Impact of statin use on COVID-19 outcomes in hospitalized patients in Saudi Arabia: a retrospective cohort study
Omar M. Al NozhaAhmed AbulkhairAmal HawsawiSameh SayedKhlood AlrowathiNawaf AldeebHadel M. AlghabbanGhaidaa ElmehallawyDalya Ayman IskandaraniMohammed LhmdiInass M. Taha
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There is an increasing requirement for new therapeutic approaches to address lung inflammation caused by COVID-19. Recent evidence suggests that statins may reduce mortality in patients with respiratory infections. This study aimed to investigate the impact of statin use on COVID-19 outcomes among hospitalized patients at Ohud Hospital and King Salman Medical City (KSMC) in Madinah, Saudi Arabia. A retrospective cohort study was conducted, including 547 patients with confirmed COVID-19 diagnoses admitted between March 2020 and December 2022. Patients were classified into statin and non-statin users based on statin administration during hospitalization. Logistic regression analyses-including univariate, multivariate, and predictive stepwise models-were employed to assess associations between statin use and clinical factors. Among the 547 patients, 200 (36.5%) were prescribed statins upon admission. Statin users were predominantly men and older. The presence of low-density lipoprotein (LDL) levels ≥ 100 mg/dL, cardiovascular disease (CVD), and advanced age were identified as strong predictors of statin use, with odds ratios (ORs) of 11.1, 3.8, and 3.1, respectively. Furthermore, the odds of receiving statins were significantly higher in male patients, individuals with hypertension, those with HbA1c levels ≥ 8%, and patients with positive cultures and sensitivity results. Statin use was associated with an 18%% reduction in the risk of mortality, with an adjusted OR of 0.80 (95% CI, 0.30-2.32), and a 7% reduction in the risk of hospital stay > 10 days, although these findings did not reach statistical significance. Among patients with COVID-19, LDL ≥ 100 mg/dl, CVD, and patients older than 60 years were identified as strong predictors for statin prescription.Keywords:
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In this research we investigated the incidence of Bronchopulmonary Dysplasia among Infants using modeling approach. The data used were obtained from University of Maiduguri Teaching Hospital (UMTH), Maiduguri and Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto with sample size of Seventy (70) patients in 2014. Fifty (50) patients were from Maiduguri and Twenty (20) patients from Sokoto. Logistic regression model was employed for the analysis with the help of SPSS. The result of the analysis indicates that the logistic regression model has a perfect classification of five new cases in Sokoto while it has misclassified two 0f five new cases in Maiduguri. This result shows that the prediction of Broncho-Pulmonary Dysplasia is moderately done with logistic model in Maiduguri and is more preferred for the same purpose in Sokoto. The study recommends that Doctors and Clinics should adopt the use of the model built by this research to detect the prevalence of BPD among Infants.
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The prelims comprise: The aim of logistic regression The logistic model Using Stata for logistic regression analysis The receiver operating characteristic curve Indicator variables in logistic regression Testing the linear trend Evaluating how well the logistic model fits the data Using Stata to compute sensitivity and specificity Key points in evaluating a logistic model
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In this paper, we compare logistic regression and 2 other classification methods in predicting hypertension given the genotype information. We use logistic regression analysis in the first step to detect significant single-nucleotide polymorphisms (SNPs). In the second step, we use the significant SNPs with logistic regression, support vector machines (SVMs), and a newly developed permanental classification method for prediction purposes. We also detect rare variants and investigate their impact on prediction. Our results show that SVMs and permanental classification both outperform logistic regression, and they are comparable in predicting hypertension status.
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Hepatic retransplantation is controversial because the results are inferior to primary transplants and organs are so scarce. To determine the factors that are associated with poor outcome within the first year following retransplantation, we performed a multivariate analysis, using stepwise logistic regression, of 418 hepatic retransplantations performed at a single institution from November 1987 to December 1993. The minimum follow-up was 1 year. Seven variables were found to be independently associated with subsequent graft failure (defined as either patient death or retransplantation): donor age (odds ratio 2.2 for each 10-year increase over age 45, 95% CI 1.3 to 3.7), female donor sex (odds ratio 1.7, 95% CI 1.05 to 2.7), recipient age (odds ratio 1.6 for each 10-year increase over age 45, 95% CI 1.2 to 2.3), need for preoperative mechanical ventilation (odds ratio 1.8, 95% CI 1.1 to 2.9), pretransplant serum creatinine (odds ratio 1.24 for each increase of 1 mg/dl, 95% CI 1.1 to 1.4), pretransplant total serum bilirubin(odds ratio 1.4 for each 10-mg/dl increase over 15 mg/dl, 95% CI 1.1 to 1.8), and the primary immunosuppressant, using tacrolimus as the reference category(odds ratio for cyclosporine-based immunosuppression 3.9, 95% CI 2.3 to 6.8). Although not part of the logistic regression model, the timing of retransplantation was also found to be important, with the overall probability of failure increasing from 0.58 on day 0 to a peak of 0.8 on day 38 and decreasing slowly after that. The implications of these results regarding the appropriateness of retransplantation are discussed.
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The relationship between passive smoking and the onset of Legg-Calvè-Perthes disease is still controversial. Therefore, we conducted the study to systematically evaluate and analyze the relationship. A comprehensive search was conducted. Meta-analysis was performed with RevMan 5.3 software, with the odds ratio as the effect size. Eight English articles with a total of 1379 Legg-Calvè-Perthes disease patients were eventually included. Passive smoking type of family members smoking in indoor (odds ratio = 2.53), paternal smoking (odds ratio = 2.76), maternal smoking (odds ratio = 2.02), maternal smoking during pregnancy (odds ratio = 1.68), using stove indoor (odds ratio = 2.56) are statistically significant ( P < 0.05). For the family members smoking indoor, region may be a confounding factor (European group I 2 = 92%, odds ratio = 2.51; USA group I 2 = 5%, odds ratio = 3.26; and Asian group I 2 = 0%, odds ratio = 2.25). In addition, the type of maternal smoking (odds ratio = 0.80, for 1–10 per day; odds ratio = 2.73, for 10–20 per day; odds ratio = 2.78, for >20 per day) and the type of maternal smoking during pregnancy (odds ratio = 1.36, for 1–9 per day; odds ratio = 2.02, for ≥10 per day) may show a dose-effect relationship. Passive smoking is a risk factor for the onset of Legg-Calvè-Perthes disease, but the specific types of passive smoking (haze, etc.), dose, dose-effect relationship, regional confounding, pathological mechanisms, etc. also require clinicians and researchers to continue exploring.
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Objective: To determine whether statin use is associated with improved discharge disposition after ischemic stroke. Methods: We analyzed 12,689 patients with ischemic stroke over a 7 year period at 17 hospitals in Kaiser Permanente Northern California. We used multivariable generalized ordinal logistic regression and instrumental variable analysis of treatment patterns by hospital to control for the possibility of confounding. Results: Statin users before and during stroke hospitalization were more likely to be discharged home (54.9% for statin users, 46.3% for statin non-users) and less likely to die in hospital (5.3% for statin users, 10.3% for statin non-users). Patients who underwent statin withdrawal in-hospital were less likely to be discharged home (39.1% for statin withdrawal, 54.9% for statin continuation) and more likely to die in hospital (22.3% for statin withdrawal, 5.3% for statin continuation). Users of higher statin doses (>60 mg / day) were even more likely to be discharged home (62.5% for high dose statin, 56.5% for usual dose statin, and 47.4% for no statin) and less likely to die in hospital in-hospital (3.5% for high dose statin, 5.6% for usual dose statin, and 10.6% for no statin). These results were confirmed by multivariable analysis. The association of statin use and improved outcomes was also confirmed by instrumental variable analysis of treatment patterns by hospital, and thus this association cannot be explained by confounding at the individual patient level. Conclusions: Statin use is associated with improved discharge disposition after ischemic stroke, particularly at higher doses.
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Background: Studies about the influence of patient characteristics on mechanical failure of cups in total hip replacement have applied different methodologies and revealed inconclusive results. The fixation mode has rarely been investigated. Therefore, we conducted a detailed analysis of the influence of patient characteristics and fixation mode on cup failure risks. Methods: We conducted a case-control study of total hip arthroplasties in 4420 patients to test our hypothesis that patient characteristics of sex, age, weight, body mass index, and diagnosis have different influences on risks for early mechanical failure in cemented and uncemented cups. Results: Women had significantly reduced odds for failure of cups with cemented fixation (odds ratio = 0.59; 95% confidence interval, 0.43 to 0.83; p = 0.002) and uncemented fixation (odds ratio = 0.63; 95% confidence interval, 0.5 to 0.81; p = 0.0003) compared with that for men (odds ratio = 1). Each additional year of patient age at the time of surgery reduced the failure odds by a factor of 0.98 for both cemented cups (odds ratio = 0.98; 95% confidence interval, 0.96 to 0.99; p = 0.016) and uncemented cups (odds ratio = 0.98; 95% confidence interval, 0.97 to 0.99; p = 0.0002). In patients with cemented cups, the weight group of 73 to 82 kg had significantly lower failure odds (odds ratio = 0.63; 95% confidence interval, 0.4 to 0.98) than the lightest (<64 kg) weight group or the heaviest (>82 kg) weight group (odds ratios = 1.00 and 1.07, respectively). No significant effects of weight were noted in the uncemented group. In contrast, obese patients (a body mass index of >30 kg/m2) with uncemented cups had significantly elevated odds relative to patients with a body mass of <25 kg/m2 (odds ratio = 1.41; 95% confidence interval, 1.03 to 1.91) for early failure of the cups compared with an insignificant effect in the cemented arm of the study. Compared with osteoarthritis as the reference diagnosis (odds ratio = 1), developmental dysplasia (odds ratio = 0.52; 95% confidence interval, 0.28 to 0.97) and hip fracture (odds ratio = 0.38; 95% confidence interval, 0.16 to 0.92) were significantly protective in cemented cups. Conclusions: Female sex and older age have similarly protective effects on the odds for early failure of cemented and uncemented cups. Although a certain body-weight range has a significant protective effect in cemented cups, the more important finding was the significantly increased risk for failure of uncemented cups in obese patients. Patients with developmental dysplasia and hip fracture were the only diagnostic groups with a significantly decreased risk for cup failure, but only with cemented fixation. Level of Evidence: Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.
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