scholarly journals RISK FACTORS OF POSTOPERATIVE PULMONARY COMPLICATIONS AFTER SURGERY FOR ESOPHAGEAL CANCER USING UNIVARIATE AND STEPWISE LOGISTIC REGRESSION ANALYSES

1997 ◽  
Vol 58 (11) ◽  
pp. 2493-2498
Author(s):  
Chikara KUNISAKI ◽  
Hiroyuki YAMAOKA ◽  
Masazumi TAKAHASHI ◽  
Daisuke MINABE ◽  
Noriomi HOSAKA ◽  
...  
2021 ◽  
Author(s):  
Zhang Peng ◽  
Zhao Song

Abstract Background Postoperative pulmonary complications (PPCs) are the most common postoperative complications in patients with esophageal cancer. Prediction of PPCs by establishing a preoperative physiological function parameter model can help patients make adequate preoperative preparation, reduce treatment costs, and improve prognosis and quality of life. The purpose of this study was to investigate the relationship between albumin-to-fibrinogen ratio (AFR), prognostic nutritional index (PNI), albumin-to-globulin ratio (AGR), neutrophils-to-lymphocyte ratio (NLR), platelet-to-lymphocyte (PLR), and monocyte-to -lymphocyte ratio (MLR) and other preoperative laboratory tests and PPCs in patients after esophagectomy. Methods Retrospective analysis was performed on total 712 consecutive patients who underwent esophagectomy in the Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University from July 2018 to December 2020. Patients were divided into training (535 patients) and validation (177) groups for comparison of baseline data, perioperative indicators, and laboratory examination data. Receiver operating characteristic (ROC) curve analysis was used to evaluate the efficacy, sensitivity and specificity of AFR, and Youden’s index was used to calculate the cut-off values of AFR. Univariate and multivariate logistic regression analyses were used to assess the risk factors for PPCs in training group. Results 112 (20.9%) in training group and 36 (20.3%) in validation group developed PPCs. The AUC value predicted by AFR using ROC curve analysis was 0.817, sensitivity 76.2% and specificity 78.7% in training group while AUC 0.803, sensitivity 69.4% and specificity 85.8%. Multivariate logistic regression analysis showed that smoking index, American Society of Anesthesiologists (ASA), AFR, and recurrent laryngeal nerve palsy were independent risk factors for PPCs. Conclusion Preoperative AFR can effectively predict the occurrence of PPCs in patients with esophageal cancer


2020 ◽  
Author(s):  
Yiqin Ji ◽  
Hui Yuan ◽  
Yijun Chen ◽  
Xincai Zhang ◽  
Fan Wu ◽  
...  

Abstract Background Use of sugammadex is associated with fewer postoperative pulmonary complications. This study investigated the relationship between sugammadex and postoperative pulmonary complications (PPC) in specific patients with respiratory dysfunction. Methods The authors reviewed the electronic medical and anesthesia records of patients with respiratory dysfunction who had laparoscopic gastric or intestinal surgery at a single center between May 01, 2018, and December 31, 2019. The patients were divided into the sugammadex group and the non-sugammadex group, based on whether or not they received sugammadex. Binary logistic regression analyses were used to characterize the differences in incidence of PPC. Results A total of 112 patients were included, of which 46 patients (41.07%) received sugammadex. In the logistic regression analysis, the incidences of PPC were fewer in the sugammadex group. Postoperative fever [Odds Ratio (OR) 0.330; 95% Confidence Interval (CI) 0.137–0.793, p = 0.0213], postoperative ICU admission (OR 0.204; 95% CI 0.065 to 0.644, p = 0.007), cough (OR 0.143; 95% CI 0.061 to 0.333, p < 0.001), pleural effusion (all) (OR: 0.280; 95% CI 0.104 to 0.759, p = 0.012), pleural effusion (massive) (OR: 0.142; 95% CI 0.031 to 0.653, p = 0.012), and difficulty in breathing (OR: 0.111; 95% CI 0.014 to 0.849, p = 0.039) showed significant differences between the two groups. Conclusions Sugammadex-mediated reversal of neuromuscular blockade can reduce the PPC in patients with respiratory dysfunction.


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Luca Giannella ◽  
Lillo Bruno Cerami ◽  
Tiziano Setti ◽  
Ezio Bergamini ◽  
Fausto Boselli

Objective. To create a prediction model including clinical variables for the prediction of premalignant/malignant endometrial pathology in premenopausal women with abnormal uterine bleeding (AUB). Methods. This is an observational retrospective study including 240 premenopausal women with AUB referred to diagnostic hysteroscopy. Based on the presence of endometrial hyperplasia (EH) or cancer (EC), the women were divided into cases (EH/EC) and controls (no EH/EC). Univariate, stepwise logistic regression and ROC curve analysis were performed. Results. 12 women had EH/EC (5%). Stepwise logistic regression analysis showed that EH/EC associated significantly with BMI ≥ 30 (OR=7.70, 95% CI 1.90 to 31.17), diabetes (OR=9.71, 95% CI 1.63 to 57.81), and a thickened endometrium (OR=1.20, 95% CI 1.08 to 1.34, criterion > 11 mm). The AUC was 0.854 (95% confidence intervals 0.803 to 0.896, p<0.0001). Considering the pretest probability for EH/EC of 5%, the prediction model with a positive likelihood ratio of 8.14 showed a posttest probability of 30%. The simultaneous presence of two or three risk factors was significantly more common in women with EH/EC than controls (50% vs. 6.6 and 25% vs. 0%, respectively, p<0.0001). Conclusion. When premenopausal vaginal bleeding occurs in diabetic obese women with ET > 11 mm, the percentage of premalignant/malignant endometrial pathology increases by 25%. It is likely that the simultaneous presence of several risk factors is necessary to significantly increase the probability of endometrial pathology.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. M. van Rees ◽  
W. Hartman ◽  
J. J. M. E. Nuyttens ◽  
E. Oomen-de Hoop ◽  
J. L. A. van Vugt ◽  
...  

Abstract Background Chemoradiation with capecitabine followed by surgery is standard care for locally advanced rectal cancer (LARC). Severe diarrhea is considered a dose-limiting toxicity of adding capecitabine to radiation therapy. The aim of this study was to describe the risk factors and the impact of body composition on severe diarrhea in patients with LARC during preoperative chemoradiation with capecitabine. Methods A single centre retrospective cohort study was conducted in a tertiary referral centre. All patients treated with preoperative chemoradiation with capecitabine for LARC from 2009 to 2015 were included. Patients with locally recurrent rectal cancer who received chemoradiation for the first time were included as well. Logistic regression analyses were performed to identify risk factors for severe diarrhea. Results A total of 746 patients were included. Median age was 64 years (interquartile range 57–71) and 477 patients (64%) were male. All patients received a radiation dosage of 25 × 2 Gy during a period of five weeks with either concomitant capecitabine administered on radiation days or continuously during radiotherapy. In this cohort 70 patients (9%) developed severe diarrhea. In multivariable logistic regression analyses female sex (OR: 4.42, 95% CI 2.54–7.91) and age ≥ 65 (OR: 3.25, 95% CI 1.85–5.87) were the only risk factors for severe diarrhea. Conclusions Female patients and patients aged sixty-five or older had an increased risk of developing severe diarrhea during preoperative chemoradiation therapy with capecitabine. No relation was found between body composition and severe diarrhea.


Author(s):  
Magaji Garba Taura ◽  
Lawan Hassan Adamu ◽  
Abdullahi Yusuf Asuku ◽  
Kabiru Bilkisu Umar ◽  
Musa Abubakar

Abstract Background Sex determination is one of the leading criterion in identification and verification of an individual. However, the potential roles of differences in adjacent fingerprint white line count (FWLC) in sex inference are not well elucidated in the literature especially among Hausa population. The study was conducted to determine sexual dimorphism and predict sex using adjacent digit FWLC difference (adj. DFWLCD) among Hausa population of Kano state, Nigeria. Methods The study population involved 300 participants. FWLC was determined from a plain fingerprint captured using live scanner. The formula for adj. DFWLCD of thumb and fifth digit is dR15 for right hand. The same applied for possible combination in cephalocaudal direction. Mann-Whitney and t tests were used for comparison of variables between sexes. Binary logistic regression analyses were employed for determination of sex. Results We observed a significantly larger adj. DFWLCD in males compared with females in most of the digit combination. A significant sexual dimorphism was observed in most of the adj. DFWLCD involving ring digit in both right (dR14, dR24, and dR34) and left (dL14, dL24, and dL34). The best discrimination was observed in adjacent FWLC difference of second and fourth digits in both right and left digits (dR24 and dL24). This was further supported by stepwise logistic regression analyses. Conclusion The adj. DFWLCD exhibits sexual dimorphism. The best prediction potentials were found to be dR24 and dL24 for right and left hands respectively.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Sha Sha ◽  
Jigang Dong ◽  
Maoyu Wang ◽  
Ziyu Chen ◽  
Peng Gao

Abstract Background The radiation-induced lung injury (RILI) in patients with advanced non-small cell lung cancer (NSCLS) is very common in clinical settings; we aimed to evaluate the risk factors of RILI in NSCLS patients, to provide insights into the treatment of NSCLS. Methods NSCLC patients undergoing three-dimensional conformal radiotherapy (3D-CRT) in our hospital from June 1, 2018, to June 30, 2020, were included. The characteristics and treatments of RILI and non-RILI patients were analyzed. Logistic regression analyses were conducted to assess the risk factors of RILI in patients with NSCLC. Results A total of 126 NSCLC patients were included; the incidence of RILI in NSCLC patients was 35.71%. There were significant differences in diabetes, smoke, chronic obstructive pulmonary disease (COPD), concurrent chemotherapy, radiotherapy dose, and planning target volume (PTV) between the RILI group and the non-RILI group (all P < 0.05). Logistic regression analyses indicated that diabetes (OR 3.076, 95%CI 1.442~5.304), smoke (OR 2.745, 95%CI 1.288~4.613), COPD (OR 3.949, 95%CI 1.067~5.733), concurrent chemotherapy (OR 2.072, 95%CI 1.121~3.498), radiotherapy dose ≥ 60 Gy (OR 3.841, 95%CI 1.932~5.362), and PTV ≥ 396 (OR 1.247, 95%CI 1.107~1.746) were the independent risk factors of RILI in patients with NSCLC (all P < 0.05). Conclusions RILI is commonly seen in NSCLS patients; early targeted measures are warranted for patients with those risk factors; future studies with larger sample sizes and different areas are needed to further elucidate the influencing factors of RILI in the treatment of NSCLS.


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