Prognostic significance of international normalised ratio and prothrombin time in Chinese acute ischaemic stroke patients

BackgroundWe investigated the association between international normalised ratio (INR) and prothrombin time (PT) levels on hospital admission and in-hospital outcomes in acute ischaemic stroke (AIS) patients.MethodsA total of 3175 AIS patients enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city were included. We divided patients into four groups according to their level of admission INR: (<0.92), Q2 (0.92–0.98), Q3 (0.98–1.04) and Q4 (≥1.04) and PT. Logistic regression models were used to estimate the effect of INR and PT on death or major disability (modified Rankin Scale score (mRS)>3), death and major disability (mRS scores 4–5) separately on discharge in AIS patients.ResultsHaving an INR level in the highest quartile (Q4) was associated with an increased risk of death or major disability (OR 1.69; 95% CI 1.23 to 2.31; P-trend=0.001), death (OR, 2.64; 95% CI 1.12 to 6.19; P-trend=0.002) and major disability on discharge (OR, 1.56; 95% CI 1.13 to 2.15; P-trend=0.008) in comparison to Q1 after adjusting for potential covariates. Moreover, in multivariable logistic regression models, having a PT level in the highest quartile also significantly increased the risk of death (OR, 2.38; 95% CI 1.06 to 5.32; P-trend=0.006) but not death or major disability (P-trend=0.240), major disability (P-trend=0.606) on discharge.ConclusionsHigh INR at admission was independently associated with death or major disability, death and major disability at hospital discharge in AIS patients and increased PT was also associated with death at hospital discharge.

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Does Flipping the Tubercle for Improved Cartilage Repair Exposure Increase the Risk for Arthrofibrosis?

Cartilage ◽

10.1177/1947603520968209 ◽

2020 ◽

pp. 194760352096820

Author(s):

Gergo Merkely ◽

Jakob Ackermann ◽

Emily Sheehy ◽

Andreas H. Gomoll

Keyword(s):

Logistic Regression ◽

Cartilage Repair ◽

Regression Models ◽

Case Control Study ◽

Level Of Evidence ◽

Logistic Regression Models ◽

Increased Risk ◽

Repair Procedure ◽

Control Study

Objective We sought to determine whether rates of postoperative arthrofibrosis following tibial tuberosity osteotomy (TTO) with complete mobilization of the fragment (TTO-HD) are comparable to TTOs where the hinge remained intact (TTO-HI). Design Patients who underwent TTO with concomitant cartilage repair procedure between January 2007 and May 2017, with at least 2 years of follow-up were included in this study. Postoperative reinterventions following TTO-HD and TTO-HI were assessed and multivariant logistic regression models were used to identify whether postoperative reinterventions can be attributed to either technique when controlled for defect size or defect number. Results A total of 127 patients (TTO-HD, n = 80; TTO-HI, n = 47) were included in this study. Significantly more patients in the TTO-HD group (31.2%) developed postoperative arthrofibrosis compared with TTO-HI (6.4%; P < 0.05). Multivariant logistic regression revealed that TTO-HD is an independent risk factor for predicting postoperative arthrofibrosis (OR 6.5, CI = 1.7-24.2, P < 0.05). Conclusion Patients who underwent TTO with distal hinge detachment and a proximally flipped tubercle for better exposure during concomitant cartilage repair were at a significantly higher risk of postoperative arthrofibrosis than patients with similar size and number of defects treated without mobilization of the tubercle. While certain procedures can benefit from larger exposure, surgeons should be aware of the increased risk of postoperative arthrofibrosis. Level of Evidence Level III, case-control study.

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Gastrointestinal bleeding during acute ischaemic stroke hospitalisation increases the risk of stroke recurrence

Stroke and Vascular Neurology ◽

10.1136/svn-2019-000314 ◽

2020 ◽

Vol 5 (2) ◽

pp. 116-120

Author(s):

Wanliang Du ◽

Xingquan Zhao ◽

Yilong Wang ◽

Yuesong Pan ◽

Gaifen Liu ◽

...

Keyword(s):

Ischaemic Stroke ◽

Acute Ischaemic Stroke ◽

Patient Characteristics ◽

Recurrence Risk ◽

Stroke Recurrence ◽

Gi Bleeding ◽

Stroke Registry ◽

Risk Of Death ◽

Increased Risk ◽

Death And Loss

ObjectiveGastrointestinal (GI) bleeding in patients who had a stroke is strongly associated with a higher risk of death and loss of independence. However, it is unknown whether GI bleeding increases risk for recurrence of stroke. In this study, we assess the potential relationship between GI bleeding and stroke recurrence in patients within 12 months of an acute ischaemic stroke (AIS), using the China National Stroke Registry (CNSR).MethodsThis study included 22 216 patients who had an ischaemic stroke included in the CNSR from 2007 to 2008. We analysed baseline patient characteristics, GI bleeding and outcomes of patients who had an AIS, specifically stroke recurrence at 3, 6 and 12 months. We used multivariable logistic regression to evaluate a possible association between GI bleeding and stroke recurrence.ResultsOf the 12 415 patients included in our study, 12.3%, 15.5% and 17.7% had a stroke recurrence at 3, 6 and 12 months, respectively. GI bleeding was an independent stroke recurrence risk factor in patients after ischaemic stroke at 3 months (adjusted OR 1.481, 95% CI 1.118 to 1.962), 6 months (adjusted OR 1.448, 95% CI 1.106 to 1.896) and 12 months (adjusted OR 1.350; 95% CI 1.034 to 1.763).ConclusionGI bleeding was associated with the increased risk of stroke recurrence after an AIS.

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Prevalence and population structure of Staphylococcus aureus nasal carriage in healthcare workers in a general population. The Tromsø Staph and Skin Study

Epidemiology and Infection ◽

10.1017/s0950268812000465 ◽

2012 ◽

Vol 141 (1) ◽

pp. 143-152 ◽

Cited By ~ 28

Author(s):

K. OLSEN ◽

M. SANGVIK ◽

G. S. SIMONSEN ◽

J. U. E. SOLLID ◽

A. SUNDSFJORD ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Logistic Regression ◽

Population Structure ◽

Regression Models ◽

Healthcare Workers ◽

Nasal Carriage ◽

Population Based ◽

Family Status ◽

Logistic Regression Models ◽

Increased Risk

SUMMARYHealthcare workers (HCWs) may be a reservoir for Staphylococcus aureus transmission to patients. We examined whether HCW status is associated with S. aureus nasal carriage and population structure (spa types) in 1302 women (334 HCWs) and 977 men (71 HCWs) aged 30–69 years participating in the population-based Tromsø Study in 2007–2008. Multivariable logistic regression models were used. While no methicillin-resistant S. aureus (MRSA) was isolated, overall, 26·2% of HCWs and 26·0% of non-HCWs were S. aureus nasal carriers. For women overall and women residing with children, the odds ratios for nasal carriage were 1·54 [95% confidence interval (CI) 1·09–2·19] and 1·86 (95% CI 1·14–3·04), respectively, in HCWs compared to non-HCWs. Moreover, HCWs vs. non-HCWs had a 2·17 and 3·16 times higher risk of spa types t012 and t015, respectively. This supports the view that HCWs have an increased risk of S. aureus nasal carriage depending on gender, family status and spa type.

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In-Hospital Mortality and Trends Associated with Splenectomy in Patients with Immune-Mediated Thrombocytopenia (ITP).

Blood ◽

10.1182/blood.v114.22.1398.1398 ◽

2009 ◽

Vol 114 (22) ◽

pp. 1398-1398

Author(s):

Samantha M. Jaglowski ◽

John C. Byrd ◽

Jeffrey A. Jones

Keyword(s):

Logistic Regression ◽

Hospital Mortality ◽

Mortality Risk ◽

Medical Management ◽

Regression Models ◽

Multivariate Logistic Regression ◽

Logistic Regression Models ◽

Risk Of Death ◽

Teaching Status ◽

Observation Period

Abstract Abstract 1398 Poster Board I-420 Background: Splenectomy remains a standard treatment for ITP patients not responding to medical management, but anecdotal reports suggest that use of the procedure is in decline. We studied patterns of use and outcome of splenectomy performed for ITP at the population level. Methods: Using data from the Nationwide Inpatient Sample and ICD-9 diagnosis and procedure codes, we identified 39,543 splenectomies among hospital admissions including a diagnosis of ITP (ICD-9 287.3) from 1993-2005. Admissions were characterized by patient and hospital facility characteristics. Laparascopic procedures were identified by published procedure coding algorithms. Factors influencing in-hospital mortality for 2005 were further evaluated using multivariate logistic regression models. Results: Annual estimates for incidence of splenectomy are displayed in Figure 1. Between 1993 and 2005, there was a decrease in the total number of splenectomies performed for ITP, with the most significant drop occurring from 1997 to 2000, concurrent with the FDA approval of rituximab. Over the same period, there has been an increase in the proportion of splenectomies performed laparoscopically from 3.4% to 18.6%. Patient gender, age, presence of comorbid malignancy, and Charlson score were not significantly associated with type of splenectomy procedure. Among facility factors, only hospital teaching status was a statistically significant predictor of laparoscopic splenectomy use, early but not later in the observation period. On an annual basis, in-hospital mortality did not vary significantly over the observation period, with risks ranging from 1.5% (95% CI 0.83-2.86%) in 1993 to 4% (95% CI 2.8%-5.7%) in 1997. Annual mortality risk between open and laparoscopic procedures likewise did not significantly differ. However, over the total 13-year observation period there was a >60% increased risk of death with an open versus laparoscopic procedure (OR 1.669, p<0.0001). In 2005, 2869 splenectomy procedures were performed. Multivariate logistic regression models for in-hospital mortality that year found that presence of a malignancy (OR 9.65, p=0.003) significantly increased mortality risk. Charlson comorbidity approached statistical significance (0 v. ≥1, OR 6.83, p=0.087). Hospital bed-size (OR 0.87, p=0.73), location (rural v. urban, OR 3.80, p=0.127), and teaching status (OR 0.39, p=0.203) were not significantly associated with outcome. Conclusions: While the overall mortality risk from splenectomy in ITP is low, it is influenced by the presence of malignancy and other comorbid conditions. Further studies designed to evaluate newer medical management strategies (e.g. rituximab, thrombopoeitin mimetics, etc.) versus surgical intervention in these higher-risk populations are warranted. Disclosures: No relevant conflicts of interest to declare.

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Severity of COVID-19 and survival in patients with rheumatic and inflammatory diseases: data from the French RMD COVID-19 cohort of 694 patients

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-218310 ◽

2020 ◽

pp. annrheumdis-2020-218310

Author(s):

Keyword(s):

Logistic Regression ◽

Regression Models ◽

Musculoskeletal Diseases ◽

Severe Disease ◽

Forward Selection ◽

Logistic Regression Models ◽

Risk Of Death ◽

Hospitalised Patients ◽

Epidemiological Characteristics ◽

The Impact

ObjectivesThere is little known about the impact of SARS-CoV-2 on patients with inflammatory rheumatic and musculoskeletal diseases (iRMD). We examined epidemiological characteristics associated with severe disease, then with death. We also compared mortality between patients hospitalised for COVID-19 with and without iRMD.MethodsIndividuals with suspected iRMD-COVID-19 were included in this French cohort. Logistic regression models adjusted for age and sex were used to estimate adjusted ORs and 95% CIs of severe COVID-19. The most significant clinically relevant factors were analysed by multivariable penalised logistic regression models, using a forward selection method. The death rate of hospitalised patients with iRMD-COVID-19 (moderate–severe) was compared with a subset of patients with non-iRMD-COVID-19 from a French hospital matched for age, sex, and comorbidities.ResultsOf 694 adults, 438 (63%) developed mild (not hospitalised), 169 (24%) moderate (hospitalised out of the intensive care unit (ICU) and 87 (13%) severe (patients in ICU/deceased) disease. In multivariable imputed analyses, the variables associated with severe infection were age (OR=1.08, 95% CI: 1.05–1.10), female gender (OR=0.45, 95% CI: 0.25–0.80), body mass index (OR=1.07, 95% CI: 1.02–1.12), hypertension (OR=1.86, 95% CI: 1.01–3.42), and use of corticosteroids (OR=1.97, 95% CI: 1.09–3.54), mycophenolate mofetil (OR=6.6, 95% CI: 1.47–29.62) and rituximab (OR=4.21, 95% CI: 1.61–10.98). Fifty-eight patients died (8% (total) and 23% (hospitalised)). Compared with 175 matched hospitalised patients with non-iRMD-COVID-19, the OR of mortality associated with hospitalised patients with iRMD-COVID-19 was 1.45 (95% CI: 0.87–2.42) (n=175 each group).ConclusionsIn the French RMD COVID-19 cohort, as already identified in the general population, older age, male gender, obesity, and hypertension were found to be associated with severe COVID-19. Patients with iRMD on corticosteroids, but not methotrexate, or tumour necrosis factor alpha and interleukin-6 inhibitors, should be considered as more likely to develop severe COVID-19. Unlike common comorbidities such as obesity, and cardiovascular or lung diseases, the risk of death is not significantly increased in patients with iRMD.Trial registration numberClinicalTrials.gov Registry (NCT04353609).

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Plasmatic Extracellular Vesicles in Acute Graft-Versus-Host Disease after Haplo-Identical Allografting with Post-Transplant Cyclophosphamide

Blood ◽

10.1182/blood-2019-126521 ◽

2019 ◽

Vol 134 (Supplement_1) ◽

pp. 598-598

Author(s):

Giuseppe Lia ◽

Clara Di Vito ◽

Marta Tapparo ◽

Stefania Bruno ◽

Elisa Zaghi ◽

...

Keyword(s):

Logistic Regression ◽

Extracellular Vesicles ◽

Graft Versus Host Disease ◽

Research Funding ◽

Regression Models ◽

Logistic Regression Models ◽

Graft Versus Host ◽

Increased Risk ◽

Acute Graft

INTRODUCTION: Acute Graft-versus-Host-Disease (aGVHD) is a frequent complication where the endothelium may play a pivotal role. We recently investigated the potential role of extracellular vesicles (EVs) as novel biomarkers of aGVHD (Lia G. et al. Leukemia 2018). In this study we further investigated the correlation of plasma EVs and their content in miRNAs with the risk of developing aGVHD in the setting of post-transplant cyclophosphamide (PTCY) haploidentical-stem cell transplantation (Haplo-SCT). METHODS: Thirty-two patients who underwent a Haplo-SCT were included. Plasma samples were collected from peripheral blood at given time-points (pre-transplant, on day 0, 3, 7, 14, 21, 28, 35, 45, 60, 75 and 90 after transplant). EVs were extracted by a protamine-based precipitation method and were characterized by Nano-tracking Particle Analysis (Nanosight). EVs were then analyzed by flow-cytometry (Guava EasyCyte Flow Cytometer) with a panel of 14 antibodies (CD44, CD138, CD146, KRT18, CD120a, CD8, CD30, CD106, CD25, CD26, CD31, CD144, CD86, and CD140a). MiRNAs were extracted from EVs by miRNeasy Mini Kit (Qiagen) and retrotranscribed by miScript II RT Kit (Qiagen). Three miRNAs (miR100, miR194, miR155) were studied and quantified by qRT-PCR using the miScript SYBR Green PCR Kit (Qiagen). Concomitant plasma concentrations of human Tumor Necrosis Factor Receptor I (TNFR1) and human ST2 were also evaluated using a commercially available sandwich enzyme-linked immunosorbent assay (DualSET® ELISA R&D Systems). The risk of aGVHD was evaluated by logistic regression models and Odds Ratios (ORs) were estimated as absolute levels and as proportional changes compared with pre-transplant baseline levels of each marker. Moreover, among biomarkers significantly associated with a higher risk of aGVHD, a multivariable logistic regression model using Akaike's information criteria (AIC) was estimated to define a biomarker combination. Ors were reported for 1-unit increase of standardized variables. RESULTS: AGVHD (grade II-IV) was observed in 7/32 patients (22%) at a median of 41 (range 33-90) days after transplant. Logistic regression models showed that CD146 fluorescence was associated with a significantly increased risk of acute GVHD (OR 2.93 p<0.001) as well as expression changes in miR100, miR155 and miR194 (OR 3.90 p<0.001; OR 1.84 p=0.008; OR 2.68 p<0.001, respectively). Concentrations of plasmatic hTNFR1 and ST2 were also confirmed to be associated with increased risk of aGVHD (OR 1.47 p=0.04; OR 1.55 p=0.05, respectively) as previously described. Of note, all biomarkers associated with risk of aGVHD showed a consensual change in signal levels before the onset of aGVHD (Figure 1). By applying a backward selection on a multivariable logistic model using the AICapproach, we found that the combination of CD146-miR100-TNFR1 with an individual AUROC of 0.858, 0.923, and 0.794, respectively, increased their discrimination ability to predict aGVHD (multivariable AUROC = 0.987). CONCLUSIONS: This study, in the setting of haplo-transplant, confirms the association of CD146, a cell adhesion molecule, and the risk of aGVHD suggesting an important role of endothelium damage in the pathogenesis of aGVHD. The association of miRNA100, miRNA155 and miRNA194, carried by EVs, and aGVHD was also significant. Interestingly, MiRNA100 was reported to regulate inflammatory neovascularization during GvHD while miR-155 plays a role in donor T cell expansion. We have also found that using three markers in combination (CD146-miR100-TNFR1) could greatly improve aGVHD predictivity. To translate our results into an in vivo model, we have recently designed preclinical mouse models to evaluate if a) antagomir (against miRNA100 and/or miRNA155) injections or b) pre-emptive treatments with endothelium protective agents such as defibrinotide or OMS721 (Anti-Masp2) may reduce the risk of aGVHD. Figure1 a) Signal variation from baseline level (preTx) of CD146 fluorescence, miR100 expression, and TNFR1 concentration before aGVHD onset. Disclosures Boccadoro: Sanofi: Honoraria, Research Funding; Celgene: Honoraria, Research Funding; Amgen: Honoraria, Research Funding; Janssen: Honoraria, Research Funding; Novartis: Honoraria, Research Funding; AbbVie: Honoraria; Mundipharma: Research Funding; Bristol-Myers Squibb: Honoraria, Research Funding.

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Association between admission haematocrit and mortality among men with acute ischaemic stroke

Stroke and Vascular Neurology ◽

10.1136/svn-2018-000149 ◽

2018 ◽

Vol 3 (3) ◽

pp. 160-168 ◽

Cited By ~ 2

Author(s):

Jason J Sico ◽

Laura J Myers ◽

Brenda J Fenton ◽

John Concato ◽

Linda S Williams ◽

...

Keyword(s):

Heart Disease ◽

Ischaemic Stroke ◽

Acute Ischaemic Stroke ◽

Severe Anaemia ◽

Impact Factors ◽

Fiscal Year ◽

Health Administration ◽

Risk Of Death ◽

Increased Risk ◽

The Relationship

ObjectiveAnaemia is associated with higher mortality among patients with non-stroke cardiovascular conditions; less is known regarding the relationship between anaemia and mortality among patients with acute ischaemic stroke.MethodsMedical records were abstracted for n=3965 veterans from 131 Veterans Health Administration facilities who were admitted with ischaemic stroke in fiscal year 2007. Haematocrit values within 24 hours of admission were classified as ≤27%, 28%–32%, 33%–37%, 38%–42%, 43%–47% or ≥48%. Multivariate logistic regression was used to examine the relationship between anaemia and in-hospital, 30-day, 6-month and 1-year mortality, adjusting for age, medical comorbidities, modified Acute Physiology and Chronic Health Evaluation-III and stroke severity. Impact factors were calculated to standardise comparisons between haematocrit tier and other covariates.ResultsAmong n=3750 patients included in the analysis, the haematocrit values were ≤27% in 2.1% (n=78), 28%–32% in 6.2% (n=234), 33%–37% in 17.9% (n=670), 38%–42% in 36.4% (n=1366), 43%–47% in 28.2% (n=1059) and ≥48% in 9.1% (n=343). Patients with haematocrit ≤27%, compared with patients in the 38%–42% range, were more likely to have died across all follow-up intervals, with statistically significant adjusted ORs (aORs) ranging from 2.5 to 3.5. Patients with polycythaemia (ie, haematocrit ≥48%) were at increased risk of in-hospital mortality (aOR=2.9; 95% CI 1.4 to 6.0), compared with patients with mid-range admission haematocrits. Pronounced differences between patients receiving and not receiving blood transfusion limited our ability to perform a propensity analysis. Impact factors in the 1-year mortality model were 0.46 (severe anaemia), 0.06 (cancer) and 0.018 (heart disease).ConclusionsAnaemia is independently associated with an increased risk of death throughout the first year post stroke; high haematocrit is associated with early poststroke mortality. Severe anaemia is associated with 1-year mortality to a greater degree than cancer or heart disease. These data cannot address the question of whether interventions targeting anaemia might improve patient outcomes.

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Electronic Cigarette Use Is Not Associated with COVID-19 Diagnosis

Journal of Primary Care & Community Health ◽

10.1177/21501327211024391 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110243

Author(s):

Thulasee Jose ◽

Ivana T. Croghan ◽

J. Taylor Hays ◽

Darrell R. Schroeder ◽

David O. Warner

Keyword(s):

Logistic Regression ◽

Cigarette Smoking ◽

Medical Care ◽

Mayo Clinic ◽

Regression Models ◽

Health Record ◽

Cigarette Use ◽

Logistic Regression Models ◽

Beneficial Effects ◽

Increased Risk

This analysis tested the hypothesis that current e-cigarette use was associated with an increased risk of SARS-CoV-2 infection in patients seeking medical care. E-cigarette and conventional cigarette use were ascertained using a novel electronic health record tool, and COVID-19 diagnosis was ascertained by a validated institutional registry. Logistic regression models were fit to assess whether current e-cigarette use was associated with an increased risk of COVID-19 diagnosis. A total of 69,264 patients who were over the age of 12 years, smoked cigarettes or vaped, and were sought medical care at Mayo Clinic between September 15, 2019 and November 30, 2020 were included. The average age was 51.5 years, 62.1% were females and 86.3% were white; 11.1% were currently smoking cigarettes or using e-cigarettes and 5.1% tested positive for SARS-CoV-2. Patients who used only e-cigarettes were not more likely to have a COVID-19 diagnosis (OR 0.93 [0.69-1.25], P = .628), whereas those who used only cigarettes had a decreased risk (OR 0.43 [0.35-0.53], P < .001). The OR for dual users fell between these 2 values (OR 0.67 [0.49-0.92], P = .013). Although e-cigarettes have the well-documented potential for harm, they do not appear to increase susceptibility to SARS-CoV-2 infection. This result suggests the hypothesis that any beneficial effects of conventional cigarette smoking on susceptibility are not mediated by nicotine.

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Potential Predictors for HPV Vaccination Completion Rates

STEM Fellowship Journal ◽

10.17975/sfj-2018-004 ◽

2018 ◽

Vol 4 (1) ◽

pp. 12-20

Author(s):

Arushi Sachdev ◽

Kerman Sekhon

Keyword(s):

Cervical Cancer ◽

Logistic Regression ◽

Regression Models ◽

Completion Rates ◽

Vaccination Regimen ◽

Black Females ◽

Logistic Regression Models ◽

Female Patients ◽

Increased Risk ◽

Vaccination Completion

Background Human papillomavirus (HPV) is the most common sexually transmitted pathogen; its ease in transmission significantly contributes to its prevalence within the population. While most HPV infections are asymptomatic, a subset of infections cause genital warts, cervical cancer and various anogenital cancers. Accordingly, the vaccine Gardasil has been designed to prevent HPV infection and its associated sequelae. While Gardasil is effective against over 75% of cervical cancers, recent studies have demonstrated its limited adoption. In 2010, only 49% of females between the ages of 13-17 had received at least one dose. Moreover, Gardasil is a three-dose vaccine, and consequently, female patients that initiate the vaccination series often do not complete it in its entirety. Methods Data obtained from researchers at the Johns Hopkins Medical Institutions (JHMI) was used to determine which socioeconomic factors influence a female’s likelihood of vaccination completion. The dataset consisted of female patients between the ages of 11-26 that had received at least one of the Gardasil vaccine doses from a JHMI clinic in Baltimore, USA, between the years 2006 and 2008. First, three logistic regression models were run with vaccination regimen completion, one shot completed and two shots completed as the dependent variables. Then, three LASSO logistic regression models were run to find relationships that were not influenced by model overfitting. The two regression methods were compared to determine if different results could be achieved. Results For the logistic regression, findings revealed that black females (P = 0.006881), females between the ages of 18-26 (P = 0.000483), and females that visited urban clinics (P = 0.004582) are at an increased risk of incomplete vaccinations. In contrast, females that were treated by obstetrician-gynecologists (P = 0.006269) had increased compliance with the Gardasil vaccination regimen compared to women that visited other healthcare professionals. For the LASSO logistic regression, the model that penalized the most for overfitting showed that black females have a higher likelihood of only receiving one shot. Conclusions Due to the retrospective nature of the data, no causation can be established. However, these correlations shed light on what female populations should be studied further and potentially targeted to improve Gardasil vaccination completion rates. Moreover, the differences in vaccination completion rates can, in turn, aggravate the existing disparities in cervical cancer risk among females.

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A novel biomarker signature to predict aggressive disease in African-American men with prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.7_suppl.24 ◽

2015 ◽

Vol 33 (7_suppl) ◽

pp. 24-24

Author(s):

Kosj Yamoah ◽

Michael Hiroshi Johnson ◽

Voleak Choeurng ◽

Kasra Yousefi ◽

Zaid Haddad ◽

...

Keyword(s):

Logistic Regression ◽

African American ◽

Regression Models ◽

African American Men ◽

Conditional Logistic Regression ◽

Dependent Manner ◽

Specific Expression ◽

Significant Differential Expression ◽

Logistic Regression Models ◽

Increased Risk

24 Background: Numerous studies have reported a significantly higher incidence of PCa and/or adverse pathological features associated with African-American men compared to European-American men. Less however is known about the genomic disparities that exist between these two groups. In this report we compared the race-specific expression of biomarkers linked to PCa pathogenesis in a matched cohort of AA and EA men. Methods: PCa data from AA and EA patients were analyzed from four medical centers. Cases were matched based on CAPRA-S within each institution for a total sample size of 300 (121-AA; 179-EA). The distribution of mRNA expression levels of 20 validated biomarkers associated with PCa initiation and progression was compared by race using a false-discovery-rate adjusted Mann-Whitney U, and logistic regression models. Conditional logistic regression models were used to evaluate the interaction between race and biomarker expression for predicting pathologic T3 PCa. Results: Of 20 biomarkers interrogated, 6 showed statistically significant differential expression in AA compared with EA men in one or more statistical models. These include TMPRSS2-ERG (p<0.001), AMACR (p<0.001), SPINK1 (p=0.005), AR (p=0.018), SRD5A2 (p=0.005), and GSTP1 (p=0.021). Dysregulation of MYCBP (p=0.043) increases risk of pT3 disease in AA but decreases the risk in EA men, while the reverse is true for AMACR (p=0.013), TMPRSS2-ERG (p=0.026), FOXP1 (p=0.016), and GSTP1 (p=0.032). Loss-of-function mutation for tumor suppressors PTEN (p=0.046), TP53 (p=0.042), and RB1 (p=0.027), and dysregulation of AR (p=0.015), EZH2 (p=0.043), NKX3-1 (p=0.024), SRD5A2 (p=0.032), and SPOP (p=0.032) increased risk of pT3 disease for both AA and EA men. Conclusions: We have identified a subset of PCa biomarkers that predict risk of clinico-pathologic outcomes in a race-dependent manner. These biomarkers may in part explain the biological contribution to racial disparity in PCa outcomes between EA and AA men.

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