101 Predicting and Estimating Burn Outcomes: A Single Institution Analysis of over 4000 Cases

Abstract Introduction Advances in burn care have improved patient outcomes, and independently validated indices, scores, and predictors of burn outcomes warrant re-evaluation. The purpose of this study is to consolidate predictors of burn outcomes and determine the factors that significantly contribute to length-of-stay (LOS) and mortality. Methods A retrospective review of all burn patients (n = 5778) admitted to a quaternary provincial burn unit from 1973 to 2017, was conducted. Removal of blank and pediatric entries yielded 4622 independent cases. Goodness-of-fit models and multivariate logistic regression was performed. Burn predictors included %TBSA, Baux (classic, revised) index, Abbreviated Burn Severity Index, and Ryan score. Primary outcomes were mortality and LOS. Variables considered in the multivariate logistic regression included: diabetes, hypertension, smoking, obesity, alcohol use, drug abuse, full-thickness burn, ventilator support, and ICU referral. Results Multivariate logistic regression for mortality showed the classic Baux index to be a significant predictor for mortality (OR = 1.118, p < 0.001). Other predictors included male sex, ICU referral, diabetes, smoking, and alcoholism (OR = 1.96, 4.97, 2.38, 1.63, 1.98, all p < 0.05). Interestingly, hypertension had a protective effect (OR = 0.24, p < 0.013). Linear regression for LOS found %TBSA, ICU referral, alcoholism, age, male sex, significant. The area under the ROC curve for Baux index was 0.945. Conclusions The regressions show that burn mortality and LOS are best predicted with the Baux index. Hypertension may have a protective effect on burn outcomes and may be attributed to increased perfusion to the periphery. Goodness-of-fit models, although variable, tended to show tighter grouping in patients with TBSA >20%. LOS ratios prove to be useful benchmarks for burn units with TBSA >20%. Similar findings are preliminary found in the NBR, national burn repository, database. Applicability of Research to Practice LOS ratios and burn index scores prove to be valuable markers to predict burn outcomes. The results of this study will directly help the clinician make decisions and communicate clinical severity to patient and family members.

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Abstract TP321: Is Weekend Admission Associated With Increased 30-day Stroke Mortality? The Effect of Adjustment Using a Claims-Based Stroke Severity Index

Stroke ◽

10.1161/str.47.suppl_1.tp321 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Cheng-Yang Hsieh ◽

Sheng-Feng Sung

Keyword(s):

Logistic Regression ◽

Regression Models ◽

Severity Index ◽

Case Mix ◽

Stroke Severity ◽

Stroke Mortality ◽

Multivariate Logistic Regression ◽

Stroke Patients ◽

Logistic Regression Models ◽

Case Mix Adjustment

Introduction: Whether weekend admission is associated with increased stroke mortality in Taiwan remains uncertain, partly because of an inadequate case-mix adjustment in other studies using an insurance claims databases. Hypothesis: Adding the 7-item claims-based stroke severity index (SSI) to a multivariate logistic regression model might alter the analysis of the effect of weekend admission on 30-day stroke mortality. Methods: We identified, in the Taiwan Longitudinal Health Insurance Database, which is linked with the National Death Registry, patients hospitalized for acute ischemic stroke between 2001 and 2013. The primary outcome was mortality 30 days post-admission. In base logistic regression models with and without the SSI, we tested the odds ratio (OR) of 30-day mortality in patient admitted on weekends using the covariates of age, sex, year of admission, Charlson’s comorbidity index, brain surgery, physician specialty and surgical volume, hospital ownership, accreditation, and patient volume. Results: We analyzed 46,007 consecutive hospitalized stroke patients (mean age: 68.8 ± 12.0 years; male: 59%), with an SSI of 7.5 ± 5.3 (range: 4.1-27.1), 23.0% were admitted on the weekend, and 4.2% died within 30 days. Patients who died within 30 days were more likely to have been admitted on a weekend (4.9% vs. 4.0%, p < 0.001). Nevertheless, patients admitted on a weekend had a higher SSI than those admitted on a weekday (7.8 vs. 7.4, p < 0.001). In multivariate logistic regression models, weekend admission was associated with 30-day mortality (OR: 1.22, 95% CI: 1.10-1.35) in the base model but not in the base model plus SSI (OR: 1.07, 95% CI: 0.95-1.20). Conclusions: We confirmed that, after stroke severity had been adjust by adding the SSI, weekend admission did not increase the 30-day mortality of stroke patients in Taiwan. A case-mix adjustment in comparative outcome studies of stroke patients is important when using an insurance claims database.

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Development and Validation of a Risk Scoring System for Cephamycin-Associated Hemorrhagic Events

Scientific Reports ◽

10.1038/s41598-019-49340-5 ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Tong-Ling Chien ◽

Fei-Yuan Hsiao ◽

Li-Ju Chen ◽

Yu-Wen Wen ◽

Shu-Wen Lin

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Scoring System ◽

Goodness Of Fit ◽

Bleeding Tendency ◽

Multivariate Logistic Regression ◽

Goodness Of Fit Test ◽

Hemorrhagic Events ◽

Risk Scoring ◽

Risk Scoring System

Abstract Cephamycin-associated hemorrhages have been reported since their launch. This research aimed to determine risk factors for cephamycin-associated hemorrhagic events and produce a risk scoring system using National Taiwan University Hospital (NTUH) database. Patients who were older than 20 years old and consecutively used study antibiotics for more than 48 hours (epidode) at NTUH between January 1st, 2009 and December 31st, 2015 were included. The population was divided into two cohorts for evaluation of risk factors and validation of the scoring system. Multivariate logistic regression was used for the assessment of the adjusted association between factors and the outcome of interest. Results of the multivariate logistic regression were treated as the foundation to develop the risk scoring system. There were 46402 and 22681 episodes identified in 2009–2013 and 2014–2015 cohorts with 356 and 204 hemorrhagic events among respective cohorts. Use of cephamycins was associated with a higher risk for hemorrhagic outcomes (aOR 2.03, 95% CI 1.60–2.58). Other risk factors included chronic hepatic disease, at least 65 years old, prominent bleeding tendency, and bleeding history. A nine-score risk scoring system (AUROC = 0.8035, 95% CI 0.7794–0.8275; Hosmer-Lemeshow goodness-of-fit test p = 0.1044) was developed based on the identified risk factors, with higher scores indicating higher risk for bleeding. Use of cephamycins was associated with more hemorrhagic events compared with commonly used penicillins and cephalosporins. The established scoring system, CHABB, may help pharmacists identify high-risk patients and provide recommendations according to the predictive risk, and eventually enhance the overall quality of care.

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Siesta and Risk for Ischemic Stroke: Results from a Case-Control Study

Medicina ◽

10.3390/medicina56050222 ◽

2020 ◽

Vol 56 (5) ◽

pp. 222

Author(s):

Yousef Mohammad

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Ischemic Stroke ◽

Protective Effect ◽

Case Control Study ◽

Multivariate Logistic Regression Analysis ◽

Case Control ◽

Multivariate Logistic Regression ◽

Neurology Clinic ◽

Control Study

Background and objectives: Siesta, which is a short afternoon nap, is a habit that is commonly practiced in the Mediterranean and tropical areas. Data on the association between siesta and coronary artery disease has been conflicting. A protective effect has been demonstrated in the countries that commonly practice siesta, but a harmful effect has been observed in the countries that infrequently practice the siesta habit. Information on the association between siesta and ischemic stroke has been, however, lacking. Hence, the purpose of our study was to determine the effect of siesta on ischemic stroke. Materials and Methods: This was a case-control study, conducted on the patients with acute ischemic stroke who came for their first follow-up visit to the neurology clinic. Controls were randomly selected from the patients visiting the neurology clinic on the same day as the patients with ischemic stroke. In addition to basic demographics and the occurrence of established stroke risk factors, information about siesta practice was also collected from both groups. A multivariate logistic regression analysis was utilized to determine the relationship between siesta practice and ischemic stroke. Results: A total of 206 patients were recruited from the neurology clinic of King Khalid university hospital; of which only 194 subjects were included in the analysis (98 ischemic stroke cases and 96 controls). The mean age of the participants was 59.68 ± 13.75 years and 98 (50.52%) were male. Interestingly, 43% of the whole study cohort practiced regular siesta. However, when compared to the stroke population, the control group practiced siesta more frequently (30% vs. 56%). In a multivariate logistic regression analysis, hypertension, diabetes mellitus, excess body weight (body mass index > 25 kg/m2) and dyslipidemia were found to increase the risk of ischemic stroke (OR 2.12, 95% CI: 1.02–4.66, p = 0.005; OR 2.72, 95% CI: 1.94–4.88, p = 0.014; OR 2.94, 95% CI: 1.5164–5.7121 p = 0.0014; OR 3.27, 95% CI: 2.42–5.199, p ≤ 0.001, respectively). On the contrary, the practice of regular siesta lowered the risk of ischemic stroke (OR 0.58, 95% CI: 0.3551–0.9526, p = 0.031). Conclusions: Siesta was associated with a reduced risk for the occurrence of ischemic stroke. Large prospective longitudinal studies should be conducted to verify the protective effect of siesta on stroke.

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Plasma Catecholamine Profile of Subarachnoid Hemorrhage Patients with Neurogenic Cardiomyopathy

Cerebrovascular Diseases Extra ◽

10.1159/000431155 ◽

2015 ◽

Vol 5 (2) ◽

pp. 57-67 ◽

Cited By ~ 12

Author(s):

Michael Moussouttas ◽

Elizabeth Mearns ◽

Arthur Walters ◽

Matthew DeCaro

Keyword(s):

Logistic Regression ◽

Subarachnoid Hemorrhage ◽

Linear Regression ◽

Roc Curves ◽

Clinical Severity ◽

Plasma Catecholamine ◽

Clinical Grade ◽

Regression Analyses ◽

Linear Regression Models ◽

Multivariate Logistic Regression

Purpose: To investigate the connection between sympathetic function and neurogenic cardiomyopathy (NC), and to determine whether NC is mediated primarily by circulating adrenal epinephrine (EPI) or neuronally transmitted norepinephrine (NE), following subarachnoid hemorrhage (SAH). Methods: This is a prospective observational investigation of consecutive severe-grade SAH patients. All participants had transthoracic echocardiography and serological assays for catecholamine levels - dopamine (DA), NE and EPI - within 48 h of hemorrhage onset. Clinical and serological independent predictors of NC were determined using multivariate logistic regression analyses, and the accuracy of predictors was assessed by receiver operating characteristic (ROC) curves. Multivariate linear regression analyses were used to evaluate correlations among the catecholamines. Results: The investigation included a total of 94 subjects: the mean age was 55 years, 81% were female and 57% were Caucasian. NC was identified in approximately 10% (9/94) of cases. Univariate analyses revealed associations between NC and worse clinical severity (p = 0.019), plasma DA (p = 0.018) and NE levels (p = 0.024). Plasma NE correlated with DA levels (ρ = 0.206, p = 0.046) and EPI levels (ρ = 0.392, p < 0.001), but was predicted only by plasma EPI in bivariate [parameter estimate (PE) = 1.95, p < 0.001] and multivariate (PE = 1.89, p < 0.001) linear regression models. Multivariate logistic regression analyses consistently demonstrated the predictive value of clinical grade for NC (p < 0.05 for all analyses) except in models incorporating plasma NE, where NC was independently predicted by NE level (OR 1.25, 95% CI 1.01-1.55) over clinical grade (OR 4.19, 95% CI 0.874-20.1). ROC curves similarly revealed the greater accuracy of plasma NE [area under the curve (AUC) 0.727, 95% CI 0.56-0.90, p = 0.02] over clinical grade (AUC 0.704, 95% CI 0.55-0.86, p = 0.05) for identifying the presence or absence of NC. Conclusions: Following SAH, the development of NC is primarily related to elevated plasma NE levels. Findings implicate a predominantly neurogenic process mediated by neuronal NE (and not adrenal EPI), but cannot exclude synergy between the catecholamines.

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A Novel Prediction Model for Long-Term SARS-CoV-2 RNA Shedding in Non-death Hospitalized Patients with COVID-19: A Retrospective Cohort Study

10.21203/rs.3.rs-940304/v1 ◽

2021 ◽

Author(s):

Xiaoli Lei ◽

Junli Wang ◽

Lijie Kou ◽

Zhigang Yang

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Prediction Model ◽

Predictive Model ◽

Goodness Of Fit ◽

Multivariate Logistic Regression Analysis ◽

Hospitalized Patients ◽

Multivariate Logistic Regression ◽

Data Set

Abstract Background: Because of the lack of compelling evidence for predicting the duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA shedding, the purpose of this retrospective study was to establish a predictive model for long-term SARS-CoV-2 RNA shedding in non-death hospitalized patients with coronavirus disease-19 (COVID-19).Methods: 97 non-death hospitalized patients with COVID-19 admitted to two hospitals in Henan province of China from February 3, 2020 to March 31, 2020 were retrospectively enrolled. Multivariate logistic regression was performed to identify the high risk factors associated with long-term SARS-CoV-2 RNA shedding and a predictive model was established and represented by a nomogram. Its performance was assessed with discrimination and calibration.Results: 97 patients were divided into the long-term (>21 days) group (n = 27, 27.8%) and the short-term (≤ 21 days) group (n = 70, 72.2%) based on their viral shedding duration. Multivariate logistic regression analysis showed that time from illness onset to diagnosis (OR 1.224, 95% CI 1.070-1.400, P = 0.003) and interstitial opacity in chest computerized tomography(CT) scan (OR 6.516, 95% CI 2.041-20.798, P = 0.002) were independent risk factors for long-term SARS-CoV-2 RNA shedding. A prediction model, which is presented with a nomogram, was established by incorporating the two risk factors. The goodness-of-fit statistics for the nomogram was not statistically significant (χ2 = 8.292; P = 0.406), and its area under the receiver operator characteristic curve was 0.834 (95% CI 0.731- 0.936; P < 0.001).Conclusion: The established model has a good predictive performance on the long-term viral RNA shedding in non-death hospitalized patients with COVID-19, but it still needs further validation by independent data set of large samples in the future.

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The association between BMI, smoking, drinking and thyroid disease: a cross-sectional study in Wuhan, China

BMC Endocrine Disorders ◽

10.1186/s12902-021-00852-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xiao Chen ◽

Juan-juan Wang ◽

Li Yu ◽

Han-yu Wang ◽

Hui Sun

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Protective Effect ◽

Logistic Regression Analysis ◽

Thyroid Disease ◽

Thyroid Diseases ◽

Central China ◽

Multivariate Logistic Regression ◽

Cross Sectional ◽

Significant Difference

Abstract Background There is no clear conclusion on the relationship between thyroid disease and obesity and lifestyle factors such as smoking and drinking. In this study, we analysed the association of body mass index (BMI), smoking and drinking with subclinical hypothyroidism (SHO) and thyroid nodules (TNs) with the results of a cross-sectional survey of urban residents in central China and discussed the potential mechanism linking these predictive factors and the two diseases. Methods This study included 1279 participants who were recruited from a Chinese community in 2011 and 2012. A questionnaire, laboratory examination and ultrasound diagnosis were conducted on these participants. Binary logistic regression analysis was used to analyse these factors. Results Overweight (BMI ≥ 25 kg/m2) was closely related to SHO and TNs in univariate and multivariate logistic regression analyses. Smoking had a protective effect on SHO and TNs, while drinking had a protective effect on TNs in univariate logistic regression and multivariate logistic regression with some covariates, but there was no significant difference between smoking and drinking and the two kinds of thyroid diseases in multivariate logistic regression analysis with all the covariates. In subgroup analysis, BMI ≥ 25 kg/m2 was significantly associated with SHO in people with positive thyroid antibodies (odds ratio (OR) = 2.221, 95 % confidence interval (CI): 1.168–4.184, P = 0.015) and smokers (OR = 2.179, 95 % CI: 1.041–4.561, P = 0.039). BMI ≥ 25 kg/m2 was significantly associated with TNs in people over 60 years old (OR = 2.069, 95 % CI: 1.149–3.724, P = 0.015) and drinkers (OR = 3.065, 95 % CI: 1.413–6.648, P = 0.005). Drinking alcohol had a protective effect on TNs in smokers (OR = 0.456, 95 % CI: 0.240–0.865, P = 0.016) and people with BMI ≥ 25 kg/m2 (OR = 0.467, 95 % CI: 0.236–0.925, P = 0.029). No significant association was found between smoking and the two thyroid diseases in different subgroups. Conclusions Obesity is a risk factor for both TNs and SHO, especially in elderly individuals and people with positive thyroid autoantibodies. Obesity and metabolic syndrome may be more associated with TNs than SHO. Smoking may have a protective effect on thyroid disease, while drinking may have a protective effect only on TNs.

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Crude Oil Source Identification of Asphalt via ATR-FTIR Approach Combined with Multivariate Statistical Analysis

Advances in Materials Science and Engineering ◽

10.1155/2020/2025072 ◽

2020 ◽

Vol 2020 ◽

pp. 1-13

Author(s):

Ruibo Ren ◽

Wenmiao Fan ◽

Pinhui Zhao ◽

Hao Zhou ◽

Weikun Meng ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Crude Oil ◽

Logistic Regression Analysis ◽

Principal Components ◽

Goodness Of Fit ◽

Multivariate Logistic Regression Analysis ◽

Fingerprint Recognition ◽

Multivariate Logistic Regression ◽

Oil Source

The types of crude oil for producing asphalt have a decisive influence on various performance measures (including aging resistance and durability) of asphalt. To discriminate and predict the crude oil source of different asphalt samples, a discrimination model was established using 12 greatly different infrared (IR) characteristic absorption peaks (CAPs) as predictive variables. The model was established based on diverse fingerprint recognition technologies (such as principal component analysis (PCA) and multivariate logistic regression analysis) by using attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR). In this way, the crude oil source of different asphalt samples can be effectively discriminated. At first, by using PCA, the 12 CAPs in the IR spectra of asphalt samples were subjected to dimension reduction processing to control the variables of key factors. Moreover, the scores of various principal components in asphalt samples were calculated. Afterwards, the scores of principal components were analysed through modelling based on multivariate logistic regression analysis to discriminate and predict the crude oil source of different asphalt samples. The result showed that the logistic regression model shows a favourable goodness of fit, with the prediction accuracy reaching 93.9% for the crude oil source of asphalt samples. The method exhibits some outstanding advantages (including ease of operation and high accuracy), which is important when controlling the source and quality and improving the performance of asphalt.

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MO773THE VASCULAR REALITY BEHIND ULTRASOUND VASCULAR MAPPING: WHICH FACTORS PREDICT THE BEST CANDIDATES FOR RADIOCEPHALIC ARTERIOVENOUS FISTULA?

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab103.0011 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Rui Barata ◽

Tiago Pereira ◽

Joana Marques ◽

Miguel Bigotte Vieira ◽

Fernando Nolasco

Keyword(s):

Logistic Regression ◽

Arteriovenous Fistula ◽

Pulse Wave ◽

Arterial Calcification ◽

P Value ◽

Distributed Data ◽

Obese Patients ◽

Multivariate Logistic Regression ◽

Vascular Mapping ◽

Male Sex

Abstract Background and Aims Vascular accesses (VA) are key components for efficient hemodialysis. Arteriovenous fistulas (AVF) are recommended over arteriovenous graft (AVG), but deciding the type and location of a VA is challenging. Preoperative vascular mapping before surgical creation of VA, especially trough ultrasound (US), is helpful in this decision, contributing to improve AVF e AVG outcomes. Our study aims to identify patient factors associated with appropriate arterial US parameters that predict feasibility for radiocephalic fistula creation. Method We analyzed a cohort of chronic kidney disease patients who underwent US vascular mapping for preoperative planning of dialysis access from 2019 to 2020, in a tertiary referral center. Patients were characterized based on its demographical characteristics, and the presence of diabetes, hypertension, obesity, and smoking. Arterial indicators were analyzed by ultrasound techniques in both upper arms, including radial, ulnar and brachial arteries. Those indicators included arterial diameter, calcification, doppler wave form, and pulse wave velocity. Continuous variables were recorded as means (±SD) for normally distributed data and as medians (interquartile ranges) for nonnormally distributed data. Comparisons were made using t tests or Wilcoxon rank sum tests as appropriate. Categorical variables were examined by frequency distribution and recorded as proportions. Comparisons were made using the x2 test. Unadjusted and adjusted multivariate logistic regression models were fitted to identify predictors for a good candidate for radiocephalic arteriovenous fistula. Results A total of 252 patients were included. The mean age was 65±16 years, 144 (57%) were male, 211 (84%) where white, 40 (16%) were black, and 1 (0.4%) was asian. Most had arterial hypertension (205, 81%), 98 (39%) had diabetes mellitus, 89 (35%) were smokers, and 72 (29%) were obese. The majority of patients were attending for the first VA (186; 74%). Most patients were considered appropriate candidates for arteriovenous fistula creation (207, 82%), whereas 45 (18%) were assigned to PTFE graft. Obesity and male sex were found to be predictors for being a good candidate for radiocephalic arteriovenous fistula in a multivariate logistic regression model adjusted for age, hypertension, and diabetes (OR 3.21, CI 95% 1.63-6.32, p-value 0.001 and OR 2.09, CI 95% 1.07-4.08, p-value 0.031, respectively). Figure 1 presents the arterial indicators analyzed during ultrasound mapping, including both upper limbs. Conclusion Our results show that obesity and male sex are predictors for radiocephalic arteriovenous fistula creation. While female sex has long been known to be a risk factor for VA failure, possibly because of worse arterial indicators, an association between obesity and higher probability of distal AVF creation has not been established yet. Comparison between arterial indicators in obese and nonobese patients shows that obese patients generally have better arterial indicators, especially higher pulse wave velocities, and less arterial calcification. Given that some studies show an association between obesity and shorter fistula survival (due to higher secondary failure rate), our results may come as. A possible explanation for this difference is that obesity may exert a physical protective effect of the forearm vascular bed against iatrogenic damage (blood sampling and vessel cannulation). Besides that, factors other than vascular indicators may contribute to ulterior VA failure, like the proinflammatory state in obese patients and its consequent myointimal hyperplasia. However, our conclusions are based on preoperative findings, and not on VA outcomes, especially its patency and complications. Moreover, which further help to determine the better location for a VA creation, were not evaluated in this study.

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Epidemiology of pediatric hydrocephalus in Haiti: analysis of a surgical case series

Journal of Neurosurgery Pediatrics ◽

10.3171/2018.12.peds18568 ◽

2019 ◽

Vol 23 (5) ◽

pp. 568-576

Author(s):

Michael Ragheb ◽

Ashish H. Shah ◽

Sarah Jernigan ◽

Tulay Koru-Sengul ◽

John Ragheb

Keyword(s):

Public Health ◽

Logistic Regression ◽

Head Circumference ◽

Rainy Season ◽

Statistical Tests ◽

Multivariate Logistic Regression Analysis ◽

Case Series ◽

Multivariate Logistic Regression ◽

Surgical Case ◽

Operative Notes

OBJECTIVEHydrocephalus is recognized as a common disabling pediatric disease afflicting infants and children disproportionately in the developing world, where access to neurosurgical care is limited and risk of perinatal infection is high. This surgical case series describes the Project Medishare Hydrocephalus Specialty Surgery (PMHSS) program experience treating hydrocephalus in Haiti between 2008 and 2015.METHODSThe authors conducted a retrospective review of all cases involving children treated for hydrocephalus within the PMHSS program in Port-au-Prince, Haiti, from 2008 through 2015. All relevant epidemiological information of children treated were prospectively collected including relevant demographics, birth history, hydrocephalus etiology, head circumference, and operative notes. All appropriate associations and statistical tests were performed using univariate and multivariate logistic regression analyses.RESULTSAmong the 401 children treated within PMHSS, postinfectious hydrocephalus (PIH) accounted for 39.4% (n = 158) of cases based on clinical, radiographic, and endoscopic findings. The majority of children with hydrocephalus in Haiti were male (54.8%, n = 197), born in the rainy season (59.7%, n = 233), and born in a coastal/inland location (43.3%, n = 61). The most common surgical intervention was endoscopic third ventriculostomy with choroid plexus cauterization (ETV/CPC) (45.7%, n = 175). Multivariate logistic regression analysis yielded coastal birth location (OR 3.76, 95% CI 1.16–12.18) as a statistically significant predictor of PIH. Increasing head circumference (adjusted OR 1.06, 95% CI 0.99–1.13) demonstrated a slight trend toward significance with the incidence of PIH.CONCLUSIONSThis information will provide the foundation for future clinical and public health studies to better understand hydrocephalus in Haiti. The 39.4% prevalence of PIH falls within observed rates in Africa as does the apparently higher prevalence for those born during the rainy season. Although PIH was the most frequent etiology seen in almost all birth locations, the potential relationship with geography noted in this series will be the focus of further research in an effort to understand the link between climate and PIH in Haiti. The ultimate goal will be to develop an appropriate public health strategy to reduce the burden of PIH on the children of Haiti.

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Preoperative Circulating MiR-210, a Risk Factor for Postoperative Delirium Among Elderly Patients with Gastric Cancer Undergoing Curative Resection

Current Pharmaceutical Design ◽

10.2174/1381612826666200617163857 ◽

2020 ◽

Vol 26 (40) ◽

pp. 5213-5219

Author(s):

Yun Chen ◽

Jinwei Zheng ◽

Junping Chen

Keyword(s):

Gastric Cancer ◽

Logistic Regression ◽

Risk Factor ◽

Elderly Patients ◽

Curative Resection ◽

Postoperative Delirium ◽

Area Under The Curve ◽

Multivariate Logistic Regression Model ◽

Multivariate Logistic Regression ◽

Clinicopathologic Characteristics

Background: Postoperative delirium (POD) is a very common complication in elderly patients with gastric cancer (GC) and associated with poor prognosis. MicroRNAs (miRNAs) serve as key post-transcriptional regulators of gene expression via targeting mRNAs and play important roles in the nervous system. This study aimed to investigate the potential predictive role of miRNAs for POD. Methods: Elderly GC patients who were scheduled to undergo elective curative resection were consequently enrolled in this study. POD was assessed at 1 day before surgery and 1-7 days after surgery following the guidance of the 5th edition of Diagnostic and Statistical Manual of Mental Disorders (DSM V, 2013). The demographics, clinicopathologic characteristics and preoperative circulating miRNAs by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) were compared between patients with or without POD. Risk factors for POD were assessed via univariate and multivariate logistic regression analyses. Results: A total of 370 participants were enrolled, of which 63 had suffered from POD within postoperative 7 days with an incidence of 17.0%. Preoperative miR-210 was a predictor for POD with an area under the curve (AUC) of 0.921, a cut-off value of 1.67, a sensitivity of 95.11%, and a specificity of 92.06%, (P<0.001). In the multivariate logistic regression model, the relative expression of serum miR-210 was an independent risk factor for POD (OR: 3.37, 95%CI: 1.98–5.87, P=0.003). Conclusions: In conclusion, the present study highlighted that preoperative miR-210 could serve as a potential predictor for POD in elderly GC patients undergoing curative resection.

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