scholarly journals Prospective Analysis of Risk for Hypothyroidism after Hemithyroidectomy

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Virgilijus Beisa ◽  
Darius Kazanavicius ◽  
Arminas Skrebunas ◽  
Gintaras Simutis ◽  
Justinas Ivaska ◽  
...  
Keyword(s):  
Risk Factors ◽  
Scoring System ◽  
Significant Risk ◽  
Thyroid Stimulating Hormone ◽  
Risk Scores ◽  
Weight Index ◽  
Risk Scoring ◽  
Lower Ratio ◽  
Risk Scoring System ◽  
Benign Thyroid

Objectives. To evaluate risk factors and to develop a simple scoring system to grade the risk of postoperative hypothyroidism (PH).Methods. In a controlled prospective study, 109 patients, who underwent hemithyroidectomy for a benign thyroid disease, were followed up for 12 months. The relation between clinical data and PH was analyzed for significance. A risk scoring system based on significant risk factors and clinical implications was developed.Results. The significant risk factors of PH were higher TSH (thyroid-stimulating hormone) level and lower ratio of the remaining thyroid weight to the patient’s weight (derived weight index). Based on the log of risk factor, preoperative TSH level greater than 1.4 mU/L was assigned 2 points; 1 point was for 0.8–1.4 mU/L. The derived weight index lower than 0.8 g/kg was assigned 1 point. A risk scoring system was calculated by summing the scores. The incidences of PH were 7.3%, 30.4%, and 69.2% according to the risk scores of 0-1, 2, and 3.Conclusion. Risk factors for PH are higher preoperative TSH level and lower derived weight index. Our developed risk scoring system is a valid and reliable tool to identify patients who are at risk for PH before surgery.

scholarly journals Development of a Sex-Specific Risk Scoring System for Predicting Cognitive Normal to Mild Cognitive Impairment (SRSS-CNMCI)

2021 ◽  
Author(s):  
Wen Luo ◽  
Hao Wen ◽  
Shuqi Ge ◽  
Chunzhi Tang ◽  
Xiufeng Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
High Risk ◽  
Scoring System ◽  
External Validation ◽  
Scoring Systems ◽  
Cutoff Point ◽  
Risk Scoring ◽  
Risk Scoring System

Abstract Objective: We aim to develop a sex-specific risk scoring system for predicting cognitive normal (CN) to mild cognitive impairment (MCI), abbreviated SRSS-CNMCI, to provide a reliable tool for the prevention of MCI.Methods: Participants aged 61-90 years old with a baseline diagnosis of CN and an endpoint diagnosis of MCI were screened from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database with at least one follow-up. Multivariable Cox proportional hazards models were used to identify risk factors associated with conversion from CN to MCI and to build risk scoring systems for male and female groups. Receiver operating characteristic (ROC) curve analysis was applied to determine the risk probability cutoff point corresponding to the optimal prediction effect. We ran an external validation of the discrimination and calibration based on the Harvard Aging Brain Study (HABS) database.Results: A total of 471 participants, including 240 women (51%) and 231 men (49%), aged 61 to 90 years, were included in the study cohort for subsequent primary analysis. The final multivariable models and the risk scoring systems for females and males included age, APOE ε4, Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). The scoring systems for females and males revealed C statistics of 0.902 (95% CI 0.840-0.963) and 0.911 (95% CI 0.863-0.959), respectively, as measures of discrimination. The cutoff point of high and low risk was 33% in females, and more than 33% was considered high risk, while more than 9% was considered high risk for males. The external validation effect of the scoring systems was good: C statistic 0.950 for the females and C statistic 0.965 for the males. Conclusions: Our parsimonious model accurately predicts conversion from CN to MCI with four risk factors and can be used as a predictive tool for the prevention of MCI.

scholarly journals The Efficacy of Risk Score System Establishment and Methylprednisolone Stratification Treatment for Pre-Engraftment Syndrome after Unrelated Cord Blood Transplantation: A Retrospective (development) and a Prospective (validation) Study

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4501-4501
Author(s):  
Xiaoyu Zhu ◽  
Jiang Zhu ◽  
Baolin Tang ◽  
Kaidi Song ◽  
Linlin Jin ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Risk Score ◽  
Cumulative Incidence ◽  
Scoring System ◽  
Cord Blood Transplantation ◽  
High Risk Factors ◽  
Risk Scoring ◽  
Risk Scoring System ◽  
Different Doses

Introduction Pre-engraftment syndrome (PES) is a common immune reaction prior to neutrophil engraftment after unrelated cord blood transplantation (UCBT), with a unique clinical manifestation of non-infectious fever and skin rash. The reported incidence of PES ranges from 20% to 78%. Although many researchers believe that PES is associated with a high incidence of acute graft-versus-host disease (GVHD) but not with transplant-related mortality (TRM) , relapse, or overall survival (OS), they did not stratify the risk factors of PES, and how to carry out different doses of methylprednisolone (MP) stratified intervention therapy still remains unknown. Method s First, 136 hematological malignancy patients treated with UCBT from April 2000 to February 2012 in our transplantation center were retrospectively analysis. Among them, 92 patients occurred PES. High-risk factors for 180-day TRM in PES patients were established by univariate and multivariate analysis. Then, from January 2013 to August 2016, 221 PES patients were scored according to the risk scoring system and stratified treated with different doses of MP. Finally, in order to validate the efficacy of MP stratification treatment, we conducted a prospective, open label and non-randomized clinical trial including 240 PES patients who underwent UCBT from September 2016 to December 2018. This trial is registered at www.chictr.org.cn as ChiCTR-ONC-16009013. Results The cumulative incidence of neutrophil and platelet engraftment was significantly higher in PES group than non-PES group (97.8% vs 70.5%, P<0.001; 75.0% vs 54.5%, P=0.05). In 92 PES patients, multivariate analysis showed that failed MP treatment, multiple clinical symptoms and early onset of PES were independent high risk factors affecting180-day TRM. One high risk factor was scored as 1. The 92 PES patients were divided into PES-0, PES-1,PES-2 and PES-3, and the higher the score, the higher the TRM (17.7% vs 21.9% vs 62.5% vs 100%,respectively; P<0.001), and the lower the OS (68.3% vs 56.2% vs 25.0% vs 0%, respectively; P<0.001). Then, from January 2013 to August 2016, 221 PES patients were scored as PES-0, PES-1 and PES-2 according to the following two high risk factors (multiple clinical symptoms and early onset of PES) and stratified treated with different doses of MP (0.5mg/kg/d for PES-0, 1mg/kg/d for PES-1 and 2mg/kg/d for PES-2). Compared to the previous PES patients with the same risk score, the 180-day TRM of PES-1 and PES-2 patients was significantly reduced and the OS, disease free survival (DFS), and GVHD-free and Relapse-free survival (GRFS) were significantly increased after stratified treatment. The results in the prospective trial were similar to the retrospective study. In addition, although stratified therapy could significantly improve the prognosis of PES-2 patients cohort, the cumulative incidence of acute GVHD and GRFS are still the worst compared with other risk score patients. Therefore, how to improve the outcomes of PES-2 patients remains to be further studied. Conclusion s PES after UCBT is benefit for engraftment, but should be graded according the risk scoring system. Different doses of MP stratified intervention therapy can significantly improve the prognosis of severe PES patients. The risk scoring system of PES after UCBT and MP stratification treatment are worthy of clinical application. But the cumulative incidence of acute GVHD and GRFS in severe PES patients still need to be ameliorated in the further study. Disclosures No relevant conflicts of interest to declare.

scholarly journals Development and Validation of a Risk Scoring System for Cephamycin-Associated Hemorrhagic Events

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Tong-Ling Chien ◽  
Fei-Yuan Hsiao ◽  
Li-Ju Chen ◽  
Yu-Wen Wen ◽  
Shu-Wen Lin
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Scoring System ◽  
Goodness Of Fit ◽  
Bleeding Tendency ◽  
Multivariate Logistic Regression ◽  
Goodness Of Fit Test ◽  
Hemorrhagic Events ◽  
Risk Scoring ◽  
Risk Scoring System

Abstract Cephamycin-associated hemorrhages have been reported since their launch. This research aimed to determine risk factors for cephamycin-associated hemorrhagic events and produce a risk scoring system using National Taiwan University Hospital (NTUH) database. Patients who were older than 20 years old and consecutively used study antibiotics for more than 48 hours (epidode) at NTUH between January 1st, 2009 and December 31st, 2015 were included. The population was divided into two cohorts for evaluation of risk factors and validation of the scoring system. Multivariate logistic regression was used for the assessment of the adjusted association between factors and the outcome of interest. Results of the multivariate logistic regression were treated as the foundation to develop the risk scoring system. There were 46402 and 22681 episodes identified in 2009–2013 and 2014–2015 cohorts with 356 and 204 hemorrhagic events among respective cohorts. Use of cephamycins was associated with a higher risk for hemorrhagic outcomes (aOR 2.03, 95% CI 1.60–2.58). Other risk factors included chronic hepatic disease, at least 65 years old, prominent bleeding tendency, and bleeding history. A nine-score risk scoring system (AUROC = 0.8035, 95% CI 0.7794–0.8275; Hosmer-Lemeshow goodness-of-fit test p = 0.1044) was developed based on the identified risk factors, with higher scores indicating higher risk for bleeding. Use of cephamycins was associated with more hemorrhagic events compared with commonly used penicillins and cephalosporins. The established scoring system, CHABB, may help pharmacists identify high-risk patients and provide recommendations according to the predictive risk, and eventually enhance the overall quality of care.

scholarly journals Development of a risk scoring system for prognostication in HIV-related toxoplasma encephalitis

2020 ◽  
Author(s):  
Yao Li ◽  
Yanming Zeng ◽  
Min Liu ◽  
Yanqiu Lu ◽  
Xueyan Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Scoring System ◽  
Risk Model ◽  
Therapeutic Interventions ◽  
Scoring Model ◽  
Cell Counts ◽  
Toxoplasma Encephalitis ◽  
Specific Risk ◽  
Risk Scoring ◽  
Risk Scoring System

Abstract Objective: This study aims to evaluate specific risk factors influencing prognosis of HIV-infected patients with toxoplasma encephalitis (TE) in order to develop a prognostic risk scoring system for them. Methods: This is a six-center retrospective study of hospitalized HIV/TE patients. Data including six-week mortality after diagnosis, baseline characteristics, clinical features, laboratory tests and radiological characteristics of eligible patients were assimilated for risk model establishing.Results: In this study, the six-week mortality among 94 retrospective cases was 11.7% (11/94). Seven specific risk factors, viz. time from symptom onset to presentation, fever, dizziness, CD4+ T-cell counts, memory deficits, patchy brain lesions, and disorders of consciousness were calculated to be statistically associated with mortality. A criterion value of ‘9’ was selected as the optimal cut-off value of the established model. The AUC of the ROC curve of this scoring model was 0.976 (p<0.001). The sensitivity and specificity of the risk scoring model was 100.0% and 86.9%, respectively, which were 81.8% and 94.1% of this scoring model in the verification cohort, respectively. Conclusions: The developed scoring system was established with simple risk factors, which also allows expeditious implementation of accurate prognostication, and appropriate therapeutic interventions in HIV-infected patients with TE.

A risk scoring system to predict overall survival for patients with liver cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16635-e16635
Author(s):  
Haibei Xin ◽  
Guanxiong Zhang ◽  
Wei Zhou ◽  
Huan Chen ◽  
Dandan Liang ◽  
...  
Keyword(s):  
Machine Learning ◽  
Risk Factors ◽  
Overall Survival ◽  
Surgical Resection ◽  
Scoring System ◽  
Therapeutic Interventions ◽  
Primary Hepatocellular Carcinoma ◽  
Cd8 Cells ◽  
Risk Scoring ◽  
Risk Scoring System

e16635 Background: Surgical resection is a common curative treatment for patients with primary hepatocellular carcinoma (HCC), and conventional strategies of assessing clinical and pathologic risk factors have been adopted to predict clinic outcomes in patients after curative surgery. We hypothesized that an ensemble learning approach which incorporates multidimensional features would enable effective prediction of patient survival. Methods: We analyzed data from 222 stage II-III HCC patients who underwent surgical resection at Eastern Hepatobiliary Surgery Hospital (Shanghai, China). Baseline information for each patient includes clinical and pathologic risk factors, laboratory tests and in situ immunological profiles. Using machine learning, we developed CoxPH, GBS, CGBS, FSVM and NSVM models for patient overall survival (OS). Models were trained on 155 cases with 48 features. Thirteen-fold cross-validation (CV) was used to measure performance with area under the ROC curve (AUC) and C-Index (CI). The ensemble model was used to predict patient OS and validated on the subsequent 67 cases. Results: For all models tested, immune features, including the fraction of CD68+ and CD8+ cells in tumor, and CD8+ cells in stroma, play a crucial role in predicting patient OS. Using the ensemble CoxPH model (with superior value of AUC and CI), a risk scoring system for patient OS was developed. The scoring system could stratify patients into high-risk or low-risk groups, revealing different prognosis (validation cohort: HR, 6.5, 95% CI, 2.4-18, P = 3.4e-05). The CoxPH model was also predictive of the time to-recurrence (p < 0.0001). In validation set, the scoring system predicted half-year mortality of patients with AUC of 0.9, and 1-year mortality of patients with AUC of 0.897. The scoring system could also predict half-year recurrence and 1-year recurrence with AUC more than 0.83. Conclusions: The machine learning-based risk scoring system offers a novel strategy for incorporating multidimensional risk factors to predict clinic outcome and may help medical practitioners to optimize clinical follow-up or therapeutic interventions. [Table: see text]

scholarly journals An Inflammatory Polymorphisms Risk Scoring System for the Differentiation of Ischemic Stroke Subtypes

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Elena Muiño ◽  
Jurek Krupinski ◽  
Caty Carrera ◽  
Cristina Gallego-Fabrega ◽  
Joan Montaner ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Genetic Risk ◽  
Scoring System ◽  
Cardioembolic Stroke ◽  
Risk Scores ◽  
Stroke Subtype ◽  
Stroke Subtypes ◽  
Risk Scoring ◽  
Risk Scoring System ◽  
Independent Cohort

Inflammation has been associated with atherothrombotic stroke and recently with cardioembolic stroke. Different genetic risk factors have been specifically associated with the subtypes of ischemic stroke (cardioembolic, atherothrombotic, and lacunar). However, there are no studies that have generated genetic risk scores for the different subtypes of ischemic stroke using polymorphisms associated with inflammation.Methods.We have analyzed 68 polymorphisms of 30 inflammatory mediator genes in 2,685 subjects: 1,987 stroke cases and 698 controls. We generated a genetic scoring system with the most significant polymorphisms weighted by the odds ratio of every polymorphism and taken into consideration the stroke subtype.Results.Three polymorphisms, rs1205 (CRPgene), rs1800779, and rs2257073 (NOS3gene), were associated with cardioembolic stroke (pvalue<0.05). The score generated was only associated with the cardioembolic stroke subtype (pvalue: 0.001) and was replicated in an independent cohort (pvalue: 0.017). The subjects with the highest score presented a cardioembolic stroke in 92.2% of the cases (pvalue: 0.002).Conclusion.The genetics of inflammatory markers is more closely associated with cardioembolic strokes than with atherothrombotic or lacunar strokes. The genetic risk scoring system could be useful in the prediction and differentiation of ischemic stroke; however, it might be specific to particular ischemic stroke subtypes.

scholarly journals A Comparative Study of JASO TP15002-Based Security Risk Assessment Methods for Connected Vehicle System Design

2019 ◽  
Vol 2019 ◽  
pp. 1-35 ◽  
Author(s):  
Yasuyuki Kawanishi ◽  
Hideaki Nishihara ◽  
Daisuke Souma ◽  
Hirotaka Yoshida ◽  
Yoichi Hata
Keyword(s):  
Risk Assessment ◽  
Comparative Study ◽  
Scoring System ◽  
Risk Scores ◽  
Connected Vehicle ◽  
Security Risk ◽  
Multiple Use ◽  
Vehicle Systems ◽  
Risk Scoring ◽  
Risk Scoring System

In recent years, much attention has been paid to autonomous vehicles and security threats on such vehicles have become an important issue. One of these examples is a command injection issue on a gateway ECU, which was reported in 2016. In order to mitigate these threats, the secure design of connected vehicle systems, which is done at the concept phase during development, has become increasingly important in industry. From this perspective, a security guideline such as JASO TP15002 which specifies two concrete methods, CRSS (CVSS Based Risk Scoring System) and RSMA (Risk Scoring Methodology for Automotive System), was made public in 2015. The latest work on the application of TP15002 to the ITU-T X.1373 standard was published in 2017. However, the risk assessment in this publication seems limited. It is not clear from this publication how systematically the risk assessment task in TP15002 can be performed at the implementation level. Another interesting question is how different methods affect the risk scores of connected vehicle systems. In this paper, we focus on the risk assessment phase in JASO TP15002. For a systematic risk assessment, we introduce an idea of asset container and propose to extend CRSS to a novel RSS (Risk Scoring System), RSS-CVSSv3, by appropriately replacing CVSSv2 vulnerability scoring system on which CRSS is based with CVSSv3. To address the above questions, we perform a comparative study on CRSS, RSMA, and RSS-CVSSv3 for multiple use cases such as a CGW (Central Gateway) and a drone, to examine the efficiency and usefulness of our methods. For this comparative purpose, we devise an interesting approach for the refinement of RSMA to the obstacles in comparing CRSS with RSMA.

scholarly journals An innovative risk-scoring system of dental procedures and safety protocols in the COVID-19 era

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
M. E. Bizzoca ◽  
G. Campisi ◽  
Lorenzo Lo Muzio
Keyword(s):  
Scoring System ◽  
Direct Contact ◽  
Infection Risk ◽  
Risk Scores ◽  
Risk Level ◽  
Clinical Tool ◽  
Dental Procedures ◽  
Risk Scoring ◽  
General Dentists ◽  
Risk Scoring System

Abstract Background The aim of this paper is to assess an innovative risk score for common dental procedures, based on the most recent contaminant SARS-CoV-2. After scoring the level of infection risk, safety procedures, advice and personal protective equipment (PPE) are recommended for the dental team in each dental practice. Methods The authors of this research analysed 42 common dental procedures on the basis of known transmission risks. In increasing order, many consider the parameters leading to different risk scores for the dental team and patients for each procedure to be: direct contact with saliva (score 1), direct contact with blood (score 2), production of low levels of spray/aerosol via air–water syringes (score 3), the production of high levels of spray/aerosol from rotating, ultrasound and piezoelectric tools (score 4); and the duration of the procedure, which may increase the risk of procedures producing droplets and aerosols. Results Using this innovative risk-scoring system, the authors classified the different dental procedures according to low, medium or high risk: low (1–3), medium (4–5), high (≥ 6). A safety protocol for each procedure was thereafter matched with the calculated risk level. Conclusions The innovative risk-scoring system presented in this research permits the reclassification of dental procedures according to the infection risk level. Consequently, specific procedures, previously considered as entry level, will now merit revision. This paper also highlighted an effective and routine clinical tool for general dentists and oral medicine practitioners.

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