Abstract P016: Physical Activity as Key Risk Factors for Incident Dementiain a Thai Population: Health Checks Ubon Ratchathani (HCUR) Study

Introduction: There is little evidence to describe risk factors for dementia in a Thai general population. Hypothesis: This study was aimed to examine factors associated with the risk of developing dementia in a Thai general population in Ubon Ratchathani. Methods: Data on 761,935 men and women participating in the Health Check Ubon Ratchathani (HCUR) Project in 2006-7 were merged with diagnostic information from hospital’s electronic medical records in the following 5 years (2006-2012). Using a retrospective cohort study design, we examined the incidence of physician-diagnosed dementia over 5 years. Factors independently associated with the risk of developing dementia were examined using multivariate cox proportional hazard regression. Results: Over a total time at risk of 4,407,201 person-years, 519 individuals developed dementia, the incidence rate of dementia was 0.12 (95%CI 0.11-0.13) per 1,000 person-years. Factors independently associated with the risk of developing dementia in multivariate cox regression included increasing age, diabetes and lack of physical exercise. The risk of dementia rose by 9% for every one year of age older (Hazard ratio (HR) of 1.09 (1.08-1.09), p<0.001). Diabetes increased the risk of dementia by almost 2 times (HR 1.67 (1.26-2.23), p<0.05). Compared to no physical exercise, regular physical exercise of 3-5 days/week and >5 days/week reduced the risk of dementia by 36% and 57% (HR 0.64 (0.52-0.78) and 0.43 (0.28-0.67) respectively). These associations remained significant after controlling for sex, hypertension, systolic blood pressure, smoking, body mass index, waist circumference, high salt diet and alcohol drinking. Discussion: In this Thai general population, the incidence of dementia was modest and its independent risk factors included increasing age, diabetes and lack of physical exercise. Regular physical exercise may counter balance aging process, the main drive of dementia. The more physical exercise you do, the lower risk of dementia.

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O6: EARLY ANASTOMOTIC BILIARY COMPLICATIONS AFTER LIVER TRANSPLANTATION

British Journal of Surgery ◽

10.1093/bjs/znab117.006 ◽

2021 ◽

Vol 108 (Supplement_1) ◽

Author(s):

SJ Tingle ◽

ER Thompson ◽

SS Ali ◽

IK Ibrahim ◽

E Irwin ◽

...

Keyword(s):

Risk Factors ◽

Liver Transplantation ◽

Hospital Stay ◽

Graft Survival ◽

Cox Regression ◽

Risk Groups ◽

Biliary Complications ◽

Anastomotic Strictures ◽

Selection Of Variables ◽

Independent Risk Factors

Abstract Introduction Biliary leaks and anastomotic strictures are common early biliary complications (EBC) following liver transplantation. However, their impact on outcomes remains controversial and poorly described. Method The NHS registry on adult liver transplantation between 2006 and 2017 was retrospectively reviewed (n=8304). Multiple imputations were performed to account for missing data. Adjusted regression models were used to assess predictors of EBC, and their impact on outcomes. 35 potential variables were included, and backwards stepwise selection enabled unbiased selection of variables for inclusion in final models. Result EBC occurred in 9.6% of patients. Adjusted cox regression revealed that EBCs have a significant and independent impact on graft survival (Leak HR=1.325; P=0.021, Stricture HR=1.514; P=0.002, Leak plus stricture HR=1.533; P=0.034) and patient survival (Leak HR=1.218; P=0.131, Stricture HR=1.578; P<0.001, Leak plus stricture HR=1.507; P=0.044). Patients with EBC had longer median hospital stay (23 versus 15 days; P<0.001) and increased chance for readmission within the first year (56% versus 32%; P<0.001). On adjusted logistic regression the following were identified as independent risk factors for development of EBC: donation following circulatory death (OR=1.280; P=0.009), accessory hepatic artery (OR=1.324; P=0.005), vascular anastomosis time in minutes (OR=1.005; P=0.032) and ethnicity ‘other’ (OR=1.838; P=0.011). Conclusion EBCs prolong hospital stay, increase readmission rates and are independent risk factors for diminished graft survival and increased mortality in liver transplantation. We have identified factors that increase the likelihood of EBC occurrence; further research into interventions to prevent EBCs in these at-risk groups is vital to improve liver transplantation outcomes. Take-home message Using a large registry database we have shown that early anastomotic biliary complications are independent risk factors for decreased graft survival and increased mortality after liver transplantation. Research into interventions to prevent biliary complications in high risk groups are essential to improve liver transplant outcomes.

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A Prognostic Model for Patients With Gastric Signet Ring Cell Carcinoma

Technology in Cancer Research & Treatment ◽

10.1177/15330338211027912 ◽

2021 ◽

Vol 20 ◽

pp. 153303382110279

Author(s):

Qinping Guo ◽

Yinquan Wang ◽

Jie An ◽

Siben Wang ◽

Xiushan Dong ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Cox Regression ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Training Set ◽

Cox Regression Analysis ◽

Signet Ring ◽

Ring Cell ◽

Independent Risk Factors

Background: The aim of our study was to develop a nomogram model to predict overall survival (OS) and cancer-specific survival (CSS) in patients with gastric signet ring cell carcinoma (GSRC). Methods: GSRC patients from 2004 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database and randomly assigned to the training and validation sets. Multivariate Cox regression analyses screened for OS and CSS independent risk factors and nomograms were constructed. Results: A total of 7,149 eligible GSRC patients were identified, including 4,766 in the training set and 2,383 in the validation set. Multivariate Cox regression analysis showed that gender, marital status, race, AJCC stage, TNM stage, surgery and chemotherapy were independent risk factors for both OS and CSS. Based on the results of the multivariate Cox regression analysis, prognostic nomograms were constructed for OS and CSS. In the training set, the C-index was 0.754 (95% CI = 0.746-0.762) for the OS nomogram and 0.762 (95% CI: 0.753-0.771) for the CSS nomogram. In the internal validation, the C-index for the OS nomogram was 0.758 (95% CI: 0.746-0.770), while the C-index for the CSS nomogram was 0.762 (95% CI: 0.749-0.775). Compared with TNM stage and SEER stage, the nomogram had better predictive ability. In addition, the calibration curves also showed good consistency between the predicted and actual 3-year and 5-year OS and CSS. Conclusion: The nomogram can effectively predict OS and CSS in patients with GSRC, which may help clinicians to personalize prognostic assessments and clinical decisions.

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Impact of the Bag Exchange Procedure on Risk of Peritonitis

Peritoneal Dialysis International ◽

10.3747/pdi.2009.00117 ◽

2010 ◽

Vol 30 (4) ◽

pp. 440-447 ◽

Cited By ~ 46

Author(s):

Jie Dong ◽

Yuan Chen

Keyword(s):

Risk Factors ◽

Peritoneal Dialysis ◽

Cox Regression ◽

Face Mask ◽

First Episode ◽

Independent Risk Factors ◽

Randomized Control ◽

The Relationship ◽

Control Study

ObjectiveWe studied whether improper bag exchange predicts the first peritonitis episode in continuous ambulatory peritoneal dialysis (CAPD) patients.Patients and MethodsOur single-center prospective observational study of 130 incident urban CAPD patients who started peritoneal dialysis (PD) between March 2005 and August 2008 aimed to determine the relationship between bag exchange procedures examined at the 6th month of PD and risk for a first peritonitis episode. All patients were followed until a first peritonitis episode, censoring, or the end of the study.ResultsThese 130 patients experienced 22 first peritonitis episodes during the 14-month follow-up. During bag exchange evaluation, 51.5% of patients washed their hands improperly, 46.2% failed to check expiration date or bag leakage, and 11.5% forgot to wear a face mask and cap. Patients experiencing peritonitis were more likely to forget to wear a face mask and cap. In multivariate Cox regression model, not wearing a face mask and cap [hazard ratio (HR): 7.26; 95% confidence interval (CI): 2.6 to 20.1; p < 0.001] and having anemia (HR: 0.96; 95% CI: 0.94 to 0.99; p = 0.005) were independent risk factors for a first episode of peritonitis.ConclusionsNot wearing a face mask and cap and having anemia were independent risk factors for peritonitis. A further randomized control study needs to verify the correlation between improper bag exchange technique and peritonitis in PD patients.

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Implications of cytogenetics for venous thromboembolism in acute myeloid leukaemia

Thrombosis and Haemostasis ◽

10.1160/th13-12-1020 ◽

2015 ◽

Vol 113 (01) ◽

pp. 201-208 ◽

Cited By ~ 4

Author(s):

Ji-hyun Kwon ◽

Sung Yoon ◽

Leo Song ◽

Jae-Ho Yoon ◽

Seung-Hwan Shin ◽

...

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Advanced Age ◽

Leukemia Diagnosis ◽

Incidence Risk ◽

Thrombotic Complications ◽

Predictive Role ◽

Independent Risk Factors ◽

One Year ◽

Acute Myeloid

SummaryDue to the high risk of thrombocytopenia and haemorrhage, thrombotic complications have received little attention in patients with acute myeloid leukemia (AML). Furthermore, the predictive role of cytogenetics on venous thromboembolism (VTE) has largely been ignored. This study aimed to evaluate the incidence, risk factors, and prognostic aspects of VTE in AML. A total of 811 consecutive patients with AML were enrolled and analysed retrospectively. Cox time-dependent covariate regression analysis was used to identify the significant predictors of VTE development. To minimise potential confounding factors, we used propensity-score matching to compare overall survival between patients with and without VTE. The six-month and one-year cumulative incidences of VTE were 3.1 % (95 % confidence interval [CI], 2.0–4.7) and 3.9 % (95 % CI, 2.6–5.7), respectively. Of the 26 cases of VTE, 22 (85 %) developed within 6 months of leukemia diagnosis and 13 (50 %) were catheter-related. In multivariate analysis, advanced age (≥ 65 years) (hazard ratio [HR], 2.70; p = 0.03) and increasing cytogenetic risk (common HR, 1.84; p = 0.05) were independent predictors of VTE. There was no significant association between VTE development and decreased survival (p = 0.32 for matched analysis). Advanced age and increasing cytogenetic risk, well-known predictors for clinical outcome in AML, were also independent risk factors of VTE development. Our results suggest that VTE does not hold prognostic implications for AML.

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Nomogram for Predicting COVID-19 Disease Progression Based on Single-Center Data: Observational Study and Model Development (Preprint)

10.2196/preprints.19588 ◽

2020 ◽

Author(s):

Tao Fan ◽

Bo Hao ◽

Shuo Yang ◽

Bo Shen ◽

Zhixin Huang ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Clinical Characteristics ◽

Cox Regression ◽

Disease Onset ◽

Lasso Regression ◽

Prediction Ability ◽

Calibration Curves ◽

Independent Risk Factors ◽

Critical Patients

BACKGROUND In late December 2019, a pneumonia caused by SARS-CoV-2 was first reported in Wuhan and spread worldwide rapidly. Currently, no specific medicine is available to treat infection with COVID-19. OBJECTIVE The aims of this study were to summarize the epidemiological and clinical characteristics of 175 patients with SARS-CoV-2 infection who were hospitalized in Renmin Hospital of Wuhan University from January 1 to January 31, 2020, and to establish a tool to identify potential critical patients with COVID-19 and help clinical physicians prevent progression of this disease. METHODS In this retrospective study, clinical characteristics of 175 confirmed COVID-19 cases were collected and analyzed. Univariate analysis and least absolute shrinkage and selection operator (LASSO) regression were used to select variables. Multivariate analysis was applied to identify independent risk factors in COVID-19 progression. We established a nomogram to evaluate the probability of progression of the condition of a patient with COVID-19 to severe within three weeks of disease onset. The nomogram was verified using calibration curves and receiver operating characteristic curves. RESULTS A total of 18 variables were considered to be risk factors after the univariate regression analysis of the laboratory parameters (P<.05), and LASSO regression analysis screened out 10 risk factors for further study. The six independent risk factors revealed by multivariate Cox regression were age (OR 1.035, 95% CI 1.017-1.054; P<.001), CK level (OR 1.002, 95% CI 1.0003-1.0039; P=.02), CD4 count (OR 0.995, 95% CI 0.992-0.998; P=.002), CD8 % (OR 1.007, 95% CI 1.004-1.012, P<.001), CD8 count (OR 0.881, 95% CI 0.835-0.931; P<.001), and C3 count (OR 6.93, 95% CI 1.945-24.691; P=.003). The areas under the curve of the prediction model for 0.5-week, 1-week, 2-week and 3-week nonsevere probability were 0.721, 0.742, 0.87, and 0.832, respectively. The calibration curves showed that the model had good prediction ability within three weeks of disease onset. CONCLUSIONS This study presents a predictive nomogram of critical patients with COVID-19 based on LASSO and Cox regression analysis. Clinical use of the nomogram may enable timely detection of potential critical patients with COVID-19 and instruct clinicians to administer early intervention to these patients to prevent the disease from worsening.

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Incidence and risk factors for severe tardive dyskinesia in older patients

The British Journal of Psychiatry ◽

10.1192/bjp.171.2.148 ◽

1997 ◽

Vol 171 (2) ◽

pp. 148-153 ◽

Cited By ~ 37

Author(s):

Michael P. Caligiuri ◽

Jonathan P. Lacro ◽

Enid Rockwell ◽

Lou Ann McAdams ◽

Dilip V. Jeste

Keyword(s):

Risk Factors ◽

Tardive Dyskinesia ◽

Movement Disorder ◽

Cumulative Incidence ◽

Older Patients ◽

Negative Symptoms ◽

Cox Regression ◽

Effective Dosage ◽

Regression Analyses ◽

One Year

BackgroundSevere tardive dyskinesia (TD) represents a serious and potentially disabling movement disorder, yet relatively little is known about the incidence of and risk factors for severeTD.MethodWe report the results of a longitudinal prospective incidence study of severeTD in 378 middle-aged and elderly neuropsychiatric patients. Psychiatric, neuropsychological, pharmacological and motor variables were obtained at intake and at regular intervals for 36 months.ResultsThe cumulative incidence of severeTD was 2.5% after one year, 12.1% after two years, and 22.9% after three years. Individual univariable Cox regression analyses were conducted to identify demographic, psychiatric, motor and pharmacological predictors of severeTD. Results indicated that higher daily doses of neuroleptics at study entry, greater cumulative amounts of prescribed neuroleptic, and greater severity of worsening negative symptoms were predictive of severeTD Conclusions These findings suggest that conventional neuroleptics may be prescribed to older patients only when necessary and at the lowest effective dosage. Additional caution is recommended in patients exhibiting negative symptoms.

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O30 NON-RADICAL ESOPHAGECTOMY FOR ESOPHAGEAL CANCER; A NATIONWIDE STUDY ON INCIDENCE, RISK FACTORS AND OUTCOMES IN SWEDEN

Diseases of the Esophagus ◽

10.1093/dote/doz092.30 ◽

2019 ◽

Vol 32 (Supplement_2) ◽

Author(s):

David Edholm ◽

Petter Hollertz ◽

Per Sandström ◽

Bergthor Björnsson ◽

Dennis Björk ◽

...

Keyword(s):

Risk Factors ◽

Esophageal Cancer ◽

Cox Regression ◽

Regional Lymph Node ◽

Neoadjuvant Treatment ◽

Resected Specimen ◽

Radical Esophagectomy ◽

Term Survival ◽

R1 Resection ◽

Independent Risk Factors

Abstract Aim To identify potential risk factors for a microscopically non-radical esophageal cancer resection (R1) and investigate how such a resection affects long-term survival. Background & Methods Esophageal cancer resections that are considered R1 have been associated with worse survival. The Swedish National Register for Esophageal and Gastric Cancer includes information on all esophageal cancer resections in Sweden. All patients having undergone esophageal resection with curative intent 2006-2017 were included. Risk factors for R1 resection were assessed through logistic regression. Factors predicting five-year survival were assessed through Cox-regression, adjusted for T-stage, N-stage, age and R-status. Results The study included 1,504 patients. The margins were microscopically involved in 146 patients (10%). Of these the circumferential margin was involved in 115 (8%). The proximal margin was involved in 55 patients (4%) and the distal in 30 (2%). In 54 (4%) specimens two margins were involved. Independent risk factors for R1-resection were absence of neoadjuvant treatment and clinical T3 stage or higher. The 5-year survival for the entire cohort was 41%, but only 19% for those with an R1 resection. Independent risk factors for death within 5-year from resection were regional lymph node metastasis (Hazard Ratio (HR) 2.6 (95% CI 2.2-3.1), histopathological stage T3 or higher (HR 1.2 95% CI 1.1-1.5), age above 60 years and R1-resection (HR 1.6 95% CI 1.4-2.0) Conclusion Involved margin in the resected specimen is an independent risk factor predicting worse 5-year survival. Besides striving for adequate surgical margins, the rate of R1-resections could be decreased through neoadjuvant treatment in fit patients.

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The Crescentic Implication of Renal Outcomes in Proliferative Lupus Nephritis

The Journal of Rheumatology ◽

10.3899/jrheum.170553 ◽

2018 ◽

Vol 45 (4) ◽

pp. 513-520 ◽

Cited By ~ 7

Author(s):

Fanghao Cai ◽

Fei Han ◽

Hongya Wang ◽

Haidongqin Han ◽

Jingyun Le ◽

...

Keyword(s):

Risk Factors ◽

Lupus Nephritis ◽

Renal Survival ◽

Endstage Renal Disease ◽

Tubular Atrophy ◽

Renal Outcomes ◽

Proliferative Lupus Nephritis ◽

Independent Risk Factors ◽

Cox Proportional Hazard Regression ◽

Renal Tubular

Objective.To determine the association between crescents and renal outcomes, and the implications on therapeutic choices.Methods.There were 231 patients with biopsy-proven proliferative lupus nephritis (PLN) who were divided into 4 groups: 59 patients were in the noncrescent group (NC); 59 patients exclusively with segmental crescents were in the segmental crescent group (SC); patients with circumferential crescents were categorized into 2 groups according to the crescentic ratio (C1 had 64 patients with ≤ 25%, and C2 had 49 patients with > 25%). Their baseline laboratory tests, histopathological manifestations, and outcomes were compared.Results.Remission rates in NC, SC, C1, and C2 groups were 92.1%, 85.4%, 95.0%, and 76.1%, respectively. Fewer patients in the C2 group achieved complete remission than the other 3 groups. For longterm outcomes evaluated by serum creatinine (SCr) doubling or endstage renal disease (ESRD), the renal survival rate was lowest in the C2 group (p = 0.003). Including clinical and pathological variables in the Cox proportional hazard regression model separately, the multivariate analysis revealed that these were independent risk factors for SCr doubling or ESRD: baseline SCr (with every 1 mg/dl increase: HR = 1.834, 95% CI 1.465–2.296; p < 0.001), hemoglobin (with every 1 g/l increase: HR = 0.970, 95% CI 0.947–0.992; p = 0.009), the proportions of cellular crescents (with every 1% increase: HR = 1.040, 95% CI 1.015–1.066; p = 0.002) and fibrocellular crescents (with every 1% increase: HR = 1.085, 95% CI 1.013–1.163; p = 0.020), and severe renal tubular atrophy (HR = 5.348, 95% CI 1.278–22.373; p = 0.022).Conclusion.PLN with crescents > 25% had worse renal outcomes both in short and long terms. Proportions of cellular and fibrocellular crescents were independent risk factors for poor renal survival.

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Defining heart disease risk for death in COVID-19 infection

QJM ◽

10.1093/qjmed/hcaa246 ◽

2020 ◽

Vol 113 (12) ◽

pp. 876-882 ◽

Cited By ~ 1

Author(s):

J Li ◽

T Guo ◽

D Dong ◽

X Zhang ◽

X Chen ◽

...

Keyword(s):

Risk Factors ◽

Cox Regression ◽

Disease Risk ◽

Demographic Data ◽

Kidney Injury ◽

Laboratory Findings ◽

Course Of Disease ◽

Clinical Observations ◽

Independent Risk Factors ◽

Heart Disease Risk

Summary Background Cardiovascular disease (CVD) was in common in coronavirus disease 2019 (COVID-19) patients and associated with unfavorable outcomes. We aimed to compare the clinical observations and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients with or without CVD. Methods Patients with laboratory-confirmed SARS-CoV-2 infection were clinically evaluated at Wuhan Seventh People’s Hospital, Wuhan, China, from 23 January to 14 March 2020. Demographic data, laboratory findings, comorbidities, treatments and outcomes were collected and analyzed in COVID-19 patients with and without CVD. Results Among 596 patients with COVID-19, 215 (36.1%) of them with CVD. Compared with patients without CVD, these patients were significantly older (66 vs. 52 years) and had higher proportion of men (52.5% vs. 43.8%). Complications in the course of disease were more common in patients with CVD, included acute respiratory distress syndrome (22.8% vs. 8.1%), malignant arrhythmias (3.7% vs. 1.0%) including ventricular tachycardia/ventricular fibrillation, acute coagulopathy(7.9% vs. 1.8%) and acute kidney injury (11.6% vs. 3.4%). The rate of glucocorticoid therapy (36.7% vs. 25.5%), Vitamin C (23.3% vs. 11.8%), mechanical ventilation (21.9% vs. 7.6%), intensive care unit admission (12.6% vs. 3.7%) and mortality (16.7% vs. 4.7%) were higher in patients with CVD (both P < 0.05). The multivariable Cox regression models showed that older age (≥65 years old) (HR 3.165, 95% CI 1.722–5.817) and patients with CVD (HR 2.166, 95% CI 1.189–3.948) were independent risk factors for death. Conclusions CVD are independent risk factors for COVID-19 patients. COVID-19 patients with CVD were more severe and had higher mortality rate, early intervention and vigilance should be taken.

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