ArticleScientific reports2025
Development and validation of a risk assessment tool for ischemic stroke in cancer patients.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Cancer patients have an increased risk of ischemic stroke. However, there is no reliable risk prediction model. We aimed to create a risk prediction model for ischemic stroke in cancer patients within the first 2 years after cancer diagnosis. A cohort of 26,717 cancer patients from the University of Osaka Hospital was used to develop the model. A cohort of 31,881 patients from Osaka International Cancer Institute was used for external validation. Data in the development cohort generated an AHANDS score: Age ≥ 75 years, Hypertension, Atrial fibrillation, a high Neutrophil-to-lymphocyte ratio, an elevated D-dimer level, and cancer Stage IV or distant metastasis at the time of cancer diagnosis. Discrimination was assessed using the c-statistic. We compared the AHANDS and Khorana scores in the development cohort. Ischemic stroke occurred within 2 years of diagnosis of cancer in 163 patients (0.61%) in the development cohort and in 99 (0.31%) in the validation cohort. The AHANDS score performed better than the Khorana score (c-statistic 0.703 vs. 0.54; p < 0.0001). A similar result was obtained in the external validation cohort (c-statistic 0.75). This score is intended to guide future stroke prevention strategies in patients with cancer.
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