Prognostic Models of Mortality Following First‐Ever Acute Ischemic Stroke: A Population‐Based Retrospective Cohort Study
<h3>Background and Aims</h3><p dir="ltr">There is a lack of population‐based studies focusing on guideline‐based prognostic models for stroke. This study aimed to develop and validate a prognostic model that predicts mortality following a first‐ever acute ischemic stroke....
محفوظ في:
| المؤلف الرئيسي: | |
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| مؤلفون آخرون: | , , , , , , , , , |
| منشور في: |
2025
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| _version_ | 1864513538446327808 |
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| author | Mustapha Mohammed (5737328) |
| author2 | Hadzliana Zainal (9684050) Siew Chin Ong (9314213) Balamurugan Tangiisuran (652015) Fatimatuzzahra Abdul Aziz (21638594) Norsima N. Sidek (22330168) Abubakar Sha'aban (9875443) Umar Idris Ibrahim (21349316) Surajuddeen Muhammad (11767587) Irene Looi (14263993) Zariah A. Aziz (21638597) |
| author2_role | author author author author author author author author author author |
| author_facet | Mustapha Mohammed (5737328) Hadzliana Zainal (9684050) Siew Chin Ong (9314213) Balamurugan Tangiisuran (652015) Fatimatuzzahra Abdul Aziz (21638594) Norsima N. Sidek (22330168) Abubakar Sha'aban (9875443) Umar Idris Ibrahim (21349316) Surajuddeen Muhammad (11767587) Irene Looi (14263993) Zariah A. Aziz (21638597) |
| author_role | author |
| dc.creator.none.fl_str_mv | Mustapha Mohammed (5737328) Hadzliana Zainal (9684050) Siew Chin Ong (9314213) Balamurugan Tangiisuran (652015) Fatimatuzzahra Abdul Aziz (21638594) Norsima N. Sidek (22330168) Abubakar Sha'aban (9875443) Umar Idris Ibrahim (21349316) Surajuddeen Muhammad (11767587) Irene Looi (14263993) Zariah A. Aziz (21638597) |
| dc.date.none.fl_str_mv | 2025-02-13T09:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1002/hsr2.70445 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Prognostic_Models_of_Mortality_Following_First_Ever_Acute_Ischemic_Stroke_A_Population_Based_Retrospective_Cohort_Study/30233710 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Cardiovascular medicine and haematology Neurosciences Health sciences Public health acute ischemic stroke calibration discrimination mortality prognostic model validation |
| dc.title.none.fl_str_mv | Prognostic Models of Mortality Following First‐Ever Acute Ischemic Stroke: A Population‐Based Retrospective Cohort Study |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Background and Aims</h3><p dir="ltr">There is a lack of population‐based studies focusing on guideline‐based prognostic models for stroke. This study aimed to develop and validate a prognostic model that predicts mortality following a first‐ever acute ischemic stroke.</p><h3>Methods</h3><p dir="ltr">The study included 899 adult patients ( ≥ 18 years) with confirmed diagnosis of first‐ever acute ischemic stroke enrolled in the Malaysian National Stroke Registry (NSR) from January 2009 to December 2019. The primary outcome was mortality within 90 days post‐stroke (266 events [29.6%]). The prognostic model was developed using logistic regression (75%, <i>n</i>= 674) and internally validated (25%, <i>n</i>= 225). Model performance was assessed using discrimination (area under the curve (AUC]) and calibration (Hosmer‐Lemeshow test [HL]).</p><h3>Results</h3><p dir="ltr">The final model includes factors associated with increased risk of mortality, such as age (adjusted odds ratio, aOR 1.06 [95% confidence interval, CI 1.03, 1.10; <i>p </i>< 0.001]), National Institutes of Health Stroke Scale (NIHSS) score aOR 1.08 (95% CI 1.08, 1.13; <i>p</i> = 0.004), and diabetes aOR 2.29 (95% CI 1.20, 4.37; <i>p </i> = 0.012). The protective factors were antiplatelet within 48 h. aOR 0.40 (95% CI 0.19, 0.81; <i>p</i> = 0.01), dysphagia screening aOR 0.30 (95% CI 0.15, 0.61; <i>p </i>= 0.001), antiplatelets upon discharge aOR 0.17 (95% CI 0.08, 0.35; <i>p </i> < 0.001), lipid‐lowering therapy aOR 0.37 (95% CI 0.17, 0.82; <i>p </i>= 0.01), stroke education aOR 0.02 (95% CI 0.01, 0.05; <i>p </i>< 0.001) and rehabilitation aOR 0.08 (95% CI 0.04, 0.16; <i>p </i>< 0.001). The model demonstrated excellent performance (discrimination [AUC = 0.94] and calibration [HL, X2 <i>p </i>= 0.63]).</p><h3>Conclusion</h3><p dir="ltr">The study developed a validated prognostic model that excellently predicts mortality after a first‐ever acute ischemic stroke with potential clinical utility in acute stroke care decision‐making. The predictors could be valuable for creating risk calculators and aiding healthcare providers and patients in making well‐informed clinical decisions during the stroke care process.</p><h2>Other Information</h2><p dir="ltr">Published in: Health Science Reports<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1002/hsr2.70445" target="_blank">https://dx.doi.org/10.1002/hsr2.70445</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_1b03495a91f225e3cfa75c9a5dd6d3dc |
| identifier_str_mv | 10.1002/hsr2.70445 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/30233710 |
| publishDate | 2025 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Prognostic Models of Mortality Following First‐Ever Acute Ischemic Stroke: A Population‐Based Retrospective Cohort StudyMustapha Mohammed (5737328)Hadzliana Zainal (9684050)Siew Chin Ong (9314213)Balamurugan Tangiisuran (652015)Fatimatuzzahra Abdul Aziz (21638594)Norsima N. Sidek (22330168)Abubakar Sha'aban (9875443)Umar Idris Ibrahim (21349316)Surajuddeen Muhammad (11767587)Irene Looi (14263993)Zariah A. Aziz (21638597)Biomedical and clinical sciencesCardiovascular medicine and haematologyNeurosciencesHealth sciencesPublic healthacute ischemic strokecalibrationdiscriminationmortalityprognostic modelvalidation<h3>Background and Aims</h3><p dir="ltr">There is a lack of population‐based studies focusing on guideline‐based prognostic models for stroke. This study aimed to develop and validate a prognostic model that predicts mortality following a first‐ever acute ischemic stroke.</p><h3>Methods</h3><p dir="ltr">The study included 899 adult patients ( ≥ 18 years) with confirmed diagnosis of first‐ever acute ischemic stroke enrolled in the Malaysian National Stroke Registry (NSR) from January 2009 to December 2019. The primary outcome was mortality within 90 days post‐stroke (266 events [29.6%]). The prognostic model was developed using logistic regression (75%, <i>n</i>= 674) and internally validated (25%, <i>n</i>= 225). Model performance was assessed using discrimination (area under the curve (AUC]) and calibration (Hosmer‐Lemeshow test [HL]).</p><h3>Results</h3><p dir="ltr">The final model includes factors associated with increased risk of mortality, such as age (adjusted odds ratio, aOR 1.06 [95% confidence interval, CI 1.03, 1.10; <i>p </i>< 0.001]), National Institutes of Health Stroke Scale (NIHSS) score aOR 1.08 (95% CI 1.08, 1.13; <i>p</i> = 0.004), and diabetes aOR 2.29 (95% CI 1.20, 4.37; <i>p </i> = 0.012). The protective factors were antiplatelet within 48 h. aOR 0.40 (95% CI 0.19, 0.81; <i>p</i> = 0.01), dysphagia screening aOR 0.30 (95% CI 0.15, 0.61; <i>p </i>= 0.001), antiplatelets upon discharge aOR 0.17 (95% CI 0.08, 0.35; <i>p </i> < 0.001), lipid‐lowering therapy aOR 0.37 (95% CI 0.17, 0.82; <i>p </i>= 0.01), stroke education aOR 0.02 (95% CI 0.01, 0.05; <i>p </i>< 0.001) and rehabilitation aOR 0.08 (95% CI 0.04, 0.16; <i>p </i>< 0.001). The model demonstrated excellent performance (discrimination [AUC = 0.94] and calibration [HL, X2 <i>p </i>= 0.63]).</p><h3>Conclusion</h3><p dir="ltr">The study developed a validated prognostic model that excellently predicts mortality after a first‐ever acute ischemic stroke with potential clinical utility in acute stroke care decision‐making. The predictors could be valuable for creating risk calculators and aiding healthcare providers and patients in making well‐informed clinical decisions during the stroke care process.</p><h2>Other Information</h2><p dir="ltr">Published in: Health Science Reports<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1002/hsr2.70445" target="_blank">https://dx.doi.org/10.1002/hsr2.70445</a></p>2025-02-13T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1002/hsr2.70445https://figshare.com/articles/journal_contribution/Prognostic_Models_of_Mortality_Following_First_Ever_Acute_Ischemic_Stroke_A_Population_Based_Retrospective_Cohort_Study/30233710CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/302337102025-02-13T09:00:00Z |
| spellingShingle | Prognostic Models of Mortality Following First‐Ever Acute Ischemic Stroke: A Population‐Based Retrospective Cohort Study Mustapha Mohammed (5737328) Biomedical and clinical sciences Cardiovascular medicine and haematology Neurosciences Health sciences Public health acute ischemic stroke calibration discrimination mortality prognostic model validation |
| status_str | publishedVersion |
| title | Prognostic Models of Mortality Following First‐Ever Acute Ischemic Stroke: A Population‐Based Retrospective Cohort Study |
| title_full | Prognostic Models of Mortality Following First‐Ever Acute Ischemic Stroke: A Population‐Based Retrospective Cohort Study |
| title_fullStr | Prognostic Models of Mortality Following First‐Ever Acute Ischemic Stroke: A Population‐Based Retrospective Cohort Study |
| title_full_unstemmed | Prognostic Models of Mortality Following First‐Ever Acute Ischemic Stroke: A Population‐Based Retrospective Cohort Study |
| title_short | Prognostic Models of Mortality Following First‐Ever Acute Ischemic Stroke: A Population‐Based Retrospective Cohort Study |
| title_sort | Prognostic Models of Mortality Following First‐Ever Acute Ischemic Stroke: A Population‐Based Retrospective Cohort Study |
| topic | Biomedical and clinical sciences Cardiovascular medicine and haematology Neurosciences Health sciences Public health acute ischemic stroke calibration discrimination mortality prognostic model validation |