Analyzing post‐endovascular treatment stroke prognosis with transcranial Doppler and quantitative electroencephalography

Abstract Objective Despite successful recanalization following acute ischemic stroke, patients may have a poor prognosis. We investigated whether transcranial Doppler combined with quantitative electroencephalography can identify patients with a poor prognosis at an early stage. Methods Prospectivel...

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Main Authors: Yajie Qi, Yingqi Xing, Qingduo Wang, Yanting Cao, Hongxiu Chen, Ying Chen
Format: Article
Language:English
Published: Wiley 2024-09-01
Series:Annals of Clinical and Translational Neurology
Online Access:https://doi.org/10.1002/acn3.52157
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author Yajie Qi
Yingqi Xing
Qingduo Wang
Yanting Cao
Hongxiu Chen
Ying Chen
author_facet Yajie Qi
Yingqi Xing
Qingduo Wang
Yanting Cao
Hongxiu Chen
Ying Chen
author_sort Yajie Qi
collection DOAJ
description Abstract Objective Despite successful recanalization following acute ischemic stroke, patients may have a poor prognosis. We investigated whether transcranial Doppler combined with quantitative electroencephalography can identify patients with a poor prognosis at an early stage. Methods Prospectively recruited patients with successful recanalization after endovascular treatment for acute ischemic stroke were assessed for prognosis at 90 days using the modified Rankin Scale. Clinical information and National Institute of Health Stroke Scale scores were recorded. Transcranial Doppler combined with quantitative electroencephalography was used to evaluate brain function. Results Of the 37 patients (63.5 ± 11.7 years) studied, 18 had a poor prognosis at 90 days (modified Rankin Scale >3). Multivariable analysis revealed that transcranial Doppler indicators of the pulsatility index of the unaffected side, quantitative electroencephalography indicators of the pairwise‐derived Brain Symmetry Index, and National Institute of Health Stroke Scale score were independent prognostic indicators. Modeling indicated that combining these independent predictors yielded superior accuracy and net clinical benefit to any single variable. With the final predictive model presented as a nomogram, internal validation by bootstrap resampling showed good discrimination with a concordance index of 0.961. The calibration curve displayed good agreement of predicted and actual probabilities. Interpretation The nomogram prediction model combining transcranial Doppler with quantitative electroencephalography and National Institute of Health Stroke Scale scores can provide guidance for individualized risk prediction in patients with acute ischemic stroke after revascularization.
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spelling doaj-art-c37e82f04e2c4bac91e78c932df5735e2025-08-20T02:26:13ZengWileyAnnals of Clinical and Translational Neurology2328-95032024-09-011192417242510.1002/acn3.52157Analyzing post‐endovascular treatment stroke prognosis with transcranial Doppler and quantitative electroencephalographyYajie Qi0Yingqi Xing1Qingduo Wang2Yanting Cao3Hongxiu Chen4Ying Chen5Department of Neurology The First Hospital of Jilin University Changchun ChinaDepartment of Vascular Ultrasonography, Xuanwu Hospital Capital Medical University Beijing ChinaCadiovascular Center Northern Jiangsu People's Hospital Affiliated to Yangzhou University Yangzhou ChinaDepartment of Neurology Linyi People's Hospital Linyi ChinaDepartment of Vascular Ultrasonography, Xuanwu Hospital Capital Medical University Beijing ChinaDepartment of Neurology The First Hospital of Jilin University Changchun ChinaAbstract Objective Despite successful recanalization following acute ischemic stroke, patients may have a poor prognosis. We investigated whether transcranial Doppler combined with quantitative electroencephalography can identify patients with a poor prognosis at an early stage. Methods Prospectively recruited patients with successful recanalization after endovascular treatment for acute ischemic stroke were assessed for prognosis at 90 days using the modified Rankin Scale. Clinical information and National Institute of Health Stroke Scale scores were recorded. Transcranial Doppler combined with quantitative electroencephalography was used to evaluate brain function. Results Of the 37 patients (63.5 ± 11.7 years) studied, 18 had a poor prognosis at 90 days (modified Rankin Scale >3). Multivariable analysis revealed that transcranial Doppler indicators of the pulsatility index of the unaffected side, quantitative electroencephalography indicators of the pairwise‐derived Brain Symmetry Index, and National Institute of Health Stroke Scale score were independent prognostic indicators. Modeling indicated that combining these independent predictors yielded superior accuracy and net clinical benefit to any single variable. With the final predictive model presented as a nomogram, internal validation by bootstrap resampling showed good discrimination with a concordance index of 0.961. The calibration curve displayed good agreement of predicted and actual probabilities. Interpretation The nomogram prediction model combining transcranial Doppler with quantitative electroencephalography and National Institute of Health Stroke Scale scores can provide guidance for individualized risk prediction in patients with acute ischemic stroke after revascularization.https://doi.org/10.1002/acn3.52157
spellingShingle Yajie Qi
Yingqi Xing
Qingduo Wang
Yanting Cao
Hongxiu Chen
Ying Chen
Analyzing post‐endovascular treatment stroke prognosis with transcranial Doppler and quantitative electroencephalography
Annals of Clinical and Translational Neurology
title Analyzing post‐endovascular treatment stroke prognosis with transcranial Doppler and quantitative electroencephalography
title_full Analyzing post‐endovascular treatment stroke prognosis with transcranial Doppler and quantitative electroencephalography
title_fullStr Analyzing post‐endovascular treatment stroke prognosis with transcranial Doppler and quantitative electroencephalography
title_full_unstemmed Analyzing post‐endovascular treatment stroke prognosis with transcranial Doppler and quantitative electroencephalography
title_short Analyzing post‐endovascular treatment stroke prognosis with transcranial Doppler and quantitative electroencephalography
title_sort analyzing post endovascular treatment stroke prognosis with transcranial doppler and quantitative electroencephalography
url https://doi.org/10.1002/acn3.52157
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