31. Development a Novel Score (SAD-60) for Predicting Mortality in Hospitalised Patients with COVID-19 Pneumonia: A Multicenter Retrospective Study of 1013 Patients

Abstract Background We aimed to explore a novel risk score to predict mortality in hospitalised patients with COVID-19 pneumonia. In additoon, we compared the accuracy of the novel risk score with CURB-65, qSOFA and NEWS2 scores. Methods The study was conducted in hospitalised patients with laboratory and radiologically confirmed COVID-19 pneumonia between November 1, 2020 and November 30, 2020. In this retrospective multicenter study. independent predictors were identified using multivariate logistic regression analysis. A receiver operating characteristics (ROC) analysis with area under the curve (AUC) was used to evaluate the performance of the novel score. The optimal cut-off points of the candidate variables were calculated by the Youden’s index of ROC curve. Mortality was defined as all cause in-hospital death. Results A total of 1013 patients with COVID-19 were included. The mean age was 60,5 ±14,4 years, and 581 (57,4%) patients were male. In-hospital death was occured in 124 (12,2%) patients. Multivariate analysis revealed that peripheral capillary oxygen saturation (SpO2), albumin, D-dimer, and age were independent predictors for mortality (Table). A novel scoring model was named as SAD-60 (SpO2, Albumin, D-dimer, ≥60 years old). SAD-60 score (0,776) had the highest AUC compared to CURB-65 (0,753), NEWS2 (0,686), and qSOFA (0,628) scores (Figure). Conclusion We demonstrated that SAD-60 score had a promising predictive capacity for mortality in hospitalised patients with COVID-19. Univariate and multivariate analysis of factors predicting mortality Comparison of CURB-65, qSOFA, NEWS-2 and SAD-60 for predicting pneumonia mortality in hospitalised patients with COVID-19 by ROC analysis Disclosures All Authors: No reported disclosures

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Validation of Michigan risk score and D-dimer to predict peripherally inserted central catheter-related thrombosis: A study of 206,132 catheter days

The Journal of Vascular Access ◽

10.1177/11297298211008772 ◽

2021 ◽

pp. 112972982110087

Author(s):

Junren Kang ◽

Wenyan Sun ◽

Hailong Li ◽

En ling Ma ◽

Wei Chen

Keyword(s):

Sensitivity And Specificity ◽

Risk Score ◽

Primary Objective ◽

Class Iii ◽

Operating Characteristics ◽

Central Venous ◽

Sensitivity Specificity ◽

Catheter Related Thrombosis ◽

D Dimer ◽

Independent Cohort

Background: The Michigan Risk Score (MRS) was the only predicted score for peripherally inserted central venous catheters (PICC) associated upper extremity venous thrombosis (UEVT). Age-adjusted D-dimer increased the efficiency for UEVT. There were no external validations in an independent cohort. Method: A retrospective study of adult patients with PICC insertion was performed. The primary objective was to evaluate the performance of the MRS and age-adjusted D-dimer in estimating risk of PICC-related symptomatic UEVT. The sensitivity, specificity and areas under the receiver operating characteristics (ROC) of MRS and age-adjusted D-dimer were calculated. Results: Two thousand one hundred sixty-three patients were included for a total of 206,132 catheter days. Fifty-six (2.6%) developed PICC-UEVT. The incidences of PICC-UEVT were 4.9% for class I, 7.5% for class II, 2.2% for class III, 0% for class IV of MRS ( p = 0.011). The incidences of PICC-UEVT were 4.5% for D-dimer above the age-adjusted threshold and 1.5% for below the threshold ( p = 0.001). The areas under ROC of MRS and age-adjusted D-dimer were 0.405 (95% confidence interval (CI) 0.303–0.508) and 0.639 (95% CI 0.547–0.731). The sensitivity and specificity of MRS were 0.82 (95% CI, 0.69–0.91), 0.09 (95% CI, 0.08–0.11), respectively. The sensitivity and specificity of age-adjusted D-dimer were 0.64 (95% CI, 0.46–0.79) and 0.64 (95% CI, 0.61–0.66), respectively. Conclusions: MRS and age-adjusted D-dimer have low accuracy to predict PICC-UEVT. Further studies are needed.

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Predictive Value of Endocan Based on TIMI Risk Score on Major Adverse Cardiovascular Events After Acute Coronary Syndrome

Angiology ◽

10.1177/0003319718815241 ◽

2018 ◽

Vol 70 (10) ◽

pp. 952-959 ◽

Cited By ~ 3

Author(s):

Mojtaba Ziaee ◽

Sina Mashayekhi ◽

Samad Ghaffari ◽

Javad Mahmoudi ◽

Parvin Sarbakhsh ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Risk Score ◽

Troponin I ◽

Multivariate Logistic Regression Analysis ◽

Major Adverse Cardiovascular Events ◽

Hospital Death ◽

Coronary Syndrome ◽

Creatine Kinase Mb ◽

Timi Risk Score

We assessed the prognostic value of serum levels of endocan in patients with the acute coronary syndrome (ACS) through its correlation with the Thrombolysis in Myocardial Infarction (TIMI) risk score and compared the possible association with clinical outcomes. In this prospective cross-sectional study, we enrolled 320 patients with documented ST-segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), or unstable angina (UA) who underwent diagnostic coronary angiography. Endocan was measured soon after admission in the emergency department. In-hospital death, heart failure, and recurrent infarction were considered major adverse cardiac events (MACEs). There was a significant positive correlation between endocan level and TIMI risk score and MACE. The optimal cutoff values of endocan to predict clinical end points were 3.45 ng/mL in patients with STEMI and 2.85 ng/mL in patients with UA/NSTEMI. Multivariate logistic regression analysis indicated that endocan independently correlated with MACE. Moreover, cardiac troponin I, creatine kinase-MB, and circulating endocan were found to be independently associated with MACE in patients with ACS. In conclusion, a high endocan level on hospital admission is an independent predictor of worse cardiovascular outcomes and higher TIMI risk score in patients with ACS.

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Hemophagocytosis, hyper-inflammatory responses, and multiple organ damages in COVID-19-associated hyperferritinemia

Annals of Hematology ◽

10.1007/s00277-021-04735-1 ◽

2021 ◽

Author(s):

Guiying Dong ◽

Jianbo Yu ◽

Weibo Gao ◽

Wei Guo ◽

Jihong Zhu ◽

...

Keyword(s):

General Practice ◽

Multivariate Analysis ◽

Inflammatory Responses ◽

Multiple Organ ◽

Hospital Death ◽

Mechanical Ventilator ◽

Chronic Pulmonary Disease ◽

Ventilator Support ◽

The Relationship ◽

D Dimer

Abstract Hyperferritinemia comes to light frequently in general practice. However, the characteristics of COVID-19-associated hyperferritinemia and the relationship with the prognosis were not well described. The retrospective study included 268 documented COVID-19 patients. They were divided into the hyperferritinemia group (≥ 500 µg/L) and the non-hyperferritinemia group (< 500 µg/L). The prevalence of fever and thrombocytopenia and the proportion of patients with mechanical ventilator support and in-hospital death were much higher in the hyperferritinemia group (P < 0.001). The hyperferritinemia patients showed higher median IL-6, D-dimer, and hsCRP (P < 0.001) and lowered FIB level (P = 0.036). The hyperferritinemia group had a higher proportion of patients with AKI, ARDS, and CSAC (P < 0.001). According to the multivariate analysis, age, chronic pulmonary disease, and hyperferritinemia were found to be significant independent predictors for in-hospital mortality [HR 1.041 (95% CI 1.015–1.068), P = 0.002; HR 0.427 (95% CI 0.206–0.882), P = 0.022; HR 6.176 (95% CI 2.447–15.587), P < 0.001, respectively]. The AUROC curve was 0.88, with a cut-off value of ≥ 971 µg/L. COVID-19 patients with hyperferritinemia had a high proportion of organ dysfunction, were more likely to show hyper-inflammation, progressed to hemophagocytic lymphohistiocytosis, and indicated a higher proportion of death.

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A four prognosis-associated lncRNAs (PALnc) based risk score system reflects immune cell infiltration and predicts patient survival in pancreatic cancer

Cancer Cell International ◽

10.1186/s12935-020-01588-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Hongkai Zhuang ◽

Shanzhou Huang ◽

Zixuan Zhou ◽

Zuyi Ma ◽

Zedan Zhang ◽

...

Keyword(s):

Pancreatic Cancer ◽

Multivariate Analysis ◽

Signaling Pathway ◽

Risk Score ◽

Roc Analysis ◽

Immune Cell ◽

Patient Survival ◽

Immune Cell Infiltration ◽

Score System ◽

Risk Score System

Abstract Background Pancreatic cancer (PC) is one of the most common cancers and the leading cause of cancer-related death worldwide. Exploring novel predictive biomarkers for PC patients’ prognosis is in urgent need. Methods In the present study, we conducted Cox proportional hazards regression to identify critical prognosis-associated lncRNAs (PALncs) in TCGA PC dataset. Based on the results of multivariate analysis, a PALnc-based risk score system was established, and validated in GSE62452 dataset. The validity and reliability of the risk score system for prognosis of PC were evaluated through ROC analysis. And function enrichment analyses for the PALncs were also performed. Result In the multivariate analysis, four PALncs (LINC00476, C9orf163, LINC00346 and DSCR9) were screened out to develop a risk score system, which showed a high AUC at 3 and 5 years overall survival (0.785 at 3 year OS, 0.863 at 5 year OS) in TCGA datasets. And the ROC analysis of the risk score system for RFS in TCGA dataset revealed that AUC for RFS was 0.799 at 3 years and 0.909 at 5 years. Further, the AUC for OS in the validation cohort was 0.705 at 3 years and 0.959 at 5 years. Furthermore, the functional enrichment analysis revealed that these PALncs may be involved in various pathways related to cancer, including Ras family activation, autophagy in cancer, MAPK signaling pathway, HIF-1 signaling pathway, PI3K-Akt signaling pathway, etc. And correlation analysis of these tumor infiltrating immune cells and risk score system revealed that the infiltration level of B cell naïve, plasma cells, and CD8+ T cells are negatively correlated to the risk score system, while macrophages M2 positively correlated to the risk score system. Conclusion Our study established a four PALncs based risk score system, which reflects immune cell infiltration and predicts patient survival for PC.

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D-Dimer Analysis in COVID-19 Patients

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v28i1.1812 ◽

2021 ◽

Vol 28 (1) ◽

pp. 5

Author(s):

Rahim Mubarak ◽

Tenri Esa ◽

Yuyun Widaningsih ◽

Uleng Bahrun

Keyword(s):

Predictive Value ◽

Roc Analysis ◽

Operating Characteristics ◽

Coagulation Marker ◽

Significant Difference ◽

Hospital Patients ◽

Severe Group ◽

Severity Of The Disease ◽

Group D ◽

D Dimer

The COVID-19 incidence is increasing around the world. Some countries are experiencing worsening conditions, evendeaths. One coagulation marker that noticeably increases in COVID-19 patients is D-dimer. This study aimed to analyzeD-dimer levels of COVID-19 patients. Retrospective study using medical records of 84 COVID-19 patients, conducted fromApril to August 2020 at UNHAS Hospital. Patients were grouped based on the severity of the disease as non-severe andsevere. D-dimer levels were measured using the Alere Triage® D-dimer with the fluorescent immunoassay method. Thestatistical test used was Mann-Whitney, D-dimer prognostic levels were calculated with ROC analysis to get the cut-off.Significant if the p < of 0.05. The sample consisted of 74 non-severe and ten severe COVID-19 patients, mostly in the 30-39age group. D-dimer levels in non-severe (0.31±0.38 μg/L) significantly differ from severe group (3.09±2.56 μg/L) (p<0.001).The Receiver Operating Characteristics (ROC) curve showed D-dimer sensitivity and specificity of 90.0% and 89.2%,respectively at the ≥ 0.80 μg/L cut-off, Negative Predictive Value (NPV) of 98.5%, and Positive Predictive Value (PPV) of52.9%. D-dimer levels increased in severe COVID-19 patients due to an increased inflammatory response resulting inexcessive thrombin. The ROC D-dimer curve indicated a cut-off rate of 0.80 μg/L, providing optimal sensitivity andspecificity. D-dimer has a significant difference in non-severe and severe COVID-19 patients and shows good value todetermine the severity of COVID-19 disease with a cut-off value ≥ 0.80 μg /L.

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Validation of the demographic Fetal Medicine Foundation Risk Calculator in predicting singleton antepartum stillbirth -- A retrospective case-control study

10.22541/au.160647664.48915218/v1 ◽

2020 ◽

Author(s):

Dana Muin ◽

Karin Windsperger ◽

Nadia Attia ◽

Herbert Kiss

Keyword(s):

Risk Score ◽

Roc Analysis ◽

Case Control Study ◽

Case Control ◽

Risk Calculator ◽

Operating Characteristics ◽

Retrospective Case ◽

Fetal Medicine ◽

Live Births ◽

Control Study

Objectives: To externally validate the demographic setting of the online Fetal Medicine Foundation (FMF) Stillbirth Risk Calculator based upon maternal medical and obstetric history in a case-matched cohort. Design: Retrospective case-control study Setting: Tertiary referral hospital Population: 144 fetuses after singleton intrauterine fetal death (IUFD) and a matched control group of 247 singleton live births between 2003 and 2019 Methods: Nonparametric receiver operating characteristics (ROC) analysis was performed to predict the prognostic power of the risk score and to generate a cut-off value to discriminate best between the events of stillbirth versus live birth. Main Outcome Measures: FMF Stillbirth risk score Results: The IUFD cohort conveyed a significantly higher overall risk assessment with a median FMF Stillbirth risk score of 0.45% (0.19-5.70%) compared to live births [0.23% (0.18-1.30%); p<0.001]. Demographic factors mainly contributing to the increased risk were BMI (p=0.002), smoking (p<0.001), chronic hypertension (p=0.015), APS (p=0.017), type 2 diabetes (p<0.001) and need for insulin (p<0.001). ROC analysis to evaluate the discriminative ability of the FMF Stillbirth Risk Calculator showed an area under the curve (AUC) of 0.72 (95% CI 0.67–0.78; p<0.001). The FMF Stillbirth risk score at a cut-off level of 0.34% (OR 6.22; 95% CI 3.91–9.89; p<0.001) yielded a specificity of 82% and a sensitivity of 58% in predicting singleton antepartum stillbirths. Conclusion: The FMF Stillbirth Risk Calculator achieved a similar performance in our cohort of women as in the reference group.

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Different Profiles of Cytokines, Chemokines and Coagulation Mediators Associated with Severity in Brazilian Patients Infected with Dengue Virus

Viruses ◽

10.3390/v13091789 ◽

2021 ◽

Vol 13 (9) ◽

pp. 1789

Author(s):

Victor Edgar Fiestas Solórzano ◽

Nieli Rodrigues da Costa Faria ◽

Caroline Fernandes dos Santos ◽

Gladys Corrêa ◽

Márcio da Costa Cipitelli ◽

...

Keyword(s):

Tissue Factor ◽

Multivariate Logistic Regression Analysis ◽

Principal Component ◽

Operating Characteristics ◽

Mediators Of Inflammation ◽

Receiver Operating Characteristics Curve ◽

Tnf Α ◽

Tissue Factor Pathway ◽

Independent Risk Factors ◽

D Dimer

The incidence of dengue in Latin America has increased dramatically during the last decade. Understanding the pathogenic mechanisms in dengue is crucial for the identification of biomarkers for the triage of patients. We aimed to characterize the profile of cytokines (IFN-γ, TNF-α, IL-1β, IL-6, IL-18 and IL-10), chemokines (CXCL8/IL-8, CCL2/MCP-1 and CXCL10/IP-10) and coagulation mediators (Fibrinogen, D-dimer, Tissue factor-TF, Tissue factor pathway inhibitor-TFPI and Thrombomodulin) during the dengue-4 epidemic in Brazil. Laboratory-confirmed dengue cases had higher levels of TNF-α (p < 0.001), IL-6 (p = 0.005), IL-10 (p < 0.001), IL-18 (p = 0.001), CXCL8/IL-8 (p < 0.001), CCL2/MCP-1 (p < 0.001), CXCL10/IP-10 (p = 0.001), fibrinogen (p = 0.037), D-dimer (p = 0.01) and TFPI (p = 0.042) and lower levels of TF (p = 0.042) compared to healthy controls. A principal component analysis (PCA) distinguished between two profiles of mediators of inflammation and coagulation: protective (TNF-α, IL-1β and CXCL8/IL-8) and pathological (IL-6, TF and TFPI). Lastly, multivariate logistic regression analysis identified high aspartate aminotransferase-to-platelet ratio index (APRI) as independent risk factors associated with severity (adjusted OR: 1.33; 95% CI 1.03–1.71; p = 0.027), the area under the receiver operating characteristics curve (AUC) was 0.775 (95% CI 0.681–0.869) and an optimal cutoff value was 1.4 (sensitivity: 76%; specificity: 79%), so it could be a useful marker for the triage of patients attending primary care centers.

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Diagnostic Accuracy of D-Dimers for Predicting Pulmonary Embolism in COVID-19-Patients

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/10760296211057901 ◽

2021 ◽

Vol 27 ◽

pp. 107602962110579

Author(s):

Falmata Laouan Brem ◽

Boudouh Asmae ◽

Yassine Amane ◽

Mohammed-Amine Bouazzaoui ◽

Miri Chaymae ◽

...

Keyword(s):

Pulmonary Embolism ◽

Clinical Symptoms ◽

University Hospital ◽

The Novel ◽

Test Results ◽

Operating Characteristics ◽

Study Population ◽

Novel Coronavirus ◽

The University ◽

D Dimer

Importance Proinflammatory and hypercoagulable states with marked elevation seen in D-Dimer levels have been accurately described in patients infected by the SARS- Cov2 even without pulmonary embolism (PE). Objectives To compare D-dimers values in patients infected by the novel Coronavirus 2019 (COVID-19) with and without PE and to establish an optimal D-dimer cut-off to predict the occurrence of PE, which guides pulmonary computed tomography angiography (CTPA) indication. Methods We retrospectively enrolled all COVID-19-patients admitted between October first and November 22th, 2020, at the University Hospital Center of Mohammed VI, Oujda (Morocco), suspected to have PE and underwent a CTPA. Demographic characteristics and blood test results were compared between PE-positive and PE-negative. The receiver operating characteristics (ROC) curve was constructed to establish an optimal D-Dimer cut-off to predict the occurrence of PE. Results The study population consisted of 84 confirmed COVID-19-patients. The mean age was 64.93 years (SD 14.19). PE was diagnosed on CTPA in 31 (36.9%) patients. Clinical symptoms and in-hospital outcomes were similar in both groups except that more men had PE ( p = .025). The median value of D-dimers in the group of patients with PE was significantly higher (14 680[IQR 33620-3450]ng/mL compared to the group of patients without PE 2980[IQR 6870-1600]ng/mL [P < .001]. A D-dimer at 2600 ng/mL was the optimal cut-off for predicting PE with a sensitivity of 90.3%, and AUC was .773[CI 95%, .667 −.876). Conclusion A D-dimer cut-off value of 2600 ng/mL is a significant predictor of PE in COVID-19-patients with a sensitivity of 90.3%.

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VIDROS AUTOMOBILÍSTICOS COMO VESTÍGIOS DE CENA DE CRIME: UMA ABORDAGEM MULTIVARIADA

Química Nova ◽

10.21577/0100-4042.20170720 ◽

2021 ◽

Vol 44 ◽

Author(s):

Caio Rodrigues ◽

Aline Bruni

Keyword(s):

Multivariate Analysis ◽

Roc Analysis ◽

Principal Component ◽

Unsupervised Classification ◽

Crime Scene ◽

Multivariate Approach ◽

Operating Characteristics ◽

Trace Evidence ◽

X Ray ◽

Main Components

AUTOMOBILISTIC GLASSES AS CRIME SCENE TRACES: A MULTIVARIATE APPROACH. Glasses are common trace evidence elements in crime scenes, and the analysis of this material can be essential for evaluating different criminal dynamics. This work aimed to analyze the possibility of differentiating and classifying windshield glass using multivariate analysis methods. Automotive glass fragments from different vehicle brands were evaluated according to internal and external faces. We have collected from literature EDXRF (Energy Dispersive X-ray Fluorescence) data for different oxides concentrations. These data were organized in a matrix with 56 samples and nine variables. We applied unsupervised (PCA, Principal Component Analysis) and supervised (SIMCA, Soft Interclass Modeling Classification Analogy) methods. We assessed the classification responses through ROC (Receiver Operating Characteristics). As a result, the PCA indicated the presence of two groups of glasses in three main components. SIMCA verified the unsupervised classification, and the distances and interclass residues parameters were adequate with no outliers. The ROC analysis indicated a sensitivity of 0.793, a specificity of 0.815, and an efficiency of 0.804 for predictions. We concluded that multivariate analysis was successful in discriminating between the internal and external faces of automotive glasses.

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P3794MOODS: a novel risk score to identify patients with atrial fibrillation and sleep apnoea

European Heart Journal ◽

10.1093/eurheartj/ehz745.0639 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

K Kadhim ◽

A Elliott ◽

M Middeldorp ◽

J Hendriks ◽

C Gallagher ◽

...

Keyword(s):

Atrial Fibrillation ◽

Risk Score ◽

Clinical Characteristics ◽

Validation Cohort ◽

Multivariate Logistic Regression Analysis ◽

Positive Likelihood Ratio ◽

Resource Utilisation ◽

Operating Characteristics ◽

Derivation Cohort ◽

Sleep Studies

Abstract Background Sleep-disordered breathing (SDB) is an important risk factor for developing atrial fibrillation (AF), and treatment of concomitant SDB can improve AF rhythm outcomes. Diagnosis of SDB requires sleep studies which can pose a significant time and resource burden. We sought to develop a prediction score based on clinical characteristics that can help identify AF patients who require further assessment for SDB. Methods Prospectively-collected data for 442 consecutive patients treated for AF from 2009 to 2017 were analysed. All patients were considered candidates for rhythm-control and therefore referred for sleep studies. The diagnosis of SDB was confirmed using in-lab polysomnography and classified using the apnoea-hypopnoea-index (AHI), with cut-offs of ≥15/hr and ≥30/hr indicating moderate-to-severe and severe SDB respectively. Patients treated up to 2015 formed the derivation cohort (n=311) and the remainder (n=113) formed the validation cohort. Multivariate logistic regression analysis was used to identify clinical variables predictive of moderate-to-severe SDB. A risk score model was developed based on regression coefficients and tested using receiver-operating-characteristics analyses on the validation cohort. Results Overall, mean age was 60±11 years, mean body mass index (BMI) was 30±5 kg/m2 and 69% were men. The prevalence of moderate-to-severe SDB was 33.7%. There were no significant differences in baseline characteristics between the derivation and validation cohorts. Male gender (score=1), overweight (BMI: 25–29 kg/m2, score=2), obesity (BMI≥30 kg/m2, score=3), diabetes (score=1), and stroke (score=2) were significantly independently predictive of moderate-to-severe SDB and formulated the score. The score performed well to predict moderate-to-severe SDB with a C-statistic of 0.73 (95% CI: 0.67–0.79, P<0.001) in the derivation cohort, and 0.67 (95% CI: 0.57–0.77, P<0.001) in the validation cohort. As a rule-out test, a score of ≤3 had a negative predictive value of 77% for moderate-to-severe SDB (91% for severe SDB). A score of ≥4 had an intermediate positive likelihood ratio (PLR) of 2 for moderate-to-severe SDB (2.2 for severe SDB), while a score of ≥5 had a high PLR of 6.5 and 6.8 for moderate-to-severe SDB and severe SDB respectively. Sensitivity and specificity table Conclusion A novel risk score comprising clinical characteristics can identify patients with AF likely to benefit from further assessment for SDB. Application of this model may aid optimise resource utilisation and facilitate timely patient care.

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