Incidence and risk factors predicting deep venous thrombosis of lower extremity following spinal fractures

AbstractThe aim of this study was to investigate the presence of preoperative DVT following spinal fracture and the association between the presence of DVT and risk factors. Ultrasonography and blood analyses were performed preoperatively in patients diagnosed with spinal fracture between October 2014 and December 2018. Univariate analyses were performed on the data of demographics, comorbidities, location of injury, spinal cord injury (SCI) grading and laboratory biomarkers. The receiver operating characteristic (ROC) curve analysis was employed to obtain the optimal D-dimer cut-off value for diagnosis. In total, 2432 patients with spinal fractures were included, among whom 108 (4.4%) patients had preoperative DVTs. The average interval between fracture and initial diagnosis of DVT was 4.7 days (median, 2 days), ranging from 0 to 20 days; 78 (72.2%) were diagnosed within 7 days after injury and 67 (62.0%) within 3 days; 19 (17.5%) patients had proximal vein involved and 89 (82.4%) presented in distal veins. Multivariate logistic regression suggested six risk factors independently correlated to DVT, including delay to DUS (in each day) (odds ratio [OR] = 1.11), ASA class III–IV (OR = 2.36), ASIA grade (A/B) (OR = 2.36), ALB < 3.5 g/dL (OR = 2.08), HDL-C < 1.1 mmol/L (OR = 1.68) and d-Dimer > 1.08 µg/ml (OR = 2.49).

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Incidence and locations of deep venous thrombosis of the lower extremity following surgeries of tibial plateau fractures: a prospective cohort study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-02136-0 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Junyong Li ◽

Yanbin Zhu ◽

Wei Chen ◽

Kuo Zhao ◽

Junzhe Zhang ◽

...

Keyword(s):

Risk Factors ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Tibial Plateau ◽

Lower Extremities ◽

Tibial Plateau Fractures ◽

Targeted Prevention ◽

Independent Risk Factors ◽

Laboratory Biomarkers ◽

Univariate Analyses

Abstract Objective To investigate the incidence of deep venous thrombosis (DVT) of the lower extremities following surgeries of tibial plateau fractures. Methods Retrospective analysis of the prospectively collected data on patients undergoing surgeries of tibial plateau fractures between October 2014 and December 2018 was conducted. Duplex ultrasonography (DUS) was used to screen for postoperative DVT of the bilateral lower extremities. Data on demographics, comorbidities, injury, surgery, and laboratory biomarkers at admission were collected. Univariate analyses and multivariate logistic regression analyses were used to identify the independent risk factors associated with DVT. Results Among 987 patients included, 46 (4.7%) had postoperative DVT, with incidence rate of 1.0% for proximal and 3.7% for distal DVT. The average interval between operation and DVT was 8.3 days (median, 5.8 days), ranging from 2 to 42 days. DVT involved the injured extremity in 39 (84.8%) patients, both the injured and uninjured extremity in 2 patients (4.3%) and only the uninjured extremity in 5 patients (10.9%). Five risk factors were identified to be associated with postoperative DVT, including age (≥ 41 vs < 41 years) (OR 3.08; 95% CI 1.43–6.61; p = 0.004), anesthesia (general vs regional) (OR 2.08; 95% CI 1.12–3.85; p = 0.021), hyponatremia (OR 2.21; 95% CI 1.21–4.06; p = 0.010), prolonged surgical time (OR 1.04; 95% CI 1.01–1.07; p = 0.017) and elevated D-dimer level (OR 2.79; 95% CI 1.34–4.83; p = 0.004). Conclusion These epidemiologic data may be helpful in individualized assessment, risk stratification, and development of targeted prevention programs.

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EPIDEMIOLOGICAL PROFILE OF PATIENTS WITH TRAUMATIC SPINAL FRACTURE

Coluna/Columna ◽

10.1590/s1808-185120171603176399 ◽

2017 ◽

Vol 16 (3) ◽

pp. 224-227

Author(s):

MATEUS BERGAMO LOMAZ ◽

LEONEL ANTÔNIO FREITAS SALES NETTO ◽

MARIO SILVA GARROTE FILHO ◽

ALEX PEREIRA ALVES ◽

FABIANO RICARDO DE TAVARES CANTO

Keyword(s):

Traffic Accidents ◽

Lumbar Vertebra ◽

Spinal Fractures ◽

Spinal Fracture ◽

Statistical Correlation ◽

University Hospital ◽

Age Group ◽

Cord Injury ◽

The Mean ◽

Epidemiological Profile

ABSTRACT Objective: To analyze the epidemiological profile of patients with spinal fractures and the characteristics of the population at risk attended at a university hospital. Methods: The study population is composed of 202 patients diagnosed and treated for vertebral fracture due to trauma. The variables were correlated with each other and the correlations with p<0.05 were considered statistically significant. Results: The ratio of incidence of trauma between the sexes was 3:1 for males. The mean age was 37 years and the age group with the highest incidence was between 20 and 39 years. Traffic accidents were the most frequent mechanism (51.2%) and secondly, falls (33.2%). There was a statistical correlation between trauma mechanisms to age group and region of the spine. The first lumbar vertebra (L1) fracture alone accounted for 21.5% of all cases studied associated with the fall mechanism. Spinal cord injury was recorded in 33.7% of the individuals in the sample. A total of 57.3% of the patients were submitted to surgical treatment and 41.7% to the conservative treatment. The mean hospitalization time was 15 days. Conclusions: Spinal fractures are important determinants of morbidity and mortality in the population with a major impact on economically active individuals, especially males. They are directly associated to traffic accidents in the young population and to falls in the higher age brackets. Primary prevention of trauma is the main mechanism for change in this scenario.

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Title: Preoperative albumin-to-fibrinogen ratio predicts postoperative pulmonary complications in patients after minimally invasive esophagectomy

10.21203/rs.3.rs-604731/v1 ◽

2021 ◽

Author(s):

Zhang Peng ◽

Zhao Song

Keyword(s):

Risk Factors ◽

Esophageal Cancer ◽

Logistic Regression ◽

Roc Curve ◽

Training Group ◽

Pulmonary Complications ◽

Curve Analysis ◽

Postoperative Pulmonary Complications ◽

Multivariate Logistic Regression ◽

Roc Curve Analysis

Abstract Background Postoperative pulmonary complications (PPCs) are the most common postoperative complications in patients with esophageal cancer. Prediction of PPCs by establishing a preoperative physiological function parameter model can help patients make adequate preoperative preparation, reduce treatment costs, and improve prognosis and quality of life. The purpose of this study was to investigate the relationship between albumin-to-fibrinogen ratio (AFR), prognostic nutritional index (PNI), albumin-to-globulin ratio (AGR), neutrophils-to-lymphocyte ratio (NLR), platelet-to-lymphocyte (PLR), and monocyte-to -lymphocyte ratio (MLR) and other preoperative laboratory tests and PPCs in patients after esophagectomy. Methods Retrospective analysis was performed on total 712 consecutive patients who underwent esophagectomy in the Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University from July 2018 to December 2020. Patients were divided into training (535 patients) and validation (177) groups for comparison of baseline data, perioperative indicators, and laboratory examination data. Receiver operating characteristic (ROC) curve analysis was used to evaluate the efficacy, sensitivity and specificity of AFR, and Youden’s index was used to calculate the cut-off values of AFR. Univariate and multivariate logistic regression analyses were used to assess the risk factors for PPCs in training group. Results 112 (20.9%) in training group and 36 (20.3%) in validation group developed PPCs. The AUC value predicted by AFR using ROC curve analysis was 0.817, sensitivity 76.2% and specificity 78.7% in training group while AUC 0.803, sensitivity 69.4% and specificity 85.8%. Multivariate logistic regression analysis showed that smoking index, American Society of Anesthesiologists (ASA), AFR, and recurrent laryngeal nerve palsy were independent risk factors for PPCs. Conclusion Preoperative AFR can effectively predict the occurrence of PPCs in patients with esophageal cancer

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Spinal fracture and luxation in dogs and cats

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0037-1618862 ◽

2008 ◽

Vol 21 (03) ◽

pp. 280-284 ◽

Cited By ~ 37

Author(s):

B.A. Brisson ◽

K. Gyselinck ◽

C.W. Bruce

Keyword(s):

Medical Records ◽

Spinal Fractures ◽

Neurological Status ◽

Spinal Fracture ◽

Good Prognosis ◽

Pain Sensation ◽

Single Centre ◽

Neurological Score ◽

Pertinent Data ◽

Cord Injury

SummaryThe purpose of this retrospective study was to review cases of spinal fractures or luxations (SFL) treated with various modalities in order to describe fracture location, neurological status, treatment, outcome and complications in a patient population at a single centre. The medical records of dogs and cats that had been diagnosed with a SFL between C1 and L7 between January 1995 and June 2005 were reviewed in order to collect pertinent data. Ninety-five cases were included in this study. The severity of spinal cord injury was graded on a scale from 0 to 5. Vehicular trauma was the most common cause of SFL. Spinal fractures were localized between C1-C5 in 10 cases, C6-T2 in one case, T3-L3 in 54 cases, L4-L7 in 36 cases. Thirty patients that were euthanatized without treatment had a median neurological score of 5. Twenty-eight patients, all of which had motor function, were treated conservatively and there was not any change in their median neurological grade at the time of discharge. Thirty-seven patients had surgery, 27 of which were non ambulatory. Thirty-five of 37 were stabilized using pins and/or screws and PMMA or various other techniques. The median neurological grade of surgically treated patients improved by one point between the time of initial diagnosis and discharge. Implant removal was performed in five cases. The patients that were treated with pins and/or screws and PMMA were significantly more improved than conservatively managed patients at the time of discharge, although the surgically treated patients were hospitalized significantly longer than the conservatively managed patients. Our results suggest that dogs that retain pain sensation prior to surgery have a good prognosis for functional recovery. In this study, the dogs that were treated conservatively retained purposeful movement and had a good prognosis for recovery.

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Preoperative Albumin-to-Fibrinogen Ratio Predicts Postoperative Pneumonia in Patients with Esophageal Squamous Cell Carcinoma: A Retrospective Study

10.21203/rs.3.rs-127793/v1 ◽

2020 ◽

Author(s):

Peng Zhang ◽

Song Zhao

Keyword(s):

Risk Factors ◽

Esophageal Cancer ◽

Logistic Regression ◽

Roc Curve ◽

Laboratory Tests ◽

Curve Analysis ◽

Postoperative Pneumonia ◽

Function Parameter ◽

Multivariate Logistic Regression ◽

Roc Curve Analysis

Abstract Background: Postoperative pneumonia is the most common postoperative complication in patients with esophageal cancer. Prediction of postoperative pneumonia by establishing a preoperative physiological function parameter model can help patients make adequate preoperative preparation, reduce treatment costs, and improve prognosis and quality of life. The purpose of this study was to investigate the relationship between albumin, fibrinogen, albumin-to-fibrinogen ratio(AFR) , and other preoperative laboratory tests and postoperative pneumonia in patients with esophageal cancer after esophagectomy.Methods: Retrospective analysis was performed on 177 consecutive patients who underwent esophagectomy in the Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University from December 2018 to December 2019.Postoperative pneumonia was defined according to the revised Uniform Pneumonia Score(rUPS).Patients were divided into pneumonia and non-pneumonia groups for comparison of baseline data, perioperative indicators, and laboratory examination data.(Receiver operating characteristic)ROC curve analysis was used to evaluate the efficacy, sensitivity and specificity of AFR, and Youden’s index was used to calculate the cut-off values of AFR and other laboratory tests data. Univariate and multivariate logistic regression analyses were used to assess the risk factors for postoperative pneumoniaResults: Of the 177 patients, 32 (18%) developed postoperative pneumonia. The AUC value predicted by AFR using ROC curve analysis was 0.767, 65.6% sensitivity and 83.4% specificity. Multivariate logistic regression analysis showed that albumin (P=0.013), creatinine (P=0.01), and AFR (P=0.016) were independent risk factors for postoperative pneumonia.Conclusion: Preoperative AFR can effectively predict the occurrence of postoperative pneumonia in patients with esophageal cancer

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Nomogram-Based Prediction of the Risk of Macrosomia: A Prospective Cohort Study in a Chinese Population

10.21203/rs.3.rs-268792/v1 ◽

2021 ◽

Author(s):

Jing Du ◽

Sanbao Chai ◽

Xin Zhao ◽

Jianbin Sun ◽

Ning Yuan ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Operating Characteristic ◽

Multivariate Logistic Regression Analysis ◽

Maternal Factors ◽

Multivariate Logistic Regression ◽

History Of

Abstract Objective: This study aimed to establish a nomogram for predicting the risk of macrosomia in early pregnancy.Methods: We performed a prospective cohort study involving 1,549 pregnant women. According to the birth weight of newborn, the subjects were divided into two groups: macrosomia group and non-macrosomia group. Multivariate logistic regression was used to analyze the risk factors for macrosomia.Results: The prevalence of macrosomia was 6.13% (95/1549) in our hospital. Multivariate logistic regression analysis showed the risk factors of macrosomia were prepregnancy overweight (OR: 2.126, 95% CI: 1.181-3.826)/obesity (OR: 3.536, 95% CI: 1.555-8.036), multiparity (OR:1.877, 95% CI: 1.160-3.039), the history of macrosomia (OR: 36.971, 95% CI: 19.903-68.674), the history of GDM/DM (OR: 2.285, 95% CI: 1.314-3.976), the higher levels of HbA1c (OR: 1.763, 95% CI: 1.004-3.097) and TC (OR: 1.360, 95% CI: 1.004-1.842). A nomogram was developed for predicting macrosomia based on maternal factors related to the risk of macrosomia in early pregnancy. The area under the receiver operating characteristic (ROC) curve of the nomogram was 0.807 (95% CI: 0.755–0.859), the sensitivity and specificity of the model were 0.716 and 0.777, respectively.Conclusion: The nomogram model provides an accurate mothed for clinicians to early predict macrosomia.

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The Predictive Value of Serum Uric Acid on Acute Kidney Injury following Traumatic Brain Injury

BioMed Research International ◽

10.1155/2020/2874369 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Ruo Ran Wang ◽

Min He ◽

Xiao Feng Ou ◽

Xiao Qi Xie ◽

Yan Kang

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Uric Acid ◽

Serum Creatinine ◽

Serum Uric Acid ◽

Operating Characteristic ◽

Kidney Injury ◽

Multivariate Logistic Regression ◽

Training Set ◽

Validation Set

Backgrounds. Acute kidney injury (AKI) is a prevalent nonneurological complication in patients with traumatic brain injury (TBI). We designed this study to explore the association between serum uric acid (SUA) level and the occurrence of AKI following TBI. Methods. This is a retrospective single-center study. A total of 479 patients admitted with TBI were included in this study. We utilized SUA and other risk factors for AKI to construct a predictive model by performing multivariate logistic regression. 374 patients and 105 patients were, respectively, divided into a training set and validation set. The predictive value of the single SUA and constructed model was evaluated by drawing a receiver operating characteristic (ROC) curve. AKI was diagnosed according to the KIDGO criteria. Results. 79 (21.12%) patients were diagnosed with AKI in the training cohort. The patients in the AKI group are older than those in the non-AKI group (p=0.01). And the Glasgow Coma Scale (GCS) of the AKI group was lower than that of the non-AKI group (p<0.001). In a multivariate logistic regression analysis, we found that heart rate (p=0.041), shock (p=0.018), serum creatinine (p<0.001), and serum uric acid (SUA) (p<0.001) were significant risk factors for AKI. Bivariate correlation analyses showed that serum creatinine was moderately positively correlated with SUA (r=0.523, p<0.001). Finally, the area under the receiver operating characteristic curve (AUC) of SUA for predicting AKI in the training set and validation set was 0.850 (0.805-0.895) and 0.869 (0.801-0.938), respectively. Conclusions. SUA is an effective risk factor for AKI following TBI. Combining SUA with serum creatinine could more accurately identify TBI patients with high risk of developing AKI.

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Detection of cardio-metabolic risk by BMI and waist circumference among a population of Guatemalan adults

Public Health Nutrition ◽

10.1017/s1368980007001504 ◽

2008 ◽

Vol 11 (10) ◽

pp. 1037-1045 ◽

Cited By ~ 4

Author(s):

Cria O Gregory ◽

Camila Corvalán ◽

Manuel Ramirez-Zea ◽

Reynaldo Martorell ◽

Aryeh D Stein

Keyword(s):

Risk Factors ◽

Waist Circumference ◽

Roc Curve ◽

Operating Characteristic ◽

Hdl Cholesterol ◽

Curve Analysis ◽

Metabolic Risk ◽

Roc Curve Analysis ◽

High Prevalence ◽

Childhood Stunting

AbstractBackgroundBMI and waist circumference (WC) are used to screen for cardio-metabolic risk; however it is unclear how well these indices perform in populations subject to childhood stunting.ObjectivesTo evaluate BMI and WC as indicators of cardio-metabolic risk and to determine optimal cut-off points among 1325 Guatemalan adults (44 % stunted: ≤150 cm women; ≤162 cm men).MethodsCardio-metabolic risk factors were systolic/diastolic blood pressure ≥130/≥85 mmHg, glucose ≥5·5 mmol/l, TAG ≥1·7 mmol/l, ratio of total cholesterol to HDL-cholesterol ≥5·0, and the presence of two or more and three or more of the preceding risk factors. Receiver operating characteristic (ROC) curve analysis was used.ResultsAreas under the ROC curve were in the range of 0·59–0·77 for BMI and 0·59–0·78 for WC among men and 0·66–0·72 and 0·64–0·72 among women, respectively. Optimal cut-off points for BMI were 24·7–26·1 kg/m2 among men (24·5–26·1 kg/m2 stunted; 24·8–26·3 kg/m2 non-stunted) and 26·5–27·6 kg/m2 among women (26·3–27·8 kg/m2 stunted; 26·6–27·9 kg/m2 non-stunted). Optimal cut-off points for WC were 87·3–91·1 cm among men (85·3–89·4 cm stunted; 88·5–93·3 cm non-stunted) and 91·3–95·3 cm among women (90·9–94·4 cm stunted; 91·8–95·6 cm non-stunted).ConclusionOptimal cut-off points for BMI were slightly higher among women than men with no meaningful differences by stature. Optimal cut-off points for WC were several centimetres lower for stunted compared with non-stunted men, and both were substantially lower than the current recommendations among Western populations. Cut-off points derived from Western populations may not be appropriate for developing countries with a high prevalence of stunting.

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Adults Aging With Spinal Cord Injury: Prevalence and Associated Risk Factors for Diagnosis of Diabetes Mellitus

Innovation in Aging ◽

10.1093/geroni/igab046.3170 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 877-877

Author(s):

Junha Park ◽

Lisa Bratzke

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Logistic Regression ◽

Model Systems ◽

Multivariate Logistic Regression ◽

Factors Associated ◽

Cord Injury ◽

Associated Risk Factors

Abstract With the increased life expectancy, people aging with spinal cord injury (SCI) are more likely to experience chronic conditions, including diabetes mellitus (DM). The results of previous literature related to the prevalence of DM are mixed and risk factors associated with diagnosis of DM after SCI are not well defined. This study aims to investigate the prevalence of DM and explore associated risk factors for diagnosis of DM among adults aging with long-standing spinal cord injury in the United States. This is a secondary data analysis using the National Spinal Cord Injury Model Systems Database. Participants included 516 people age 45 and older who have been living with SCI for more than 10 years. The prevalence of DM in this sample was 13.2%. Multivariate logistic regression, controlling for confounding variables, was conducted to identify risk factors associated with DM diagnosis in this sample. The multivariate logistic regression model found that the participants who responded with less severe SCI measured by the ASIA impairment scale were less likely to be diagnosed with DM (OR=0.332, p=.017). Also, DM was found to be significantly associated with BMI (OR=1.043, p=.010) and age (OR=1.038, p= .010) respectively. Duration of disability was not significantly associated with DM. Future research is needed to validate these findings and identify other common risk factors for DM such as diet/nutrition. Further, exploration of the effect size of risk factors is also warranted. Such findings will inform interventions to aid prevention and early detection of DM.

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CANPT Score: A Tool to Predict Severe COVID-19 on Admission

Frontiers in Medicine ◽

10.3389/fmed.2021.608107 ◽

2021 ◽

Vol 8 ◽

Author(s):

Yuanyuan Chen ◽

Xiaolin Zhou ◽

Huadong Yan ◽

Huihong Huang ◽

Shengjun Li ◽

...

Keyword(s):

Risk Factors ◽

Operating Characteristic ◽

Total Bilirubin ◽

Predictive Accuracy ◽

Characteristic Curve ◽

Severe Disease ◽

Multivariate Logistic Regression ◽

Independent Risk Factors ◽

Operating Characteristic Curve ◽

Cr Creatine

Background and Aims: Patients with critical coronavirus disease 2019 (COVID-19) have a mortality rate higher than 50%. The purpose of this study was to establish a model for the prediction of the risk of severe disease and/or death in patients with COVID-19 on admission.Materials and Methods: Patients diagnosed with COVID-19 in four hospitals in China from January 22, 2020 to April 15, 2020 were retrospectively enrolled. The demographic, laboratory, and clinical data of the patients with COVID-19 were collected. The independent risk factors related to the severity of and death due to COVID-19 were identified with a multivariate logistic regression; a nomogram and prediction model were established. The area under the receiver operating characteristic curve (AUROC) and predictive accuracy were used to evaluate the model's effectiveness.Results: In total, 582 patients with COVID-19, including 116 patients with severe disease, were enrolled. Their comorbidities, body temperature, neutrophil-to-lymphocyte ratio (NLR), platelet (PLT) count, and levels of total bilirubin (Tbil), creatinine (Cr), creatine kinase (CK), and albumin (Alb) were independent risk factors for severe disease. A nomogram was generated based on these eight variables with a predictive accuracy of 85.9% and an AUROC of 0.858 (95% CI, 0.823–0.893). Based on the nomogram, the CANPT score was established with cut-off values of 12 and 16. The percentages of patients with severe disease in the groups with CANPT scores <12, ≥12, and <16, and ≥16 were 4.15, 27.43, and 69.64%, respectively. Seventeen patients died. NLR, Cr, CK, and Alb were independent risk factors for mortality, and the CAN score was established to predict mortality. With a cut-off value of 15, the predictive accuracy was 97.4%, and the AUROC was 0.903 (95% CI 0.832, 0.974).Conclusions: The CANPT and CAN scores can predict the risk of severe disease and mortality in COVID-19 patients on admission.

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