Risk factors of early postoperative bowel obstruction for patients undergoing selective colorectal surgeries

Abstract Objective Postoperative bowel obstruction was one of the most severe complications in patients who received colorectal surgeries. This study aimed to explore risk factors of early postoperative obstruction and to construct a nomogram to predict the possibility of occurrence. Methods The records of 1437 patients who underwent elective colorectal surgery in Peking University People’s Hospital from 2015 to 2020 were retrospectively collected. Risk factors of early postoperative bowel obstruction were identified by logistic regression analysis and a nomogram was then constructed. Bootstrap was applied to verify the stability of the model. Results COPD, hypothyroidism, probiotic indications, duration of antibiotics, and time to postoperative feeding were identified as independent risk factors and were put into a nomogram for predicting early postoperative bowel obstruction. The nomogram showed robust discrimination, with the area under the receiver operating characteristic curve was 0.894 and was well-calibrated. Conclusion A nomogram including independent risk factors of COPD, hypothyroidism, probiotic indications, duration of antibiotics, and time to postoperative feeding were established to predict the risk of early postoperative bowel obstruction.

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Risk Factors of Early Postoperative Bowel Obstruction for Patients Undergoing Selective Colorectal Surgeries

10.21203/rs.3.rs-624962/v1 ◽

2021 ◽

Author(s):

Shuguang Yang ◽

Zhidong Gao ◽

Huiying Zhao ◽

Youzhong An ◽

Jianghui Yang ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Bowel Obstruction ◽

Operating Characteristic ◽

Characteristic Curve ◽

Peking University ◽

Independent Risk Factors ◽

Operating Characteristic Curve ◽

The Stability ◽

Postoperative Feeding

Abstract Objective: Postoperative bowel obstruction was one of the most severe complications in patients received colorectal surgeries. The aim of this study was to explore risk factors of early postoperative obstruction and to construct a nomogram to predict the possibility of occurrence. Methods: The records of 1437 patients who underwent selective colorectal surgery in Peking University People’s Hospital from 2015 to 2020 was retrospectively collect. Risk factors of early postoperative bowel obstruction were identified by logistic regression analysis and a nomogram was then constructed. Bootstrap was applied to verify the stability of the model. Results: COPD, hypothyroidism, probiotic indications, duration of antibiotics, and time to postoperative feeding were identified as independent risk factors and were put into a nomogram for predicting early postoperative bowel obstruction. The nomogram showed a robust discrimination, with area under the receiver operating characteristic curve was 0.894 and was well calibrated. Conclusion: A nomogram including independent risk factors of COPD, hypothyroidism, probiotic indications, duration of antibiotics, and time to postoperative feeding were established to predict the risk of early postoperative bowel obstruction.

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Prediction of anemia at delivery

Scientific Reports ◽

10.1038/s41598-021-85622-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Enav Yefet ◽

Avishag Yossef ◽

Zohar Nachum

Keyword(s):

Risk Factors ◽

Operating Characteristic ◽

Complete Blood Count ◽

Characteristic Curve ◽

Secondary Analysis ◽

Area Under The Curve ◽

Iron Supplement ◽

Independent Risk Factors ◽

Operating Characteristic Curve ◽

Study Database

AbstractWe aimed to assess risk factors for anemia at delivery by conducting a secondary analysis of a prospective cohort study database including 1527 women who delivered vaginally ≥ 36 gestational weeks. Anemia (Hemoglobin (Hb) < 10.5 g/dL) was assessed at delivery. A complete blood count results during pregnancy as well as maternal and obstetrical characteristics were collected. The primary endpoint was to determine the Hb cutoff between 24 and 30 gestational weeks that is predictive of anemia at delivery by using the area under the curve (AUC) of the receiver operating characteristic curve. Independent risk factors for anemia at delivery were assessed using stepwise multivariable logistic regression. Hb and infrequent iron supplement treatment were independent risk factors for anemia at delivery (OR 0.3 95%CI [0.2–0.4] and OR 2.4 95%CI [1.2–4.8], respectively; C statistics 83%). Hb 10.6 g/dL was an accurate cutoff to predict anemia at delivery (AUC 80% 95%CI 75–84%; sensitivity 75% and specificity 74%). Iron supplement was beneficial to prevent anemia regardless of Hb value. Altogether, Hb should be routinely tested between 24 and 30 gestational weeks to screen for anemia. A flow chart for anemia screening and treatment during pregnancy is proposed in the manuscript.Trial registration: ClinicalTrials.gov Identifier: NCT02434653.

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CANPT Score: A Tool to Predict Severe COVID-19 on Admission

Frontiers in Medicine ◽

10.3389/fmed.2021.608107 ◽

2021 ◽

Vol 8 ◽

Author(s):

Yuanyuan Chen ◽

Xiaolin Zhou ◽

Huadong Yan ◽

Huihong Huang ◽

Shengjun Li ◽

...

Keyword(s):

Risk Factors ◽

Operating Characteristic ◽

Total Bilirubin ◽

Predictive Accuracy ◽

Characteristic Curve ◽

Severe Disease ◽

Multivariate Logistic Regression ◽

Independent Risk Factors ◽

Operating Characteristic Curve ◽

Cr Creatine

Background and Aims: Patients with critical coronavirus disease 2019 (COVID-19) have a mortality rate higher than 50%. The purpose of this study was to establish a model for the prediction of the risk of severe disease and/or death in patients with COVID-19 on admission.Materials and Methods: Patients diagnosed with COVID-19 in four hospitals in China from January 22, 2020 to April 15, 2020 were retrospectively enrolled. The demographic, laboratory, and clinical data of the patients with COVID-19 were collected. The independent risk factors related to the severity of and death due to COVID-19 were identified with a multivariate logistic regression; a nomogram and prediction model were established. The area under the receiver operating characteristic curve (AUROC) and predictive accuracy were used to evaluate the model's effectiveness.Results: In total, 582 patients with COVID-19, including 116 patients with severe disease, were enrolled. Their comorbidities, body temperature, neutrophil-to-lymphocyte ratio (NLR), platelet (PLT) count, and levels of total bilirubin (Tbil), creatinine (Cr), creatine kinase (CK), and albumin (Alb) were independent risk factors for severe disease. A nomogram was generated based on these eight variables with a predictive accuracy of 85.9% and an AUROC of 0.858 (95% CI, 0.823–0.893). Based on the nomogram, the CANPT score was established with cut-off values of 12 and 16. The percentages of patients with severe disease in the groups with CANPT scores <12, ≥12, and <16, and ≥16 were 4.15, 27.43, and 69.64%, respectively. Seventeen patients died. NLR, Cr, CK, and Alb were independent risk factors for mortality, and the CAN score was established to predict mortality. With a cut-off value of 15, the predictive accuracy was 97.4%, and the AUROC was 0.903 (95% CI 0.832, 0.974).Conclusions: The CANPT and CAN scores can predict the risk of severe disease and mortality in COVID-19 patients on admission.

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Prognostic significance of urine paraquat concentrations of patients with acute paraquat poisoning on admission at the emergency department

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907917742873 ◽

2018 ◽

Vol 25 (1) ◽

pp. 3-11 ◽

Cited By ~ 1

Author(s):

Xiaowei Liu ◽

Tao Ma ◽

Zhi Liu

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Receiver Operating Characteristic ◽

Operating Characteristic ◽

Characteristic Curve ◽

Prognostic Significance ◽

Urine Concentration ◽

Paraquat Poisoning ◽

Independent Risk Factors ◽

Receiver Operating

Objective: To assess the prognostic significance of urine paraquat concentrations of patients with acute paraquat poisoning on admission at the emergency department. Methods: Patients with acute paraquat poisoning admitted to the emergency department were recruited. Survivors and non-survivors were compared with regard to urinary paraquat concentration. The urinary level predictive of mortality was assessed by receiver operating characteristic curve. Risk factors of mortality were evaluated by regression analysis. Results: The overall mortality rate was 70.9% over the 28-day follow-up period. There was a significant difference in the urine paraquat concentrations recorded on admission between non-surviving and surviving patients ( p = 0.022). Receiver operating characteristic curve analysis revealed that the area under the curve when applied to receiver operating characteristic of the admission urine paraquat concentrations for predicting mortality was 0.854 with a cut-off value of 34.5 µg/mL. The dose of paraquat ingested, arterial lactate, and urine concentration were independent risk factors predicting 28-day mortality. The time interval between ingestion and hemoperfusion, arterial lactate, and urine concentration of paraquat were independent risk factors predicting acute kidney injury, while the partial pressure of carbon dioxide (PaCO2) and urine concentration of paraquat were independent risk factors predicting acute lung injury. Conclusion: The urine concentrations of paraquat on admission at emergency department demonstrated predictive ability for the prognosis of patients with acute paraquat poisoning.

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Traditional Cardiovascular Risk Factors and Individual Prediction of Cardiovascular Events in Childhood Cancer Survivors

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/djz108 ◽

2019 ◽

Vol 112 (3) ◽

pp. 256-265 ◽

Cited By ~ 6

Author(s):

Yan Chen ◽

Eric J Chow ◽

Kevin C Oeffinger ◽

William L Border ◽

Wendy M Leisenring ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Cardiovascular Risk ◽

Childhood Cancer ◽

Cardiovascular Risk Factors ◽

Operating Characteristic ◽

Prediction Models ◽

Characteristic Curve ◽

Childhood Cancer Survivors ◽

Operating Characteristic Curve

Abstract Background Childhood cancer survivors have an increased risk of heart failure, ischemic heart disease, and stroke. They may benefit from prediction models that account for cardiotoxic cancer treatment exposures combined with information on traditional cardiovascular risk factors such as hypertension, dyslipidemia, and diabetes. Methods Childhood Cancer Survivor Study participants (n = 22 643) were followed through age 50 years for incident heart failure, ischemic heart disease, and stroke. Siblings (n = 5056) served as a comparator. Participants were assessed longitudinally for hypertension, dyslipidemia, and diabetes based on self-reported prescription medication use. Half the cohort was used for discovery; the remainder for replication. Models for each outcome were created for survivors ages 20, 25, 30, and 35 years at the time of prediction (n = 12 models). Results For discovery, risk scores based on demographic, cancer treatment, hypertension, dyslipidemia, and diabetes information achieved areas under the receiver operating characteristic curve and concordance statistics 0.70 or greater in 9 and 10 of the 12 models, respectively. For replication, achieved areas under the receiver operating characteristic curve and concordance statistics 0.70 or greater were observed in 7 and 9 of the models, respectively. Across outcomes, the most influential exposures were anthracycline chemotherapy, radiotherapy, diabetes, and hypertension. Survivors were then assigned to statistically distinct risk groups corresponding to cumulative incidences at age 50 years of each target outcome of less than 3% (moderate-risk) or approximately 10% or greater (high-risk). Cumulative incidence of all outcomes was 1% or less among siblings. Conclusions Traditional cardiovascular risk factors remain important for predicting risk of cardiovascular disease among adult-age survivors of childhood cancer. These prediction models provide a framework on which to base future surveillance strategies and interventions.

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Risk Factors for Nonischemic St-segment Elevation in Patients With Electrocardiographic Left Ventricular Hypertrophy

10.21203/rs.3.rs-136160/v1 ◽

2021 ◽

Author(s):

Haisen Guo ◽

Weidai Zhang ◽

Jiawei Zhang ◽

Chumin Ni ◽

Zhixiong Cai ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Receiver Operating Characteristic Curve ◽

Receiver Operating Characteristic ◽

Operating Characteristic ◽

Characteristic Curve ◽

St Segment Elevation ◽

St Segment ◽

Operating Characteristic Curve ◽

Receiver Operating

Abstract Background ST-segment elevation (STE) is not a specific change for ST-segment elevation myocardial infarction (STEMI). This may lead to a mistaken diagnosis of STEMI and false-positive cardiac catheterization laboratory activation. We aimed to investigate risk factors for STE secondary to electrocardiographic LVH in order to provide more information for differential diagnosis.Methods A total of 1,590 inpatients with electrocardiographic LVH without confounding factors (such as myocardial infarction) were enrolled in this study. Data on potential risk factors and patient characteristics were collected. Logistic regression analysis and receiver operating characteristic curve (ROC) were used to identify the risk of STE in patients with LVH.Results After reviewing the ECGs, 1590 cases of electrocardiographic LVH were divided into an ST-segment elevation group (STE group, 81 cases) and non-ST segment elevation group (1509 cases). Eighty-seven cases were randomly selected from the non-ST segment elevation group to form a new non-ST segment elevation group (non-STE group, 87 cases) for further analysis. The mean age of the 168 participants (119 men, 70.83%) was 62.33 ± 16.27. Multivariate analysis showed that stroke, infection, and the value of SV1+RV5 were significantly associated with STE secondary to LVH. The area under the receiver operating characteristic curve showed that the optimal value of SV1+RV5 cut-off for predicting STE was 4.805 (sensitivity: 40.74%; specificity: 80.46%; AUC: 0.634; 95% CI: 0.550–0.719; P < 0.05).Conclusions A value of SV1+RV5 larger than 4.8 mV, stroke, and infection are independent risk factors for STE in patients with electrocardiographic LVH.

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Risk Factors and Predictive Value of Perioperative Neurocognitive Disorders in Elderly Patients With Gastrointestinal Tumors

10.21203/rs.3.rs-244830/v1 ◽

2021 ◽

Author(s):

Yongli Li ◽

Hui-Fan Huang ◽

Yuan Le

Keyword(s):

Risk Factors ◽

Elderly Patients ◽

Predictive Value ◽

Operating Characteristic ◽

Characteristic Curve ◽

Alcohol Exposure ◽

Curve Analysis ◽

Vas Score ◽

History Of ◽

Independent Risk Factors

Abstract Background: This study aims to investigate the risk factors of perioperative neurocognitive disorders (PNDs) mainly including postoperative cognitive dysfunction (POCD) in elderly patients with gastrointestinal tumors, and evaluate its predictive value.Methods: A total of 222 eligible elderly patients (≥65 years) scheduled for elective gastroenterectomy under general anesthesia were enrolled. The cognitive function assessment was carried out 1 day before surgery and 7 days after surgery. Receiver operating characteristic curve analysis was performed to evaluate the predictive value of risk factors for early POCD. The risk factors for POCD were analyzed using a multivariate logistic regression mode.Results: Of all the 222 enrolled patients, 91 (41.0%) developed early POCD and 40 (18.0%) were identified as major POCD within 7 days after the surgery. Visual analogue score (VAS, 1st day, resting) ≥4 (OR=7.618[3.231–17.962], P<0.001) and alcohol exposure (OR= 2.398[1.174–4.900], P=0.016) were independent risk factors for early POCD. VAS score (1st, resting) ≥4 (OR=13.823[4.779–39.981], P<0.001), preoperative white blood cell (WBC) levels ≥10x10*9/L(OR=5.548[1.128-26.221], P=0.035), blood loss ≥500ml (OR=3.317[1.094-10.059], P=0.034), history of hypertension (OR=3.046[1.267-7.322], P=0.013), and neutrophil–lymphocyte ratio (NLR) ≥2 (OR=3.261[1.020-10.419], P=0.046) were independent risk factors for major POCD. Receiver operating characteristic curve analysis indicated that VAS score (1st day, resting) was a significant predictor for major POCD with a cut-off value of 2.68 and an area under the curve of 0.860 (95% confidence interval: 0.801–0.920, P<0.001).Conclusions: The risk factors for early POCD after gastroenterectomy included high VAS score (1st day, resting) and alcohol exposure. High VAS score, preoperative WBC levels ≥10x10*9/L, blood loss ≥500ml, NLR ≥2, and history of hypertension were independent risk factors for major POCD. Among them, VAS score had a high predictive value.

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Complications and risk factors for severe outcome in children with measles

Archives of Disease in Childhood ◽

10.1136/archdischild-2018-315290 ◽

2019 ◽

Vol 105 (9) ◽

pp. 896-899 ◽

Cited By ~ 2

Author(s):

Andrea Lo Vecchio ◽

Andrzej Krzysztofiak ◽

Carlotta Montagnani ◽

Piero Valentini ◽

Nadia Rossi ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care ◽

Retrospective Study ◽

Operating Characteristic ◽

Characteristic Curve ◽

Multivariable Analysis ◽

C Reactive Protein ◽

Reactive Protein ◽

Operating Characteristic Curve ◽

Organ Complications

Objective and designRisk factors for severe measles are poorly investigated in high-income countries. The Italian Society for Paediatric Infectious Diseases conducted a retrospective study in children hospitalised for measles from January 2016 to August 2017 to investigate the risk factors for severe outcome defined by the presence of long-lasting sequelae, need of intensive care or death.ResultsNineteen hospitals enrolled 249 children (median age 14.5 months): 207 (83%) children developed a complication and 3 (1%) died. Neutropaenia was more commonly reported in children with B3-genotype compared with other genotypes (29.5% vs 7.7%, p=0.01). Pancreatitis (adjusted OR [aOR] 9.19, p=0.01) and encephalitis (aOR 7.02, p=0.04) were related to severe outcome in multivariable analysis, as well as C reactive protein (CRP) (aOR 1.1, p=0.028), the increase of which predicted severe outcome (area under the receiver operating characteristic curve 0.67, 95% CI 0.52 to 0.82). CRP values >2 mg/dL were related to higher risk of complications (OR 2.0, 95% CI 1.15 to 3.7, p=0.01) or severe outcome (OR 4.13, 95% CI 1.43 to 11.8, p<0.01).ConclusionThe risk of severe outcome in measles is independent of age and underlying conditions, but is related to the development of organ complications and may be predicted by CRP value.

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Derivation and Diagnostic Accuracy of the Surgical Lung Injury Prediction Model

Anesthesiology ◽

10.1097/aln.0b013e31821b5839 ◽

2011 ◽

Vol 115 (1) ◽

pp. 117-128 ◽

Cited By ~ 85

Author(s):

Daryl J. Kor ◽

David O. Warner ◽

Anas Alsara ◽

Evans R. Fernández-Pérez ◽

Michael Malinchoc ◽

...

Keyword(s):

Risk Factors ◽

Receiver Operating Characteristic Curve ◽

Receiver Operating Characteristic ◽

Operating Characteristic ◽

Characteristic Curve ◽

Slip Model ◽

Preoperative Risk ◽

Preoperative Risk Factors ◽

Operating Characteristic Curve ◽

Receiver Operating

Background Acute lung injury (ALI) is a serious postoperative complication with limited treatment options. A preoperative risk-prediction model would assist clinicians and scientists interested in ALI. The objective of this investigation was to develop a surgical lung injury prediction (SLIP) model to predict risk of postoperative ALI based on readily available preoperative risk factors. Methods Secondary analysis of a prospective cohort investigation including adult patients undergoing high-risk surgery. Preoperative risk factors for postoperative ALI were identified and evaluated for inclusion in the SLIP model. Multivariate logistic regression was used to develop the model. Model performance was assessed with the area under the receiver operating characteristic curve and the Hosmer-Lemeshow goodness-of-fit test. Results Out of 4,366 patients, 113 (2.6%) developed early postoperative ALI. Predictors of postoperative ALI in multivariate analysis that were maintained in the final SLIP model included high-risk cardiac, vascular, or thoracic surgery, diabetes mellitus, chronic obstructive pulmonary disease, gastroesophageal reflux disease, and alcohol abuse. The SLIP score distinguished patients who developed early postoperative ALI from those who did not with an area under the receiver operating characteristic curve (95% CI) of 0.82 (0.78-0.86). The model was well calibrated (Hosmer-Lemeshow, P = 0.55). Internal validation using 10-fold cross-validation noted minimal loss of diagnostic accuracy with a mean ± SD area under the receiver operating characteristic curve of 0.79 ± 0.08. Conclusions Using readily available preoperative risk factors, we developed the SLIP scoring system to predict risk of early postoperative ALI.

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Risk factors and predictive value of perioperative neurocognitive disorders in elderly patients with gastrointestinal tumors

BMC Anesthesiology ◽

10.1186/s12871-021-01405-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yong-Li Li ◽

Hui-Fan Huang ◽

Yuan Le

Keyword(s):

Risk Factors ◽

Elderly Patients ◽

Predictive Value ◽

Operating Characteristic ◽

Characteristic Curve ◽

Alcohol Exposure ◽

Curve Analysis ◽

Vas Score ◽

History Of ◽

Independent Risk Factors

Abstract Background This study aims to investigate the risk factors of perioperative neurocognitive disorders (PNDs) mainly including postoperative cognitive dysfunction (POCD) in elderly patients with gastrointestinal tumors, and evaluate its predictive value. Methods A total of 222 eligible elderly patients (≥65 years) scheduled for elective gastroenterectomy under general anesthesia were enrolled. The cognitive function assessment was carried out 1 day before surgery and 7 days after surgery. Receiver operating characteristic curve analysis was performed to evaluate the predictive value of risk factors for early POCD. The risk factors for POCD were analyzed using univariate and multivariate logistic regression model. Results Of all the 222 enrolled patients, 91 (41.0%) developed early POCD and 40 (18.0%) were identified as major POCD within 7 days after the surgery. Visual analogue score (VAS, 1st day, resting) ≥4 (OR = 7.618[3.231–17.962], P < 0.001) and alcohol exposure (OR = 2.398[1.174–4.900], P = 0.016) were independent risk factors for early POCD. VAS score (1st, resting) ≥4 (OR = 13.823[4.779–39.981], P < 0.001), preoperative white blood cell (WBC) levels ≥10 × 10*9/L (OR = 5.548[1.128–26.221], P = 0.035), blood loss ≥500 ml (OR = 3.317[1.094–10.059], P = 0.034), history of hypertension (OR = 3.046[1.267–7.322], P = 0.013), and neutrophil–lymphocyte ratio (NLR) ≥2 (OR = 3.261[1.020–10.419], P = 0.046) were independent risk factors for major POCD. Receiver operating characteristic curve analysis indicated that VAS score (1st day, resting) was a significant predictor for major POCD with a cut-off value of 2.68 and an area under the curve of 0.860 (95% confidence interval: 0.801–0.920, P < 0.001). Conclusions The risk factors for early POCD after gastroenterectomy included high VAS score (1st day, resting) and alcohol exposure. High VAS score, preoperative WBC levels ≥10 × 10*9/L, blood loss ≥500 ml, NLR ≥2, and history of hypertension were independent risk factors for major POCD. Among them, VAS score was one of the important predictors.

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