scholarly journals Risk factors analysis and establishment of a clinical predictive model for recurrence after first attack of myasthenia gravis: a single-center retrospective study

2021 ◽  
Author(s):  
Jiayi Liu ◽  
Lulu Liu ◽  
Zhengxiang Zhang
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Drug Use ◽  
Myasthenia Gravis ◽  
Predictive Model ◽  
Age Of Onset ◽  
Univariate Analysis ◽  
First Onset ◽  
First Relapse ◽  
Clinical Predictive Model

Abstract Background Myasthenia gravis (MG) is a rare and recurrent disease. The purpose of this study was to investigate the risk factors for relapse in MG patients after their first attack and establish a clinical predictive model. We conducted a retrospective study of 86 MG patients, followed and reviewed the clinical data of patients from the first onset to the first relapse, including age of onset, site of first symptom, MGFA at onset, thymoma, surgical resection of the thymoma, infection history, irregular drug use, combination of other autoimmune diseases, AChR antibody, and anti-Musk antibody, etc. The R software was used for statistical analysis. Univariate analysis and multivariate analysis were used to analyze risk factors. The clinical predictive model was established by Logistic regression analysis. Results Within 2 years after the first attack, 61.2% of MG patients relapsed. MGFA at onset, irregular drug use and infection history were independent risk factors for MG relapse within 2 years after the first attack ( p < 0.05). The clinical prediction model has good discrimination and calibration. Conclusion The relapse of MG is affected by a variety of factors. The clinical predictive model that was established in this study can help clinicians predict the probability of relapse in MG patients, identify early high-risk relapse patients, and serve for high-quality clinical management.

Narcotics Addicts: Effect of Family and Parental Risk Factors on Timing of Emancipation, Drug Use Onset, Pre-Addiction Incarcerations and Educational Achievement

1990 ◽  
Vol 20 (1) ◽  
pp. 99-123 ◽  
Author(s):  
William J. McCarthy ◽  
M. Douglas Anglin
Keyword(s):  
Risk Factors ◽  
Drug Use ◽  
Educational Attainment ◽  
Birth Order ◽  
Family Size ◽  
Age Of Onset ◽  
Juvenile Detention ◽  
Parental History ◽  
Parental Absence ◽  
History Of

The family background characteristics of 756 male heroin users were examined to determine the effects of selected family risk factors on the timing of onset of emancipation and drug use, on pre-addiction incarcerations and on educational attainment. These risk factors included family size, birth order, socioeconomic status, family drug use, parental history of alcoholism, parental absence, and family history of incarceration. The two measures of age of emancipation were age on leaving school and age on leaving home. Age of onset of regular use was measured for the following drugs: tobacco, alcohol, marijuana and heroin. Incarceration measures included the occurrence of juvenile detention and the time spent in prison prior to first addiction. Educational attainment was a score on a California State achievement test. Larger family size, higher birth order, parental alcoholism and parental absence were found to have a cumulatively negative effect on how young the respondents were when they first left home and when they first used particular drugs regularly, on their level of tested academic achievement, and on their probability of juvenile detention. Implications for social policies designed to prevent drug abuse are discussed.

Anticipating Outcome: Predictors of First and Subsequent Relapses in Schizoprenia. A 3-year Follow-up

2017 ◽  
Vol 41 (S1) ◽  
pp. S97-S97
Author(s):  
M. Gomez Revuelta ◽  
V. Gajardo Galan ◽  
M. Juncal Ruiz ◽  
O. Porta Olivares ◽  
R. Landera Rodriguez ◽  
...  
Keyword(s):  
Intervention Program ◽  
Age Of Onset ◽  
Univariate Analysis ◽  
First Episode ◽  
Long Term Outcome ◽  
Factors Associated ◽  
Adherence To Medication ◽  
Modifiable Factors ◽  
Wide Range ◽  
First Relapse

IntroductionRelapse prevention during early stages after psychosis onset is a key factor for long term outcome. While factors associated with first relapse have been widely studied, factors associated with subsequent relapses are poorly described.ObjectivesTo determine predictive factors of first and subsequent relapses among patients recruited from a cohort of PAFIP Early Intervention Program.Material and methodsWe analyzed socio-demographic and clinical data of a cohort of 393 first episode psychosis (FEP) patients that were recruited since February 2001 to May 2011. Of these, 341 achieved clinical remission and were, therefore, considered to be at risk of relapse. They were followed-up for 3 years. A wide range of potential factors were included as possible predictors of relapse. Test univariate, analysis logistics of regression, regression of Cox and analysis of survival of Kaplan-Meier were carried out.ResultsPoor adherence to medication was the main predictor associated to first relapse (ExpB: 2.979; P < 0.001). After the first relapse, only 56 patients (33.9%) underwent a second relapse, being the diagnosis (ExpB: 1.975; P = 0.074), the age of onset, (ExpB: 1.078; P = 0.003) and a low level of positive symptomatology (ExpB: 0.863; P = 0.03) the predictors of associated with a second relapse.ConclusionsAfter a FEP, non-adherence to medication is the main predictor of first relapse. Second and subsequent relapses relate with non-modifiable factors such as age of onset or schizophrenia diagnosis. This subgroup of patients could have greater predisposition to relapse related with the severity of the disease itself.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Establishment of a Predictive Model for Factors Related to Systemic  Inflammatory Response Syndrome (SIRS) after Percutaneous Nephrolithotomy (PCNL)

2020 ◽  
Author(s):  
Min Ju ◽  
Jin Zheng ◽  
Lin Lin Gao ◽  
Li Ying Pan
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Predictive Model ◽  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Univariate Analysis ◽  
Renal Stones ◽  
Systemic Inflammatory Response

Abstract Background: Percutaneous nephrolithotomy (PCNL) is a primary treatment method for renal stones, but infection is a very common postoperative complication. Systemic inflammatory response syndrome (SIRS) is a stage of the infection process and a very important early clinical manifestation of sepsis, so identifying the risk factors associated with SIRS after PCNL is important for ensuring patient safety and preventing sepsis.Objective: To analyze the risk factors for SIRS after PCNL, identify the predictive factors, and perform risk factor analysis.Methodology: Between September 2016 and September 2017, 352 patients who were diagnosed with renal stones and treated with PCNL were included in this study. The patients were divided into two groups according to whether SIRS occurred. Univariate analysis was performed on the related risk factors, including patient age; gender; body mass index; urine culture; number, types and quantity of rental stones; diabetes; blood glucose; complications; hospital stay; residual stones; and Guy’s degree. Then, logistic regression was used to perform multivariate analysis and establish a predictive model.Results: A total of 352 patients with renal stones were treated with PCNL, and 106 patients (30.1%) developed SIRS after surgery. Operative time, preoperative fever and diabetes were found to be risk factors, and the logistic regression results indicated that diabetes (OR=2.049, 95%CI 1.008~4.166) and operative time (OR=1.011, 95%CI 1.003~1.019) could be entered into the regression equation. Therefore, the predictive regression model was P=1/[1+e-(-2.097+0.712 diabetes + 0.012 operative time)].Conclusion: Diabetes and operative time are independent risk factors for SIRS after PCNL, so the probability of SIRS after PCNL can be determined according to these two indicators.

scholarly journals Risk Factors Predicting Candida glabrata Bloodstream Infection

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S75-S75
Author(s):  
Jane O’Halloran ◽  
Ryan Kronen ◽  
Charlotte Lin ◽  
Kevin Hsueh ◽  
William Powderly ◽  
...  
Keyword(s):  
Risk Factors ◽  
Predictive Model ◽  
Candida Glabrata ◽  
Demographic Data ◽  
Univariate Analysis ◽  
Blood Stream ◽  
Central Line ◽  
Parenteral Feeding ◽  
Tertiary Referral Hospital ◽  
History Of

Abstract Background Increased incidence of Candida glabrata (CG) infection is a growing concern in recent years due to the higher rates of fluconazole resistance associated with C. glabrata . This study aimed to create a risk predictive model for C. glabrata in patients with culture-positive candidemia. Methods Demographic data, risk factors, laboratory parameters, and outcomes were retrospectively collected on all cases of candidemia occurring at a large tertiary referral hospital between January 2002 and January 2015. Between-group differences were compared using 2 square tests. A risk predictive model was built using multivariate logistic regression. Results Of 1,913 subjects with candidemia, 398 (21%) had C. glabrata isolated. Those with C. glabrata were older (mean [SD] 61 [23] vs. 58 [23] years; P &lt; 0.001) and more often female (231 (58%) vs. 681 (45%); P &lt; 0.001). On univariate analysis, age (OR 1.01 [95% CI 1.01,1.02]), gender (0.6 [0.5, 0.7]), history of rectal cancer (2.00 [1.2, 3.5]), other GI malignancy (3.0 [1.5, 6.2]), breast cancer (1.8 [1.1, 3.0]), enteral and parenteral feeding (1.9 [1.2, 3.2]), bowel resection (3.0 [1.4, 6.2]), temperature (0.9 [0.8, 1.0], recent fluconazole use (2.0 [1.4, 2.9]), and The presence of urinary catheter (2.3 [1.4, 3.6]), central line (1.4 [1.1, 1.7) or ventilator (2.2 [1.3, 3.8]) were all associated with C. glabrata infection (P &lt; 0.05) and included in the multivariate modeling. Age, gender, history of rectal malignancy, other GI malignancies, use of enteral or parenteral feeding and recent fluconazole use remained significant (effect size 1.2 [95% CI 1.1, 1.3]; 1.8 [1.4, 2.3]; 2.0 [1.1, 3.6]; 3.0 [1.3, 6.9]; 1.9 [1.0, 3.3]; 2.0 [1.3, 3.0], respectively). The final model had a c-statistic of 0.66 [95% CI 0.63–0.69]). Ninety-day mortality in the C. glabrata group was not significantly different from the non-C. glabrata group (40% (158/398) vs. 42.5% (644/1515). Conclusion Underlying bowel pathology was more commonly associated with C. glabrata candidemia than with other candida species. Further exploration of the direct association between C. glabrata and GI malignancy and indirect effects of prior surgery or antifungal use on risk of C. glabrata candidemia are required. Interestingly, mortality did not differ between groups with glabrata and non-glabrata candida blood stream infections. This may reflect increasing empiric use of echinocandin therapy. Disclosures A. Spec, Astellas Pharma US, Inc.: Grant Investigator, Research grant

scholarly journals CAN WE Predict Risk Factors of Venous Thromboembolism Among Cancer Inpatients?

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5871-5871 ◽  
Author(s):  
Shiva Shrotriya ◽  
Prajwal Dhakal ◽  
Mukta Sharma ◽  
Joseph Gardiner ◽  
Anas Al-Janadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Renal Disease ◽  
Predictive Model ◽  
Cancer Patients ◽  
Validation Cohort ◽  
Univariate Analysis ◽  
Renal Diseases ◽  
Operating Characteristics ◽  
Increased Risk

Abstract Introduction Increased risk of venous thromboembolism (VTE) has been noted among cancer patients as compared to non-cancer. VTE identified as leading cause of death among those with cancer. Cancer associated thrombosis caused increased hospitalizations, increased inpatient/outpatient medical and prescription claims, and increased total health care costs per patient. Our objective was to study demographic, clinical and laboratory risk factors for venous thromboembolism (VTE) among hospitalized cancer patients and built a predictive model for VTE risk. Methods Ours was a retrospective cohort study focused on patients with VTE and cancer from January 2013 - September 2015. Univariate and multivariate logistic regression analysis using stepwise approach was performed. A final predictive model was derived using receiver-operating characteristics (ROC) curves and concordance indices (c-statistics). Results N=3948 cancer inpatients were identified which was split into a derivation cohort and a validation cohort, each with 1957. Mean age 65.9±13.8 years; 52.6% were male; 85.6% Caucasian, 7% African Americans; 15.5% were obese; common comorbidities were hypertension (46%), pulmonary disease (34.5%), diabetes (22.9%), renal disease (20.9%) and congestive heart failure (10.4%). Overall, there was 152 (3.9%) events of VTE with 77 (3.9%) in derivation and 75 (3.8%) in validation cohort. On univariate analysis, comorbidities such as infection and renal diseases, laboratory findings such as low hemoglobin and low albumin was associated with high VTE risk. The derivation set had a c-statistic or AUC of 0.668 while the validation set had an AUC of 0.65. Conclusions Infection, renal disease (comorbidity) and low albumin levels were associated with a higher risk of VTE. Digestive and respiratory cancers were associated with higher VTE risk. We identified three clinical and laboratory variable that was associated with increased risk of VTE in addition to the cancer group. Future research could use this analysis as a basis for forming a risk score that could be used by clinicians to identify those cancer patients at risk for VTE. Disclosures No relevant conflicts of interest to declare.

Abstract WMP49: White Matter Hyperintensities in a High Risk Population Living in Marginal Housing (HOTEL study)

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Lily W Zhou ◽  
William J Panenka ◽  
Allen Thornton ◽  
Geoffrey Smith ◽  
Alasdair Barr ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
Drug Use ◽  
Injection Drug Use ◽  
White Matter Hyperintensities ◽  
Univariate Analysis ◽  
Injection Drug ◽  
High Risk Population ◽  
Young Cohort ◽  
Perivascular Spaces

Background: White Matter Hyperintensities (WMH) are features of cerebral small vessel disease (cSVD) along with lacunes, cerebral microbleeds and perivascular spaces. Vascular risk factors account for only a small proportion of the variability of the presence of WMH, and the role of additional risk factors including drug use/dependence or infections is not well defined. Objective: Examine prevalence and risk factors associated with WMH of presumed vascular origin within the HOTEL cohort, a population living in marginal housing with a high prevalence of prior homelessness, substance dependence, head trauma, mental illness and infectious diseases. Methods: Baseline imaging on 3T MRI included T1, T2-FLAIR and SWI sequences. WMH not consistent with vascular origins were excluded. Two raters assessed WMH using the Fazekas scale. Participants were divided into those with or without moderate-severe WMH (periventricular Fazekas score >2 or deep score >1). Potential cSVD risk factors which were significant on univariate analysis were entered into a multivariable stepwise binomial logistic regression to identify independent risk factors for moderate-severe WMH. Results: Intraclass coefficient for inter-rater reliability was 0.948 (95% CI, 0.924 to 0.965) for periventricular WMH and 0.848 (95% CI, 0.782 to 0.895) for deep WMH. Baseline prevalence of moderate-severe WMH (mean age 43.6 ± 9.5 years, 78% male) was 24.5%, much higher than in other, older healthy aging cohorts (Table). Age (OR 1.085, 95%CI 1.042-1.130), systolic blood pressure (OR 1.033, 95%CI 1.008-1.058) and regular injection drug use (OR 3.655, 95%CI 1.284-10.403) together explained 23.5% of variance in the presence of moderate-severe WMH within this population, with injection drug use having the largest effect. Conclusions: This young cohort appears to have an accelerated burden of cSVD, with injected drug use as a major risk factor. Further research is needed to elucidate potential mechanisms.

scholarly journals Recurrence of Retinopathy of Prematurity in Zone II Stage 3+ after Ranibizumab Treatment: A Retrospective Study

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Qinrui Hu ◽  
Yujing Bai ◽  
Xiaoli Chen ◽  
Lvzhen Huang ◽  
Yi Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Retrospective Study ◽  
Intravitreal Injection ◽  
Retinopathy Of Prematurity ◽  
Initial Treatment ◽  
Univariate Analysis ◽  
Outcome Data ◽  
Zone Ii ◽  
Ranibizumab Treatment

Objective. To determine the prevalence and risk factors for the recurrence of retinopathy of prematurity (ROP) in Zone II Stage 3+ after ranibizumab treatment.Methods. This was a retrospective, nonrandomized, noncontrolled study that excluded Zone I and aggressive posterior ROP (APROP) cases. Infants who developed Zone II Stage 3 ROP with plus disease and underwent initial intravitreal injection of ranibizumab (IVR) were recruited. Patients were divided into 2 groups based on the outcome after initial ranibizumab treatment: recurrence of ROP or favorable outcome. Data was collected and analyzed by SPSS 16.0.Results. Forty-two patients were included, and 80 eyes with Zone II Stage 3+ were subjected to IVR treatment. Eleven of 42 patients (26.2%, 18 eyes) had a recurrence of ROP after the initial treatment. On univariate analysis, preretinal hemorrhage before treatment was significantly different between the two groups (P=0.000). Multivariate analysis found that preretinal hemorrhage before treatment was the only factor associated with the recurrence of ROP in our study (P=0.004).Conclusions. The recurrence rate of ROP in Zone II Stage 3+ after initial ranibizumab treatment was notable and preretinal hemorrhage before treatment was associated with the recurrence of ROP in our study.

scholarly journals Risk Factors for the Development of Hemophagocytic Lymphohistiocytosis in Children With Severe Adenovirus Pneumonia: A Single-Center Retrospective Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Hua-yong Zhang ◽  
Min Xiao ◽  
Fan Yan ◽  
Mao-rong Zhang ◽  
Yong Zhang
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Operating Characteristic ◽  
Univariate Analysis ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Two Factors ◽  
Adenovirus Pneumonia ◽  
Relevant Factors

Objective: To investigate and analyze the relevant risk factors for hemophagocytic lymphohistiocytosis (HLH) in children with severe adenovirus pneumonia (SAP).Methods: A retrospective study of children with SAP was performed in 30 cases developing HLH and 94 cases not developing HLH from December 2018 to August 2019. The binary logistic regression analysis was used to identify risk factors that were significantly associated with the development of HLH after the univariate analysis, and the receiver operating characteristic (ROC) curve was performed to find out the cut-off value for the significant relevant factors.Results: Two factors were associated with the development of HLH, which were the length of fever (OR = 1.331, 95%CI: 1.002–1.769) and triglycerides (TG) (OR = 17.345, 95%CI: 1.358–221.538). The cut-off value of the length of fever was 12.5 days, and the cut-off value of TG was 3.02 mmol/L.Conclusion: Children with SAP who had a duration of fever over 12.5 days and the TG level over 3.02 mmol/L are more likely to develop HLH.

scholarly journals Postoperative Morbidity Risk Factors After Conservative Surgery of Hydatic Cyst of the Liver: A Retrospective Study of 151 Hydatic Cysts of the Liver

2021 ◽  
Author(s):  
Mossaab Ghannouchi ◽  
Hawas Rodayna ◽  
Mohamed Ben khlifa ◽  
karim nacef ◽  
moez boudokhan
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Hydatid Cyst ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Conservative Surgery ◽  
Categorical Variables ◽  
Cyst Infection ◽  
Hydatic Cyst ◽  
Hepatic Hydatid

Abstract Background: Hepatic hydatid cyst is an endemic parasitosis in Tunisia. Although most of these cysts are benign; their treatment may lead to several complications which can cause an important post-operative morbidity and mortality.The purpose of the present paper is to assess the morbidity and mortality specifics risk factors of hepatic hydatid cysts after conservative surgery.Methods: We conducted a retrospective study of 102 patients over a period of 13 years, from 2006 to 2019. We included all patients operated on for hydatid cyst of the liver, complicated and uncomplicated, in the Department of General Surgery of Mahdia, Tunisia.We excluded patients who received an exclusive medical treatment and those who have other hydatic cyst localizations.Descriptive statistics,bivariate analysis using chi-squared test and Fisher’s exact test for categorical variables;t-test,ANOVA , and Kruskal–Wallis for continuous variables; odds ratio calculations, ordinal and multivariate logistic regression models were appliedResults: The cohort was composed of 102 patients with a total of 151 cysts operated on using conservative surgery, among them there was 75 women (73, 5%) and 27 men (26.5%). The median age was 43, with extremes ranging from 12 to 88 years. The majority of patients (94. 1%) were from rural areas. The cysts were uncomplicated in about half of the cases (48%), elsewhere complications such as compression of neighboring organs (25,5%), opening in the bile ducts (16,7%), infection (9,8%), and rupture in the peritoneum (2%) were found. Conservative surgery was the mainstay of treatment with an overall mortality rate of 1. 9%. The overall morbidity rate was 22%: 14% specific morbidity and 8% non-specific morbidity. External biliary fistula was the most common postoperative complication (9%). The predictive factors of morbidity in univariate analysis were Preoperative hydatid cyst infection (P = 0.01), Compressive cysts (P=0.05), preoperative fever and jaundice, (respectively P=0. 03 and P=0. 02), no one achieved statistical significance in the multivariate modelConclusions:Preoperative hydatid cyst infection, compressive cysts and preoperative fever and jaundice are significant predictor factors of morbidity after conservative surgery for liver hydatid cyst. They must be considered in the treatment and the surgical decision for patients with hydatid cyst.

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