scholarly journals Sarcopenia measured with paraspinous muscle using computed tomography for predicting prognosis in elderly pneumonia patients

2021 ◽  
pp. 102490792110418
Author(s):  
Sung Jin Bae ◽  
Keon Kim ◽  
Seong Jong Yun ◽  
Sun Hwa Lee

Background: In the elderly, diagnostic findings of pneumonia are often atypical. Computed tomography was recommended for the diagnosis of pneumonia in elderly patients. Recently, the usage of computed tomography as a screening tool for pneumonia in emergency departments has increased. Sarcopenia is defined as the loss of skeletal muscle mass and strength with aging. In this study, the association between sarcopenia and prognosis measured through computed tomography was evaluated compared to CURB-65. Methods: This study was conducted on patients diagnosed with pneumonia through computed tomography from 1 March 2018 to 31 March 2020. The paraspinous muscle size and attenuation were measured at a level located at the T12 pedicle level on axial computed tomography images. Paraspinous muscle size was presented as paraspinous muscle index. Differences in the prognostic performance among the paraspinous muscle size and attenuation, and CURB-65 were evaluated by the area under the receiver operating characteristic curve. Results: A total of 509 patients were included and 132 patients (25.9%) were admitted to the ICU, and 58 patients (11.4%) died in hospital. Paraspinous muscle index was the significant factor for predicting in-hospital mortality and ICU admission. The area under the receiver operating characteristic value of paraspinous muscle index for prediction of mortality was 0.738 and CURB-65 was 0.707. The area under the receiver operating characteristic of paraspinous muscle index and CURB-65 for predicting ICU admission were 0.766 and 0.704, respectively. Conclusion: As a method of measuring sarcopenia, paraspinous muscle index was superior to CURB-65 in elderly pneumonia patients. The use of computed tomography in predicting prognosis for elderly pneumonia patients will ease the economic burden.

2021 ◽  

Sarcopenia is a major physical factor of frailty and can be predicted by existing patient computed tomography (CT) scans. The objective of this study was to investigate the relationships between prognosis of elderly patients visiting the emergency department and psoas muscle size measurements from CT scans that were acquired in other purpose. This was a retrospective study in a single center. The psoas muscle size (cross-section) and attenuation at the L3 vertebra were measured on CT scans. Logistic regression analysis was used to determine the association between mortality and muscle size and muscle attenuation after adjustment of basic characteristics. Also, we constructed receiver operating characteristic curves. A total of 279 patients were enrolled with diagnoses categorized from 13 chapters from on International Classification of Diseases-10th Revision (ICD-10). There were 56 patients (20.1%) admitted to the ICU, and 51 patients (18.3%) died in the hospital during the clinical process. The area under the receiver operating characteristic (AUROC) of muscle size for prediction of ICU admission was 0.706 (0.649–0.759), and the cut-off value was 390.18 with 51.8%sensitivity and 87.9% specificity. The AUROC of muscle size for prediction of death was 0.904 (0.864–0.936), and the cut-off value was 587.41 with 92.2% sensitivity and 78.5% specificity. Using existing CT can be an appropriate method for an early diagnosis of sarcopenia in older patients. In this study, measurement of muscle size using CT was shown to be a feasible modality for predicting poor prognoses for older patients.


2019 ◽  
Vol 30 (7-8) ◽  
pp. 221-228
Author(s):  
Shahab Hajibandeh ◽  
Shahin Hajibandeh ◽  
Nicholas Hobbs ◽  
Jigar Shah ◽  
Matthew Harris ◽  
...  

Aims To investigate whether an intraperitoneal contamination index (ICI) derived from combined preoperative levels of C-reactive protein, lactate, neutrophils, lymphocytes and albumin could predict the extent of intraperitoneal contamination in patients with acute abdominal pathology. Methods Patients aged over 18 who underwent emergency laparotomy for acute abdominal pathology between January 2014 and October 2018 were randomly divided into primary and validation cohorts. The proposed intraperitoneal contamination index was calculated for each patient in each cohort. Receiver operating characteristic curve analysis was performed to determine discrimination of the index and cut-off values of preoperative intraperitoneal contamination index that could predict the extent of intraperitoneal contamination. Results Overall, 468 patients were included in this study; 234 in the primary cohort and 234 in the validation cohort. The analyses identified intraperitoneal contamination index of 24.77 and 24.32 as cut-off values for purulent contamination in the primary cohort (area under the curve (AUC): 0.73, P < 0.0001; sensitivity: 84%, specificity: 60%) and validation cohort (AUC: 0.83, P < 0.0001; sensitivity: 91%, specificity: 69%), respectively. Receiver operating characteristic curve analysis also identified intraperitoneal contamination index of 33.70 and 33.41 as cut-off values for feculent contamination in the primary cohort (AUC: 0.78, P < 0.0001; sensitivity: 87%, specificity: 64%) and validation cohort (AUC: 0.79, P < 0.0001; sensitivity: 86%, specificity: 73%), respectively. Conclusions As a predictive measure which is derived purely from biomarkers, intraperitoneal contamination index may be accurate enough to predict the extent of intraperitoneal contamination in patients with acute abdominal pathology and to facilitate decision-making together with clinical and radiological findings.


Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 949
Author(s):  
Cecil J. Weale ◽  
Don M. Matshazi ◽  
Saarah F. G. Davids ◽  
Shanel Raghubeer ◽  
Rajiv T. Erasmus ◽  
...  

This cross-sectional study investigated the association of miR-1299, -126-3p and -30e-3p with and their diagnostic capability for dysglycaemia in 1273 (men, n = 345) South Africans, aged >20 years. Glycaemic status was assessed by oral glucose tolerance test (OGTT). Whole blood microRNA (miRNA) expressions were assessed using TaqMan-based reverse transcription quantitative-PCR (RT-qPCR). Receiver operating characteristic (ROC) curves assessed the ability of each miRNA to discriminate dysglycaemia, while multivariable logistic regression analyses linked expression with dysglycaemia. In all, 207 (16.2%) and 94 (7.4%) participants had prediabetes and type 2 diabetes mellitus (T2DM), respectively. All three miRNAs were significantly highly expressed in individuals with prediabetes compared to normotolerant patients, p < 0.001. miR-30e-3p and miR-126-3p were also significantly more expressed in T2DM versus normotolerant patients, p < 0.001. In multivariable logistic regressions, the three miRNAs were consistently and continuously associated with prediabetes, while only miR-126-3p was associated with T2DM. The ROC analysis indicated all three miRNAs had a significant overall predictive ability to diagnose prediabetes, diabetes and the combination of both (dysglycaemia), with the area under the receiver operating characteristic curve (AUC) being significantly higher for miR-126-3p in prediabetes. For prediabetes diagnosis, miR-126-3p (AUC = 0.760) outperformed HbA1c (AUC = 0.695), p = 0.042. These results suggest that miR-1299, -126-3p and -30e-3p are associated with prediabetes, and measuring miR-126-3p could potentially contribute to diabetes risk screening strategies.


2021 ◽  
pp. 096228022199595
Author(s):  
Yalda Zarnegarnia ◽  
Shari Messinger

Receiver operating characteristic curves are widely used in medical research to illustrate biomarker performance in binary classification, particularly with respect to disease or health status. Study designs that include related subjects, such as siblings, usually have common environmental or genetic factors giving rise to correlated biomarker data. The design could be used to improve detection of biomarkers informative of increased risk, allowing initiation of treatment to stop or slow disease progression. Available methods for receiver operating characteristic construction do not take advantage of correlation inherent in this design to improve biomarker performance. This paper will briefly review some developed methods for receiver operating characteristic curve estimation in settings with correlated data from case–control designs and will discuss the limitations of current methods for analyzing correlated familial paired data. An alternative approach using conditional receiver operating characteristic curves will be demonstrated. The proposed approach will use information about correlation among biomarker values, producing conditional receiver operating characteristic curves that evaluate the ability of a biomarker to discriminate between affected and unaffected subjects in a familial paired design.


Molecules ◽  
2021 ◽  
Vol 26 (7) ◽  
pp. 1996
Author(s):  
 Oluwafemi Adeleke Ojo ◽  
Adebola Busola Ojo ◽  
Charles Okolie ◽  
Mary-Ann Chinyere Nwakama ◽  
Matthew Iyobhebhe ◽  
...  

Neurodegenerative diseases, for example Alzheimer’s, are perceived as driven by hereditary, cellular, and multifaceted biochemical actions. Numerous plant products, for example flavonoids, are documented in studies for having the ability to pass the blood-brain barrier and moderate the development of such illnesses. Computer-aided drug design (CADD) has achieved importance in the drug discovery world; innovative developments in the aspects of structure identification and characterization, bio-computational science, and molecular biology have added to the preparation of new medications towards these ailments. In this study we evaluated nine flavonoid compounds identified from three medicinal plants, namely T. diversifolia, B. sapida, and I. gabonensis for their inhibitory role on acetylcholinesterase (AChE), butyrylcholinesterase (BChE) and monoamine oxidase (MAO) activity, using pharmacophore modeling, auto-QSAR prediction, and molecular studies, in comparison with standard drugs. The results indicated that the pharmacophore models produced from structures of AChE, BChE and MAO could identify the active compounds, with a recuperation rate of the actives found near 100% in the complete ranked decoy database. Moreso, the robustness of the virtual screening method was accessed by well-established methods including enrichment factor (EF), receiver operating characteristic curve (ROC), Boltzmann-enhanced discrimination of receiver operating characteristic (BEDROC), and area under accumulation curve (AUAC). Most notably, the compounds’ pIC50 values were predicted by a machine learning-based model generated by the AutoQSAR algorithm. The generated model was validated to affirm its predictive model. The best models achieved for AChE, BChE and MAO were models kpls_radial_17 (R2 = 0.86 and Q2 = 0.73), pls_38 (R2 = 0.77 and Q2 = 0.72), kpls_desc_44 (R2 = 0.81 and Q2 = 0.81) and these externally validated models were utilized to predict the bioactivities of the lead compounds. The binding affinity results of the ligands against the three selected targets revealed that luteolin displayed the highest affinity score of −9.60 kcal/mol, closely followed by apigenin and ellagic acid with docking scores of −9.60 and −9.53 kcal/mol, respectively. The least binding affinity was attained by gallic acid (−6.30 kcal/mol). The docking scores of our standards were −10.40 and −7.93 kcal/mol for donepezil and galanthamine, respectively. The toxicity prediction revealed that none of the flavonoids presented toxicity and they all had good absorption parameters for the analyzed targets. Hence, these compounds can be considered as likely leads for drug improvement against the same.


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