scholarly journals Logistic regression analysis and a risk prediction model of pneumothorax after CT-guided needle biopsy

2017 ◽  
Vol 9 (11) ◽  
pp. 4750-4757 ◽  
Author(s):  
Yanfeng Zhao ◽  
Xiaoyi Wang ◽  
Yong Wang ◽  
Zheng Zhu
Author(s):  
Masaru Samura ◽  
Naoki Hirose ◽  
Takenori Kurata ◽  
Keisuke Takada ◽  
Fumio Nagumo ◽  
...  

Abstract Background In this study, we investigated the risk factors for daptomycin-associated creatine phosphokinase (CPK) elevation and established a risk score for CPK elevation. Methods Patients who received daptomycin at our hospital were classified into the normal or elevated CPK group based on their peak CPK levels during daptomycin therapy. Univariable and multivariable analyses were performed, and a risk score and prediction model for the incidence probability of CPK elevation were calculated based on logistic regression analysis. Results The normal and elevated CPK groups included 181 and 17 patients, respectively. Logistic regression analysis revealed that concomitant statin use (odds ratio [OR] 4.45, 95% confidence interval [CI] 1.40–14.47, risk score 4), concomitant antihistamine use (OR 5.66, 95% CI 1.58–20.75, risk score 4), and trough concentration (Cmin) between 20 and <30 µg/mL (OR 14.48, 95% CI 2.90–87.13, risk score 5) and ≥30.0 µg/mL (OR 24.64, 95% CI 3.21–204.53, risk score 5) were risk factors for daptomycin-associated CPK elevation. The predicted incidence probabilities of CPK elevation were <10% (low risk), 10%–<25% (moderate risk), and ≥25% (high risk) with the total risk scores of ≤4, 5–6, and ≥8, respectively. The risk prediction model exhibited a good fit (area under the receiving-operating characteristic curve 0.85, 95% CI 0.74–0.95). Conclusions These results suggested that concomitant use of statins with antihistamines and Cmin ≥20 µg/mL were risk factors for daptomycin-associated CPK elevation. Our prediction model might aid in reducing the incidence of daptomycin-associated CPK elevation.


2021 ◽  
Author(s):  
Zhi xiang Du ◽  
Fang Chang ◽  
Zi jian Wang ◽  
Da ming Zhou ◽  
Yang Li ◽  
...  

Abstract Background Acute kidney injury (AKI) is not a rare complication during anti-tuberculosis treatment in some pulmonary tuberculosis (PTB) patients. We aimed to develop a risk prediction model to early recognize PTB patients at high risk of AKI during anti-TB treatment.Methods In this retrospective cohort study, clinical baseline, and laboratory test data of 315 inpatients with active PTB from January 2019 and June 2020 were screened for predictive factors. The factors were analyzed by logistic regression analysis. A nomogram was established by the results of the logistic regression analysis. The prediction model discrimination and calibration were evaluated by the concordance index (C-Index), ROC Curve, and Hosmer-Lemeshow analysis.Results 7 factors (Microalbuminuria, Hematuria, CYS-C, Albumin, eGFR, BMI and CA-125) are acquired to develop the predictive model. According to the logistic regression, Microalbuminuria (OR=3.038, 95% CI 1.168-7.904), Hematuria (OR=3.656, 95% CI 1.325-10.083), CYS-C (OR=4.416, 95% CI 2.296-8.491), CA-125 (OR=3.93, 95% CI 1.436-10.756) were risk parameter and ALB (OR=0.741, 95% CI 0.650-0.844) was protective parameter. The nomogram demonstrated a good prediction in estimating AKI. C-Index= 0.967, AUC=0.967, 95% CI (0.941-0.984) Sensitivity=91.04%, Specificity=93.95%, Hosmer-Lemeshow analysis SD=0.00054, Quantile of absolute error=0.049. Conclusion Microalbuminuria, Hematuria, Albumin reduction, elevated CYS-C, and CA125 are predictive factors for AKI in PTB patients during anti-tuberculosis treatments. The predictive nomogram based on five predictive factors is achieved a good risk prediction of AKI during anti-tuberculosis treatments.


2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Cheng Hu ◽  
Qian Li ◽  
Ji Shou ◽  
Feng-xian Zhang ◽  
Xia Li ◽  
...  

Objectives. Depression is highly prevalent in non-Hodgkin’s lymphoma (NHL) patients undergoing chemotherapy. The social stress associated with malignancy induces neurovascular pathology promoting clinical levels of depressive symptomatology. The purpose of this study was to establish an effective depressive symptomatology risk prediction model to those patients. Methods. This study included 238 NHL patients receiving chemotherapy, 80 of whom developed depressive symptomatology. Different types of variables (sociodemographic, medical, and psychosocial) were entered in the models. Three prediction models (support vector machine-recursive feature elimination model, random forest model, and nomogram prediction model based on logistic regression analysis) were compared in order to select the one with the best predictive power. The selected model was then evaluated using calibration plots, ROC curves, and C -index. The clinical utility of the nomogram was assessed by the decision curve analysis (DCA). Results. The nomogram prediction has the most efficient predictive ability when 10 predictors are included ( AUC = 0.938 ). A nomogram prediction model was constructed based on the logistic regression analysis with the best predictive accuracy. Sex, age, medical insurance, marital status, education level, per capita monthly household income, pathological stage, SSRS, PSQI, and QLQ-C30 were included in the nomogram. The C -index was 0.944, the AUC value was 0.972, and the calibration curve also showed the good predictive ability of the nomogram. The DCA curve suggested that the nomogram had a strong clinical utility. Conclusions. We constructed a depressive symptomatology risk prediction model for NHL chemotherapy patients with good predictive power and clinical utility.


Author(s):  
Sneha Sharma ◽  
Raman Tandon

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.


2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Jessica K. Sexton ◽  
Michael Coory ◽  
Sailesh Kumar ◽  
Gordon Smith ◽  
Adrienne Gordon ◽  
...  

Abstract Background Despite advances in the care of women and their babies in the past century, an estimated 1.7 million babies are born still each year throughout the world. A robust method to estimate a pregnant woman’s individualized risk of late-pregnancy stillbirth is needed to inform decision-making around the timing of birth to reduce the risk of stillbirth from 35 weeks of gestation in Australia, a high-resource setting. Methods This is a protocol for a cross-sectional study of all late-pregnancy births in Australia (2005–2015) from 35 weeks of gestation including 5188 stillbirths among 3.1 million births at an estimated rate of 1.7 stillbirths per 1000 births. A multivariable logistic regression model will be developed in line with current TransparentReporting of a multivariable prediction model forIndividualPrognosis orDiagnosis (TRIPOD) guidelines to estimate the gestation-specific probability of stillbirth with prediction intervals. Candidate predictors were identified from systematic reviews and clinical consultation and will be described through univariable regression analysis. To generate a final model, elimination by backward stepwise multivariable logistic regression will be performed. The model will be internally validated using bootstrapping with 1000 repetitions and externally validated using a temporally unique dataset. Overall model performance will be assessed with R2, calibration, and discrimination. Calibration will be reported using a calibration plot with 95% confidence intervals (α = 0.05). Discrimination will be measured by the C-statistic and area underneath the receiver-operator curves. Clinical usefulness will be reported as positive and negative predictive values, and a decision curve analysis will be considered. Discussion A robust method to predict a pregnant woman’s individualized risk of late-pregnancy stillbirth is needed to inform timely, appropriate care to reduce stillbirth. Among existing prediction models designed for obstetric use, few have been subject to internal and external validation and many fail to meet recommended reporting standards. In developing a risk prediction model for late-gestation stillbirth with both providers and pregnant women in mind, we endeavor to develop a validated model for clinical use in Australia that meets current reporting standards.


2021 ◽  
Author(s):  
Lu Ma ◽  
Dong Cheng ◽  
Qinghua Li ◽  
Jingbo Zhu ◽  
Yu Wang ◽  
...  

Abstract Objective: To explore the predictive value of white blood cell (WBC), monocyte (M), neutrophil-to-lymphocyte ratio (NLR), fibrinogen (FIB), free prostate-specific antigen (fPSA) and free prostate-specific antigen/prostate-specific antigen (f/tPSA) in prostate cancer (PCa).Materials and methods: Retrospective analysis of 200 cases of prostate biopsy and collection of patients' systemic inflammation indicators, biochemical indicators, PSA and fPSA. First, the dimensionality of the clinical feature parameters is reduced by the Lass0 algorithm. Then, the logistic regression prediction model was constructed using the reduced parameters. The cut-off value, sensitivity and specificity of PCa are predicted by the ROC curve analysis and calculation model. Finally, based on Logistic regression analysis, a Nomogram for predicting PCa is obtained.Results: The six clinical indicators of WBC, M, NLR, FIB, fPSA, and f/tPSA were obtained after dimensionality reduction by Lass0 algorithm to improve the accuracy of model prediction. According to the regression coefficient value of each influencing factor, a logistic regression prediction model of PCa was established: logit P=-0.018-0.010×WBC+2.759×M-0.095×NLR-0.160×FIB-0.306×fPSA-2.910×f/tPSA. The area under the ROC curve is 0.816. When the logit P intercept value is -0.784, the sensitivity and specificity are 72.5% and 77.8%, respectively.Conclusion: The establishment of a predictive model through Logistic regression analysis can provide more adequate indications for the diagnosis of PCa. When the logit P cut-off value of the model is greater than -0.784, the model will be predicted to be PCa.


2021 ◽  
Author(s):  
Jun Chen ◽  
Yimin Wang ◽  
Xinyang Shou ◽  
Qiang Liu ◽  
Ziwei Mei

Abstract BACKGROUND Despite the large number of studies focus on the prognosis and in-hospital outcomes risk factors of patients with takotsubo syndrome, there was still lack of utility and visual risk prediction model for predicting the in-hospital mortality of patients with takotsubo syndrome. OBJECTIVES Our study aimed to establish a utility risk prediction model for the prognosis of in-hospital patients with takotsubo syndrome (TTS). METHODS The study is a retrospective cohort study. Model of in-hospital mortality of TTS patients was developed by multivariable logistic regression analysis. Calibration and discrimination were used to assess the performance of the nomogram. The clinical utility of the model was evaluated by decision curve analysis (DCA). RESULTS Overall, 368 TTS patients (320 Survivals and 48 deaths) were included in our research from MIMIC-IV database. The incidence of in-hospital mortality with TTS is 13.04%. Lasso regression and multivariate logistic regression model verified that potassium, pt, age, myocardial infarction, WBC, hematocrit, anion gap and SOFA score were significantly associated with in-hospital mortality of TTS patients. The nomogram demonstrated a good discrimination with a AUC of ROC 0.811(95%Cl: 0.746-0.876) in training set and 0.793(95%Cl: 0.724-0.862) in test set. The calibration plot of risk prediction model showed predicted probabilities against observed death rates indicated excellent concordance. DCA showed that the nomogram has good clinical benefits. Conclusion We developed a nomogram that predict hospital mortality in patients with TTS according to clinical data. The nomogram exhibited excellent discrimination and calibration capacity, favoring its clinical utility.


2021 ◽  
Vol 11 ◽  
Author(s):  
Lu Lu ◽  
Le-Ping Liu ◽  
Qiang-Qiang Zhao ◽  
Rong Gui ◽  
Qin-Yu Zhao

Lung adenocarcinoma (LUAD) is a highly heterogeneous malignancy, which makes prognosis prediction of LUAD very challenging. Ferroptosis is an iron-dependent cell death mechanism that is important in the survival of tumor cells. Long non-coding RNAs (lncRNAs) are considered to be key regulators of LUAD development and are involved in ferroptosis of tumor cells, and ferroptosis-related lncRNAs have gradually emerged as new targets for LUAD treatment and prognosis. It is essential to determine the prognostic value of ferroptosis-related lncRNAs in LUAD. In this study, we obtained RNA sequencing (RNA-seq) data and corresponding clinical information of LUAD patients from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database and ferroptosis-related lncRNAs by co-expression analysis. The best predictors associated with LUAD prognosis, including C5orf64, LINC01800, LINC00968, LINC01352, PGM5-AS1, LINC02097, DEPDC1-AS1, WWC2-AS2, SATB2-AS1, LINC00628, LINC01537, LMO7DN, were identified by Least Absolute Shrinkage and Selection Operator (LASSO) Cox regression analysis, and the LUAD risk prediction model was successfully constructed. Kaplan-Meier analysis, receiver operating characteristic (ROC) time curve analysis and univariate and multivariate Cox regression analysis and further demonstrated that the model has excellent robustness and predictive ability. Further, based on the risk prediction model, functional enrichment analysis revealed that 12 prognostic indicators involved a variety of cellular functions and signaling pathways, and the immune status was different in the high-risk and low-risk groups. In conclusion, a risk model of 12 ferroptosis related lncRNAs has important prognostic value for LUAD and may be ferroptosis-related therapeutic targets in the clinic.


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