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. 2023 Dec;13(12):e3297.
doi: 10.1002/brb3.3297. Epub 2023 Nov 13.

Dynamic and visual nomograms to online predict unfavorable outcome of mechanical thrombectomy for acute basilar artery occlusion

Xiding Pan #  1   2   3 , Shiteng Lin #  4 , Liang Xiang #  5 , Feng Zhou  2 , Mengyi Xu  2 , Qiong Jie  1 , Zhihong Zhao  5 , Chen Chen  1 , Junshan Zhou  2 , Jianjun Zou  1   3
Affiliations

Dynamic and visual nomograms to online predict unfavorable outcome of mechanical thrombectomy for acute basilar artery occlusion

Xiding Pan et al. Brain Behav. 2023 Dec.

Abstract

Background: The evidence of mechanical thrombectomy (MT) in basilar artery occlusion (BAO) was limited. This study aimed to develop dynamic and visual nomogram models to predict the unfavorable outcome of MT in BAO online.

Methods: BAO patients treated with MT were screened. Preoperative and postoperative nomogram models were developed based on clinical parameters and imaging features. An independent dataset was collected to perform external validation. Web-based calculators were constructed to provide convenient access.

Results: A total of 127 patients were included in the study, and 117 of them were eventually included in the analysis. The nomogram models showed robust discrimination, with an area under the receiver operating characteristic (ROC) of 0.841 (preoperative) and 0.916 (postoperative). The calibration curves showed good agreement. The preoperative predictors of an unfavorable outcome were previous stroke, the National Institutes of Health Stroke Scale (NIHSS) at admission, and the posterior circulation Alberta Stroke Program Early Computed Tomography Score (pc-ASPECTS). The postoperative predictors were previous stroke, NIHSS at 24 h, and pc-ASPECTS.

Conclusion: Dynamic and visual nomograms were constructed and validated for the first time for BAO patients treated with MT, which provided precise predictions for the risk of an unfavorable outcome. The preoperative model may assist clinicians in selecting eligible patients, and the postoperative model may facilitate individualized poststroke management.

Keywords: basilar artery occlusion; mechanical thrombectomy; nomogram; unfavorable outcome.

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Conflict of interest statement

The authors declared that there is no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart demonstrating the number (n) of patients included in the analysis.
FIGURE 2
FIGURE 2
Preoperative (a) and postoperative (b) nomogram to predict unfavorable outcome (modified Rankin Scale 4–6) at 90 days.
FIGURE 3
FIGURE 3
The receiver operating characteristic curves (ROC) of the pre‐ and postoperative nomogram model.
FIGURE 4
FIGURE 4
Calibration plots of the preoperative (a) and postoperative (b) nomogram model.
FIGURE 5
FIGURE 5
The receiver operating characteristic curves (ROC) of the preoperative (a) and postoperative (b) nomogram model on the external validation cohort.
See this image and copyright information in PMC

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