{
  "abstract": "Background Observational studies have shown that endovascular thrombectomy (EVT) benefits patients with acute basilar artery occlusion (aBAO) in the ultra-late window, yet subgroups at high risk of unfavourable outcome remain unclear. We sought to identify predictors and develop and validate a nomogram for identifying these patients.Methods This observational, retrospective study enrolled patients with aBAO who underwent EVT beyond 24 hours between January 2019 and March 2025. Eight hospitals were assigned to the training cohort and seven hospitals to the validation cohort, with a 7:3 random allocation based on hospital geographical location. A nomogram was constructed to estimate the probability of 90-day unfavourable outcomes (modified Rankin Scale score, 4–6) and generate actionable risk categories. We assessed the performance of the nomogram and conducted external validation.Results Overall, 203 patients were included in the analysis. Independent predictors, including late neurological deterioration (OR 3.12, 95% CI 1.22 to 8.02), National Institutes of Health Stroke Scale score (OR 1.10, 95% CI 1.04 to 1.17), Glasgow Coma Scale score ≤8 (OR 3.98, 95% CI 1.06 to 14.96), male (OR 5.75, 95% CI 1.59 to 20.74) and coronary heart disease (OR 6.53, 95% CI 1.40 to 30.55), were identified in the training cohort and entered into the nomogram. The area under the receiver operating characteristic curve of the nomogram was 0.798 (95% CI 0.727 to 0.870) and 0.721 (95% CI 0.587 to 0.856) in the training and external validation cohorts, respectively.Conclusion We developed a nomogram that can identify patients with aBAO at high risk of unfavourable outcome following EVT in the ultra-late window.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Na Liu"
    },
    {
      "affiliations": [
        "Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Haodong Li"
    },
    {
      "affiliations": [
        "Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Qiuting Wang"
    },
    {
      "affiliations": [
        "Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Yuxin Chen"
    },
    {
      "affiliations": [
        "Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China"
      ],
      "name": "Shouchun Wang"
    },
    {
      "affiliations": [
        "Department of Neurology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China"
      ],
      "name": "Shimin Liu"
    },
    {
      "affiliations": [
        "Department of Neurology, The First Affiliated Hospital (People’s Hospital of Hunan Province), Hunan Normal University, Changsha, Hunan, China"
      ],
      "name": "Chunhua Li"
    },
    {
      "affiliations": [
        "Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China"
      ],
      "name": "Jin Zhang"
    },
    {
      "affiliations": [
        "Department of Neurology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan, China"
      ],
      "name": "Hongli Pang"
    },
    {
      "affiliations": [
        "Dapartment of Neurosurgery, Liaoyang City Central Hospital, Liaoyang, Liaoning, China"
      ],
      "name": "Chun-Guang Chen"
    },
    {
      "affiliations": [
        "Department of Neurology, Shandong Provincial Qianfoshan Hospital (The First Affiliated Hospital of Shandong First Medical University), Jinan, Shandong, China"
      ],
      "name": "Yanbin Li"
    },
    {
      "affiliations": [
        "Department of Neurology, The 960th Hospital of People’s Liberation Army (PLA), Jinan, Shandong, China"
      ],
      "name": "Huaiqiang Hu"
    },
    {
      "affiliations": [
        "Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China"
      ],
      "name": "Xiaolin Zhao"
    },
    {
      "affiliations": [
        "Clinical Research Center, Capital Medical University, Beijing, China",
        "Chinese Institutes for Medical Research Beijing, Beijing, China"
      ],
      "name": "Lan Liu"
    },
    {
      "affiliations": [
        "Chinese Institutes for Medical Research Beijing, Beijing, China",
        "Capital Medical University, Beijing, China"
      ],
      "name": "Qing Zhang"
    },
    {
      "affiliations": [
        "Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Chuanjie Wu"
    },
    {
      "affiliations": [
        "Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Longfei Wu"
    },
    {
      "affiliations": [
        "Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Wenbo Zhao"
    },
    {
      "affiliations": [
        "Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Qingfeng Ma"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Jian Chen"
    },
    {
      "affiliations": [
        "Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China",
        "Neuro Cardio Vascular Diseases Center, Xuanwu Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Xunming Ji"
    },
    {
      "affiliations": [
        "Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China",
        "The Stroke Center, Xuanwu Hospital Capital Medical University, Beijing, China"
      ],
      "name": "Chuanhui Li"
    }
  ],
  "title": "Nomogram with late neurological deterioration as a key predictor for poor functional outcomes after endovascular therapy in acute basilar artery occlusion beyond 24 hours",
  "uid": "f258fa41-7187-5ae9-86d9-a98fcd68cf7e"
}