Prognostic factors for mortality in malignant pleural effusion: Is it possible to predict survival?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21638-e21638
Author(s):  
Fernando Abrao ◽  
Mariana Campello de Oliveira ◽  
Geisa Garcia ◽  
Igor Abreu ◽  
Renata D'Alpino D'Alpino ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Pulmonary Infiltrate ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Factors Affecting ◽  
Group I

e21638 Background: The aim of this study was to identify predictors of overall survival (OS) following palliative pleural procedures in patients with malignant pleural effusion (MPE). Methods: Data was collected from our database between January 2012 and December 2016 including all patients with MPE. All patients were followed-up for at least 30 days after the pleural procedure. We evaluated radiological aspects, biochemical and hematologic parameters as well as clinical features. For OS analysis, patients were divided into two groups. Group I included OS < 30 days and Group II included OS > 30 days. Prognostic factors for OS were identified by univariate analysis, using Fisher's exact for the categorical variables and Student's t-test for the quantitative ones. The cutoff points for any significant continuous variables were determined by the ROC curve. Subsequently, significant variables were entered into a multivariate logistic regression analysis ( p < 0.05). Results: A total of 238 patients were included in the analysis (37,6% males). Median age was 62 year-old (range 24-965) and median follow-up time for surviving patients was 127 days. Median OS was 83 days for therapeutic pleural aspiration (TPA), 353 days for pleurodesis, 135 days for VAT drainages without pleurodesis due to trapped lung and 39 days for indwelling pleural catheter. Regarding primary site, median OS was 170 days for lung (n = 91), 253 days for breast (n = 70), 90 days for gynecological (n = 18), 33 for gastrointestinal (n = 34) and 305 days for others (n = 26). Factors affecting OS in univariate analysis with p < 0.0001 were ECOG, procedure, protein, albumin, neutrophil to lymphocyte ratio(NLR) and hemoglobin, pulmonary infiltrate (p < 0.0438), hematocrit (p < 0.0002), and chemotherapy line (p < 0.0229). In multivariate analysis the following variables were identified as independent prognostic factor: ECOG 3/4 (p < 0.0095), pulmonary infiltrate (p < 0.0011), albumin < 2.5 (p < 0.0325), and hematocrit < 35 (p < 0.0055). Conclusions: Patients with MPE who presented with ECOG 3/4, pulmonary infiltrate, albumin < 2.5 and hematocrit < 35 had shorter OS. The identification of these prognostic factors may assist physicians in choosing the optimal palliative technique.

Prognostic factors of mortality and recurrence of malignant pleural effusion in high-risk tumors according to the LENT Score.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21666-e21666
Author(s):  
Fernando Abrao ◽  
Mariana Campello de Oliveira ◽  
Igor Abreu ◽  
Geisa Garcia ◽  
Renata D'Alpino D'Alpino ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
First Line ◽  
Primary Tumors ◽  
Factors Affecting ◽  
Group I

e21666 Background: The aim of this study was to identify predictors of overall survival (OS) and recurrence after palliative pleural procedures in patients with malignant pleural effusion (MPE) and high-risk tumors according to the LENT Score. Methods: Data was collected from our database between January 2013 and December 2015 of patients with MPE and high-risk tumors according to the LENT Score. All patients were followed-up for at least 30 days after the pleural procedure. We evaluated radiological aspects, biochemical and hematologic parameters as well as clinical features. For OS analysis, patients were divided into two groups. Group I included OS < 30 days and group II included OS > 30 days. Prognostic factors for pleural recurrence and OS were identified by univariate analysis, using Fisher's exact and Student's t-test. Subsequently, significant variables were entered into a multivariate logistic regression analysis ( p < 0.05). Results: A total of 134 patients were included. Median follow-up time for surviving patients was 56 (range: 2-623) days. High-risk primary tumors included lung (66.4%), gastrointestinal (24.6%) , sarcoma (3.7%), urologic (3.7%) and others (1.5%). Forty-four patients in Group I had OS < 30 days while 22 patients had MPE recurrence. Factors affecting OS in univariate analysis were: type of procedure, ECOG, albumin, leukocytes, neutrophil to lymphocyte ratio( NRL) and hemoglobin. Factors affecting recurrence were: type of procedure, chemotherapy line (CT), albumin and platelets. In multivariate analysis for Group I, type of procedure (therapeutic pleural aspiration – TPA) ( p= 0.011), ECOG 3/4 ( p= 0.004), NLR > 5 ( p= 0.037) and leukocytes > 8000 ( p= 0.042) were identified as independent predictors of OS. In terms of recurrence, only CT beyond first line ( p = 0.042) was identified as an independent prognostic factor. Conclusions: Patients with MPE who underwent TPA, had ECOG 3/4, leukocytes > 8000, and NLR > 5 were significantly associated with shorter OS,. CT beyond first line was associated with recurrence. The identification of these prognostic factors may assist physicians in choosing the optimal palliative technique.

scholarly journals Post operative acute kidney injury in abdominal Surgeries – A retrospective analysis of single center in western India

2021 ◽  
Author(s):  
Bhavin Vasavada ◽  
Hardik Patel
Keyword(s):  
Acute Kidney Injury ◽  
Operative Time ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
T Test ◽  
Categorical Variables ◽  
Western India ◽  
Continuous Variables

ABSTRACTAIMThe aim of our study was to evaluate the incidence and causative factors for acute kidney injury in abdominal surgeries.Material and MethodsAll the abdominal surgeries performed between April 2018 to December 2020, in our institution have been analyzed for acute kidney injury. Acute kidney injury defined according to acute kidney injury network classification. Categorical variables were evaluated by chi-square t-test or fisher’s t-test wherever appropriate and continuous variables by Mann Whitney U test for nonparametric data and student t-test for parametric test after skewness and kurtosis analysis. Statistical analysis was done using SPSS version 23. P< 0.05 was considered statistically significant.ResultsWe performed 402 gastrointestinal and hepatobiliary surgery from April 2018 to December 2020. After exclusion 372 patients were included in the study population. 20 patients (5.37%) were defined as having acute kidney injury according to acute kidney injury network classifications. On univariate analysis acute kidney injury was associated with open surgery (p= 0.003), Intraoperative hypotension (p<0.001), Colorectal surgeries (p<0.0001), Emergency surgery (p=0.028), CDC grade of surgery (p<0.001), increased used to blood products (p=0.001), higher ASA grade (p<0.0001), increased operative time(p<0.0001). On multivariate logistic regression analysis higher ASA grade (p<0.0001) and increased operative time (0.049) independently predicted acute kidney injury. Acute kidney injury was also significantly associated with 90 days mortality. (p= <0.0001).ConclusionPost-operative acute kidney injury was associated with significant mortality in abdominal surgery. Higher ASA grades and increased operative time predicted acute kidney injury.

PROGNOSTIC FACTORS OF 30-DAY MORTALITY AND RECURRENCE OF MALIGNANT PLEURAL EFFUSION IN HIGH-RISK TUMORS ACCORDING TO THE LENT SCORE STUDY

CHEST Journal ◽  
2018 ◽  
Vol 154 (4) ◽  
pp. 623A
Author(s):  
MARIANA CAMPELLO DE OLIVEIRA ◽  
FERNANDO ABRAO ◽  
GEISA VIANA ◽  
IGOR RENATO LOURO BRUNO DE ABREU ◽  
ANTONIO FLÁVIO BINA BIAZZOTTO
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Score Study

scholarly journals Antiretroviral Resistance and Pregnancy Characteristics of Women with Perinatal and Nonperinatal HIV Infection

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Gweneth B. Lazenby ◽  
Okeoma Mmeje ◽  
Barbra M. Fisher ◽  
Adriana Weinberg ◽  
Erika K. Aaron ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Hiv Infection ◽  
Univariate Analysis ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Resistance Mutations ◽  
Hiv Drug Resistance ◽  
Fourfold Increase ◽  
Perinatal Hiv ◽  
Adverse Pregnancy

Objective. To compare HIV drug resistance in pregnant women with perinatal HIV (PHIV) and those with nonperinatal HIV (NPHIV) infection.Methods. We conducted a multisite cohort study of PHIV and NPHIV women from 2000 to 2014. Sample size was calculated to identify a fourfold increase in antiretroviral (ARV) drug resistance in PHIV women. Continuous variables were compared using Student’st-test and Wilcoxon rank-sum tests. Categorical variables were compared usingχ2and Fisher’s exact tests. Univariate analysis was used to determine factors associated with antiretroviral drug resistance.Results. Forty-one PHIV and 41 NPHIV participants were included. Women with PHIV were more likely to have drug resistance than those with NPHIV ((55% versus 17%,p=0.03), OR 6.0 (95% CI 1.0–34.8),p=0.05), including multiclass resistance (15% versus 0,p=0.03), and they were more likely to receive nonstandard ARVs during pregnancy (27% versus 5%,p=0.01). PHIV and NPHIV women had similar rates of preterm birth (11% versus 28%,p=0.08) and cesarean delivery (47% versus 46%,p=0.9). Two infants born to a single NPHIV woman acquired HIV infection.Conclusions. PHIV women have a high frequency of HIV drug resistance mutations, leading to nonstandard ARVs use during pregnancy. Despite nonstandard ARV use during pregnancy, PHIV women did not experience increased rates of adverse pregnancy outcomes.

scholarly journals Non-Prescription Antibiotic Use For People Aged 15 Years Or Older For Cough In China: A Community-Based Survey

2021 ◽  
Author(s):  
Yan Luo ◽  
Xuewen Tang ◽  
Lingling Ding ◽  
Zhujun Shao ◽  
Jianxing Yu ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Univariate Analysis ◽  
Antibiotic Use ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Main Driver ◽  
Antibiotics Use ◽  
Chi Square Test ◽  
Use Behavior

Abstract Background Non-prescription antibiotic use at community is a main driver of antimicrobial resistance. Cough is a common condition and prevalent in all communities, including China. This study aims to investigate the non-prescription antibiotic use for cough in China and explore to which extent antibiotic use knowledge was correctly instructed in communities.Methods A probability-proportionate-to-size (PPS) sampling method was adopted to survey from all 14 communities in Yiwu city, China. All participants were investigated by face-to-face interview on Portable Android Devices (PADs). The continuous variables were presented by mean and standard deviation (SD) or medium and inter-quartile range (IQR). The categorical variables were presented using percentage or constituent ratio. Chi-square test for univariate analysis and logistic regression for multivariate analysis were conducted to assess the odds ratios (ORs) and 95% confidence intervals (CIs), respectively.Results A total of 3034 respondents across the 14 communities and the 50 natural villages/streets completed all key items of the questionnaire. Of 2400 (79.10%) respondents stated that they experienced cough in the past 12 months with the medium age of 36.5 (IQR: 26-49) and 12.21% (293/2400) respondents had the non-prescription antibiotic use behavior. Among those 293 respondents, the proportion of non-prescription antibiotic use for cough peaked at around 16% among people aged 30-39 years old. The major sources of antibiotics were pharmacy (77.70%) and/or family storage (43.92%). As for antibiotic knowledge in 3034 participants, 61.8% participants had minimal knowledge on broad-spectrum antibiotic and 53.76% were not familiar about the effects of joint use.Conclusions Non-prescription antibiotics use for cough is prevalent in the community, especially among people in their thirties. Strengthened drug purchase regulation and well-trained professional pharmacists would be promising alternatives to ameliorate AMR. Moreover, penetrating antibiotics knowledge to common citizens and is an urgent task to alleviate antimicrobial resistance. Therefore, proactive policies and regulations should be made to improve current situations.

scholarly journals Factors Influencing Utilization of Physiotherapy Service among Children with Cerebral Palsy in Jalandhar District of Punjab

2017 ◽  
Vol 08 (02) ◽  
pp. 209-215 ◽  
Author(s):  
Akhoury Gourang Sinha ◽  
Raju Sharma
Keyword(s):  
Cerebral Palsy ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Life Time ◽  
Sociodemographic Factors ◽  
Chi Square ◽  
Factors Affecting ◽  
Physiotherapy Service ◽  
Children With Cerebral Palsy ◽  
Age Of Diagnosis

ABSTRACTBackground: Physiotherapy plays a central role in the management of children with cerebral palsy (CP); however, literature describing the use of physiotherapy service and the factors affecting utilization of physiotherapy service for this group of children in the Indian context remain unexplored. Aims and Objectives: To describe the utilization of physiotherapy services and explore the factors affecting utilization of physiotherapy services among children with CP of Jalandhar district of Punjab. Methodology: During June 2009 to March 2012 interview of family members of 248 children with CP (male = 159; female = 89) was conducted using a schedule focusing on demography, constraints of resources, expectations, beliefs, awareness, and service utilization. Cross tabulation with Chi-square, univariate, and multivariate logistic regression analysis were the tools of statistical analysis. Results: 44.4% children had not received any physiotherapy in their life time. In univariate analysis exposure to physiotherapy was found significantly associated with age of diagnosis (odds ratio [OR] = 2.47), finance constraint (OR = 2.27), personal constraint (OR = 2.54), transportation constraint (OR = 3.01), lack of advice for rehabilitation (OR = 2.36), ignorance about condition (OR = 11.94), and rehabilitation services (OR = 2.88). Multivariate model (χ2 = 57.16, df = 15, P < 0.001, pseudo R2 Cox and Snell = 0.22, Nagelkerke = 0.27) identified two main predictor variables of nonexposure to physiotherapy-ignorance about condition (OR = 7.3) and expectation of normalcy (OR = 0.43). Conclusion: The main drivers for the use of physiotherapy among children with CP in Jalandhar district of Punjab were awareness about the condition of CP and expectation of normalcy which demonstrated a complex relationship with sociodemographic factors.

Malignant Pleural Effusion: Prognostic Factors for Survival and Response to Chemical Pleurodesis in a Series of 120 Cases

Respiration ◽  
1998 ◽  
Vol 65 (2) ◽  
pp. 108-113 ◽  
Author(s):  
Eva Martínez-Moragón ◽  
Jorge Aparicio ◽  
José Sanchis ◽  
Rosario Menéndez ◽  
M. Cruz Rogado ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Chemical Pleurodesis

scholarly journals Tuberculum sellae meningiomas: A series of 41 cases; surgical and ophthalmological outcomes with proposal of a new prognostic scoring system

2012 ◽  
Vol 03 (03) ◽  
pp. 286-293 ◽  
Author(s):  
Arun Palani ◽  
Manas K Panigrahi ◽  
Anirudh K Purohit
Keyword(s):  
Prognostic Factors ◽  
Scoring System ◽  
Visual Outcome ◽  
Categorical Variables ◽  
P Value ◽  
Visual Recovery ◽  
Chi Square ◽  
Factors Affecting ◽  
Chi Square Test ◽  
Tuberculum Sellae

ABSTRACT Context: Tuberculum sellae meningiomas have proved difficult to treat, partly because of their intimate association with the optic nerves and chiasma, hypothalamus, and internal carotid arteries. Aims: The aim of this study is to analyze the degree of influence of various prognostic factors affecting visual outcome; the pattern of visual recovery and develop a scoring system for prognostication. Settings and Design: This is a retrospective study carried out from January 2004 till June 2011. Materials and Methods: Patients were analyzed on the basis of clinical, radiological, and surgical factors that appeared to affect the outcome. A special scoring system (according to the guidelines of the German Ophthalmological Society) was adopted to quantify the extent of ophthalmological disturbances. Statistical Analysis Used: Comparison of categorical variables between the two was performed using chi-square test and a P value of ≤ 0.05 was considered significant. Logistic regression was used when multivariate analysis was required. Results: Vision improved in 27% and deteriorated in 7.3%. A prognostic scoring system (score 4–13) was developed depending on the degree of influence of significant prognostic factors. The patients with a score of ≤6 had improved vision postoperatively (44%), whereas none of those with a score > 6 improved. Completeness of visual recovery was perceived in 100% of patients within 3 months. Complete resectability was achieved in 73% of patients. Conclusions: The proposed scoring system is very useful in prognosticating the visual outcome of these patients. The patients with a score of ≤6 have the best visual outcome postoperatively. Complete resectability is better achieved with extended bifrontal and unilateral frontal approaches. Short-term postoperative visual outcome is a strong indicator of permanent visual outcome after surgery.

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