scholarly journals Surgical Outcomes of Selective Laminectomy for Patients With Cervical Kyphosis: A Retrospective Study of 379 Cases

2021 ◽  
pp. 219256822110497
Author(s):  
Ken Ninomiya ◽  
Kunimasa Okuyama ◽  
Ryoma Aoyama ◽  
Satoshi Nori ◽  
Junichi Yamane ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Roc Curve ◽  
Surgical Outcomes ◽  
Recovery Rate ◽  
Japanese Orthopaedic Association ◽  
Curve Analysis ◽  
Cervical Kyphosis ◽  
Roc Curve Analysis ◽  
Spinal Cord Shift ◽  
The Impact

Study Design A retrospective study. Objectives This study aimed to investigate the impact of cervical kyphosis on patients with cervical spondylotic myelopathy (CSM) following selective laminectomy (SL) regarding posterior spinal cord shift (PSS), and a number of SLs. Methods We evaluated 379 patients with CSM after SL. The patients with kyphosis (group K) were compared with those without kyphosis (group L). Moreover, groups K and L were divided into subgroups KS and KL (SLs ≤ 2) and LS and LL (SLs ≥ 3), respectively, and analyzed. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off value of the C2–C7 angle for satisfactory surgical outcomes, which was defined as a Japanese Orthopaedic Association (JOA) recovery rate of ≥50% in group KS. Results The average PSS (mm) in group K was smaller than that in group L (.8 vs 1.4; P < .01), but the JOA recovery rate was comparable between the 2 groups. Meanwhile, the mean PSS and JOA recovery rate (%) in group KS was lower than those in group KL, respectively (.3 vs 1.0; P < .01, 35.1 vs 52.3; P = .047). Moreover, the average PSS of group KS (.6) was smaller than those of other subgroups ( < .01). In addition, the ROC curve analysis showed that the C2–C7 angle of −14.5° could predict satisfactory surgical outcomes in group KS. Conclusion Selective laminectomy is not contraindicated for patients with kyphosis, but a larger number of SLs may be indicated for the patients with C2–C7 angles of ≤ −14.5°.

scholarly journals Impact of comorbidity burden on mortality in patients with COVID-19 using the Korean health insurance database

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Soo Ick Cho ◽  
Susie Yoon ◽  
Ho-Jin Lee
Keyword(s):  
Risk Factors ◽  
Health Insurance ◽  
Roc Curve ◽  
Significant Risk ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Comorbidity Burden ◽  
Comorbidity Index ◽  
The Impact ◽  
Age And Sex

AbstractWe aimed to investigate the impact of comorbidity burden on mortality in patients with coronavirus disease (COVID-19). We analyzed the COVID-19 data from the nationwide health insurance claims of South Korea. Data on demographic characteristics, comorbidities, and mortality records of patients with COVID-19 were extracted from the database. The odds ratios of mortality according to comorbidities in these patients with and without adjustment for age and sex were calculated. The predictive value of the original Charlson comorbidity index (CCI) and the age-adjusted CCI (ACCI) for mortality in these patients were investigated using the receiver operating characteristic (ROC) curve analysis. Among 7590 patients, 227 (3.0%) had died. After age and sex adjustment, hypertension, diabetes mellitus, congestive heart failure, dementia, chronic pulmonary disease, liver disease, renal disease, and cancer were significant risk factors for mortality. The ROC curve analysis showed that an ACCI threshold > 3.5 yielded the best cut-off point for predicting mortality (area under the ROC 0.92; 95% confidence interval 0.91–0.94). Our study revealed multiple risk factors for mortality in patients with COVID-19. The high predictive power of the ACCI for mortality in our results can support the importance of old age and comorbidities in the severity of COVID-19.

scholarly journals Investigation of correlation between surface runoff rate and stream water quality

2021 ◽  
Author(s):  
Sunsook Jang ◽  
Hyunseo Ji ◽  
Jiyong Choi ◽  
Kyo Suh ◽  
Hakkwan Kim
Keyword(s):  
Water Quality ◽  
Roc Curve ◽  
Surface Runoff ◽  
Stream Water ◽  
Land Development ◽  
Curve Analysis ◽  
Stream Water Quality ◽  
Roc Curve Analysis ◽  
Runoff Rate ◽  
The Impact

Abstract The purpose of this study was to investigate the relationship between stream water quality and the surface runoff rate defined as the ratio of annual surface runoff to annual average precipitation. The surface runoff rate was first estimated in the Han River basin located in South Korea using the calibrated and validated HSPF model. Then a linear regression analysis was performed to investigate the correlation between the computed surface runoff rate and the observed water quality. It was found that there were statistically significant relationships between the surface runoff rate and concentrations of BOD, COD, and T-P and higher surface runoff rate led to the deterioration of water quality in streams. Finally, the applicability of the surface runoff rate as an indicator to measure the impact of land development on stream water quality was evaluated using a receiver operating characteristic (ROC) curve analysis. The ROC curve analysis indicated that the surface runoff rate could be utilized as a useful indicator to illustrate the degradation of stream water quality at the watershed scale. The results from this study also suggest that the surface runoff rate needs to be managed and controlled within about 15% to prevent the degradation of stream water quality.

scholarly journals Echocardiographic evaluation of total anomalous pulmonary venous connection: comparison of obstructed and unobstructed type

2019 ◽  
Author(s):  
Yonghua Xiang ◽  
Xuehua Zhang ◽  
Jun Qiu ◽  
Qing Gan ◽  
Ke Jin
Keyword(s):  
Retrospective Study ◽  
Sensitivity And Specificity ◽  
Roc Curve ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Echocardiographic Evaluation ◽  
Significant Difference ◽  
Echocardiographic Parameters ◽  
Anomalous Pulmonary Venous Connection ◽  
First Admission

Abstract Purpose The purpose of this study was to compare the differences between obstructed and unobstructed TAPVC using echocardiography, then to predict PVO by assessing clinical and echocardiographic parameters. Methods We conducted a retrospective study included 70 patients with TAPVC between 2014 and 2018. The morphological and hemodynamic echocardiographic parameters were observed and measured. The clinical and echocardiographic parameters that existed difference between obstructed and unobstructed TAPVC were selected to predict PVO by running ROC curve analysis. Results Between obstructed and unobstructed TAPVC, there were significant differences in ASD size, PA Vmax, MV VE, LVFS, LVEF, SV and the incidence of PDA, but there was no significant difference in birth weight. The first admission age of obstructed TAPVC was earlier than unobstructed type. The ROC curve analysis for the first admission age in predicting PVO showed the sensitivity and specificity were 76.7%, 80% respectively. The ROC curve analysis for multiple echocardiographic parameters showed the sensitivity and specificity were 82.6%, 100% respectively. Conclusions The presence of PVO led to anatomical and functional abnormity of patients with TAPVC, and then led to hospitalize earlier. The first admission age was a simple and feasible parameter in predicting PVO. The integrated use of multiple echocardiographic parameters had an excellent value in predicting PVO.

scholarly journals Influence of Imprecision on ROC Curve Analysis for Cardiac Markers

2006 ◽  
Vol 52 (4) ◽  
pp. 752-753 ◽  
Author(s):  
Peter Kupchak ◽  
Alan HB Wu ◽  
Farooq Ghani ◽  
L Kristen Newby ◽  
E Magnus Ohman ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Roc Curve ◽  
Troponin I ◽  
Curve Analysis ◽  
Cardiac Biomarkers ◽  
Cardiac Events ◽  
Roc Curve Analysis ◽  
Critical Determinant ◽  
Significant Difference ◽  
The Impact

Abstract Background: There has been considerable debate regarding the impact of assay imprecision on the performance of cardiac biomarkers for diagnosis of acute coronary syndromes (ACS) and risk stratification for future adverse cardiac events. Methods: Using existing data from 2 published clinical trials, we used a resampling method to statistically introduce 5%, 10%, and 20% imprecision to results for B-type natriuretic peptide (BNP) and cardiac troponin I (cTnI) and examined its impact on ROC curve analysis. Results: Superimposition of artificial imprecision produced no significant difference in the area under the ROC curve observed for BNP for diagnosis of heart failure or for cTnI for 30-day risk stratification of patients with ACS. Conclusion: Assay imprecision does not appear to be a critical determinant in the interpretation of cardiac marker results for patients with heart disease.

scholarly journals Impact of comorbidity burden on mortality in patients with COVID-19: a retrospective analysis of the Korean health insurance database

2020 ◽  
Author(s):  
Soo Ick Cho ◽  
Susie Yoon ◽  
Ho-Jin Lee
Keyword(s):  
Risk Factors ◽  
Health Insurance ◽  
Roc Curve ◽  
Significant Risk ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Comorbidity Burden ◽  
Comorbidity Index ◽  
The Impact ◽  
Age And Sex

Abstract We aimed to investigate the impact of comorbidity burden on mortality in patients with COVID-19. We analyzed the COVID-19 data from the nationwide health insurance claims of South Korea. Data on demographic characteristics, comorbidities, and mortality records of patients with COVID-19 were extracted from the database. The odds ratios of mortality according to comorbidities in patients with COVID-19 with and without adjustment for age and sex were calculated. The predictive value of the original Charlson comorbidity index (CCI) and the age-adjusted CCI (ACCI) for mortality in patients with COVID-19 were investigated using the receiver operating characteristic (ROC) curve analysis. Among 7,590 patients with COVID-19, 227 (3.0%) had died. After age and sex adjustment, hypertension, diabetes mellitus, congestive heart failure, dementia, chronic pulmonary disease, liver, renal, and cancer were significant risk factors for mortality. The ROC curve analysis showed that ACCI threshold ≥4 yielded the best cut-off point for predicting mortality (area under the ROC 0.92; 95% CI, 0.91–0.94). Our study revealed multiple risk factors that were associated with mortality in patients with COVID-19. The high predictive power of the ACCI for mortality in our results could support the importance of old age and comorbidities in the severity of COVID-19.

Acute heart failure: predicting early in-hospital outcomes

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Santos ◽  
S Paula ◽  
I Almeida ◽  
H Santos ◽  
H Miranda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Logistic Regression ◽  
Acute Heart Failure ◽  
Roc Curve ◽  
Real Life ◽  
Study Data ◽  
Curve Analysis ◽  
Older Age ◽  
Invasive Ventilation ◽  
Roc Curve Analysis

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Patients (P) with acute heart failure (AHF) are a heterogeneous population. Risk stratification at admission may help predict in-hospital complications and needs. The Get With The Guidelines Heart Failure score (GWTG-HF) predicts in-hospital mortality (M) of P admitted with AHF. ACTION ICU score is validated to estimate the risk of complications requiring ICU care in non-ST elevation acute coronary syndromes. Objective To validate ACTION-ICU score in AHF and to compare ACTION-ICU to GWTG-HF as predictors of in-hospital M (IHM), early M [1-month mortality (1mM)] and 1-month readmission (1mRA), using real-life data. Methods Based on a single-center retrospective study, data collected from P admitted in the Cardiology department with AHF between 2010 and 2017. P without data on previous cardiovascular history or uncompleted clinical data were excluded. Statistical analysis used chi-square, non-parametric tests, logistic regression analysis and ROC curve analysis. Results Among the 300 P admitted with AHF included, mean age was 67.4 ± 12.6 years old and 72.7% were male. Systolic blood pressure (SBP) was 131.2 ± 37.0mmHg, glomerular filtration rate (GFR) was 57.1 ± 23.5ml/min. 35.3% were admitted in Killip-Kimball class (KKC) 4. ACTION-ICU score was 10.4 ± 2.3 and GWTG-HF was 41.7 ± 9.6. Inotropes’ usage was necessary in 32.7% of the P, 11.3% of the P needed non-invasive ventilation (NIV), 8% needed invasive ventilation (IV). IHM rate was 5% and 1mM was 8%. 6.3% of the P were readmitted 1 month after discharge. Older age (p &lt; 0.001), lower SBP (p = 0,035) and need of inotropes (p &lt; 0.001) were predictors of IHM in our population. As expected, patients presenting in KKC 4 had higher IHM (OR 8.13, p &lt; 0.001). Older age (OR 1.06, p = 0.002, CI 1.02-1.10), lower SBP (OR 1.01, p = 0.05, CI 1.00-1.02) and lower left ventricle ejection fraction (LVEF) (OR 1.06, p &lt; 0.001, CI 1.03-1.09) were predictors of need of NIV. None of the variables were predictive of IV. LVEF (OR 0.924, p &lt; 0.001, CI 0.899-0.949), lower SBP (OR 0.80, p &lt; 0.001, CI 0.971-0.988), higher urea (OR 1.01, p &lt; 0.001, CI 1.005-1.018) and lower sodium (OR 0.92, p = 0.002, CI 0.873-0.971) were predictors of inotropes’ usage. Logistic regression showed that GWTG-HF predicted IHM (OR 1.12, p &lt; 0.001, CI 1.05-1.19), 1mM (OR 1.10, p = 1.10, CI 1.04-1.16) and inotropes’s usage (OR 1.06, p &lt; 0.001, CI 1.03-1.10), however it was not predictive of 1mRA, need of IV or NIV. Similarly, ACTION-ICU predicted IHM (OR 1.51, p = 0.02, CI 1.158-1.977), 1mM (OR 1.45, p = 0.002, CI 1.15-1.81) and inotropes’ usage (OR 1.22, p = 0.002, CI 1.08-1.39), but not 1mRA, the need of IV or NIV. ROC curve analysis revealed that GWTG-HF score performed better than ACTION-ICU regarding IHM (AUC 0.774, CI 0.46-0-90 vs AUC 0.731, CI 0.59-0.88) and 1mM (AUC 0.727, CI 0.60-0.85 vs AUC 0.707, CI 0.58-0.84). Conclusion In our population, both scores were able to predict IHM, 1mM and inotropes’s usage.

scholarly journals Does Diabetes Affect the Surgical Outcomes in Cases With Cervical Ossification of the Posterior Longitudinal Ligament? A Multicenter Study From Asia Pacific Spine Study Group

2021 ◽  
pp. 219256822199630
Author(s):  
Narihito Nagoshi ◽  
Kota Watanabe ◽  
Masaya Nakamura ◽  
Morio Matsumoto ◽  
Nan Li ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Surgical Outcomes ◽  
Hemoglobin A1c ◽  
Perioperative Complications ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Asia Pacific ◽  
C5 Palsy ◽  
Significant Difference ◽  
The Impact

Study Design: Retrospective multicenter study. Objectives: To evaluate the surgical outcomes of cervical ossification of the posterior longitudinal ligament (OPLL) in diabetes mellitus (DM) patients. Methods: Approximately 253 cervical OPLL patients who underwent surgical decompression with or without fixation were registered at 4 institutions in 3 Asian countries. They were followed up for at least 2 years. Demographics, imaging, and surgical information were collected, and cervical Japanese Orthopaedic Association (JOA) scores and the visual analog scale (VAS) for the neck were used for evaluation. Results: Forty-seven patients had DM, showing higher hypertension and cardiovascular disease prevalence. Although they presented worse preoperative JOA scores than non-DM patients (10.5 ± 3.1 vs. 11.8 ± 3.2; P = 0.01), the former showed comparable neurologic recovery at the final follow-up (13.9 ± 2.9 vs. 14.2 ± 2.6; P = 0.41). No correlation was noted between the hemoglobin A1c level in the DM group and the pre- and postoperative JOA scores. No significant difference was noted in VAS scores between the groups at pre- and postsurgery. Regarding perioperative complications, DM patients presented a higher C5 palsy frequency (14.9% vs. 5.8%; P = 0.04). A similar trend was observed when surgical procedure was limited to laminoplasty. Conclusions: This is the first multicenter Asian study to evaluate the impact of DM on cervical OPLL patients. Surgical results were favorable even in DM cases, regardless of preoperative hemoglobin A1c levels or operative procedures. However, caution is warranted for the occurrence of C5 palsy after surgery.

scholarly journals Presepsin values and prognostic nutritional index predict mortality in intensive care unit patients with sepsis: a pilot study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuichiro Shimoyama ◽  
Osamu Umegaki ◽  
Noriko Kadono ◽  
Toshiaki Minami
Keyword(s):  
Multivariate Analysis ◽  
Roc Curve ◽  
Operating Characteristic ◽  
Prognostic Nutritional Index ◽  
Early Mortality ◽  
Curve Analysis ◽  
Rank Test ◽  
Roc Curve Analysis ◽  
Log Rank Test ◽  
Nutritional Index

Abstract Objective Sepsis is a major cause of mortality for critically ill patients. This study aimed to determine whether presepsin values can predict mortality in patients with sepsis. Results Receiver operating characteristic (ROC) curve analysis, Log-rank test, and multivariate analysis identified presepsin values and Prognostic Nutritional Index as predictors of mortality in sepsis patients. Presepsin value on Day 1 was a predictor of early mortality, i.e., death within 7 days of ICU admission; ROC curve analysis revealed an AUC of 0.84, sensitivity of 89%, and specificity of 77%; and multivariate analysis showed an OR of 1.0007, with a 95%CI of 1.0001–1.0013 (p = 0.0320).

scholarly journals Soluble cytotoxic T-lymphocyte–associated antigen 4 (sCTLA-4) as a potential biomarker for diagnosis and evaluation of the prognosis in Glioma

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jiajia Liu ◽  
Xiaoyi Tian ◽  
Yan Wang ◽  
Xixiong Kang ◽  
Wenqi Song
Keyword(s):  
T Lymphocyte ◽  
Roc Curve ◽  
Cytotoxic T Lymphocyte ◽  
Tumor Grade ◽  
Curve Analysis ◽  
Enzyme Linked Immunosorbent Assay ◽  
Low Grade ◽  
High Grade ◽  
Healthy Individuals ◽  
Roc Curve Analysis

Abstract Background The cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) is widely considered as a pivotal immune checkpoint molecule to suppress antitumor immunity. However, the significance of soluble CTLA-4 (sCTLA-4) remains unclear in the patients with brain glioma. Here we aimed to investigate the significance of serum sCTLA-4 levels as a noninvasive biomarker for diagnosis and evaluation of the prognosis in glioma patients. Methods In this study, the levels of sCTLA-4 in serum from 50 patients diagnosed with different grade gliomas including preoperative and postoperative, and 50 healthy individuals were measured by an enzyme-linked immunosorbent assay (ELISA). And then ROC curve analysis and survival analyses were performed to explore the clinical significance of sCTLA-4. Results Serum sCTLA-4 levels were significantly increased in patients with glioma compared to that of healthy individuals, and which was also positively correlated with the tumor grade. ROC curve analysis showed that the best cutoff value for sCTLA-4 for glioma is 112.1 pg/ml, as well as the sensitivity and specificity with 82.0 and 78.0%, respectively, and a cut-off value of 220.43 pg/ml was best distinguished in patients between low-grade glioma group and high-grade glioma group with sensitivity 73.1% and specificity 79.2%. Survival analysis revealed that the patients with high sCTLA-4 levels (> 189.64 pg/ml) had shorter progression-free survival (PFS) compared to those with low sCTLA-4 levels (≤189.64 pg/ml). In the univariate analysis, elder, high-grade tumor, high sCTLA-4 levels and high Ki-67 index were significantly associated with shorter PFS. In the multivariate analysis, sCTLA-4 levels and tumor grade remained an independent prognostic factor. Conclusion These findings indicated that serum sCTLA-4 levels play a critical role in the pathogenesis and development of glioma, which might become a valuable predictive biomarker for supplementary diagnosis and evaluation of the progress and prognosis in glioma.

scholarly journals Predictive CT features for the diagnosis of primary pulmonary mucoepidermoid carcinoma: comparison with squamous cell carcinomas and adenocarcinomas

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaohua Ban ◽  
Xinping Shen ◽  
Huijun Hu ◽  
Rong Zhang ◽  
Chuanmiao Xie ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Roc Curve ◽  
Multinomial Logistic Regression ◽  
Univariate Analysis ◽  
Ct Imaging ◽  
Squamous Cell Carcinomas ◽  
Curve Analysis ◽  
Imaging Features ◽  
Roc Curve Analysis ◽  
Ct Features

Abstract Background To determine the predictive CT imaging features for diagnosis in patients with primary pulmonary mucoepidermoid carcinomas (PMECs). Materials and methods CT imaging features of 37 patients with primary PMECs, 76 with squamous cell carcinomas (SCCs) and 78 with adenocarcinomas were retrospectively reviewed. The difference of CT features among the PMECs, SCCs and adenocarcinomas was analyzed using univariate analysis, followed by multinomial logistic regression and receiver operating characteristic (ROC) curve analysis. Results CT imaging features including tumor size, location, margin, shape, necrosis and degree of enhancement were significant different among the PMECs, SCCs and adenocarcinomas, as determined by univariate analysis (P < 0.05). Only lesion location, shape, margin and degree of enhancement remained independent factors in multinomial logistic regression analysis. ROC curve analysis showed that the area under curve of the obtained multinomial logistic regression model was 0.805 (95%CI: 0.704–0.906). Conclusion The prediction model derived from location, margin, shape and degree of enhancement can be used for preoperative diagnosis of PMECs.

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