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PubMed2003

Clinicopathologic predictors of death and ESRD in patients with pauci-immune necrotizing glomerulonephritis.

BACKGROUND: Pauci-immune necrotizing glomerulonephritis (PING) occurs in various settings and has a very variable prognosis. We investigated whether clinicopathologic findings at the time of renal biopsy may predict major disease outcomes. METHODS: We evaluated 72 consecutive patients with biopsy-documented PING. Kaplan-Meier curves and Cox models assessed event rates and risk factors for death, end-stage renal disease (ESRD), and death or new ESRD (after the renal biopsy). RESULTS: During a follow-up of 305 person-years, 11 patients died, 13 patients developed ESRD, and 16 patients died or developed new ESRD. Among patients first seen within 3 months of renal biopsy (incident cases), the 5-year mortality rate was 20%, whereas the death or new ESRD rate was 34%. In univariate analyses, older age, lower creatinine clearance, erythrocyte sedimentation rate, and percentages of abnormal glomeruli, glomeruli with fibrous crescents, and glomeruli with global sclerosis were significant predictors of mortality, whereas antineutrophil cytoplasmic autoantibodies with cytoplasmic staining conferred borderline protection. For ESRD, significant predictors included a greater creatinine level, lower hematocrit, interstitial fibrosis, tubular necrosis, greater C-reactive protein level, and percentages of abnormal glomeruli, glomeruli with extracapillary proliferation, cellular crescents, and global glomerulosclerosis. For death or new ESRD, predictors were fairly similar. Adjusting for baseline creatinine level, the risk for ESRD increased 1.78-fold (95% confidence interval [CI], 1.23 to 2.58) per each 10% increase in global sclerosis and 1.47-fold (95% CI, 1.05 to 2.07) per each 10% increase in glomeruli with cellular crescents. CONCLUSION: Global glomerulosclerosis and crescents in a renal biopsy are strong predictors of the long-term outcome of PING.

Adult↗

PubMed2002

Predictors of life satisfaction: a spinal cord injury cohort study.

OBJECTIVE: To determine unique demographic, medical, perceived health, and handicap predictors of life satisfaction 2 years after spinal cord injury (SCI), as well as the predictors of change in life satisfaction from year 1 to year 2. DESIGN: Prospective predictive study performed by using longitudinal data from 18 Spinal Cord Injury Model Systems. SETTING: University physical medicine and rehabilitation department. PARTICIPANTS: Adults with traumatic onset SCI (N = 940) evaluated at 1 and 2 years' postinjury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Satisfaction with Life Scale (SWLS) 2 years post-SCI. PREDICTOR VARIABLES: demographic characteristics, impairment and disability classifications, and 1 year post-SCI measures of life satisfaction (SWLS), medical complications, self-perceived health (Medical Outcomes Study 12-Item Short-Form Health Survey), and extent of handicap (Craig Handicap Assessment and Reporting Technique). RESULTS: The factors uniquely associated with an increased risk of lower self-reported life satisfaction at year 2 post-SCI included being male and unemployed, with poor perceived health, decreased mobility, and decreased social integration. After controlling for year 1 estimates of life satisfaction (ie, examining change in life satisfaction), only mobility and perceived health were uniquely related to life satisfaction 2 years post-SCI. CONCLUSION: Mobility and perceived health appear to be the consistent predictors of life satisfaction at year 2 post-SCI, as well as change in satisfaction from year 1 to year 2. Because both factors are amenable to change, they are reasonable targets of intervention programs. Identifying specific mechanisms of perceived health and mobility associated with life satisfaction should be an important area of continued research.

Adult↗

PubMed2001

Predictors of pain catastrophizing in women with rheumatoid arthritis.

Catastrophizing has been conceptualized as an appraisal, a cognitive distortion, and a coping mechanism in the psychosocial literature. Regardless of its conceptualization, catastrophizing has been associated with negative psychological and physical outcomes in numerous studies, including our intervention study with 90 women with rheumatoid arthritis. Because of catastrophizing's robust relationship with negative outcomes, predictors of catastrophizing as a pain coping behavior were investigated in this sample, using data collected from two points in time before the intervention. Using Lazarus and Folkman's stress and coping theoretical framework to guide the analyses, variables with a proximal relationship to catastrophizing in the framework were examined for significant associations with pain catastrophizing using correlational analyses. Subsequent stepwise regression involving all variables from Time 1 with significant associations resulted in a model that explained 63% of the variance in Time 2 pain catastrophizing scores. The four predictors in this model were dispositional pessimism, passive pain coping, venting (as a pain coping behavior), and arthritis helplessness. Potential clinical implications related to these predictors are also discussed. Knowledge about predictors of catastrophizing may enhance efforts to address this maladaptive pattern through educational and therapeutic approaches.

Adaptation, Psychological↗

PubMed1998

Predictors of left ventricular thrombus formation and disappearance after anterior wall myocardial infarction.

AIMS: This study sought to determine predictors of left ventricular thrombus formation and resolution after acute anterior wall myocardial infarction. METHODS AND RESULTS: We have analysed clinical, echocardiographic and angiographic data in 53 consecutive patients with anterior myocardial infarction. Two-dimensional and Doppler echocardiographic examinations were performed on days 1, 2, 3 and 7, after 3 and 6 weeks, and 3, 6, and 12 months following infarction. Coronary angiography was performed in 44 patients before hospital discharge. Left ventricular thrombus was detected in 30/53 patients (29/30 in the first week after infarction). Univariate analysis showed that left ventricular thrombus formation was associated with a higher initial end-systolic volume index (beta = 0.04, P = 0.001), and end-diastolic volume index (beta = 0.03, P = 0.03), a larger infarct perimeter (beta = 0.02, P = 0.01), a lower initial ejection fraction (beta = 0.06, P =0.001), a higher initial wall motion score index (beta = 1.75, P = 0.023), a higher peak creatine kinase level (beta = 3.90, P = 0.01), Killip class >1 (beta = 1.11, P = 0.003), infarct expansion (beta = 0.78, P = 0.04), occluded infarct-related artery (beta = -0.87, P = 0.04) and non-thrombolytic therapy (beta = -0.76, P = 0.047). According to the Cox proportional regression model, independent predictors of thrombus formation after anterior myocardial infarction were high end-systolic volume index (beta = 0.06, P = 0.001) and high peak creatine kinase level (beta = 5.17, P = 0.046). Thrombus disappeared in 11/30 (36.7%) patients during one-year echocardiographic follow-up. The only independent predictor of thrombus disappearance after acute myocardial infarction was the absence of apical dyskinesis 6 weeks after infarction (beta = -1.53, P = 0.045). CONCLUSIONS: Our data demonstrate that the best predictor of left ventricular thrombus formation after acute anterior myocardial infarction is a high initial end-systolic volume. Thrombus resolution is more likely to occur in patients without apical dyskinesis at the end of the healing phase of infarction.

Anticoagulants↗

PubMed2000

Pulmonary atypical carcinoid: predictors of survival in 106 cases.

Pulmonary neuroendocrine tumors (NE) include a spectrum of tumors from typical carcinoid (TC) to atypical carcinoid (AC), large cell neuroendocrine carcinoma (LCNEC), and small cell carcinoma (SCLC). Little is known about prognostic predictors for AC because of its rarity. Survival analysis was performed on 106 ACs with clinical follow-up from the AFIP and the Pathology Panel of the International Association for the Study of Lung Cancer (IASLC). The tumors fulfilled the 1999 WHO/IASLC criteria for AC of a NE tumor with a mitotic rate of 2 to 10 per 2 mm(2) of viable tumor or coagulative necrosis. Multiple clinical and histologic features were analyzed by Kaplan-Meier and Cox regression analysis. Of the clinical features, higher stage (P = .003) and a tumor size of 3.5 cm or greater (P = .003) were associated with a worse prognosis. Features that were histologically unfavorable by univariate analysis were mitotic rate (P =.002), pleomorphism (P = .018), and aerogenous spread (P =.007). Histologically favorable features by univariate analysis were the presence of palisading (P = .008), papillary (P = .039), pseudoglandular (P =.026), and rosette (P = .022) patterns. Female gender showed a trend toward a poorer prognosis (P =.085) and was included in the multivariate model. Multivariate analysis stratified for stage showed mitoses (P<.001), a tumor size of 3.5 cm or greater (P =.017), and female gender (P =.012) to be the only negative independent predictors of prognosis and the presence of rosettes (P = .016) to be the only independent positive predictor. We further divided the AC into subgroups of low (2 to 5 mitoses/2 mm(2)) and high (6 to 10 mitoses/2 mm(2)) mitotic rate and compared the survival with TC and with LCNEC. Within the category of AC, the patients with a higher mitotic rate had a significantly worse survival than those with a lower mitotic rate (P<.001) stratified for stage. Five- and 10-year survival rates for AC (61% and 35%, respectively) stratified for stage were significantly worse than for TC and better than that for LCNEC and SCLC. Chemotherapy or radiation therapy was given in 12 of 52 and 14 of 52 cases, respectively, but the data were insufficient to evaluate tumor response. We conclude that AC is an aggressive neuroendocrine neoplasm with survival intermediate between TC and LCNEC and SCLC. Higher mitotic rate, tumor size of 3.5 cm or greater, female gender, and presence of rosettes are the only independent predictors of survival. Surgical resection remains the treatment of choice, and the role of chemotherapy and radiation therapy remains to be proven.

Adult↗

PubMed2006

Renal dysfunction after thoracic aortic surgery requiring deep hypothermic circulatory arrest: definition, incidence, and clinical predictors.

OBJECTIVE: The purpose of this study was to evaluate renal dysfunction (RD) after thoracic aortic surgery (TAS) requiring deep hypothermic circulatory arrest (DHCA), to determine the influence of definition on RD after TAS-DHCA, to determine univariate predictors of RD after TAS-DHCA, and to determine multivariate predictors for RD TAS-DHCA. RD was defined in 3 ways: (1) >25% reduction in creatinine clearance, (2) >50% increase in serum creatinine, and (3) >50% increase in serum creatinine with an abnormal peak serum creatinine (>1.3 mg/dL for men and >1.0 mg/dL for women). STUDY DESIGN: Retrospective and observational. STUDY SETTING: Single large university hospital. PARTICIPANTS: All adults requiring TAS-DHCA in 2000 and 2001. MAIN RESULTS: The cohort size was 144. Antifibrinolytic exposure was 100%: aprotinin 66% and aminocaproic acid 34%. The incidence of RD TAS-DHCA was 22.9% to 38.2%, depending on the definition. The incidence of renal replacement therapy was 2.8%. Multivariate predictors for RD after TAS-DHCA were sepsis, aprotinin exposure, preoperative hypertension, age, and donor exposures. CONCLUSIONS: Although RD after TAS-DHCA varies substantially because of definition, it is still very common. Its multivariate predictors merit further focused research to enhance perioperative protection of the kidney.

Adult↗

PubMed2002

Predictors of HBeAg loss after lamivudine treatment for chronic hepatitis B.

Elevated alanine transaminase (ALT) levels and low serum hepatitis B virus (HBV) DNA predict a higher likelihood of hepatitis B e antigen (HBeAg) loss in patients with chronic hepatitis B treated with interferon. Predictors of HBeAg loss in patients treated with lamivudine are not known. The objective of this analysis of 4 lamivudine-controlled Phase III trials was to determine patient-dependent or laboratory variables that predict HBeAg loss. Predictors of HBeAg loss in patients treated with interferon, lamivudine plus interferon, or placebo are also described. A total of 805 adults with chronic hepatitis B were treated either with lamivudine (n = 406), matching placebo (n = 196), interferon (n = 68), or the combination of lamivudine plus interferon (n = 135). Demographic and baseline disease characteristics were used in stepwise multivariate analyses to identify features that were predictive of lamivudine-induced HBeAg loss. HBeAg loss correlated with increased pretreatment ALT levels in all groups. The rate of HBeAg loss was highest among patients with pretreatment ALT levels greater than 5 times the upper limit of normal (ULN) and was most pronounced in the lamivudine group (56%). Multivariate modeling indicated that elevated baseline ALT levels (P <.001) and histologic activity index (HAI) score (P <.001) were important predictors of HBeAg loss in response to lamivudine. The effect of pretreatment ALT levels on HBeAg loss was similar for Asians and Caucasians. In conclusion, elevated pretreatment ALT levels and/or active histologic disease were the most important predictors of lamivudine-induced HBeAg loss. Asians and Caucasians had similar rates of response to lamivudine at comparable ALT levels.

Adolescent↗

PubMed2000

Pressure ulcer risk in spinal cord injury: predictors of ulcer status over 3 years.

OBJECTIVE: To identify predictors of pressure ulcers in men with spinal cord injury over a 3-year period. DESIGN: Longitudinal, two-panel, cohort. SETTING: Community. PARTICIPANTS: One hundred eighteen men with spinal cord injury. MEASURES: Interviews, questionnaires, and physical examinations were completed in two phases, 3 years apart. Information obtained included demographic and spinal cord injury characteristics; ulcer history; health beliefs and practices; measures of impairment, disability, and handicap; and skin integrity. RESULTS: Thirty-one percent of the participants reported having a pressure ulcer in the 12 months before Phase 2. Some Phase 1 predictors of self-reported ulcers in the year before Phase 2 were a younger age at onset of spinal cord injury, previous pressure ulcer surgery, and the presence of a pressure ulcer in the year before Phase 1. On examination at Phase 2, 59% presented with an ulcer. Phase 1 predictors of ulcer presence at Phase 2 examination were similar to predictors for self-reported ulcers. CONCLUSION: Individuals with the identified predictive characteristics are at greater risk for developing pressure ulcers. These individuals should receive additional interventions to reduce that risk. Potential interventions include more systematic and frequent follow-up, frequent review of pressure ulcer prevention and management strategies, and provision of needed personal assistance and relevant equipment.

Activities of Daily Living↗

PubMed1999

Predictors for recurrence of epileptic seizures in a general epilepsy population.

The aim of our study was to identify predictors for recurrence of epileptic seizures in a large county hospital population. We identified 956 patients (18-67 years) with ICD 9 code 345 as primary diagnosis, seen at the Central Hospital of Akershus over 7 years (1987-1994). The diagnosis of epilepsy was confirmed for 696 of the patients. These were divided into two groups: (1) no seizures during the previous year (n = 485) and (2) seizures during the previous year (n = 184). To identify predictors for recurrence of seizures, we used neurologic deficit, number of AEDs used, CT-scan findings, EEG findings, aetiology, gender, age below and above 50 years and comorbidity as independent variables in a logistic regression model. In a univariate analysis, the strongest predictors for recurrence of seizures were: age above 50 years (OR = 5.2;P < 0.0001), known aetiology (OR = 1.4;P = 0.04) and use of two or more AEDs (OR = 5. 7;P < 0.0001). In the multivariate analysis age, more than 50 years (OR = 1.7;P = 0.0216) and use of two or more AEDs (OR = 5.6;P < 0.0001) were the only predictors for recurrence of epileptic seizures.

Adolescent↗

PubMed2002

Predictors of pain during invasive medical procedures.

This study explored whether cardiovascular response and heart rate response to surgical stress were related to pain during percutaneous transcatheter diagnostic and therapeutic peripheral vascular and renal interventions. One hundred twenty-nine patients, 61 men and 68 women, provided repeated measures of pain on a 0 to 10 scale every 15 minutes during and at the end of the procedure. We tested 2 hypotheses: (1) baseline blood pressure and heart rate predict pain report and (2) initial procedural changes in blood pressure and heart rate predict pain report. Results of regression analysis showed that heart rate response is a significant independent predictor of pain regardless of whether pain is defined as the maximum level during the procedure or as the pain level at the end. Baseline pain, anxiety, and heart rate were significantly correlated to maximum pain report but did not enter the final model as significant independent predictors. We also found that patients whose heart rate increased during surgery from their baseline level had significantly lower pain report than those who did not show an increase. Neither baseline blood pressure nor blood pressure changes were significant predictors of pain level. Thus, we concluded that heart rate response is a powerful negative predictor of procedural pain even after controlling for baseline variables, type of procedure, and units of pain medication.

Journal Article↗

PubMed1976

[Some somatic and psychological predictors of psychopathological disorders after cardiac surgery (author's transl)].

Some new predictors of postoperative psychosis in open-heart surgery have been identified in a multifactorial study of somatic and psychological factors: Somatic predictors are lower body weight, higher blood levels of urea nitrogen and creatinine, preoperative use of tranquilizers, especially in patients with double valve replacement or congenital heart disease and preoperative cerebral embolism in mitral valve disease. Bypass-time has not proved to be a valid predictor. Psychological predictors are distress provoked by severity and duration of illness, repeated delay of surgery as well as the manner of psychological coping with the illness.

Blood Urea Nitrogen↗

PubMed2004

Loudness dependence of primary auditory-cortex-evoked activity as predictor of therapeutic outcome to prophylactic lithium treatment in affective disorders--a retrospective study.

INTRODUCTION: Lithium has been found to be very effective in prophylactic treatment of affective disorders. However, approximately one-third of patients do not respond to this treatment, which does not become apparent until after a year or more of treatment. Therefore, predictors are needed to avoid a long and unsuccessful therapy with risk of severe side effects. Since lithium acts as a serotonin agonist in prophylactic treatment, a predictor of being able to identify patients with low serotonergic activity, who may be responders to lithium, is promising. To determine whether the loudness dependence (LDAEP) of primary, but not of secondary, auditory-cortex-evoked activity, which is inversely related to central serotonergic neurotransmission, could be such a predictor, responders and non-responders to prophylactic lithium treatment were compared. METHODS: Thirty patients with uni- and bipolar affective disorders, who have taken a prophylactic lithium medication continuously for at least 3 years, were included in the study. Patients were classified as responders if they had no hospitalization within the past 3 years. Dipole source analysis allowing us to separate evoked activity of the primary and secondary auditory cortex was used. RESULTS: The LDAEP of the primary, but not of the secondary, auditory cortex was significantly stronger in the responders to the lithium treatment than in the non-responders, implicating low serotonergic function in these patients. DISCUSSION: This finding, which is in line with previous studies, suggests that loudness dependence of primary auditory-cortex-evoked activity could be a clinically relevant predictor of prophylactic treatment with lithium in affective disorders.

Adult↗

PubMed1981

[Predictors of the course of schizophrenic diseases under neuroleptic long-term medication (author's transl)].

70 schizophrenic outpatients have been treated continuously after index hospital discharge with neuroleptic drugs for an average of 14.3 years. In predicting their outcome in several dimensions (rehospitalization rate, symptoms, social and work adjustment, self ratings) differential predictor patterns could be confirmed, at most accounting for 65% of the outcome variance. In part work adjustment at follow-up cold be predicted by premorbid social and sexual adjustment as well as by working capability at index discharge. The most powerful predictor for the number of social relations was the former frequency of social contacts. Rehospitalization was related to higher neuroleptic equivalence dose at index discharge among other predictors, whereas presence of symptoms could be predicted e.g. by formerly longer hospital stays. Although at the beginning of the treatment our sample was classified as "process schizophrenic" on "classic" prognostic scales, 40-60% of our cases had a relative good outcome. This results and the considerable decrease of the rehospitalization rate from 0.57 before treatment to 0.11 during treatment stand for a clear treatment related improvement of the spontaneous prognosis. The partly mutually independence of the outcome criteria and predictor patterns underlines the importance of multiaxial diagnosis.

Adult↗

PubMed1996

Conicity index as a predictor of blood pressure levels, insulin and triglyceride concentrations of healthy premenopausal women.

Conicity index (C index), an index of abdominal obesity that was developed based on a model of geometric reasoning, proved to be a sensitive and better than the waist to hip ratio indicator of risk for hyperlipidemia in Western populations. To evaluate comparatively the C index and the Waist-to-Hip Ratio (WHR) as predictors of blood pressure levels, insulin and triglyceride concentrations, we performed a cross-sectional study on 280 healthy women, 18-24 year-old. C index was found to be within the expected range (0.95 to 1.73) and significantly correlated with WHR (r = 0.562, p = 0.0001) and body weight (r = 0.312, p = 0.0001). Additionally, C index correlated with fasting insulin levels (r = 0.13, p = 0.03), and systolic blood pressure (r = 0.14, p = 0.02). WHR correlated with fasting insulin levels (r = 0.12, p = 0.05), systolic blood pressure (r = 0.12, p = 0.13) and triglycerides (r = 0.22, p = 0.0006). C index and WHR are equally good, albeit weak, predictors of fasting insulin and blood pressure levels, while WHR proved to be a better than C index predictor of triglyceride concentrations in this population of healthy premenopausal Greek women. Further epidemiologic studies to comparatively evaluate the two indexes as predictors of risk for the development of metabolic disorders and cardiovascular disease in various populations are needed.

Adolescent↗

PubMed2001

Early predictors of neurodevelopmental outcome in symptomatic congenital cytomegalovirus infection.

OBJECTIVE: To determine the ability of neonatal clinical, audiologic, and computed tomography (CT) findings to predict long-term neurodevelopmental outcome in children with symptomatic congenital cytomegalovirus (CMV) infection. METHODS: Longitudinal cohort study of children (n = 41) with symptomatic congenital CMV infection evaluated at birth and followed up with serial age-appropriate neurodevelopmental testing. The performance of birth characteristics as predictors of long-term outcome were determined, and clinical and CT scoring systems were developed and correlated with intellectual outcome. RESULTS: Microcephaly was the most specific predictor of mental retardation (100%; 95% CI 84.5-100) and major motor disability (92.3%; 95% CI 74.8-99). An abnormality detected by CT was the most sensitive predictor for mental retardation (100%; 95% CI 82.3-100) and motor disability (100%; 95% CI 78.2-100). A highly significant (P <.001) positive correlation was found between head size at birth and the intelligence/developmental quotient (IQ/DQ). Approximately 29% of children had an IQ/DQ >90. There was no association between sensorineural hearing loss at birth and cognitive outcome. However, children with sensorineural hearing loss on follow-up (congenital and late-onset) had a lower IQ/DQ (P =.006) than those with normal hearing. CONCLUSIONS: The presence of microcephaly at birth was the most specific predictor of poor cognitive outcome in children with symptomatic congenital CMV infection, whereas children with normal findings on head CT and head circumference proportional to weight exhibited a good cognitive outcome.

Cerebral Palsy↗

PubMed2001

Predictors of hospitalization in children with acute asthma.

OBJECTIVE: To identify predictors of long duration of bronchodilator therapy in children with acute asthma. STUDY DESIGN: An emergency department prospective cohort study of 278 children > or =12 months of age, with clinical and socioeconomic parameters collected at baseline and 4 hours after administration of corticosteroids. Patients were classified into short and long therapy groups, with interval from first albuterol dose to initiation of administration every 4 hours < or =12 or >12 hours, respectively. Predictors significant by univariate analysis were examined by multiple logistic regression. RESULTS: Five variables were associated with long therapy (n = 85) versus short therapy (n = 193): previous intensive care unit admission (odds ratio [OR] 7.2, 95% CI = 1.85, 27.7); baseline oxygen saturation < or =92% (OR 2.6, 95% CI = 0.89, 7.4), asthma score > or =6/9 (OR 2.9, 95% CI = 1.9, 4.37), oxygen saturation < or =92% (OR 6.6, 95% CI = 1.34, 32.0), and hourly albuterol dosing interval (OR 4.3, 95% CI = 0.82, 22.12) 4 hours after administration of corticosteroids. Probability of long therapy was 91.8% to 99% for > or =3 predictors, but only 40.6% to 61.8% for individual factors. CONCLUSION: A combination of 3 or more factors predicts long bronchodilator therapy and signals the need for hospitalization. Children with only one predictor can be safely treated in the emergency department or observation unit and reevaluated.

Acute Disease↗

PubMed2002

Predictors of signs and symptoms of temporomandibular disorders: a 20-year follow-up study from childhood to adulthood.

The aim of this study was to find possible predictors of signs and symptoms of temporomandibular disorders (TMD) in a long-term perspective. Baseline questionnaire and clinical examinations focusing on function and dysfunction of the masticatory system were performed in a sample of 402 subjects 7, 11, and 15 years old. After 20 years, 320 subjects (80% of the original sample) completed a similar questionnaire as at baseline. From the oldest age group, now aged 35 years, 100 subjects (74% of the original sample) also attended a clinical examination. Three variables from the 20-year follow-up were chosen as dependent variables in logistic regression analyses, with independent variables selected from the baseline examinations. Three variables at baseline were significant predictors for reported TMJ clicking at the 20-year follow-up, tooth wear index being the strongest (odds ratio = 4.3). Reported TMJ clicking at the start was the only significant predictor for TMD symptoms without clicking 20 years later (odds ratio = 2.3). The third logistic regression model, using the Helkimo Clinical Dysfunction Score as dependent variable, resulted in four significant predictors from the baseline examinations (bruxism, oral parafunctions, TMJ clicking, and deep bite). The results indicated that some signs and symptoms might predict TMD signs and symptoms in a long-term perspective. However, it cannot be concluded from this study whether these symptoms recorded in childhood--oral parafunction, tooth wear, TMJ clicking, and deep bite--can be used for predicting manifest TMD in adult age.

Adolescent↗

PubMed2002

Level and predictors of agreement between patients and their dentists concerning need for replacement of teeth at the time of extraction.

The aims were to determine the level of agreement between patient and dentist about the need for a replacement of teeth at the time of extraction, and to identify and assess the effect of predictor variables on the level of agreement. Data were obtained from questionnaires. A systematic random sample of 1,500 Norwegian general dental practitioners were contacted, 67% of them responded and 75% of their patients. The final sample consisted of 427 patients (16-92 years old) and 224 dentists. Overall agreement was 62% of the cases and agreement about replacement 26%. Multiple logistic regression analysis with overall agreement as dependent variable identified tooth type (OR = 2.7 for anterior teeth versus molars, 95% CI: 1.3; 5.6 and OR = 1.9 for molars versus premolars, 95% CI: 1.2; 3.2), service sector, dentist's age and patient gender as significant predictors. Tooth type (OR = 36.0 for anterior teeth versus molars, 95% CI: 12.5; 104.0 and OR = 5.8 for premolars versus molars, 95% CI: 2.7; 12.3), service sector (OR = 7.0, 95% CI: 2.3; 21.1), the number of teeth extracted and the number of remaining natural teeth affected the likelihood of agreement about the need for replacement of extracted teeth. Predictors of no need for replacement were tooth type (OR = 6.7 for molars versus premolars, 95% CI: 3.3; 13.7) and the dentist's age (OR = 2.1, 95% CI: 1.2; 3.6). Clinical factors were the most important predictors of patients' and dentists' likelihood to agree about replacement, but service sector, dentist's age and patient's gender had also a significant impact on the level of agreement.

Adolescent↗