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Zhao F, Zhang L, Chen X, Lei M, Sun L, Ma L, Wang C. Construction and Verification of Urinary Tract Infection Prediction Model for Hospitalized Rehabilitation Patients with Spinal Cord Injury. World Neurosurg 2024:S1878-8750(24)00885-4. [PMID: 38810877 DOI: 10.1016/j.wneu.2024.05.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/20/2024] [Indexed: 05/31/2024]
Abstract
OBJECTIVE To explore the influencing factors of urinary tract infection (UTI) in hospitalized patients with spinal cord injury and to construct and verify the nomogram prediction model. METHODS This study is a retrospective cohort study. From January 2017 to March 2022, 558 patients with spinal cord injury admitted to the Department of Rehabilitation Medicine of a tertiary hospital in Anhui Province, China, were selected as the research objects, and they were randomly divided into training group (n = 390) and verification group (n = 168) according to the ratio of 7:3, and clinical data including socio-demographic characteristics, disease-related data, and laboratory examination data were collected. Univariate analysis and multivariate logistic regression were used to analyze the influencing factors of UTI in hospitalized patients with spinal cord injuries. Based on this, a nomogram prediction model was constructed with the use of R software, and the risk prediction efficiency of the nomogram model was verified by the receiver operating characteristic curve and calibration curve. RESULTS Logistic regression analysis showed that the American Spinal Cord Injury Association (ASIA)-E grade (compared with ASIA-A grade) was an independent protective factor for UTI in hospitalized patients with spinal cord injury (odds ratio < 1, P < 0.05), while white blood cell count and indwelling catheter were independent risk factors for UTI in hospitalized patients with spinal cord injury (odds ratio > 1, P < 0.05). Based on this, a nomogram risk predictive model for predicting UTI in hospitalized rehabilitation patients with spinal cord injury was constructed, which proved to have good predictive efficiency. In the training group and the verification group, the area under the receiver operating characteristic curve of the nomogram model is 0.808 and 0.767, and the 95% confidence interval of the area under the receiver operating characteristic curve of the nomogram in the training group and the verification group is 0.760∼0.856 and 0.688∼0.845, respectively, indicating the nomogram model has good discrimination. According to the calibration curve, the prediction probability of the nomogram model and the actual frequency of UTI in the training group and the verification group are in good consistency, and the results of the Hosmer-Lemeshow bias test also suggest that the nomogram model has a good calibration degree in both the training group and the verification group (P = 0.329, 0.067). CONCLUSIONS ASIA classification level, white blood cell count, and indwelling catheter are independent influencing factors of UTI in hospitalized patients with spinal cord injury. The nomogram prediction model based on the above factors can simply and effectively predict the risk of UTI in hospitalized patients with spinal cord injury, which is helpful for clinical medical staff to identify high-risk groups early and implement prevention, treatment, and nursing strategies in time.
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Affiliation(s)
- Fangfang Zhao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Lixiang Zhang
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Xia Chen
- Department of Nursing, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Mengling Lei
- Department of Rehabilitation Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China; The Graduate School, Bengbu Medical University, Bengbu, Anhui, China
| | - Liai Sun
- Department of Rehabilitation Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Lina Ma
- Department of Rehabilitation Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Cheng Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
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Luo P, Li YY, Huang C, Guo J, Yao X. A novel conditional survival nomogram for monitoring real-time prognosis of non-metastatic colorectal cancer. Discov Oncol 2024; 15:179. [PMID: 38772985 PMCID: PMC11109079 DOI: 10.1007/s12672-024-01042-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 05/17/2024] [Indexed: 05/23/2024] Open
Abstract
AIMS The aim of this study is to enhance the accuracy of monitoring and treatment information for patients diagnosed with colorectal cancer (CRC). METHODS Utilizing the Surveillance, Epidemiology, and End Results (SEER) database, a cohort of 335,948 eligible CRC patients was included in this investigation. Conditional survival probability and actuarial overall survival were employed as methodologies to investigate the association between clinicopathological characteristics and cancer prognosis. RESULTS Among CRC patients, the 5-year survival rate was 59%, while the 10-year survival rate was 42%. Over time, conditional survival showed a consistent increase, with rates reaching 45% and 48% for individuals surviving 1 and 2 years, respectively. Notably, patients with unfavorable tumor stages exhibited substantial improvements in conditional survival, thereby narrowing the disparity with actuarial overall survival over time. CONCLUSION This study underscores the significance of time-dependent conditional survival probability, particularly for patients with a poorer prognosis. The findings suggest that long-term CRC survivors may experience improved cancer prognosis over time.
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Affiliation(s)
- Pei Luo
- Department of Gastroenterology, People's Hospital of Qianxinan Prefecture, Xingyi, Guizhou, 562400, China.
| | - Ying-Ying Li
- Department of Gerontology, People's Hospital of Qianxinan Prefecture, Xingyi, Guizhou, 562400, China
| | - Can Huang
- Department of Gastroenterology, People's Hospital of Qianxinan Prefecture, Xingyi, Guizhou, 562400, China
| | - Jun Guo
- Department of Gastroenterology, People's Hospital of Qianxinan Prefecture, Xingyi, Guizhou, 562400, China
| | - Xin Yao
- Department of Gastroenterology, People's Hospital of Qianxinan Prefecture, Xingyi, Guizhou, 562400, China
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Wu Q, Chen J, Ma B. Investigation on the alleviating effect of standardized three-step nursing on perioperative pressure injury in patients with spinal fracture accompanied by spinal cord injury. Int J Neurosci 2024:1-7. [PMID: 38712679 DOI: 10.1080/00207454.2024.2352042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 04/30/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVE To explore the alleviating effect of standardized three-step nursing on perioperative pressure injury in patients with spinal fractures accompanied by spinal cord injury. METHODS A retrospective analysis was conducted on the clinical data of 153 patients who underwent surgical treatment for spinal fracture accompanied by spinal cord injury in our hospital from January 2021 to January 2024. All patients met the criteria for inclusion and exclusion. According to the nursing interventions received during the perioperative period, the patients were divided into a control group (n = 76) and an observation group (n = 77). The control group received routine nursing interventions during the perioperative period, while the observation group received standardized three-step nursing interventions. The occurrence, severity, area, and pain [Visual Analog Scale (VAS)], coagulation indicators [prothrombin time (PT), fibrinogen (FIB), D-dimer (D-D)], activities of daily living [Barthel Index], and quality of life [General Quality of Life Inventory (GQOLI-74)] were compared between the two groups. RESULTS (1) Occurrence and severity of perioperative pressure injury: in the control group, 18 cases of pressure injury occurred, including 5 cases of stage I, 11 cases of stage II, and 2 cases of stage III; in the observation group, 7 cases of pressure injury occurred, including 4 cases of stage I and 3 cases of stage II. The occurrence rate and severity of pressure injury in the observation group were lower than those in the control group (p < 0.05). (2) Area of injury and pain: The area of injury on the day of surgery and 5 days after surgery in the observation group was lower than that in the control group (p < 0.05); the VAS score 5 days after surgery in the observation group was lower than that in the control group (p < 0.05). (3) Coagulation indicators: 5 days after surgery, the levels of D-D and FIB in the observation group were lower than those in the control group, while PT was higher than that in the control group (p < 0.05). (4) Activities of daily living and quality of life: 3 months after surgery, the Barthel score and GQOLI-74 score in the observation group were higher than those in the control group (p < 0.05). CONCLUSION Standardized three-step nursing can significantly reduce the occurrence rate, severity, and area of perioperative pressure injury in patients with spinal fracture accompanied by spinal cord injury, alleviate patient pain, improve coagulation function, and enhance levels of activities of daily living and quality of life.
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Affiliation(s)
- Qunfang Wu
- Second Ward of Spinal Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University Medical School, Shanghai, China
| | - Jiaying Chen
- Second Ward of Spinal Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University Medical School, Shanghai, China
| | - Bitao Ma
- Department of Traditional Chinese Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Ning C, Ouyang H, Shen D, Sun Z, Liu B, Hong X, Lin C, Li J, Chen L, Li X, Huang G. Prediction of survival in patients with infected pancreatic necrosis: a prospective cohort study. Int J Surg 2024; 110:777-787. [PMID: 37851523 PMCID: PMC10871654 DOI: 10.1097/js9.0000000000000844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/28/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Infected pancreatic necrosis (IPN) is a severe complication of acute pancreatitis, with mortality rates ranging from 15 to 35%. However, limited studies exist to predict the survival of IPN patients and nomogram has never been built. This study aimed to identify predictors of mortality, estimate conditional survival (CS), and develop a CS nomogram and logistic regression nomogram for real-time prediction of survival in IPN patients. METHODS A prospective cohort study was performed in 335 IPN patients consecutively enrolled at a large Chinese tertiary hospital from January 2011 to December 2022. The random survival forest method was first employed to identify the most significant predictors and capture clinically relevant nonlinear threshold effects. Instantaneous death risk and CS was first utilized to reveal the dynamic changes in the survival of IPN patients. A Cox model-based nomogram incorporating CS and a logistic regression-based nomogram were first developed and internally validated with a bootstrap method. RESULTS The random survival forest model identified seven foremost predictors of mortality, including the number of organ failures, duration of organ failure, age, time from onset to first intervention, hemorrhage, bloodstream infection, and severity classification. Duration of organ failure and time from onset to first intervention showed distinct thresholds and nonlinear relationships with mortality. Instantaneous death risk reduced progressively within the first 30 days, and CS analysis indicated gradual improvement in real-time survival since diagnosis, with 90-day survival rates gradually increasing from 0.778 to 0.838, 0.881, 0.974, and 0.992 after surviving 15, 30, 45, 60, and 75 days, respectively. After further variables selection using step regression, five predictors (age, number of organ failures, hemorrhage, time from onset to first intervention, and bloodstream infection) were utilized to construct both the CS nomogram and logistic regression nomogram, both of which demonstrated excellent performance with 1000 bootstrap. CONCLUSION Number of organ failures, duration of organ failure, age, time from onset to first intervention, hemorrhage, bloodstream infection, and severity classification were the most crucial predictors of mortality of IPN patients. The CS nomogram and logistic regression nomogram constructed by these predictors could help clinicians to predict real-time survival and optimize clinical decisions.
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Affiliation(s)
- Caihong Ning
- Department of General Surgery
- National Clinical Research Center for Geriatric Disorders
- Department of Pancreatic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Hui Ouyang
- Department of General Surgery
- National Clinical Research Center for Geriatric Disorders
| | - Dingcheng Shen
- Department of General Surgery
- National Clinical Research Center for Geriatric Disorders
- Department of Pancreatic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Zefang Sun
- Department of General Surgery
- National Clinical Research Center for Geriatric Disorders
- Department of Pancreatic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Baiqi Liu
- Department of General Surgery
- National Clinical Research Center for Geriatric Disorders
- Department of Pancreatic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Xiaoyue Hong
- Department of General Surgery
- National Clinical Research Center for Geriatric Disorders
- Department of Pancreatic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Chiayen Lin
- Department of General Surgery
- National Clinical Research Center for Geriatric Disorders
- Department of Pancreatic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Jiarong Li
- Department of General Surgery
- National Clinical Research Center for Geriatric Disorders
- Department of Pancreatic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Lu Chen
- Department of General Surgery
- National Clinical Research Center for Geriatric Disorders
- Department of Pancreatic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Xinying Li
- Department of General Surgery
- National Clinical Research Center for Geriatric Disorders
| | - Gengwen Huang
- Department of General Surgery
- National Clinical Research Center for Geriatric Disorders
- Department of Pancreatic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
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Liu Y, Yang X, He Z, Li J, Li Y, Wu Y, Manyande A, Feng M, Xiang H. Spinal cord injury: global burden from 1990 to 2019 and projections up to 2030 using Bayesian age-period-cohort analysis. Front Neurol 2023; 14:1304153. [PMID: 38116113 PMCID: PMC10729761 DOI: 10.3389/fneur.2023.1304153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 11/22/2023] [Indexed: 12/21/2023] Open
Abstract
Background Spinal cord injuries, often resulting from spine fractures, can lead to severe lifelong symptoms such as paraplegia and even mortality. Over the past few decades, there has been a concerning increase in the annual incidence and mortality rates of spinal cord injuries, which has also placed a growing financial strain on healthcare systems. This review aims to offer a comprehensive overview of spinal cord injuries by estimating their global incidence, prevalence, and the impact in terms of years lived with disability, using data obtained from the 2019 Global Burden of Disease Study. Method In this study, we utilized data from the 2019 Global Burden of Disease Study, a widely recognized source for global health data. Our methodology involved estimating the global incidence and prevalence of spinal cord injuries while also assessing the impact on years lived with a disability. We analyzed this data comprehensively to identify patterns and trends and made predictions. Finding This research delved into the evolving trends in the global burden of spinal cord injuries, identified key risk factors, and examined variations in incidence and disability across different Socio-demographic Index (SDI) levels and age groups. Briefly, in 2019, the global incidence and burden of YLDs of SCI significantly increased compared to 1990. While males had higher incidence rates compared to females. Falls were identified as the primary cause of SCI. Trend projections up to 2030 revealed a slight decrease in ASIR for males, an upward trend in age-specific incidence rates for both sexes and a similar pattern in age-standardized YLD rates. Additionally, our findings provided crucial groundwork for shaping future policies and healthcare initiatives, with the goal of mitigating the burden of spinal cord injuries, enhancing patient outcomes, and fortifying prevention efforts. Interpretation Understanding the global burden of spinal cord injuries is essential for designing effective healthcare policies and prevention strategies. With the alarming increase in prevalence rates and their significant impact on individuals and healthcare systems, this research contributes vital insights to guide future efforts in reducing the incidence of spinal cord injuries, improving the quality of life for affected individuals, and reducing the economic burden on healthcare systems worldwide.
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Affiliation(s)
- Yanbo Liu
- Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuesong Yang
- Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhigang He
- Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Juan Li
- Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yijing Li
- Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanqiong Wu
- Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Anne Manyande
- School of Human and Social Sciences, University of West London, London, United Kingdom
| | - Maohui Feng
- Department of Gastrointestinal Surgery, Zhongnan Hospital of Wuhan University, Clinical Medical Research Center of Peritoneal Cancer of Wuhan, Clinical Cancer Study Center of Hubei Provence, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China
| | - Hongbing Xiang
- Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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