Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-06-20 Cooperative journals: 《中国全科医学》
Abstract： Background Systemic inflammatory response index（SIRI）is an emerging biomarker associated with ischemic stroke（IS），but its correlation with recurrent IS remains unclear. Objective To investigate the correlation between SIRI and one-year recurrence of IS. Methods Patients diagnosed with IS and hospitalized in the First Affiliated Hospital of Nanchang University，the Second Affiliated Hospital of Nanchang University，the Second Hospital of Nanchang，and the Third Hospital of Nanchang between March 2019 and March 2021 were enrolled into the cohort. All patients were followed up for one year. Relevant clinical information within 48 hours of admission was collected. The recurrence of IS was recorded during the 1-year follow-up. The correlation between SIRI and one-year recurrence of IS was examined using Cox regression model，restricted cubic splines（RCS），and subgroup analysis. Results A total of 1 023 eligible patients were enrolled in the cohort，including 107（10.46%）experiencing a recurrence of IS during the one-year follow-up period. After adjusting for confounders，multivariable Cox regression analysis showed that an elevated SIRI was a risk factor for IS recurrence（HR=1.06，95%CI=1.01-1.10）. Categorized into quartiles，patients in the highest quartile（fourth quartile，Q4 subgroup，n=256）of SIRI exhibited a significantly higher risk of IS recurrence compared to those in the lowest quartile（first quartile，Q1 subgroup，n=256）（HR=1.80，95%CI=1.08-3.00）. RCS analysis demonstrated a J-shaped dose-response relationship between SIRI and the risk of IS recurrence（P-Nonlinear=0.025）. Subgroup analyses stratified by gender，age，history of stroke，and the National Institutes of Health Stroke Scale（NIHSS）score at admission were performed. A significant correlation was identified between SIRI and NIHSS score（P<0.001）. Specifically，for patients with an NIHSS score of 0-1 point，an elevated SIRI was significantly correlated with an increased risk of IS recurrence（HR=1.25，95%CI=1.04-1.51，P=0.020）. For those with an NIHSS score of 5-15 points，an elevated SIRI was significantly correlated with a higher recurrence risk（HR=1.20，95%CI=1.12-1.28，P<0.001）.It was indicated that a higher SIRI was significantly correlated with an increased risk of IS recurrence within these score ranges. Conclusion A higher SIRI is significantly correlated with an increased risk of IS recurrence. A J-shaped association is observed between SIRI and IS recurrence risk. Notably，in IS patients with NIHSS scores of 0-1 and 5-15，elevated SIRI is significantly correlated with an increased risk of recurrence.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-05-27 Cooperative journals: 《中国全科医学》
Abstract： Acute ischemic stroke（AIS）is characterized by high rates of disability，mortality，and recurrence，posing a significant burden on patients and society. In the era of big data，predictive models are increasingly used in patient diagnosis，treatment decisions，prognosis management，and healthcare resource allocation，highlighting their growing importance. Machine learning methods have become a crucial tool for predicting the prognosis of AIS patients and have been widely applied. This review explores recent advancements in the study of AIS prognosis prediction，focusing on machine learning methods. It discusses current issues and challenges faced by machine learning models，aiming to provide new insights and references for methods of early assessment and prediction of prognosis outcomes in AIS patients.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-05-14 Cooperative journals: 《中国全科医学》
Abstract： Background Serum remnant cholesterol（RC）is associated with the onset of ischemic stroke（IS）. However，studies on the correlation between RC levels and recurrent IS are limited，and the predictive value of RC in recurrent IS has not been analyzed. Objective To investigate the correlation between serum RC and the recurrence of IS，and to evaluate the predictive value of RC levels in recurrent IS by detecting serum RC levels in patients with IS. Methods Patients diagnosed as IS and hospitalized in the First Affiliated Hospital of Nanchang University，the Second Affiliated Hospital of Nanchang University，the Second Hospital of Nanchang，and the Third Hospital of Nanchang from March 2019 to March 2021 were included in the study. Relevant clinical information within 48 hours of admission was collected. All patients were followed up for 12 months to record the cases of recurrent IS. COX regression and Restricted Cubic Spline（RCS）were performed to identify the correlation between RC levels and recurrent IS. Receiver operating characteristic（ROC）curves were plotted to evaluate the predictive value of RC levels in recurrent IS. Results A total of 1 023 eligible patients were included in the study，and 107（10.46%）of them experienced IS recurrence within 1 year. Multivariable Cox regression analysis showed that RC was an independent risk factor for recurrent IS（HR=2.709，95%CI=1.150-6.382； P<0.05）. There was a nonlinear positive dose-response relationship between RC levels and the risk of recurrent IS（P-Nonlinear=0.0193）. The area under the curve（AUC）of RC in discriminating 1-year recurrence of IS was 0.687（95%CI：0.631-0.743），with the optimal cutoff of 0.58 mmol/L. There was a significant difference in the AUC between the combination detection of RC and the Essen Stroke Risk Score（ESRS）versus ESRS alone in discriminating 1-year recurrence of IS（Z=2.3562，P<0.05）. Conclusion RC is an independent risk factor for recurrent IS， showing a predictive value in the recurrence of IS.
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