scholarly journals High Prevalence of Post-stroke Anxiety in Elderly Patients Following COVID-19 Outbreak

2021 ◽  
Vol 12 ◽  
Author(s):  
Meiling Yao ◽  
Hongjie Li ◽  
Ying Luo ◽  
Ling Li ◽  
Jian Yu
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Elderly Patients ◽  
Binary Logistic Regression ◽  
Female Gender ◽  
Binary Logistic Regression Analysis ◽  
Independent Risk Factors ◽  
Cutoff Threshold

Objective: Post-stroke anxiety (PSA) is a common affective disorder in patients with ischemic stroke. The elderly are more susceptible to mental health issues, however, few studies have so far focused on PSA in elderly patients, especially in the context of the COVID-19, causing psychological issues in the general population. The aim of the present study was to assess the prevalence and risk factors of PSA in elderly patients following COVID-19 outbreak.Methods: We retrospectively analyzed 206 elderly inpatients with newly diagnosed acute ischemic stroke in the First Affiliated Hospital, Sun Yat-sen University, from January 2020 to December 2020. Patients were categorized into the PSA group and the non-PSA group based on Hamilton Anxiety Scale scores at admission (within 1 week after stroke onset). Demographic and clinical data, mental state by Mini-Mental State Examination, depression by Hamilton Depression Scales (HAMD), and stroke severity and outcome by National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale were compared between the two groups. Univariate analysis and binary logistic regression analysis were used to analyze risk factors associated with PSA. We determined the cutoff scores for significant predictors of PSA using the area under the curve (AUC) and receiver operating characteristic.Results: Of the 206 stroke patients, 62 (30.1%) developed anxiety. Binary logistic regression analysis showed that female gender [adjusted odds ratio (aOR): 2.288, 95% confidence interval (CI):1.021–5.128, P = 0.044], high NIHSS scores [aOR: 1.264, 95% CI: 1.074–1.486, P = 0.005] and HAMD scores [aOR: 1.345, 95% CI: 1.215–1.490, P < 0.001] were independent risk factors for PSA. The cutoff threshold for the NIHSS scores was 3.5 points with an AUC of 0.64 and the cutoff threshold for HAMD scores was 5.5 points with an AUC of 0.89.Conclusion: Our results showed a high incidence of PSA in elderly patients after the COVID-19 outbreak. Female gender, high NIHSS and HAMD scores were the independent risk factors for PSA.

scholarly journals Asphyxia and Neonatal Respiratory Distress Syndrome Are Independent Predictors of the Non-response to Inhaled Nitric Oxide in the Newborns With PPHN

2021 ◽  
Vol 9 ◽  
Author(s):  
Yuwei Zhao ◽  
Lei Liang ◽  
Guanghui Liu ◽  
Hong Zheng ◽  
Liying Dai ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Distress Syndrome ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Neonatal Respiratory Distress ◽  
Independent Risk Factors

Aim: Not all the neonates respond with improvement in oxygenation following inhaled nitric oxide treatment (iNO) treatment. The aim of this study was to assess the independent risk factors associated with non-response to iNO during the 2 weeks of postnatal treatment in neonates diagnosed with persistent pulmonary hypertension (PPHN).Materials and Methods: This retrospective cohort study included all newborns with PPHN who received iNO treatment for more than 24 h. Demographic, obstetric, perinatal data and clinical complications were extracted from the hospitalization records. Subjects were divided into two groups according to their response to iNO inspiration during the first 24 h of iNO treatment. No response was defined as an increase in SpO2 < 5% or the inability to sustain saturation levels in the first 24 h of iNO treatment. For descriptive statistics, χ2 and t-test analysis were used to compare categorical and continuous variables between the two groups. To evaluate independent risk factors of non-responsiveness to iNO treatment, binary logistic regression analysis were performed.Results: A total of 75 newborns were included in the study. Sixty-two cases were in the responders group, and 13 cases were in the non-responders group. Univariate analysis showed that asphyxia, neonatal respiratory distress syndrome (NRDS), pulmonary surfactant administration, meconium aspiration syndrome (MAS), the severity of pulmonary hypertension (PH), and high-frequency oscillatory ventilation (HFOV) therapy were the high-risk factors affecting the response to iNO treatment in the newborns with PPHN. The binary logistic regression analysis indicated that asphyxia and NRDS incidence were independent predictors of non-responsiveness to iNO treatment [asphyxia: OR 4.193, 95% CI 1.104–15.927, P = 0.035; NRDS: OR 0.154, 95% CI 0.036–0.647, P = 0.011]. The patients in the non-responders group had shorter iNO inspiration followed by MV duration, supplemental oxygen and hospital stay, and higher mortality. There were no significant differences in IVH, PVL, and BPD between two groups.Conclusion: In the newborns with PPHN, asphyxia and NRDS resulted as the independent risk factors of non-responsiveness to iNO therapy. Asphyxia in the newborns with PPHN is detrimental to the response to iNO treatment, while NRDS is beneficial.

scholarly journals Serum markers change for intraocular metastasis in renal cell carcinoma

2021 ◽  
Author(s):  
Tie Sun ◽  
Jing Tang ◽  
Yi-Cong Pan ◽  
Chen-Yu Yu ◽  
Biao Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Cell Carcinoma ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Factor ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Intraocular Metastasis

Objective: Intraocular metastasis(IOM) of renal cell carcinoma is rare. In this study, we studied the relationship between different biochemical indicators and the occurrence of IOM in renal cancer patients, and identified the potential risk factors. Methods: A retrospective analysis of the clinical data of 214 patients with renal cell carcinoma from October 2001 to August 2016. Analyze the difference and correlation of various indicators between the two groups with or without IOM, and use binary logistic regression analysis to explore the risk factors of IOM in renal cancer patients. Calculate the diagnostic value of each independent related factor according to the receiver operating curve (ROC). Results: The level of neuron specific enolase （NSE） in renal cell carcinoma patients with IOM was significantly higher than that in patients without IOM (P < 0.05). There was no significant difference in ALP, Hb, serum calcium concentration, AFP, CEA, CA-125 etc. between IOM group and non-intraocular metastasis (NIOM) group (P > 0.05). Binary logistic regression analysis showed that NSE was an independent risk factor for IOM in renal cell carcinoma patients (P < 0.05). ROC curve shows that the factor has high accuracy in predicting IOM, and the area under the curve is 0.774. The cut-off value of NSE was 49.5U/L, the sensitivity was 72.2%, and the specificity was 80.1%. Conclusion：NSE concentration is a risk factor for IOM in patients with renal cell cancer. If the concentration of NSE in the patient's body is ≥49.5U/L, disease monitoring and eye scans should be strengthened.

scholarly journals Changes in Cognitive Function and Risk Factors for Cognitive Impairment of the Elderly in China: 2005–2014

2019 ◽  
Vol 16 (16) ◽  
pp. 2847 ◽  
Author(s):  
Qilin Zhang ◽  
Yanli Wu ◽  
Tiankuo Han ◽  
Erpeng Liu
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Logistic Regression Analysis ◽  
Binary Logistic Regression ◽  
The Elderly ◽  
Binary Logistic Regression Analysis ◽  
Chinese Elderly

Background: The cognitive function of the elderly has become a focus of public health research. Little is known about the changes of cognitive function and the risk factors for cognitive impairment in the Chinese elderly; thus, the purposes of this study are as follows: (1) to describe changes in cognitive function in the Chinese elderly from 2005–2014 and (2) to explore risk factors for cognitive impairment of the Chinese elderly. Design and setting: A total of 2603 participants aged 64 years and above participated in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and were followed up from 2005 to 2014. Cognitive function and cognitive impairment were assessed using the Chinese version of the Mini-Mental State Examination (MMSE). Binary logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence intervals (CI) of cognitive impairment. Results: Results revealed that the cognitive function of the Chinese elderly shows diversified changes: deterioration (55.09%), unchanged (17.21%) and improvement (27.70%). In addition, there are significant demographic differences in gender, age, education, marriage and other aspects when it comes to the changes of cognitive function in Chinese elderly. In the binary logistic regression analysis, female, increased age, lower education level, no spouse, less income, worse PWB (psychological well-being), less fresh fruit and vegetable intake, more activities of daily living (ADL) limitations, lower social engagement were significantly associated with higher odds for cognitive impairment. Conclusions: Various interventions should be implemented to maintain cognitive function in Chinese elderly.

scholarly journals Brain Metastases in Lung Cancer Patients: Clinical Potential Risk Factors of CYFRA21-1 and CEA

2021 ◽  
Author(s):  
Jing Tang ◽  
Tie Sun ◽  
Qian-Min Ge ◽  
Rong-Bin Liang ◽  
Ting Su ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Cancer Patients ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Lung Cancer Patients

Abstract Background At present, little is known about the specific risk factors of brain metastasis in patients with lung cancer. This study aims to explore the risk factors of brain metastasis. Methods From April 1999 to July 2017, a total of 1,615 lung cancer patients were included in this retrospective study. The patients were divided into two groups, namely brain metastasis group and non-brain metastasis group. Student's t test, non-parametric rank sum test and chi-square test were used to describe whether there is a significant difference between the two groups. We compared the serum biomarkers of the two groups of patients, including alkaline phosphatase (ALP), Calcium, calcium hemoglobin (HB), alpha fetoprotein (AFP), cancer embryonic antigen (CEA), CA-125, CA-199, CA- 153, CA-724, cytokeratin fragment 19 (CYFRA 21 − 1), total prostate specific antigen (TPSA), squamous cell carcinoma antigen (SCC-Ag) ,and neuron specific enolase (NSE). Binary logistic regression analysis was used to determine its risk factors, and receiver operating curve (ROC) analysis was used to evaluate its diagnostic value for brain metastases in patients with lung cancer. Results In the analysis of brain metastases in patients with lung cancer, binary logistic regression analysis showed that CYFRA21-1 and CEA are independent risk factors for brain metastases in patients with lung cancer (both P < 0.001). The sensitivity and specificity of diagnosing brain metastasis were CYFRA21-1, 38.0% and 87.4%, respectively; CEA was 39.7% and 79.3%, respectively. Conclusion Serum CYFRA21-1 and CEA have predictive value in the diagnosis of brain metastases in patients with lung cancer.

Computed Tomography–Guided Microcoil Localization of Pulmonary Nodules: Effects of Multiple Punctures

2021 ◽  
Author(s):  
Ye Tian ◽  
Jianli An ◽  
Zibo Zou ◽  
Yanchao Dong ◽  
Jingpeng Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Logistic Regression ◽  
Pulmonary Nodules ◽  
Binary Logistic Regression ◽  
Pulmonary Vasculature ◽  
Binary Logistic Regression Analysis ◽  
Ct Guided ◽  
Independent Risk Factors ◽  
Multiple Puncture

Abstract Background The aim of the study is to analyze the effect of multiple punctures in computed tomography (CT)-guided microcoil localization of pulmonary nodules with other risk factors for common complications. Methods Consecutive patients who underwent CT-guided microcoil localization and subsequent video-assisted thoracoscopic surgery (VATS) between January 2020 and February 2021 were enrolled. Nodules successfully located after only one puncture were defined as the single puncture group, and nodules requiring two or more punctures were defined as the multiple puncture group. Binary logistic regression analysis was performed to assess the relationship between the number of punctures and pneumothorax and intrapulmonary hemorrhage. Results A total of 121 patients were included. There were 98 (68.1%) pulmonary nodules in the single puncture group compared with 46 (31.9%) nodules in the multiple puncture group. The frequencies of pneumothorax and intrapulmonary hemorrhage were higher in the multiple puncture group than in the single puncture group (p = 0.019 and <0.001, respectively). Binary logistic regression demonstrated that independent risk factors for developing pneumothorax included lateral positioning of the patient (p < .001) and prone positioning (p = 0.014), as well as multiple punctures (p = 0.013). Independent risk factors for intrapulmonary hemorrhage included the distance between the distal end of the coil and the surface of the pleura (p = 0.033), multiple punctures (p = 0.003), and passage through the pulmonary vasculature (p < 0.001). Conclusion Multiple punctures resulted in an increased incidence of pneumothorax and intrapulmonary hemorrhage compared with single puncture during CT-guided microcoil localization of pulmonary nodules and were independently associated with both pneumothorax and intrapulmonary hemorrhage.

scholarly journals Effects of Non-intubated Video-Assisted Thoracic Surgery on Patients With Pulmonary Dysfunction

2022 ◽  
Vol 8 ◽  
Author(s):  
Shiyu Deng ◽  
Yanyi Cen ◽  
Long Jiang ◽  
Lan Lan
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Thoracic Surgery ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Pulmonary Dysfunction ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Different Types

Background: Non-intubated video-assisted thoracic surgery (NIVATS) can be safely performed in lung volume reduction surgery for patients with severe pulmonary dysfunction. However, there is still no cohort observation on the effects of NIVATS on patients with pulmonary dysfunction undergoing different types of thoracic procedures. This retrospective study aimed to observe the effects of NIVATS for this kind of patients.Methods: Three hundred and twenty-eight patients with moderate to severe obstructive pulmonary dysfunction, who underwent video-assisted thoracic surgery (VATS), were retrospectively collected from June 1st, 2017 to September 30th, 2019. Patients in NIVATS were case-matched with those in intubated video-assisted thoracic surgery (IVATS) by a propensity score-matched analysis. The primary outcome was the comparison of perioperative values, the secondary outcome was the risk factors for postoperative clinical complications (PCP) which were identified by binary logistic regression analysis.Results: After being matched, there were no differences in demographics and preoperative values of pulmonary function between NIVATS and IVATS groups. The duration of surgery and anesthesia had no difference (P = 0.091 and P = 0.467). As for the postoperative recovery, except for the mean intensive care unit (ICU) stay was longer in the IVATS group than in the NIVATS group (P = 0.015), the chest tube removal time and the postoperative hospital stay had no difference (P = 0.394 and P = 0.453), and the incidence of PCP also had no difference (P = 0.121). The binary logistic regression analysis revealed that the history of pulmonary disease, anesthesia method, and surgical location were risk factors of PCP.Conclusion: For patients with pulmonary dysfunction when undergoing different types of thoracic procedures, the NIVATS can be performed as effectively and safely as the IVATS, and can reduce the ICU stay.

scholarly journals Risk Factors for Postoperative Prolonged Ventilation Time in Acute Type A Aortic Dissection Patients Received Modified Aortic Root Procedure

2019 ◽  
Vol 22 (6) ◽  
pp. E476-E480
Author(s):  
Yanjing Chen ◽  
Ning Li ◽  
Yang Li ◽  
Zhigang Song ◽  
An Zhao
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Female Gender ◽  
Ascending Aorta ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Ventilation Time ◽  
Prolonged Ventilation ◽  
Independent Risk Factors

Background: Postoperative prolonged ventilation time (PPVT) is associated with increased mortality in acute type A aortic dissection (ATAAD). The aim of this study is to investigate risk factors for PPVT in ATAAD patients. Methods: We retrospectively collected ATAAD patient data for those who received modified aortic root procedure and extensive arch repair between June 2017 and June 2018 at our institution. Patients were included in PPVT (N = 30) and No-PPVT (N = 72) groups, according to whether postoperative ventilation time > 72 hours. Univariate and multivariate logistic regression analysis were adopted to determine the independent risk factors for PPVT. Results: More female in the PPVT Group (56.67% versus 23.61%, P < .05). Max diameter (MD) of ascending aorta was wider in the PPVT Group (4.71 ± 1.02 versus 4.30 ± 0.61, P < .05). Postoperative data showed a higher in-hospital mortality in the PPVT Group (26.67% versus 5.56%, P < .05). There were more patients in the PPVT Group who experienced postoperative acute renal failure (ARF) (36.67% versus 5.56%, P < .05). Multivariable logistic regression analysis showed female gender, MD of ascending aorta > 4.05 cm, and postoperative ARF were independent risk factors for PPVT with the OR of 3.55 (1.13 – 11.20, P < .05), 2.89 (1.02 – 8.22, P < .05), and 4.31 (1.03 – 18.02, P < .05), respectively. Conclusions: In the present study, we determined female gender, MD of ascending aorta > 4.05 cm, and postoperative ARF within 72 hours were independent risk factors for PPVT in ATAAD patients received modified root procedure and extensive arch repair.

scholarly journals Independent Risk Factors and The Long-term Outcomes for Postoperative Continuous Renal Replacement Treatment in Patients Who Underwent Emergency Surgery for Type A Acute Aortic Dissection

2020 ◽  
Author(s):  
Zhigang Wang ◽  
Min Ge ◽  
Tao Chen ◽  
Cheng Chen ◽  
Qiuyan Zong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Acute Aortic Dissection ◽  
Univariate Analysis ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Long Term Outcomes ◽  
Replacement Treatment ◽  
Independent Risk Factors

Abstract Objective: The study objective was to investigate the incidence and risk factors of continuous renal replacement treatment (CRRT) in patients undergoing emergency surgery for type A acute aortic dissection (TA-AAD) and evaluate the perioperative and long-term outcomes. Methods: From January 2014 to December 2018, 712 consecutive patients were enrolled in the study. These patients were divided into two groups according to whether or not needed severe postoperative acute kidney injury (AKI) requiring CRRT: the CRRT group vs the control group. Univariate analysis and binary logistic regression analysis were used to analyze the risk factors of CRRT. Significant variables by univariate analysis were included in binary logistic regression analysis. To avoid the selection bias and confounders, baseline characteristics were matched for propensity scores. One-to-one pair matching was performed using nearest neighbor matching without replacement within 0.02 standard deviations of the logit of the propensity score as caliper width. Kaplan-Meier curves were generated to provide survival estimates at postoperative points in time. Differences between the 2 groups were determined by log-rank tests. Results: Before propensity score matching, univariate analysis showed that there significant differences in age, preoperative hypertension, pericardial effusion, preoperative serum creatinine (sCr), intraoperative need for combined coronary artery bypass grafting (CABG) or mitral valve or tricuspid valve surgery, cardiopulmonary bypass (CPB) time, extracorporeal circulation assistant time, aortic cross-clamp time, drainage volume 24 hours after surgery and ventilator time between two groups. All were higher in the CRRT group (p<0.05). These risk factors were included in binary logistic regression. It showed that preoperative sCr (OR=1.008, 95% CI:1.002-1.014, P=0.005) and CPB time (OR=1.022, 95% CI:1.003-1.042, P=0.026) were independent risk factors for CRRT patients undergoing surgery for TA-AAD. And there were significant differences regarding 30-day mortality (P<0.001) and long-term overall cumulative survival (P<0.001) with up to a 6-year follow-up. After propensity scoring, 29 pairs (58 patients) were successfully matched. Among these patients, the analysis showed that CPB time was still significantly longer in the CRRT group (P = 0.004), and the 30-day mortality rate was also higher in this group (44.8% vs 10.3%; P = 0.003).Conclusion: CRRT after TA-AAD is common and worsened short- and long- term mortality. The preoperative sCr and CPB time are independent risk factors for postoperative CRRT patients. Shorten the CPB time as much as possible is recommended to reduce the risk of CRRT after the operation.

scholarly journals Distal Adding On In Lenke 2AR Adolescent Idiopathic Scoliosis:risk Factors Analysis and Clinical Assessment

2020 ◽  
Author(s):  
Yulei Dong ◽  
Ning Tang ◽  
Shengru Wang ◽  
Jianguo Zhang ◽  
Hong Zhao
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Clinical Assessment ◽  
Lumbar Lordosis ◽  
Binary Logistic Regression ◽  
Thoracic Curve ◽  
Binary Logistic Regression Analysis

Abstract Background: Risk factors and clinical outcome associated with distal adding on in Lenke 2AR adolescent idiopathic scoliosis (AIS) are not fully elucidated.Methods: Radiographic data of Lenke 2AR AIS patients treated by posterior pedicle screws in a single institution were retrospectively analyzed. Patients who developed distal adding on were compared with patients who did not. Clinical assessment were carried out by SF-36 and SRS-22 questionnaire. Risk factors of distal adding on were explored by binary logistic regression analysis.Results: A total of 88 patients completed an average of 2.9 (2-12.9) years of follow-up were included. 18 (20.5%) patients met the criterion of distal adding on while the rest of 70 cases did not at follow up.Clinical parameters were comparable before surgery and became lower at follow up in adding on group in dimensions of vitality (63.1±11.4Vs.67.5±11.8,P=0.026), mental health (73.9±9.2Vs.77.8±10.2,P=0.039), self-image (3.9±0.3Vs.4.2±0.3,P=0.021) and satisfaction (4.0±0.3Vs.4.5±0.4,P=0.035). The proportion of selection lowest instrumented vertebra (LIV) higher than last touching vertebra(LTV) was significantly higher in adding on group. (6/18vs 4/70, P=0.004) Binary logistic regression analysis revealed that preoperative main thoracic curve magnitude (OR=1.118,P=0.041), preoperative lumbar lordosis (OR=1.091,P=0.029), and the gap between LIV and LTV(OR=6.123,P=0.043) were independent risk factors associated with adding on.Conclusions: In Lenke 2AR AIS cases, the selection of LIV higher than LTV is closely correlated with the development of adding-on. Patients with minor main thoracic curve and lumbar lordosis are more likely to develop distal adding on. Adding on may cause discontent of patients .

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