scholarly journals Whether Start Time of Elective Lung Surgery Impacts Perioperative Outcomes and Cost?

2021 ◽  
Author(s):  
Gu-Ha A-Lai ◽  
Jian-Rong Hu ◽  
Zhi-Jie Xu ◽  
Peng Yao ◽  
Xia Zhong ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Hospital Cost ◽  
Lung Surgery ◽  
Perioperative Outcomes ◽  
Multivariable Logistic Regression Analysis ◽  
Total Hospital ◽  
Early Start ◽  
Late Start

Abstract BackgroundFatigue and long work hours of surgeons attracts increasing concerns in recent years. In clinical practice, most patients prefer to receiving surgery in the morning. So, we aimed to explore whether starting time is associated with perioperative outcomes and hospital cost for elective lung surgery. MethodsA retrospective study was conducted on elective lung surgery patients between September 2019-November 2019. Patients were divided into “early start group” if surgery started before 4pm while “late start group” was after 4pm. Perioperative outcomes and total hospital costs were compared between two groups. Besides, multivariable logistic regression analysis was performed for further analysis.ResultsA total of 398 patients were finally enrolled for analysis in this study. Of all the cases, 295 patients were divided into early start group while 103 patients belonged to late start group. There were no differences in postoperative hospital duration, operation time, complication incidence and total hospital cost. In multivariable logistic regression analysis, surgery start late was still found not to be a risk factor.ConclusionIn elective lung surgery, perioperative outcomes and cost were all similar between early start and late start surgery, it was not necessary to worry about surgery order for these patients.

scholarly journals Prediction of successful de-cannulation of tracheostomised patients in medical intensive care units

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chul Park ◽  
Ryoung-Eun Ko ◽  
Jinhee Jung ◽  
Soo Jin Na ◽  
Kyeongman Jeon
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Goodness Of Fit ◽  
Characteristic Curve ◽  
Multivariable Logistic Regression Analysis ◽  
Limited Data ◽  
Underlying Malignancy ◽  
Medical Intensive Care ◽  
Good Calibration

Abstract Background Limited data are available on practical predictors of successful de-cannulation among the patients who undergo tracheostomies. We evaluated factors associated with failed de-cannulations to develop a prediction model that could be easily be used at the time of weaning from MV. Methods In a retrospective cohort of 346 tracheostomised patients managed by a standardized de-cannulation program, multivariable logistic regression analysis identified variables that were independently associated with failed de-cannulation. Based on the logistic regression analysis, the new predictive scoring system for successful de-cannulation, referred to as the DECAN score, was developed and then internally validated. Results The model included age > 67 years, body mass index < 22 kg/m2, underlying malignancy, non-respiratory causes of mechanical ventilation (MV), presence of neurologic disease, vasopressor requirement, and presence of post-tracheostomy pneumonia, presence of delirium. The DECAN score was associated with good calibration (goodness-of-fit, 0.6477) and discrimination outcomes (area under the receiver operating characteristic curve 0.890, 95% CI 0.853–0.921). The optimal cut-off point for the DECAN score for the prediction of the successful de-cannulation was ≤ 5 points, and was associated with the specificities of 84.6% (95% CI 77.7–90.0) and sensitivities of 80.2% (95% CI 73.9–85.5). Conclusions The DECAN score for tracheostomised patients who are successfully weaned from prolonged MV can be computed at the time of weaning to assess the probability of de-cannulation based on readily available variables.

scholarly journals Impact of histologic chorioamnionitis on pulmonary hypertension and respiratory outcomes in preterm infants

2018 ◽  
Vol 8 (2) ◽  
pp. 204589401876016 ◽  
Author(s):  
Sook Kyung Yum ◽  
Min-Sung Kim ◽  
Yoojin Kwun ◽  
Cheong-Jun Moon ◽  
Young-Ah Youn ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Preterm Infants ◽  
Logistic Regression Analysis ◽  
Multivariable Logistic Regression Analysis ◽  
Multivariable Logistic Regression ◽  
Histologic Chorioamnionitis ◽  
Respiratory Outcomes ◽  
Lower Birthweight

We aimed to evaluate the association between the presence of histologic chorioamnionitis (HC) and development of pulmonary hypertension (PH) during neonatal intensive care unit (NICU) stay. Data of preterm infants born at 32 weeks of gestation or less were reviewed. The development of PH and other respiratory outcomes were compared according to the presence of HC. Potential risk factors associated with the development of PH during NICU stay were used for multivariable logistic regression analysis. A total of 188 infants were enrolled: 72 in the HC group and 116 in the no HC group. The HC group infants were born at a significantly shorter gestational age and lower birthweight, with a greater proportion presenting preterm premature rupture of membrane (pPROM) > 18 h before delivery. More infants in the HC group developed pneumothorax ( P = 0.008), and moderate and severe bronchopulmonary dysplasia (BPD; P = 0.001 and P = 0.006, respectively). PH in the HC group was significantly more frequent compared to the no HC group (25.0% versus 8.6%, P = 0.002). Based on a multivariable logistic regression analysis, birthweight ( P = 0.009, odds ratio [OR] = 0.997, 95% confidence interval [CI] = 0.995–0.999), the presence of HC ( P = 0.047, OR = 2.799, 95% CI = 1.014–7.731), and duration of invasive mechanical ventilation (MV) > 14 days ( P = 0.015, OR = 8.036, 95% CI = 1.051–43.030) were significant factors. The presence of HC and prolonged invasive MV in infants with lower birthweight possibly synergistically act against preterm pulmonary outcomes and leads to the development of PH. Verification of this result and further investigation to establish effective strategies to prevent or ameliorate these adverse outcomes are needed.

Abstract 1847: Prognostic Impact Of Previous Percutaneous Coronary Interventions On Coronary Artery Bypass Graft Surgery: A Multicentric Analysis FromThe German Federal State North-Rhine-Westphalia

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Parwis Massoudy ◽  
Matthias Thielmann ◽  
Nils Lehmann ◽  
Anja Marr ◽  
Georg Kleikamp ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Coronary Artery ◽  
Hospital Mortality ◽  
Logistic Regression Analysis ◽  
Artery Bypass ◽  
Federal State ◽  
Multivariable Logistic Regression Analysis ◽  
Percutaneous Coronary ◽  
German Federal State

Background: We have previously shown that multiple prior percutaneous coronary intervention (PCI) procedures adversely affect outcome after subsequent coronary artery bypass grafting (CABG). We were now interested to investigate this effect on a multicentric basis. Methods: Eight cardiac surgical centers from the German Federal State of North-Rhine-Westphalia provided outcome data of 37140 consecutive patients having undergone isolated first-time CABG between 01/2000 and 12/2005. Twenty-two patient characteristics and outcome variables, which are part of a collection of data claimed by the national medical quality-control commission, were retrieved from the individual databases. Three groups of patients were analyzed for overall in-hospital mortality and major adverse cardiac events (MACE): Patients without a previous PCI procedure, patients with 1 previous PCI procedure and patients with ≥2 previous PCI procedures before surgery. Unadjusted univariable and risk-adjusted multivariable logistic regression analysis were applied. Computed propensity-score matching was performed based on 15 patient major risk factors to correct for and minimize selection bias. Results: A total of 10.3% of patients had 1 previous PCI procedure, and 3.7% of patients had ≥2 previous PCI procedures. Risk-adjusted multivariable logistic regression analysis of ≥2 previous PCI significantly correlated with in-hospital mortality (odds ratio [OR], 2.0; confidence interval [CI], 1.4–3.0; P <0.0005) and MACE (OR, 1.5; CI, 1.2–1.9; P <0.0013). After propensity score matching, conditional logistic regression analysis confirmed the results of adjusted analysis. A history of ≥2 previous PCI procedures was significantly associated with in-hospital mortality (OR, 1.9; CI, 1.3–2.7; P =0.0016) and MACE (OR, 1.5; CI, 1.2–1.9; P =0.0019). Conclusions: This large multicentric trial supports earlier results of our single-center analysis, multiple previous PCI procedures significantly increased the event of in-hospital mortality and MACE after subsequent CABG.

Abstract TP3: Early Reocclusion After Mechanical Thrombectomy for Acute Stroke Due to Intracranial Atherosclerotic Stenosis-Related Occlusions

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Masatomo Miura ◽  
Yoichiro Nagao ◽  
Makoto Nakajima ◽  
Seigo Shindo ◽  
Kuniyasu Wada ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Balloon Angioplasty ◽  
Mechanical Thrombectomy ◽  
Rescue Therapy ◽  
Multivariable Logistic Regression Analysis ◽  
Intracranial Stenting ◽  
Atherosclerotic Stenosis

Background: In acute ischemic stroke (AIS) patients due to intracranial atherosclerosis-related occlusions (ICAS-O), despite successful reperfusion with mechanical thrombectomy (MT), unexpected early reocclusion sometimes occurs and worsens clinical outcome. We investigated prevalence, outcomes, and predictors of early reocclusion within 48 hours of MT in AIS due to ICAS-O. Methods: In 557 consecutive AIS patients who underwent MT from January, 2016 to March, 2019 in two stroke centers, 71 patients due to ICAS-O were retrospectively evaluated. We divided them into two groups: patients with early reocclusion and those without. Clinical and angiographical findings and outcomes were compared between the 2 groups. Multivariable logistic regression analysis was used to investigate predictors of early reocclusion after MT. Results: Of 71 patients (aged 72 ± 10 years; 23 women; median NIHSS score, 15), early reocclusion was observed in 11 (15%). The first procedure for recanalization was stent retriever in 25 patients (35%), Penumbra system in 25 patients (35%), and balloon angioplasty in 21 patients (30%). Of these, 63 patients (88%) received rescue therapy (balloon angioplasty, 50; intracranial stenting, 13). In the early reocclusion group, more number of intraprocedural reocclusion (median [IQR], 3 [2-3] vs. 1 [0-1], p < 0.001), a higher rate of remaining stenosis on the final angiography (67.6 ± 5.9% vs 57.3 ± 15.9%, p = 0.044), and a higher rate of procedure-related adverse events (27% vs 5%, p = 0.043) were observed compared to the other group. On logistic regression analysis, a total number of intraprocedural reocclusion was independently associated with early reocclusion (odds ratio, 31.4; 95% confidence interval, 2.6-375.2). Early reocclusion was related to a low rate of favorable outcome at 90 days (modified Rankin Scale ≤ 2, 9% vs 54%, p = 0.007). Conclusions: In AIS patients due to ICAS-O, early reocclusion within 48 hours was not rare and associated with unfavorable outcome. Patients with repeated intraprocedural reocclusion are at high risk for early reocclusion; they might need follow-up angiographical assessment and intensive antithrombotic treatment.

scholarly journals Hounsfield unit attenuation value can differentiate pyonephrosis from hydronephrosis and predict septic complications in patients with obstructive uropathy

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Luca Boeri ◽  
Irene Fulgheri ◽  
Franco Palmisano ◽  
Elena Lievore ◽  
Vito Lorusso ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Obstructive Uropathy ◽  
Hounsfield Unit ◽  
Infectious Complications ◽  
Multivariable Logistic Regression Analysis ◽  
Ureteral Catheter ◽  
Septic Complications ◽  
Multivariable Logistic Regression

Abstract We aimed to assess the role of computerized tomography attenuation values (Hounsfield unit—HU) for differentiating pyonephrosis from hydronephrosis and for predicting postoperative infectious complications in patients with obstructive uropathy. We analysed data from 122 patients who underwent nephrostomy tube or ureteral catheter placement for obstructive uropathy. A radiologist drew the region of interest for quantitative measurement of the HU values in the hydronephrotic region of the affected kidney. Descriptive statistics and logistic regression models tested the predictive value of HU determination in differentiating pyonephrosis from hydronephrosis and in predicting postoperative sepsis. A HU cut-off value of 6.3 could diagnose the presence of pyonephrosis with 71.6% sensitivity and 71.5% specificity (AUC 0.76; 95%CI: 0.66–0.85). At multivariable logistic regression analysis HU ≥ 6.3 (p ≤ 0.001) was independently associated with pyonephrosis. Patients who developed sepsis had higher HU values (p ≤ 0.001) than those without sepsis. A HU cut-off value of 7.3 could diagnose the presence of sepsis with 76.5% sensitivity and 74.3% specificity (AUC 0.79; 95%CI: 0.71–0.90). At multivariable logistic regression analysis, HU ≥ 7.3 (p ≤ 0.001) was independently associated with sepsis, after accounting for clinical and laboratory parameters. Measuring HU values of the fluid of the dilated collecting system may be useful to differentiate pyonephrosis from hydronephrosis and to predict septic complications in patients with obstructive uropathy.

scholarly journals Perceived discrimination and psychotic experiences in the English general population

2019 ◽  
Vol 62 ◽  
pp. 50-57
Author(s):  
Andrew Stickley ◽  
Hans Oh ◽  
Tomiki Sumiyoshi ◽  
Zui Narita ◽  
Jordan E. DeVylder ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Sexual Orientation ◽  
General Population ◽  
Logistic Regression Analysis ◽  
Perceived Discrimination ◽  
Auditory Hallucination ◽  
Psychiatric Morbidity ◽  
Multivariable Logistic Regression Analysis ◽  
Psychotic Experiences

Abstract Background: Perceived discrimination has been linked to psychotic experiences (PEs). However, as yet, information is lacking on the relationship between different forms of discrimination and PEs. This study examined this association in the English general population. Methods: Nationally representative, cross-sectional data were analyzed from 7363 adults aged 16 and above that came from the Adult Psychiatric Morbidity Survey, 2007. Self-reported information was obtained on six forms of discrimination (ethnicity, sex, religious beliefs, age, physical health problems/disability, sexual orientation), while PEs were assessed with the Psychosis Screening Questionnaire (PSQ). Multivariable logistic regression analysis was used to assess associations. Results: In a fully adjusted logistic regression analysis, any discrimination was significantly associated with PEs (odds ratio [OR]: 2.47, 95% confidence interval [CI]: 1.75–3.48). All individual forms of discrimination were significantly associated with PEs except sexual orientation. Multiple forms of discrimination were associated with higher odds for PEs in a monotonic fashion with those experiencing ≥ 3 forms of discrimination having over 5 times higher odds for any PE. In addition, experiencing any discrimination was associated with significantly increased odds for all individual forms of PE with ORs ranging from 2.16 (95%CI: 1.40–3.35) for strange experience to 3.36 (95%CI: 1.47–7.76) for auditory hallucination. Conclusion: Different forms of discrimination are associated with PEs in the general population. As discrimination is common at the societal level, this highlights the importance of public policy and evidence-based interventions to reduce discrimination and improve population mental health.

scholarly journals Determinants of the Continuum of Maternal Healthcare Services in Northwest Ethiopia: Findings from the Primary Health Care Project

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Asmamaw Atnafu ◽  
Adane Kebede ◽  
Bisrat Misganaw ◽  
Destaw Fetene Teshome ◽  
Gashaw Andargie Biks ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Service Delivery ◽  
Health Facility ◽  
Logistic Regression Analysis ◽  
Healthcare Services ◽  
Multivariable Logistic Regression Analysis ◽  
Maternal Healthcare ◽  
Factors Associated ◽  
The Continuum

Background. The maternity continuum of care is the continuity of maternal healthcare services that a woman uses, which includes antenatal care (ANC 4+), skill birth attendant (SBA), and postnatal care (PNC) within 48 hours of delivery. It is one of the essential strategies for reducing maternal and newborn mortality. This study aimed to assess the factors associated with the completion of a continuum of maternal healthcare services among mothers who gave birth in the past five years. Methods. A community-based cross-sectional study was conducted from May 01 to June 29, 2019, among 565 randomly selected mothers who gave birth in five years before the study in primary healthcare project implementation districts of north Gondar zone, Amhara National Regional State, Ethiopia. Bivariable and multivariable logistic regression analysis were computed, and in the multivariable logistic regression analysis, adjusted odds ratio (AOR) with 95% confidence interval (CI) and a p value of less than 0.05 were used to identify the associated factors with completion of the continuum of maternal healthcare services. Results. The study revealed that the overall completion of the continuum of maternal healthcare services was 21.60% (95% CI: 18.20, 24.90). Women who were able to read and write (AOR: 2.70, 95% CI: 1.22, 6.04), using car/motorcycle as a means of transportation to get the health facility (AOR: 5.59, 95% CI: 2.29, 9.50), travel time less than an hour to get the health facility (AOR: 4.98, 95% CI: 2.97, 8.38), being satisfied with the service delivery (AOR: 1.89, 95% CI: 1.15, 3.11), and getting health education on maternal healthcare services in the last 6 months (AOR: 2.77, 95% CI: 1.52, 5.05) were factors associated with the completion of the continuum of maternal healthcare services. Conclusions. The completion of the continuum of maternal healthcare services was relatively low, indicating that women were not getting the likely health benefit from the present health services. Therefore, interventions should focus on increasing women’s awareness, improving the availability of services at nearby health facilities, and improving service delivery by considering women’s preferences and needs to increase their satisfaction are essential to increase the completion of maternal healthcare services.

scholarly journals Real-world clopidogrel utilization in acute coronary syndromes: patients selection and outcomes in a single-center experience

2017 ◽  
Vol 11 (12) ◽  
pp. 323-331 ◽  
Author(s):  
Diego Castini ◽  
Simone Persampieri ◽  
Sara Cazzaniga ◽  
Giulia Ferrante ◽  
Marco Centola ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Adverse Events ◽  
Hospital Mortality ◽  
Logistic Regression Analysis ◽  
Left Ventricular ◽  
Hospital Death ◽  
Multivariable Logistic Regression Analysis ◽  
Killip Class ◽  
Female Sex

Background: With this study, we sought to identify patient characteristics associated with clopidogrel prescription and its relationship with in-hospital adverse events in an unselected cohort of ACSs patients. Materials and Methods: We studied all consecutive patients admitted at our institution for ACSs from 2012 to 2014. Patients were divided into two groups based on clopidogrel or novel P2Y12 inhibitors (prasugrel or ticagrelor) prescription and the relationship between clopidogrel use and patient clinical characteristics and in-hospital adverse events was evaluated using logistic regression analysis. Results: The population median age was 68 years (57–77 year) and clopidogrel was prescribed in 230 patients (46%). Patients characteristics associated with clopidogrel prescription were older age, female sex, non-ST-elevation ACS diagnosis, the presence of diabetes mellitus and anemia, worse renal and left ventricular functions and a higher Killip class. Patients on clopidogrel demonstrated a significantly higher incidence of in-hospital mortality (4.8%) than prasugrel and ticagrelor-treated patients (0.4%), while a nonstatistically significant trend emerged considering bleeding events. However, on multivariable logistic regression analysis female sex, the presence of anemia and Killip class were the only variables independently associated with in-hospital death. Conclusion: Patients treated with clopidogrel showed a higher in-hospital mortality. However, clinical variables associated with its use identify a population at high risk for adverse events and this seems to play a major role for the higher in-hospital mortality observed in clopidogrel-treated patients.

Pride, shame and health among adolescents – a cross-sectional survey

2017 ◽  
Vol 30 (6) ◽  
Author(s):  
Eva Randell ◽  
Junia Joffer ◽  
Renée Flacking ◽  
Bengt Starrin ◽  
Lars Jerdén
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Identity Development ◽  
Logistic Regression Analysis ◽  
Strong Predictor ◽  
Well Being ◽  
Multivariable Logistic Regression Analysis ◽  
Protective Mechanism ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background Pride and shame are important emotions known to influence identity development and psychological well-being in adolescence. Research evidence indicates that self-rated health (SRH) is a strong predictor of future health. This cross-sectional study, conducted during 2008–2009, aimed to investigate the associations between pride, shame and SRH among adolescent boys and girls. Methods The study sample comprised 705 adolescents in Sweden aged 17–18 years (318 boys and 387 girls) who completed a questionnaire that included items on SRH, shame and pride (participation rate 67%). Logistic regression analyses (univariable and multivariable) were used to investigate the associations between pride and shame as separate and combined constructs on SRH, adjusting for potential confounders (country of birth, parental educational level, school experience, having enough friends, mood in family and being active in associations). Results Pride and shame separately were significantly associated with SRH in both genders. Logistic regression analysis of the pride-shame model showed that the odds of having lower SRH were highest in boys and girls with lower pride-higher shame. In a multivariable logistic regression analysis of the pride-shame model the odds of having lower SRH remained significant in boys and girls with lower pride-higher shame [boys: odds ratio (OR) 3.51, confidence interval (CI) 1.40–8.81; girls: OR 2.70, CI 1.22–5.96] and in girls with lower pride-lower shame (OR 2.16, CI 1.02–4.56). Conclusion The emotions of shame and pride are associated with SRH in adolescence. Experiencing pride seems to serve as a protective mechanism in SRH in adolescents exposed to shame. We believe that this knowledge should be useful in adolescent health promotion.

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