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<p>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: <i>A</i>ge ≥ 75 years, <i>H</i>ypertension, <i>A</i>trial fibrillation, a high <i>N</i>eutrophil-to-lymphocyte ratio, an elevated <i>D</i>-dimer level, and cancer <i>S</i>tage 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; <i>p</i> &lt; 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.</p>

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Development and validation of a risk assessment tool for ischemic stroke in cancer patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月12日

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  • Tomohiro Kawano,
  • Yasufumi Gon,
  • Toshitaka Morishima,
  • Junji Takasugi,
  • Hideaki Kanki,
  • Tsutomu Sasaki,
  • Isao Miyashiro,
  • Hideki Mochizuki

摘要

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.