scholarly journals The Relationship Between Preoperative Cervical Sagittal Balance and Clinical Outcome of Patients With Hirayama Disease Treated With Anterior Cervical Discectomy and Fusion

Neurospine ◽  
2021 ◽  
Vol 18 (3) ◽  
pp. 618-627
Author(s):  
Xiao Lu ◽  
Guang-Yu Xu ◽  
Cong Nie ◽  
Yu Xuan Zhang ◽  
Jian Song ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cobb Angle ◽  
Clinical Outcomes ◽  
Roc Curve ◽  
Sagittal Balance ◽  
Postoperative Outcome ◽  
Anterior Cervical Discectomy ◽  
Hirayama Disease ◽  
Cervical Sagittal Balance ◽  
The Relationship

Objective: Anterior cervical discectomy and fusion (ACDF) is a common surgical method used to treat patients with Hirayama disease. And sagittal balance indexes have been revealed to be predictors of clinical outcomes in patients with cervical diseases, but their relationships with ACDF-treated Hirayama disease outcomes remain unknown. The purpose of this study is to evaluate the relationship of preoperative cervical sagittal balance indexes and clinical outcomes in ACDF-treated Hirayama disease patients.Methods: Eighty patients with Hirayama disease treated by ACDF were reviewed retrospectively. Six cervical sagittal balance parameters were collected including Cobb angle, T1 slope, C1–7 sagittal vertical axis (SVA), C2–7 SVA, center of gravity of the head (CGH)-C7 SVA, range of motion. The recovery outcomes of the patients were divided into 2 groups by Odom score and the differences in recovery between the 2 groups were confirmed by electromyography. The correlation between imaging parameters and postoperative outcome was evaluated with logistic regression. The receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) were used to evaluate the significant result of logistic regression and the optimal diagnostic value.Results: Only 2 parameters, Cobb angle and CGH-C7 SVA, showed statistical correlation with the postoperative outcome assessment by logistic regression. AUC of Cobb angle and CGH-C7 SVA were 0.559 and 0.702 respectively. The optimal predictive threshold was 1.50° and 5.40 mm, respectively.Conclusion: A larger Cobb angle and smaller CGH-C7 SVA seemed to correlate with a better postoperative outcome. These 2 factors could be used to predict the outcome of surgical treatment of Hirayama disease preoperatively.

scholarly journals LDH, CRP and ALB predict nucleic acid turn negative within 14 days in symptomatic patients with COVID-19

2021 ◽  
pp. 003693302199424
Author(s):  
Gaoli Liu ◽  
Bicheng Zhang ◽  
Shaowen Zhang ◽  
Haifeng Hu ◽  
TingTing Liu
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Nucleic Acid ◽  
Hospital Stay ◽  
Prognostic Marker ◽  
Roc Curve ◽  
Prognostic Value ◽  
Statistical Significance ◽  
Biochemical Indicators ◽  
The Relationship

Aims To search for biochemical indicators that can identify symptomatic patients with COVID-19 whose nucleic acid could turn negative within 14 days, and assess the prognostic value of these biochemical indicators in patients with COVID-19. Patients and methods We collected the clinical data of patients with COVID-19 admitted to our hospital, by using logistic regression analysis and AUC curves, explored the relationship between biochemical indicators and nucleic acid positive duration, the severity of COVID-19, and hospital stay respectively. Results A total of two hundred and thirty-three patients with COVID-19 were enrolled in the study. We found patients whose nucleic acid turned negative within 14 days had lower LDH, CRP and higher ALB ( P < 0.05). ROC curve results indicated that lower LDH, TP, CRP and higher ALB predicted the nucleic acid of patients turned negative within 14 days with statistical significance( P < 0.05), AST, LDH, CRP and PCT predicted the severe COVID-19 with statistical significance, and CRP predicted hospital stay >31days with statistical significance ( P < 0.05). After verification, the probability of nucleic acid turning negative within 14 days in patients with low LDH (<256 U/L), CRP (<44.5 mg/L) and high ALB (>35.8 g/L) was about 4 times higher than that in patients with high LDH, CRP and low ALB ( P < 0.05). Conclusions LDH, CRP and ALB are useful prognostic marker for predicting nucleic acid turn negative within 14 days in symptomatic patients with COVID-19.

scholarly journals Association Between Triglyceride Glucose Index and Non-Small Cell Lung Cancer Risk in Chinese Population

2021 ◽  
Vol 11 ◽  
Author(s):  
Xin Yan ◽  
Yujuan Gao ◽  
Jingzhi Tong ◽  
Mi Tian ◽  
Jinghong Dai ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cancer Risk ◽  
Small Cell Lung Cancer ◽  
Roc Curve ◽  
Small Cell ◽  
Small Cell Lung ◽  
Tyg Index ◽  
The Relationship

BackgroundNumerous studies showed that insulin resistance (IR) was associated with cancer risk. However, few studies investigated the relationship between IR and non-small cell lung cancer (NSCLC). The aim of this study is to explore the association of triglyceride glucose (TyG) index, a simple surrogate marker of IR, with NSCLC risk.Methods791 histologically confirmed NSCLC cases and 787 controls were enrolled in the present study. Fasting blood glucose and triglyceride were measured. The TyG index was calculated as ln [fasting triglycerides (mg/dl) ×fasting glucose (mg/dl)/2]. Logistic regression analysis was performed to estimate the relationship between NSCLC risk and the TyG index.ResultsThe TyG index was significantly higher in patients with NSCLC than that in controls (8.42 ± 0.55 vs 8.00 ± 0.45, P &lt; 0.01). Logistic regression analysis showed that the TyG index (OR = 3.651, 95%CI 2.461–5.417, P &lt; 0.001) was independently associated with NSCLC risk after adjusting for conventional risk factors. In addition, a continuous rise in the incidence of NSCLC was observed along the tertiles of the TyG index (29.4 vs 53.8 vs 67.2%, P &lt; 0.001). However, there were no differences of the TyG index in different pathological or TNM stages. In receiver operating characteristic (ROC) curve analysis, the optimal cut-off level for the TyG index to predict incident NSCLC was 8.18, and the area under the ROC curve (AUROC) was 0.713(95% CI 0.688–0.738).ConclusionsThe TyG index is significantly correlated with NSCLC risk, and it may be suitable as a predictor for NSCLC.

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.

scholarly journals Posterior open-door laminoplasty secured with titanium miniplates vs anchors: a comparative study of clinical efficacy and cervical sagittal balance

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Dongyue Li ◽  
Yong Hai ◽  
Xianglong Meng ◽  
Jincai Yang ◽  
Peng Yin
Keyword(s):  
Cobb Angle ◽  
Sagittal Balance ◽  
Open Door ◽  
Intraoperative Blood Loss ◽  
Surgical Time ◽  
T1 Slope ◽  
Cervical Sagittal Balance ◽  
Group A ◽  
Group B ◽  
Better Than

Abstract Objective Posterior open-door laminoplasty (PODL) is a common procedure for treating multilevel cervical spondylotic myelopathy (MCSM). Little information is available regarding the cervical sagittal balance and surgical efficacy of PODL when securing with different methods. Therefore, this study aims to investigate the clinical outcomes and the changes in cervical sagittal parameters and balance associated with PODL secured with titanium miniplates vs anchors. Method A retrospective analysis was performed on the clinical data of 79 patients with MCSM who were treated in our institution from January 2015 to December 2016. Among them, 42 patients were treated by PODL secured with titanium miniplates (group A) and 37 patients by PODL secured with anchors (group B). Surgical time, intraoperative blood loss, hospital stay, hospitalized cost, VAS scores of neck pain, JOA scores, neck disability index (NDI), and improvement rate of spinal neurological function (IRNF) were recorded before surgery and at 12 months after surgery. Before surgery, at 1 month and 2 years after surgery, the following radiological parameters were recorded and compared on the lateral cervical X-ray images: the distance from the vertical axis of C2 sagittal plane to the posterior superior edge of C7 (C2-7 SVA), the inclusion angle of tangent between C2 and C7 trailing edge (C2-7 Cobb angle), and the intersection angle between the upper edge of T1 and the horizontal line (T1 Slope). Result Comparing the two groups, there were no significant differences in surgical time, intraoperative blood loss, hospital stay, VAS, JOA, and NDI scores before surgery (P > 0.05); however, the hospitalized cost of group A were much higher than those of the group B (P < 0.05). At 2 years after surgery in the two groups, there was a significant reduction in VAS and NDI scores (P < 0.05), and JOA scores increased significantly (P < 0.05). In addition, there were no significant differences in VAS, JOA and IRNF between the two groups (P > 0.05); however, NDI scores of group A were better than those of group B (P < 0.05). In radiological parameters, before surgery, the two groups showed no significant differences in C2-7 SVA, C2-7 Cobb angle, and T1 slope (P > 0.05); however, after surgery, C2-7 SVA and T1 slope increased (P < 0.05), while C2-7 Cobb angle decreased (P < 0.05). At 2 years after surgery, the two groups did not differ significantly in C2-7 Cobb angle and T1 slope (P > 0.05), while C2-7 SVA of group A was superior to that of group B (P < 0.05). The difference value of C2-7 SVA measured before and after surgery was correlated negatively with that of NDI scores (P < 0.05). Conclusion PODL secured with titanium miniplates or anchors achieved good clinical efficacy in the treatment of MCSM. However, the patients with miniplates feel a better cervical functional status, while those with anchors spend less on hospitalization. Both methods lead to anteversion of cervical spine, but cervical sagittal balance after miniplates is better than that of anchors.

scholarly journals Sequential changes in Rotterdam CT scores related to outcomes for patients with traumatic brain injury who undergo decompressive craniectomy

2016 ◽  
Vol 124 (6) ◽  
pp. 1640-1645 ◽  
Author(s):  
Kenji Fujimoto ◽  
Masaki Miura ◽  
Tadahiro Otsuka ◽  
Jun-ichi Kuratsu
Keyword(s):  
Traumatic Brain Injury ◽  
Logistic Regression ◽  
Brain Injury ◽  
Decompressive Craniectomy ◽  
Roc Curve ◽  
Area Under The Curve ◽  
Prognostic Indicator ◽  
Unfavorable Outcome ◽  
Multivariable Logistic Regression Analysis ◽  
The Relationship

OBJECT Rotterdam CT scoring is a CT classification system for grouping patients with traumatic brain injury (TBI) based on multiple CT characteristics. This retrospective study aimed to determine the relationship between initial or preoperative Rotterdam CT scores and TBI prognosis after decompressive craniectomy (DC). METHODS The authors retrospectively reviewed the medical records of all consecutive patients who underwent DC for nonpenetrating TBI in 2 hospitals from January 2006 through December 2013. Univariate and multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were used to determine the relationship between initial or preoperative Rotterdam CT scores and mortality at 30 days or Glasgow Outcome Scale (GOS) scores at least 3 months after the time of injury. Unfavorable outcomes were GOS Scores 1–3 and favorable outcomes were GOS Scores 4 and 5. RESULTS A total of 48 cases involving patients who underwent DC for TBI were included in this study. Univariate analyses showed that initial Rotterdam CT scores were significantly associated with mortality and both initial and preoperative Rotterdam CT scores were significantly associated with unfavorable outcomes. Multivariable logistic regression analysis adjusted for established predictors of TBI outcomes showed that initial Rotterdam CT scores were significantly associated with mortality (OR 4.98, 95% CI 1.40–17.78, p = 0.01) and unfavorable outcomes (OR 3.66, 95% CI 1.29–10.39, p = 0.02) and preoperative Rotterdam CT scores were significantly associated with unfavorable outcomes (OR 15.29, 95% CI 2.50–93.53, p = 0.003). ROC curve analyses showed cutoff values for the initial Rotterdam CT score of 5.5 (area under the curve [AUC] 0.74, 95% CI 0.59–0.90, p = 0.009, sensitivity 50.0%, and specificity 88.2%) for mortality and 4.5 (AUC 0.71, 95% CI 0.56–0.86, p = 0.02, sensitivity 62.5%, and specificity 75.0%) for an unfavorable outcome and a cutoff value for the preoperative Rotterdam CT score of 4.5 (AUC 0.81, 95% CI 0.69–0.94, p < 0.001, sensitivity 90.6%, and specificity 56.2%) for an unfavorable outcome. CONCLUSIONS Assessment of changes in Rotterdam CT scores over time may serve as a prognostic indicator in TBI and can help determine which patients require DC.

scholarly journals Lipid Levels and 3-Month Prognosis After Spontaneous Intracerebral Hemorrhage in Women

2021 ◽  
Vol 12 ◽  
Author(s):  
Hao Feng ◽  
Xin Wang ◽  
Wenjuan Wang ◽  
Xingquan Zhao
Keyword(s):  
Logistic Regression ◽  
Intracerebral Hemorrhage ◽  
Clinical Outcomes ◽  
Poor Prognosis ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Lipid Levels ◽  
Multivariate Logistic Regression ◽  
Low Levels ◽  
High Density Cholesterol ◽  
The Relationship

Background: The relationship between serum lipids levels and prognosis after spontaneous intracerebral hemorrhage (ICH) is still unclear. We aim to examine the association between lipid levels and 3-month ICH prognosis in women.Method: We went through a registry of spontaneous ICH cases and selected female patients to study according to our criteria. We collected demographic, clinical, and laboratory information and evaluated serum triglyceride (TG) levels, total cholesterol (TC) levels, low-density cholesterol (LDLC) levels, high-density cholesterol (HDLC) levels, non-high-density cholesterol (non-HDLC) levels, and 3-month modified Rankin Scale (mRS). Multivariate logistic regression was performed, and receiver operating characteristic (ROC) curves were plotted to explore the relationship between serum lipid levels and 3-month ICH clinical outcomes.Results: Two hundred six female patients were included in this study, and 96 (46.6%) of them had poor functional outcomes. In the univariate analysis, low TG (p = 0.006), TC (p = 0.025), LDLC (p = 0.001), non-HDLC (p &lt; 0.001) levels, and high HDL (p = 0.036) levels were associated with poor 3-month clinical outcomes in women. In the multivariate logistic regression, low levels of TG (OR = 0.711, 95% CI = 0.542–0.933, p = 0.014), TC (OR = 0.523, 95% CI = 0.304–0.903, p = 0.020), LDLC (OR = 0.538, 95% CI = 0.307–0.942, p = 0.030), non-HDLC (OR = 0.327, 95% CI = 0.177–0.603, p &lt; 0.001), and a high level of HDLC (OR = 2.075, 95% CI = 1.064–4.047, p = 0.032) with area under the curve (AUC) of 0.610, 0.590, 0.630, 0.645, and 0.415, respectively, remained as independent indicators of poor prognosis at 3 months after adjusting for confounding factors.Conclusion: Low levels of TG, TC, LDLC, non-HDLC, and high levels of HDLC were independently associated with poor prognosis of spontaneous ICH in women.

scholarly journals Why the patients with Hirayama disease have abnormal cervical sagittal alignment? A radiological measurement analysis of posterior cervical extensors

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Ye Tian ◽  
Lin Xie ◽  
Jianyuan Jiang ◽  
Hongli Wang
Keyword(s):  
Cobb Angle ◽  
Sagittal Alignment ◽  
Spearman Correlation ◽  
Kyphosis Angle ◽  
Hirayama Disease ◽  
Cutoff Value ◽  
T1 Slope ◽  
Cervical Sagittal Alignment ◽  
Local Kyphosis ◽  
The Relationship

Abstract Purpose To explore the relationship between the strength of posterior cervical extensors (PCEs) and cervical sagittal alignment in Hirayama disease (HD) patients. Methods We analyzed the (magnetic resonance imaging) MRI T2WI and X-rays of 60 HD patients who visited Huashan Hospital from June 2017 to February 2020. Symptoms of these patients include adolescent onset, manifestation of unilateral upper limb muscle weakness and muscle atrophy of the forearm and hand. MRI images were used to measure (the cross-sectional area) CSA of cervical PCEs. The ratio of muscle CSA to vertebral body areas at the same level is defined as R-CSA. Cervical sagittal alignment includes the C2–7 Cobb angle, T1 slope and C2–7 sagittal vertical axis (SVA). The geometric center of the C3–6 vertebral body was determined using the line connecting the C2 inferior endplate and the C7 upper endplate. When located behind the line, it is defined as a “local kyphotic deformity.” The number of vertebral bodies involved in kyphotic deformity was determined by measuring the local kyphosis angle (LKA). Spearman correlation analysis (α = 0.05) was used to determine the relationship between R-CSA and sagittal parameters. ROC curves were used to analyze the sensitivity and specificity of relevant variables. Results Spearman correlation test revealed that R-CSA negatively correlated with T1S (S = 0.34, r = 0.34, p = 0.01) and LKA (S = 0.44, r = 0.5, p = 0.01), but did not correlate with the C2-C7 Cobb angle (S = 0.20, p = 0.12) or C2-C7 SVA (S =  − 0.17, p = 0.46). (p < 0.05). ROC curve analysis showed that the areas under the curve (AUCs) of the T1 slope and LKA was 0.6696 and 0.7646, respectively. T1 slope, cutoff value: 17.2°; sensitivity: 0.5806; specificity: 0.7241; p < 0.05. LKA: cutoff value: − 14°; sensitivity: 1; specificity: 0.5333; p < 0.05. Conclusions In patients with Hirayama disease, the strength of posterior cervical extensors and cervical sagittal alignment are closely related. The local kyphosis angle can be used as a reference for the strength of posterior cervical extensors. These results indicate the weakness of PCEs, which may predispose the cervical spine of HD patients to a less stable situation. Therefore, patients with Hirayama disease should strengthen the exercise of the PCEs.

Sign in / Sign up

Export Citation Format

Share Document