ArticleBMC neurology2026
Clinical guideline-guided prognostic models of functional disability after acute ischemic stroke: a retrospective cohort study.
Article in BMC neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Development and validation of a population-based prediction model for prevalent hypertension: evidence from Qatar biobank.Frontiers in cardiovascular medicine · 2026Article
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Abstract
backgroundThere is limited evidence on prognostic models that incorporate clinical guideline recommendations during the acute management of ischemic stroke. This study aimed to develop and validate clinical guideline-based prognostic models of functional disability following a first-ever acute ischemic stroke.
methodsA multicenter retrospective cohort study was conducted using data from 899 adult patients (aged 18 years or older) with a first-ever acute ischemic stroke, and enrolled in the Malaysian National Stroke Registry (NSR) between January 2009 and December 2019. The primary outcome was functional disability at three months post-discharge, defined as a modified Rankin Scale (mRS) score of 3 to 5. A multivariable logistic regression model was developed using random sampling data splitted into two cohorts: the development (n = 674; 75%) and the internal validation (n = 225; 25%). Model performance was evaluated by discrimination [area under the curve (AUC)] and calibration [Hosmer–Lemeshow (HL) test].
resultsThe final prognostic model showed factors associated with increased risk of functional disability include age [adjusted odds ratio (aOR) 1.02, 95% CI 1.00–1.04, p = 0.024], female gender [aOR 1.54, 95% CI 1.06–2.23, p = 0.024], and diabetes [aOR 1.66, 95% CI 1.15–2.40, p = 0.007]. While those factors associated with decreased risk of disability include posterior circulation infarct (POCI) [aOR 0.38, 95% CI 0.18–0.78, p = 0.009], and adherence to key performance indicators (KPIs); antiplatelet therapy [aOR 0.48, 95% CI 0.29–0.80, p = 0.005], lipid-lowering therapy [aOR 0.56, 95% CI 0.37–0.83, p = 0.004], stroke education [aOR 0.09, 95% CI 0.05–0.16, p < 0.001], and rehabilitation [aOR 0.43, 95% CI 0.29–0.64, p < 0.001]. The fitted model demonstrated good discrimination (AUC: 0.803; 95% CI, 0.78–0.83 for development, and 0.777; 95% CI, 0.75–0.81 for validation) and calibration (HL test: p = 0.473 for development, p = 0.967 for validation).
conclusionA clinical guideline-guided prognostic model of functional disability following a first-ever acute ischemic stroke was successfully developed and validated, demonstrating strong performance and potential clinical relevance. This model can help clinicians predict stroke outcomes, guide informed clinical decision-making, and support the development of personalized stroke care.
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