A multivariate analysis of otological, surgical and patient-related factors in determining success in myringoplasty

Background and Aims. The insertion of the guidewires (GWs) into the pancreatic duct is technically difficult, and there is a risk of post-ERCP pancreatitis (PEP). The aim of this study was to evaluate the safety and efficacy of a small J-tipped guidewire for pancreatic duct endoscopic intervention. Methods. This single-site retrospective study was conducted to assess the procedural success rate and adverse events of endoscopic transpapillary interventions to the pancreatic duct in 114 cases using the small J-tipped GW and 180 cases using the angle-tipped GW. Results. The procedural success rate was significantly higher in the small J-tipped GW group compared with that in the angle-tipped GW group (76% versus 47%, P < 0.001). The procedural success-related factors were chronic pancreatitis (OR 0.43, 95% CI 0.22–0.82, P = 0.01), flexion angle of the pancreatic duct < 90° (OR 0.50, 95% CI 0.30–0.80, P = 0.01), and use of the small J-tipped GW (OR 4.63, 95% CI 2.61–8.20, P < 0.001). The rates of total post-ERCP pancreatitis were significantly lower in the small J-tipped GW group compared with that in the angle-tipped GW group (3.5% versus 12.2%, P = 0.01). Multivariate analysis of pancreatitis risk factors indicated that only the use of the small J-tipped GW was a factor in decreasing the risk of developing pancreatitis (OR 0.12, 95% CI 0.09–0.85, P = 0.02). Conclusions. Small J-tipped GWs increase the success rate of the pancreatic duct endoscopic intervention as well as a reduced risk of developing postoperative pancreatitis.

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Prognostic analysis of Chinese patients with metastasic renal cell cancer (mRCC) receiving sorafenib: A multicenter retrospective study.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e15582 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e15582-e15582 ◽

Cited By ~ 1

Author(s):

Fang Guo ◽

Xiaodong Xie ◽

Zhaozhe Liu ◽

Xishuang Song ◽

Qifu Zhang ◽

...

Keyword(s):

Multivariate Analysis ◽

Lung Metastasis ◽

Univariate Analysis ◽

Chinese Patients ◽

Related Factors ◽

Metastatic Lesions ◽

Long Term Study ◽

Previous Therapy ◽

Ecog Ps

e15582 Background: This study was to investigate long-term efficacy of sorafenib and survival-related factors in Chinese patients with mRCC. Methods: 406 consecutive patients enrolled in this study between Oct. 2006 and Oct. 2009 from 6 comprehensive cancer centres in China. All cases were diagnosed as mRCC histopathologically without exception. 400mg sorafenib was orally taken twice daily until PD, death or intolerable toxic reaction. The primary endpoint was OS. The secondary endpoints were PFS and survival-related factors such as gender, age, ECOG PS, previous therapy and primary metastatic lesions. Data was analyzed using the SPSS statistical software. OS and PFS curves were output using the Kaplan-Meier method. Clinical parameters were included on univariate and multivariate analysis to evaluate associations with OS and PFS by the log-rank test and Cox proportional hazard models, P<0.05 (two-sided) was considered statistically significant. Results: 131 patients were available for survival analysis, including 96 males and 35 females. The median age was 60 years old. The median follow-up periods were 16.9 months. The median OS was 16.1 months. 1-year, 2-year and 3-year survival rates were 64.9%, 35.9% and 5.3%, respectively. The median PFS was 10.5 months. Univariate analysis demonstrated that OS was significantly associated with ECOG PS, metastatic lesions and previous therapy, whereas PFS was merely associated with ECOG PS and previous therapy. Multivariate analysis suggested that ECOG PS and previous therapy were independent prognostic factors for OS(P=0.004, P=0.019) and PFS (P=0.000, P=0.003), metastatic lesions was merely independent prognostic factor for OS (P=0.003). In the subgroup of patients with visceral metastasis, patients with lung metastasis alone had better prognosis than those with liver metastasis or dimerous metastasis. Conclusions: This long-term study demonstrated that sorafenib had good effects on Chinese patients with mRCC, especially for patients with lung metastasis alone. ECOG PS, metastatic lesions and previous therapy could be important parameters for survival and need attention in future.

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Factors Influencing Complication Rates at Colonic Polypectomy: A Prospective Study from a Tertiary-Referral Center

Romanian Journal Of Internal Medicine ◽

10.1515/rjim-2015-0007 ◽

2015 ◽

Vol 53 (1) ◽

pp. 52-55

Author(s):

Th. Voiosu ◽

B. Busuioc ◽

A. Voiosu ◽

Andreea Bengus ◽

M. Rimbas ◽

...

Keyword(s):

Multivariate Analysis ◽

Standard Form ◽

Real Life ◽

Colon Resection ◽

Complication Rates ◽

Polyp Size ◽

Related Factors ◽

Tertiary Referral Center ◽

Low Volume ◽

The Impact

AbstractBackground and aims. Colon polypectomy decreases the incidence of colorectal cancer and related mortality. Several factors such as the size, location and type of polyp as well as endoscopist experience have been shown to correlate with the risk of ensuing procedure-related complications. This study aims to evaluate the impact of polyp and endoscopist-related factors on the rate of postpolypectomy complication in a real-life setting.Methods. During the study period all polypectomies performed in our unit were reported on a standard form that included data on polyp type (flat, sessile, pedunculated), size, location in the colon, resection method, endoscopist volume and procedure-related complications arising up to 30 days. The main outcome was the complication rate of polypectomies. The factors that associated with a higher risk of complications were assessed on univariate and multivariate analysis.Results. 244 polyp resections from 95 patients were included in the analysis. 199 polyps were resected by low-volume endoscopists (44.7%) and 135 polypectomies were performed by highvolume endoscopists (55.3%). On multivariate analysis only polyp size correlated with the risk of procedure-related complications.Conclusion. Polyp size is the most important risk factor for procedure-related complications. Both high and low-volume endoscopists have a low overall rate of serious complications.

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Abstract WP51: Preoperative Light Transmission Aggregometry Values Predict Thromboembolic Complications After Stent-Assisted Coil Embolization

Stroke ◽

10.1161/str.51.suppl_1.wp51 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Issei Kan ◽

Toshihiro Ishibashi ◽

Kenichi Sakuta ◽

Soichiro Fujimura ◽

Ichiro Yuki ◽

...

Keyword(s):

Multivariate Analysis ◽

Coil Embolization ◽

Roc Analysis ◽

Light Transmission ◽

Maximum Diameter ◽

Significant Variable ◽

Thromboembolic Complications ◽

Related Factors ◽

Stent Type ◽

Light Transmission Aggregometry

Background: Control of risks of thromboembolic complications (TEC) during stent assisted coil embolization (SACE) for unruptured intracranial aneurysm (UIA) is crucial for outcome. We evaluated retrospectively our cohort of SACE for UIA, analyzing the role of anatomical, clinical and stent type related factors to determine optimal presurgical values of light transmission aggregometry (LTA) for TEC prevention. Methods: From July 2015 to May 2018 we retrospectively analyzed 132 SACE treated UIA patients at our hospital. Aneurysm location and maximum diameter, preoperative LTA-value, ischemic and hemorrhagic complications, preoperative and discharge Modified Rankin scale (mRS) were collected. Aspirin 100 mg and clopidogrel 75 mg were started 7 days before operation, with “boost” therapy (additional 75mg clopidogrel in LTA-value >60) added after August 2016, addressing clopidogrel resistance. After multivariate analysis we developed our original combined parameter called TEC predictor (TEP). Receiver operating characteristic (ROC) analysis for TEP and each significant variable were performed. Results: TEC were confirmed in five (3.8%, 5/132) and hemorrhagic - in nine patients (6.8%, 9/132), with mRS deterioration post-operatively in five patients (5/132, 3.8%). By multivariate analysis, LTA-value and maximum diameter were chosen as significant variables, and included in TEP. ROC analysis of LTA-value showed sensitivity and specificity of 0.866 and 0.600 respectively (AUC=0.747) with cut-off point of 62. TEP permitted establishing optimal LTA-value according to the aneurysm maximum diameter to predict TEC. Neuroform-EZ, Enterprise, Neuroform-Atlas, and LVIS stents complications were 2.9%, 10.5%, 1.4%, and 14.3%, respectively. Conclusions: Preoperative LTA-value contributes to predicting TEC after SACE of UIA. TEP (relating LTA cutoff value to aneurysm size) provides improved antiplatelet therapy adjustment prior to SACE for TEC reduction.:

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Prognostic Indicators and Survival in Patients With Stage IIIB Inflammatory Breast Carcinoma After Dose-Intense Chemotherapy

Journal of Clinical Oncology ◽

10.1200/jco.2004.10.147 ◽

2004 ◽

Vol 22 (10) ◽

pp. 1839-1848 ◽

Cited By ~ 42

Author(s):

George Somlo ◽

Paul Frankel ◽

Warren Chow ◽

Lucille Leong ◽

Kim Margolin ◽

...

Keyword(s):

Multivariate Analysis ◽

Radiation Therapy ◽

Stage Iiib ◽

Prognostic Indicators ◽

Related Factors ◽

Free Survival ◽

Axillary Nodes ◽

Conventional Dose ◽

Single Versus

Purpose To improve treatment outcome for patients presenting with inflammatory breast cancer (IBC), we have sequentially developed and tested single and tandem dose-intense chemotherapy regimens (DICT). Tumor- and treatment-related factors were analyzed to generate a prognostic model. Patients and Methods Between May 1989 and April 2002, 120 patients received conventional-dose chemotherapy, surgery, and sequentially developed single- or tandem-cycle DICT. Disease- and treatment-specific features were subjected to univariate and multivariate analysis to correlate with outcome. Results At a median follow-up of 61 months (range, 21 to 161 months), estimated 5-year relapse-free survival (RFS) and overall survival (OS) were 44% (95% CI, 34% to 53%) and 64% (95% CI, 55% to 73%), respectively. In an age-adjusted multivariate analysis, RFS was better in patients with estrogen receptor (ER)/progesterone receptor (PR)–positive tumors (P = .002), for patients with fewer than four involved axillary nodes before DICT (P = .01), and in patients treated with radiation therapy (P = .001) and tandem DICT (P = .049). OS was improved in patients with ER/PR-positive tumors (P = .002), in those with fewer than four involved axillary nodes before DICT (P = .03), and in patients treated with radiation therapy (P = .002). Conclusion This retrospective analysis suggests that either single or tandem DICT can be administered safely and may benefit selected patients with stage IIIB IBC. Those with receptor-negative IBC and with four or more involved axillary nodes before DICT need improved neoadjuvant and postadjuvant intensification therapy. A prospective randomized trial of single versus tandem DICT would be required to confirm the potential benefit of tandem DICT in the setting of IBC.

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Perioperative outcomes following surgery for brain tumors: Objective assessment and risk factor evaluation

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.91927 ◽

2012 ◽

Vol 03 (01) ◽

pp. 28-35 ◽

Cited By ~ 13

Author(s):

Aliasgar V Moiyadi ◽

Prakash M Shetty

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Brain Tumors ◽

Univariate Analysis ◽

Tertiary Care ◽

Morbidity And Mortality ◽

Perioperative Outcomes ◽

Related Factors ◽

Important Indicator ◽

Systemic Complications

ABSTRACT Background: Perioperative outcomes following surgery for brain tumors are an important indicator of the safety as well as efficacy of surgical intervention. Perioperative morbidity not only has implications on direct patient care, but also serves as an indicator of the quality of care provided, and enables objective documentation, for comparision in various clinical trials. We document our experience at a tertiary care referral, a dedicated neuro-oncology center in India. Materials and Methods: One hundred and ninety-six patients undergoing various surgeries for intra-axial brain tumors were analyzed. Routine microsurgical techniques and uniform antibiotic policy were used. Navigation/ intraoperative electrophysiological monitoring was not available. The endpoints assessed included immediate postoperative neurological status, neurological outcome at discharge, regional complications, systemic complications, overall morbidity, and mortality. Various risk factors assessed included clinico-epidemiological factors, tumor-related factors, and surgery-related factors. Univariate and multivariate analysis were performed. Results: Median age was 38 years. 72% had tumors larger than 4 cm. Neurological morbidity, and regional and systemic complications occurred in 16.8, 17.3, and 10.7%, respectively. Overall, major morbidity occurred in 18% and perioperative mortality rate was 3.6%. Although a few of the known risk factors were found to be significant on univariate analysis, none achieved significance on multivariate analysis. Conclusions: Our patients were younger and had larger tumors than are generally reported. Despite the unavailability of advanced intraoperative aids we could achieve acceptable levels of morbidity and mortality. Objective recording of perioperative events is crucial to document outcomes after surgery for brain tumors.

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Factors associated with hospital admission in patients reaching the emergency department with COPD exacerbation

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2012.593 ◽

2012 ◽

Vol 7 ◽

Author(s):

Maria Teresa García-Sanz ◽

Carlos Pol-Balado ◽

Concepción Abellás ◽

Juan Carlos Cánive-Gómez ◽

Diana Antón-Sanmartin ◽

...

Keyword(s):

Emergency Department ◽

Multivariate Analysis ◽

Observational Study ◽

Hospital Admission ◽

Prospective Observational Study ◽

County Hospital ◽

Copd Exacerbation ◽

Related Factors ◽

Factors Associated ◽

Copd Exacerbations

Background: The aim of this study was to determine the frequency of COPD exacerbations in our Emergency Department, as well as the hospitalization-related factors. Methods: Prospective observational study conducted in the Emergency Department of Salnés County Hospital among patients admitted for COPD exacerbation. Admission predictors were determined by multivariate analysis. Results: There were 409 exacerbations in 239 patients (79% male, mean age 75). 57% of exacerbations required hospitalization. Hospitalization-related factors were impaired oxygenation (p<0.001), presence of neutrophilia (p<0.01) and prescription of antibiotics in the Emergency Department (p<0.05). Conclusions: COPD exacerbation accounts for over 1% of all visits to our Emergency Department. 57% of them required hospitalization. Impaired oxygenation, greater neutrophilia and prescription of antibiotics in the Emergency Department were associated with greater probability of admission.

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Organ/space infection is a common cause of high output stoma and outlet obstruction in diverting ileostomy

10.21203/rs.2.16505/v2 ◽

2020 ◽

Author(s):

Yutaro Hara ◽

Takuya Miura ◽

Yoshiyuki Sakamoto ◽

Hajime Morohashi ◽

Hayato Nagase ◽

...

Keyword(s):

Multivariate Analysis ◽

Univariate Analysis ◽

Outlet Obstruction ◽

Related Factor ◽

Diverting Ileostomy ◽

Related Factors ◽

Space Infection ◽

Wbc Count ◽

Organ Space Infection ◽

High Output

Abstract Aim: The objectives of this study are to identify causes of high-output stoma (HOS) and outlet obstruction (OO), which are major complications of diverting ileostomy. Methods: A retrospective analysis was performed in 103 patients who underwent colorectal surgery and diverting ileostomy between December 2015 and November 2018. Results: HOS was found in 32 patients (31.1%) and OO in 19 (18.4%). Organ/space surgical site infection (SSI), anastomotic leakage and OO were significant HOS-related factors in univariate analysis, and OO (odds ratio [OR] 3.39, p=0.034) was a independent HOS-related factor in multivariate analysis. Organ/space SSI and male were significant OO-related factors in univariate analysis, and organ/space SSI (OR 3.77, p=0.018) was a independent OO-related factor in multivariate analysis. The white blood cell (WBC) count on postoperative day (POD) 3 was significantly higher in the HOS group compared to the non-HOS group (9765 vs. 8130 /mL, p<0.05), and the WBC count (9400 vs. 7475 /mL, p<0.05) and C-reactive protein level (6.01 vs. 2.92 mg/L, p<0.05) on POD 6 were significantly higher in the OO group compared to the non-OO group.Conclusion: Organ/space infection is involved in the common pathology of HOS and OO. Decreased intestinal absorption due to intestinal edema caused by organ/space SSI and relative stenosis at the abdominal wall-penetrating site are major causes of HOS and OO.

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Prognostic clinical factors in pretreated colorectal cancer patients receiving regorafenib: Implications for clinical management.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.591 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 591-591

Author(s):

Michela Del Prete ◽

Riccardo Giampieri ◽

Fotios Loupakis ◽

Tiziana Prochilo ◽

Lisa Salvatore ◽

...

Keyword(s):

Colorectal Cancer ◽

Multivariate Analysis ◽

Cancer Patients ◽

Lymphocyte Count ◽

Progression Free Survival ◽

Serum Levels ◽

Clinical Factors ◽

Roc Curve Analysis ◽

Related Factors ◽

Colorectal Cancer Patients

591 Background: Most of the patients receiving regorafenib do not seem to benefit from this treatment approach and are therefore exposed to unnecessary toxicity. Angiogenesis and inflammation-related factors may have a relevant role in modulating the activity of anti-angiogenetic drugs such as regorafenib. In our study, we investigated LDH serum levels, platelet, neutrophil, and lymphocyte counts, and neutrophil-to-lymphocyte ratio (NLR) in predicting clinical outcomes for colorectal cancer patients receiving regorafenib. The final aim was to individuate an easy to use and reliable selection tool for these patients in the clinical practice. Methods: We collected LDH serum levels, neutrophil, lymphocyte, and platelet counts within one month before the start of regorafenib in 208 pretreated metastatic colorectal cancer patients. Cut-off values were calculated by ROC curve analysis. Survival analysis was performed by Kaplan-Meier method, and multivariate analysis by Cox method. Results: At multivariate analysis: high platelet count (p=0.0439), low lymphocyte count (p=0.0013), and high NLR (p=0.0237) were related to worse overall survival (OS); high neutrophil count and high NLR (p=0.0058) were related to worse progression free survival (PFS). Among 52 (25%) patients who were negative for all risk factors, a significant correlation was found with improved OS and PFS if compared with the group of patients with at least one risk factor. In particular, median OS was respectively 15.9 vs. 3.1 months (HR: 3.81, 95% CI: 2.32-4.82, p<0.0001) whereas median PFS was 5.9 vs. 2.1 months (HR: 2.62, 95% CI: 2.06-3.86, p<0.0001). Conclusions: We can speculate that colorectal cancer patients showing high neutrophil, high platelet, low lymphocyte count or high NLR may not be optimal candidates for regorafenib treatment. After confirmation in further prospective series, these clinical factors could play a role in the treatment strategy process.

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A Clinical Prediction Tool for Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae Urinary Tract Infection

10.21203/rs.3.rs-517907/v1 ◽

2021 ◽

Author(s):

Hui Liu ◽

Suishan Qiu ◽

Minghao Chen ◽

Jun lyu ◽

Guangchao Yu ◽

...

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Urinary Tract ◽

Clinical Decision Making ◽

Susceptibility Testing ◽

Empirical Treatment ◽

Related Factors ◽

Data Set ◽

Extended Spectrum ◽

Tract Infections

Abstract Background To explore the risk factors of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) infection through urine samples of hospitalized patients and establish a predictive model to improve treatment outcomes.MethodsThis retrospective study included all patients with an Enterobacteriaceae-positive urine sample at the first affiliated hospital of Jinan university from January 2018 to December 2019. Antimicrobial susceptibility patterns of ESBL-PE were analyzed, and multivariate analysis of related factors was performed. From these, a nomogram was established to predict the possibility of ESBL-PE infection. Simultaneously, susceptibility testing of a broad array of carbapenem antibiotics was performed on ESBL-PE cultures to explore possible alternative treatment options.ResultsOf the total 874 patients with urinary tract infections (UTIs), 272 (31.1%) were ESBL-PE positive. In the predictive analysis, five variables were identified as independent risk factors for ESBL-PE infection: male gender (OR=1.607, 95% CI 1.066-2.416), older age (OR=4.100, 95% CI 1.678-12.343), a hospital stay in preceding 3 months (OR=1.872, 95% CI 1.141-3.067), invasive urological procedure (OR=1.810, 95% CI 1.197-2.729), and antibiotic use within the previous 3 months (OR 0.546, 95% CI 0.314-0.948). In multivariate analysis, the data set was divided into a training set of 611 patients and a validation set of 263 patients The model developed to predict ESBL-PE infection was effective, with the AuROC of 0.650 (95% CI 0.577-0.725). Among the antibiotics tested, several showed very high effectiveness against ESBL-PE: amikacin (85.7%), carbapenems (83.8%), tigecycline (97.1%) and polymyxin (98.2%). ConclusionsThe nomogram is useful for estimating a bacteremic patient’s likelihood of infection with ESBL-PE. It could improve clinical decision making and enable more efficient empirical treatment. Empirical treatment may be informed by the results of the antibiotic susceptibility testing.

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