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A nomogram to predict the probability of mortality after first-ever acute manifestations of cerebral small vessel disease.

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Title: A nomogram to predict the probability of mortality after first-ever acute manifestations of cerebral small vessel disease.
Authors: Cappellari, Manuel1 manuel.cappellari@aovr.veneto.it, Zivelonghi, Cecilia1, Turcato, Gianni2, Forlivesi, Stefano1, Micheletti, Nicola1, Tomelleri, Giampaolo1, Bovi, Paolo1, Bonetti, Bruno1
Source: Journal of the Neurological Sciences. Feb2018, Vol. 385, p92-95. 4p.
Subject Terms: *Nomography (Mathematics), *Mortality -- Mathematical models, *Cerebral small vessel diseases, *Creatinine, *Glucose
Abstract: Background and purpose Symptomatic lacunar stroke (LS) and deep intracerebral hemorrhage (dICH) represent the acute manifestations of type 1 cerebral small vessel disease (cSVD). Recently, two studies showed that the risk factor profile of dICH differs from that associated with LS in subjects with biologically plausible cSVD; however, the prognostic predictors after acute manifestations are currently lacking. We aimed to develop a nomogram for individualized prediction of the mortality probability in a cohort of patients with a first-ever acute manifestation of biologically plausible cSVD. Methods We conducted a retrospective analysis of data collected from consecutive patients with acute symptomatic non-embolic LS or primary dICH. The outcome measure was 3-month mortality. Based on multivariate logistic model, the nomogram was generated. Results Of the 288 patients who entered into the study for biologically plausible cSVD, 131 (45%) experienced a LS and 157 (55%) a dICH. After multivariate logistic regression, 5 variables remained predictors of mortality to compose the nomogram: dICH (OR:11.36; p = 0.001), severe presentation (OR:8.08; p < 0.001), age (OR:1.08; p = 0.001), glucose (OR:1.23; p = 0.003) and creatinine (OR:1.01; p = 0.024) at admission were predictors of mortality. The discriminative performance of nomogram assessed by using the area under the receiver operating characteristic curve (AUC-ROC) was 0.898. The model was internally validated by using bootstrap (1000 samples) with AUC-ROC of 0.895 and cross-validation (deleted-d method repeated 1000 times) with AUC-ROC of 0.895. Conclusions We developed the first nomogram for prediction of the mortality probability in a cohort of patients with a first-ever acute manifestation of biologically plausible cSVD. [ABSTRACT FROM AUTHOR]
Database: Academic Search Index
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  Data: A nomogram to predict the probability of mortality after first-ever acute manifestations of cerebral small vessel disease.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Cappellari%2C+Manuel%22&quot;&gt;Cappellari, Manuel&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;i&gt; manuel.cappellari@aovr.veneto.it&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Zivelonghi%2C+Cecilia%22&quot;&gt;Zivelonghi, Cecilia&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Turcato%2C+Gianni%22&quot;&gt;Turcato, Gianni&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Forlivesi%2C+Stefano%22&quot;&gt;Forlivesi, Stefano&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Micheletti%2C+Nicola%22&quot;&gt;Micheletti, Nicola&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Tomelleri%2C+Giampaolo%22&quot;&gt;Tomelleri, Giampaolo&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bovi%2C+Paolo%22&quot;&gt;Bovi, Paolo&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bonetti%2C+Bruno%22&quot;&gt;Bonetti, Bruno&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Journal+of+the+Neurological+Sciences%22&quot;&gt;Journal of the Neurological Sciences&lt;/searchLink&gt;. Feb2018, Vol. 385, p92-95. 4p.
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  Data: *&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Nomography+%28Mathematics%29%22&quot;&gt;Nomography (Mathematics)&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Mortality+--+Mathematical+models%22&quot;&gt;Mortality -- Mathematical models&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Cerebral+small+vessel+diseases%22&quot;&gt;Cerebral small vessel diseases&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Creatinine%22&quot;&gt;Creatinine&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Glucose%22&quot;&gt;Glucose&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background and purpose Symptomatic lacunar stroke (LS) and deep intracerebral hemorrhage (dICH) represent the acute manifestations of type 1 cerebral small vessel disease (cSVD). Recently, two studies showed that the risk factor profile of dICH differs from that associated with LS in subjects with biologically plausible cSVD; however, the prognostic predictors after acute manifestations are currently lacking. We aimed to develop a nomogram for individualized prediction of the mortality probability in a cohort of patients with a first-ever acute manifestation of biologically plausible cSVD. Methods We conducted a retrospective analysis of data collected from consecutive patients with acute symptomatic non-embolic LS or primary dICH. The outcome measure was 3-month mortality. Based on multivariate logistic model, the nomogram was generated. Results Of the 288 patients who entered into the study for biologically plausible cSVD, 131 (45%) experienced a LS and 157 (55%) a dICH. After multivariate logistic regression, 5 variables remained predictors of mortality to compose the nomogram: dICH (OR:11.36; p = 0.001), severe presentation (OR:8.08; p &lt; 0.001), age (OR:1.08; p = 0.001), glucose (OR:1.23; p = 0.003) and creatinine (OR:1.01; p = 0.024) at admission were predictors of mortality. The discriminative performance of nomogram assessed by using the area under the receiver operating characteristic curve (AUC-ROC) was 0.898. The model was internally validated by using bootstrap (1000 samples) with AUC-ROC of 0.895 and cross-validation (deleted-d method repeated 1000 times) with AUC-ROC of 0.895. Conclusions We developed the first nomogram for prediction of the mortality probability in a cohort of patients with a first-ever acute manifestation of biologically plausible cSVD. [ABSTRACT FROM AUTHOR]
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        Value: 10.1016/j.jns.2017.12.020
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      – Code: eng
        Text: English
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        PageCount: 4
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        Type: general
      – SubjectFull: Mortality -- Mathematical models
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      – SubjectFull: Cerebral small vessel diseases
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      – SubjectFull: Creatinine
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      – SubjectFull: Glucose
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              Text: Feb2018
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