scholarly journals Lipid Levels and 3-Month Prognosis After Spontaneous Intracerebral Hemorrhage in Women

2021 ◽  
Vol 12 ◽  
Author(s):  
Hao Feng ◽  
Xin Wang ◽  
Wenjuan Wang ◽  
Xingquan Zhao
Keyword(s):  
Logistic Regression ◽  
Intracerebral Hemorrhage ◽  
Clinical Outcomes ◽  
Poor Prognosis ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Lipid Levels ◽  
Multivariate Logistic Regression ◽  
Low Levels ◽  
High Density Cholesterol ◽  
The Relationship

Background: The relationship between serum lipids levels and prognosis after spontaneous intracerebral hemorrhage (ICH) is still unclear. We aim to examine the association between lipid levels and 3-month ICH prognosis in women.Method: We went through a registry of spontaneous ICH cases and selected female patients to study according to our criteria. We collected demographic, clinical, and laboratory information and evaluated serum triglyceride (TG) levels, total cholesterol (TC) levels, low-density cholesterol (LDLC) levels, high-density cholesterol (HDLC) levels, non-high-density cholesterol (non-HDLC) levels, and 3-month modified Rankin Scale (mRS). Multivariate logistic regression was performed, and receiver operating characteristic (ROC) curves were plotted to explore the relationship between serum lipid levels and 3-month ICH clinical outcomes.Results: Two hundred six female patients were included in this study, and 96 (46.6%) of them had poor functional outcomes. In the univariate analysis, low TG (p = 0.006), TC (p = 0.025), LDLC (p = 0.001), non-HDLC (p < 0.001) levels, and high HDL (p = 0.036) levels were associated with poor 3-month clinical outcomes in women. In the multivariate logistic regression, low levels of TG (OR = 0.711, 95% CI = 0.542–0.933, p = 0.014), TC (OR = 0.523, 95% CI = 0.304–0.903, p = 0.020), LDLC (OR = 0.538, 95% CI = 0.307–0.942, p = 0.030), non-HDLC (OR = 0.327, 95% CI = 0.177–0.603, p < 0.001), and a high level of HDLC (OR = 2.075, 95% CI = 1.064–4.047, p = 0.032) with area under the curve (AUC) of 0.610, 0.590, 0.630, 0.645, and 0.415, respectively, remained as independent indicators of poor prognosis at 3 months after adjusting for confounding factors.Conclusion: Low levels of TG, TC, LDLC, non-HDLC, and high levels of HDLC were independently associated with poor prognosis of spontaneous ICH in women.

scholarly journals Association Between Alkaline Phosphatase and Clinical Outcomes in Patients With Spontaneous Intracerebral Hemorrhage

2021 ◽  
Vol 12 ◽  
Author(s):  
Sijia Li ◽  
Wenjuan Wang ◽  
Qian Zhang ◽  
Yu Wang ◽  
Anxin Wang ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Logistic Regression ◽  
Intracerebral Hemorrhage ◽  
Clinical Outcomes ◽  
Functional Outcomes ◽  
Adverse Outcomes ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Mortality And Morbidity ◽  
The Third ◽  
Increased Risk

Background: Spontaneous intracerebral hemorrhage (ICH) is associated with high rates of mortality and morbidity. Alkaline phosphatase (ALP) is related to increased risk of cardiovascular events and is also closely associated with adverse outcomes after ischemic or hemorrhagic stroke. However, there are limited data about the effect of ALP on clinical outcomes after ICH. Therefore, we aimed to investigate the relationship between serum ALP level and prognosis in ICH patients.Methods: From January 2014 to September 2016, 939 patients with spontaneous ICH were enrolled in our study from 13 hospitals in Beijing. Patients were categorized into four groups based on the ALP quartiles (Q1, Q2, Q3, Q4). The main outcomes were 30-day, 90-day, and 1-year poor functional outcomes (modified Rankin Scale score of 3–6). Multivariable logistic regression and interaction analyses were performed to evaluate the relationships between ALP and clinical outcomes after ICH.Results: In the logistic regression analysis, compared with the third quartile of ALP, the adjusted odds ratios of the Q1, Q2, and Q4 for 30-day poor functional outcome were 1.31 (0.80–2.15), 1.16 (0.71–1.89), and 2.16 (1.32–3.55). In terms of 90-day and 1-year poor functional outcomes, the risks were significantly higher in the highest quartile of ALP compared with the third quartile after adjusting the confounding factors [90-day: highest quartile OR = 1.86 (1.12–3.10); 1-year: highest quartile OR = 2.26 (1.34–3.80)]. Moreover, there was no significant interaction between ALP and variables like age or sex.Conclusions: High ALP level (>94.8 U/L) was independently associated with 30-day, 90-day, and 1-year poor functional outcomes in ICH patients. Serum ALP might serve as a predictor for poor functional outcomes after ICH onset.

Predictors and outcome of seizures after spontaneous intracerebral hemorrhage

2009 ◽  
Vol 111 (1) ◽  
pp. 87-93 ◽  
Author(s):  
Tzu-Ming Yang ◽  
Wei-Che Lin ◽  
Wen-Neng Chang ◽  
Jih-Tsun Ho ◽  
Hung-Chen Wang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Intracerebral Hemorrhage ◽  
Neurological Complication ◽  
Multiple Logistic Regression ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Seizure Rate ◽  
Symptomatic Seizures ◽  
The Mean ◽  
The Relationship

Object Seizures are an important neurological complication of spontaneous intracerebral hemorrhage (ICH). A better understanding of the risk factors of seizures following ICH is needed to predict which patients will require treatment. Methods Two hundred and forty-three adult patients were enrolled in this 1-year retrospective study. Multiple logistic regression was used to evaluate the relationship between baseline clinical factors and the presence or absence of seizure during the study period. Results Seizures occurred in 20 patients with ICH, including acute symptomatic seizures in 9 and unprovoked seizures in 11. None progressed to status epilepticus during hospitalization. After a minimum 3-year follow-up period, the mean Glasgow Outcome Scale score was 3.8 ± 1.1 for patients who had had seizures and 3.5 ± 1.3 for those who had not. The multiple logistic regression model demonstrated that the mean ICH volume was independently associated with seizures, and any increase of 1 mm3 in ICH volume increased the seizure rate by 2.7%. Conclusions Higher mean ICH volumes at presentation were predictive of seizure, and the presence of late seizures was predictive of developing epilepsy. Most seizures occurred within 2 years of spontaneous ICH over a minimum of 3 years of follow-up.

scholarly journals Associations of Clinical Characteristics and Etiology With Death in Hospitalized Chinese Children After Spontaneous Intracerebral Hemorrhage: A Single-Center, Retrospective Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiaoyan Huang ◽  
Zicheng Cheng ◽  
Ye Xu ◽  
Lingfan Xia ◽  
Zhenxiang Zhan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Surgical Treatment ◽  
Intracerebral Hemorrhage ◽  
Arteriovenous Malformation ◽  
Lower Risk ◽  
Clinical Characteristics ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Multivariate Logistic Regression ◽  
Risk Of Mortality

Objective: We retrospectively analyzed clinical characteristics, etiology, and mortality risk factors in pediatric cases of non-traumatic spontaneous intracerebral hemorrhage.Methods: This study involved children between 29 days and 18 years old with confirmed spontaneous intracerebral hemorrhage based on head CT or MRI at the Second Affiliated Hospital of Wenzhou Medical University and Yuying Children's Hospital from January 2008 to March 2020. Demographic and clinical characteristics, etiology, imaging, and treatment data were collected at baseline. Potential risk factors of in-hospital death were identified using univariate analysis and multivariate logistic regression.Result: A total of 200 children (126 males, median age 5 years) were included in the study. Clinical symptoms of spontaneous intracerebral hemorrhage were typically non-specific (79.5%). One third of patients (31.1%) had a Glasgow Coma Scale score (GCS) ≤ 8, and nearly two-thirds (60.5%) showed a combination of ventricular hemorrhage or subarachnoid hemorrhage. Supratentorial hemorrhage was more common. Cerebrovascular disease (37.0%) and hematological disease (33.5%) were the most frequent etiologies of spontaneous intracerebral hemorrhage. Most patients (74.5%) received non-surgical treatment, while 25.5% received surgical treatment. After an average of 12 days of treatment, 167 children (83.5%) survived and 33 (16.5%) died. Multivariate logistic regression showed herniation syndrome, and low GCS (≤ 8) to be associated with increased risk of mortality, while hemorrhage due to arteriovenous malformation was associated with lower risk of mortality.Conclusion: Our data suggest that cerebrovascular disease is the most common cause of spontaneous intracerebral hemorrhage among children, and that arteriovenous malformation is associated with lower risk of death in hospital. Conversely, the presence of herniation syndrome, low GCS (≤ 8) increase risk of in-hospital mortality. Our results underscore the importance of timely imaging and supplementary examinations in cases of suspected spontaneous intracerebral hemorrhage.

Abstract 211: Variation of NEDD4L is Associated with Hypertension in Chinese Hans Chronic Kidney Disease Patients

Hypertension ◽  
2013 ◽  
Vol 62 (suppl_1) ◽  
Author(s):  
Cheng Wang ◽  
Jun Zhang ◽  
Cuicui Li ◽  
Wenyu Gong ◽  
Tanqi Lou
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Logistic Regression ◽  
Kidney Disease ◽  
Blood Pressure Monitoring ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Functional Studies ◽  
Chi Squared ◽  
The Relationship

Background: Neural precursor cell expressed developmentally down-regulated 4-like (NEDD4L) is a candidate gene for hypertension, and carriers of an intact NEDD4L C2-domain,encoded by the NEDD4L rs4149601 (G/A) GG genotype, together with the C-allele of the NEDD4L rs2288774 (C/T) polymorphism have been found be associated with hypertension both in African Americans and whites. However, there is no data on the relationship between polymorphism of NEDD4L rs4149601 and rs2288774 and hypertension in Chinese chronic kidney disease (CKD) patients. The purpose of the current study was to investigate the relationship between the variation of NEDD4L rs4149601, rs2288774 and hypertension in CKD patients. Methods: A total of 546 Chines Hans CKD patients were enrolled in our study. The SNPs were genotyped using PCR-based techniques. All patients underwent ambulatory blood pressure monitoring, and clinical data were also collected. Multivariate logistic regression analysis was used to identify the relationship between polymorphisms and hypertension. Results: 506 patients carried GG/GA genotype and 30 carried AA genotype. Rs4149601 AA genotype carriers had significantly higher rate of hypertension (68.3% vs 46.2%, P = 0.022) than GG/GA genotype carriers by Chi-squared test. AA genotype carriers also had a higher day-time and bedtime systolic blood pressure (142±16 vs 135±23, P=0.036; 137±18 vs 127±13, P=0.022, respectively) when compared with GG/GA genotype carriers. AA genotype [OR= 3.08, 95% CI (1.06-9.80)], lowever eGFR [OR=0.98, 95% CI (0.97-0.99)], older age [OR=1.03, 95% CI (1.01-1.05)] were independently associated with hypertension in CKD patients by multivariate logistic regression. However, No difference was found in blood pressure with rs2288774 TT/TC/CC genotypes, and no difference was found in the incidence of hypertension among patients with three genotypes. Conclusions: Our results suggested 4149601AA genotype of NEDD4L may be associated with hypertension in CKD patients, and further genetic and functional studies are required to understand its role in the manifestation of hypertension in Chinese CKD patients.

Prognostic Nutritional Index Predicts Clinical Outcome in Patients with Cerebral Venous Sinus Thrombosis

2021 ◽  
Author(s):  
Jiawei Zhao ◽  
Kai Liu ◽  
Shen Li ◽  
Yuan Gao ◽  
Lu Zhao ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Poor Prognosis ◽  
Sinus Thrombosis ◽  
Multivariate Logistic Regression Analysis ◽  
Prognostic Nutritional Index ◽  
Cerebral Venous Sinus Thrombosis ◽  
Multivariate Logistic Regression ◽  
Venous Sinus Thrombosis ◽  
Nutritional Index

Abstract Background: Lower prognostic nutritional index (PNI) is related to poor prognosis of cardiovascular disease. However, little is known about PNI and its relationship with prognosis in cerebral venous sinus thrombosis (CVST).Methods: From January 2013 to June 2019, we retrospectively identified consecutive CVST patients. We selected patients in acute / subacute phase as subjects. Poor prognosis was defined as modified Rankin Scale (mRS) of 3-6. Multivariate logistic regression analysis was used to confirm if lower PNI was associated with poor prognosis. Results: A total of 297 subjects with 12-month follow-up data were enrolled. Thirty-three (11.1%) had poor outcome. Multivariate logistic regression analysis suggested that PNI was an important predictive factor of poor outcome in acute/subacute CVST (odds ratio, 0.903; 95% CI, 0.833-0.978; P = 0.012). The optimal cut-off value for predicting a poor prognosis of PNI was 44.2. Kaplan-Meier analysis and log-rank test suggested that the lower the PNI value, the higher the mortality rate (P<0.001). In addition, the nomogram we set up showed that lower PNI was an index of poor prognosis. The c-indexes for the cute/subacute patients with CVST was 0.872.Conclusions: Lower PNI is correlated with a higher risk of adverse clinical outcome in patients with acute/subacute CVST.

scholarly journals Machine Learning-Based Approaches for Prediction of Patients’ Functional Outcome and Mortality after Spontaneous Intracerebral Hemorrhage

2022 ◽  
Vol 12 (1) ◽  
pp. 112
Author(s):  
Rui Guo ◽  
Renjie Zhang ◽  
Ran Liu ◽  
Yi Liu ◽  
Hao Li ◽  
...  
Keyword(s):  
Machine Learning ◽  
Logistic Regression ◽  
Intracerebral Hemorrhage ◽  
Functional Outcome ◽  
Laboratory Data ◽  
Predictive Performance ◽  
High Morbidity ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Receiver Operating Characteristic Curves ◽  
Ich Score

Spontaneous intracerebral hemorrhage (SICH) has been common in China with high morbidity and mortality rates. This study aims to develop a machine learning (ML)-based predictive model for the 90-day evaluation after SICH. We retrospectively reviewed 751 patients with SICH diagnosis and analyzed clinical, radiographic, and laboratory data. A modified Rankin scale (mRS) of 0–2 was defined as a favorable functional outcome, while an mRS of 3–6 was defined as an unfavorable functional outcome. We evaluated 90-day functional outcome and mortality to develop six ML-based predictive models and compared their efficacy with a traditional risk stratification scale, the intracerebral hemorrhage (ICH) score. The predictive performance was evaluated by the areas under the receiver operating characteristic curves (AUC). A total of 553 patients (73.6%) reached the functional outcome at the 3rd month, with the 90-day mortality rate of 10.2%. Logistic regression (LR) and logistic regression CV (LRCV) showed the best predictive performance for functional outcome (AUC = 0.890 and 0.887, respectively), and category boosting presented the best predictive performance for the mortality (AUC = 0.841). Therefore, ML might be of potential assistance in the prediction of the prognosis of SICH.

scholarly journals Early Plasma Osmolality Levels and Clinical Outcomes in Children Admitted to the Pediatric Intensive Care Unit: A Single-Center Cohort Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Huabin Wang ◽  
Zhongyuan He ◽  
Jiahong Li ◽  
Chao Lin ◽  
Huan Li ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Regression Model ◽  
Clinical Outcomes ◽  
Poor Prognosis ◽  
Logistic Regression Model ◽  
Plasma Osmolality ◽  
Pediatric Intensive Care ◽  
Linear Spline

Objective: Identifying high-risk children with a poor prognosis in pediatric intensive care units (PICUs) is critical. The aim of this study was to assess the predictive value of early plasma osmolality levels in determining the clinical outcomes of children in PICUs.Methods: We retrospectively assessed critically ill children in a pediatric intensive care database. The locally weighted-regression scatter-plot smoothing (LOWESS) method was used to explore the approximate relationship between plasma osmolality and in-hospital mortality. Linear spline functions and stepwise expansion models were applied in conjunction with a multivariate logistic regression to further analyze this relationship. A subgroup analysis by age and complications was performed.Results: In total, 5,620 pediatric patients were included in this study. An approximately “U”-shaped relationship between plasma osmolality and mortality was detected using LOWESS. In the logistic regression model using a linear spline function, plasma osmolality ≥ 290 mmol/L was significantly associated with in-hospital mortality [odds ratio (OR) 1.020, 95% confidence interval (CI) 1.010–1.031], while plasma osmolality &lt;290 mmol/L was not significantly associated with in-hospital mortality (OR 0.990, 95% CI 0.966–1.014). In the logistic regression model with plasma osmolality as a tri-categorical variable, only high osmolality was significantly associated with in-hospital mortality (OR 1.90, 95% CI 1.38–2.64), whereas low osmolality was not associated with in-hospital mortality (OR 1.28, 95% CI 0.84–1.94). The interactions between plasma osmolality and age or complications were not significant.Conclusion: High osmolality, rather than low osmolality, can predict a poor prognosis in children in PICUs.

Loneliness as a Predictor of Work Disability Onset Among Nondisabled, Working Older Adults in 14 Countries

2019 ◽  
Vol 32 (7-8) ◽  
pp. 554-563 ◽  
Author(s):  
Zachary A. Morris
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Mediation Analysis ◽  
Work Disability ◽  
Multivariate Logistic Regression ◽  
Work Limitations ◽  
Disablement Process ◽  
Health Aging ◽  
Future Work ◽  
The Relationship

Objective: The objective of this study is to examine the relationship between loneliness and work disability and whether depression mediates the hypothesized relationship. Method: We draw on data from the 2013 and 2015 waves of the Survey of Health, Aging, and Retirement in Europe. We limited the sample to adults between the ages of 50 and 65 who were working and without work limitations in 2013, which consisted of 10,154 adults from 14 countries. We apply multivariate logistic regression and a binary mediation analysis with logistic regression to examine predictors of the onset of work disability in 2015. Results: Loneliness was predictive of future work disability onset when adjusting for other factors in the disablement process. Depression partly mediated the longitudinal relationship between loneliness and work disability. Discussion: The results indicate that addressing loneliness could mitigate the risk of depression and, in turn, work disability onset.

Predicting Amputation and Multiple Debridements in Tooth Knuckle Injuries

2019 ◽  
Vol 24 (01) ◽  
pp. 6-12
Author(s):  
H.R. Smith ◽  
C. Conyard ◽  
J. Loveridge ◽  
R. Gunnarsson
Keyword(s):  
Logistic Regression ◽  
Cohort Study ◽  
Predictor Variables ◽  
Delayed Presentation ◽  
Multivariate Logistic Regression ◽  
Outcome Measurements ◽  
Major Predictor ◽  
Laboratory Variables ◽  
The Relationship ◽  
Historic Cohort

Background: Tooth knuckle injuries can be expensive to treat and may necessitate amputation in some cases. Several limitations exist in the literature regarding our knowledge around the factors predicting amputation and the need for multiple debridements in treating this injury.Methods: A historic cohort study of 321 patients treated for tooth knuckle injuries was undertaken. Twenty-one demographic, clinical and laboratory variables were collected. Two outcome measurements were collected - the need for amputation and the need for more than one surgical debridement. A multivariate logistic regression was performed to determine the relationship between the predictor variables and the outcome measurements.Results: Of the 321 patients examined, 1.6% required amputations and 25% required multiple debridements. Osteomyelitis was found to be a major predictor for amputation in these patients (OR = 35). Delayed presentation (OR = 1.1) and diabetes (OR = 2.6) were found to significantly increase the risk of requiring multiple debridements.Conclusions: Our models were able to predict what patients were at the greatest risk for amputation and multiple debridement. Reducing rates of osteomyelitis and delays in presentation may help reduce the incidence of amputation and reoperation in this injury.

Oxidative markers in spontaneous intracerebral hemorrhage: leukocyte 8-hydroxy-2′-deoxyguanosine as an independent predictor of the 30-day outcome

2011 ◽  
Vol 115 (6) ◽  
pp. 1184-1190 ◽  
Author(s):  
Yi-Chun Chen ◽  
Chiung-Mei Chen ◽  
Jun-Liang Liu ◽  
Sien-Tsong Chen ◽  
Mei-Ling Cheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Vitamin E ◽  
Vitamin A ◽  
Intracerebral Hemorrhage ◽  
Redox Status ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Oxidative Markers ◽  
Traditional Risk Factors ◽  
Gpx Activity

Object Oxidative stress may play a role in spontaneous intracerebral hemorrhage (ICH), but data on oxidative burden in cerebral hemorrhage are limited, and it is not clear whether oxidative markers add predictive power regarding ICH outcome beyond that of traditional factors. The authors therefore examined redox status and traditional factors in ICH patients within 3 days of hemorrhage onset to delineate redox status in ICH and investigate the predictive value with respect to 30-day functional outcome. Methods Sixty-four patients with ICH and 114 controls were prospectively enrolled in this study. Blood samples were collected within 3 days of ICH onset and processed for isolation of plasma, erythrocytes, and leukocytes. The authors evaluated levels or activities of leukocyte 8-hydroxy-2′-deoxyguanosine (8-OHdG), erythrocyte glucose-6-phosphate dehydrogenase (G6PD), erythrocyte glutathione peroxidase (GPx), plasma malondialdehyde (MDA), vitamin E, and vitamin A, as well as traditional factors including the presence of hypertension or diabetes mellitus, total cholesterol level, and measures of liver function. A general linear model and multivariable logistic regression were used for analyses where appropriate. Results After adjustment for age and sex and traditional risk factors, ICH was significantly associated with an increased level of 8-OHdG (p < 0.0001), decreased GPx activity (p = 0.0002), and a decreased level of vitamin E (p = 0.003). There was no association of ICH risk with G6PD activity or MDA or vitamin A level. Considering all the oxidative markers and traditional risk factors together, logistic regression showed an independent association of ICH with 8-OHdG (OR 2.7, 95% CI 1.7–4.2, p < 0.0001). The association between increased 8-OHdG level and lower 30-day Barthel Index was also independent of the effects of age, sex, hemorrhage location and size, and traditional factors (p = 0.026). Unfavorable outcome (modified Rankin Scale score ≥ 3) at 30 days after ICH onset was not significantly associated with any of the examined oxidative markers. Conclusions Increased leukocyte 8-OHdG levels, as well as decreased GPx activity and vitamin E levels, were found during acute ICH. Only 8-OHdG was associated with ICH and the 30-day outcome independently from the other oxidative markers and traditional factors. Leukocyte 8-OHdG may add power beyond the traditional factors in predicting ICH outcome and thus may be used as an independent surrogate for clinical ICH study.

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