scholarly journals Establishment and Verification On A Death Risk Model of Sepsis Patients Within 30 Days

2021 ◽  
Author(s):  
Wang Bin ◽  
Chen Jianping ◽  
Ouyang Jian
Keyword(s):  
Risk Factors ◽  
Roc Curve ◽  
Risk Model ◽  
Oxygenation Index ◽  
Treatment Regimens ◽  
Decline Curve ◽  
Modeling Group ◽  
Discriminant Ability ◽  
Lemeshow Test ◽  
Independent Risk Factors

Abstract Background/Objective: To establish and validate an individualized nomogram to predict the probability of death within 30 days in patients with sepsis would help clinical physicians to make correct decision. Methods We collected data of 1,205 patients with sepsis. These included 16 indexes like age and blood, randomly assigned to the modeling and verification groups. In the modeling group, the independent risk factors related to death within 30 days were analyzed. Besides, a nomogram was established to draw the receiver-operating characteristic (ROC) curve of the subjects. Subsequently, the discriminant ability of the model was evaluated by the area under the ROC curve (AUC). Then, a calibration chart and Hosmer-Lemeshow test were employed to evaluate the calibration degree of the model, and the Decline Curve Analysis (DCA) test was used to evaluate the clinical effect of the model. Results The different independent risk factors related to the death of sepsis patients within 30 days included pro-brain natriuretic peptide (pro.bnp), albumin, lactic acid (lac), oxygenation index, mean arterial pressure (map), and hematocrit (hct). The AUC of the modeling and verification groups were 0.815 and 0.806, respectively. Moreover, the P-values of the Hosmer-Lemeshow test in the two groups were 0.391 and 0.100, respectively, and the DCA curves of the two groups were both above the two extreme curves. Conclusion Our model presents good significance for predicting the death of sepsis patients within 30 days. Therefore, there is a need to implement this model in clinical practice, as prompt prediction could help tailor treatment regimens and enhance survival outcomes.

Factors predictive of cystoid macular oedema following endothelial keratoplasty: a single-centre review of 2233 cases

2021 ◽  
pp. bjophthalmol-2020-318076
Author(s):  
James Myerscough ◽  
Harry William Roberts ◽  
Angeli Christy Yu ◽  
Michael Mimouni ◽  
Luca Furiosi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Roc Curve ◽  
Macular Oedema ◽  
Curve Analysis ◽  
Cystoid Macular Oedema ◽  
Continuous Variables ◽  
Endothelial Keratoplasty ◽  
Roc Curve Analysis ◽  
Close Observation ◽  
Independent Risk Factors

AimsTo describe the incidence of postoperative cystoid macular oedema (CMO) after endothelial keratoplasty (EK) and to identify its contributory risk factors.Methods2233 patients undergoing EK at Ospedali Privati Forlì ‘Villa Igea’, between January 2005 to October 2018 for Descemet stripping automated endothelial keratoplasty (DSAEK) and June 2014 to August 2018 for Descemet membrane endothelial keratoplasty (DMEK) with a minimum follow-up of 18 months were evaluated. Univariate and multivariate analyses were conducted to identify and quantify contributory risk factors. Receiver operating characteristic (ROC) curve analysis were performed to determine ideal cut-off points of continuous variables.ResultsCMO was identified in 2.82% (n=63) of the cases. CMO occurred in 2.36% of DSAEK eyes and in 5.56% of DMEK eyes (p=0.001). Average onset of CMO was 4.27±6.63 months (range: 1–34 months) postoperatively. Compared with those who did not develop CMO, a higher proportion of patients in the CMO group had diabetes (24.2% vs 9.8%, p<0.001) (OR=3.16, 95% CI: 1.72 to 5.81, p<0.001), a higher proportion of patients who underwent DMEK rather than DSAEK (28.6% vs 14.1%, p=0.001) (OR=2.42, 95% CI: 1.35 to 4.33, p=0.003) and were older (70.5±10.0 vs 67.1±14.3 years, p=0.01). Using the cut-off of 67 years as identified by ROC curve analysis, subjects aged >67 years (OR=2.35, 95% CI: 1.30 to 4.26, p=0.005) were more likely to develop CMO. There were no other significant differences between the groups.ConclusionsOlder age (>67 years), diabetes mellitus and DMEK have been identified as independent risk factors for postoperative CMO following EK. Close observation is necessary during the first postoperative year after EK, particularly in patients with risk factors.

scholarly journals Construction and Evaluation of a Sepsis Risk Prediction Model for Urinary Tract Infection

2021 ◽  
Vol 8 ◽  
Author(s):  
Luming Zhang ◽  
Feng Zhang ◽  
Fengshuo Xu ◽  
Zichen Wang ◽  
Yinlong Ren ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Prediction Model ◽  
Stepwise Logistic Regression ◽  
Distribution Width ◽  
Sepsis Risk ◽  
Lemeshow Test ◽  
Independent Risk Factors

Background: Urinary tract infection (UTI) is one of the common causes of sepsis. However, nomograms predicting the sepsis risk in UTI patients have not been comprehensively researched. The goal of this study was to establish and validate a nomogram to predict the probability of sepsis in UTI patients.Methods: Patients diagnosed with UTI were extracted from the Medical Information Mart for Intensive Care III database. These patients were randomly divided into training and validation cohorts. Independent prognostic factors for UTI patients were determined using forward stepwise logistic regression. A nomogram containing these factors was established to predict the sepsis incidence in UTI patients. The validity of our nomogram model was determined using multiple indicators, including the area under the receiver operating characteristic curve (AUC), correction curve, Hosmer-Lemeshow test, integrated discrimination improvement (IDI), net reclassification improvement (NRI), and decision-curve analysis (DCA).Results: This study included 6,551 UTI patients. Stepwise regression analysis revealed that the independent risk factors for sepsis in UTI patients were congestive heart failure, diabetes, liver disease, fluid electrolyte disorders, APSIII, neutrophils, lymphocytes, red blood cell distribution width, urinary protein, urinary blood, and microorganisms. The nomogram was then constructed and validated. The AUC, NRI, IDI and DCA of the nomogram all showed better performance than traditional APSIII score. The calibration curve and Hosmer-Lemeshow test results indicate that the nomogram was well-calibrated. Improved NRI and IDI values indicate that our nomogram scoring system is superior to other commonly used ICU scoring systems. The DCA curve indicates that the DCA map of the nomogram has good clinical application ability.Conclusion: This study identified the independent risk factors of sepsis in UTI patients and used them to construct a prediction model. The present findings may provide clinical reference information for preventing sepsis in UTI patients.

scholarly journals Prediction of risk factors of bronchial mucus plugs in children with Mycoplasma pneumoniae pneumonia

2020 ◽  
Author(s):  
Jiahui zhang ◽  
Ting Wang ◽  
Wei Ji ◽  
Yongdong Yan ◽  
Zhichao Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Mycoplasma Pneumoniae ◽  
Roc Curve ◽  
Scoring System ◽  
Clinical Laboratory ◽  
Risk Group ◽  
Independent Risk Factors ◽  
Mucus Plug ◽  
Plug Formation

Abstract Background: Recently, many cases of pneumonia in children with Mycoplasma pneumoniae infection have been shown to have varying degrees of intrabronchial mucus plug formation. The clinical, laboratory, radiological characteristics, and treatment of patients with Mycoplasma infection are analyzed in this study. The risk factors for M. pneumoniae pneumonia (MPP) mucus plug formation in children are explored, and a risk factor scoring system is established.Methods: MPP patients treated with bronchoscopy were retrospectively enrolled in the study from February 2015 to December 2019. The children were divided into a mucus plug group and a control group according to the presence or absence of mucus plug formation. The clinical, laboratory, radiological characteristics, and treatment of the two groups of children were compared. Univariate and multivariate logistic regression models were used to identify the risk factors for MPP mucus plug formation. The receiver operating characteristic (ROC) curve was drawn to evaluate the regression model and establish the MPP mucous plug risk factor scoring system.Results: A univariate analysis showed that the children in the mucous group were older and had a longer fever duration, longer hospital stay, higher fever peak, more cases of wheezing symptoms and allergies, and azithromycin or corticosteroids were administered later. In addition, neutrophil, C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer (DD), sputum MP-DNA copy number, and total immunoglobulin A (IgA) levels were higher, while prealbumin (PA) levels were lower. The ROC curve analysis showed that children with MPP had PA ≤144.5 mg/L, had used corticosteroids during the course of the illness of ≥4.5 days, CRP ≥12.27 mg/L, an LDH≥462.65 U/L, and there was a possibility of intra-airway mucus formation. The independent risk factors were scored according to their odds ratio (OR) value. Among the 255 children with MPP, the high-risk group had 44 (83.02%) mucus plugs out of 53; the middle-risk group had 35 (34.3%) mucus plugs out of 102; and the low-risk group had 11 (11%) mucus plugs out of 100.Conclusions: PA levels, timing of corticosteroid use (use in the first few days), CRP levels, and LDH levels were independent risk factors for MPP mucus plug formation. This provides a basis for the early identification of MPP in children combined with mucus plug formation.

scholarly journals Comparative Study of Preoperative Scores to Predict Lymph Node Metastasis in Patients With Gastric and Colon Cancers: A Case Control Study

2020 ◽  
Author(s):  
Xiangjian Zheng ◽  
Xiaodong Chen ◽  
Min Li ◽  
Chunmeng Li ◽  
Xian Shen
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Roc Curve ◽  
Serum Markers ◽  
Tumor Characteristics ◽  
Immune Markers ◽  
Node Metastasis ◽  
Colon Cancers ◽  
Independent Risk Factors

Abstract Background:Surgery combined with chemo-radiotherapy is a recognized model for the treatment of gastric and colon cancers. Lymph node metastasis determines the patient's surgical or comprehensive treatment plan.The purpose of this study was to compare preoperative scores to better predict lymph node metastasis in patients with gastric and colon cancers.Methods:A total of 768 patients with gastric cancer (312) and colon cancer (462) were enrolled in our study. Preoperative serum markers, immune markers, and clinical tumor characteristics were evaluated by single-factor analysis. Logistic analysis was used to identify independent predictors of lymph node metastasis in patients with gastric and colon cancers. These independent risk factors were integrated into preoperative scores, which was evaluated by receiver operating characteristic (ROC) curves.Results:The result showed that serum markers (CA125, hemoglobin, albumin), immune markers (S100, CD31, d2–40), and tumor characteristics (pathological type, tumor size) were independent risk factors for lymph node metastasis in patients with gastric and colon cancers. The preoperative scores reliably predicted lymph node metastasis in patients with gastric and colon cancers with a higher area under the ROC curve (0.901). Compared to the other independent risk factors, the area under the ROC curve of this indicator was 0.923 and 0.870, for gastric and colon cancers, respectively. Based on the ROC curve, the ideal cutoff value of preoperative scores to predict lymph node metastasis was established to be 287. Conclusion: The preoperative scores is a useful indicator that could be used to predict lymph node metastasis in patients with gastric and colon cancers.

scholarly journals Acute kidney injury at early stage as a negative prognostic indicator of patients with COVID-19: a hospital-based retrospective analysis

2020 ◽  
Author(s):  
Shen Xu ◽  
Lin Fu ◽  
Jun Fei ◽  
Hui-Xian Xiang ◽  
Ying Xiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Early Stage ◽  
Kidney Injury ◽  
Oxygenation Index ◽  
Prognostic Indicator ◽  
Critical Ill Patients ◽  
Patients With Diabetes ◽  
Independent Risk Factors ◽  
Critical Ill

AbstractCoronavirus disease 2019 (COVID-19) is a newly emerged infection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and has been pandemic all over the world. This study described acute kidney injury (AKI) at early stage of COVID-19 and its clinical significance. Three-hundred and fifty-five COVID-19 patients with were recruited and clinical data were collected from electronic medical records. Patient’s prognosis was tracked and risk factors of AKI was analyzed. Of 355 COVID-19 patients, common, severe and critical ill cases accounted for 63.1%, 16.9% and 20.0%, respectively. On admission, 56 (15.8%) patients were with AKI. Although AKI was more common in critical ill patients with COVID-19, there was no significant association between oxygenation index and renal functional indices among COVID-19 patients with AKI. By multivariate logistic regression, male, older age and comorbidity with diabetes were three important independent risk factors predicting AKI among COVID-19 patients. Among 56 COVID-19 patients with AKI, 33.9% were died on mean 10.9 day after hospitalization. Fatality rate was obviously higher among COVID-+19 patients with AKI than those without AKI (RR=7.08, P<0.001). In conclusion, male elderly COVID-19 patients with diabetes are more susceptible to AKI. AKI at early stage may be a negative prognostic indicator for COVID-19.

scholarly journals Risk Factors for Metachronous Isolated Peritoneal Metastasis after Preoperative Chemotherapy and Potentially Curative Gastric Cancer Resection: Results from the CRITICS Trial

Cancers ◽  
2021 ◽  
Vol 13 (18) ◽  
pp. 4626
Author(s):  
Irene A. Caspers ◽  
Karolina Sikorska ◽  
Astrid E. Slagter ◽  
Romy M. van Amelsfoort ◽  
Elma Meershoek-Klein Kranenbarg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Preoperative Chemotherapy ◽  
Peritoneal Metastasis ◽  
Risk Model ◽  
Treatment Strategies ◽  
Histological Subtype ◽  
Multivariable Analyses ◽  
Independent Risk Factors

Gastric cancer (GC) patients at high risk of developing peritoneal metastasis (PM) as a single site of metastasis after curative treatment may be candidates for adjuvant prophylactic strategies. Here we investigated risk factors for metachronous isolated PM in patients who were treated in the CRITICS trial (NCT00407186). Univariable and multivariable analyses on both metachronous isolated PM and ‘other events’, i.e., (concurrent) distant metastasis, locoregional recurrence or death, were performed using a competing risk model and summarized by cumulative incidences. Isolated PM occurred in 64 of the 606 (11%) included patients. Diffuse or mixed histological subtype, ypT4 tumor stage and LNhigh (ypN3 lymph node stage or a lymph node ratio >20%) were independent risk factors for isolated PM in both univariable and multivariable analyses. Likewise, LNhigh was an independent risk factor for ‘other events’. Patients with tumors who were positive for all three independent risk factors had the highest two-year cumulative incidence of 43% for isolated PM development. In conclusion, diffuse or mixed histological subtype, ypT4 and LNhigh were identified as independent risk factors for isolated PM in patients treated with preoperative chemotherapy followed by surgical resection. The combination of these factors may identify a subgroup that may benefit from PM-preventing treatment strategies.

Development of a prediction model for 1-year poor prognosis in patients with acute ischemic stroke

2019 ◽  
Vol 67 (6) ◽  
pp. 957-963 ◽  
Author(s):  
Xia Ling ◽  
Bo Shen ◽  
Kangzhi Li ◽  
Lihong Si ◽  
Xu Yang
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Ischemic Stroke ◽  
Prediction Model ◽  
Acute Ischemic Stroke ◽  
Poor Prognosis ◽  
Multivariate Logistic Regression ◽  
Lemeshow Test ◽  
Independent Risk Factors ◽  
Auc Value

The goals of this study were to develop a new prediction model to predict 1-year poor prognosis (death or modified Rankin scale score of ≥3) in patients with acute ischemic stroke (AIS) and to compare the performance of the new prediction model with other prediction scales. Baseline data of 772 patients with AIS were collected, and univariate and multivariate logistic regression analyses were performed to identify independent risk factors for 1-year poor prognosis in patients with AIS. The area under the receiver operating characteristics curve (AUC) value of the new prediction model and the THRIVE, iScore and ASTRAL scores was compared. The Hosmer-Lemeshow test was used to assess the goodness of fit of the model. We identified 196 (25.4%) patients with poor prognosis at 1-year follow-up, and of these 68 (68/196, 34.7%) had died. Multivariate logistic regression and receiver operating characteristic curve analyses showed that age ≥70 years, consciousness (lethargy or coma), history of stroke or transient ischemic attack, cancer, abnormal fasting blood glucose levels ≥7.0 mmol/L, and National Institutes of Health Stroke Scale score were independent risk factors for 1-year poor prognosis in patients with AIS. Scores were assigned for each variable by rounding off β coefficient to the integer score, and a new prediction model with a maximum total score of 9 points was developed. The AUC value of the new prediction model was higher than the THRIVE score (p<0.05). The χ2 value for the Hosmer-Lemeshow test was 7.337 (p>0.05), suggesting that the prediction model had a good fit. The new prediction model can accurately predict 1-year poor prognosis in Chinese patients with AIS.

scholarly journals Prediction of risk factors of bronchial mucus plugs in children with Mycoplasma pneumoniae pneumonia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiahui Zhang ◽  
Ting Wang ◽  
Rongrong Li ◽  
Wei Ji ◽  
Yongdong Yan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Mycoplasma Pneumoniae ◽  
Roc Curve ◽  
Scoring System ◽  
Clinical Laboratory ◽  
Risk Group ◽  
Independent Risk Factors ◽  
Mucus Plug ◽  
Plug Formation

Abstract Background Recently, many cases of pneumonia in children with Mycoplasma pneumoniae infection have been shown to have varying degrees of intrabronchial mucus plug formation. The clinical, laboratory, radiological characteristics, and treatment of patients with Mycoplasma infection are analyzed in this study. The risk factors for M. pneumoniae pneumonia (MPP) mucus plug formation in children are explored, and a risk factor scoring system is established. Methods MPP patients treated with bronchoscopy were retrospectively enrolled in the study from February 2015 to December 2019. The children were divided into a mucus plug group and a control group according to the presence or absence of mucus plug formation. The clinical, laboratory, radiological characteristics, and treatment of the two groups of children were compared. Univariate and multivariate logistic regression models were used to identify the risk factors for MPP mucus plug formation. The receiver operating characteristic (ROC) curve was drawn to evaluate the regression model and establish the MPP mucous plug risk factor scoring system. Results A univariate analysis showed that the children in the mucous group were older and had a longer fever duration, longer hospital stay, higher fever peak, more cases of wheezing symptoms and allergies, and azithromycin or corticosteroids were administered later. In addition, neutrophil, C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer (DD), sputum MP-DNA copy number, and total immunoglobulin A (IgA) levels were higher, while prealbumin (PA) levels were lower. The ROC curve analysis showed that children with MPP had PA ≤144.5 mg/L, had used corticosteroids during the course of the illness of ≥4.5 days, CRP ≥12.27 mg/L, an LDH ≥ 462.65 U/L, and there was a possibility of intra-airway mucus formation. The independent risk factors were scored according to their odds ratio (OR) value. Among the 255 children with MPP, the high-risk group had 44 (83.02%) mucus plugs out of 53; the middle-risk group had 35 (34.3%) mucus plugs out of 102; and the low-risk group had 11 (11%) mucus plugs out of 100. Conclusions PA levels, timing of corticosteroid use (use in the first few days), CRP levels, and LDH levels were independent risk factors for MPP mucus plug formation. This provides a basis for the early identification of MPP in children combined with mucus plug formation.

scholarly journals PaO2/FiO2 and IL-6 are risk factors of mortality for intensive care COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yanli Gu ◽  
Donghui Wang ◽  
Cen Chen ◽  
Wanjun Lu ◽  
Hongbing Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Clinical Laboratory ◽  
Area Under The Curve ◽  
Oxygenation Index ◽  
Categorical Variables ◽  
Imaging Data ◽  
Chi Square ◽  
Independent Risk Factors ◽  
Student’S T

AbstractTo identify the risk factors of mortality for the coronavirus disease 19 (COVID-19) patients admitted to intensive care units (ICUs) through a retrospective analysis. The demographic, clinical, laboratory, and chest imaging data of patients admitted to the ICU of Huoshenshan Hospital from February 10 to April 10, 2020 were retrospectively analyzed. Student's t-test and Chi-square test were used to compare the continuous and categorical variables, respectively. The logistic regression model was employed to ascertain the risk factors of mortality. This retrospective study involved 123 patients, including 64 dead and 59 survivors. Among them, 57 people were tested for interleukin-6 (IL-6) (20 died and 37 survived). In all included patients, the oxygenation index (PaO2/FiO2) was identified as an independent risk factor (odd ratio [OR] = 0.96, 95% confidence interval [CI]: 0.928–0.994, p = 0.021). The area under the curve (AUC) was 0.895 (95% CI: 0.826–0.943, p < 0.0001). Among the patients tested for IL-6, the PaO2/FiO2 (OR = 0.955, 95%CI: 0.915–0.996, p = 0.032) and IL-6 (OR = 1.013, 95%CI: 1.001–1.025, p = 0.028) were identified as independent risk factors. The AUC was 0.9 (95% CI: 0.791–0.964, p < 0.0001) for IL-6 and 0.865 (95% CI: 0.748–0.941, p < 0.0001) for PaO2/FiO2. PaO2/FiO2 and IL-6 could potentially serve as independent risk factors for predicting death in COVID-19 patients requiring intensive care.

scholarly journals LDL-C/HDL-C is associated with ischaemic stroke in patients with non-valvular atrial fibrillation: a case-control study

2020 ◽  
Author(s):  
Xiao-Xue Zhang ◽  
Meng Wei ◽  
Lu-Xiang Shang ◽  
Yan-Mei Lu ◽  
Ling Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Roc Curve ◽  
Principal Component Regression ◽  
Principal Component ◽  
Multivariate Logistic Regression ◽  
Principal Component Regression Analysis ◽  
Independent Risk Factors

Abstract Background: This study explored the relationships between the low-/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and other clinical indicators and ischaemic stroke (IS) in patients with non-valvular atrial fibrillation (NVAF) in Xinjiang. The findings could provide a theoretical and therapeutic basis for NVAF patients.Methods: NVAF patients who were admitted to 10 medical centres across Xinjiang were divided into stroke (798 patients) and control (2671 patients) groups according to the occurrence of first acute IS occurred. Univariate and multivariate logistic regression analysis were used to examine the independent risk factors for IS in NVAF patients. Factor analysis and principal component regression analysis were used to analyse the main factors influencing IS. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminatory ability of LDL-C/HDL-C for predicting the occurrence of IS.Results: The stroke group had an average age of 71.64 ± 9.96 years and included 305 females (38.22%). The control group had a mean age of 67.30 ± 12.01 years and included 825 females (30.89%). Multivariate logistic regression showed that the risk of IS in the highest LDL-C/HDL-C quartile ( ≥2.73) was 16.23-fold that of the lowest quartile ( < 1.22); IS risk was 2.27-fold higher in obese patients than in normal-weight subjects; IS risk was 3.15-fold higher in smoking patients than in non-smoking patients. The area under the ROC curve of LDL-C/HDL-C was 0.76, the optimal critical value was 2.33, the sensitivity was 63.53%, and the specificity was 76.34%. Principal component regression analysis showed that LDL-C/HDL-C, age, smoking, drinking, LDL-C and hypertension were risk factors for IS in NVAF patients.Conclusions: LDL-C/HDL-C >1.22, smoking, BMI ≥24 kg/m2 and CHA2DS2-VASc score were independent risk factors for IS in NVAF patients; LDL-C/HDL-C was the main risk factor.

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