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At least 1,063 records · Page 59Linked to original sources
PubMed2006

Hemodynamic significance of mitral stenosis: use of a simple, novel index by 2-dimensional echocardiography.

OBJECTIVE: We sought to assess the hemodynamic significance of mitral stenosis (MS) using a new index. METHODS: We studied 88 patients with MS. Maximum separation of mitral leaflet tips in diastole in parasternal long-axis and apical 4-chamber views was measured. These two parameters were averaged to yield the mitral leaflet separation index. The index was compared with mitral valve area by planimetry and pressure half-time. RESULTS: The mitral leaflet separation index was measurable in 76 (86.4%) patients. There was excellent correlation with mitral valve area by planimetry (r = 0.91, P < .001) and pressure half-time (r = 0.86, P < .001) across a wide range of mitral valve areas. Good correlation was found even in atrial fibrillation (r = 0.86 and r = 0.79, respectively). The index could discriminate between hemodynamically significant and insignificant MS (P < .001). An index of 0.81 cm or less predicted severe MS with 92.3% sensitivity and 100% specificity whereas a value of 1.11 cm or more identified mild MS with 85.7% sensitivity and 100% specificity. CONCLUSION: The mitral leaflet separation index is an independent and reliable measure of MS severity that is easy to measure.

Echocardiography, Doppler↗
PubMed2006

Tei index and neurohormonal activation in patients with incident heart failure: serial changes and prognostic value.

BACKGROUND: Natriuretic peptides and Tei index are useful indices for risk stratification in advanced left ventricular dysfunction (LVD). Their role in early stages is less clear. AIMS: In relation to first diagnosis of LVD to assess the relation of plasma B-type-natriuretic peptide (NT-proBNP) with Tei index, assess serial changes in indices, and to assess the value of indices to predict functional status. METHODS: Doppler echocardiography and neurohormonal analysis were performed (n=150). NYHA class was registered. RESULTS: Tei index correlated with p-NT-proBNP (r=0.75, p<0.0001), and changes in indices correlated (r=0.36, p=0.001) in LVD (n=80). No functional improvement (n=47) was related to a median increase in Tei index (-0.2, -0.16; 0.09); an improvement (n=31) to a reduction (0.06; -0.19; 0.35), p=0.02. In the group with functional improvement, more patients had >/=30% reduction in p-NT-proBNP (75% vs. 45%, p<0.01). Addition of NT-proBNP or Tei index to a clinical model, of no functional improvement, improved log-likelihood chi(2) from 9.32 to 20.18 (p=0.001) and 20.67 (p=0.001). CONCLUSION: Tei index and p-NT-proBNP demonstrated a fair correlation. Unimproved NYHA class was related to progressive LVD and might be identified by monitoring Tei index or p-NT-proBNP. Advanced LVD and high pre-treatment p-NT-proBNP levels indicated a potential of improvement in functional status.

Adult↗
PubMed2005

Doppler echocardiographic profile and indexes in the evaluation of aortic coarctation in patients before and after stenting.

OBJECTIVES: We sought to assess the effect of successful stenting on the Doppler profile of aortic coarctation and to identify echocardiographic indexes that could be used for follow-up of such patients. BACKGROUND: Doppler echocardiography demonstrates characteristic flow patterns in significant aortic coarctation. METHODS: We undertook retrospective echocardiographic analyses before and at six to nine months after coarctation stenting in consecutive patients from 2002 to 2003. Peak systolic pressure gradient (SPG), diastolic velocity (DV), end-diastolic tail velocity (EDTV), systolic velocity half-time index (SVHTi) and diastolic velocity half-time index (DVHTi), and systolic pressure half-time index (SPHTi) and diastolic pressure half-time index (DPHTi) were measured. The severity of aortic coarctation was compared with cardiovascular magnetic resonance (CMR) imaging using the coarctation index (CoAi). RESULTS: The patient cohort was divided into two groups: group 1 (13 patients; age 30 +/- 8 years), which consisted of patients with significant aortic coarctation treated with stenting, and group 2 (11 patients; age 39 +/- 16 years), which consisted of patients with previous surgical repair of aortic coarctation without evidence of re-coarctation. After stenting, there was significant reduction in SPG (p = 0.001), DV (p = 0.001), EDTV (p = 0.005), DVHTi (p = 0.001), and DPHTi (p = 0.001) values. In the patient group as a whole, there was a significant correlation between SPG and DV (r = 0.86; p < 0.001), EDTV (r = 0.80; p < 0.001), DVHTi (r = 0.56; p < 0.001), and DPHTi (r = 0.50; p = 0.002). In addition, DV >193 cm/s (100% sensitivity, 100% specificity) and diastolic/systolic velocity ratio >0.53 (100% sensitivity, 96% specificity) had high predictive values for severe aortic coarctation (CoAi <0.25). CONCLUSIONS: After stenting, peak SPG, DV, and pressure half-time indexes (i.e., DVHTi and DPHTi) decreased significantly. These findings can confidently be used in the follow-up of coarctation patients after stenting, particularly in those with limited two-dimensional images.

Adult↗
PubMed2006

Quantitative calcaneal ultrasonometry: normative data and age-related changes for stiffness index in the Turkish population.

The aim of this cross-sectional study was to define the normative data for stiffness index in a large sample of Turkish population and to clarify sex differences as well as age-related changes. A total of 10,435 subjects (aged 18-89 yr) were screened with calcaneal ultrasound and were requested to complete a detailed questionnaire listing all important risk factors, diseases, and treatments affecting bone metabolism. To be included in the study, subjects had to be free of any disease and any medical treatment known to affect bone metabolism. A total of 8,156 subjects (1,389 males and 6,767 females) were included in the study. Normative data was expressed using two statistical models including mean and 95th percentile, and regression analysis. The mean value of stiffness index in females peaked in the third decade, whereas in males it peaked in the age group of 18-29 yr. The stiffness index of females decreased by 24.26%. The total age-related decrease was 17.8% for stiffness index in the males. Stiffness index in males was a function of age (negatively) and body mass index (positively). Stiffness index in females was a function of age (negatively) and weight (positively). The results of this study could be useful as a guide for comparing the data of individual studies and may serve as reference normative data for the Turkish population.

Adolescent↗
PubMed2002

Prospective validation of an echocardiographic index for determining the severity of chronic mitral regurgitation.

The aim of this study is to prospectively validate a recently reported semiquantitative index of mitral regurgitation (MR) severity. MR is a common echocardiographic finding with no single reference standard to evaluate its severity. We recently developed and retrospectively tested a semiquantitative index of MR severity. The MR index is a composite of 6 echocardiographic variables: jet penetration, proximal isovelocity surface area, continuous-wave Doppler characteristics of the regurgitant jet, pulmonary artery pressure, pulmonary venous flow pattern, and left atrial size. Sixty-two consecutive patients with varying grades of MR were prospectively studied. Patients were divided into 3 groups for comparison: mild MR, moderate MR, and severe MR. Each patient was evaluated for the 6 variables, with each variable scored on a 4-point scale (0 to 3). The reference standards for MR severity were qualitative evaluation by an expert, measurement of the regurgitant fraction (RF), and the effective regurgitant orifice area. The MR index increased in proportion to MR severity with a significant difference among the 3 groups (F = 84; p <0.0001). The MR index also correlated with RF (r = 0.73; p <0.0001) and the effective regurgitant orifice area (r = 0.74; p = 0.0001). A MR index > or = 2.2 identified 13 of 16 patients with severe MR (sensitivity 82%, specificity 98%, positive predictive value 93%). No patient with severe MR had a score <2.0 and no patient with mild MR had a score >1.67. These results concurred with those obtained in a previously published retrospective study. Thus, the MR index is a simple, reproducible semiquantitative estimate of MR severity, that is widely applicable in routine clinical practice.

Adult↗
PubMed2003

Pseudonormalized Doppler total ejection isovolume (Tei) index in patients with right ventricular acute myocardial infarction.

The Doppler total ejection isovolume (Tei) index is useful for estimating global cardiac function. However, the relation between the right ventricular (RV) Tei index and RV infarction has not been investigated. The relation between the RV Tei index and severity of RV infarction was evaluated in 25 patients with inferior wall acute myocardial infarction (13 with and 12 without RV infarction). RV infarction was diagnosed when right atrial pressure was > or = 10 mm Hg or when right atrial pressure/pulmonary capillary wedge pressure was >0.8 by catheterization. The RV Tei index was significantly increased in patients with RV infarction compared with those without (0.53 +/- 0.15 vs 0.38 +/- 0.14, p <0.05). The RV Tei index in patients with severe RV infarction (right atrial pressure > or = 15 mm Hg) was significantly smaller compared with those with mild/moderate RV infarction (right atrial pressure <15 mm Hg) and showed no significant difference in patients with myocardial infarction but without RV infarction (0.44 +/- 0.09 vs 0.61 +/- 0.16 vs 0.38 +/- 0.14, severe RV infarction vs mild/moderate RV infarction vs no RV infarction, p <0.01). The RV Tei index is generally increased in patients with RV infarction; however, severe RV infarction can be manifested with limited or no increase in the Tei index (pseudonormalization).

Adult↗
PubMed1999

Body mass index in young men and the risk of subsequent knee and hip osteoarthritis.

PURPOSE: Obesity in middle age is associated with an increased risk of osteoarthritis of the knees in later life. We sought to determine whether body mass index in young men was a risk factor for the subsequent development of osteoarthritis of the knee and hip. SUBJECTS AND METHODS: Body mass index was assessed in 1,180 male medical students at age 23 +/- 2 (mean +/- SD) years and at several times during follow-up. The incidence of knee and hip osteoarthritis was ascertained by self-report and corroborated with information on symptoms and radiographic findings. RESULTS: During a median follow-up of 36 years, 62 participants developed knee osteoarthritis and 27 developed hip osteoarthritis. The incidence of knee, but not hip, osteoarthritis was strongly associated with body mass index assessed at ages 20 to 29 years and 30 to 39 years (both P <0.001). For body mass index assessed at ages 20 to 29 years, the incidence of knee osteoarthritis at age 65 years was 12.8% among the heaviest subjects (range 24.7 to 37.6 kg/m2), threefold greater than the incidence of 4.0% in the leanest (15.6 to 22.8 kg/m2) category of body mass index (P = 0.0001). Thus, for a man who was 180 cm (5'11") tall, each 8 kg (18 lb) greater weight at ages 20 to 29 years was associated with an increased risk of subsequent knee osteoarthritis (relative risk = 1.7, 95% confidence interval 1.3 to 2.1), after adjustment for year of birth, physical activity, and knee injury. Body mass index at ages 20 to 29 years was more predictive of future osteoarthritis than at ages 30 to 39 or 40 to 49 years. CONCLUSION: Greater body mass index in young men ages 20 to 29 years is associated with an increased risk of subsequent knee, but not hip, osteoarthritis, suggesting that cumulative exposure to greater weight during young adult life is an important cause of osteoarthritis.

Adult↗
PubMed1997

Evaluation of facial palsy by moiré topography index.

We investigated the usefulness of moiré topography for evaluating facial nerve function in 51 patients with facial palsy and 10 normal volunteers. This method visualizes the shape of objects in three dimensions. We devised three moiré indexes as a simple method of quantifying the severity of facial palsy: the nasolabial groove moiré index, the oral angle moiré index, and the inner canthus moiré index. We compared the results obtained by the moiré indexes with findings obtained using the House-Brackmann grading system and found that they were highly correlated. These three moiré indexes included all the standard factors of the House-Brackmann grading system, allowing us to develop the total moiré index.

Adolescent↗
PubMed2001

Volume-corrected mitotic index as a prognostic factor in oral squamous cell carcinomas.

In order to predict the prognosis of patients with oral squamous cell carcinomas, volume-corrected mitotic index (M/V index), as well as histopathological and clinical indices were estimated in 50 oral squamous cell carcinoma tumors. Histological malignancy (P = 0.0005), mode of invasion (P = 0.0168) and M/V index (P = 0.0093) showed a significant correlation with survival according to univariate survival analysis. According to multivariate survival analysis (Cox's regression model), the M/V index was the best predictor of the techniques studied of patient prognosis. The M/V index also showed significant correlation with DNA ploidy. The present results suggest that the M/V index is an important prognostic factor for oral carcinoma. Furthermore, the M/V index and DNA ploidy appear to provide similar prognostic information.

Adult↗
PubMed2000

Body mass index and alternative indices of obesity in relation to height, triceps skinfold and subsequent mortality: the Busselton health study.

OBJECTIVES: The ideal index for leanness and obesity in epidemiological studies should correlate strongly with body weight and with a direct measure of fat while minimizing the influence of height. The preferred index is expected to show meaningful associations with subsequent mortality. Our aims were to compare weight/height, weight/height(2) (body mass index or BMI), and weight/height(3) as candidates for this index. DESIGN: We analysed cross-sectional data from surveys of 6948 adults (3334 men (mean age 43 y, mean BMI 24.8 kg/m2), and 3614 women (mean age 42 y, mean BMI 24.3 kg/m2)) in Busselton, Australia whose weight, height, triceps skinfold, and cardiovascular risk factors were measured from 1966 through to 1978. In these same subjects we studied the mortality risks of indices of obesity using Cox regression analysis for survival time from first survey to death, or to follow up at the end of December 1995, after adjustment for age. Subjects dying within 5 y of the baseline survey were excluded from the analysis to avoid the bias of concurrent illness. We also studied subgroups including never smokers, subjects with no heart disease, and subjects <60 years of age at first survey. RESULTS: In men, weight/height2 met the criteria for a satisfactory index in that there was a very strong correlation with triceps skinfold, and a negligible correlation with height. For women, weight/height was as good a measure as weight/height2, with both having strong correlations with triceps skinfold, and minimal correlations with height. Weight/height2 as a predictor of mortality in men of all ages showed the typical U-shaped associations that were similar and consistent and of variable statistical significance. The significances of the hazard ratio curves were the strongest for cardiovascular disease deaths (all men P=0.001; men without heart disease at baseline P<0.001; never smoking men P=0.007). In never smoking men there was a near linear positive relationship with all-cause mortality (P=0.018). In women weight/height2 showed no consistent associations with mortality. There was a shallow U-shaped relationship with all-cause mortality (P=0.087), also seen in never smoking women (P=0.075). In assessing 'ideal' weight for height in this population, a weight/height2 of 25 kg/m2 (range 22.5-27.5 kg/m2) is appropriate. Weight/height and mortality showed very similar patterns in men to weight/height2 with quite similar levels of statistical significance. In women much more pronounced U-shaped curves were apparent in all groups and subgroups, with a significant all-cause mortality trend for all women (P=0.029) and never smoking women (P=0.034). In assessing 'ideal' weight for height a weight/height of 42.5 kg/m (range 35-50 kg/m) appears appropriate for men and women. CONCLUSIONS: Weight/height2 is an appropriate index of leanness and obesity in males at all ages, whereas weight/height is at least as good an index for females. In mortality studies weight/height2 and weight/height predict mortality similarly in males, but weight/height is a better discriminant of mortality in females. International Journal of Obesity (2000)24, 108-115

Adult↗
PubMed2002

Improving access to the international coverage of reports of controlled trials in electronic databases: a search of the Australasian Medical Index.

INTRODUCTION: Locating reports of trials from journals not indexed in the major databases presents difficulties to systematic reviewers, and may be a factor in improving the reliability of the reviews. OBJECTIVES: To identify and make available reports of controlled trials from the Australasian Medical Index (AMI). To measure the quality of indexing of trials in AMI. METHODS: Using a highly sensitive search strategy consisting of methodology indexing and free-text terms, records from AMI were read for reports of controlled trials. Trials meeting the criteria were submitted for inclusion in The Cochrane Controlled Trials Register (CCTR) and assessed for the quality of their indexing. RESULTS: 3621 records were downloaded, of which 512 were identified as reports of controlled trials (317 RCTs; 195 CCTs) and submitted to CCTR. The precision of methodology indexing terms was 60%, but sensitivity just 18%. The quality of indexing of trials was generally poor with only 50 tagged with the RCT/CCT publication type term. 453 reports (88%) were not previously available in CCTR. CONCLUSIONS: The large proportion of trials found to be unique to the AMI database increases the pool of studies available to systematic reviewers, and helps ensure CCTR remains the most comprehensive source of trials.

Abstracting and Indexing↗
PubMed2004

Development of a new Delayed Memory Index for the WMS-III.

This paper presents the Delayed Memory Index (DMI) as an alternative to the General Memory Index (GMI) of the Weschler Memory Scale-Third Edition (WMS-III). The WMS-III Immediate Memory Index (IMI) and the GMI are not parallel in structure, making a direct comparison between these index scores (i.e., immediate vs. delayed memory variables) difficult. The IMI is composed of the sum of scaled scores of four subtests (Logical Memory I, Verbal Paired Associates I, Faces I, and Family Pictures I) while the GMI is composed of the sum of scaled scores of five subtests (Logical Memory II, Verbal Paired Associates II, Faces II, Family Pictures II and Auditory Recognition Delayed). Inclusion of Auditory Recognition Delayed in the GMI is also problematic as it is highly skewed and limited by extreme ceiling effects (see Tulsky, Chiaravalloti, Palmer, & Chelune, 2003). To remedy these problems, we present a new index score that does not include auditory recognition, the Delayed Memory Index. Normative tables for the new Delayed Memory Index based on the inclusion of the Faces subtest, or alternatively the Visual Reproduction subtest, are presented, and initial estimates of their psychometric properties are described.

Abstracting and Indexing↗
PubMed2004

Insulin resistance, body mass index, waist circumference are independent risk factor for high blood pressure.

OBJECTIVES: The purpose of the present study was to investigate the relationships between blood pressure (BP), insulin resistance as determined by a homeostasis model (HOMA-IR), and body fat distribution. METHODS: Anthropometric indices of adiposity, metabolic variables (fasting serum insulin and a homeostasis model assessment [HOMA] index of insulin sensitivity), BP and several cardiovascular risk factors were measured during a cross sectional survey of 53477 apparently healthy Korean subjects who requested a health status check. Hypertension was defined as a systolic BP > or = 140 mmHg or a diastolic BP > or = 90 mmHg and we excluded the subjects taking BP-lowering medication. RESULTS: Systolic and diastolic blood pressure (SBP, DBP) were positively and significantly associated with age, body mass index, waist circumference, and waist/hip ratio. In addition, SBP and DBP were positively associated with fasting serum insulin levels and the HOMA index. By multiple regression analysis age, waist circumference, body mass index, HOMA index and female sex were independently associated with either increased SBP or DBP. When the population is divided into quintiles according to insulin resistance (measured by HOMA analysis) prevalence of hypertension in the second, third, fourth and fifth quintiles compared to subjects in the first quintile are 1.004(95% CI 0.875-1.152, p = 0.957), 1.200(95% CI 1.052-1.369, p = 0.007), 1.312(95% CI 1.151-1.494 p < 0.001 ), and 1.603(95% CI 1.408-1.825 p < 0.001). In addition age, sex, body mass index and waist circumference were found to be significantly associated with hypertension. CONCLUSION: Our results showed that insulin resistance, body mass index and waist circumference are independent risk factors of a high BP in Koreans.

Adult↗
PubMed2003

LV mass index significantly impacts on patient and renal outcomes in patients with coronary artery bypass grafting and poor left-ventricular function.

BACKGROUND: A recent report demonstrated that the presence of left ventricular hypertrophy was an independent predictor of mortality in patients with coronary artery bypass grafting (CABG) severely depressed left ventricular function. However, the impact of left ventricle (LV) mass index on the renal and patient outcomes in such patients with CABG has previously not been addressed. The present study thus considers this group of patient and uses LV mass index to assess renal and patient outcomes for these patients. MATERIAL AND METHOD: All patients who arrived at the emergency room with severe cardiac dysfunction (EF < 60%), triple vessel disease, and required CABG and LV hypertrophy (LVH) (LV mass index gamma110 g/m2 in women, gamma134 g/m2 in men) were admitted preoperatively to the intensive care unit (ICU) for supportive intervention from January 1, 1998 to January 1, 2001. Of all LVH patients, 44 underwent CABG, and were divided into two groups according to LV mass index. RESULTS: Of all patients, 72.7% had severe echocardiographic LVH. The echocardiographic data of both dialysis and non-dialysis groups showed no difference with respect to echocardiographic findings. Histories of myocardial infarction were more frequent in the severe LVH group that in the mild LVH group. As for pre-operative systolic blood pressure and diastolic blood pressure, mean systolic and diastolic blood pressure values were significantly lower in the severe LVH group. Ejection fraction was also significantly lower in the severe LVH group than in the mild LVH group. The patients in the severe LVH group were significantly more likely to have received hemodialysis following CABG surgery (62.5% vs. 33.4%, p < 0.05). Mortality was higher in the higher LV mass index group that in the lower LV mass index group (56.2% vs. 25%, p < 0.05). CONCLUSION; Patients with a significantly higher LV mass index usually manifest lower pre-operative blood pressure and poor cardiac function. Consequently, these patients will have a poor renal outcome and higher mortality.

Acute Kidney Injury↗
PubMed1999

Evaluation of the SENIC risk index in a Spanish university hospital.

OBJECTIVE: To assess the performance of the Study of the Efficacy of Nosocomial Infection Control (SENIC) risk index for the evaluation of the risk of surgical-site infection (SSI) in a country other than the United States, having a different health system. SETTING: 350-bed university hospital in Spain belonging to the National Health System (Insalud). DESIGN: Observational cohort study of 1,019 patients who underwent consecutive surgery from January to December 1992. Surgical-infection risk factors assessed by the traditional wound-classification system (clean, clean-contaminated, contaminated, and dirty-infected wound) and by the SENIC risk index (length of intervention more than 2 hours, more than three discharge diagnoses, abdominal surgery, and contaminated or dirty-infected wound) were compared by forward logistic regression. RESULTS: The SENIC risk index showed a greater ability to predict SSI than the traditional wound-classification system. The study carried out in our institution reproduced the estimators provided by the SENIC study in the United States. The SENIC risk index provided a stepwise increase in SSI rates, according to the number of factors present, for every traditional wound-classification group. In the case of clean wounds, the incidence of surgical infection (per 100 interventions) increased (1.5, 2.4, 5.3, and 50; P<.001) for patients having from zero to three risk factors of the SENIC risk index. CONCLUSIONS: This study shows that the SENIC risk index results are reproducible, and the index can be used to compare rates of wound infection across countries with different health systems than the United States.

Abstracting and Indexing↗
PubMed2006

Dietary carbohydrate, glycemic index, and glycemic load in relation to risk of colorectal cancer in women.

Diets with a high glycemic index and glycemic load have been hypothesized to be implicated in the etiology of colorectal cancer owing to their potential to increase postprandial glucose and insulin levels. Prospective data on glycemic index and glycemic load in relation to colorectal cancer risk are limited and inconsistent. Therefore, the authors prospectively investigated the associations of dietary carbohydrate, glycemic index, and glycemic load with the incidence of colorectal cancer among 61,433 Swedish women who were free of cancer in 1987-1990 and completed a 67-item food frequency questionnaire. During follow-up through June 2005, 870 incident cases of colorectal adenocarcinoma were diagnosed. Carbohydrate intake, glycemic index, and glycemic load were not associated with risk of colorectal cancer, colon cancer, or rectal cancer. The multivariate hazard ratios for colorectal cancer comparing the highest with the lowest quintile were 1.10 (95% confidence interval: 0.85, 1.44) for carbohydrate intake, 1.00 (95% confidence interval: 0.75, 1.33) for glycemic index, and 1.06 (95% confidence interval: 0.81, 1.39) for glycemic load. Results did not vary by body mass index. The findings from this prospective study do not support the hypothesis that a high carbohydrate intake, a high glycemic index, and a high glycemic load increase the risk of colorectal cancer.

Adenocarcinoma↗
PubMed2004

Relationships of craniofacial morphology and body mass index with sleep-disordered breathing in Japanese men.

OBJECTIVE/HYPOTHESIS: Obesity is an established risk factor for sleep-disordered breathing, but the impact of craniofacial morphology is uncertain. The aim of this study was to assess the impact of craniofacial morphology and body weight on sleep-disordered breathing in Japanese men. STUDY DESIGN: A cross-sectional study. METHODS: We measured body mass index, seven cephalometric variables, and 3% oxygen desaturation index recorded by a pulse oximeter in 313 Japanese men aged 20 to 65 years who attended a sleep clinic. We defined craniofacial score as the sums of quartile points (0-3) for distance from sella to nasion and that from hyoid bone to mandibular plane. RESULTS: The mean value of 3% oxygen desaturation index and odds ratios of 3% oxygen desaturation index 15 or greater progressively increased with craniofacial score as well as body mass index. Multivariate odds ratios associated with craniofacial score were higher in men with body mass index 25.0 kg/m or greater (odds ratio = 4.2, 95% confidence interval [CI] = 2.1-8.6) than in men with lower body mass index (odds ratio = 1.6, 95% CI = 0.7-3.6). CONCLUSIONS: Our results imply the importance of cephalometric assessment in overweight patients.

Adult↗
PubMed1992

Development and validation of the Nursing Severity Index. A new method for measuring severity of illness using nursing diagnoses. Nurses of University Hospitals of Cleveland.

The purpose of this study was to develop and validate the Nursing Severity Index, a new method used to measure the admission severity of illness of hospital patients using nursing diagnoses, which categorize biologic, functional, cognitive, and psychosocial abnormalities. This retrospective cohort study with independent development and testing phases was conducted at a U.S. academic medical center. In the development phase, data regarding 14,183 adult medical-surgical patients admitted to the medical center in 1985 and 1986 was used. In the testing phase, data regarding 7,302 patients admitted in 1987 and 1988 was used. Primary nurses prospectively recorded the presence or absence of 61 nursing diagnoses on admission. Demographic and clinical data were obtained from hospital data bases. In the development phase, the number of admission nursing diagnoses was highly related (P < 0.001) to in-hospital mortality. Using multiple logistic regression, 34 nursing diagnoses were identified as independent predictors of mortality; the Nursing Severity Index equals the number of these 34 diagnoses. In the testing phase of 7,302 patients, the Nursing Severity Index was related (P < 0.001) to mortality rates, which were 0.5%, 1%, 2%, 6%, 13%, 22%, and 31% in seven hierarchical strata defined by the Index. The Index was as accurate in predicting mortality as MedisGroups (receiver-operating-characteristic curve areas, 0.814 +/- 0.016 vs. 0.845 +/- 0.015, respectively, P = 0.12). Furthermore, the Nursing Severity Index and MedisGroups together (receiver operating characteristic curve area 0.880 +/- 0.014), were more accurate (P < 0.01) than either measure alone. The Nursing Severity Index assesses multiple dimensions of illness, can be easily measured during routine patient care, accurately predicts the risk of in-hospital death, and has similar prognostic accuracy as MedisGroups. Its usefulness in outcomes assessment, quality assurance, and case management merits further study.

Academic Medical Centers↗