scholarly journals D6 blastocyst transfer on day 6 in frozen-thawed cycles should be avoided: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Huiling Xu ◽  
Shumin Qiu ◽  
Xiaojing Chen ◽  
Suqin Zhu ◽  
Yan Sun ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Logistic Regression Analysis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hormone Replacement ◽  
Implantation Rate ◽  
Blastocyst Transfer ◽  
Miscarriage Rate

Abstract Background There is no definitive evidence about the suitable timing to transfer blastocysts formed and cryopreserved on day 6 (D6 blastocysts) in frozen-thawed embryo transfer (FET) cycles. This study aimed to investigate the suitable timing to transfer D6 blastocysts in FET cycles and to identify factors affecting clinical pregnancy rate (CPR) and early miscarriage rate (EMR) in FET cycles with blastocysts. Methods This retrospective cohort study included 1788 FET cycles with blastocysts. There were 518 cycles with D6 blastocysts, and 1270 cycles with blastocysts formed and cryopreserved on day 5 (D5 blastocysts) (D5 group). According to the blastocyst transfer timing, the cycles with D6 blastocysts were divided into cycles with D6 blastocysts transferred on day 5 (D6-on-D5 group, 103 cycles) and cycles with D6 blastocysts transferred on day 6 (D6-on-D6 group, 415 cycles). The chi-square test, independent t-test or Mann-Whitney test, and logistic regression analysis were used for data analysis. Results The CPR and implantation rate (IR) were significantly higher in the D6-on-D5 group than in the D6-on-D6 group (55.3% vs. 37.3%, 44.8% vs. 32.6%, P < 0.01). The CPR and IR were significantly higher in the D5 group than in the D6-on-D5 group (66.0% vs. 55.3%, 62.1% vs. 44.8%, P < 0.05), and the EMR was significantly lower in the D5 group than in the D6-on-D5 group (11.2% vs. 21.1%, P < 0.05). Logistic regression analysis demonstrated that transfer D6 blastocysts on day 5, instead of day 6, could significantly increase the CPR (odds ratio[OR]: 2.031, 95% confidence interval (CI): 1.296–3.182, P = 0.002). FET cycles with D6 blastocysts transferred on day 5 had a higher EMR than those with D5 blastocysts (OR: 2.165, 95% CI: 1.040–4.506, P = 0.039). Hormone replacement therapy (HRT) cycles exhibited a higher EMR than natural cycles (OR: 1.953, 95% CI: 1.254–3.043, P = 0.003), while no difference was observed in the CPR (P > 0.05). Conclusions These results indicate that the suitable timing to transfer D6 blastocysts in FET cycles may be day 5, and D6 blastocyst transfer on day 6 in FET cycles should be avoided. D6 blastocysts transfer and HRT cycles may be associated with a higher EMR.

scholarly journals Development of a preoperative index-based nomogram for the prediction of hypokalemia in patients with pituitary adenoma: a retrospective cohort study

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11650
Author(s):  
Wenpeng Li ◽  
Lexiang Zeng ◽  
Deping Han ◽  
Shanyi Zhang ◽  
Bingxi Lei ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Pituitary Adenoma ◽  
Logistic Regression Analysis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Close Monitoring ◽  
Training Set ◽  
Nonlinear Association

Objective To develop and validate a preoperative index-based nomogram for the prediction of hypokalemia in patients with pituitary adenoma (PA). Methods This retrospective cohort study included 205 patients with PAs between January 2013 and April 2020 in the Sun Yat-sen Memorial Hospital, Guangzhou, China. The patients were randomly classified into either a training set (N = 143 patients) and a validation set (N = 62 patients) at a ratio of 7:3. Variables, which were identified by using the LASSO regression model were included for the construction of a nomogram, and a logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) in the training set. The area under the curve (AUC) was used to evaluate the performance of the nomogram for predicting hypokalemia. Multivariate logistic regression analysis with a restricted cubic spline analysis was conducted to identify a potential nonlinear association between the preoperative index and hypokalemia. Results The incidence of hypokalemia was 38.05%. Seven preoperative indices were identified for the construction of the nomogram: age, type of PA, weight, activated partial thromboplastin time, urea, eosinophil percentage, and plateletocrit. The AUCs of the nomogram for predicting hypokalemia were 0.856 (95% CI [0.796–0.915]) and 0.652 (95% CI [0.514–0.790]) in the training and validation sets, respectively. Restricted cubic splines demonstrated that there was no nonlinear association between hypokalemia and the selected variables. Conclusion In this study, we constructed a preoperative indices-based nomogram that can assess the risk of hypokalemia after the surgical treatment of pituitary adenomas. This nomogram may also help to identify high risk patients who require close monitoring of serum potassium.

Inhaled Albuterol Use and Impaired Lactate Clearance in Patients With Sepsis: A Retrospective Cohort Study

2020 ◽  
pp. 088506661990109 ◽  
Author(s):  
Tetsuro Maeda ◽  
Janvi Paralkar ◽  
Toshiki Kuno ◽  
Paru Patrawalla
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Logistic Regression Analysis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Multivariate Logistic Regression Analysis ◽  
Lactate Clearance ◽  
Multivariate Logistic Regression

Background: Lactate clearance has become important in the management of sepsis. However, factors unrelated to sepsis-induced hyperlactatemia, including β-2 adrenergic agonists, can interfere with lactate clearance. Objectives: To investigate the association of inhaled albuterol with lactate clearance in patients with sepsis. Methods: This was a single-center retrospective cohort study. Adult patients with sepsis diagnosed in the emergency department from May 2015 to May 2016 with initial lactate levels >2 mmol/L and serial lactate measurements 2 to 6 hours apart were included. Patients were divided into 2 groups based on whether they received inhaled albuterol between lactate measurements. The primary end point was lactate clearance of 10%. Secondary end points included intensive care unit (ICU) consultation and in-hospital mortality. A multivariate logistic regression analysis was performed to assess the effect of inhaled albuterol on lactate clearance. Results: Of 269 patients included, 58 (22%) received inhaled albuterol between lactate measurements. This group had a significantly higher prevalence of pulmonary disease and a lower initial lactate compared to those who did not receive inhaled albuterol. They had a significantly lower rate of lactate clearance (45% vs 77%, P < .001); however, ICU consultation (71% vs 57%, P = .066) and in-hospital mortality (19% vs 22%, P = .64) were not significantly different. A multivariate logistic regression analysis adjusting for age, sex, chronic kidney disease, cirrhosis, cancer, septic shock or severe sepsis, and the amount of intravenous fluids received showed that inhaled albuterol was independently associated with impaired lactate clearance (adjusted odds ratio: 0.26, 95% confidence interval: 0.14-0.50, P < .001). Conclusions: Inhaled albuterol in patients with sepsis was associated with impaired lactate clearance without an increase in ICU consultation or in-hospital mortality. Impaired lactate clearance in patients with sepsis who receive inhaled albuterol should be interpreted with caution.

scholarly journals Risk Factors for Mortality in Melioidosis: A Single-Centre, 10-Year Retrospective Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Raviraj Menon ◽  
Poornima Baby ◽  
Anil Kumar V. ◽  
Sandeep Surendran ◽  
Manu Pradeep ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Logistic Regression Analysis ◽  
Mortality Risk ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Therapeutic Benefits ◽  
Chi Square Analysis

Melioidosis is a tropical infectious disease with diverse clinical presentations. We aimed to investigate the characteristics and mortality risk factors of patients diagnosed with melioidosis in the past 10 years. This was a retrospective cohort study conducted at a quaternary care centre in South India. Clinical, demographic, and biochemical data in patients diagnosed with melioidosis with cultures were collected between January 2011 and December 2020 from medical records. Logistic regression analysis was performed to screen mortality risk factors of melioidosis in addition to descriptive statistics and chi-square analysis. Seventy-three melioidosis patients’ records were analysed, and the most common comorbidity was type 2 diabetes mellitus (n = 53, 72.6%). The patients showed diverse presentations: pulmonary involvement, 30 (41.1%); splenomegaly, 29 (39.7%); abscesses and cutaneous involvement, 18 (24.7%); lymph node, 10 (13.7%); arthritis and osteomyelitis, 9 (12.3%); and genitourinary infection, 4 (5.4%). The mortality was noted to be 15 (20.5%). Logistic regression analysis indicated that chronic kidney disease (OR = 14.0), CRP >100 IU/L (OR = 6.964), and S. albumin <3 gm/dl (OR = 8.0) were risk factors associated with mortality and can guide in risk stratification. Hypoalbuminemia is a novel mortality risk factor, detected in this study, and requires further investigation to validate its utility as a prognostic marker and reveal possible therapeutic benefits in clinical correction.

scholarly journals New/Different Look at the Presence of Aspergillus in Mycobacterial Pulmonary Diseases. Long-Term Retrospective Cohort Study

2021 ◽  
Vol 9 (2) ◽  
pp. 270
Author(s):  
Kiyoharu Fukushima ◽  
Hiroshi Kida
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Logistic Regression Analysis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Multivariate Logistic Regression Analysis ◽  
Observation Time ◽  
Aspergillus Species ◽  
Multivariate Logistic Regression

Chronic pulmonary aspergillosis (CPA) has been reported to be associated with poor prognosis in non-tuberculous mycobacteria (NTM)-pulmonary disease (PD) patients. However, whether isolation of Apergillus species is associated with poor outcome or mostly just the reflection of colonization is a widely debated issue and a yet unsolved question. We conducted this single-centered retrospective cohort study of 409 NTM-PD patients to assess the impacts and prevalence of Aspergillus isolation and CPA development. The median observation time was 85 months. Aspergillus species were isolated from 79 (19.3%) and 23 (5.6%) developed CPA. Isolation of Aspergillus species was not associated with mortality in NTM-PD patients (p = 0.9016). Multivariate logistic regression analysis revealed that higher CRP (p = 0.0213) and AFB stain positivity (p = 0.0101) were independently associated with Aspergillus isolation. Different mycobacterial species were not associated with Aspergillus isolation. Survival curves for patients with CPA diagnosis were significantly and strikingly different from those without (p = 0.0064), suggesting that CPA development severely affects clinical outcome. Multivariate logistic regression analysis revealed that the use of systemic steroids (p = 0.0189) and cavity (p = 0.0207) were independent risk factors for the progression to CPA. Considering the high mortality rate of CPA in NTM-PD, early diagnosis and treatment are essential to improve outcomes for NTM-PD patients.

scholarly journals Association Between Use of Preoperative Antihypertensive Medication and 90-Day Mortality After Noncardiac Surgery: A Retrospective Cohort Study

2020 ◽  
Vol 33 (6) ◽  
pp. 534-542
Author(s):  
Chami Im ◽  
Tak Kyu Oh ◽  
In-Ae Song
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Confidence Interval ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Antihypertensive Medication ◽  
Noncardiac Surgery ◽  
Hypertensive Patients

Abstract Background This study aimed to determine whether use of preoperative antihypertensive medication is associated with postoperative 90-day mortality in the hypertensive adult population that underwent elective noncardiac surgery. Methods In this retrospective cohort study, medical records of preoperative hypertensive patients who underwent noncardiac surgery at a single tertiary academic hospital from 2012 to 2018 were reviewed. Among the hypertensive patients, those prescribed to take antihypertensive medication continuously for more than 1 month before admission were defined as the HTN MED group; others were defined as the non-HTN MED group. Multiple imputation, propensity score (PS) matching, and logistic regression analysis were used for statistical analysis. Results Overall, 35,589 preoperative hypertensive adult patients (HTN MED group: 26,154 patients, non-HTN MED group: 9,435 patients) were included in the analysis. After PS matching, each group comprised 6,205 patients; thus, 12,410 patients were included in the final analysis. The odds for 90-day mortality of the HTN MED group in the PS-matched cohort were 41% lower (odds ratio: 0.59, 95% confidence interval: 0.41–0.85; P = 0.005) than those of the non-HTN MED group. Comparable results were obtained in the multivariable logistic regression analysis of the entire cohort (odds ratio: 0.54, 95% confidence interval: 0.41–0.72; P &lt; 0.001). Conclusions This study showed that the use of preoperative antihypertensive medication was associated with lower 90-day mortality among hypertensive patients who underwent noncardiac surgery. Therefore, preoperative screening and treatment with appropriate antihypertensive medication are important for hypertensive patients.

scholarly journals Thin endometrial thickness is a risk factor for singleton low birth weight from single blastocyst transfer: A retrospective cohort study

2021 ◽  
Author(s):  
Mingze Du ◽  
Junwei Zhang ◽  
Manman Liu ◽  
Xingling Wang
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Cohort Study ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Independent Risk Factor ◽  
Endometrial Thickness ◽  
Blastocyst Transfer

Objective To explore whether thin endometrial thickness (EMT) is associated with singleton low birth weight (LBW) from single fresh blastocyst transfer. Design Retrospective cohort study. Setting Reproductive center. Population All women were ≤40 years old and underwent single fresh blastocyst transfer and singleton live birth. Interventions None. Methods Multivariable logistic regression was used to evaluate the association between thin EMT and singleton LBW. Main outcome measures LBW was the primary concern of this study. Results In total, 2847 women met the study inclusion criteria. The neonatal birthweight in the EMT ≤7.5 mm group was significantly lower than that in the EMT 7.6~12.0 mm and EMT >12.0 mm group (P<0.001). The rate of LBW in the EMT ≤7.5 mm group was 24.9%, which was significantly higher than the 4.0% in the EMT 7.6~12.0 mm group and the 5.3% in the EMT >12.0 mm group (P<0.001). The total neonatal malformation rate was similar between the groups (1.1%, 0.8% and 1.5%, P=0.21). After multiple logistic regression analysis, EMT≤7.5 mm was an independent risk factor for LBW (adjusted odds ratio [AOR]: 4.39, 95% CI: 1.85～10.46, P<0.001). Conclusions Thin EMT (≤7.5 mm) on the hCG trigger day is an independent risk factor for singleton LBW from single fresh blastocyst transfer. The neonatal birthweight in the EMT ≤7.5 mm group was significantly lower than that in the EMT 7.6~12.0 mm and EMT >12.0 mm groups. The total neonatal malformation rate was comparable between the groups.

scholarly journals Thin endometrium is associated with the risk of hypertensive disorders of pregnancy in fresh IVF/ICSI embryo transfer cycles: a retrospective cohort study of 9,266 singleton births

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiaojie Liu ◽  
Jingwan Wang ◽  
Xiao Fu ◽  
Jing Li ◽  
Meng Zhang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hypertensive Disorders Of Pregnancy ◽  
Thin Endometrium ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Confounding Variables

Abstract Background Thin endometrial thickness (EMT) has been suggested to be associated with reduced incidence of pregnancy rate after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment, but the effect of thin endometrium on obstetric outcome is less investigated. This study aims to determine whether EMT affects the incidence of obstetric complications in fresh IVF/ICSI-embryo transfer (ET) cycles. Methods We conducted a retrospective cohort study collecting a total of 9266 women who had singleton livebirths after fresh IVF/ICSI-ET treatment cycles at the Center for Reproductive Medicine Affiliated to Shandong University between January 2014 and December 2018. The women were divided into three groups according to the EMT: 544 women with an EMT ≤8 mm, 6234 with an EMT > 8–12 mm, and 2488 with an EMT > 12 mm. The primary outcomes were the incidence of obstetric complications including hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), placental abruption, placenta previa, postpartum hemorrhage (PPH) and cesarean section. Multivariable logistic regression analysis was performed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for associations between the EMT measured on the day of human chorionic gonadotropin (HCG) trigger and the risk of the outcomes of interest. Results The HDP incidence rate of pregnant women was highest in EMT ≤ 8 mm group and significantly higher than those in EMT from > 8–12 mm and EMT > 12 mm group, respectively (6.8% versus 3.6 and 3.5%, respectively; P = 0.001). After adjustment for confounding variables by multivariate logistic regression analysis, a thin EMT was still statistically significant associated with an increased risk of HDP. Compared with women with an EMT > 8–12 mm, women with an EMT ≤8 mm had an increased risk of HDP (aOR = 1.853, 95% CI 1.281–2.679, P = 0.001). Conclusion A thin endometrium (≤8 mm) was found to be associated with an increased risk of HDP after adjustment for confounding variables, indicating that the thin endometrium itself is a risk factor for HDP. Obstetricians should remain aware of the possibility of HDP when women with a thin EMT achieve pregnancy through fresh IVF/ICSI–ET treatment cycles.

scholarly journals Endometrial Thickness Is a Risk Factor for Singleton Low Birth Weight From Single Blastocyst Transfer: A Retrospective Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Mingze Du ◽  
Junwei Zhang ◽  
Manman Liu ◽  
Yichun Guan ◽  
Xingling Wang
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Cohort Study ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Independent Risk Factor ◽  
Endometrial Thickness ◽  
Blastocyst Transfer

ObjectiveTo explore whether endometrial thickness (EMT) ≤7.5 mm is associated with singleton low birth weight (LBW) from single fresh blastocyst transfer.MethodsThis was a retrospective cohort study. Only women ≤ 40 years old who underwent single fresh blastocyst transfer and had singleton live births were included in the study. LBW was the primary outcome of this study. Neonatal malformation was the secondary outcome. Logistic regression was used to evaluate the association between (EMT) ≤7.5 mm and singleton LBW.ResultsA total number of 2847 women met the study inclusion criteria. The neonatal birthweight in the EMT ≤7.5 mm group was significantly lower than that in the EMT 7.6~12.0 mm and EMT &gt;12.0 mm group (P&lt;0.001). The rate of LBW in the EMT ≤7.5 mm group was 24.9%, which was significantly higher than the 4.0% in the EMT 7.6~12.0 mm group and the 5.3% in the EMT &gt;12.0 mm group (P&lt;0.001). The total neonatal malformation rate was similar between the groups (1.1%, 0.8% and 1.5%, P=0.21). After logistic regression analysis, EMT ≤7.5 mm was found to be an independent risk factor for LBW (adjusted odds ratio [AOR]: 4.39, 95% CI: 1.85˜10.46, P&lt;0.001).ConclusionEMT ≤7.5 mm on the hCG trigger day is an independent risk factor for LBW in singleton pregnancies from single fresh blastocyst transfer. The neonatal birthweight in the EMT ≤7.5 mm group was significantly lower than that in the EMT 7.6~12.0 mm and EMT &gt;12.0 mm groups. The total neonatal malformation rate was comparable between the groups.

scholarly journals Association between Big Five Personality Traits and Participation in Cardiac Rehabilitation in Japanese Patients with Cardiovascular Disease: A Retrospective Cohort Study

2021 ◽  
Vol 18 (16) ◽  
pp. 8589
Author(s):  
Takuji Adachi ◽  
Yuki Tsunekawa ◽  
Akihito Matsuoka ◽  
Daisuke Tanimura
Keyword(s):  
Cardiovascular Disease ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Personality Traits ◽  
Big Five ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Big Five Personality Traits ◽  
Big Five Personality

Cardiac rehabilitation (CR) remains underutilised, despite its established clinical benefit. A personality traits assessment may help promote CR implementation, as they are determinants of health-related behaviour. This study aimed to examine the association between the Big Five personality traits and outpatient CR participation in patients with cardiovascular disease (CVD) after discharge. This retrospective cohort study included 163 patients aged <80 years, who underwent inpatient CR when hospitalised for CVD. The Big Five personality traits (conscientiousness, neuroticism, openness, extraversion, and agreeableness) of each patient were evaluated at discharge, using the Japanese version of the Ten-Item Personality Inventory. We examined the relationship of each personality trait with non-participation in outpatient CR and dropout within three months, using logistic regression analysis. Out of 61 patients who initiated the outpatient CR, 29 patients dropped out, leaving us with 32 subjects. The logistic regression analysis results showed that high conscientiousness was associated with non-participation in CR. The primary reason for this was a lack of motivation. Conversely, low conscientiousness and high openness were predictors of dropout. This study suggests that the assessment of the Big Five personality traits, especially conscientiousness and openness, can help improve health communication with patients to promote outpatient CR participation after discharge.

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