scholarly journals Multivariate ordered logistic regression analysis of the postoperative effect of symptomatic discoid lateral meniscus

2021 ◽  
Author(s):  
Shun-Jie Yang ◽  
Jian Li ◽  
Yang Xue ◽  
Zhong Zhang ◽  
Gang Chen
Keyword(s):  
Logistic Regression ◽  
Age Of Onset ◽  
Univariate Analysis ◽  
Arthroscopic Surgery ◽  
Lateral Meniscus ◽  
Postoperative Outcomes ◽  
Discoid Lateral Meniscus ◽  
Work Intensity ◽  
Duration Of Symptoms ◽  
Ordered Logistic Regression

Abstract Introduction The postoperative effect of arthroscopy in the treatment of symptomatic discoid lateral meniscus (DLM) varies greatly among individuals. Therefore, this study aims to investigate the factors affecting the postoperative outcomes of symptomatic DLM. Materials and methods According to the inclusion and exclusion criteria, patients with symptomatic single-knee DLM who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were included. Retrospectively collected 16 factors probably affecting postoperative outcomes. The Ikeuchi grade system was used to evaluate the knee joint function. Univariate analysis was performed by Kruskal–Wallis rank-sum test or Mann–Whitney U test, and multivariate analysis by ordered logistic regression. P < 0.05 was considered statistically significant. Results A sum of 502 patients was included, including 353 females (70.3%) and 149 males (29.7%). Difference between preoperative and postoperative Ikeuchi grade was statistically significant (P < 0.001). Female was bad to obtain a good Ikeuchi grade (P = 0.009, OR 0.458). Outerbridge grade (P = 0.018, OR 0.638) was negatively correlated with Ikeuchi grade. BMI (P = 0.001, OR 0.875) and work intensity (P = 0.020, OR 0.611) were inversely correlated with Ikeuchi grade. Age of onset (P < 0.001, OR 0.956) and symptoms duration (P < 0.001, OR 0.988) were negatively correlated with Ikeuchi grade. Besides, compared to total meniscectomy, meniscoplasty with a repair was an unfavourable factor for Ikeuchi grade (P = 0.044, OR 0.245). Conclusions With the increase of BMI, work intensity, age of onset, duration of symptoms, and the severity of cartilage lesion, the postoperative results become worse. Moreover, female and meniscoplasty with repair are risk factors for the postoperative outcomes.

scholarly journals Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

2020 ◽  
Author(s):  
ShunJie Yang ◽  
Zhong-Jun Ding ◽  
Jian Li ◽  
Yang Xue ◽  
Gang Chen
Keyword(s):  
Clinical Symptoms ◽  
Age Of Onset ◽  
Arthroscopic Surgery ◽  
Lateral Meniscus ◽  
International Knee Documentation Committee ◽  
Influential Factors ◽  
Postoperative Outcomes ◽  
Discoid Lateral Meniscus ◽  
Ikdc Score ◽  
Male Sex

Abstract Background: Due to its abnormal morphology and ultrastructure, discoid lateral meniscus (DLM) is prone to tear and degeneration, leading to clinical symptoms. Arthroscopy is the main treatment for symptomatic DLM; however, postoperative outcomes vary widely due to the effects of diverse factors. This research aims to explore the factors influencing postoperative outcomes of symptomatic DLM. Methods: Patients with DLM who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were enrolled according to the inclusion and exclusion criteria. Fourteen variables, including sex, body mass index (BMI) and other variables, were chosen as factors for study. Knee function was assessed using the International Knee Documentation Committee (IKDC) score. Univariate analyses (Mann-Whitney U test or Kruskall-Wallis rank sum test) and multivariate analyses (ordinal logistic regression) were used to identify the factors that influenced postoperative outcomes. P<0.05 was considered statistically significant.Results: A total of 502 patients, including 353 females (70.3%) and 149 males (29.7%), were enrolled. The median IKDC score postoperatively (87.4; range, 41.4~97.7; IQR, 14.6) was higher than that preoperatively (57.6; range, 26.9~ 64.9; IQR, 9.7) (P<0.001). Male sex was predictive of a higher IKDC score (P=0.023, OR=1.702). Compared with BMI ≥25 kg/m2, <18.5 kg/m2 was associated with better IKDC score (P=0.026, OR=3.016). Contrasting with age of onset ≥45 years, ≤14 years (P<0.001, OR=20.780) and 14~25 years (P<0.001, OR=8.516) were associated with better IKDC score. In comparison with symptoms duration>24 months, IKDC scores for patients with symptoms duration ≤1 month (P=0.001, OR=3.511), 1 ~ 6 months (P < 0.001, OR = 3.463) and 6 ~ 24 months (P < 0.001, OR = 3.254) were significantly elevated. Compared to Outerbridge grade III ~ IV, no injury (P<0.001, OR=6.379) and grade I (P=0.01, OR=4.332) were associated with higher IKDC score.Conclusions: Arthroscopic treatment of symptomatic DLM is safe and effective, but its clinical efficacy is affected by many factors. Specifically, male sex, BMI < 18.5kg/m2, age of onset < 25 years (especially < 14 years) and symptoms duration < 24 months are conducive to good postoperative outcomes. However, combined articular cartilage injury (Outbridge grade≥2) reduces postoperative effect.

scholarly journals Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

2020 ◽  
Author(s):  
ShunJie Yang ◽  
Zhong-Jun Ding ◽  
Jian Li ◽  
Yang Xue ◽  
Gang Chen
Keyword(s):  
Logistic Regression ◽  
Clinical Outcomes ◽  
Protective Factor ◽  
Age Of Onset ◽  
Postoperative Outcomes ◽  
Discoid Lateral Meniscus ◽  
Work Intensity ◽  
Discoid Meniscus ◽  
Cartilage Lesions ◽  
Outerbridge Grade

Abstract Background: Discoid lateral meniscus (DLM) have a higher rate of tear and degeneration for its abnormal shape and structure. Arthroscopy is the main treatment for symptomatic DLM, however, postoperative clinical outcomes vary widely resulting from effects of diverse factors. Therefore, the present research aims to explore the factors influencing postoperative clinical outcomes of symptomatic DLM . Methods: Patients with discoid meniscus who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were selected according to the inclusion and exclusion criteria. Gender, body mass index (BMI) ,and 18 other factors were selected as potential predictors that might affect postoperative outcomes . Knee function was assessed by the Lysholm, Tegner, International Knee Documentation Committee (IKDC) and Ikeuchi scales. Univariate analyses (rank-sum test and chi-squared test) and multivariate analyses (ordered logistic regression and logistic regression) were used to detect the risk factors bearing on postoperative outcomes. P<0.05 was considered statistically significant. Results: A total of 502 patients were enrolled. Female gender was an influencing factor for Lysholm (P=0.002, odds ratio (OR) =2.713), Tegner (P=0.001, OR=2.526) , IKDC (P=0.022, OR=1.735) and Ikeuchi scores (P=0.010, OR=2.164). BMI was negatively correlated with Lysholm (P=0.007, OR=1.119) and IKDC (P=0.029, OR=1.088) scores. Work intensity was negatively related to IKDC (P=0.038, OR=1.492) and Ikeuchi (P=0.014, OR=1.689) scores. Age of onset was inversely correlated with Tegner (P<0.001, OR=1.109) score.Symptoms duration and IKDC (P=0.002, OR=1.020) had an inverse correlation. Lack of cartilage lesions was a protective factor in terms of Tegner score (P<0.001, OR=0.261). Outerbridge grade was negatively correlated with Lysholm (P=0.016, OR=1.589) and Ikeuchi (P=0.017, OR=1.582) scores. Saucerization with repair was a risk factor for poor Ikeuchi scores (P=0.037, OR=4.328) in terms of subtotal/total meniscectomy. Conclusion: Arthroscopic treatment of symptomatic DLM is safe and effective . Female sex, cartilage lesions and saucerization with repair may be related to unfavourable postoperative outcomes. Clinical efficacy may worsen with increasingBMI, work intensity, symptomatic duration, age of onset and Outerbridge grade.

scholarly journals Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

2019 ◽  
Author(s):  
ShunJie Yang ◽  
Zhong-Jun Ding ◽  
Jian Li ◽  
Yang Xue ◽  
Gang Chen
Keyword(s):  
Logistic Regression ◽  
Clinical Outcomes ◽  
Protective Factor ◽  
Age Of Onset ◽  
Postoperative Outcomes ◽  
Discoid Lateral Meniscus ◽  
Work Intensity ◽  
Discoid Meniscus ◽  
Cartilage Lesions ◽  
Outerbridge Grade

Abstract Background: Discoid lateral meniscus (DLM) have a higher rate of tear and degeneration for its abnormal shape and structure. Arthroscopy is the main treatment for symptomatic DLM, however, postoperative clinical outcomes vary widely resulting from effects of diverse factors. Therefore, the present research aims to explore the factors influencing postoperative clinical outcomes of symptomatic DLM. Methods: Patients with discoid meniscus who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were selected according to the inclusion and exclusion criteria. Gender, body mass index (BMI), and 18 other factors were selected as potential predictors that might affect postoperative outcomes. Knee function was assessed by the Lysholm, Tegner, International Knee Documentation Committee (IKDC) and Ikeuchi scales. Univariate analyses (rank-sum test and chi-squared test) and multivariate analyses (ordered logistic regression and logistic regression) were used to detect the risk factors bearing on postoperative outcomes. P<0.05 was considered statistically significant.Results: A total of 502 patients were enrolled. Female gender was an influencing factor for Lysholm (P=0.002, odds ratio (OR)=2.713), Tegner (P=0.001, OR=2.526), IKDC (P=0.022, OR=1.735) and Ikeuchi scores (P=0.010, OR=2.164). BMI was negatively correlated with Lysholm (P=0.007, OR=1.119) and IKDC (P=0.029, OR=1.088) scores. Work intensity was negatively related to IKDC (P=0.038, OR=1.492) and Ikeuchi (P=0.014, OR=1.689) scores. Age of onset was inversely correlated with Tegner (P<0.001, OR=1.109) score. Symptoms duration and IKDC (P=0.002, OR=1.020) had an inverse correlation. Lack of cartilage lesions was a protective factor in terms of Tegner score (P<0.001, OR=0.261). Outerbridge grade was negatively correlated with Lysholm (P=0.016, OR=1.589) and Ikeuchi (P=0.017, OR=1.582) scores. Saucerization with repair was a risk factor for poor Ikeuchi scores (P=0.037, OR=4.328) in terms of subtotal/total meniscectomy.Conclusion: Arthroscopic treatment of symptomatic DLM is safe and effective. Female sex, cartilage lesions and saucerization with repair may be related to unfavourable postoperative outcomes. Clinical efficacy may worsen with increasing BMI, work intensity, symptomatic duration, age of onset and Outerbridge grade.

Nongenetic Factors as Modifiers of the Age of Onset of Familial Alzheimer's Disease

2003 ◽  
Vol 15 (4) ◽  
pp. 337-349 ◽  
Author(s):  
Silvia Mejía ◽  
Margarita Giraldo ◽  
David Pineda ◽  
Alfredo Ardila ◽  
Francisco Lopera
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Logistic Regression ◽  
Early Onset ◽  
Age Of Onset ◽  
Univariate Analysis ◽  
Personal Factors ◽  
Familial Alzheimer’S Disease ◽  
Familial Alzheimer's Disease ◽  
High Level

Objective: The purpose of this research was to identify environmental and personal factors that could be related to the variability in the age of onset of familial Alzheimer's disease (FAD) (36–62 years). Methods: A sample was taken of 49 subjects with FAD and with the mutation E280A in the presenilin-1 gene on chromosome 14; the sample was divided into two subgroups: 27 individuals with age of onset of the disease between 36 and 46 years (early onset) and 22 individuals whose disease began between 47 and 62 years (late onset). Information on environmental and personal factors was collected by means of a questionnaire answered by the patients if their clinical condition allowed it, or by their relatives; such information was organized in a categorical way. Comparisons between the two groups for each categorical variable were done by means of the chi-square test. Noncollinear variables that showed statistical significance were included as independent variables in a logistic regression analysis to predict their association with early onset of the disease. Results: Only 5 of the 140 studied variables were different between the two groups in univariate analysis: education, surgical history, type of stressful event, depression, and affective losses. The logistic regression model was constituted by education, depression, and affective losses. High-level education had approximately 15 times more probability of association with an early onset of the disease; both the history of affective losses and depressive symptoms had 4 times more probability of a similar association. Conclusions: The association of high-level education and early onset of the disease could be related to an earlier detection of symptoms, in turn determined by greater intellectual and environmental demands. The occurrence of depression and affective losses has been considered a prodromic manifestation of the disease. Our findings are evidence of high clinical heterogeneity even in a genetically homogeneous group.

scholarly journals Pre-operative and Post-Operative Alpha Angles are Significant Independent Predictors of Patient-Reported Outcome Measures at Two Years After Hip Arthroscopy

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0017
Author(s):  
Drew A. Lansdown ◽  
Kyle Kunze ◽  
Gift Ukwuani ◽  
Brian Robert Waterman ◽  
William H. Neal ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Univariate Analysis ◽  
Arthroscopic Surgery ◽  
Alpha Angle ◽  
Joint Space Width ◽  
Postoperative Outcomes ◽  
Harris Hip Score ◽  
Multivariate Modeling ◽  
Center Edge ◽  
Patient Reported

Objectives: Residual impingement after hip arthroscopy for femoroacetabular impingement (FAI) is a common cause for re-operation; however, the relationship between preoperative and postoperative radiographic parameters and patient-reported outcomes has not been defined. Methods: 749 consecutive patients were reviewed two years after primary hip arthroscopy. Patients undergoing revision surgery were excluded. Pre-operative and post-operative radiographs were analyzed to measure the alpha angle on standardized anteroposterior (AP) pelvis, Dunn-lateral, and false profile (FP) views and anterior and lateral center-edge angles (ACEA, LCEA). Univariate analysis evaluated the association between demographic variables, radiographic measures and hip outcome scores (Hip Outcome Score (HOS)-Activities of Daily Living (ADL), HOS-Sports Specific (SS), and Modified Harris Hip Score (mHHS)). Multivariate modeling was subsequently performed. Significance was defined as p<0.05. Results: 706 patients with mean age of 33.2±12.3 years and mean BMI 25.1± 5kg/m2 were included for final analysis. The alpha angle on the AP, Dunn-lateral, and FP views and the ACEA and LCEA decreased after surgery (p<0.001 for all). Significant univariate correlations with the postoperative HOS-ADL included age, BMI, pre-operative AP, FP, and Dunn and postoperative FP alpha angles. Postoperative HOS-SS was correlated with age, BMI, medial post-operative joint space width (JSW), pre-operative AP, FP, and Dunn and postoperative FP alpha angles, and pre-operative and post-operative (ACEA). Postoperative mHHS correlated with age, BMI, post-operative lateral JSW, pre-operative AP, FP, and Dunn and postoperative FP and Dunn alpha angles, and post-operative ACEA. Multivariate modeling (Table 2) demonstrated that preoperative and postoperative FP alpha angles were independent predictors of postoperative outcomes. Conclusion: Pre-operative and post-operative alpha angles were negatively correlated with the HOS-ADL, HOS-SS, and mHHS at 2 years after arthroscopic surgery for FAI. Specifically, pre-operative and postoperative FP alpha angles were independent predictors of postoperative outcomes. These results highlight the importance of resecting anterior cam lesions to prevent residual impingement and inferior outcomes. [Table: see text]

scholarly journals Relationship Between Medication Literacy and Frailty in Elderly Inpatients With Coronary Heart Disease: A Cross-Sectional Study in China

2021 ◽  
Vol 12 ◽  
Author(s):  
Jiling Qu ◽  
Ting Zhou ◽  
Mengxin Xue ◽  
Huiping Sun ◽  
Yijing Shen ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Logistic Regression ◽  
Heart Disease ◽  
Correlation Analysis ◽  
Univariate Analysis ◽  
Outcome Variable ◽  
Cross Sectional ◽  
Ordered Logistic Regression ◽  
The Relationship ◽  
Spearman’S Correlation

Background: Mastering medication literacy may be related to medication safety, and the identification of frailty is very important for the prognosis of coronary heart disease (CHD). Few studies have examined the relationship between medication literacy and frailty in patients with CHD. The aim of this study was to investigate the state of medication literacy and frailty in patients with CHD and to explore the relationship between medication literacy and frailty.Methods: A cross-sectional investigation evaluated 295 inpatients with CHD recruited from hospitals in Yangzhou, China. Demographic and clinical data on participants were collected using a general information questionnaire. The Chinese medication literacy scale was used to evaluate medication literacy. The Fried Frailty Phenotype scale was used to evaluate frailty. Univariate analysis employed chi-square test and Kruskal-Wallis H test to examine the potential factors affecting frailty. Taking frailty status as the outcome variable, the ordered logistic regression model was used to analyze the relationship between the degree of medication literacy and frailty. Spearman’s correlation analysis was used to analyze the correlation between medication literacy and frailty.Results: A total of 280 elderly CHD inpatients were included in the analysis. There were 116 (41.4%) individuals with inadequate medication literacy and 89 (31.8%) frail individuals. Ordered logistic regression analysis showed that the age (p &lt; 0.001, OR = 1.089), Charson Comorbidity Index (p = 0.029, OR = 1.300), number of medications taken (p = 0.012, OR = 1.137), and medication literacy (p &lt; 0.05, OR &gt; 1) were independent predictors of debilitating risk factors. The population with inadequate medication literacy had a 2.759 times greater risk of frailty than adequate medication literacy (p &lt; 0.001, OR = 2.759); The population with marginal medication literacy had a 2.239 times greater risk of frailty than adequate medication literacy (p = 0.010, OR = 2.239). Spearman’s correlation analysis showed that the medication literacy grade was associated with the frailty grade in elderly CHD patients (R = -0.260, p &lt; 0.001).Conclusion: The study showed a significant correlation between medical literacy and frailty in patients with CHD. The results suggested that medication literacy was an important consideration in the development, implementation, and evaluation of frailty.

scholarly journals Prognostic Factors for Open-Wedge High Tibial Osteotomy with Spacer Implantation in Patients with Medial Compartmental Knee Osteoarthritis

2021 ◽  
Author(s):  
Fengkun Wang ◽  
Wenru Ma ◽  
Jinli Chen ◽  
Wenbin Cong ◽  
Yingze Zhang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Prognostic Factors ◽  
High Tibial Osteotomy ◽  
Univariate Analysis ◽  
Womac Score ◽  
Neutral Position ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Duration Of Symptoms ◽  
Wedge High Tibial Osteotomy

Abstract Background: To identify the medial open-wedge high tibial osteotomy (MOWHTO) prognostic factors with wedge-shaped spacer implantation (spacer-type MOWHTO) for varus medial compartment knee osteoarthritis.Methods: Patients who underwent spacer-type MOWHTO between August 2018 and September 2019 were prospectively enrolled in this study. Patients were divided into two groups based on Western Ontario and McMasters University Osteoarthritis Index (WOMAC) scores of 40 points at 1 year postoperatively: the effective group (n=88, 84.6%), with post-WOMAC scores 40 or less, and the invalid group (n=16, 15.4%), with post-WOMAC scores more than 40. The variables assessed at baseline and 1 year postoperatively including age, sex, body mass index (BMI), Kellgren-Lawrence (K-L) grade, hip-knee-ankle angle (HKAA), medial proximal tibial angle (MPTA), posterior tibial slope angle (PTSA), Blackburn-Peel index (BPI), duration of symptoms and WOMAC score, were compared. Prognostic factors were analyzed using logistic regression, and the corresponding odds ratios were also calculated.Results: A total of 104 patients were enrolled in the study protocol at 1 year postoperatively. The WOMAC score decreased from 72.39±12.95 at baseline to 20.06±12.96 at 1 year postoperatively. The preoperative varus was corrected to a neutral position or to mild valgus. In addition, the PTSA was decreased. At the same time, the patellar height was not significantly changed postoperatively. Univariate analysis revealed that the significant predictors of the WOMAC score were age >70 years, BMI >30 kg/m², K-L grade IV, and pre-HKAA >10° (P<0.1 for all). Multivariable logistic regression analysis revealed that age>70 (OR=4.861) and K-L grade IV (OR=6.590) were significantly associated with the WOMAC score at 1 year postoperatively.Conclusion: Spacer-type MOWHTO is an effective treatment for osteoarthritis with varus deformity. The prognostic factors for spacer-type MOWHTO were age and K-L grade.Level of evidence: III

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