scholarly journals Predicting Outcomes in Emergency Medical Admissions Using a Laboratory Only Nomogram

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Seán Cournane ◽  
Richard Conway ◽  
Declan Byrne ◽  
Deirdre O’Riordan ◽  
Bernard Silke
Keyword(s):  
Predictive Value ◽  
Laboratory Data ◽  
Illness Severity ◽  
Acute Illness ◽  
Distribution Width ◽  
Emergency Medical ◽  
Admission Data ◽  
Triage Category ◽  
Illness Severity Score ◽  
The Relationship

Background. We describe a nomogram to explain an Acute Illness Severity model, derived from emergency room triage and admission laboratory data, to predict 30-day in-hospital survival following an emergency medical admission. Methods. For emergency medical admissions (96,305 episodes in 50,612 patients) between 2002 and 2016, the relationship between 30-day in-hospital mortality and admission laboratory data was determined using logistic regression. The previously validated Acute Illness Severity model was then transposed to a Kattan-style nomogram with a Stata user-written program. Results. The Acute Illness Severity was based on the admission Manchester triage category and biochemical laboratory score; these latter were based on the serum albumin, sodium, potassium, urea, red cell distribution width, and troponin status. The laboratory admission data was predictive with an AUROC of 0.85 (95% CI: 0.85, 0.86). The sensitivity was 94.4%, with a specificity of 62.7%. The positive predictive value was 21.2%, with a negative predictive value of 99.1%. For the Kattan-style nomogram, the regression coefficients are converted to a 100-point scale with the predictor parameters mapped to a probability axis. The nomogram would be an easy-to-use tool at the bedside and for educational purposes, illustrating the relative importance of the contribution of each predictor to the overall score. Conclusion. A nomogram to illustrate and explain the prognostic factors underlying an Acute Illness Severity Score system is described.

Calculated globulin as a screening tool for hypogammaglobulinaemia or paraproteins in hospitalized patients

2021 ◽  
pp. 000456322198973
Author(s):  
Teng Hoo ◽  
Ee Mun Lim ◽  
Mina John ◽  
Lloyd D’Orsogna ◽  
Andrew McLean-Tooke
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Screening Tool ◽  
Haematological Malignancy ◽  
Laboratory Data ◽  
Liver Function Tests ◽  
Serum Globulin ◽  
Tertiary Hospitals ◽  
Low Sensitivity ◽  
Diagnostic Delays

Background Calculated globulin fraction is derived from the liver function tests by subtracting albumin from the total protein. Since immunoglobulins comprise the largest component of the serum globulin concentration, increased or decreased calculated globulins and may identify patients with hypogammaglobulinaemia or hypergammaglobulinaemia, respectively. Methods A retrospective study of laboratory data over 2.5 years from inpatients at three tertiary hospitals was performed. Patients with paired calculated globulins and immunoglobulin results were identified and clinical details reviewed. The results of serum electrophoresis testing were also assessed where available. Results A total of 4035 patients had paired laboratory data available. A calculated globulin ≤20 g/L (<2nd percentile) had a low sensitivity (5.8%) but good positive predictive value (82.5%) for hypogammaglobulinaemia (IgG ≤5.7 g/L), with a positive predictive value of 37.5% for severe hypogammaglobulinaemia (IgG ≤3 g/L). Paraproteins were identified in 123/291 (42.3%) of patients with increased calculated globulins (≥42 g/L) who also had a serum electrophoresis performed. Significantly elevated calculated globulin ≥50 g/L (>4th percentile) were seen in patients with either liver disease (37%), haematological malignancy (36%), autoimmune disease (13%) or infections (9%). Conclusions Calculated globulin is an inexpensive and easily available test that assists in the identification of hypogammaglobulinaemia or hypergammaglobulinaemia which may prompt further investigation and reduce diagnostic delays.

scholarly journals The prognostic and predictive value of platelet parameters in diabetic and nondiabetic patients with sudden sensorineural hearing loss

2020 ◽  
Vol 15 (1) ◽  
pp. 884-889
Author(s):  
İbrahim Özcan ◽  
İbrahim Hira ◽  
Altan Kaya ◽  
Mehmet Yaşar ◽  
Murat Doğan ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Predictive Value ◽  
Study Groups ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Diabetic Patients ◽  
Microvascular Damage ◽  
Distribution Width ◽  
Group 1

AbstractBackgroundWe aimed to evaluate the association between mean platelet volume, platelet distribution width (PDW), platelet count (PC) and plateletcrit (PCT), and the presence of sudden sensorineural hearing loss (SSNHL) and treatment response. In the literature, there is no study that investigates the platelet functions in diabetic patients with SSNHL.MethodsThe patients were retrospectively assigned into Group 1 (68 diabetic patients with SSNHL), Group 2 (63 nondiabetic patients with SSNHL) and Group 3 (64 healthy controls).ResultsPC was not significantly different between the groups (p > 0.05). MPV, PDW and PCT values were significantly higher in Group 1 as compared to Groups 2 and 3 (p < 0.05). Platelet parameters were not significantly different between the patients who were responsive and nonresponsive to the treatment. Therefore, the platelet parameters did not affect prognosis significantly in this study samples (p > 0.05).ConclusionsThis study showed that platelet parameters did not have a significant effect as a prognostic and predictive value in diabetic and nondiabetic patients with SSNHL. Further studies with more homogenous and larger study groups investigating the platelet parameters are needed to demonstrate microvascular damage and vascular alterations induced by diabetes mellitus.

scholarly journals Correction to: The relationship between level of the red cell distribution width and the outcomes of patients who acquired pneumonia from community

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Yousef Ahmed ◽  
Manal A. Mahmoud
Keyword(s):  
Red Cell Distribution Width ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
The Relationship

An amendment to this paper has been published and can be accessed via the original article.

scholarly journals CT pulmonary angiography in COVID-19 pneumonia: relationship between pulmonary embolism and disease severity

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Aya Yassin ◽  
Maryam Ali Abdelkader ◽  
Rehab M. Mohammed ◽  
Ahmed M. Osman
Keyword(s):  
Pulmonary Embolism ◽  
Disease Severity ◽  
Laboratory Data ◽  
Pulmonary Angiography ◽  
Significant Relation ◽  
Ct Pulmonary Angiography ◽  
Laboratory Results ◽  
Severity Of The Disease ◽  
The Relationship ◽  
D Dimer

Abstract Background Pulmonary embolism (PE) is one of the known sequels of COVID-19 infection. We aimed to assess the incidence of PE in patients with COVID-19 infection and to evaluate the relationship between the CT severity of the disease and the laboratory indicators. This was a retrospective study conducted on 96 patients with COVID-19 infection proved by positive PCR who underwent CT pulmonary angiography (CTPA) with a calculation of the CT severity of COVID-19 infection. Available patients’ complaint and laboratory data at the time of CTPA were correlated with PE presence and disease severity. Results Forty patients (41.7%) showed positive PE with the median time for the incidence of PE which was 12 days after onset of the disease. No significant correlation was found between the incidence of PE and the patients’ age, sex, laboratory results, and the CT severity of COVID-19. A statistically significant relation was found between the incidence of PE and the patients’ desaturation, hemoptysis, and chest pain. A highly significant correlation was found between the incidence of PE and the rising in the D-dimer level as well as the progressive CT findings when compared to the previous one. Conclusion CT progression and the rising in D-dimer level are considered the most important parameters suggesting underlying PE in patients with positive COVID-19 infection which is commonly seen during the second week of infection and alert the use of CT pulmonary angiography to exclude or confirm PE. This is may help in improving the management of COVID-19 infection.

Visual and quantitative assessment of COVID-19 pneumonia on chest CT: The relationship with disease severity and clinical findings

2021 ◽  
Vol 17 ◽  
Author(s):  
Furkan Kaya ◽  
Petek Şarlak Konya ◽  
Emin Demirel ◽  
Neşe Demirtürk ◽  
Semiha Orhan ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Disease Severity ◽  
Pearson Correlation ◽  
Laboratory Data ◽  
Length Of Hospital Stay ◽  
Chest Ct ◽  
Laboratory Findings ◽  
Pneumonia Severity ◽  
High Attenuation ◽  
The Relationship

Background: Lungs are the primary organ of involvement of COVID-19, and the severity of pneumonia in COVID-19 patients is an important cause of morbidity and mortality. Aim: We aimed to evaluate the visual and quantitative pneumonia severity on chest computed tomography (CT) in patients with coronavirus disease 2019 (COVID-19) and compare the CT findings with clinical and laboratory findings. Methods: We retrospectively evaluated adult COVID-19 patients who underwent chest CT, clinical scores, laboratory findings, and length of hospital stay. Two independent radiologists visually evaluated the pneumonia severity on chest CT (VSQS). Quantitative CT (QCT) assessment was performed using a free DICOM viewer, and the percentage of the well-aerated lung (%WAL), high-attenuation areas (%HAA) at different threshold values, and mean lung attenuation (MLA) values were calculated. The relationship between CT scores and the clinical, laboratory data, and length of hospital stay were evaluated in this cross-sectional study. The student's t-test and chi-square test were used to analyze the differences between variables. The Pearson correlation test analyzed the correlation between variables. The diagnostic performance of the variables was assessed using receiver operating characteristic (ROC) analysis was used. Results: The VSQS and QCT scores were significantly correlated with procalcitonin, d-dimer, ferritin, and C-reactive protein levels. Both VSQ and QCT scores were significantly correlated with disease severity (p<0.001). Among the QCT parameters, the %HAA-600 value showed the best correlation with the VSQS (r=730,p<0.001). VSQS and QCT scores had high sensitivity and specificity in distinguishing disease severity and predicting prolonged hospitalization. Conclusion: The VSQS and QCT scores can help manage the COVID-19 and predict the duration of hospitalization.

RELATIONS OF MOTOR ABILITY OF BALANCE AND SUCCESS OF PERFORMANCE OF GYMNASTICS ELEMENTS ON THE FLOOR EXERCISE

sportlogia ◽  
2021 ◽  
Vol 17 (1) ◽  
pp. 34-43
Author(s):  
Saša Jovanović ◽  
◽  
Snežana Bijelić ◽  
Adriana Ljubojević ◽  
Dalibor Fulurija ◽  
...  
Keyword(s):  
Physical Education ◽  
Prediction Model ◽  
Motor Skills ◽  
Predictive Value ◽  
Predictor Variable ◽  
The Other ◽  
Motor Ability ◽  
Training Methodology ◽  
Balance Ability ◽  
The Relationship

The purpose of this study is to investigate the relationship between motor ability for balance and the performance of selected gymnastic elements on the floor in students aged 7-8 years, to provide an overview of the current motor status of the respondents at this age, and to develop suggestions for possible changes in the curriculum at this age, and to develop suggestions for supplementing training methodology. Training of selected gymnastics elements was conducted on a sample of 42 subjects who had no previous experience in performing gymnastics elements during regular physical education classes, and the predictor variable was tested using four tests assessing motor balance ability. The tests assessing motor balance ability showed a statistically significant predictive value for the performance of all three gymnastics exercises. It is noticeable that the value of the prediction model increased the more complex an item was derived, indicating the complexity of the motor balance space and the high and stable level of the same in the subjects at the time of testing. Regarding the tests used, it can be noted that the test FLAM was significantly involved in the prediction of performance success in all three gymnastic elements, while the other two tests showed their predictive value in the execution of the hand stand. On the other hand, the study shows that the gymnastic elements used should be used in physical education classes to contribute to the promotion and development of all motor skills of students and as part of the preparation for the execution of more complex elements on the floor and apparatus in higher grades.

Abstract 3775: Average Blood Glucose and Mortality in Patients Hospitalized with Acute Myocardial Infarction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Mikhail Kosiborod ◽  
Silvio Inzucchi ◽  
Harlan M Krumholz ◽  
Lan Xiao ◽  
Phillip G Jones ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Hospital Mortality ◽  
Regression Models ◽  
Independent Predictor ◽  
Laboratory Data ◽  
Logistic Regression Models ◽  
Average Blood Glucose ◽  
The Relationship ◽  
Multivariable Adjustment ◽  
Better Than

Background: Elevated blood glucose (BG) on admission is associated with higher mortality risk in patients (pts) hospitalized with AMI. However, the prognostic value of average BG, which reflects overall glycemic exposure much better than admission BG, is unknown. Furthermore, the nature of the relationship between average BG and mortality has not been determined. Methods: We evaluated a cohort of 16,871 AMI pts hospitalized from January 2000-December 2005, using Cerner Corporation’s Health Facts® database from 40 hospitals, which contains demographics, clinical and comprehensive laboratory data. Logistic regression models evaluated the nature of the relationship between mean BG during the entire AMI hospitalization and in-hospital mortality, after adjusting for multiple patient factors and confounders. Similar analyses were performed in subgroups of pts with and without diabetes (DM). Results: A J-shaped relationship was observed between mean BG and in-hospital mortality, which persisted after multivariable adjustment (Figure ). Mortality increased with each 10 mg/dL incremental rise in mean BG over >120 mg/dL, and with incremental decline in mean BG <80 mg/dL. The slope of these relationships was much steeper in pts without DM. Conclusions: Average BG during the entire AMI hospitalization is a powerful independent predictor of in-hospital mortality. Both persistent hyper- and hypoglycemia are associated with adverse prognosis. Whether strategies directed at optimizing BG control will improve survival remains to be established. Association Between Mean BG and In-Hospital Mortality After Multivariable Adjustment (Reference: Mean BG 100 to <110)

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