scholarly journals Cognitive Ability as a Non-modifiable Risk Factor for Post-prostatectomy Urinary Incontinence: A Double-Blinded, Prospective, Single-Center Trial

2022 ◽  
Vol 8 ◽  
Author(s):  
Mathias Reichert ◽  
Ionel Valentin Popeneciu ◽  
Annemarie Uhlig ◽  
Lutz Trojan ◽  
Mirjam Naomi Mohr
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Urinary Incontinence ◽  
Cognitive Ability ◽  
Modifiable Risk Factor ◽  
Postoperative Phase ◽  
Single Center ◽  
Multivariate Logistic Regression ◽  
Patient Side ◽  
Double Blinded

Introduction: Urinary incontinence (UI) is a wide-spread and feared side-effect of conventional or even robot-assisted laparoscopic prostatectomy (RALP) due to its high impact on patients' quality of life (QoL). Non-modifiable risk factors for UI have already been identified – on surgical and patient side. Yet, to our knowledge, focus thus far has not been placed on functional aspects regarding general cognitive ability.Materials and Methods: This is an observational single-center, prospective, double-blinded evaluation of 109 RALPs performed between 07/2020 and 03/2021. All patients underwent a Mini Mental State Examination (MMSE) prior to surgery to evaluate their cognitive ability. Early post-prostatectomy incontinence (PPI) was evaluated using a standardized 1 h pad test performed 24 h after removal of the urinary catheter. The association between MMSE results and PPI were evaluated using univariate and multivariate logistic regression models.Results: Multivariate logistic regression analyses identified MMSE results and nerve sparing (NS) as independent predictors for PPI in patients with an intermediate MMSE result (25–27 points) having a 3.17 times higher risk of PPI when compared to patients with a good MMSE result (≥28) (95% Confidence Interval (CI): 1.22–9.06, p = 0.023), while patients without NS had a 3.53 times higher risk of PPI when compared to patients with NS (95% CI: 1.54–11.09, p = 0.006).Conclusion: A lower cognitive ability should be treated as a non-modifiable risk-factor for early PPI. In the future it could find its place as a clinical screening tool to identify patients who require more attention especially in the pre-, but also in the postoperative phase.

Preoperative Circulating MiR-210, a Risk Factor for Postoperative Delirium Among Elderly Patients with Gastric Cancer Undergoing Curative Resection

2020 ◽  
Vol 26 (40) ◽  
pp. 5213-5219
Author(s):  
Yun Chen ◽  
Jinwei Zheng ◽  
Junping Chen
Keyword(s):  
Gastric Cancer ◽  
Logistic Regression ◽  
Risk Factor ◽  
Elderly Patients ◽  
Curative Resection ◽  
Postoperative Delirium ◽  
Area Under The Curve ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Clinicopathologic Characteristics

Background: Postoperative delirium (POD) is a very common complication in elderly patients with gastric cancer (GC) and associated with poor prognosis. MicroRNAs (miRNAs) serve as key post-transcriptional regulators of gene expression via targeting mRNAs and play important roles in the nervous system. This study aimed to investigate the potential predictive role of miRNAs for POD. Methods: Elderly GC patients who were scheduled to undergo elective curative resection were consequently enrolled in this study. POD was assessed at 1 day before surgery and 1-7 days after surgery following the guidance of the 5th edition of Diagnostic and Statistical Manual of Mental Disorders (DSM V, 2013). The demographics, clinicopathologic characteristics and preoperative circulating miRNAs by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) were compared between patients with or without POD. Risk factors for POD were assessed via univariate and multivariate logistic regression analyses. Results: A total of 370 participants were enrolled, of which 63 had suffered from POD within postoperative 7 days with an incidence of 17.0%. Preoperative miR-210 was a predictor for POD with an area under the curve (AUC) of 0.921, a cut-off value of 1.67, a sensitivity of 95.11%, and a specificity of 92.06%, (P<0.001). In the multivariate logistic regression model, the relative expression of serum miR-210 was an independent risk factor for POD (OR: 3.37, 95%CI: 1.98–5.87, P=0.003). Conclusions: In conclusion, the present study highlighted that preoperative miR-210 could serve as a potential predictor for POD in elderly GC patients undergoing curative resection.

scholarly journals Endocan, a Risk Factor for Developing Acute Respiratory Distress Syndrome among Severe Pneumonia Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Jun Ying ◽  
Danfei Zhou ◽  
Tongjie Gu ◽  
Jianda Huang
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Factor ◽  
Acute Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Multivariate Logistic Regression Analysis ◽  
Severe Pneumonia ◽  
Curve Analysis ◽  
Multivariate Logistic Regression ◽  
Roc Curve Analysis

Background. Severe pneumonia (SP) has been widely accepted as a major cause for acute respiratory distress syndrome (ARDS), and the development of ARDS is significantly associated with increased mortality. This study aimed to identify potential predictors for ARDS development in patients with SP. Methods. Eligible SP patients at admission from January 2013 to June 2017 were prospectively enrolled, and ARDS development within hospital stay was identified. Risk factors for ARDS development in SP patients were analyzed by univariate and multivariate logistic regression analysis. The receiver operating characteristic (ROC) curve analysis with the area under the curve (AUC) was performed for the predictive value of endocan for ARDS development. Results. A total of 145 SP patients were eventually enrolled into the final analysis, of which 37 developed ARDS during the hospital stay. Our final multivariate logistic regression analysis suggested plasma endocan expression as the only independent risk factor for ARDS development in SP patients (OR: 1.57, 95% CI: 1.14–2.25, P=0.021). ROC curve analysis of plasma endocan resulted in an AUC of 0.754, 95% CI of 0.642–0.866, a cutoff value of 11.6 ng/mL, a sensitivity of 78.7%, and a specificity of 70.3%, respectively (P<0.01). Conclusions. Endocan expression at ICU admission is a reliable predictive factor in predicting ARDS in patients with SP.

scholarly journals RELATIONSHIP BETWEEN CIGARETTE SMOKING AND NASOPHARYNGEAL CARCINOMA

2019 ◽  
Vol 1 (1) ◽  
pp. 17-23
Author(s):  
Ibrahim Irsan Nasution ◽  
Ramsi Lutan ◽  
Delfitri Munir ◽  
Arlinda Sari Wahyuni
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Factor ◽  
Nasopharyngeal Carcinoma ◽  
Cigarette Smoking ◽  
Logistic Regression Analysis ◽  
Significant Relationship ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Salted Fish

Introduciton Since then the pathogenesis of NPC has been intensively studied, specifically aimed at geography and racial variation. In recent years many environmental and biological factors have shown a risky relationship to the occurrence of NPC and the latest research results indicate the role of genetic and viral factors in the development of this disease Objectives Etiology of nasopharyngeal cancer (NPC) is multifactorial, and many of these factors overlap where one factor may occur together with other elements as a cause. Cigarette smoking is thought to also play a role in the development of NPC.   Methods The study design was in case of control with an analytical approach during February-October 2007.  To find out the relationship between Cigarette smoking NPC, a case-control study was conducted, with a sample of 96 patients with NPC as case and 96 people as a control. Case group and control samples were taken from RSUP H. Adam Malik Medan and RSU Dr. Pirngadi Medan.  Results The majority of NPC patients are: Men (compared with women 2.84: 1), 50-59 years (29.2%), and farming (32.3%). The Batak ethnic is the largest ethnic group suffering from NPC 54 people (56.3%) and followed in the second place the most are Javanese (29.2%). The most histopathological type is WHO type 3 (38.6%). Most stages were III (58.4%), followed by stage IV (40.6%), stage II (1%), and there was none of stage I.In univariate logistic regression showed a significant relationship between smokers with consumption of cigarettes 11-20 cigarettes per day with OR=2.530 (p=0.021) with the occurrence of NPC. However, in the multivariate logistic regression analysis, the number of cigarettes per day did not show a significant relationship (p=0.587). The results of multivariate logistic regression analysis, nasopharyngeal carcinoma were significantly associated with people who had started smoking before the age of 20 years (p=0.000; OR 5.35 and CI 95% 2.290-12.499), consuming habits of salted fish before 10 years of age with sometimes frequency  consumption of  salted  fish  p=0.000;   OR  7.766  (95% CI 2.937-20.538), often p=0.000; OR 16.515 (95% CI 5.3000-51.463), and the habit of using firewood p=0.014; OR 3.147 (95% CI 1.260-7.860). There was no significant relationship between the duration of cigarette smoking (p=0.293), a number of cigarettes (p=0.021) and the types of cigarettes smoked (p=0.081) with the incidence of NPC. Conclusion Cigarette smoking as a risk factor for NPC cannot act stand-alone as a risk factor, but there is a role for other factors that also influence as a risk factor.

scholarly journals Predictive Factors of Chronic Post-Surgical Pain at 6 Months Following Knee Replacement: Influence of Postoperative Pain Trajectory and Genetics

2016 ◽  
Vol 5;19 (5;19) ◽  
pp. E729-E741
Author(s):  
Dr Célia Lloret-Linares
Keyword(s):  
Logistic Regression ◽  
Postoperative Pain ◽  
Knee Replacement ◽  
Predictive Factors ◽  
High Intensity ◽  
Walking Ability ◽  
Single Center ◽  
Multivariate Logistic Regression ◽  
Postsurgical Pain ◽  
Chronic Postsurgical Pain

Background: The frequency of chronic postsurgical pain (CPSP) after knee replacement remains high, but might be decreased by improvements to prevention. Objectives: To identify pre- and postsurgical factors predictive of CPSP 6 months after knee replacement. Study Design: Single-center prospective observational study. Setting: An orthopedic unit in a French hospital. Methods: Consecutive patients referred for total or unicompartmental knee arthroplasty from March to July 2013 were prospectively invited to participate in this study. For each patient, we recorded preoperative pain intensity, anxiety and depression levels, and sensitivity and pain thresholds in response to an electrical stimulus. We analyzed OPRM1 and COMT single-nucleotide polymorphisms. Acute postoperative pain (APOP) in the first 5 days after surgery was modeled by a pain trajectory. Changes in the characteristics and consequences of the pain were monitored 3 and 6 months after surgery. Bivariate analysis and multivariate logistic regression were conducted to identify predictors of CPSP. Results: We prospectively evaluated 104 patients in this study, 74 (28.8%) of whom reported CPSP at 6 months. Three preoperative factors were found to be associated with the presence of CPSP in multivariate logistic regression analysis: high school diploma level (OR = 3.83 [1.20 – 12.20]), consequences of pain in terms of walking ability, as assessed with the Brief Pain Inventory short form “walk” item (OR = 4.06 [1.18 – 13.94]), and a lack of physical activity in adulthood (OR = 4.01 [1.33 – 12.10]). One postoperative factor was associated with the presence of CPSP: a high-intensity APOP trajectory. An association of borderline statistical significance was found with the A allele of the COMT gene (OR = 3.4 [0.93 – 12.51]). Two groups of patients were identified on the basis of their APOP trajectory: high (n = 28, 26%) or low (n = 80, 74%) intensity. Patients with high-intensity APOP trajectory had higher anxiety levels and were less able to walk before surgery (P < 0.05). Limitations: This was a single-center study and the sample may have been too small for the detection of some factors predictive of CPSP or to highlight the role of genetic factors. Conclusion: Our findings suggest that several preoperative and postoperative characteristics could be used to facilitate the identification of patients at high risk of CPSP after knee surgery. All therapeutic strategies decreasing APOP, such as anxiety management or performing knee replacement before the pain has a serious effect on ability to walk, may help to decrease the risk of CPSP. Further prospective studies testing specific management practices, including a training program before surgery, are required. Key words: Chronic postsurgical pain, opioids, arthroplasty, pain trajectory, genetics, COMT, predictive factors

0899 Long-term Effects Of Adenotonsillectomy In Children Diagnosed With Obstructive Sleep Apnea On Risk Factors For Cardiovascular Morbidity

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A342-A342
Author(s):  
J Even Tsur ◽  
R Auhasira ◽  
A Shiloh ◽  
V Novack ◽  
A Goldbart
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Obstructive Sleep Apnea ◽  
Logistic Regression ◽  
Risk Factor ◽  
Cardiovascular Morbidity ◽  
Long Term Effects ◽  
Multivariate Logistic Regression ◽  
Obstructive Sleep

Abstract Introduction Obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular morbidity in adults. In children, cardiovascular morbidity associated with OSA is usually thought to resolve after tonsillectomy and adenoidectomy (T&A). There is no information regarding the long term effects of T&A on future cardiovascular morbidity in children diagnosed with OSA. In this study, we performed data mining to assess long-term effects of adenotonsillectomy on risk factors for cardiovascular disease, in young adults. Methods This study retrospectively investigated the population defined by a previous study in our institution [Tarasiuk etal Pediatrics 2004] and compared a group of children diagnosed with OSA and underwent T&A(n=130) to a group of children diagnosed with OSA that did not undergo T&A(n=90) to a control group without OSA (n=505). Demographic data, vital signs, anthropometric measurements, medical diagnoses (9th revision (ICD-9) codes) and medication purchases were captured from the HMO computerized database, between the years 1998-2018. When appropriate, univariate comparisons were made using χ 2-test or Fisher’s exact test for categorical variables, and one-way ANOVA or Kruskal-Wallis tests for quantitative variables. We performed multivariate logistic regression to model the factors associated with the diagnosis of obesity. IBM SPSS software, version 25.0, was used for statistical analysis. Results We have found that 20 years after their OSA diagnosis, patients (25.1 years, 52.2% males, 26.2 BMI) who were diagnosed with OSA at age 5 and did not undergo T&A consumed more medications associated with cardiovascular morbidity (anti-hypertensive, statins, aspirin) than those who underwent T&A(P&lt;0.001). Surprisingly, multivariate logistic regression revealed that only females diagnosed with OSA (with or without T&A) were diagnosed as obese in comparison to those that did not have OSA (P&lt;0.001). Conclusion Children who were diagnosed with OSA and were not operated will consume more medications (anti-hypertensive, anti-hyperlipidemia, aspirin) as young adults, a surrogate marker for early cardiovascular disease. OSA in girls seems to serve as a risk factor for obesity in their third decade of life. It is important to diagnose and treat OSA in children, and to monitor and prevent obesity, mainly in females. Support Israel Science Foundation (ISF) 1344/15

The Association Between Influenza Infection Rates and the Incidence of Orofacial Clefts in the United States

FACE ◽  
2020 ◽  
pp. 273250162097303
Author(s):  
Kyle Dymanus ◽  
Taylor Chishom ◽  
Jason Moraczewski ◽  
William Carroll ◽  
Maria Lima ◽  
...  
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Risk Factor ◽  
Influenza Infection ◽  
The United States ◽  
Modifiable Risk Factor ◽  
Protective Effects ◽  
Orofacial Clefts ◽  
Online Data ◽  
Increased Risk

Objective: To investigate seasonal variation of orofacial clefts (OC) and measure association between United States (U.S.) influenza incidences and OC development for the purpose of identifying a potential modifiable risk factor for pregnant women. Design: Retrospective population-based observational study from 2004 to 2013. Setting: National Inpatient Sample Database (NIS), Wide-ranging Online Data for Epidemiologic Research (WONDER) Database, and National Respiratory and Enteric Virus Surveillance System’s (NRVESS) FluView database. Patients: U.S.-born infants with OC from 2004 to 2013 and monthly influenza incidence from 2003 to 2013. Main outcome measures: Using logistic regression, monthly odds ratios (OR) of OC were derived using January as baseline. Mixed-effects logistic regression was utilized to test association between national influenza and OC incidences. Results: There were 58 270 U.S. babies born with OC from 2004 to 2013. September births had the highest OC association (OR = 1.094, 95% CI = 1.051-1.138, E-value = 1.41), followed by June. For each additional influenza case per 1000 people, odds of OC event occurring during the 2nd month of pregnancy, or 7 months before delivery, was increased by 2.7 (OR = 2.659, CI = 1.456-4.856, E-value = 4.76). Odds of OC event occurring was decreased at the 3rd month of pregnancy, or 6 months before delivery by 7.8 (OR = 0.129, 95% CI = 0.068-0.246, E-value = 14.99). Conclusion: September and June births have the highest OC association. There is increased risk for OC with influenza occurring at the 2nd pregnancy month. Conversely, there are protective effects against OC with influenza occurring at the 3rd pregnancy month. These findings demonstrate an association between influenza rate and OC, suggesting a connection between maternal immune activation (mIA) and OC. Although further research is needed to determine the definitive link between the use of flu vaccines and OC occurrence, as well as the mechanism behind mIA secondary to influenza infection impacting OC incidence, this study presents a modifiable risk factor that could decrease the potential for mIA causing OC.

Postoperative Serum Albumin Decrease Independently Predicts Delirium in the Elderly Subjects after Total Joint Arthroplasty

2020 ◽  
Vol 26 (3) ◽  
pp. 386-394 ◽  
Author(s):  
Jianmin Qi ◽  
Cheng Liu ◽  
Li'an Chen ◽  
Junping Chen
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Total Joint Arthroplasty ◽  
Independent Risk Factor ◽  
Area Under The Curve ◽  
Joint Arthroplasty ◽  
Elderly Subjects ◽  
Regression Analyses ◽  
Multivariate Logistic Regression ◽  
Roc Curve Analysis

Background: Postoperative delirium (POD), a neurobehavioral syndrome induced by dysfunction of neural activity, is a common and serious complication. This current study aimed to investigate independent predictors for POD in elderly subjects after total joint arthroplasty (TJA). Methods: Eligible elderly patients (≥65 years) who underwent elective unilateral primary hip or knee arthroplasty under epidural anesthesia from October 2016 to January 2019 were consecutively enrolled. POD was diagnosed following the guidance of the 5th edition of Diagnostic and Statistical Manual of Mental Disorders, (DSM V, 2013). The relative change in serum Alb (ΔAlb) was defined as the absolute value of (preoperative Alb value– nadir value within postoperative day 2)/preoperative Alb ×100%. The predictive value of ΔAlb for POD was evaluated by receiver operating characteristic (ROC) curve analysis. Univariate and multivariate logistic regression analyses were used for evaluating risk factors for POD. Results: A total of 328 patients were enrolled in the analysis, of which 68 (20.7%, 68/328) patients developed POD within postoperative 7 days. ΔAlb was an effective predictor for POD with an area under the curve (AUC) of 0.821, a sensitivity of 76.15% and a specificity of 70.59%, respectively (P<0.001). Univariate and multivariate logistic regression analyses indicated that ΔAlb was the only independent risk factor for POD (OR: 2.43, 95%CI: 1.17–4.86, P=0.015). Conclusions: ΔAlb was an independent risk factor for POD in elderly subjects after TJA.

scholarly journals Delayed diagnosis of critical congenital heart defects predicting risk factors and survival rate in newborns in Beijing: a retrospective study

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110280
Author(s):  
Wen Zhang ◽  
Hong-Yan Xu ◽  
Yan-Chun Zhang ◽  
Kai-Bo Liu
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Factor ◽  
Retrospective Study ◽  
Congenital Heart ◽  
Heart Defects ◽  
Delayed Diagnosis ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression

Objective To assess the prevalence and survival rate of newborns with a delayed diagnosis of critical congenital heart defects (CCHD) in Beijing. Methods This retrospective study analysed data from births between 2010 and 2017 from the Birth Defects Monitoring Network in Beijing. Newborns with CCHD were analysed according to seven categories. Statistical analyses were used to calculate the mortality rate within the first week (days 0–6) after live birth. Multivariate logistic regression analysis of survival was performed to analyse the potential risk factors for newborn mortality. Results A total of 1 773 935 perinatal newborns were screened in Beijing and 1851 newborns were diagnosed with CCHD, showing a prevalence of 10.43 per 10 000. Among the total 1851 CCHD patients, the majority (1692 of 1851; 91.41%) were identified through prenatal diagnosis, 104 of 1851 (5.62%) were diagnosed before obstetric discharge/transfer and 55 of 1851 (2.97%) were identified through delayed diagnosis. The prevalence of CCHD in newborns was 1.96 per 10 000 births. Multivariate logistic regression analysis of survival demonstrated that gestational age at delivery was the only risk factor for death within the first week after birth. Conclusions Within the first week after birth, gestational age was the only risk factor for death in newborns with CCHD.

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