scholarly journals A 19 Year Analysis of Small Mammals Associated with Human Hantavirus Cases in Chile

Viruses ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 848
Author(s):  
Torres-Pérez ◽  
Palma ◽  
Boric-Bargetto ◽  
Vial ◽  
Ferrés ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Small Mammals ◽  
Zoonotic Diseases ◽  
Human Populations ◽  
Southern Chile ◽  
Seropositivity Rate ◽  
Oligoryzomys Longicaudatus ◽  
Eleven Species

Small mammals present in areas where hantavirus cardiopulmonary syndrome (HCPS) cases had occurred in central and southern Chile were captured and analyzed to evaluate the abundance of rodents and seroprevalence rates of antibodies to Andes orthohantavirus (ANDV). Sampling areas ranged from the Coquimbo to Aysén regions (30–45° S approx.) regions. Ninety-two sites in peridomestic and countryside areas were evaluated in 19 years of sampling. An antibody against ANDV was detected by strip immunoassay in 58 of 1847 specimens captured using Sherman traps. Of the eleven species of rodents sampled, Abrothrix olivacea, Oligoryzomys longicaudatus and Abrothrix hirta were the most frequently trapped. O. longicaudatus had the highest seropositivity rate, and by logistic regression analysis, O. longicaudatus of at least 60 g had 80% or higher probability to be seropositive. Sex, age and wounds were significantly related to seropositivity only for O. longicaudatus. Across administrative regions, the highest seropositivity was found in the El Maule region (34.8–36.2° S), and the highest number of HCPS cases was registered in the Aysén region. Our results highlight the importance of long term and geographically extended studies, particularly for highly fluctuating pathogens and their reservoirs, to understand the implications of the dynamics and transmission of zoonotic diseases in human populations.

scholarly journals FRI0118 RISK OF LIVER FIBROSIS ON TRANSIENT ELASTOGRAPHY IN PATIENTS WITH RHEUMATIC DISEASE UNDER LONG-TERM METHOTREXATE TREATMENT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 640.1-640
Author(s):  
S. J. Choi ◽  
J. S. Lee ◽  
S. H. Nam ◽  
W. J. Seo ◽  
J. S. Oh ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Autoimmune Disease ◽  
Liver Fibrosis ◽  
Rheumatic Disease ◽  
Logistic Regression Analysis ◽  
Takayasu Arteritis ◽  
Transient Elastography ◽  
Liver Stiffness

Background:Methotrexate (MTX) is a cornerstone drug for the treatment of rheumatic disease and low doses of MTX are both tolerable and safe, with monitored toxicity, assessed via the liver function test. However, there is still controversy regarding the risk of liver fibrosis with long-term use of MTX. Transient elastography is commonly used to assess and monitor fibrosis progression in patients with chronic liver disease.Objectives:The present study aims to investigate liver fibrosis using transient elastography and related factors in patients with rheumatic disease receiving long-term MTX.Methods:The present retrospective, longitudinal, cross-sectional study included patients with an autoimmune disease who are taking cumulative MTX dosed over 7 g, and who had liver fibrosis upon examination using transient elastography. Liver fibrosis was defined as liver stiffness, valued over 7.2 kPa. Logistic regression analysis was performed to identify factors associated with liver fibrosis, and receiver operating characteristics analysis was used to determine the predictive value of each factor.Results:We included 83 patients with autoimmune disease, with a median MTX cumulative dose of 11.6 (range 7.3-16.0) g. Sixty-eight patients (81.9%) had rheumatoid arthritis (RA), and 13 patients (15.7%) had Takayasu arteritis. The median MTX exposure duration was 18 (range 9-31) years. The median liver stiffness value was 4 (range 1.8-10.2) kPa. Five patients (6%) showed liver fibrosis (3 patients; RA, 2 patients; Takayasu arteritis). In the linear regression analysis, cumulative MTX dose showed a tendency towards a positive correlation with increasing liver stiffness value (r2 =0.039, p = 0.074). In the logistic regression analysis, cumulative MTX dose was associated with a higher risk of liver fibrosis (OR: 1.734, 95% CI: 1.060–2.837, p = 0.029). In addition, cumulative MTX dose had an area under the curve (AUC) of 0.813 (95% CI 0.695-0.930) and a sensitivity of 80% and specificity of 71.8% at a cut-off value of 12.7 g.Conclusion:Liver fibrosis was observed in 6% of patients with long-term MTX use and higher cumulative MTX doses increased the risk of liver fibrosis. Thus, transient elastography should be considered in patients exposed to high cumulative doses of MTX.Disclosure of Interests:None declared

Abstract WP202: Decompressive Hemicraniectomy After Malignant Middle Cerebral Artery Ischemic Stroke in a Developing Country is Associated With Poor Long Term Functional Outcome and High Mortality

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Hellen C Homem ◽  
Francisco J Montalverne ◽  
Fernanda M Carvalho ◽  
Francisco Ramos Junior ◽  
Heitor F Ramos ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Middle Cerebral Artery ◽  
Functional Outcome ◽  
Stroke Care ◽  
Rehabilitation Services ◽  
Decompressive Hemicraniectomy ◽  
Malignant Mca Infarction

Background: Decompressive hemicraniectomy (DH) is a level IA therapy for malignant middle cerebral artery (MCA) infarction. However, randomized trials were performed in high income countries with better access to post-stroke care and rehabilitation services. We aimed to assess long term functional outcome and the associated prognostic factors of patients undergoing DH in Brazil. Methods: From January 2013 and July 2018, all patients undergoing DH for malignant MCA infarction in a single comprehensive stroke center were retrospectively identified. Outcomes were the modified Rankin Scale (mRS) (dichotomized as ≤ 4 vs. > 4) and mortality at follow-up. The mRS at follow-up was collected prospectively by telephone using a validated structured interview. Logistic regression analysis was performed to assess independent predictors of outcome. Results: Eighty patients who underwent DH for malignant MCA infarction were identified. Age ranged from 16 to 78 years (median 48 years, IQR 42 - 54,7 years), 46 (57.6%) were males and median time from stroke onset to hemicraniectomy was 30.75 hours (IQR 17.8-46.0). Hospital discharge mRS ≤ 3 and ≤ 4 was observed in 5 (6.2%) and 74 (92,5%) patients respectively. Follow-up information was available for 65 (81.2%) patients. At follow-up (raging from 1.1 to 5.6 years), mRS ≤ 4 was observed in 23 (35.3%) patients. In binary logistic regression analysis, age (OR 1.09, 95% CI 1.02 - 1.17, p=0.01), and right MCA infarction (OR 16.70, 95% CI 1.8-152.30, p=0.01) were independently associated with a worse functional outcome at follow-up. Admission NIHSS (OR 1.0 ,95% CI 0.8-1.3, p=0.45), IV rt-PA (OR 0.5, 95% CI 0.08-3.00, p=0.46) or time of hemicraniectomy (OR 1.00, 95% CI 1.00 - 1.00, p=0.94) were not associated with functional outcome at follow-up. Mortality was 26% (N=21) at hospital discharge and 46% (N=30) at follow-up. Conclusion: The large effect size of DH for malignant MCA infarction is significantly diminished in the population of patients treated under the less than ideal conditions typically found in the public healthcare system of a developing country. Poor access to post-stroke care and rehabilitation services might be possible reasons for the results observed.

Abstract TMP81: Artificial Intelligence Beats Conventional Regression Analysis in Predicting Short and Long Term Risk of Stroke in Patients Undergoing Percutaneous Coronary Interventions

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Pradyumna Agasthi ◽  
Chieh-Ju Chao ◽  
Han Lun Wu ◽  
Farouk Mookadam ◽  
Nithin Venepally ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Area Under The Curve ◽  
Coronary Intervention ◽  
Test Sample ◽  
Training Sample ◽  
Logistic Regression Models ◽  
Percutaneous Coronary ◽  
Short And Long Term

Introduction: Ischemic stroke (IS) causes substantial morbidity and mortality in patients undergoing percutaneous coronary intervention (PCI) with a 5 yr incidence ~ 3%. We sought the test the accuracy of Machine learning (ML) algorithms in predicting IS in patients undergoing PCI. Methods: Mayo Clinic CathPCI registry data were retrospectively analyzed from Jan 2003 - June 2018 including 21,872 patients who underwent PCI. The cohort was randomly divided into a training sample (75%, n=16404) and a unique test sample (25%, n=5468) prior to model generation. The risk prediction model was generated utilizing a random forest algorithm (RF model) on 188 unique variables to predict the risk of IS at 6-month, 1, 2, and 5-year post PCI. Conventional risk factors for stroke were used for logistic regression. The receiver operating characteristic (ROC) curve and area under the curve for the RF and logistic regression models were compared for the test cohort. Results: The mean age was 66.9 ± 12.4 years, and 71% were male. Patient demographics and outcomes are shown in Table 1 . The ROC area under the curve for the RF model was superior compared to the logistic regression model in predicting IS at 6 months, 1,2 and 5 yrs for the test cohort ( Figure 1 .) Conclusions: The RF model accurately predicts short and long term risk of IS and outperforms logistic regression analysis in patients undergoing PCI.

Abstract 349: Target Temperature Management After Return of Spontaneous Circulation Did Not Ameliorate Mid-term (30 to 90-day) Neurological Improvement in Out-of-hospital Cardiac Arrest Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Hiromichi Naito ◽  
Takashi Yorifuji ◽  
Tetsuya Yumoto ◽  
Tsuyoshi Nojima ◽  
Noritomo Fujisaki ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cardiac Arrest ◽  
Regression Analysis ◽  
Spontaneous Circulation ◽  
Temperature Management ◽  
Multivariable Logistic Regression Analysis ◽  
Return Of Spontaneous Circulation ◽  
Neurological Improvement ◽  
Hospital Cardiac Arrest

Introduction: Mid/long-term outcomes of out-of-hospital cardiac arrest (OHCA) survivors have not been extensively studied. Targeted temperature management (TTM) after return of spontaneous circulation is one known therapeutic approach to ameliorate short-term neurological improvement of OHCA patients; however, the prognostic significance of TTM in the mid/long-term clinical setting have not been defined. Hypothesis: TTM would confer additional improvement of OHCA patients’ mid-term neurological outcomes. Methods: Retrospective study using the Japanese Association for Acute Medicine OHCA Registry (Jun 2014 - Dec 2017): a nationwide multicenter registry. Patients who did not survive 30 days after OHCA, those with missing 30-day Cerebral Performance Category (CPC) scores, and those < 18 years old were excluded. Primary endpoint was alteration of neurological function evaluated with 30-day and 90-day CPC. Association between application of TTM (33-36°C) and mid-term CPC alteration was evaluated. Multivariable logistic regression analysis was used for the primary outcome; results are expressed with odds ratio (OR) and 95% confidence interval (CI). Results: We included 2,905 in the analysis. Patient characteristics were: age: 67 [57 - 78] years old, male gender: 70.8%, witnessed collapse: 81.4%, dispatcher instruction for CPR: 51.6%, initial shockable rhythm: 67.0%, and estimated cardiac origin: 76.5%. TTM was applied to 1,352/2,905 (46.5%) patients. Thirty-day CPC values in surviving patients were: CPC 1: 1,155/2,905 (39.8%), CPC 2: 321/2,905 (11.1%), CPC 3: 497/2,905 (17.1%), and CPC 4: 932/2,905 (32.1%), respectively. Ninety-day CPC values were: CPC 1: 866/1,868 (46.4%), CPC 2: 154/1,868 (8.2%), CPC 3: 224/1,868 (12.0%), CPC 4: 392/1,868 (20.1%), and CPC 5: 232/1,868 (12.4%), respectively. Of 1,636 patients with 90-day survival, 28 (1.7%) demonstrated improved CPC at 90 days, whereas, 133 (8.1%) showed worsened CPC at 90 days compared with 30-day CPC, respectively. Multivariable logistic regression analysis revealed TTM did not result in favorable mid-term neurological changes (adjusted OR: 1.44, 95% CI: 0.48 - 4.31). Conclusions: TTM may not contribute to the beneficial effect on OHCA patients’ mid-term neurological changes.

Postoperative Day 1 Morning Cortisol Value as a Biomarker to Predict Long-term Remission of Cushing Disease

2020 ◽  
Vol 106 (1) ◽  
pp. e94-e102
Author(s):  
Fang Wang ◽  
Michael P Catalino ◽  
Wenya Linda Bi ◽  
Ian F Dunn ◽  
Timothy R Smith ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Serum Cortisol ◽  
Serum Cortisol Level ◽  
Cushing Disease ◽  
Kaplan Meier ◽  
Free Cortisol ◽  
Morning Serum Cortisol

Abstract Context Recurrence of Cushing disease (CD) can occur even decades after surgery. Biomarkers to predict recurrence of CD after surgery have been studied but are inconclusive. Objective The aim of our study was to identify specific biomarkers that can predict long-term remission after neurosurgery. Design Identification of specific biomarkers to predict long-term remission of CD was performed by logistic regression analysis followed by Kaplan–Meier survival analysis, using recurrence as the dependent variable. Setting A total of 260 patients with CD identified from our institutional research patient data registry search tool and from patients who presented to our longitudinal multidisciplinary clinic between May 2008 and May 2018 underwent statistical analysis. Interventions Data on clinical features, neuro-imaging study, pathology, biochemistry, and treatments were collected by reviewing digital chart records. Main Outcome Measure Postoperative cortisol as a biomarker to predict long-term remission after surgical treatment for CD. Results By logistic regression analysis, postoperative day 1 (POD1) morning (5-10 am) serum cortisol, female sex, and proliferative index had significant association with CD recurrence (odds ratio [OR] = 1.025, 95% CI: 1.002-1.048, P = .032). In contrast, the postoperative nadir cortisol (OR = 1.081, 95% CI: 0.989-1.181, P = .086), urinary free cortisol (OR = 1.032, 95% CI: 0.994-1.07, P = .098), and late night salivary cortisol (OR = 1.383, 95% CI: 0.841-2.274, P = .201) had no significant correlation with recurrence. A significant association between POD1 morning serum cortisol and long-term CD remission was verified by Kaplan–Meier analysis when using POD1 morning serum cortisol &lt;5 μg/dL as the cut-off. Conclusions The POD1 morning serum cortisol level has a significant association with CD recurrence.

“Non-Hodgkin's Lymphomas and Diabetes of Type 2 in Elderly Patients: Impact On Management in the Real Life”.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4998-4998
Author(s):  
Stephane Moreau ◽  
Liliane Remenieras ◽  
Mohamed Touati ◽  
Marie Jose RAPP ◽  
Marie-Pierre Gourin ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Logistic Regression ◽  
Multivariate Analysis ◽  
Regression Analysis ◽  
Regional Network ◽  
Diabetes Status ◽  
Significant Difference ◽  
Dose Reductions

Abstract Abstract 4998 Purpose Prevalence of patients (pts) suffering of non-Hodgkin's lymphoma (NHL) and diabetes is increasing. Previous investigations were mainly focused on possible association with an increased risk of NHL in pts with type 2 diabetes. In another way, it is well known that NHL patients (pts) with co-morbidity are treated less intensively and have worse prognosis. We propose a retrospective analysis of a homogeneous aggressive lymphoma cohort based on a multicentric regional network database to assess the cross-impact of diabetes and NHL in term of pts management and survival. Patients and methods All pts with high-grade NHL cases, histologically proven, diagnosed between 2003 and 2008 in the Hematology Department of regional network HEMATOLIM, have been included. Diabetes of type 2 has been defined according to international criteria. Data about diabetes and lymphoma treatments, toxicity, relapse, progression or death, have been collected from the Database Structure Régionale de Référence sur les Lymphomes en Limousin. Statistical analysis had been done by StatView and SAS 9.1.2 softwares. Results We included 251 NHL pts with aggressive NHL concerning 69.3% Diffuse Large B Cell Lymphoma (DLBCL) (n=174), 7.6% Mantle cell (n=19), 5.2% Peripheral T-cell (n=13), 5.2% Burkitt (n=13) and 12.7% others (anaplastic (n=9), Follicular grade 3B (n=8),T angioimmunoblastic (n=8), primary mediastinal NHL (n=3), nasal NK-T (n=2), T-cell-rich BCL (n=1), centroblastic BCL (n=1)). Among these NHL, 16.7% had type 2 diabetes (n=42). Sex ratio was 1 for diabetic pts (dp) versus (vs) 1.4 for non-diabetic pts (ndp), the average age was 65.1±15.8, 71.3±8.4 for dp vs 63.8±16.6 for ndp (p=0.005). All received first-line chemotherapy mainly Cyclophosphamide/Oncovin/ Adriamycine/Prednisone ± Rituximab (54.6%, n=137), with no difference between dp and ndp (respectively 59.5% vs 57.0%). Chemo-resistance was reported for 22.7% of pts (28.6% dp (n=12) and 21.5% ndp (n=45)). Chemotherapy-related toxicities were more frequent in dp (71.4%, n=30, vs 47.8%, n=100 ndp) (p=0.005), mainly fever and/or bleeding and infectious complications or back to hospitalization. Dose reductions were more frequent in dp, 31.0%, (n=13) vs ndp 12.0%, n=25) (p=0.0017) and adjustements in time-interval (54.8%, n=23, vs 38.8%, n=81 ndp) (p=0.05) of chemotherapy course. A logistic regression analysis showed that dose reductions and treatment-related toxicities were associated to diabetes status (p=0.015 and p=0.026, respectively). Complete remission (CR) was achieved for 66% ndp (n=138) vs 40.5% dp (n=17) with significant difference (p=0.0019). Relapses: no significant difference between both groups with 13.9% ndp (n=29) vs 19% dp (n=8). Mortality rate was significantly increased: 41.6 % ndp vs 59.5% dp (p=0.033), mainly due to NHL complications, 41.6% ndp (n=87) vs 59.5% dp (n=25) (p=0.033). With a median follow-up of 17 months (m) (range 0-72), median overall survival (OS) was not reached for ndp vs 12±9 m for dp (p=0.006), median event-free survival (EFS) was 41±6.2 m for ndp vs 11±4.3 m for dp (p=0.002). In a multivariate analysis, the differences disappeared on OS and EFS after adjustment on age. A logistic regression analysis showed an important increasing of complications, adjustment of doses, and CR but these chemotherapy-related toxicities had no impact on dp survival. The impact of chemotherapy mainly including corticosteroids on the long term diabetes status has been assessed at the end of NHL treatment, 35.7% increased oral medication to oral insulin or received an intensified dose of the antidiabetic treatment (9.5%, n=4). Some dp with oral treatment improved their glycemia (7.1%, n=3), and used only hygiene-dietary measures. Long term insulin treatment was introduced after glycemia disorders for 3.8% ndp (n=8). Conclusion Aggressive NHL were more frequently associated with type 2 diabetes (16%) in our regional cohort probably due to the study population median age around 68 years. A real impact of incidence of the chemotherapy-related toxicities, back to hospitalization, a less dose-intensity chemotherapy on dp CR has been significantly demonstrated. EFS and OS were not significant in multivariate analysis especially with adjustment on age. These results claim for a cautious management of diabetes at the initial assessment and during chemotherapy for decreasing complications and by an intensive patient education. Disclosures No relevant conflicts of interest to declare.

Predictors of long-term survival in patients with metastatic renal cell carcinoma in the cytokine era: An analysis of 473 patients treated between 1995 and 2005.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 335-335
Author(s):  
N. Shinohara ◽  
S. Maruyama ◽  
T. Abe ◽  
A. Sazawa ◽  
K. Nonomura ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Renal Cell ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Term Survival ◽  
Long Term Survivors ◽  
Metastatic Rcc

335 Background: Based on the clinical data in Japanese renal cell carcinoma (RCC) patients who underwent cytokine therapy (Naito et al, Eur Urol 2010), the overall survival (OS) of these patients has been considered to be better than that of Caucasian patients. We identified long-term survivors among a cohort of 473 metastatic RCC patients, and explored clinical predictors of OS in these patients. Methods: Between 1995 and 2005, 473 patients with metastatic RCC were the subjects of this retrospective analysis. Three hundred sixty-one (76%) patients received IFN-α and no patient did molecular-targeted drugs. The patients with survival times of greater than 5 years after the development of metastases were identified as long-term survivors. Multiple logistic regression analysis was performed to evaluate the impact of clinical variables potentially influencing OS. Results: Median OS for all patients was 22.3 months (95%CI 18.7-27.6), the estimated 5-year survival rate was 27.4% (95% CI 22.9-31.9). Sixty-eight patients (14.4%) among 473 patients were identified as long-term survivors. Twenty-six (38%) had metastases at diagnosis of kidney cancer, 3 (4%) and 11 (16%) had liver mets and bone mets, respectively. According to MSKCC risk classification, 19 (28%), 28 (41%), and 6 (9%) were classified as favorable, intermediate, and poor risk, respectively. All patients had undergone prior nephrectomy, and 40 (59%) underwent metastatectomy. Multiple logistic regression analysis from all patients identified metastatectomy (HR 5.0; 95%CI 2.7-9.5) and MSKCC risk group (HR 3.7; 95%CI 1.5-9.1) as adverse prognostic factors for long-term OS. Conclusions: Selected patients with metastatic RCC who can undergo metastatectomy have a good opportunity for long-term survival, especially those with favorable or intermediate risk classified by MSKCC risk classification. No significant financial relationships to disclose.

scholarly journals Predictive Value of Admission D-dimer for Contrast-induced Acute Kidney Injury and Poor Outcomes after Primary Percutaneous Coronary Intervention

2020 ◽  
Author(s):  
Kai-Yang Lin ◽  
Han-Chuan Chen ◽  
Hui Jiang ◽  
Sun-Ying Wang ◽  
Hong-mei Chen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Serum Creatinine ◽  
Logistic Regression Analysis ◽  
Predictive Value ◽  
Independent Predictor ◽  
Multivariate Logistic Regression Analysis ◽  
Increased Risk ◽  
Long Term Mortality

Abstract Background DD was found to be associated with acute myocardial infarction (AMI) and renal insufficiency. However, it is uncertain whether DD is an independent risk factor of CI-AKI in patients undergoing pPCI. Methods We prospectively enrolled 550 consecutive patients with STEMI undergoing pPCI between January 2012 and December 2016. The predictive value of admission DD for CI-AKI was assessed by receiver operating characteristic(ROC) and multivariable logistic regression analysis. CI-AKI was defined as an absolute serum creatinine increase ≥0.3 mg/dl or a relative increase in serum creatinine ≥50% within 48 h of contrast medium exposure. Results Overall, the incidence of CI-AKI was 13.1%. The ROC analysis showed that the cutoff point of DD was 0.69 ug/ml for predicting CI-AKI with a sensitivity of 77.8% and a specificity of 57.3%. The predictive value of DD was similar to the Mehran score for CI-AKI (AUC DD =0.729 vs AUC Mehran =0.722; p =0.8298). Multivariate logistic regression analysis indicated that DD >0.69 ug/ml was an independent predictor of CI-AKI (odds ratio[OR]=3.37,95%CI:1.80-6.33, p <0.0001). Furthermore, DD >0.69 ug/ml was associated with an increased risk of long-term mortality during during a mean follow-up period of 16 months(hazard ratio=3.41, 95%CI:1.4-8.03, p =0.005). Conclusion admission DD >0.69 ug/ml is a significant and independent predictor of CI-AKI and long-term mortality in patients undergoing pPCI.

scholarly journals Predictive Value of Admission D-dimer for Contrast-induced Acute Kidney Injury and Poor Outcomes after Primary Percutaneous Coronary Intervention

2020 ◽  
Author(s):  
Kai-Yang Lin ◽  
Han-Chuan Chen ◽  
Hui Jiang ◽  
Sun-Ying Wang ◽  
Hong-mei Chen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Serum Creatinine ◽  
Logistic Regression Analysis ◽  
Predictive Value ◽  
Independent Predictor ◽  
Multivariate Logistic Regression Analysis ◽  
Increased Risk ◽  
Long Term Mortality

Abstract Background DD was found to be associated with acute myocardial infarction (AMI) and renal insufficiency. However, it is uncertain whether DD is an independent risk factor of CI-AKI in patients undergoing pPCI. Methods We prospectively enrolled 550 consecutive patients with STEMI undergoing pPCI between January 2012 and December 2016. The predictive value of admission DD for CI-AKI was assessed by receiver operating characteristic(ROC) and multivariable logistic regression analysis. CI-AKI was defined as an absolute serum creatinine increase ≥0.3 mg/dl or a relative increase in serum creatinine ≥50% within 48 h of contrast medium exposure. Results Overall, the incidence of CI-AKI was 13.1%. The ROC analysis showed that the cutoff point of DD was 0.69 ug/ml for predicting CI-AKI with a sensitivity of 77.8% and a specificity of 57.3%. The predictive value of DD was similar to the Mehran score for CI-AKI (AUC DD =0.729 vs AUC Mehran =0.722; p =0.8298). Multivariate logistic regression analysis indicated that DD >0.69 ug/ml was an independent predictor of CI-AKI (odds ratio[OR]=3.37,95%CI:1.80-6.33, p <0.0001). Furthermore, DD >0.69 ug/ml was associated with an increased risk of long-term mortality during during a mean follow-up period of 16 months(hazard ratio=3.41, 95%CI:1.4-8.03, p =0.005). Conclusion admission DD >0.69 ug/ml is a significant and independent predictor of CI-AKI and long-term mortality in patients undergoing pPCI.

scholarly journals Long-term evaluation of pediatric ACL reconstruction: high risk of further surgery but a restrictive postoperative management was related to a lower revision rate

2021 ◽  
Author(s):  
Frida Hansson ◽  
Eva Bengtsson Moström ◽  
Magnus Forssblad ◽  
Anders Stålman ◽  
Per-Mats Janarv
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Revision Rate ◽  
Weight Bearing ◽  
Multivariable Logistic Regression Analysis ◽  
Return To Sports ◽  
Postoperative Rehabilitation ◽  
Rehabilitation Protocol ◽  
The Mean

Abstract Introduction The guidelines regarding rehabilitation after pediatric anterior cruciate ligament reconstruction (ACLR) are sparse. The aim of the study was to retrospectively describe the long-term outcome regarding further surgery and with special emphasis on the revision rate after two different postoperative rehabilitation programs following pediatric ACLR. Material and methods 193 consecutive patients < 15 years of age who had undergone ACLR at two centers, A (n = 116) and B (n = 77), in 2006–2010 were identified. Postoperative rehabilitation protocol at A: a brace locked in 30° of flexion with partial weight bearing for 3 weeks followed by another 3 weeks in the brace with limited range of motion 10°–90° and full weight bearing; return to sports after a minimum of 9 months. B: immediate free range of motion and weight bearing as tolerated; return to sports after a minimum of 6 months. The mean follow-up time was 6.9 (range 5–9) years. The mean age at ACLR was 13.2 years (range 7–14) years. The primary outcome measurement in the statistical analysis was the occurrence of revision. Multivariable logistic regression analysis was performed to investigate five potential risk factors: surgical center, sex, age at ACLR, time from injury to ACLR and graft diameter. Results Thirty-three percent had further surgery in the operated knee including a revision rate of 12%. Twelve percent underwent ACLR in the contralateral knee. The only significant variable in the statistical analysis according to the multivariable logistic regression analysis was surgical center (p = 0.019). Eight percent of the patients at center A and 19% of the patients at B underwent ACL revision. Conclusions Further surgery in the operated knee could be expected in one third of the cases including a revision rate of 12%. The study also disclosed a similar rate of contralateral ACLR at 12%. The revision rate following pediatric ACLR was lower in a center which applied a more restrictive rehabilitation protocol. Level of evidence Case-control study, Level III.

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