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

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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Relationship between 24-h venous blood glucose variation and mortality among patients with acute respiratory failure

Scientific Reports ◽

10.1038/s41598-021-87409-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Xiaoling Zhang ◽

Jingjing Zhang ◽

Jiamei Li ◽

Ya Gao ◽

Ruohan Li ◽

...

Keyword(s):

Blood Glucose ◽

Respiratory Failure ◽

Hospital Mortality ◽

Acute Respiratory Failure ◽

Venous Blood ◽

Sensitivity Analyses ◽

Icu Mortality ◽

Logistic Regression Models ◽

The Mean ◽

The Relationship

AbstractEvidence indicates that glucose variation (GV) plays an important role in mortality of critically ill patients. We aimed to investigate the relationship between the coefficient of variation of 24-h venous blood glucose (24-hVBGCV) and mortality among patients with acute respiratory failure. The records of 1625 patients in the Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC II) database were extracted. The 24-hVBGCV was calculated as the ratio of the standard deviation (SD) to the mean venous blood glucose level, expressed as a percentage. The outcomes included ICU mortality and in-hospital mortality. Participants were divided into three subgroups based on tertiles of 24-hVBGCV. Multivariable logistic regression models were used to evaluate the relationship between 24-hVBGCV and mortality. Sensitivity analyses were also performed in groups of patients with and without diabetes mellitus. Taking the lowest tertile as a reference, after adjustment for all the covariates, the highest tertile was significantly associated with ICU mortality [odds ratio (OR), 1.353; 95% confidence interval (CI), 1.018–1.797] and in-hospital mortality (OR, 1.319; 95% CI, 1.003–1.735), especially in the population without diabetes. The 24-hVBGCV may be associated with ICU and in-hospital mortality in patients with acute respiratory failure in the ICU, especially in those without diabetes.

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Blood glucose-related indicators are associated with in-hospital mortality in critically ill patients with acute pancreatitis

Scientific Reports ◽

10.1038/s41598-021-94697-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yan Lu ◽

Qiaohong Zhang ◽

Jianjie Lou

Keyword(s):

Acute Pancreatitis ◽

Blood Glucose ◽

Hospital Mortality ◽

Critically Ill ◽

Critically Ill Patients ◽

Glucose Variability ◽

Logistic Regression Models ◽

Patient Prognosis ◽

Mean Glucose ◽

The Relationship

AbstractAcute pancreatitis (AP) results in potentially harmful blood glucose fluctuations, affecting patient prognosis. This study aimed to explore the relationship between blood glucose-related indicators and in-hospital mortality in critically ill patients with AP. We extracted data on AP patients from the Multiparameter Intelligent Monitoring in Intensive Care III database. Initial glucose (Glucose_initial), maximum glucose (Glucose_max), minimum glucose (Glucose_min), mean glucose (Glucose_mean), and glucose variability (glucose standard deviation [Glucose_SD] and glucose coefficient of variation [Glucose_CV]) were selected as blood glucose-related indicators. Logistic regression models and the Lowess smoothing curves were used to display the association between significant blood glucose-related indicators and in-hospital mortality. Survivors and non-survivors showed significant differences in Glucose_max, Glucose_mean, Glucose_SD, and Glucose_CV (P < 0.05). Glucose_max, Glucose_mean, Glucose_SD, and Glucose_CV were risk factors for in-hospital mortality in AP patients (OR > 1; P < 0.05). According to the Lowess smoothing curve, the overall trends of blood glucose-related indicators showed a non-linear correlation with in-hospital mortality. Glucose_max, Glucose_mean, Glucose_SD, and Glucose_CV were associated with in-hospital mortality in critically ill patients with AP.

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Soluble ST2 levels for predicting the presence and severity of metabolic syndrome

Endocrine Connections ◽

10.1530/ec-20-0645 ◽

2021 ◽

Author(s):

Xiao Zong ◽

Qin Fan ◽

Hang Zhang ◽

Qian Yang ◽

Hongyang Xie ◽

...

Keyword(s):

Metabolic Syndrome ◽

Logistic Regression ◽

Confidence Interval ◽

Subgroup Analysis ◽

Odds Ratio ◽

Regression Models ◽

Soluble St2 ◽

Logistic Regression Models ◽

The Relationship ◽

Multivariable Adjustment

To explore the relationship between soluble ST2 (sST2) and metabolic syndrome (MetS) and determine whether sST2 levels can predict the presence and severity of MetS. We evaluated 550 consecutive subjects (58.91 ± 9.69 years, 50% male) with or without MetS from the Department of Vascular and Cardiology, Shanghai Jiao Tong University-Affiliated Ruijin Hospital. Serum sST2 concentrations were measured. The participants were divided into three groups according to the sST2 tertiles. Univariate and multivariable logistic regression models were used to evaluate the association between serum sST2 concentrations and the presence of MetS. Serum sST2 concentrations were significantly higher in the MetS group than in those in the no MetS group (14.80 ± 7.01 vs. 11.58 ± 6.41 ng/ml, P < 0.01). Subjects with more MetS components showed higher levels of sST2. sST2 was associated with the occurrence of MetS after multivariable adjustment as a continuous log-transformed variable (per 1 SD, odds ratio [OR]: 1.42, 95% confidence interval [CI]: 1.13-1.80, P < 0.01). Subgroup analysis showed that individuals with MetS have significantly higher levels of sST2 than those without MetS regardless of sex and age.High serum sST2 levels were significantly and independently associated with the presence and severity of MetS. Thus, sST2 levels may be a novel biomarker and clinical predictor of MetS.

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The impact of blood glucose on community-acquired pneumonia: a retrospective cohort study

ERJ Open Research ◽

10.1183/23120541.00114-2016 ◽

2017 ◽

Vol 3 (2) ◽

pp. 00114-2016 ◽

Cited By ~ 6

Author(s):

Andreas Vestergaard Jensen ◽

Gertrud Baunbæk Egelund ◽

Stine Bang Andersen ◽

Pelle Trier Petersen ◽

Thomas Benfield ◽

...

Keyword(s):

Diabetes Mellitus ◽

Intensive Care Unit ◽

Cohort Study ◽

Blood Glucose ◽

Hospital Mortality ◽

Retrospective Cohort ◽

Regression Models ◽

Community Acquired Pneumonia ◽

Logistic Regression Models ◽

The Impact

Hyperglycaemia is common in patients with community-acquired pneumonia (CAP) and is a predictor of severe outcomes. Data are scarce regarding whether this association is affected by diabetes mellitus (DM) and also regarding its importance for severe outcomes in hospital. We determined the impact of blood glucose on severe outcomes of CAP in hospital.We studied 1318 adult CAP patients hospitalised at three Danish hospitals. The association between blood glucose and DM status and severe clinical outcome (admission to an intensive care unit (ICU) and/or in-hospital mortality) was assessed by logistic regression. Models were adjusted for CURB-65 score and comorbidities.12% of patients had DM. In patients without DM an increase in admission blood glucose was associated with risk for ICU admittance (OR 1.25, 95% CI 1.13–1.39), but not significantly associated with in-hospital mortality (OR 1.10, 95% CI 0.99–1.23). In patients with DM an increase in admission blood glucose was not associated with ICU admittance (OR 1.05, 95% CI 1.00–1.12) or in-hospital mortality (OR 1.05, 95% CI 0.99–1.12).An increase in admission blood glucose (only in patients without DM) was associated with a higher risk for ICU admittance and a trend towards higher in-hospital mortality. DM was not associated with a more severe outcome of CAP.

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785 Reported Restful Sleep Predicting Emotional Distress: Does Exercise (and its modalities) moderate?

SLEEP ◽

10.1093/sleep/zsab072.782 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A305-A306

Author(s):

Jesse Moore ◽

Ellita Williams ◽

Collin Popp ◽

Anthony Briggs ◽

Judite Blanc ◽

...

Keyword(s):

Logistic Regression ◽

Aerobic Exercise ◽

Regression Models ◽

Regression Analyses ◽

Logistic Regression Models ◽

The Past ◽

Strengthening Exercise ◽

Waking Up ◽

The Relationship ◽

Age And Sex

Abstract Introduction Literature shows that exercise moderates the relationship between sleep and emotional distress (ED.) However, it is unclear whether different types of exercise, such as aerobic and strengthening, affect this relationship differently. We investigated the moderating role of two types of exercise (aerobic and strengthening) regarding the relationship between ED and sleep. Methods Our analysis was based on data from 2018 National Health Interview Survey (NHIS), a nationally representative study in which 2,814 participants provided all data. Participants were asked 1) “how many days they woke up feeling rested over the past week”, 2) the Kessler 6 scale to determine ED (a score >13 indicates ED), and 3) the average frequency of strengthening or aerobic exercise per week. Logistic regression analyses were performed to determine if the reported days of waking up rested predicted level of ED. We then investigated whether strengthening or aerobic exercise differentially moderated this relationship. Covariates such as age and sex were adjusted in the logistic regression models. Logistic regression analyses were performed to determine if subjective reporting of restful sleep predicted level of ED. We investigated whether strengthening exercise or aerobic exercise differentially moderated this relationship. Covariates such as age and sex were adjusted in the logistic regression models. Results On average, participants reported 4.41 restful nights of sleep (SD =2.41), 3.43 strengthening activities (SD = 3.19,) and 8.47 aerobic activities a week (SD=5.91.) We found a significant association between days over the past week reporting waking up feeling rested and ED outcome according to K6, Χ2(1) = -741, p= <.001. The odds ratio signified a decrease of 52% in ED scores for each unit of restful sleep (OR = .48, (95% CI = .33, .65) p=<.001.) In the logistic regression model with moderation, aerobic exercise had a significant moderation effect, Χ2(1) = .03, p=.04, but strengthening exercise did not. Conclusion We found that restful sleep predicted reduction in ED scores. Aerobic exercise moderated this relationship, while strengthening exercise did not. Further research should investigate the longitudinal effects of exercise type on the relationship between restful sleep and ED. Support (if any) NIH (K07AG052685, R01MD007716, K01HL135452, R01HL152453)

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An analysis of Italian university students’ performance through segmented regression models: gender differences in STEM courses

Genus ◽

10.1186/s41118-021-00118-6 ◽

2021 ◽

Vol 77 (1) ◽

Author(s):

Andrea Priulla ◽

Nicoletta D’Angelo ◽

Massimo Attanasio

Keyword(s):

Gender Differences ◽

Regression Models ◽

First Year ◽

Strongly Correlated ◽

Segmented Regression ◽

Freshmen Students ◽

Female Performance ◽

And Mathematics ◽

The Relationship ◽

Better Than

AbstractThis paper investigates gender differences in university performances in Science, Technology, Engineering and Mathematics (STEM) courses in Italy, proposing a novel application through the segmented regression models. The analysis concerns freshmen students enrolled at a 3-year STEM degree in Italian universities in the last decade, with a focus on the relationship between the number of university credits earned during the first year (a good predictor of the regularity of the career) and the probability of getting the bachelor degree within 4 years. Data is provided by the Italian Ministry of University and Research (MIUR). Our analysis confirms that first-year performance is strongly correlated to obtaining a degree within 4 years. Furthermore, our findings show that gender differences vary among STEM courses, in accordance with the care-oriented and technical-oriented dichotomy. Males outperform females in mathematics, physics, chemistry and computer science, while females are slightly better than males in biology. In engineering, female performance seems to follow the male stream. Finally, accounting for other important covariates regarding students, we point out the importance of high school background and students’ demographic characteristics.

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Abstract P394: Association Between Admission Dehydration and In-Hospital Mortality in Patients With Intracerebral Hemorrhage

Stroke ◽

10.1161/str.52.suppl_1.p394 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Bin Gao ◽

Hongqiu Gu ◽

Shimeng Liu ◽

Qi Zhou ◽

Kang Kaijiang ◽

...

Keyword(s):

Logistic Regression ◽

Intracerebral Hemorrhage ◽

Hospital Mortality ◽

Blood Urea Nitrogen ◽

Regression Models ◽

Fluid Management ◽

Urea Nitrogen ◽

Logistic Regression Models ◽

Acute Intracerebral Hemorrhage ◽

Stroke Center

Background and purpose: Our aim was to investigate the associations between dehydration status at admission and in-hospital mortality in patients with intracerebral hemorrhage. Methods: Data of consecutive patients with intracerebral hemorrhage between August 2015 and July 2019 based on China Stroke Center Alliance (CSCA) were analyzed. The patients were stratified based on the blood urea nitrogen (BUN) to creatinine (CR) ratio (BUN/CR) on admission, into dehydrated (BUN/CR ≥ 15) and non-dehydrated (BUN/CR < 15) groups. Data were analyzed with multi-variate logistic regression models to analyze the risks of death at hospital and baseline dehydration status. Results: A total number of 84043 patients with intracerebral hemorrhage were included in the study. The median age of patients on admission was 63.0 years, and 37.5% of them were women. Based on the baseline BUN/CR, 59153 (70.4%) patients were classified into dehydration group. Patients with admission dehydration (BUN/CR ≥ 15) had 13% lower risks of in-hospital mortality than those without dehydration (BUN/CR < 15, adjusted OR=0.87, 95%CI: [0.78-0.96]). In patients aged <65 years, patients with baseline dehydration (BUN/CR ≥ 15) showed 19% lower risks of in-hospital mortality (adjusted OR=0.81, 95%CI: [0.70-0.94].adjusted p=0.0049) than non-dehydrated patients (BUN/CR<15). Conclusion: Admission dehydration is associated with lower in-hospital mortality in intracerebral hemorrhage,which provides an imaging clue that fluid management could be important for acute intracerebral hemorrhage.

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Patient-Reported Disease-Modifying Therapy Adherence in the Clinic: A Reliable Metric?

Multiple Sclerosis Journal - Experimental Translational and Clinical ◽

10.1177/2055217318777894 ◽

2018 ◽

Vol 4 (2) ◽

pp. 205521731877789 ◽

Cited By ~ 1

Author(s):

Devon S Conway ◽

Maria Cecilia Vieira ◽

Nicolas R Thompson ◽

Kaila N Parker ◽

Xiangyi Meng ◽

...

Keyword(s):

Regression Models ◽

Patient Reported Outcomes ◽

Patient Reporting ◽

Lesion Formation ◽

Logistic Regression Models ◽

Disease Modifying Therapy ◽

Patient Reported ◽

Relapsing Remitting ◽

Disease Modifying ◽

The Relationship

Background Adherence to multiple sclerosis (MS) disease-modifying therapy (DMT) is commonly assessed through patient reporting, but patient-reported adherence is rarely studied. Objective To determine rates of DMT adherence reported from patient to clinician, reasons for nonadherence, and relationships between adherence and outcomes. Methods We identified relapsing–remitting MS patients on DMT for ≥3 months. DMT adherence was defined as taking ≥80% of doses. Linear and logistic regression models were created used to determine the association of baseline adherence with several patient reported outcomes and the timed 25-foot walk at 6 months, 1 year, 2 years, and 3 years after the index visit. Results The analysis included 1148 patients, of whom 501 had data at 6 months, 544 at 1 year, 331 at 2 years, and 247 at 3 years. Baseline adherence was 94.9% and overall adherence was 93.1%. Forgetting was the most common reason for missed doses. In the adjusted models, adherence was not associated with the outcomes. Conclusions Higher than expected adherence and a lack of association between adherence and outcomes suggests patient reported adherence may not be reliable. Further research is needed to clarify the relationship between patient-reported adherence and relapses or new lesion formation.

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The updated Charlson comorbidity index is a useful predictor of mortality in patients with Staphylococcus aureus bacteraemia

Epidemiology and Infection ◽

10.1017/s0950268818002480 ◽

2018 ◽

Vol 146 (16) ◽

pp. 2122-2130 ◽

Cited By ~ 9

Author(s):

H. G. Ternavasio-de la Vega ◽

F. Castaño-Romero ◽

S. Ragozzino ◽

R. Sánchez González ◽

M. P. Vaquero-Herrero ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Charlson Comorbidity Index ◽

Regression Models ◽

Model Fit ◽

Logistic Regression Models ◽

Relevant Variables ◽

Comorbidity Index ◽

The Mean ◽

Related Mortality ◽

Better Than

AbstractThe objective was to compare the performance of the updated Charlson comorbidity index (uCCI) and classical CCI (cCCI) in predicting 30-day mortality in patients with Staphylococcus aureus bacteraemia (SAB). All cases of SAB in patients aged ⩾14 years identified at the Microbiology Unit were included prospectively and followed. Comorbidity was evaluated using the cCCI and uCCI. Relevant variables associated with SAB-related mortality, along with cCCI or uCCI scores, were entered into multivariate logistic regression models. Global model fit, model calibration and predictive validity of each model were evaluated and compared. In total, 257 episodes of SAB in 239 patients were included (mean age 74 years; 65% were male). The mean cCCI and uCCI scores were 3.6 (standard deviation, 2.4) and 2.9 (2.3), respectively; 161 (63%) cases had cCCI score ⩾3 and 89 (35%) cases had uCCI score ⩾4. Sixty-five (25%) patients died within 30 days. The cCCI score was not related to mortality in any model, but uCCI score ⩾4 was an independent factor of 30-day mortality (odds ratio, 1.98; 95% confidence interval, 1.05–3.74). The uCCI is a more up-to-date, refined and parsimonious prognostic mortality score than the cCCI; it may thus serve better than the latter in the identification of patients with SAB with worse prognoses.

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The association between body dysmorphic symptoms and suicidality among adolescents and young adults: a genetically informative study

Psychological Medicine ◽

10.1017/s0033291720002998 ◽

2020 ◽

pp. 1-9

Author(s):

Georgina Krebs ◽

Lorena Fernández de la Cruz ◽

Frühling V. Rijsdijk ◽

Daniel Rautio ◽

Jesper Enander ◽

...

Keyword(s):

Suicidal Ideation ◽

Regression Models ◽

Genetic Factors ◽

Body Dysmorphic Disorder ◽

Early Adulthood ◽

Self Report ◽

Logistic Regression Models ◽

Substantial Risk ◽

The Relationship ◽

Report Measure

Abstract Background Previous research indicates that body dysmorphic disorder (BDD) is associated with risk of suicidality. However, studies have relied on small and/or specialist samples and largely focussed on adults, despite these difficulties commonly emerging in youth. Furthermore, the aetiology of the relationship remains unknown. Methods Two independent twin samples were identified through the Child and Adolescent Twin Study in Sweden, at ages 18 (N = 6027) and 24 (N = 3454). Participants completed a self-report measure of BDD symptom severity. Young people and parents completed items assessing suicidal ideation/behaviours. Logistic regression models tested the association of suicidality outcomes with: (a) probable BDD, classified using an empirically derived cut-off; and (b) continuous scores of BDD symptoms. Bivariate genetic models examined the aetiology of the association between BDD symptoms and suicidality at both ages. Results Suicidal ideation and behaviours were common among those with probable BDD at both ages. BDD symptoms, measured continuously, were linked with all aspects of suicidality, and associations generally remained significant after adjusting for depressive and anxiety symptoms. Genetic factors accounted for most of the covariance between BDD symptoms and suicidality (72.9 and 77.7% at ages 18 and 24, respectively), but with significant non-shared environmental influences (27.1 and 22.3% at ages 18 and 24, respectively). Conclusions BDD symptoms are associated with a substantial risk of suicidal ideation and behaviours in late adolescence and early adulthood. This relationship is largely explained by common genetic liability, but non-shared environmental effects are also significant and could provide opportunities for prevention among those at high-risk.

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