ABSTRACT
Objective:To explore the application value of regional oxygen saturation (rSO 2) level in the prognosis evaluation of patients with acute lower limb ischemia (ALLI). Methods:Retrospective analysis of clinical data of 82 ALLI patients admitted to the ICU of Xinjiang Uygur Autonomous Region People's Hospital from June 2021 to June 2022. The subjects were divided into event group and non-event group according to the incidence of adverse events during the follow-up. The general clinical data of the two groups were compared. Multiple stepwise linear regression was used to analyze the independent related factors of rSO 2. Multivariate Cox regression was used to analyze independent risk factors of adverse events. Receiver operating characteristic (ROC) curve was used to obtain the optimal cut-off value of rSO 2 prediction adverse events. The subjects were divided into high-value group and low-value group according to the optimal cut-off value. Kaplan-Meier curve was used to analyze the difference in survival rate between groups during the follow-up. Results:A total of 82 ALLI patients were included in this study, and the incidence of adverse events during follow-up was 25.6% (21 cases). The rSO 2 of four periods and maximum, minimum, average and ankle-brachial index in the event group were significantly lower than those in the non-event group. The troponin I, troponin T, myoglobin, creatine kinase, C-reactive protein, and lactate in the event group were significantly higher than those in the non event group ( P?0.05). Multiple stepwise linear regression analysis showed that: C-reactive protein ( β=-0.320, P=0.002), lactate ( β=-0.262, P=0.009), troponin Ⅰ ( β=-0.230, P=0.025), and smoking history ( β=-0.211, P=0.034) were all independent predictors of rSO 2. Multivariate Cox regression analysis showed that 24 h rSO 2 (mean) was an independent influencing factor for adverse events in ALLI patients (adjusted HR=0.67, 95% CI:0.54-0.83, P<0.001). The 24 h rSO 2 (mean) was good in predicting the incidence of adverse events at 30, 60, and 90 days in ALLI patients (AUC were 0.934, 0.867 and 0.823), and the corresponding optimal cut-off values of rSO 2 were 59.36, 59.03 and 59.03. The sensitivity and specificity to predict adverse events in ALLI patients were 85.7% and 85.3% when the 24 h rSO 2 (mean) was 59.36 as the best cut-off value. According to the optimal cut-off , the subjects were divided into high value group (rSO 2>59.36%, 59 cases) and low value group (rSO 2≤59.36%, 23 cases), Kaplan Meier survival curve analysis showed that there was significant difference in event free survival between the two groups ( P<0.001), the high value group significantly better than the low value group. Conclusion:The 24 h rSO 2 (mean) is an independent influencing factor for adverse events in ALLI patients, and has good predictive value for prognosis.
ABSTRACT
Introduction: Fat excess in the organism can behave as a multifactorial problem and predisposes to the presence of non-transmissible chronic diseases, in which cardiovascular diseases can be mentioned. Objective: To establish the optimal cut-off for anthropometric indices to predict Metabolic Syndrome in army personnel, attended at the primary health care. Method: An analytical, non-experimental study that was carried out in army personnel at the University of the Armed Forces, during the year 2020. The sample was represented by 203 participants, the collection methods were the medical and anthropometric records, taking into consideration variables such as height and weight, hip and waist circumference, body mass index, laboratory tests, among others. All the data was analyzed using international classification criteria. Results: The prevalence of MetSyn was obtained, according to the different criteria: MetSyn ALAD: 4.08% (SD: 0.52), MetSyn ATP III: 7.65% (SD: 0.52), MetSyn HARM: 5.4% (SD: 0.52) and finally, MetSyn OMS: 7.65% (SD: 0.52). Likewise, the predictive anthropometric indices according to the highest AUC are the WC and WHtR in all the criteria studied, in addition, according to MetSyn ATP III, the optimal WC cut-off is 91 cm and the WHtR is 0.53. Conclusions: The optimal cut-off for anthropometric indices that predict Metabolic syndrome in army personnel are WC and WHtR, with an optimal cut off lower than the criteria established by ALAD to the diagnosis of MetSyn.
Introducción: El exceso de grasa en el organismo puede ser un problema multifactorial y predispone a la presencia de enfermedades crónicas no transmisibles, entre las que se encuentran las cardiovasculares. Objetivo: Establecer el corte óptimo de los índices antropométricos para predecir el síndrome metabólico en personal militar que se atiende en la atención primaria de salud. Métodos: Estudio analítico, no experimental, llevado a cabo en personal militar de la Universidad de las Fuerzas Armadas, durante el año 2020. La muestra está representada por 203 participantes, los métodos de colección fueron los registros médicos y antropométricos, tomando en consideración variables como talla y peso, circunferencia de cintura y cadera, índice de masa corporal, pruebas de laboratorio, entre otros. Todos los datos fueron analizados usando criterios de clasificación internacional. Resultado: La prevalencia de síndrome metabólico (MetSyn), según los diferentes criterios es: MetSyn ALAD: 4,08 % (SD: 0,52), MetSyn ATP III: 7,65 % (SD: 0,52), MetSyn HARM: 5,4 % (SD: 0,52) y finalmente, MetSyn OMS: 7,65 % (SD: 0,52). Además, los índices antropométricos predictivos son el WC y WHtR en todos los criterios estudiados, y según MetSyn ATP III, el corte óptimo del WC es de 91 cm y del WHtR es de 0,53. Conclusiones: Los puntos de corte óptimos para los índices antropométricos que predicen el síndrome metabólico en el personal militar son WC y WHtR, con un punto de corte óptimo inferior a los criterios establecidos por ALAD para el diagnóstico de MetSyn.
ABSTRACT
Objective To investigate the relationship between the optimal cutoff point of serum homocyste-ine(Hcy)and premature delivery in pregnant women ,and to analyze the influence of Hcy levels on the outcome of preterm infants. Methods Totally 114 cases of pregnant women were chosen as observation group and 103 cases of normal as control group. Hcy,D-D and hypersensitive C reactive protein were detected;analysis of the ROC curve was conducted by using the SPSS 13 software and the risk factors for preterm delivery were analyzed using logistic multivariate regression analysis. Results (1)The levels of Hcy,HS-CRP and D-D in preterm pregnant women were higher than those in control group and the difference was statistically significant (P < 0.05). (2) Logistic regression analysis showed that the relative risk coefficient(OR)of Hcy was 9.736,and the regression equation of premature birth probability was obtained.(3)ROC curve to evaluate the predictive value of Hcy in risk factors of preterm birth was 0.931;when Hcy was 13.8μmol/L,the Youden index was 0.784.(4)Elevated levels of Hcy in preterm women led to a marked increase in the likelihood of SGA. Conclusion When predicting risk factors for preterm birth,the best predictive cutoff value for Hcy is 13.8μmol/L,which is one of the independent risk factors for preterm birth.
ABSTRACT
Objective To investigate the relationship between the optimal cutoff point of serum homocyste-ine(Hcy)and premature delivery in pregnant women ,and to analyze the influence of Hcy levels on the outcome of preterm infants. Methods Totally 114 cases of pregnant women were chosen as observation group and 103 cases of normal as control group. Hcy,D-D and hypersensitive C reactive protein were detected;analysis of the ROC curve was conducted by using the SPSS 13 software and the risk factors for preterm delivery were analyzed using logistic multivariate regression analysis. Results (1)The levels of Hcy,HS-CRP and D-D in preterm pregnant women were higher than those in control group and the difference was statistically significant (P < 0.05). (2) Logistic regression analysis showed that the relative risk coefficient(OR)of Hcy was 9.736,and the regression equation of premature birth probability was obtained.(3)ROC curve to evaluate the predictive value of Hcy in risk factors of preterm birth was 0.931;when Hcy was 13.8μmol/L,the Youden index was 0.784.(4)Elevated levels of Hcy in preterm women led to a marked increase in the likelihood of SGA. Conclusion When predicting risk factors for preterm birth,the best predictive cutoff value for Hcy is 13.8μmol/L,which is one of the independent risk factors for preterm birth.
ABSTRACT
Sensitivity and specificity are two components that measure the inherent validity of a diagnostic test for dichotomous outcomes against a gold standard. Receiver operating characteristic (ROC) curve is the plot that depicts the trade-off between the sensitivity and (1-specificity) across a series of cut-off points when the diagnostic test is continuous or on ordinal scale (minimum 5 categories). This is an effective method for assessing the performance of a diagnostic test. The aim of this article is to provide basic conceptual framework and interpretation of ROC analysis to help medical researchers to use it effectively. ROC curve and its important components like area under the curve, sensitivity at specified specificity and vice versa, and partial area under the curve are discussed. Various other issues such as choice between parametric and non-parametric methods, biases that affect the performance of a diagnostic test, sample size for estimating the sensitivity, specificity, and area under ROC curve, and details of commonly used softwares in ROC analysis are also presented.
ABSTRACT
OBJECTIVES: The authors attempted to evaluate the diagnostic validity of the Korean version, Geri-atric Depression Scale(GDS) for screening geriatric DSM-III-R major depression among clinical pop-ulations. METHODS: Through of preliminary trials 3 times, the authors translated GDS including Short form Geriatric Depression Scale(SGDS) into Korean. GDS, SGDS, HRS-D, CES-D was adminis-tered to 88 elderly psychiatric patients(35 major depressives, 51 were non-major depression) and also Diagnostic Interview Schedule(DIS-III-R) was administered independently to diagnoses DSM-III-R major depression. Reliability and validity test 5, optimal cut-off point estimation, and ROC curve analysis were done to investigate the diagnostic validity of GDS and SGDS. RESULTS: Internal consistency-reliability and concurrent validity of GDS, SGDS associated with other depression scales(HRS-D, CES-D) were excellent. Content validity and discriminant validity which differentiate DSM-III-R major depression from non-major depression was also good. The authors suggest the score '17' as the optimal cut-off point of GDS for screening DSM-III-R major depression among clinical populations and the score '8' as optimal cut-off score of SGDS. ROC curve analysis revealed wide AUC of both GDS and SGDS, which indicates its high diagnostic validity in assessing DSM-III-R major depression. The GDS and SGDS were found to be highly correlated(r=0.9594) and any difference of AUC between both scales in ROC curve analysis were not found. This finding suggests that SGDS can be an adequate substitute for GDS. CONCLUSION: The GDS and SGDS are valid and reliable case finding tools for screening DSM-III-R major depression among clinical populations in Korea but relatively high cut-off point demands the further evaluation in the viewpoint of culturally determined style of response for the depression questionnaire in Korea.