1
|
Li Y, Huan L, Lu W, Li J, Wang H, Wang B, Song Y, Peng C, Wang J, Yang X, Hao J. Integrate prediction of machine learning for single ACoA rupture risk: a multicenter retrospective analysis. Front Neurol 2023; 14:1126640. [PMID: 37920830 PMCID: PMC10619904 DOI: 10.3389/fneur.2023.1126640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 09/11/2023] [Indexed: 11/04/2023] Open
Abstract
Background Statistically, Anterior communicating aneurysm (ACoA) accounts for 30 to 35% of intracranial aneurysms. ACoA, once ruptured, will have an acute onset and cause severe neurological dysfunction and even death. Therefore, clinical analysis of risk factors related to ACoA and the establishment of prediction model are the benefits to the primary prevention of ACoA. Methods Among 1,436 cases of single ACoA patients, we screened 1,325 valid cases, classified risk factors of 1,124 cases in the ruptured group and 201 cases in the unruptured group, and assessed the risk factors, respectively, and predicted the risk of single ACoA rupture by using the logistic regression and the machine learning. Results In the ruptured group (84.8%) of 1,124 cases and the unruptured group (15.2%) of 201 cases, the multivariable logistic regression (MLR) model shows hemorrhagic stroke history (OR 95%CI, p:0.233 (0.120-0.454),<0.001) and the age stratification of 60-69 years (OR 95%CI, p:0.425 (0.271-0.668),<0.001) has a significant statistic difference. In the RandomForest (RF) model, hemorrhagic stroke history and age are the best predictive factors. Conclusion We combined the analysis of MLR, RF, and PCA models to conclude that hemorrhagic stroke history and gender affect single ACoA rupture. The RF model with web dynamic nomogram, allows for real-time personalized analysis based on different patients' conditions, which is a tremendous advantage for the primary prevention of single ACoA rupture. Clinical trial registration https://www.chictr.org.cn/showproj.html?proj=178501.
Collapse
Affiliation(s)
- Yang Li
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Linchun Huan
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Department of Neurosurgery, Linyi People's Hospital of Shandong Province, Linyi, Shandong, China
| | - Wenpeng Lu
- Department of Neurosurgery, The First People's Hospital of Jining, Jining, Shandong, China
| | - Jian Li
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Hongping Wang
- Department of Neurosurgery, Tangshan Workers Hospital, Tangshan, Hebei, China
| | - Bangyue Wang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Yunfei Song
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Chao Peng
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Jiyue Wang
- Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng, Shandong, China
| | - Xinyu Yang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Jiheng Hao
- Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng, Shandong, China
| |
Collapse
|
2
|
Yang J, Liu X, Zhai Z, Liao W, He Y, Wu X, Wang C, Sun C, Li Y. The independent and combined association of napping and night sleep duration with stroke in Chinese rural adults. Sleep Breath 2023; 27:265-274. [PMID: 35469369 DOI: 10.1007/s11325-022-02619-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Inappropriate sleep duration is a potential cause of stroke. But the effect of napping on stroke risk remains controversial and the interaction between night sleep and napping duration remains unclear. The objective of this study was to examine the independent and combined effects of napping and nocturnal sleep duration on stroke. METHODS Subjects were derived from a rural cohort study in Henan. The Pittsburgh Sleep Quality Index (PSQI) was applied to identify nap duration and nocturnal sleep duration. Binary logistic regression was employed to indicate the dose-response relationships between naps, nocturnal sleep, total 24-h sleep duration, and stroke. RESULTS Among the 37,341 participants (14,485 men), 2600 suffered from a stroke. The odds ratios (ORs) and 95% confidence level (CI) for stroke in the fully adjusted model were 1.37 (1.13-1.65) for men nappers compared to non-nappers. Compared to 7-8 h of sleep per day, night sleep durations < 6 h and ≥ 9 h and 24-h sleep duration ≥ 10 h were linked to increased odds of stroke in men. The ORs (95%CI) were 1.34 (1.06-1.69) in nocturnal sleep duration < 6 h, 1.30 (1.06-1.59) in nocturnal sleep duration ≥ 9 h, and 1.40 (1.15-1.71) in 24-h sleep duration ≥ 10 h in men. In addition, long naps and prolonged nocturnal sleep duration have a joint effect on stroke in the fully adjusted model. CONCLUSION The napping duration and nocturnal sleep duration have independently and jointly effects on stroke in rural populations. More research is required to explore the underlying mechanisms for this relationship. CLINICAL TRIAL REGISTRATION The Henan Rural Cohort Study has been registered on the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699) ( http://www.chictr.org.cn/showproj.aspx?proj=11375 ).
Collapse
Affiliation(s)
- Jing Yang
- Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.,Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Zhihan Zhai
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Wei Liao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Yaling He
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Xueyan Wu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Chunyang Sun
- Department of Preventive Medicine, Henan University of Chinese Medicine, Zhengzhou, Henan, People's Republic of China
| | - Yuqian Li
- Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, People's Republic of China. .,Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China.
| |
Collapse
|
3
|
Zhao Y, Hua X, Ren X, Ouyang M, Chen C, Li Y, Yin X, Song P, Chen X, Wu S, Song L, Anderson CS. Increasing burden of stroke in China: A systematic review and meta-analysis of prevalence, incidence, mortality, and case fatality. Int J Stroke 2023; 18:259-267. [PMID: 36274585 DOI: 10.1177/17474930221135983] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The epidemiology of stroke is evolving in China as the population undergoes demographic, lifestyle, and economic transitions. An updated review is pertinent to providing feedback on current, and in planning future, prevention and management strategies. AIMS To identify high-quality epidemiological studies for quantifying the prevalence, incidence, mortality, and case fatality for stroke in China. METHODS A search was undertaken across a range of bibliographic databases on 30 November 2021 without time limitation. Assessments were made of the risk of bias of the included studies. The outcomes were synthesized using a random-effects model. Subgroup analysis and meta-regression models were used to define the source of heterogeneity. RESULTS Of 9407 identified records, 26 population-based studies were included. Due to significant heterogeneity across the studies, the original range for crude rates of indices was wide. The pooled annual prevalence was 1329.5/100,000 (95% confidence interval (CI) 713.6-2131.9, p < 0.001), incidence 442.1/100,000 (327.6-573.8, p < 0.001), mortality 154.1/100,000 (52.6-308.8, I2 = 100%, p < 0.001), and case fatality 35.8% (26.1% to 46.1%, I2 = 97%, p < 0.001). The prevalence and incidence of stroke have increased, but stroke-related case fatality has declined in China over recent decades. There are significant regional and rural-urban differences in incidence rates. CONCLUSION Despite improved public health policies and healthcare delivery, the burden of stroke remains high in China. Further coordinated efforts are required in prevention and community care to offset the likelihood of further expansion in the absolute number of stroke cases in this large population.
Collapse
Affiliation(s)
- Yang Zhao
- The George Institute for Global Health China, Beijing, China.,The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Xing Hua
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Xinwen Ren
- The George Institute for Global Health China, Beijing, China
| | - Menglu Ouyang
- The George Institute for Global Health China, Beijing, China.,The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Chen Chen
- The George Institute for Global Health China, Beijing, China.,The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.,Neurology Department, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yunke Li
- The George Institute for Global Health China, Beijing, China
| | - Xiaoya Yin
- The George Institute for Global Health China, Beijing, China.,Shanghai Municipal Center for Disease Control & Prevention, Shanghai, China
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaoying Chen
- The George Institute for Global Health China, Beijing, China.,The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Simiao Wu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Lili Song
- The George Institute for Global Health China, Beijing, China.,The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Craig S Anderson
- The George Institute for Global Health China, Beijing, China.,The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.,Department of Neurology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| |
Collapse
|
4
|
Wang Y, Li S, Zhou Q, Wang Y, Shi J. Vascular dementia has the highest hospitalisation rate in China: a nationwide hospital information system study. Stroke Vasc Neurol 2023; 8:59-68. [PMID: 36219569 PMCID: PMC9985804 DOI: 10.1136/svn-2022-001637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/16/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Although vascular dementia (VaD) is not uncommon in the hospital, most studies on VaD are community based. This study on VaD is the first to use a national hospital information system (HIS) in China. METHODS This study was a hospital population-based cohort study, and data were acquired from the Hospital Quality Monitoring System, a Chinese national database that covers 1531 tertiary hospitals in China. The medical records in the HIS included demographic information, diagnoses, procedures, expenses, etc. VaD was diagnosed by hospital attending physicians and identified by the International Classification of Diseases (ICD) 10 code (F01.0-F01.9). RESULTS 1259 (82.23%) tertiary hospitals were included in this study, and 274 230 hospitalisation records of 123 700 VaD patients from 2016 to 2018 were identified for analysis. VaD (51.27%) was the most common type of dementia in hospitalised patients. The age-adjusted and sex-adjusted hospital incidence of VaD was estimated to be 2.97 per 100 000 person-years (95% CI 2.92 to 3.02). The mean age of VaD patients admitted to hospitals was 74.13±10.88, with more male (61.0%) patients. The main comorbidities were hypertension (67.2%), heart disease (63.6%) and cerebral infarction (55.5%). The mortality rate of VaD in hospital was 28.91‰ (95% CI 28.0 to 29.9) between 2016 and 2018. The top 1 cause of death due to VaD was pneumonia and other respiratory disorders. CONCLUSIONS VaD is the most common form of dementia in hospitalised patients. It casts huge burdens on affected patients and their caregivers. Vascular risk factors are prevalent in VaD patients. Reducing these factors is essential to improve patient care. The leading causes of death by VaD are pneumonia and other respiratory disorders. Hospital care and the management of respiratory illness are critical for VaD care in the hospital.
Collapse
Affiliation(s)
- Yue Wang
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China.,National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Shiping Li
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China.,National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Qi Zhou
- National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China .,National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jiong Shi
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China .,National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| |
Collapse
|
5
|
Wang Q, Tian S, Xiao D, Zhao R, Zhang X, Dou Z, Li C, Ma Z. Correlation of serum RBP4 level with oxidative stress and unstable carotid plaque in patients with cerebral infarction. Transl Neurosci 2022; 13:354-360. [PMID: 36304097 PMCID: PMC9552776 DOI: 10.1515/tnsci-2022-0252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 11/07/2022] Open
Abstract
Objectives This study aimed to investigate the changes in serum levels of retinol-binding protein 4 (RBP4) with cerebral infarction, relationship of RBP4 with oxidative stress and carotid atherosclerosis, and its possible role in cerebral infarction. Materials and methods According to the results of cervical vascular ultrasound, the experimental group was divided into three groups: intima thickening group (n = 31), stable plaque group (n = 51), and unstable plaque group (n = 54). Forty healthy subjects were selected as the control group. Their serum levels of RBP4, 8-iso-prostaglandin-F2alpha (8-iso-PGF2α), and catalase (CAT) were measured. Carotid vascular ultrasound was used to measure the plaque area and intima-media thickness (IMT). Results The serum RBP4 and 8-iso-PGF2α levels, IMT and plaque area in the control, intimal thickening, stable plaque, and unstable plaque groups increased, while the serum level of CAT decreased (P < 0.001). The serum levels of RBP4 positively correlated with 8-iso-PGF2α, IMT, and plaque area and negatively correlated with CAT level. The area under the receiver operating characteristic curve was 0.778 in predicting unstable plaques. Conclusions The serum levels of RBP4 were significantly elevated in elderly patients with cerebral infarction and correlated with oxidative stress injury and the degree of atherosclerosis. Serum RBP4 has diagnostic value for unstable plaques in carotid arteries.
Collapse
Affiliation(s)
- Qingqing Wang
- Department of Neurology, Chengde Medical University Affiliated Hospital, Hebei, China
| | - Sha Tian
- Department of Neurology, Chengde Medical University Affiliated Hospital, Hebei, China
| | - Dahai Xiao
- Department of Neurology, Chengde Medical University Affiliated Hospital, Hebei, China
| | - Ruotong Zhao
- Department of Neurology, Chengde Medical University Affiliated Hospital, Hebei, China
| | - Xiaoxuan Zhang
- Department of Neurology, Chengde Medical University Affiliated Hospital, Hebei, China
| | - Zhijie Dou
- Department of Neurology, Chengde Medical University Affiliated Hospital, Hebei, China
| | - Chengbo Li
- Department of Neurology, Chengde Medical University Affiliated Hospital, Hebei, China
| | - Zheng Ma
- Department of Neurology, Chengde Medical University Affiliated Hospital, Hebei, China
| |
Collapse
|
6
|
Yao R, Yao L, Yuan C, Gao BL. Accuracy of Calf Circumference Measurement, SARC-F Questionnaire, and Ishii's Score for Screening Stroke-Related Sarcopenia. Front Neurol 2022; 13:880907. [PMID: 35572926 PMCID: PMC9099210 DOI: 10.3389/fneur.2022.880907] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/01/2022] [Indexed: 12/21/2022] Open
Abstract
Objective The purpose of this study was to investigate the accuracy of sarcopenia diagnosis in patients with stroke using calf circumference (CC), SARC-F questionnaire, and Ishii's score in comparison with the Asian Working Group for Sarcopenia 2019 (AWGS) sarcopenia diagnostic criteria. Materials and Methods In this cross-sectional study, a total of 364 consecutive patients with stroke were enrolled and evaluated with the CC measurement, SARC-F questionnaire, and Ishii's score. The diagnostic accuracy was analyzed. Results Based on the AWGS criteria, sarcopenia was present in 180 (49.5%) patients, with an age range of 49–74 (mean 63 ± 14.7) years. In all patients, the cutoff value of CC in the accuracy of diagnosing sarcopenia was 30.5 cm, with an AUC of 0.85, sensitivity of 81.8%, specificity of 90.1%, Kappa value of 0.72, and Youden index of 0.72. In the accuracy of diagnosing sarcopenia in all patients, Ishii's score had a cutoff value of 118, AUC of 0.78, sensitivity of 90.1%, specificity of 36.0%, Kappa value of 0.4, and Youden index of 0.55. For accuracy of diagnosing sarcopenia, the SARC-F questionnaire had a cutoff value of 5, AUC of 0.731, sensitivity of 94.7%, specificity of 40%, Kappa value of 0.34, and Youden index of 0.41. Conclusions Based on the AWGS criteria, calf circumference measurement has the optimal performance in screening stroke-related sarcopenia compared with the SARC-F questionnaire and Ishii's score. In patients with stroke, the cutoff value of calf circumference for sarcopenia is < 31 cm in men and 30 cm in women, and with an AUC of 0.85.
Collapse
Affiliation(s)
- Ruihong Yao
- Medical Imaging Department, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Liqing Yao
- Rehabilitation Medicine Department, Second Affiliated Hospital of Kunming Medical University, Kunming, China
- *Correspondence: Liqing Yao
| | - Changli Yuan
- Rehabilitation Medicine Department, Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Bu-Lang Gao
- Medical Imaging Department, First Affiliated Hospital of Kunming Medical University, Kunming, China
| |
Collapse
|