A Study On Related Factors And Predictive Model Of Hemorrhagic Transformation In Elderly Patients With Non-Large Area Cerebral Infarction

Objective:The purpose of this study is to explore the related factors of hemorrhagic transformation in elderly patients,who were treated with non-large area cerebral infarction without thrombolytic therapy,and to establish a prediction model of hemorrhagic transformation by the combination of traditional Chinese and western medicine,which provides an efficient method to identify hemorrhagic transformation.Methods:The study collects the data samples of 148 elderly patients who met the inclusion criteria.The detailed information including the baseline,laboratory examination,anticoagulation,antiplatelet and lipid lowering therapy are recoreded.The stroke syndrome elements were extracted by the clinical symptoms,and the relevant data were statistically analyzed by Excel.The influencing factors were screened by univariate analysis,and the factors were compared as covariates.Taking the occurrence of HT as a dependent variable,excluding the influence of confounding factors,multi-factor Logistic regression analysis was carried out to obtain the risk factors related to the occurrence of HT,and the odds ratio and 95%confidence interval(95%CI)were calculated.According to the analysis results,the prediction model of HT was established by fitting,and the prediction ability was tested by ROC curve.All the above processes use SPSS26.0.Results:1.A total of 148 patients were included in this study,61 patients had no HT and 87 patients had HT.In univariate analysis,drinking history,smoking index,Cys C,PT,LDL-C,anticoagulation,antiplatelet aggregation and lipid lowering therapy,located in kidney、brain and meridians.Phlegm and blood stasis were related to hemorrhagic transformation(P<0.05).2.In multivariate logistic regression analysis,drinking history(OR=14.22,95%CI:2.368-85.410,P=0.004),Cys-C(OR=5.329,95%CI:1.292-21.980,P=0.021),blood stasis(OR=1.4,95%CI:1.002-2.054,P=0.000),brain(OR=1.1,95%CI:1.002-1.495,P=0.000),meridian(OR=1.79,95%CI:1.432-2.744,P=0.000)are independent risk factors of HT,High level of LDL-C(OR=0.157,95%CI:0.132-0.810,P=0.016)is the protective factor of HT.3.A prediction model for the transformation of non-thrombolytic hemorrhage was established,Log(grouping)=drinking history×2.655+Cys C×1.673-LDL-C×1.119+blood stasis×4.653+brain×4.523+1.719×Meridians+3.383,The area under the curve of the ROC is 0.959(standard error=0.018,95%CI:0.924-0.995,P=0.000),the best critical value is 0.874,the sensitivity is 98.9%,and the specificity is 88.5%.Conclusion:1.Drinking history,high level of Cys C,location of disease in the brain and meridians,disease of blood stasis are independent risk factors for the occurrence of HT,and high level of low density lipoprotein is the protective factor to prevent the occurrence of HT.2.The area under the ROC curve of the model AUC is 0.959,the optimal critical value is 0.874,the sensitivity is 98.9%,and the specificity is 88.5%.It has high prediction ability.When the score of the model was more than 0.874,the patient had a higher risk of developing HT.