Introduction of direct oral anticoagulant within 7 days of stroke onset: a nomogram to predict the probability of 3-month modified Rankin Scale score > 2
| Autor: | Carolina Gentile, Anna Gaudenzi, Alessandro Adami, Bruno Bonetti, Nicola Micheletti, Gianni Turcato, Roberto Eleopra, Giovanni Merlino, Manuel Cappellari, Sandro Bruno, Monia Russo, Paolo Bovi, Roberto L’Erario, Giampaolo Tomelleri, Stefano Forlivesi |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Time Factors 030204 cardiovascular system & hematology Logistic regression Severity of Illness Index Nomogram law.invention Direct oral anticoagulants 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Risk Factors Modified Rankin Scale law Internal medicine Atrial Fibrillation medicine Humans Prospective Studies cardiovascular diseases Prospective cohort study Stroke Outcome Aged Aged 80 and over Receiver operating characteristic business.industry Anticoagulants Atrial fibrillation Hematology Middle Aged Prognosis medicine.disease Nomograms Treatment Outcome ROC Curve Cardiology Female Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Thrombosis and Thrombolysis. 46:292-298 |
| ISSN: | 1573-742X 0929-5305 |
| Popis: | In clinical practice, direct oral anticoagulants (DOACs) are often started earlier (≤ 7 days) than in randomized clinical trials after stroke. We aimed to develop a nomogram model incorporating time of DOAC introduction ≤ 7 days of stroke onset in combination with different degrees of stroke radiological/neurological severity at the time of treatment to predict the probability of unfavorable outcome. We conducted a multicenter prospective study including 344 patients who started DOAC 1–7 days after atrial fibrillation-related stroke onset. Computed tomography scan 24–36 h after stroke onset was performed in all patients before starting DOAC. Unfavorable outcome was defined as modified Rankin Scale (mRS) score > 2 at 3 months. Based on multivariate logistic model, the nomogram was generated. We assessed the discriminative performance by using the area under the receiver operating characteristic curve (AUC–ROC) and calibration of risk prediction model by using the Hosmer–Lemeshow test. Onset-to-treatment time for DOAC (OR: 1.21, p = 0.030), NIH Stroke Scale (NIHSS) score at the time of treatment (OR: 1.00 for NIHSS = 0–5; OR: 2.67, p = 0.016 for NIHSS = 6–9; OR: 26.70, p |
| Databáze: | OpenAIRE |
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