scholarly journals Blood routine risk factors for coronary artery aneurysm in infants younger than 8 months with Kawasaki disease

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Ge Haiyan ◽  
Lai Jianming ◽  
Tong Suqian ◽  
Qu Dong ◽  
Liu Shuang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Platelet Count ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Acute Phase ◽  
Logistic Regression Analysis ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm

Abstract Objective The aims of this study were to characterize the evolution of routine blood values within the first 10 days of illness and coronary artery outcome in infants < 8 months with Kawasaki disease (KD) and to identify risk factors for coronary artery aneurysm (CAA). Methods Laboratory data, clinical features and coronary artery outcomes from 78 infants < 8 months old and 86 patients between 8 months and 7 years old were retrospectively analyzed. Logistic regression analysis was conducted to evaluate the potential risk factors for CAA. Results Infants < 8 months old were more likely to present with incomplete KD (37.2% vs 4.7%, P < 0.001), erythema and induration at the BCG inoculation site (24.4% vs 3.5%, P < 0.001) and CAA (47.4% vs 15.1%, P < 0.001) even with timely diagnosis and treatment with intravenous immunoglobulin (IVIG) compared with patients ≥8 months old. Clinical feature related to diagnostic criteria for KD including bilateral conjunctival injection, oral changes, unilateral cervical lymphadenopathy and extremity changes were less common in the younger group. During the acute phase, the percentage neutrophils and neutrophil to lymphocyte ratio [NLR] peaked on median illness day 3, followed by white blood cell (WBC) and CRP on median illness day 4, hemoglobin on median illness day 7 and platelet count on median illness day 9. CAA occurred on median illness day 6 and regressed on median illness day 28. Multivariate logistic regression analysis revealed that the peak percentage neutrophils (odds ratio [OR] per 0.1: 1.597, 95% confidence interval [CI]: 1.041–2.452, P = 0.032) and the peak platelet count (OR per 10 × 109/L: 1.029, 95% CI: 1.004–1.055, P = 0.024) were independent risk factors for CAA. Hemoglobin on the 5th day was associated with persistent CAA at 1 year after KD onset. Conclusion Factors associated with CAA include a high peak percentage neutrophils, increased peak platelet count, and reduced hemoglobin within 4–6 days during the acute phase of KD. Therefore, this population should receive primary therapy with IVIG and adjunctive anti-inflammatory medications.

Prognostic nutrition index as a predictor of coronary artery aneurysm in Kawasaki Disease

2020 ◽  
Author(s):  
I Hsin Tai ◽  
Pei-Lin Wu ◽  
Mindy Ming-Huey Guo ◽  
Jessica Lee ◽  
Chi-Hsiang Chu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Platelet Count ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Disease Outcome ◽  
Prognostic Nutrition Index

Abstract Background: Kawasaki Disease (KD) is considered a major acquired heart disease in children under the age of 5. Coronary artery aneurysm (CAA) can occur in serious cases despite extreme therapy efforts. Previous studies have reported low serum albumin level was associated with disease outcome, but no further investigation was addressed yet. Method: This retrospective (case-control) study randomly included children with KD who were admitted and underwent laboratory tests before undergoing IVIG treatment in this institution, the largest tertiary medical center in southern Taiwan from 2012-2016. Prognostic nutrition index (PNI), an albumin-based formula product, was evaluated as a predictor of CAA the first time. The progression of CAA was monitored using serial echocardiography for six months. We performed multivariable logistic regression analysis on the laboratory test and PNI with the disease outcome of the KD patients. Result: Of the 275 children, 149 had CAA, including transient dilatation, while the other 126 did not develop CAA during the 6-month follow-up period. A multivariate logistic regression model revealed that PNI, gender, IVIG non-responder, and platelet count are significant predictors of CAA with a 95% confidence interval estimator of 1.999, 3.058, 3.864 and1.004, respectively. Using PNI to predict CAA presence gave an area under the receiver-operating-characteristics (ROC) curve of 0.596. For a cutoff of 0.5 in the logistic regression model and the PNI cut-off point is taken as 55 together with IVIG non-responder, boy gender, and platelet count take into account, sensitivity and specificity were 65.7% and 70.4%. Conclusion: PNI could be a candidate of adjunctive predictor of coronary artery aneurysm in addition to IVIG non-responder. Together with low PNI, IVIG non-responder, male gender and platelet count will give high odds to predict coronary artery aneurysm within 6 months of illness.

scholarly journals Predictive Factors of Medium-Large Coronary Artery Aneurysm in Children with Acute Kawasaki Disease: A Retrospective Cohort Study

2022 ◽  
Author(s):  
Jie Liu ◽  
Danyan Su ◽  
Bingbing Ye ◽  
Suyuan Qin ◽  
Cheng Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Artery Aneurysm ◽  
Characteristic Curve ◽  
Artery Aneurysm ◽  
Risk Scores ◽  
Cardiac Complications ◽  
Close Monitoring ◽  
G Ratio

Abstract Background: The severity of the cardiac complications resulting from Kawasaki disease (KD) appears to be directly correlated to the magnitude of the coronary artery aneurysm (CAA). However, there remains some unclear about the risk factors for medium-large CAA identified after acute KD.Methods: We analyzed 90 patients diagnosed with CAA in KD hospitalized from January 2013 through August 2021. Patients were stratified based on the coronary artery z-score adjusted for body surface area as the medium-large CAA group and small-sized CAA group. The association of baseline characteristics was investigated within the groups. Multivariable logistic regression analyses were performed to evaluate potential risk factors associated with medium-large CAA development.Results: In total, 353 pediatric cases with KD were investigated during the study period, of whom 90 (25.5%) presented with CAA, including medium-large CAA in 20 patients (5.7%) after acute KD. The medium-large CAA group showed significantly higher Harada risk scores, the incidence of thrombosis, serum globulin concentration values, proportions of C-reactive protein > 40 mg/L, proportions of albumin < 35 g/L, and lower values of albumin-to-globulin ratio (A/G ratio) than those in the small-sized CAA group (P < 0.05). Medium-large CAA was significantly associated with the A/G ratio (odds ratio, 3.503; 95% confidence interval [CI]: 1.068–11.492). The area under the receiver operating characteristic curve was 0.684 (95% CI: 0.558–0.810), and the cutoff point of 1.35 showed a sensitivity and specificity for predicting medium-large CAA of 80% and 59%, respectively.Conclusions: A lower A/G ratio independently predicts medium-large CAA in patients with KD. Medium-large CAA is associated with greater odds of developing thrombosis. Thus, close monitoring with routine echocardiography is recommended.

scholarly journals Coronary risk factors used to predict coronary artery disease by logistic regression analysis.

1992 ◽  
Vol 56 (12) ◽  
pp. 1199-1205 ◽  
Author(s):  
HIROFUMI KAMBARA ◽  
AKIRA IMOTO ◽  
CHIE OWADA ◽  
SHUNICHI TAMAKI ◽  
TETSURO FUDO ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Coronary Artery ◽  
Logistic Regression Analysis ◽  
Coronary Risk Factors ◽  
Coronary Risk ◽  
Artery Disease

scholarly journals A Radiomics Nomogram for Preoperative Prediction of Early Recurrence of Small Hepatocellular Carcinoma After Surgical Resection or Radiofrequency Ablation

2021 ◽  
Vol 11 ◽  
Author(s):  
Liting Wen ◽  
Shuping Weng ◽  
Chuan Yan ◽  
Rongping Ye ◽  
Yuemin Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Platelet Count ◽  
Logistic Regression Analysis ◽  
Early Recurrence ◽  
Small Hepatocellular Carcinoma ◽  
Final Model ◽  
Small Hcc

BackgroundPatients with small hepatocellular carcinoma (HCC) (≤3 cm) still have a poor prognosis. The purpose of this study was to develop a radiomics nomogram to preoperatively predict early recurrence (ER) (≤2 years) of small HCC.MethodsThe study population included 111 patients with small HCC who underwent surgical resection (SR) or radiofrequency ablation (RFA) between September 2015 and September 2018 and were followed for at least 2 years. Radiomic features were extracted from the entire tumor by using the MaZda software. The least absolute shrinkage and selection operator (LASS0) method was applied for feature selection, and radiomics signature construction. A rad-score was then calculated. Multivariable logistic regression analysis was used to establish a prediction model including independent clinical risk factors, radiologic features and rad-score, which was ultimately presented as a radiomics nomogram. The predictive ability of the nomogram was evaluated using the area under the receiver operating characteristic (ROC) curve and internal validation was performed via bootstrap resampling and 5-fold cross-validation method.ResultsA total of 53 (53/111, 47.7%) patients had confirmed ER according to the final clinical outcomes. In univariate logistic regression analysis, cirrhosis and hepatitis B infection (P=0.015 and 0.083, respectively), hepatobiliary phase hypointensity (P=0.089), Child-Pugh score (P=0.083), the preoperative platelet count (P=0.003), and rad-score (P&lt;0.001) were correlated with ER. However, after multivariate logistic regression analysis, only the preoperative platelet count and rad-score were included as predictors in the final model. The area under ROC curve (AUC) of the radiomics nomogram to predict ER of small HCC was 0.981 (95% CI: 0.957, 1.00), while the AUC verified by bootstrap is 0.980 (95% CI: 0.962, 1.00), indicating the goodness-of-fit of the final model.ConclusionsThe radiomics nomogram containing the clinical risk factors and rad-score can be used as a quantitative tool to preoperatively predict individual probability of ER of small HCC.

Neutropenia in the acute phase of Kawasaki disease and prevention of coronary artery aneurysm

2009 ◽  
Vol 51 (4) ◽  
pp. 448-452 ◽  
Author(s):  
Zenshiro Onouchi ◽  
Kenji Hamaoka ◽  
Seiichiro Ozawa ◽  
Koichi Sakata ◽  
Nobuyuki Kiyosawa ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Acute Phase ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm

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.

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