Carotid Stenosis in Cardiac Surgery—No Difference in Postoperative Outcomes

Background Debate over revascularization of asymptomatic carotid stenosis before cardiac surgery is ongoing. In this study, we analyze cardiac surgery outcomes in patients with asymptomatic carotid stenosis at a single hospital. Methods In this study, 1,781 patients underwent cardiac surgery from January 2012 to June 2013; 1,357 with preoperative screening carotid duplex were included. Patient demographics, comorbidities, degree of stenosis, postoperative complications, and mortality were evaluated. Chi-square test and logistic regression analysis were performed. Results Asymptomatic stenosis was found in 403/1,357 patients (29.7%; 355 moderate and 48 severe). Patients with stenosis, compared with those without, were older (71.7 ± 11 vs. 66.3 ± 12 years; p < 0.01). Females were more likely to have stenosis (odd ratio, = 1.7; 95% confidence interval, 1.4–2.2); however, patients were predominantly male in both groups. There were no significant differences in the rates of mortality and postoperative complications, including stroke and transient ischemic attack (TIA). Postoperative TIA occurred in 3/1,357(0.2%); only one had moderate stenosis. Inhospital stroke occurred in 21/1,357 (1.5%) patients; stroke rates were 2.3% (8/355) with moderate stenosis and 2.1% (1/48) severe stenosis. There were 59/1,357 (4.3%) deaths; patients with stenosis had a mortality rate of 4.2% (17/403); however, no postoperative stroke lead to death. Multivariable logistic regression analysis with adjustment for age, gender, race, comorbidities, and postoperative complications did not show an impact of carotid stenosis on postoperative mortality and development of stroke after cardiac surgery. Conclusion This study suggests that patients with asymptomatic carotid stenosis undergoing cardiac surgery are not at increased risk of postoperative complications and mortality; thus, prophylactic carotid revascularization may not be indicated.

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Prior Admissions as a Risk Factor for Readmission in Patients Surgically Treated for Femur Fractures: Implications for a Potential Hip Fracture Bundle

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459321996169 ◽

2021 ◽

Vol 12 ◽

pp. 215145932199616

Author(s):

Robert Erlichman ◽

Nicholas Kolodychuk ◽

Joseph N. Gabra ◽

Harshitha Dudipala ◽

Brook Maxhimer ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Hip Fracture ◽

Logistic Regression Analysis ◽

Hip Fractures ◽

Surgical Procedure ◽

Hospital Admissions ◽

Fracture Care ◽

Increased Risk ◽

Payment Models

Introduction: Hip fractures are a significant economic burden to our healthcare system. As there have been efforts made to create an alternative payment model for hip fracture care, it will be imperative to risk-stratify reimbursement for these medically comorbid patients. We hypothesized that patients readmitted to the hospital within 90 days would be more likely to have a recent previous hospital admission, prior to their injury. Patients with a recent prior admission could therefore be considered higher risk for readmission and increased cost. Methods: A retrospective chart review identified 598 patients who underwent surgical fixation of a hip or femur fracture. Data on readmissions within 90 days of surgical procedure and previous admissions in the year prior to injury resulting in surgical procedure were collected. Logistic regression analysis was used to determine if recent prior admission had increased risk of 90-day readmission. A subgroup analysis of geriatric hip fractures and of readmitted patients were also performed. Results: Having a prior admission within one year was significantly associated (p < 0.0001) for 90-day readmission. Specifically, logistic regression analysis revealed that a prior admission was significantly associated with 90-day readmission with an odds ratio of 7.2 (95% CI: 4.8-10.9). Discussion: This patient population has a high rate of prior hospital admissions, and these prior admissions were predictive of 90-day readmission. Alternative payment models that include penalties for readmissions or fail to apply robust risk stratification may unjustly penalize hospital systems which care for more medically complex patients. Conclusions: Hip fracture patients with a recent prior admission to the hospital are at an increased risk for 90-day readmission. This information should be considered as alternative payment models are developed for hip fracture care.

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Clinical profile and factors determining outcome of intramural very low birth weight babies in a tertiary care centre: a retrospective study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20170143 ◽

2017 ◽

Vol 5 (2) ◽

pp. 520

Author(s):

Devi Meenakshi K. ◽

Arasar Seeralar A. T. ◽

Srinivasan Padmanaban

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Birth Weight ◽

Low Birth Weight ◽

Logistic Regression Analysis ◽

Very Low Birth Weight ◽

Tertiary Care ◽

P Value ◽

Increased Risk

Background: Very low birth weight (VLBW) babies are at increased risk of a number of complications both immediate and late. Worldwide it has been observed that these babies contribute to a significant extent to neonatal mortality and morbidity. Aim of the study was to study the risk factors contributing to mortality in VLBW babies and to evaluate the morbidity pattern in these infants.Methods: A retrospective analysis of data retrieved from the case records of VLBW babies admitted in the NICU of Kilpauk Medical College between January 2015 to December 2015. Out of the 2360 intramural babies admitted during the study period, 99 babies were less than 1500 gms. The risk factors for these babies were analyzed for their association with the outcome. Data were statistically analyzed.Results: In present study, we found that sex of the baby, gestational age, obstetric score, birth asphyxia, pulmonary haemorrhage, ROP and presence of shock were found to be associated with increased mortality. By logistic regression analysis it was observed that birth weight of the baby (p value 0.002), duration of stay (p value 0.0006), presence of shock (p<0.0001), were the risk factors significantly associated with poor outcome.Conclusions: Among the maternal and neonatal factors analyzed in the study using logistic regression analysis, birth weight, duration of hospital stay and presence of shock were significantly related to poor outcome. Of these presence of shock was the single most important factor that predicted increased mortality.

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O-207 Which infertile patients mostly deserve to have a sperm DNA fragmentation index done? Findings from a cross-sectional study

Human Reproduction ◽

10.1093/humrep/deab128.018 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

E Pozzi ◽

L Boeri ◽

L Candela ◽

D Cignoli ◽

G Colandrea ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Dna Fragmentation ◽

Logistic Regression Analysis ◽

Roc Curve ◽

Sperm Concentration ◽

Testicular Volume ◽

Sperm Dna Fragmentation ◽

Sperm Dna ◽

Increased Risk

Abstract Study question Current scientific guidelines do not clearly suggest which patients would benefit the most from a sperm DNA fragmentation (SDF) test. Summary answer We aimed to investigate potential predictive factors for altered SDF in a homogenous cohort of white-European men presenting for primary couple’s infertility. What is known already High SDF has been associated with reduced fertilization rates, reduced chances of natural conception and an increased risk of early pregnancy loss. Study design, size, duration Data from 478 consecutive men with normal or altered SDF were analysed. Infertility was defined according to the WHO criteria. Semen analysis, SDF (according to SCSA) and serum hormones were measured in every patient. Health significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Altered SDF was considered with a threshold of > 30%. Participants/materials, setting, methods Descriptive statistics compared the overall characteristics of patients with normal SDF and altered SDF. Logistic regression analysis tested potential predictors of altered SDF. ROC curve was used to test the accuracy of the model in predicting SDF alteration Main results and the role of chance Of 478 patients, 253 (57.7%) had altered SDF. Median (IQR) age and BMI of the whole cohort were 38 (35-42) years and 25.1 (23.3-27.1) kg/m2 respectively. Patients with altered SDF were older (median (IQR) age: 39 (36-43) vs. 37 (34-38) years, p < 0.0001), had lower sperm concentration (5 (1.1–18) vs. 17 x106/mL (6–38.8), p < 0.0001), testicular volume (15.1 (12 –20) vs. 16.8 (12 – 25) Prader, p = 0.0005), and total motile sperm count (TMSC) (1.8 (0.21–10.71) vs. 11.8x106 (2–37.26), p < 0.0001). Conversely, men with altered SDF had higher FSH (6.1 (3.85–9.7) vs. 4.8 (3.85 – 7.9) mIU/mL, p < 0.0001) and prolactin levels (9.8 (7.43–14.04) vs. 8.3 (6.6–11.3) pg/mL, p = 0.0004) than those with normal SDF. At multivariable logistic regression analysis, patients’ age >35 years (OR: 2.45, p = 0.0009), FSH > 8.0 mIU/mL (OR: 2.23, p < 0.0001) and lower TMSC (OR: 2.04, p = 0.002) were identified as indipendent predictors of altered SDF, after adjusting for testicular volume and CCI≥1. ROC curve (Figure 1) revealed that the model has a good predictive ability to identify patients with SDF alteration (AUC: 0.72, 95%CI: 0.67 - 0.77). Limitations, reasons for caution It is a retrospective analysis at a single, tertiary-referral academic centre, thus raising the possibility of selection biases. In spite of this, all patients have been consistently analysed over time with a rigorous follow-up, thus limiting potential heterogeneity in terms of data reporting Wider implications of the findings Primary infertile men older than 35 years, with high serum FSH and low TMSC at baseline are the ones who mostly deserve a SDF test over their diagnostic work-up and that would potentially benefit the most of certain treatments to improve SDF value, thus increasing chances of conceiving. Trial registration number Not applicable

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Effect of Sleep Disorder on Delirium in Post-Cardiac Surgery Patients

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2020.62 ◽

2020 ◽

Vol 47 (5) ◽

pp. 627-633 ◽

Cited By ~ 2

Author(s):

Hongbai Wang ◽

Liang Zhang ◽

Qipeng Luo ◽

Yinan Li ◽

Fuxia Yan

Keyword(s):

Intensive Care Unit ◽

Logistic Regression ◽

Regression Analysis ◽

Cardiac Surgery ◽

Intensive Care ◽

Sleep Quality ◽

Sleep Disorder ◽

Logistic Regression Analysis ◽

Univariate Analysis ◽

Post Cardiac Surgery

ABSTRACT:Background:Post-cardiac surgery patients exhibit a higher incidence of postoperative delirium (PD) compared to non-cardiac surgery patients. Patients with various cardiac diseases suffer from preoperative sleep disorder (SPD) induced by anxiety, depression, breathing disorder, or other factors.Objective:To examine the effect of sleep disorder on delirium in post-cardiac surgery patients.Methods:We prospectively selected 186 patients undergoing selective cardiac valve surgery. Preoperative sleep quality and cognitive function of all eligible participants were assessed through the Pittsburgh Sleep Quality Index (PSQI) and the Montreal Cognitive Assessment, respectively. The Confusion Assessment Method for Intensive Care Unit was used to assess PD from the first to seventh day postoperatively. Patients were divided into two groups according to the PD diagnosis: (1) No PD group and (2) the PD group.Results:Of 186 eligible patients, 29 (15.6%) were diagnosed with PD. A univariate analysis showed that gender (p = 0.040), age (p = 0.009), SPD (p = 0.008), intraoperative infusion volume (p = 0.034), postoperative intubation time (p = 0.001), and intensive care unit stay time (p = 0.009) were associated with PD. A multivariate logistic regression analysis demonstrated that age (odds ratio (OR): 1.106; p = 0.001) and SPD (OR: 3.223; p = 0.047) were independently associated with PD. A receiver operating characteristic curve demonstrated that preoperative PSQI was predictive of PD (area under curve: 0.706; 95% confidence interval: 0.595–0.816). A binomial logistic regression analysis showed that there was a significant association between preoperative 6 and 21 PSQI scores and PD incidence (p = 0.009).Conclusions:Preoperative SPD was significantly associated with PD and a main predictor of PD.

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Decreased eGFR Is Associated With Ischemic Stroke in Patients With Dilated Cardiomyopathy

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029619866909 ◽

2019 ◽

Vol 25 ◽

pp. 107602961986690 ◽

Cited By ~ 1

Author(s):

Yuqing Deng ◽

Zhiqing Chen ◽

Lili Hu ◽

Zhenyan Xu ◽

Jinzhu Hu ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Ischemic Stroke ◽

Dilated Cardiomyopathy ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Analysis Model ◽

Multivariate Logistic Regression ◽

Increased Risk

Dilated cardiomyopathy (DCM) is increasingly indicated as a cause of cardioembolic syndrome, in particular, cardioembolic ischemia stroke. However, the potential risk factors for stroke among DCM patients remain under investigated. DCM patients hospitalized from June 2011 to June 2016 were included. The cases were defined as the group of DCM patients with stroke compared with those without stroke. Clinical characteristic data were collected and compared between the two groups including demographic data, complicated diseases, echocardiography index, and laboratory parameters and estimated glomerular filtration rate (eGFR). A multivariate logistic regression analysis model adjusted by sex and age was used to explore the related risk factors for stroke in DCM patients. A total of 779 hospitalized patients with DCM were included. Of these, 55 (7.1%) had experienced a stroke. Significantly lower eGFR levels (68.03 ± 26.22 vs 79.88 ± 24.25 mL/min/1.73 m2, P = .001) and larger left atrial diameters (45.32 ± 7.79 vs 43.25 ± 7.11 mm, P = .04) were found in the group of patients having DCM with stroke compared to those without stroke. When the eGFR was categorized as eGFR >60, 30<eGFR≤ 60 and eGFR ≤ 30, there were more patients with 30<eGFR≤ 60 (30.9% vs 17.7%) and eGFR≤ 30 (9.1% vs 3.3%) in the ischemic stroke group ( P = 0.003). A multivariate logistic regression analysis model adjusted by sex and age showed that 30 <eGFR≤60 (odds ratio [OR]: 2.07, 95% confidence interval [CI]: [1.05-4.07], P = .035) and eGFR≤30 (OR: 4.04, 95% CI: [1.41-11.62], P = .009) were statistically associated with ischemic stroke in patients with DCM. It is concluded that decreased eGFR is significantly associated with an increased risk of ischemic stroke in patients with DCM.

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352. Characteristics Associated with Pre-Frailty in Older People Living with HIV

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.425 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S186-S186

Author(s):

Peter Mazonson ◽

Theoren Loo ◽

Jeff Berko ◽

Sarah-Marie Chan ◽

Ryan Westergaard ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Cognitive Function ◽

Older People ◽

Logistic Regression Analysis ◽

The United States ◽

People Living With Hiv ◽

Factors Associated ◽

Increased Risk ◽

Living With Hiv

Abstract Background Frailty is a concern among older people living with HIV (PLHIV). There is a paucity of research characterizing PLHIV who are at risk of becoming frail (pre-frailty). To investigate how HIV impacts older PLHIV in the United States, a new study called Aging with Dignity, Health, Optimism and Community (ADHOC) was launched at ten sites to collect self-reported data. This analysis uses data from ADHOC to identify factors associated with pre-frailty. Methods Pre-frailty was assessed using the Frailty Index for Elders (FIFE), where a score of zero indicated no frailty, 1–3 indicated pre-frailty, and 4–10 indicated frailty. A cross-sectional analysis was performed on 262 PLHIV (age 50+) to determine the association between pre-frailty and self-reported sociodemographic, health, and clinical indicators using bivariate analyses. Factors associated with pre-frailty were then included in a logistic regression analysis using backward selection. Results The average age of ADHOC participants was 59 years. Eighty-two percent were male, 66% were gay or lesbian, and 56% were white. Forty-seven percent were classified with pre-frailty, 26% with frailty, and 27% with no frailty. In bivariate analyses, pre-frailty was associated with depression, low cognitive function, depression, multiple comorbidities, low income, low social support and unemployment (Table 1). In the multiple logistic regression analysis, pre-frailty was associated with having low cognitive function (Odds Ratio [OR] 8.56, 95% Confidence Interval [CI]: 3.24–22.63), 4 or more comorbid conditions (OR 4.00, 95% CI: 2.23–7.06), and an income less than $50,000 (OR 2.70, 95% CI: 1.56–4.68) (Table 2). Conclusion This study shows that commonly collected clinical and sociodemographic metrics can help identify PLWH who are more likely to have pre-frailty. Early recognition of factors associated with pre-frailty among PLHIV may help to prevent progression to frailty. Understanding markers of increased risk for pre-frailty may help clinicians and health systems better target multi-modal interventions to prevent negative health outcomes associated with frailty. Disclosures All authors: No reported disclosures.

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Association of Mannose Binding Lectin (MBL-2) Deficiency with Pulmonary Infection after Allogeneic Hematopoietic Stem Cell Transplantation (HSCT).

Blood ◽

10.1182/blood.v112.11.2209.2209 ◽

2008 ◽

Vol 112 (11) ◽

pp. 2209-2209

Author(s):

Dick Chung ◽

Lily Ding ◽

Isabelle Amigues ◽

Katuna Kadeishvili ◽

Theresa Lo ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Stem Cell ◽

Logistic Regression Analysis ◽

Pulmonary Infection ◽

Multivariate Logistic Regression Analysis ◽

Wild Type ◽

Multivariate Logistic Regression ◽

Increased Risk ◽

The Relationship

Abstract Background: Low MBL2 concentration and MBL2 genotype variants have been associated with an increased risk of infection in various clinical settings. Pulmonary infection is a major complication of HSCT. We examined the relationship of MBL genotypes with post-engraftment bacterial (B-PNA) and fungal (F-PNA) pneumonia Methods: Retrospective review of 236 non-consecutive, non-selected patients who underwent HSCT at MSKCC from 1/1/2000–4/30/2007. Microbiologically confirmed infections and pneumonias were recorded. Antifungal prophylaxis consisted of fluconazole 400 mg daily. Patients at high risk for mold infection received mold-active prophylaxis. After 1/1/2006 voriconazole was the first line anti-mold prophylaxis. Genotype was determined by PR-Melting Curve Analysis on blood or buccal swab specimens. MBL genotype was classified as wild-type: A/A (MBL-sufficient, MBL-S) or variant-type: A/O, O/O (MBL deficient, MBL-D). Patients were followed for up to 2 years. Statistical analysis: Fisher’s Exact test was used to compare the incidence rate between MBL-S and MBL-D patients. Multivariate logistical regression models were used to investigate the relationship between bacterial or fungal pneumonia and MBL genotype, matched related donor (MRD), myeloablative conditioning (MC) peripheral blood as stem cell source (PBSC), acute GVHD grade 2–4 (aGVHD). The results from Maximum Likelihood Estimates were summarized. Results: Transplant characteristics: 80% MC, 76% PBSC, 48.6% MRD. Incidence of aGVHD: 22.4%. MBL genotypes: One-hundred and forty-two (60%) patients were homozygous for wild-type MBL2 (AA), 85(36%) were heterozygous (A/0) and 9 (3.8%) were homozygous for variant genotypes (OO). Transplant characteristics, rates of GVHD, relapse-free and overall survival were similar between MBL-D and MBL-S. There was higher incidence of overall bacterial infections in MBL-D compared to MBL-S pts (47.87% vs 36.62%, p=0.1049). MBL-D had a higher incidence of B-PNA (12.7% vs 4.9%, p=0.048). In multivariate logistic regression analysis, MBL-D(p=0.04) and aGVHD(p=0.06) were likely associated with B-PNA. Rates of overall fungal infections and F-PNA were similar [among MBL-D and MBL-S pts (12.77% vs 9.86%, p=0.5277) and (8.51% vs 7.75%, p=0.1049) respectively]. In multivariate logistic regression analysis only aGVHD was statistically significantly associated with F-PNA p=0.0002. Conclusions: 1) MBL-D genotype was likely associated with increased risk of bacterial pneumonia. 2) MBL-D and aGVHD were risk factors for B-PNA. 3) Further analyses are in progress to evaluate the effect of MBL-D on fungal pneumonia in patients who received mold prophylaxis versus patients who did not receive mold prophylaxis. 4) Prospective studies are needed to assess the relative contribution of MBL-D genotype on the risk of pulmonary infection in HSCT.

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Is rising BMI associated with an increased rate of clinically relevant pancreatic fistula after distal pancreatectomy for pancreatic adenocarcinoma?

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.360 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 360-360

Author(s):

Evan Scott Glazer ◽

Yixuan Zhou ◽

Justin Drake ◽

Jeremiah Lee Deneve ◽

Stephen W Behrman ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Pancreatic Fistula ◽

Distal Pancreatectomy ◽

Logistic Regression Analysis ◽

Older Age ◽

Ductal Adenocarcinoma ◽

Multivariable Logistic Regression Analysis ◽

Term Survival ◽

Increased Risk

360 Background: Clinically relevant pancreatic fistula (CR-POPF), following distal pancreatectomy (DP) remains a clinical challenge. Prior studies investigating the relationship between body mass index (BMI) and CR-POPF have yielded conflicting results. We examined this relationship utilizing our institutional database and hypothesized that BMI is associated with CR-POPF in patients having DP for pancreatic ductal adenocarcinoma (PDAC). Methods: Patients who underwent DP for PDAC at a single institution from 2007 to 2018 were retrospectively reviewed. A CR-POPF was defined as ISGPS grade B or C fistula. Uni- and multi-variable logistic regression analysis to assess factors associated with CR-POPF following DP was performed, controlling for factors such as gland texture, operative drain placement, gender, and smoking status. Results: 78 patients met the inclusion criteria. 51% were female, 51% were Caucasian, and the average age was 59 ± 15 years. The median BMI was 26 (interquartile range 24 to 29). Overall, 19% (n = 15) of patients had a CR-POPF. With a mean follow up 2.8 ± 2.5 years, the presence of a CR-POPF was not associated with long-term survival (P = 0.17). On univariable logistic regression, older age was associated with a decreased risk of CR-POPF (OR = 0.95, P = 0.015) while increasing BMI was associated with an increased risk of CR-POPF (OR = 1.1, P = 0.044). After controlling for multiple factors on multivariable logistic regression analysis, BMI (OR = 1.12, P = 0.035) was the only factor associated with development of a CR-POPF while older age (OR = 0.94, P < 0.001) was slightly protective of CR-POPF development. Conclusions: For patients undergoing DP for PDAC, increasing BMI is associated with an increased risk of CR-POPF, independent of other factors. These findings should be considered during preoperative counseling. Although there is no specific cut-off for the association between BMI and CR-POPF, efforts to diminish the risk of CR-POPF should be focused on patients with higher BMI based on this data.

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The rs13347 Polymorphism of the CD44 Gene Is Associated with the Risk of Kidney Stones Disease in the Chinese Han Population of Northeast Sichuan, China

Computational and Mathematical Methods in Medicine ◽

10.1155/2022/6481260 ◽

2022 ◽

Vol 2022 ◽

pp. 1-6

Author(s):

Qiao Ying ◽

Guixi Liu ◽

Wenjun Zhou ◽

Jianhua Lan ◽

Jianhui Du ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Stone Disease ◽

Multivariate Logistic Regression ◽

Chinese Han ◽

Han Population ◽

Increased Risk ◽

Hardy Weinberg Equilibrium

Objective. To investigate the association between the rs13347 polymorphism of the CD44 gene and the risk of kidney stone disease (KSD) in the Han population of northeast Sichuan, China, so as to provide a theoretical basis for the treatment of KSD. Methods. We used PCR-restriction fragment length polymorphism (RFLP) technique to perform genotyping at rs13347 locus of the CD44 gene in the KSD group and the gontrol group. SNP Hardy-Weinberg equilibrium (HWE) testing was used to confirm the balance of genetic inheritance. Multivariate logistic regression analysis was used for the assessment of rs13347 polymorphism and the risk of developing KSD and to compare the relationship between the polymorphism of rs13347 and clinical characteristics of patients with KSD. Results. Genotypic results of rs13347 locus of the CD44 gene in the two groups were consistent with the SNP-HWE test, indicating the genetic balance. At the same time, multivariate logistic regression analysis indicated that subjects with CT and TT genotypes at rs13347 in the CD44 gene were more likely to have KSD, and there was a higher prevalence rate in males. Furthermore, carrying allele T at rs13347 was also a risk factor for KSD. In addition, people carrying CT and TT genotypes at rs13347 also have a significantly increased risk of relapsing KSD. Conclusion. The rs13347 polymorphism of the CD44 gene may be associated with the risk of KSD in the Han population of northeast Sichuan in China, and the recurrence rate of KSD in the carriers of CT and TT genotypes is higher.

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Predictive Value of Admission D-dimer for Contrast-induced Acute Kidney Injury and Poor Outcomes after Primary Percutaneous Coronary Intervention

10.21203/rs.2.17408/v5 ◽

2020 ◽

Author(s):

Kai-Yang Lin ◽

Han-Chuan Chen ◽

Hui Jiang ◽

Sun-Ying Wang ◽

Hong-mei Chen ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Serum Creatinine ◽

Logistic Regression Analysis ◽

Predictive Value ◽

Independent Predictor ◽

Multivariate Logistic Regression Analysis ◽

Increased Risk ◽

Long Term Mortality

Abstract Background DD was found to be associated with acute myocardial infarction (AMI) and renal insufficiency. However, it is uncertain whether DD is an independent risk factor of CI-AKI in patients undergoing pPCI. Methods We prospectively enrolled 550 consecutive patients with STEMI undergoing pPCI between January 2012 and December 2016. The predictive value of admission DD for CI-AKI was assessed by receiver operating characteristic(ROC) and multivariable logistic regression analysis. CI-AKI was defined as an absolute serum creatinine increase ≥0.3 mg/dl or a relative increase in serum creatinine ≥50% within 48 h of contrast medium exposure. Results Overall, the incidence of CI-AKI was 13.1%. The ROC analysis showed that the cutoff point of DD was 0.69 ug/ml for predicting CI-AKI with a sensitivity of 77.8% and a specificity of 57.3%. The predictive value of DD was similar to the Mehran score for CI-AKI (AUC DD =0.729 vs AUC Mehran =0.722; p =0.8298). Multivariate logistic regression analysis indicated that DD >0.69 ug/ml was an independent predictor of CI-AKI (odds ratio[OR]=3.37,95%CI:1.80-6.33, p <0.0001). Furthermore, DD >0.69 ug/ml was associated with an increased risk of long-term mortality during during a mean follow-up period of 16 months(hazard ratio=3.41, 95%CI:1.4-8.03, p =0.005). Conclusion admission DD >0.69 ug/ml is a significant and independent predictor of CI-AKI and long-term mortality in patients undergoing pPCI.

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