Abstract P165: Comparing Grip Strength, Weakness, And Frailty Based On Comorbidity And Laboratory Data Among Patients With Cardiovascular Disease

Introduction: Some approaches to frailty screening use diagnostic or laboratory data that may be incomplete. Grip strength can identify weakness, a component of phenotype-based frailty assessment. We compared grip strength as a reductionist, phenotype-based approach to frailty screening with comorbidity and laboratory-based alternatives. Hypothesis: Grip strength and categorical weakness are correlated with the modified frailty index-5 (mFI-5) and lab values associated with frailty. Methods: Weakness based on grip, BMI, and gender was compared with mFI-5 comorbidities and lab values. Patients with at least 3/5 mFI-5 comorbidities were considered frail. Lab data collected within 6 months of grip measurement was assessed. Associations were evaluated using multivariable models and kappa. Methods: 2,597 patients had grip strength measured over 5 months. Mean age was 64.4±14.6, mean BMI was 29.5±6.9;46% were women, and 87% white. Prevalent comorbidities included hypertension (28%), CHF (22%), diabetes (29%), and COPD (26%); 9% were functionally dependent. 34% were weak, but only 13% were frail based on mFI-5. Hemoglobin, creatinine, and CRP differed significantly based on weakness ( Table ). Laboratory data were missing for 36%- 95% of patients. Multivariable models identified significant associations between weakness, hemoglobin, and all MFI-5 comorbidities. Categorical agreement between weakness and frailty was limited (kappa =0.09; 95% CL 0.0641-0.1232). Conclusion: Weakness based on grip strength provides a practical, inexpensive approach to risk assessment, especially when incomplete data excludes other approaches. Comorbidity-based assessment categorizes many weak patients as non-frail. Table. Demographic, laboratory values, and comorbidities by categorical weakness based on grip 20 th percentile. Mean values for continuous variables by weakness adjusted for gender and BMI, p-value for T-test; frequency and total percent for categorical variables, p-value represents chi-square test.

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VOMITING

The Professional Medical Journal ◽

10.29309/tpmj/18.4556 ◽

2018 ◽

Vol 25 (12) ◽

pp. 1887-1891

Author(s):

Malik Jamil Ahmed ◽

Muhammad Nasir ◽

Aamir Furqan

Keyword(s):

Computer Software ◽

Outcome Variable ◽

Categorical Variables ◽

P Value ◽

Continuous Variables ◽

Postoperative Vomiting ◽

Hospital Data ◽

Chi Square ◽

Oral Ketamine ◽

The Difference

Objectives: To investigate whether the addition of dexamethasone and chloropheniramine to oral ketamine premedication affects the incidence of postoperative vomiting. Study Design: Randomized control trail. Setting: Department of Anesthesia and Intensive Care Nishtar Hospital, Multan. Period: March 2016 to March 2017. Methodology: After obtaining ethical approval ethical and review board of hospital. Data was entered in a computer software SPSS version 23.1 and analyzed for possible variables. Continuous variables were presented as mean and standard deviation like age, weight, sedation time, anesthesia time, admission time and PACU time. Categorical variables were presented as gender, ASA statusand postoperative vomiting. Student test and chi square test was applied to see association of outcome variable. P value of 0.05 was taken as significant. Results: Overall, 100% (n=80) patients were included in this study, both genders. The study group was further divided into twoequal groups, 50% (n=40) in each, i.e. Group K (Ketamine) group and group KD (Ketamine-Dexamethasone). The main outcome variable of this study was postoperative vomiting. In this study, Postoperative vomiting observed in 35% (n=10) and 10% (n=4) patients, for group K and group KD respectively. The difference was statistically significant (p=0.007). Conclusion: Addition of dexamethasone and chloropheniramine with ketamine as premedication reduce the incidence of postoperative vomiting.

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HEMORRHOIDECTOMY;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.09.879 ◽

2017 ◽

Vol 24 (09) ◽

pp. 1316-1321

Author(s):

Shibber Ahmed ◽

Ishtiaq Ahmad ◽

Humayun Amjid ◽

Aamir Furqan

Keyword(s):

Hospital Stay ◽

Severe Pain ◽

Conventional Technique ◽

Categorical Variables ◽

P Value ◽

Chi Square ◽

Post Operative Pain ◽

Group A ◽

And Gender ◽

Group B

Objectives: Is to compare outcomes in terms of mean post-operative pain andhospital stay between stapled versus conventional hemorrhoidectomy. Hypothesis: There isa difference in mean post-operative pain and hospital stay between stapled and conventionalhemorrhoidectomy, stapled technique is better than conventional technique. Study Design:Randomized control trial. Setting: Department of General Surgery Bakhtawar Amin MemorialHospital Multan. Period: February 2016 February 2017. Methodology: A total number of 60patients enrolled in the study, both genders. Statistical software SPSS ver.23 was used toanalyze the data. Mean and SD were calculated and presented for numerical variables likeduration of hemorrhoids, age and pain score while frequencies and percentage were calculatedand presented for categorical variables like ender and grade of hemorrhoids. Independent t-testand chi square test were applied to see effect modification. P value ≤0.05 was considered assignificant. Results: Total number of 60 (100%) patients in the study, 32 (53.3%) were maleand 28 (46.7 %) were female. Mean hospital stay in group A was 1.63 ± 0.71 and in groupB means duration of hospital stay was 1.73 ± 0.74. A P value was 0.001. On stratification ofdata it is concluded that in group A 9 patients have no pain 6 have mild and 6 have moderatepain and 5 patients have severe pain, similarly in group B, 3 patients have no pain 2 have mildpain 1 have moderate pain and no patient have severe pain. P value for male patients was2.65. Conclusion: This study confirms that stapled hemorrhoidectomy is associated with lesspostoperative pain with no effect of age and gender on outcome.

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A nomogramic model based on clinical and laboratory parameters at admission for predicting the survival of COVID-19 patients

10.21203/rs.3.rs-34708/v1 ◽

2020 ◽

Author(s):

Xiaojun Ma ◽

Huifang Wang ◽

Junwei Huang ◽

Yan Geng ◽

Shuqi Jiang ◽

...

Keyword(s):

Risk Factors ◽

Bootstrap Method ◽

Characteristic Curve ◽

Laboratory Data ◽

Categorical Variables ◽

P Value ◽

Continuous Variables ◽

Model Based ◽

Independent Risk Factors ◽

D Dimer

Abstract Background and Aim COVID-19 has become a major global threat. The present study aimed to develop a nomogram model to predict the survival of COVID-19 patients based on their clinical and laboratory data at admission. Methods COVID-19 patients who were admitted at Hankou Hospital and Huoshenshan Hospital in Wuhan, China from January 12, 2020 to March 20, 2020, whose outcome during the hospitalization was known, were retrospectively reviewed. The categorical variables were compared using Pearson’s χ2-test or Fisher’s exact test, and continuous variables were analyzed using Student’s t-test or Mann Whitney U-test, as appropriate. Then, variables with a P-value of ≤0.1 were included in the multivariate model, and merely these independent risk factors were used to establish the nomogram model. The discrimination of the nomogram was evaluated using the area under the receiver operating characteristic curve (AUC), and internally verified using the Bootstrap method. Results A total of 262 patients (134 surviving and 128 non-surviving patients) were included in the analysis. Seven variables, which included age (odds ratio [OR]: 0.905, 95% confidence interval [CI]: 0.868-0.944; P<0.001), chronic heart disease (CHD, OR: 0.048, 95% CI: 0.013-0.180; P<0.001), the percentage of lymphocytes (Lym%, OR: 1.116, 95% CI: 1.051-1.184; P<0.001), platelets (OR: 1.008, 95% CI: 1.003-1.012; P=0.001), C-reaction protein (OR: 0.982, 95% CI: 0.973-0.991; P<0.001), lactate dehydrogenase (LDH, OR: 0.993, 95% CI: 0.990-0.997; P<0.001) and D-dimer (OR: 0.734, 95% CI: 0.615-0.875; P=0.001), were identified as the independent risk factors. The nomogram model based on these factors exhibited a good discrimination, with an AUC of 0.948 (95% CI: 0.923-0.973). Conclusion A nomogram based on age, CHD, Lym%, platelets, C-reaction protein, LDH and D-dimer was established to accurately predict the prognosis of COVID-19 patients. This can be used as an alerting tool for clinicians to take early intervention measures, when necessary.

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Analysis of pre-prosthetic surgeries performed in a private dental institution

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl3.3504 ◽

2020 ◽

Vol 11 (SPL3) ◽

pp. 1737-1742

Author(s):

Nurul Syamimi Binti Mohd Azlan Sunil ◽

Santhosh Kumar M P ◽

Revathi Duraisamy

Keyword(s):

Maxillofacial Surgery ◽

Categorical Variables ◽

P Value ◽

Oral And Maxillofacial Surgery ◽

Age Group ◽

Chi Square ◽

Tests Of Association ◽

Spss Software ◽

And Gender ◽

Prosthetic Surgery

Pre-prosthetic surgery is part of the oral and maxillofacial surgery, which concerns restoration of facial form and oral function. Pre-prosthetic surgery is a surgery done to obtain a better anatomic environment and to provide proper supporting structures for denture construction. The aim of this study was to analyse the various pre-prosthetic surgeries performed in a private dental institution. In this retrospective study, digital case records of all patients who underwent pre-prosthetic surgeries in Saveetha Dental College and Hospital from June 2019 to March 2020 were reviewed. Demographic details of patients and types of pre-prosthetic surgeries performed were recorded from digital case records. Retrieved data was analysed using IBM SPSS Software Version 23.0. Descriptive statistics and tests of association for categorical variables by Chi square tests were done and results were obtained. P value <0.05 was considered statistically significant. In this study, we observed that pre-prosthetic surgery was more commonly performed in the age group of 51-60 yrs (23.3%). Pre-prosthetic surgeries were done more in males than females. The most common type of pre-prosthetic surgery was valvuloplasty (62.2%), followed by frenectomy (20.7%). Statistically, a significant association was found between pre-prosthetic surgery and age group; pre-prosthetic surgery and gender; pre-prosthetic surgery and quadrant involved (p<0.05) Within the limits of this study, it can be concluded that the most common pre-prosthetic surgery performed was valvuloplasty. Pre-prosthetic surgery was performed more in males and the age group of 51-60 years, mostly in the third quadrant.

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Comparison of Visuospatial Skill Development Between Preclinical and Clinical Undergraduate Students Using Dentinal Pin Placement Exercise

Journal of The Pakistan Dental Association ◽

10.25301/jpda.303.147 ◽

2021 ◽

Vol 30 (03) ◽

pp. 147-151

Author(s):

Alia Ahmed ◽

◽

Usman Anwer Bhatti

Keyword(s):

Undergraduate Students ◽

Dental Students ◽

Two Dimensions ◽

Categorical Variables ◽

P Value ◽

Psychomotor Skills ◽

Continuous Variables ◽

Chi Square ◽

Significant Difference ◽

Second Year

OBJECTIVE: The objective of this study was to compare visuospatial and psychomotor skills of second year pre-clinical dental students with final year dental students using an exercise in dentinal pin placement. METHODOLOGY:A total of 120 BDS undergraduate students who had completed second or final year Operative dentistry rotation were included. While students from second and final year who had not consented to participate or had missed the practical demonstration or whose dentinal pins were misplaced after becoming loose from the tooth were excluded. Participating students placed the dentinal pins, following which Adobe Photoshop (version CC 2014) was used to analyze the photographs of the taken radiographs in two dimensions. Parameters assessed were pulpal perforations, periodontal perforations and pin angulation. Independent sample t-test was used to compare continuous variables while chi-square test was used for testing association for categorical variables. RESULTS: Final year students fared better in all categories of pin placement except periodontal perforation which was the same for both years. Statistically significant difference in the angulation for pin placement were observed between the two student groups in mesiodistal direction (p value =0.001) and in buccolingual direction (p value <.001). CONCLUSION: There is a significant difference in the psychomotor and visuospatial skill of second year pre-clinical when compared with the final year clinical undergraduate students. KEYWORDS: curriculum, dental, learning, operative, students.

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Cartas de control para monitorear variables multinomiales

Respuestas ◽

10.22463/0122820x.441 ◽

2014 ◽

Vol 19 (2) ◽

pp. 93-100

Author(s):

Luz Marcela Restrepo-Tamayo ◽

Juan Carlos Correa-Morales

Keyword(s):

Control Chart ◽

Control Charts ◽

Average Run Length ◽

Stable Condition ◽

Poor Performance ◽

Categorical Variables ◽

P Value ◽

Homogeneity Test ◽

Continuous Variables ◽

Chi Square

Antecedentes: La carta de control como herramienta de monitoreo de la calidad de un producto, permite estudiar la estabilidad de los procesos en el tiempo, contrastando dos hipótesis, una que expresa que el proceso se encuentra en estado estable y otra que lo niega. Su utilización ha sido masiva para variables continuas más no para variables categóricas, motivo por el cual es imperante el diseño de tales herramientas para ese tipo de variables. Objetivo: Proponer dos (2) cartas de control para procesos con variables multinomiales basadas en el valor-p resultado de la prueba de homogeneidad de proporciones, empleando la transformación chicuadrado para variables uniformes y la aproximación Wilson - Hilferty para variables chi cuadrado. Métodos: El desempeño de las cartas propuestas es estimado vía simulación considerando un proceso en Fase II y considerando incrementos en la primera categoría de 2%, 4% y 6% en la etapa de control. Resultados: La carta de control multinomial usando aproximación Wilson- Hilferty para variables chi cuadrado, provenientes de la transformación del valor-p, presenta un desempeño deficiente comparado con las cartas de control usando valor-p y usando transformación chi cuadrado al valor-p, pues tienen menor habilidad para detectar cambios pequeños. Conclusión: Proponemos dos cartas de control para monitorear variables multinomiales y, una vez estudiadas vía simulación, con base en la Longitud de corrida promedio (ARL) y la probabilidad de rechazar la hipótesis nula de igualdad de proporciones, se recomienda el uso de la carta de control usando valor-p,o equivalentemente, de la carta de control usando transformación chi cuadrado del valor-p.Palabras clave: carta de control, distribución multinomial, prueba de homogeneidad, valor-p. Abstract Background: The control as a tool for monitoring the quality of a product, allows to study the stability of processes over time, contrasting two hypothesis, which states that the process is in stable condition and the other denies it. Its use has been massive for continuous variables but not for categorical variables, why it is imperative to design such tools for such variables. Objective: To propose two (2) control charts for variables multinomial processes based on the p-value test result for homogeneity of proportions using the chi square test for uniform processing variables and approximation Wilson - Hilferty for variables chi square. Methods: The performance of proposed charts via simulation is estimated considering a Phase II process and considering the first category increments of 2%, 4% and 6% in the control stage. Results: The multinomial control chart using Wilson-Hilferty approximation for variables chi square, from the transformation of value-p, has poor performance compared to the control charts using p-value processing and using chi-square p-value, as they have less ability to detect small changes. Conclusion: We propose two control charts to monitor multinomial variables and once studied via simulation, based on the average run length (ARL) and the probability of rejecting the null hypothesis of equal proportions, we recommend the control chart using value-p, or equivalently, the control chart processing using chi square p-value.Keywords: control chart, multinomial distribución, homogeneity test, p-value.

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Shift Length and Shift Length Preference Among Acute Care Surgeons

The American Surgeon ◽

10.1177/00031348211025752 ◽

2021 ◽

pp. 000313482110257

Author(s):

John Kepros ◽

Susan Haag ◽

Karen Lewandowski ◽

Frank Bauer ◽

Hirra Ali ◽

...

Keyword(s):

Acute Care ◽

Trauma Center ◽

The United States ◽

Categorical Variables ◽

Continuous Variables ◽

Chi Square ◽

Significant Difference ◽

And Gender ◽

High Level ◽

Shift Length

Background Work hour restrictions have been imposed by the Accreditation Council for Graduate Medical Education since 2003 for medical trainees. Many acute care surgeons currently work longer shifts but their preferred shift length is not known. Methods The purpose of this study was to characterize the distribution of the current shift length among trauma and acute care surgeons and to identify the surgeons’ preference for shift length. Data collection included a questionnaire with a national administration. Frequencies and percentages are reported for categorical variables and medians and means with SDs are reported for continuous variables. A chi-square test of independence was performed to examine the relation between call shift choice and trauma center level (level 1 and level II), age, and gender. Results Data from 301 surgeons in 42 states included high-level trauma centers. Assuming the number of trauma surgeons in the United States is 4129, a sample of 301 gives the survey a 5% margin of error. The median age was 43 years (M = 46, SD = 9.44) and 33% were female. Currently, only 23.3% of acute care surgeons work a 12-hour shift, although 72% prefer the shorter shift. The preference for shorter shifts was statistically significant. There was no significant difference between call shift length preference and trauma center level, age, or gender. Conclusion Most surgeons currently work longer than 12-hour shifts. Yet, there was a preference for 12-hour shifts indicating there is a gap between current and preferred shift length. These findings have the potential to substantially impact staffing models.

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The Effects of Ovulation Documentation before Insemination on Intrauterine Insemination Cycle Outcomes: A Retrospective Analysis

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/46802.14629 ◽

2021 ◽

Author(s):

Sujata Pradhan ◽

Padmalaya Thakur

Keyword(s):

Pregnancy Rate ◽

Live Birth ◽

Birth Rate ◽

Intrauterine Insemination ◽

Live Birth Rate ◽

Categorical Variables ◽

P Value ◽

Continuous Variables ◽

Chi Square ◽

Exact Test

Introduction: Ovulation is the key event in Intrauterine Insemination (IUI) cycles. Monitoring ovulation prior to insemination will help to alter insemination time to improve pregnancy rate. Aim: To compare pregnancy rates and live birth rates in presence and absence of ultrasonographic features of ovulation before insemination in IUI cycles. Materials and Methods: This was a retrospective cohort study conducted in a Institute of Medical Sciences and SUM Hospital, Bhubaneswar. Three hundred eighty eight IUI cycles performed in the period of January 2017 to December 2018 were analysed. On the day of IUI prior to insemination, transvaginal ultrasonography was done 36-38 hours after ovulation trigger to document ovulation. Presumptive signs of ovulation were documented in 201 cycles (Group A) and there was no feature suggestive of ovulation in 187 cycles (Group B). In all the cycles, single insemination was performed at 38-40 hours after ovulation trigger. Baseline characteristics were compared. Mann-Whitney U test was used to compare continuous variables. Chi-square test and Fisher’s-exact test were applied to find out the differences in the categorical variables as well as the pregnancy outcomes among the groups. Pregnancy rate and live birth rate were considered as the primary outcomes. Results: Pregnancy rate (17.9% vs 18.2%, p-value=0.945) and live birth rate (17.9% vs 16.0%, p-value=0.625) were similar irrespective of ovulation status documented in ultrasonography performed before insemination. Conclusion: IUI cycle outcomes are independent of the ovulation status documented before insemination.

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Are Fractures To The Bony Cage Protecting the Abdomen Associated with Splenectomy in Cases of Abdominal Trauma? A Cohort Study

10.21203/rs.3.rs-640046/v1 ◽

2021 ◽

Author(s):

Amay Banker ◽

Martin Gerdin Wärnberg ◽

Anita Gadgil ◽

Bhakti Sarang ◽

Ramlal Prajapati ◽

...

Keyword(s):

Splenic Injury ◽

Trauma Registry ◽

Categorical Variables ◽

P Value ◽

Continuous Variables ◽

Chi Square ◽

Initial Hypothesis ◽

Chi Square Test ◽

Care Outcomes ◽

Unadjusted Analysis

Abstract Background The spleen is protected by the ribs anteriorly, the vertebral column posteriorly and the pelvis inferiorly. Fractures to this bony cage may indicate a high-grade splenic injury necessitating splenectomy. We aim to determine whether fractures to the bony cage protecting the abdomen are associated with splenectomy. Methods We performed a subgroup analysis of patients with splenic injury from a prospective trauma registry study named ‘Towards Improved Trauma Care Outcomes’ (TITCO) in India. Out of the 16047 patients enrolled in the TITCO study, 267 patients with splenic injury were included. Categorical variables were analyzed using the chi square test and logistic regression was used to assess the significance of continuous variables. A multivariate analysis was performed on the factors deemed clinically most significant. Results Patients with a higher grade of splenic injury were more likely to require splenectomy when adjusted for other variables (p value < 0.05). Patients with fractures to the vertebrae or pelvis had reduced odds of splenectomy on unadjusted analysis [Odds ratio 0.43 (0.19–0.94)], but this was not significant when adjusted for other variables. Conclusion In contradiction to our initial hypothesis, we found that fractures to the bony cage protecting the abdomen were not significantly associated with the splenectomy.

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Patterns of Clinical Presentation of Thrombotic Thromboxytopenic Purpura. Is There a Racial Difference?. A Single Institution Experience.)

Blood ◽

10.1182/blood.v120.21.4653.4653 ◽

2012 ◽

Vol 120 (21) ◽

pp. 4653-4653

Author(s):

Muath Dawod ◽

Mohammad Alhyari ◽

Philip Kuriakose

Keyword(s):

African Americans ◽

Clinical Presentation ◽

Conflicts Of Interest ◽

Laboratory Evaluation ◽

Categorical Variables ◽

P Value ◽

Continuous Variables ◽

Chi Square ◽

Gi Symptoms ◽

Serious Disease

Abstract Abstract 4653 Background: Thrombotic thrombocytopenic purpura (TTP) is a rare but serious disease that has been reported more frequently in African-Americans (AA). While recent reports have showed an increased incidence of TTP amongs AA patients, there is no data with regards to the patterns of clinical presentation in this racial subgroup and if there is any difference as compared to other racial subgroups. Patients and methods: In this retrospective study we reviewed characterstics and clinical presentation of 91 patients with the diagnosis of TTP. Sixty four patients were AAs (70%). The second largest racial subgroup was Caucasians (24 patients, 26%). Demographics, lab values and symptoms were compared between AAs and Caucasians. Continuous variables were compared using two-sided two-sample t-tests. Alternatively, the Wilcoxon rank-sum test was used if the data were not normally distributed. Categorical variables were compared using Chi-square tests. Results: AA patients were older [median age of 47.6 years as compared to 40 years, P-value of 0.057] and more likely to be females [68.8%, (n=44/64) as compared to 45.8%, (n=11/24), P-value of 0.048]. As for laboratory evaluation, AA patients were more likely to have positive ANA [44% (n=22/64) as compared to 14.3% (n=2/24), P-value of 0.042] and higher ESR (median of 75.5 as compared to 40.7, P-value 0.03). Other laboratory evaluation including hemoglobin, platelet counts and creatinine were comparable. The most common patterns of clinical presentation in AA patients were in the form of constitutional symptoms (fatigue, malaise and generalized weakness) which were seen in 67% of patients (n=43), followed by neurological symptoms (mainly headache and confusion) in 53% of pateints (n=34). Gastrointestinal (GI) symptoms (nausea, vomiting or abdominal pain) were seen in 44% of patients (n=28). This pattern was comparable to what is seen in Caucasian patients. Skin symptoms were reported less frequently in AA as compared to Caucasians (17.2% vs. 41.7%, p = 0.016). Conclusion: While AA patients are more likely to be females, older and have positive ANA, the clinical presentation of TTP is similar among different racial subgroups (African Americans and Caucasians). Disclosures: No relevant conflicts of interest to declare.

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