scholarly journals Development and Validation of an Easy-to-Use Risk Scoring System for Screening High-Risk Varices in Patients with HBV-Related Compensated Advanced Chronic Liver Disease

2021 ◽  
Author(s):  
Yuling Yan ◽  
Xian Xing ◽  
Xiaoze Wang ◽  
Ruoting Men ◽  
Xuefeng Luo ◽  
...  
Keyword(s):  
Liver Disease ◽  
High Risk ◽  
Chronic Liver Disease ◽  
Scoring System ◽  
Chronic Liver ◽  
Risk Scoring ◽  
Development And Validation ◽  
Risk Scoring System

scholarly journals Development of a Sex-Specific Risk Scoring System for Predicting Cognitive Normal to Mild Cognitive Impairment (SRSS-CNMCI)

2021 ◽  
Author(s):  
Wen Luo ◽  
Hao Wen ◽  
Shuqi Ge ◽  
Chunzhi Tang ◽  
Xiufeng Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
High Risk ◽  
Scoring System ◽  
External Validation ◽  
Scoring Systems ◽  
Cutoff Point ◽  
Risk Scoring ◽  
Risk Scoring System

Abstract Objective: We aim to develop a sex-specific risk scoring system for predicting cognitive normal (CN) to mild cognitive impairment (MCI), abbreviated SRSS-CNMCI, to provide a reliable tool for the prevention of MCI.Methods: Participants aged 61-90 years old with a baseline diagnosis of CN and an endpoint diagnosis of MCI were screened from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database with at least one follow-up. Multivariable Cox proportional hazards models were used to identify risk factors associated with conversion from CN to MCI and to build risk scoring systems for male and female groups. Receiver operating characteristic (ROC) curve analysis was applied to determine the risk probability cutoff point corresponding to the optimal prediction effect. We ran an external validation of the discrimination and calibration based on the Harvard Aging Brain Study (HABS) database.Results: A total of 471 participants, including 240 women (51%) and 231 men (49%), aged 61 to 90 years, were included in the study cohort for subsequent primary analysis. The final multivariable models and the risk scoring systems for females and males included age, APOE ε4, Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). The scoring systems for females and males revealed C statistics of 0.902 (95% CI 0.840-0.963) and 0.911 (95% CI 0.863-0.959), respectively, as measures of discrimination. The cutoff point of high and low risk was 33% in females, and more than 33% was considered high risk, while more than 9% was considered high risk for males. The external validation effect of the scoring systems was good: C statistic 0.950 for the females and C statistic 0.965 for the males. Conclusions: Our parsimonious model accurately predicts conversion from CN to MCI with four risk factors and can be used as a predictive tool for the prevention of MCI.

scholarly journals The Efficacy of Risk Score System Establishment and Methylprednisolone Stratification Treatment for Pre-Engraftment Syndrome after Unrelated Cord Blood Transplantation: A Retrospective (development) and a Prospective (validation) Study

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4501-4501
Author(s):  
Xiaoyu Zhu ◽  
Jiang Zhu ◽  
Baolin Tang ◽  
Kaidi Song ◽  
Linlin Jin ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Risk Score ◽  
Cumulative Incidence ◽  
Scoring System ◽  
Cord Blood Transplantation ◽  
High Risk Factors ◽  
Risk Scoring ◽  
Risk Scoring System ◽  
Different Doses

Introduction Pre-engraftment syndrome (PES) is a common immune reaction prior to neutrophil engraftment after unrelated cord blood transplantation (UCBT), with a unique clinical manifestation of non-infectious fever and skin rash. The reported incidence of PES ranges from 20% to 78%. Although many researchers believe that PES is associated with a high incidence of acute graft-versus-host disease (GVHD) but not with transplant-related mortality (TRM) , relapse, or overall survival (OS), they did not stratify the risk factors of PES, and how to carry out different doses of methylprednisolone (MP) stratified intervention therapy still remains unknown. Method s First, 136 hematological malignancy patients treated with UCBT from April 2000 to February 2012 in our transplantation center were retrospectively analysis. Among them, 92 patients occurred PES. High-risk factors for 180-day TRM in PES patients were established by univariate and multivariate analysis. Then, from January 2013 to August 2016, 221 PES patients were scored according to the risk scoring system and stratified treated with different doses of MP. Finally, in order to validate the efficacy of MP stratification treatment, we conducted a prospective, open label and non-randomized clinical trial including 240 PES patients who underwent UCBT from September 2016 to December 2018. This trial is registered at www.chictr.org.cn as ChiCTR-ONC-16009013. Results The cumulative incidence of neutrophil and platelet engraftment was significantly higher in PES group than non-PES group (97.8% vs 70.5%, P<0.001; 75.0% vs 54.5%, P=0.05). In 92 PES patients, multivariate analysis showed that failed MP treatment, multiple clinical symptoms and early onset of PES were independent high risk factors affecting180-day TRM. One high risk factor was scored as 1. The 92 PES patients were divided into PES-0, PES-1,PES-2 and PES-3, and the higher the score, the higher the TRM (17.7% vs 21.9% vs 62.5% vs 100%,respectively; P<0.001), and the lower the OS (68.3% vs 56.2% vs 25.0% vs 0%, respectively; P<0.001). Then, from January 2013 to August 2016, 221 PES patients were scored as PES-0, PES-1 and PES-2 according to the following two high risk factors (multiple clinical symptoms and early onset of PES) and stratified treated with different doses of MP (0.5mg/kg/d for PES-0, 1mg/kg/d for PES-1 and 2mg/kg/d for PES-2). Compared to the previous PES patients with the same risk score, the 180-day TRM of PES-1 and PES-2 patients was significantly reduced and the OS, disease free survival (DFS), and GVHD-free and Relapse-free survival (GRFS) were significantly increased after stratified treatment. The results in the prospective trial were similar to the retrospective study. In addition, although stratified therapy could significantly improve the prognosis of PES-2 patients cohort, the cumulative incidence of acute GVHD and GRFS are still the worst compared with other risk score patients. Therefore, how to improve the outcomes of PES-2 patients remains to be further studied. Conclusion s PES after UCBT is benefit for engraftment, but should be graded according the risk scoring system. Different doses of MP stratified intervention therapy can significantly improve the prognosis of severe PES patients. The risk scoring system of PES after UCBT and MP stratification treatment are worthy of clinical application. But the cumulative incidence of acute GVHD and GRFS in severe PES patients still need to be ameliorated in the further study. Disclosures No relevant conflicts of interest to declare.

A Risk Scoring System to Identify Emergency Department Patients With Heart Failure at High Risk for Serious Adverse Events

2013 ◽  
Vol 20 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Ian G. Stiell ◽  
Catherine M. Clement ◽  
Robert J. Brison ◽  
Brian H. Rowe ◽  
Bjug Borgundvaag ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
High Risk ◽  
Adverse Events ◽  
Scoring System ◽  
Serious Adverse Events ◽  
Patients With Heart Failure ◽  
Risk Scoring ◽  
Emergency Department Patients ◽  
Risk Scoring System

scholarly journals Increasing incidence of hepatitis A in Bangladesh

2012 ◽  
Vol 47 (3) ◽  
pp. 309-312 ◽  
Author(s):  
MZ Amin ◽  
LN Siddique ◽  
MA Slatter ◽  
KK Biswas
Keyword(s):  
Liver Disease ◽  
High Risk ◽  
Chronic Liver Disease ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Age Groups ◽  
Hepatitis E ◽  
Immunoglobulin M ◽  
Chronic Liver ◽  
High Risk Population

Hepatitis A (HAV) infection is caused by the hepatitis A virus which is transmitted through the fecal-oral route. Life long protective antibodies are present after infection. The number of cases of adult hepatitis A has progressively been increasing during the last several decades in Bangladesh. In addition, the pattern of age-specific seroprevalence of anti-HAV has changed with economic growth. The prevalence of anti-HAV in 20-40 year age range has declined rapidly during the last 3 decades. As a result, this age groups has a high risk for HAV infection and clinically overt hepatitis A is increasing in adolescents and adult. The aim of the present study were to assess whether the proportion of adults with acute HAV infection has been increasing over the years and analyze the seroprevalence of immunoglobulin M(IgM) anti- HAV antibodies in young adults below the age of 20 years as well as in cases of chronic liver disease. Sera collected from 530 patients with acute and chronic liver disease attends the Somorita Hospital Ltd. during the previous 2 years and 6 months (Jan. 2008- Jun. 2010) were tested for various serological markers of acute and chronic hepatitis. In addition, 530 normal healthy attendants of the patients above the age of 20 years were tested for IgM anti-HAV as controls. Of 530 patients with acute hepatitis (13.42%) were positive for immunoglobulin M. The patients who were IgM anti-HAV negative were found to be hepatitis B (106 patients), hepatitis C, (10 patients), hepatitis E (150 patients) and unclassified (273 patients). Although the frequency of HAV infection among young adult (< 20 age) had increased (33.33% to 42.35%) in the 2 years and 6 months period, the frequency of HAV infection among adults had also increased (15.38% to 28.13%) during the same period. This study should be helpful for the identification of high risk population for vaccination of hepatitis A. DOI: http://dx.doi.org/10.3329/bjsir.v47i3.13065 Bangladesh J. Sci. Ind. Res. 47(3), 309-312 2012

A risk scoring system to identify travellers who qualify for pre-exposure rabies vaccination

2020 ◽  
Vol 27 (7) ◽  
Author(s):  
Mieke Croughs ◽  
Patrick Soentjens
Keyword(s):  
High Risk ◽  
Scoring System ◽  
Evidence Based ◽  
Risk Scoring ◽  
Risk Predictors ◽  
Risk Scoring System ◽  
Rabies Vaccination

We want to introduce a free online scoring system to identify high risk travellers who qualify for pre-travel rabies vaccination. The system uses evidence based risk predictors and the probable availability of HRIG at the destination.

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