Turbinate Submucosal Reduction Operation Reduced Migraine Admission among Patients with Chronic Hypertrophic Rhinitis

Rhinitis increases migraine risk. Chronic hypertrophic rhinitis can be treated with turbinate submucosal reduction operation. The relationship between migraine and chronic hypertrophic rhinitis after turbinate submucosal reduction operation is still unclear. The goal of this study was to evaluate the correlation between turbinate submucosal reduction operation and subsequent migraine admission in Asian chronic hypertrophic rhinitis patients. We identified patients suffering from chronic hypertrophic rhinitis and receiving turbinate submucosal reduction operation. The control group was selected from patients with chronic hypertrophic rhinitis without operation. The event was migraine admission. The risk factors of migraine admission were established using multivariate Cox proportional hazard regression. The risk of migraine admission after turbinate submucosal reduction operation is represented by a hazard ratio (HR) of 0.858 (95% confidence interval (CI): 0.633–0.962). The higher risk of migraine included depression with HR 4.348 (95% CI: 2.826–6.69), anxiety with HR 3.75 (95% CI: 2.267–6.203), fibromyalgia with HR of 7.326 (95% CI: 3.427–15.661), and asthma with HR 1.969 (95% CI: 1.11–3.491). Our study revealed that turbinate submucosal reduction operation led to a 14.2% reduction in migraine admission. Clinicians should understand the benefit of turbinate submucosal reduction operation and provide suitable treatments for comorbid conditions. Further prospective studies are required to confirm our findings.

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Association of Dementia-Related Psychosis With Long-term Care Use and Death

Neurology ◽

10.1212/wnl.0000000000011632 ◽

2021 ◽

Vol 96 (12) ◽

pp. e1620-e1631

Author(s):

James B. Wetmore ◽

Yi Peng ◽

Heng Yan ◽

Suying Li ◽

Muna Irfan ◽

...

Keyword(s):

Long Term Care ◽

Fold Increase ◽

Proportional Hazard ◽

Comorbid Conditions ◽

Term Care ◽

Risk Of Death ◽

Cox Proportional Hazard ◽

Increased Risk ◽

Cox Proportional Hazard Regression

ObjectiveTo determine the association of dementia-related psychosis (DRP) with death and use of long-term care (LTC); we hypothesized that DRP would be associated with increased risk of death and use of LTC in patients with dementia.MethodsA retrospective cohort study was performed. Medicare claims from 2008 to 2016 were used to define cohorts of patients with dementia and DRP. Outcomes were LTC, defined as nursing home stays of >100 consecutive days, and death. Patients with DRP were directly matched to patients with dementia without psychosis by age, sex, race, number of comorbid conditions, and dementia index year. Association of DRP with outcomes was evaluated using a Cox proportional hazard regression model.ResultsWe identified 256,408 patients with dementia. Within 2 years after the dementia index date, 13.9% of patients developed DRP and 31.9% had died. Corresponding estimates at 5 years were 25.5% and 64.0%. Mean age differed little between those who developed DRP (83.8 ± 7.9 years) and those who did not (83.1 ± 8.7 years). Patients with DRP were slightly more likely to be female (71.0% vs 68.3%) and white (85.7% vs 82.0%). Within 2 years of developing DRP, 16.1% entered LTC and 52.0% died; corresponding percentages for patients without DRP were 8.4% and 30.0%, respectively. In the matched cohort, DRP was associated with greater risk of LTC (hazard ratio [HR] 2.36, 2.29–2.44) and death (HR 2.06, 2.02–2.10).ConclusionsDRP was associated with a more than doubling in the risk of death and a nearly 2.5-fold increase in risk of the need for LTC.

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The elevated risk of sight-threatening cataract in diabetes with retinopathy: a retrospective population-based cohort study

BMC Ophthalmology ◽

10.1186/s12886-021-02114-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chan-Wei Nien ◽

Chia-Yi Lee ◽

Hung-Chi Chen ◽

Shih-Chun Chao ◽

Hung-Jui Hsu ◽

...

Keyword(s):

Cataract Surgery ◽

Multivariable Analysis ◽

Population Based ◽

Cumulative Probability ◽

Control Group ◽

Study Group ◽

Research Database ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Cox Proportional Hazard Regression

Abstract Background The effect of diabetic retinopathy (DR) on the development of sight-threatening cataracts was assessed using the National Health Insurance Research Database of Taiwan. Methods Patients diagnosed with diabetes mellitus (DM) and DR were enrolled in the study group. Age- and sex-matched DM individuals without DR and patients without DM served as the DM control group and non-DM control group, respectively, both with 1:4 ratios. The outcome was set as the performance of cataract surgery. Cox proportional hazard regression was used to calculate the adjusted hazard ratio (aHR) of DR considering multiple factors underlying cataract formation. Results A total of 3297 DR patients, 13,188 DM control patients and 13,188 non-DM control subjects were enrolled. The study group included 919 events of sight-threatening cataracts (27.87%), the DM control group included 1108 events (8.40%), and the non-DM control group included 957 events (7.26%). A multivariable analysis indicated that the study group presented a higher aHR of cataract surgery (2.93, 95% CI: 2.60–3.30) and a higher cumulative probability of cataract surgery than both the DM control and non-DM control groups (both log rank P < 0.001). In addition, both the proliferative DR (3.90, 95% CI: 3.42–4.45) and nonproliferative DR (2.35, 95% CI: 2.08–2.65) subgroups showed a higher aHR of cataract surgery than the DM control group. Conclusion The presence of DR increases the risk of sight-threatening cataracts that warrant surgery, and the effect is prominent among patients with both proliferative DR and nonproliferative DR.

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CMTM6 significantly relates to PD-L1 and predicts the prognosis of gastric cancer patients

PeerJ ◽

10.7717/peerj.9536 ◽

2020 ◽

Vol 8 ◽

pp. e9536

Author(s):

Xin Li ◽

Ling Chen ◽

Chuan Gu ◽

Qiaoli Sun ◽

Jia Li

Keyword(s):

Gastric Cancer ◽

Prognostic Indicator ◽

Proportional Hazard ◽

Regression Analyses ◽

Multivariate Logistic Regression ◽

Related Factors ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Cox Proportional Hazard Regression ◽

The Relationship

Background The CKLF-like MARVEL transmembrane domain containing 6 (CMTM6) is a key regulator of the programed death receptor ligand-1 (PD-L1) protein. However, the usefulness of CMTM6 expression as a prognostic indicator and the relationship between CMTM6 and PD-L1 expression in gastric cancer (GC) remains unclear. Objectives We evaluated the expression and prognostic implications of CMTM6 in GC tissue and its relationship with PD-L1 expression. Patients and methods The protein expressions of CMTM6 and PD-L1 were detected in 122 cases of postoperative GC tissue using immunohistochemical (IHC) assays. Kaplan–Meier survival analysis was used to calculate the survival probability and a log-rank test was used to compare the survival curves. Univariate and multivariate Cox proportional hazard regression analyses were used to evaluate the clinically-related factors associated with survival. Pearson’s correlation was used to determine the correlation analysis and estimate the statistical significance. The univariate and multivariate logistic regression analyses were used to analyze the relationship between clinically-related factors and PD-L1 expression. Results Kaplan–Meier survival analysis showed that patients with high CMTM6 expression had shorter overall survival (OS) than those with low expression (P < 0.001). The expression of CMTM6 was an independent risk factor for prognosis in multivariate Cox proportional hazard regression analyses (HR:2.221, CI% [1.36–3.628], P = 0.001). The OS of patients with positively expressed PD-L1 was significantly shorter than those with negatively expressed PD-L1 (P = 0.003). The expression of CMTM6 was significantly related to the positive expression of PD-L1 in gastric cancer tissues (r = 0.186, P = 0.041). The expression of CMTM6 was the independent risk factor for PD-L1 expression in multivariate logistic regression analysis (OR:2.538, CI% [1.128–5.714], P = 0.024). Conclusion CMTM6 expression is significantly related to PD-L1 and may be a useful prognostic indicator and a specific therapeutic target for cancer immunotherapy for GC patients.

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P0411PREDICTORS OF RENAL AND PATIENT OUTCOME IN PATIENTS WITH IDIOPATHIC MEMBRANOUS NEPHROPATHY: FROM KOGNET DATA

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0411 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Ji-Young Choi ◽

Ji Hye Kim ◽

Ga Young Lee ◽

Hee Won Noh ◽

Soojee Jeon ◽

...

Keyword(s):

Risk Factors ◽

Patient Outcome ◽

Serum Albumin ◽

Serum Albumin Level ◽

Patient Survival ◽

Albumin Level ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Cox Proportional Hazard Regression

Abstract Background and Aims Idiopathic membranous nephropathy (iMN) is a leading cause of nephrotic syndrome and one of the major causes of end-stage renal disease (ESRD). Various factors can affect renal and patient outcome in patients with iMN. In this study, we analyzed the predictors of renal and patient survival in patients with iMN. Method We analyzed 1,776 patients diagnosed with iMN in Korean GlomeruloNEphritis STudy (KoGNET), a retrospective database of patients with renal biopsy from 1979 to 2018 from 18 centers in Korea. Student t-test for continuous variables and Chi-square test for categorical variables were performed for analyses. Cox proportional hazard regression was used to determine risk factors affecting renal and patient survival. Results The mean age of patients was 53.0 ± 14.7 years old and 1,075 (60.5%) were male. At the time of renal biopsy, 755 (46.0%) and 266 (16.2%) had hypertension and diabetes, respectively. Serum albumin level was 2.7 ± 0.8 g/dL and 871 (49.0%) had nephrotic range of proteinuria. When analyzed by dividing over 65 and under, the hemoglobin and serum albumin level were lower, more patients showed nephrotic ranged proteinuria, and higher prevalence of comorbidities such as hypertension, diabetes, coronary heart disease and cerebrovascular disease in the group over 65 than in the group under 65. Median duration of follow-up was 88.0 (38.0 – 115.1) months. Complete or partial remission rates were 48.5%, 63.8%, and 68.0% at 6 months, 12months after biopsy, and last follow-up, respectively. In Cox proportional hazard regression, high hemoglobin [HR 0.66 (0.47 – 0.93), p=0.017], high serum albumin level [HR 0.41 (0.18 – 0.94), p=0.034], and high estimated GFR by CKD-EPI equation [HR 0.94 (0.91 – 0.96), p<0.001] at biopsy were good predictors for renal outcome, whereas presence of cerebrovascular disease at biopsy [HR 6.45 (1.16 – 35.71), p=0.033] were poor prognostic factors for ESRD. Age 65 and older [HR 3.26 (1.53 – 6.95), p=0.002] and presence of hypertension at biopsy [HR 2.45 (1.09 – 5.54), p=0.031] were significant risk factors for patient survival in multivariate Cox proportional regression analysis. Conclusion High hemoglobin and serum albumin, and good renal function at biopsy were good predictors for renal survival. Older age and hypertension at biopsy were poor prognostic factors for patient survival in iMN patients. Prognostic information of outcomes in this study might be helpful to optimize management in iMN patients.

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Abstract TP186: Incidence and Risk Factors for Stroke and All-Cause Mortality in Korean Adults Congenital Heart Diseases

Stroke ◽

10.1161/str.51.suppl_1.tp186 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Jin-Man Jung ◽

Hong Ju Shin ◽

Jae-Young Kim ◽

Woo-Keun Seo

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Ischemic Stroke ◽

Hemorrhagic Stroke ◽

Heart Diseases ◽

Multivariable Analysis ◽

Control Group ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

All Cause Mortality

Objective: To compare incidence of ischemic stroke, hemorrhagic stroke and all-cause mortality in Korean adults congenital heart disease (ACHD) to that of control and scrutinize risk factors for these outcomes. Methods: Subjects aged over 20 were collected from the Korea National Health Insurance Service from 2006 through 2017. ACHD group as case was extracted from the diagnosis records related to CHD according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD 10). Those without CHD (control group) was selected as 4 controls for each patient through random sampling. We compared incidence rate of ischemic stroke, hemorrhagic stroke and all-cause mortality. Cox proportional hazard models were used to investigate relevant risk factors for each of outcomes. Results: Case and control group were 49,445 and 249,649, respectively. Age-adjusted rates of ischemic stroke, hemorrhagic stroke and all-cause mortality in case was by about 4 times more higher than those of control. Cumulative survival plot demonstrated that ACHD was associated with ischemic stroke (HR 1.31 95% CI 1.25-1.36), hemorrhagic stroke (HR 1.49 95% CI 1.36-1.63), and all-cause mortality (HR 1.41 95% CI 1.35-1.46). Case group was associated with younger age, female, hypertension, diabetes mellitus, coronary artery disease, heart failure, atrial fibrillation (all p <.001). In Cox proportional hazard model for ischemic stroke, diabetes (HR 2.13 95% CI 1.93-2.35) and coararctation of aorta (HR 1.54 95% CI 1.13 - 2.09) carried highest risk. In multivariable analysis for hemorrhagic stroke, hypertension (HR 2.28 95% CI 1.74-2.98) was highest risk factor. Multivariable analysis for all-cause mortality showed that congestive heart failure (HR 1.78 95% CI 1.65-1.92) and Eisenmenger syndrome (HR 2.91 95% CI 2.53-3.35) was highest risk factor. Conclusions: Korean ACHD patients have significantly higher incidence of co-morbidities including hypertension, diabetes mellitus, several heart diseases. They have a higher tendency of ischemic, hemorrhagic stroke and mortality. These findings suggest that medical surveillance and risk factor management is sustainedly needed for ACHD patients to reduce stroke and mortality in the future.

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ANALISIS KETAHANAN HIDUP PENDERITA DENGUE HEMORRHAGIC FEVER (DEMAM BERDARAH) DENGAN REGRESI COX KEGAGALAN PROPORSIONAL (Studi Kasus : Rumah Sakit Islam Nahdlatul Ulama Demak)

Jurnal Gaussian ◽

10.14710/j.gauss.v10i3.32793 ◽

2021 ◽

Vol 10 (3) ◽

pp. 367-376

Author(s):

Putri Qodar Ummayah ◽

Sudarno Sudarno ◽

Budi Warsito

Keyword(s):

Survival Analysis ◽

Dengue Fever ◽

Dengue Hemorrhagic Fever ◽

Recovery Time ◽

Hemorrhagic Fever ◽

Proportional Hazard ◽

Hazard Regression ◽

Cox Proportional Hazard ◽

Cox Proportional Hazard Regression ◽

The Relationship

Dengue hemorrhagic fever is an acute febrile disease caused by the dengue virus, which enters the human bloodstream through the bite of a mosquito of the genus Aedes Aegypti or Aedes Albopictus. Based on World Health Organization (WHO) records, it is estimated that 500,000 dengue hemorrhagic fever patients require hospital treatment every year and most of the sufferers are children. To analyze the relationship between recovery time in dengue fever patients and the factors that influence it using regression analysis, the dependent variable is the failure time and the function of the response variable tends to fail constant so to find out the relationship using Cox proportional hazard regression. Cox proportional hazard regression is a regression model that is often used in survival analysis. Survival analysis is a method used to describe data analysis in terms of time from the time of origin defined until a certain event occurs. In this study, the recovery time of dengue fever patients as a function of failure is proportional. The observations used by the researchers for each patient were not the same. The population of this study were all patients with dengue fever. The data used was obtained from the medical record section for data on the length of hospitalization of patients regarding the recovery of patients with dengue fever. The conclusion of the research shows that the factors that affect the recovery time of dengue fever patients are hematocrit, platelets, immunoglobulin G, and immunoglobulin M.

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COVID-19 cases with delayed absorption of lung lesion

Open Medicine ◽

10.1515/med-2021-0265 ◽

2021 ◽

Vol 16 (1) ◽

pp. 692-695

Author(s):

BinBin Li ◽

WeiZhen Hu ◽

ChunMiao Bao

Keyword(s):

Confidence Interval ◽

Regression Model ◽

Proportional Hazard ◽

Rt Pcr ◽

Medical Expense ◽

Lung Lesions ◽

Cox Proportional Hazard ◽

Imported Cases ◽

Pulmonary Infiltration ◽

Cox Proportional Hazard Regression

Abstract Objective Over 90% of the COVID-19 patients with computed tomographic (CT) manifestations showed radiological improvement on dissipating stage. Cases with refractory pulmonary infiltration were discussed in this study. Methods During hospitalization, chest CT scan and reverse transcriptase polymerase chain reaction (RT-PCR) test were repeatedly performed. While drawing parallels to RT-PCR, the impact of delayed absorption of lung lesions on length of hospital stay (LOS) and medical expense was investigated. Features for delayed absorption of lung lesions were identified using cox proportional hazard regression model. Results Cases with delayed absorption of lung lesions had a prolonged LOS (18.00 ± 4.90 vs 9.25 ± 4.20, p < 0.01) and increased medical expense (9124.55 ± 2421.31 vs 4923.88 ± 2218.56, p < 0.01). Time interval from admission to a negative RT-PCR (ATN) was also prolonged (13.29 ± 4.72 vs 9.25 ± 4.20, p = 0.03). The cox proportional hazard regression model indicated that imported cases bore high risk of delayed absorption of lung lesions (hazard ratio = 2.54, 95% confidence interval 1.05, 6.11, p = 0.04). Sensitivity analysis revealed similar pattern (hazard ratio = 6.64, 95% confidence interval 1.62, 27.18, p = 0.01). Conclusion Imported cases of COVID-19 were more likely to have refractory pulmonary infiltration, which subsequently prolongs LOS and increases medical expense.

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Association between type of birth attendants and neonatal mortality: Evidence from a National survey

African Health Sciences ◽

10.4314/ahs.v21i4.45 ◽

2021 ◽

Vol 21 (4) ◽

pp. 1870-6

Author(s):

Ololade Julius Baruwa ◽

Acheampong Yaw Amoateng ◽

Sibusiso Mkwananzi

Keyword(s):

Neonatal Mortality ◽

Scale Up ◽

Demographic Characteristics ◽

Childhood Mortality ◽

Proportional Hazard ◽

Birth Attendants ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Cox Proportional Hazard Regression ◽

The Relationship

Background: Although Lesotho has one of the highest childhood mortality levels in Southern Africa, there has been limited research on the link between type of birth attendant and neonatal mortality in Lesotho. This study examined the relationship between type of birth attendant and neonatal mortality while controlling for socio-demographic characteristics of mothers in LesothoMethods: The study used data from the children’s file of 2014 Lesotho Demographic and Health Survey data. Kaplan-Meier method was used to estimate neonatal mortality rate and Cox proportional hazard regression model was used to assess the association between type of birth attendant and neonatal mortality.Results: Result shows that 5.3% of all births attended to by non-SBAs resulted into neonatal mortality compared to 2.8% of those attended to by SBA. Result further shows that regardless of socio-demographic characteristics, the risks of neonatal mortality were significantly higher with non-SBAs compared to SBA in Lesotho (HR: 2.00, CI: 1.31-3.06).Conclusion: The risk of neonatal mortality is two times higher among children delivered by Non-SBA. Scale-up in access and uptake of SBA is recommended in Lesotho. Thus, Policy on scale-up access to SBA at delivery at no costs need to be put in place. Keywords: Neonatal; mortality; Lesotho.

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Correlation between Fasting Blood Glucose Level at Admission and Mortality in COVID-19 Patients: A Retrospective Study

10.21203/rs.3.rs-18484/v2 ◽

2020 ◽

Author(s):

Bin Zhu ◽

Chunguo Jiang ◽

Xiaokai Feng ◽

Yanfei Zheng ◽

Jie Yang ◽

...

Keyword(s):

Regression Analysis ◽

Blood Glucose ◽

Fasting Blood Glucose ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Single Center Study ◽

And Gender ◽

Cox Proportional Hazard Regression ◽

Relationship Of ◽

The Relationship

Abstract Background Coronavirus disease-19 (COVID-19) has spread rapidly, with a growing number of cases confirmed around the world. This study explores the relationship of fasting blood glucose (FBG) at admission with mortality. Methods In this retrospective, single-center study, we analyzed the clinical characteristics of confirmed cases of COVID-19 in Wu Han from 29 January 2020 to 23 February 2020. Cox proportional hazard regression analysis was performed to evaluate the relationship between FBG and mortality. Results A total of 107 patients were enrolled in our study. The average age was 59.49 ± 13.33 and the FBG at admission was 7.35 ± 3.13 mmol/L. There were 16 people died of COVID-19 with an average age 68.1 ± 9.5 and the FBG was 8.94 ± 4.76 mmol/L. Regression analysis showed that there were significant association between FBG and death (HR = 1.13, 95%CI: 1.02-1.24). After adjusting for covariables, the significance still exists. In addition, our result showed that FBG > 7.0 mmol/L or diabetic mellitus can significantly increase mortality after adjusting for the age and gender. Conclusions This study suggests that FBG at admission is an effective and reliable indicator for disease prognosis in COVID-19 patients.

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Breastfeeding training for health professionals and resultant changes in breastfeeding duration

Sao Paulo Medical Journal ◽

10.1590/s1516-31802000000600007 ◽

2000 ◽

Vol 118 (6) ◽

pp. 185-191 ◽

Cited By ~ 26

Author(s):

José Augusto de Aguiar Carrazedo Taddei ◽

Marcia Faria Westphal ◽

Sonia Venancio ◽

Cláudia Bogus ◽

Sonia Souza

Keyword(s):

Health Professionals ◽

Course Design ◽

Breastfeeding Duration ◽

Control Group ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Maternity Hospitals ◽

Cox Proportional Hazard Regression ◽

Trial Setting

CONTEXT: Promotion of breastfeeding in Brazilian maternity hospitals. OBJECTIVE: To quantify changes in the breastfeeding duration among mothers served by hospitals exposed to the Wellstart-SLC course, comparing them with changes among mothers attended by institutions not exposed to this course. DESIGN: Randomized Institutional Trial. SETTING: The effects of training on breastfeeding duration was assessed in eight Brazilian hospitals assigned at random to either an exposed group (staff attending the Wellstart-SLC course) or a control group. SAMPLE: For each of the eight study hospitals, two cohorts of about 50 children were visited at home at one and six months after birth. The first cohort (n = 494) was composed of babies born in the month prior to exposure to the Wellstart-SLC course, and the second cohort (n = 476) was composed of babies born six months subsequent to this exposure. MAIN MEASUREMENTS: Kaplan-Meier curves were plotted to describe the weaning process and log-rank tests were used to assess statistical differences among survival curves. Hazard ratio (HR) estimates were calculated by fitting Cox proportional hazard regression models to the data. RESULTS: The increases in estimated, adjusted rates for children born in hospitals with trained personnel were 29% (HR = 0.71) and 20% (HR = 0.80) for exclusive and full breastfeeding, respectively. No changes were identified for total breastfeeding. CONCLUSION: This randomized trial supports a growing body of evidence that training hospital health professionals in breastfeeding promotion and protection results in an increase in breastfeeding duration.

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