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Development and validation of a clinical model (DREAM-LDL) for post-stroke cognitive impairment at 6 months.
- Source :
-
Aging [Aging (Albany NY)] 2021 Sep 10; Vol. 13 (17), pp. 21628-21641. Date of Electronic Publication: 2021 Sep 10. - Publication Year :
- 2021
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Abstract
- Introduction: This multicenter, retrospective study assessed the prevalence of post-stroke cognitive impairment (PSCI) 6 months after acute ischemic stroke (AIS) and its risk factors to build a bedside early predictive model for PSCI using the Montreal Cognitive Assessment (MoCA).<br />Methods: Records of consecutive patients with AIS treated at 4 stroke centers in Shanghai had MoCA assessments within 2 weeks after AIS onset and 6 months later were reviewed. Prevalence of PSCI (MoCA<22) was calculated and risk factors were identified by multivariate logistic regression analysis. The modeling and validation and identified risk factors were included in a predictive model using multivariate regression.<br />Results: There were 383 patients included and prevalence of PSCI 6 months after AIS was 34.2%, significantly lower than prevalence of patients with acute cognitive impairment (49.6%). Aging, less education, higher glucose level and severe stroke were PSCI risk factors, while level of low-density lipoprotein cholesterol (LDL-C) had a paradox effect on the risk of PSCI. 40.0% of the patients with cognitive impairment at acute phase reverted to normal, and patients with LDL-C 1.8-2.5 mmol/L were more likely to revert. The predictive model we built, DREAM-LDL (Diabetes [fasting blood glucose level], Rating [NIHSS], level of Education, Age, baseline MoCA and LDL-C level), had an AUROC of 0.93 for predicting PSCI at 6 months.<br />Conclusion: PSCI was common among AIS patients 6 months after AIS. We provided a practical tool to predict PSCI based on MoCA and risk factors present during acute phase of AIS.
- Subjects :
- Age Factors
Aged
Aged, 80 and over
Area Under Curve
China epidemiology
Diagnostic Tests, Routine methods
Educational Status
Female
Humans
Logistic Models
Male
Mental Status Schedule
Middle Aged
Multivariate Analysis
Neuropsychological Tests
Prevalence
ROC Curve
Retrospective Studies
Risk Factors
Time Factors
Cognitive Dysfunction epidemiology
Cognitive Dysfunction etiology
Stroke complications
Subjects
Details
- Language :
- English
- ISSN :
- 1945-4589
- Volume :
- 13
- Issue :
- 17
- Database :
- MEDLINE
- Journal :
- Aging
- Publication Type :
- Academic Journal
- Accession number :
- 34506303
- Full Text :
- https://doi.org/10.18632/aging.203507