scholarly journals Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kunyan Sun ◽  
Hong Zhang ◽  
Wei Zhang ◽  
Yuan Cheng ◽  
Guangfa Wang
Keyword(s):  
Logistic Regression ◽  
Prognostic Factors ◽  
Clinical Success ◽  
Current Smoker ◽  
Subglottic Stenosis ◽  
Multivariate Logistic Regression ◽  
Interventional Bronchoscopy ◽  
Airway Stenosis ◽  
Central Airway

Abstract Background Scarring central airway stenosis (SCAS) is a potentially life-threatening condition with debilitating symptoms. Interventional bronchoscopy is increasingly used to relieve symptoms in patients with SCAS, but recurrent stenosis is frequently observed. Little data exist on the long-term prognosis of interventional bronchoscopy for SCAS. We aimed to assess the prognostic factors of bronchoscopic interventions in patients with SCAS to optimize treatment. Methods This was a retrospective study that enrolled 119 consecutive patients with SCAS from January 2010 to April 2019 at our institution. Long-term clinical success was defined as airway stenosis < 50%, no limitation of physical activity, and a stable condition for > 12 months after the last interventional procedure. We compared patients’ demographics, airway stenosis characteristics, and interventional procedures between the successful and unsuccessful groups, and identified significant predictors of long-term outcome with univariate and multivariate logistic regression. Results A total of 119 patients with 577 therapeutic bronchoscopies were included. Seventy-five (63%) patients were considered to have long-term clinical success. Older age, male gender, smoking, elevated C-reactive protein level, subglottic stenosis, stent or T-tube implantation, previous interventional treatment, and multiple procedures per year were potentially associated with unsuccessful long-term outcomes in the univariate analysis. Current smoker status (odds ratio [OR] 5.70, 95% confidence interval [CI] 1.35–24.17, P = 0.018), subglottic stenosis (OR 4.35, 95% CI 1.31–14.46, P = 0.017), and stent implantation (OR 4.96, 95% CI 1.33–18.48, P = 0.017) were associated with decreased odds of long-term success in the multivariate logistic regression analysis. Of note, there was no significant difference in odds of success between former smokers and nonsmokers. Conclusions Current smoker status, subglottic stenosis, and stent implantation are independent factors associated with reduced long-term efficacy of interventional bronchoscopy for SCAS. Smoking cessation should be encouraged to improve the outcome of therapeutic bronchoscopy.

Contributions of Airway Stent for Long-term Outcome in Patients With Malignant Central Airway Stenosis or Obstruction

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Akira Iyoda ◽  
Yoko Azuma ◽  
Atsushi Sano ◽  
Takashi Sakai ◽  
Satoshi Koezuka ◽  
...  
Keyword(s):  
Stenosis Or Obstruction ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Airway Stenosis ◽  
Airway Stent ◽  
Central Airway

Identification of characteristics associated with long-term survival in patients with metastatic urothelial carcinoma (mUC) who received durvalumab (D) with or without tremelimumab (T) in clinical studies.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 441-441
Author(s):  
Marie Alt ◽  
Carlos Stecca ◽  
Shaum Kabadi ◽  
Benga Kazeem ◽  
Srikala S. Sridhar
Keyword(s):  
Logistic Regression ◽  
Phase I ◽  
Regression Model ◽  
Clinical Studies ◽  
Logistic Regression Model ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Term Survival ◽  
Long Term Survival

441 Background: Immune checkpoint inhibitors (ICI) have changed the landscape of mUC, yet outcomes are variable as some patients (pts) do not respond to treatment while others have a durable response. To optimally select pts who may derive benefit from ICIs, predictive factors are required. This retrospective, post-hoc analysis evaluated pt characteristics to determine differences between short and long-term survivors among pts with mUC who received D (anti–PD-L1) with or without T (anti–CTLA-4) in two clinical studies. Methods: Pts with platinum-refractory mUC who received D monotherapy in the phase I/II study 1108 (10 mg/kg Q2W, up to 12 mo) or D+T in the phase I study 10 (D at 20 mg/kg + T at 1 mg/kg Q4W for 4 mo, then D at 10 mg/kg Q2W for 12 mo) were included. Pt characteristics, tumor characteristics, radiological assessments, and biological assessments were collected. The primary outcome measure was long-term overall survival (OS). Pts were categorized as OS ≥2 yrs (from 1st dose of study drug) or OS <2 yrs. A univariate analysis was conducted on each baseline characteristic to assess independent associations with long-term OS; a multivariate logistic regression model was employed including each variable with a p-value ≤0.1 as factors or covariates. Results: A total of 367 pts with mUC were included in the analysis: 88 (24.0%) had OS ≥2 yrs (range: 2.09–4.99) and 279 (76.0%) had OS <2 yrs (range: 0.03–1.98). Pts with OS ≥2 yrs had a significantly higher objective response rates than those with OS <2 yrs (71.6% vs 5.7%; p<0.0001) and a significantly longer duration of response (median 2.3 yrs vs 0.39 yrs; p<0.0001). The characteristics included in the multivariate logistic regression model are listed in the Table. Long-term OS was significantly associated with ECOG PS, PD-L1 status, baseline hemoglobin level, and baseline absolute neutrophils count. Conclusions: Our analyses show that several characteristics, including tumor response to treatment, are associated with long-term OS for pts with mUC treated with D or D+T. Further investigation into these and other characteristics may provide additional insights into long-term survival outcomes with ICIs. [Table: see text]

scholarly journals Prognostic Factors of Long-Term Outcomes in Endodontic Microsurgery: A Retrospective Cohort Study over Five Years

2020 ◽  
Vol 9 (7) ◽  
pp. 2210
Author(s):  
Yeon-Jee Yoo ◽  
Dong-Won Kim ◽  
Hiran Perinpanayagam ◽  
Seung-Ho Baek ◽  
Qiang Zhu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Prognostic Factors ◽  
Periodontal Disease ◽  
Maxillary Sinus ◽  
Long Term Outcomes ◽  
Chi Square ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Endodontic Microsurgery

The aim of this study was to analyze the long-term outcomes of endodontic microsurgeries in a cohort and identify their association with prognostic factors. A cohort of endodontic microsurgeries followed up periodically with complete clinical and radiographic records for at least 5 years were reviewed retrospectively. Their survival and healing status and profile characteristics were analyzed by Pearson chi-square test and logistic regression (α = 0.05) to identify prognostic factors that influenced outcomes. Of 652 cases in the cohort, 225 (34.5%) were included. The mean follow-up period was 90.4 months (range, 60–168 months). The long-term success rate was 80.5%, and the 5-year survival rate was 83.5%. Logistic regression showed higher success in anteriors compared to molars (OR = 5.405, (95% CI, 1.663–17.571; p = 0.005)) and in teeth with crown restorations (OR = 10.232, (95% CI, 3.374–31.024; p < 0.001)). Conversely, lower success was found in teeth with periodontal disease (OR = 0.170, (95% CI, 0.032–0.900; p = 0.037)) and maxillary sinus involvement (OR = 0.187, (95% CI, 0.035–0.994; p = 0.049)). Endodontic microsurgery has a highly favorable long-term outcome. Tooth position, crown restoration, periodontal disease, and maxillary sinus involvement were identified as main prognostic factors.

scholarly journals The predictive prognostic factors and risk factors of lymph node metastasis in patients with early gastric cancer

2019 ◽  
Author(s):  
hongliang zu ◽  
huiling Wang ◽  
yan MA ◽  
yingwei xue
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Prognostic Factors ◽  
Treatment Strategies ◽  
Multivariate Logistic Regression Analysis ◽  
Clinicopathological Features ◽  
Multivariate Logistic Regression ◽  
Node Metastasis

Abstract Background: Determining the prognosis of early gastric cancer (EGC) is very important for the selection of preoperative treatment strategies. The purpose of this paper was to investigate the clinicopathological features and prognostic factors in EGC and the related risk factors of lymph node metastasis (LNM). Methods: From March 2007 through December 2010, 1004 patients who underwent gastrectomy at Harbin Medical University were retrospectively identified; 120 patients were diagnosed with EGC. The clinicopathological features and prognostic factors were analysed by univariate and multivariate analyses. Multivariate logistic regression analysis was used to discern risk factors for LNM in EGC. Results: The incidence of EGC was 11.96%. A univariate analysis showed that age, preoperative haemoglobin (Hb) level, prealbumin level, tumour size and LNM were significant prognostic factors. A multivariate analysis showed that the preoperative Hb level and LNM were independent prognostic factors. A multivariate logistic regression analysis revealed that age, Ca-199 level and macroscopic tumour type were independent risk factors for LNM in EGC. Conclusions: Preoperative Hb level and LNM were both independent prognostic factors for EGC. These factors may help surgeons implement appropriate treatment strategies during the perioperative period.

Interventional Bronchoscopy for the Treatment of Malignant Central Airway Stenosis: An Expert Recommendation for China

Respiration ◽  
2019 ◽  
Vol 97 (5) ◽  
pp. 484-494
Author(s):  
Faguang Jin ◽  
Qiang Li ◽  
Shiyue Li ◽  
Hongwu Wang ◽  
Chong Bai ◽  
...  
Keyword(s):  
Interventional Bronchoscopy ◽  
Airway Stenosis ◽  
Expert Recommendation ◽  
Central Airway

0899 Long-term Effects Of Adenotonsillectomy In Children Diagnosed With Obstructive Sleep Apnea On Risk Factors For Cardiovascular Morbidity

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A342-A342
Author(s):  
J Even Tsur ◽  
R Auhasira ◽  
A Shiloh ◽  
V Novack ◽  
A Goldbart
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Obstructive Sleep Apnea ◽  
Logistic Regression ◽  
Risk Factor ◽  
Cardiovascular Morbidity ◽  
Long Term Effects ◽  
Multivariate Logistic Regression ◽  
Obstructive Sleep

Abstract Introduction Obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular morbidity in adults. In children, cardiovascular morbidity associated with OSA is usually thought to resolve after tonsillectomy and adenoidectomy (T&A). There is no information regarding the long term effects of T&A on future cardiovascular morbidity in children diagnosed with OSA. In this study, we performed data mining to assess long-term effects of adenotonsillectomy on risk factors for cardiovascular disease, in young adults. Methods This study retrospectively investigated the population defined by a previous study in our institution [Tarasiuk etal Pediatrics 2004] and compared a group of children diagnosed with OSA and underwent T&A(n=130) to a group of children diagnosed with OSA that did not undergo T&A(n=90) to a control group without OSA (n=505). Demographic data, vital signs, anthropometric measurements, medical diagnoses (9th revision (ICD-9) codes) and medication purchases were captured from the HMO computerized database, between the years 1998-2018. When appropriate, univariate comparisons were made using χ 2-test or Fisher’s exact test for categorical variables, and one-way ANOVA or Kruskal-Wallis tests for quantitative variables. We performed multivariate logistic regression to model the factors associated with the diagnosis of obesity. IBM SPSS software, version 25.0, was used for statistical analysis. Results We have found that 20 years after their OSA diagnosis, patients (25.1 years, 52.2% males, 26.2 BMI) who were diagnosed with OSA at age 5 and did not undergo T&A consumed more medications associated with cardiovascular morbidity (anti-hypertensive, statins, aspirin) than those who underwent T&A(P&lt;0.001). Surprisingly, multivariate logistic regression revealed that only females diagnosed with OSA (with or without T&A) were diagnosed as obese in comparison to those that did not have OSA (P&lt;0.001). Conclusion Children who were diagnosed with OSA and were not operated will consume more medications (anti-hypertensive, anti-hyperlipidemia, aspirin) as young adults, a surrogate marker for early cardiovascular disease. OSA in girls seems to serve as a risk factor for obesity in their third decade of life. It is important to diagnose and treat OSA in children, and to monitor and prevent obesity, mainly in females. Support Israel Science Foundation (ISF) 1344/15

scholarly journals Appropriate treatment sessions of flexible bronchoscopic balloon dilation for patients with nonmalignant central airway stenosis

2019 ◽  
Vol 13 ◽  
pp. 175346661983196
Author(s):  
Weiquan Liang ◽  
Peicun Hu ◽  
Wenliang Guo ◽  
Zhuquan Su ◽  
Jingxian Li ◽  
...  
Keyword(s):  
Cox Regression ◽  
Balloon Dilation ◽  
Effective Rate ◽  
Primary Treatment ◽  
Treatment Session ◽  
Chinese Patients ◽  
Airway Stenosis ◽  
Number Of Treatment ◽  
Central Airway

Background: Balloon dilation is a primary treatment for nonmalignant tracheobronchial stenosis, but often requires multiple treatment sessions to maintain therapeutic efficacy. No guideline is available to suggest the appropriate maximum number of treatment sessions. This study aimed to investigate the relationship between the number of balloon dilation sessions and its long-term therapeutic effectiveness in Chinese patients with nonmalignant central airway stenosis. Methods: A total of 111 patients with nonmalignant central airway stenosis treated with flexible bronchoscopic balloon dilation from January 2005 to September 2012 were included. The cumulative long-term effective rate was compared between any two adjacent sessions of balloon dilation treatment by McNemar’s test. Multivariate Cox regression was performed to investigate the independent factors associated with long-term effectiveness. Results: The cumulative long-term effective rate was significantly increased between any two adjacent sessions before the 6th session of treatment (all p < 0.05) but was no longer significantly increased after the 6th session. The stenosis diameter was larger in the patients receiving ⩽6 treatment sessions than those receiving ⩾6 treatment sessions. Multivariate Cox regression showed that the treatment session was an independent factor associated with long-term effectiveness (hazard ratio = 0.65, 95% confidence interval: 0.57–0.76, p < 0.001). Conclusion: These results suggest that the maximum number of treatment sessions of balloon dilation may be six, and patients requiring more treatment sessions were more likely to have delayed long-term effectiveness.

scholarly journals Low psoas muscle index is a poor prognostic factor for lower gastrointestinal perforation: a single-center retrospective cohort study

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hajime Kayano ◽  
Eiji Nomura ◽  
Rin Abe ◽  
Yasuhiko Ueda ◽  
Takashi Machida ◽  
...  
Keyword(s):  
Body Composition ◽  
Logistic Regression ◽  
Adipose Tissue ◽  
Prognostic Factors ◽  
Emergency Surgery ◽  
Odds Ratio ◽  
Psoas Muscle ◽  
Lower Gastrointestinal Tract ◽  
Multivariate Logistic Regression ◽  
Tract Perforation

Abstract Background Various body composition indices have been reported as prognostic factors for different cancers. However, whether body composition affects prognosis after lower gastrointestinal tract perforation requiring emergency surgery and multidisciplinary treatment has not been clarified. This study examined whether body composition evaluations that can be measured easily and quickly from computed tomography (CT) are useful for predicting prognosis. Methods Subjects comprised 64 patients diagnosed with perforation at final diagnosis after emergency surgery for a preoperative diagnosis of lower gastrointestinal tract perforation and penetration. They were divided into a survival group and a non-survival (in-hospital mortality) group and compared. Body composition indices (psoas muscle index (PMI); psoas muscle attenuation (PMA); subcutaneous adipose tissue index (SATI); visceral adipose tissue index (VATI); visceral-to-subcutaneous fat area ratio (VSR)) were measured from preoperative CT. Cross-sectional psoas muscle area at the level of the 3rd lumbar vertebra was quantified. Optimal cut-off values were calculated using receiver operating characteristic curve analysis. Poor prognostic factors were investigated from multivariate logistic regression analyses that included patient factors, perioperative factors, intraoperative factors, and body composition indices as explanatory variables. Results The cause of perforation was malignant disease in 12 cases (18.7%), and benign disease in 52 cases (81.2%). The most common cause was diverticulum of the large intestine. Emergency surgery for the 64 patients led to survival in 52 patients and death in 12 patients. On multivariate logistic regression analysis, independent predictors of poor prognosis were Sequential Organ Failure Assessment score (odds ratio 1.908; 95% confidence interval (CI) 1.235–3.681; P = 0.0020) and PMI (odds ratio 13.478; 95%CI 1.342–332.690; P = 0.0252). The cut-off PMI was 4.75 cm2/m2 for males and 2.89 cm2/m2 for females. Among survivors, duration of hospitalization was significantly longer in the low PMI group (29 days) than in the high PMI group (22 days, p = 0.0257). Conclusions PMI is easily determined from CT and allows rapid evaluation of prognosis following lower gastrointestinal perforation.

Abstract 14472: Indications for ICD Implantation Differ Between Women and Men

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sebastian Ingelaere ◽  
Ruben Hoffmann ◽  
Georges Mairesse ◽  
Yves R Vandekerckhove ◽  
Jean-Benoît le Polain de Waroux ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Nyha Class ◽  
Total Mortality ◽  
Categorical Variables ◽  
Multivariate Logistic Regression ◽  
Icd Implantation ◽  
Term Survival ◽  
Kaplan Meier ◽  
The Impact

Introduction: The impact of gender on ICD implantation practice and survival remain a topic of controversy. We analysed differences between men and women in patients implanted with an ICD in Belgium. Methods: The Belgian governmental health care institution (RIZIV/INAMI) keeps track of every ICD implantation by a digital registry. Participation is mandatory for reimbursement. From this registry, we analysed all new ICD implantations between 01/02/2010 and 31/01/2019 in Belgian patients. We compared men with women for baseline patient characteristics. We used a Chi 2 test for categorical variables (NYHA class, primary vs secondary prevention, underlying heart disease, type of device, QRS duration, presence of atrial fibrillation, diabetes and other comorbidity, center volume, population density and average income of the area of residency) and a Mann-Whitney U test for continuous variables [age and ejection fraction(EF)]. We used the Bonferroni method to correct for multiple testing. Secondly, we performed a Kaplan-Meier analysis. At last, we performed a multivariate logistic regression for 3-year and total mortality. Results: Only 3146 (20.8%) on 14747 implantations were in women. Women were significantly younger and had a better EF compared to men. Except for oncological history, women had less comorbidities (table 1). More women functioned in NYHA class > II and had a QRS > 150ms, which was consistent with a higher CRT-D vs VVI/DDD ratio. Kaplan-Meier showed a survival benefit in women (log-rank, p=<0.001). Further exploration with multivariate logistic regression showed that female gender was significant protective for long-term total mortality, but not for short-term 3-year mortality. Conclusions: Only a minority of patients implanted with a new ICD in Belgium are women. Their clinical profile differs from men. Their long-term survival is better, which can in part be explained by differences in indications and comorbidities.

scholarly journals Low psoas muscle index is a poor prognostic factor for lower gastrointestinal perforation: a single-center retrospective cohort study

2019 ◽  
Author(s):  
Hajime Kayano ◽  
Eiji Nomura ◽  
Rin Abe ◽  
Yasuhiko Ueda ◽  
Takashi Machida ◽  
...  
Keyword(s):  
Body Composition ◽  
Logistic Regression ◽  
Adipose Tissue ◽  
Prognostic Factors ◽  
Emergency Surgery ◽  
Odds Ratio ◽  
Psoas Muscle ◽  
Lower Gastrointestinal Tract ◽  
Multivariate Logistic Regression ◽  
Tract Perforation

Abstract Background Various body composition indices have been reported as prognostic factors for different cancers. However, whether body composition affects prognosis after lower gastrointestinal tract perforation requiring emergency surgery and multidisciplinary treatment has not been clarified. This study examined whether body composition evaluations that can be measured easily and quickly from computed tomography (CT) are useful for predicting prognosis. Methods Subjects comprised 64 patients diagnosed with perforation at final diagnosis after emergency surgery for a preoperative diagnosis of lower gastrointestinal tract perforation and penetration. They were divided into a survival group and a non-survival (in-hospital mortality) group and compared. Body composition indices (psoas muscle index (PMI); psoas muscle attenuation (PMA); subcutaneous adipose tissue index (SATI); visceral adipose tissue index (VATI); visceral-to-subcutaneous fat area ratio (VSR)) were measured from preoperative CT. Cross-sectional psoas muscle area at the level of the 3rd lumbar vertebra was quantified. Optimal cut-off values were calculated using receiver operating characteristic curve analysis. Poor prognostic factors were investigated from multivariate logistic regression analyses that included patient factors, perioperative factors, intraoperative factors, and body composition indices as explanatory variables. Results The cause of perforation was malignant disease in 12 cases (18.7%), and benign disease in 52 cases (81.2%). The most common cause was diverticulum of the large intestine. Emergency surgery for the 64 patients led to survival in 52 patients and death in 12 patients. On multivariate logistic regression analysis, independent predictors of poor prognosis were Sequential Organ Failure Assessment score (odds ratio 1.908; 95% confidence interval (CI) 1.235–3.681; P =0.0020) and PMI (odds ratio 13.478; 95%CI 1.342–332.690; P =0.0252). The cut-off PMI was 4.75 cm 2 /m 2 for males and 2.89 cm 2 /m 2 for females. Among survivors, duration of hospitalization was significantly longer in the low PMI group (29 days) than in the high PMI group (22 days, p=0.0257). Conclusions PMI is easily determined from CT and allows rapid evaluation of prognosis following lower gastrointestinal perforation.

Sign in / Sign up

Export Citation Format

Share Document