115195
论文已发表
注册即可获取德孚的最新动态
IF 收录期刊
- 3.6 Breast Cancer (Dove Med Press)
- 4.3 Clin Epidemiol
- 2.6 Cancer Manag Res
- 3.2 Infect Drug Resist
- 4.1 Clin Interv Aging
- 6.1 Drug Des Dev Ther
- 4.1 Int J Chronic Obstr
- 8.7 Int J Nanomed
- 2.5 Int J Women's Health
- 3.2 Neuropsych Dis Treat
- 2.4 OncoTargets Ther
- 2.6 Patient Prefer Adher
- 2.6 Ther Clin Risk Manag
- 3.1 J Pain Res
- 3.5 Diabet Metab Synd Ob
- 4.5 Psychol Res Behav Ma
- 3.4 Nat Sci Sleep
- 2.4 Pharmgenomics Pers Med
- 2.6 Risk Manag Healthc Policy
- 4.6 J Inflamm Res
- 2.3 Int J Gen Med
- 3.9 J Hepatocell Carcinoma
- 3.3 J Asthma Allergy
- 2.5 Clin Cosmet Investig Dermatol
- 3.0 J Multidiscip Healthc
已发表论文
自发性颈动脉夹层不良结局预测列线图的开发和验证
Authors Chen S, Yang Z, Yang L
Received 30 July 2025
Accepted for publication 31 December 2025
Published 13 January 2026 Volume 2026:19 556836
DOI https://doi.org/10.2147/IJGM.S556836
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Redoy Ranjan
Shimeng Chen,1,* Zhicheng Yang,2,* Lijuan Yang2
1Department of Ultrasound, the Affiliated Central Clinical Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, 014040, People’s Republic of China; 2Department of Ultrasound, Baotou Central Hospital, Baotou, 014040, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Lijuan Yang, Department of Ultrasound, Baotou Central Hospital, Inner Mongolia, Baotou, 014040, People’s Republic of China, Tel +86-13739923766, Email yanglijuan20251@outlook.com
Objective: This exploratory study aimed to develop a preliminary nomogram for risk assessment of poor prognosis in spontaneous cervical artery dissection (sCAD) and evaluate its statistical performance using internal validation.
Methods: We retrospectively analyzed 75 patients with sCAD (mean age 51.8 ± 14.0 years; 41 males [55%] and 34 females [45%]) diagnosed between November 2013 and April 2024. Poor prognosis was defined as imaging-confirmed acute cerebral infarction or hemorrhage (n=38); the remaining 37 patients comprised the good prognosis group. Due to the small sample size, variables with p< 0.2 in univariate analysis (sex, extracranial CAD type, hypertension, hyperhomocysteinemia) were considered for multivariate modeling, though none were statistically significant predictors (all p> 0.05). A multivariate logistic regression-based nomogram was constructed and internally validated using 1000 bootstrap resamples.
Results: The final model included the four variables above. Only non-intramural hematoma (other) CAD type showed statistical significance in the multivariate model (OR=13.41, 95% CI: 2.89– 62.17, P< 0.01), while sex, hypertension, and hyperhomocysteinemia did not, likely reflecting statistical instability from inadequate power. In bootstrap internal validation, the model demonstrated moderate discrimination (AUC=0.788, 95% CI: 0.686– 0.891) with a Brier score of 0.185. Hosmer-Lemeshow test indicated acceptable calibration (χ2=8.11, P=0.23). Mean AUC across bootstrap samples was 0.763 (95% CI: 0.662– 0.863), suggesting minimal overfitting within this dataset, though this does not imply generalizability.
Conclusion: This pilot study generates the hypothesis that ultrasonographic CAD type, combined with clinical variables, may aid in predicting sCAD outcomes. However, due to the small sample size (9.5 events/variable), lack of external validation, and inclusion of non-significant predictors, this model is not ready for clinical application. Multi-center prospective validation in a cohort of at least 400 patients is required before any clinical utility can be claimed.
Keywords: cervical artery dissection, poor prognosis, nomogram, risk prediction, pilot study
1Department of Ultrasound, the Affiliated Central Clinical Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, 014040, People’s Republic of China; 2Department of Ultrasound, Baotou Central Hospital, Baotou, 014040, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Lijuan Yang, Department of Ultrasound, Baotou Central Hospital, Inner Mongolia, Baotou, 014040, People’s Republic of China, Tel +86-13739923766, Email yanglijuan20251@outlook.com
Objective: This exploratory study aimed to develop a preliminary nomogram for risk assessment of poor prognosis in spontaneous cervical artery dissection (sCAD) and evaluate its statistical performance using internal validation.
Methods: We retrospectively analyzed 75 patients with sCAD (mean age 51.8 ± 14.0 years; 41 males [55%] and 34 females [45%]) diagnosed between November 2013 and April 2024. Poor prognosis was defined as imaging-confirmed acute cerebral infarction or hemorrhage (n=38); the remaining 37 patients comprised the good prognosis group. Due to the small sample size, variables with p< 0.2 in univariate analysis (sex, extracranial CAD type, hypertension, hyperhomocysteinemia) were considered for multivariate modeling, though none were statistically significant predictors (all p> 0.05). A multivariate logistic regression-based nomogram was constructed and internally validated using 1000 bootstrap resamples.
Results: The final model included the four variables above. Only non-intramural hematoma (other) CAD type showed statistical significance in the multivariate model (OR=13.41, 95% CI: 2.89– 62.17, P< 0.01), while sex, hypertension, and hyperhomocysteinemia did not, likely reflecting statistical instability from inadequate power. In bootstrap internal validation, the model demonstrated moderate discrimination (AUC=0.788, 95% CI: 0.686– 0.891) with a Brier score of 0.185. Hosmer-Lemeshow test indicated acceptable calibration (χ2=8.11, P=0.23). Mean AUC across bootstrap samples was 0.763 (95% CI: 0.662– 0.863), suggesting minimal overfitting within this dataset, though this does not imply generalizability.
Conclusion: This pilot study generates the hypothesis that ultrasonographic CAD type, combined with clinical variables, may aid in predicting sCAD outcomes. However, due to the small sample size (9.5 events/variable), lack of external validation, and inclusion of non-significant predictors, this model is not ready for clinical application. Multi-center prospective validation in a cohort of at least 400 patients is required before any clinical utility can be claimed.
Keywords: cervical artery dissection, poor prognosis, nomogram, risk prediction, pilot study