The Impact of Perioperative Hypothermia on Plastic Surgery Outcomes: A Multivariate Logistic Regression of 1062 Cases

Abstract Background After the implementation of the universal two-child policy in China, the increase in parity has led to an increase in adverse pregnancy outcomes. The impact of one and two fetuses on the incidence of fetal macrosomia has not been fully confirmed in China. This study aimed to explore the differences in the incidence of fetal macrosomia in first and second pregnancies in Western China after the implementation of the universal two-child policy. Methods A total of 1598 pregnant women from three hospitals were investigated by means of a cross-sectional study from August 2017 to January 2018. Participants were recruited by convenience and divided into first and second pregnancy groups. These groups included 1094 primiparas and 504 women giving birth to their second child. Univariate and multivariate logistic regression analyses were performed to discuss the differences in the incidence of fetal macrosomia in first and second pregnancies. Results No significant difference was found in the incidence of macrosomia in the first pregnancy group (7.2%) and the second pregnancy group (7.1%). In the second-time pregnant mothers, no significant association was found between the macrosomia of the second child (5.5%) and that of the first child (4.7%). The multivariate logistic regression model showed that mothers older than 30 years are not likely to give birth to children with macrosomia (odds ratio (OR) 0.6, 95% confidence interval (CI) 0.4,0.9). Conclusions The incidence of macrosomia in Western China is might not be affected by the birth of the second child and is not increased by low parity.

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P2744Age distribution of valvular heart disease in China: from a national multicenter prospective cohort study

European Heart Journal ◽

10.1093/eurheartj/ehz748.1061 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

B Zhang ◽

H T Zhang ◽

H Y Xu ◽

Y J Wu

Keyword(s):

Logistic Regression ◽

Cohort Study ◽

Heart Disease ◽

Mitral Valve ◽

Valvular Heart Disease ◽

Mitral Valve Disease ◽

Multimodality Imaging ◽

Valve Disease ◽

Multivariate Logistic Regression ◽

The Impact

Abstract Background Valvular heart disease (VHD) has been caught in two important cross-currents in recent decades: aging demography and the rise of multimodality imaging and transcatheter valve therapy. In this setting, we aim to identify the distribution, characteristics, and management of Chinese VHD patients according to age. Methods China Valvular Heart Disease Cohort Study (China-VHD) was conducted from March to September 2019 in 46 centers over China. It included prospectively 12331 adults with native moderate or severe VHD, of which we described the distribution, management, and in-hospital events according to age (18–44, 45–54, 55–64, 65–74, ≥75). Multivariate Logistic regression was employed to investigate the impact of age on in-hospital events composed of in-hospital mortality, acute heart failure, and stoke. Results In Chinese VHD population, overall percentage peaked in 55–64 year olds. The frequency of multivalvular heart disease (MVHD) saw an increasing trend with age (p for trend <0.001). Of single valvular heart disease, mitral regurgitation (MR) was the most frequent left-sided VHD followed by aortic regurgitation (AR), aortic stenosis (AS), and mitral stenosis (MS). AS frequency significantly grew with age (p for trend = 0.02) while AR peaked in 18–44 year olds and fluctuated at a lower level in the older population. In contrast, mitral valve disease (MS, MR, and mixed mitral valve disease) was most frequent in 45–54 year olds and dropped with age (p for trend all <0.001). Noteworthily, all aortic valve disease was notably frequent in men whereas mitral valve disease and MVHD more common in women. Similar to developed countries, degenerative etiology rose steeply while rheumatic and congenital origin fell with age. Regarding management, surgical valve replacement rate was similar in age groups lower than 75 years old with increasing frequency of concomitant CABG. No matter aortic or mitral, the percentage of bio-prosthesis rocketed after 65 years (aortic: 74.7%, mitral: 70.6%). In multivariate logistic regression, covariables included age, sex, BMI, hypertension, diabetes, coronary heart disease, aortic disease, cardiomyopathy, COPD, NYHA class and valvular intervention. Compared to patients younger than 45, in-hospital events significantly higher in patients over 75 only (OR: 1.69 [95% CI: 1.07–2.66], p<0.02). Moreover, women showed a lower risk of in-hospital events (OR: 0.78 [95% CI: 0.63–0.96], p<0.01). Age distribution of VHD Conclusion Age plays a crucial role in valvular heart disease, best illustrated in AS. Unlike the western world, AR and MR are more frequent than AS but show a slightly decreasing trend with age. As expected, degenerative etiology is becoming more prevalent whereas rheumatism decreases. Age over 75 and male are associated with growing in-hospital events. Degenerative VHD thus present an important public-health burden. Acknowledgement/Funding Innovation project of Chinese academy of medical science

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Impact of the primary information source used for decision making and implications for treatment regret in prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.6_suppl.17 ◽

2017 ◽

Vol 35 (6_suppl) ◽

pp. 17-17 ◽

Cited By ~ 1

Author(s):

Narek Shaverdian ◽

Amar Upadhyaya Kishan ◽

Darlene Veruttipong ◽

D. Jeffrey Demanes ◽

Patrick Kupelian ◽

...

Keyword(s):

Prostate Cancer ◽

Decision Making ◽

Logistic Regression ◽

Radiation Treatment ◽

Information Source ◽

The Internet ◽

Radiation Oncologist ◽

Multivariate Logistic Regression ◽

Treatment Experience ◽

The Impact

17 Background: Patients with localized prostate cancer (PCa) assimilate information from varying sources to inform their treatment decision. We assessed the impact of the primary information source used to select a modern radiation treatment on patient perceptions of their treatment experience and on treatment regret. Methods: Patients with favorable-risk PCa treated with SBRT, IMRT or HDR brachytherapy and at least one year of follow-up were surveyed. The questionnaire explored the decision-making experience, expected treatment experience vs. the reality, and treatment regret via a validated tool. Multivariate logistic regression adjusted for demographics, disease characteristics, treatment modality, time since treatment and current bowel, urinary and sexual function. Results: 322 consecutive patients were surveyed with an 86% (n = 276) response rate. 48% (n = 132) selected their radiation oncologist as the primary information source, 23% (n = 62) selected their urologist, 16% (n = 44) selected the internet, 6% (n = 17) selected other patients and 8% (n = 21) selected other. Overall, 13% (n = 36) endorsed treatment regret. 39% of patients who selected the internet as their primary information source reported their actual treatment experience to be worse than expected vs. 13% of respondents who selected their urologist, 12% who selected other patients, 2% who selected their radiation oncologist and 9% who selected other ( p< 0.01). Similarly, 43% who selected the internet as their primary information source endorsed treatment regret vs. 10% who selected their urologist, 7% who selected their radiation oncologist, 6% who selected other patients and 6% who selected other ( p< 0.01). On multivariate logistic regression, only patients who selected the internet as their primary information source were more likely to endorse treatment regret (OR = 46.5, p< 0.01) and were more likely to choose a treatment they thought ‘had the least side effects’ (OR = 2.1, p= 0.016). Conclusions: Patients who used the internet as their primary source of information had a worse perception of their treatment experience and had more treatment regret, highlighting the need for physicians to proactively counsel patients.

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Abstract 14472: Indications for ICD Implantation Differ Between Women and Men

Circulation ◽

10.1161/circ.142.suppl_3.14472 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Sebastian Ingelaere ◽

Ruben Hoffmann ◽

Georges Mairesse ◽

Yves R Vandekerckhove ◽

Jean-Benoît le Polain de Waroux ◽

...

Keyword(s):

Logistic Regression ◽

Nyha Class ◽

Total Mortality ◽

Categorical Variables ◽

Multivariate Logistic Regression ◽

Icd Implantation ◽

Term Survival ◽

Kaplan Meier ◽

The Impact

Introduction: The impact of gender on ICD implantation practice and survival remain a topic of controversy. We analysed differences between men and women in patients implanted with an ICD in Belgium. Methods: The Belgian governmental health care institution (RIZIV/INAMI) keeps track of every ICD implantation by a digital registry. Participation is mandatory for reimbursement. From this registry, we analysed all new ICD implantations between 01/02/2010 and 31/01/2019 in Belgian patients. We compared men with women for baseline patient characteristics. We used a Chi 2 test for categorical variables (NYHA class, primary vs secondary prevention, underlying heart disease, type of device, QRS duration, presence of atrial fibrillation, diabetes and other comorbidity, center volume, population density and average income of the area of residency) and a Mann-Whitney U test for continuous variables [age and ejection fraction(EF)]. We used the Bonferroni method to correct for multiple testing. Secondly, we performed a Kaplan-Meier analysis. At last, we performed a multivariate logistic regression for 3-year and total mortality. Results: Only 3146 (20.8%) on 14747 implantations were in women. Women were significantly younger and had a better EF compared to men. Except for oncological history, women had less comorbidities (table 1). More women functioned in NYHA class > II and had a QRS > 150ms, which was consistent with a higher CRT-D vs VVI/DDD ratio. Kaplan-Meier showed a survival benefit in women (log-rank, p=<0.001). Further exploration with multivariate logistic regression showed that female gender was significant protective for long-term total mortality, but not for short-term 3-year mortality. Conclusions: Only a minority of patients implanted with a new ICD in Belgium are women. Their clinical profile differs from men. Their long-term survival is better, which can in part be explained by differences in indications and comorbidities.

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Abstract P480: Impact of Intravenous Thrombolysis on Reperfusion Status in Stroke Thrombectomy

Stroke ◽

10.1161/str.52.suppl_1.p480 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Helio P Carvalho ◽

Aaron Wessell ◽

Gregory Cannarsa ◽

Timothy R Miller ◽

Dheeraj Gandhi ◽

...

Keyword(s):

Logistic Regression ◽

Intracranial Hemorrhage ◽

Mechanical Thrombectomy ◽

Intravenous Thrombolysis ◽

Procedure Time ◽

Multivariate Logistic Regression ◽

Poor Outcome ◽

Number Of Patients ◽

The Impact ◽

Number Of Passes

Introduction: It remains unclear whether use of intravenous thrombolysis (IVT) with intravenous tissue plasminogen activator (tPA) provides additional benefit to patients with emergent large vessel occlusion (ELVO) stroke undergoing mechanical thrombectomy (MT). We sought to determine the impact of IVT on procedure time, number of passes, and successful reperfusion (SR) during MT. Method: We retrospectively analyzed all patients who underwent anterior circulation mechanical thrombectomy for treatment of ELVO stroke at our institution from April 2012 to November 2019. Univariate and multivariate logistic regression analyzes were used to determine independent predictors of poor functional outcome at 90 days,and independent predictors of >2 thrombectomy passes in patients with successful revascularization (SR: TICI 2B, 2C and 3). Results: A total of 400 patients were eligible for analysis. 189 patients received IVT before thrombectomy. Last known well time-to-endovascular therapy was shorter in the IVT group (290.0 min vs 452.75 min; P=<0.001). The IVT group had a trend towards better outcomes at 90 days (mRS 0—2: 44% vs 35%; P=0.076). The number of passes and revascularization status did not significantly differ between IVT and non-IVT patients. The number of patients with any intracranial hemorrhage was higher in the IVT group than non- IVT group [10% vs 4%; p=0.038].Multivariate logistic regression demonstrated ICA occlusion site was an independent predictors of >2 passes relative to M1 occlusion in patients with successful revascularization. Multivariate logistic regression revealed that age (OR 1.05, 95% CI 1.03-1.07; p<0.001), NIHSS (OR 1.11, 95% CI 1.06-1.17; p<0.001), ≥3 thrombectomy passes (OR 2.47, 95% CI 1.23-5.00; p=0.011) and intracranial hemorrhage (OR 5.50, 95% CI 1.45-20.84; p=0.012)were independently associated with an increased odds of poor outcome. TICI 2C/3 was associated with reduced odds of poor outcome (OR 0.16, 95% CI 0.07-0.35; p<0,001). Conclusion: IVT pretreatment did not increase rates of SR and did not shorten MT procedure time nor number of passes needed to achieve SR during MT in our patient population. Randomized controlled trials are required for further evaluation of the impact of IVT on reperfusion status during MT.

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Controlling for Severity of Illness in Outcome Studies Involving Infectious Diseases: Impact of Measurement at Different Time Points

Infection Control and Hospital Epidemiology ◽

10.1086/591453 ◽

2008 ◽

Vol 29 (11) ◽

pp. 1048-1053 ◽

Cited By ~ 25

Author(s):

Kerri A. Thom ◽

Michelle D. Shardell ◽

Regina B. Osih ◽

Marin L. Schweizer ◽

Jon P. Furuno ◽

...

Keyword(s):

Logistic Regression ◽

Hospital Mortality ◽

Antimicrobial Therapy ◽

Severity Of Illness ◽

Multivariate Logistic Regression ◽

Gram Negative ◽

Time Points ◽

Gram Negative Bacteremia ◽

Appropriate Therapy ◽

The Impact

Background.Severity of illness is an important confounder in outcome studies involving infectious diseases. However, it is unclear whether the time at which severity of illness is measured is important.Methods.We performed a retrospective study of 328 episodes of gram-negative bacteremia in adult patients to assess the impact of the time of measurement of severity of illness on the association between empirical antimicrobial therapy received and in-hospital mortality. Using a modified Acute Physiology Score (APS), severity of illness was measured at 2 time points: (1) hospital admission and (2) 24 hours before the first culture-positive blood sample was collected. Multivariate logistic regression was used to estimate the impact of adjusting for the APS on the relationship between empirical therapy received (ie, the exposure) and in-hospital mortality (ie, the outcome).Results.The mean APS ( ± standard deviation) of patients with bacteremia increased during their hospital stay (from 19.2 ± 11.6 at admission to 24.2 ± 13.6 at the second time point; P < .01). When examining the association between empirical antimicrobial therapy received and in-hospital mortality, and controlling for the APS, there was a trend toward a decreased impact of appropriate therapy received on in-hospital mortality. The unadjusted odds ratio (OR) for the association between appropriate therapy received and in-hospital mortality was 0.83 (95% confidence interval [CI], 0.51-1.34). After controlling for the APS at admission, this association was attenuated (OR, 0.94 [95% CI, 0.57-1.55]), and when a change in the APS was also included in the multivariate logistic regression model, the association was further attenuated (OR, 0.99 [95% CI, 0.58-1.69]).Conclusions.The magnitude of the association between appropriate antimicrobial therapy received and in-hospital mortality among patients with gram-negative bacteremia was sensitive to the timing of adjustment for severity of illness.

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Prevalence and Predictors of PTSD during the Containment Stage of COVID-19 Epidemic among College Female Students in China

10.21203/rs.3.rs-368796/v1 ◽

2021 ◽

Author(s):

Mingyu Si ◽

Xiaoyou Su ◽

Yu Jiang ◽

Wenjun Wang ◽

Xiaofen Gu ◽

...

Keyword(s):

Social Support ◽

Logistic Regression ◽

Perceived Social Support ◽

Cognitive Status ◽

Female Students ◽

Ptsd Symptoms ◽

Multivariate Logistic Regression ◽

Event Scale ◽

College Female ◽

The Impact

Abstract Background College students are a uniquely vulnerable group and may experience high stress levels due to COVID-19, especially for girls. This study aims to identify the post-traumatic stress disorder (PTSD) symptoms and related factors among the target population during the initial phases of the COVID-19 pandemic.Methods A cross-sectional online survey was conducted during the initial phases of the COVID-19 pandemic in China. A total of 2205 college female students from six provinces enrolled in this study and completed the questions about cognitive status of COVID-19, the Impact of Event Scale-6 (IES-6), the Multidimensional Perceived Social Support Scale (MPSSS) and a self-developed 10-item Perceived threat scale. Univariate and multivariate logistic regression were performed by SPSS software to explore the determinants of PTSD symptoms.Results PTSD symptoms were prevalent in this sample of college female students, and 34.20% met the cut-off for PTSD. Self-reported fair or poor health (AOR=1.78, 95%CI: 1.22-2.59), high concern about COVID-19 (AOR=1.66, 95%CI: 1.35-2.03), beliefs that 'COVID-19 can cause a global outbreak' (AOR=1.26, 95%CI: 1.02-1.56), the perception of ‘risk of infection’ (AOR=2.46, 95%CI: 2.16-2.81), beliefs that ‘closed management’ and ‘COVID-19 as a public health emergency of international concern’ would have an impact, and the fear of ‘impact on life planning’ were all positively associated with PTSD (AOR=1.37, 1.22 and 1.29, respectively), whereas perceived social support from family (AOR=0.81, 95%CI: 0.70-0.93) was negatively associated with PTSD. Among the significant variables at the bivariate level, multivariate logistic regression revealed that the greatest protector for PTSD was the high knowledge score (AOR=0.73, 95%CI: 0.60-0.90), while had confirmed cases among relatives and friends (AOR=7.70, 95%CI: 1.28-46.25) was the strongest predictor of PTSD.Conclusions In summary, PTSD symptoms were prevalent among college female students in China during the COVID-19 epidemic. Targeting vulnerable populations to improve their knowledge of COVID-19 and create an atmosphere of social support would be beneficial to improve the mental health of the female students during the COVID-19 epidemic.

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Elevated Serum Interleukin-18 Level is Correlated with Vascular Access Dysfunction in Patients on Maintenance Haemodialysis

Annals of the Academy of Medicine, Singapore ◽

10.47102/annals-acadmedsg.2019239 ◽

2020 ◽

Vol 49 (3) ◽

pp. 119-126

Author(s):

Li Li You ◽

Yuanhao Wu ◽

Yin Zheng ◽

Junfeng Liu ◽

Jun Xue

Keyword(s):

Logistic Regression ◽

Vascular Access ◽

Elevated Serum ◽

Youden Index ◽

Chronic Haemodialysis ◽

Interleukin 18 ◽

Multivariate Logistic Regression ◽

Short Term ◽

Kaplan Meier ◽

The Impact

Introduction: We evaluated the impact of serum interleukin-18 (IL-18) level on short-term vascular access (VA) function in chronic haemodialysis (HD) patients. Materials and Methods: Samples were collected from 80 clinically stable patients (58.8% were men) with a mean age of 60.9 years (standard deviation 11.7 years) who were undergoing maintenance HD and were followed up for 1 year. Multivariate logistic regression was used to analyse data on demographics, biochemical parameters and serum IL-18 level to predict VA dysfunction events. The cut-off for IL-18 was derived from the highest score obtained on Youden index. Survival data was analysed using Cox proportional hazards regression analysis and Kaplan-Meier method. Results: Patients were classified as having either low IL-18 (<199.3 pg/mL) or high IL-18 (≥199.3 pg/mL). Multivariate logistic regression showed that serum IL-18 level was independently correlated with VA dysfunction events; patients with high IL-18 had a higher risk of VA dysfunction events than those with low IL-18 (odds ratio 9.47, 95% confidence interval 1.75–51.31, P = 0.009). In patients with high IL-18, Kaplan- Meier survival analysis found that incidence of VA dysfunction was significantly higher than patients with low IL-18 (P = 0.047). After adjustment for age, gender, inflammation (C-reactive protein) and calcium-phosphorus metabolism, decreased serum albumin and increased serum IL-18 levels were found to be independent prognostic predictors of VA dysfunction. Conclusion: HD patients with high IL-18 level tend to have worse rates of VA dysfunction. In HD outpatients, IL-18 is an independent risk factor for short-term VA dysfunction. Key words: Access survival, Cytokines, Short-term

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Early Referral to Nephrological Care and the Uptake of Peritoneal Dialysis. An Analysis of German Claims Data

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168359 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8359

Author(s):

Isabell Schellartz ◽

Sunita Mettang ◽

Arim Shukri ◽

Nadine Scholten ◽

Holger Pfaff ◽

...

Keyword(s):

Logistic Regression ◽

Peritoneal Dialysis ◽

Claims Data ◽

Multivariate Logistic Regression Model ◽

Symptomatic Therapy ◽

Multivariate Logistic Regression ◽

Early Referral ◽

Dialysis Treatment ◽

The Impact ◽

Nephrological Care

Background: Hemodialysis (HD) and peritoneal dialysis (PD) are medically equivalent alternatives for symptomatic therapy of end-stage renal disease (ESRD). An early referral (ER) of patients with chronic kidney disease (CKD) to a nephrological specialist is associated with a higher proportion of patients choosing PD. Germany historically shows a low PD uptake. This article is the first investigation into the impact of ER on the uptake of PD, using a large German claims database. Methods: Claims data of 4727 incident dialysis patients in 2015 and 2016 were analyzed. Accounting codes for nephrological care and dialysis modalities were identified. Their first documentation was defined as their first encounter with a nephrologist and their first dialysis treatment (HD or PD). ER was determined as receiving nephrological care at least six months before the first dialysis. A multivariate logistic regression model with adjusted odds ratios (AOR) investigates the impact of ER, outpatient dialysis start, age, comorbidities, and sex on the chance for PD. Results: Forty-three percent were referred to the nephrologist six months before their first dialysis (ER). Single tests, as well as the adjusted multivariate logistic regression, highlighted that ER significantly increases the chance for PD. In the multivariate model, the uptake of PD was associated with ER (AOR = 3.05; p < 0.001; 95% CI = 2.16–4.32), outpatient dialysis start (AOR = 0.71; p = 0.044; 95% CI = 0.51–0.99), younger age (AOR = 0.96; p < 0.001; 95% CI = 0.95–0.97), and fewer comorbidities (AOR = 0.85; p < 0.001; 95% CI = 0.44–1.58). Conclusions: ER of patients with CKD to a nephrologist increases PD uptake. It gives both nephrologists and patients enough time for patient education about different treatment options and can contribute to informed decisions about the dialysis treatment.

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