EXPRESS: A Composite Risk Model Predicts Disease Progression in Early Stages of COVID-19: a Propensity Score-matched Cohort Study

Background: Recently, studies on COVID-19 have focused on the epidemiology of the disease and clinical characteristics of patients, as well as on the risk factors associated with mortality during hospitalization in critical COVID-19 cases. However, few research has been performed on the prediction of disease progression in particular group of patients in the early stages of COVID-19. Methods: The study included 338 patients with COVID-19 treated at two hospitals in Wuhan, China, from December, 2019 to March, 2020. Predictors of the progression of COVID-19 from mild to severe stages were selected by the logistic regression analysis. Results: COVID-19 progression to severe and critical stages was confirmed in 78(23.1%) patients. The average value of the neutrophil-to-lymphocyte ratio (NLR) was higher in patients in the disease progression group than in the improvement group. Multivariable logistic regression analysis revealed that elevated NLR, LDH, and IL-10, were independent predictors of disease progression. The optimal cut-off value of NLR was 3.75. The values of the area under the curve, reflecting the accuracy of predicting COVID-19 progression by NLR was 0.739(95%CI: 0.605-0.804). The risk model based on NLR, LDH and IL-10 had the highest area under the ROC curve. Conclusions: The performed analysis demonstrates that high level of NLR, LDH, and IL-10 were independent risk factors for predicting disease progression in patients at the early stage of COVID-19. The risk model combined with NLR, LDH and IL-10 improved the accuracy of the prediction of disease progression in patients in the early stages of COVID-19.

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A Composite Index Predicts Disease Progression in Early Stages of COVID-19: a Propensity Score-matched Cohort Study

10.21203/rs.3.rs-30635/v1 ◽

2020 ◽

Author(s):

Jianjun Xu ◽

Shaobo Hu ◽

Suzhen Li ◽

Weimin Wang ◽

Yuzhe Wu ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Propensity Score ◽

Disease Progression ◽

Logistic Regression Analysis ◽

Independent Predictor ◽

Early Stage ◽

Multivariable Logistic Regression Analysis ◽

Matched Cohort ◽

Early Stages

Abstract Background: Thus far, studies on COVID-19 have focused on the epidemiology of the disease and clinical characteristics of patients (14-19), as well as on the risk factors associated with mortality during hospitalization in critical COVID-19 cases. However, no research has been performed on the prediction of progression in patients in the early stages of the disease. The aim of this work was to identify the early predictors of COVID-19 progression.Methods: The study included 338 patients with COVID-19 treated at two hospitals in Wuhan, Chian, from December, 2019 to March, 2020. Predictors of the progression of COVID-19 from mild to severe stages were selected by the logistic regression analysis. The predictive accuracy was evaluated further in the propensity score-matched cohort.Results: COVID-19 progression to severe and critical stages was confirmed in 78(23.1%) patients. The average value of the neutrophil-to-lymphocyte ratio (NLR) was higher in patients in the disease progression group than in the improvement group. Multivariable logistic regression analysis revealed that elevated NLR, LDH, and IL-10, were independent predictors of disease progression. The optimal cut-off value of NLR for predicting the progression of COVID-19 was 3.75. In the propensity score-matched cohort, NLR ≥ 3.75 was still an independent predictor of COVID-19 progression after multivariate analysis.Conclusions: The performed analysis demonstrates that NLR qualiﬁes as an independent predictor of disease progression in COVID-19 patients at the early stage of the disease. The combined evaluation of NLR and LDH improved the accuracy of the prediction of COVID-19 progression. Assessment of predictors might facilitate early identification of COVID-19 patients at high risk for disease progression and ensure timely administration of appropriate treatment to prevent mild cases from becoming severe.

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Weight Loss in Parkinson’s Disease: The Relationship with Motor Symptoms and Disease Progression

BioMed Research International ◽

10.1155/2018/9642524 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 11

Author(s):

Maria G. Cersosimo ◽

Gabriela B. Raina ◽

Luis A. Pellene ◽

Federico E. Micheli ◽

Cristian R. Calandra ◽

...

Keyword(s):

Weight Loss ◽

Logistic Regression ◽

Regression Analysis ◽

Disease Progression ◽

Logistic Regression Analysis ◽

Disease Duration ◽

Multivariable Logistic Regression Analysis ◽

Single Session ◽

Multivariable Logistic Regression ◽

The Relationship

Objectives.To determine the prevalence of weight loss (WL) in PD patients, its relationship to the severity of motor manifestations and appetite changes.Methods.144 PD patients and 120 controls were evaluated in a single session. All subjects were asked about changes in body weight and appetite. PD patients were examined with the UPDRS-III and the Hoehn and Yahr (HY) scales. Subscores of tremor, bradykinesia /rigidity, and non-dopaminergic symptoms (NDS) were analyzed individually. Multivariable logistic regression analysis was used to determine an association between WL and PD motor manifestations.Results.48.6 % of PD patients presented WL compared to 20.8 % of controls (p < 0.001). Weight losers were significantly older and had longer disease duration, higher scores in HY stages, UPDRS-III, and NDS-subscore. Multivariable logistic regression analysis demonstrated that WL was associated with NDS-subscore (p= 0.002; OR: 1.33) and older age (p= 0.037; OR: 1.05). Appetite in PD cases losing weight was unchanged (35.7 %), decreased (31.4 %), or even increased (32.9).Conclusions.Our results showed that WL occurs in almost half of PD patients and it is largely the consequence of disease progression rather than involuntary movements or a decrease in food intake.

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Outcomes of cancer patients with takotsubo cardiomyopathy.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e18101 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e18101-e18101

Author(s):

Achuta Kumar Guddati ◽

Gagan Kumar ◽

Iuliana Shapira ◽

Parijat Saurav Joy

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Cancer Patients ◽

Logistic Regression Analysis ◽

Takotsubo Cardiomyopathy ◽

Primary Diagnosis ◽

Multivariable Logistic Regression Analysis ◽

Solid Organ ◽

Multivariable Logistic Regression

e18101 Background: Chemotherapy induced cardiomyopathy is an important complication of some chemotherapeutic agents. The stress of a cancer diagnosis and ongoing chemotherapy may contribute to cardiac morbidity in these patients. The burden of Takotsubo Cardiomyopathy (TCP) in cancer patients is unknown. The incidence of TCP and related outcomes in cancer patients was investigated in this study. Methods: The 2007-2013 National Inpatient Sample (NIS) was analyzed for patients with a prior and new diagnosis of TCP with and without malignancy. Risk factors for mortality were adjusted for associated conditions by multivariable logistic regression analysis. Results: From 2007 through 2013, an estimated 122,750 adults were admitted with a diagnosis of TCP. In 2013, the incidence of admissions in US of patients with coexisting TCP and malignancy was 1.13%. Admissions in 34,957 patients were for a primary diagnosis of TCP with 91.7% females; overall, 665 (2.1%) had solid organ cancer, 237 (0.74%) had hematological malignancy and 354 (1.11%) had metastatic cancer. Patients admitted for TCP with coexisting malignancy had a significantly higher mortality (13.8% vs. 2.9%, p < 0.0001), length of stay (7 vs. 4 days, p < 0.0001) and total charges ($29291 vs. $ 36231, p < 0.0001), compared to those with no malignancy. In patients with a primary diagnosis of TCP and without any underlying malignancy, males had a higher mortality (4.02% vs. 1.03%, p < 0.0001) whereas there was no gender difference in mortality in those with coexisting malignancy (6.25% vs 6.45%, p = 0.965). On multivariable logistic regression analysis, risk factors associated with mortality were solid cancer (OR 3.43, p = 0.008), stroke (OR 18.33, p < 0.0001), venous thromboembolic disease (OR 4.52, p = 0.004), malnutrition (OR 2.41, p = 0.006) and heart failure (OR 1.918, p = 0.004). Conclusions: Outcomes are significantly worse in patients with TCP and solid malignancy. Hence, this patient population must be regarded as high-risk and early diagnostic consideration for TCP is warranted. Early intervention may help lower mortality, decrease resource utilization and reduce the health care costs in these patients.

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Elevated De Ritis Ratio as a Predictor for Acute Kidney Injury after Radical Retropubic Prostatectomy

Journal of Personalized Medicine ◽

10.3390/jpm11090836 ◽

2021 ◽

Vol 11 (9) ◽

pp. 836

Author(s):

Jun-Young Park ◽

Jihion Yu ◽

Jun Hyuk Hong ◽

Bumjin Lim ◽

Youngdo Kim ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Roc Curve ◽

Kidney Injury ◽

Radical Retropubic Prostatectomy ◽

Multivariable Logistic Regression Analysis ◽

Retropubic Prostatectomy

Acute kidney injury (AKI) is related to mortality and morbidity. The De Ritis ratio, calculated by dividing the aspartate aminotransferase by the alanine aminotransferase, is used as a prognostic indicator. We evaluated risk factors for AKI after radical retropubic prostatectomy (RRP). This retrospective study included patients who performed RRP. Multivariable logistic regression analysis and a receiver operating characteristic (ROC) curve analysis were conducted. Other postoperative outcomes were also evaluated. Among the 1415 patients, 77 (5.4%) had AKI postoperatively. The multivariable logistic regression analysis showed that estimated glomerular filtration rate, albumin level, and the De Ritis ratio at postoperative day 1 were risk factors for AKI. The area under the ROC curve of the De Ritis ratio at postoperative day 1 was 0.801 (cutoff = 1.2). Multivariable-adjusted analysis revealed that the De Ritis ratio at ≥1.2 was significantly related to AKI (odds ratio = 8.637, p < 0.001). Postoperative AKI was associated with longer hospitalization duration (11 ± 5 days vs. 10 ± 4 days, p = 0.002). These results collectively show that an elevated De Ritis ratio at postoperative day 1 is associated with AKI after RRP in patients with prostate cancer.

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Risk factors for stillbirth among pregnant women infected with syphilis from 2010–2016, Zhejiang Province, China

10.21203/rs.2.16820/v1 ◽

2019 ◽

Author(s):

Cuicui Duan ◽

Xiao-hui Zhang ◽

Shan-shan Li ◽

Wei Wu ◽

Li-qian Qiu ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Pregnant Women ◽

Logistic Regression Analysis ◽

Zhejiang Province ◽

Multivariable Logistic Regression Analysis ◽

Adequate Treatment ◽

Multivariable Logistic Regression ◽

Latent Syphilis

Abstract Background: Syphilis infection is one of the most common maternal factors related to stillbirth. The study aims to determine the risk factors for stillbirth among pregnant women infected with syphilis. Methods : This was a retrospective study. Data on stillbirth and gestational syphilis were extracted from the PMTCT program database 2010–2016 in Zhejiang Province. A total of 8724 pregnancy women infected with syphilis were included. Multivariable logistic regression analysis was performed to assess the associations between gestational syphilis and stillbirth. Results : The stillbirth rate among pregnant women infected with syphilis was 1.74% (152/8724) in Zhejiang Province, China, from 2010–2016. Compared with live birth, stillbirth was significantly associated with lower maternal age, not being married, lower gravidity, previous history of syphilis, non-latent syphilis stage, and higher maternal serum titer for syphilis, inadequate treatment for syphilis, and later first antenatal care visit. With multivariable logistic regression analysis, non-latent syphilis (adjusted OR=2.03; 95% CI 1.17–3.53) and maternal titers over 1:4 (adjusted OR=1.78; 95% CI 1.25–2.53) were risk factors for stillbirth. Adequate treatment was the only protective factor for stillbirth (adjusted OR=0.16; 95% CI 0.10–0.25). Conclusions : Adequate treatment is effective in reducing the incidence of stillbirths among pregnant women infected with syphilis, and this is particularly important in women diagnosed with high RPR titer (under 1:4). Keywords: risk factors, syphilis, stillbirth, pregnant, syphilis stage, RPR

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Prevalence and risk factors of Helicobacter pylori infection among children in Kuichong Subdistrict of Shenzhen City, China

PeerJ ◽

10.7717/peerj.8878 ◽

2020 ◽

Vol 8 ◽

pp. e8878

Author(s):

Jingjing Hu ◽

Xiangyu Wang ◽

Eng Guan Chua ◽

Yongsheng He ◽

Qing Shu ◽

...

Keyword(s):

Risk Factors ◽

Helicobacter Pylori ◽

Logistic Regression ◽

Regression Analysis ◽

Young Children ◽

Logistic Regression Analysis ◽

Multivariable Logistic Regression Analysis ◽

Shenzhen City ◽

H Pylori ◽

Feed Temperature

Background Helicobacter pylori infection is a significant burden to the public health in China as it can lead to various gastric diseases including peptic ulcers and gastric cancer. Since most infections occurred during childhood, it is therefore necessary to understand the prevalence and risk determinants of this bacterial infection in children. Herewith, we conducted a cross-sectional study in the Kuichong Subdistrict of Shenzhen City to assess the prevalence and risk factors of H. pylori infection among children. Methods From September 2018 to October 2018, 1,355 children aged 6–12 years from four primary schools in the Kuichong Subdistrict of Shenzhen City were recruited. These children were screened for H. pylori infection using the 13C-urea breath test. In addition, parents were requested to fill out a standardized questionnaire. The chi-square test and multivariable logistic regression analysis were used to identify risk factors for H. pylori. Results Among 1,355 children recruited in this study, 226 (16.7%; 95% CI [14.7–18.7]) were positive of H. pylori infection. Multivariable logistic regression analysis identified six factors significantly associated with H. pylori infection children including parent(s) with tertiary education level (OR: 0.64; 95% CI [0.46–0.89]), testing bottle feed temperature using the mouth (OR: 1.79; 95% CI [1.19–2.68]), sharing of cutlery between the feeding person and young children during meals (OR: 1.84; 95% CI [1.22–2.78]), eating fruit after peeling (OR: 2.56; 95% CI [1.4–4.71]), frequent dining out (OR: 3.13; 95% CI [1.46–6.68]) and snacking (OR: 1.43; 95% CI [1.01–2.01]). Conclusions Overall, better educated parent(s) played a protective role against the acquisition of H. pylori infection in children. Testing bottle feed temperature using the mouth, cutlery sharing between the feeding person and young children, and snacking posed a lower but significant risk for H. pylori infection. Only eating peeled fruits and frequent dining out were associated with greater infection risks.

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Disease burden and prognostic factors for clinical failure in elderly community acquired pneumonia patients

10.21203/rs.3.rs-21428/v1 ◽

2020 ◽

Author(s):

Xiudi Han ◽

Xuedong Liu ◽

Liang Chen ◽

Yimin Wang ◽

Hui Li ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Pleural Effusion ◽

Elderly Patients ◽

Clinical Outcomes ◽

Logistic Regression Analysis ◽

Community Acquired Pneumonia ◽

Multivariable Logistic Regression Analysis ◽

Clinical Failure

Abstract Background: The study was to evaluate initial antimicrobial regimen and clinical outcomes and to explore risk factors for clinical failure (CF) in elderly patients with community-acquired pneumonia (CAP). Methods: 3,011 hospitalized elderly patients were enrolled from 13 national teaching hospitals between January 1, 2014 and December 31, 2014 initiated by the CAP-China network. Risk factors for CF were screened by multivariable logistic regression analysis. Results: The incidence of CF in elderly CAP patients was 13.1%. CF patients were older, longer hospital stays and higher treatment costs than clinical success (CS) patients. The CF patients were more prone to present hyperglycemia, hyponatremia, hypoproteinemia, pleural effusion, respiratory failure and cardiovascular events. Inappropriate initial antimicrobial regimens in CF group were significantly higher than CS group. Undertreatment, CURB-65, PH<7.3, PaO 2 /FiO 2 < 200 mmHg, sodium <130 mmol/L, healthcare-associated pneumonia, white blood cells >10000/mm 3 , pleural effusion and congestive heart failure were independent risk factors for CF in multivariable logistic regression analysis. Male and bronchiectasis were protective factors. Conclusions: Discordant therapy was a cause of CF. Early accurate detection and management of prevention to potential causes is likely to improve clinical outcomes in elderly patients CAP. Trial registration : A Retrospective Study on Hospitalized Patients With Community-acquired Pneumonia in China (CAP-China) (RSCAP-China), NCT02489578. Registered 16 March 2015, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0005E5S&selectaction=Edit&uid=U0000GWC&ts=2&cx=1bnotb

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Disease burden and prognostic factors for clinical failure in elderly community acquired pneumonia patients

BMC Infectious Diseases ◽

10.1186/s12879-020-05362-3 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Xiudi Han ◽

◽

Xuedong Liu ◽

Liang Chen ◽

Yimin Wang ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Pleural Effusion ◽

Elderly Patients ◽

Clinical Outcomes ◽

Logistic Regression Analysis ◽

Community Acquired Pneumonia ◽

Multivariable Logistic Regression Analysis ◽

Clinical Failure

Abstract Background The study was to evaluate initial antimicrobial regimen and clinical outcomes and to explore risk factors for clinical failure (CF) in elderly patients with community-acquired pneumonia (CAP). Methods 3011 hospitalized elderly patients were enrolled from 13 national teaching hospitals between January 1, 2014 and December 31, 2014 initiated by the CAP-China network. Risk factors for CF were screened by multivariable logistic regression analysis. Results The incidence of CF in elderly CAP patients was 13.1%. CF patients were older, longer hospital stays and higher treatment costs than clinical success (CS) patients. The CF patients were more prone to present hyperglycemia, hyponatremia, hypoproteinemia, pleural effusion, respiratory failure and cardiovascular events. Inappropriate initial antimicrobial regimens in CF group were significantly higher than CS group. Undertreatment, CURB-65, PH < 7.3, PaO2/FiO2 < 200 mmHg, sodium < 130 mmol/L, healthcare-associated pneumonia, white blood cells > 10,000/mm3, pleural effusion and congestive heart failure were independent risk factors for CF in multivariable logistic regression analysis. Male and bronchiectasis were protective factors. Conclusions Discordant therapy was a cause of CF. Early accurate detection and management of prevention to potential causes is likely to improve clinical outcomes in elderly patients CAP. Trial registration A Retrospective Study on Hospitalized Patients With Community-acquired Pneumonia in China (CAP-China) (RSCAP-China), NCT02489578. Registered 16 March 2015, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0005E5S&selectaction=Edit&uid=U0000GWC&ts=2&cx=1bnotb

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Enlarged subarachnoid space on cranial ultrasound in preterm infants: Neurodevelopmental implication

Scientific Reports ◽

10.1038/s41598-019-55604-x ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Sook Kyung Yum ◽

Soo Ah Im ◽

Yu Mi Seo ◽

In Kyung Sung

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Preterm Infants ◽

Logistic Regression Analysis ◽

Subarachnoid Space ◽

Multivariable Logistic Regression Analysis ◽

Cranial Ultrasound ◽

Factors Associated ◽

Equivalent Age

AbstractThe role of enlarged subarachnoid space (ESS) in preterm infants has not been described in concrete. We aimed to evaluate whether ESS should be considered a risk factor potentially associated with adverse neurodevelopmental outcomes in prematurity. Electronic medical records of 197 preterm infants (median 32.1 weeks' gestation) including cranial ultrasound (cUS) images, head circumferences, and Korean Developmental Screening Tests for Infants and Children (K-DST) results at 18–24 months corrected age were reviewed. The clinical characteristics and K-DST results were compared in infants with and without ESS (sinocortical width > 3.5 mm). A multivariable logistic regression analysis was performed to identify potential risk factors associated with positive K-DST results. At a median corrected age of 39.0 weeks, 81/197 (41.1%) infants presented ESS. A significantly greater percent of infants in the ESS group screened positive on the K-DST than in the no ESS group (27.2% vs 12.1%, p = 0.007). Within the ESS group, micro-/macrocephaly at term-equivalent age was not different with regard to the K-DST results. From the multivariable logistic regression analysis, gestational age (p = 0.016, OR = 0.855, 95% CI = 0.753–0.971) and ESS (p = 0.019, OR = 1.310, 95% CI = 1.046–1.641) were two significant risk factors associated with positive K-DST results. ESS identified on cUS at term-equivalent age in preterm infants is associated with possible developmental delays. Macrocephaly at term-equivalent age does not guarantee a benign prognosis. Future studies are required to verify ESS as a potential marker for neurodevelopmental delay in preterm infants.

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Development and Validation of a Diagnostic Model to Predict the Risk of Ischemic Liver Injury After Stanford A Aortic Dissection Surgery

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.701537 ◽

2021 ◽

Vol 8 ◽

Author(s):

Maomao Liu ◽

Wen Tan ◽

Wen Yuan ◽

Tengke Wang ◽

Xuran Lu ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Liver Injury ◽

Aortic Dissection ◽

Risk Prediction ◽

Logistic Regression Analysis ◽

Risk Model ◽

Multivariable Logistic Regression Analysis ◽

Diagnostic Model ◽

Lemeshow Test

Objective: To define the risk factors of ischemic liver injury (ILI) following Stanford A aortic dissection surgery and to propose a diagnostic model for individual risk prediction.Methods: We reviewed the clinical parameters of ILI patients who underwent cardiac surgery from Beijing Anzhen Hospital, Capital Medical University between January 1, 2015 and October 30, 2020. The data was analyzed by the use of univariable and multivariable logistic regression analysis. A risk prediction model was established and validated, which showed a favorable discriminating ability and might contribute to clinical decision-making for ILI after Stanford A aortic dissection (AAD) surgery. The discriminative ability and calibration of the diagnostic model to predict ILI were tested using C statistics, calibration plots, and clinical usefulness.Results: In total, 1,343 patients who underwent AAD surgery were included in the study. After univariable and multivariable logistic regression analysis, the following variables were incorporated in the prediction of ILI: pre-operative serum creatinine, pre-operative RBC count <3.31 T/L, aortic cross-clamp time >140 min, intraoperative lactic acid level, the transfusion of WRBC, atrial fibrillation within post-operative 24 h. The risk model was validated by internal sets. The model showed a robust discrimination, with an area under the receiver operating characteristic (ROC) curve of 0.718. The calibration plots for the probability of perioperative ischemic liver injury showed coherence between the predictive probability and the actual probability (Hosmer-Lemeshow test, P = 0.637). In the validation cohort, the nomogram still revealed good discrimination (C statistic = 0.727) and good calibration (Hosmer-Lemeshow test, P = 0.872). The 10-fold cross-validation of the nomogram showed that the average misdiagnosis rate was 9.95% and the lowest misdiagnosis rate was 9.81%.Conclusion: Our risk model can be used to predict the probability of ILI after AAD surgery and have the potential to assist clinicians in making treatment recommendations.

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