A prediction model for functional outcome following rescue therapy in patients with acute ischemic stroke undergoing endovascular treatment

OBJECTIVE: To evaluate the association between key preoperative and intraoperative factors and 90-day functional outcomes in acute ischemic stroke (AIS) patients undergoing endovascular treatment (EVT) with rescue therapy, and to establish a prognostic model for estimating 90-day functional outcomes. METHODS: We retrospectively enrolled AIS patients with EVT plus rescue therapy from January 2018 to December 2024. The primary endpoint was a 90-day modified Rankin Scale (mRS) score >2. Logistic regression identified predictors incorporated into a nomogram. Model performance was assessed with receiver operating characteristic (ROC) curves, the Hosmer-Lemeshow test, and decision curve analysis (DCA). Bootstrap resampling and 10-fold cross-validation assessed robustness. RESULTS: > 0.05 in both cohorts), and DCA demonstrated consistent clinical benefit. Bootstrap and cross-validation confirmed model reliability. CONCLUSION: Our model integrating HbA1c, NIHSS, OPT, PRT, and refractory thrombectomy demonstrated acceptable performance in predicting 90-day outcomes after rescue therapy. However, as a development-phase model, its clinical applicability should be interpreted with caution.