Systemic Immune-Inflammation Index Predicted Short-Term Outcomes in Patients Undergoing Isolated Tricuspid Valve Surgery

Systemic immune-inflammation index (SII, platelet × neutrophil/lymphocyte ratio) has recently been identified as an inflammatory marker. We aimed to evaluate the prognostic implications of preoperative SII in patients undergoing isolated tricuspid valve (TV) surgery. In total, 213 patients who underwent isolated TV surgery between January 2000 and December 2018 were enrolled. They were divided into two groups, as follows: low SII (<455.6 × 109/L), and high SII (≥455.6 × 109/L). The correlation between SII and clinical outcomes was analyzed via the Cox regression and the Kaplan–Meier analyses. The primary outcomes considered were all-cause mortality and major postoperative complications within a 30-day period after isolated TV surgery, including major adverse cardiovascular or cerebrovascular events, pulmonary and renal complications, stroke, sepsis, multi-organ failure, wound, and gastrointestinal complications. In total, 82 (38.5%) patients experienced postoperative complications. Multivariable analyses revealed that high preoperative SII values were independently associated with the major 30-day postoperative complications (hazard ratio 3.58, 95% confidence interval 1.62–7.95, p = 0.001). Additionally, Kaplan–Meier analysis revealed that the probability of undergoing major 30-day postoperative complications was significantly elevated in patients with high versus low SII values (p < 0.001). These results indicate that SII, a readily available parameter, is significantly associated with poor outcomes in patients undergoing isolated TV surgery.

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The impact of multimodality therapies in marginally inoperable soft tissue sarcomas (STS): The Toronto Sarcoma Program (TSP) experience.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.11548 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 11548-11548

Author(s):

Olga Vornicova ◽

Jay Wunder ◽

Peter W. M. Chung ◽

Abha A. Gupta ◽

Rebecca Anne Gladdy ◽

...

Keyword(s):

Cox Regression ◽

Soft Tissue Sarcomas ◽

Tumor Board ◽

Disease Characteristics ◽

Kaplan Meier ◽

Progression Of Disease ◽

Modality Approach ◽

Poor Outcomes ◽

The Impact

11548 Background: The mainstay therapy of operable STS remains surgery, which may include (neo)adjuvant therapies. Within the TSP, marginally inoperable STS are often treated with sequential chemo (CTX) and radiation (RT) therapy, followed by surgery (SX). Herein we present our experience of multi-modality therapies for marginally inoperable STS patients (pts). Methods: This was a dual-center, single program, retrospective review. Pts were included if deemed to have marginally inoperable primary or recurrent STS, as determined at the TSP tumor board. Pts included must have had CTX with the intent of having RT and SX after. Pts demographics, treatment details and clinical outcomes data were collected. Relapse free survival (RFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Multivariate analysis of the influence of disease characteristics and treatment on outcomes was assessed using Cox regression. Results: From June 2005 to May 2019, 75 pts were identified. Median age was 52 years (range 16-72). Pts were predominantly male (55%). Histological subtypes included dedifferentiated liposarcoma (29%), leiomyosarcoma (27%), synovial sarcoma (19%) and others (25%). Primary tumor was located in the retroperitoneum (48%), extremity (23%), pelvis (12%), thorax (9%), and other sites (8%). All pts had doxorubicin and ifosfamide CTX (median 4 cycles; range 1-6), while RT dose delivered was 50.4Gy/28 fractions in 58 (77%) of cases. Twenty three pts (31%) achieved partial response, 40 pts (53%) had stable disease and 12 pts (16%) had progression of disease (PD) on CTX, of which half (8%) did not undergo further treatment. Nine pts (12%) underwent CTX followed by SX due to significant response, 9 pts (12%) underwent CTX and RT without SX due to persistent tumor unresectability or PD. The final 50 pts (67%) completed multi-modality treatment (CTX, RT & SX). Overall, 59 pts (79%) had SX; negative margins were achieved in 53 (71%). 19 pts (25%) had postoperative complications, causing death in 2 pts (2.7%). With a median follow-up of 72 months, median RFS and OS were 26.9 months (95% CI: 0-86.0), and 65 months (95% CI: 13.5-116.4). Extremity location was associated with superior RFS (median not reached [NR], HR 0.28 95% CI 0.09-0.83, p = 0.022), and OS (median NR, HR 0.29 95% CI 0.09-0.90, p = 0.032). Receipt of RT was associated with superior RFS (median NR, HR 0.23 95% CI 0.10-0.52, p < 0.001); and OS (median NR, HR 0.21 95% CI 0.09-0.50, p < 0.001). Pts who had PD after CTX were associated with poor outcomes - RFS (median 4.7 months, HR 2.03 95% CI 0.61-6.76, p = 0.24); and OS (median 21.9 months, HR 2.48 95% CI 0.73-8.47, P = 0.144). Conclusions: Multi-modality approach resulted in successful resection for most pts with marginally inoperable STS. Extremity location and RT administration were associated with better RFS and OS, while progression on CTX confers worse survival outcomes.

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Prognostic value of systemic immune–inflammation index in acute/subacute patients with cerebral venous sinus thrombosis

Stroke and Vascular Neurology ◽

10.1136/svn-2020-000362 ◽

2020 ◽

Vol 5 (4) ◽

pp. 368-373

Author(s):

Shen Li ◽

Kai Liu ◽

Yuan Gao ◽

Lu Zhao ◽

Rui Zhang ◽

...

Keyword(s):

Regression Analysis ◽

Cox Regression ◽

Sinus Thrombosis ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Cox Regression Analysis ◽

Venous Sinus Thrombosis ◽

Immune Inflammation ◽

Poor Outcomes

ObjectiveTo evaluate the prognosis values of systemic immune–inflammation index (SII) in non-chronic cerebral venous sinus thrombosis (CVST).Methodspatients with CVST, admitted to the First Affiliated Hospital of Zhengzhou University, were retrospectively identified from January 2013 to December 2018. We selected patients in acute/subacute phase from database. Functional outcomes of patients were evaluated with the modified Rankin Scale (mRS)—mRS 3–6 as poor outcomes and mRS 6 as death. The overall survival time was defined as the date of onset to the date of death or last follow-up date. Survival analysis was described by the Kaplan-Meier curve and Cox regression analysis. Multivariate logistic regression analysis assessed the relationship between SII and poor functional outcome. The area under the Receiver Operating Curve curve (AUC) was estimated to evaluate the ability of SII in prediction.ResultsA total of 270 patients were included and their duration of follow-up was 22 months (6–66 months), of whom 31 patients had poor outcomes and 24 patients dead. Cox regression analysis showed that SII (HR=1.304, 95% CI: 1.101 to 1.703, p=0.001) was a predictor of death in non-chronic CVST. Patients with higher SII presented lower survival rates (p=0.003). The AUC of SII was 0.792 (95% CI: 0.695 to 0.888, p=0.040) with a sensitivity of 69.6% and specificity of 80.1%. Subgroups analysis demonstrated that SII was an important predictor of poor outcomes in male (OR=1.303, 95% CI: 1.102 to 1.501, p=0.011) and pregnancy/puerperium female (OR=1.407, 95% CI: 1.204 to 1.703, p=0.034).ConclusionsSII was a potential predictor in the poor prognosis of patients with acute/subacute CVST, especially in male and pregnancy/puerperium female.

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Associations between K-ras mutation, smoking, and prognosis of pancreatic cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.298 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 298-298

Author(s):

Kei Saito ◽

Yousuke Nakai ◽

Hiroyuki Isayama ◽

Takashi Sasaki ◽

Naminatsu Takahara ◽

...

Keyword(s):

Pancreatic Cancer ◽

Colon Cancer ◽

Cox Regression ◽

Performance Status ◽

Rank Test ◽

Ras Mutation ◽

Kaplan Meier ◽

Never Smokers ◽

Poor Outcomes ◽

The University

298 Background: Smoking is recognized as a risk factor for pancreatic cancer, but its associations with prognosis are not fully elucidated. Smoking was associated with poor outcomes in colon cancer, especially in patients with K-ras mutation (J Clin Oncol. 2013;31:2016-23). Therefore, we conducted this retrospective analysis of the associations of K-ras mutation, smoking and prognosis in patients with pancreatic cancer. Methods: Patients with pancreatic cancer who received surgery or chemotherapy at the University of Tokyo Hospital were retrospectively studied. The prognosis of patients with mutant and wild K-ras were compared. Overall survival was evaluated using Kaplan-Meier methods and compared by long-rank test. Cox regression models were used to calculate hazard ratios (HRs) to evaluate the prognostic factors in patients with pancreatic cancer with mutant K-ras or wild K-ras. Results: Between January 2009 and August 2013, K-ras mutation analysis was evaluated in 187 patients (47 surgical resection and 140 chemotherapy). K-ras mutation was detected in 74.3%. The rates of current-, ex- and never-smokers were 18.2%, 31.6% and 50.3%, respectively. In patients with mutant K-ras, the rate of male gender (46.0% vs. 29.0%), presence of distant metastasis (50.4% vs. 31.3%) and median CA19-9 (374 U/mL vs. 136 U/mL) were significantly higher than that in patients with wild K-ras. The rate of ever smokers (current- and ex-smokers) did not differ significantly (48.2% in mutant K-ras vs. 56.3% in wild K-ras, p=0.403). Median survival time (MST) was 16.7 (95%CI, 11.9-21.8) months in patients with mutant K-ras, compared with 20.3 (95%CI, 15.8-34.6) in patients with wild K-ras (p=0.193). Meanwhile, MST was 22.2 (95%CI, 16.9-27.9) vs. 14.8 (95%CI, 9.1-19.4) months in patients with and without smoking (p=0.024). After adjustment by age, gender, performance status, CA19-9 and treatment, HRs of smoking were 1.96 (95%CI, 1.06-3.68, p=0.032) in patients with mutant K-ras, but the association was not significant in patients with wild-K-ras (HR 1.35 [95%CI, 0.37-5.28], p=0.653). Conclusions: As previously reported in colon cancer, smoking was associated with poor prognosis in pancreatic cancer with K-ras mutation.

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Postoperative Inflammatory Marker Surveillance in Colorectal Peritoneal Carcinomatosis

Annals of Surgical Oncology ◽

10.1245/s10434-020-09544-w ◽

2021 ◽

Author(s):

Sasinthiran Thiagarajan ◽

Joey Wee-Shan Tan ◽

Siqin Zhou ◽

Qiu Xuan Tan ◽

Josephine Hendrikson ◽

...

Keyword(s):

Peritoneal Carcinomatosis ◽

Inflammatory Markers ◽

Inflammatory Marker ◽

Prognostic Significance ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Clinicopathologic Parameters ◽

Cox Proportional Hazard Regression

Abstract Background The prognostic significance of inflammatory markers in solid cancers is well-established, albeit with considerable heterogeneity. This study sought to investigate the postoperative inflammatory marker trend in peritoneal carcinomatosis (PC), with a focus on colorectal PC (CPC), and to propose optimal surveillance periods and cutoffs. Methods Data were collected from a prospectively maintained database of PC patients treated at the authors’ institution from April 2001 to March 2019. The platelet–lymphocyte ratio (PLR), the neutrophil–lymphocyte ratio (NLR), and the lymphocyte–monocyte ratio (LMR) were collected preoperatively and on postoperative days 0, 1 to 3, 4 to 7, 8 to 21, 22 to 56, and 57 to 90 as averages. Optimal surveillance periods and cutoffs for each marker were determined by maximally selected rank statistics. The Kaplan–Meier method and Cox proportional hazard regression models were used to investigate the association of inflammatory markers with 1-year overall survival (OS) and recurrence-free survival (RFS) using clinicopathologic parameters. Results The postoperative inflammatory marker trend and levels did not differ between the patients with and those without hyperthermic intraperitoneal chemotherapy (HIPEC). Low postoperative LMR (days 4–7), high postoperative NLR (days 8–21), and high postoperative PLR (days 22–56) were optimal for prognosticating poor 1-year OS, whereas high postoperative PLR and NLR (days 57–90) and low postoperative LMR (days 8–21) were associated with poor 1-year RFS. A composite score of these three markers was prognostic for OS in CPC. Conclusions The reported cutoffs should be validated in a larger population of CPC patients. Future studies should account for the inflammatory response profile when selecting appropriate surveillance periods.

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Prognostic score to predict time to castration-resistance in underserved patients with metastatic prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e16518 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e16518-e16518

Author(s):

Ankit Mangla ◽

Muhammad Umair Mushtaq ◽

Udit Yadav ◽

Ahmed T Ahmed ◽

Jiaxiang Liu ◽

...

Keyword(s):

Prostate Cancer ◽

Metastatic Prostate Cancer ◽

Cox Regression ◽

Prognostic Score ◽

Tertiary Care ◽

Specific Antigen ◽

Care Hospital ◽

Castration Resistance ◽

Neutrophil Lymphocyte Ratio ◽

Kaplan Meier

e16518 Background: This study aimed to identify predictors of time to castration-resistance prostate cancer (tCRPC) from initial diagnosis of metastatic prostate cancer (mPC) and develop a prognostic score in the underserved population of an inner-city tertiary care hospital. Methods: We retrospectively reviewed charts of 278 men diagnosed with mPC between 2001 and 2015, of which 155 patients were analyzed. Socio-demographic, clinical and pathologic factors were ascertained at the time of diagnosis. Kaplan-Meier and cox regression analyses were done to explore correlates tCRPC. Crude (HR) and adjusted (aHR) hazard ratios with 95% confidence intervals (CI) were obtained. Results: Over a median follow-up of 46 months (95% CI 23-69), 73.5% of men developed castration-resistance. Median tCRPC was 16 months (95% CI 12.5-19.5). All patients received medical or surgical castration at the time of diagnosis. Significant correlates of short tCRPC included: prostate specific antigen >20 ng/mL (HR 2.56, 95% CI 1.25-5.23, P=0.010), core involvement >50% (HR 2.11, 95% CI 1.43-3.11, P<0.001), bone metastases (HR 2.94, 95% CI 1.36-6.35, P=0.006), visceral metastases (HR 01.65, 95% CI 1.08-2.53, P=0.021), hemoglobin <10 g/dL (HR 2.02, 95% CI 1.26-3.23, P=0.003), alkaline phosphatase (ALP) >240 U/L (HR 2.42, 95% CI 1.62-3.61, P<0.001), lactate dehydrogenase (LDH) >200 U/L (HR 1.68, 95% CI 1.16-2.43, P=0.006) and neutrophil-lymphocyte ratio >2.4 (HR 1.50, 95% CI 1.03-2.20, P=0.035). In multivariate model, core involvement >50% (aHR 2.99, 95% CI 1.79-5.01, P<0.001), ALP >240 U/L (aHR 2.08, 95% CI 1.13-3.84, P=0.019) and LDH >200 U/L (aHR 1.71, 95% CI 1.02-2.86, P=0.043) independently predicted short tCRPC and each factor decreased tCRPC by almost 50%. Mean prognostic score (PS), based on 1 point for each independent predictor (scale 0-3), was 1.23 (SD 0.91) and significantly predicted short tCRPC (P<0.001). [Table] Conclusions: Our PS based on core involvement (>50%), high ALP (>240 U/L) and high LDH (>200 U/L) significantly predicts tCRPC in men with mPC. Prospective studies are warranted to further validate this score. [Table: see text]

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Baseline Serum sLOX-1 Concentrations Are Associated with 2-Year Major Adverse Cardiovascular and Cerebrovascular Events in Patients after Percutaneous Coronary Intervention

Disease Markers ◽

10.1155/2019/4925767 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8

Author(s):

Zi-wen Zhao ◽

Yi-wei Xu ◽

Shu-mei Li ◽

Jin-jian Guo ◽

Jian-min Sun ◽

...

Keyword(s):

Risk Factors ◽

Percutaneous Coronary Intervention ◽

Prognostic Value ◽

Cox Regression ◽

Coronary Intervention ◽

Enzyme Linked Immunosorbent Assay ◽

Baseline Serum ◽

Kaplan Meier ◽

Cerebrovascular Events ◽

Percutaneous Coronary

Background. Soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) may be a potential biomarker of coronary artery disease (CAD) and stroke. Objective. We aimed to investigate the association and prognostic value of elevated sLOX-1 concentrations with regard to long-term major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with CAD undergoing primary percutaneous coronary intervention (PCI). Methods. A total of 1011 patients were enrolled. Serum sLOX-1 concentrations were detected by the enzyme-linked immunosorbent assay (ELISA). Patients were followed for 2 years. Multivariate Cox regression and Kaplan-Meier survival curve were explored to assess the association between sLOX-1 and MACCEs. A receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of sLOX-1. Results. Two-year MACCEs were associated with serum sLOX-1 concentrations (HR 1.278, 95% CI 1.019-1.604, P=0.034), left main disease (HR 2.938, 95% CI 1.246-6.925, P=0.014), small-caliber stents used (HR 2.207, 95% CI 1.189-4.095, P=0.012), and total stent length (HR 1.057, 95% CI 1.005-1.112, P=0.030). Serum sLOX-1 concentration≥1.10 ng/ml had maximum sensitivity and specificity in predicting the occurrence of 2-year MACCEs (P<0.001). Patients with higher serum sLOX-1 concentrations showed a significantly higher incidence of MACCEs in the Kaplan-Meier curve (P<0.001). The combination of any of the risk factors identified in multiple Cox regression was associated with a stepwise increase in MACCE rate (P<0.001). Conclusions. High baseline serum sLOX-1 concentration predicts 2-year MACCEs and shows an additional prognostic value to conventional risk factors in patients after primary PCI. sLOX-1 determination might play a complementary role in the risk stratification of patients with CAD treated with PCI.

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XEN45 real-life evaluation: Survival analysis with bleb needling and major revision outcomes

European Journal of Ophthalmology ◽

10.1177/11206721211012847 ◽

2021 ◽

pp. 112067212110128

Author(s):

Néstor Ventura-Abreu ◽

Marina Dotti-Boada ◽

María Jesús Muniesa-Royo ◽

Jordi Izquierdo-Serra ◽

Andrea González-Ventosa ◽

...

Keyword(s):

Cox Regression ◽

Real Life ◽

Glaucoma Surgery ◽

Success Rates ◽

Life Outcomes ◽

Kaplan Meier ◽

Real Life Setting ◽

Complete Failure ◽

Poor Outcomes

Purpose: To evaluate real-life outcomes of XEN45 stent surgery including bleb needling (BN) and surgical bleb revision (SBR). Methods: Retrospective analysis of all XEN45 gel stents implanted in a tertiary glaucoma center with a minimum follow-up of 6 months. The main outcomes were intraocular pressure (IOP), the number of glaucoma medications, postoperative maneuvers like BN, and subsequent SBR. Success was defined as IOP ⩽ 18 and 20% reduction (criterion A), ⩽15 and 25% reduction (criterion B), and ⩽12 mmHg and 30% reduction (criterion C) reached with (qualified) or without (complete) medications at the last visit. Complete failure was defined as additional glaucoma surgery, loss of light perception, or sight-threatening complications. Multivariable Cox regression and Kaplan-Meier survival estimates tests were performed. Results: Fifty-eight eyes with either stand-alone or combined Phaco-XEN surgery were included. Complete success by the different definitions was 50.0% (95% confidence interval, 5.8%–84.5%) (A), 50.0% (5.8%–84.5%) (B), and 25% (0.9%–66.5%) (C) whereas qualified success was 38.3% (1.6%–80.1%), 31.7% (2.0%–71.4%), and 0%, respectively, at the 24-months visit. 30% of cases underwent BN with 5-Fluorouracil, and SBR was performed in 17.5% of eyes. Low IOP levels at 1-month and early BN were significantly associated with success. The highest chance of failure was achieved in the combined Phaco-XEN group undergoing SBR. Conclusions: In our real-life setting, the first month IOP was associated with greater success rates. Although BN obtained improved IOP values, SBR was associated with a greater bleb survival in the stand-alone XEN group. Both BN and SBR had poor outcomes in the combined Phaco-XEN group.

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Contextualizing a single-arm trial of ceralasertib (cer) plus paclitaxel with real-world data (RWD) in patients (pts) with advanced melanoma previously treated with anti-PD-(L)1(PDx) therapies.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e21542 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e21542-e21542

Author(s):

Miao Jiang ◽

Jeeyun Lee ◽

Daniel Jackson ◽

Simon Smith ◽

Sajan Khosla ◽

...

Keyword(s):

Cox Regression ◽

Unmet Need ◽

Clinical Trial Data ◽

Advanced Melanoma ◽

Real World Data ◽

Kaplan Meier ◽

Improved Outcomes ◽

Recent Phase ◽

Previously Treated ◽

Poor Outcomes

e21542 Background: Metastatic melanoma, especially in pts who do not respond to PDx therapy, is an area of high unmet need. Chemotherapy may be used but clinical efficacy is limited. A recent Phase I study (NCT02630199) showed that cer + paclitaxel had promising anti-tumor activity with durable responses in 34 melanoma pts after failing PDx therapy. Given the lack of published prospective clinical trial data in the post-PDx setting, RWD was used to contextualize the results of the trial. Methods: Adult pts (≥18 years) diagnosed with advanced melanoma between Jan2011-Jun2020, who received PDx therapy alone or in combination with anti-CTLA4, and also received chemotherapy immediately after the PDx line (chemo cohort) were selected from the nationwide US-based Flatiron Health EHR-derived de-identified database. A subgroup of pts who received taxane was also selected. Overall survival (OS) was assessed using Kaplan-Meier methods. Key covariates such as age, gender, LDH level, number of prior lines of therapy, presence of brain and liver metastases, and prior BRAF/MEK treatment, were adjusted using propensity score-based weighting approach. Cox regression models were used to obtain the effect estimates for OS comparing the trial arm against the RWD cohorts. Results: A cohort of 114 pts met the inclusion criteria, of which 69 received taxane. Compared with the trial arm, the RWD cohorts were older, contained more males, with higher proportions receiving prior BRAF/MEK inhibitors, with brain metastasis, and LDH≤ULN. Median OS was 7.4 months (mo) in the trial arm, compared to 5.6 (unadjusted) and 3.5 mo (adjusted) in the chemo cohort. Hazard ratio of 0.49 (95% CI: 0.29-0.83, trial vs. chemo) indicated significant benefits of the trial arm over the chemo cohort. Analyses using taxane subgroup showed similar findings. Conclusions: The RWD cohorts demonstrated poor outcomes for the pts receiving chemotherapy, in particular taxanes, confirming this is a population of unmet need. The results show the potential for improved outcomes using cer + paclitaxel in pts previously treated with PDx.[Table: see text]

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Postoperative hypothermia following non-cardiac high-risk surgery: A prospective study of temporal patterns and risk factors

PLoS ONE ◽

10.1371/journal.pone.0259789 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0259789

Author(s):

Itajiba Paternosti Sabbag ◽

Fabio Barlem Hohmann ◽

Murillo Santucci Cesar Assunção ◽

Renato Carneiro de Freitas Chaves ◽

Thiago Domingos Corrêa ◽

...

Keyword(s):

Risk Factors ◽

Postoperative Complications ◽

Outcome Measure ◽

Cox Regression ◽

National Level ◽

Main Outcome Measure ◽

Strong Risk Factor ◽

Kaplan Meier ◽

Nationally Representative ◽

A Prospective Study

Background and objectives Hypothermia occurs commonly during surgery and can cause postoperative complications. We aimed to describe the characteristics and outcomes of hypothermia in patients undergoing major surgeries. Methods This prospective, observational, multicenter study of a nationally representative sample included all patients over 18 years of age admitted to an intensive care unit (ICU). Thirty ICUs were selected randomly at national level. The main outcome measure was the proportion of patients who developed postoperative hypothermia in the first 24 hours of ICU admission. Patients were divided into three groups based on temperature: <35°C, <36°C, and ≥36°C (no hypothermia). Patients’ characteristics, postoperative complications, and risk factors were evaluated in all groups. To verify whether hypothermia was a strong risk factor for postoperative complications, a Kaplan–Meier curve was generated and adjusted using a Cox regression model. Results In total, 738 patients had their temperatures measured. The percentage of patients with temperature <35°C (median [Q1-Q3], 34.7°C [34.3–34.9°C]) was 19.1% (95% confidence interval [CI] = 16.1–22.5) and that of patients with temperature <36°C (median [Q1-Q3], 35.4°C [35.0–35.8°C]) was 64% (95% CI = 58.3–70.0). The percentage of surgical complications was 38.9%. Patients with hypothermia were older, had undergone abdominal surgeries, had undergone procedures of longer duration, and had more comorbidities. A postoperative temperature ≤35°C was an independent risk for composite postoperative complications (hazard ratio = 1.523, 95% CI = 1.15–2.0), especially coagulation and infection. Conclusions Inadvertent hypothermia was frequent among patients admitted to the ICU and occurred more likely after abdominal surgery, after a long procedure, in elderly patients, and in patients with a higher number of comorbidities. Low postoperative temperature was associated with postoperative complications.

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Fam20C Overexpression Predicts Poor Outcomes and is a Diagnostic Biomarker in Lower-Grade Glioma

Frontiers in Genetics ◽

10.3389/fgene.2021.757014 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jing Feng ◽

Jinping Zhou ◽

Lin Zhao ◽

Xinpeng Wang ◽

Danyu Ma ◽

...

Keyword(s):

Prognostic Value ◽

Cox Regression ◽

Enrichment Analysis ◽

Research Field ◽

Gene Set Enrichment Analysis ◽

Lower Grade ◽

Kaplan Meier ◽

Lower Grade Glioma ◽

Poor Outcomes

Glioma is a relatively low aggressive brain tumor. Although the median survival time of patients for lower-grade glioma (LGG) was longer than that of patients for glioblastoma, the overall survival was still short. Therefore, it is urgent to find out more effective molecular prognostic markers. The role of the Fam20 kinase family in different tumors was an emerging research field. However, the biological function of Fam20C and its prognostic value in brain tumors have rarely been reported. This study aimed to evaluate the value of Fam20C as a potential prognostic marker for LGG. A total of 761 LGG samples (our cohort, TCGA and CGGA) were included to investigate the expression and role of Fam20C in LGG. We found that Fam20C was drastically overexpressed in LGG and was positively associated with its clinical progression. Kaplan-Meier analysis and a Cox regression model were employed to evaluate its prognostic value, and Fam20C was found as an independent risk factor in LGG patients. Gene set enrichment analysis also revealed the potential signaling pathways associated with Fam20C gene expression in LGG; these pathways were mainly enriched in extracellular matrix receptor interactions, cell adhesion, cell apoptosis, NOTCH signaling, cell cycle, etc. In summary, our findings provide insights for understanding the potential role of Fam20C and its application as a new prognostic biomarker for LGG.

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