scholarly journals Coagulation Status and Surgical Approach as Predictors of Postoperative Anemia in Patients Undergoing Thoracic Surgery: A Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhongping Lang ◽  
Yue Wu ◽  
Minwei Bao
Keyword(s):  
Logistic Regression ◽  
Retrospective Study ◽  
Thoracic Surgery ◽  
Surgical Approach ◽  
Multiple Logistic Regression Analysis ◽  
International Normalized Ratio ◽  
Major Surgery ◽  
Multiple Logistic Regression ◽  
Open Thoracotomy ◽  
Coagulation Status

Objective: Postoperative anemia is a common complication after a major surgery. Our study aims to identify factors that are associated with higher risk of developing postoperative anemia after thoracic surgery.Methods: We conducted a retrospective study of 465 patients who underwent pulmonary surgery in 2017 in Shanghai Pulmonary Hospital, China. Of them, 191 patients underwent standard open thoracotomy (OT), and 274 patients underwent video-assisted thoracic surgery (VATS). A total of 350 patients were diagnosed with postoperative anemia, and 115 patients did not have anemia. Multiple logistic regression was used to compute odds ratios for predicting preoperative anemia.Results: Postoperative anemia was associated with significantly lower weight (p < 0.001) and height (p = 0.022) of the patients, as well as higher prothrombin time (PT), and international normalized ratio (INR) (p = 0.012). Open thoracotomy resulted in a 1.2-fold increase in the incidence of postoperative anemia compared to VATS (p = 0.002). Multiple logistic regression analysis identified INR [OR (95% CI) 24.46 (2.05–292.27; p = 0.012] and surgical approach [OR (95% CI) 0.48 (0.31–0.74); p < 0.001] as predictors of postoperative anemia and postoperative drop in hemoglobin (Hb).Conclusion: Postoperative coagulation status and surgical approach are statistically significant predictors of postoperative anemia in patients undergoing thoracic surgery. International normalized ratio and surgical approach are specifically associated with Hb drop immediately after the surgery.

scholarly journals Complications and Neurological Outcome Following Intraoperative Aneurysm Rupture in Adult Patients Undergoing Intracranial Aneurysmal Clipping: A Retrospective Study

2021 ◽  
Author(s):  
Nayani Radhakrishna ◽  
Ankur Khandelwal ◽  
Rajendra Singh Chouhan ◽  
Mihir Prakash Pandia ◽  
Sourav Burman ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Neurological Outcome ◽  
Multiple Logistic Regression Analysis ◽  
Univariate Analysis ◽  
Adult Patients ◽  
Multiple Logistic Regression ◽  
Duration Of Surgery

Abstract Background Intraoperative aneurysmal rupture (IAR) is a catastrophic complication; however, its impact on neurological outcome is debatable. We studied the effects of IAR on intraoperative and postoperative complications and neurological outcome. Methods In this retrospective study, adult patients who underwent aneurysmal clipping over a period of 2 years were divided as follows: group R (with IAR) and group N (without IAR). Various perioperative parameters, intraoperative and postoperative complications were noted. Glasgow outcome scale (GOS) was noted at discharge from hospital and categorized as favorable (GOS IV and V) and unfavorable (GOS I, II and III). Collected data was statistically analyzed. Univariate and multiple logistic regression analyses were performed to identify predictors of IAR. A p value < 0.05 was considered significant. Results Thirty-two out of 195 (16.41%) patients suffered IAR, with majority involving anterior communicating artery aneurysm (46.88%). Duration of temporary clipping (p < 0.001), volume of blood loss, and fluid and blood transfusion were significantly more in group R. Postoperatively, significantly more patients in group R developed intracranial hematoma, cerebral infarct, and required prolonged ventilatory support (≥5 days). Unfavorable neurological outcome was observed more in group R (p = 0.013). In univariate analysis, blood loss > 500 mL, use of colloids, and duration of surgery > 5 hours were found to be associated with IAR. After multiple logistic regression analysis, only use of colloids and duration of surgery > 5 hours were the most predictive variables for IAR. Conclusions IAR is associated with serious intraoperative and postoperative complications and unfavorable neurological outcome.

scholarly journals MRCP Combined With CT Promotes the Differentiation of Benign and Malignant Distal Bile Duct Strictures

2021 ◽  
Vol 11 ◽  
Author(s):  
Guang-xian Wang ◽  
Xiao-dong Ge ◽  
Dong Zhang ◽  
Hai-ling Chen ◽  
Qi-chuan Zhang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Diagnostic Accuracy ◽  
Multiple Logistic Regression Analysis ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Threshold Value ◽  
Arterial Phase ◽  
Multiple Logistic Regression ◽  
Scoring Model ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced

ObjectiveTo determine whether contrast-enhanced computed tomography (CT) can promote the identification of malignant and benign distal biliary strictures (DBSs) compared to the use of magnetic resonance cholangiopancreatography (MRCP) alone and to identify imaging findings of malignant DBSs.Materials and MethodsA total of 168 consecutive patients with confirmed DBSs were reviewed. MRCP alone and MRCP combined with CT images were blindly analyzed by two radiologists (e.g., stricture pattern, margins), and malignant or benign DBSs were identified based on surgical findings, endoscopy findings, or follow-up. The diagnostic accuracy of the two reviewers using MRCP alone and MRCP combined with CT were evaluated. MRCP and CT features of malignant and benign DBSs were compared using multiple logistic regression analysis to identify independent malignant risk factors.ResultsMRCP combined with CT examination could improve the diagnostic accuracy, which increased from 70.2% to 81.5% in Doctor A and from 85.1% to 89.3% in Doctor B. The multiple logistic regression model revealed that stricture length [odds ratio (OR) 1.070, P=0.016], angle of the DBS (OR 1.061, P&lt;0.001), double duct sign (OR 4.312, P=0.003) and low density in the arterial phase (OR 0.319, P=0.018) were associated with malignant DBS. A scoring model incorporating these four factors was established; at a threshold value of 1.75, and the sensitivity and specificity for the detection of malignant DBSs were 73.5 and 85.9%, respectively.ConclusionsCompared to the use of MRCP alone, MRCP combined with contrast-enhanced CT can improve the accuracy of DBS diagnosis. The scoring model accurately predicts malignant DBSs and helps make treatment decisions.

scholarly journals Analysis and Factors Associated with Measles in Larut, Matang and Selama Districts, Perak, Malaysia

2020 ◽  
Vol 27 (5) ◽  
pp. 130-140
Author(s):  
Asraf Ahmad Qamruddin ◽  
Reza Qamruddin ◽  
Ayu Malik
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Incidence Rate ◽  
Logistic Regression Analysis ◽  
Protective Factor ◽  
Multiple Logistic Regression Analysis ◽  
Prior History ◽  
Multiple Logistic Regression ◽  
Case Definitions ◽  
Factors Associated

Objectives: To determine the incidence rate of measles and the factors associated with confirmed measles cases in Larut, Matang and Selama districts. Methods: Cross-sectional analysis was carried out looking at all suspected and laboratoryconfirmed measles cases in Larut, Matang and Selama districts between 2015 and 2019. Multiple logistic regression analysis was used to determine the associated factors for laboratory-confirmed measles cases. Results: The incidence rate for suspected measles showed an increasing trend from 2015–2019. For laboratory-confirmed measles cases, the incidence rate showed more variation with an increase to 36.11 per million population in 2017 from 5.67 per million population in 2015. The incidence rate later decreased to 10.99 per million population in 2018 and increased again to 24.47 per million population in 2019. From multiple logistic regression analysis, cases that fulfilled the case definition of measles were more likely to be laboratory-confirmed measles. On the other hand, a prior history of measles immunisation was a protective factor. Conclusion: Measles incidence is increasing in trend. Any suspected measles cases that fulfilled the clinical case definitions need to be further investigated. Immunisation should be promoted as they are effective in preventing and eliminating measles.

scholarly journals Risk Factors of Atrial Arrhythmia in Patients With Liver Cirrhosis: A Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiya Lu ◽  
Zhijing Wang ◽  
Liu Yang ◽  
Changqing Yang ◽  
Meiyi Song
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Liver Cirrhosis ◽  
Retrospective Study ◽  
Logistic Regression Analysis ◽  
Multiple Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Clinical Information ◽  
Atrial Arrhythmia

Background and Objectives: Liver cirrhosis is known to be associated with atrial arrhythmia. However, the risk factors for atrial arrhythmia in patients with liver cirrhosis remain unclear. This retrospective study aimed to investigate the risk factors for atrial arrhythmia in patients with liver cirrhosis.Methods: In the present study, we collected data from 135 patients with liver cirrhosis who were admitted to the Department of Gastroenterology at Shanghai Tongji Hospital. We examined the clinical information recorded, with the aim of identifying the risk factors for atrial arrhythmia in patients with liver cirrhosis. Multiple logistic regression analysis was used to screen for significant factors differentiating liver cirrhosis patients with atrial arrhythmia from those without atrial arrhythmia.Results: The data showed that there were seven significantly different factors that distinguished the group with atrial arrhythmia from the group without atrial arrhythmia. The seven factors were age, white blood cell count (WBC), albumin (ALB), serum Na+, B-type natriuretic peptide (BNP), ascites, and Child-Pugh score. The results of multivariate logistic regression analysis suggested that age (β = 0.094, OR = 1.098, 95% CI 1.039–1.161, P = 0.001) and ascites (β =1.354, OR = 3.874, 95% CI 1.202–12.483, P = 0.023) were significantly associated with atrial arrhythmia.Conclusion: In the present study, age and ascites were confirmed to be risk factors associated with atrial arrhythmia in patients with liver cirrhosis.

scholarly journals SAT-564 Effectiveness of Treatment with Mineralocorticoid Receptor Antagonistsin Primary Aldosteronism

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Yuta Tezuka ◽  
Adina Turcu
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Primary Aldosteronism ◽  
Odds Ratio ◽  
Mineralocorticoid Receptor ◽  
Beta Blockers ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Low Renin Hypertension

Abstract Background: Medical treatment with mineralocorticoid receptor antagonists (MRAs) is preferred for patients with primary aldosteronism (PA) who are not surgical candidates. Adequate mineralocorticoid receptor blockade, as suggested by renin elevation above suppression levels, has been associated with lower rates of cardiovascular and renal complications as compared with PA with sustained renin suppression. Objectives: To assess the timeline and rates of achieving target renin levels in patients with PA and low renin hypertension treated with MRAs. Patients and Methods: We conducted a retrospective cohort study of adult patients with hypertension who were treated with MRAs in an academic center between 2003-2019. Of these, we included patients who had suppressed renin at baseline, and repeated renin measurement(s) during MRAs therapy. Renin suppression was defined as plasma renin activity (PRA) 1.0 ng/mL/h or direct renin concentration (DRC) 8.0 pg/mL. We excluded patients with adrenal cancer, end-stage renal disease, exogenous glucocorticoids, and critically ill. Mann-Whitney test, Wilcoxon signed rank test, Chi-Square test and multiple logistic regression analysis were employed, as appropriate. Results: So far, 89 patients (45 men), median age 56 (range, 19-84), have been included. Of these, 46% had confirmed PA; 25% had positive PA screening, but no confirmatory tests; and 29% had other forms of low-renin hypertension. On average, patients were on 2.9 1.6 antihypertensive agents; 62% of patients were prescribed beta blockers, and 38% were on K+ supplements. Overall, renin (PRA in 69 cases, and DRC in 20 cases) increased after MRA treatment (from 0.40 [0.10, 0.60] ng/mL/h to 1.10 [0.60, 2.23] ng/mL/h; and from 2.1 [2.1, 3.7] pg/mL to 5.7 [2.9, 16.7] pg/mL, respectively, p&lt;0.0001 for both). The cumulative proportions of patients in whom renin reached target levels during MRA treatment were: 25% at 2 weeks; 38.9% at 1 month; 34.2% at 3 months; 39.5% at 6 months; and 47.2% at 1 year. Age, sex, race, blood pressure, use of beta blockers, renal function, serum K+ and aldosterone concentrations were similar between patients with target vs. suppressed renin. Multiple logistic regression analysis suggested that after adjusting for age and sex, higher MRA dose and higher BMI were associated with higher likelihood of achieving target renin during MRA therapy (odds ratio (95%CI): 1.021 (1.001-1.041) and 1.097 (1.008-1.193), respectively, p&lt;0.05 for both); conversely, beta blockers use tended to be less often associated with target renin (odds ratio, 0.37 (0.13-1.008), p=0.052). Conclusion: Although raising renin above suppression levels is important for reducing the cardiovascular risk associated with PA, this goal is achieved in less than half of patients, even after one year of treatment with MRAs, in an academic setting. Strategies for optimizing PA treatment are critically needed.

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