Risk Factors for Progression to Severe Sepsis or Septic Shock in Patients with Urolith Induced Obstructive Urosepsis

Abstract Introduction: To analyze the risk factors for the progression to severe sepsis,or septic shock,in pre-hospital patients with urolith Induced obstructive urosepsis, so as to facilitate the early identification of high-risk patients.Materials and Methods: Datas were retrospectively reviewed from 160 patients of urolith induced obstructive urosepsis between December 2013 and December 2019. There were 49 patients complicated by severe sepsis (severe sepsis group), 12 patients with septic shock (septic shock group), and 99 patients without progression to severe sepsis or septic shock (sepsis group). The data covered age, gender, BMI , time interval from ED to admission, WBC count, NLR, HGB, etc. Datas were analyzed by univariate analyses and multivariate logistic regression analysis.Results: Univariate analysis showed that the differences of age, the time interval from ED to admission, history of diabetes mellitus, history of CKI, NLR, HGB, platelet count, TBil, SCr, ALB, PT, APTT, INR, PCT, and positive rate of pathogens in blood culture were statistically significant (P < 0.05). Multivariate logistic regression analysis showed that age, SCr, and history of CKI were independent risk factors for progression to severe sepsis, or septic shock (P < 0.05).Conclusions: Aged ≥ 65 years, SCr ≥ 248 mol/L, and history of CKI were independent risk factors for progression to severe sepsis, or septic shock, in patients with urolith induced obstructive urosepsis. The key to prevent urosepsis from progression is to improve our understanding of disease dynamics, control the risk factors, and intervene the pre-hospital patients with multidisciplinary modalities as early as possible.

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Identification of independent risk factors for diabetic neuropathy progression in patients with type 2 diabetes mellitus

Journal of International Medical Research ◽

10.1177/03000605211044366 ◽

2021 ◽

Vol 49 (9) ◽

pp. 030006052110443

Author(s):

Linjing Huang ◽

Ximei Shen ◽

Lingning Huang ◽

Sunjie Yan ◽

Peiwen Wu

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Logistic Regression ◽

Diabetic Nephropathy ◽

Multivariate Logistic Regression ◽

History Of ◽

Independent Risk Factors

Objective To identify independent risk factors for diabetic neuropathy (DN) in patients with type 2 diabetes mellitus (T2DM). Methods We retrospectively analyzed 376 patients with T2DM at the First Affiliated Hospital of Fujian Medical University, China between January 2013 and October 2016. Multivariate logistic regression was used to explore potential risk factors for progression of DN in patients with T2DM. Effect sizes were estimated using odds ratios (ORs) and 95% confidence intervals (CIs). Results The prevalence of DN in patients with T2DM was 43.1%. Multivariate logistic regression indicated that retinopathy (OR: 2.755, 95% CI: 1.599–4.746); diabetic nephropathy (OR: 2.196, 95% CI: 1.279–3.772); longer duration of T2DM (OR: 1.081, 95% CI: 1.045–1.120); use of insulin (OR: 1.091, 95% CI: 1.018–1.170); longer history of alcohol consumption (OR: 1.034, 95% CI: 1.010–1.059); and higher blood urea nitrogen (OR: 1.081, 95% CI: 1.009–1.159) were associated with increased risk of DN in patients with T2DM. Conclusions Retinopathy, diabetic nephropathy, longer duration of T2DM, use of insulin, longer history of alcohol consumption, and higher blood urea nitrogen were independent risk factors for DN. These findings should be verified in large-scale prospective studies.

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Risk Factors and Neurologic Outcomes in Patients With Traumatic Brain Injury and Coagulopathy Within 72 Hours Post-operatively

10.21203/rs.3.rs-145018/v1 ◽

2021 ◽

Author(s):

Tao Chang ◽

Xigang Yan ◽

Chao Zhao ◽

Yufu Zhang ◽

Bao Wang ◽

...

Keyword(s):

Risk Factors ◽

Traumatic Brain Injury ◽

Logistic Regression ◽

Brain Injury ◽

Multivariate Logistic Regression ◽

Neurologic Outcomes ◽

Post Operative Period ◽

Duration Of Surgery ◽

Independent Risk Factors ◽

Time Of Admission

Abstract Background There are few studies on the development and effect of coagulopathy in patients with a traumatic brain injury (TBI) during the early post-operative period. We determined the risk factors and neurologic outcomes of in patients with a TBI and coagulopathy diagnosed by routine laboratory tests within 72 hours post-operatively. Methods The baseline characteristics, intra-operative management, and follow-up results of 462 patients with TBIs were obtained and retrospectively analyzed by multivariate logistic regression from January 2015 to June 2019. Coagulopathy was defined as an activated partial thromboplastin time > 40 seconds, international normalized ratio >1.4, or a platelet count < 100×109 /L.Results Multivariate logistic regression analysis revealed that the Glasgow Coma Scale (GCS) at the time of admission, Injury Severity Score (ISS) at the time of admission, pupil mydriasis, duration of surgery, intra-operative blood loss, and intra-operative crystalloid resuscitation were independent risk factors for patients who developed a coagulopathy post-operatively. There were statistical differences in mortality (p = 0.049), the Glasgow Outcome Scale-Extended (GCS-E; p = 0.024), and the modified Rankin Scale (p = 0.043) between patients with and without coagulopathy 1 week after surgery. Coagulopathy within 72 h after surgery revealed a trend for higher mortality at 1 week (66.7%), 3 months (71.4%), and 6 months (76.2%). Furthermore, coagulopathy and contusion expansion in the early post-operative period were independent risk factors for TBI mortality after surgery. Intra-operative crystalloid resuscitation had a substantial diagnostic accuracy in predicting coagulopathy within 72 h post-operatively (area under the curve [AUC] = 0.972).Conclusion Coagulopathy within 72 h post-operatively in patients with a TBI predicted worse disease progression and unfavorable neurologic outcomes. Hence, we should take practical and reasonable measures to manage these risk factors, which may protect patients with a TBI from post-operative coagulopathy.

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Middle Cerebral Artery-to-Uterine Artery Pulsatility Index Ratio Independently Predicts Adverse Perinatal Outcome in Pregnancies at Term

10.21203/rs.3.rs-51822/v1 ◽

2020 ◽

Author(s):

Sufen Zhou ◽

Hongyan Guo ◽

Heng Liu ◽

Mingqun Li

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Middle Cerebral Artery ◽

Perinatal Outcome ◽

Pulsatility Index ◽

Uterine Artery ◽

Regression Analyses ◽

Multivariate Logistic Regression ◽

Adverse Perinatal Outcome ◽

Independent Risk Factors

Abstract Background: This study aimed to investigate potential predictors, including cerebroplacental ratio (CPR), middle cerebral artery (MCA)/uterine artery pulsatility index (PI) ratio, for adverse perinatal outcome in pregnancies at term.Methods: This was an observational, prospective study of recruited pregnancies at term. An adverse perinatal outcome was set as the primary observational endpoint. The receiver operating characteristic (ROC) curve was plotted to investigate the predictive and cut-off values of risk factors for adverse perinatal outcome. Independent risk factors (maternal, neonatal, prenatal ultrasound and Doppler variables) for adverse perinatal outcome were evaluated by the univariate and multivariate logistic regression analyses.Results: A total of 392 pregnancies at term were included and 19.4% of them had suffered adverse perinatal outcome. CPR (OR: 0.42, 95%CI: 0.20-0.93, P=0.032) and MCA/uterine artery PI ratio (OR: 0.25, 95%CI: 0.16-0.42, P=0.032) were two independent risk factors for adverse perinatal outcome by univariate and multivariate logistic regression analyses.Conclusions: MCA/uterine artery PI ratio is a good predictor of adverse perinatal outcome in pregnancies at term.

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Risk Factors for Silent Cerebral Infarcts in a Pediatric Sickle Cell Anemia (SCA) Cohort

Blood ◽

10.1182/blood.v112.11.2487.2487 ◽

2008 ◽

Vol 112 (11) ◽

pp. 2487-2487 ◽

Cited By ~ 1

Author(s):

Francoise Bernaudin ◽

Suzanne Verlhac ◽

Annie Kamdem ◽

Cécile Arnaud ◽

Lena Coïc ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Risk Factor ◽

Logistic Regression Analysis ◽

G6pd Deficiency ◽

Significant Risk ◽

Significant Risk Factor ◽

History Of ◽

Independent Risk Factors

Abstract Background Silent infarcts are associated with impaired cognitive functioning and have been shown to be predictors of stroke (Miller ST J Pediatr 2001). Until now, reported risk factors for silent infarcts were low pain event rate, history of seizures, high leukocyte count and Sen bS haplotype (Kinney TR Pediatrics 1999). Here, we seek to define the prevalence and risk factors of silent infarcts in the Créteil SCA pediatric cohort comprising patients assessed at least yearly by transcranial doppler (TCD) since 1992, and by MRI/MRA. Methods This study retrospectively analyzed data from the Créteil cohort stroke-free SS/Sb0 children (280; 134 F, 146 M), according to institutional review board. Time-averaged mean of maximum velocities higher than 200 cm/sec were considered as abnormal, resulting in initiation of a transfusion program (TP). A switch to hydroxyurea was proposed to patients with normalized velocities (< 170 cm/sec) and normal MRA on TP, although TP was re-initiated in case of abnormal velocities recurrence. Patients with “conditional” velocities (170–199 cm/sec) were assessed by TCD 4 times yearly. Alpha genes and beta-globin haplotypes were determined. Baseline biological parameters (G6PD activity; WBC, PMN, Reticulocytes, Platelets counts; Hemoglobin, Hematocrit, HbF, LDH levels; MCV; SpO2) were obtained a minimum of 3 months away from a transfusion, one month from a painful episode, after 12 months of age, before the first TCD, and always before therapy intensification. Results. Patients were followed for a total of 2139 patient-years. Alpha-Thal was present in 114/254 patients (45%) and 27/241 (11.2%) had G6PD deficiency. Beta genotype, available in 240 patients, was BaBa in 102 (42.5%), BeBe in 54 (22.5%), SeSe in 19 (7.9%) and “other” in 65 (27.1%); TCD was abnormal in 52 of 280 patients (18.6%). MRA showed stenoses in 30 of 226 evaluated patients (13.3%) while MRI demonstrated presence of silent infarcts in 81/280 patients (28.9%). Abnormal TCD (p<0.001), G6PD deficiency (p=0.008), high LDH (p=0.03), and low Hb (p=0.026) were significant risk factors for stenoses by univariate analysis while multivariate analysis retained only abnormal TCD as a significant risk factor for stenoses ([OR= 10.6, 95% CI (4.6–24.4)]; p<0.001). Univariate logistic regression analysis showed that the risk of silent infarcts was not related to alpha-Thal, beta genotype, abnormal TCD, WBC, PMN, platelets, reticulocyte counts, MCV, LDH level, HbF %, pain or ACS rates but was significantly associated with stenoses detected by MRA (p<0.001), gender (male; p=0.04), G6PD deficiency (p=0.05), low Hb (p=0.016) and Hct (p=0.012). Multivariate logistic regression analysis showed that gender ([OR= 2.1, 95% CI (1.03–4.27)]; p=0.042), low Hb ([OR= 1.4, 95% CI (1.0–1.1)]; p=0.05) and stenoses ([OR= 4.8, 95% CI (1.88–12.28)]; p=0.001) were all significant independent risk factors for silent infarcts. The presence of stenoses was the only significant risk factor for silent infarcts in patients with a history of abnormal TCD ([OR= 5.9, 95% CI (1.6–21.7)]; p=0.008). Conclusion We recently showed that G6PD deficiency, absence of alpha-Thal, and hemolysis are independent significant risk factors for abnormal TCD in stroke-free SCA patients (Bernaudin et al, Blood, 2008, in press). Here, we report that an abnormal TCD is the most significant risk factor for stenoses and, expanding previous studies, we demonstrate that stenoses, low Hb and gender are significant independent risk factors for silent infarcts.

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In-hospital gastrointestinal bleeding in patients with acute myocardial infarction: incidence, outcomes and risk factors analysis from China Acute Myocardial Infarction Registry

BMJ Open ◽

10.1136/bmjopen-2020-044117 ◽

2021 ◽

Vol 11 (9) ◽

pp. e044117

Author(s):

Wence Shi ◽

Xiaoxue Fan ◽

Jingang Yang ◽

Lin Ni ◽

Shuhong Su ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Logistic Regression ◽

Gastrointestinal Bleeding ◽

Secondary Outcome ◽

Multivariate Logistic Regression ◽

Independent Risk Factors ◽

Receptor Inhibitor

ObjectiveTo investigate the incidence of gastrointestinal bleeding (GIB) in patients with acute myocardial infarction (AMI), clarify the association between adverse clinical outcomes and GIB and identify risk factors for in-hospital GIB after AMI.DesignRetrospective cohort study.Setting108 hospitals across three levels in China.ParticipantsFrom 1 January 2013 to 31 August 2014, after excluding 2659 patients because of incorrect age and missing GIB data, 23 794 patients with AMI from 108 hospitals enrolled in the China Acute Myocardial Infarction Registry were divided into GIB-positive (n=282) and GIB-negative (n=23 512) groups and were compared.Primary and secondary outcome measuresMajor adverse cardiovascular and cerebrovascular events (MACCEs) are a composite of all-cause death, reinfarction and stroke. The association between GIB and endpoints was examined using multivariate logistic regression and Cox proportional hazards models. Independent risk factors associated with GIB were identified using multivariate logistic regression analysis.ResultsThe incidence of in-hospital GIB in patients with AMI was 1.19%. GIB was significantly associated with an increased risk of MACCEs both in-hospital (OR 2.314; p<0.001) and at 2-year follow-up (HR 1.407; p=0.0008). Glycoprotein IIb/IIIa (GPIIb/IIIa) receptor inhibitor, percutaneous coronary intervention (PCI) and thrombolysis were novel independent risk factors for GIB identified in the Chinese AMI population (p<0.05).ConclusionsGIB is associated with both in-hospital and follow-up MACCEs. Gastrointestinal prophylactic treatment should be administered to patients with AMI who receive primary PCI, thrombolytic therapy or GPIIb/IIIa receptor inhibitor.Trial registration numberNCT01874691.

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Nomogram for Predicting Persistent Organ Failure with Acute Pancreatitis in Pregnancy

10.21203/rs.3.rs-1223472/v1 ◽

2022 ◽

Author(s):

Chengcheng Sheng ◽

Zongxu Xu ◽

Jun Wang

Keyword(s):

Risk Factors ◽

Acute Pancreatitis ◽

Logistic Regression ◽

Regression Analysis ◽

Organ Failure ◽

Multivariate Logistic Regression Analysis ◽

Concordance Index ◽

Multivariate Logistic Regression ◽

Independent Risk Factors ◽

In Pregnancy

Abstract Background: Acute pancreatitis in pregnancy (APIP) with persistent organ failure (POF) poses a high risk of death for mother and fetus. This study sought to create a nomogram model for early prediction of POF with APIP patients.Methods: We conducted a cross-sectional study on APIP patients with organ failure (OF) between January 2012 and March 2021 in a university hospital. 131 patients were collected. Their clinical courses and pregnancy outcomes were obtained. Risk factors for POF were identified by univariate and multivariate logistic regression analysis. Prediction models with POF were built and nomogram was plotted. The performance of the nomogram was evaluated by using a bootstrapped-concordance index and calibration plots.Results: Hypertriglyceridemia was the most common etiology in this group of APIP patients, which accounted for 50% of transient organ failure (TOF) and 72.3% of POF. All in-hospital maternal death was in the POF group (P<0.05), which also had a significantly higher perinatal mortality rate than the TOF group (P<0.05). Univariate and multivariate logistic regression analysis determined that lactate dehydrogenase, triglycerides, serum creatinine, and procalcitonin were independent risk factors for predicting POF in APIP. A nomogram for POF was created by using the four indicators. The area under the curve was 0.875 (95% confidence interval 0.80–0.95). The nomogram had a bootstrapped-concordance index of 0.85 and was well-calibrated.Conclusions: Hypertriglyceridemia was the leading cause of organ failure-related APIP. Lactate dehydrogenase, triglycerides, serum creatinine, and procalcitonin were the independent risk factors of POF in APIP. Our nomogram model showed an effective prediction of POF with the four indicators in APIP patients.

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Diabetes and Younger Age Are Vital and Independent Risk Factors for Acute Pancreatitis in Patients with Severe Hypertriglyceridemia

BioMed Research International ◽

10.1155/2019/2620750 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Qiang Li ◽

Chaoqun Hou ◽

Yunpeng Peng ◽

Xiaole Zhu ◽

Chenyuan Shi ◽

...

Keyword(s):

Risk Factors ◽

Acute Pancreatitis ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Severe Hypertriglyceridemia ◽

Younger Age ◽

History Of ◽

Independent Risk Factors

Background. The incidence of hypertriglyceridemia-induced acute pancreatitis (HIAP) is increasing worldwide, and now it is the third leading cause of acute pancreatitis in the United States. But, there are only 5% of patients with severe hypertriglyceridemia (>1000 mg/dl) which might generate acute pancreatitis. In order to explore which part of the patients is easy to develop into pancreatitis, a case-control study was performed by us to consider which patient population tend to develop acute pancreatitis in patients with severe hypertriglyceridemia. To perform a retrospective case-control study, we identified severe hypertriglyceridemia patients without AP (HNAP) and with HIAP with a fasting triglyceride level of >1000 mg/dl from The First Affiliated Hospital of Nanjing Medical University during January 1, 2014, to December 31, 2016. Baseline patient characteristics, comorbidities, and risk factors were recorded and evaluated by the univariate and multivariate logistic regression analysis for HIAP and HNAP patients. A total of 124 patients with severe hypertriglyceridemia were included in this study; of which, 62 patients were in the HIAP group and 62 were in the HNAP group. Univariate logistic regression analysis showed that there was no gender difference in both groups; however, there were more younger patients in the HIAP group than in the HNAP group (P value < 0.001), and the HIAP group had low level of high-density lipoprotein compared to the HNAP group (P<0.05). Meanwhile, the presence of pancreatitis was associated with higher level of glycemia and a history of diabetes (P<0.05). Multivariate logistic regression analysis indicated that a history of diabetes and younger age were independent risk factors for acute pancreatitis in patients with severe hypertriglyceridemia. Uncontrolled diabetes and younger age are potential risk factors in patients with severe hypertriglyceridemia to develop acute pancreatitis.

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Risk Factors for Mortality in 220 Patients With COVID-19 in Wuhan, China: A Single-Center, Retrospective Study

Ear Nose & Throat Journal ◽

10.1177/0145561320972608 ◽

2020 ◽

pp. 014556132097260

Author(s):

Shuliang Zhou ◽

Sulin Mi ◽

Shuilian Luo ◽

Ying Wang ◽

Bin Ren ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Respiratory Rate ◽

Sofa Score ◽

Laboratory Data ◽

Older Age ◽

Univariable Analysis ◽

Multivariate Logistic Regression ◽

Failure Assessment ◽

Independent Risk Factors

Background: An outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 infection occurred in Wuhan, China, in December 2019. To date, the analysis of fatal cases and the risk factors for death have rarely been reported. Methods: In this study, 220 adult patients with confirmed and suspected COVID-19 were enrolled. Clinical characteristics, laboratory data, treatments, and complications were compared between 168 survivors and 52 nonsurvivors. Univariable analysis and multivariable logistic regression were used to investigate the risk factors for mortality. Results: A total of 220 patients (168 were discharged and 52 died in the hospital) were enrolled in the study. The median age of all patients was 59.5 (47.0-69.0) years, and the median age of patients who died was significantly older than that of patients who survived (70.5 vs 56.0 years, respectively; P < .001). According to multivariate logistic regression, older age (odds ratio: 1.09, 95% CI: 1.03-1.15; P = .001), initial Sequential Organ Failure Assessment (SOFA) score >2 (37.4, 9.4-148.0; P = .011), and respiratory rate >24 per minute (10.89, 1.47-80.67; P = .019) were independent risk factors for mortality. Conclusion: Clinical and laboratory parameters predicting poor prognosis including older age, baseline SOFA score >2, and respiratory rate >24 per minute were identified.

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An 11-Year Retrospective Research Study of the Predictive Factors of Peri-Implantitis and Implant Failure: Analytic-Multicentric Study of 1279 Implants in Peru

International Journal of Dentistry ◽

10.1155/2019/3527872 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Frank Mayta-Tovalino ◽

Yens Mendoza-Martiarena ◽

Percy Romero-Tapia ◽

María Álvarez-Paucar ◽

Luis Gálvez-Calla ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Dental Implants ◽

Bone Quality ◽

Private Institutions ◽

Multivariate Logistic Regression ◽

Public And Private ◽

Multicentric Study ◽

Kaplan Meier ◽

History Of

Aim. To analyze the risk factors by logistic regression and perform the analysis of the survival rate of osseointegrated dental implants placed in public and private institutions. Methods. An analytic-multicentric study was carried out, where 1279 dental implants that were placed by specialists from January 2006 to October 2017 in public and private institutions (UPCH-SI, HCFAP, CMNAVAL, UPCH-SM, and UPSJB) were evaluated. The variables sex (X1), location (X2), hypertension (X3), antibiotic prophylaxis (X4), diabetes (X5), osteoporosis (X6), bisphosphonates (X7), history of periodontitis (X8), hypercholesterolemia (X9), bone quality (X10), bone quantity (X11), design (X12), smoker (X13), connection (X14), edentulism type (X15), staging (X16), 3D guided surgery (X17), load (X18), bone graft (X19), peri-implantitis (X20), mucositis (X21), and GBR (X22) were collected and analyzed by the Kaplan–Meier survival analysis. The logit analysis was performed among all the variables to choose the best statistical model that explains the true risk factors. The analysis was performed by multivariate logistic regression and the Kaplan–Meier test, at a level of statistical significance of p<0.05. Results. It was found that the failure rate of the 1279 implants evaluated was 17.98% corresponding to only 23 implants lost as they have good longevity over time. When establishing the best multivariate logistic regression model, it was found that the variables that remained stable in relation to their statistically significant value and more stable confidence intervals were age, osteoporosis, bisphosphonates, history of periodontitis, bone quality, bone graft, connection, number of implants, GBR (guided bone regeneration), and follow-up. Conclusions. Dental implants placed by specialists in public and private institutions had a failure rate similar to that in studies previously published in other countries.

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Nonocclusive Ischemic Colitis: Analysis of Risk Factors for Severity

The American Surgeon ◽

10.1177/000313481408000515 ◽

2014 ◽

Vol 80 (5) ◽

pp. 454-460 ◽

Cited By ~ 4

Author(s):

Eran Sadot ◽

Dana A. Telem ◽

Leslie Cohen ◽

Manjit Arora ◽

Celia M. Divino

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Logistic Regression ◽

Ischemic Colitis ◽

Severe Disease ◽

Multivariate Logistic Regression ◽

Logistic Regression Models ◽

History Of ◽

N 93 ◽

The Right

The purpose of this study was to identify risk factors predictive of severe nonocclussive ischemic colitis (IC) requiring operation or resulting in mortality. One hundred seventeen patients with nonocclussive IC were identified and divided into two groups: those with severe disease (n = 24) and those with disease that resolved with supportive care (n = 93). Univariate and multivariate logistic regression models were used. The splenic flexure was the most common involved segment (57.3%), whereas the right colon was involved in 17.9 per cent of patients. Multivariate logistic regression identified three independent risk factors for severe disease: leukocytosis greater than 15 3 109/L (odds ratio [OR], 5.7; confidence interval [CI], 1.5 to 21), hematocrit less than 35 per cent (OR, 4.5; CI, 1.1 to 17), and history of atrial fibrillation (OR, 15; CI, 1.3 to 190). Right-sided IC and chronic renal insufficiency did not affect severity. Special attention should be given to patients with the following risk factors for a severe course: atrial fibrillation, elevated white blood cell count, and anemia. These factors might enable earlier identification of patients who may benefit from early operation. Further prospective studies focusing on subgroups of IC (occlusive and nonocclusive) are required.

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