International Journal of General Medicine最新文献

{"title":"Association of Butyryl Cholinesterase and Recurrent Ischemic Stroke: A Cross-Sectional Study.","authors":"Ruomeng Chen, Kun Zhang, Hui Liu, Lijuan Liu, Hui Li, Yan Yan, Zhou Zhou, Chaoyue Meng, Xuelin Wang, Haoran Wu, Ruihan Miao, Rui Wang, Xiaoyun Liu","doi":"10.2147/IJGM.S509543","DOIUrl":"10.2147/IJGM.S509543","url":null,"abstract":"<p><strong>Objective: </strong>Exploring novel relevant factors associated with recurrent ischemic stroke.</p><p><strong>Methods: </strong>This is a retrospective study, patients were divided into first-ever ischemic stroke group and recurrent ischemic stroke groups. We conducted a comparative analysis of baseline data between the two groups. Multifactorial logistic regression analysis was performed to identify factors associated with recurrent ischemic stroke. Grouped according to butyryl cholinesterase levels, to elucidate the relationship between butyryl cholinesterase levels and stroke recurrence.</p><p><strong>Results: </strong>A total of 2029 patients were included, with 1174 in the first-ever ischemic stroke group and 855 in the recurrent ischemic stroke group. Age, hypertension, diabetes, alanine aminotransferase, and lipoprotein(a) were identified as risk factors for recurrent ischemic stroke (ALL <i>p</i><0.05). Erythrocyte count, butyryl cholinesterase, low-density lipoprotein, and non-atherosclerotic type of large arteries were found to be negative associated with recurrent ischemic stroke (ALL <i>p</i><0.05). Subgroup analyses indicated that butyryl cholinesterase levels were significantly negatively associated with recurrent ischemic stroke in males (OR=0.814, <i>p</i><0.001, 95% CI: 0.761 ~ 0.871), especially under 60 years (OR=0.781, <i>p</i><0.001, 95% CI: 0.708 ~ 0.862). After adjusting for multifactorial regression analyses, the recurrent rate in the lowest quartile of butyryl cholinesterase levels was 2.281 times that of the highest quartile (OR=2.281, <i>p</i><0.05, 95% CI: 1.318 ~ 3.948).</p><p><strong>Conclusion: </strong>Age, hypertension, diabetes, alanine aminotransferase, and lipoprotein(a) are independent risk factors for the recurrence of ischemic stroke. The inverse association between butyryl cholinesterase levels and stroke recurrence suggests butyryl cholinesterase may serve as a potential target for therapeutic intervention to improve the prognosis of ischemic stroke.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"1709-1720"},"PeriodicalIF":2.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conditional Survival Rate of Patients Undergoing Gastrectomy with D2 Lymph Node Dissection After Neoadjuvant Chemotherapy: A Retrospective Study.","authors":"Xiuding Yang, Feiyu Meng, Fenglin Cai, Jingyu Deng","doi":"10.2147/IJGM.S514702","DOIUrl":"10.2147/IJGM.S514702","url":null,"abstract":"<p><strong>Background: </strong>The conditional survival rate is a dynamic estimation method that changes over time. Our research aimed to assesses the conditional disease-specific survival rate and conditional recurrence-free survival rate among patients who undergoing radical gastrectomy for gastric cancer after neoadjuvant chemotherapy.</p><p><strong>Methods: </strong>This study included 260 patients who undergoing gastrectomy with D2 lymph node dissection after preoperative chemotherapy. The 2-year conditional disease-specific survival rate (CDS2) indicates that patients who have survived for x years after initial treatment will survive for another 2 years, calculated as follows: CDS2 = Disease-Specific Survival (DSS) (<i>x</i> + 2)/ Disease-Specific Survival (<i>x</i>). Similarly, the 2-year conditional recurrence free survival rate (CRFS2) formula is as follows: CRFS2 = Recurrence-Free Survival (RFS) (<i>x</i> + 2)/ Recurrence-Free Survival (<i>x</i>). Cox proportional risk regression analysis was used to identify factors related to DSS and RFS.</p><p><strong>Results: </strong>The 1-, 3-, and 5-year actuarial DSS rates were 82%, 57.6%, and 50.7%, respectively. According to conditional disease-specific survival rate (CDS) estimation, the CDS2 of patients who have already survived for 1 year, 3 years, and 5 years is 70.2%, 88%, and 93.3%, respectively. The RFS actuarial rates for 1 year, 3 years, and 5 years were 73.1%, 52.5%, and 46.4%, respectively. According to conditional recurrence free survival rate (CRFS) estimation, the CRFS2 of patients who survived for 1 year, 3 years, and 5 years without recurrence was 71.8%, 88.4%, and 100%, respectively. Lymph vessel infiltration, ypN stage, tumor differentiation, TRG grading, and surgical type are risk factors for DSS and RFS.</p><p><strong>Conclusion: </strong>The CDS and CRFS of patients undergoing gastrectomy with D2 lymph node dissection after neoadjuvant chemotherapy demonstrate gradual increase over time. Patients with adverse tumor characteristics exhibited the most substantial improvement in both CDS and CRFS.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"1657-1668"},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing GLIM and SGA Nutritional Criteria for Malnutrition Assessment and Prognosis in Chronic Heart Failure Patients.","authors":"Yi-Qiu Zhou, Wen-Ming He, Sheng Jing, Yan-Qing Xie, Si Chen, Jia-Ning Li","doi":"10.2147/IJGM.S514143","DOIUrl":"10.2147/IJGM.S514143","url":null,"abstract":"<p><strong>Background: </strong>Chronic heart failure (CHF) is a prevalent condition with high morbidity and mortality. Malnutrition is common in CHF patients and is associated with poor prognosis. The Subjective Global Assessment (SGA) and Global Leadership Initiative on Malnutrition (GLIM) criteria are widely used to assess nutritional status, but their prognostic value in CHF remains unclear. This study aimed to compare the effectiveness of SGA and GLIM criteria in assessing malnutrition and predicting adverse outcomes in CHF patients.</p><p><strong>Material and methods: </strong>This retrospective cohort study included 240 CHF patients admitted between January 2022 and June 2024. Nutritional status was assessed using both SGA and GLIM within 48 hours of admission. The primary outcome was the occurrence of adverse events (worsening heart failure, readmission, or all-cause mortality) within 90 days post-discharge. Statistical analyses included Cohen's kappa for agreement, Receiver Operating Characteristic (ROC) curves for predictive value, and multivariate logistic regression to identify independent risk factors for adverse outcomes.</p><p><strong>Results: </strong>The agreement between SGA and GLIM criteria was good (Cohen's Kappa = 0.8). ROC analysis showed an AUC of 0.744 for SGA and 0.793 for GLIM in predicting adverse outcomes. The DeLong test revealed that GLIM had a significantly better predictive value (Z = -1.93, p = 0.043). Multivariate analysis identified malnutrition (both SGA and GLIM), smoking, and elevated BNP as independent risk factors for adverse outcomes. Nomograms incorporating these factors showed good predictive accuracy, with the GLIM model yielding a higher AUC of 0.854 compared to 0.816 for SGA.</p><p><strong>Conclusion: </strong>Malnutrition was identified in 38.8% of patients when assessed by the SGA and in 40.0% when evaluated using the GLIM criteria. GLIM criteria are a reliable and superior tool for predicting adverse outcomes in CHF patients compared to SGA. Incorporating nutritional assessments, BNP, and smoking history into predictive models can enhance risk stratification and guide clinical decision-making in managing CHF patients.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"1669-1679"},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound and Clinicopathological Characteristics of Papillary Thyroid Carcinoma Predict the Coexistence of TERT Promoter and BRAF^V600E Mutations.","authors":"Mei Yu, ChengZheng Zhang, ZhengTong Wang, ShaoWen Lv, YiFang Sun, WenWen Zhao, Lu Li, QingFeng Kong, Kun Liu, Shuanglong Wang","doi":"10.2147/IJGM.S513319","DOIUrl":"10.2147/IJGM.S513319","url":null,"abstract":"<p><strong>Purpose: </strong>The coexistence of TERT promoter and BRAFV600E mutations is strongly linked to aggressive behavior and poor prognosis in papillary thyroid carcinoma (PTC). This study aimed to develop preoperative and postoperative predictive models for coexisting mutations based on ultrasound and clinicopathological characteristics to stratify prognostic risks and guide clinical decision-making.</p><p><strong>Methods: </strong>Retrospective analysis of the ultrasound and clinicopathological characteristics of 120 patients with a surgical pathology of PTC with TERT promoter and BRAF^V600E gene testing results in the Affiliated Hospital of Jining Medical University from December 2020 to December 2023. Univariate and multivariate logistic regression identified independent predictors, and nomograms were constructed. Model performance was evaluated using ROC curves, calibration curves, and decision curves, with internal validation via Bootstrap resampling.</p><p><strong>Results: </strong>Age (OR: 1.24; 95% CI 1.12-1.37, P<0.001), tumor size (OR: 5.51; 95% CI 2.26-13.46, P<0.001), lateral lymph node metastasis (OR: 7.36; 95% CI 1.48-36.48, P=0.015), and irregular/ill-defined margins (OR: 6.06; 95% CI 1.19-30.75, P=0.030) were independent predictors of coexisting mutations. The cutoff values for age and tumor size were 44.5 years and 1.55 cm, respectively. Two models incorporating the four independent predictors were established to predict coexisting mutations in the preoperative and postoperative periods, achieving AUCs of 0.95 and 0.96, respectively, with both models demonstrating good calibration ability and clinical practicability through calibration and decision curve analyses.</p><p><strong>Conclusion: </strong>The predictive models enable clinicians to identify high-risk patients with coexisting mutations both preoperatively and postoperatively, supporting the development of individualized treatment strategies and potentially improving patient outcomes. However, the study is limited by its single-center design, and further external validation is needed to confirm the generalizability of the model.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"1643-1656"},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological Analysis of Patients with Isolated Hematuria and/or Mild Proteinuria.","authors":"Junping Tang, Pingping Luo, Min He, Lin Ning, Zhenqin Tan","doi":"10.2147/IJGM.S504226","DOIUrl":"10.2147/IJGM.S504226","url":null,"abstract":"<p><strong>Objective: </strong>This investigation aimed to explore the clinicopathological features of patients with isolated hematuria and/or mild proteinuria in kidney disease.</p><p><strong>Materials and methods: </strong>We conducted a retrospective review of the clinical and pathological information of patients initially diagnosed with chronic nephritis syndrome in the Nephrology Department of Yuebei People's Hospital.</p><p><strong>Results: </strong>In total, 227 participants were recruited for the study, including 79 patients (34.8%) in the group with isolated hematuria and/or mild proteinuria and 148 patients (65.2%) in the group with medium-large amounts of proteinuria. There were 29 cases (36.7%) of IgA nephropathy, seven cases (8.9%) of focal segmental glomerulosclerosis, six cases (7.6%) of membranous nephropathy, and six cases (7.9%) of acute renal tubular injury in the group with isolated hematuria and/or mild proteinuria. The common pathological types in the medium-large proteinuria group were membranous nephropathy in 68 cases (45.9%), minimal change nephropathy in 25 cases (16.9%), and IgA nephropathy in 20 cases (13.5%).</p><p><strong>Conclusion: </strong>IgA nephropathy is the main pathological type in the group with isolated hematuria and/or mild proteinuria, while membranous nephropathy is the common pathological type in the group with moderate to severe proteinuria. There was a significantly stronger correlation between the level of hematuria/proteinuria and both BMI and MAP.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"1623-1628"},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Nomogram for Predicting the Risk of Twin and Preterm Births After Two Cleavage-Stage Embryo Transfer.","authors":"Yunzhu Lan, Shuang Liu, Emmanuel Osei Nkansah, Fang Wang, Shaowei Chen, Jun Zhang, Lan Yuan, Jian Xu","doi":"10.2147/IJGM.S510014","DOIUrl":"10.2147/IJGM.S510014","url":null,"abstract":"<p><strong>Objective: </strong>To propose a prediction model aimed at increasing the live birth rate of patients undergoing two-cell embryo transfer while eliminating multiple pregnancy complications.</p><p><strong>Methods: </strong>Women who underwent their first In Vitro Fertilization (IVF) cycle with transferred cleavage-stage embryos at the Affiliated Hospital of Southwest Medical University between January 2016 and December 2024 were included. This study recruited women who received the GnRH agonist long protocol (GnRH-a) or antagonist protocol (GnRH-ant) for ovarian stimulation. In addition, the clinical parameters related to the basic protocol and embryo characteristics were recorded.</p><p><strong>Results: </strong>In the multivariate analysis, we found that female age, endometrial thickness on the Human Chorionic Gonadotropin (HCG) days, patients with Body Mass Index (BMI) >30, high-quality embryos with 4 cells between 1 and 4 pieces, high-quality embryos with 8 cells, available embryos between 5 and 15 pieces and high-quality embryos between 1 and 4 pieces were crucial factors in the twin pregnancies prediction model (<i>p</i> < 0.05). On the basis of these characteristics, we constructed a nomogram for twin pregnancies. Additionally, we compared the difference between premature and normal births and found that endometrial thickness on HCG days positively correlated with the model score. In the premature group, the endometrial thickness on HCG days was lower than that found in patients without premature births.</p><p><strong>Conclusion: </strong>Endometrial thickness on the HCG day may influence the outcome of twin pregnancies. The high-quality embryos showed a higher positive correlation with the model score. Patients with preterm birth had less endometrial thickness on the HCG day than patients without premature birth. For patients with high-quality embryos, it is advisable to use single embryo transfer to reduce the rate of twin pregnancies. This nomogram will enhance the counseling of patients with infertility challenges.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"1629-1641"},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Preoperative Blood Pressure Fluctuations in Patients Undergoing Elective Surgery: A Retrospective Observational Study.","authors":"Zifei Cheng, Lihui Zhang, Minglei Liu, Dali Liang, Yue Li, Xiansong Huang, Li Peng","doi":"10.2147/IJGM.S507706","DOIUrl":"10.2147/IJGM.S507706","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the factors influencing preoperative blood pressure fluctuations in patients undergoing elective surgery.</p><p><strong>Patients and methods: </strong>This retrospective observational study included 776 patients who underwent elective surgery between January and October 2021. Preoperative blood pressure fluctuations were defined las a systolic or diastolic change exceeding 20% compared to baseline measurements taken one day prior to surgery. Patients were divided into two groups: the elevated blood pressure group (n=328) and the non-fluctuating group (n=448). Multivariate logistic regression analysis was employed to identify independent risk factors associated with blood pressure fluctuations.</p><p><strong>Results: </strong>Among the 776 patients (335 males and 441 females), the average systolic blood pressure increased by 12.98 ± 19.33 mmHg, and diastolic blood pressure increased by 6.67 ± 13.20 mmHg on the day of surgery compared to the previous day. Preoperative blood pressure fluctuations exceeding 20% were observed in 42.27% of patients. Multivariate logistic regression revealed that older age (OR = 1.021; 95% CI: 1.007-1.035; P = 0.003), preoperative hypertension (OR = 1.785; 95% CI: 1.142-2.807; P = 0.011), and shorter sleep duration the night before surgery (OR = 0.835; 95% CI: 0.747-0.932; P = 0.001) were independent risk factors for blood pressure fluctuations.</p><p><strong>Conclusion: </strong>Significant increases in preoperative blood pressure were observed upon patient entry into the operating room. Older age, preoperative hypertension, and inadequate sleep duration were identified as independent risk factors for blood pressure fluctuations. These findings underscore the need for targeted preoperative interventions to minimize blood pressure variability, particularly in elderly and hypertensive patients with inadequate sleep duration.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"1615-1622"},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiometabolic Comorbidities in Patients With Chronic Hepatitis B and Impact on Incidence of Liver Complications. A Danish Nationwide Cohort Study.","authors":"Sofie Jespersen, Signe Bollerup, Sten Madsbad, Rikke Krogh-Madsen, Stine Byberg, Nina Weis","doi":"10.2147/IJGM.S471083","DOIUrl":"10.2147/IJGM.S471083","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate liver complications in patients with chronic hepatitis B, both with and without cardiometabolic comorbidities, and to compare the incidence of cardiometabolic comorbidities in these patients with that of the general population.</p><p><strong>Study population and methods: </strong>This nationwide registry-based cohort study included data from 2002-2020. In the primary analysis, we used multivariate Poisson regression to estimate the incidence rate and incidence rate ratio of liver complications in patients with chronic hepatitis B, stratified by the presence of cardiometabolic comorbidities. In the secondary analysis, we compared the incidence rate of developing cardiometabolic comorbidities in patients with chronic hepatitis B to those of the general population. Both analyses were adjusted for sex, age, and country of origin, while the primary analysis was additionally adjusted for time since cardiometabolic comorbidity diagnosis and calendar year.</p><p><strong>Results: </strong>The primary analysis included 4731 patients with chronic hepatitis B, of whom 532 (11%) had at least one cardiometabolic comorbidity. The unadjusted overall incidence rate of liver complications in patients with cardiometabolic comorbidities was 1.0 per 100 person-years (95% confidence intervals: 0.84-1.30) compared to 0.4 per 100 person-years (95% confidence intervals: 0.30-0.42) in those without. The incidence rate ratio for liver complications was highest in the first year following the diagnosis of cardiometabolic comorbidity. The incidence rate ratio for developing cardiometabolic comorbidities in the chronic hepatitis B cohort compared to the general population, was 1.10 (95% confidence intervals: 1.02-1.19). Sensitivity analyses revealed a higher incidence rate ratio for type 2 diabetes and hypertension but a lower incidence rate ratio for hypercholesterolemia.</p><p><strong>Conclusion: </strong>Patients with chronic hepatitis B and cardiometabolic comorbidities exhibit a higher incidence of liver complications, particularly in the first year following comorbidity diagnosis compared to those without comorbidities. Furthermore, patients with chronic hepatitis B have a higher incidence of cardiometabolic comorbidities than the general population.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"1591-1604"},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Visualized Nomogram to Predict the Risk of Acute Ischemic Stroke Among Patients With Cervical Artery Dissection.","authors":"Changyu Li, Jincheng Guan, Qingshi Zhao, Jiahua Li, Yuying Wang, Kui Zhao","doi":"10.2147/IJGM.S507043","DOIUrl":"10.2147/IJGM.S507043","url":null,"abstract":"<p><strong>Background: </strong>Acute ischemic stroke (AIS) is a significant global health concern, with cervical artery dissection (CAD) being a notable yet frequently overlooked cause, particularly in young adults. Despite advancements in imaging technologies, there remains a deficiency in effective methodologies for the prompt identification of AIS attributable to CAD. This research aims to create a predictive model combining clinical, imaging, and laboratory data to improve risk stratification and guide timely interventions.</p><p><strong>Methods: </strong>Between 2019 and 2024, patients diagnosed with CAD were enrolled in the study. Nomogram models were constructed utilizing a two-step methodological approach. Initially, the least absolute shrinkage and selection operator (LASSO) regression analysis was utilized to improve variable selection. Subsequently, logistic regression analysis was conducted to develop an estimation model using the significant indicators identified by the LASSO. The model's accuracy was evaluated using the application of receiver operating characteristic (ROC) curves, calibration curves, decision curve analyses, and clinical impact curves. The model underwent internal validation through bootstrap resampling with 1,000 iterations.</p><p><strong>Results: </strong>In the cohort of 102 patients, 75 individuals with CAD experienced had an acute ischemic stroke. This cohort was characterized by a significantly older median age (42 years vs 51 years, p=0.041) and a comparable proportion of males (78.7% vs 74.1%,p=0.825). The analysis identified hyperlipidemia (aOR=0.19, 95% CI=0.040-0.893, p=0.036), lumen occlusion (aOR=5.41, 95% CI=1.236-23.648, p=0.025), a lower lymphocyte-to-monocyte ratio (LMR) (aOR=0.68, 95% CI=0.476-0.797, p=0.038), and higher systemic immune-inflammation index (SII) (aOR=1.01, 95% CI=1.001-1.016, p=0.026) are independent factors linked to ischemic stroke in CAD patients. The predictive model showed strong performance with an AUC of 0.870 (95% CI=0.789-0.950) under the ROC curve. Decision curve analysis (DCA) indicated that the constructed nomogram was clinically applicable, with a risk threshold ranging from 9% to 95%.</p><p><strong>Conclusion: </strong>This study developed a dynamic and visualized nomogram model for the precise prediction of stroke risk in patients with CAD, exhibiting robust performance, calibration, and clinical utility. Future multi-center studies are anticipated to further substantiate its clinical applicability.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"1569-1580"},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Predictive Value of Neutrophil Percentage-to-Albumin Ratio and Modified Glasgow Prognostic Score for the Risk of Stroke-Associated Pneumonia Among Stroke Patients.","authors":"Zhu Tian, Yufeng Lin, Yang Song, Chi Zhang, Zhiyun Wang","doi":"10.2147/IJGM.S504231","DOIUrl":"10.2147/IJGM.S504231","url":null,"abstract":"<p><strong>Objective: </strong>To assess the predicting value of neutrophil percentage-to-albumin ratio (NPAR) and modified Glasgow Prognostic Score (mGPS) for Stroke-Associated Pneumonia (SAP) occurrence among stroke patients.</p><p><strong>Methods: </strong>We recruited stroke patients (aged 18 years) hospitalized at Tianjin First Central Hospital from January 2022 to February 2023 for this retrospective cohort study. NPAR was categorized into four groups by considering the quartiles: Q1 (<1.38), Q2 (≥1.38 and <1.62), Q3 (≥1.62 and <1.87), Q4 (≥1.87). SAP incident was the primary outcome in this study. Univariate and multivariate logistic regression models were employed to explore the association between NPAR, mGPS and SAP occurrence among individuals with stroke. Besides, we compared the predicting value of NPAR and mGPS for SAP occurrence by the receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>Our study encompassed 851 patients with stroke. One hundred and forty-seven patients (17.27%) developed SAP. After accounting for confounding factors, we observed significant positive association of high NPAR with SAP occurrence [(for the third quartile: odds ratio (OR)=2.35, 95% confidence interval (CI): 1.01-5.47; for the fourth quartile: OR=3.35, 95% CI: 1.44-7.77)]. Additionally, the results also indicated that mGPS 1 (OR=2.26, 95% CI: 1.25-4.08) and mGPS 2 (OR=7.37, 95% CI: 2.63-20.70) were related to the increased probability of SAP, respectively. ROC analysis demonstrated that both the NPAR [area under the curve (AUC)=0.729, 95% CI: 0.687-0.771] and mGPS (AUC=0.671, 95% CI: 0.627-0.716) exhibited good predictive power for SAP occurrence. Based on the DeLong test, the predictive value of NPAR for SAP may be significantly superior to that of mGPS (<i>P</i><0.05).</p><p><strong>Conclusion: </strong>Our findings suggest that both NPAR and mGPS serve as reliable biomarker for assessing SAP risk in stroke patients, with NPAR demonstrating superior predictive value for SAP compared to mGPS.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"1605-1614"},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}