• Title/Summary/Keyword: cutoff age

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A New D-dimer Cutoff Value to Improve the Exclusion of Deep Vein Thrombosis in Cancer Patients

  • Chen, Chong;Li, Gang;Liu, Yun-De;Gu, Ya-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1655-1658
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    • 2014
  • Objective: To find a more appropriate alternative to D-dimer cutoff value for the diagnosis of deep vein thrombosis (DVT) in cancer patients. Methods: A total of 711 cancer patients with symptoms suspicious of DVT were included in the study. D-dimer levels were assessed using ELISA. All patients were subjected to imaging procedures. Results: Among 711 patients with cancer, 466 (65.5%) were females and 245 (34.5%) were males, with an average age of $57.3{\pm}13.23$ years. The mean age in the DVT group was significantly higher than in the non-DVT group (P<0.05). The D-dimer levels of the DVT group were significantly higher than those of the non-DVT group (P<0.05). The incidence rate of DVT varied significantly according to cancer type (P<0.05). Increasing age and lung cancer were significantly correlated with D-dimer levels (P<0.05), and a one-year increase in age was associated with a 14.28 ng/ml increase in the D-dimer value. The optimal cutoff point for D-dimer was found to be 981 ng/ml, with a sensitivity of 86.4%, specificity of 79.4%, and accuracy of 82.6%. If the D-dimer cutoff point was set to 981ng/ml, the specificity would increase from 61.8% to 85.5% without loss of sensitivity in patients aged 40 years or younger. In patients aged more than 40 years, the new cutoff almost doubled the specificity with slightly reduced sensitivity. Conclusion: In cancer patients, a new cutoff value of 981 ng/ml effectively improved the exclusion of DVT, especially for patients aged more than 40 years.

Measuring Thresholds of Serum Lipid Level related to Hypertension and Age Using Receiver Operating Characteristic Curve in Korean Adult

  • Kim, Seong-Gil;Park, So-Hyun
    • Journal of the Korean Society of Physical Medicine
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    • v.9 no.3
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    • pp.301-305
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    • 2014
  • PURPOSE: The purpose of this study was to determine the optimal thresholds of serum lipid level related to hypertension according to age in Korean adults. METHODS: In total, 564 adults who visited the health examine center in general hospital were included. The blood pressure and lipid profiles of low density lipoprotein cholesterol(LDL), high density lipoprotein cholesterol (HDL), triglyceride(TG) were measured. Receiver operating characteristic (ROC) curve were used to establish optimal thresholds between blood pressure and lipid profiles. RESULTS: The optimal TG cutoff value were 110.50(mg/dl) in the 18-39 and 81.50(mg/dl) in the 40-59 age group, and optimal cutoff value of LDL were 126.50(mg/dl) in the 40-59 age group and 111.00(mg/dl) in the 60 and over age group. There was a negative correlation between HDL and hypertension, a higher HDL decreased hypertension. The optimal cutoff value of HDL was 49.50(mg/dl) in the 18-39 age group. CONCLUSION: The thresholds of hypertension were lower in LDL and TG with aging. This result indicated that elderly people needs to concern more about their lipid profiles to maintain healthy cardiovascular function.

5 Repetition Sit-to-Stand Test of Stroke patients and Healthy Older (뇌졸중 환자와 노인의 의자에서 일어서기 수행평가)

  • Kwon, Mi-Ji
    • Journal of the Korean Society of Physical Medicine
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    • v.9 no.1
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    • pp.101-106
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    • 2014
  • PURPOSE: This study was to provide reference data and examine stroke and healty older differences in sit-to-stand test. This study were to determine utility of the 5 repetition sit to stand for discriminating between fallers and non-fallers, identifying an appropriate cutoff score to delineate between the groups. METHODS: Ninety-five participants were recruited. Seventy-two individuals with stroke and twenty-three healthy older agreed to participate in the study. Falls were recorded using a self-administered questionnaire. The 5 repetition sit to stand test measured the time taken to complete t repetitions of the sit to stand maneuver. The time from the initial seated position to the final seated position after completing five stands was the test measure. A cutoff score regarding 5 repetition sit to stand performance in fallers vs. non-fallers, stroke patients vs. healthy older and <60 vs. $$\geq_-$$ age groups was determined using and ROC curve. RESULTS: Cutoff score of 9.9 seconds were found to be discriminatory between healthy older and subjects with stroke. Cutoff score of 15.5 seconds were found to be discriminatory between fallers and non-fallers. Cutoff score of 18.3 seconds were found to be discriminatory between <60 and $$\geq_-$$ age groups. CONCLUSION: The 5-repetition sit-to stand test is quick, easily administered measure useful for gross determination of fall risk in people with stroke.

Comparison of the Characteristics according to Injury Severity Score between Elderly and Non-elderly with Trauma (노인과 비노인 외상환자의 손상중증도에 따른 특성 비교)

  • Kim, Hyunju;Kim, Younkyoung
    • Journal of Korean Public Health Nursing
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    • v.32 no.2
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    • pp.304-318
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    • 2018
  • Purpose: This study examined the characteristic of the Injury Severity Score (ISS) of Korean geriatric patients with a traumatic injury in a nationally representative sample to determine the optimal cutoff of ISS of mortality according to age. Methods: The subjects were 3,018 non-elderly patients and 1,584 elderly patients with an ISS and Korean Triage and Acuity Scale (KTAS) in 2016 from the data of the Health Insurance Review and Assessment Service. The traumatic characteristics of the elderly and non-elderly were compared by stratifying the ISS. Receiver Operating Characteristic (ROC) curve analysis was used to find the optimal cutoff of ISS of mortality according to age. Results: The elderly were more prone to severe trauma than the non-elderly were. The distribution of KTAS grades was lower, even though the severity of ISS was as high as that of the non-elderly. The optimal cutoff score of the ISS for mortality in the ROC curve was lower in elderly over 65 years than in the other age group. Conclusion: The elderly are more prone to severe trauma and death than non-elderly, even though their ISS is low. Therefore, a strategy to prevent elderly from experiencing serious trauma and managing their geriatric trauma actively is needed.

Hypothesis Proposal about Predictive Factors and Optimal Age for Response to Herbal Medicine Treatment for Height Gain in Children: a Retrospective Review

  • Leem, Jungtae;Kim, Jeeyeun;Suh, Kyeungsuk;Lim, Youngkwern;Lee, Junhee
    • The Journal of Korean Medicine
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    • v.39 no.4
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    • pp.16-29
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    • 2018
  • Introduction: We aimed to investigate the predictive factors and optimal age for response to herbal medicine treatment for height gain in children. Methods: This retrospective chart review included 61 children (age range, 5-16 years) treated for height gain between 2011 and 2015. A predictive model was established by multiple linear regression analysis. Dependent variables were defined by the differences in percentile before and after herbal medicine treatment. The optimal cutoff value of patient age was determined by receiver operating curve analysis. Results : The age of initiation of herbal medicine therapy (p = 0.012) and administration of Forsythiae fructus (p = 0.002) were significant variables for treatment response. The adjusted R2 value was 0.231. The mean ages of the responder and non-responder groups were significantly different (p = 0.023). The optimal cutoff value of age for predicting treatment response was 9.75 years. Treatment response was better among children below 9.75 years of age. Conclusions: Patient age and administration of Forsythiae fructus were identified as determinants of response to herbal medicine treatment. Treatment of rhinitis and initiation of height gain treatment at an early age are critical for better response. These findings will provide fundamental data for further research.

Cutoff Values of Serum Carcinoembryonic Antigen(CEA) in Normal Korean Adults and Factors Influencing Serum CEA Level (정상 한국 성인에서 혈청 암태아성항원의 경계치 및 이에 영향을 미치는 인자)

  • Kim, Sun-Wook;Chung, June-Key;Lee, Dong-Soo;Kwark, Cheol-Eun;Jeong, Jae-Min;Kim, Myung-Ki;Lee, Myung-Chul;Koh, Chang-Soon;Lee, Hyung-Kee;Yoo, Keun-Young;Ahn, Yoon-Ok;Kim, Jong-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.391-396
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    • 1994
  • Carcinoembryonic Antigen is one of most frequently checked tumor markers in cancer management. We performed statistical analysis with serum CEA data of 2626 persons who received regular health examination and were thought to be free of active disease to determine the cutoff values of serum CEA level in normal Korean adults and to study the factors influencing serum CEA levels in normal subjects. 1) The cutoff values of serum CEA in normal Korean adults in general were 9.28ng/ml for men, 5.90 ng/ml for women. 2) Serum CEA level was influenced by age, present smoking history, sex, and abnormal findings in chest X ray. 3) Serum CEA level had no correlation with the history of amount of alcohol consumption or obesity. 4) Cutoff values of serum CEA in normal Korean adults were tabulated according to age, sex, and smoking history. Serum CEA level was influenced by age, sex, present smoking history and abnormal findings in chest X ray and cutoff values of serum CEA were tabulated according to age, sex, and smoking history.

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The Usefulness of Spot Urine Protein/Creatinine Ratio in Evaluating Proteinuria in Children and the Correlation between 24-hour Urinary Protein Amount and Spot Urine Protein/Creatinine Ratio (소아 단백뇨 검사에 있어서 단회뇨 단백/크레아티닌 비의 유용성 및 일일 요단백량과의 연관성)

  • Hong, Seon Young;Kim, Ji Young;Chung, Woo Yeong
    • Clinical and Experimental Pediatrics
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    • v.46 no.2
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    • pp.173-177
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    • 2003
  • Purpose : Recently, different results about factors affecting accurate quantitation of 24-hr urinary protein(24UP) amount using spot urine protein/creatinine ratio(PCR) have been reported. The current study was designed to evaluate correlation between 24UP amounts and PCR in children, and the effect of 24UP amounts, age, sex, and glomerular filtration rate(GFR) on this correlation. Methods : Among 94 patients who visited the department of pediatrics in Busan Paik Hospital from March 2002 to August 2002, 68 patients whose urinary creatinine excretion was ${\geq}15mg/kg/day$ were included in this study. All the patients were divided into I, II/A, B group(I : 24UP<500 mg/day, II : $24UP{\geq}500mg/day$, A : <10 years of age, B : ${\geq}10years$ of age). Pearson correlation analysis was performed between 24UP and PCR to evaluate the relationship. We defined fractional difference between 24UP and PCR, and then performed multiple regression analysis with 24UP amount, age, GFR and fractional difference. Results : There was a strong positive linear correlation between 24UP and PCR(R=0.936, P<0.0001) in all patients, and the correlation was also good in each group. Using PCR cutoff values of 0.5, the PCR provided high sensitivity, specificity, positive and negative predictive value in predicting 24UP amount ${\geq}500mg$. The factors affecting accurate quantitation of proteinuria using spot urine PCR was age, not 24UP amount, GFR or sex. Conclusion : Spot urine PCR is a useful test but has limitations in predicting 24UP amount. Therefore, it should be used only as screening method. Age-adjusted PCR cutoff values may be necessary to predict 24UP amount in children with proteinuria.

Influence of Age and Type 1 Diabetes Mellitus on Serological Test for Celiac Disease in Children

  • Maheshwari, Anshu;He, Zhaoping;Weidner, Melissa Nicole;Lin, Patrick;Bober, Ryan;Del Rosario, Fernando J.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.2
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    • pp.218-229
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    • 2021
  • Purpose: Serological tests of tissue transglutaminase (TTG) and deamidated gliadin (DGP) antibodies for celiac disease diagnosis show conflicting correlation with histology in young children and in type 1 diabetes mellitus (T1DM). Tests' ability to predict histology and cutoff values based on age and T1DM was evaluated. Methods: A retrospective study of children who had celiac serological tests between 6/1/2002 and 12/31/2014 at a pediatric hospital. Results: TTG IgA displayed similar results in predicting histology between <4.0 and ≥4.0 years age groups with sensitivity 98% and 93%, and specificity 88% and 86%, respectively. In children <4.0 years old, sensitivity for DGP antibodies was 100% and specificity 94%; in ≥4.0 years age groups, sensitivity was 60%, 88% for DGP IgA and IgG and specificity 95%, 96%, respectively. TTG IgA had low specificity in patients with T1DM compared with non-T1DM, 42% vs. 91%. Positive TTG IgA with normal histology was associated with higher T1DM prevalence at 36% compared with negative tests at 4%. Finally, the TTG IgA cutoff value was higher in T1DM at 36 vs. 16.3 units in non-T1DM. DGP IgG cutoff showed similar values between age groups; TTG IgA and DGP IgA cutoffs were lower in <4.0 years at 8.3 and 11.9 units than ≥4.0 years at 23.4 and 19.9, respectively. Conclusion: TTG IgA is sufficient for the <4.0 years age group and DGP antibodies had no advantage over TTG IgA in older children. The cutoff value to determine a positive TTG IgA should be higher for children with T1DM.

Clinical Usefulness of Serum Uric Acid and Resting Heart Rate in the Diagnosis of Metabolic Syndrome in Korean Adults

  • Shin, Kyung-A
    • Biomedical Science Letters
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    • v.23 no.2
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    • pp.118-127
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    • 2017
  • Elevated serum uric acid and resting heart rate are risk factors and predictors of metabolic syndrome. However, few studies have examined the optimal cutoff value for serum uric acid and resting heart rate to predict metabolic syndrome in Korean adults. Subjects for this study were 22,302 adults (average age 45 years old), who underwent health screening examination from January 2010 to December 2012 at the Health Promotion Center of one hospital in Gyeonggi-do for general health check-up. The uric acid and resting heart rate cutoff values were calculated by ROC analysis for metabolic syndrome. Elevated serum uric acid and resting heart rate were associated with an increased prevalence of metabolic syndrome in Korean adults. The optimal cutoff value for uric acid level to predict metabolic syndrome in adults was 4.95 mg/dL (male 6.35, female 4.55) and optimal cutoff value for resting heart rate to predict metabolic syndrome was 68 beats per minute (male 66, female 68). However, serum uric acid and resting heart rate were found to have limitations for the diagnosis of metabolic syndrome.

Optimal Starting Age for Colorectal Cancer Screening in an Era of Increased Metabolic Unhealthiness: A Nationwide Korean Cross-Sectional Study

  • Choi, Yoon Jin;Lee, Dong Ho;Han, Kyung-Do;Kim, Hyun Soo;Yoon, Hyuk;Shin, Cheol Min;Park, Young Soo;Kim, Nayoung
    • Gut and Liver
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    • v.12 no.6
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    • pp.655-663
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    • 2018
  • Background/Aims: The association between metabolic syndrome and colorectal cancer (CRC) has been suggested as one of causes for the increasing incidence of CRC, particularly in younger age groups. The present study examined whether the current age threshold (50 years) for CRC screening in Korea requires modification when considering increased metabolic syndrome. Methods: We analyzed data from the National Health Insurance Corporation database, which covers ~97% of the population in Korea. CRC risk was evaluated with stratification based on age and the presence/absence of relevant metabolic syndrome components (diabetes, dyslipidemia, and hypertension). Results: A total of 51,612,316 subjects enrolled during 2014 to 2015 were analyzed. Among them, 19.3% had diabetes, hypertension, dyslipidemia, or some combination thereof. This population had a higher incidence of CRC than did those without these conditions, and this was more prominent in subjects <40 years of age. The optimal cutoff age for detecting CRC, based on the highest Youden index, was 45 years among individuals without diabetes, dyslipidemia, and hypertension. Individuals with at least one of these components of metabolic syndrome had the highest Youden index at 62 years old, but the value was only 0.2. Resetting the cutoff age from 50 years to 45 years achieved a 6% increase in sensitivity for CRC detection among the total population. Conclusions: Starting CRC screening earlier, namely, at 45 rather than at 50 years of age, may improve secondary prevention of CRC in Korea.