scholarly journals Association Between Smoking and Postoperative Delirium in Surgical Patients With Pulmonary Hypertension: a Secondary Analysis of a Cohort Study

2021 ◽  
Author(s):  
Sai Zhou ◽  
Shuqing Shi ◽  
Chang Xie ◽  
Gong Chen
Keyword(s):  
Pulmonary Hypertension ◽  
Cohort Study ◽  
Postoperative Delirium ◽  
Smoking Status ◽  
Secondary Analysis ◽  
The United States ◽  
Curvilinear Relationship ◽  
Heavy Smoking ◽  
Intracranial Surgery ◽  
The Relationship

Abstract Background: Previous studies have declared that smoking is a risk factor for postoperative delirium (POD), but others have inconsistent results. Up till now, the association between smoking and POD has not been verified. This study aims to investigate the relationship between smoking and POD in patients with pulmonary hypertension (PHTN) in the United States.Methods: This study is a secondary analysis of a retrospective cohort study completed by Aalap C. et al. Patients with PHTN who underwent non-cardiac, non-obstetric surgery were enrolled in the original study. We further excluded the patients undergoing intracranial surgery and the patients with sepsis and perioperative stroke to avoid interference with POD assessment. The generalized linear model and generalized additive model were used to explore the relationship between smoking and POD.Results: After adjusting the potential confounders (age, gender, BMI, poor functional status, PHTN severity, some comorbidities such as hypertension, angina, coronary artery disease, arrhythmia, COPD, asthma, diabetes and renal failure, length of surgery, open surgical approach, intraabdominal surgery, intrathoracic surgery, vascular surgery, some medications such as anticoagulant, antiplatelet, steroids, statin, and atropine, some inhalational anesthesia agent such as isoflurane and sevoflurane), a positive relationship was found between smoking status and POD (OR=5.61, 95% CI: 1.14 to 27.51, P=0.0334). In addition, the curvilinear relationship between smoking burden (pack-years) and POD is close to a linear relationship.Conclusion: Smoking shows a positive correlation with POD in patients with PHTN. Surgical individuals need to prevent POD especially those with a heavy smoking burden.

scholarly journals Sleep Disturbance and the Risk of Cognitive Decline or Clinical Conversion in the ADNI Cohort

2018 ◽  
Vol 45 (3-4) ◽  
pp. 232-242 ◽  
Author(s):  
Adam P. Mecca ◽  
Hannah R. Michalak ◽  
Julia W. McDonald ◽  
Emily C. Kemp ◽  
Erika A. Pugh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Sleep Disturbance ◽  
Secondary Analysis ◽  
Study Results ◽  
Global Cognition ◽  
The Relationship ◽  
Normal Cognition

Background: We investigated the relationship between sleep disturbance and cognitive decline or clinical conversion in individuals with normal cognition (CN), as well as those with mild cognitive impairment (MCI) and dementia due to Alzheimer disease (AD-dementia). Methods: Secondary analysis of 1,629 adults between 48 and 91 years of age with up to 24 months of follow-up from the ADNI (Alzheimer’s Disease Neuroimaging Initiative), a longitudinal cohort study. Results: Sleep disturbance was not associated with decline in memory, executive function, or global cognition. The presence of sleep disturbance did not significantly increase the risk of diagnostic conversion in CN, early MCI, or late MCI participants. Conclusion: This study investigated the effect of sleep disturbance on cognitive decline using several outcomes and does not support the hypothesis that sleep disturbance predicts subsequent cognitive decline.

scholarly journals Relationship between Body Roundness Index and Risk of Type 2 Diabetes in Japanese Men and Women: A Reanalysis of a Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Wei Zhao ◽  
Jingjing Tong ◽  
Jinghua Li ◽  
Yongtong Cao
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Dose Response ◽  
Cox Regression ◽  
Function Analysis ◽  
Smoking Status ◽  
Smoothing Function ◽  
Predictive Values ◽  
The Relationship

Purpose. The purpose of this study was to investigate the association between body roundness index (BRI) and type 2 diabetes (T2DM) in each sex, explore the dose-response relationship between them, and evaluate the predictive value of BRI for T2DM. Materials and Methods. A retrospective cohort study was performed on 15,464 Japanese patients at the Murakami Memorial Hospital. Data on anthropometric indices and biochemical parameters were obtained. Multivariate Cox regression models were used to estimate the hazard ratios (HRs) of incident T2DM associated with BRI. Dose-response relationships were evaluated using a smoothing function analysis and the threshold effect. Receiver operating characteristic curves were used to evaluate and compare the predictive values of BRI, body mass index (BMI), and waist circumference (WC) for T2DM. Results. During a median 5.4-year follow-up period, 373 subjects were diagnosed with T2DM. After adjusting for age, alcohol intake, smoking status, fatty liver, systolic blood pressure, fasting plasma glucose, glycated hemoglobin, high-density lipoprotein cholesterol, triglycerides, and total cholesterol, the relationship between BRI and T2DM was linear in women (HR (95% CI) for BRI Z score = 1.48 (1.26,1.74)) and curvilinear in men (HR (95% CI) on the left and right of the inflection point = 0.70 (0.44, 1.10) and 1.46 (1.27, 1.67), respectively). Compared with BMI (area under the curve (AUC) = 0.684; p < 0.001 ) and WC (AUC = 0.700; p = 0.007 ), BRI was the strongest predictor of T2DM in men (AUC = 0.715). Similarly, the AUC of BRI was larger than that of BMI (AUC = 0.757; p = 0.966 ) and WC (AUC = 0.733; p = 0.015 ) in women. Conclusions. BRI was positively linearly associated with an elevated risk of incident T2DM in women. In men, the relationship between BRI and T2DM was J-shaped. BRI is an effective indicator of predicting T2DM. Its discriminatory power was higher than that of BMI and WC in both sexes.

scholarly journals Nonlinear relationship between HbA1c and coronary artery calcium score progression: a secondary analysis based on a retrospective cohort study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Jing Yu ◽  
Bo Gao
Keyword(s):  
Cohort Study ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Retrospective Cohort ◽  
Inflection Point ◽  
Coronary Artery Calcium Score ◽  
Secondary Analysis ◽  
Calcium Score ◽  
Nonlinear Relationship ◽  
The Relationship

Abstract Objective Coronary artery calcium score and glycated hemoglobin(HbA1c) are both considered risk factors for coronary heart disease. However, the relationship between coronary artery calcium score and HbA1c is still unclear. Consequently, the present study was undertaken to explore HbA1c association with coronary artery calcium score progression in South Korea. Methods This study is a secondary analysis based on a retrospective cohort study in which 8151 participants received Health examination kits at the Health Promotion Center, Samsung Medical Center in Seoul, South Korea, from March 1, 2003–December 31, 2013. Cox proportional-hazards regression model was then used to evaluate the independent relationship between HbA1c and coronary artery calcium score progression. Results After adjusting potential confounding factors (age, sex, BMI, height, weight, SBP, DBP, TC, LDL-C, HDL-C, triglycerides, smoking status, alcohol consumption, reflux esophagitis status, hypertension, diabetes, dyslipidemia, ischemic heart disease and cerebrovascular disease), it was revealed that there was a nonlinear relationship between HbA1c and coronary artery calcium score progression, while the scoring point was 5.8%. The effect size was 2.06 to the left of the inflection point, while the 95% CI was 1.85 to 2.29. Whereas, the effect size was 1.04, on the right side of the inflection point while 95% CI was 0.99 to1.10. Conclusion The relationship between HbA1c and coronary artery calcium score progression is nonlinear. HbA1c is positively related to coronary artery calcium score progression when HbA1c level was less than 5.8%.

scholarly journals Cognitive Habits Linked to Resilience: Surprising Commonalities across the United States

2020 ◽  
pp. 1-14
Keyword(s):  
United States ◽  
Regional Differences ◽  
Secondary Analysis ◽  
The United States ◽  
Individual Level ◽  
Interaction Terms ◽  
Life Challenges ◽  
Appraisal Processes ◽  
The Relationship ◽  
The Way

Abstract: Background: Research has documented many geographic inequities in health. Research has also documented that the way one thinks about health and quality of life (QOL) affects one’s experience of health, treatment, and one’s ability to cope with health problems. Purpose: We examined United-States (US) regional differences in QOL appraisal (i.e., the way one thinks about health and QOL), and whether resilience-appraisal relationships varied by region. Methods: Secondary analysis of 3,955 chronic-disease patients and caregivers assessed QOL appraisal via the QOL Appraisal Profile-v2 and resilience via the Centers for Disease Control Healthy Days Core Module. Covariates included individual-level and aggregate-level socioeconomic status (SES) characteristics. Zone improvement plan (ZIP) code was linked to publicly available indicators of income inequality, poverty, wealth, population density, and rurality. Multivariate and hierarchical residual modeling tested study hypotheses that there are regional differences in QOL appraisal and in the relationship between resilience and appraisal. Results: After sociodemographic adjustment, QOL appraisal patterns and the appraisal-resilience connection were virtually the same across regions. For resilience, sociodemographic variables explained 26 % of the variance; appraisal processes, an additional 17 %; and region and its interaction terms, just an additional 0.1 %. Conclusion: The study findings underscore a geographic universality across the contiguous US in how people think about QOL, and in the relationship between appraisal and resilience. Despite the recent prominence of divisive rhetoric suggesting vast regional differences in values, priorities, and experiences, our findings support the commonality of ways of thinking and responding to life challenges. These findings support the wide applicability of cognitive-based interventions to boost resilience

scholarly journals Length of Stay in Hospice Care across Racial/Ethnic Minorities over 65 Years of Age: A Descriptive Analysis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 778-778
Author(s):  
Heshuo Yu ◽  
J Scott Brown
Keyword(s):  
African Americans ◽  
Length Of Stay ◽  
Hospice Care ◽  
Descriptive Analysis ◽  
Secondary Analysis ◽  
Female Gender ◽  
The United States ◽  
Future Research ◽  
Race Ethnicity ◽  
The Relationship

Abstract Purpose This study aims to explore the relationship between race/ethnicity and length of stay in hospice care among adults over 65 years of age in the United States. This topic is understudied within a population-representative sample, particularly among non-White decedents. Methods Secondary analysis of data from the 2007 NHHCS (n=3,918). Race/ethnicity included Hispanics/Latinos, Non-Hispanic Whites, African Americans, and other races. Length of hospice stay was measured by the number of days that patients received hospice care from hospice agencies. Results The study found that African Americans have a longer length of stay in hospice agencies than Whites, even after controlling for all other factors in the model. Female gender, older age, and several diseases are covariates that significantly impact length of hospice stay. Discussion Compared to other races/ethnicities, the long length of stay in hospice among African Americans may negatively impact the quality of end-of-life care and quantity of skilled staff visits. Future research is recommended to further explore potential consequences of longer hospice stays, especially within African American communities. Studies with larger samples of minorities that integrate socioeconomic factors need to be done to better study the relationship between length of hospice stay and race/ethnicity.

scholarly journals The relationship between anxiety, health, and potential stressors among adults in the United States during the COVID-19 pandemic

2020 ◽  
Author(s):  
Angela M Parcesepe ◽  
McKaylee Robertson ◽  
Amanda Berry ◽  
Andrew Maroko ◽  
Rebecca Zimba ◽  
...  
Keyword(s):  
United States ◽  
Cohort Study ◽  
Prevalence Ratio ◽  
The United States ◽  
Anxiety Symptoms ◽  
Poisson Models ◽  
Increased Risk ◽  
The Relationship ◽  
Severe Anxiety ◽  
The U.S

ABSTRACTObjectiveTo estimate the prevalence of anxiety symptoms and the association between moderate or severe anxiety symptoms and health and potential stressors among adults in the U.S. during the COVID-19 pandemicMethodsThis analysis includes data from 5,250 adults in the Communities, Households and SARS/CoV-2 Epidemiology (CHASING) COVID Cohort Study surveyed in April 2020. Poisson models were used to estimate the association between moderate or severe anxiety symptoms and health and potential stressors among U.S. adults during the COVID-19 pandemic.ResultsGreater than one-third (35%) of participants reported moderate or severe anxiety symptoms. Having lost income due to COVID-19 (adjusted prevalence ratio [aPR] 1.27 (95% CI 1.16, 1.30), having recent COVID-like symptoms (aPR 1.17 (95% CI 1.05, 1,31), and having been previously diagnosed with depression (aPR 1.49, (95% CI 1.35, 1.64) were positively associated with anxiety symptoms.ConclusionsAnxiety symptoms were common among adults in the U.S. during the COVID-19 pandemic. Strategies to screen and treat individuals at increased risk of anxiety, such as individuals experiencing financial hardship and individuals with prior diagnoses of depression, should be developed and implemented.

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