Background: As a leading cause of severe morbidity, acute ischemic stroke (AIS) necessitates precise prognostic evaluation to inform critical treatment strategies. Recent advancements have identified quantitative electroencephalography (qEEG) as a pivotal instrument in refining prognostic accuracy for AIS. This investigation aimed to construct a robust prognostic model, anchored in qEEG parameters, to enhance the precision of clinical prognosis 6 months after discharge in AIS patients. Methods: In a retrospective observational study, we analyzed AIS cases from January 2022 to March 2023. Data encompassing demographic profiles, clinical manifestations, qEEG findings, and modified Rankin Scale (mRS) assessments were evaluated for 109 patients with AIS. These metrics were instrumental in developing prognostic models, segregating outcomes into either favorable (mRS: 0–2) or unfavorable categories (mRS: 3–6) at 6 months post-discharge. Prognostic models were developed using clinical and qEEG parameters. Results: The formulation of two distinct prognostic models was predicated on an integration of baseline clinical data (age, unilateral limb weakness, ataxia and red blood cell count) and specific qEEG metrics (T3-P3 (TAR) and T4-P4 (TAR)). The synthesis of these models culminated in the Prognostic Model 3, which exhibited a marked enhancement in prognostic accuracy, as evidenced by an area under the curve (AUC) of 0.8227 (95% CI: 0.7409–0.9045), thereby signifying a superior prediction of AIS prognosis 6 months after discharge relative to the individual models. Conclusion: Quantitative EEG, especially increased theta/alpha power ratio (TAR), might improve the prediction of prognosis 6 months after discharge of acute ischemic stroke in clinical practice.
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