scholarly journals Correlation analysis between preoperative systemic immune inflammation index and prognosis of patients after radical gastric cancer surgery: based on propensity score matching method

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Xu Zhaojun ◽  
Chen Xiaobin ◽  
An Juan ◽  
Yuan Jiaqi ◽  
Jiang Shuyun ◽  
...  
Keyword(s):  
Overall Survival ◽  
Risk Factor ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Roc Curve ◽  
Independent Risk Factor ◽  
Gastrointestinal Surgery ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Immune Inflammation

Abstract Background To explore the correlation between the preoperative systemic immune inflammation index (SII) and the prognosis of patients with gastric carcinoma (GC). Methods The clinical data of 771 GC patients surgically treated in the Department of Gastrointestinal Surgery, Qinghai University Affiliated Hospital from June 2010 to June 2015 were retrospectively analyzed, and their preoperative SII was calculated. The optimal cut-off value of preoperative SII was determined using the receiver operating characteristic (ROC) curve, the confounding factors between the two groups were eliminated using the propensity score matching (PSM) method, and the correlation between preoperative SII and clinicopathological characteristics was assessed by chi-square test. Moreover, the overall survival was calculated using Kaplan-Meier method, the survival curve was plotted, and log-rank test was performed for the significance analysis between the curves. Univariate and multivariate analyses were also conducted using the Cox proportional hazards model. Results It was determined by the ROC curve that the optimal cut-off value of preoperative SII was 489.52, based on which 771 GC patients were divided into high SII (H-SII) group and low SII (L-SII) group, followed by PSM in the two groups. The results of Kaplan-Meier analysis showed that before and after PSM, the postoperative 1-, 3-, and 5-year survival rates in L-SII group were superior to those in H-SII group, and the overall survival rate had a statistically significant difference between the two groups (P < 0.05). Before PSM, preoperative SII [hazard ratio (HR) = 2.707, 95% confidence interval (CI) 2.074-3.533, P < 0.001] was an independent risk factor for the prognosis of GC patients. After 1:1 PSM, preoperative SII (HR = 2.669, 95%CI 1.881–3.788, P < 0.001) was still an independent risk factor for the prognosis of GC patients. Conclusions Preoperative SII is an independent risk factor for the prognosis of GC patients. The increase in preoperative SII in peripheral blood indicates a worse prognosis.

scholarly journals Correlation Analysis Between Preoperative Systemic Immune Inflammation Index and Prognosis of Gastric Carcinoma Patients: Based on Propensity Score Matching Method

2021 ◽  
Author(s):  
Zhaojun Xu ◽  
Xiaobin Chen ◽  
Juan An ◽  
Jiaqi Yuan ◽  
Shuyun Jiang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Risk Factor ◽  
Propensity Score ◽  
Gastric Carcinoma ◽  
Propensity Score Matching ◽  
Roc Curve ◽  
Independent Risk Factor ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Immune Inflammation

Abstract Background: To explore the correlation between the preoperative systemic immune inflammation index (SII) and the prognosis of patients with gastric carcinoma (GC).Methods: The clinical data of 771 GC patients surgically treated in the Department of Gastrointestinal Surgery, Qinghai University Affiliated Hospital from June 2010 to June 2015 were retrospectively analyzed, and their preoperative SII was calculated. The optimal cut-off value of preoperative SII was determined using the receiver operating characteristic (ROC) curve, the confounding factors between the two groups were eliminated using the propensity score matching (PSM) method, and the correlation between preoperative SII and clinicopathological characteristics was assessed by chi-square test. Moreover, the overall survival was calculated using Kaplan-Meier method, the survival curve was plotted, and log-rank test was performed for the significance analysis between the curves. Univariate and multivariate analyses were also conducted using the Cox proportional hazards model.Results: It was determined by the ROC curve that the optimal cut-off value of preoperative SII was 489.52, based on which 771 GC patients were divided into high SII (H-SII) group and low SII (L-SII) group, followed by PSM in the two groups. The results of Kaplan-Meier analysis showed that before and after PSM, the postoperative 1-, 3- and 5-year survival rates in L-SII group were superior to those in H-SII group, and the overall survival rate had a statistically significant difference between the two groups (P<0.05). Before PSM, preoperative SII [hazard ratio (HR) =2.707, 95% confidence interval (CI): 2.074-3.533, P<0.001] was an independent risk factor for the prognosis of GC patients. After 1:1 PSM, preoperative SII (HR=2.669, 95%CI: 1.881-3.788, P<0.001) was still an independent risk factor for the prognosis of GC patients.Conclusions: Preoperative SII is an independent risk factor for the prognosis of GC patients. The increase in preoperative SII in peripheral blood indicates a worse prognosis.

scholarly journals The right atrial diameter as a risk factor predicting recurrence of atrial fibrillation after catheter ablation at mid-term follow-up

2020 ◽  
Author(s):  
Wang Xiaofei ◽  
Wang Wenli ◽  
Zou Cao
Keyword(s):  
Risk Factor ◽  
Independent Risk Factor ◽  
Cox Regression ◽  
Survival Curve ◽  
Right Atrial ◽  
Cutoff Value ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Meier Survival Curve

Abstract Background Left atrial diameter (LAD) has been confirmed to predict recurrence of atrial fibrillation (AF) after catheter ablation (CA). The influence of right atrium (RA) size on the prognosis after CA was relatively unclear and lack of research. The objective of the present study was to investigate the relationship between right atrial diameter (RAD) and the mid-term outcome of AF after CA. Methods This study retrospectively examined 121 patients who underwent initial CA for symptomatic AF. Cox regression model was used to find risk factors of recurrence. Receiver operating characteristic (ROC) curve was used to evaluate predictive power and determine clinic cutoff value. Kaplan-Meier survival curve and log-rank test were used to analyze success rate. Results There were 94 (77.7%) patients of freedom from AF after 24.2 ± 4.5 months’ follow-up. Multivariate Cox regression analysis showed both hypertension and RAD were independent risk factors of arrhythmia recurrence after ablation regardless of AF type (HR: 4.915; 95% CI: 1.370-17.635; P = 0.015 and HR: 1.059; 95% CI: 1.001–1.120; P = 0.045, respectively). However, in patients with paroxysmal AF (par-AF), Multivariate analysis showed RAD become the only independent risk factor (HR: 1.031; 95% CI: 1.016–1.340; P = 0.029). ROC curve demonstrated the cutoff value of RAD was 35.5 mm with an area under the curve (AUC) of 0.715 (95% CI: 0.586–0.843, P = 0.009), sensitivity of 81.3% and specificity of 54.2%. Kaplan-Meier survival curve showed significant difference of freedom from par-AF (67.5 vs. 91.4%, log-rank, P = 0.015) between patients with RAD ≥ 35.5 mm and < 35.5 mm in this subgroup. Nevertheless, in patients with persistent AF (per-AF), no risk factor of arrhythmia recurrence was found. In addition, Kaplan-Meier survival curve showed no significant difference of freedom from per-AF (69.7 vs. 87.5%, log-rank, P = 0.31) between patients with RAD ≥ 35.5 mm and < 35.5 mm. Conclusions RAD was the independent risk factor predicting recurrence of AF after CA only in patients with par-AF. In patients with RAD < 35.5 mm, there was a significantly higher freedom from par-AF recurrence compared with RAD ≥ 35.5 mm after a mid-term follow-up.

scholarly journals Presepsin as a predictor of severe sepsis in urinary tract infection

2021 ◽  
Author(s):  
Yoshitaka Sekine ◽  
Kazuhiko Kotani ◽  
Daisuke Oka ◽  
Hiroshi Nakayama ◽  
Yoshiyuki Miyazawa ◽  
...  
Keyword(s):  
Septic Shock ◽  
Risk Factor ◽  
Severe Sepsis ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Roc Curve ◽  
Independent Risk Factor ◽  
Good Marker ◽  
Significant Difference ◽  
Tract Infections

Abstract Background Recently, presepsin is reported to be a biomarker for early diagnosis of sepsis and evaluation of prognosis in septic patients, but there are few reports about urinary-tract infections. The objective of this study is to evaluate whether presepsin is a recent marker for detecting severe sepsis, and whether it can predict the therapeutic course in UTI when compared with procalcitonin (PCT) and C-reactive protein (CRP), already used markers.Methods From April 2014 to December 2016, a total of 50 patients, who were admitted into Gunma university hospital with urinary-tract infections, were enrolled in this study. Vital signs, presepsin, PCT, CRP, white blood cell (WBC), causative diseases of urinary-tract infections and other data were evaluated at the enrollment, third and fifth days. The patients were divided into two groups; with (n=11) or without (n=39) septic shock at the enrollment day, and with (n=7) or without (n=43) sepsis at the fifth day, respectively. Presepsin was evaluated for systemic inflammatory response syndrome (SIRS) or septic shock. Results Concerning the enrollment day, there was no significant difference of presepsin between SIRS and non-SIRS groups (p=0.276). The median presepsin (pg/mL) was significantly higher in the septic shock group (p<0.001). Multivariate logistic regression analysis showed presepsin (≧ 500 pg/ml) was an independent risk factor associated with septic shock (p=0.007). ROC curve for diagnosing septic shock indicated an area under the curve (AUC) at 0.881 for presepsin (vs. 0.690, 0.583 and 0.527 for PCT, CRP and WBC, respectively). Concerning the 5th day after admission, the median presepsin of the enrollment day was significantly higher in SIRS groups than non-SIRS groups (p=0.006). On the other hand, PCT (≥ 2 ng/ml) of the enrollment day was an independent risk factor associated with SIRS. ROC curve for diagnosing sepsis at the fifth day indicated an AUC at 0.837 for PCT (vs. 0.817, 0.811 and 0.802 for presepsin, CRP and WBC, respectively).Conclusions This study shows that presepsin may be a good marker for diagnosis of severe patients who need vasopressor therapy at the data of admission, and PCT may be a good marker for predicting hard-to-treat cases in UTI.

scholarly journals Effectiveness of Teicoplanin Versus β-lactam for Bacteremia Due to Methicillin-Susceptible Staphylococcus Aureus: A Propensity Score-Based Study

2020 ◽  
Author(s):  
Chen-Hsiang Lee ◽  
Ching-Yen Tsai ◽  
I-Ling Chen
Keyword(s):  
Staphylococcus Aureus ◽  
Risk Factor ◽  
Treatment Group ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Clinical Outcomes ◽  
Significant Risk ◽  
Outcome Analysis ◽  
Significant Difference ◽  
Before And After

Abstract Background: Many studies have shown that vancomycin is inferior to β-lactam antibiotics in terms of effectiveness in the treatment of methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia. However, limited data are available regarding the comparison of clinical outcomes between patients receiving initial teicoplanin and those receiving β-lactam antibiotics for MSSA bacteremia.Methods: Eighty-four adults with MSSA bacteremia were included: initial teicoplanin treatment group (n=28) and β-lactam treatment group (n=56). The two groups were further stratified based on propensity score matching according to the outcome analysis using a logistic regression model. We investigated the clinical outcomes between the groups before and after propensity score matching after treatment completion.Results: Pittsburgh bacteremia score ≥4 (odds ratio, 60.6; 95%CI, 7.4–496.8) was an independent risk factor for unfavorable outcome. After propensity score matching, the initial teicoplanin treatment group and the β-lactam treatment group consisted of 28 patients each. No statistically significant differences were observed in the proportions of patients with favorable outcomes and 30-day overall mortality rates between the groups before and after propensity score matching after the completion of teicoplanin or β-lactam treatment. The Kaplan-Meier 30-day survival curve also showed no significant difference between the patients receiving initial teicoplanin treatment and those receiving β-lactam treatment before and after matching (hazard ratio, 1.84, 95%CI, 0.60–5.64; and 3.12, 95%CI, 0.98–9.99, respectively).Conclusions: There were no significant difference in clinical outcomes between initial teicoplanin treatment and β-lactam treatment among patients with MSSA bacteremia. Pittsburgh bacteremia score ≥4 was a significant risk factor for mortality.

scholarly journals Presepsin as a predictor of septic shock in patients with urinary tract infection

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoshitaka Sekine ◽  
Kazuhiko Kotani ◽  
Daisuke Oka ◽  
Hiroshi Nakayama ◽  
Yoshiyuki Miyazawa ◽  
...  
Keyword(s):  
Septic Shock ◽  
Risk Factor ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Roc Curve ◽  
Independent Risk Factor ◽  
Multivariate Logistic Regression Analysis ◽  
University Hospital ◽  
Significant Difference ◽  
Tract Infections

Abstract Background Recently, presepsin has been reported to be a useful biomarker for early diagnosis of sepsis and evaluation of prognosis in septic patients. However, few reports have evaluated its usefulness in patients with urinary tract infections (UTI). This study aimed to evaluate whether presepsin could be a valuable marker for detecting severe sepsis, and whether it could predict the therapeutic course in patients with UTI compared with markers already used: procalcitonin (PCT) and C-reactive protein (CRP). Methods From April 2014 to December 2016, a total of 50 patients with urinary tract infections admitted to Gunma university hospital were enrolled in this study. Vital signs, presepsin, PCT, CRP, white blood cell (WBC) count, causative agents of urinary-tract infections, and other data were evaluated on the enrollment, third, and fifth days. The patients were divided into two groups: with (n = 11) or without (n = 39) septic shock on the enrollment day, and with (n = 7) or without (n = 43) sepsis on the fifth day, respectively. Presepsin was evaluated as a biomarker for systemic inflammatory response syndrome (SIRS) or septic shock. Results Regarding the enrollment day, there was no significant difference of presepsin between the SIRS and non-SIRS groups (p = 0.276). The median value of presepsin (pg/mL) was significantly higher in the septic shock group (p < 0.001). Multivariate logistic regression analysis showed that presepsin (≥ 500 pg/ml) was an independent risk factor for septic shock (p = 0.007). ROC curve for diagnosing septic shock indicated an area under the curve (AUC) of 0.881 for presepsin (vs. 0.690, 0.583, and 0.527 for PCT, CRP and WBC, respectively). Regarding the 5th day after admission, the median presepsin value on the enrollment day was significantly higher in the SIRS groups than in the non-SIRS groups (p = 0.006). On the other hand, PCT (≥ 2 ng/ml) on the enrollment day was an independent risk factor for SIRS. ROC curve for diagnosing sepsis on the fifth day indicated an AUC of 0.837 for PCT (vs. 0.817, 0.811, and 0.802 for presepsin, CRP, and WBC, respectively). Conclusions This study showed that presepsin may be a good marker for diagnosing septic shock based on admission data in patients with UTI.

scholarly journals Radical Nephrectomy Provides a Worse Prognosis Than Partial Nephrectomy in T3aN0M0 Renal Cancer of Small (≤4 cm) Size and No Invasion of Perisinus Fat

2020 ◽  
Author(s):  
Shiliang Liu ◽  
Zhixian Wang ◽  
Chang Liu
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Partial Nephrectomy ◽  
Tumor Size ◽  
Radical Nephrectomy ◽  
Risk Of Death ◽  
Recommended Treatment ◽  
Risk Of Mortality ◽  
Significant Difference

Abstract Background: Radical nephrectomy (RN) is the recommended treatment for T3aN0M0 renal cell carcinoma (RCC). However, it is not necessarily the best treatment for small T3aN0M0 RCCs. We evaluated the effect of tumor size combined with consideration of anatomic types of extrarenal-fat invasion on the surgical decision-making between partial nephrectomy (PN) vs. RN in T3aN0M0 RCC.Methods: Data were obtained from the Surveillance, Epidemiology, and End Results database (2004 to 2015) with 6125 patients suffering from T3aN0M0 RCC. Cox and Fine and Gray models were used for survival analyses. Propensity-score matching was used for PN vs. RN.Results: A larger T3aN0M0 RCC was associated with higher risk of mortality (hazard ratio (HR)all-cause mortality: 1.07, 95% confidence interval (CI): 1.02–1.13, P = 0.011; HRRCC-cause mortality: 1.13, 95%CI: 1.06–1.21, P < 0.001) compared with a small T3aN0M0 RCC. After propensity-score matching, in T3aN0M0 ≤4 cm, RN compared with PN significantly increased the risk of death (HR: 1.77; 95%CI: 1.14–2.74, P = 0.011) and offered no significant difference in RCC-specific survival (HR: 1.57, 95%CI: 0.74–3.36, P = 0.240). However, RN and PN showed no significant difference in overall survival in T3aN0M0 RCC >4 cm (HR: 0.98; 95%CI: 0.59–1.62, P= 0.929) or in T3aN0M0 RCC with sinus/perisinus-fat invasion (HR: 1.18; 95%CI: 0.61–2.27, P = 0.631).Conclusion: PN provided better overall survival compared with RN for small (≤4 cm) T3aN0M0 RCCs without sinus/perisinus-fat invasion. Focusing only on anatomic-invasion characteristics rather than type and tumor size is not sufficient for treatment decisions in T3aN0M0 RCC.

scholarly journals P1174STUDY ON THE RELATIONSHIP BETWEEN HYPOCHLOREMIA AND ALL-CAUSE DEATH IN PATIENTS RECEIVING CONTINUOUS AMBULATORY PERITONEAL DIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Tao Xu ◽  
Niansong Wang ◽  
Cheng Qiao
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Roc Curve ◽  
Independent Risk Factor ◽  
Chloride Level ◽  
Kaplan Meier ◽  
Serum Chloride ◽  
The Relationship

Abstract Background and Aims To investigate the relationship between hypochloremia on all-cause death in patients receiving continuous ambulatory peritoneal dialysis (CAPD). Method 300 CAPD patients from January 2013 to December 2019 in the Sixth People's Hospital affiliated to Shanghai Jiaotong University. According to the serum chloride level, the patients were divided into two groups: hypochloremia group (serum chlorine ≤ 96mmol / L, n = 135) and normal chloride group (106mmol / L &lt; serum chlorine &gt; 96mmol / L, n = 165). The endpoint was all-cause death. We used the receiver-operating characteristic (ROC) curve to analysis the diagnostic value and logistic regression to assess the predictive value in relation to serum chloride with all-cause death in CAPD patients. Kaplan Meier curve was used to evaluate the effect of serum chloride on all-cause death survival analysis. All statistics were analyzed by SPSS 20.0 software, P &lt; 0.05, indicating significant difference. Results 114 cases of all-cause death occurred in CAPD patients during follow-up (62.1 ± 11.1 months). The results of correlation analysis showed that serum chloride was positively correlated with serum sodium and potassium (r=0.721,0.199, P=0.001) and the negative correlation between serum chloride and dialysis age and serum phosphorus (r=-0.321, - 0.300, P=0.001). ROC curve analysis showed that serum chloride was statistically significant in predicting all-cause death in CAPD patients (AUC = 0.666, 95% Cl = 0.601-0.730, sensitivity / specificity = 64.6% / 59.8%, best threshold = 95.5mmol/l). Kaplan Meier analysis of all-cause death risk curve shows that the incidence of all-cause death in the low chloride group is higher than that in the normal serum chloride group. Logistic regression analysis showed that low chloride level was an independent risk factor for all-cause death in CAPD patients. Conclusion Hypochloremia is an independent risk factor for all-cause death in CAPD patients.

Surgical resection of the primary lesion for osteosarcoma patients with metastasis at initial diagnosis

2020 ◽  
Author(s):  
Liuzhe Zhang ◽  
Toru Akiyama ◽  
Takashi Fukushima ◽  
Shintaro Iwata ◽  
Katsushi Takeshita ◽  
...  
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Confidence Interval ◽  
Propensity Score Matching ◽  
Surgical Resection ◽  
Primary Lesion ◽  
Rank Test ◽  
Factors Affecting ◽  
Kaplan Meier ◽  
Unresectable Metastasis

Abstract Background Approximately 10–20% of osteosarcoma patients present with metastasis on diagnosis. Completely resecting the lesion is associated with better prognosis. However, evidence regarding optimal surgical strategies for patients with unresectable metastasis is limited. Methods This retrospective analysis was based on the Japanese Nationwide Bone and Soft Tissue Tumor registry. In total, 335 patients diagnosed with osteosarcoma with metastasis were included. Factors affecting overall survival were identified using multivariate analysis. Kaplan–Meier method was used to compare the overall survival by the status of surgical intervention. Two hundred and four patients who did not undergo surgery for metastasis were divided into two groups, depending on whether they underwent surgery for the primary lesion. The background differences between these two groups were adjusted with propensity score matching, with 43 patients per group. The overall survival was calculated using the Kaplan–Meier method and compared with a log-rank test. Results Factors positively impacting overall survival were age &lt;40, female sex, extremity origin, surgery for the primary lesions, surgery for metastasis and radiotherapy without surgery. For patients with unresectable metastasis, after propensity score matching, the survival rate was higher in the group that underwent primary lesion surgery than the group without surgery. Their median survival was 19 (95% confidence interval: 11.7–26.3) and 11 months (95% confidence interval: 4.5–17.5) (P = 0.02), respectively. Conclusions Surgical resection of the primary osteosarcoma lesion did not worsen prognosis, even in patients with unresectable metastasis. Further study is needed to identify which patient group will benefit from primary lesion resection.

scholarly journals Direct versus indirect bypasses for adult ischemic-type moyamoya disease: a propensity score–matched analysis

2018 ◽  
Vol 128 (6) ◽  
pp. 1785-1791 ◽  
Author(s):  
Xiaofeng Deng ◽  
Faliang Gao ◽  
Dong Zhang ◽  
Yan Zhang ◽  
Rong Wang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Moyamoya Disease ◽  
Recurrent Stroke ◽  
Neurological Status ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Surgical Modality ◽  
Direct Bypass

OBJECTIVEThe optimal surgical modality for moyamoya disease (MMD) remains unclear. The aim of this study was to compare the surgical effects of direct bypass (DB) and indirect bypass (IB) in the treatment of adult ischemic-type MMD.METHODSAdult patients with ischemic-type MMD who underwent either DB or IB from 2009 to 2015 were identified retrospectively from a prospective database. Patients lost to follow-up or with a follow-up period less than 12 months were excluded. Recurrent stroke events and modified Rankin Scale (mRS) scores at the last follow-up were compared between the 2 surgical groups after 1:1 propensity score matching.RESULTSA total of 220 patients were considered, including 143 patients who underwent DB and 77 patients who underwent IB. After propensity score matching, 70 pairs were obtained. The median follow-up period was 40.5 months (range 14–75 months) in the DB group and 31.5 months (range 14–71 months) in the IB group (p = 0.004). Kaplan-Meier analysis showed that patients who received DB had a longer stroke-free time (mean 72.1 months) compared with patients who received IB (mean 61.0 months) (p = 0.045). Good neurological status (mRS score ≤ 2) was achieved in 64 patients in the DB group (91.4%) and 66 patients in the IB group (94.3%), but there was no significant difference (p = 0.512).CONCLUSIONSAlthough neurological function outcome was not determined by the surgical modality, DB is more effective in preventing recurrent ischemic strokes than IB for adult ischemic-type MMD.

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