Abstract WP459: Advanced Practice Providers versus Neurology Residents: Similar Stroke Code Quality Metrics and Functional Outcomes

Background: Advanced Practice Providers (APPs) are important members of stroke code teams. However, the impact of APP involvement on quality metrics and functional outcomes is unclear. We sought to evaluate if APPs perform similarly to neurology residents for stroke code quality metrics and functional outcome at 90 days. Methods: We retrospectively analyzed data of consecutive patients who underwent thrombectomy in a single center cohort. Demographics, National Institute of Health Stroke Scale (NIHSS), last known normal (LKN) to emergency department (ED) presentation time, ED door to skin puncture time, recanalization (mTICI IIb/III) rates, and modified rankin scale (mRS) at 90 days were compared between neurology residents and APPs. A multiple logistic regression was used to determine factors independently associated with a favorable mRS at 90 days. Results: A total of 172 patients were included in the study of which 80 (47%) were managed by neurology residents. Both groups (residents vs. APPs) were balanced for age ( p =0.87), NIHSS ( p =0.18), LKN to ED Door time ( p =0.19), ED door to skin puncture time ( p =0.08), recanalization rate ( p =0.28), and favorable outcome (mRS 0-2) ( p =0.27). The multiple logistic regression model found patients with recanalization were 8.9 times more likely to have a favorable outcome. Age and initial NIHSS were found to be negative predictors of mRS (Table 1). Resident or APP involvement in the stroke code process did not impact outcome ( p =0.08). Conclusion: APPs achieve similar acute stroke code metrics and functional outcomes when compared to neurology residents. Further studies are needed to confirm our findings.

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Abstract WP501: Stroke Code Quality Metrics and Functional outcomes: Advanced Practice Providers versus Neurology Residents

Stroke ◽

10.1161/str.50.suppl_1.wp501 ◽

2019 ◽

Vol 50 (Suppl_1) ◽

Author(s):

Laurel Packard ◽

Hattie LaCroix ◽

Tricia Tubergen ◽

Cuyler Huffman ◽

Bassel Raad ◽

...

Keyword(s):

Functional Outcomes ◽

Quality Metrics ◽

Advanced Practice ◽

Code Quality

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764. Will the Addition of Probiotics to Patients Receiving Intravenous Antimicrobial Therapy Reduce the Incidence of Healthcare Facility-Onset Clostridium difficile Infection?

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.961 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S479-S479

Author(s):

Punit Shah ◽

Jessica Kay ◽

Adanma Akogun ◽

Silvia Wise ◽

Sarfraz Aly ◽

...

Keyword(s):

Logistic Regression ◽

Clostridium Difficile ◽

Clostridium Difficile Infection ◽

Primary Outcome ◽

Standard Of Care ◽

Healthcare Facility ◽

Polymerase Chain Reaction Test ◽

Multiple Logistic Regression ◽

Icu Admission ◽

The Impact

Abstract Background Exposure to antimicrobials is a known risk factor for Clostridium difficile infection (CDI). Antimicrobials cause collateral damage by disrupting the natural intestinal microbiota allowing for C.difficile to thrive and production of C.difficile toxins. Probiotics could modulate the onset and course of CDI. However, the data on probiotics for the prevention of CDI is conflicting. Methods We conducted an IRB approved retrospective cohort study at a 340-bed community hospital. All hospitalized patients from August 1, 2017 through July 31, 2020 were evaluated for enrollment. Patients were included if they received at least one dose of intravenous (IV) antibiotic and had a length of stay of at least 3 days. Patients were excluded if they were younger than 18 years, or if they had a positive C.difficile polymerase chain reaction test before antibiotics were started. The primary outcome was the incidence of healthcare facility-onset Clostridium difficile infection (HO-CDI). Descriptive statistics were used to analyze demographics data, and the primary outcome of HO-CDI was analyzed using Fisher’s exact test and multiple logistic regression. Results A total of 20,257 patients received IV antibiotics during the study time frame. Of these, 2,659 patients received probiotics. Primary outcome of HO-CDI occurred in 46 patients in the IV antibiotics alone cohort (0.26%) and 5 patients in the probiotics plus IV antibiotics cohort (0.19%). The difference in HO-CDI between these two groups was not statistically significant, p=0.677. A multiple logistic regression was performed to see the impact of proton pump inhibitor use, age, ICU admission, Charlson Comorbidity Index, probiotic use and CDI in the past 12 months on the primary outcome. C.difficile infection in prior 12 months [OR 3.37, 95%CI 1.04-10.97] and ICU admission [OR 1.81, 95%CI 1.02-3.19] were associated with higher CDI. The addition of probiotics to patients on IV antibiotics did not exhibit a protective effect [OR 0.72, 95% CI 0.28-1.81]. Conclusion The addition of probiotics to standard of care was not beneficial in the prevention of HO-CDI. We endorse robust antibiotic stewardship practices as part of the standard of care bundle that institutions should employ to decrease the incidence of HO-CDI. Disclosures All Authors: No reported disclosures

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Revealing images as Facebook profile pictures: Influences of demographics and relationship status

Social Behavior and Personality An International Journal ◽

10.2224/sbp.6004 ◽

2017 ◽

Vol 45 (6) ◽

pp. 987-997 ◽

Cited By ~ 1

Author(s):

Amir Hetsroni ◽

Dror A. Guldin

Keyword(s):

Logistic Regression ◽

Romantic Relationship ◽

Logistic Regression Model ◽

Relationship Status ◽

Multiple Logistic Regression ◽

Self Presentation ◽

Level Of Education ◽

Younger Age ◽

The Impact ◽

Profile Pictures

In this study, we examined the impact of demographics and relationship status on posting a revealing picture of oneself as a profile picture on Facebook. We randomly sampled and coded 1,000 profiles of Israeli Facebook users ranging in age between 18 and 61 years. Over 40% of the profiles showed at least 1 picture of the user dressed in a skimpy outfit. Results of a multiple logistic regression model indicated that younger age, a lower level of education, and not being engaged in a committed romantic relationship were significant predictors of the posting of these pictures. Further, gender alone was not a significant predictor, but the interaction of gender and level of education was. Specifically, women with a high-schoollevel education posted revealing pictures of themselves more often than did men with a similar level of education. We analyzed our results in light of Goffman's theory of self-presentation.

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The Impact of Radiotherapy Parameters on Lymphopenia and Overall Survival in Patients With Esophageal Cancer

10.21203/rs.3.rs-78837/v1 ◽

2020 ◽

Author(s):

Ming Liu ◽

Xiaoyang Li ◽

Huaidong Cheng ◽

Yansu Wang ◽

Ye Tian

Keyword(s):

Overall Survival ◽

Logistic Regression ◽

Prognostic Factors ◽

Cox Regression ◽

Multiple Logistic Regression Analysis ◽

Cox Proportional Hazards Model ◽

Thoracic Vertebrae ◽

Multiple Logistic Regression ◽

Operating Characteristics ◽

The Impact

Abstract PurposeWe sought to perform survival analysis of patients with thoracic esophageal squamous cell carcinoma (ESCC) receiving definitive radiotherapy and identify prognostic factors among hematological and dosimetric factors.MethodsCases of thoracic ESCC treated with chemoradiation between 2014 and 2017 were identified. The impact of clinicopathological factors’ on overall survival (OS) was analyzed via Cox proportional hazards model. Absolute lymphocyte counts (ALC) and the neutrophil-to-lymphocyte ratio (NLR = ANC/ALC) were assessed before radiotherapy (RT), during RT, and after RT. Cox regression was used to correlate clinical factors with both hematologic toxicities and overall survival. Multiple logistic regression analyses were used to find associations between lymphopenia and dosimetric parameters. The receiver operating characteristics (ROC) curve was used to determine cut-off points.ResultsNinety-nine ESCC patients were enrolled with the median overall survival of 23 months. The median RT dose was 55.75Gy(46–66Gy), and the mean does (Dmean) of thoracic vertebrae dose (TVB) was 27.04±9.65Gy. Based on multivariate analysis, V20 of TVB, pretreatment NLR, and ALC nadir were associated with a worse OS significantly. Concurrent CRT, increasing mean TVB dose and V20 of TVB were associated with higher odds of lymphopenia risk (P＜0.05) through multiple logistic regression analysis.ConclusionsIn ESCC patients who received definitive RT, V20 of TVB, pretreatment NLR, and ALC nadir during RT were independent prognostic factors and chemotherapy regimen, mean TVB dose, and V20 of TVB were associated with lymphopenia.

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Abstract WMP6: Stenting Placement During Endovascular Treatment in VBAO Was Not Associated With 90-Day Outcome in the Basilar Artery Occlusion Endovascular Intervention versus Standard Medical Treatment (BEST) Trial

Stroke ◽

10.1161/str.51.suppl_1.wmp6 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Qiliang Dai ◽

Gelin Xu ◽

Xinfeng Liu ◽

Raul Nogueira

Keyword(s):

Logistic Regression ◽

Endovascular Treatment ◽

Artery Occlusion ◽

Favorable Outcome ◽

Basilar Artery Occlusion ◽

Intracranial Stenting ◽

Safety Outcome ◽

Vertebrobasilar Artery ◽

Standard Medical Treatment ◽

The Impact

Background: The impact of intracranial stenting placement during endovascular treatment for acute vertebrobasilar artery occlusion (VBAO) remains elusive. We aim to investigate the influence of intracranial stenting on 90-day outcomes in the BEST trial. Methods: All patients who underwent endovascular treatment in BEST trial were included in the analysis. The primary efficacy and safety outcome measures were the 90-day rate of favorable outcome (mRS 0-3) and mortality, respectively. Logistic regression was used to investigate the association between stenting placement and outcome. Results: All 77 patients who received endovascular treatment in the trial were included (e.g. full As-Treated population). Baseline and procedural characteristics are summarized in Table 1 . Stenting was performed in 26% (20/77) of the patients. Favorable outcome was achieved in 46.8% patients and mortality rate was 29.9%. Multivariable logistic regression showed that stenting placement in VBAO was not a predictor of either 90-day favorable outcome (adjusted OR, 0.91; 95% CI, 0.31 to 2.65, p=0.86) or 90-day mortality (adjusted OR, 0.91; 95% CI, 0.28 to 3.00, p=0.88). Conclusion: Stenting placement in VBAO during endovascular treatment did not impact outcomes in the BEST trial. Our data suggest that stent placement is a reasonable option for selected VBAO patients. Table 1: Baseline Characteristics and Outcomes Measures in as-treated population.

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Associations between Commonly Used Characteristics in Frailty Assessment and Mental State in Frail Elderly People

Proceedings ◽

10.3390/proceedings2191247 ◽

2018 ◽

Vol 2 (19) ◽

pp. 1247 ◽

Cited By ~ 1

Author(s):

Iván González ◽

Rocío Garrido ◽

Fco Navarro ◽

Jesús Fontecha ◽

Ramón Hervás ◽

...

Keyword(s):

Logistic Regression ◽

Cognitive Decline ◽

Elderly People ◽

Mental State ◽

Mini Mental State Examination ◽

Multiple Logistic Regression ◽

Frail Elders ◽

Frailty Assessment ◽

The Impact ◽

State Examination

This paper presents a cross-sectional study to analyze the impact on cognitive decline of a set of characteristics used for frailty assessment in elderly people. Considered characteristics come from several dimensions, including anthropometric, biological, nutritional, functional and mobility. Cognitive functioning is estimated by the Mini-Mental State Examination test. Additionally, mobility dimension is assessed from two perspectives: one based on direct observation of ambulation through subjective gait analyses; and the other performing explicit gait trials by using the instrumentation provided. In order to accomplish the purpose of this research, a multiple logistic regression analysis is carried out. Variables are grouped according to popular and/or standardized categories adopted in other clinical studies. Mini-Mental State Examination represents the dependent variable, while the characteristics for frailty assessment make up the set of explanatory variables. The multiple logistic regression is performed using a sample of 81 frail elders from two nursing homes in Spain. The results obtained indicate that frail elders aged 90 years of older, with moderate dependence in daily functioning, moderate risk of falls and with a stride interval gait variability greater than 6% were most likely to suffer cognitive decline, representing what is called cognitive frails.

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Analysis of Environmental Factors with Chronic Diarrhea in Toddlers in Jambi City in 2019

International Journal of Science and Society ◽

10.54783/ijsoc.v2i4.216 ◽

2020 ◽

Vol 2 (4) ◽

pp. 300-310

Author(s):

Eko Misriyanto ◽

Rico J. Sitorus ◽

Misnaniarti

Keyword(s):

Logistic Regression ◽

Diarrheal Disease ◽

Chronic Diarrhea ◽

Growth Failure ◽

The Body ◽

P Value ◽

Multiple Logistic Regression ◽

Chi Square ◽

Confidence Degree ◽

The Impact

Chronic diarrhea is defecation with a frequency of 3 or more times in infants and children lasting for 14 days. The impact of diarrheal disease in general causes loss of fluid in the body (dehydration) and chronic diarrhea can cause a child to experience poor nutritional status and experience growth failure. This study uses a case-control design using a retrospective approach. The number of samples in this study was 135 respondents. Instruments for collecting data in the form of questionnaires and observations. Data were analyzed by univariate, bivariate using the Chi-Square test, and multivariate analysis with multiple logistic regression. The statistical test results obtained p-value on the variables of clean water supply (0.007), latrine ownership (0.001), sewerage system (0.04), confidence degree 95% Confidence Interval (95% CI) and p-value ˂ 0, 05, it can be concluded that there is a significant relationship with chronic diarrheal disease in infants. The results of multiple logistic regression tests, on the variable wastewater discharge obtained OR = 3.801, meaning that sewerage is closely related to causing chronic diarrheal disease in infants.

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Deliberate employment of postoperative hypotension for brain arteriovenous malformation surgery and the incidence of delayed postoperative hemorrhage: a prospective cohort study

Journal of Neurosurgery ◽

10.3171/2016.9.jns161333 ◽

2017 ◽

Vol 127 (5) ◽

pp. 1025-1040 ◽

Cited By ~ 6

Author(s):

Michael Kerin Morgan ◽

Markus Karl Hermann Wiedmann ◽

Nazih N. A. Assaad ◽

Michael J. A. Parr ◽

Gillian Z. Heller

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Neurological Deficit ◽

Multiple Logistic Regression Analysis ◽

Postoperative Hemorrhage ◽

Maximum Diameter ◽

Multiple Logistic Regression ◽

Arterial Blood ◽

The Impact

OBJECTIVEThe aim of this study was to examine the impact of deliberate employment of postoperative hypotension on delayed postoperative hemorrhage (DPH) for all Spetzler-Ponce Class (SPC) C brain arteriovenous malformations (bAVMs) and SPC B bAVMs ≥ 3.5 cm in diameter (SPC B 3.5+).METHODSA protocol of deliberate employment of postoperative hypotension was introduced in June 1997 for all SPC C and SPC B 3.5+ bAVMs. The aim was to achieve a maximum mean arterial blood pressure (BP) ≤ 70 mm Hg (with cerebral perfusion pressure > 50 mm Hg) for a minimum of 7 days after resection of bAVMs (BP protocol). The authors compared patients who experienced DPH (defined as brain hemorrhage into the resection bed that resulted in a new neurological deficit or that resulted in reoperation during the hospitalization for microsurgical bAVM resection) between 2 periods (prior to adopting the BP protocol and after introduction of the BP protocol) and 4 bAVM categories (SPC A, SPC B 3.5− [that is, SPC B < 3.5 cm maximum diameter], SPC B 3.5+, and SPC C). Patients excluded from treatment by the BP protocol were managed in the intensive care unit to avoid moderate hypertensive episodes. The pooled cases of all bAVM treated by surgery were analyzed to identify characteristics associated with the risk of DPH. These identified characteristics were then examined by multiple logistic regression analysis in both SPC B 3.5+ and SPC C cases.RESULTSFrom a cohort of 641 bAVMs treated by microsurgery, 32 patients with DPH were identified. Of those, 66% (95% CI 48–80) had a permanent new neurological deficit with a modified Rankin Scale score of 2–6. This included a mortality rate of 13% (95% CI 4.4–29). The BP protocol was used to treat 162 patients with either SPC B 3.5+ or SPC C. For SPC B 3.5+, there was no significant reduction in DPH with the introduction of the BP protocol (p = 0.77). For SPC C, there was a significant (p = 0.035) reduction of DPH from 29% (95% CI 13%–53%) to 8.2% (95% CI 3.2%–18%) associated with the introduction of the BP protocol. Multiple logistic regression analysis found that the absence of the BP protocol (p = 0.011, odds ratio 7.5, 95% CI 1.6–36) remained significant for the development of DPH in patients with SPC C bAVMs.CONCLUSIONSTreating patients with SPC C bAVMs with a protocol that lowers BP immediately after resection seems to reduce the risk of DPH. For SPC A and SPC B 3.5− bAVMs, there is unlikely to be a need to do more than avoid postoperative hypertension. For SPC B 3.5+ bAVMs, a larger number of patients would be required to test the absence of benefit of the BP protocol.

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Hospital-level intracranial pressure monitoring utilization and functional outcome in severe traumatic brain injury: a post hoc analysis of prospective multicenter observational study

Scandinavian Journal of Trauma Resuscitation and Emergency Medicine ◽

10.1186/s13049-020-00825-7 ◽

2021 ◽

Vol 29 (1) ◽

Author(s):

Tomoya Okazaki ◽

Kenya Kawakita ◽

Yasuhiro Kuroda

Keyword(s):

Logistic Regression ◽

Functional Outcome ◽

Functional Outcomes ◽

Multiple Logistic Regression Analysis ◽

Multiple Logistic Regression ◽

Icp Monitoring ◽

Hospital Level ◽

High Group ◽

Severe Tbi ◽

Post Hoc

Abstract Background Several observational studies have shown that hospital-level intracranial pressure (ICP) monitoring utilization varies considerably in patients with severe traumatic brain injury (TBI). However, the relationship between hospital-level ICP monitoring utilization and clinical functional outcomes is unknown. This study examined whether patients with severe TBI treated at hospitals with high ICP monitoring utilization have better functional outcomes. Methods A post hoc analysis of the data from a prospective multicenter cohort study in Japan was undertaken, and included severe TBI patients (Glasgow Come Scale score ≤ 8). The primary exposure was hospital-level ICP monitoring utilization. Patients treated at hospitals with more than 80% ICP monitoring utilization were assigned to a high group and the others to a low group. The primary endpoint was a favorable functional outcome at 6 months after injury, defined as a Glasgow Outcome Scale score of good recovery or moderate disability. We conducted multiple logistic regression analyses adjusted for potential confounders. Results Of the 427 included patients, 60 were assigned to the high group and 367 to the low group. Multiple logistic regression analysis revealed that patients in the high group had significantly better functional outcome (adjusted odds ratio [OR]: 2.36; 95% confidence interval [CI]: 1.17–4.76; p = 0.016). Multiple logistic regression analysis adjusted for additional confounders supported this result (adjusted OR: 2.30; 95% CI: 1.07–4.92; p = 0.033). Conclusion Treatment at hospitals with high ICP monitoring utilization for severe TBI patients could be associated with better functional outcome.

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