Development and validation of a new clinical prediction model of catheter-related thrombosis in cancer patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14031-e14031
Author(s):  
Binliang Liu ◽  
Junying Xie ◽  
Xiaoying Sun ◽  
Yanfeng Wang ◽  
Zhong Yuan ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Prediction Model ◽  
Receiver Operating Characteristic ◽  
Cancer Patients ◽  
Retrospective Cohort ◽  
Operating Characteristic ◽  
Risk Group ◽  
Cancer Center ◽  
Catheter Related Thrombosis

e14031 Background: The central venous catheter brings convenience for drug delivery and improves comfort for cancer patients, it also causes serious complications. The most common one is catheter-related thrombosis (CRT). This study aimed to evaluate the incidence and risk factors of CRT in cancer patients, and to develop an effective prediction model for CRT in cancer patients. Methods: The development of our prediction model was based on the data of a retrospective cohort (n = 3131) from National Cancer Center. The validation of our prediction model was done in a prospective cohort from National Cancer Center (n = 685) and a retrospective cohort from Hunan Cancer Hospital (n = 61). The predictive accuracy and the discriminative ability were determined by the receiver operating characteristic curves and calibration plots. Results: Multivariate analysis demonstrated that sex, cancer type, catheter type, position of the catheter tip, chemotherapy status, and antiplatelet/anticoagulation status at baseline were independent risk factors for CRT. The area under receiver operating characteristic (ROC) curve of our prediction model was 0.741 (CI: 0.715-0.766) in the primary cohort; 0.754 (CI: 0.704-0.803) and 0.658 (CI: 0.470-0.845) in validation cohorts respectively. Good calibration and clinical impact were also shown in primary and validation cohorts. The high-risk group had a higher incidence of CRTs than the low-risk group in the primary cohort and two validation cohort (p < 0.001). Conclusions: Our model is a novel prediction tool for CRT risk which helps to assigning cancer patients into high-risk or low-risk group accurately. Our model will be valuable for clinicians in decision making of thromboprophylaxis.

Development and Validation of a Nomogram for Renal Involvement in Primary Sjögren Syndrome Patients: A Retrospective Analysis

2021 ◽  
Author(s):  
Xinshi Huang ◽  
Xiaobing Wang ◽  
Dinglai Yu
Keyword(s):  
Risk Factors ◽  
Prediction Model ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Renal Involvement ◽  
Calibration Plot ◽  
Receiver Operating Characteristic Curves ◽  
Logistic Analysis ◽  
Validation Set ◽  
Multivariate Logistic Analysis

Abstract Objective To establish and validate a nomogram for individualized prediction of renal involvement in pSS patients. Methods A total of 1293 patients with pSS from the First Affiliated Hospital of Wenzhou Medical University between January 2008 to January 2020 were recruited and further analyzed retrospectively. The patients were randomly divided into a development set (70%, n = 910) and a validation set (30%, n = 383). The univariable and multivariate logistic regression were performed to analyze the risk factors of renal involvement in pSS. Based on the regression β coefficients derived from multivariate logistic analysis, an individualized nomogram prediction model was developed. The prediction model of discrimination and calibration was evaluated with the area under the receiver operating characteristic curves and Calibration plot. Results Multivariate logistic analysis showed that hypertension, anemia, albumin, uric acid, anti-Ro52, hematuria and Chisholm-Mason grade were independent risk factors of renal involvement in pSS. The area under the receiver operating characteristic curves were 0.797 and 0.750 respectively in development set and validation set, indicating the nomogram had a good discrimination capacity. The Calibration plot showed nomogram had a strong concordance performance between the prediction probability and the actual probability. Conclusion The individualized nomogram for pSS patients those who had renal involvement could be used by clinicians to predict the risk of pSS patients developing into renal involvement and improve early screening and intervention.

Impact of the Addition of Concurrent Chemotherapy to Pelvic Radiotherapy in Surgically Treated Stage IB1-IIB Cervical Cancer Patients With Intermediate-Risk or High-Risk Factors: A 13-Year Experience

2013 ◽  
Vol 23 (3) ◽  
pp. 567-575 ◽  
Author(s):  
Mika Okazawa ◽  
Seiji Mabuchi ◽  
Fumiaki Isohashi ◽  
Osamu Suzuki ◽  
Yasuo Yoshioka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Prognostic Factors ◽  
High Risk ◽  
Cancer Patients ◽  
Risk Group ◽  
Figo Stage ◽  
High Risk Group ◽  
Intermediate Risk ◽  
Stromal Invasion

ObjectivesTo identify groups of patients who derive clinical benefit from postoperative adjuvant concurrent chemoradiotherapy (CCRT), we retrospectively investigated the survival outcomes of surgically treated early-stage cervical cancer patients.MethodsWe reviewed the medical records of 316 patients with FIGO stage IB1-IIB cervical cancer who had been treated with adjuvant radiotherapy (RT) (n = 124, RT group) or adjuvant CCRT (n = 192, CCRT group) after radical hysterectomy between January 1996 and December 2009. Of these, 187 patients displayed high-risk prognostic factors (high-risk group), and 129 displayed intermediate-risk prognostic factors (intermediate-risk group). Sixty patients with 1 intermediate-risk prognostic factor who received no adjuvant therapy were also identified and used as controls (NFT group). Survival was calculated using the Kaplan-Meier method and compared using the log-rank test.ResultsIn the high-risk group, adjuvant CCRT was significantly superior to RT alone with regard to recurrence rate, progression-free survival (PFS), and overall survival. In the intermediate-risk group, CCRT was superior to RT with regard to recurrence rate and PFS in patents with 2 or more risk factors. Among the patients with only 1 intermediate-risk factor, although no survival benefit of CCRT over RT was observed, addition of adjuvant treatment resulted in significantly improved PFS compared with the NFT group in patients with deep stromal invasion (log-rank, P = 0.012).ConclusionsPostoperative CCRT improved the prognosis of FIGO stage IB1-IIB cervical cancer patients in the high-risk group and patients who displayed 2 or more intermediate-risk factors. Patients who displayed deep stromal invasion alone also derived clinical benefit from adjuvant treatment.

Clinical impact of LncRNA XIST and LncRNA NEAT1 for diagnosis of high-risk group breast cancer patients

2021 ◽  
pp. 100709
Author(s):  
Menha Swellam ◽  
Hekmat M EL Magdoub ◽  
May A Shawki ◽  
Marwa Adel ◽  
Mona M Hefny ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Cancer Patients ◽  
Risk Group ◽  
High Risk Group ◽  
Clinical Impact ◽  
Breast Cancer Patients ◽  
Lncrna Xist ◽  
Lncrna Neat1

scholarly journals Comparative risk assessment for the development of cardiovascular diseases in the Hungarian general and Roma population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Peter Piko ◽  
Zsigmond Kosa ◽  
Janos Sandor ◽  
Roza Adany
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Average Risk ◽  
Cvd Risk ◽  
Roma Population

AbstractCardiovascular diseases (CVDs) are the number one cause of death globally, and the early identification of high risk is crucial to prevent the disease and to reduce healthcare costs. Short life expectancy and increased mortality among the Roma are generally accepted (although not indeed proven by mortality analyses) which can be partially explained by the high prevalence of cardiovascular risk factors (CVRF) among them. This study aims to elaborate on the prevalence of the most important CVD risk factors, assess the estimation of a 10-year risk of development of fatal and nonfatal CVDs based on the most used risk assessment scoring models, and to compare the Hungarian general (HG) and Roma (HR) populations. In 2018 a complex health survey was accomplished on the HG (n = 380) and HR (n = 347) populations. The prevalence of CVRS was defined and 10-year cardiovascular risk was estimated for both study populations using the following systems: Framingham Risk Score for hard coronary heart disease (FRSCHD) and for cardiovascular disease (FRSCVD), Systematic COronary Risk Evaluation (SCORE), ACC/AHA Pooled Cohort Equations (PCE) and Revised Pooled Cohort Equations (RPCE). After the risk scores had been calculated, the populations were divided into risk categories and all subjects were classified. For all CVD risk estimation scores, the average of the estimated risk was higher among Roma compared to the HG independently of the gender. The proportion of high-risk group in the Hungarian Roma males population was on average 1.5–3 times higher than in the general one. Among Roma females, the average risk value was higher than in the HG one. The proportion of high-risk group in the Hungarian Roma females population was on average 2–3 times higher compared to the distribution of females in the general population. Our results show that both genders in the Hungarian Roma population have a significantly higher risk for a 10-year development of cardiovascular diseases and dying from them compared to the HG one. Therefore, cardiovascular interventions should be focusing not only on reducing smoking among Roma but on improving health literacy and service provision regarding prevention, early recognition, and treatment of lipid disorders and diabetes among them.

scholarly journals Risk factors for pegylated liposomal doxorubicin-induced moderate to severe hand-foot syndrome in breast cancer patients: assessment of baseline clinical parameters

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guohua Liang ◽  
Wenjie Ma ◽  
Yanfang Zhao ◽  
Eryu Liu ◽  
Xiaoyu Shan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Prediction Model ◽  
Cancer Patients ◽  
Blood Circulation ◽  
Pegylated Liposomal Doxorubicin ◽  
Dose Intensity ◽  
Breast Cancer Patients ◽  
Hand Foot Syndrome ◽  
Peripheral Blood Circulation

Abstract Background Hand-foot syndrome (HFS) is a side effect of skin related to pegylated liposomal doxorubicin (PLD) application. Moderate to severe hand-foot syndrome (MSHFS) might have a serious impact on patients’ quality of life and treatment. However, information on risk factors for the development of MSHFS is still limited. To analyze the risk factors for PLD-induced MSHFS in breast cancer patients and constructed a logistic regression prediction model. Methods We conducted a retrospective analysis of breast cancer patients who were treated with a PLD regimen in the Tumor Hospital of Harbin Medical University from January 2017 to August 2019. A total of 26 factors were collected from electronic medical records. Patients were divided into MSHFS (HFS > grade 1) and NMHFS (HFS ≤ grade 1) groups according to the NCI classification. Statistical analysis of these factors and the construction of a logistic regression prediction model based on risk factors. Results A total of 44.7% (206/461) of patients developed MSHFS. The BMI, dose intensity, and baseline Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) levels in the MSHFS group, as well as good peripheral blood circulation, excessive sweat excretion, history of gallstones, and tumour- and HER2-positive percentages, were all higher than those in the NMHFS group (P < 0.05). The model for predicting the occurrence of MSHFS was P = 1/1 + exp. (11.138–0.110*BMI-0.234*dose intensity-0.018*baseline ALT+ 0.025*baseline AST-1.225*gallstone history-0.681* peripheral blood circulation-1.073*sweat excretion-0.364*with or without tumor-0.680*HER-2). The accuracy of the model was 72.5%, AUC = 0.791, and Hosmer-Lemeshow fit test P = 0.114 > 0.05. Conclusions Nearly half of the patients developed MSHFS. The constructed prediction model may be valuable for predicting the occurrence of MSHFS in patients.

scholarly journals Predicting Burn Mortality Using a Simple Novel Prediction Model

2021 ◽  
Author(s):  
Sneha Sharma ◽  
Raman Tandon
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Prediction Model ◽  
Receiver Operating Characteristic ◽  
Logistic Regression Analysis ◽  
Operating Characteristic ◽  
Binary Logistic Regression ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Binary Logistic Regression Analysis

Abstract Background Prediction of outcome for burn patients allows appropriate allocation of resources and prognostication. There is a paucity of simple to use burn-specific mortality prediction models which consider both endogenous and exogenous factors. Our objective was to create such a model. Methods A prospective observational study was performed on consecutive eligible consenting burns patients. Demographic data, total burn surface area (TBSA), results of complete blood count, kidney function test, and arterial blood gas analysis were collected. The quantitative variables were compared using the unpaired student t-test/nonparametric Mann Whitney U-test. Qualitative variables were compared using the ⊠2-test/Fischer exact test. Binary logistic regression analysis was done and a logit score was derived and simplified. The discrimination of these models was tested using the receiver operating characteristic curve; calibration was checked using the Hosmer—Lemeshow goodness of fit statistic, and the probability of death calculated. Validation was done using the bootstrapping technique in 5,000 samples. A p-value of <0.05 was considered significant. Results On univariate analysis TBSA (p <0.001) and Acute Physiology and Chronic Health Evaluation II (APACHE II) score (p = 0.004) were found to be independent predictors of mortality. TBSA (odds ratio [OR] 1.094, 95% confidence interval [CI] 1.037–1.155, p = 0.001) and APACHE II (OR 1.166, 95% CI 1.034–1.313, p = 0.012) retained significance on binary logistic regression analysis. The prediction model devised performed well (area under the receiver operating characteristic 0.778, 95% CI 0.681–0.875). Conclusion The prediction of mortality can be done accurately at the bedside using TBSA and APACHE II score.

scholarly journals Impact of the preoperative prognostic nutritional index as a predictor for postoperative complications after resection of locally recurrent rectal cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masakatsu Paku ◽  
Mamoru Uemura ◽  
Masatoshi Kitakaze ◽  
Shiki Fujino ◽  
Takayuki Ogino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Receiver Operating Characteristic ◽  
Odds Ratio ◽  
Inflammatory Markers ◽  
Operating Characteristic ◽  
Recurrent Rectal Cancer ◽  
Prognostic Nutrition Index

Abstract Background Local recurrence is common after curative resections for rectal cancer. Surgical intervention is among the best treatment choices. However, achieving a negative resection margin often requires extensive pelvic organ resections; thus, the postoperative complication rate is quite high. Recent studies have reported that the inflammatory index could predict postoperative complications. This study aimed to validate the correlation between clinical factors, including inflammatory markers, and severe complications after surgery for local recurrent rectal cancer. Methods This retrospective study included 99 patients that underwent radical resections for local recurrences of rectal cancer. Postoperative complications were graded according to the Clavien-Dindo classification. Grades ≥3 were defined as severe complications. Risk factors for severe complications were identified with univariate and multivariate logistic regression models and assessed with receiver-operating characteristic curves. Results Severe postoperative complications occurred in 38 patients (38.4%). Analyses of correlations between inflammatory markers and severe postoperative complications revealed that the strongest correlation was found between the prognostic nutrition index and severe postoperative complications. The receiver-operating characteristic analysis showed that the optimal prognostic nutrition index cut-off value was 42.2 (sensitivity: 0.790, specificity: 0.508). In univariate and multivariate analyses, a prognostic nutrition index ≤44.2 (Odds ratio: 3.007, 95%CI:1.171–8.255, p = 0.02) and a blood loss ≥2850 mL (Odds ratio: 2.545, 95%CI: 1.044–6.367, p = 0.04) were associated with a significantly higher incidence of severe postoperative complications. Conclusions We found that a low preoperative prognostic nutrition index and excessive intraoperative blood loss were risk factors for severe complications after surgery for local recurrent rectal cancer.

Accuracy of the CARG chemotherapy toxicity risk prediction tool in older Indian patients with cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24023-e24023
Author(s):  
Shreya Gattani ◽  
Vanita Noronha ◽  
Anant Ramaswamy ◽  
Renita Castelino ◽  
Vandhita Nair ◽  
...  
Keyword(s):  
High Risk ◽  
Cancer Patients ◽  
Risk Prediction ◽  
Risk Group ◽  
High Risk Group ◽  
Low Risk ◽  
Chemotherapy Toxicity ◽  
Patients With Cancer ◽  
Indian Patients ◽  
Grade 3

e24023 Background: Clinical judgement alone is inadequate in accurately predicting chemotherapy toxicity in older adult cancer patients. Hurria and colleagues developed and validated, the CARG score (range, 0–17) as a convenient and reliable tool for predicting chemotherapy toxicity in older cancer patients in America, however, its applicability in Indian patients is unknown. Methods: An observational retrospective and prospective study between 2018 and 2020 was conducted in the Department of Medical Oncology at Tata Memorial Hospital, Mumbai, India. The study was approved by the institutional ethics committee (IEC-III; Project No. 900596) and registered in the Clinical Trials Registry of India (CTRI/2020/04/024675). Written informed consent was obtained in the prospective part of the study. Patients aged ≥ 60 years and planned for systemic therapy were evaluated in the geriatric oncology clinic and their CARG score was calculated. Patients were stratified into low (0-4), intermediate (5-9) and high risk (10-17) based on the CARG scores. The CARG score was provided to the treating physicians, along with the results of the geriatric assessment. Chemotherapy-related toxicities were captured from the electronic medical record and graded as per the NCI CTCAE, version 4.0. Results: We assessed 130 patients, with a median age 69 years (IQR, 60 to 84); 72% patients were males. The common malignancies included gastrointestinal (52%) and lung (30%). Approximately 78% patients received polychemotherapy and 53% received full dose chemotherapy. Based on the CARG score, 28 (22%) patients belonged to low risk, 80 (61%) to intermediate risk and 22 (17%) to the high risk category. The AU-ROC of the CARG score in predicting grade 3-5 toxicities was 0.61 (95% CI, 0.51-0.71). The sensitivity and specificity of the CARG score in predicting grade 3-5 toxicities were 60.8% and 78.6%. Grade 3-5 toxicities occurred in 6/28 patients (21%) in the low risk group, compared to 62/102 patients (61%) in the intermediate /high risk group, p = 0.0002. There was also a significant difference in the time to development of grade 3-5 toxicities, which occurred at a median of 2.5 cycles (IQR, 1-3.8) in the intermediate /high risk group and at a median of 6 cycles (IQR, 3.5-8) in the low risk group, p = 0.0011. Conclusions: In older Indian patients with cancer, the CARG score reliably stratifies patients into low risk and intermediate/high risk categories, predicting both the occurrence and the time to occurrence of grade 3-5 toxicities from chemotherapy. The CARG score may aid the oncologist in estimating the risk-benefit ratio of chemotherapy. An important limitation was that we provided the CARG score to the treating oncologists prior to the start of chemotherapy, which may have resulted in alterations in the chemotherapy regimen and dose and may have impacted the CARG risk prediction model. Clinical trial information: CTRI/2020/04/024675.

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