scholarly journals New Time-Related Insights into an Old Laboratory Parameter: Early CRP Discovered by IBM Watson Trauma Pathway Explorer© as a Predictor for Sepsis in Polytrauma Patients

2021 ◽  
Vol 10 (23) ◽  
pp. 5470
Author(s):  
Ladislav Mica ◽  
Hans-Christoph Pape ◽  
Philipp Niggli ◽  
Jindřich Vomela ◽  
Cédric Niggli
Keyword(s):  
Logistic Regression ◽  
Binary Logistic Regression ◽  
University Hospital ◽  
Threshold Method ◽  
Reactive Protein ◽  
Polytrauma Patients ◽  
Ibm Watson ◽  
Level Of Significance ◽  
Time Specific ◽  
New Time

The University Hospital Zurich together with IBM® invented an outcome prediction tool based on the IBM Watson technology, the Watson Trauma Pathway Explorer®. This tool is an artificial intelligence to predict three outcome scenarios in polytrauma patients: the Systemic Inflammatory Response Syndrome (SIRS) and sepsis within 21 days as well as death within 72 h. The knowledge of a patient’s future under standardized trauma treatment might be of utmost importance. Here, new time-related insights on the C-reactive protein (CRP) and sepsis are presented. Meanwhile, the validated IBM Watson Trauma Pathway Explorer® offers a time-related insight into the most frequent laboratory parameters. In total, 3653 patients were included in the databank used by the application, and ongoing admissions are constantly implemented. The patients were grouped according to sepsis, and the CRP was analyzed according to the point of time at which the value was acquired (1, 2, 3, 4, 6, 8, 12, 24, and 48 h and 3, 4, 5, 7, 10, 14, and 21 days). The differences were analyzed using the Mann–Whitney U-Test; binary logistic regression was used to determine the dependency of prediction, and the Closest Top-left Threshold Method presented time-specific thresholds at which CRP is predictive for sepsis. The data were considered as significant at p < 0.05, all analyses were performed in R. The differences in the CRP value of the non-sepsis and sepsis groups are starting to be significant between 6 and 8 h (p < 0.05) after admission inclusive of post hoc analysis, and the binary logistic regression depicts a similar picture. The level of significance is reached between 6 and 8 h (p < 0.05) after admission. The knowledge of the outcome reflected by the CRP in polytrauma patients improves the surgeon’s tactical position to indicate operations to reduce antigenic load and avoid an infectious adverse outcome.

scholarly journals High sensitivity C-reactive protein: Potential biomarker of inflammation in acute mTBI

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S18.1-S18
Author(s):  
Teena Shetty ◽  
Cogsil Taylor ◽  
Aashka Dalal ◽  
Kristin Halvorsen ◽  
Kelianne Cummings ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Binary Logistic Regression ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Hscrp Level ◽  
Reactive Protein ◽  
Blood Biomarker ◽  
Diagnosis And Prognosis ◽  
Potential Factors ◽  
Delayed Time

ObjectiveThis study investigated the utility of high-sensitivity C-Reactive Protein (hsCRP) as a blood biomarker for mild traumatic brain injury (mTBI).BackgroundValidation of a blood biomarker panel will greatly improve mTBI diagnosis and prognosis. hsCRP has been validated as a sensitive biomarker for inflammation. Previous studies have established relationships between CRP levels and TBI, but the utilization of hsCRP levels in assessing mTBI requires further exploration.MethodsRetrospective chart review collected hsCRP values in acute mTBI patients seen within 30 days of injury. Patients with any comorbid diagnosis known to cause elevation of inflammatory proteins were excluded. Continuous hsCRP levels were transformed into quartiles: <0.200 mg/L for Quartile 1 (Q1); 0.200–0.415 mg/L for Quartile 2 (Q2); 0.415–1.100 mg/L for Quartile 3 (Q3); and ≥1.100 mg/L for Quartile 4 (Q4). Multivariable binary logistic regression modeling identified potential factors for elevated hsCRP at first visit. Cox regression analysis identified potential factors for delayed time to recovery.ResultsThree hundred twelve injuries in 311 patients were reviewed (mean age 21 ± 12 years, 53% female). Mean hsCRP was elevated patients who presented within 2 days of injury and was found to significantly decrease between first visit and 4 weeks post-injury (p = 0.016). Initial hsCRP level was positively correlated with age (r = 0.163, p = 0.004) and negatively associated with previous concussion history (p = 0.031). When analyzed as quartiles, patients in Q4 were more likely to have endorsed headache (p = 0.036) or fatigue (p = 0.030). Age significantly increased between quartiles (p = 0.013). Multivariable binary logistic regression showed that increased age (OR: 3.48) and patients presenting with headache (OR: 3.48) or fatigue (OR: 2.16) were significantly associated with increased risk of having an hsCRP level in Q4. Females (HR: 0.32) and increased age (HR: 0.95) were associated delayed time to recovery.ConclusionshsCRP may be a viable addition to acute and longitudinal biomarker panels for diagnosis and prognosis of mTBI.

Surgeon specific effects on the postoperative systemic inflammatory response and complications following surgery for colorectal cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 799-799
Author(s):  
Stephen Thomas McSorley ◽  
Campbell SD Roxburgh ◽  
Donald C McMillan ◽  
Paul G. Horgan
Keyword(s):  
Colorectal Cancer ◽  
Logistic Regression ◽  
Inflammatory Response ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Binary Logistic Regression ◽  
Systemic Inflammatory Response ◽  
C Reactive Protein ◽  
Binary Logistic Regression Model ◽  
Reactive Protein

799 Background: The present study examined the impact of surgeon specific differences on the postoperative systemic inflammatory response (SIR) as measured by postoperative C-reactive protein (CRP), and complications, following elective surgery for colorectal cancer. Methods: 684 patients who underwent elective colorectal cancer resection performed by 10 consultant surgeons at single centre between 2008 and 2016 were included. Exceeding the established C-reactive protein (CRP) threshold of 150mg/L on postoperative days (POD) 3 and 4 was used to identify outliers by funnel plot analysis. Surgeons with significant differences in the proportion of patients exceeding POD 3 CRP 150mg/L were compared. Significantly different perioperative variables amongst surgeons, and the surgeons themselves, were then entered into a multivariate binary logistic regression model to asses association with POD 3 CRP. Results: Perioperative factors were compared between 3 surgeons with the highest volumes and greatest difference in the proportion of patients exceeding POD 3 CRP 150mg/L (Figure 1); (35% of 137, 50% of 117, 60% of 92, p < 0.001). Amongst the 3 surgeons there were significant differences in comorbid state (p = 0.042), the proportion of patients undergoing minimally invasive surgery (p < 0.001), or surgery lasting over 4 hours (p < 0.001), requiring blood transfusion (p = 0.038), epidural anaesthesia (p < 0.001), and receiving perioperative steroids (p < 0.001). When those factors which were significantly different between surgeons were entered into a multivariate binary logistic regression model to predict exceeding the POD 3 CRP threshold of 150mg/L, only perioperative dexamethasone (OR 0.40, 95% CI 0.19-0.82, p = 0.012), and postoperative complications (OR 2.22, 95% CI 1.14-4.32, p = 0.018), remained independently associated whilst the surgeons themselves were not significantly associated (OR 1.16, 95% CI 0.59-2.30, p = 0.663). Conclusions: This study suggests that surgeon specific difference in the magnitude of the postoperative systemic inflammatory response are related to differences in surgical approach, anaesthetic technique and complications.

Cardiorespiratory Fitness, But Not Central Obesity or C-Reactive Protein, Is Related to Liver Function in Obese Children

2013 ◽  
Vol 25 (1) ◽  
pp. 3-11 ◽  
Author(s):  
Clarice Martins ◽  
Ismael Freitas ◽  
Andréia Pizarro ◽  
Luísa Aires ◽  
Gustavo Silva ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Public Schools ◽  
Liver Function ◽  
Cardiorespiratory Fitness ◽  
Cardiovascular Fitness ◽  
Obese Children ◽  
C Reactive Protein ◽  
Nonalcoholic Fatty Liver ◽  
Reactive Protein ◽  
Level Of Significance

Nonalcoholic fatty liver disease (NAFLD) is one of the most frequent complications associated with excess adiposity. Its pathogenesis is complex and there are multiple factors that may contribute to it. AIM: To analyze whether cardiorespiratory fitness (CRF), waist circumference (WC), and C-reactive protein (CRP) are associated with alanine aminotransferase (ALT) in children with obesity. METHODS: 79 overweight/obese children of both genders, 11–13 year-olds, with abnormal serum ALT from Porto public schools comprised the sample. Measurements included CRF (20-m Shuttle Run Test), WC (NHANES protocol), CRP and ALT (Cholestech LDX analyzer). Logistic regression adjusted for gender, maturation, and weight with ALT levels as dependent variable (risk vs. non risk), and WC (risk vs. non risk), CRP (risk vs. non risk), and CRF (fit vs. unfit) as independent variables. Level of significance was set at 95%. RESULTS: Logistic regression showed that obese fit children were less likely to have abnormal ALT values (OR=.031) CONCLUSION: In obese children, higher cardiovascular fitness appears to reduce the chance of decreased liver function.

scholarly journals Dependency in Activities of Daily Living During the First Year After Stroke

2021 ◽  
Vol 12 ◽  
Author(s):  
Hannah E. Wurzinger ◽  
Tamar Abzhandadze ◽  
Lena Rafsten ◽  
Katharina S. Sunnerhagen
Keyword(s):  
Logistic Regression ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Stroke Unit ◽  
Binary Logistic Regression ◽  
Early Discharge ◽  
University Hospital ◽  
Regression Analyses ◽  
Patient Centered ◽  
Post Stroke

Background: Dependency in personal activities of daily living (ADL) is a common short-term and long-term consequence of stroke and requires targeted rehabilitation. As the duration of hospital stay has become shorter in recent decades, early identification of patients who require rehabilitation has become vital. To our knowledge, no study has investigated whether ADL dependency in the very early stages after admission to the stroke unit can explain ADL dependency 3 and 12 months later. This knowledge would facilitate planning for very early discharge and patient-centered rehabilitation.Objective: This study evaluated whether ADL dependency within 2 days after stroke could explain ADL dependency at 3 and 12 months after stroke.Methods: This longitudinal cohort study included patients with stroke who were treated at a stroke unit in the Sahlgrenska University Hospital (Gothenburg, Sweden) between May 2011 and March 2016. The primary independent variable was ADL dependency at 36–48 h after admission to the stroke unit, which was assessed using a Barthel Index (BI) score of ≤90. The dependent variables were self-reported personal ADL dependency at 3 and 12 months after stroke. Binary logistic regression analyses were performed.Results: Of 366 eligible patients (58% male; median age 71 years), a majority (76%) had mild stroke and 60% were ADL dependent 36–48 h after stroke. Univariable and multivariable logistic regression analyses showed that patients who were dependent within the first 2 days after stroke had higher odds for being dependent 3 months as well as 12 months after stroke.Conclusion: The results indicated that dependency in personal ADL during the first 2 days can explain dependency at 3- and 12-month post-stroke. Therefore, early ADL assessments post-stroke can be used for understanding rehabilitation needs after stroke.

scholarly journals Precision of the models of Altman, Springate, Zmijewski, and Grover for predicting the financial distress

2015 ◽  
Vol 17 (3) ◽  
pp. 405 ◽  
Author(s):  
M. Fakhri Husein ◽  
Galuh Tri Pambekti
Keyword(s):  
Logistic Regression ◽  
Financial Distress ◽  
Early Warning System ◽  
Warning System ◽  
Binary Logistic Regression ◽  
Analytical Tool ◽  
The Other ◽  
Leverage Ratio ◽  
Dummy Variable ◽  
Level Of Significance

Financial distress models need to be developed as a model of an early warning system. Such an effort is intended to anticipate the conditions that can lead to the bankruptcy of the company. This study aims to analyze the accuracy of the model of Altman, Springate, Zmijewski, and Grover as the best predictor of financial distress. This research is a quantitative study in which the data were collected by means of a data pool. This is done by using a dummy variable. The sample consists of 132 companies which are listed on the list of Daftar Efek Syariah (DES) in 2009-2012. The analysis isdone by using an analytical tool that is a Binary Logistic Regression. It shows that the model of Altman, Zmijewski models, Springate, and Grover can be used for prediction of financial distress. However, the model of Zmijewski is the most appropriate model to be used for predicting the financial distress because it has the highest level of significance compared to the other models. Zmijewski model is used for having more emphasis on the leverage ratio as an indicator of financial distress.

scholarly journals Factors influencing the intention of Indonesian nursing students to work in rural areas

2019 ◽  
Vol 7 (3) ◽  
pp. e000144 ◽  
Author(s):  
Amanatul Firdaus ◽  
Ferry Efendi ◽  
Setho Hadisuyatmana ◽  
Gading Ekapuja Aurizki ◽  
Khatijah Lim Abdullah
Keyword(s):  
Logistic Regression ◽  
Nursing Students ◽  
Rural Areas ◽  
Binary Logistic Regression ◽  
Education Programme ◽  
Cross Sectional Study ◽  
Local Context ◽  
Cross Sectional ◽  
Place Of Origin ◽  
Level Of Significance

ObjectiveThe aim of this study was to analyse the factors associated with the intention of Indonesian nursing students to work in rural areas.DesignThis was a cross-sectional study. The instrument used was a self-developed questionnaire consisting of 13 questions.The data were analysed using the χ2 statistics test and binary logistic regression with a level of significance <0.05.SettingThe study was conducted at a public nursing school located in urban Surabaya, East Java, Indonesia, in December 2017.ParticipantsA total of 714 nursing students from four different programmes were involved.ResultsThis study found that almost 60% of nursing students were reluctant to work in rural areas. Of the three variables which were significant in the χ2 analysis, only two were significant following the logistic regression test, namely the class programmes of undergraduate regulars (OR=2.274; 95% CI 1.326 to 3.900), profession regulars (OR=2.262; 95% CI 1.110 to 4.607) and rural place of origin (OR=1.405; 95% CI 1.036 to 1.906).ConclusionThe education programme and place of origin were associated with the intention of nursing students to work in rural areas. Therefore, the recruitment of prospective nurses should consider these factors by considering the local context.

Prevalence and association of syphilis reactivity in an Asian memory clinic population

2018 ◽  
Vol 29 (14) ◽  
pp. 1368-1374
Author(s):  
Bibek Gyanwali ◽  
Muhammad A Shaik ◽  
Saima Hilal ◽  
Jemellee Cano ◽  
Christopher Chen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Binary Logistic Regression ◽  
University Hospital ◽  
Memory Clinic ◽  
Community Based ◽  
Logistic Regression Models ◽  
Gender Education ◽  
National University ◽  
Memory Clinics ◽  
Clinic Population

Data on the association between syphilis reactivity and dementia in memory clinic patients are scarce. We studied the prevalence of syphilis reactivity and investigated its association with dementia and markers of cerebrovascular disease (CeVD) and neurodegeneration. Data on age, gender, education, brain computed tomography scan findings and syphilis reactivity were obtained from patients who attended the National University Hospital memory clinics (February 2006–February 2016) and subjects from the community. Binary logistic regression models were used to investigate associations between syphilis reactivity and dementia, CeVD and neurodegeneration, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Of 1271 memory clinic patients eligible for the study, 57 (4.5%) were syphilis reactive, with the rate of syphilis reactivity higher in demented (44/745; 5.9%) compared to non-demented (13/526; 2.5%) patients ( p = 0.004) and non-demented community-based (21/872; 2.4%) subjects ( p < 0.001). Binary logistic regression showed a significant association between syphilis reactivity and dementia in memory clinic patients independent of demographic factors (odds ratio: 2.06; 95% CI: 1.02–4.17, p = 0.044). A significant association between syphilis reactivity and dementia was found in memory clinic patients. The mechanism of this association requires further research and may involve neuroinflammation.

Evaluating the implementation potential of a transcultural tool for Tamil migrants with gestational diabetes mellitus living in Switzerland

2017 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Logistic Regression ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Binary Logistic Regression ◽  
Private Practices ◽  
Populations At Risk ◽  
Management Procedures

Background: Gestational diabetes mellitus is a condition that affects many pregnancies and ethnicity appears to be a risk factor. Data indicate that approximately 18% of Tamil women are diagnosed with gestational diabetes mellitus. Today, approximately 50,000 of Tamils live in Switzerland. To date, there is no official tool available in Switzerland that considers the eating and physical activity habits of this migrant Tamil population living in Switzerland, while offering a quick overview of gestational diabetes mellitus and standard dietetics management procedures. The NutriGeD project led by Bern University of Applied Sciences in Switzerland aimed at closing this gap. The aim of this present study was to evaluate the implementation potential of the tools developed in the project NutriGeD for dietetic counseling before their wide scale launch in Swiss hospitals, clinics and private practices. Method: An online survey was developed and distributed to 50 recruited healthcare professionals working in the German speaking region of Switzerland from October – December 2016 (31% response rate). The transcultural tools were sent to participants together with the link to the online survey. The evaluation outcome was analysed using binary logistic regression and cross tabulation analysis with IBM SPSS version 24.0, 2016. Results: 94% (N=47) respondents believed that the transcultural tools had good potential for implementation in hospitals and private practices in Switzerland. A binary logistic regression analysis revealed that the age of participants had a good correlation (42.1%) on recommending the implementation potential of the transcultural tool. The participants with age group 34- 54 years old where the highest group to recommend the implementation potential of the transcultural tool and this was found to be statistically significant (p=0.05). 74% (34 out of 50) of the respondents clearly acknowledged the need for transcultural competence knowledge in healthcare practices. 80% (N =40) of the respondents agreed that the information presented in the counseling display folder was important and helpful while 60% (N= 30) agreed to the contents being clinically applicable. 90% (N=45) participants recommended the availability of the evaluated transcultural tools in healthcare settings in Switzerland. Conclusion: The availability in healthcare practice of the evaluated transcultural tools was greatly encouraged by the Swiss healthcare practitioners participating in the survey. While they confirmed the need for these transcultural tools, feed-backs for minor adjustments were given to finalize the tools before their official launch in practice. The developed materials will be made available for clinical visits, in both hospitals and private practices in Switzerland. The Migmapp© transcultural tool can serve as a good approach in assisting healthcare professionals in all fields, especially professionals who practice in areas associated with diet - related diseases or disorders associated with populations at risk.

Intimate Partner Violence and its Association With Contraceptive Use Among Women in Pakistan

2019 ◽  
Vol 34 (Spring 2019) ◽  
pp. 157-173
Author(s):  
Kashif Siddique ◽  
Rubeena Zakar ◽  
Ra’ana Malik ◽  
Naveeda Farhat ◽  
Farah Deeba
Keyword(s):  
Intimate Partner Violence ◽  
Logistic Regression ◽  
Partner Violence ◽  
Contraceptive Use ◽  
Binary Logistic Regression ◽  
Intimate Partner ◽  
Married Women ◽  
Reproductive Age ◽  
Outcome Variable ◽  
Odds Ratios

The aim of this study is to find the association between Intimate Partner Violence (IPV) and contraceptive use among married women in Pakistan. The analysis was conducted by using cross sectional secondary data from every married women of reproductive age 15-49 years who responded to domestic violence module (N = 3687) of the 2012-13 Pakistan Demographic and Health Survey. The association between contraceptive use (outcome variable) and IPV was measured by calculating unadjusted odds ratios and adjusted odds ratios with 95% confidence intervals using simple binary logistic regression and multivariable binary logistic regression. The result showed that out of 3687 women, majority of women 2126 (57.7%) were using contraceptive in their marital relationship. Among total, 1154 (31.3%) women experienced emotional IPV, 1045 (28.3%) women experienced physical IPV and 1402 (38%) women experienced both physical and emotional IPV together respectively. All types of IPV was significantly associated with contraceptive use and women who reported emotional IPV (AOR 1.44; 95% CI 1.23, 1.67), physical IPV (AOR 1.41; 95% CI 1.20, 1.65) and both emotional and physical IPV together (AOR 1.49; 95% CI 1.24, 1.72) were more likely to use contraceptives respectively. The study revealed that women who were living in violent relationship were more likely to use contraceptive in Pakistan. Still there is a need for women reproductive health services and government should take initiatives to promote family planning services, awareness and access to contraceptive method options for women to reduce unintended or mistimed pregnancies that occurred in violent relationships.

Sign in / Sign up

Export Citation Format

Share Document