scholarly journals The Construction and Development of a Clinical Prediction Model to Assess Lymph Node Metastases in Osteosarcoma

2022 ◽  
Vol 9 ◽  
Author(s):  
Wenle Li ◽  
Shengtao Dong ◽  
Bing Wang ◽  
Haosheng Wang ◽  
Chan Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Validation Cohort ◽  
Predictive Ability ◽  
Multivariable Logistic Regression Analysis ◽  
Clinical Prediction ◽  
Clinical Prediction Model ◽  
Multivariable Logistic Regression

Background: This study aimed to construct a clinical prediction model for osteosarcoma patients to evaluate the influence factors for the occurrence of lymph node metastasis (LNM).Methods: In our retrospective study, a total of 1,256 patients diagnosed with chondrosarcoma were enrolled from the SEER (Surveillance, Epidemiology, and End Results) database (training cohort, n = 1,144) and multicenter dataset (validation cohort, n = 112). Both the univariate and multivariable logistic regression analysis were performed to identify the potential risk factors of LNM in osteosarcoma patients. According to the results of multivariable logistic regression analysis, A nomogram were established and the predictive ability was assessed by calibration plots, receiver operating characteristics (ROCs) curve, and decision curve analysis (DCA). Moreover, Kaplan-Meier plot of overall survival (OS) was plot and a web calculator visualized the nomogram.Results: Five independent risk factors [chemotherapy, surgery, lung metastases, lymphatic metastases (M-stage) and tumor size (T-stage)] were identified by multivariable logistic regression analysis. What's more, calibration plots displayed great power both in training and validation group. DCA presented great clinical utility. ROCs curve provided the predictive ability in the training cohort (AUC = 0.805) and the validation cohort (AUC = 0.808). Moreover, patients in LNN group had significantly better survival than that in LNP group both in training and validation group.Conclusion: In this study, we constructed and developed a nomogram with risk factors, which performed well in predicting risk factors of LNM in osteosarcoma patients. It may give a guide for surgeons and oncologists to optimize individual treatment and make a better clinical decision.

Outcomes of cancer patients with takotsubo cardiomyopathy.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18101-e18101
Author(s):  
Achuta Kumar Guddati ◽  
Gagan Kumar ◽  
Iuliana Shapira ◽  
Parijat Saurav Joy
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cancer Patients ◽  
Logistic Regression Analysis ◽  
Takotsubo Cardiomyopathy ◽  
Primary Diagnosis ◽  
Multivariable Logistic Regression Analysis ◽  
Solid Organ ◽  
Multivariable Logistic Regression

e18101 Background: Chemotherapy induced cardiomyopathy is an important complication of some chemotherapeutic agents. The stress of a cancer diagnosis and ongoing chemotherapy may contribute to cardiac morbidity in these patients. The burden of Takotsubo Cardiomyopathy (TCP) in cancer patients is unknown. The incidence of TCP and related outcomes in cancer patients was investigated in this study. Methods: The 2007-2013 National Inpatient Sample (NIS) was analyzed for patients with a prior and new diagnosis of TCP with and without malignancy. Risk factors for mortality were adjusted for associated conditions by multivariable logistic regression analysis. Results: From 2007 through 2013, an estimated 122,750 adults were admitted with a diagnosis of TCP. In 2013, the incidence of admissions in US of patients with coexisting TCP and malignancy was 1.13%. Admissions in 34,957 patients were for a primary diagnosis of TCP with 91.7% females; overall, 665 (2.1%) had solid organ cancer, 237 (0.74%) had hematological malignancy and 354 (1.11%) had metastatic cancer. Patients admitted for TCP with coexisting malignancy had a significantly higher mortality (13.8% vs. 2.9%, p < 0.0001), length of stay (7 vs. 4 days, p < 0.0001) and total charges ($29291 vs. $ 36231, p < 0.0001), compared to those with no malignancy. In patients with a primary diagnosis of TCP and without any underlying malignancy, males had a higher mortality (4.02% vs. 1.03%, p < 0.0001) whereas there was no gender difference in mortality in those with coexisting malignancy (6.25% vs 6.45%, p = 0.965). On multivariable logistic regression analysis, risk factors associated with mortality were solid cancer (OR 3.43, p = 0.008), stroke (OR 18.33, p < 0.0001), venous thromboembolic disease (OR 4.52, p = 0.004), malnutrition (OR 2.41, p = 0.006) and heart failure (OR 1.918, p = 0.004). Conclusions: Outcomes are significantly worse in patients with TCP and solid malignancy. Hence, this patient population must be regarded as high-risk and early diagnostic consideration for TCP is warranted. Early intervention may help lower mortality, decrease resource utilization and reduce the health care costs in these patients.

scholarly journals Risk factors for stillbirth among pregnant women infected with syphilis from 2010–2016, Zhejiang Province, China

2019 ◽  
Author(s):  
Cuicui Duan ◽  
Xiao-hui Zhang ◽  
Shan-shan Li ◽  
Wei Wu ◽  
Li-qian Qiu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Pregnant Women ◽  
Logistic Regression Analysis ◽  
Zhejiang Province ◽  
Multivariable Logistic Regression Analysis ◽  
Adequate Treatment ◽  
Multivariable Logistic Regression ◽  
Latent Syphilis

Abstract Background: Syphilis infection is one of the most common maternal factors related to stillbirth. The study aims to determine the risk factors for stillbirth among pregnant women infected with syphilis. Methods : This was a retrospective study. Data on stillbirth and gestational syphilis were extracted from the PMTCT program database 2010–2016 in Zhejiang Province. A total of 8724 pregnancy women infected with syphilis were included. Multivariable logistic regression analysis was performed to assess the associations between gestational syphilis and stillbirth. Results : The stillbirth rate among pregnant women infected with syphilis was 1.74% (152/8724) in Zhejiang Province, China, from 2010–2016. Compared with live birth, stillbirth was significantly associated with lower maternal age, not being married, lower gravidity, previous history of syphilis, non-latent syphilis stage, and higher maternal serum titer for syphilis, inadequate treatment for syphilis, and later first antenatal care visit. With multivariable logistic regression analysis, non-latent syphilis (adjusted OR=2.03; 95% CI 1.17–3.53) and maternal titers over 1:4 (adjusted OR=1.78; 95% CI 1.25–2.53) were risk factors for stillbirth. Adequate treatment was the only protective factor for stillbirth (adjusted OR=0.16; 95% CI 0.10–0.25). Conclusions : Adequate treatment is effective in reducing the incidence of stillbirths among pregnant women infected with syphilis, and this is particularly important in women diagnosed with high RPR titer (under 1:4). Keywords: risk factors, syphilis, stillbirth, pregnant, syphilis stage, RPR

scholarly journals Distinguish Coronavirus Disease 2019 Patients in General Surgery Emergency by CIAAD Scale: Development and Validation of a Prediction Model Based on 822 Cases in China

2020 ◽  
Author(s):  
Bangbo Zhao ◽  
Yingxin Wei ◽  
Wenwu Sun ◽  
Cheng Qin ◽  
Xingtong Zhou ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Prediction Model ◽  
Acute Abdomen ◽  
Logistic Regression Analysis ◽  
Validation Cohort ◽  
Curve Analysis ◽  
Multivariable Logistic Regression Analysis ◽  
Decision Curve Analysis ◽  
Multivariable Logistic Regression

ABATRACTIMPORTANCEIn the epidemic, surgeons cannot distinguish infectious acute abdomen patients suspected COVID-19 quickly and effectively.OBJECTIVETo develop and validate a predication model, presented as nomogram and scale, to distinguish infectious acute abdomen patients suspected coronavirus disease 2019 (COVID-19).DESIGNDiagnostic model based on retrospective case series.SETTINGTwo hospitals in Wuhan and Beijing, China.PTRTICIPANTS584 patients admitted to hospital with laboratory confirmed SARS-CoV-2 from 2 Jan 2020 to15 Feb 2020 and 238 infectious acute abdomen patients receiving emergency operation from 28 Feb 2019 to 3 Apr 2020.METHODSLASSO regression and multivariable logistic regression analysis were conducted to develop the prediction model in training cohort. The performance of the nomogram was evaluated by calibration curves, receiver operating characteristic (ROC) curves, decision curve analysis (DCA) and clinical impact curves in training and validation cohort. A simplified screening scale and managing algorithm was generated according to the nomogram.RESULTSSix potential COVID-19 prediction variables were selected and the variable abdominal pain was excluded for overmuch weight. The five potential predictors, including fever, chest computed tomography (CT), leukocytes (white blood cells, WBC), C-reactive protein (CRP) and procalcitonin (PCT), were all independent predictors in multivariable logistic regression analysis (p ≤0.001) and the nomogram, named COVID-19 Infectious Acute Abdomen Distinguishment (CIAAD) nomogram, was generated. The CIAAD nomogram showed good discrimination and calibration (C-index of 0.981 (95% CI, 0.963 to 0.999) and AUC of 0.970 (95% CI, 0.961 to 0.982)), which was validated in the validation cohort (C-index of 0.966 (95% CI, 0.960 to 0.972) and AUC of 0.966 (95% CI, 0.957 to 0.975)). Decision curve analysis revealed that the CIAAD nomogram was clinically useful. The nomogram was further simplified into the CIAAD scale.CONCLUSIONSWe established an easy and effective screening model and scale for surgeons in emergency department to distinguish COVID-19 patients from infectious acute abdomen patients. The algorithm based on CIAAD scale will help surgeons manage infectious acute abdomen patients suspected COVID-19 more efficiently.

scholarly journals Invasive Mechanical Ventilation May Be an Important Factor of Mortality in Severe/Critical COVID-19 Pneumonia: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Jing Wei ◽  
Lei Shi ◽  
Zhi Cheng ◽  
Xinye Jin ◽  
Wei Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Invasive Mechanical Ventilation ◽  
Trial Registration ◽  
Hospital Death ◽  
Multivariable Logistic Regression Analysis ◽  
Multivariable Logistic Regression

Abstract Background: Many of severe COVID-19 patients are admitted to the hospital or even to the Intensive Care Unit(ICU). The present study was aimed to investigated the risk factors in death from COVID-19.Methods: In this retrospective study, all inpatients confirmed severe or critical COVID-19 from two tertiary hospital in Huangshi were included, who had been discharged or died by March19,2020. Demographic,clinical,treatment,laboratory data and information were extracted from electronic medical records and compared between survivors group and non-survivors group. The univariable and multivariable logistic regression analysis was used to analyze the risk factors associated with in-hospital death.Results: 81 patients were included in this study, of whom 55 were discharged and 26 died in hospital. In all patients, 36(44.4%) patients had comorbidity, including hypertension(27[33.3%]), diabetes(11[13.6%]) and coronary heart disease (CHD)(11[13.6%]), and 16(19.8%) patients accompanied with more than 2 kinds of underlying diseases. The proportion of CHD in non-survivors group was significantly higher than that in survivors group(26.9% vs 7.3%, P=0.032), but there were no differences in hypertension, diabetes and COPD between the non-survivors group and the survivors group. Multivariable logistic regression analysis showed increasing odds of in-hospital death associated with aspartate aminotransferase(AST) and invasive mechanical ventilation (IMV) (P<0.001)(P=0.017）.Conclusions: Invasive Mechanical Ventilation may contribute to mortality of severe/critical COVID-19 pneumonia, and with higher AST at admission was one of the indicators of poor prognosis.Trial registration: Chinese Clinical Trial Registration; ChiCTR2000031494; Registered 02 April 2020; http://www.medresman.org

scholarly journals Impact of histologic chorioamnionitis on pulmonary hypertension and respiratory outcomes in preterm infants

2018 ◽  
Vol 8 (2) ◽  
pp. 204589401876016 ◽  
Author(s):  
Sook Kyung Yum ◽  
Min-Sung Kim ◽  
Yoojin Kwun ◽  
Cheong-Jun Moon ◽  
Young-Ah Youn ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Preterm Infants ◽  
Logistic Regression Analysis ◽  
Multivariable Logistic Regression Analysis ◽  
Multivariable Logistic Regression ◽  
Histologic Chorioamnionitis ◽  
Respiratory Outcomes ◽  
Lower Birthweight

We aimed to evaluate the association between the presence of histologic chorioamnionitis (HC) and development of pulmonary hypertension (PH) during neonatal intensive care unit (NICU) stay. Data of preterm infants born at 32 weeks of gestation or less were reviewed. The development of PH and other respiratory outcomes were compared according to the presence of HC. Potential risk factors associated with the development of PH during NICU stay were used for multivariable logistic regression analysis. A total of 188 infants were enrolled: 72 in the HC group and 116 in the no HC group. The HC group infants were born at a significantly shorter gestational age and lower birthweight, with a greater proportion presenting preterm premature rupture of membrane (pPROM) > 18 h before delivery. More infants in the HC group developed pneumothorax ( P = 0.008), and moderate and severe bronchopulmonary dysplasia (BPD; P = 0.001 and P = 0.006, respectively). PH in the HC group was significantly more frequent compared to the no HC group (25.0% versus 8.6%, P = 0.002). Based on a multivariable logistic regression analysis, birthweight ( P = 0.009, odds ratio [OR] = 0.997, 95% confidence interval [CI] = 0.995–0.999), the presence of HC ( P = 0.047, OR = 2.799, 95% CI = 1.014–7.731), and duration of invasive mechanical ventilation (MV) > 14 days ( P = 0.015, OR = 8.036, 95% CI = 1.051–43.030) were significant factors. The presence of HC and prolonged invasive MV in infants with lower birthweight possibly synergistically act against preterm pulmonary outcomes and leads to the development of PH. Verification of this result and further investigation to establish effective strategies to prevent or ameliorate these adverse outcomes are needed.

scholarly journals Hounsfield unit attenuation value can differentiate pyonephrosis from hydronephrosis and predict septic complications in patients with obstructive uropathy

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Luca Boeri ◽  
Irene Fulgheri ◽  
Franco Palmisano ◽  
Elena Lievore ◽  
Vito Lorusso ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Obstructive Uropathy ◽  
Hounsfield Unit ◽  
Infectious Complications ◽  
Multivariable Logistic Regression Analysis ◽  
Ureteral Catheter ◽  
Septic Complications ◽  
Multivariable Logistic Regression

Abstract We aimed to assess the role of computerized tomography attenuation values (Hounsfield unit—HU) for differentiating pyonephrosis from hydronephrosis and for predicting postoperative infectious complications in patients with obstructive uropathy. We analysed data from 122 patients who underwent nephrostomy tube or ureteral catheter placement for obstructive uropathy. A radiologist drew the region of interest for quantitative measurement of the HU values in the hydronephrotic region of the affected kidney. Descriptive statistics and logistic regression models tested the predictive value of HU determination in differentiating pyonephrosis from hydronephrosis and in predicting postoperative sepsis. A HU cut-off value of 6.3 could diagnose the presence of pyonephrosis with 71.6% sensitivity and 71.5% specificity (AUC 0.76; 95%CI: 0.66–0.85). At multivariable logistic regression analysis HU ≥ 6.3 (p ≤ 0.001) was independently associated with pyonephrosis. Patients who developed sepsis had higher HU values (p ≤ 0.001) than those without sepsis. A HU cut-off value of 7.3 could diagnose the presence of sepsis with 76.5% sensitivity and 74.3% specificity (AUC 0.79; 95%CI: 0.71–0.90). At multivariable logistic regression analysis, HU ≥ 7.3 (p ≤ 0.001) was independently associated with sepsis, after accounting for clinical and laboratory parameters. Measuring HU values of the fluid of the dilated collecting system may be useful to differentiate pyonephrosis from hydronephrosis and to predict septic complications in patients with obstructive uropathy.

scholarly journals Weight Loss in Parkinson’s Disease: The Relationship with Motor Symptoms and Disease Progression

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Maria G. Cersosimo ◽  
Gabriela B. Raina ◽  
Luis A. Pellene ◽  
Federico E. Micheli ◽  
Cristian R. Calandra ◽  
...  
Keyword(s):  
Weight Loss ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Disease Progression ◽  
Logistic Regression Analysis ◽  
Disease Duration ◽  
Multivariable Logistic Regression Analysis ◽  
Single Session ◽  
Multivariable Logistic Regression ◽  
The Relationship

Objectives.To determine the prevalence of weight loss (WL) in PD patients, its relationship to the severity of motor manifestations and appetite changes.Methods.144 PD patients and 120 controls were evaluated in a single session. All subjects were asked about changes in body weight and appetite. PD patients were examined with the UPDRS-III and the Hoehn and Yahr (HY) scales. Subscores of tremor, bradykinesia /rigidity, and non-dopaminergic symptoms (NDS) were analyzed individually. Multivariable logistic regression analysis was used to determine an association between WL and PD motor manifestations.Results.48.6 % of PD patients presented WL compared to 20.8 % of controls (p < 0.001). Weight losers were significantly older and had longer disease duration, higher scores in HY stages, UPDRS-III, and NDS-subscore. Multivariable logistic regression analysis demonstrated that WL was associated with NDS-subscore (p= 0.002; OR: 1.33) and older age (p= 0.037; OR: 1.05). Appetite in PD cases losing weight was unchanged (35.7 %), decreased (31.4 %), or even increased (32.9).Conclusions.Our results showed that WL occurs in almost half of PD patients and it is largely the consequence of disease progression rather than involuntary movements or a decrease in food intake.

scholarly journals Treatment Strategy of Oxaliplatin-induced Peripheral Neuropathy: A Retrospective, Nationwide Study

2021 ◽  
Author(s):  
Satoshi Yokoyama ◽  
Chihiro Nakagawa ◽  
Kouichi Hosomi
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Peripheral Neuropathy ◽  
Logistic Regression Analysis ◽  
Multivariable Logistic Regression Analysis ◽  
Prescription Patterns ◽  
Nationwide Study ◽  
Multivariable Logistic Regression ◽  
Oxaliplatin Treatment ◽  
Prolonged Duration

Abstract PurposeChemotherapy-induced peripheral neuropathy (CIPN) is a common adverse events of cancer treatment; however, no drug is recommended for the prevention of CIPN. In Japan, several drugs such as Gosha-Jinki-Gan and duloxetine have been frequently administered for the treatment of CIPN. The aim of this study was to elucidate prescription patterns of drugs administered for the treatment of CIPN caused by oxaliplatin and the association between these drugs and the duration of oxaliplatin treatment.MethodsWe conducted a retrospective nationwide study using the JMDC administrative claims database (January 2005–June 2020). Patients newly treated with oxaliplatin were identified, and prescription patterns of CIPN medication including Gosha-Jinki-Gan, pregabalin, duloxetine, mecobalamin, and mirogabalin were investigated. The primary outcome was the duration of oxaliplatin treatment. Multivariable logistic regression analysis was performed to examine the association between CIPN medication and duration of oxaliplatin treatment.ResultsA total of 4,739 patients who newly received oxaliplatin were identified. Of these, 759 (16.0%) had received CIPN medication. Duloxetine was administered in 99 (2.1%) patients. Multivariable logistic regression analysis revealed that CIPN medication was significantly associated with the prolonged duration of oxaliplatin treatment (odds ratio: 2.35, [95% confidence interval: 1.99-2.77]).ConclusionReal-world data demonstrated that the administration rate of CIPN medication was higher in patients who underwent oxaliplatin treatment for over 6 months. Increasing administration preference of duloxetine and conducting prospective studies to verify the causal relationship between CIPN medication and prolonged duration of oxaliplatin treatment are needed.

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