.108220-108220, Article 108220 |
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| description | The systemic inflammation score (SIS) has been utilised as a representative biomarker for evaluating nutritional and inflammation status. However, the predictive value of SIS has not been reported in patients with acute ischemic stroke (AIS). We aimed to evaluate whether SIS is associated with prognosis in stroke.
A total of 4801 patients with AIS were included in the study. The primary outcome was a modified Rankin Scale score>2 at the 3-month follow-up. A total of 4801 patients were randomly allocated into training (n=3361) and validation cohorts (n=1440) at a ratio of 7:3. Model performance was validated using the receiver operating characteristic (ROC) curve and calibration curve. Additionally, a comparison was made between the nomogram and the THRIVE score in regards to their respective predictive capabilities.
Overall, 1091(32.5%) patients in the training cohort and 446 (31.0%) patients in the validation cohort experienced an unfavorable outcome. The multivariate logistic regression analysis revealed that a high SIS, age, NIHSS, diabetes and prior stroke were associated with unfavorable outcome. Our nomogram was developed based on the variables mentioned above. The area under the curve (AUC) of the training set and the validation set are 0.702 and 0.708, respectively, indicating that the model has modest agreement and discrimination. The results of AUC, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) showed that nomogram had significantly higher predictive value than THRIVE scores (all P |
| doi_str_mv | 10.1016/j.clineuro.2024.108220 |
| format | Article |
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A total of 4801 patients with AIS were included in the study. The primary outcome was a modified Rankin Scale score>2 at the 3-month follow-up. A total of 4801 patients were randomly allocated into training (n=3361) and validation cohorts (n=1440) at a ratio of 7:3. Model performance was validated using the receiver operating characteristic (ROC) curve and calibration curve. Additionally, a comparison was made between the nomogram and the THRIVE score in regards to their respective predictive capabilities.
Overall, 1091(32.5%) patients in the training cohort and 446 (31.0%) patients in the validation cohort experienced an unfavorable outcome. The multivariate logistic regression analysis revealed that a high SIS, age, NIHSS, diabetes and prior stroke were associated with unfavorable outcome. Our nomogram was developed based on the variables mentioned above. The area under the curve (AUC) of the training set and the validation set are 0.702 and 0.708, respectively, indicating that the model has modest agreement and discrimination. The results of AUC, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) showed that nomogram had significantly higher predictive value than THRIVE scores (all P<0.001). However, unlike the THRIVE publication, all patients who had undergone intravenous thrombolysis or endovascular thrombectomy therapy were excluded in our study. In consequence, our derived THRIVE scores cannot be compared to those in the original THRIVE study.
The SIS exhibits potential as a simple prognostic biomarker, and the nomogram, which utilizes the SIS, may serve as a valuable tool for clinicians in the early identification of patients at heightened risk for unfavorable outcomes.
•The predictive value of systemic inflammation score (SIS) has not been reported in patients with acute ischemic stroke (AIS).•We aimed to prospectively investigate whether SIS is associated with the prognosis of ischemic stroke patients in a large-scale cohort study.•The nomogram based on SIS may serve as a valuable tool for clinicians identifying patients at heightened risk for unfavorable outcomes.</description><identifier>ISSN: 0303-8467</identifier><identifier>EISSN: 1872-6968</identifier><identifier>DOI: 10.1016/j.clineuro.2024.108220</identifier><identifier>PMID: 38447484</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Acute ischemic stroke ; Biomarker ; Biomarkers ; Blood pressure ; Calibration ; Cancer ; Cardiac arrhythmia ; Cardiovascular system ; Diabetes ; Diabetes mellitus ; Inflammation ; Intravenous administration ; Ischemia ; Lymphocytes ; Medical prognosis ; Nomograms ; Normal distribution ; Probability ; Prognosis ; Reclassification ; Regression analysis ; Risk factors ; Stroke ; Systemic inflammation score ; Thrombolysis ; Thrombolytic drugs</subject><ispartof>Clinical neurology and neurosurgery, 2024-04, Vol.239, p.108220-108220, Article 108220</ispartof><rights>2024</rights><rights>Copyright © 2024. Published by Elsevier B.V.</rights><rights>Copyright Elsevier Limited Apr 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c343t-262704406962f1c527bb242dc8d80b1ff109addc3c32dabb6fffb30018bc3e293</cites><orcidid>0000-0001-7459-6546</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0303846724001070$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38447484$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chu, Min</creatorcontrib><creatorcontrib>Wang, Daosheng</creatorcontrib><title>The systemic inflammation score is a prognostic factor for patients with ischemic stroke who have not undergone intravenous thrombolysis or endovascular thrombectomy therapy</title><title>Clinical neurology and neurosurgery</title><addtitle>Clin Neurol Neurosurg</addtitle><description>The systemic inflammation score (SIS) has been utilised as a representative biomarker for evaluating nutritional and inflammation status. However, the predictive value of SIS has not been reported in patients with acute ischemic stroke (AIS). We aimed to evaluate whether SIS is associated with prognosis in stroke.
A total of 4801 patients with AIS were included in the study. The primary outcome was a modified Rankin Scale score>2 at the 3-month follow-up. A total of 4801 patients were randomly allocated into training (n=3361) and validation cohorts (n=1440) at a ratio of 7:3. Model performance was validated using the receiver operating characteristic (ROC) curve and calibration curve. Additionally, a comparison was made between the nomogram and the THRIVE score in regards to their respective predictive capabilities.
Overall, 1091(32.5%) patients in the training cohort and 446 (31.0%) patients in the validation cohort experienced an unfavorable outcome. The multivariate logistic regression analysis revealed that a high SIS, age, NIHSS, diabetes and prior stroke were associated with unfavorable outcome. Our nomogram was developed based on the variables mentioned above. The area under the curve (AUC) of the training set and the validation set are 0.702 and 0.708, respectively, indicating that the model has modest agreement and discrimination. The results of AUC, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) showed that nomogram had significantly higher predictive value than THRIVE scores (all P<0.001). However, unlike the THRIVE publication, all patients who had undergone intravenous thrombolysis or endovascular thrombectomy therapy were excluded in our study. In consequence, our derived THRIVE scores cannot be compared to those in the original THRIVE study.
The SIS exhibits potential as a simple prognostic biomarker, and the nomogram, which utilizes the SIS, may serve as a valuable tool for clinicians in the early identification of patients at heightened risk for unfavorable outcomes.
•The predictive value of systemic inflammation score (SIS) has not been reported in patients with acute ischemic stroke (AIS).•We aimed to prospectively investigate whether SIS is associated with the prognosis of ischemic stroke patients in a large-scale cohort study.•The nomogram based on SIS may serve as a valuable tool for clinicians identifying patients at heightened risk for unfavorable outcomes.</description><subject>Acute ischemic stroke</subject><subject>Biomarker</subject><subject>Biomarkers</subject><subject>Blood pressure</subject><subject>Calibration</subject><subject>Cancer</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular system</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Inflammation</subject><subject>Intravenous administration</subject><subject>Ischemia</subject><subject>Lymphocytes</subject><subject>Medical prognosis</subject><subject>Nomograms</subject><subject>Normal distribution</subject><subject>Probability</subject><subject>Prognosis</subject><subject>Reclassification</subject><subject>Regression analysis</subject><subject>Risk factors</subject><subject>Stroke</subject><subject>Systemic inflammation score</subject><subject>Thrombolysis</subject><subject>Thrombolytic drugs</subject><issn>0303-8467</issn><issn>1872-6968</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkctu1DAUhi0EokPhFSpLbNhk8I3EswNV3KRKbMracuzjJkNiD7YzVR6Kd-SUmbJgw8KyfPyd_1x-Qq4423LG27f7rZvGCEtOW8GEwqAWgj0hG6470bS7Vj8lGyaZbLRquwvyopQ9Y0zKVj8nF1Ir1SmtNuTX7QC0rKXCPDo6xjDZebZ1TJEWlzLQsVBLDzndxVQqIsG6mjINeA7IQayF3o91QNANf0RKzekH0Psh0cEegcZU6RI95LsUUS_WjNGYlkLrkNPcp2ktWAUFIfp0tMUtk83nT8Bq84oPyPawviTPgp0KvDrfl-T7p4-311-am2-fv15_uGmcVLI2ohUdU4rhGkTg7p3o-l4o4Z32mvU8BM521nsnnRTe9n0bQuglY1z3ToLYyUvy5qSLg_9coFQz43gwTTYCNm7ETgmud7wViL7-B92nJUfszkjGFeOd7jhS7YlyOZWSIZhDHmebV8OZeTDU7M2joebBUHMyFBOvzvJLP4P_m_boIALvTwDgPo4jZFMcuuLAjxmXZ3wa_1fjN-XquqQ</recordid><startdate>20240401</startdate><enddate>20240401</enddate><creator>Chu, Min</creator><creator>Wang, Daosheng</creator><general>Elsevier B.V</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7459-6546</orcidid></search><sort><creationdate>20240401</creationdate><title>The systemic inflammation score is a prognostic factor for patients with ischemic stroke who have not undergone intravenous thrombolysis or endovascular thrombectomy therapy</title><author>Chu, Min ; Wang, Daosheng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c343t-262704406962f1c527bb242dc8d80b1ff109addc3c32dabb6fffb30018bc3e293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Acute ischemic stroke</topic><topic>Biomarker</topic><topic>Biomarkers</topic><topic>Blood pressure</topic><topic>Calibration</topic><topic>Cancer</topic><topic>Cardiac arrhythmia</topic><topic>Cardiovascular system</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Inflammation</topic><topic>Intravenous administration</topic><topic>Ischemia</topic><topic>Lymphocytes</topic><topic>Medical prognosis</topic><topic>Nomograms</topic><topic>Normal distribution</topic><topic>Probability</topic><topic>Prognosis</topic><topic>Reclassification</topic><topic>Regression analysis</topic><topic>Risk factors</topic><topic>Stroke</topic><topic>Systemic inflammation score</topic><topic>Thrombolysis</topic><topic>Thrombolytic drugs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chu, Min</creatorcontrib><creatorcontrib>Wang, Daosheng</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical neurology and neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chu, Min</au><au>Wang, Daosheng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The systemic inflammation score is a prognostic factor for patients with ischemic stroke who have not undergone intravenous thrombolysis or endovascular thrombectomy therapy</atitle><jtitle>Clinical neurology and neurosurgery</jtitle><addtitle>Clin Neurol Neurosurg</addtitle><date>2024-04-01</date><risdate>2024</risdate><volume>239</volume><spage>108220</spage><epage>108220</epage><pages>108220-108220</pages><artnum>108220</artnum><issn>0303-8467</issn><eissn>1872-6968</eissn><abstract>The systemic inflammation score (SIS) has been utilised as a representative biomarker for evaluating nutritional and inflammation status. However, the predictive value of SIS has not been reported in patients with acute ischemic stroke (AIS). We aimed to evaluate whether SIS is associated with prognosis in stroke.
A total of 4801 patients with AIS were included in the study. The primary outcome was a modified Rankin Scale score>2 at the 3-month follow-up. A total of 4801 patients were randomly allocated into training (n=3361) and validation cohorts (n=1440) at a ratio of 7:3. Model performance was validated using the receiver operating characteristic (ROC) curve and calibration curve. Additionally, a comparison was made between the nomogram and the THRIVE score in regards to their respective predictive capabilities.
Overall, 1091(32.5%) patients in the training cohort and 446 (31.0%) patients in the validation cohort experienced an unfavorable outcome. The multivariate logistic regression analysis revealed that a high SIS, age, NIHSS, diabetes and prior stroke were associated with unfavorable outcome. Our nomogram was developed based on the variables mentioned above. The area under the curve (AUC) of the training set and the validation set are 0.702 and 0.708, respectively, indicating that the model has modest agreement and discrimination. The results of AUC, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) showed that nomogram had significantly higher predictive value than THRIVE scores (all P<0.001). However, unlike the THRIVE publication, all patients who had undergone intravenous thrombolysis or endovascular thrombectomy therapy were excluded in our study. In consequence, our derived THRIVE scores cannot be compared to those in the original THRIVE study.
The SIS exhibits potential as a simple prognostic biomarker, and the nomogram, which utilizes the SIS, may serve as a valuable tool for clinicians in the early identification of patients at heightened risk for unfavorable outcomes.
•The predictive value of systemic inflammation score (SIS) has not been reported in patients with acute ischemic stroke (AIS).•We aimed to prospectively investigate whether SIS is associated with the prognosis of ischemic stroke patients in a large-scale cohort study.•The nomogram based on SIS may serve as a valuable tool for clinicians identifying patients at heightened risk for unfavorable outcomes.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>38447484</pmid><doi>10.1016/j.clineuro.2024.108220</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0001-7459-6546</orcidid></addata></record> |
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| ispartof | Clinical neurology and neurosurgery, 2024-04, Vol.239, p.108220-108220, Article 108220 |
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| source | Elsevier ScienceDirect Journals |
| subjects | Acute ischemic stroke Biomarker Biomarkers Blood pressure Calibration Cancer Cardiac arrhythmia Cardiovascular system Diabetes Diabetes mellitus Inflammation Intravenous administration Ischemia Lymphocytes Medical prognosis Nomograms Normal distribution Probability Prognosis Reclassification Regression analysis Risk factors Stroke Systemic inflammation score Thrombolysis Thrombolytic drugs |
| title | The systemic inflammation score is a prognostic factor for patients with ischemic stroke who have not undergone intravenous thrombolysis or endovascular thrombectomy therapy |
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