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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2025-04-01
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| 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. |
| format | Article |
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| institution | OA Journals |
| issn | 1472-6947 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Informatics and Decision Making |
| 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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