scholarly journals Predictive risk score model for severe fever with thrombocytopenia syndrome mortality based on qSOFA and SIRS scoring system

2020 ◽  
Author(s):  
Li Wang ◽  
Zhiqiang Zou ◽  
Kun Ding ◽  
Chunguo Hou
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Risk Score ◽  
Predictive Value ◽  
Multivariable Logistic Regression Analysis ◽  
Predictive Values ◽  
Independent Risk Factors ◽  
Score Model ◽  
Qsofa Score ◽  
Severe Fever

Abstract Background: Severe fever with thrombocytopenia syndrome (SFTS) is a severe systemic virus infectious disease usually having multi-organ dysfunction which resembles sepsis.Methods: Data of 321 patients with laboratory-confirmed SFTS from May 2013 to July 2017 were retrospectively analyzed. Demographic and clinical characteristics, calculated quick sequential organ failure assessment (qSOFA) score and systemic inflammatory response syndrome (SIRS) criteria for survivors and nonsurvivors were compared. Independent risk factors associated with in-hospital mortality were obtained using multivariable logistic regression analysis. Risk score models containing different risk factors for mortality in stratified patients were established whose predictive values were evaluated using the area under ROC curve (AUC).Results: Of 321 patients, 87 died (27.1%). Age (p<0.001) and percentage numbers of patients with qSOFA≥2 and SIRS≥2 (p<0.0001) were profoundly greater in nonsurvivors than in survivors. Age, qSOFA, SIRS score and aspartate aminotransferase (AST) were independent risk factors for mortality for all patients. And qSOFA score was the only common risk factor in all patients, those age≥60 years and those enrolled in the intensive care unit (ICU). A risk score model containing all these risk factors (Model1) has high predictive value for in-hospital mortality in these three groups with AUCs (95% CI): 0.919 (0.883-0.946), 0.929 (0.862-0.944) and 0.815 (0.710-0.894), respectively. A model only including age and qSOFA also has high predictive value for mortality in these groups with AUCs (95% CI): 0.872 (0.830-0.906), 0.885(0.801-0.900) and 0.865 (0.767-0.932), respectively.Conclusions: Risk models containing qSOFA have high predictive validity for SFTS mortality.

scholarly journals Predictive risk score model for severe fever with thrombocytopenia syndrome mortality based on qSOFA and SIRS scoring system

2020 ◽  
Author(s):  
Li Wang ◽  
Zhiqiang Zou ◽  
Kun Ding ◽  
Chunguo Hou ◽  
Song Qin
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Risk Score ◽  
Predictive Value ◽  
Multivariable Logistic Regression Analysis ◽  
Predictive Values ◽  
Independent Risk Factors ◽  
Score Model ◽  
Qsofa Score ◽  
Severe Fever

Abstract Background: Severe fever with thrombocytopenia syndrome (SFTS) is a severe systemic virus infectious disease usually having multi-organ dysfunction which resembles sepsis. Methods: Data of 321 patients with laboratory-confirmed SFTS from May 2013 to July 2017 were retrospectively analyzed. Demographic and clinical characteristics, calculated quick sequential organ failure assessment (qSOFA) score and systemic inflammatory response syndrome (SIRS) criteria for survivors and nonsurvivors were compared. Independent risk factors associated with in-hospital mortality were obtained using multivariable logistic regression analysis. Risk score models containing different risk factors for mortality in stratified patients were established whose predictive values were evaluated using the area under ROC curve (AUC). Results: Of 321 patients, 87 died (27.1%). Age ( p <0.001) and percentage numbers of patients with qSOFA≥2 and SIRS≥2 ( p <0.0001) were profoundly greater in nonsurvivors than in survivors. Age, qSOFA, SIRS score and aspartate aminotransferase (AST) were independent risk factors for mortality for all patients. And qSOFA score was the only common risk factor in all patients, those age≥60 years and those enrolled in the intensive care unit (ICU). A risk score model containing all these risk factors (Model1) has high predictive value for in-hospital mortality in these three groups with AUCs (95% CI): 0.919 (0.883-0.946), 0.929 (0.862-0.944) and 0.815 (0.710-0.894), respectively. A model only including age and qSOFA also has high predictive value for mortality in these groups with AUCs (95% CI): 0.872 (0.830-0.906), 0.885(0.801-0.900) and 0.865 (0.767-0.932), respectively. Conclusions: Risk models containing qSOFA have high predictive validity for SFTS mortality.

scholarly journals Predictive risk score model for severe fever with thrombocytopenia syndrome mortality based on qSOFA and SIRS scoring system

2019 ◽  
Author(s):  
Li Wang ◽  
Kun Ding ◽  
Chunguo Hou ◽  
Zhiqiang Zou ◽  
Song Qin
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Risk Score ◽  
Risk Groups ◽  
Multivariable Logistic Regression Analysis ◽  
Predictive Values ◽  
Independent Risk Factors ◽  
Score Model ◽  
Qsofa Score ◽  
Severe Fever

Abstract Background: Severe fever with thrombocytopenia syndrome (SFTS) is a severe systemic virus infectious disease usually having multi-organ dysfunction which resembles sepsis.Methods: A total of 321 patients with laboratory-confirmed SFTS from May 2013 to July 2017 were retrospectively analysed. Demographic and clinical characteristics, calculated quick sequential organ failure assessment (qSOFA) score and systemic inflammatory response syndrome (SIRS) criteria for survivors and nonsurvivors were compared. Independent risk factors associated with in-hospital mortality were obtained using multivariable logistic regression analysis. Risk score models containing different risk factors for mortality in stratified patients were established whose predictive values were evaluated using area under ROC curve (AUC).Results: Of 321 patients, 87 died (27.1%). Age (p<0.001) and percentage numbers of patients with qSOFA≥2 and SIRS≥2 (p<0.0001) were profoundly greater in nonsurvivors than in survivors. Age, qSOFA, SIRS score and aspartate aminotransferase (AST) were independent risk factors for mortality for all patients. And qSOFA score was the only common risk factor in all patients, those of age≥60 years and those enrolled in intensive care unit (ICU). A risk score model containing all these risk factors (Model1) has high predictive value for in-hospital mortality in these three groups with AUCs (95% CI): 0.919 (0.883-0.946), 0.929 (0.862-0.944) and 0.815 (0.710-0.894), respectively. Kaplan-Meier survival analysis showed a strong difference between high-risk and low-risk groups at a cutoff value > 9.22 (log-rank c2 = 126.3, p <0.0001) Conclusions: qSOFA and risk models containing qSOFA have high predictive validity for SFTS in-hospital mortality.

scholarly journals A New Rapid Approach for Predicting Death in Coronavirus Patients: The Development and Validation of the COVID-19 Risk-Score in Fars Province (CRSF)

2022 ◽  
Author(s):  
Mehrdad Sharifi ◽  
Mohammad Hossein Khademian ◽  
Razieh Sadat Mousavi-Roknabadi ◽  
Vahid Ebrahimi ◽  
Robab Sadegh
Keyword(s):  
Risk Factors ◽  
Risk Score ◽  
Predictive Value ◽  
Assessment Tool ◽  
Fars Province ◽  
Risk Of Mortality ◽  
Risk Patients ◽  
Independent Risk Factors ◽  
Development And Validation ◽  
Underlying Diseases

Background:Patients who are identified to be at a higher risk of mortality from COVID-19 should receive better treatment and monitoring. This study aimed to propose a simple yet accurate risk assessment tool to help decision-making in the management of the COVID-19 pandemic. Methods: From Jul to Nov 2020, 5454 patients from Fars Province, Iran, diagnosed with COVID-19 were enrolled. A multiple logistic regression model was trained on one dataset (training set: n=4183) and its prediction performance was assessed on another dataset (testing set: n=1271). This model was utilized to develop the COVID-19 risk-score in Fars (CRSF). Results: Five final independent risk factors including gender (male: OR=1.37), age (60-80: OR=2.67 and >80: OR=3.91), SpO2 (≤85%: OR=7.02), underlying diseases (yes: OR=1.25), and pulse rate (<60: OR=2.01 and >120: OR=1.60) were significantly associated with in-hospital mortality. The CRSF formula was obtained using the estimated regression coefficient values of the aforementioned factors. The point values for the risk factors varied from 2 to 19 and the total CRSF varied from 0 to 45. The ROC analysis showed that the CRSF values of ≥15 (high-risk patients) had a specificity of 73.5%, sensitivity of 76.5%, positive predictive value of 23.2%, and negative predictive value (NPV) of 96.8% for the prediction of death (AUC=0.824, P<0.0001). Conclusion:This simple CRSF system, which has a high NPV,can be useful for predicting the risk of mortality in COVID-19 patients. It can also be used as a disease severity indicator to determine triage level for hospitalization.

scholarly journals Increasing Newly Diagnosed Inflammatory Bowel Disease and Improving Prognosis in China: A 30-year Retrospective Study From a Single Center

2020 ◽  
Author(s):  
Hong Lv ◽  
Meng Jin ◽  
Huimin Zhang ◽  
Xuanfu Chen ◽  
Meixu Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Pearson Correlation ◽  
Cohort Analysis ◽  
Tertiary Hospital ◽  
Intestinal Fistula ◽  
Multivariable Logistic Regression Analysis ◽  
Newly Diagnosed ◽  
College Hospital ◽  
Independent Risk Factors

Abstract Background: We aimed to characterize the trends of prognosis in Ulcerative Colitis (UC) and Crohn’s Disease (CD) in a Chinese tertiary hospital. Methods: A 30-year retrospective cohort analysis was conducted at Peking Union Medical College Hospital. Consecutive patients newly diagnosed with UC or CD from 1985 to 2014 were included. The primary outcome was in-hospital mortality. Second outcomes included surgery and length of stay in hospital. Pearson correlation coefficient was performed to determine the relationship between time and prognosis. Multivariable logistic regression analysis was performed to determine the risk factors for in-hospital mortality and surgery. Results: In total, 1467 patients were included in this study (898 cases with UC and 569 cases with CD). Annual admissions of UC and CD rose significantly over the last 30 years (UC, r=0.918, P<0.05; CD, r=0.898, P<0.05). Decreased in-hospital mortalities were observed in patients with UC and CD (UC, from 2.44% to 0.27%, r=-0.827, P<0.05; CD, from 12.50% to 0.00%, r=-0.978, P<0.05). A decreasing surgery rate was observed in patients with CD (r=-0.847, P<0.05) while an increasing surgery rate was observed in patients with UC (r=0.956, P<0.05). Shortened average lengths of stay in hospital were observed both in patients with UC and CD (UC, from 47.83±34.35 days to 23.58±20.05 days, r=-0.970, P<0.05; CD, from 65.50±50.57days to 26.41±18.43 days, r=-0.913, P<0.05). Toxic megacolon, sepsis shock were independent risk factors for in-hospital mortality in patients with UC. Intestinal fistula, intestinal perforation were independent risk factors for in-hospital mortality in patients with CD. Conclusions: In this cohort, the admissions of patients with UC and CD were increased with a significantly improved prognosis during past 30 years.

scholarly journals Increasing newly diagnosed inflammatory bowel disease and improving prognosis in China: a 30-year retrospective study from a single centre

2020 ◽  
Author(s):  
Hong Lv ◽  
Meng Jin ◽  
Huimin Zhang ◽  
Xuanfu Chen ◽  
Meixu Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Pearson Correlation ◽  
Cohort Analysis ◽  
Tertiary Hospital ◽  
Intestinal Fistula ◽  
Multivariable Logistic Regression Analysis ◽  
Newly Diagnosed ◽  
College Hospital ◽  
Independent Risk Factors

Abstract Background: We aimed to characterize the trends of prognosis in ulcerative colitis (UC) and Crohn’s disease (CD) in a Chinese tertiary hospital. Methods: A 30-year retrospective cohort analysis was conducted at Peking Union Medical College Hospital. Consecutive patients newly diagnosed with UC or CD from 1985 to 2014 were included. The primary outcome was in-hospital mortality. The secondary outcomes included surgery and length of stay in hospital. The Pearson correlation coefficient was applied to determine the relationship between time and prognosis. Multivariable logistic regression analysis was performed to determine the risk factors for in-hospital mortality and surgery. Results: In total, 1467 patients were included in this study (898 cases with UC and 569 cases with CD). Annual admissions for UC and CD have increased significantly over the last 30 years (UC, r=0.918, P<0.05; CD, r=0.898, P<0.05). Decreased in-hospital mortality was observed both in patients with UC and CD (UC, from 2.44% to 0.27%, r=-0.827, P<0.05; CD, from 12.50% to 0.00%, r=-0.978, P<0.05). A decreasing surgery rate was observed in patients with CD (r=-0.847, P<0.05), while an increasing surgery rate was observed in patients with UC (r=0.956, P<0.05). Shortened average lengths of hospital stay were observed in both UC and CD patients (UC, from 47.83±34.35 days to 23.58±20.05 days, r=-0.970, P<0.05; CD, from 65.50±50.57 days to 26.41±18.43 days, r=-0.913, P<0.05). Toxic megacolon and septic shock were independent risk factors for in-hospital mortality in patients with UC. Intestinal fistula and intestinal perforation were independent risk factors for in-hospital mortality in patients with CD. Conclusions: In this cohort, the admissions of patients with UC and CD were increased, with significantly improved prognoses during the past 30 years.

A Risk Score Model for Evaluation and Management of Patients with Thyroid Nodules

2018 ◽  
Vol 50 (07) ◽  
pp. 543-550 ◽  
Author(s):  
Yongwen Zhang ◽  
Fanrong Meng ◽  
Lianqing Hong ◽  
Lanfang Chu
Keyword(s):  
Risk Factors ◽  
Risk Score ◽  
Standard Error ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Cervical Lymph Nodes ◽  
Score System ◽  
Diagnosis System ◽  
Score Model ◽  
Risk Score System

AbstractThe study is aimed to establish a simplified and practical tool for analyzing thyroid nodules. A novel risk score model was designed, risk factors including patient history, patient characteristics, physical examination, symptoms of compression, thyroid function, ultrasonography (US) of thyroid and cervical lymph nodes were evaluated and classified into high risk factors, intermediate risk factors, and low risk factors. A total of 243 thyroid nodules in 162 patients were assessed with risk score system and Thyroid Imaging-Reporting and Data System (TI-RADS). The diagnostic performance of risk score system and TI-RADS was compared. The accuracy in the diagnosis of thyroid nodules was 89.3% for risk score system, 74.9% for TI-RADS respectively. The specificity, accuracy and positive predictive value (PPV) of risk score system were significantly higher than the TI-RADS system (χ2=26.287, 17.151, 11.983; p <0.05), statistically significant differences were not observed in the sensitivity and negative predictive value (NPV) between the risk score system and TI-RADS (χ2=1.276, 0.290; p>0.05). The area under the curve (AUC) for risk score diagnosis system was 0.963, standard error 0.014, 95% confidence interval (CI)=0.934–0.991, the AUC for TI-RADS diagnosis system was 0.912 with standard error 0.021, 95% CI=0.871–0.953, the AUC for risk score system was significantly different from that of TI-RADS (Z=2.02; p <0.05). Risk score model is a reliable, simplified and cost-effective diagnostic tool used in diagnosis of thyroid cancer. The higher the score is, the higher the risk of malignancy will be.

scholarly journals Risk factors for the treatment outcome of retreated pulmonary tuberculosis patients in China: an optimized prediction model

2017 ◽  
Vol 145 (9) ◽  
pp. 1805-1814 ◽  
Author(s):  
X.-M. WANG ◽  
S.-H. YIN ◽  
J. DU ◽  
M.-L. DU ◽  
P.-Y. WANG ◽  
...  
Keyword(s):  
Risk Factors ◽  
Treatment Outcome ◽  
Pulmonary Tuberculosis ◽  
Treatment Failure ◽  
Risk Score ◽  
Risk Scores ◽  
Predictive Values ◽  
Factors Associated ◽  
Positive Culture Result ◽  
Score Model

SUMMARYRetreatment of tuberculosis (TB) often fails in China, yet the risk factors associated with the failure remain unclear. To identify risk factors for the treatment failure of retreated pulmonary tuberculosis (PTB) patients, we analyzed the data of 395 retreated PTB patients who received retreatment between July 2009 and July 2011 in China. PTB patients were categorized into ‘success’ and ‘failure’ groups by their treatment outcome. Univariable and multivariable logistic regression were used to evaluate the association between treatment outcome and socio-demographic as well as clinical factors. We also created an optimized risk score model to evaluate the predictive values of these risk factors on treatment failure. Of 395 patients, 99 (25·1%) were diagnosed as retreatment failure. Our results showed that risk factors associated with treatment failure included drug resistance, low education level, low body mass index (<18·5), long duration of previous treatment (>6 months), standard treatment regimen, retreatment type, positive culture result after 2 months of treatment, and the place where the first medicine was taken. An Optimized Framingham risk model was then used to calculate the risk scores of these factors. Place where first medicine was taken (temporary living places) received a score of 6, which was highest among all the factors. The predicted probability of treatment failure increases as risk score increases. Ten out of 359 patients had a risk score >9, which corresponded to an estimated probability of treatment failure >70%. In conclusion, we have identified multiple clinical and socio-demographic factors that are associated with treatment failure of retreated PTB patients. We also created an optimized risk score model that was effective in predicting the retreatment failure. These results provide novel insights for the prognosis and improvement of treatment for retreated PTB patients.

scholarly journals Increasing newly diagnosed inflammatory bowel disease and improving prognosis in China: a 30-year retrospective study from a single centre

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hong Lv ◽  
Meng Jin ◽  
Huimin Zhang ◽  
Xuanfu Chen ◽  
Meixu Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Pearson Correlation ◽  
Cohort Analysis ◽  
Tertiary Hospital ◽  
Intestinal Fistula ◽  
Multivariable Logistic Regression Analysis ◽  
Newly Diagnosed ◽  
College Hospital ◽  
Independent Risk Factors

Abstract Background We aimed to characterize the trends of prognosis in ulcerative colitis (UC) and Crohn’s disease (CD) in a Chinese tertiary hospital. Methods A 30-year retrospective cohort analysis was conducted at Peking Union Medical College Hospital. Consecutive patients newly diagnosed with UC or CD from 1985 to 2014 were included. The primary outcome was in-hospital mortality. The secondary outcomes included surgery and length of stay in hospital. The Pearson correlation coefficient was applied to determine the relationship between time and prognosis. Multivariable logistic regression analysis was performed to determine the risk factors for in-hospital mortality and surgery. Results In total, 1467 patients were included in this study (898 cases with UC and 569 cases with CD). Annual admissions for UC and CD have increased significantly over the last 30 years (UC, r = 0.918, P < 0.05; CD, r = 0.898, P < 0.05). Decreased in-hospital mortality was observed both in patients with UC and CD (UC, from 2.44 to 0.27%, r = − 0.827, P < 0.05; CD, from 12.50 to 0.00%, r = − 0.978, P < 0.05). A decreasing surgery rate was observed in patients with CD (r = − 0.847, P < 0.05), while an increasing surgery rate was observed in patients with UC (r = 0.956, P < 0.05). Shortened average lengths of hospital stay were observed in both UC and CD patients (UC, from 47.83 ± 34.35 to 23.58 ± 20.05 days, r = − 0.970, P < 0.05; CD, from 65.50 ± 50.57 to 26.41 ± 18.43 days, r = − 0.913, P < 0.05). Toxic megacolon and septic shock were independent risk factors for in-hospital mortality in patients with UC. Intestinal fistula and intestinal perforation were independent risk factors for in-hospital mortality in patients with CD. Conclusions In this cohort, the admissions of patients with UC and CD were increased, with significantly improved prognoses during the past 30 years.

scholarly journals Increasing newly diagnosed inflammatory bowel disease and improving prognosis in China: a 30-year retrospective study from a single center

2020 ◽  
Author(s):  
Hong Lv ◽  
Meng Jin ◽  
Huimin Zhang ◽  
Xuanfu Chen ◽  
Meixu Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Pearson Correlation ◽  
Cohort Analysis ◽  
Tertiary Hospital ◽  
Intestinal Fistula ◽  
Multivariable Logistic Regression Analysis ◽  
Newly Diagnosed ◽  
College Hospital ◽  
Independent Risk Factors

Abstract Background: We aimed to characterize the trends of prognosis in ulcerative colitis (UC) and Crohn’s disease (CD) in a Chinese tertiary hospital. Methods: A 30-year retrospective cohort analysis was conducted at Peking Union Medical College Hospital. Consecutive patients newly diagnosed with UC or CD from 1985 to 2014 were included. The primary outcome was in-hospital mortality. The secondary outcomes included surgery and length of stay in hospital. The Pearson correlation coefficient was applied to determine the relationship between time and prognosis. Multivariable logistic regression analysis was performed to determine the risk factors for in-hospital mortality and surgery. Results: In total, 1467 patients were included in this study (898 cases with UC and 569 cases with CD). Annual admissions for UC and CD have increased significantly over the last 30 years (UC, r=0.918, P<0.05; CD, r=0.898, P<0.05). Decreased in-hospital mortality was observed both in patients with UC and CD (UC, from 2.44% to 0.27%, r=-0.827, P<0.05; CD, from 12.50% to 0.00%, r=-0.978, P<0.05). A decreasing surgery rate was observed in patients with CD (r=-0.847, P<0.05), while an increasing surgery rate was observed in patients with UC (r=0.956, P<0.05). Shortened average lengths of hospital stay were observed in both UC and CD patients (UC, from 47.83±34.35 days to 23.58±20.05 days, r=-0.970, P<0.05; CD, from 65.50±50.57 days to 26.41±18.43 days, r=-0.913, P<0.05). Toxic megacolon and septic shock were independent risk factors for in-hospital mortality in patients with UC. Intestinal fistula and intestinal perforation were independent risk factors for in-hospital mortality in patients with CD. Conclusions: In this cohort, the admissions of patients with UC and CD were increased, with significantly improved prognoses during the past 30 years.

scholarly journals Association of biomarkers related to preoperative inflammatory and coagulation with postoperative in-hospital deaths in patients with type A acute aortic dissection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ming Li ◽  
Suochun Xu ◽  
Yang Yan ◽  
Haichen Wang ◽  
Jianjie Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Hospital Mortality ◽  
Logistic Regression Analysis ◽  
Type A ◽  
Multivariable Logistic Regression Analysis ◽  
Hospital Deaths ◽  
Independent Risk Factors ◽  
D Dimer

AbstractThe aim of this study was to analyze the role of blood biomarkers regarding preoperative inflammation and coagulation in predicting the postoperative in-hospital mortality of patients with type A acute aortic dissection (AAD). A total of 206 patients with type A AAD who had received surgical treatment were enrolled in this study. Patients were divided into two groups: the death group (28 patients who died during hospitalization) and the survival group (178 patients). Peripheral blood samples were collected before anesthesia induction. Preoperative levels of D-dimer, fibrinogen (FIB), platelet (PLT), white blood cells (WBC) and neutrophil (NEU) were compared between the two groups. Univariable and multivariable logistic regression analysis were utilized to identify the independent risk factors for postoperative in-hospital deaths of patients with type A AAD. Receiver operating characteristic (ROC) curve were used to analyze the predictive value of these indices in the postoperative in-hospital mortality of the patients. Univariable logistic regression analysis showed that the P values of the five parameters including D-dimer, FIB, PLT, WBC and NEU were all less than 0.1, which may be risk factors for postoperative in-hospital deaths of patients with type A AAD. Further multivariable logistic regression analysis indicated that higher preoperative D-dimer and WBC levels were independent risk factors for postoperative in-hospital mortality of patients with type A AAD. ROC curve analysis indicated that application of combining FIB and PLT could improve accuracy in prediction of postoperative in-hospital mortality in patients with type A AAD. Both preoperative D-dimer and WBC in patients with type A AAD may be used as independent risk factors for the postoperative in-hospital mortality of such patients. The combination of FIB and PLT may improve the accuracy of clinical prognostic assessment.

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