scholarly journals Diagnostic Utility of Combined 2D Ultrasonography and Contrast-Enhanced Ultrasonography in Evaluation of Carotid Plaque Vulnerability for Predicting Recurrent Ischemic Strokes

2021 ◽  
Author(s):  
Fuyong Ye ◽  
Yuwen Yang ◽  
Yinting Liang ◽  
Jianhua Liu
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Sensitivity And Specificity ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Independent Risk Factors

Abstract Objective: To evaluate the sensitivity and specificity of combined 2D ultrasonography (USG) and contrast-enhanced ultrasonography (CEUS) in analyzing the carotid plaque vulnerability for predicting the recurrent ischemic strokes (IS). Methods: One hundred and fifteen patients with first IS were studied by 2D USG and CEUS. The carotid plaques were then classified on the basis of echogenicity (2D USG) and neovascularization (CEUS). The presence or absence of recurrent IS was considered as the dependent variable. Age, gender, body mass index (BMI), hypertension, hyperglycemia, hyperlipidemia, history of smoking and drinking, type of plaque echogenicity, and grade of plaque neovascularization were considered as independent variables. The risk factors of recurrent IS were analyzed by both univariate and multivariate logistic regression analysis. Finally, the sensitivity and specificity of combined 2D USG and CEUS in the diagnosis of recurrent IS was evaluated by receiver operating characteristic curve. Results: Univariate logistic regression analysis revealed that hypertension, echogenicity type, and grade of plaque neovascularization were predictors of recurrent IS. Further, multivariate logistic regression analysis revealed that the echogenicity type (OR=0.282, P=0.012) and grade of plaque neovascularization (OR=7.408, P<0.0001) were independent risk factors for recurrent IS. The sensitivity, specificity, and area under the curve of combined method were 0.865, 0.769, and 0.817, respectively (95%CI: 0.733-0.902, P<0.0001), which were higher than both 2D USG and CEUS.Conclusions: The echogenicity type and grade of plaque neovascularization are independent risk factors for recurrent IS. The combination of two methods has high sensitivity and specificity in predicting the recurrent IS.

scholarly journals Analysis of Risk Factors For Sepsis And Indicators of Prognosis In Patients With Sepsis: A Retrospective Observational Study

2021 ◽  
Author(s):  
Huifeng Wang ◽  
Zhiling Zhao ◽  
Zhao-hui Tong
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Albumin Level ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Multivariate Logistic Regression ◽  
Independent Risk Factors

Abstract Background: To investigate the independent risk factors for sepsis and the prognostic indicators of sepsis-related mortality to guide clinical practice.Methods: Adult patients diagnosed with sepsis in the respiratory intensive care unit (RICU), emergency ICU (EICU), and surgical ICU (SICU) of Beijing Chao-Yang Hospital, Capital Medical University, from January 2016 to April 2021 were enrolled. Comorbidities, complications, and laboratory indicators were retrospectively analyzed. Variables with a p value < 0.05 in the univariate analysis were entered into multivariate logistic regression analysis to identify the independent risk factors for sepsis. Receiver operating characteristic curve (ROC) analysis was used for those variables with P < 0.05 in multivariate regression to evaluate the fit of the predictive model and its prognostic efficacy. Results: A total of 123 adult patients with sepsis were enrolled, with 80 males and 43 females and a mean age of 61.56 ± 17.12 years. Acute respiratory distress syndrome (ARDS) occurred in 84 patients (68.3%), acute kidney injury (AKI) occurred in 28 patients (22.8%), acute myocardial injury (AMI) occurred in 6 patients (4.9%), disseminated intravascular coagulation (DIC) occurred in 14 patients (11.4%), septic shock occurred in 40 patients (32.5%), and 41 patients (33.3%) died. Multivariate logistic regression analysis showed that mean arterial pressure (MAP), acute physiology and chronic health evaluation II (APACHE II) score, albumin level, and the presence of DIC were independent risk factors for sepsis (P < 0.05). The area under the ROC curve for the model including MAP, albumin, and APACHE II score was the highest at 0.890.Conclusion: The MAP, APACHE II score, albumin level, and DIC were independent risk factors for sepsis. The inclusion of the MAP, albumin level, and APACHE II score in the model yielded the most accurate prediction of the risk of mortality.

Risk Factors for Wound Infection in Outpatients With Lower Extremity Burns

2020 ◽  
pp. 000313482095238
Author(s):  
Husayn A. Ladhani ◽  
Brian T. Young ◽  
Sarah E. Posillico ◽  
Charles J. Yowler ◽  
Christopher P. Brandt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Lower Extremity ◽  
Wound Infection ◽  
Logistic Regression Analysis ◽  
Total Body Surface Area ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Independent Risk Factors

Background We sought to evaluate risk factors for wound infection in patients with lower extremity (LE) burn. Methods Adults presenting with LE burn from January 2014 to July 2015 were included. Data regarding demographics, injury characteristics, and outcomes were obtained. The primary outcome was wound infection. Multivariate logistic regression analysis was performed to identify independent risk factors for wound infection. Results 317 patients were included with a mean age of 43 years and median total body surface area of .8%; 22 (7%) patients had a component of full-thickness (FT) burn; and 212 (67%) patients had below-the-knee (BTK) burn. The incidence of wound infection was 15%. The median time to infection was 5 days, and majority (61%) of the patients developed wound infection by day 5. Patients who developed wound infection were more likely to have an FT burn (22% vs. 5%, P < .001) and BTK burn (87% vs. 64%, P = .002), without a difference in other variables. Multivariate logistic regression analysis showed age (Odds ratio (OR) 1.02 and CI 1.00-1.04), presence of FT burn (OR 5.33 and CI 2.09-13.62), and BTK burn (OR 3.42 and CI 1.37-8.52) as independent risk factors for wound infection (area under the curve = .72). Conclusion Age, presence of FT burn, and BTK burn are independent risk factors for wound infection in outpatients with LE burns.

scholarly journals Risk factors for tissue expander infection in scar reconstruction: a retrospective cohort study of 2374 consecutive cases

2020 ◽  
Vol 8 ◽  
Author(s):  
Chen Dong ◽  
Minhui Zhu ◽  
Luguang Huang ◽  
Wei Liu ◽  
Hengxin Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Treatment Failure ◽  
Logistic Regression Analysis ◽  
Disease Duration ◽  
Multivariate Logistic Regression Analysis ◽  
Tissue Expansion ◽  
Multivariate Logistic Regression ◽  
Hematoma Evacuation

Abstract Background Tissue expansion is used for scar reconstruction owing to its excellent clinical outcomes; however, the complications that emerge from tissue expansion hinder repair. Infection is considered a major complication of tissue expansion. This study aimed to analyze the perioperative risk factors for expander infection. Methods A large, retrospective, single-institution observational study was carried out over a 10-year period. The study enrolled consecutive patients who had undergone tissue expansion for scar reconstruction. Demographics, etiological data, expander-related characteristics and postoperative infection were assessed. Univariate and multivariate logistic regression analysis were performed to identify risk factors for expander infection. In addition, we conducted a sensitivity analysis for treatment failure caused by infection as an outcome. Results A total of 2374 expanders and 148 cases of expander infection were assessed. Treatment failure caused by infection occurred in 14 expanders. Multivariate logistic regression analysis identified that disease duration of ≤1 year (odds ratio (OR), 2.07; p &lt; 0.001), larger volume of expander (200–400 ml vs &lt;200 ml; OR, 1.74; p = 0.032; &gt;400 ml vs &lt;200 ml; OR, 1.76; p = 0.049), limb location (OR, 2.22; p = 0.023) and hematoma evacuation (OR, 2.17; p = 0.049) were associated with a high likelihood of expander infection. Disease duration of ≤1 year (OR, 3.88; p = 0.015) and hematoma evacuation (OR, 10.35; p = 0.001) were so related to high risk of treatment failure. Conclusions The rate of expander infection in patients undergoing scar reconstruction was 6.2%. Disease duration of &lt;1 year, expander volume of &gt;200 ml, limb location and postoperative hematoma evacuation were independent risk factors for expander infection.

scholarly journals Predictive risk factors for worse outcomes in COVID-19 patients with different clinical features at baseline

2021 ◽  
Author(s):  
Elisabetta Schiaroli ◽  
Anna Gidari ◽  
Giovanni Brachelente ◽  
Sabrina Bastianelli ◽  
Alfredo Villa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Critical Illness ◽  
Serum Ferritin ◽  
Logistic Regression Analysis ◽  
Severe Disease ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Neutrophil Lymphocyte Ratio

IntroductionCOVID-19 is characterized by a wide range of clinical expression and by possible progression to critical illness and death. Therefore it is essential to identify risk factors predicting progression towards serious and fatal diseases. The aim of our study was to identify laboratory predictive markers of clinical progression in patients with moderate/severe disease and in those with acute respiratory distress syndrome (ARDS).Material and methodsUsing electronic medical records for all demographic, clinical and laboratory data, a retrospective study on all consecutive patients with COVID-19 admitted to the Infectious Disease Clinic of Perugia was performed. The PaO2/FiO2 ratio (P/F) assessment cut‑off of 200 mm Hg was used at baseline to categorize the patients into two clinical groups. The progression towards invasive ventilation and/or death was used to identify critical outcome. Statistical analysis was performed. Multivariate logistic regression analysis was adopted to identify risk factors of critical illness and mortality.ResultsIn multivariate logistic regression analysis neutrophil/lymphocyte ratio (NLR) was the only significant predictive factor of progression to a critical outcome (p = 0.03) and of in-hospital mortality (p = 0.03). In ARDS patients no factors were associated with critical progression. Serum ferritin > 1006 ng/ml was the only predictive value of critical outcome in COVID-19 subjects with moderate/severe disease (p = 0.02).ConclusionsNeutrophil/lymphocyte ratio and serum ferritin are the only biomarkers that can help to stratify the risk of severity and mortality in patients with COVID-19.

scholarly journals Factors associated with depression in the patients with diabetes mellitus type 2

2019 ◽  
Vol 76 (11) ◽  
pp. 1178-1183 ◽  
Author(s):  
Admir Sabanovic ◽  
Natasa Maksimovic ◽  
Mirjana Stojanovic-Tasic ◽  
Marijan Bakic ◽  
Anita Grgurevic
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Diabetes Mellitus Type 2 ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Factors Associated

Background/Aim. The assessment of association of depression and diabetes mellitus type 2 using the Patient Health Questionaire (PHQ-9) has not been done in Montenegro. The aim of this study was to assess the prevalence of depression in the patients with type 2 diabetes mellitus, and to identify the risk factors associated with the presence of depression. Methods. A cross-sectional study was conducted at the General Hospital in Bijelo Polje, from July to September, 2015. It included 70 patients over 35 years of age with the diagnosis of diabetes for at least six months. For the assessment of depression presence and intensity PHQ?9 was used. All variables associated with the presence of depression at a significance level of p < 0.05 were included into the final method of the multivariate logistic regression analysis. Results. Comorbidities were statistically significant more frequent among patients with depression (?2 = 5.40; p = 0.020). Duration of diabetes over five years was significantly associated with depression (?2 = 12.48; p < 0.001). Depression occurred more frequently among physically inactive subjects (?2 = 10.74; p = 0.005). The presence of diabetic polyneuropathy (?2 = 6.04; p = 0.014) and cataract (?2 = 5.351; p = 0.021) were also significantly associated with depression. A multivariate logistic regression analysis showed that the duration of diabetes over five years and presence of cataract were independently associated with depression. Conclusion. The risk factors for depression among the subjects with diabetes were disease duration more than five years and the presence of cataract. Since depression is a serious disease and can be a risk factor for many chronic diseases, the best way of prevention is its early detection and treatment.

scholarly journals Decreased eGFR Is Associated With Ischemic Stroke in Patients With Dilated Cardiomyopathy

2019 ◽  
Vol 25 ◽  
pp. 107602961986690 ◽  
Author(s):  
Yuqing Deng ◽  
Zhiqing Chen ◽  
Lili Hu ◽  
Zhenyan Xu ◽  
Jinzhu Hu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Dilated Cardiomyopathy ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Analysis Model ◽  
Multivariate Logistic Regression ◽  
Increased Risk

Dilated cardiomyopathy (DCM) is increasingly indicated as a cause of cardioembolic syndrome, in particular, cardioembolic ischemia stroke. However, the potential risk factors for stroke among DCM patients remain under investigated. DCM patients hospitalized from June 2011 to June 2016 were included. The cases were defined as the group of DCM patients with stroke compared with those without stroke. Clinical characteristic data were collected and compared between the two groups including demographic data, complicated diseases, echocardiography index, and laboratory parameters and estimated glomerular filtration rate (eGFR). A multivariate logistic regression analysis model adjusted by sex and age was used to explore the related risk factors for stroke in DCM patients. A total of 779 hospitalized patients with DCM were included. Of these, 55 (7.1%) had experienced a stroke. Significantly lower eGFR levels (68.03 ± 26.22 vs 79.88 ± 24.25 mL/min/1.73 m2, P = .001) and larger left atrial diameters (45.32 ± 7.79 vs 43.25 ± 7.11 mm, P = .04) were found in the group of patients having DCM with stroke compared to those without stroke. When the eGFR was categorized as eGFR >60, 30<eGFR≤ 60 and eGFR ≤ 30, there were more patients with 30<eGFR≤ 60 (30.9% vs 17.7%) and eGFR≤ 30 (9.1% vs 3.3%) in the ischemic stroke group ( P = 0.003). A multivariate logistic regression analysis model adjusted by sex and age showed that 30 <eGFR≤60 (odds ratio [OR]: 2.07, 95% confidence interval [CI]: [1.05-4.07], P = .035) and eGFR≤30 (OR: 4.04, 95% CI: [1.41-11.62], P = .009) were statistically associated with ischemic stroke in patients with DCM. It is concluded that decreased eGFR is significantly associated with an increased risk of ischemic stroke in patients with DCM.

Minimally invasive surfactant therapy failure: risk factors and outcome

2019 ◽  
Vol 104 (6) ◽  
pp. F636-F642 ◽  
Author(s):  
Lobke CE Janssen ◽  
Jooske Van Der Spil ◽  
Anton H van Kaam ◽  
Jeanne P Dieleman ◽  
Peter Andriessen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Intensive Care ◽  
Minimally Invasive ◽  
Logistic Regression Analysis ◽  
Neonatal Intensive Care ◽  
Multivariate Logistic Regression Analysis ◽  
Surfactant Therapy ◽  
Multivariate Logistic Regression

ObjectiveTo evaluate incidence of minimally invasive surfactant therapy (MIST) failure, identify risk factors and assess the impact of MIST failure on neonatal outcome.DesignRetrospective cohort study. MIST failure was defined as need for early mechanical ventilation (<72 hours of life). Multivariate logistic regression analysis was performed to identify risk factors for MIST failure and compare outcomes between groups.SettingTwo tertiary neonatal intensive care centres in the Netherlands.PatientsInfants born between 24 weeks’ and 31 weeks’ gestational age (GA) (n=185) with MIST for respiratory distress syndrome.InterventionsMIST procedure with poractant alfa (100–200 mg/kg).Main outcome measuresContinuous positive airway pressure (CPAP) failure after MIST in the first 72 hours of life.Results30% of the infants failed CPAP after MIST. In a multivariate logistic regression analysis, four risk factors were independently associated with failure: GA <28 weeks, C reactive protein ≥10 mg/L, absence of antenatal corticosteroids and lower surfactant dose. Infants receiving 200 mg/kg surfactant had a failure rate of 14% versus 35% with surfactant dose <200 mg/kg. Mean body temperature was 0.4°C lower at neonatal intensive care unit admission and before the procedure in infants with MIST failure.Furthermore, MIST failure was independently associated with an increased risk of severe intraventricular haemorrhage.ConclusionWe observed moderate MIST failure rates in concordance with the results of earlier studies. Absence of corticosteroids and lower surfactant dose are risk factors for MIST failure that may be modifiable in order to improve MIST success and patient outcome.

Comprehensive study of risk factors for chemotherapy-induced nausea and vomiting in cancer patients receiving cisplatin-based chemotherapy: A TRIPLE pharmacogenomics study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10091-10091
Author(s):  
Hideaki Ayuhara ◽  
Daiki Tsuji ◽  
Mari Yokoi ◽  
Kenichi Suzuki ◽  
Yohei Kawasaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Nausea And Vomiting ◽  
Multivariate Logistic Regression ◽  
Independent Variables ◽  
Female Sex ◽  
Antiemetic Treatment

10091 Background: Chemotherapy-induced nausea and vomiting (CINV) is one of the most unpleasant adverse effects of chemotherapy. Resistance to prophylactic antiemetic treatment is problematic, with 30%–50% of patients experiencing unsatisfactory control. Younger age and female sex are well-known risk factors for CINV. Genetic polymorphisms are suggested to influence antiemetic treatment response. Methods: This study included a subset of patients previously enrolled in a randomised controlled trial. This study aimed to evaluate the role of pharmacogenomic polymorphisms relevant to antiemetic response in patients with cancer receiving cisplatin-based chemotherapy. The study’s efficacy endpoint was the proportion of patients with complete response (CR). The study endpoint was evaluated separately in the acute (CR0-24) and delayed (CR24-120) phases. Thirteen polymorphisms were genotyped, and the association of these genotypes with the efficacy of prophylactic antiemetics was then investigated. Confounding variables for CR were identified using stepwise multivariate logistic regression analysis. Age and sex were included as independent variables by the forced-entry method, and the stepwise method was used to select the pharmacogenomic factors for inclusion as independent variables. Results: In this genetic polymorphism association study, 156 patients with solid cancer were evaluated. Multivariate logistic regression analysis revealed that ERCC1 8092AA (odd ratio [OR]: 11.251; 95% confidence interval [CI]: 1.741–72.712, P = 0.011) and female sex (OR = 3.630; 95% CI = 1.138–11.578, P = 0.029) were significant predictors of CR0-24. No significant association of CR24-120 with pharmacogenomic polymorphisms was found via multivariate logistic regression analysis. Conclusions: ERCC1 polymorphism might be influenced the extent of CINV control in patients receiving cisplatin-based chemotherapy. Clinical trial information: 000009335.

scholarly journals Endoscopic ultrasound in diagnosis of solid pancreatic lesions: Elastography or contrast-enhanced harmonic alone versus the combination

2017 ◽  
Vol 05 (11) ◽  
pp. E1136-E1143 ◽  
Author(s):  
Tanyaporn Chantarojanasiri ◽  
Yoshiki Hirooka ◽  
Hiroki Kawashima ◽  
Eizaburo Ohno ◽  
Takamichi Kuwahara ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Differential Diagnosis ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Endoscopic Ultrasound ◽  
Inflammatory Pseudotumor ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Contrast Enhanced ◽  
The Individual

Abstract Background and study aims Endoscopic ultrasound (EUS) elastography (EUS-E) and contrast-enhanced harmonic EUS (CH-EUS) are useful methods for the diagnosis of pancreatic lesions. This study aims to compare the accuracy of combined EUS-E and CH-EUS with that of EUS-E or CH-EUS alone in the differential diagnosis of pancreatic solid lesions. Patients and methods One hundred thirty-six patients with solid pancreatic lesions underwent EUS with both EUS-E and CH-EUS were included. Diagnoses were classified as adenocarcinoma, neuroendocrine tumor (NET), and inflammatory pseudotumor in 95, 22, and 19 patients, respectively. EUS records in each case were rearranged into 3 groups: EUS-E, CH-EUS, and combination. Each modality was randomly reviewed by 3 reviewers with different levels of clinical experience. Sensitivity, specificity, and accuracy of each modality according to each diagnosis group were evaluated. For the combined diagnosis populations, the proportions of correct diagnoses among the 3 modalities were compared by using the multivariate logistic regression analysis. Results The accuracies of EUS-E, CH-EUS, and the combination of them were 68.4 %, 65.4 %, and 75.7 %, respectively, for adenocarcinoma group; 83.8 %, 82.4 %, and 86.8 % for NET group; 80.1 %, 78.7 %, and 81.6 % for inflammatory pseudotumor group. The multivariate logistic regression analysis for the combined diagnosis populations showed that the proportion of correct diagnoses when EUS-E and CH-EUS were combined was slightly higher than with the other 2 modalities, although the significant differences among them were not observed. Conclusion EUS-E and CH-EUS combined may improve differential diagnosis of solid pancreatic lesions compared with use of the individual modalities.

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