scholarly journals Prediction and follow-up of risk factors for severe SARS-CoV-2 pneumonia and application of CT visual scoring

2021 ◽  
pp. 1-12
Author(s):  
Yingjian Ye ◽  
Xiaxia Wu ◽  
Xiumei Li ◽  
Chunmei Xu ◽  
Qingpeng Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Clinical Features ◽  
Lymphocyte Count ◽  
Clinical Symptoms ◽  
Multivariate Logistic Regression Analysis ◽  
Clinical Treatment ◽  
Severe Illness ◽  
Multivariate Logistic Regression ◽  
Clinical Value

BACKGROUND: The SARS-CoV-2 pneumonia infection is associated with high rates of hospitalization and mortality and this has placed healthcare systems under strain. Our study provides a novel method for the progress prediction, clinical treatment and prognosis of NCP, and has important clinical value for timely treatment of severe NCP patients. OBJECTIVE: To summarize the clinical features and severe illness risk factors of the patients with novel coronavirus pneumonia (NCP), in order to provide support for the progression prediction, clinical treatment and prognosis of NCP patients. MATERIALS AND METHODS: A total of 196 NCP patients treated in our hospital from January 25, 2020 to June 21, 2020 were divided into the severe group and the mild group. The clinical features of the two groups were analyzed and compared. The risk factors were explored by using multivariate logistic regression, and the receiver operating characteristic (ROC) curve was obtained. The correlations of the risk factors with the prognosis of NCP were investigated combined with the lung function test. RESULTS: The primary clinical symptoms of 196 cases of NCP included fever in 167 cases (85.2%) and cough in 121 cases (61.73%). The chest computed tomography (CT) scans of the 178 cases (90.81%) showed a typical ground-glass opacification. In 149 cases, the lymphocyte count was decreased, while the levels of creatine kinase (CK), lactate dehydrogenase (LDH), c-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and D-dimer (D-D) increased. 44 cases (22.45%) were found to be severely ill. The multivariate logistic regression analysis demonstrated that age, underlying disease, length of hospital stay, body mass index (BMI), LDH, chest CT visual score, absolute lymphocyte count (ALC) and CRP were risk factors for severe

scholarly journals Clinical Features and Risk Factors for Active Tuberculosis in Takayasu Arteritis: A Single-Center Case-Control Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Jiawei Zhou ◽  
Ruoyu Ji ◽  
Rui Zhu ◽  
Jingya Zhou ◽  
Jing Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Clinical Features ◽  
Takayasu Arteritis ◽  
Multivariate Logistic Regression Analysis ◽  
Active Tuberculosis ◽  
Case Group ◽  
Multivariate Logistic Regression

BackgroundsTakayasu arteritis (TAK) is a chronic, granulomatous vasculitis correlated with tuberculosis (TB). The two diseases share similar pathological characteristics and clinical manifestations which increase the difficulty to diagnose. Active tuberculosis (ATB) has implications for treatment strategies in TAK patients. Therefore, the investigation of clinical features and potential risk factors of ATB in TAK patients is vital.MethodsThe study reviewed hospitalized patients diagnosed with TAK in our hospital from 2008, to 2021. TAK patients with ATB were enrolled as the case group. The control group was randomly selected in a 3:1 ratio. The clinical characteristics of TAK patients with and without ATB were compared. Multivariate logistic regression analysis was performed to determine risk factors for ATB in TAK patients.ResultsWe reviewed 1,789 patients and ultimately identified 30 (1.7%) ATB cases. TAK patients with ATB were more prone to develop symptoms including fever (p=0.001), fatigue (p=0.003), cough (p=0.037), expectoration (p<0.001), weight loss (p=0.003), and night sweating (p<0.001). Increased level of hypersensitive C reactive protein (hsCRP, p=0.001), decreased level of albumin (p=0.031), and higher positive rate of T-SPOT.TB test (p<0.001) were observed in the case group. Multivariate logistic regression analysis revealed that hsCRP >8 mg/L (OR 9.108; 95% CI, 1.096–75.711; p=0.041) and positive T-SPOT.TB result (OR 68.669; 95% CI, 7.291–646.738; p<0.001) were risk factors for ATB in TAK patients. The proportion of patients undergoing subsequent surgery for Takayasu arteritis was lower in patients with ATB (p<0.001).ConclusionOur study suggested that the diagnosis of ATB should be considered when TAK patients experienced symptoms including fever, fatigue, weight loss, etc. hsCRP >8 mg/L and positive T-SPOT.TB result were identified as independent risk factors for ATB in TAK patients.

scholarly journals The Correlation Between Clinical Features and Viral RNA Shedding in Outpatients With COVID-19

2020 ◽  
Vol 7 (8) ◽  
Author(s):  
Tingting Liao ◽  
Zhengrong Yin ◽  
Juanjuan Xu ◽  
Zhilei Lv ◽  
Sufei Wang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Clinical Features ◽  
Symptom Onset ◽  
Protective Factor ◽  
Multivariate Logistic Regression Analysis ◽  
Viral Rna ◽  
Severe Illness ◽  
Time Interval ◽  
Multivariate Logistic Regression ◽  
Virus Shedding

Abstract Background Patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can shed virus, thereby causing human-to-human transmission, and the viral RNA shedding is commonly used as a proxy measure for infectivity. Methods We retrospectively reviewed confirmed cases of COVID-19 who attended the fever clinic of Wuhan Union Hospital from January 14 to February 24. In terms of the viral RNA shedding (median values) at first visit, patients were divided into a high–viral RNA shedding group and a low–viral RNA shedding group. Univariate and multivariate logistic regression analysis were performed to investigate the correlation between viral RNA shedding and clinical features. Results A total of 918 consecutive COVID-19 patients were enrolled, and severe patients made up 26.1%. After univariate and multivariate logistic regression, advanced age (odds ratio [OR], 1.02; 95% CI, 1.01–1.03; P = .001), having severe chronic diseases (OR, 1.44; 95% CI, 1.03–2.01; P = .04), and severe illness (OR, 1.60; 95% CI, 1.12–2.28; P = .01) were independent risk factors for high viral RNA shedding. Shorter time interval from symptom onset to viral detection was a protective factor for viral RNA shedding (OR, 0.97; 95% CI, 0.94–0.99; P = .01). Compared with mild patients, severe patients have higher virus shedding over a long period of time after symptom onset (P = .01). Conclusions Outpatients who were old, had severe illness, and had severe underlying diseases had high viral RNA shedding.

scholarly journals Construction and Validation of a Convenient Clinical Nomogram to Predict the Risk of Brain Metastasis in Renal Cell Carcinoma Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Yuexin Tong ◽  
Zhangheng Huang ◽  
Chuan Hu ◽  
Changxing Chi ◽  
Meng Lv ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Cell Carcinoma ◽  
Logistic Regression ◽  
Brain Metastasis ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Clinical Tool ◽  
Clinical Value

Brain metastasis (BM) is a typical type of metastasis in renal cell carcinoma (RCC) patients. The early detection of BM is likely a crucial step for RCC patients to receive appropriate treatment and prolong their overall survival. The aim of this study was to identify the independent predictors of BM and construct a nomogram to predict the risk of BM. Demographic and clinicopathological data were obtained from the Surveillance, Epidemiology, and End Results (SEER) database for RCC patients between 2010 and 2015. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors, and then, a visual nomogram was constructed. Multiple parameters were used to evaluate the discrimination and clinical value. We finally included 42577 RCC patients. Multivariate logistic regression analysis showed that histological type, tumor size, bone metastatic status, and lung metastatic status were independent BM-associated risk factors for RCC. We developed a nomogram to predict the risk of BM in patients with RCC, which showed favorable calibration with a C -index of 0.924 (0.903-0.945) in the training cohort and 0.911 (0.871-0.952) in the validation cohort. The calibration curves and decision curve analysis (DCA) also demonstrated the reliability and accuracy of the clinical prediction model. The nomogram was shown to be a practical, precise, and personalized clinical tool for identifying the RCC patients with a high risk of BM, which not only will contribute to the more reasonable allocation of medical resources but will also enable a further improvements in the prognosis and quality of life of RCC patients.

scholarly journals Occurrence of Cryptosporidium Infection and Associated Risk Factors among HIV-Infected Patients Attending ART Clinics in the Central Region of Ghana

2021 ◽  
Vol 6 (4) ◽  
pp. 210
Author(s):  
Kwabena Dankwa ◽  
Samuel Victor Nuvor ◽  
Dorcas Obiri-Yeboah ◽  
Patrick Kwame Feglo ◽  
Mohamed Mutocheluh
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Central Region ◽  
Clinical Symptoms ◽  
Multivariate Logistic Regression Analysis ◽  
Cryptosporidium Infection ◽  
Multivariate Logistic Regression ◽  
Water Closet

Cryptosporidium species are intestinal protozoan parasites that infect and cause diarrhoea in animals and humans. The current study was conducted to determine the prevalence and risk factors of Cryptosporidium infection among HIV-infected patients in the Central region of Ghana. In this cross-sectional study, four hundred eighteen documented HIV-infected participants from four health facilities that provide antiretroviral therapy (ART) services across the Central region of Ghana were selected by systematic random sampling. An enzyme-linked immunosorbent assay (CoproELISATM, Cryptosporidium Savyon® Diagnostics Ltd., Ashdod, Israel) was used to detect Cryptosporidium antigens in stool samples obtained from participants. Information regarding participants’ sociodemographic characteristics and clinical symptoms as well as potential environmental and behavioral risk factors were collected using a structured questionnaire. Chi-square or Fisher’s exact tests were used to determine associations between Cryptosporidium infections and explanatory variables, while risk factors were assessed using multivariate logistic regression analysis. The overall prevalence of Cryptosporidium infection among HIV-infected participants in this study was 6.2% (95% CI: 3.90–8.54). Cryptosporidium was not significantly associated with any of the sociodemographic variables, patient clinical symptoms, and environmental factors. However, the prevalence of the parasite was significantly higher 25% (95% CI: 1.17–48.83; p = 0.013) among participants who did not always wash their hands before meals and those who did not always wash vegetables before eating them, 23.5% (95% CI: 1.05–46.01; p = 0.016). Multivariate logistic regression analysis showed that participants who used public water closet facilities were approximately 9 times more likely to become infected with the parasite than those who practised open defecation (OR: 8.83; 95% CI: 1.22–64.13; p = 0.031). In conclusion, Cryptosporidium is prevalent among HIV-infected patients in the Central region of Ghana. An important risk factor identified was the use of the public water closet toilet facility. More attention should be given to ensuring cleanliness at shared water closet facilities in addition to adequate disinfection of hands after using such facilities.

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

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

Abstract Background Tissue expansion is used for scar reconstruction owing to its excellent clinical outcomes; however, the complications that emerge from tissue expansion hinder repair. Infection is considered a major complication of tissue expansion. This study aimed to analyze the perioperative risk factors for expander infection. Methods A large, retrospective, single-institution observational study was carried out over a 10-year period. The study enrolled consecutive patients who had undergone tissue expansion for scar reconstruction. Demographics, etiological data, expander-related characteristics and postoperative infection were assessed. Univariate and multivariate logistic regression analysis were performed to identify risk factors for expander infection. In addition, we conducted a sensitivity analysis for treatment failure caused by infection as an outcome. Results A total of 2374 expanders and 148 cases of expander infection were assessed. Treatment failure caused by infection occurred in 14 expanders. Multivariate logistic regression analysis identified that disease duration of ≤1 year (odds ratio (OR), 2.07; p < 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.

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

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

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

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

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

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

Risk factor analysis of progressive spinal deformity after resection of intramedullary spinal cord tumors in patients who underwent laminoplasty: a report of 105 consecutive cases

2019 ◽  
Vol 30 (5) ◽  
pp. 655-663 ◽  
Author(s):  
Wei Shi ◽  
Shan Wang ◽  
Huifang Zhang ◽  
Guoqin Wang ◽  
Yi Guo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Spinal Deformity ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord

OBJECTIVELaminoplasty has been used in recent years as an alternative approach to laminectomy for preventing spinal deformity after resection of intramedullary spinal cord tumors (IMSCTs). However, controversies exist with regard to its real role in maintaining postoperative spinal alignment. The purpose of this study was to examine the incidence of progressive spinal deformity in patients who underwent laminoplasty for resection of IMSCT and identify risk factors for progressive spinal deformity.METHODSData from IMSCT patients who had undergone laminoplasty at Beijing Tsinghua Changgung Hospital between January 2014 and December 2016 were retrospectively reviewed. Univariate tests and multivariate logistic regression analysis were used to assess the statistical relationship between postoperative spinal deformity and radiographic, clinical, and surgical variables.RESULTSOne hundred five patients (mean age 37.0 ± 14.5 years) met the criteria for inclusion in the study. Gross-total resection (> 95%) was obtained in 79 cases (75.2%). Twenty-seven (25.7%) of the 105 patients were found to have spinal deformity preoperatively, and 10 (9.5%) new cases of postoperative progressive deformity were detected. The mean duration of follow-up was 27.6 months (SD 14.5 months, median 26.3 months, range 6.2–40.7 months). At last follow-up, the median functional scores of the patients who did develop progressive spinal deformity were worse than those of the patients who did not (modified McCormick Scale: 3 vs 2, and p = 0.04). In the univariate analysis, age (p = 0.01), preoperative spinal deformity (p < 0.01), extent of tumor involvement (p < 0.01), extent of abnormal tumor signal (p = 0.02), and extent of laminoplasty (p < 0.01) were identified as factors associated with postoperative progressive spinal deformity. However, in subsequent multivariate logistic regression analysis, only age ≤ 25 years and preoperative spinal deformity emerged as independent risk factors (p < 0.05), increasing the odds of postoperative progressive deformity by 4.1- and 12.4-fold, respectively (p < 0.05).CONCLUSIONSProgressive spinal deformity was identified in 25.7% patients who had undergone laminoplasty for IMSCT resection and was related to decreased functional status. Younger age (≤ 25 years) and preoperative spinal deformity increased the risk of postoperative progressive spinal deformity. The risk of postoperative deformity warrants serious reconsideration of providing concurrent fusion during IMSCT resection or close follow-up after laminoplasty.

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

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

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

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