Does Age Itself Have an Adverse Effect on Survivorship of Meniscal Allograft Transplantation? A Cartilage Status and Time From Previous Meniscectomy–Matched Cohort Study

2020 ◽  
Vol 48 (7) ◽  
pp. 1696-1701 ◽  
Author(s):  
Ju-Ho Song ◽  
Seong-Il Bin ◽  
Jong-Min Kim ◽  
Bum-Sik Lee ◽  
Dong-Wook Son
Keyword(s):  
Clinical Outcomes ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Rank Test ◽  
Meniscal Allograft Transplantation ◽  
Log Rank Test ◽  
Meniscal Allograft ◽  
Age Related ◽  
Significant Difference ◽  
Operating Characteristic Curve

Background: The aging process is accompanied by several conditions that could affect the outcome of meniscal allograft transplantation (MAT). These conditions have made it difficult for clinicians to determine the effect of chronologic age on survivorship after MAT. Hypothesis: Advanced age does not have an adverse effect on survivorship of MAT when controlling for age-related factors, such as cartilage status and time from previous meniscectomy. Study Design: Cohort study; Level of evidence, 3. Methods: The records of 264 consecutive patients who underwent primary medial or lateral MAT were reviewed. To check whether there was a difference in MAT survivorship according to age, a cutoff value was calculated from a time-dependent receiver operating characteristic curve. Survival rates, as well as clinical improvement as determined using the Lysholm score, were compared between groups divided by the cutoff value. Patients were matched for cartilage status and elapsed time from previous meniscectomy. Differences in survivorship and clinical outcomes were assessed between the matched groups. Results: A time-dependent receiver operating characteristic curve showed that the difference in MAT survivorship was maximized with a cutoff age of 43 years. Kaplan-Meier analysis showed a significant difference in MAT survivorship between the older and younger groups (log-rank test, P = .01). However, after matching for cartilage status and time from previous meniscectomy, which left 56 patients per group, there was no significant difference in MAT survivorship (log-rank test, P = .10) between the groups. Regarding clinical outcomes, the mean Lysholm scores were not significantly different between the older and younger groups ( P = .19, before matching; P = .39, after matching). Conclusion: MAT survivorship was more affected by age-related prognostic factors, such as cartilage status and time from previous meniscectomy, than age itself. Clinical outcomes did not show differences according to age, either.

scholarly journals Evaluation of Nottingham Hip Fracture Score, Age-Adjusted Charlson Comorbidity Index and the Physiological and Operative Severity Score for the enumeration of Mortality and morbidity as predictors of mortality in elderly neck of femur fracture patients

2020 ◽  
Vol 8 ◽  
pp. 205031212091826 ◽  
Author(s):  
Michael James Nelson ◽  
Justin Scott ◽  
Palvannan Sivalingam
Keyword(s):  
Hip Fracture ◽  
Charlson Comorbidity Index ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Mortality Prediction ◽  
Mortality And Morbidity ◽  
Operative Severity Score ◽  
Significant Difference ◽  
Comorbidity Index ◽  
Operating Characteristic Curve

Background: This study evaluated the use of several risk prediction models in estimating short- and long-term mortality following hip fracture in an Australian population. Methods: Data from 195 patients were retrospectively analysed and applied to three models of interest: the Nottingham Hip Fracture Score, the Age-Adjusted Charlson Comorbidity Index and the Physiological and Operative Severity Score for enUmeration of Mortality and Morbidity. The performance of these models was assessed with receiver operating characteristic curve as well as logistic regression modelling. Results: The median age of participants was 83 years and 69% were women. Ten percent of patients were deceased by 30 days, 25% at 6 months and 31% at 12 months post-operatively. While there was no statistically significant difference between the models, the Age-Adjusted Charlson Comorbidity Index had the largest area under the receiver operating characteristic curve for within 30 day and 12 month mortality, while the Nottingham Hip Fracture Score was largest for 6-month mortality. There was no evidence to suggest that the models were selecting a specific subgroup of our population, therefore, no indication was present to suggest that using multiple models would improve mortality prediction. Conclusions: While there was no statistically significant difference in mortality prediction, the Nottingham Hip Fracture Score is perhaps the best suited clinically, due to its ease of implementation. Larger prospective data collection across a variety of sites and its role in guiding clinical management remains an area of interest.

Clinical Outcomes of Meniscal Allograft Transplantation With or Without Other Procedures: A Systematic Review and Meta-analysis

2017 ◽  
Vol 46 (12) ◽  
pp. 3047-3056 ◽  
Author(s):  
Bum-Sik Lee ◽  
Hyun-Jung Kim ◽  
Chang-Rack Lee ◽  
Seong-Il Bin ◽  
Dae-Hee Lee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Tibial Osteotomy ◽  
Failure Rates ◽  
Meniscal Allograft Transplantation ◽  
Allograft Transplantation ◽  
Meniscal Allograft ◽  
Significant Difference

Background: While additional procedures correcting accompanying pathological conditions can improve the clinical outcomes of meniscal allograft transplantation (MAT), whether those outcomes are comparable or poorer than those of isolated MAT has yet to be clarified. Purpose:  To evaluate whether there is a difference in clinical outcomes between isolated MAT and MAT combined with other procedures (combined MAT). Study Design: Meta-analysis and systematic review. Methods: For the comparison of clinical outcomes between isolated MAT and combined MAT, the authors searched MEDLINE, Embase, and the Cochrane Library. Studies that separately reported the clinical outcomes of isolated MAT and combined MAT were included. Clinical outcomes were evaluated in terms of patient-reported outcomes (PROs) and complication, reoperation, survivorship, and failure rates. We conducted a meta-analysis of the PROs that were used in more than 3 studies. Results: A total of 24 studies were included in this study. In the meta-analysis, no significant differences in Lysholm scores (95% CI, –5.92 to 1.55; P = .25), Tegner activity scores (95% CI, –0.54 to 0.22; P = .41), International Knee Documentation Committee subjective scores (95% CI, –5.67 to 3.37; P = .62), and visual analog scale scores (95% CI, –0.15 to 0.94; P = .16) were observed between isolated MAT and combined MAT. For PROs that were not included in the meta-analysis, most studies reported no significant difference between the 2 groups. As for the survivorship and failure rates, studies showed varying outcomes. Four studies reported that additional procedures did not affect MAT failure or survivorship. However, 3 studies reported that ligament surgery, realignment osteotomy, and osteochondral autograft transfer were risk factors of failure. One study reported that the medial MAT group in which high tibial osteotomy was performed showed a higher survival rate than the isolated medial MAT group. Conclusion: Overall, there seems to be no significant difference between the postoperative PROs in terms of isolated MAT and combined MAT. However, more data are required to verify the effects of osteotomy and cartilage procedures on the clinical outcomes of MAT. We could not draw conclusions about the differences in complication, reoperation, survivorship, and failure rates between the 2 groups because we did not obtain sufficient data.

scholarly journals Cut-off value of serum homocysteine in relation to increase of coronary artery calcification

2020 ◽  
pp. jim-2020-001478
Author(s):  
Nam-Seok Joo ◽  
Susie Jung ◽  
Yu-Na Kim ◽  
Beom-Hee Choi
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Homocysteine Concentration ◽  
Serum Homocysteine ◽  
Significant Difference ◽  
Operating Characteristic Curve ◽  
Age And Sex

A recent study reported that coronary artery calcification (CAC) and serum homocysteine were well associated; however, no report is available for the cut-off value of serum homocysteine according to increase of coronary-artery calcification volume score (CVS). The data of 469 out of 777 subjects in 1 health promotion center located in Seoul were selected after exclusion of the missing data of serum homocysteine and CVS. CVS was categorized into 2 groups: CVS=0 and CVS>0. Serum homocysteine according to the CVS groups was compared, and the cut-off value of serum homocysteine according to the increase of CVS (>0) was calculated using the receiver operating characteristic curve. Mean age was 54.5 years and the proportion of females was 22.2%. Mean serum homocysteine concentration and CVS were 11.2 μmol/L and 50.4, respectively. After adjustments for age and sex, serum homocysteine was associated with CVS (r=0.167, p=0.001), and Log(Homocysteine) also showed a significant difference according to the CVS groups. The cut-off value of serum homocysteine according to the increase of CVS (>0) was 9.45 μmol/L (area under the curve=0.569 (95% CI 0.512 to 0.625), p=0.015). The cut-off value of serum homocysteine was 9.45 μmol/L according to the increase of coronary-artery CVS.

scholarly journals Usefulness of procalcitonin clearance to predict mortality in abdominal sepsis

2020 ◽  
Vol 18 ◽  
pp. 205873922094263
Author(s):  
Jiang-Chen Peng ◽  
Qiao-Yi Xu ◽  
Jia Ding ◽  
Zhe Li ◽  
Jie-Min Wang ◽  
...  
Keyword(s):  
Plasma Levels ◽  
Operating Characteristic ◽  
Primary Outcome ◽  
Independent Predictor ◽  
Characteristic Curve ◽  
Abdominal Sepsis ◽  
Rank Test ◽  
Prognostic Accuracy ◽  
Log Rank Test ◽  
Kaplan Meier

To evaluate the plasma levels and clearance of procalcitonin (PCTc) as prognostic biomarkers for patients with abdominal sepsis. A retrospective study of 103 patients with abdominal sepsis was conducted in our intensive care unit (ICU) from 2016 to 2018. Procalcitonin (PCT) plasma levels were measured at the time of diagnosis of abdominal sepsis and daily over the next 5 days. PCTc was calculated from day 3 to day 5. The prognostic accuracy of PCTc was expressed as the area under the receiver operating characteristic curve (AUROC). The Kaplan–Meier method was used to compare the survival curves by log-rank test. Logistic regression analysis was used to predict the 28-day mortality. The primary outcome was 28-day mortality since admission to ICU. Serum PCT levels from day 1 to day 5 did not differ significantly between survivors and non-survivors, while PCTc on day 5 was statistically significantly higher in survivors than that in non-survivors (86.4% vs 38.7%, P < 0.001). The cutoff value for PCTc-day 5 was 70%, with AUROC of 0.726, sensitivity of 64.6%, and specificity of 78.3%. The 28-day mortality was significantly lower among those with PCTc-day 5 >70% compared with those with PCTc-day 5 <70% (9.1% vs 38.3%, log-rank test, P < 0.001), and odds ratio (OR) was 0.16 (95% confidence interval (CI): 0.05–0.48, P < 0.001). The ability to decrease PCT by at least 70% on day 5 was an independent predictor of 28-day mortality after admission to ICU with moderate accuracy.

scholarly journals Predicting 30-Day and 180-Day Mortality in Elderly Proximal Hip Fracture Patients: Evaluation of 4 Risk Prediction Scores at a Level I Trauma Center

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 497
Author(s):  
Arastoo Nia ◽  
Domenik Popp ◽  
Georg Thalmann ◽  
Fabian Greiner ◽  
Natasa Jeremic ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Risk Prediction ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Acs Nsqip ◽  
Significant Difference ◽  
Operating Characteristic Curve ◽  
Receiver Operating

This study evaluated the use of risk prediction models in estimating short- and mid-term mortality following proximal hip fracture in an elderly Austrian population. Data from 1101 patients who sustained a proximal hip fracture were retrospectively analyzed and applied to four models of interest: Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM), Charlson Comorbidity Index, Portsmouth-POSSUM and the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP®) Risk Score. The performance of these models according to the risk prediction of short- and mid-term mortality was assessed with a receiver operating characteristic curve (ROC). The median age of participants was 83 years, and 69% were women. Six point one percent of patients were deceased by 30 days and 15.2% by 180 days postoperatively. There was no significant difference between the models; the ACS-NSQIP had the largest area under the receiver operating characteristic curve for within 30-day and 180-day mortality. Age, male gender, and hemoglobin (Hb) levels at admission <12.0 g/dL were identified as significant risk factors associated with a shorter time to death at 30 and 180 days postoperative (p < 0.001). Among the four scores, the ACS-NSQIP score could be best-suited clinically and showed the highest discriminative performance, although it was not specifically designed for the hip fracture population.

scholarly journals Serum Levels of Cancer Antigen 125 before Hormone Replacement Therapy are not Associated with the Clinical Outcome of Frozen Embryo Transfer Cycles among Women with Adenomyosis

2019 ◽  
Author(s):  
Ling Huang ◽  
Minghui Chen ◽  
Zengyan Wang ◽  
Canquan Zhou ◽  
Yubin Li
Keyword(s):  
Clinical Outcomes ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Hormone Replacement ◽  
Serum Levels ◽  
Frozen Embryo Transfer ◽  
Cancer Antigen 125 ◽  
Cancer Antigen ◽  
Serum Ca125 ◽  
Operating Characteristic Curve

Abstract Background: Serum levels of cancer antigen 125 (CA125) are reportedly closely associated with the extent of adenomyosis. However, the association between serum CA125 levels before hormone replacement therapy (HRT) and the clinical outcome of frozen embryo transfer (FET) in patients with adenomyosis is unknown.Methods: A total of 509 women with adenomyosis undergoing in vitro fertilization/intracytoplasmic sperm injection treatment between January 2013 and April 2019 were screened. Following the inclusion and exclusion criteria, the included patients were divided into two groups based on the serum CA125 levels (≤ or >35 IU/ml) before HRT. The basic characteristics and main outcomes of the two groups were compared.A receiver operating characteristic curve was used to evaluate the ability of serum CA125 levels before HRT to predict the clinical outcomes of FET. Besides, data were also separately analyzed in the GnRH agonist pretreatment subgroup. Results: There were no significant differences in clinical outcomes between the two groups of women before HRT. A receiver operating characteristic curve demonstrated that CA125 levels were not predictive of clinical pregnancy outcomes. Conclusions: Serum CA125 levels before HRT were not associated with the clinical outcomes of FET among women with adenomyosis. Hence, the discovery of other new markers is necessary.

scholarly journals Are HE4 and CA 125 suitable to detect a Paget disease of the vulva?

2020 ◽  
Author(s):  
Miriam Dellino ◽  
Giulio Gargano ◽  
Carmine Carriero ◽  
Carla Minoia ◽  
Tetania Skrypets ◽  
...  
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
The Other ◽  
Ca 125 ◽  
Control Group ◽  
P Value ◽  
Paget Disease ◽  
Significant Difference ◽  
Operating Characteristic Curve

Abstract Background: Paget disease is a rare neoplasia, most commonly diagnosed in postmenopausal women and which can be identified in the breast (mammary Paget disease) or in other locations (extramammary Paget’s disease) such as ano-genital skin (Paget disease of the vulva -PVD). This condition is associated with low mortality, but a late diagnosis and recurrence can negatively impact the prognosis. Therefore, the main objective of this study is to evaluate if the human epididymis protein 4 (HE4) and cancer antigen125 (CA125) can promote recognition of PVD in early stages and during the relapses.Materials and Methods: we have conducted a prospective, observational and laboratory-based study, that included 50 patients, whose 25 healthy women represented the control group and 25 PVD patients, which have been operated in our Oncology Institute, from May 2017 to September 2019. Both in control group and in PVD patients, the CA-125 and HE4 were evaluated before surgery and after 6 months. Finally, a comparison of markers serum level, both between before/after surgery and with control group, and a ROC (Receiver Operating Characteristic) curve were performed.Results: Dosing the markers in PVD patients, 3/25 (12%) showed a higher value of CA125 and 11/25 (44%) an increased HE4. In addition, after surgical treatment there were no statistically significant difference between levels of CA-125 (p= 0.3) and HE4 (p=0.19). On the other hand, comparing HE4 in PVD patients with the control group, a statistically significant difference was found (p-value= 0.0036). Contrary, comparing CA-125 in PVD patients with the control group (p-value= 0.1969), no statistically significant difference was evidenced. Moreover, ROC (Receiver Operating Characteristic) curve showed low sensitivity and specificity for CA125 with area under curve (AUC) =0.5608. Instead, the ROC curve of HE4 revealed a sensitivity and specificity of 76% and 88% respectively (AUC= 0.7408) using a cut-off at 90 pmol/L.Conclusions: Despite the limited cases, our data showed that CA125 is not a sensitive marker for PVD. On the other hand, in 44% of PVD we’ve seen an increase in HE4. So, this could be a starting point for further research that could confirm the possibility to use this marker in order to support PVD early identification.

scholarly journals Could IL-6 predict the clinical severity of COVID-19?

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Guzin Aykal ◽  
Hatice Esen ◽  
Derya Seyman ◽  
Tuğba Çalışkan
Keyword(s):  
Intensive Care Unit ◽  
Prognostic Value ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Clinical Severity ◽  
Longitudinal Analyses ◽  
Significant Difference ◽  
Severe Group ◽  
Operating Characteristic Curve ◽  
Excessive Inflammatory Response

Abstract Objectives An excessive inflammatory response to SARS-CoV-2 is thought to be a major cause of disease severity in COVID-19. The aim herein was to determine the prognostic value of IL-6, and demonstrate the comparison between IL-6 and related parameters in COVID-19. Methods Data were collected from 115 COVID-19 patients. Results The median age was 46.04 years in the mild group, 56.42 years in the moderate group, and 62.92 years in the severe group (p=0.001). There was a significant difference in the hospitalized clinic to intensive care unit ratio among the patients (p<0.001). The IL-6 values were significantly higher in the severe group than those in the mild (p=0.04) and moderate groups (p=0.043). The area under the receiver operating characteristic curve for IL-6, as predictor of severe clinical condition, was 0.864 (95% CI 0.765–0.963 p=0.000). The longitudinal analyses showed that the severe group presented with significantly increased IL-6 levels during hospitalization. Conclusions IL‐6 seemed to be a guide in the early diagnosis of severe COVID-19 and an ideal marker for monitoring negative outcome.

Serum miR-21 and miR-26a Levels Negatively Correlate with Severity of Cirrhosis in Patients with Chronic Hepatitis B

MicroRNA ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. 86-92 ◽  
Author(s):  
Shili Jiang ◽  
Wei Jiang ◽  
Ying Xu ◽  
Xiaoning Wang ◽  
Yongping Mu ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Curve Analysis ◽  
Pugh Class ◽  
Operating Characteristic Curve ◽  
Class C ◽  
Circulating Levels

Background and Objective: Accurately evaluating the severity of liver cirrhosis is essential for clinical decision making and disease management. This study aimed to evaluate the value of circulating levels of microRNA (miR)-26a and miR-21 as novel noninvasive biomarkers in detecting severity of cirrhosis in patients with chronic hepatitis B. </P><P> Methods: Thirty patients with clinically diagnosed chronic hepatitis B-related cirrhosis and 30 healthy individuals were selected. The serum levels of miR-26a and miR-21 were quantified by qRT-PCR. Receiver operating characteristic curve analysis was performed to evaluate the sensitivity and specificity of the miRNAs for detecting the severity of cirrhosis. Results: Serum miR-26a and miR-21 levels were found to be significantly downregulated in patients with severe cirrhosis scored at Child-Pugh class C in comparison to healthy controls (miR-26a p<0.01, and miR-21 p<0.001, respectively). The circulating miR-26a and miR-21 levels in patients were positively correlated with serum albumin concentration but negatively correlated with serum total bilirubin concentration and prothrombin time. Receiver operating characteristic curve analysis revealed that both serum miR-26a and miR-21 levels were associated with a high diagnostic accuracy for patients with cirrhosis scored at Child-Pugh class C (miR-26a Cut-off fold change at ≤0.4, Sensitivity: 84.62%, Specificity: 89.36%, P<0.0001; miR-21 Cut-off fold change at ≤0.6, Sensitivity: 84.62%, Specificity: 78.72%, P<0.0001). Our results indicate that the circulating levels of miR-26a and miR-21 are closely related to the extent of liver decompensation, and the decreased levels are capable of discriminating patients with cirrhosis at Child-Pugh class C from the whole cirrhosis cases.

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