scholarly journals Functional outcomes at 2 years of age following treatment for posthemorrhagic hydrocephalus of prematurity: what do we know at the time of consult?

2020 ◽  
Vol 25 (5) ◽  
pp. 453-461 ◽  
Author(s):  
Samuel G. McClugage ◽  
Nicholas M. B. Laskay ◽  
Brian N. Donahue ◽  
Anastasia Arynchyna ◽  
Kathrin Zimmerman ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Visual Impairment ◽  
Premature Infants ◽  
Logistic Regression Analysis ◽  
Gestational Age ◽  
Functional Outcomes ◽  
Independent Predictor ◽  
Posthemorrhagic Hydrocephalus ◽  
Grade Iii

OBJECTIVEPosthemorrhagic hydrocephalus of prematurity remains a significant problem in preterm infants. In the literature, there is a scarcity of data on the early disease process, when neurosurgeons are typically consulted for recommendations on treatment. Here, the authors sought to evaluate functional outcomes in premature infants at 2 years of age following treatment for posthemorrhagic hydrocephalus. Their goal was to determine the relationship between factors identifiable at the time of the initial neurosurgical consult and outcomes of patients when they are 2 years of age.METHODSThe authors performed a retrospective chart review of premature infants treated for intraventricular hemorrhage (IVH) of prematurity (grade III and IV) between 2003 and 2014. Information from three time points (birth, first neurosurgical consult, and 2 years of age) was collected on each patient. Logistic regression analysis was performed to determine the association between variables known at the time of the first neurosurgical consult and each of the outcome variables.RESULTSOne hundred thirty patients were selected for analysis. At 2 years of age, 16% of the patients had died, 88% had cerebral palsy/developmental delay (CP), 48% were nonverbal, 55% were nonambulatory, 33% had epilepsy, and 41% had visual impairment. In the logistic regression analysis, IVH grade was an independent predictor of CP (p = 0.004), which had an estimated probability of occurrence of 74% in grade III and 96% in grade IV. Sepsis at or before the time of consult was an independent predictor of visual impairment (p = 0.024), which had an estimated probability of 58%. IVH grade was an independent predictor of epilepsy (p = 0.026), which had an estimated probability of 18% in grade III and 43% in grade IV. The IVH grade was also an independent predictor of verbal function (p = 0.007), which had an estimated probability of 68% in grade III versus 41% in grade IV. A higher weeks gestational age (WGA) at birth was an independent predictor of the ability to ambulate (p = 0.0014), which had an estimated probability of 15% at 22 WGA and up to 98% at 36 WGA. The need for oscillating ventilation at consult was an independent predictor of death before 2 years of age (p = 0.001), which had an estimated probability of 42% in patients needing oscillating ventilation versus 13% in those who did not.CONCLUSIONSIVH grade was consistently an independent predictor of functional outcomes at 2 years. Gestational age at birth, sepsis, and the need for oscillating ventilation may also predict worse functional outcomes.

scholarly journals Predictive Value of Admission D-dimer for Contrast-induced Acute Kidney Injury and Poor Outcomes after Primary Percutaneous Coronary Intervention

2020 ◽  
Author(s):  
Kai-Yang Lin ◽  
Han-Chuan Chen ◽  
Hui Jiang ◽  
Sun-Ying Wang ◽  
Hong-mei Chen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Serum Creatinine ◽  
Logistic Regression Analysis ◽  
Predictive Value ◽  
Independent Predictor ◽  
Multivariate Logistic Regression Analysis ◽  
Increased Risk ◽  
Long Term Mortality

Abstract Background DD was found to be associated with acute myocardial infarction (AMI) and renal insufficiency. However, it is uncertain whether DD is an independent risk factor of CI-AKI in patients undergoing pPCI. Methods We prospectively enrolled 550 consecutive patients with STEMI undergoing pPCI between January 2012 and December 2016. The predictive value of admission DD for CI-AKI was assessed by receiver operating characteristic(ROC) and multivariable logistic regression analysis. CI-AKI was defined as an absolute serum creatinine increase ≥0.3 mg/dl or a relative increase in serum creatinine ≥50% within 48 h of contrast medium exposure. Results Overall, the incidence of CI-AKI was 13.1%. The ROC analysis showed that the cutoff point of DD was 0.69 ug/ml for predicting CI-AKI with a sensitivity of 77.8% and a specificity of 57.3%. The predictive value of DD was similar to the Mehran score for CI-AKI (AUC DD =0.729 vs AUC Mehran =0.722; p =0.8298). Multivariate logistic regression analysis indicated that DD >0.69 ug/ml was an independent predictor of CI-AKI (odds ratio[OR]=3.37,95%CI:1.80-6.33, p <0.0001). Furthermore, DD >0.69 ug/ml was associated with an increased risk of long-term mortality during during a mean follow-up period of 16 months(hazard ratio=3.41, 95%CI:1.4-8.03, p =0.005). Conclusion admission DD >0.69 ug/ml is a significant and independent predictor of CI-AKI and long-term mortality in patients undergoing pPCI.

scholarly journals A Composite Index Predicts Disease Progression in Early Stages of COVID-19: a Propensity Score-matched Cohort Study

2020 ◽  
Author(s):  
Jianjun Xu ◽  
Shaobo Hu ◽  
Suzhen Li ◽  
Weimin Wang ◽  
Yuzhe Wu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Propensity Score ◽  
Disease Progression ◽  
Logistic Regression Analysis ◽  
Independent Predictor ◽  
Early Stage ◽  
Multivariable Logistic Regression Analysis ◽  
Matched Cohort ◽  
Early Stages

Abstract Background: Thus far, studies on COVID-19 have focused on the epidemiology of the disease and clinical characteristics of patients (14-19), as well as on the risk factors associated with mortality during hospitalization in critical COVID-19 cases. However, no research has been performed on the prediction of progression in patients in the early stages of the disease. The aim of this work was to identify the early predictors of COVID-19 progression.Methods: The study included 338 patients with COVID-19 treated at two hospitals in Wuhan, Chian, from December, 2019 to March, 2020. Predictors of the progression of COVID-19 from mild to severe stages were selected by the logistic regression analysis. The predictive accuracy was evaluated further in the propensity score-matched cohort.Results: COVID-19 progression to severe and critical stages was confirmed in 78(23.1%) patients. The average value of the neutrophil-to-lymphocyte ratio (NLR) was higher in patients in the disease progression group than in the improvement group. Multivariable logistic regression analysis revealed that elevated NLR, LDH, and IL-10, were independent predictors of disease progression. The optimal cut-off value of NLR for predicting the progression of COVID-19 was 3.75. In the propensity score-matched cohort, NLR ≥ 3.75 was still an independent predictor of COVID-19 progression after multivariate analysis.Conclusions: The performed analysis demonstrates that NLR qualifies as an independent predictor of disease progression in COVID-19 patients at the early stage of the disease. The combined evaluation of NLR and LDH improved the accuracy of the prediction of COVID-19 progression. Assessment of predictors might facilitate early identification of COVID-19 patients at high risk for disease progression and ensure timely administration of appropriate treatment to prevent mild cases from becoming severe.

scholarly journals Facial nerve elongation as predictive factors of facial nerve outcome after the vestibular schwannoma resection

2021 ◽  
Author(s):  
Zhi Zhu ◽  
Weichao Jiang ◽  
Xi Chen ◽  
Sifang Chen ◽  
Guowei Tan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Facial Nerve ◽  
Nerve Injury ◽  
Logistic Regression Analysis ◽  
Vestibular Schwannoma ◽  
Functional Outcomes ◽  
Tumor Volume ◽  
Facial Nerve Injury

Abstract Background: To analyze risk factors affecting the long-term facial nerve functional outcomes in patients receiving vestibular schwannoma surgery. Method: A total of 89 cases receiving vestibular schwannoma surgery via retrosigmoid sinus approach were analyzed retrospectively. The facial nerve functional outcomes of all enrolled patients were evaluated 6 months after the operation according to House-Brackmann grading scale. The relationships between facial nerve injury and its potential risk factors were analyzed. Results: Postoperative facial nerve injury was found in 53 patients (59.6%) 6 months after the operation. The results of univariate logistic regression analysis indicated that the tumor volume, the maximum tumor diameter, the facial nerve elongation, the enlargement of internal auditory canal (IAC), the IAC size on the affected side, and the facial nerve adhesion to tumor were significantly correlated with the occurrence of facial nerve injury. The multivariate logistic regression analysis revealed that the facial nerve elongation, the facial nerve adhesion to tumor, the tumor volume, and the enlargement of IAC were the independent risk factors of facial nerve injury 6 months after vestibular schwannoma surgery. The ROC curve showed that the cut-off points of the facial nerve elongation, tumor volume and enlargement of IAC were 2.925cm,10.965 cm³ and 1.818 respectively. When the cut-off points were exceeded, the possibility of facial nerve injury would largely increase. Conclusion: With the growth of the facial nerve elongation, the tumor volume, the facial nerve adhesion to tumor, and the enlargement of IAC, the possibility of facial nerve injury after the vestibular schwannoma surgery would accordingly increase.

scholarly journals Predictive Value of Admission D-dimer for Contrast-induced Acute Kidney Injury and Poor Outcomes after Primary Percutaneous Coronary Intervention

2020 ◽  
Author(s):  
Kai-Yang Lin ◽  
Han-Chuan Chen ◽  
Hui Jiang ◽  
Sun-Ying Wang ◽  
Hong-mei Chen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Serum Creatinine ◽  
Logistic Regression Analysis ◽  
Predictive Value ◽  
Independent Predictor ◽  
Multivariate Logistic Regression Analysis ◽  
Increased Risk ◽  
Long Term Mortality

Abstract Background DD was found to be associated with acute myocardial infarction (AMI) and renal insufficiency. However, it is uncertain whether DD is an independent risk factor of CI-AKI in patients undergoing pPCI. Methods We prospectively enrolled 550 consecutive patients with STEMI undergoing pPCI between January 2012 and December 2016. The predictive value of admission DD for CI-AKI was assessed by receiver operating characteristic(ROC) and multivariable logistic regression analysis. CI-AKI was defined as an absolute serum creatinine increase ≥0.3 mg/dl or a relative increase in serum creatinine ≥50% within 48 h of contrast medium exposure. Results Overall, the incidence of CI-AKI was 13.1%. The ROC analysis showed that the cutoff point of DD was 0.69 ug/ml for predicting CI-AKI with a sensitivity of 77.8% and a specificity of 57.3%. The predictive value of DD was similar to the Mehran score for CI-AKI (AUC DD =0.729 vs AUC Mehran =0.722; p =0.8298). Multivariate logistic regression analysis indicated that DD >0.69 ug/ml was an independent predictor of CI-AKI (odds ratio[OR]=3.37,95%CI:1.80-6.33, p <0.0001). Furthermore, DD >0.69 ug/ml was associated with an increased risk of long-term mortality during during a mean follow-up period of 16 months(hazard ratio=3.41, 95%CI:1.4-8.03, p =0.005). Conclusion admission DD >0.69 ug/ml is a significant and independent predictor of CI-AKI and long-term mortality in patients undergoing pPCI.

scholarly journals Impact of prematurity and the CTG repeat length on outcomes in congenital myotonic dystrophy

2020 ◽  
Author(s):  
Yu Saito ◽  
Kenta Matsumura ◽  
Misao Kageyama ◽  
Yuichi Kato ◽  
Eiji Ohta ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Predictive Model ◽  
Myotonic Dystrophy ◽  
Logistic Regression Analysis ◽  
Gestational Age ◽  
Multivariate Logistic Regression Analysis ◽  
Repeat Length ◽  
Congenital Myotonic Dystrophy ◽  
Ctg Repeat

Abstract Objective: Patients with congenital myotonic dystrophy (CDM) tend to be born preterm. Although the CDM severity generally depends on the CTG repeat length, prematurity may also affect the prognosis in patients with CDM. Given that preterm birth is expected to increase the risk of CDM in newborns, we investigated the outcomes of newborns with CDM according to gestational age to assess prematurity and the CTG repeat length for predicting prognosis. Results: We assessed the outcomes of 54 infants with CDM using data collected from our hospitals and previously published studies. The patients were divided into mild and severe groups based on clinical outcomes. Multivariate logistic regression analysis was performed to estimate odds ratios (ORs) for CDM prognosis according to gestational age and the CTG repeat length and to construct a predictive model. Logistic regression analysis showed both the CTG repeat and gestational age were significantly associated with severe outcomes in patients with CDM (OR:150.24, 95% CI: 5.97–3778.14; p = .0023 and OR: 0.73, 95% CI: 0.58–0.93; p = .0094, respectively). This predictive model for CDM prognosis exhibited good sensitivity (63%) and specificity (86%). Both prematurity and the CTG repeat length were significantly associated with the CDM severity.

scholarly journals Impact of prematurity and the CTG repeat length on outcomes in congenital myotonic dystrophy

2020 ◽  
Author(s):  
Yu Saito ◽  
Kenta Matsumura ◽  
Misao Kageyama ◽  
Yuichi Kato ◽  
Eiji Ohta ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Predictive Model ◽  
Myotonic Dystrophy ◽  
Logistic Regression Analysis ◽  
Gestational Age ◽  
Repeat Length ◽  
Congenital Myotonic Dystrophy ◽  
Using Data ◽  
Ctg Repeat

Abstract Objective: Patients with congenital myotonic dystrophy (CDM) tend to be born preterm. Although the CDM severity generally depends on the CTG repeat length, prematurity may also affect the prognosis in patients with CDM. Given that preterm birth is expected to increase the risk of CDM in newborns, we investigated the outcomes of newborns with CDM according to gestational age to assess prematurity and the CTG repeat length for predicting prognosis. Results: We assessed the outcomes of 54 infants with CDM using data collected from our hospitals and previously published studies. The patients were divided into mild and severe groups based on clinical outcomes. Logistic regression analysis was performed to estimate odds ratios (ORs) for CDM prognosis according to gestational age and the CTG repeat length and to construct a predictive model. Logistic regression analysis showed both the CTG repeat and gestational age were significantly associated with severe outcomes in patients with CDM (OR: 32.27, 95% CI: 3.45–300.7; p = .002 and OR: 0.73, 95% CI: 0.58–0.93; p = .0094, respectively). This predictive model for CDM prognosis exhibited good sensitivity (63%) and specificity (86%). Both prematurity and the CTG repeat length were significantly associated with the CDM severity.

Abstract 12535: Decreased Six-Minute Walk Distance at Hospital Discharge, Its Cut-off Value of 370 Meters, is an Independent Predictor for Poor Activities of Daily Living After Discharge in Elderly Patients With Chronic Heart Failure

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kohei Nozaki ◽  
Takashi Masuda ◽  
Kentaro Kamiya ◽  
Nobuaki Hamazaki ◽  
Ryota Matsuzawa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Elderly Patients ◽  
Hospital Discharge ◽  
Logistic Regression Analysis ◽  
Independent Predictor ◽  
Multivariate Logistic Regression Analysis ◽  
Quadriceps Strength ◽  
Minute Walk Distance

Background: Elderly patients with chronic heart failure (CHF) is well known to have poor activities of daily living (ADL) after hospital discharge because of their prolonged hospital stays and subsequent physical deconditioning. Although many studies demonstrated that decreased six-minute walk distance (6MWD) was an independent predictor of rehospitalization and mortality in them, the relationship between decreased 6MWD and poor ADL is not thoroughly evaluated. The purpose of this study was to investigate whether decreased 6MWD measured at hospital discharge reflected poor ADL after discharge in elderly patients with CHF. Methods: We recruited 290 patients, 179 males and 111 females, who were 65 years or more and admitted to our hospital because of first heart failure. We excluded the patients who had needed assistance with ADL or walking aid before admission. Plasma brain natriuretic peptide, left ventricular ejection fraction, 6MWD and motor functions including isometric quadriceps strength and one-leg standing time were measured at hospital discharge. ADL was evaluated using the performance measure for ADL-8 (PMADL-8) 3 months after discharge, while PMADL-8 score of 20 or more indicated poor ADL. To determine significant predictors affecting poor ADL and their cut-off values, a multivariate logistic regression analysis and the area under the receiver operating characteristics (ROC) curve were performed. Results: Patients’ mean age was 75.4 ± 6.4 years old and their mean PMADL-8 and 6MWD were 18.9 ± 5.9 points and 379 ± 109 meters, respectively. The univariate logistic regression analysis showed that age, 6MWD, quadriceps strength, one-leg standing time were significant predictors for PMADL-8 of ≥20 points (P<0.05, respectively). The multivariate logistic regression analysis detected only 6MWD as a significant and independent predictor for PMADL-8 of ≥20 points (P<0.001). The odds ratio of poor ADL was 1.16 (95% confidence interval: 1.10-1.25, P<0.001) with each 10-meter decrease of 6MWD. The ROC curve showed 370 meters as a cut-off value of 6MWD. Conclusions: Decreased 6MWD at hospital discharge was identified as an independent strong predictor for poor ADL after discharge in elderly patients with CHF, and its cut-off value was 370 meters.

scholarly journals Y chromosome polymorphisms may contribute to an increased risk of male-induced unexplained recurrent miscarriage

2017 ◽  
Vol 37 (2) ◽  
Author(s):  
Yan Wang ◽  
Gang Li ◽  
Man-Zhen Zuo ◽  
Jun-Hua Fang ◽  
Hai-Rong Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Y Chromosome ◽  
Logistic Regression Analysis ◽  
Gestational Age ◽  
Recurrent Miscarriage ◽  
Control Group ◽  
Case Group ◽  
Unexplained Recurrent Miscarriage

The present study aims to explore the relationship between the Y chromosome polymorphisms (1qh+, inv(9), 9qh+, 16qh+, group D/G, Yqh– and Yqh+) and the risk of unexplained recurrent miscarriage (URM). A total of 507 couples with URM were recruited as case group and 465 healthy couples as control group. The Y chromosome polymorphisms of the male individuals were analysed with the G-banding technique, and the results of the chromosome G-banding analysis were determined using the International Naming Standards of Human Genetics (ISCN). Logistic regression analysis was used to analyse the risk factors for URM. The detection rate of Y chromosome polymorphisms in the case group (12.03%) was higher than that in the control group (2.15%). Y chromosome polymorphisms were detected at significantly higher rates in the case group than in the control group. Using the normal Y chromosomes in individuals of the case group as reference, the partners of their counterparts were more likely to experience miscarriage. The couples who were Y chromosome-polymorphism carriers had shorter gestational age, increased frequency of URM and longer average interval between pregnancies. The results of logistic regression analysis revealed that Y chromosome polymorphisms, shorter gestational age, a higher frequency of miscarriage and longer pregnancy interval were independent risk factors for URM. Y chromosome polymorphisms may be associated with the risk of URM and may play an important role in the development of URM.

Correlation between ventriculomegaly on prenatal magnetic resonance imaging and the need for postnatal ventricular shunt placement

2009 ◽  
Vol 3 (5) ◽  
pp. 365-370 ◽  
Author(s):  
Todd C. Hankinson ◽  
Monique Vanaman ◽  
Peter Kan ◽  
Sherelle Laifer-Narin ◽  
Robert DeLaPaz ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Mr Imaging ◽  
Logistic Regression Analysis ◽  
Gestational Age ◽  
Imaging Studies ◽  
Fetal Sex ◽  
Shunt Placement ◽  
Imaging Time ◽  
Cns Anomalies

Object Pediatric neurosurgeons are increasingly called on to provide prognostic data regarding the antenatal diagnosis of ventriculomegaly. This study was designed to determine if there is a correlation between prenatal MR imaging results and the need for ventricular shunt placement during the neonatal period. Methods The authors retrospectively reviewed the prenatal MR imaging data of 38 consecutive patients who had been referred for neurosurgical consultation following the diagnosis of ventriculomegaly. The outcome measure was placement of a ventricular shunt. Assessed parameters included prenatal atrial diameter (AD), gestational age at MR imaging, time between imaging studies, presence of concomitant CNS anomalies, laterality of ventriculomegaly, fetal sex, and temporal evolution of ventriculomegaly. Logistic regression analysis was completed with the calculation of appropriate ORs and 95% CIs. Results Six patients (16%) required shunt placement, all with an AD ≥ 20 mm (mean 23.8 mm) at the time of imaging. Eight patients had presented with an AD ≥ 20 mm. Atrial diameter was the only presenting feature that correlated with shunt placement (OR 1.58, 95% CI 1.10–2.25, p = 0.01). Logistic regression analysis revealed no statistical correlation between the need for ventricular shunting and gestational age at MR imaging, time between imaging studies, fetal sex, presence of additional CNS anomalies, and laterality of the ventriculomegaly. Conclusions When assessed using MR imaging, an AD ≥ 20 mm at any gestational age is highly associated with the need for postnatal shunting. Patients with concomitant CNS anomalies did not require shunts at a greater rate than those with isolated ventriculomegaly. Further studies are required to assess the long-term outcome of this patient population.

scholarly journals Predictive Value of Admission D-dimer for Contrast-induced Acute Kidney Injury and Poor Outcomes after Primary Percutaneous Coronary Intervention

2020 ◽  
Author(s):  
Kai-Yang Lin ◽  
Han-Chuan Chen ◽  
Hui Jiang ◽  
Sun-Ying Wang ◽  
Hong-mei Chen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Serum Creatinine ◽  
Logistic Regression Analysis ◽  
Predictive Value ◽  
Independent Predictor ◽  
Multivariate Logistic Regression Analysis ◽  
Increased Risk ◽  
Long Term Mortality

Abstract Background DD was found to be associated with acute myocardial infarction (AMI) and renal insufficiency. However, it is uncertain whether DD is an independent risk factor of CI-AKI in patients undergoing pPCI. Methods We prospectively enrolled 550 consecutive patients with STEMI undergoing pPCI between January 2012 and December 2016. The predictive value of admission DD for CI-AKI was assessed by receiver operating characteristic(ROC) and multivariable logistic regression analysis. CI-AKI was defined as an absolute serum creatinine increase ≥0.3 mg/dl or a relative increase in serum creatinine ≥50% within 48 h of contrast medium exposure. Results Overall, the incidence of CI-AKI was 13.1%. The ROC analysis showed that the cutoff point of DD was 0.69 ug/ml for predicting CI-AKI with a sensitivity of 77.8% and a specificity of 57.3%. The predictive value of DD was similar to the Mehran score for CI-AKI (AUC DD =0.729 vs AUC Mehran =0.722; p =0.8298). Multivariate logistic regression analysis indicated that DD >0.69 ug/ml was an independent predictor of CI-AKI (odds ratio[OR]=3.37,95%CI:1.80-6.33, p <0.0001). Furthermore, DD >0.69 ug/ml was associated with an increased risk of long-term mortality during during a mean follow-up period of 16 months(hazard ratio=3.41, 95%CI:1.4-8.03, p =0.005). Conclusion admission DD >0.69 ug/ml is a significant and independent predictor of CI-AKI and long-term mortality in patients undergoing pPCI.

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