• Title/Summary/Keyword: Multivariate Logistic Regression

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Benign versus Malignant Soft-Tissue Tumors: Differentiation with 3T Magnetic Resonance Image Textural Analysis Including Diffusion-Weighted Imaging

  • Lee, Youngjun;Jee, Won-Hee;Whang, Yoon Sub;Jung, Chan Kwon;Chung, Yang-Guk;Lee, So-Yeon
    • Investigative Magnetic Resonance Imaging
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    • 제25권2호
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    • pp.118-128
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    • 2021
  • Purpose: To investigate the value of MR textural analysis, including use of diffusion-weighted imaging (DWI) to differentiate malignant from benign soft-tissue tumors on 3T MRI. Materials and Methods: We enrolled 69 patients (25 men, 44 women, ages 18 to 84 years) with pathologically confirmed soft-tissue tumors (29 benign, 40 malignant) who underwent pre-treatment 3T-MRI. We calculated MR texture, including mean, standard deviation (SD), skewness, kurtosis, mean of positive pixels (MPP), and entropy, according to different spatial-scale factors (SSF, 0, 2, 4, 6) on axial T1- and T2-weighted images (T1WI, T2WI), contrast-enhanced T1WI (CE-T1WI), high b-value DWI (800 sec/mm2), and apparent diffusion coefficient (ADC) map. We used the Mann-Whitney U test, logistic regression, and area under the receiver operating characteristic curve (AUC) for statistical analysis. Results: Malignant soft-tissue tumors had significantly lower mean values of DWI, ADC, T2WI and CE-T1WI, MPP of ADC, and CE-T1WI, but significantly higher kurtosis of DWI, T1WI, and CE-T1WI, and entropy of DWI, ADC, and T2WI than did benign tumors (P < 0.050). In multivariate logistic regression, the mean ADC value (SSF, 6) and kurtosis of CE-T1WI (SSF, 4) were independently associated with malignancy (P ≤ 0.009). A multivariate model of MR features worked well for diagnosis of malignant soft-tissue tumors (AUC, 0.909). Conclusion: Accurate diagnosis could be obtained using MR textural analysis with DWI and CE-T1WI in differentiating benign from malignant soft-tissue tumors.

글루포시네이트 암모늄 제초제 중독환자에서 혈중 암모니아 농도와 사망률과의 연관성에 대한 연구 (Initial Serum Ammonia as a Predictor of Mortality in Patients with Acute Glufosinate Ammonium Herbicide Poisoning)

  • 고은나래;김동훈;이수훈;정진희;이상봉;성애진;서자현;강창우
    • 대한임상독성학회지
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    • 제18권2호
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    • pp.136-140
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    • 2020
  • Purpose: The association of the initial serum ammonia level with in-hospital mortality in patients with acute glufosinate-ammonium herbicide poisoning was studied. Methods: This retrospective cohort study was conducted between March 2012 and August 2019 in the emergency department after glufosinate-ammonium herbicide poisoning. Survivors and non-survivors were analyzed using a Mann-Whitney U test and Fisher's exact test. Multivariate logistic regression analysis was performed to determine the independent risk factors for mortality. Results: One hundred and six patients were enrolled; 11 died, yielding a mortality of 10.4%. The serum bicarbonate level was significantly lower in the non-survival group than the survival group. Age, serum ammonia, blood urea nitrogen, creatinine levels, SOFA score, and APACHE II score were significantly higher in the non-survival group than the survival group. Age, serum ammonia, and creatinine level were independent risk factors for mortality in multivariate logistic regression analysis. Conclusion: The initial serum ammonia level is associated with mortality in patients with acute glufosinate herbicide poisoning.

Validity of the scoring system for traumatic liver injury: a generalized estimating equation analysis

  • Lee, Kangho;Ryu, Dongyeon;Kim, Hohyun;Jeon, Chang Ho;Kim, Jae Hun;Park, Chan Yong;Yeom, Seok Ran
    • Journal of Trauma and Injury
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    • 제35권1호
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    • pp.25-33
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    • 2022
  • Purpose: The scoring system for traumatic liver injury (SSTLI) was developed in 2015 to predict mortality in patients with polytraumatic liver injury. This study aimed to validate the SSTLI as a prognostic factor in patients with polytrauma and liver injury through a generalized estimating equation analysis. Methods: The medical records of 521 patients with traumatic liver injury from January 2015 to December 2019 were reviewed. The primary outcome variable was in-hospital mortality. All the risk factors were analyzed using multivariate logistic regression analysis. The SSTLI has five clinical measures (age, Injury Severity Score, serum total bilirubin level, prothrombin time, and creatinine level) chosen based on their predictive power. Each measure is scored as 0-1 (age and Injury Severity Score) or 0-3 (serum total bilirubin level, prothrombin time, and creatinine level). The SSTLI score corresponds to the total points for each item (0-11 points). Results: The areas under the curve of the SSTLI to predict mortality on post-traumatic days 0, 1, 3, and 5 were 0.736, 0.783, 0.830, and 0.824, respectively. A very good to excellent positive correlation was observed between the probability of mortality and the SSTLI score (γ=0.997, P<0.001). A value of 5 points was used as the threshold to distinguish low-risk (<5) from high-risk (≥5) patients. Multivariate analysis using the generalized estimating equation in the logistic regression model indicated that the SSTLI score was an independent predictor of mortality (odds ratio, 1.027; 95% confidence interval, 1.018-1.036; P<0.001). Conclusions: The SSTLI was verified to predict mortality in patients with polytrauma and liver injury. A score of ≥5 on the SSTLI indicated a high-risk of post-traumatic mortality.

Risk factors for unexpected admission following arthroscopic and open treatment of shoulder instability: a national database study of 11,230 cases

  • Joshua Giordano;John M. Tarazi;Matthew J. Partan;Randy M. Cohn
    • Clinics in Shoulder and Elbow
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    • 제26권1호
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    • pp.41-48
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    • 2023
  • Background: Shoulder instability procedures have low morbidity; however, complications can arise that result in readmission to an inpatient healthcare facility. The purpose of this study is to identify the demographics and risk factors associated with unplanned 30-day readmission and reoperation following arthroscopic and open treatment for shoulder instability. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried to find patients who underwent shoulder instability surgery from 2015 to 2019. Independent sample Student t-tests, chi-square, and (where appropriate) Fisher's exact tests were used in univariate analyses to identify demographic, lifestyle, and perioperative variables related to 30-day readmission and reoperation following repair for shoulder instability. Multivariate logistic regression modeling was subsequently performed. Results: Of the 11,230 cases included in our sample, only 0.54% were readmitted, and 0.23% underwent reoperation within the 30-day postoperative period. Multivariate logistic regression modeling confirmed that the following patient variables were associated with statistically significantly increased odds of readmission and reoperation: open repair, congestive heart failure (CHF), and hospital length of stay. Conclusions: Unplanned 30-day readmission and reoperation after shoulder instability surgery is infrequent. Patients with American Society of Anesthesiologists class II, CHF, longer than average hospital length of stay, or an open procedure have higher odds of readmission than patients without those factors. Patients who have CHF, longer than average hospital length of stay, and open surgery have higher odds of reoperation than others. Arthroscopic procedures should be used to manage shoulder instability, if possible. Level of evidence: III.

Predisposing, Enabling, and Reinforcing Factors of COVID-19 Prevention Behavior in Indonesia: A Mixed-methods Study

  • Putri Winda Lestari;Lina Agestika;Gusti Kumala Dewi
    • Journal of Preventive Medicine and Public Health
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    • 제56권1호
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    • pp.21-30
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    • 2023
  • Objectives: To prevent the spread of coronavirus disease 2019 (COVID-19), behaviors such as mask-wearing, social distancing, decreasing mobility, and avoiding crowds have been suggested, especially in high-risk countries such as Indonesia. Unfortunately, the level of compliance with those practices has been low. This study was conducted to determine the predisposing, enabling, and reinforcing factors of COVID-19 prevention behavior in Indonesia. Methods: This cross-sectional study used a mixed-methods approach. The participants were 264 adults from 21 provinces in Indonesia recruited through convenience sampling. Data were collected using a Google Form and in-depth interviews. Statistical analysis included univariate, bivariate, and multivariate logistic regression. Furthermore, qualitative data analysis was done through content analysis and qualitative data management using Atlas.ti software. Results: Overall, 44.32% of respondents were non-compliant with recommended COVID-19 prevention behaviors. In multivariate logistic regression analysis, low-to-medium education level, poor attitude, insufficient involvement of leaders, and insufficient regulation were also associated with decreased community compliance. Based on in-depth interviews with informants, the negligence of the Indonesian government in the initial stages of the COVID-19 pandemic may have contributed to the unpreparedness of the community to face the pandemic, as people were not aware of the importance of preventive practices. Conclusions: Education level is not the only factor influencing community compliance with recommended COVID-19 prevention behaviors. Changing attitudes through health promotion to increase public awareness and encouraging voluntary community participation through active risk communication are necessary. Regulations and role leaders are also required to improve COVID-19 prevention behavior.

경도인지장애에서 우울증 유병률과 관련요인 (Prevalence and Associated Factors of Depression in Mild Cognitive Impairment)

  • 이준호;최영민;변민수;최효정;백혜원;손보경;이동영
    • 노인정신의학
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    • 제18권2호
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    • pp.86-91
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    • 2014
  • Objective : The aims of this study were to investigate the prevalence of co-morbid depression and related factors of depression in mild cognitive impairment (MCI) patients. Methods : Nine hundred and six MCI individuals were included in this study. Depression was defined as major and minor depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). Depression-related demographic and clinical factors were also explored through multivariate logistic regression analysis. Results : In MCI patients, the prevalence of depression as defined according to the DSM-IV diagnostic criteria was 1.8% for major depressive disorder, 11.4% for minor depressive disorder, and overall 13.2% for both. Multivariate logistic regression showed that increased prevalence of overall depression was associated with female gender and non-amnestic subtype of MCI. Conclusion : Our findings based on a large number of MCI subjects who visited memory clinic indicated that more than ten percent of MCI patients have comorbid depression. In addition, female and non-amnestic subtype of MCI patients seems to be more vulnerable to depression.

The Role of Core Needle Biopsy for the Evaluation of Thyroid Nodules with Suspicious Ultrasound Features

  • Sae Rom Chung;Jung Hwan Baek;Young Jun Choi;Tae-Yon Sung;Dong Eun Song;Tae Yong Kim;Jeong Hyun Lee
    • Korean Journal of Radiology
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    • 제20권1호
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    • pp.158-165
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    • 2019
  • Objective: Recent studies demonstrated that core needle biopsy (CNB) can effectively reduce the possibility of inconclusive results and prevent unnecessary diagnostic surgery. However, the effectiveness of CNB in patients with suspicious thyroid nodules has not been fully evaluated. This prospective study aimed to determine the potential of CNB to assess thyroid nodules with suspicious ultrasound (US) features. Materials and Methods: Patients undergoing CNB for thyroid nodules with suspicious features on US were enrolled between May and August 2016. Diagnostic performance and the incidence of non-diagnostic results, inconclusive results, conclusive results, malignancy, unnecessary surgery, and complications were analyzed. Subgroup analysis according to nodule size was performed. The risk factors associated with inconclusive results were evaluated using multivariate logistic regression analysis. Results: A total of 93 patients (102 thyroid nodules) were evaluated. All samples obtained from CNB were adequate for diagnosis. Inconclusive results were seen in 12.7% of cases. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for diagnosis of malignancy were 93.8%, 100%, 100%, 78.9%, and 95%, respectively. None of the patients underwent unnecessary surgery. The diagnostic performance was not significantly different according to nodule size. On multivariate logistic regression analysis, larger nodule size and shorter needle length were independent risk factors associated with inconclusive results. Conclusion: Samples obtained by CNB were sufficient for diagnosis in all cases and resulted in high diagnostic values and conclusive results in the evaluation of suspicious thyroid nodules. These findings indicated that CNB is a promising diagnostic tool for suspicious thyroid nodules.

가공 식품의 영양성분표시 이용과 주관적, 객관적 비만의 관련성 (The Association of Food Label Use with Objective and Subjective Obesity among a Korean Population)

  • 이인숙;이고운
    • 지역사회간호학회지
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    • 제27권3호
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    • pp.262-271
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    • 2016
  • Purpose: Using food labels has been related to healthy eating habits and positive health outcomes. The purpose of this study is to describe the prevalence of food labels utilization and the association between food label use and obesity related factors. Methods: We conducted a self-reported population-based survey including health behaviors, 24-hour recalls, measurements of body mass indices with 6,266 Koreans aged 10 or older. ${\chi}^2$-test and ANOVA examined differences in demographic factors, health behavioral factors, and nutrition factors in tandem with food label use categories. Multivariates logistic regression was used to estimate association between food label use and obesity factors. Results: The percentages of food label users and non-users who perceive food labels were 21.8% and 48.5% respectively. In the multivariate logistic regression, food label use had significant positive associations with women, age, income, education attainment, and subjective obesity. After adjusting for socioeconomic factors and dietetic treatments, the positive associations between food label use and subjective obesity, weight control, and subjective obesity with objective normal weight remained. Conclusion: In order to improve eating habits and weight management, the obesity population that does not use food labels needs to receive proper nutrition education including food choice and body image correction.

폐경 후 연령대별 골밀도 영향 요인 (Factors Influencing Bone Mineral Density by Postmenopausal Ages)

  • 최금자;김경희
    • 보건의료산업학회지
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    • 제11권4호
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    • pp.145-155
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    • 2017
  • Objectives : To investigate the factors affecting bone mineral density in across stratified postmenopausal ages. Methods : Data from 1,698 subjects who completed the 2010-2011 National Health and Nutrition Survey were analyzed using SPSS Statistics 21.0 The $x^2$ test and one way (ANOVA) were used to verify the relationship between general characteristics and health behaviors and the prevalence of osteoporosis. Logistic regression analysis was used to verify the factors Influencing bone mineral density. Results : The bone mineral density distribution was the highest among those with osteopenia, with proportions of 21.8% in healthy subjects, 58.1% in osteopenia, and 20.0% in those with osteoporosis. The distribution of osteoporosis by age group was 5.2% among subjects in their 50s, 15.4% among those in their 60s, and 42.4% among those in their 70s. In multivariate logistic regression analysis, the prevalence of osteoporosis according to ages was significantly correlated with age, educational level, body mass index(BMI), and parity 4 of more than 1-2 babies. Conclusions : Although age is an uncontrollable factor in the prevention of osteoporosis, educational level and BMI are correctable factors to maintain bone mineral density. There is a need to maintain healthy BMI and expand osteoporosis prevention education.

패밀리레스토랑 음식서비스에 대한 만족에 영향을 미치는 요인들의 평가 (Factor Influencing on Satisfaction of Foodservice in Family Restaurant)

  • 강종헌;양소영
    • 한국식품조리과학회지
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    • 제20권4호
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    • pp.371-379
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    • 2004
  • The purpose of this study was to identify factors associated with high satisfaction with foodservices in family restaurant. Accordingly, this study surveyed questionnaire concerning 20 measures of foodservice as well as major subject descriptors. The result of this study were as follows. KMO and Bartlett's test statistics showed that the data fitted factor analysis well. Results of factor analysis, average variance extracted estimates and shared variance showed that the convergent and discriminant validitys of 3 factors are supported, and cronbach's alpha showed that the internal consistency of 3 factors is supported. It was found that expensive groups, except gender groups and frequency of purchase groups, were differentially associated with high levels of overall satisfaction with foodservices. Multivariate analyses showed that satisfaction with service factor was the best predictor of overall satisfaction, followed by facilities factor. Three factors emerged from the logistic regression analysis as predictors of level of overall satisfaction. Overall, approximately 77% of university students could be correctly classified as being satisfied or unsatisfied. Finally, the results of the study provide some insights into the market-oriented types of foodservice marketing strategies or tactics to enable family restaurant to effectively manage and more competitive.