scholarly journals Predictors of Relapse to Significant Alcohol Drinking after Liver Transplantation

2010 ◽  
Vol 24 (4) ◽  
pp. 245-250 ◽  
Author(s):  
Zamil Karim ◽  
Pongphob Intaraprasong ◽  
Charles H Scudamore ◽  
Siegfried R Erb ◽  
John G Soos ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Logistic Regression ◽  
Liver Disease ◽  
Alcohol Consumption ◽  
Standard Error ◽  
Multivariate Logistic Regression ◽  
Harmful Drinking ◽  
Alcohol Relapse ◽  
Female Sex ◽  
Harmful Alcohol

BACKGROUND: End-stage alcoholic liver disease is common, with many of these patients referred for liver transplantation (LT). Alcohol relapse after LT can have detrimental outcomes such as graft loss and can contribute to a negative public perception of LT.OBJECTIVE: To identify factors that predict the recurrence of harmful alcohol consumption after LT.METHODS: A total of 80 patients who underwent LT for alcoholic cirrhosis or had significant alcohol consumption in association with another primary liver disease, from July 1992 to June 2006 in British Columbia, were retrospectively evaluated by chart review. Several demographic-, psychosocial- and addiction-related variables were studied. Univariate and multivariate logistic regression analyses were used to test possible associations among the variables studied and a return to harmful drinking after LT.RESULTS: The relapse rate of harmful alcohol consumption post-liver transplant was 10%, with two patient deaths occurring directly as a result of alcohol relapse. Univariate analysis revealed relapse was significantly associated with pretransplant abstinence of less than six months (P=0.003), presence of psychiatric comorbidities (P=0.016), female sex (P=0.019) and increased personal stressors (P=0.044), while age at transplant of younger than 50 years approached significance (P=0.054). Multivariate logistic regression analysis revealed the following independent factors for relapse: pretransplant abstinence of less than six months (OR 77.07; standard error 1.743; P=0.013) and female sex (OR 18.80; standard error 1.451; P=0.043).CONCLUSION: The findings of the present study strongly support a required minimum of six months of abstinence before LT because duration of abstinence was found to be the strongest predictor of recidivism. Female sex, younger age at transplant and psychiatric comorbidities were also associated with relapse to harmful drinking.

scholarly journals Alcohol consumption, substance use, and depression in relation to HIV Pre-Exposure Prophylaxis (PrEP) nonadherence among gay, bisexual, and other men-who-have-sex-with-men

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Paul A. Shuper ◽  
Narges Joharchi ◽  
Isaac I. Bogoch ◽  
Mona Loutfy ◽  
Frederic Crouzat ◽  
...  
Keyword(s):  
Substance Use ◽  
Logistic Regression ◽  
High Risk ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Multivariate Logistic Regression ◽  
Harmful Alcohol ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis

Abstract Background Although HIV pre-exposure prophylaxis (PrEP) substantially diminishes the likelihood of HIV acquisition, poor adherence can decrease the HIV-protective benefits of PrEP. The present investigation sought to identify the extent to which alcohol consumption, substance use, and depression were linked to PrEP nonadherence among gay, bisexual, and other men-who-have-sex-with-men (gbMSM). Methods gbMSM (age ≥ 18, prescribed PrEP for ≥3 months) were recruited from two clinics in Toronto, Canada for an e-survey assessing demographics; PrEP nonadherence (4-day PrEP-focused ACTG assessment); hazardous and harmful alcohol use (AUDIT scores of 8–15 and 16+, respectively); moderate/high risk substance use (NIDA M-ASSIST scores > 4); depression (CESD-10 scores ≥10); and other PrEP-relevant factors. The primary outcome, PrEP nonadherence, entailed missing one or more PrEP doses over the past 4 days. A linear-by-linear test of association assessed whether increasing severity of alcohol use (i.e., based on AUDIT categories) was linked to a greater occurrence of PrEP nonadherence. Univariate logistic regression was employed to determine factors associated with PrEP nonadherence, and factors demonstrating univariate associations at the p < .10 significance level were included in a multivariate logistic regression model. Additive and interactive effects involving key significant factors were assessed through logistic regression to evaluate potential syndemic-focused associations. Results A total of 141 gbMSM (Mean age = 37.9, white = 63.1%) completed the e-survey. Hazardous/harmful drinking (31.9%), moderate/high risk substance use (43.3%), and depression (23.7%) were common; and one in five participants (19.9%) reported PrEP nonadherence. Increasing alcohol use level was significantly associated with a greater likelihood of nonadherence (i.e., 15.6, 25.0, and 44.4% of low-risk, hazardous, and harmful drinkers reported nonadherence, respectively (χ2(1) = 4.79, p = .029)). Multivariate logistic regression demonstrated that harmful alcohol use (AOR = 6.72, 95%CI = 1.49–30.33, p = .013) and moderate/high risk cocaine use (AOR = 3.11, 95%CI = 1.01–9.59, p = .049) independently predicted nonadherence. Furthermore, an additive association emerged, wherein the likelihood of PrEP nonadherence was highest among those who were hazardous/harmful drinkers and moderate/high risk cocaine users (OR = 2.25, 95%CI = 1.19–4.25, p = .013). Depression was not associated with nonadherence. Conclusions Findings highlight the need to integrate alcohol- and substance-focused initiatives into PrEP care for gbMSM. Such initiatives, in turn, may help improve PrEP adherence and reduce the potential for HIV acquisition among this group.

scholarly journals Risk factors on admission associated with hospital length of stay in patients with COVID-19: a retrospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anping Guo ◽  
Jin Lu ◽  
Haizhu Tan ◽  
Zejian Kuang ◽  
Ying Luo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Liver Disease ◽  
Length Of Stay ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Hospital Length ◽  
Clinical Treatment ◽  
Hospital Length Of Stay ◽  
Female Sex

AbstractTreating patients with COVID-19 is expensive, thus it is essential to identify factors on admission associated with hospital length of stay (LOS) and provide a risk assessment for clinical treatment. To address this, we conduct a retrospective study, which involved patients with laboratory-confirmed COVID-19 infection in Hefei, China and being discharged between January 20 2020 and March 16 2020. Demographic information, clinical treatment, and laboratory data for the participants were extracted from medical records. A prolonged LOS was defined as equal to or greater than the median length of hospitable stay. The median LOS for the 75 patients was 17 days (IQR 13–22). We used univariable and multivariable logistic regressions to explore the risk factors associated with a prolonged hospital LOS. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated. The median age of the 75 patients was 47 years. Approximately 75% of the patients had mild or general disease. The univariate logistic regression model showed that female sex and having a fever on admission were significantly associated with longer duration of hospitalization. The multivariate logistic regression model enhances these associations. Odds of a prolonged LOS were associated with male sex (aOR 0.19, 95% CI 0.05–0.63, p = 0.01), having fever on admission (aOR 8.27, 95% CI 1.47–72.16, p = 0.028) and pre-existing chronic kidney or liver disease (aOR 13.73 95% CI 1.95–145.4, p = 0.015) as well as each 1-unit increase in creatinine level (aOR 0.94, 95% CI 0.9–0.98, p = 0.007). We also found that a prolonged LOS was associated with increased creatinine levels in patients with chronic kidney or liver disease (p < 0.001). In conclusion, female sex, fever, chronic kidney or liver disease before admission and increasing creatinine levels were associated with prolonged LOS in patients with COVID-19.

Urinary ethyl glucuronide testing detects alcohol consumption in alcoholic liver disease patients awaiting liver transplantation

2007 ◽  
Vol 13 (5) ◽  
pp. 757-761 ◽  
Author(s):  
Yesim Erim ◽  
Michael Böttcher ◽  
Uta Dahmen ◽  
Olof Beck ◽  
Christoph E. Broelsch ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Alcohol Consumption ◽  
Alcoholic Liver Disease ◽  
Ethyl Glucuronide

scholarly journals Satisfaction With Life, Mental Health Problems and Potential Alcohol-Related Problems Among Norwegian University Students

2021 ◽  
Vol 12 ◽  
Author(s):  
Pia Jensen ◽  
Ellen Haug ◽  
Børge Sivertsen ◽  
Jens Christoffer Skogen
Keyword(s):  
Mental Health ◽  
Logistic Regression ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Satisfaction With Life ◽  
Mental Health Problems ◽  
Health Problems ◽  
Harmful Alcohol ◽  
Risky Alcohol ◽  
Alcohol Related Problems

Objective: Recent studies have shown that today's college students more than ever are struggling with mental health and alcohol problems. While poor satisfaction with life and mental health problems have been linked to higher alcohol consumption, there is still a lack of studies examining in detail the shape and nature of the relationship between mental health and alcohol consumption.Aim: To investigate the associations between satisfaction with life, mental health problems and potential alcohol-related problems among Norwegian university students. The shape of the associations was also examined.Methods: Data were drawn from a 2018 national survey of students in higher education in Norway (the SHoT-study). Associations between satisfaction with life, mental health problems and potential alcohol-related problems (AUDIT; risky and harmful alcohol use) were investigated using logistic regression. Both crude models and models adjusted for age, gender and marital status were conducted. To investigate the shape of the associations, logistic regression with quadric and cubic terms was tested.Results: Decreased satisfaction with life and increased mental health problems were associated with potential alcohol-related problems. For satisfaction with life, a curvilinear association with risky alcohol use and a linear association with harmful alcohol use was identified. For mental health problems, curvilinear associations were found for both risky and harmful alcohol use.Conclusion: Many students report potential alcohol-related problems. Students with harmful alcohol use seem to be more at risk of reduced satisfaction with life and increased mental health problems than students with risky alcohol use. Educational institutions may be an ideal setting for raising awareness of mental health issues and responsible alcohol consumption among students. The present study contributes with important information about the shape of the associations between satisfaction with life, mental health problems and potential alcohol-related problems in the student population.

scholarly journals Drinking in denial: a cross-sectional analysis of national survey data in Ireland to measure drinkers’ awareness of their alcohol use

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e034520
Author(s):  
Deirdre Mongan ◽  
Sean R Millar ◽  
Claire O'Dwyer ◽  
Jean Long ◽  
Brian Galvin
Keyword(s):  
Logistic Regression ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Risk Taking ◽  
Drinking Pattern ◽  
Self Awareness ◽  
Drinking Patterns ◽  
Prevalence Survey ◽  
Cross Sectional ◽  
Harmful Drinking

ObjectivesIreland has high per capita alcohol consumption and also has high levels of problematic drinking patterns. While it is accepted that patterns of alcohol consumption in Ireland are a cause for concern, it is not clear if Irish people are actually aware of the extent of their hazardous or harmful pattern of drinking. The aim of this study was to determine awareness of drinking pattern in an Irish population using a representative random sample and to identify characteristics associated with self-awareness of hazardous or harmful drinking.MethodsWe analysed data from Ireland’s 2014/2015 Drug Prevalence Survey which recruited a stratified clustered sample of 7005 individuals aged 15 years and over living in private households. Logistic regression analysis was used to determine characteristics associated with self-awareness of hazardous or harmful drinking.ResultsAlmost one half of drinkers had a hazardous or harmful pattern of drinking; 38% engaged in monthly risky single occasion drinking (RSOD) and 10.5% met Diagnostic and Statistical Manual version IV (DSM-IV) criteria for alcohol dependence. Of the 2420 respondents who had a hazardous or harmful pattern of drinking, 67% were unaware of this and misclassified themselves as being either a light or moderate drinker who did not engage in RSOD. An adjusted logistic regression model identified that hazardous and harmful drinkers were more likely to be aware of their drinking pattern if they had completed third level education (OR=1.80, 95% CI: 1.30 to 2.49) while older drinkers (aged 65 and over) were less likely to be aware of their drinking pattern (OR=0.30, 95% CI: 0.14 to 0.65). Subjects who engaged in risk taking behaviours such as illicit drug use and gambling were also significantly more likely to be aware of their drinking pattern.ConclusionsThe results of this study suggest that patterns of alcohol use in Ireland are problematic. Older respondents and those with lower educational attainment are less likely to be aware of their hazardous or harmful drinking pattern. There is also a population of younger, more-educated drinkers who engage in potentially risk-taking behaviours and these subjects are aware of their harmful drinking pattern. Initiatives to reduce overall alcohol consumption and raise awareness around drinking patterns are required.

P5328Clinical and demographic predictors of attenuated LDL-C response to PCSK9 inhibition with bococizumab: Insights from the SPIRE trials

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Siddiqi ◽  
B M Everett ◽  
L M Rose ◽  
P M Ridker
Keyword(s):  
Logistic Regression ◽  
Neutralizing Antibodies ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Multivariate Logistic Regression ◽  
White Race ◽  
Female Sex ◽  
Younger Age ◽  
Pcsk9 Inhibition ◽  
Robust Response

Abstract Background While there exists significant inter-individual variability in low density lipoprotein cholesterol (LDL-C) response to proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition, predictors of this response remain uncertain. The Studies of PCSK9 Inhibition and the Reduction of Vascular Events (SPIRE) randomized control trials evaluated the efficacy of bococizumab, a humanized murine PCSK9 antibody, in patients at high cardiovascular risk. Purpose This study's purpose is to determine predictors of attenuated LDL-C response to bococizumab. Methods SPIRE 1 and 2 trial subjects allocated to bococizumab (n=13,675) were included. Subjects with an increase in LDL-C or non-compliance to bococizumab, or development of anti-drug or neutralizing antibodies were excluded. The remaining 8281 subjects were divided into quintiles of percent LDL-C reduction from baseline to 14 weeks. The first quintile (Q1) was considered an attenuated response. Multivariate logistic regression was used to discern significant predictors of attenuated response (Q1) compared to robust response (Q5). Results Q1 included 1657 subjects with median 35% LDL-C reduction (range 0.4% - 48%), whereas Q5 included 1658 subjects with median 83% LDL-C reduction (range 78% - 99%). Female sex, diabetes, white race, younger age, higher baseline non-high-density lipoprotein cholesterol (non-HDL-C), lipoprotein (a) [Lp(a)] and high-sensitivity C-reactive protein (hsCRP) were significantly associated with an attenuated response compared to a robust response (each p<0.05, Table). Multivariate logistic regression for attenuated percent LDL-C response to bococizumab from baseline to 14 week Baseline characteristic Adjusted odds ratio (95% confidence interval) P-value Female 3.30 (2.72, 4.00) <0.0001 Diabetes 1.57 (1.32, 1.86) <0.0001 White race 1.44 (1.07, 1.93) 0.016 BMI (per 1kg/m2) 1.09 (1.07, 1.11) <0.0001 Age (per year) 0.98 (0.98, 0.99) 0.0005 Ln hs-CRP (per 1mg/L) 1.19 (1.11, 1.29) <0.0001 Lp (a) (per 10mg/dL) 1.11 (1.09, 1.14) <0.0001 Non-HDL-C (per 10mg/dL) 1.05 (1.02, 1.07) <0.0001 Odds ratios mutually adjusted for the listed variables. Conclusions In the SPIRE 1 and 2 trials, excluding subjects with anti-drug and neutralizing antibodies, significant predictors of an attenuated LDL-C response to PCSK9 inhibition with bococizumab included female sex, diabetes, younger age and white race. Acknowledgement/Funding Pfizer

Alcohol Consumption in the Australian Mining Industry: The Role of Workplace, Social, and Individual Factors

2021 ◽  
pp. 216507992110057
Author(s):  
Carole L. James ◽  
Ross J. Tynan ◽  
Aaron T. Bezzina ◽  
Md Mijanur Rahman ◽  
Brian J. Kelly
Keyword(s):  
Psychological Distress ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Alcohol Misuse ◽  
Site Response ◽  
Convenience Sample ◽  
Harmful Drinking ◽  
Factors Associated ◽  
Harmful Alcohol ◽  
Metalliferous Mining

Background: Coal miners have been reported to have higher rates of risky/harmful alcohol misuse; however, it is not known if metalliferous mining employees whose working conditions differ in workplace practices, also have increased rates of risky/harmful alcohol misuse. This study aimed to examine alcohol consumption in a sample of Australian metalliferous mining workers and to examine the demographic and workplace factors associated with risky/harmful alcohol use. Methods: All employees from a convenience sample of four Australian mine sites were invited to complete a paper-based cross-sectional survey between June 2015 and May 2017. The survey contained questions relating to social networks, health behaviors, psychological distress, demographic characteristics, and risky/harmful drinking. Current alcohol use was measured by the Alcohol Use Disorders Identification Test (AUDIT), a validated measure of risky and/or harmful drinking. Factors associated with risky/harmful drinking were investigated using univariate and multivariable logistic regression. Findings: A total of 1,799 participants completed the survey (average site response rate 95%). Overall, 94.8% of males and 92.1% of females reported using alcohol in the preceding 12 months. The odds of risky/harmful alcohol use were significantly higher in those who were male, younger, and reported higher psychological distress. Conclusions/Application to Practice: This study identified that metalliferous mining employees engage in at-risk levels of alcohol consumption significantly higher than the national average despite workplace policies and practices that restrict alcohol use. Personal and workplace risk factors that may help target specific employee groups and inform the development of tailored, integrated multicomponent intervention strategies for the industry were identified.

Comprehensive study of risk factors for chemotherapy-induced nausea and vomiting in cancer patients receiving cisplatin-based chemotherapy: A TRIPLE pharmacogenomics study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10091-10091
Author(s):  
Hideaki Ayuhara ◽  
Daiki Tsuji ◽  
Mari Yokoi ◽  
Kenichi Suzuki ◽  
Yohei Kawasaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Nausea And Vomiting ◽  
Multivariate Logistic Regression ◽  
Independent Variables ◽  
Female Sex ◽  
Antiemetic Treatment

10091 Background: Chemotherapy-induced nausea and vomiting (CINV) is one of the most unpleasant adverse effects of chemotherapy. Resistance to prophylactic antiemetic treatment is problematic, with 30%–50% of patients experiencing unsatisfactory control. Younger age and female sex are well-known risk factors for CINV. Genetic polymorphisms are suggested to influence antiemetic treatment response. Methods: This study included a subset of patients previously enrolled in a randomised controlled trial. This study aimed to evaluate the role of pharmacogenomic polymorphisms relevant to antiemetic response in patients with cancer receiving cisplatin-based chemotherapy. The study’s efficacy endpoint was the proportion of patients with complete response (CR). The study endpoint was evaluated separately in the acute (CR0-24) and delayed (CR24-120) phases. Thirteen polymorphisms were genotyped, and the association of these genotypes with the efficacy of prophylactic antiemetics was then investigated. Confounding variables for CR were identified using stepwise multivariate logistic regression analysis. Age and sex were included as independent variables by the forced-entry method, and the stepwise method was used to select the pharmacogenomic factors for inclusion as independent variables. Results: In this genetic polymorphism association study, 156 patients with solid cancer were evaluated. Multivariate logistic regression analysis revealed that ERCC1 8092AA (odd ratio [OR]: 11.251; 95% confidence interval [CI]: 1.741–72.712, P = 0.011) and female sex (OR = 3.630; 95% CI = 1.138–11.578, P = 0.029) were significant predictors of CR0-24. No significant association of CR24-120 with pharmacogenomic polymorphisms was found via multivariate logistic regression analysis. Conclusions: ERCC1 polymorphism might be influenced the extent of CINV control in patients receiving cisplatin-based chemotherapy. Clinical trial information: 000009335.

Sign in / Sign up

Export Citation Format

Share Document