scholarly journals Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

2019 ◽  
Author(s):  
ShunJie Yang ◽  
Zhong-Jun Ding ◽  
Jian Li ◽  
Yang Xue ◽  
Gang Chen
Keyword(s):  
Logistic Regression ◽  
Clinical Outcomes ◽  
Protective Factor ◽  
Age Of Onset ◽  
Postoperative Outcomes ◽  
Discoid Lateral Meniscus ◽  
Work Intensity ◽  
Discoid Meniscus ◽  
Cartilage Lesions ◽  
Outerbridge Grade

Abstract Background: Discoid lateral meniscus (DLM) have a higher rate of tear and degeneration for its abnormal shape and structure. Arthroscopy is the main treatment for symptomatic DLM, however, postoperative clinical outcomes vary widely resulting from effects of diverse factors. Therefore, the present research aims to explore the factors influencing postoperative clinical outcomes of symptomatic DLM. Methods: Patients with discoid meniscus who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were selected according to the inclusion and exclusion criteria. Gender, body mass index (BMI), and 18 other factors were selected as potential predictors that might affect postoperative outcomes. Knee function was assessed by the Lysholm, Tegner, International Knee Documentation Committee (IKDC) and Ikeuchi scales. Univariate analyses (rank-sum test and chi-squared test) and multivariate analyses (ordered logistic regression and logistic regression) were used to detect the risk factors bearing on postoperative outcomes. P<0.05 was considered statistically significant.Results: A total of 502 patients were enrolled. Female gender was an influencing factor for Lysholm (P=0.002, odds ratio (OR)=2.713), Tegner (P=0.001, OR=2.526), IKDC (P=0.022, OR=1.735) and Ikeuchi scores (P=0.010, OR=2.164). BMI was negatively correlated with Lysholm (P=0.007, OR=1.119) and IKDC (P=0.029, OR=1.088) scores. Work intensity was negatively related to IKDC (P=0.038, OR=1.492) and Ikeuchi (P=0.014, OR=1.689) scores. Age of onset was inversely correlated with Tegner (P<0.001, OR=1.109) score. Symptoms duration and IKDC (P=0.002, OR=1.020) had an inverse correlation. Lack of cartilage lesions was a protective factor in terms of Tegner score (P<0.001, OR=0.261). Outerbridge grade was negatively correlated with Lysholm (P=0.016, OR=1.589) and Ikeuchi (P=0.017, OR=1.582) scores. Saucerization with repair was a risk factor for poor Ikeuchi scores (P=0.037, OR=4.328) in terms of subtotal/total meniscectomy.Conclusion: Arthroscopic treatment of symptomatic DLM is safe and effective. Female sex, cartilage lesions and saucerization with repair may be related to unfavourable postoperative outcomes. Clinical efficacy may worsen with increasing BMI, work intensity, symptomatic duration, age of onset and Outerbridge grade.

scholarly journals Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

2020 ◽  
Author(s):  
ShunJie Yang ◽  
Zhong-Jun Ding ◽  
Jian Li ◽  
Yang Xue ◽  
Gang Chen
Keyword(s):  
Logistic Regression ◽  
Clinical Outcomes ◽  
Protective Factor ◽  
Age Of Onset ◽  
Postoperative Outcomes ◽  
Discoid Lateral Meniscus ◽  
Work Intensity ◽  
Discoid Meniscus ◽  
Cartilage Lesions ◽  
Outerbridge Grade

Abstract Background: Discoid lateral meniscus (DLM) have a higher rate of tear and degeneration for its abnormal shape and structure. Arthroscopy is the main treatment for symptomatic DLM, however, postoperative clinical outcomes vary widely resulting from effects of diverse factors. Therefore, the present research aims to explore the factors influencing postoperative clinical outcomes of symptomatic DLM . Methods: Patients with discoid meniscus who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were selected according to the inclusion and exclusion criteria. Gender, body mass index (BMI) ,and 18 other factors were selected as potential predictors that might affect postoperative outcomes . Knee function was assessed by the Lysholm, Tegner, International Knee Documentation Committee (IKDC) and Ikeuchi scales. Univariate analyses (rank-sum test and chi-squared test) and multivariate analyses (ordered logistic regression and logistic regression) were used to detect the risk factors bearing on postoperative outcomes. P<0.05 was considered statistically significant. Results: A total of 502 patients were enrolled. Female gender was an influencing factor for Lysholm (P=0.002, odds ratio (OR) =2.713), Tegner (P=0.001, OR=2.526) , IKDC (P=0.022, OR=1.735) and Ikeuchi scores (P=0.010, OR=2.164). BMI was negatively correlated with Lysholm (P=0.007, OR=1.119) and IKDC (P=0.029, OR=1.088) scores. Work intensity was negatively related to IKDC (P=0.038, OR=1.492) and Ikeuchi (P=0.014, OR=1.689) scores. Age of onset was inversely correlated with Tegner (P<0.001, OR=1.109) score.Symptoms duration and IKDC (P=0.002, OR=1.020) had an inverse correlation. Lack of cartilage lesions was a protective factor in terms of Tegner score (P<0.001, OR=0.261). Outerbridge grade was negatively correlated with Lysholm (P=0.016, OR=1.589) and Ikeuchi (P=0.017, OR=1.582) scores. Saucerization with repair was a risk factor for poor Ikeuchi scores (P=0.037, OR=4.328) in terms of subtotal/total meniscectomy. Conclusion: Arthroscopic treatment of symptomatic DLM is safe and effective . Female sex, cartilage lesions and saucerization with repair may be related to unfavourable postoperative outcomes. Clinical efficacy may worsen with increasingBMI, work intensity, symptomatic duration, age of onset and Outerbridge grade.

scholarly journals Multivariate ordered logistic regression analysis of the postoperative effect of symptomatic discoid lateral meniscus

2021 ◽  
Author(s):  
Shun-Jie Yang ◽  
Jian Li ◽  
Yang Xue ◽  
Zhong Zhang ◽  
Gang Chen
Keyword(s):  
Logistic Regression ◽  
Age Of Onset ◽  
Univariate Analysis ◽  
Arthroscopic Surgery ◽  
Lateral Meniscus ◽  
Postoperative Outcomes ◽  
Discoid Lateral Meniscus ◽  
Work Intensity ◽  
Duration Of Symptoms ◽  
Ordered Logistic Regression

Abstract Introduction The postoperative effect of arthroscopy in the treatment of symptomatic discoid lateral meniscus (DLM) varies greatly among individuals. Therefore, this study aims to investigate the factors affecting the postoperative outcomes of symptomatic DLM. Materials and methods According to the inclusion and exclusion criteria, patients with symptomatic single-knee DLM who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were included. Retrospectively collected 16 factors probably affecting postoperative outcomes. The Ikeuchi grade system was used to evaluate the knee joint function. Univariate analysis was performed by Kruskal–Wallis rank-sum test or Mann–Whitney U test, and multivariate analysis by ordered logistic regression. P < 0.05 was considered statistically significant. Results A sum of 502 patients was included, including 353 females (70.3%) and 149 males (29.7%). Difference between preoperative and postoperative Ikeuchi grade was statistically significant (P < 0.001). Female was bad to obtain a good Ikeuchi grade (P = 0.009, OR 0.458). Outerbridge grade (P = 0.018, OR 0.638) was negatively correlated with Ikeuchi grade. BMI (P = 0.001, OR 0.875) and work intensity (P = 0.020, OR 0.611) were inversely correlated with Ikeuchi grade. Age of onset (P < 0.001, OR 0.956) and symptoms duration (P < 0.001, OR 0.988) were negatively correlated with Ikeuchi grade. Besides, compared to total meniscectomy, meniscoplasty with a repair was an unfavourable factor for Ikeuchi grade (P = 0.044, OR 0.245). Conclusions With the increase of BMI, work intensity, age of onset, duration of symptoms, and the severity of cartilage lesion, the postoperative results become worse. Moreover, female and meniscoplasty with repair are risk factors for the postoperative outcomes.

scholarly journals Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

2020 ◽  
Author(s):  
ShunJie Yang ◽  
Zhong-Jun Ding ◽  
Jian Li ◽  
Yang Xue ◽  
Gang Chen
Keyword(s):  
Clinical Symptoms ◽  
Age Of Onset ◽  
Arthroscopic Surgery ◽  
Lateral Meniscus ◽  
International Knee Documentation Committee ◽  
Influential Factors ◽  
Postoperative Outcomes ◽  
Discoid Lateral Meniscus ◽  
Ikdc Score ◽  
Male Sex

Abstract Background: Due to its abnormal morphology and ultrastructure, discoid lateral meniscus (DLM) is prone to tear and degeneration, leading to clinical symptoms. Arthroscopy is the main treatment for symptomatic DLM; however, postoperative outcomes vary widely due to the effects of diverse factors. This research aims to explore the factors influencing postoperative outcomes of symptomatic DLM. Methods: Patients with DLM who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were enrolled according to the inclusion and exclusion criteria. Fourteen variables, including sex, body mass index (BMI) and other variables, were chosen as factors for study. Knee function was assessed using the International Knee Documentation Committee (IKDC) score. Univariate analyses (Mann-Whitney U test or Kruskall-Wallis rank sum test) and multivariate analyses (ordinal logistic regression) were used to identify the factors that influenced postoperative outcomes. P<0.05 was considered statistically significant.Results: A total of 502 patients, including 353 females (70.3%) and 149 males (29.7%), were enrolled. The median IKDC score postoperatively (87.4; range, 41.4~97.7; IQR, 14.6) was higher than that preoperatively (57.6; range, 26.9~ 64.9; IQR, 9.7) (P<0.001). Male sex was predictive of a higher IKDC score (P=0.023, OR=1.702). Compared with BMI ≥25 kg/m2, <18.5 kg/m2 was associated with better IKDC score (P=0.026, OR=3.016). Contrasting with age of onset ≥45 years, ≤14 years (P<0.001, OR=20.780) and 14~25 years (P<0.001, OR=8.516) were associated with better IKDC score. In comparison with symptoms duration>24 months, IKDC scores for patients with symptoms duration ≤1 month (P=0.001, OR=3.511), 1 ~ 6 months (P < 0.001, OR = 3.463) and 6 ~ 24 months (P < 0.001, OR = 3.254) were significantly elevated. Compared to Outerbridge grade III ~ IV, no injury (P<0.001, OR=6.379) and grade I (P=0.01, OR=4.332) were associated with higher IKDC score.Conclusions: Arthroscopic treatment of symptomatic DLM is safe and effective, but its clinical efficacy is affected by many factors. Specifically, male sex, BMI < 18.5kg/m2, age of onset < 25 years (especially < 14 years) and symptoms duration < 24 months are conducive to good postoperative outcomes. However, combined articular cartilage injury (Outbridge grade≥2) reduces postoperative effect.

scholarly journals Classifying Crohn’s disease into colon-involving versus non-colon-involving groups is a better predictor of clinical outcomes than the Montreal classification

2020 ◽  
Vol 13 ◽  
pp. 175628482096873
Author(s):  
Si-Nan Lin ◽  
Dan-Ping Zheng ◽  
Yun Qiu ◽  
Sheng-Hong Zhang ◽  
Yao He ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Abdominal Surgery ◽  
Clinical Outcomes ◽  
Protective Factor ◽  
Age Of Onset ◽  
Disease Classification ◽  
Major Abdominal Surgery ◽  
Montreal Classification

Background: A suitable disease classification is essential for individualized therapy in patients with Crohn’s disease (CD). Although a potential mechanistic classification of colon-involving and non-colon-involving disease was suggested by recent genetic and microbiota studies, the clinical implication has seldom been investigated. We aimed to explore the association of this colonic-based classification with clinical outcomes in patients with CD compared with the Montreal classification. Methods: This was a retrospective study of CD patients from a tertiary referral center. Patients were categorized into colon-involving and non-colon-involving disease, and according to the Montreal classification. Clinico-demographic data, medications, and surgeries were compared between the two classifications. The primary outcome was the need for major abdominal surgery. Results: Of 934 patients, those with colonic involvement had an earlier median (interquartile range) age of onset [23.0 (17.0–30.0) versus 26.0 (19.0–35.0) years, p = 0.001], higher frequency of perianal lesions (31.2% versus 14.5%, p < 0.001) and extraintestinal manifestations (21.8% versus 14.5%, p = 0.010), but lower frequency of stricture (B2) (16.3% versus 24.0%, p = 0.005), than those with non-colon-involving disease. Colon-involving disease was a protective factor against major abdominal surgery [hazard ratio, 0.689; 95% confidence interval (CI), 0.481–0.985; p = 0.041]. However, patients with colon-involving CD were more prone to steroids [odds ratio (OR), 1.793; 95% CI, 1.206–2.666; p = 0.004] and azathioprine/6-mercaptopurine (AZA/6-MP) treatment (OR, 1.732; 95% CI, 1.103–2.719; p = 0.017) than were patients with non-colon-involving disease. The Montreal classification was not predictive of surgery or steroids and AZA/6-MP treatment. Conclusion: This study supports the rationale for disease classification based on the involvement of colon. This new classification of CD is a better predictor of clinical outcomes than the Montreal classification.

scholarly journals Current trends in optimal medical therapy after PCI and its influence on clinical outcomes in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jian Zhang ◽  
Jing-Yan Hao ◽  
Rui Jing ◽  
Jing-Jing Liu ◽  
Cheng-Ye Di ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Clinical Outcomes ◽  
Medical Therapy ◽  
Protective Factor ◽  
Cox Regression ◽  
Angiotensin Receptor Blockers ◽  
Optimal Medical Therapy ◽  
Binary Logistic Regression Analysis ◽  
Converting Enzyme Inhibitors ◽  
Current Trends

Abstract Background Limited data were available on the current trends in optimal medical therapy (OMT) after PCI and its influence on clinical outcomes in China. We aimed to evaluate the utilization and impact of OMT on the main adverse cardiovascular and cerebrovascular events (MACCEs) in post-PCI patients and analyzed the factors predictive of OMT after discharge. Methods We collected data from 3812 individuals from 2016.10 to 2017.09 at TEDA International Cardiovascular Hospital. They were classified into an OMT group and a non-OMT group according to their OMT status, which was defined as the combination of dual antiplatelet therapy, statins, β-blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers after PCI. Multivariable Cox regression models were developed to assess the association between OMT and MACCEs, defined as all-cause mortality, nonfatal myocardial infarction, stroke, and target vessel revascularization. A logistic regression model was established to analyze the factors predictive of OMT. Results Our results revealed that the proportion of patients receiving OMT and its component drugs decreased over time. A total of 36.0% of patients were still adherent to OMT at the end of follow-up. Binary logistic regression analysis revealed that baseline OMT (P < 0.001, OR = 52.868) was the strongest predictor of OMT after PCI. The Cox hazard model suggested that smoking after PCI was associated with the 1-year risk of MACCE (P = 0.001, HR = 2.060, 95% CI 1.346–3.151), while OMT (P = 0.001, HR = 0.486, 95% CI 0.312–0.756) was an independent protective factor against postoperative MACCEs. Conclusions There was still a gap between OMT utilization after PCI and the recommendations in the evidence-based guidelines. Sociodemographic and clinical factors influence the application of OMT. The management of OMT and smoking cessation after PCI should be emphasized.

scholarly journals Autoantibody profiles and clinical association in Thai patients with autoimmune retinopathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aulia Rahmi Pawestri ◽  
Niracha Arjkongharn ◽  
Ragkit Suvannaboon ◽  
Aekkachai Tuekprakhon ◽  
Vichien Srimuninnimit ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Age Of Onset ◽  
Male Gender ◽  
Blurred Vision ◽  
Autoimmune Retinopathy ◽  
Immune Mediated ◽  
Underlying Malignancy ◽  
Clinical Presentations ◽  
Treatment Plans ◽  
Autoantibody Profiles

AbstractAutoimmune retinopathy (AIR) is a rare immune-mediated inflammation of the retina. The autoantibodies against retinal proteins and glycolytic enzymes were reported to be involved in the pathogenesis. This retrospective cohort study assessed the antiretinal autoantibody profiles and their association with clinical outcomes of AIR patients in Thailand. We included 44 patients, 75% were females, with the overall median age of onset of 48 (17–74, IQR 40–55.5) years. Common clinical presentations were nyctalopia (65.9%), blurred vision (52.3%), constricted visual field (43.2%), and nonrecordable electroretinography (65.9%). Underlying malignancy and autoimmune diseases were found in 2 and 12 female patients, respectively. We found 41 autoantibodies, with anti-α-enolase (65.9%) showing the highest prevalence, followed by anti-CAII (43.2%), anti-aldolase (40.9%), and anti-GAPDH (36.4%). Anti-aldolase was associated with male gender (P = 0.012, OR 7.11, 95% CI 1.54–32.91). Anti-CAII showed significant association with age of onset (P = 0.025, 95% CI − 17.28 to − 1.24), while anti-α-enolase (P = 0.002, OR 4.37, 95% CI 1.83–10.37) and anti-GAPDH (P = 0.001, OR 1.87, 95% CI 1.32–2.64) were significantly associated with nonrecordable electroretinography. Association between the antibody profiles and clinical outcomes may be used to direct and adjust the treatment plans and provide insights in the pathogenesis of AIR.

scholarly journals 270. Clinical Outcomes of Ceftriaxone versus Penicillin G for Complicated Viridans Group Streptococci Bacteremia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S137-S137
Author(s):  
Stephanie Wo ◽  
Yanina Dubrovskaya ◽  
Justin Siegfried ◽  
John Papadopoulos ◽  
Shin-Pung Jen
Keyword(s):  
Clinical Outcomes ◽  
Hospital Readmission ◽  
Protective Factor ◽  
Primary Outcome ◽  
Bloodstream Infections ◽  
Penicillin G ◽  
Eligibility Criteria ◽  
Extended Spectrum Beta Lactamase ◽  
Increased Risk ◽  
Viridans Group Streptococci

Abstract Background Viridans group streptococci (VGS) is an infrequent yet significant cause of bloodstream infections, and complicated cases may require prolonged antibiotic therapy. Ceftriaxone (CTX) and penicillin G (PCN G) are both considered first line options for VGS infections, but comparisons between these agents are limited. We evaluated the clinical outcomes amongst patients treated with CTX and PCN G for complicated VGS bacteremia. Methods This was a single-center, retrospective study of adult patients with ≥1 positive VGS blood culture who were treated with either CTX or PCN G/ampicillin (both included in PCN G arm) between January 2013 and June 2019. The primary outcome was a composite of safety endpoints, including hospital readmission due to VGS or an adverse event (AE) from therapy, Clostridioides difficile infections, treatment modification or discontinuation due to an antibiotic-related AE, and development of extended-spectrum beta lactamase resistance. Secondary outcomes included the individual safety endpoints, VGS bacteremia recurrence, hospital readmission, and all-cause mortality. Results Of 328 patients screened for inclusion, 94 patients met eligibility criteria (CTX n= 64, PCN G n=34). Median age was 68 years (IQR 56–81) and 68% were male. Study patients did not present with critical illness, as reflected by a median Pitt bacteremia score of 0 in the CTX and 1 in the PCN G arms, P=0.764. Streptococcus mitis was the most common VGS isolate and infective endocarditis (IE) was the predominant source of infection. CTX was not significantly associated with increased risk of the primary outcome (14% vs. 27%; P= 0.139). The driver of the composite outcome was hospital readmission due to VGS bacteremia or therapy complications. Results were similar in the subgroup of patients with IE (12.5% vs. 23.5%). No secondary endpoints differed significantly between groups. On multivariate analysis, source removal was a protective factor of the primary outcome (OR 0.1; 95% CI 0.020–0.6771; P= 0.017). Conclusion Despite potential safety concerns with the prolonged use of CTX in complicated VGS bacteremia, this study did not demonstrate a higher rate of treatment failure, adverse events, or resistance. These findings warrant further exploration. Disclosures All Authors: No reported disclosures

Risk factors and clinical outcomes associated with blood culture contamination

2021 ◽  
pp. 1-7
Author(s):  
Justin M. Klucher ◽  
Kevin Davis ◽  
Mrinmayee Lakkad ◽  
Jacob T. Painter ◽  
Ryan K. Dare
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Blood Culture ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Tertiary Care ◽  
Blood Cultures ◽  
Hospital Charges ◽  
Patient Specific ◽  
Contaminated Blood

Abstract Objective: To determine patient-specific risk factors and clinical outcomes associated with contaminated blood cultures. Design: A single-center, retrospective case-control risk factor and clinical outcome analysis performed on inpatients with blood cultures collected in the emergency department, 2014–2018. Patients with contaminated blood cultures (cases) were compared to patients with negative blood cultures (controls). Setting: A 509-bed tertiary-care university hospital. Methods: Risk factors independently associated with blood-culture contamination were determined using multivariable logistic regression. The impacts of contamination on clinical outcomes were assessed using linear regression, logistic regression, and generalized linear model with γ log link. Results: Of 13,782 blood cultures, 1,504 (10.9%) true positives were excluded, leaving 1,012 (7.3%) cases and 11,266 (81.7%) controls. The following factors were independently associated with blood-culture contamination: increasing age (adjusted odds ratio [aOR], 1.01; 95% confidence interval [CI], 1.01–1.01), black race (aOR, 1.32; 95% CI, 1.15–1.51), increased body mass index (BMI; aOR, 1.01; 95% CI, 1.00–1.02), chronic obstructive pulmonary disease (aOR, 1.16; 95% CI, 1.02–1.33), paralysis (aOR 1.64; 95% CI, 1.26–2.14) and sepsis plus shock (aOR, 1.26; 95% CI, 1.07–1.49). After controlling for age, race, BMI, and sepsis, blood-culture contamination increased length of stay (LOS; β = 1.24 ± 0.24; P < .0001), length of antibiotic treatment (LOT; β = 1.01 ± 0.20; P < .001), hospital charges (β = 0.22 ± 0.03; P < .0001), acute kidney injury (AKI; aOR, 1.60; 95% CI, 1.40–1.83), echocardiogram orders (aOR, 1.51; 95% CI, 1.30–1.75) and in-hospital mortality (aOR, 1.69; 95% CI, 1.31–2.16). Conclusions: These unique risk factors identify high-risk individuals for blood-culture contamination. After controlling for confounders, contamination significantly increased LOS, LOT, hospital charges, AKI, echocardiograms, and in-hospital mortality.

scholarly journals Epidemiologic Study of the Discoid Meniscus: Investigating Demographic-Based Predictors in Large-Scale Claims Database

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0008
Author(s):  
Sahej S Randhawa ◽  
Emily P Tran ◽  
Nicole A Segovia ◽  
Theodore J Ganley ◽  
Marc Tompkins ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Total Population ◽  
Clinical Care ◽  
Epidemiologic Study ◽  
Case Series ◽  
Incidence Rates ◽  
National Database ◽  
Discoid Meniscus ◽  
Racial Categories ◽  
Claims Database

Background: Discoid meniscus epidemiology remains poorly defined for race and sex, in part, due to limitations of retrospective studies and small case series. A better understanding of epidemiology may improve clinical care and diagnostic precision. Purpose: Our purpose is to better define the epidemiology of discoid meniscus by analyzing a large, national database for incidence rates by sex and race. Methods: Analysis was conducted on the national-scale Clinformatics Data Mart Database by Optum. Proportions of the database’s racial categories (Asian, Black, Hispanic, White, and Unknown) in the total population of diagnosed discoid meniscus cases (n = 1,006) were calculated and compared via chi-squared tests to the total database population (n = 65,759,970). This analysis was repeated for the population of patients who received knee arthroscopies (81,205). Incidence rates were calculated from these populations as well. Finally, a multivariable logistic regression analysis based on the population of arthroscopy-receiving patients was performed to control for age, reported gender, and income. Results: Proportions of Asian, Black, Hispanic, and White racial categories in the discoid meniscus group were 5.7%, 7.3%, 20.6%, 66.4%, respectively; the proportions of each racial category in the total population were 5.2%, 10.3%, 13.5%, 71.0%, respectively. Incidence rates (per 10,000) for these groups in the arthroscopy population were 72.9, 25.6, 49.2, 25.6, respectively. Our logistic regression model indicated that race was not a statistically significant predictor for our dataset after income adjusting. Adjusting for other covariates, the odds of a discoid meniscus diagnosis decreased by 6% for each increase in age (p < 0.001) and were 41% lower for males compared to females (p < 0.001). Conclusion: Prior studies have suggested that race (Asian and Hispanic, is a predictor of higher incidence of discoid meniscus – this study did not show a difference in incidence based upon race. Patient sex and age was identified as significant predictors for discoid meniscus, and increasing age showed a decreasing incidence of this condition. This study’s analysis of a large, national claims database allows for a comprehensive epidemiological study on this topic, offering proportions and incidence rates by race appropriate for application to the US population. Its conclusions promote patient sex and age as significant predictors and question the beliefs on race-associated incidence often based on comparing results from the corpus of single-site cohort studies. Tables/Figures: [Table: see text]

Nongenetic Factors as Modifiers of the Age of Onset of Familial Alzheimer's Disease

2003 ◽  
Vol 15 (4) ◽  
pp. 337-349 ◽  
Author(s):  
Silvia Mejía ◽  
Margarita Giraldo ◽  
David Pineda ◽  
Alfredo Ardila ◽  
Francisco Lopera
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Logistic Regression ◽  
Early Onset ◽  
Age Of Onset ◽  
Univariate Analysis ◽  
Personal Factors ◽  
Familial Alzheimer’S Disease ◽  
Familial Alzheimer's Disease ◽  
High Level

Objective: The purpose of this research was to identify environmental and personal factors that could be related to the variability in the age of onset of familial Alzheimer's disease (FAD) (36–62 years). Methods: A sample was taken of 49 subjects with FAD and with the mutation E280A in the presenilin-1 gene on chromosome 14; the sample was divided into two subgroups: 27 individuals with age of onset of the disease between 36 and 46 years (early onset) and 22 individuals whose disease began between 47 and 62 years (late onset). Information on environmental and personal factors was collected by means of a questionnaire answered by the patients if their clinical condition allowed it, or by their relatives; such information was organized in a categorical way. Comparisons between the two groups for each categorical variable were done by means of the chi-square test. Noncollinear variables that showed statistical significance were included as independent variables in a logistic regression analysis to predict their association with early onset of the disease. Results: Only 5 of the 140 studied variables were different between the two groups in univariate analysis: education, surgical history, type of stressful event, depression, and affective losses. The logistic regression model was constituted by education, depression, and affective losses. High-level education had approximately 15 times more probability of association with an early onset of the disease; both the history of affective losses and depressive symptoms had 4 times more probability of a similar association. Conclusions: The association of high-level education and early onset of the disease could be related to an earlier detection of symptoms, in turn determined by greater intellectual and environmental demands. The occurrence of depression and affective losses has been considered a prodromic manifestation of the disease. Our findings are evidence of high clinical heterogeneity even in a genetically homogeneous group.

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