SPRIN2D nomogram: predicting 90-day unfavorable outcomes in patients with minor ischemic stroke receiving intravenous thrombolysis.

OBJECTIVE: This study aimed to construct and validate a nomogram for the intuitive prediction of 90-day unfavorable outcomes in patients with minor ischemic stroke who underwent intravenous thrombolysis. METHODS: Data were extracted from the Multicenter Clinical Trial of Revascularization Treatment for Acute Ischemic Stroke (TRAIS) study. Multivariable logistic regression was used to identify independent factors associated with 90-day unfavorable outcomes (modified Rankin Scale [mRS] score 2-6) in patients with minor ischemic stroke (National Institutes of Health Stroke Scale [NIHSS] score 0-5) receiving intravenous thrombolysis. A nomogram (designated as SPRIN2D) was developed based on the final prediction model, incorporating 6 key variables: NIHSS score, functional disability, systolic blood pressure, neutrophil count, international normalized ratio and renal dysfunction. RESULTS: A total of 1,438 eligible patients were enrolled and randomly assigned to a derivation cohort (n = 1,007) and a validation cohort (n = 431). In the overall cohort, the median age was 65 years (interquartile range, 56-73); 67.94% of participants were male, and the median admission NIHSS score of 2 (interquartile range, 1-4). The SPRIN2D nomogram exhibited robust performance in predicting 90-day unfavorable outcomes in minor ischemic stroke patients treated with intravenous thrombolysis. The area under the curve was 0.784 (95% confidence interval [CI], 0.744-0.822) in the derivation cohort and 0.776 (95% CI, 0.716-0.835) in the validation cohort. Moreover, the SPRIN2D nomogram demonstrated superior discriminative ability compared with other existing prognostic models for acute ischemic stroke and minor ischemic stroke. CONCLUSION: The SPRIN2D nomogram is a stable and promising tool for predicting 90-day unfavorable outcomes in minor ischemic stroke patients treated with intravenous thrombolysis.