Incidence and Risk Factors for Severe Thrombocytopenia in Lymphoma Patients Receiving Chemotherapy.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3994-3994
Author(s):  
Auris Huen ◽  
Xiao Zhou ◽  
Shyam Teegala ◽  
Yuan Ji ◽  
Luis Fayad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Medical Records ◽  
Cell Lymphoma ◽  
Significant Risk ◽  
Severe Thrombocytopenia ◽  
Multivariate Logistic Regression ◽  
Prior Therapy ◽  
Burkitts Lymphoma ◽  
Grade 3

Abstract Background: Severe thrombocytopenia (TCP) can be a serious complication of chemotherapy (CT) in lymphoma patients (pts), however the exact incidence with the current regimens and risk factors for TCP are not well known. Methods: A retrospective cohort study was conducted to determine the incidence of TCP, and logistic regression analysis were performed to identify the clinical and laboratory features correlated with severe TCP in lymphoma. Medical records of 538 consecutive pts out of the 1050 lymphoma pts, who were newly referred to MDACC in 2003, were reviewed. Results: 202 pts who received > 1 cycle of treatment were included in the analysis. The total number of CT cycles (with PLT counts) for the 202 pts was 985 (median 6, range, 1–20). Grade (gr) 4 TCP (PLT nadir < 25x103/μL) was observed in 39% (79/202) of pts and 20% (196/985) of cycles. The median cycle in which gr 4 TCP occurred was 2 (range, 1 to 11), and median PLT nadir count for gr 4 TCP was 12x103/μL (3 to 24x103/μL). The regimens most commonly associated with gr 4 TCP were Hyper-CVAD/ Ara-c/Mtx (31/35=89%), ESHAP (6/7=86%), ASHAP (3/4=75%), and ICE (5/7=71%) + rituxan, and the most common histological subtypes were MCL (15/19=79%), Burkitts lymphoma (7/9=78%), T cell lymphoma (10/17=58%), and LCL (31/64=48%). Thirty two of 79 (41%) gr 4 TCP pts had bleeding as compared to 8 of 123 (7%) pts with higher PLT counts (p=0.0001). Overall, the incidence of bleeding was 20% (40/202) by pts and 6% (60/985) by cycles; however, the most incidents [95% (57/60)] were minor. 80% (63/79) of Grade 4 TCP pts received PLT transfusions, as compared to only 2% (2/123) of the rest (p<0.0001). Using multivariate logistic regression, histological gr, (highly aggressive or aggressive vs indolent: OR=10.402, 95% CI, 3.991 to 27.107, p<0.0001), baseline PLT count (≤150 vs >150x103/μL: OR=4.610, 95% CI, 1.366 to 15.560, p=0.0138), prior therapy (yes vs. no: OR=2.575, 95% CI, 1.337 to 4.961, p=0.0047), Beta2 Microglobulin (B2M) (≥2 vs <2mg/L: OR=2.846, 95% CI, 1.401 to 5.783, p=0.0038), age (>60 vs. ≤60 yrs: OR=0.479, 95% CI, 0.241 to 0.952, p=0.0356) were the most important risk factors for grade 3 or 4 TCP. Conclusions: The incidence of severe TCP in this population is high. Baseline pt characteristics including histological gr, PLT counts, prior therapy, age and serum B2M were found to be significant risk factors predictive for chemotherapy-induced TCP (CIT). These findings could be useful to identify high risk pts for consideration of treatment approaches for prevention and treatment of CIT.

Risk factors for neutropenic fever in lymphoma patients receiving chemotherapy

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19616-19616 ◽  
Author(s):  
S. R. Teegala ◽  
X. Zhou ◽  
A. Huen ◽  
Y. Ji ◽  
L. E. Fayad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
High Risk ◽  
Medical Records ◽  
Significant Risk ◽  
Neutropenic Fever ◽  
Baseline Risk ◽  
Multivariate Logistic Regression ◽  
Number Of Cycles

19616 Background: Neutropenic fever (NF) can be a serious complication of chemotherapy (CT) in lymphoma patients (pts), however the exact incidence with the current regimens and risk factors for NF are not well known. Methods: A retrospective cohort study was conducted to determine the incidence of NF, and logistic regression analysis were performed to identify the clinical and laboratory features correlated with NF in lymphoma. Medical records of all newly referred lymphoma pts (n=1046) in 2003 were reviewed. Results: 425 pts who received ≥ 1 cycle of treatment at MDACC were included in the analysis. Median age was 57 (range 17–87) with 262 (62%) newly diagnosed. Most common first regimens were (± rituxan) CHOP (29%), Hyper-CVAD ± Ara-c-MTX (23%), and ABVD (8%), with the total number of cycles were 1638 (median 3, range, 1–10). NF was observed in 23 % (97/425) of pts and 8 % (123/1638) of cycles, with the highest number in cycle 1 (49/123). The NF incidence among most common regimens were (± rituxan) Hyper-CVAD/ Ara-c/MTX 53% (31/58), Hyper-CVAD 24% (9/37), CHOP 22% (27/125), and ABVD 6% (2/34), and most common subtypes were MCL (33%), LCL (23%), HD (16%), and FL (13%). In the univariate regression analysis, CT, Hb, Ca, LDH, lymphocyte (ALC) and neutrophil (ANC) counts, were significantly associated with the NF. Using multivariate logistic regression, baseline ALC count (=1000 vs. >1000/μL: OR=2.251, 95% CI, 1.194 to 4.244, p=0.0121), Hb (<12 g/dL vs. ≥ 12g/dL: OR=2.117, 95% CI, 1.122 to 3.996, p=0.0207), age (>60 vs. ≤60: OR=2.035, 95% CI, 1.066 to 3.884, p=0.0312), CT (high vs. low risk: OR=2.913, 95% CI, 1.520 to 5.583, p=0.0013) were the most important baseline risk factors for NF in cycle-1. Conclusions: The incidence of NF in this population is high in cycle 1. Baseline pt characteristics including old age, high risk CT, low ALC and Hb were found to be significant risk factors predictive for NF in cycle-1. These findings could be useful to identify high risk pts for consideration of treatment approaches for prevention of NF. No significant financial relationships to disclose.

scholarly journals Risk factors associated with stillbirth of piglets born from oxytocin-assisted parturitions

2020 ◽  
Vol 13 (10) ◽  
pp. 2172-2177
Author(s):  
Nguyen Hoai Nam ◽  
Peerapol Sukon
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Models ◽  
Significant Risk ◽  
Gestation Length ◽  
Stillbirth Rate ◽  
Multivariate Logistic Regression ◽  
Crown Rump Length ◽  
Logistic Regression Models ◽  
Factors Associated

Aim: The present study aimed to investigate the effects of different risk factors on stillbirth of piglets born from oxytocin-assisted parturitions. Materials and Methods: Data were collected from a total of 1121 piglets born from 74 Landrace x Yorkshire crossbred sows from a herd. Logistic regression models were used to determine the associations between stillbirth and different risk factors including parity (1, 2, 3-5, and 6-10), gestation length (GL) (112-113, 114-116, and 117-119 days), litter size, birth order (BO), sex, birth interval (BI), cumulative farrowing duration, birth weight (BW), crown rump length, BW deviation, body mass index, ponderal index (PI), and the use of oxytocin during expulsive stage of farrowing. Results: The incidence of stillbirth at litter level and stillbirth rate was 59.5% (44/74) and 8.1% (89/1094), respectively. The final multivariate logistic regression selected BO, BI, PI, GL, and parity as the five most significant risk factors for stillbirth. Increased BO and BI, GL <114 and >116 days, parity 6-10, and low PI increased the stillbirth rate in piglets. Conclusion: Several factors previously determined as risks for stillbirth in exogenous oxytocin-free parturitions also existed in exogenous oxytocin-assisted parturitions. One dose of oxytocin at fairly high BO did not increase stillbirth, whereas two doses of oxytocin were potentially associated with increased values.

Postoperative facial palsy after pediatric posterior fossa tumor resection

2021 ◽  
pp. 1-6
Author(s):  
Jason K. Chu ◽  
Peter A. Chiarelli ◽  
Nolan D. Rea ◽  
Norianne Pimentel ◽  
Benjamin E. Flyer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Posterior Fossa ◽  
Facial Palsy ◽  
Tumor Resection ◽  
Significant Risk ◽  
Posterior Fossa Tumor ◽  
Facial Weakness ◽  
Multivariate Logistic Regression ◽  
Study Results

OBJECTIVE Facial palsy can be caused by masses within the posterior fossa and is a known risk of surgery for tumor resection. Although well documented in the adult literature, postoperative facial weakness after posterior fossa tumor resection in pediatric patients has not been well studied. The objective of this work was to determine the incidence of postoperative facial palsy after tumor surgery, and to investigate clinical and radiographic risk factors. METHODS A retrospective analysis was conducted at a single large pediatric hospital. Clinical, radiographic, and histological data were examined in children who were surgically treated for posterior fossa tumors between May 1, 1994, and June 1, 2011. The incidence of postoperative facial weakness was documented. A multivariate logistic regression model was used to analyze the predictive ability of clinicoradiological variables for facial weakness. RESULTS A total of 163 patients were included in this study. The average age at surgery was 7.4 ± 4.7 years, and tumor pathologies included astrocytoma (44%), medulloblastoma (36%), and ependymoma (20%). The lesions of 27 patients (17%) were considered high grade in nature. Thirteen patients (8%) exhibited preoperative symptoms of facial palsy. The overall incidence of postoperative facial palsy was 26% (43 patients), and the incidence of new postoperative facial palsy in patients without preoperative facial weakness was 20% (30 patients). The presence of a preoperative facial palsy had a large and significant effect in univariate analysis (OR 11.82, 95% CI 3.07–45.44, p < 0.01). Multivariate logistic regression identified recurrent operation (OR 4.45, 95% CI 1.49–13.30, p = 0.01) and other preoperative cranial nerve palsy (CNP; OR 3.01, 95% CI 1.24–7.29, p = 0.02) as significant risk factors for postoperative facial weakness. CONCLUSIONS Facial palsy is a risk during surgical resection of posterior fossa brain tumors in the pediatric population. The study results suggest that the incidence of new postoperative facial palsy can be as high as 20%. The presence of preoperative facial palsy, an operation for recurrent tumor, and the presence of other preoperative CNPs were found to be significant risk factors for postoperative facial weakness.

Development and Validation of a Novel Nomogram to Predict Lymph Node Involvement in T1 Stage Lung Adenocarcinoma.

2020 ◽  
Author(s):  
Jianjun Wang ◽  
Li Wei ◽  
Jiwei Li ◽  
Quan Zhang ◽  
Zeheng Ma
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Lymph Node ◽  
Lung Adenocarcinoma ◽  
Bootstrap Method ◽  
Significant Risk ◽  
Lymph Node Involvement ◽  
Tumor Diameter ◽  
Multivariate Logistic Regression ◽  
Lymph Node Swelling

Abstract A total of 326 patients with T1 lung adenocarcinoma from March 2012 to April 2016 in our center were included. The relationship between LNI and different risk factors were accessed by univariate and multivariate logistic regression analyses. Four significant risk factors identified by multivariate logistic regression were tumor diameter (OR = 2.175, 95%CI:1.277–3.072, p = 0.0045), lymph node swelling exist preoperative (OR = 6.144, 95%CI:6.947–14.059, p = 0.003), platelet to lymphocyte ratio (OR = 3.149, 95%CI:1.546–6.673, p = 0.003), CEA (OR = 4.375, 95%CI: 2.613–7.537, p = 0.00694). A nomogram was constructed by combing risk factors and validated with an internal set. The C-index of this nomogram was 0.875, which was validated by bootstrap method. At last we concluded that the novel nomogram showed the potential value of LNI prediction for lung adenocarcinoma.

Short-Term Outcomes Following Removal of Infected Hernia Mesh

2021 ◽  
pp. 000313482110241
Author(s):  
Christine Tung ◽  
Junko Ozao-Choy ◽  
Dennis Y. Kim ◽  
Christian de Virgilio ◽  
Ashkan Moazzez
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Logistic Regression ◽  
Body Mass ◽  
Smoking History ◽  
Multivariate Logistic Regression ◽  
Short Term ◽  
Mesh Removal ◽  
Mesh Placement ◽  
Infected Mesh

There are limited studies regarding outcomes of replacing an infected mesh with another mesh. We reviewed short-term outcomes following infected mesh removal and whether placement of new mesh is associated with worse outcomes. Patients who underwent hernia repair with infected mesh removal were identified from 2005 to 2018 American College of Surgeons-National Surgical Quality Improvement Program database. They were divided into new mesh (Mesh+) or no mesh (Mesh-) groups. Bivariate and multivariate logistic regression analyses were used to compare morbidity between the two groups and to identify associated risk factors. Of 1660 patients, 49.3% received new mesh, with higher morbidity in the Mesh+ (35.9% vs. 30.3%; P = .016), but without higher rates of surgical site infection (SSI) (21.3% vs. 19.7%; P = .465). Mesh+ had higher rates of acute kidney injury (1.3% vs. .4%; P = .028), UTI (3.1% vs. 1.3%, P = .014), ventilator dependence (4.9% vs. 2.4%; P = .006), and longer LOS (8.6 vs. 7 days, P < .001). Multivariate logistic regression showed new mesh placement (OR: 1.41; 95% CI: 1.07-1.85; P = .014), body mass index (OR: 1.02; 95% CI: 1.00-1.03; P = .022), and smoking (OR: 1.43; 95% CI: 1.05-1.95; P = .025) as risk factors independently associated with increased morbidity. New mesh placement at time of infected mesh removal is associated with increased morbidity but not with SSI. Body mass index and smoking history continue to contribute to postoperative morbidity during subsequent operations for complications.

scholarly journals Risk factors for tissue expander infection in scar reconstruction: a retrospective cohort study of 2374 consecutive cases

2020 ◽  
Vol 8 ◽  
Author(s):  
Chen Dong ◽  
Minhui Zhu ◽  
Luguang Huang ◽  
Wei Liu ◽  
Hengxin Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Treatment Failure ◽  
Logistic Regression Analysis ◽  
Disease Duration ◽  
Multivariate Logistic Regression Analysis ◽  
Tissue Expansion ◽  
Multivariate Logistic Regression ◽  
Hematoma Evacuation

Abstract Background Tissue expansion is used for scar reconstruction owing to its excellent clinical outcomes; however, the complications that emerge from tissue expansion hinder repair. Infection is considered a major complication of tissue expansion. This study aimed to analyze the perioperative risk factors for expander infection. Methods A large, retrospective, single-institution observational study was carried out over a 10-year period. The study enrolled consecutive patients who had undergone tissue expansion for scar reconstruction. Demographics, etiological data, expander-related characteristics and postoperative infection were assessed. Univariate and multivariate logistic regression analysis were performed to identify risk factors for expander infection. In addition, we conducted a sensitivity analysis for treatment failure caused by infection as an outcome. Results A total of 2374 expanders and 148 cases of expander infection were assessed. Treatment failure caused by infection occurred in 14 expanders. Multivariate logistic regression analysis identified that disease duration of ≤1 year (odds ratio (OR), 2.07; p &lt; 0.001), larger volume of expander (200–400 ml vs &lt;200 ml; OR, 1.74; p = 0.032; &gt;400 ml vs &lt;200 ml; OR, 1.76; p = 0.049), limb location (OR, 2.22; p = 0.023) and hematoma evacuation (OR, 2.17; p = 0.049) were associated with a high likelihood of expander infection. Disease duration of ≤1 year (OR, 3.88; p = 0.015) and hematoma evacuation (OR, 10.35; p = 0.001) were so related to high risk of treatment failure. Conclusions The rate of expander infection in patients undergoing scar reconstruction was 6.2%. Disease duration of &lt;1 year, expander volume of &gt;200 ml, limb location and postoperative hematoma evacuation were independent risk factors for expander infection.

Abstract 16543: Severe Thrombocytopenia is Common in Adults Undergoing Venoarterial Extracorporeal Membrane Oxygenation and is Predictive of Hemorrhage

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Tia C Kohs ◽  
Vikram Raghunathan ◽  
Patricia Liu ◽  
Ramin Amirsoltani ◽  
Michael Oakes ◽  
...  
Keyword(s):  
Overall Survival ◽  
Logistic Regression ◽  
Platelet Count ◽  
Extracorporeal Membrane Oxygenation ◽  
Clinical Implications ◽  
Severe Thrombocytopenia ◽  
Multivariate Logistic Regression ◽  
Membrane Oxygenation ◽  
Increased Risk ◽  
Va Ecmo

Introduction: Extracorporeal membrane oxygenation (ECMO) is used to provide circulatory support and facilitate gas exchange via cardiopulmonary bypass. The relationship between ECMO and the incidence of severe thrombocytopenia (platelet count <50 x 10 9 /L) and subsequent clinical consequences are ill defined. We aimed to identify the risk factors for the development of thrombocytopenia and its clinical implications. Methods: This is a single-center retrospective cohort study of adults who received venoarterial (VA) ECMO. We examined consecutive platelet counts while on ECMO. Univariate logistic regression was used to determine if mean platelet count, platelet count range, or severe thrombocytopenia were predictors of overall survival, hemorrhage and thrombosis. A multivariate logistic regression model was used to identify factors that contribute to the development of the aforementioned patient outcomes. Results: In our cohort, 33 patients were included with a mean age of 55 years and duration of ECMO of 5.9 days. All patients received heparin, 33.3% received antiplatelet therapy and 45.5% developed severe thrombocytopenia. In univariate, analysis the development of severe thrombocytopenia increased the odds of major bleeding by 450% (OR 5.500, 95% CI 1.219 - 24.813, P -value 0.027), and the odds of surviving hospitalization decreased 84.1% (OR 0.159, 95% CI 0.033 - 0.773, P -value 0.023). Multivariate logistic regression controlling for additional clinical variables found no significant association between the development of severe thrombocytopenia and rates of thrombosis, hemorrhage, or overall survival. Platelet count decreased over time while on ECMO. Conclusions: Nearly half of the patients requiring VA-ECMO developed severe thrombocytopenia, which was associated with an increased risk of hemorrhage and in-hospital mortality. Additional studies are required to clarify the clinical implications of severe thrombocytopenia in ECMO patients.

scholarly journals Coxiella burnetii seroprevalence and risk factors in sheep farmers and farm residents in The Netherlands

2013 ◽  
Vol 142 (6) ◽  
pp. 1231-1244 ◽  
Author(s):  
M. M. A. De LANGE ◽  
B. SCHIMMER ◽  
P. VELLEMA ◽  
J. L. A. HAUTVAST ◽  
P. M. SCHNEEBERGER ◽  
...  
Keyword(s):  
Risk Factors ◽  
The Netherlands ◽  
Coxiella Burnetii ◽  
High Frequency ◽  
Significant Risk ◽  
Infection Risk ◽  
Multivariate Logistic Regression ◽  
Dairy Sheep ◽  
Sheep Farm ◽  
Farm Residents

SUMMARYIn this study, Coxiella burnetii seroprevalence was assessed for dairy and non-dairy sheep farm residents in The Netherlands for 2009–2010. Risk factors for seropositivity were identified for non-dairy sheep farm residents. Participants completed farm-based and individual questionnaires. In addition, participants were tested for IgG and IgM C. burnetii antibodies using immunofluorescent assay. Risk factors were identified by univariate, multivariate logistic regression, and multivariate multilevel analyses. In dairy and non-dairy sheep farm residents, seroprevalence was 66·7% and 51·3%, respectively. Significant risk factors were cattle contact, high goat density near the farm, sheep supplied from two provinces, high frequency of refreshing stable bedding, farm started before 1990 and presence of the Blessumer breed. Most risk factors indicate current or past goat and cattle exposure, with limited factors involving sheep. Subtyping human, cattle, goat, and sheep C. burnetii strains might elucidate their role in the infection risk of sheep farm residents.

scholarly journals 10-Year Renal Function Trajectories in Community-Dwelling Older Adults: Exploring the Risk Factors for Different Patterns

2018 ◽  
Vol 7 (10) ◽  
pp. 373
Author(s):  
Chia-Ter Chao ◽  
Yung-Ming Chen ◽  
Fu-Hui Ho ◽  
Kun-Pei Lin ◽  
Jen-Hau Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Logistic Regression ◽  
Renal Function ◽  
Estimated Glomerular Filtration Rate ◽  
Community Dwelling ◽  
Multivariate Logistic Regression ◽  
Improve Risk Stratification ◽  
Leukocyte Counts ◽  
Community Dwelling Older Adults

Longitudinal changes of renal function help inform patients’ clinical courses and improve risk stratification. Rare studies address risk factors predicting changes in estimated glomerular filtration rate (eGFR) over time in older adults, particularly of Chinese ethnicity. We identified prospectively enrolled community-dwelling older adults (≥65 years) receiving annual health examinations between 2005 and 2015 with serum creatinine available continuously in a single institute, and used linear regression to derive individual’s annual eGFR changes, followed by multivariate logistic regression analyses to identify features associated with different eGFR change patterns. Among 500 elderly (71.3 ± 4.2 years), their mean annual eGFR changes were 0.84 ± 1.67 mL/min/1.73 m2/year, with 136 (27.2%) and 238 (47.6%) classified as having downward (annual eGFR change <0 mL/min/1.73 m2/year) and upward eGFR (≥1 mL/min/1.73 m2/year) trajectories, respectively. Multivariate logistic regression showed that higher age (odds ratio (OR) 1.08), worse renal function (OR 13.2), and more severe proteinuria (OR 9.86) or hematuria (OR 3.39) were predictive of a declining eGFR while greater waist circumference (OR 1.06) and higher leukocyte counts (OR 1.21) were predictive of an uprising 10-year eGFR. These findings elucidate important features associated with geriatric renal function variations, which are expected to improve their renal care.

Sign in / Sign up

Export Citation Format

Share Document