A Composite Ranking of Risk Factors for COVID-19 Time-To-Event Data from a Turkish Cohort

Having a complete and reliable list of risk factors from routine laboratory blood test for COVID-19 disease severity and mortality is important for patient care and hospital management. It is common to use meta-analysis to combine analysis results from different studies to make it more reproducible. In this paper, we propose to run multiple analyses on the same set of data to produce a more robust list of risk factors. With our time-to-event survival data, the standard survival analysis were extended in three directions. The first is to extend from tests and corresponding p-values to machine learning and their prediction performance. The second is to extend from single-variable to multiple-variable analysis. The third is to expand from analyzing time-to-decease data with death as the event of interest to analyzing time-to-hospital-release data to treat early recover as a meaningful event as well. Our extension of the type of analyses leads to ten ranking lists. We conclude that 20 out of 30 factors are deemed to be reliably associated to faster-death or faster-recovery. Considering correlation among factors and evidenced by stepwise variable selection in random survival forest, 10~15 factors seem to be able to achieve the optimal prognosis performance. Our final list of risk factors contains calcium, white blood cell and neutrophils count, urea and creatine, d-dimer, red cell distribution widths, age, ferritin, glucose, lactate dehydrogenase, lymphocyte, basophils, anemia related factors (hemoglobin, hematocrit, mean corpuscular hemoglobin concentration), sodium, potassium, eosinophils, and aspartate aminotransferase.

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Glucose- and glycaemic factor-lowering effects of probiotics on diabetes: a meta-analysis of randomised placebo-controlled trials

British Journal Of Nutrition ◽

10.1017/s0007114516000076 ◽

2016 ◽

Vol 115 (7) ◽

pp. 1167-1177 ◽

Cited By ~ 58

Author(s):

Jing Sun ◽

Nicholas J. Buys

Keyword(s):

Risk Factors ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Mean Difference ◽

Controlled Trials ◽

Model Assessment ◽

Related Factors ◽

Evidence Database ◽

Associated Risk Factors

AbstractThis meta-analysis examined the effect of probiotics on glucose and glycaemic factors in diabetes and its associated risk factors. All randomised-controlled trials published in English in multiple databases from January 2000 to June 2015 were systematically searched. Only studies that addressed glucose- and glycaemic-related factors as outcome variables were included. The main outcomes of interest in trials were mean changes in glucose, HbA1c, insulin and homoeostasis model assessment-estimated insulin resistance (HOMA-IR). Using the Physiotherapy Evidence Database (PEDro) scale to assess the quality of studies, a total of eleven studies with 614 subjects were included. The pooled mean difference and effect size with a 95 % CI were extracted using a random-effect model. It was found that there are statistically significant pooled mean differences between the probiotics and the placebo-controlled groups on the reduction of glucose (−0·52 mmol/l, 95 % CI −0·92, −0·11 mmol/l; P=0·01) and HbA1c (−0·32 %, 95 % CI −0·57, −0·07 %; P=0·01). There was no statistically significant pooled mean difference between the probiotics and the placebo-controlled groups on the reduction of insulin (−0·48 µIU/ml, 95 % CI −1·34, 0·38 µIU/ml; P=0·27) and HOMA-IR (pooled effect of –0·44, 95 % CI −1·57, 0·70; P=0·45). Meta-regression analysis identified that probiotics had significant effects on reduction of glucose, HbA1c, insulin and HOMA-IR in participants with diabetes, but not in participants with other risk factors. The present meta-analysis suggested that probiotics may be used as an important dietary supplement in reducing the glucose metabolic factors associated with diabetes.

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Assessing the Cognitive Contributors to Violence

Social Science Protocols ◽

10.7565/ssp.v4.5213 ◽

2021 ◽

Vol 4 ◽

pp. 1-16

Author(s):

Sarah Janes ◽

Suzanne O'Rourke ◽

Matthias Schwannauer

Keyword(s):

Risk Factors ◽

Delphi Study ◽

Meta Analysis ◽

Community Setting ◽

Brain Regions ◽

Self Report ◽

Violence Risk ◽

Neuropsychological Battery ◽

Violent Behaviour ◽

Related Factors

In recent years there has been considerable progress in the development, validation and use of violence risk assessments (VRA). Their predictive ability however remains modest and, due to the repetitive use of certain risk factors, collectively, they appear to have hit an allegorical ‘glass ceiling’. Further limiting VRA is the use of self-report, collateral information, and file reviews to assess clinical and risk-related factors, rather than validated performance measures. Correspondingly, converging findings from neuropsychology and neurobiology have underlined brain regions associated with violent behaviour and subsequent research has further demonstrated this through observational studies. Thus, it is hypothesised that VRA may benefit from the integration of behaviourally measured neuropsychological risk factors. The current study is a feasibility and pilot study with a prospective, observational approach and a retrospective component. It aims to investigate the feasibility of using a neuropsychological battery to aid in the identification of violence risk in an inpatient and community setting, and to pilot a neuropsychological battery of measures examining risk factors for violence identified through a meta-analysis and an international Delphi study. The primary outcomes of interest are violent incidents or offences recorded during the 6-month follow-up periods.

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Which Kidney Transplant Recipients Can Benefit from the Initial Tacrolimus Dose Reduction?

BioMed Research International ◽

10.1155/2018/4573452 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Kinga Krzyżowska ◽

Aureliusz Kolonko ◽

Piotr Giza ◽

Jerzy Chudek ◽

Andrzej Więcek

Keyword(s):

Risk Factors ◽

Dose Reduction ◽

Kidney Transplant ◽

Multiple Logistic Regression Analysis ◽

Hemoglobin Concentration ◽

Blood Levels ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Related Factors ◽

Tacrolimus Dose

Background. Observational data suggest that the fixed initial recommended tacrolimus (Tc) dosing (0.2 mg/kg/day) results in supratherapeutic drug levels in some patients during the early posttransplant period. The aim of the study was to analyze a wide panel of patient-related factors and their interactions which increase the risk for first Tc blood level > 15 ng/ml. Materials and Methods. We performed a retrospective analysis of 488 consecutive adult kidney transplant recipients who were initially treated with triple immunosuppressive regimen containing tacrolimus twice daily. The analysis included the first assessment of Tc trough blood levels and several demographic, anthropometric, laboratory, and comedication data. Results. The multiple logistic regression analysis showed that age > 55 years, BMI > 24.6 kg/m2, blood hemoglobin concentration > 9.5 g/dl, and the presence of anti-HCV antibodies independently increased the risk for first Tc level > 15 ng/ml. The relative risk (RR) for first tacrolimus level > 15 ng/ml was 1.88 (95% CI 1.35–2.64, p<0.001) for patients with one risk factor and 2.81 (2.02–3.89, p<0.001) for patients with two risk factors. Conclusions. Initial tacrolimus dose reduction should be considered in older, overweight, or obese kidney transplant recipients and in subjects with anti-HCV antibodies. Moreover, dose reduction of tacrolimus is especially important in patients with coexisting multiple risk factors.

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Risk factors for new-onset atrial fibrillation in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis

PeerJ ◽

10.7717/peerj.10376 ◽

2020 ◽

Vol 8 ◽

pp. e10376

Author(s):

Qiangru Huang ◽

Huaiyu Xiong ◽

Tiankui Shuai ◽

Meng Zhang ◽

Chuchu Zhang ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Meta Analysis ◽

Chronic Obstructive ◽

Related Factors ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Potential Risk Factors ◽

Onset Atrial Fibrillation ◽

New Onset

Background New-onset atrial fibrillation (AF) in patients with chronic obstructive pulmonary disease (COPD) is associated with an accelerated decline in lung function, and a significant increase in mortality rate. A deeper understanding of the risk factors for new-onset AF during COPD will provide insights into the relationship between COPD and AF and guide clinical practice. This systematic review and meta-analysis is designed to identify risk factors for new-onset AF in patients with COPD, and to formulate recommendations for preventing AF in COPD patients that will assist clinical decision making. Methods PubMed, Embase, Web of Science and Cochrane Library databases were searched for studies, which reported the results of potential risk factors for new-onset AF in COPD patients. Results Twenty studies involving 8,072,043 participants were included. Fifty factors were examined as potential risk factors for new-onset AF during COPD. Risk factors were grouped according to demographics, comorbid conditions, and COPD- and cardiovascular-related factors. In quantitative analysis, cardiovascular- and demographic-related factors with a greater than 50% increase in the odds of new-onset AF included age (over 65 years and over 75 years), acute care encounter, coronary artery disease, heart failure and congestive heart failure. Only one factor is related to the reduction of odds by more than 33.3%, which is black race (vs white). In qualitative analysis, the comparison of the risk factors was conducted between COPD-associated AF and non-COPD-associated AF. Cardiovascular-related factors for non-COPD-associated AF were also considered as risk factors for new-onset AF during COPD; however, the influence tended to be stronger during COPD. In addition, comorbid factors identified in non-COPD-associated AF were not associated with an increased risk of AF during COPD. Conclusions New-onset AF in COPD has significant demographic characteristics. Older age (over 65 years), males and white race are at higher risk of developing AF. COPD patients with a history of cardiovascular disease should be carefully monitored for new-onset of AF, and appropriate preventive measures should be implemented. Even patients with mild COPD are at high risk of new-onset AF. This study shows that risk factors for new-onset AF during COPD are mainly those associated with the cardiovascular-related event and are not synonymous with comorbid factors for non-COPD-associated AF. The pathogenesis of COPD-associated AF may be predominantly related to the cardiac dysfunction caused by the chronic duration of COPD, which increases the risk of cardiovascular-related factors and further increases the risk of AF during COPD. PROSPERO registration number CRD42019137758.

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Impact of surgery type on survival in breast cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e12072 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e12072-e12072

Author(s):

Phuong Tuyet Ngo ◽

Shruti Bhandari ◽

Drew Murray ◽

Sarah Mudra ◽

Xiaoyong Wu ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

African American ◽

Survival Data ◽

Prophylactic Mastectomy ◽

Private Insurance ◽

Tumor Biology ◽

Breast Cancer Patients ◽

Related Factors ◽

The Impact

e12072 Background: Breast cancer is the most common malignancy affecting women, and treatment is multidisciplinary. Both patient and tumor related factors impact surgical decision making. Recently, rates of mastectomy, prophylactic mastectomy and reconstruction have increased. The impact of this on modern survival, the relationship to patient and tumor related factors is not well described. Methods: The National Cancer Database identified 1,042,057 patients who underwent surgery with lumpectomy or mastectomy with or without reconstruction for stages I-III breast cancer from 2004-2014. Variables collected included gender, race, age, stage, facility type, insurance status, and overall survival. Data was analyzed using univariable and multivariable logistic and Cox proportional hazards regression models. Results: Of all surgeries, 61.2% were lumpectomy (n = 638,088), 27.9% were mastectomy without reconstruction (n = 290,463) and 10.9% were mastectomy with reconstruction (n = 113,506). African American patients were more likely to get mastectomy without reconstruction than lumpectomy (OR 1.05; 95% CI 1.03-1.06, p < 0.001) but less likely to get reconstruction than lumpectomy (OR 0.73; 95% CI 0.71-0.75). Patients 50-65 years were less likely to get mastectomy either with and without reconstruction compared to lumpectomy (OR 0.45; 95% CI 0.44-0.46; OR 0.87; 95% CI 0.86-0.88, p < 0.001, respectively). Reconstruction was more likely in patients with private insurance compared to those with Medicare (OR 1.46; 95% CI 1.43-1.50, p < 0.001) and was less likely to occur at a community center compared to an academic facility (OR 0.48; 95% CI 0.47-0.49, p < 0.001). Mastectomy without reconstruction also had a higher likelihood of death when compared to lumpectomy patients (HR 1.28; 95% CI 1.26-1.29, p < 0.00). Conclusions: The majority of women in this large dataset had breast conserving surgery. Of those patients who underwent mastectomy, only a minority had reconstruction. Age > 50 years and treatment at a non-academic facility were associated with less reconstruction along with established risk factors for worse outcome including African American race and Medicaid/Uninsured. Despite adjusting for these risk factors, mastectomy without reconstruction was still associated with a lower survival. Further analysis including tumor biology is needed to better understand the impact of these findings.

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Critical Review on Suicide Among Nurses

Crisis ◽

10.1027/0227-5910/a000305 ◽

2015 ◽

Vol 36 (2) ◽

pp. 91-101 ◽

Cited By ~ 17

Author(s):

Marie Alderson ◽

Xavier Parent-Rocheleau ◽

Brian Mishara

Keyword(s):

Risk Factors ◽

Literature Review ◽

High Stress ◽

Related Factors ◽

Work Settings ◽

Work Related ◽

High Prevalence ◽

Full Text Review ◽

The Subject ◽

Psychiatric Problems

Background: Research shows that there is a high prevalence of suicide among nurses. Despite this, it has been 15 years since the last literature review on the subject was published. Aim: The aim of this article is to review the knowledge currently available on the risk of suicide among nurses and on contributory risk factors. Method: A search was conducted in electronic databases using keywords related to prevalence and risk factors of suicide among nurses. The abstracts were analyzed by reviewers according to selection criteria. Selected articles were submitted to a full-text review and their key elements were summarized. Results: Only nine articles were eligible for inclusion in this review. The results of this literature review highlight both the troubling high prevalence of suicide among nurses as well as the persistent lack of studies that examine this issue. Conclusion: Considering that the effects of several factors related to nurses' work and work settings are associated with high stress, distress, or psychiatric problems, we highlight the relevance of investigating work-related factors associated with nurses' risk of suicide. Several avenues for future studies are discussed as well as possible research methods.

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