MPI Predicts Outcome of CRC Elderly Patients (MPI=MULTIDIMENSIONAL PROGNOSTIC INDEX; CRC=COLORECTAL CANCER)
Ontology highlight
ABSTRACT:
DISEASE(S): Colorectal Cancer,Colorectal Neoplasms,Elderly,Fragility
PROVIDER: 2355077 | ecrin-mdr-crc |
REPOSITORIES: ECRIN MDR
Similar Datasets
Project description:prediction of length of stay (LOS) may be useful to optimise care plans to reduce the negative outcomes related to hospitalisation.to evaluate whether the Multidimensional Prognostic Index (MPI), based on a Comprehensive Geriatric Assessment (CGA), may predict LOS in hospitalised older patients.prospective multicentre cohort study.twenty Geriatrics Units.patients aged 65 and older consecutively admitted to Geriatrics Units.at admission, the CGA-based MPI was calculated by using a validated algorithm that included information on basal and instrumental activities of daily living, cognitive status, nutritional status, the risk of pressures sores, co-morbidity, number of drugs and co-habitation status. According to validated cut-offs, subjects were divided into three groups of risk, i.e. MPI-1 low risk (value ?0.33), MPI-2 moderate risk (value 0.34-0.66) and MPI-3 severe risk of mortality (value ?0.67).two thousand and thirty-three patients were included; 1,159 were women (57.0%). Age- and sex-adjusted mean LOS in patients divided according to the MPI grade was MPI-1 = 10.1 (95% CI 8.6-11.8), MPI-2 = 12.47 (95% CI 10.7-14.68) and MPI-3 = 13.41 (95% CI 11.5-15.7) days (P for trend <0.001). The overall accuracy of the MPI to predict LOS was good (C-statistic 0.74, 95% CI 0.72-0.76). Moreover, a statistically significant trend of LOS means was found even in patients stratified according to their International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) main diagnosis.the MPI is an accurate predictor of LOS in older patients hospitalised with the most frequent diseases.
| S-EPMC4711657 | biostudies-other
Project description:BackgroundThe Multidimensional Prognostic Index (MPI) is a validated predictive tool for long-term mortality based on information collected in a standardized Comprehensive Geriatric Assessment. We investigated whether the MPI is an effective predictor of intrahospital mortality and length of hospital stay after admission to acute geriatric wards.MethodsProspective study of 1,178 older patients (702 women and 476 men, 85.0±6.8 years) admitted to 20 geriatrics units. Within 48 hours from admission, the MPI, according to an earlier validated algorithm, was calculated. Subjects were divided into three groups of MPI score, low-risk (MPI-1 value ? 0.33), moderate-risk (MPI-2 value 0.34-0.66), and severe-risk of mortality (MPI-3 value ? 0.67), on the basis of earlier established cut-offs. Associations with in-hospital mortality and length of stay were examined using multivariable Cox regression models and adjusted Poisson linear mixed-effects models, respectively.ResultsAt admission, 23.6% subjects had a MPI-1 score, 33.8% had a MPI-2 score, and 42.6% had a MPI-3 score. Subjects with higher MPI score at admission were older (p < .001), more frequently women (p < .001) and had higher prevalence of common chronic conditions. After adjustment for age, gender, and diseases, patients included in the MPI-2 and MPI-3 groups had a significantly higher risk for intrahospital mortality (hazard ratio: 3.48, 95% confidence intervals: 1.02-11.88, p = .047; hazard ratio: 8.31, 95% confidence intervals: 2.54-27.19, p < .001) than patients included in the MPI-1 group, respectively. In multivariable model, length of stay significantly increased across the three MPI groups (11.29 [0.5], 13.73 [1.3], and 15.30 [1.4] days, respectively [p < .0001]).ConclusionsIn older acute care inpatients, MPI score assessed at hospital admission is an independent predictor of in-hospital mortality and the length of hospital stay.
| S-EPMC4351394 | biostudies-literature
Project description:Ageing affects a wide range of phenotypes at all scales, but an objective measure of ageing remains challenging, even in simple model organisms. To measure the ageing process, we characterized the sequence of alterations of multiple phenotypes at organismal scale. Hundreds of morphological, postural, and behavioral features were extracted from high-resolution videos. Out of the 1019 features extracted, 896 are ageing biomarkers, defined as those that show a significant correlation with relative age (age divided by lifespan). We used support vector regression to predict age, remaining life and lifespan of individual C. elegans. The quality of these predictions (age R2 = 0.79; remaining life R2 = 0.77; lifespan R2 = 0.72) increased with the number of features added to the model, supporting the use of multiple features to quantify ageing. We quantified the rate of ageing as how quickly animals moved through a phenotypic space; we quantified health decline as the slope of the declining predicted remaining life. In both ageing dimensions, we found that short lived-animals aged faster than long-lived animals. In our conditions, for isogenic wild-type worms, the health decline of the individuals was scaled to their lifespan without significant deviation from the average for short- or long-lived animals.
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Project description:Interventions: Control Intervention1: Nil: Nil
Control Intervention2: Nil: Nil
Primary outcome(s): Major post operative complications (clavien dindo class 3-4) within 30 post operative daysTimepoint: Date of surgery to 30 days post operative period
| 2604089 | ecrin-mdr-crc
Project description:Network connections have been shown to be correlated with structural or external attributes of the network vertices in a variety of cases. Given the prevalence of this phenomenon network scientists have developed metrics to quantify its extent. In particular, the assortativity coefficient is used to capture the level of correlation between a single-dimensional attribute (categorical or scalar) of the network nodes and the observed connections, i.e., the edges. Nevertheless, in many cases a multi-dimensional, i.e., vector feature of the nodes is of interest. Similar attributes can describe complex behavioral patterns (e.g., mobility) of the network entities. To date little attention has been given to this setting and there has not been a general and formal treatment of this problem. In this study we develop a metric, the vector assortativity index (VA-index for short), based on network randomization and (empirical) statistical hypothesis testing that is able to quantify the assortativity patterns of a network with respect to a vector attribute. Our extensive experimental results on synthetic network data show that the VA-index outperforms a baseline extension of the assortativity coefficient, which has been used in the literature to cope with similar cases. Furthermore, the VA-index can be calibrated (in terms of parameters) fairly easy, while its benefits increase with the (co-)variance of the vector elements, where the baseline systematically over(under)estimate the true mixing patterns of the network.
| S-EPMC4731394 | biostudies-literature
Project description:Tumor-associated macrophages (TAMs) represent a major component of the tumor microenvironment that supports tumorigenesis. Here we found that prostate tumors are strongly infiltrated by TAMs expressing the C-X-C chemokine receptor type 2 (CXCR2). Pharmacological blockade of the CXCR2 receptor by a selective antagonist promoted the re-education of TAMs towards a pro-inflammatory phenotype. In vitro gene expression profiling revealed that CXCL2 promotes a pro-tumorigenic (M2-like) functional state in macrophages.
2019-06-03 | GSE125273 | GEO
Project description:Copy number alterations (CNAs) are crucial for colorectal cancer (CRC) development. In this study, DEAD box polypeptide 27 (DDX27) was identified to be highly amplified in both TCGA CRC (474/615) and primary CRC (47/103), which was positively correlated with its mRNA overexpression. High DDX27 mRNA (N?=?199) and protein expression (N?=?260) predicted poor survival in CRC patients. Ectopic expression of DDX27 increased CRC cells proliferation, migration and invasion, but suppressed apoptosis. Conversely, silencing of DDX27 exerted opposite effects in vitro and significantly inhibited murine xenograft tumor growth and lung metastasis in vivo. Up-regulation of DDX27 enhanced and prolonged TNF-?-mediated NF-?B signaling. Nucleophosmin (NPM1) was identified as a binding partner of DDX27. DDX27 increased nuclear NPM1 and NF-?B-p65 interaction to enhance DNA binding activity of NF-?B. Silencing NPM1 abrogated DDX27-activating NF-?B signaling and its tumor-promoting function. Together, DDX27 is overexpressed and plays a pivotal oncogenic role in CRC.
| S-EPMC5978808 | biostudies-other
Project description:A common feature in patients with abdominal aortic aneurysms (AAA) is the formation of a nonocclusive intraluminal thrombus (ILT) in regions of aortic dilation. Platelets are known to maintain hemostasis and propagate thrombosis through several redundant activation mechanisms, yet the role of platelet activation in the pathogenesis of AAA associated ILT is still poorly understood. Thus, we sought to investigate how platelet activation impacts the pathogenesis of AAA. Using RNA-sequencing, we identify that the platelet-associated transcripts are significantly enriched in the ILT compared to the adjacent aneurysm wall and healthy control aortas. We found that the platelet specific receptor glycoprotein VI (GPVI) is among the top enriched genes in AAA ILT and is increased on the platelet surface of AAA patients. Examination of a specific indicator of platelet activity, soluble GPVI (sGPVI), in two independent AAA patient cohorts is highly predictive of a AAA diagnosis and associates more strongly with aneurysm growth rate when compared to D-dimer in humans. Finally, intervention with the anti-GPVI antibody (JAQ1) in mice with established aneurysms blunted the progression of AAA in two independent mouse models. In conclusion, we show that levels of sGPVI in humans can predict a diagnosis of AAA and AAA growth rate, which may be critical in the identification of high-risk patients. We also identify GPVI as a novel platelet-specific AAA therapeutic target, with minimal risk of adverse bleeding complications, where none currently exist.
2024-06-22 | GSE269845 | GEO
Project description:BACKGROUND AND AIMS:The Multidimensional Prognostic Index (MPI), an objective and quantifiable tool based on the Comprehensive Geriatric Assessment, has been shown to predict adverse outcomes in European cohorts. We conducted a validation study of the original MPI, and of adapted versions that accounted for the use of specific drugs and cultural diversity in the assessment of cognition, in older Australians. METHODS:The capacity of the MPI to predict 12-month mortality was assessed in 697 patients (median age: 80 years; interquartile range: 72-86) admitted to a metropolitan teaching hospital between September 2015 and February 2017. RESULTS:In simple logistic regression analysis, the MPI was associated with 12-month mortality (Low risk: OR reference group; moderate risk: OR 2.50, 95% CI: 1.67-3.75; high risk: OR 4.24, 95% CI: 2.28-7.88). The area under the receiver operating characteristic curve (AUC) for the unadjusted MPI was 0.61 (0.57-0.65) and 0.64 (95% CI: 0.59-0.68) with age and sex adjusted. The adapted versions of the MPI did not significantly change the AUC of the original MPI. CONCLUSION:The original and adapted MPI were strongly associated with 12-month mortality in an Australian cohort. However, the discriminatory performance was lower than that reported in European studies.
| S-EPMC6912422 | biostudies-literature
Project description:Food security (FS) during infancy is associated with lifelong outcomes. New Zealand is a developed economy that reports poor childhood nutrition-related health statistics, particularly among minority children, yet has no measure of FS applicable to infancy. The objective was to develop an FS index for New Zealand infants and examine its association with demographic covariates and health outcomes. Within a large (n = 6853) nationally representative cohort, variables describing infant food consumption, breastfeeding, and maternal food-related coping methods were collected from mothers during late infancy. An FS index was derived using confirmatory factor analysis. Associations were assessed by logistic regressions and described using odds ratios (OR) and ?95% confidence intervals (CI). Fifteen percent of the cohort was highly FS, 43% tenuously food insecure (FIS), and 16% highly food insecure (FIS). Infants from minority ethnic groups had lower odds of being food secure, as did those born to the youngest mothers, mothers who smoked, or those who lived in low-income households. FIS infants had higher odds of morbidity. Interventions to improve infant FS should focus on improving dietary quality, and should give particular consideration to minority infants. We identified that FIS shows wide ethnic and socioeconomic inequity, and is associated with poorer health. The most important driving factors of FIS included poor quality weaning diets, as well as poverty and its proxies. Any interventions to improve infant FS should focus on increasing fruit and vegetable consumption to recommended intake levels, and should give particular consideration to minority infants.
| S-EPMC6352114 | biostudies-literature