Lactate dehydrogenase to albumin ratio and poor prognosis after thrombolysis in ischemic stroke patients: developing a novel nomogram

Abstract Background Ischemic stroke (IS) is associated with high disability and mortality. This study aimed to identify the prognostic predictors and develop a nomogram for a prediction model for ischemic stroke patients after thrombolysis. Methods We retrospectively analyzed data from 359 IS patien...

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Main Authors: Xiao-Dan Zhang, Zong-Yong Zhang, Ming-Pei Zhao, Xiang-Tao Zhang, Neng Wang, Hong-Zhi Gao, Yuan-Xiang Lin, Zong-Qing Zheng
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Medical Informatics and Decision Making
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Online Access:https://doi.org/10.1186/s12911-025-02991-z
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author Xiao-Dan Zhang
Zong-Yong Zhang
Ming-Pei Zhao
Xiang-Tao Zhang
Neng Wang
Hong-Zhi Gao
Yuan-Xiang Lin
Zong-Qing Zheng
author_facet Xiao-Dan Zhang
Zong-Yong Zhang
Ming-Pei Zhao
Xiang-Tao Zhang
Neng Wang
Hong-Zhi Gao
Yuan-Xiang Lin
Zong-Qing Zheng
author_sort Xiao-Dan Zhang
collection DOAJ
description Abstract Background Ischemic stroke (IS) is associated with high disability and mortality. This study aimed to identify the prognostic predictors and develop a nomogram for a prediction model for ischemic stroke patients after thrombolysis. Methods We retrospectively analyzed data from 359 IS patients who underwent thrombolysis. Clinical characteristics, laboratory parameters, and prognosis data were collected. One-third of the subjects were randomly selected as a validation set (n = 108) for internal validation. Logistic regression analysis was used to derive independent risk indicators. A nomogram was constructed using these indicators, and the performance of the nomogram was assessed by the Area Under the Curve (AUC) of the Receiver Operating Characteristic (ROC). The agreement of the model predictions with actual observations was assessed via calibration curves, and the clinical utility of the nomogram was assessed via decision curve analysis. Results Multivariate logistic regression analysis showed that age, leukocytes, Lactate Dehydrogenase to Albumin Ratio (LAR) and NIHSS were independent predictors of three-month post-thrombolysis prognosis in IS patients. We created a nomogram based on the weighting coefficients of these factors. The AUC curves showed that our model including age, leukocytes, LAR and NIHSS was more accurate in predicting prognosis than a single factor. The calibration curves showed a good fit between actual and predicted probabilities in both the training and validation groups. Conclusion LAR has a good predictive power for the prognosis of IS patients 3 months after thrombolytic therapy and can be used as a new clinical indicator to establish a practical nomogram.
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spelling doaj-art-cc0956c65c9a45bc84ec3cfc3724954f2025-08-20T02:17:50ZengBMCBMC Medical Informatics and Decision Making1472-69472025-04-0125111010.1186/s12911-025-02991-zLactate dehydrogenase to albumin ratio and poor prognosis after thrombolysis in ischemic stroke patients: developing a novel nomogramXiao-Dan Zhang0Zong-Yong Zhang1Ming-Pei Zhao2Xiang-Tao Zhang3Neng Wang4Hong-Zhi Gao5Yuan-Xiang Lin6Zong-Qing Zheng7Neurosurgery Department, The 2nd Affiliated Hospital of Fujian Medical UniversityDepartment of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical UniversityDepartment of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical UniversityDepartment of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical UniversityDepartment of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical UniversityNeurosurgery Department, The 2nd Affiliated Hospital of Fujian Medical UniversityDepartment of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical UniversityNeurosurgery Department, The 2nd Affiliated Hospital of Fujian Medical UniversityAbstract Background Ischemic stroke (IS) is associated with high disability and mortality. This study aimed to identify the prognostic predictors and develop a nomogram for a prediction model for ischemic stroke patients after thrombolysis. Methods We retrospectively analyzed data from 359 IS patients who underwent thrombolysis. Clinical characteristics, laboratory parameters, and prognosis data were collected. One-third of the subjects were randomly selected as a validation set (n = 108) for internal validation. Logistic regression analysis was used to derive independent risk indicators. A nomogram was constructed using these indicators, and the performance of the nomogram was assessed by the Area Under the Curve (AUC) of the Receiver Operating Characteristic (ROC). The agreement of the model predictions with actual observations was assessed via calibration curves, and the clinical utility of the nomogram was assessed via decision curve analysis. Results Multivariate logistic regression analysis showed that age, leukocytes, Lactate Dehydrogenase to Albumin Ratio (LAR) and NIHSS were independent predictors of three-month post-thrombolysis prognosis in IS patients. We created a nomogram based on the weighting coefficients of these factors. The AUC curves showed that our model including age, leukocytes, LAR and NIHSS was more accurate in predicting prognosis than a single factor. The calibration curves showed a good fit between actual and predicted probabilities in both the training and validation groups. Conclusion LAR has a good predictive power for the prognosis of IS patients 3 months after thrombolytic therapy and can be used as a new clinical indicator to establish a practical nomogram.https://doi.org/10.1186/s12911-025-02991-zLARIschemic strokeLactate dehydrogenaseAlbumin
spellingShingle Xiao-Dan Zhang
Zong-Yong Zhang
Ming-Pei Zhao
Xiang-Tao Zhang
Neng Wang
Hong-Zhi Gao
Yuan-Xiang Lin
Zong-Qing Zheng
Lactate dehydrogenase to albumin ratio and poor prognosis after thrombolysis in ischemic stroke patients: developing a novel nomogram
BMC Medical Informatics and Decision Making
LAR
Ischemic stroke
Lactate dehydrogenase
Albumin
title Lactate dehydrogenase to albumin ratio and poor prognosis after thrombolysis in ischemic stroke patients: developing a novel nomogram
title_full Lactate dehydrogenase to albumin ratio and poor prognosis after thrombolysis in ischemic stroke patients: developing a novel nomogram
title_fullStr Lactate dehydrogenase to albumin ratio and poor prognosis after thrombolysis in ischemic stroke patients: developing a novel nomogram
title_full_unstemmed Lactate dehydrogenase to albumin ratio and poor prognosis after thrombolysis in ischemic stroke patients: developing a novel nomogram
title_short Lactate dehydrogenase to albumin ratio and poor prognosis after thrombolysis in ischemic stroke patients: developing a novel nomogram
title_sort lactate dehydrogenase to albumin ratio and poor prognosis after thrombolysis in ischemic stroke patients developing a novel nomogram
topic LAR
Ischemic stroke
Lactate dehydrogenase
Albumin
url https://doi.org/10.1186/s12911-025-02991-z
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