Hospitalization costs among immobile patients with hemorrhagic or ischemic stroke in China: a multicenter cross-sectional study

Abstract Background In this study, we aimed to analyze the hospitalization costs for immobile patients with hemorrhagic stroke (IHS) or ischemic stroke (IIS) in China and to determine the factors associated with hospitalization costs. Methods We evaluated patients with IHS and IIS hospitalized between November 2015 and July 2016 in six provinces or municipality cities of China. Linear regression analysis was used to examine the association with hospitalization costs and predictors. Results In total, 1573 patients with IHS and 3143 with IIS were enrolled and analyzed. For IHS and IIS, the average length of stay (LoS) was 17.40 ± 12.3 and 14.47 ± 11.55 days. The duration of immobility was 12.11 ± 9.98 and 7.36 ± 9.77 days, respectively. Median hospitalization costs were RMB 47000.68 (interquartile range 19,827.37, 91,877.09) for IHS and RMB 16578.44 (IQR 7020.13, 36,357.65) for IIS. In both IHS and IIS groups, medicine fees accounted for more than one-third of hospitalization costs. Materials fees and medical service fees accounted for the second and third largest proportions of hospital charges in both groups. Linear regression analysis showed that LoS, hospital level, and previous surgery were key determinants of hospitalization costs in all immobile patients with stroke. Subgroup analysis indicated that hospital level was highly correlated with hospitalization costs for IHS whereas pneumonia and deep vein thrombosis were key factors associated with hospitalization costs for IIS. Conclusions We found that hospitalization costs were notably higher in IHS than IIS, and medicine fees accounted for the largest proportion of hospitalization costs in both patient groups, perhaps because most patients ended up with complications such as pneumonia thereby requiring more medications. LoS and hospital level may greatly affect hospitalization costs. Increasing the reimbursement ratio of medical insurance for patients with IHS is recommended. Decreasing medicine fees and LoS, preventing complications, and improving treatment capability may help to reduce the economic burden of stroke in China.

Download Full-text

Cross-Sectional Examination of Homocysteine Levels with Sarcopenia and Its Components in Memory Clinic Outpatients

Journal of Alzheimer s Disease ◽

10.3233/jad-210083 ◽

2021 ◽

pp. 1-10

Author(s):

Yosuke Yamada ◽

Hiroyuki Umegaki ◽

Fumie Kinoshita ◽

Chi Hsien Huang ◽

Taiki Sugimoto ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Cognitive Impairment ◽

Cognitive Function ◽

Linear Regression ◽

Logistic Regression Analysis ◽

Linear Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Memory Clinic ◽

Cross Sectional

Background: Homocysteine is a common risk factor for cognitive impairment and sarcopenia. However, very few studies have shown an association between sarcopenia and serum homocysteine levels after adjustment for cognitive function. Objective: The purpose of this study was to investigate the relationship between homocysteine and sarcopenia in memory clinic patients. Methods: This cross-sectional study investigated outpatients in a memory clinic. We enrolled 1,774 participants (≥65 years old) with measured skeletal muscle mass index (SMI), hand grip strength (HGS), and homocysteine. All participants had undergone cognitive assessments and were diagnosed with dementia, mild cognitive impairment, or normal cognition. Patient characteristics were compared according to sarcopenia presence, SMI level, or HGS. Multivariate logistic regression analysis was performed to determine the association of homocysteine with sarcopenia, low SMI, or low HGS. Next, linear regression analysis was performed using HGS as a continuous variable. Results: Logistic regression analysis showed that low HGS was significantly associated with homocysteine levels (p = 0.002), but sarcopenia and low SMI were not. In linear regression analysis, HGS was negatively associated with homocysteine levels after adjustment for Mini-Mental State Examination score (β= –2.790, p < 0.001) or clinical diagnosis of dementia (β= –3.145, p < 0.001). These results were similar for men and women. Conclusion: Our results showed a negative association between homocysteine and HGS after adjustment for cognitive function. Our findings strengthen the assumed association between homocysteine and HGS. Further research is needed to determine whether lower homocysteine levels lead to prevent muscle weakness.

Download Full-text

Oxidative stress and gut-derived lipopolysaccharides in children affected by Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections.

10.21203/rs.2.19372/v3 ◽

2020 ◽

Author(s):

Lorenzo Loffredo ◽

Alberto Spalice ◽

Francesca Salvatori ◽

De Castro Giovanna ◽

Cristiana Alessia Guido ◽

...

Keyword(s):

Regression Analysis ◽

Linear Regression ◽

Linear Regression Analysis ◽

Prostaglandin F2α ◽

Neuropsychiatric Disorders ◽

Serum Levels ◽

Multiple Linear Regression Analysis ◽

Tic Disorders ◽

Streptococcal Infections ◽

Cross Sectional

Abstract Background: pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections syndrome (PANDAS) identifies patients with acute onset of obsessive-compulsive and tic disorders. The objective of this study was to assess NOX2 levels, as well as serum 8-iso-prostaglandin F2α (iso-PGF2α) and lipopolysaccharide (LPS) derived from Gram-negative bacteria in the gut of patients with PANDAS. Methods: a cross sectional study was performed to compare serum levels of soluble NOX2-dp (sNOX-2-dp), isoprostanes and LPS in 60 consecutive subjects, including 30 children affected by PANDAS and 30 controls (CT) matched for age and gender. Serum zonulin was used to assess gut permeability. Results: compared with CT, PANDAS children had higher values of sNOX-2-dp, 8-iso-PGF2-alpha and LPS. Simple linear regression analysis showed that sNOX2-dp was signiﬁcantly correlated with serum LPS (Rs=0.359; p=0.005), zonulin (Rs=0.444; p<0.001) and iso-PGF2α (Rs=0.704; p<0.001). LPS signiﬁcantly correlated with serum zonulin (Rs=0.610; p<0.001), and iso-PGF2α (Rs=0.591; p=0.001). A multiple linear regression analysis was performed to define the independent predictors of sNOX-2-dp. Isoprostanes and zonulin emerged as the only independent predictive variables associated with sNOX2-dp (R2=68%). Conclusion: this study provides evidences that children affected by PANDAS have high circulating levels of sNOX2-dp, isoprostanes and of LPS that could be potentially implicated in the process of neuroinflammation.

Download Full-text

Nutritional status and quality of life in diabetic patients on hemodialysis: a cross-sectional study from Palestine

Journal of Health Population and Nutrition ◽

10.1186/s41043-021-00255-w ◽

2021 ◽

Vol 40 (1) ◽

Author(s):

Eba’a Hafi ◽

Ro’ya Soradi ◽

Sarah Diab ◽

Ahmad M. Samara ◽

Marah Shakhshir ◽

...

Keyword(s):

Quality Of Life ◽

Regression Analysis ◽

Linear Regression ◽

Nutritional Status ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Sectional Study ◽

Cross Sectional

Abstract Background End-stage renal disease (ESRD) is a leading cause of death and morbidity worldwide. Malnutrition is a common problem among hemodialysis (HD) patients that negatively impacts their prognosis and is linked to an increase in morbidity and mortality in these patients, as well as a decrease in their quality of life (QOL). In this study, we aimed to evaluate the QOL and to investigate factors that can influence it, including nutritional status, as well as socio-demographic factors, among Palestinian diabetic patients on HD therapy. Methods This was a cross-sectional study that occurred at a large hemodialysis center in Palestine. Malnutrition was assessed by the malnutrition-inflammation scale (MIS), and the quality of life was evaluated by using the EuroQoL five-dimensional instrument (EQ-5D). Multivariable linear regression analysis was carried out to look at the effect of multiple variables on QOL. Results A total of 118 diabetic patients on HD were included. Of these, 66.9% were male, and 60.2% were aged 60 years or higher. Having multiple comorbid diseases (p=0.004) and having been on HD for >4 years (p=0.003) were significantly associated with a higher MIS score, whereas living alone (p=0.037) and having been on HD for >4 years (p=0.002) was significantly associated with lower EQ-5D score. We also observed a significant association between the MIS score and the EQ-5D score(r=−0.616, p<0.001). Multiple linear regression analysis demonstrated that diabetic hemodialysis patients who lived within a family household were positively correlated with the QOL score (standardized coefficient, 0.178; 95% confidence interval (CI), 0.042 to 0.372; p = 0.015), and MIS score was significantly and negatively correlated with QOL scores (standardized coefficient, −0.587; 95% CI, −0.047 to −0.028; p < 0.001). Conclusions We found that malnutrition was associated with a lower QOL score among diabetic patients on HD. We recommend general practitioners, dietitians, nephrologists, and nurses to make plans that pay more attention to this group of patients who show evidence of malnutrition. Patients on dialysis for ≥ 4 years, patients who live alone, and those suffering from multiple co-morbid diseases should receive special care due to their higher risk of being impacted by this problem.

Download Full-text

Analysis of the chemerin and resistin adipokines in children and adolescents

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.66.3.300 ◽

2020 ◽

Vol 66 (3) ◽

pp. 300-306

Author(s):

Vanessa S. Fontes ◽

Kácia Mateus ◽

Michele P. Netto ◽

Renata M. S. Oliveira ◽

George L. L. Machado-Coelho ◽

...

Keyword(s):

Blood Pressure ◽

Regression Analysis ◽

Linear Regression ◽

Children And Adolescents ◽

Blood Pressure Measurement ◽

Linear Regression Analysis ◽

Multiple Linear Regression Analysis ◽

Excess Weight ◽

Cross Sectional ◽

Significance Level

SUMMARY OBJECTIVES To compare the serum concentrations of adipokines resistin and chemerin in children and adolescents with eutrophic and overweight and to evaluate their relationship with anthropometric, biochemical, and blood pressure variables. METHODS a cross-sectional epidemiological study was conducted with 234 students enrolled in public elementary schools in the city of Juiz de Fora / MG. Anthropometric evaluation, biochemistry, and blood pressure measurement were performed. Statistical analyzes included the Student-t or Mann-Whitney tests, Pearson or Spearman correlation, used according to the distribution of the variables, and linear regression analysis, by means of the evaluation of the effect of the independent variables on the serum levels of chemerin and resistin, adjusted for age and sex. For the data analysis, SPSS® software version 21.0 and STATA® version 10.1 were used, assuming a significance level of 5%. RESULTS the concentrations of chemerin were higher in eutrophic individuals than in those with excess weight (p> 0.05). In contrast, levels of resistin were higher in the young with excess weight than in the eutrophic ones (p <0.05). In the multiple linear regression analysis, the levels of chemerin were associated with the values of resistin, systolic, and diastolic blood pressure. Resistance levels maintained association only with BMI and chemerin values. CONCLUSION the adipokines analyzed presented a distinct profile in the groups of children and adolescents with eutrophic and overweight.

Download Full-text

Oxidative stress and gut-derived lipopolysaccharides in children affected by Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections.

10.21203/rs.2.19372/v4 ◽

2020 ◽

Author(s):

Lorenzo Loffredo ◽

Alberto Spalice ◽

Francesca Salvatori ◽

De Castro Giovanna ◽

Cristiana Alessia Guido ◽

...

Keyword(s):

Regression Analysis ◽

Linear Regression ◽

Linear Regression Analysis ◽

Prostaglandin F2α ◽

Neuropsychiatric Disorders ◽

Serum Levels ◽

Multiple Linear Regression Analysis ◽

Tic Disorders ◽

Streptococcal Infections ◽

Cross Sectional

Abstract Background: pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections syndrome (PANDAS) identifies patients with acute onset of obsessive-compulsive and tic disorders. The objective of this study was to evaluate serum NOX2 levels, as well as 8-iso-prostaglandin F2α (iso-PGF2α) and lipopolysaccharide (LPS) of PANDAS patients. Methods: a cross sectional study was performed to compare serum levels of soluble NOX2-dp (sNOX-2-dp), isoprostanes and LPS in 60 consecutive subjects, including 30 children affected by PANDAS and 30 controls (CT) matched for age and gender. Serum zonulin was used as intestinal permeability assay. Results: compared with CT, PANDAS children had increased values of sNOX-2-dp, 8-iso-PGF2-alpha and LPS. Simple linear regression analysis showed that sNOX2-dp was signiﬁcantly correlated with serum LPS (Rs=0.359; p=0.005), zonulin (Rs=0.444; p<0.001) and iso-PGF2α (Rs=0.704; p<0.001). Serum LPS signiﬁcantly correlated with zonulin (Rs=0.610; p<0.001), and iso-PGF2α (Rs=0.591; p=0.001). Finally, a multiple linear regression analysis was performed to define the independent predictors of sNOX-2-dp. Serum isoprostanes and zonulin resulted as the only independent predictive variables associated with sNOX2-dp (R2=68%). Conclusion: this study shows that children affected by PANDAS have high circulating levels of sNOX2-dp, isoprostanes and of LPS that could be potentially implicated in the process of neuroinflammation.

Download Full-text

Oxidative stress and gut-derived lipopolysaccharides in children affected by Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections.

10.21203/rs.2.19372/v1 ◽

2019 ◽

Author(s):

Lorenzo Loffredo ◽

Alberto Spalice ◽

Francesca Salvatori ◽

De Castro Giovanna ◽

Cristiana Alessia Guido ◽

...

Keyword(s):

Oxidative Stress ◽

Regression Analysis ◽

Linear Regression ◽

Linear Regression Analysis ◽

Prostaglandin F2α ◽

Neuropsychiatric Disorders ◽

Tic Disorders ◽

Blood Levels ◽

Streptococcal Infections ◽

Cross Sectional

Abstract Backgroundpaediatric autoimmune neuropsychiatric disorders associated with streptococcal infections syndrome (PANDAS) identifies patients with acute onset of obsessive-compulsive and tic disorders. The objective of this study was to assess NOX2 activity, as well as serum 8-iso-prostaglandin F2α (iso-PGF2α) and lipopolysaccharide (LPS) derived from Gram-negative bacteria in the gut of patients with PANDAS. Methodsa cross sectional study was performed to compare serum activity of soluble NOX-2-dp (sNOX-2-dp), blood levels of isoprostanes and LPS in 60 consecutive subjects, including 30 children affected by PANDAS and 30 controls (CT) matched for age and gender. Serum zonulin was used to assess gut permeability. Resultscompared with CT, PANDAS children had higher values of sNOX-2-dp, 8-iso-PGF2-alpha and LPS. Simple linear regression analysis showed that sNOX2-dp was signiﬁcantly correlated with serum LPS (Rs=0.359; p=0.005), zonulin (Rs=0.444; p<0.001) and iso-PGF2α (Rs=0.704; p<0.001). LPS signiﬁcantly correlated with serum zonulin (Rs=0.610; p<0.001), and iso-PGF2α (Rs=0.591; p=0.001). A multiple linear regression analysis was performed to define the independent predictors of sNOX-2-dp. Isoprostanes and zonulin emerged as the only independent predictive variables associated with sNOX2-dp (R2=68%).Conclusionthis study provides the first report attesting that children affected by PANDAS have high NOX2 activation, oxidative stress and circulating levels of LPS that could be potentially implicated in the process of neuroinflammation.

Download Full-text

Normal development of the fetal spinal canal and spinal cord at T12 on 3.0-T MRI

Acta Radiologica ◽

10.1177/0284185118791197 ◽

2018 ◽

Vol 60 (5) ◽

pp. 623-627

Author(s):

Mingming Miao ◽

Xiangtao Lin ◽

Zhonghe Zhang ◽

Hui Zhao

Keyword(s):

Spinal Cord ◽

Regression Analysis ◽

Linear Regression ◽

Gestational Age ◽

Spinal Canal ◽

Linear Regression Analysis ◽

Sectional Area ◽

Cross Sectional ◽

3.0 T ◽

3.0 T Mri

Background The studies that described the dimensions of the normal fetal thoracic spinal canal and spinal cord on magnetic resonance imaging (MRI) are scarce. Purpose To determine the normal appearance of the fetal spinal canal and spinal cord at T12 across different gestational ages using 3.0-T MRI. Material and Methods The spines of 43 normal human fetuses, aged 15–40 weeks, were scanned by 3.0-T MRI. All specimens were scanned using a GE 3.0-T MRI scanner. Imaging of the T12 vertebrae was performed in the coronal, sagittal, and axial planes. The anterior-posterior (AP) diameter, width, and cross-sectional area of the spinal canal and spinal cord at T12 were measured. The influence of gestational age on these parameters was investigated with a scatter plot and linear regression analysis using Pearson correlation coefficient. Results The normal morphology of the fetal vertebra at T12 can be clearly showed by MRI; the spinal canal appeared circular, while the spinal cord was ellipsoid. Linear regression analysis showed a significant positive correlation between the AP diameter, width, and cross-sectional area of the spinal canal at T12 and gestational age. Conclusion Postmortem MRI is a reliable method for understanding the growth dynamics of the spinal canal and spinal cord at T12. Findings from this study would benefit the prenatal diagnosis of congenital malformations by MRI.

Download Full-text

Impact of the COVID-19 pandemic on migraine in Japan: a multicentre cross-sectional study

The Journal of Headache and Pain ◽

10.1186/s10194-021-01263-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Keisuke Suzuki ◽

Takao Takeshima ◽

Hisaka Igarashi ◽

Noboru Imai ◽

Daisuke Danno ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Linear Regression ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Stepwise Linear Regression Analysis ◽

Stepwise Linear Regression ◽

New Onset

Abstract Objectives To assess the impacts of social situation changes due to the coronavirus disease 2019 (COVID-19) pandemic on headache-related disability and other symptoms in patients with migraine in Japan. Methods We conducted a multicentre, cross-sectional study including 659 outpatients with migraine diagnosed by headache specialists. The participants were asked about the impacts of the first wave of the COVID-19 pandemic on headache-related disability, headache days, headache intensity, stress, physical activity, hospital access and their work and home lives. For headache-related disability, the total Migraine Disability Assessment (MIDAS) score and part A and B scores were analysed. Multivariate stepwise linear regression analysis was performed to identify the clinical predictors of changes in the total MIDAS score before and during the COVID-19 pandemic. Logistic regression analysis was performed to determine the factors related to new-onset headache during the COVID-19 pandemic. Results Finally, 606 migraine patients (73 M/533 F; age, 45.2 ± 12.0 years) were included in the study, excluding those with incomplete data. Increased stress, substantial concern about COVID-19 and negative impacts of the first wave of the COVID-19 pandemic on daily life were reported in 56.8 %, 55.1 and 45.0 % of the participants, respectively. The total MIDAS and A and B scores did not significantly change after the first wave of the COVID-19 pandemic. New-onset headache, which was observed in 95 patients (15.7 %), was associated with younger age and worsened mood and sleep in the logistic regression analysis. The multivariate stepwise linear regression analysis of changes in the total MIDAS score before and during the first wave of COVID-19 pandemic identified worsened sleep, increased acute medication use, increased stress, medication shortages, comorbidities, the absence of an aura and new-onset headache were determinants of an increased total MIDAS score during the first wave of the COVID-19 pandemic. Conclusions In this multicentre study, clinical factors relevant to headache-related disability, such as new-onset headache, stress and sleep disturbances, were identified, highlighting the importance of symptom management in migraine patients during the first wave of the COVID-19 pandemic.

Download Full-text

PENGARUH HARAPAN LAMA SEKOLAH, RATA – RATA LAMA SEKOLAH TERHADAP TINGKAT PENGANGGURAN TERBUKA DI KABUPATEN / KOTA PROVINSI RIAU

Selodang Mayang: Jurnal Ilmiah Badan Perencanaan Pembangunan Daerah Kabupaten Indragiri Hilir ◽

10.47521/selodangmayang.v7i3.231 ◽

2021 ◽

Vol 7 (3) ◽

pp. 173-177

Author(s):

Nelva Siskawati ◽

Roberta Zulfhi Surya

Keyword(s):

Regression Analysis ◽

Data Analysis ◽

Linear Regression ◽

Average Length ◽

Linear Regression Analysis ◽

Secondary Data ◽

Multiple Linear Regression Analysis ◽

Unemployment Rates ◽

Analysis Technique ◽

Expected Length

This study aims to determine how many the effect of Expected Years of Schooling and Average Length of Schooling on Open Unemployment Rates in the District/City of Riau Province, from 2017 to 2020 with a total of 44 samples. The data taken is sourced from secondary data, namely from the Central Statistics Agency of Indragiri Hilir Regency. The data analysis technique used is Multiple Linear Regression Analysis. The final result can be concluded that the variables of Average Length of School and Expected Length simultaneously or together have an influence on the open unemployment rate even though in a small percentage. Penelitian ini bertujuan mengetahui seberapa besar pengaruh dari Harapan Lama Sekolah dan Rata - Rata Lama Sekolah terhadap Tingkat Pengangguran Terbuka di Kabupaten/Kota Provisinsi Riau, mulai tahun 2017 sampai tahun 2020 dengan jumlah 44 sampel . Data yang diambil bersumber dari data sekunder yaitu dari Badan Pusat Statistik Kabupaten Indragiri Hilir. Teknik Analisis Data yang digunakan adalah Analisis Regresi Linear Berganda. Hasil akhir dapat di simpulkan bahwa variabel Rata- Rata Lama sekolah dan harapan Lama secara simultan atau secara bersama-sama memiliki pengaruh terhadap tingkat pengangguran terbuka walaupun dalam persentase yang sedikit.

Download Full-text

Weight and Abdominal Girth Predict Tidal Volume Requirement During Mechanical Ventilation for General Anaesthesia: A Cross-sectional Study

10.21203/rs.3.rs-258944/v1 ◽

2021 ◽

Author(s):

Ying-yan Shen ◽

Yan Chen ◽

Hong-mei Zhou ◽

Qi Li

Keyword(s):

Mechanical Ventilation ◽

Regression Analysis ◽

Linear Regression ◽

Tidal Volume ◽

General Anaesthesia ◽

Linear Regression Analysis ◽

Regression Equation ◽

Chest Circumference ◽

Abdominal Girth ◽

Cross Sectional

Abstract Background: Evidence that tidal volume (TV) is related to age, height, weight, chest circumference, and abdominal girth exists. However, it is unclear which of these has the strongest association with TV. This study aimed to investigate the main factors associated with TV and determine a method for accurately predicting TV requirement during mechanical ventilation. Methods: From December 2019 to January 2021, we enrolled 133 patients who were scheduled for surgery. Their age, height, weight, abdominal girth, and chest circumference were recorded. Intraoperatively, at 30 minutes after mechanical ventilation during general anaesthesia, the TV was increased or decreased by 25 ml if the partial pressure of carbon dioxide (PaCO2) was > 45 mmHg or < 35 mmHg, respectively. This was continued until we observed two consecutive PaCO2 values between 35 and 45 mmHg. The TV setting was recorded at this point. Linear regression and multiple regression analyses were performed. Results: The data of 100 patients were analysed. Linear regression analysis showed significant univariate correlations between age, weight, height, abdominal girth, chest circumference, and TV requirement. (all P ≤ 0.049). Multiple linear regression analysis showed that weight and abdominal girth were key determinants of TV requirement (both P < 0.001). The adjusted R2 for the regression equation was 0.813. The regression equation for accurately predicting TV requirement was Y = 312 + 5.717X1 - 2.798X2 (Y, TV requirement; X1, weight; and X2, abdominal girth). Conclusion: TV requirement during mechanical ventilation for general anaesthesia can accurately be set based on weight and abdominal girth.

Download Full-text