The Correlation Between Clinical Features and Viral RNA Shedding in Outpatients With COVID-19

Abstract Background Patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can shed virus, thereby causing human-to-human transmission, and the viral RNA shedding is commonly used as a proxy measure for infectivity. Methods We retrospectively reviewed confirmed cases of COVID-19 who attended the fever clinic of Wuhan Union Hospital from January 14 to February 24. In terms of the viral RNA shedding (median values) at first visit, patients were divided into a high–viral RNA shedding group and a low–viral RNA shedding group. Univariate and multivariate logistic regression analysis were performed to investigate the correlation between viral RNA shedding and clinical features. Results A total of 918 consecutive COVID-19 patients were enrolled, and severe patients made up 26.1%. After univariate and multivariate logistic regression, advanced age (odds ratio [OR], 1.02; 95% CI, 1.01–1.03; P = .001), having severe chronic diseases (OR, 1.44; 95% CI, 1.03–2.01; P = .04), and severe illness (OR, 1.60; 95% CI, 1.12–2.28; P = .01) were independent risk factors for high viral RNA shedding. Shorter time interval from symptom onset to viral detection was a protective factor for viral RNA shedding (OR, 0.97; 95% CI, 0.94–0.99; P = .01). Compared with mild patients, severe patients have higher virus shedding over a long period of time after symptom onset (P = .01). Conclusions Outpatients who were old, had severe illness, and had severe underlying diseases had high viral RNA shedding.

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Prediction and follow-up of risk factors for severe SARS-CoV-2 pneumonia and application of CT visual scoring

Technology and Health Care ◽

10.3233/thc-218016 ◽

2021 ◽

pp. 1-12

Author(s):

Yingjian Ye ◽

Xiaxia Wu ◽

Xiumei Li ◽

Chunmei Xu ◽

Qingpeng Wang ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Clinical Features ◽

Lymphocyte Count ◽

Clinical Symptoms ◽

Multivariate Logistic Regression Analysis ◽

Clinical Treatment ◽

Severe Illness ◽

Multivariate Logistic Regression ◽

Clinical Value

BACKGROUND: The SARS-CoV-2 pneumonia infection is associated with high rates of hospitalization and mortality and this has placed healthcare systems under strain. Our study provides a novel method for the progress prediction, clinical treatment and prognosis of NCP, and has important clinical value for timely treatment of severe NCP patients. OBJECTIVE: To summarize the clinical features and severe illness risk factors of the patients with novel coronavirus pneumonia (NCP), in order to provide support for the progression prediction, clinical treatment and prognosis of NCP patients. MATERIALS AND METHODS: A total of 196 NCP patients treated in our hospital from January 25, 2020 to June 21, 2020 were divided into the severe group and the mild group. The clinical features of the two groups were analyzed and compared. The risk factors were explored by using multivariate logistic regression, and the receiver operating characteristic (ROC) curve was obtained. The correlations of the risk factors with the prognosis of NCP were investigated combined with the lung function test. RESULTS: The primary clinical symptoms of 196 cases of NCP included fever in 167 cases (85.2%) and cough in 121 cases (61.73%). The chest computed tomography (CT) scans of the 178 cases (90.81%) showed a typical ground-glass opacification. In 149 cases, the lymphocyte count was decreased, while the levels of creatine kinase (CK), lactate dehydrogenase (LDH), c-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and D-dimer (D-D) increased. 44 cases (22.45%) were found to be severely ill. The multivariate logistic regression analysis demonstrated that age, underlying disease, length of hospital stay, body mass index (BMI), LDH, chest CT visual score, absolute lymphocyte count (ALC) and CRP were risk factors for severe

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Clinical Features and Risk Factors for Active Tuberculosis in Takayasu Arteritis: A Single-Center Case-Control Study

Frontiers in Immunology ◽

10.3389/fimmu.2021.749317 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jiawei Zhou ◽

Ruoyu Ji ◽

Rui Zhu ◽

Jingya Zhou ◽

Jing Li ◽

...

Keyword(s):

Risk Factors ◽

Weight Loss ◽

Logistic Regression ◽

Regression Analysis ◽

Clinical Features ◽

Takayasu Arteritis ◽

Multivariate Logistic Regression Analysis ◽

Active Tuberculosis ◽

Case Group ◽

Multivariate Logistic Regression

BackgroundsTakayasu arteritis (TAK) is a chronic, granulomatous vasculitis correlated with tuberculosis (TB). The two diseases share similar pathological characteristics and clinical manifestations which increase the difficulty to diagnose. Active tuberculosis (ATB) has implications for treatment strategies in TAK patients. Therefore, the investigation of clinical features and potential risk factors of ATB in TAK patients is vital.MethodsThe study reviewed hospitalized patients diagnosed with TAK in our hospital from 2008, to 2021. TAK patients with ATB were enrolled as the case group. The control group was randomly selected in a 3:1 ratio. The clinical characteristics of TAK patients with and without ATB were compared. Multivariate logistic regression analysis was performed to determine risk factors for ATB in TAK patients.ResultsWe reviewed 1,789 patients and ultimately identified 30 (1.7%) ATB cases. TAK patients with ATB were more prone to develop symptoms including fever (p=0.001), fatigue (p=0.003), cough (p=0.037), expectoration (p<0.001), weight loss (p=0.003), and night sweating (p<0.001). Increased level of hypersensitive C reactive protein (hsCRP, p=0.001), decreased level of albumin (p=0.031), and higher positive rate of T-SPOT.TB test (p<0.001) were observed in the case group. Multivariate logistic regression analysis revealed that hsCRP >8 mg/L (OR 9.108; 95% CI, 1.096–75.711; p=0.041) and positive T-SPOT.TB result (OR 68.669; 95% CI, 7.291–646.738; p<0.001) were risk factors for ATB in TAK patients. The proportion of patients undergoing subsequent surgery for Takayasu arteritis was lower in patients with ATB (p<0.001).ConclusionOur study suggested that the diagnosis of ATB should be considered when TAK patients experienced symptoms including fever, fatigue, weight loss, etc. hsCRP >8 mg/L and positive T-SPOT.TB result were identified as independent risk factors for ATB in TAK patients.

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The evaluation of factors affecting antibody response after administration of the BNT162b2 vaccine: A prospective study in Japan

10.1101/2021.06.20.21259177 ◽

2021 ◽

Author(s):

Toshiya Mitsunaga ◽

Yuhei Ohtaki ◽

Yutaka Seki ◽

Masakata Yoshioka ◽

Hiroshi Mori ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Antibody Response ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Antibody Test ◽

Time Interval ◽

Multivariate Logistic Regression ◽

Outdoor Activities ◽

Antibody Reaction

The aim of this study was to evaluate the antibody reaction after administration of the BNT162b2 vaccine, and to reveal the factors that affect antibody production. This prospective study was carried out in the Association of EISEIKAI Medical and Healthcare Corporation Minamitama Hospital, in Tokyo, Japan, from April 15, 2021 to June 09, 2021. All our hospital's workers who were administered the BNT162b2 vaccine as part of a routine program were included in this study. We calculated the anti-SARS-CoV-2 spike-specific antibody titter 1) before vaccination, 2) seven to twenty days after the first vaccination, and 3) seven to twenty days after the second vaccination. The low-antibody titer group (LABG) was defined as the group having less than 25 percentiles of antibody titer. Univariate and Multivariate logistic regression analysis were performed to ascertain the effects of factors on the likelihood of LABG. 374 participants were eventually included in our study, and they were divided into 94 LABG and 280 non-LABG. All samples showed significant antibody elevation in the second antibody test, with a mean value of 3476 U/mL. When comparing the LABG and non-LABG groups, the median age, blood sugar, and HbA1c were significantly higher in the LABG group. The rates of participants with low BMI (<18.5) and high BMI (>30) were significantly higher in the LABG group. The proportion of chronic lung disease, hypertension, diabetes, dyslipidemia, autoimmune disease, and cancer were significantly higher in the LABG group. Although there was no significant difference confirmed with respect to the exercise hours per day, the proportion of participants that did not perform outdoor activities was significantly higher in the LABG group. The time interval between the second vaccination and the second antibody test, and between the first and the second vaccination was significantly longer in the non-LABG group. Our logistic regression analysis revealed that the age, obesity, hypertension, diabetes, dyslipidemia, antihypertensive drug, antilipid drug, γ-GT, BS, HbA1c, and lack of outdoor activity were significant suppressors of antibody reaction, whereas maintaining the appropriate time interval between the first and the second vaccination could promote a significant antibody response. In the multivariate logistic regression analysis, age, obesity, and lack of outdoor activities were significant suppressors of antibody reaction, whereas the length of days from the first to the second vaccination promoted a significant antibody response. Our single-center study demonstrates that age, obesity, and lack of outdoor activities were significant suppressors of antibody response, whereas maintaining the appropriate time interval between the first and the second vaccination could promote a significant antibody response. Evidence from multi-center studies is needed to develop further vaccination strategies.

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Headache as a presenting symptom of glioma: A cross-sectional study

Cephalalgia ◽

10.1177/0333102417710020 ◽

2017 ◽

Vol 38 (4) ◽

pp. 730-735 ◽

Cited By ~ 8

Author(s):

Marco Russo ◽

Veronica Villani ◽

Arens Taga ◽

Antonio Genovese ◽

Irene Terrenato ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Brain Tumour ◽

Clinical Features ◽

Logistic Regression Analysis ◽

Protective Factor ◽

Multivariate Logistic Regression Analysis ◽

Cross Sectional Study ◽

Cross Sectional ◽

Potential Risk Factors

Objective The objective of this study was to analyse the prevalence and the clinical features of headache as a presenting symptom of glioma. Methods We interviewed 527 consecutive adult patients with histologically confirmed glioma, admitted to the Regina Elena National Cancer Institute between 2010 and 2015. We defined four headache phenotypes: Tension-type-like headache (TTH), migraine-like headache, worsening of a pre-existing headache (WPH) and classic brain tumour headache (BTH). Logistic regression analysis was carried out to investigate potential risk factors for headache at presentation of glioma. Results 12.5% (n = 66) of patients with glioma indicated headache as a presenting symptom of their disease. Of these, 31 patients (47%) had TTH, while BTH and WPH were reported by 28 (42%) and seven (11%) patients, respectively. We did not find any case of migraine-like headache. Infratentorial ( p = 0.038) and right-sided tumours ( p = 0.013) were more frequently associated with the presence of headache at onset. Patients with TTH were older than patients with BTH and WPH ( p = 0.035). BTH was less frequently associated with other neurological signs ( p < 0.0001). The multivariate logistic regression analysis showed the localization of the brain tumour in the left hemisphere to be a protective factor for the development of headache. Conclusions Our study includes a very large series of patients with glioma, providing a description of headache phenotype at first presentation of disease and investigating possible factors that may influence the clinical features of headache.

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Pre hospital delay and its associated factors in acute myocardial infarction in a developing country

PLoS ONE ◽

10.1371/journal.pone.0259979 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0259979

Author(s):

Ishmum Zia Chowdhury ◽

Md. Nurul Amin ◽

Mashhud Zia Chowdhury ◽

Sharar Muhib Rahman ◽

Mohsin Ahmed ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Logistic Regression ◽

Regression Analysis ◽

Chest Pain ◽

Logistic Regression Analysis ◽

Symptom Onset ◽

Associated Factors ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression

Background Early revascularization and treatment is key to improving clinical outcomes and reducing mortality in acute myocardial infarction (AMI). In low- and middle-income countries such as Bangladesh, timely management of AMI is challenging, with pre-hospital delays playing a significant role. This study was designed to investigate pre-hospital delay and its associated factors among patients presenting with AMI in the capital city of Dhaka. Methods This retrospective cohort study was conducted on 333 patients presenting with AMI over a 3-month period at two of the largest primary reperfusion-capable tertiary cardiac care centres in Dhaka. Of the total patients, 239(71.8%) were admitted in the National Institute of Cardiovascular Diseases, Dhaka and 94(28.2%) at Ibrahim Cardiac Hospital & Research Institute, Dhaka Data were collected from patients by semi-structured interview and hospital medical records. Pre-hospital delay (median and inter-quartile range) was calculated. Statistical significance was determined by Chi-square test. Multivariate logistic regression analysis was done to determine the independent predictors of pre-hospital delay. Results The mean age of the respondents was 53.8±11.2 years. Two-thirds (67.6%) of the respondents were males. Median total pre-hospital delay was 11.5 (IQR-18.3) hours with median decision time from symptom onset to seeking medical care being 3.0 (IQR: 11.0) hours. Nearly half (48.9%) of patients presented to the hospital more than 12 hours after symptom onset. On multivariate logistic regression analysis, AMI patients with absence of typical chest pain [OR 5.21; (95% CI: 2.5–9.9)], diabetes [OR: 1.7 (95% CI: 1.0–2.9)], residing/staying > 30 km away from nearest hospital at the time of onset [OR: 4.3(95% CI = 2.3–7.2)] and belonged to lower and middle class [OR: 1.9(95% CI = 1.0–3.5)] were significantly associated with pre-hospital delays. Conclusion Acute myocardial infarction (AMI) patients with atypical chest pain, diabetes, staying far away from nearest hospital and belonged to lower and middle socioeconomic strata were significantly associated with pre-hospital delays. The findings could have immense implications for improvements about timely reaching of AMI patients to the hospital within the context of their sociodemographic status and geographic barriers of the city.

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Psychological Complications at 3 Months Following Stroke: Prevalence and Correlates Among Stroke Survivors in Lebanon

Frontiers in Psychology ◽

10.3389/fpsyg.2021.663267 ◽

2021 ◽

Vol 12 ◽

Author(s):

Walaa Khazaal ◽

Maram Taliani ◽

Celina Boutros ◽

Linda Abou-Abbas ◽

Hassan Hosseini ◽

...

Keyword(s):

Logistic Regression ◽

Neuropathic Pain ◽

Protective Factor ◽

Multivariate Logistic Regression Analysis ◽

Anxiety And Depression ◽

Second Primary ◽

Stroke Survivors ◽

Multivariate Logistic Regression ◽

Post Stroke ◽

Wide Range

Introduction: Stroke continues to be a common and debilitating medical condition which has a significant effect on public health as the second primary source of mortality and the third major root of disability worldwide. A wide range of complications affecting the survivor's life and interfering with the recovery process usually follows stroke; anxiety and depression are considered one of the major complications post-stroke. This study sought to investigate the short-term psychological consequences of stroke among Lebanese survivors and to identify their correlates.Methods: This study is a prospective observational epidemiological study. 143 stroke patients admitted to hospitals in Mount Lebanon and Beirut between February and May 2018.were included in this study. Assessments of complications were carried out at 3 months post-stroke by completing a 30-min face-to-face interview questionnaire. The survey included the socio-demographic -characteristics of the patients, their lifestyle, health indicators, the severity of stroke, and the post-stroke consequences disturbing their quality of life.Results: Complications were recorded for 117 stroke survivors (mean age, 72.46 years; 60.7% male). The analysis of results 3 months post stroke showed that 29 survivors suffered from neuropathic pain (24.8%), 110 (94%) suffered from fatigue, and 81 (69.2%) from cognitive impairment. High rates of anxiety (51.3%), and depression (76.1%) were recorded as well. Multivariate logistic regression confirmed that there is a significant association between depression and the following variables: anxiety (OR = 4.814, p-value = 0.017), pain (OR = 6.868, p-value = 0.002), and physical activity, which acts as a protective factor against depression (OR = 0.261; p-value = 0.029). However, the results of the multivariate logistic regression analysis for anxiety indicated that immobility-related complications increase the risk of anxiety by 8.457 in sedentary duration longer than 12 h (ORa = 8.457, p-value = 0.01). Furthermore, patients with neuropathic pain (24.8%) are 3.858 times more likely to have anxiety compared to patients without neuropathic pain (ORa = 3.858, p-value = 0.019).Conclusion: Using a patient-centered structure more interventions should take place to evaluate stroke survivors' outcomes, and organize rehabilitation services that deal with stroke consequences, particularly high anxiety and depression levels, which are prevalent and persistent among the Lebanese stroke survivors.

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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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High Risk of One-year Stroke Recurrence in Patients with Younger Age and Prior History of Ischemic Stroke

Current Neurovascular Research ◽

10.2174/1567202616666190618164528 ◽

2019 ◽

Vol 16 (3) ◽

pp. 250-257 ◽

Cited By ~ 1

Author(s):

Jiann-Der Lee ◽

Ya-Han Hu ◽

Meng Lee ◽

Yen-Chu Huang ◽

Ya-Wen Kuo ◽

...

Keyword(s):

Logistic Regression ◽

Ischemic Stroke ◽

Multivariate Logistic Regression Analysis ◽

Stroke Recurrence ◽

Prior History ◽

Multivariate Logistic Regression ◽

Cart Analysis ◽

Younger Age ◽

History Of ◽

One Year

Background and Purpose: Recurrent ischemic strokes increase the risk of disability and mortality. The role of conventional risk factors in recurrent strokes may change due to increased awareness of prevention strategies. The aim of this study was to explore the potential risk factors besides conventional ones which may help to affect the advances in future preventive concepts associated with one-year stroke recurrence (OSR). Methods: We analyzed 6,632 adult patients with ischemic stroke. Differences in clinical characteristics between patients with and without OSR were analyzed using multivariate logistic regression and classification and regression tree (CART) analyses. Results: Among the study population, 525 patients (7.9%) had OSR. Multivariate logistic regression analysis revealed that male sex (OR 1.243, 95% CI 1.025 – 1.506), age (OR 1.015, 95% CI 1.007 - 1.023), and a prior history of ischemic stroke (OR 1.331, 95% CI 1.096 – 1.615) were major factors associated with OSR. CART analysis further identified age and a prior history of ischemic stroke were important factors for OSR when classified the patients into three subgroups (with risks of OSR of 8.8%, 3.8%, and 12.5% for patients aged > 57.5 years, ≤ 57.5 years/with no prior history of ischemic stroke, and ≤ 57.5 years/with a prior history of ischemic stroke, respectively). Conclusions: Male sex, age, and a prior history of ischemic stroke could increase the risk of OSR by multivariate logistic regression analysis, and CART analysis further demonstrated that patients with a younger age (≤ 57.5 years) and a prior history of ischemic stroke had the highest risk of OSR.

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Efficacy of flurbiprofen axetil for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries

JA Clinical Reports ◽

10.1186/s40981-020-00403-x ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Atsushi Kotera

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Postoperative Pain ◽

Logistic Regression Analysis ◽

Pain Control ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Postoperative Pain Control ◽

Flurbiprofen Axetil ◽

Postanesthetic Shivering

Abstract Background Postanesthetic shivering is an unpleasant adverse event in surgical patients. A nonsteroidal anti-inflammatory drug has been reported to be useful in preventing postanesthetic shivering in several previous studies. The aim of this study was to evaluate the efficacy of flurbiprofen axetil being a prodrug of a nonsteroidal anti-inflammatory drug for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries. Method This study is a retrospective observational study. I collected data from patients undergoing gynecologic laparotomy surgeries performed between October 1, 2019, and September 30, 2020, at Kumamoto City Hospital. All the patients were managed with general anesthesia with or without epidural analgesia. The administration of intravenous 50 mg flurbiprofen axetil for postoperative pain control at the end of the surgery was left to the individual anesthesiologist. The patients were divided into two groups: those who had received intravenous flurbiprofen axetil (flurbiprofen group) and those who had not received intravenous flurbiprofen axetil (non-flurbiprofen group), and I compared the frequency of postanesthetic shivering between the two groups. Additionally, the factors presumably associated with postanesthetic shivering were collected from the medical charts. Intergroup differences were assessed with the χ2 test with Yates’ correlation for continuity category variables. The Student’s t test was used to test for differences in continuous variables. Furthermore, a multivariate logistic regression analysis was performed to elucidate the relationship between the administration of flurbiprofen axetil and the incidence of PAS. Results I retrospectively examined the cases of 141 patients aged 49 ± 13 (range 21-84) years old. The overall postanesthetic shivering rate was 21.3% (30 of the 141 patients). The frequency of postanesthetic shivering in the flurbiprofen group (n = 31) was 6.5%, which was significantly lower than that in the non-flurbiprofen group (n = 110), 25.5% (p value = 0.022). A multivariate logistic regression analysis showed that administration of flurbiprofen axetil was independently associated with a reduced incidence of postanesthetic shivering (odds ratio 0.12; 95% confidence interval, 0.02-0.66, p value = 0.015). Conclusions My result suggests that intraoperative 50 mg flurbiprofen axetil administration for postoperative pain control is useful to prevent postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries.

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The association between hypoglycemia and glycemic variability in elderly patients with type 2 diabetes: a prospective observational study

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00656-1 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Takahisa Handa ◽

Akinobu Nakamura ◽

Aika Miya ◽

Hiroshi Nomoto ◽

Hiraku Kameda ◽

...

Keyword(s):

Type 2 Diabetes ◽

Logistic Regression ◽

Regression Analysis ◽

Observational Study ◽

Elderly Patients ◽

Prospective Observational Study ◽

Multivariate Logistic Regression Analysis ◽

Glycemic Variability ◽

Multivariate Logistic Regression

Abstract Background This study aimed to explore predictive factors of time below target glucose range (TBR) ≥ 1% among patients’ characteristics and glycemic variability (GV) indices using continuous glucose monitoring data in elderly patients with type 2 diabetes. Methods We conducted a prospective observational study on 179 (71 female) Japanese outpatients with type 2 diabetes aged ≥ 65 years. The characteristics of the participants with TBR ≥ 1% were evaluated by multivariate logistic regression analysis. Receiver-operating characteristic (ROC) curve analyses of GV indices, comprising coefficient of variation (CV), standard deviation, and mean amplitude of glycemic excursions, were performed to identify the optimal index for the identification of patients with TBR ≥ 1%. Results In the multivariate logistic regression analysis, none of the clinical characteristics, including HbA1c and C-peptide index, were independent markers for TBR ≥ 1%, while all three GV indices showed significant associations with TBR ≥ 1%. Among the three GV indices, CV showed the best performance based on the area under the curve in the ROC curve analyses. Conclusions Among elderly patients with type 2 diabetes, CV reflected TBR ≥ 1% most appropriately among the GV indices examined. Trial registration UMIN-CTR: UMIN000029993. Registered 16 November 2017

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