Comparison of pure laparoscopic versus open left hemihepatectomy by multivariate analysis: a retrospective cohort study

Background/Aims: Numerous studies have shown that NIMA-related kinase 2 (NEK2) expression in hepatocellular carcinoma (HCC) tissue is associated with survival and clinicopathological features; however, the evidence remains inconclusive. Thus, we aimed to further explore the prognostic and clinicopathological significance of NEK2 expression in HCC using a two-part study consisting of a retrospective cohort study and a meta-analysis. Methods: In the cohort study, NEK2 expression in 206 HCC samples and adjacent normal liver tissues was detected by immunohistochemistry (IHC). Patients were divided into a high NEK2 expression group and a low NEK2 expression group by the median value of the immunohistochemical scores. The Kaplan–Meier method with the log-rank test was used to analyze survival outcomes in the two groups, and multivariate analysis based on Cox proportional hazard regression models was applied to identify independent prognostic factors. In the meta-analysis, eligible studies were searched in PubMed, EMBASE, Web of Science, and CNKI databases. STATA version 12.0 (Stata Corporation, College Station, TX) was used for statistical analyses. Results: The IHC results of our cohort study showed higher NEK2 expression in HCC tissues compared with adjacent normal liver tissues. Multivariate analysis revealed that high NEK2 expression was an independent risk factor for poor overall survival (OS) [hazard ratio (HR) = 1.763; 95% CI, 1.060–2.935; P = 0.029] and disease-free survival (DFS) [hazard ratio (HR) = 1.687; 95% CI, 1.102–2.584; P = 0.016] in HCC patients. A total of 11 studies with 1,698 patients were enrolled in the meta-analysis, consisting of 10 studies from the database search and our cohort study. The pooled results revealed that high NEK2 expression correlated closely with poor OS among HCC patients (HR = 1.47; 95% CI, 1.21–1.80; P < 0.01), and DFS/recurrence-free survival (RFS) (HR = 1.92; 95% CI, 1.41–2.63; P < 0.01). Additionally, our meta-analysis also showed that the proportion of HCC patients with high NEK2 expression was greater in the group with larger tumors (> 5 cm) than in the group with smaller tumors (≤ 5 cm) [odds ratio (OR) = 2.02; 95% CI, 1.13–3.64; P < 0.01). Conclusion: Our study demonstrated that high NEK2 expression is a risk factor for poor survival in HCC patients. More prospective, homogeneous, and multiethnic studies are required to validate our findings.

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What Are the Important Predictors of Postoperative Functional Recovery in Patients With Cervical OPLL? Results of a Multivariate Analysis

Global Spine Journal ◽

10.1177/2192568218794665 ◽

2018 ◽

Vol 9 (3) ◽

pp. 315-320 ◽

Cited By ~ 2

Author(s):

Hiroaki Nakashima ◽

Tokumi Kanemura ◽

Shunsuke Kanbara ◽

Kotaro Satake ◽

Keigo Ito ◽

...

Keyword(s):

Multivariate Analysis ◽

Cohort Study ◽

Functional Recovery ◽

Retrospective Cohort Study ◽

Recovery Rate ◽

Neurological Outcome ◽

Retrospective Cohort ◽

Stepwise Logistic Regression ◽

Stepwise Logistic Regression Analysis ◽

Japanese Orthopedic Association

Study Design: A retrospective cohort study. Objective: The objective of this study was to identify important predictors of poor functional recovery in patients undergoing surgery for cervical ossification of the posterior longitudinal ligament (OPLL). Methods: This was a retrospective cohort study of 142 OPLL patients with laminoplasty; 135 had complete radiographical data and were followed up for ≥2 years. The following OPLL characteristics were compared between patients with “good” and “poor” outcomes (Japanese Orthopedic Association [JOA] recovery rate ≥50% and <50%, respectively): number of ossified levels, OPLL classification, ossification shape, K-line, canal-occupying ratio, and increased magnetic resonance imaging (MRI) signal intensity. Predictors of functional recovery were identified. Results: Pre- and postoperative (2 years following surgery) JOA scores were 10.6 ± 2.9 and 14.1 ± 2.2, respectively, indicating significant improvement following laminoplasty ( P < .001). The average JOA recovery rate was 53.4% ± 34.7%, with 81 (60.0%) and 54 (40.0%) patients in the better and poorer neurological outcome groups, respectively. The canal occupation ratio of OPLL ≤60%/>60% were 117 (86.7%) and 18 (13.3%) patients, respectively. In the stepwise logistic regression analysis, an occupation ratio greater than 60% was identified as a significant factor for poor postoperative neurological outcome (relative risk, 4.82; 95% confidential interval, 1.61-14.46, P = .005). Conclusions: This multivariate analysis demonstrated a large size OPLL (occupying ratio >60%) was associated with a risk of poor neurological recovery roughly 5 times greater, and therefore other types of surgery are recommended in cases with such a ratio.

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Abstract 16120: The Utilization of Neutrophil-lymphocyte Ratio and Platelets-lymphocyte Ratio as Prognostic Markers for Coronary Artery Disease in Person Living With Human Immunodeficiency Virus

Circulation ◽

10.1161/circ.142.suppl_3.16120 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Iyad Farouji ◽

Kok Hoe Chan ◽

Jihad Silm

Keyword(s):

Coronary Artery Disease ◽

Multivariate Analysis ◽

Cohort Study ◽

Coronary Artery ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

The United States ◽

Lymphocyte Ratio ◽

Severity Prediction ◽

Artery Disease

Background: Coronary artery disease (CAD) has emerged as an important cause of death in PLWH. T-lymphocyte cells has been shown to regulate the inflammatory response and have an inhibitory effect on atherosclerosis. NLR and PLR has been studied as severity prediction for CAD. However, to our knowledge, there were no studies to date that identify the relationship of NLR and PLR with CAD severity and outcome in PLWH. The aim of the study is to determine if NLR and PLR can be used as independent predictors of CAD severity in PLWH in our population in the United States. Methods: A retrospective cohort study of PLWH 18-year-old who underwent cardiac percutaneous coronary intervention was conducted between 2010 and December 2019. Their demographic, clinical and biochemical characteristics were extracted from the electronic medical record. Univariate and multivariate analysis were employed to identify the markers that can be used to predict CAD severity in PLWH. The study end point was number of coronary artery stenosis (85%) vessels involved. Results: A total of 74 PLWH were included in this retrospective cohort study. The median age was 60 years old (range from 30 to 79 years old). The male to female ratio was 2:1 (49 males and 25 females). As for ethnicities, 59 (80%) were African American, 9 (12%) were Caucasian and 6 (8%) were Hispanics. Comorbidities present in 64 patients (86%), with hypertension being the most common (77%), followed by CKD/ESRD (39%), diabetes mellitus (27%) and dyslipidemia (24%). Smoking and alcohol use were reported in 56 (76%) and 23 (31%) patients respectively. Female gender (p=0.042), higher triglycerides (r=0.29; p=0.014), history congestive heart failure (p=0.041) and higher CD4/CD8 ratio (r=0.30; p=0.011) were significantly correlated with greater number of coronary artery vessels involved. NLR (p=0.205) and PLR (p=0.567) are otherwise not significant. In multivariate analysis, NLR (odds ratio [OR] 1.553; 95% confidence interval [CI], 0.928-3.611), PLR (OR 0.997, CI 0.983-1.011) and CD4/CD8 ratio (OR 0.676, CI 0.042-1051) were not independently associated with the severity of CAD. Conclusion: This cohort study demonstrated that there is no relationship between the NLR and PLR with the severity of CAD in PLWH in our population in USA.

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New Predictive Models for Falls in Acute Care Setting Classified Using An Activities of Daily Living Scale in Japan: A Retrospective Cohort Study

10.21203/rs.3.rs-786305/v1 ◽

2021 ◽

Author(s):

Chihiro Saito ◽

Eiji Nakatani ◽

Yoko Sato ◽

Naoko Katuki ◽

Masaki Tago ◽

...

Keyword(s):

Multivariate Analysis ◽

Cohort Study ◽

Prediction Model ◽

Acute Care ◽

Retrospective Cohort Study ◽

Daily Living ◽

Retrospective Cohort ◽

Acute Care Hospital ◽

Care Hospital ◽

Fall Prediction

Abstract Background In several current fall prediction models, the reported predictors vary from one model to another. We developed and validated a new fall prediction model for patients admitted to an acute care hospital by identifying predictors of falls considering a combination of background factors and one crucial stratum. Methods We conducted a retrospective cohort study of patients admitted to Shizuoka General Hospital from April 2019 to September 2020, aged 20 years or older. We developed and validated a new fall prediction model by identifying predictors of falls stratified by essential activities of daily living (ADL) indicators and integrating these models. Results A total of 22,988 individuals were included in the analysis, with 653 (2.8 %) experiencing all falls and 400 (1.7 %) experiencing falls with medical resources during the study period. Multivariate analysis was performed after one stratification level, using bedridden rank (ability to move around in daily life) as a stratifying variable, a clinically important variable and highly correlated with 17 other variables. The results of multivariate analysis showed that the risk factors for falls (high risk) were age (high), sex (men), and ambulance transport (yes) for rank J (independence/autonomy); age (high),) and sex (men) for rank A (house-bound); There were no predictors for rank B (chair-bound); and there was ophthalmologic disease (no) for rank C (bed-bound). The c-index indicating the prediction model’s performance for falls within 28 days of hospitalisation was 0.705 (95 % CI, 0.664–0.746). Hosmer-Lemeshow goodness-of-fit statistics were significant (χ2 = 192.06; 8 degrees of freedom; p < 0.001). The c-index for the entire unstratified sample was 0.703 (95 % CI, 0.661–0.746), indicating that the predictive model stratified by bedriddenness rank was accurate (p < 0.001). Conclusion We identified predictors of falls using important ADLs (bedriddenness rank) and developed a more accurate prediction model in acute care hospital settings. This predictive model is an essential tool for fall prevention.

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Effectiveness of cetuximab as preemptive postsurgical therapy for oral squamous cell carcinoma patients with major risk: a single‐center retrospective cohort study

Investigational New Drugs ◽

10.1007/s10637-021-01062-0 ◽

2021 ◽

Author(s):

Chonji Fukumoto ◽

Yuta Sawatani ◽

Ryo Shiraishi ◽

Manabu Zama ◽

Michiko Shimura ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Multivariate Analysis ◽

Cohort Study ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Univariate Analysis ◽

Maxillofacial Surgery

SummaryA retrospective cohort study was performed to investigate the effectiveness of preemptive postsurgical therapy with cetuximab for patients with a major risk of recurrence or metastasis after clinical complete resection of primary oral squamous cell carcinoma (OSCC). The study period was from 2007 to 2019 for patients treated at the Department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine. OSCC patients with major risk (n = 88) in the follow-up period were divided into groups with no postsurgical treatment (NP group), with standard postsurgical treatment (SP group), and with postsurgical treatment including cetuximab (CP group), and prognosis were compared among those groups. The 5-year overall survival rate was significantly higher in patients who received postsurgical treatment with cetuximab (CP) compared to that in the other two groups ((CP vs. NP, p = 0.028; CP vs. SP, p = 0.042). Furthermore, we performed multivariate analysis to evaluate the effects of the main components of the treatment. Among CDDP, radiotherapy, and cetuximab, only cetuximab significantly contributed to improved survival by univariate analysis (crude HR:0.228, 95%CI:0.05–0.968, p = 0.045). cetuximab also showed the same tendency in multivariate analysis, although p value did not reach significant level (Adjusted HR: 0.233, 95%CI: 0.053–1.028, p = 0.054). The results suggest that the postsurgical treatment with cetuximab as a preemptive postsurgical therapy after complete surgical resection of a visible tumor is considerably effective for OSCC patients with major risk, in other words, invisible dormant metastasis.

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Antenatal Magnesium Sulfate Reduced Intestinal Morbidities Requiring Surgery in Preterm Infants With Extremely Low Gestational Age: A Retrospective Cohort Study

10.21203/rs.3.rs-29795/v1 ◽

2020 ◽

Author(s):

Seh Hyun Kim ◽

Yoo-Jin Kim ◽

Seung Hyun Shin ◽

Hannah Cho ◽

Seung Han Shin ◽

...

Keyword(s):

Multivariate Analysis ◽

Cohort Study ◽

Magnesium Sulfate ◽

Preterm Infants ◽

Gestational Age ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Dependent Manner ◽

Neurodevelopmental Outcomes ◽

Surgical Conditions

Abstract Background Antenatal magnesium sulfate is widely used as a tocolytic, for maternal seizures, and for seizure prophylaxis in preeclampsia. Recent studies have suggested that antenatal magnesium sulfate use is associated with favorable neurodevelopmental outcomes in preterm infants. However, there are concerns regarding the neonatal effects of antenatal magnesium sulfate, especially regarding gastrointestinal morbidities. This study aims to explore the effects of antenatal magnesium sulfate on intestinal morbidities requiring surgery in preterm infants.Methods This was a retrospective cohort study of 181 preterm infants who were born at less than 28 weeks of gestational age. Subjects were categorized as infants exposed to antenatal magnesium sulfate and those not exposed to antenatal magnesium sulfate.Results Antenatal magnesium sulfate was associated with a lower incidence of surgical conditions of the intestine (OR 0.393, 95% CI 0.170–0.905). Multivariate analysis showed that the duration of antenatal magnesium sulfate use was associated with surgical conditions of the intestine (adjusted OR 0.766, 95% CI 0.589–0.997). In the < 26 weeks of gestational age subgroup, use of antenatal magnesium sulfate was significantly associated with decreased intestinal morbidities requiring surgery (adjusted OR 0.234, 95% CI 0.060–0.922).Conclusion Antenatal magnesium sulfate use appears to have a protective effect on intestinal morbidities requiring surgery in preterm infants in a duration-dependent manner. Association of antenatal magnesium sulfate use and decreased intestinal morbidities requiring surgery was more distinct in preterm infants < 26 weeks of gestational age.

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A Retrospective Cohort Study of Glossopharyngeal Nerve Taste in Children with Recurrent Acute Tonsillitis

Otolaryngology ◽

10.1177/0194599816674662 ◽

2016 ◽

Vol 156 (1) ◽

pp. 189-193 ◽

Cited By ~ 1

Author(s):

Courtney A. Hill ◽

Suveera Dang ◽

Michael Beach ◽

Eunice Y. Chen

Keyword(s):

Multivariate Analysis ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Univariate Analysis ◽

Tertiary Care ◽

Healthy Children ◽

Acute Tonsillitis ◽

Insurance Type ◽

Significant Difference

Objective To compare glossopharyngeal taste between healthy children and those with recurrent acute tonsillitis. Study Design Retrospective cohort study. Setting Pediatric clinics in a tertiary care medical center and satellite location. Subjects and Methods Smell and taste testing was administered to 80 well children and 64 children with recurrent acute tonsillitis (age range, 6-17 years). Smell testing was performed with the NIH Toolbox Odor Identification Test, with scores based on national averages for age and sex. Validated Taste Strips were placed on the midline of the tongue at the circumvallate papillae in random tastant order and in increasing concentrations to test sweet, salty, sour, and bitter. Ordinal logistic regression was used for multivariate analysis. Results The healthy and tonsillitis groups were similar, with mean ages of 11.3 and 10.8 years ( P = .34), respectively. The tonsillitis group had fewer boys (n = 18 vs 43, P = .002), higher mean body mass index (BMI) percentile (n = 72.2 vs 59.8, P = .01), and more subjects with public or no insurance (n = 24 vs 13, P = .004). Univariate analysis revealed no statistically significant differences in rate of normal overall taste (67.2% vs 60%, P = .39) and in sweet (79.7% vs 82.5%, P = .67), salty (85.9% vs 82.8%, P = .82), sour (64.1% vs 70%, P = .48), and bitter (90.6% vs 86.3%, P = .45). In multivariate analysis, smell ability, sex, BMI percentile, parent BMI, and insurance type did not affect overall taste or sweet, salty, sour, or bitter alone. Conclusion Despite controlling for potential intrinsic (sex, smell, BMI) and extrinsic (parent BMI, insurance type) confounders, there was no statistically significant difference in taste among children with recurrent acute tonsillitis as compared with healthy children.

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