{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T05:20:26Z","timestamp":1766035226491,"version":"3.48.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To investigate the correlation between arterial oxygen saturation (SaO\n                      <jats:sub>2<\/jats:sub>\n                      ) and the occurrence of cerebral infarction (CI) in patients with chronic obstructive pulmonary disease (COPD), and to develop a nomogram model based on SaO\n                      <jats:sub>2<\/jats:sub>\n                      to predict the probability of CI in COPD patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study analyzed the clinical data of 846 COPD patients admitted to the Affiliated Hospital of Guangdong Medical University from June 2018 to December 2019. Logistic regression analysis was used to identify risk factors for CI, and the Wald chi-square test was applied to select predictors for inclusion in the nomogram. The performance of the model was evaluated and internally validated. External validation was conducted using data from 290 COPD patients prospectively enrolled at the Second Affiliated Hospital of Guangdong Medical University between January and October 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 846 COPD patients were included, with 592 assigned to the training cohort and 254 to the internal validation cohort. Predictive factors incorporated into the nomogram included systemic immune-inflammation index (SII), age, hypertension, cardiovascular disease (CVD), paraplegia, and SaO\n                      <jats:sub>2<\/jats:sub>\n                      . The nomogram demonstrated strong predictive accuracy and calibration, with AUCs of 0.85 (95% CI: 0.82\u20130.89) in the training cohort, 0.89 (95% CI: 0.85\u20130.94) in the internal validation cohort, and 0.90 (95% CI: 0.86\u20130.94) in the external validation cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      COPD is prone to cerebral infarction, and we verified the relationship between COPD and cerebral infarction through a visualogram model. The incidence of cerebral infarction in COPD patients is affected by systemic immune-inflammatory index (SII), age, hypertension, cardiovascular disease (C), hemiplegia, and SaO\n                      <jats:sub>2<\/jats:sub>\n                      , and the nomogram model for risk prediction based on SaO\n                      <jats:sub>2<\/jats:sub>\n                      has good predictive efficacy, which can provide a reference forbral infarction in COPD patients in clinical practice. However, this study was retrospective, the sample size of the different subtypes of ischemic stroke was small, the risk analysis of each subtype of ischemic stroke could not be performed, and there may be some unmeasured confounding factors, which had a certain impact on the of the study. In the future, we need multi-center prospective studies to verify the effectiveness and practicality of the nomogram, and the basic mechanism of each risk factor also to be studied.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1675147","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T05:15:51Z","timestamp":1766034951000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Predicting cerebral infarction in COPD patients: an individualized nomogram based on arterial oxygen saturation"],"prefix":"10.3389","volume":"12","author":[{"given":"Deyi","family":"Zhou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaomi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijuan","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boyang","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuli","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huimin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhaojun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qinghua","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingjing","family":"Pan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feiju","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sihan","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xing","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junfen","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weimin","family":"Yao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riken","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangbin","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2197","DOI":"10.1016\/S0140-6736(12)61690-0","article-title":"Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the global burden of disease study 2010","volume":"380","author":"Murray","year":"2012","journal-title":"Lancet."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2095","DOI":"10.1016\/S0140-6736(12)61728-0","article-title":"Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010","volume":"380","author":"Lozano","year":"2012","journal-title":"Lancet."},{"key":"B3","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1164\/rccm.201204-0596PP","article-title":"Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary","volume":"187","author":"Vestbo","year":"2013","journal-title":"Am J Respir Crit Care Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1055\/s-0038-1648868","article-title":"Hypercoagulability state in patients with chronic obstructive pulmonary disease. Chronic obstructive bronchitis and haemostasis group","volume":"72","author":"Alessandri","year":"1994","journal-title":"Thromb Haemost."},{"key":"B5","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/S0049-3848(98)00165-0","article-title":"Measurement of prethrombotic markers in the assessment of acquired hypercoagulable states","volume":"93","author":"L\u00f3pez","year":"1999","journal-title":"Thromb Res."},{"key":"B6","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1378\/chest.08-1516","article-title":"Prevalence of pulmonary embolism in acute exacerbations of COPD: a systematic review and metaanalysis","volume":"135","author":"Rizkallah","year":"2009","journal-title":"Chest."},{"key":"B7","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1378\/chest.130.2.326","article-title":"Systemic inflammation in patients with COPD and pulmonary hypertension","volume":"130","author":"Joppa","year":"2006","journal-title":"Chest."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1631","DOI":"10.1378\/chest.130.6.1631","article-title":"Impaired lung function and risk for stroke: role of the systemic inflammation response?","volume":"130","author":"Tamagawa","year":"2006","journal-title":"Chest."},{"key":"B9","doi-asserted-by":"publisher","first-page":"133","DOI":"10.3892\/etm.2015.2462","article-title":"Caspase-3 inhibitor prevents the apoptosis of brain tissue in rats with acute cerebral infarction","volume":"10","author":"Sun","year":"2015","journal-title":"Exp Ther Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1159\/000021993","article-title":"Hemorheological changes during human aging","volume":"44","author":"Ajmani","year":"1998","journal-title":"Gerontology."},{"key":"B11","first-page":"7","article-title":"Hemorheology in cerebral ischemia","volume":"2","author":"Kowal","year":"1996","journal-title":"Neurol Neurochir Pol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"956","DOI":"10.1136\/thx.2009.128082","article-title":"Prevalence of major comorbidities in subjects with COPD and incidence of myocardial infarction and stroke: a comprehensive analysis using data from primary care","volume":"65","author":"Feary","year":"2010","journal-title":"Thorax."},{"key":"B13","doi-asserted-by":"publisher","first-page":"2068","DOI":"10.1378\/chest.128.4.2068","article-title":"COPD and incident cardiovascular disease hospitalizations and mortality: Kaiser permanente medical care program","volume":"128","author":"Sidney","year":"2005","journal-title":"Chest."},{"key":"B14","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.annepidem.2005.04.008","article-title":"Cardiovascular disease in patients with chronic obstructive pulmonary disease, Saskatchewan Canada cardiovascular disease in COPD patients","volume":"16","author":"Curkendall","year":"2006","journal-title":"Ann Epidemiol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1001\/jama.2019.0131","article-title":"Diagnosis and outpatient management of chronic obstructive pulmonary disease: a review","volume":"321","author":"Riley","year":"2019","journal-title":"JAMA."},{"key":"B16","doi-asserted-by":"publisher","first-page":"2392","DOI":"10.3969\/j.issn.1673-5374.2012.30.010","article-title":"Neuroimaging diagnosis for cerebral infarction: an 8-year bibliometric analysis","volume":"7","author":"Du","year":"2012","journal-title":"Neural Regen Res."},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae666.1203","article-title":"Prognostic impact of systemic immune-inflammation index in patients with acute decompensated heart failure with preserved ejection fraction -PURSUIT-HFpEF registry","author":"Kokubu","year":"2024","journal-title":"Eur Heart J"},{"key":"B18","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1136\/jnnp.2003.022012","article-title":"Arterial oxygen saturation, COPD, and cerebral small vessel disease","volume":"75","author":"van Dijk","year":"2004","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"B19","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1055\/s-0040-1722610","article-title":"Cerebral infarction in immune thrombotic thrombocytopenic purpura is associated with old age, hypertension, smoking, and anti-ADAMTS13 Ig, but not with mortality","volume":"5","author":"Memon","year":"2021","journal-title":"TH Open."},{"key":"B20","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1161\/HYPERTENSIONAHA.107.103127","article-title":"Association between thrombotic microangiopathy and reduced ADAMTS13 activity in malignant hypertension","volume":"51","author":"van den Born","year":"2008","journal-title":"Hypertension."},{"key":"B21","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1016\/0002-8703(83)90532-X","article-title":"Vital capacity as a predictor of cardiovascular disease: the Framingham study","volume":"105","author":"Kannel","year":"1983","journal-title":"Am Heart J."},{"key":"B22","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1136\/bmj.1.5478.14","article-title":"Hypertension and cerebral infarction","volume":"1","author":"Prineas","year":"1966","journal-title":"Br Med J."},{"key":"B23","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s12974-021-02090-6","article-title":"The association of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and lymphocyte to monocyte ratio with post-thrombolysis early neurological outcomes in patients with acute ischemic stroke","volume":"18","author":"Gong","year":"2021","journal-title":"J Neuroinflammation."},{"key":"B24","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1001\/jamaneurol.2021.5080","article-title":"Association of ischemic stroke incidence, severity, and recurrence with dementia in the atherosclerosis risk in communities cohort study","volume":"79","author":"Koton","year":"2022","journal-title":"JAMA Neurol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"3554","DOI":"10.1161\/STROKEAHA.115.011273","article-title":"Left atrial appendage function and stroke risk","volume":"46","author":"Yaghi","year":"2015","journal-title":"Stroke."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1835","DOI":"10.3390\/biomedicines9121835","article-title":"Heart-brain relationship in stroke","volume":"9","author":"Kelley","year":"2021","journal-title":"Biomedicines."},{"key":"B27","doi-asserted-by":"publisher","first-page":"9476","DOI":"10.3390\/ijms23169476","article-title":"Molecular mechanisms and pathophysiology of acute stroke: emphasis on biomarkers in the different stroke subtypes","volume":"23","author":"Gasull","year":"2022","journal-title":"Int J Mol Sci."},{"key":"B28","doi-asserted-by":"publisher","first-page":"2396","DOI":"10.1161\/STROKEAHA.107.505776","article-title":"Large artery intracranial occlusive disease: a large worldwide burden but a relatively neglected frontier","volume":"39","author":"Gorelick","year":"2008","journal-title":"Stroke."},{"key":"B29","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.ijcard.2003.02.007","article-title":"Specific cardiac disorders in 402 consecutive patients with ischaemic cardioembolic stroke","volume":"95","author":"Pujadas Capmany","year":"2004","journal-title":"Int J Cardiol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.jns.2016.11.006","article-title":"Does stroke etiology play a role in predicting outcome of acute stroke patients who underwent endovascular treatment with stent retrievers?","volume":"372","author":"Giray","year":"2017","journal-title":"J Neurol Sci."},{"key":"B31","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1159\/000319460","article-title":"Nineteen-year trends in risk factors, clinical characteristics and prognosis in lacunar infarcts","volume":"35","author":"Arboix","year":"2010","journal-title":"Neuroepidemiology."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1675147\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T05:15:52Z","timestamp":1766034952000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1675147\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,18]]},"references-count":31,"alternative-id":["10.3389\/fmed.2025.1675147"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1675147","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,18]]},"article-number":"1675147"}}