A new nomogram for predicting the prognosis based on 24-hour blood pressure variability after intravenous thrombolysis

Abstract

Background & Objective: There is insufficient research on the use of population data to construct a predictive model of blood pressure variability (BPV) after thrombolysis to estimate the subsequent development of acute ischemic stroke (AIS) patients. The aim of this study is to construct and validate a model that uses BPV 24 hours after thrombolytic therapy to predict outcome in patients with AIS.

Methods: To construct and validate a model that uses BPV 24 hours after thrombolytic therapy to predict outcome in patients with AIS.

Results: A total of 503 patients with acute ischemic stroke who received intravenous thrombolytic therapy were enrolled in the study. The multivariate analysis outcomes have delineated several pivotal factors that are significantly prognostic of adverse outcomes in AIS patients post-thrombolysis: The initial National Institutes of Health Stroke Scale score, a recorded history of hypertension, the variability in systolic and diastolic blood pressure as indicated by their standard deviation, and the blood pressure measurements recorded 24 hours subsequent to thrombolytic therapy. These determinants have emerged as substantial predictors, shedding light on the complex interplay of clinical parameters that influence patient prognosis following AIS treatment. Within the development and validation cohorts, the area under the curve for the nomogram, which estimates the probability of an unfavorable prognosis, was determined to be 0.876 (95%CI: 0.84–0.913) and 0.849 (95%CI: 0.784–0.913), respectively. The calibration curve revealed a striking congruence between the predicted probabilities by the nomogram and the actual outcomes observed in the validation set. Furthermore, the decision curve analysis underscored the significant clinical utility and robust applicability of the prognostic model, illustrating its potential to guide clinical decision-making effectively.

Conclusion: Because of its superior predictive accuracy, discriminative power, and clinical utility, the nomogram is an important adjunct tool for the assessment of possible adverse outcomes in patients with AIS following thrombolytic therapy.