The severity and risk factors for mortality in immunocompromised adult patients hospitalized with influenza-related pneumonia

Abstract Objective To explore disease severity and risk factors for 30-day mortality of adult immunocompromised (IC) patients hospitalized with influenza-related pneumonia (Flu-p). Method A total of 122 IC and 1191 immunocompetent patients hospitalized with Flu-p from January 2012 to December 2018 were recruited retrospectively from five teaching hospitals in China. Results After controlling for confounders, multivariate logistic regression analysis showed that immunosuppression was associated with increased risks for invasive ventilation [odds ratio: (OR) 2.475, 95% confidence interval (CI): 1.511–4.053, p < 0.001], admittance to the intensive care unit (OR: 3.247, 95% CI 2.064–5.106, p < 0.001), and 30-day mortality (OR: 3.206, 95% CI 1.926–5.335, p < 0.001) in patients with Flu-p. Another multivariate logistic regression model revealed that baseline lymphocyte counts (OR: 0.993, 95% CI 0.990–0.996, p < 0.001), coinfection (OR: 5.450, 95% CI 1.638–18.167, p = 0.006), early neuraminidase inhibitor therapy (OR 0.401, 95% CI 0.127–0.878, p = 0.001), and systemic corticosteroid use at admission (OR: 6.414, 95% CI 1.348–30.512, p = 0.020) were independently related to 30-day mortality in IC patients with Flu-p. Based on analysis of the receiver operating characteristic curve (ROC), the optimal cutoff for lymphocyte counts was 0.6 × 109/L [area under the ROC (AUROC) = 0.824, 95% CI 0.744—0.887], sensitivity: 97.8%, specificity: 73.7%]. Conclusions IC conditions are associated with more severe outcomes in patients with Flu-p. The predictors for mortality that we identified may be valuable for the management of Flu-p among IC patients.

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The severity and risk factors for mortality in immunocompromised adult patients hospitalized with influenza-related pneumonia

10.21203/rs.3.rs-238430/v1 ◽

2021 ◽

Author(s):

Liang Chen ◽

Xiudi Han ◽

YanLi Li ◽

Chunxiao Zhang ◽

Xiqian Xing

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Roc Analysis ◽

Operating Characteristic ◽

Characteristic Curve ◽

Multivariate Logistic Regression Analysis ◽

Neuraminidase Inhibitor ◽

Teaching Hospitals ◽

Multivariate Logistic Regression Model ◽

Multivariate Logistic Regression

Abstract Objective To explore disease severity and risk factors for 30-day mortality of adult immunocompromised (IC) patients hospitalized with influenza-related pneumonia (Flu-p).Method A total of 122 IC and 1,191 immunocompetent patients hospitalized with Flu-p from January 2012 to December 2018 were recruited retrospectively from five teaching hospitals in China. Results After controlling for confounders, multivariate logistic regression analysis showed that immunosuppression was associated with increased risks for invasive ventilation [odds ratio: (OR) 2.475, 95% confidence interval (CI): 1.511-4.053, p < 0.001], admittance to the intensive care unit (OR: 3.247, 95% CI: 2.064-5.106, p < 0.001), and 30-day mortality (OR: 3.206, 95% CI: 1.926-5.335, p < 0.001) in patients with Flu-p. Another multivariate logistic regression model revealed that baseline lymphocyte counts (OR: 0.993, 95% CI: 0.990-0.996, p < 0.001), coinfection (OR: 5.450, 95% C:I 1.638-18.167, p = 0.006), early neuraminidase inhibitor therapy (OR 0.401, 95% CI 0.127-0.878, p = 0.001), and systemic corticosteroid use at admission (OR: 6.414, 95% C:I 1.348-30.512, p = 0.020) were independently related to 30-day mortality in IC patients with Flu-p. Based on receiver operating characteristic curve (ROC) analysis, the optimal cutoff for lymphocyte counts was 0.6×109/L [area under the ROC (AUROC) = 0.824, 95% CI: 0.744 - 0.887], sensitivity: 97.8%, specificity: 73.7%].Conclusions IC conditions are associated with more severe outcomes in patients with Flu-p. The predictors for mortality that we identified may be valuable for the management of Flu-p among IC patients.

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Clinical features and risk factors analysis of bronchitis obliterans due to refractory Mycoplasma pneumoniae pneumonia in children: a nomogram prediction model

BMC Infectious Diseases ◽

10.1186/s12879-021-06783-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Qi Cheng ◽

Han Zhang ◽

Yunxiao Shang ◽

Yuetong Zhao ◽

Ye Zhang ◽

...

Keyword(s):

Logistic Regression ◽

Mycoplasma Pneumoniae ◽

Characteristic Curve ◽

Acute Infection ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression Model ◽

Early Prediction ◽

Multivariate Logistic Regression ◽

Fiber Bronchoscopy ◽

Wbc Count

Abstract Background Early prediction of bronchitis obliterans (BO) is of great significance to the improvement of the long-term prognosis of children caused by refractory Mycoplasma pneumoniae pneumonia (RMPP). This study aimed to establish a nomogram model to predict the risk of BO in children due to RMPP. Methods A retrospective observation was conducted to study the clinical data of children with RMPP (1–14 years old) during acute infection. According to whether there is BO observed in the bronchoscope, children were divided into BO and the non-BO groups. The multivariate logistic regression model was used to construct the nomogram model. Results One hundred and forty-one children with RMPP were finally included, of which 65 (46.0%) children with RMPP were complicated by BO. According to the multivariate logistic regression analysis, WBC count, ALB level, consolidation range exceeding 2/3 of lung lobes, timing of macrolides, glucocorticoids or fiber bronchoscopy and plastic bronchitis were independent influencing factors for the occurrence of BO and were incorporated into the nomogram. The area under the receiver operating characteristic curve (AUC-ROC) value of nomogram was 0.899 (95% confidence interval [CI] 0.848–0.950). The Hosmer–Lemeshow test showed good calibration of the nomogram (p = 0.692). Conclusion A nomogram model found by seven risk factor was successfully constructed and can use to early prediction of children with BO due to RMPP.

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Decision Tree Analysis: A Retrospective Analysis of Postoperative Recurrence of Adhesions in Patients with Moderate-to-Severe Intrauterine

BioMed Research International ◽

10.1155/2019/7391965 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Ru Zhu ◽

Hua Duan ◽

Sha Wang ◽

Lu Gan ◽

Qian Xu ◽

...

Keyword(s):

Logistic Regression ◽

Decision Tree ◽

Endometrial Thickness ◽

Characteristic Curve ◽

Multivariate Logistic Regression Analysis ◽

Decision Tree Model ◽

Classification And Regression Tree ◽

Multivariate Logistic Regression Model ◽

Multivariate Logistic Regression ◽

Tree Model

Objective. To establish and validate a decision tree model to predict the recurrence of intrauterine adhesions (IUAs) in patients after separation of moderate-to-severe IUAs. Design. A retrospective study. Setting. A tertiary hysteroscopic center at a teaching hospital. Population. Patients were retrospectively selected who had undergone hysteroscopic adhesion separation surgery for treatment of moderate-to-severe IUAs. Interventions. Hysteroscopic adhesion separation surgery and second-look hysteroscopy 3 months later. Measurements and Main Results. Patients’ demographics, clinical indicators, and hysteroscopy data were collected from the electronic database of the hospital. The patients were randomly apportioned to either a training or testing set (332 and 142 patients, respectively). A decision tree model of adhesion recurrence was established with a classification and regression tree algorithm and validated with reference to a multivariate logistic regression model. The decision tree model was constructed based on the training set. The classification node variables were the risk factors for recurrence of IUAs: American Fertility Society score (root node variable), isolation barrier, endometrial thickness, tubal opening, uterine volume, and menstrual volume. The accuracies of the decision tree model and multivariate logistic regression analysis model were 75.35% and 76.06%, respectively, and areas under the receiver operating characteristic curve were 0.763 (95% CI 0.681–0.846) and 0.785 (95% CI 0.702–0.868). Conclusions. The decision tree model can readily predict the recurrence of IUAs and provides a new theoretical basis upon which clinicians can make appropriate clinical decisions.

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Risk factors for peritoneal dialysis–associated peritonitis

European Journal of Inflammation ◽

10.1177/2058739218772243 ◽

2018 ◽

Vol 16 ◽

pp. 205873921877224

Author(s):

Hongyue Wang ◽

Xiangtuo Wang ◽

Haichuan Dou ◽

Chenhao Li ◽

Mingji Cui ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Peritoneal Dialysis ◽

Serum Albumin ◽

Multivariate Logistic Regression Analysis ◽

Roc Curves ◽

Multivariate Logistic Regression Model ◽

Phosphorus Concentration ◽

Multivariate Logistic Regression ◽

Gram Positive

The purpose of this study was to summarize the pathogens that cause peritoneal dialysis (PD)-associated peritonitis and to identify risk factors for PD-associated peritonitis. This retrospective study included 115 end-stage renal disease (ESRD) patients receiving PD therapy. Patients were categorized into two groups: peritonitis group (n = 41) and non-peritonitis group (n = 74). Clinical data and laboratory tests were collected from medical records. The multivariate logistic regression model was used to evaluate associations between PD-associated peritonitis and potential risk factors. PD-associated peritonitis occurred 54 times in 41 patients. The most frequently identified pathogen was Gram-positive cocci (57.78%). Multivariate logistic regression analysis showed that serum albumin (β = –0.208, P < 0.001), blood phosphorus concentration (β = –1.732, P = 0.001), gastrointestinal disorders (β = 1.624, P = 0.043), and use of calcitriol (β = –2.239, P = 0.048) were significantly correlated with PD-associated peritonitis. Receiver operating characteristic (ROC) curves showed that the areas under the curve were 0.832 for serum albumin and 0.700 for blood phosphorus concentration with optimal cut-off values of 29.1 g/L for serum albumin and 1.795 mmol/L for blood phosphorus concentration. Gram-positive coccus is the major pathogen responsible for PD-associated peritonitis. Serum albumin <29.1 g/L, blood phosphorus concentration <1.795 mmol/L, and intestinal disorders are risk factors for PD-associated peritonitis, whereas the use of calcitriol can reduce the risk of PD-associated peritonitis.

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Prevalence and risk factors of depression and anxiety for inpatients with lung cancer in China: A hospital-based cross-sectional study

10.21203/rs.3.rs-1149458/v1 ◽

2022 ◽

Author(s):

Xueqian Wang ◽

Xuejiao Ma ◽

Mo Yang ◽

Yan Wang ◽

Yi Xie ◽

...

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Logistic Regression ◽

Risk Factor ◽

Univariate Analysis ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression Model ◽

Depression And Anxiety ◽

Multivariate Logistic Regression ◽

Cross Sectional

Abstract Background Lung cancer was often accompanied by depression and anxiety. Nowadays, most investigations for depression and anxiety were concentrated in western medical hospitals, while few related studies have been carried out in the tradition Chinese medicine (TCM) ward. It was necessary to understand the prevalence and risk factors of depression and anxiety in the inpatients with lung cancer in TCM hospital. Methods This study adopted cross-sectional research method, which enrolled a total of 222 inpatients with lung cancer in TCM hospital. PHQ-9 and GAD-7 scales were used to assess depression and anxiety for the inpatients, respectively. Demographic and clinical data were also collected. Statistical methods of the univariate analysis and the multivariate logistic regression model were used. Results The prevalence of depression and anxiety in the inpatients with lung cancer were 58.1% and 34.2%, respectively. Multivariate logistic regression analysis prompted that the common risk factor of depression and anxiety was the symptom of insomnia. Constipation and gender were the two anther risk factors of depression. Conclusion Depression and anxiety were common for the inpatients with lung cancer in TCM hospital. Gender, insomnia and constipation were risk factors for depression, and insomnia was risk factor for anxiety. Therefore, medical workers should pay close attention to the emotional changes of these high-risk patients and intervene the symptoms as early as possible.

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Comparison of Clinical Characteristics and Outcomes between Respiratory s yncytial Virus and Influenza-related Pneumonia in China from 2013 to 2019

10.21203/rs.3.rs-97784/v1 ◽

2020 ◽

Author(s):

Liang Chen ◽

Xiudi Han ◽

YanLi Li ◽

Chunxiao Zhang ◽

Xiqian Xing

Keyword(s):

Logistic Regression ◽

Influenza A ◽

Clinical Characteristics ◽

Nasal Congestion ◽

Multivariate Logistic Regression Analysis ◽

Teaching Hospitals ◽

Multivariate Logistic Regression Model ◽

Influenza B ◽

Multivariate Logistic Regression ◽

Increased Risk

Abstract Background: Differences in the clinical features and outcomes between syncytial virus-related (RSV-p) and influenza-related pneumonia (Flu-p) are largely unknown. We aimed to compare clinical characteristics and severity between adults with the two conditions . Methods: A total of 127 patients with RSV-p, 693 patients with influenza A-related pneumonia (FluA-p) and 386 patients with influenza B-related pneumonia (FluB-p) were retrospectively reviewed from 2013 through 2019 in five teaching hospitals in China. Results: A multivariate logistic regression model indicated that age ≥ 50 years, cerebrovascular disease, chronic kidney disease, solid malignant tumor, nasal congestion, myalgia, sputum production, respiratory rates ≥ 30 beats/min, lymphocytes < 0.8×109/L and blood albumin < 35 g/L were predictors that differentiated RSV-p from Flu-p. After adjusting for confounders, a multivariate logistic regression analysis confirmed that, relative to RSV-p, FluA-p (OR 2.313 , 95% CI 1.377 - 3.885, p = 0.002) incurred an increased risk for severe outcomes, including invasive ventilation, ICU admission, and 30-day mortality. FluB-p (OR 1.630 , 95% CI 0.958 - 2.741, p = 0.071) was not associated with increased risk. Conclusions: The severity of RSV-p was less than that of FluA-p, but was comparable to FluB-p. Some clinical variables were useful for discriminating RSV-p from Flu-p.

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Nomogram-Based Prediction of the Risk of Macrosomia: A Prospective Cohort Study in a Chinese Population

10.21203/rs.3.rs-268792/v1 ◽

2021 ◽

Author(s):

Jing Du ◽

Sanbao Chai ◽

Xin Zhao ◽

Jianbin Sun ◽

Ning Yuan ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Operating Characteristic ◽

Multivariate Logistic Regression Analysis ◽

Maternal Factors ◽

Multivariate Logistic Regression ◽

History Of

Abstract Objective: This study aimed to establish a nomogram for predicting the risk of macrosomia in early pregnancy.Methods: We performed a prospective cohort study involving 1,549 pregnant women. According to the birth weight of newborn, the subjects were divided into two groups: macrosomia group and non-macrosomia group. Multivariate logistic regression was used to analyze the risk factors for macrosomia.Results: The prevalence of macrosomia was 6.13% (95/1549) in our hospital. Multivariate logistic regression analysis showed the risk factors of macrosomia were prepregnancy overweight (OR: 2.126, 95% CI: 1.181-3.826)/obesity (OR: 3.536, 95% CI: 1.555-8.036), multiparity (OR:1.877, 95% CI: 1.160-3.039), the history of macrosomia (OR: 36.971, 95% CI: 19.903-68.674), the history of GDM/DM (OR: 2.285, 95% CI: 1.314-3.976), the higher levels of HbA1c (OR: 1.763, 95% CI: 1.004-3.097) and TC (OR: 1.360, 95% CI: 1.004-1.842). A nomogram was developed for predicting macrosomia based on maternal factors related to the risk of macrosomia in early pregnancy. The area under the receiver operating characteristic (ROC) curve of the nomogram was 0.807 (95% CI: 0.755–0.859), the sensitivity and specificity of the model were 0.716 and 0.777, respectively.Conclusion: The nomogram model provides an accurate mothed for clinicians to early predict macrosomia.

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Nomogram for Perinatal Prediction of Intrapartum Fever: A Case-control Study

10.21203/rs.3.rs-144513/v1 ◽

2021 ◽

Author(s):

Zhenfei Jiang ◽

Xiaoyi Hu ◽

Huabei Zeng ◽

Xinghe Wang ◽

Cheng Tan ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Vaginal Delivery ◽

Validation Cohort ◽

Multivariate Logistic Regression Analysis ◽

Labor Analgesia ◽

Multivariate Logistic Regression Model ◽

Multivariate Logistic Regression ◽

Clinical Trial Registration ◽

Training Cohort

Abstract Objective: To explore the risk factors of intrapartum fever and develop a nomogram to predict the incidence of intrapartum fever.Methods: The general demographic characteristics and perinatal factors of 696 parturient who underwent vaginal delivery in the Affiliated Hospital of Xuzhou Medical University from May 2019 to April 2020 were retrospectively analyzed. 487 patients collected from May 2019 to October 2019 were formed into a training cohort. A multivariate logistic regression model was used to identify the independent risk factors associated with intrapartum fever during vaginal delivery, then a nomogram was developed to predict the occurrence. 209 cases collected from January 2020 to April 2020 were formed into a validation cohort to verify the nomogram.Results: Intrapartum fever was found in 72 of 487 parturient (14.78%) in the training cohort, and the incidence of intrapartum fever in the validation cohort was 14.83% (31/209). Multivariate logistic regression analysis showed that primiparas (Odds Ratio [OR]2.433; 95% confidence interval [CI]1.149-5.150), epidural labor analgesia (OR2.890; 95%CI 1.225-6.818), premature rupture of membranes (OR2.366; 95%CI 1.130-4.954), second stage of labor ≥120min (OR4.363; 95%CI 1.419-13.410), amniotic fluid pollution Ⅲ degree (OR10.391; 95%CI 3.299-32.729), fetal weight ≥4000g (OR7.492; 95%CI 2.115-26.542) were significantly related to intrapartum fever. According to clinical experience and previous studies, the duration of epidural labor analgesia also seemed to be a meaningful factor for intrapartum fever, so these 7 variables were incorporated to develop a nomogram, which achieved good area under ROC curve of 0.855 in the training cohort and 0.808 in the validation cohort, and it had a well-fitted calibration curve, which showed an excellent diagnostic performance.Conclusion: We constructed a model to predict the occurrence of fever during childbirth and developed an accessible nomogram. The nomogram can help doctors assess the risk of fever during childbirth, so as to lead to reasonable treatment measures.Clinical Trial Registration: (www.chictr.org.cn ChiCTR2000035593)

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Clinical Features and Risk Factors Analysis of Bronchitis Obliterans Due to Refractory Mycoplasma Pneumoniae Pneumonia in Children: A Nomogram Prediction Model

10.21203/rs.3.rs-688491/v1 ◽

2021 ◽

Author(s):

Qi Cheng ◽

Han Zhang ◽

Yunxiao Shang ◽

Yuetong Zhao ◽

Ye Zhang ◽

...

Keyword(s):

Logistic Regression ◽

Mycoplasma Pneumoniae ◽

Characteristic Curve ◽

Acute Infection ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression Model ◽

Multivariate Logistic Regression ◽

Fiber Bronchoscopy ◽

Wbc Count ◽

Mycoplasma Pneumoniae Pneumonia

Abstract BackgroundEarly prediction of bronchitis obliterans (BO) is of great significance to the improvement of the long-term prognosis of children caused by refractory mycoplasma pneumoniae pneumonia (RMPP). This study aimed to establish a nomogram model to predict the risk of BO in children due to RMPP.MethodsA retrospective observation was conducted to study the clinical data of children with RMPP (1-14 years old) during acute infection. According to whether there is BO observed in the bronchoscope, children were divided into BO and the non-BO groups. The multivariate logistic regression model was used to construct the nomogram model.Results141 children with RMPP were finally included, of which 65 (46.0%) children with RMPP were complicated by BO. According to the multivariate logistic regression analysis, WBC count, ALB level, consolidation range exceeding 2/3 of lung lobes, timing of macrolides, glucocorticoids or fiber bronchoscopy and plastic bronchitis were independent influencing factors for the occurrence of BO and were incorporated into the nomogram. The area under the receiver operating characteristic curve (AUC-ROC) value of nomogram was 0.899 (95% confidence interval [CI]: 0.848~0.950). The Hosmer-Lemeshow test showed good calibration of the nomogram (p=0.692).Conclusion: A nomogram model found by seven risk factor was successfully constructed and can use to early prediction of children with BO due to RMPP.

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Risk Factors for Safety of Allergen-Specific Sublingual Immunotherapy in Children with Allergic Rhinitis

International Archives of Allergy and Immunology ◽

10.1159/000508523 ◽

2020 ◽

Vol 181 (12) ◽

pp. 934-940

Author(s):

Wenlong Liu ◽

Qingxiang Zeng ◽

Shengbao Yan ◽

Changzhi Sun ◽

Yiquan Tang ◽

...

Keyword(s):

Allergic Rhinitis ◽

Logistic Regression ◽

Roc Analysis ◽

Operating Characteristic ◽

Sublingual Immunotherapy ◽

Multivariate Logistic Regression Analysis ◽

Clinical Information ◽

Specific Ige ◽

Multivariate Logistic Regression Model ◽

Multivariate Logistic Regression

A good compliance often attributes to good efficacy and safety of sublingual immunotherapy (SLIT). However, few studies have been conducted on the safety of SLIT treatment in children. We aimed to confirm the pretreatment parameters to predict the safety in children who underwent SLIT. 601 children with allergic rhinitis (AR) treated with SLIT were enrolled in this study. Baseline clinical information and laboratory parameters were collected. The clinical response and adverse events (AEs) were recorded and evaluated. A multivariate logistic regression model was established to confirm the predictors for AEs. The AEs were reported in 75 children (13.8%). The serum-specific IgE (s-IgE) level was significantly correlated with the occurrence of AEs by multivariate logistic regression analysis. Our receiver operating characteristic (ROC) analysis of the serum s-IgE levels >21.6 IU/mL had the best sensitivity (83.7%) and specificity (76.7%) to predict safety. The serum s-IgE level was significantly correlated with safety of SLIT in children, which may be helpful for patient selection before SLIT.

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