急性脑梗死合并高血压患者发生认知障碍的风险预测列线图模型构建与验证OA

Objective To construct and validate the nomogram model for predicting the risk of cognitive impairment in patients with acute cerebral infarction and hypertension.Methods A total of 400 patients with acute cerebral infarction and hypertension admitted to Nanjing First Hospital from 2020 to 2024 were retrospectively selected.According to the occurrence of cognitive impairment,the patients were divided into cognitive impairment group(n=142)and non-cognitive impairment group(n=258).The clinical data of patients were collected,and the multivariate Logistic regression analysis was used to analyze the influencing factors;the nomogram model was constructed using R 4.0.0 software,and the model was verified by ROC curve,consistency index,Hosmer-Lemeshow goodness-of-fit test and decision curve.Results The age of the cognitive impairment group was older than that of the non-cognitive impairment group,the proportion of males,the proportion of patients with smoking history,the proportion of patients with drinking history,the National Institutes of Health Stroke Scale(NIHSS)score,high-sensitivity C-reactive protein(hs-CRP),Hcy,and IL-6 were higher than those of the non-cognitive impairment group,and the time from onset to treatment and the course of hypertension were longer than those of the non-cognitive impairment group(P<0.05).Multivariate Logistic regression analysis showed that age,time from onset to treatment,duration of hypertension,NIHSS score,hs-CRP,Hcy,and IL-6 were the influencing factors of cognitive impairment in patients with acute cerebral infarction and hypertension(P<0.05).Based on age,onset to treatment time,duration of hypertension,NIHSS score,hs-CRP,Hcy and IL-6,the nomogram model for predicting the risk of cognitive impairment in patients with acute cerebral infarction and hypertension was constructed.The area under the curve of the model in predicting cognitive impairment in patients with acute cerebral infarction and hypertension was 0.978[95%CI(0.964-0.991)].The consistency index of the model was 0.958.The model fitted well(P>0.05).When the threshold probability was 0-1.00,the net benefit rate of the model was>0.Conclusion Age,time from onset to treatment,duration of hypertension,NIHSS score,hs-CRP,Hcy,and IL-6 are independent influencing factors of cognitive impairment in patients with acute cerebral infarction and hypertension.The nomogram model for predicting the risk of cognitive impairment in patients with acute cerebral infarction and hypertension constructed based on the above factors in this study has good discrimination,accuracy,fitting degree and clinical applicability.