Predicting Surgical Factors for Unplanned Overnight Admission in Ambulatory Arthroscopic Surgery of the Knee: A Prospective Cohort in 184 patients

Abstract Background: Unplanned overnight admission (UOA) is an important indicator for quality of care with ambulatory knee arthroscopic surgery (AKAS). However, few studies have explored the factors related to the UOA and how to predict UOA after AKAS. This study aimed to evaluate the effectiveness of a standardized perioperative protocol for the AKAS with UOA and identify whether a correlation exists between the perioperative surgical factors and UOA in the patients undergoing AKAS. Methods: A prospective cohort study was conducted, between October 2017 and March 2021, in 184 patients. All patients operated on standard AKAS protocol. The UOA was defined as overnight hospitalization of a patient undergoing AKAS. Demographic and perioperative data were recorded, and the procedure was categorized based on the surgical invasiveness based on less invasive (n = 65) and more complex surgery (n = 119). The clinical risk factors for UOA were identified and analyzed with multivariate logistic regression analysis. Results: The incidence of UOA in the more complex group (17 cases, 14.3%) was significantly higher than in the less invasive group (3 cases, 4.6%) (p = 0.049), with the incidence of readmission as 0%. The perioperative factors significantly associated with UOA were age, more complex surgery, and tourniquet time (p < 0.10 all). However, the multivariate regression analysis revealed that tourniquet time was the only significant predictor for UOA (odds ratio = 1.045, 95% confidence interval = 1.022 to 1.067, p = 0.0001). The optimal cut-off points of tourniquet time for predicting UOA with the highest Youden index in the less invasive and more complex groups were 56 minutes and 107 minutes, respectively. Conclusion: The UOA after AKAS is more common in more complex surgery compared to less invasive surgery. Many factors—such as patient factors, surgical invasiveness, and tourniquet time—were also significantly associated with the unplanned admission. However, the results from this study showed that, under strict perioperative management protocol, tourniquet time is the only independent predictor for UOA.

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Donepezil Combined with DL-3-n-Butylphthalide Delays Cognitive Decline in Patients with Mild to Moderate Alzheimer’s Disease: A Multicenter, Prospective Cohort Study

Journal of Alzheimer s Disease ◽

10.3233/jad-201381 ◽

2021 ◽

Vol 80 (2) ◽

pp. 673-681

Author(s):

Jin Wang ◽

Xiaojuan Guo ◽

Wenhui Lu ◽

Jie Liu ◽

Hong Zhang ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Logistic Regression ◽

Regression Analysis ◽

Cohort Study ◽

Prospective Cohort ◽

Daily Living ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Significant Difference

Background: Vascular factors and mitochondria dysfunction contribute to the pathogenesis of Alzheimer’s disease (AD). DL-3-n-butylphthalide (NBP) has an effect in protecting mitochondria and improving microcirculation. Objective: The aim was to investigate the effect of donepezil combined NBP therapy in patients with mild-moderate AD. Methods: It was a prospective cohort study. 92 mild-moderate AD patients were classified into the donepezil alone group (n = 43) or the donepezil combined NBP group (n = 49) for 48 weeks. All patients were evaluated with Alzheimer’s Disease Assessment Scale-Cognitive subscale (ADAS-cog), Clinician’s Interview-Based Impression of Change plus caregiver input (CIBIC-plus), Alzheimer’s Disease Cooperative Study-Activities of Daily Living (ADCS-ADL), and Neuropsychiatric Inventory (NPI) every 12 weeks. All patients were monitored for adverse events (AEs). The efficacy was analyzed using multivariate logistic regression analysis. Results: The multivariate logistic regression analysis showed that the changes of ADAS-cog score (OR = 2.778, 95% CI: [1.087, 7. 100], p = 0.033) and ADCS-ADL score (OR = 2.733, 95% CI: [1.002, 7.459], p = 0.049) had significant difference between donepezil alone group and donepezil combined NBP group, while the changes of NPI (OR = 1.145, 95% CI: [0.463, 2.829], p = 0.769), MMSE (OR = 1.563, 95% CI: [0.615, 3.971], p = 0.348) and CIBIC-plus (OR = 2.593, 95% CI: [0.696, 9.685], p = 0.156) had no significant difference. The occurrence of AEs was similar in the two groups. Conclusion: Over the 48-week treatment period, donepezil combined NBP group had slower cognitive decline and better activities of daily living in patients with mild to moderate AD. These indicated that the multi-target therapeutic effect of NBP may be a new choice for AD treatment.

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Comparison of Treatment Response and Survival Profiles Between Drug-Eluting Bead Transarterial Chemoembolization and Conventional Transarterial Chemoembolization in Chinese Hepatocellular Carcinoma Patients: A Prospective Cohort Study

Oncology Research Featuring Preclinical and Clinical Cancer Therapeutics ◽

10.3727/096504018x15368325811545 ◽

2019 ◽

Vol 27 (5) ◽

pp. 583-592 ◽

Cited By ~ 1

Author(s):

Ping Wen ◽

Sheng-Duo Chen ◽

Jia-Rui Wang ◽

Ying-He Zeng

Keyword(s):

Hepatocellular Carcinoma ◽

Regression Analysis ◽

Cohort Study ◽

Treatment Response ◽

Prospective Cohort Study ◽

Predictive Factor ◽

Prospective Cohort ◽

Transarterial Chemoembolization ◽

Multivariate Logistic Regression Analysis ◽

Drug Eluting

This study evaluated the difference in treatment response and survival profiles between drug-eluting bead transarterial chemoembolization (DEB-TACE) and conventional transarterial chemoembolization (cTACE) treatments in Chinese hepatocellular carcinoma (HCC) patients. A total of 120 HCC patients were consecutively enrolled in this prospective cohort study, which showed that DEB-TACE achieved higher complete response (CR) (30.8%) compared with cTACE (7.4%) with no difference in overall response rate (ORR) for patients treated with DEB-TACE and cTACE (80.8% vs. 73.5%). In addition, DEB-TACE was associated with a lower rate of progressive disease (PD) compared with cTACE (1.9% vs. 11.8%). With respect to survival, patients in the DEB-TACE group achieved median progression-free survival (PFS) of 15 months (95% CI 12‐18 months), which was longer than the cTACE group [median PFS 11 months (95% CI 10‐12 months)]. Median overall survival (OS) was also longer with DEB-TACE [25 months (95% CI 22-28 months)] when compared with cTACE [21 months (95% CI 18‐24 months)]. Univariate and multivariate logistic regression analysis showed that DEB-TACE was an independent predictive factor for achieving CR. Univariate Cox’s regression analysis revealed that DEB-TACE was a predictive factor for prolonged PFS and OS, while multivariate analysis demonstrated that DEB-TACE was not an independent factor for predicting PFS or OS. In conclusion, we found that DEB-TACE achieved higher treatment response and prolonged survival compared with cTACE in Chinese HCC patients.

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Status of Two-week Prevalence Rate in Tibet: Data Base on the Sixth Health Service Survey of Tibet, China

10.21203/rs.2.14864/v1 ◽

2019 ◽

Author(s):

Rendan Deng ◽

Laba sangzhu ◽

Zhaxi deji ◽

Guihua Wang ◽

Peiwei Hong ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Health Service ◽

Marital Status ◽

Logistic Regression Analysis ◽

Prevalence Rate ◽

Employment Status ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Important Indicator

Abstract Background Tibet is located in the high altitude area of southwest China, which health level is influenced by specific factors. However, there was little research on Tibetan health condition. And the two-week prevalence rate is an important indicator to health status of residents. The purpose of this study was to understand the two-week prevalence rate and its influencing factors in Tibet. Methods Two-week prevalence rate was calculated using data from a population of 10493 aged 15 and above obtained from the sixth Health Service Survey of Tibet in 2018. Multivariate logistic regression analysis was used to further screen factors for gender, age, marital status, employment status and so on. Results The two-week illness prevalence rate was 20.1% in Tibet. According to the Multivariate logistic regression analysis the two-week prevalence rate was associated with gender, age, residence, marital status, employment status, respectively. Digestive system diseases are given priority, hypertension is the most common disease. Besides, the severity of two-week illness has differences in different groups. Conclusion This study identified a number of factors that appear to have a significant relationship with the two-week illness prevalence. Moreover, the two-week prevalence rates of women and older people were significantly higher, which should be paid attention to in the utilization of health services.

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ANALISIS HUBUNGAN SARANA, PENGETAHUAN, DAN SIKAP BIDAN PRAKTIK MANDIRI DENGAN KEPATUHAN MENJALANKAN STANDAR PELAYANAN ANTENATAL CARE DI KOTA PADANGSIDIMPUAN

Jurnal Penelitian Kebidanan & Kespro ◽

10.36656/jpk2r.v2i1.178 ◽

2019 ◽

Vol 2 (1) ◽

pp. 27-33

Author(s):

Megawati Sinambela ◽

Evi Erianty Hasibuan

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Antenatal Care ◽

Pregnant Women ◽

Logistic Regression Analysis ◽

Care Service ◽

Multivariate Logistic Regression Analysis ◽

Bivariate Analysis ◽

Cross Sectional ◽

The North

Antenatal care is a service provided to pregnant women to monitor, support maternal health and detect mothers whether normal or problematic pregnant women. According to the WHO, globally more than 70% of maternal deaths are caused by complications of pregnancy and childbirth such as hemorrhage, hypertension, sepsis, and abortion. Based on data obtained from the profile of the North Sumatra provincial health office in 2017, in the city of Padangsidimpuan in 2017 the coverage of ANC visits reached (76.58%) and had not reached the target in accordance with the 2017 Provincial Health Office strategy plan (95%). This type of research was an observational analytic study with a cross sectional design. The population in this study were independent practice midwives who were in the Padangsidimpuan, the sample in this study amounted to 102 respondents. The technique of collecting data used questionnaires and data analysis used univariate, bivariate and multivariate analysis with logistic regression analysis. Based on bivariate analysis showed that there was a relationship between facilities, knowledge and attitudes of independent midwives with compliance with the standards of antenatal care services with a value of p <0.05. The results of the study with multivariate logistic regression analysis showed that the factors associated with the compliance of independent midwives in carrying out antenatal care service standards were attitudes with values (p = 0.026).

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Efficacy of flurbiprofen axetil for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries

JA Clinical Reports ◽

10.1186/s40981-020-00403-x ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Atsushi Kotera

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Postoperative Pain ◽

Logistic Regression Analysis ◽

Pain Control ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Postoperative Pain Control ◽

Flurbiprofen Axetil ◽

Postanesthetic Shivering

Abstract Background Postanesthetic shivering is an unpleasant adverse event in surgical patients. A nonsteroidal anti-inflammatory drug has been reported to be useful in preventing postanesthetic shivering in several previous studies. The aim of this study was to evaluate the efficacy of flurbiprofen axetil being a prodrug of a nonsteroidal anti-inflammatory drug for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries. Method This study is a retrospective observational study. I collected data from patients undergoing gynecologic laparotomy surgeries performed between October 1, 2019, and September 30, 2020, at Kumamoto City Hospital. All the patients were managed with general anesthesia with or without epidural analgesia. The administration of intravenous 50 mg flurbiprofen axetil for postoperative pain control at the end of the surgery was left to the individual anesthesiologist. The patients were divided into two groups: those who had received intravenous flurbiprofen axetil (flurbiprofen group) and those who had not received intravenous flurbiprofen axetil (non-flurbiprofen group), and I compared the frequency of postanesthetic shivering between the two groups. Additionally, the factors presumably associated with postanesthetic shivering were collected from the medical charts. Intergroup differences were assessed with the χ2 test with Yates’ correlation for continuity category variables. The Student’s t test was used to test for differences in continuous variables. Furthermore, a multivariate logistic regression analysis was performed to elucidate the relationship between the administration of flurbiprofen axetil and the incidence of PAS. Results I retrospectively examined the cases of 141 patients aged 49 ± 13 (range 21-84) years old. The overall postanesthetic shivering rate was 21.3% (30 of the 141 patients). The frequency of postanesthetic shivering in the flurbiprofen group (n = 31) was 6.5%, which was significantly lower than that in the non-flurbiprofen group (n = 110), 25.5% (p value = 0.022). A multivariate logistic regression analysis showed that administration of flurbiprofen axetil was independently associated with a reduced incidence of postanesthetic shivering (odds ratio 0.12; 95% confidence interval, 0.02-0.66, p value = 0.015). Conclusions My result suggests that intraoperative 50 mg flurbiprofen axetil administration for postoperative pain control is useful to prevent postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries.

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The association between hypoglycemia and glycemic variability in elderly patients with type 2 diabetes: a prospective observational study

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00656-1 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Takahisa Handa ◽

Akinobu Nakamura ◽

Aika Miya ◽

Hiroshi Nomoto ◽

Hiraku Kameda ◽

...

Keyword(s):

Type 2 Diabetes ◽

Logistic Regression ◽

Regression Analysis ◽

Observational Study ◽

Elderly Patients ◽

Prospective Observational Study ◽

Multivariate Logistic Regression Analysis ◽

Glycemic Variability ◽

Multivariate Logistic Regression

Abstract Background This study aimed to explore predictive factors of time below target glucose range (TBR) ≥ 1% among patients’ characteristics and glycemic variability (GV) indices using continuous glucose monitoring data in elderly patients with type 2 diabetes. Methods We conducted a prospective observational study on 179 (71 female) Japanese outpatients with type 2 diabetes aged ≥ 65 years. The characteristics of the participants with TBR ≥ 1% were evaluated by multivariate logistic regression analysis. Receiver-operating characteristic (ROC) curve analyses of GV indices, comprising coefficient of variation (CV), standard deviation, and mean amplitude of glycemic excursions, were performed to identify the optimal index for the identification of patients with TBR ≥ 1%. Results In the multivariate logistic regression analysis, none of the clinical characteristics, including HbA1c and C-peptide index, were independent markers for TBR ≥ 1%, while all three GV indices showed significant associations with TBR ≥ 1%. Among the three GV indices, CV showed the best performance based on the area under the curve in the ROC curve analyses. Conclusions Among elderly patients with type 2 diabetes, CV reflected TBR ≥ 1% most appropriately among the GV indices examined. Trial registration UMIN-CTR: UMIN000029993. Registered 16 November 2017

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Comorbidity index for predicting mortality at 6 months after reperfusion therapy

Scientific Reports ◽

10.1038/s41598-021-85390-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hyo Suk Nam ◽

Young Dae Kim ◽

Joonsang Yoo ◽

Hyungjong Park ◽

Byung Moon Kim ◽

...

Keyword(s):

Prospective Cohort ◽

Multivariate Logistic Regression Analysis ◽

Area Under The Curve ◽

Reperfusion Therapy ◽

Good Prediction ◽

Multivariate Logistic Regression ◽

Stroke Patients ◽

Number Of Patients ◽

Comorbidity Index ◽

Using Data

AbstractThe eligibility of reperfusion therapy has been expanded to increase the number of patients. However, it remains unclear the reperfusion therapy will be beneficial in stroke patients with various comorbidities. We developed a reperfusion comorbidity index for predicting 6-month mortality in patients with acute stroke receiving reperfusion therapy. The 19 comorbidities included in the Charlson comorbidity index were adopted and modified. We developed a statistical model and it was validated using data from a prospective cohort. Among 1026 patients in the retrospective nationwide reperfusion therapy registry, 845 (82.3%) had at least one comorbidity. As the number of comorbidities increased, the likelihood of mortality within 6 months also increased (p < 0.001). Six out of the 19 comorbidities were included for developing the reperfusion comorbidity index on the basis of the odds ratios in the multivariate logistic regression analysis. This index showed good prediction of 6-month mortality in the retrospective cohort (area under the curve [AUC], 0.747; 95% CI, 0.704–0.790) and in 333 patients in the prospective cohort (AUC, 0.784; 95% CI, 0.709–0.859). Consideration of comorbidities might be helpful for the prediction of the 6-month mortality in patients with acute ischemic stroke who receive reperfusion therapy.

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

Burns & Trauma ◽

10.1093/burnst/tkaa037 ◽

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 < 0.001), larger volume of expander (200–400 ml vs <200 ml; OR, 1.74; p = 0.032; >400 ml vs <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 <1 year, expander volume of >200 ml, limb location and postoperative hematoma evacuation were independent risk factors for expander infection.

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Cross-Sectional Examination of Homocysteine Levels with Sarcopenia and Its Components in Memory Clinic Outpatients

Journal of Alzheimer s Disease ◽

10.3233/jad-210083 ◽

2021 ◽

pp. 1-10

Author(s):

Yosuke Yamada ◽

Hiroyuki Umegaki ◽

Fumie Kinoshita ◽

Chi Hsien Huang ◽

Taiki Sugimoto ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Cognitive Impairment ◽

Cognitive Function ◽

Linear Regression ◽

Logistic Regression Analysis ◽

Linear Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Memory Clinic ◽

Cross Sectional

Background: Homocysteine is a common risk factor for cognitive impairment and sarcopenia. However, very few studies have shown an association between sarcopenia and serum homocysteine levels after adjustment for cognitive function. Objective: The purpose of this study was to investigate the relationship between homocysteine and sarcopenia in memory clinic patients. Methods: This cross-sectional study investigated outpatients in a memory clinic. We enrolled 1,774 participants (≥65 years old) with measured skeletal muscle mass index (SMI), hand grip strength (HGS), and homocysteine. All participants had undergone cognitive assessments and were diagnosed with dementia, mild cognitive impairment, or normal cognition. Patient characteristics were compared according to sarcopenia presence, SMI level, or HGS. Multivariate logistic regression analysis was performed to determine the association of homocysteine with sarcopenia, low SMI, or low HGS. Next, linear regression analysis was performed using HGS as a continuous variable. Results: Logistic regression analysis showed that low HGS was significantly associated with homocysteine levels (p = 0.002), but sarcopenia and low SMI were not. In linear regression analysis, HGS was negatively associated with homocysteine levels after adjustment for Mini-Mental State Examination score (β= –2.790, p < 0.001) or clinical diagnosis of dementia (β= –3.145, p < 0.001). These results were similar for men and women. Conclusion: Our results showed a negative association between homocysteine and HGS after adjustment for cognitive function. Our findings strengthen the assumed association between homocysteine and HGS. Further research is needed to determine whether lower homocysteine levels lead to prevent muscle weakness.

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Prevalence, risk factors and impact on outcomes of 30-day unexpected rehospitalization in incident peritoneal dialysis patients

BMC Nephrology ◽

10.1186/s12882-020-02201-0 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jianbo Li ◽

Jing Yu ◽

Naya Huang ◽

Hongjian Ye ◽

Dan Wang ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Peritoneal Dialysis ◽

Fluid Overload ◽

Multivariate Logistic Regression Analysis ◽

Technical Failure ◽

Cox Regression Analysis ◽

Catheter Malfunction ◽

All Cause Mortality ◽

Cvd Mortality

Abstract Background Rehospitalization is a major problem for end stage renal disease (ESRD) populations. However, researches on 30-day unexpected rehospitalzation of incident peritoneal dialysis (PD) patients were limited. This study aimed to investigate the prevalence, risk factors and impact on outcomes of 30-day unexpected rehospitalization in incident PD patients. Methods This was a retrospective cohort study. Patients who accepted PD catheter implantation in our centre from Jan 1, 2006 to Dec 31, 2013 and regular follow-up were included. The demographic characteristics, laboratory parameters, and rehospitalization data were collected and analyzed. The primary outcome was all-cause mortality, and the secondary outcomes included cardiovascular disease (CVD) mortality and technical failure. Results Totally 1632 patients (46.9 ± 15.3 years old, 60.1% male, 25.6% with diabetes) were included. Among them, 149 (9.1%) had a 30-day unexpected rehospitalization after discharge. PD-related peritonitis (n = 48, 32.2%), catheter malfunction (n = 30, 20.1%) and severe fluid overload (n = 19, 12.8%) were the top three causes for the rehospitalization. Multivariate logistic regression analysis showed that length of index hospital stays [Odds ratio (OR) =1.02, 95% confidence interval (CI) 1.00–1.03, P = 0.036) and hyponatremia (OR = 1.85, 95% CI 1.06–3.24, P = 0.031) were independently associated with the rehospitalization. Multivariate Cox regression analysis indicated that 30-day rehospitalization was an independent risk factor for all-cause mortality [Hazard ratio (HR) =1.52, 95% CI 1.07–2.16, P = 0.019) and CVD mortality (HR = 1.73, 95% CI 1.03–2.90, P = 0.038). Conclusions The prevalence of 30-day unexpected rehospitalization for incident PD patients in our centre was 9.1%. The top three causes for the rehospitalization were PD-related peritonitis, catheter malfunction and severe fluid overload. Thirty-day unexpected rehospitalization increased the risk of all-cause mortality and CVD mortality for PD patients.

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