scholarly journals Early Referral to Nephrological Care and the Uptake of Peritoneal Dialysis. An Analysis of German Claims Data

2021 ◽  
Vol 18 (16) ◽  
pp. 8359
Author(s):  
Isabell Schellartz ◽  
Sunita Mettang ◽  
Arim Shukri ◽  
Nadine Scholten ◽  
Holger Pfaff ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Peritoneal Dialysis ◽  
Claims Data ◽  
Multivariate Logistic Regression Model ◽  
Symptomatic Therapy ◽  
Multivariate Logistic Regression ◽  
Early Referral ◽  
Dialysis Treatment ◽  
The Impact ◽  
Nephrological Care

Background: Hemodialysis (HD) and peritoneal dialysis (PD) are medically equivalent alternatives for symptomatic therapy of end-stage renal disease (ESRD). An early referral (ER) of patients with chronic kidney disease (CKD) to a nephrological specialist is associated with a higher proportion of patients choosing PD. Germany historically shows a low PD uptake. This article is the first investigation into the impact of ER on the uptake of PD, using a large German claims database. Methods: Claims data of 4727 incident dialysis patients in 2015 and 2016 were analyzed. Accounting codes for nephrological care and dialysis modalities were identified. Their first documentation was defined as their first encounter with a nephrologist and their first dialysis treatment (HD or PD). ER was determined as receiving nephrological care at least six months before the first dialysis. A multivariate logistic regression model with adjusted odds ratios (AOR) investigates the impact of ER, outpatient dialysis start, age, comorbidities, and sex on the chance for PD. Results: Forty-three percent were referred to the nephrologist six months before their first dialysis (ER). Single tests, as well as the adjusted multivariate logistic regression, highlighted that ER significantly increases the chance for PD. In the multivariate model, the uptake of PD was associated with ER (AOR = 3.05; p < 0.001; 95% CI = 2.16–4.32), outpatient dialysis start (AOR = 0.71; p = 0.044; 95% CI = 0.51–0.99), younger age (AOR = 0.96; p < 0.001; 95% CI = 0.95–0.97), and fewer comorbidities (AOR = 0.85; p < 0.001; 95% CI = 0.44–1.58). Conclusions: ER of patients with CKD to a nephrologist increases PD uptake. It gives both nephrologists and patients enough time for patient education about different treatment options and can contribute to informed decisions about the dialysis treatment.

scholarly journals The role of personal attitudes of control and responsibility for the uptake of peritoneal dialysis- a national survey among dialysis patients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Isabell Schellartz ◽  
Tim Ohnhaeuser ◽  
Thomas Mettang ◽  
Nadine Scholten
Keyword(s):  
Logistic Regression ◽  
Peritoneal Dialysis ◽  
Regression Models ◽  
Dialysis Modality ◽  
Multivariate Logistic Regression ◽  
Dialysis Treatment ◽  
Logistic Regression Models ◽  
Desire For Control ◽  
Personal Attitudes ◽  
The Impact

Abstract Background Although most patients are suitable for both hemodialysis (HD) and peritoneal dialysis (PD), there seem to be differences in the outlook of patients who choose one modality over the other. There is currently limited literature about the impact of patients’ personal attitudes on the decision for PD or HD. In this study, we tried to find out whether there were differences between patients who were on HD and PD in their desire for control and responsibility for their treatment. Methods The data were drawn from a nationwide postal survey of 630 HD and PD patients. Patients’ desire for control was measured by scores on the internal locus of control (ILOC) scale. Patients were also asked how important taking responsibility for their dialysis had been for their treatment decision (ITR). Two multivariate logistic regression models, both adjusted for age, were applied to investigate whether there were differences between HD and PD patients in ILOC and ITR. Having one generic measure (ILOC) and one tailored to the dialysis context (ITR) gave the opportunity to investigate if it is a generic personality trait or rather a specific attitude that affects choice of dialysis modality. Results PD patients were younger and showed higher ILOC and ITR values. Multivariate logistic regression models adjusted for age confirmed the significant influence of ILOC and ITR on the uptake of PD. The odds ratios for being in the PD group were 1.53 for ILOC (p = 0.030; 95% CI 1.04–2.25), 1.49 for ITR (p = 0.019; 95% CI 1.07–2.07), and 0.95 (p = 0.000; 95% CI 0.94–0.97) for age in both models. Conclusions Our analysis shows the impact of personal attitudes on the uptake of PD. Participants who generally want to keep control of their lives and take responsibility for their dialysis treatment tended to choose PD. As PD is a home dialysis treatment that requires patients to participate and contribute, it is beneficial if patients’ personalities support the treatment procedure. Having two completely different treatment options that suit to different personalities gives us the opportunity to consider the relationship between personal attitudes and choice of dialysis modality. Trial registration The MAU-PD study is registered at the German Clinical Trials Register. DRKS-ID: DRKS00012555. Date of Registration in DRKS: 2018/01/04.

scholarly journals The second pregnancy has no effect in the incidence of macrosomia: a cross-sectional survey in two western Chinese regions

2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Li Luo ◽  
Huan Zeng ◽  
Mao Zeng ◽  
Xueqing Liu ◽  
Xianglong Xu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Western China ◽  
Fetal Macrosomia ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Cross Sectional ◽  
Second Child ◽  
Child Policy ◽  
Significant Difference ◽  
The Impact

Abstract Background After the implementation of the universal two-child policy in China, the increase in parity has led to an increase in adverse pregnancy outcomes. The impact of one and two fetuses on the incidence of fetal macrosomia has not been fully confirmed in China. This study aimed to explore the differences in the incidence of fetal macrosomia in first and second pregnancies in Western China after the implementation of the universal two-child policy. Methods A total of 1598 pregnant women from three hospitals were investigated by means of a cross-sectional study from August 2017 to January 2018. Participants were recruited by convenience and divided into first and second pregnancy groups. These groups included 1094 primiparas and 504 women giving birth to their second child. Univariate and multivariate logistic regression analyses were performed to discuss the differences in the incidence of fetal macrosomia in first and second pregnancies. Results No significant difference was found in the incidence of macrosomia in the first pregnancy group (7.2%) and the second pregnancy group (7.1%). In the second-time pregnant mothers, no significant association was found between the macrosomia of the second child (5.5%) and that of the first child (4.7%). The multivariate logistic regression model showed that mothers older than 30 years are not likely to give birth to children with macrosomia (odds ratio (OR) 0.6, 95% confidence interval (CI) 0.4,0.9). Conclusions The incidence of macrosomia in Western China is might not be affected by the birth of the second child and is not increased by low parity.

scholarly journals Risk factors for peritoneal dialysis–associated peritonitis

2018 ◽  
Vol 16 ◽  
pp. 205873921877224
Author(s):  
Hongyue Wang ◽  
Xiangtuo Wang ◽  
Haichuan Dou ◽  
Chenhao Li ◽  
Mingji Cui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Multivariate Logistic Regression Analysis ◽  
Roc Curves ◽  
Multivariate Logistic Regression Model ◽  
Phosphorus Concentration ◽  
Multivariate Logistic Regression ◽  
Gram Positive

The purpose of this study was to summarize the pathogens that cause peritoneal dialysis (PD)-associated peritonitis and to identify risk factors for PD-associated peritonitis. This retrospective study included 115 end-stage renal disease (ESRD) patients receiving PD therapy. Patients were categorized into two groups: peritonitis group (n = 41) and non-peritonitis group (n = 74). Clinical data and laboratory tests were collected from medical records. The multivariate logistic regression model was used to evaluate associations between PD-associated peritonitis and potential risk factors. PD-associated peritonitis occurred 54 times in 41 patients. The most frequently identified pathogen was Gram-positive cocci (57.78%). Multivariate logistic regression analysis showed that serum albumin (β = –0.208, P < 0.001), blood phosphorus concentration (β = –1.732, P = 0.001), gastrointestinal disorders (β = 1.624, P = 0.043), and use of calcitriol (β = –2.239, P = 0.048) were significantly correlated with PD-associated peritonitis. Receiver operating characteristic (ROC) curves showed that the areas under the curve were 0.832 for serum albumin and 0.700 for blood phosphorus concentration with optimal cut-off values of 29.1 g/L for serum albumin and 1.795 mmol/L for blood phosphorus concentration. Gram-positive coccus is the major pathogen responsible for PD-associated peritonitis. Serum albumin <29.1 g/L, blood phosphorus concentration <1.795 mmol/L, and intestinal disorders are risk factors for PD-associated peritonitis, whereas the use of calcitriol can reduce the risk of PD-associated peritonitis.

scholarly journals The impact of early neuraminidase inhibitor therapy on clinical outcomes in patients hospitalised with influenza A-related pneumonia: a multicenter, retrospective study

2020 ◽  
Author(s):  
Liang Chen ◽  
Xiudi Han ◽  
YanLi Li ◽  
Chunxiao Zhang ◽  
Xiqian Xing
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Clinical Outcomes ◽  
Influenza A ◽  
Logistic Regression Model ◽  
Neuraminidase Inhibitor ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Severe Influenza ◽  
The Impact

Abstract Background Guidelines emphasize prompt antiviral treatment in severe influenza patients. Although nearly a 50% of severe influenza present with pneumonia, the effect of early (≤ 2 days after illness onset) neuraminidase inhibitor (NAI) use on the clinical outcomes of influenza A-related pneumonia (FluA-p) has rarely been assessed. Furthermore, data about the administration of NAIs in the real-world management of Flu-p in China are limited.Methods: Data of patients hospitalised with FluA-p from five teaching hospitals in China from 1 January 2013 to 31 December 2018 were reviewed retrospectively. The impact of early NAI therapy on the outcomes in FluA-p patients, and the indications of early NAI administration by clinicians were evaluated by logistic regression analysis.Results: In total, 693 FluA-p patients were included. Of these patients, 33.5% (232/693) were treated early. After adjusting for weighted propensity scores for treatment, systemic corticosteroid and antibiotic use, a multivariate logistic regression model showed that early NAI therapy was associated with decreased risk for invasive ventilation [odds ratio (OR) 0.511, 95% confidence interval (CI) 0.312–0.835, p = 0.007) and 30-day mortality (OR 0.533, 95% CI 0.210–0.807, p < 0.001) in FluA-p patients. A multivariate logistic regression model confirmed early NAI use (OR 0.415, 95% CI 0.195–0.858, p = 0.001) was a predictor for 30-day mortality in FluA-p patients and a positive rapid influenza diagnostic test was the only indication (OR 3.586, 95% CI 1.259–10.219, p < 0.001) related to the prescription of early NAI by clinicians.Conclusions: Early NAI therapy is associated with better outcomes in FluA-p patients. Improved education and training of clinicians on the guidelines of influenza are needed.

scholarly journals Prevalence and factors associated with postpartum depression during the COVID-19 pandemic among women in Guangzhou, China: a cross-sectional study

2020 ◽  
Author(s):  
Peiqin Liang ◽  
Yiding Wang ◽  
Si Shi ◽  
Yan Liu ◽  
Ribo Xiong
Keyword(s):  
Logistic Regression ◽  
Postpartum Depression ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Multivariate Logistic Regression Model ◽  
Sectional Study ◽  
Multivariate Logistic Regression ◽  
Cross Sectional ◽  
Female Population ◽  
The Impact

Abstract Background: The 2019 coronavirus disease (COVID-19) is a public health emergency of international concern. To date, there are limited studies that have investigated the impact of COVID-19 pandemic on mental health among female population. Therefore, the study aims to investigate the prevalence of postpartum depression (PPD) and it’s related factors among women in Guangzhou, China, during the COVID-19 pandemic.Methods: A cross-sectional study was performed from 30th March 2020 to 13th April 2020 using anonymous online questionnaire among 864 women at 6-12 weeks postpartum. The Chinese version of Edinburgh Postnatal Depression Scale and a questionnaire regarding associated factors were administered to all participants. Multivariate logistic regression was used to determine factors that were significantly associated with PPD.Results: The prevalence of PPD among women at 6-12 weeks postpartum was 30.0%. A multivariate logistic regression model identified significant factors as: immigrant women, persistent fever, poor social support, concerns about contracting COVID-19 and certain precautionary measures.Conclusions: The findings suggest the need for policies and interventions to not only mitigate the psychological impacts but also targeting disadvantaged sub-groups of women following childbirth during the COVID-19 pandemic.

scholarly journals Prevalence and Factors Associated With Postpartum Depression During the Covid-19 Pandemic Among Women in Guangzhou, China: A Cross-sectional Study

2020 ◽  
Author(s):  
Ribo Xiong ◽  
Yan Liu ◽  
Peiqin Liang ◽  
Yiding Wang ◽  
Si Shi
Keyword(s):  
Logistic Regression ◽  
Emotional Health ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Multivariate Logistic Regression Model ◽  
Sectional Study ◽  
Multivariate Logistic Regression ◽  
Cross Sectional ◽  
Female Population ◽  
The Impact

Abstract Background: The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern. To date, there are limited studies that have investigated the impact of VOVID-19 pandemic on mental health among female population. This is especially pertinent with the emotional health vulnerability surrounding pregnancy and childbirth. Therefore, the study aims to investigate the prevalence of PPD and it’s related factors among women in Guangzhou, China, during the COVID-19 pandemic.Methods: A cross-sectional study was performed from 30th March 2020 to 13th April 2020 using anonymous online questionnaire among 864 women at 6-12 weeks postpartum. The Chinese version of Edinburgh Postnatal Depression Scale and a questionnaire regarding associated factors were administered to all participants. Multivariate logistic regression was used to determine factors that were significantly associated with PPD.Results: The prevalence of PPD among women at 6-12 weeks postpartum was 30.0%. A multivariate logistic regression model identified significant factors as: immigrant women, persistent fever, poor social support, concerns about contracting COVID-19 and certain precautionary measures.Conclusions: The findings suggest the need for policies and interventions to not only mitigate the psychological impacts but also targeting disadvantaged sub-groups of women following childbirth during the COVID-19 pandemic.

scholarly journals The impact of early neuraminidase inhibitor therapy on clinical outcomes in patients hospitalised with influenza A-related pneumonia: a multicenter, retrospective study

2020 ◽  
Author(s):  
Liang Chen ◽  
Xiudi Han ◽  
YanLi Li ◽  
Chunxiao Zhang ◽  
Xiqian Xing
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Clinical Outcomes ◽  
Influenza A ◽  
Logistic Regression Model ◽  
Neuraminidase Inhibitor ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Severe Influenza ◽  
The Impact

Abstract Background Guidelines emphasize prompt antiviral treatment in severe influenza patients. Although nearly a 50% of severe influenza present with pneumonia, the effect of early (≤ 2 days after illness onset) neuraminidase inhibitor (NAI) use on the clinical outcomes of influenza A-related pneumonia (FluA-p) has rarely been assessed. And there is limited data about the administration of NAIs in the real-world management of Flu-p in China.Methods Data of patients hospitalised with FluA-p from five teaching hospitals in China from 1 January 2013 to 31 December 2018 were reviewed retrospectively. The impact of early NAI therapy on the outcomes in FluA-p patients, and the indications of early NAI administration by clinicians were evaluated by logistic regression analysis.Results Totally, 693 FluA-p patients were included. Of these patients, 33.5% (232/693) were treated early. After adjusting for weighted propensity scores for treatment, systemic corticosteroid and antibiotic use, a multivariate logistic regression model showed that early NAI therapy was associated with decreased risk for invasive ventilation [ odds ratio ( OR ) 0.511, 95% confidence interval (CI) 0.312–0.835, p = 0.007) and 30-day mortality ( OR 0.533, 95% CI 0.210–0.807, p < 0.001) in FluA-p patients. A multivariate logistic regression model confirmed early NAI use ( OR 0.415, 95% CI 0.195–0.858, p = 0.001) was a predictor for 30-day mortality in FluA-p patients and a positive rapid influenza diagnostic test was the only indication ( OR 3.586, 95% CI 1.259–10.219, p < 0.001) related to the prescription of early NAI by clinicians.Conclusions Early NAI therapy is associated with better outcomes in FluA-p patients. Improved education and training of clinicians on the guidelines of influenza are needed.

scholarly journals Prevalence and factors associated with postpartum depression during the COVID-19 pandemic among women in Guangzhou, China: a cross-sectional study

2020 ◽  
Author(s):  
Peiqin Liang ◽  
Yiding Wang ◽  
Si Shi ◽  
Yan Liu ◽  
Ribo Xiong
Keyword(s):  
Logistic Regression ◽  
Postpartum Depression ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Multivariate Logistic Regression Model ◽  
Sectional Study ◽  
Multivariate Logistic Regression ◽  
Cross Sectional ◽  
Female Population ◽  
The Impact

Abstract Background: The 2019 coronavirus disease (COVID-19) is a public health emergency of international concern. To date, there are limited studies that have investigated the impact of COVID-19 pandemic on mental health among female population. Therefore, the study aims to investigate the prevalence of postpartum depression (PPD) and it’s related factors among women in Guangzhou, China, during the COVID-19 pandemic.Methods: A cross-sectional study was performed from 30th March 2020 to 13th April 2020 using anonymous online questionnaire among 864 women at 6-12 weeks postpartum. The Chinese version of Edinburgh Postnatal Depression Scale and a questionnaire regarding associated factors were administered to all participants. Multivariate logistic regression was used to determine factors that were significantly associated with PPD.Results: The prevalence of PPD among women at 6-12 weeks postpartum was 30.0%. A multivariate logistic regression model identified significant factors as: immigrant women, persistent fever, poor social support, concerns about contracting COVID-19 and certain precautionary measures.Conclusions: The findings suggest the need for policies and interventions to not only mitigate the psychological impacts but also target disadvantaged sub-groups of women following childbirth during the COVID-19 pandemic.

scholarly journals Prevalence and factors associated with postpartum depression during the COVID-19 pandemic among women in Guangzhou, China: a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Peiqin Liang ◽  
Yiding Wang ◽  
Si Shi ◽  
Yan Liu ◽  
Ribo Xiong
Keyword(s):  
Logistic Regression ◽  
Postpartum Depression ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Multivariate Logistic Regression Model ◽  
Sectional Study ◽  
Multivariate Logistic Regression ◽  
Cross Sectional ◽  
Female Population ◽  
The Impact

Abstract Background The 2019 coronavirus disease (COVID-19) is a public health emergency of international concern. To date, there are limited studies that have investigated the impact of COVID-19 pandemic on mental health among female population. Therefore, the study aims to investigate the prevalence of postpartum depression (PPD) and it’s related factors among women in Guangzhou, China, during the COVID-19 pandemic. Methods A cross-sectional study was performed from 30th March 2020 to 13th April 2020 using anonymous online questionnaire among 864 women at 6–12 weeks postpartum. The Chinese version of Edinburgh Postnatal Depression Scale and a questionnaire regarding associated factors were administered to all participants. Multivariate logistic regression was used to determine factors that were significantly associated with PPD. Results The prevalence of PPD among women at 6–12 weeks postpartum was 30.0%. A multivariate logistic regression model identified significant factors as: immigrant women, persistent fever, poor social support, concerns about contracting COVID-19 and certain precautionary measures. Conclusions The findings suggest the need for policies and interventions to not only mitigate the psychological impacts but also target disadvantaged sub-groups of women following childbirth during the COVID-19 pandemic.

scholarly journals The impact of early neuraminidase inhibitor therapy on clinical outcomes in patients hospitalised with influenza A-related pneumonia: a multicenter, retrospective study

2020 ◽  
Author(s):  
Liang Chen ◽  
Xiudi Han ◽  
YanLi Li ◽  
Chunxiao Zhang ◽  
Xiqian Xing
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Clinical Outcomes ◽  
Influenza A ◽  
Logistic Regression Model ◽  
Neuraminidase Inhibitor ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Severe Influenza ◽  
The Impact

Abstract Background Guidelines emphasize prompt antiviral treatment in severe influenza patients. Although nearly a 50% of severe influenza present with pneumonia, the effect of early (≤ 2 days after illness onset) neuraminidase inhibitor (NAI) use on the clinical outcomes of influenza A-related pneumonia (FluA-p) has rarely been assessed. And there is limited data about the administration of NAIs in the real-world management of Flu-p in China. Methods Data of patients hospitalised with FluA-p from five teaching hospitals in China from 1 January 2013 to 31 December 2018 were reviewed retrospectively. The impact of early NAI therapy on the outcomes in FluA-p patients, and the indications of early NAI administration by clinicians were evaluated by logistic regression analysis. Results Totally, 693 FluA-p patients were included. Of these patients, 33.5% (232/693) were treated early. After adjusting for weighted propensity scores for treatment, systemic corticosteroid and antibiotic use, a multivariate logistic regression model showed that early NAI therapy was associated with decreased risk for invasive ventilation [ odds ratio ( OR ) 0.511, 95% confidence interval (CI) 0.312–0.835, p = 0.007) and 30-day mortality ( OR 0.533, 95% CI 0.210–0.807, p < 0.001) in FluA-p patients. A multivariate logistic regression model confirmed early NAI use ( OR 0.415, 95% CI 0.195–0.858, p = 0.001) was a predictor for 30-day mortality in FluA-p patients and a positive rapid influenza diagnostic test was the only indication ( OR 3.586, 95% CI 1.259–10.219, p < 0.001) related to the prescription of early NAI by clinicians. Conclusions Early NAI therapy is associated with better outcomes in FluA-p patients. Improved education and training of clinicians on the guidelines of influenza are needed.

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