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PubMed2000

QTc interval length and QT dispersion as predictors of mortality in patients with non-insulin-dependent diabetes.

Patients with non-insulin-dependent diabetes (NIDDM) are at independent risk of cardiovascular death. The reason is only partially understood. The aim of our study was therefore to evaluate the impact of corrected QT interval length (QTc) and QT dispersion (QT-disp) on mortality in a cohort of 324 Caucasian NIDDM patients. A resting 12-lead ECG was recorded at baseline. Maximum (QT-max) and minimum QT (QT-min) intervals were measured, and QT-max was corrected for heart rate (QTc-max). QT-disp was defined as the difference between QT-max and QT-min. QTc-max was 454 (376-671) ms(1/2) (median (range)) and QT-disp 61 (0-240) ms. Prolonged QTc interval (PQTc), defined as QTc-max > 440 ms(1/2), was present in 67% of the patients and prolonged QT-disp (PQT-disp), defined as QT-disp > 50 ms, was present in 51%. During the 9-year follow-up period, 100 patients died (52 from cardiovascular diseases). Thirty-seven percent of the patients with PQTc died compared with 17% with normal QTc interval (p<0.001). The Cox proportional hazard model, including putative risk factors at baseline, revealed the following independent predictors of all cause mortality; QTc-max (p<0.05), age (p<0.0001), albuminuria (p<0.01), retinopathy (p<0.01), HbA1c (p<0.05), insulin treatment (p<0.01), total cholesterol (p<0.01), serum creatinine (p<0.05) and presence of cardiac heart disease based on Minnesota coded ECG (p<0.001). Whereas QT-disp was not a predictor, QTc-max interval was an independent predictor of cardiovascular mortality. Our study showed a high prevalence of QTc and QT-disp abnormalities and indicated that QTc-max but not QT-disp is an independent predictor of all cause and cardiovascular mortality in NIDDM patients.

Albuminuria↗

PubMed2002

Surgery for late-onset ulcerative colitis: predictors of short-term outcome.

BACKGROUND: Onset of ulcerative colitis and Crohn disease after the age of 65 (late-onset disease) is not common, and is usually associated with a worse prognosis. We review our experience with late-onset ulcerative colitis and define the predictors of short-term outcome. METHODS: A retrospective analysis of our surgical experience with 33 patients suffering from late-onset ulcerative colitis. The medical records of 17 women and 16 men who had surgery between 1984 and 1999 were reviewed for age at surgery, sex, duration of disease, extent of disease, indications for surgery, surgical procedures and outcome. Additionally, we identified predictors of outcome. RESULTS: The median age at surgery was 74 years (range 65-83). The most common indication for surgery was refractoriness to medical treatment. There were 4 deaths for a mortality rate of 12%, and 7 major complications. There was no mortality for elective procedures. On univariate analysis, albumin levels of 2.8 g/dl or less and urgent surgery were predictors of poor outcome. Disease of short duration (3 years or less from onset of disease to surgery) was also associated with a poor outcome, but this did not reach statistical significance. CONCLUSIONS: We conclude that in the elderly population suffering from late-onset ulcerative colitis and requiring an operation, urgent surgery and hypoalbuminemia are predictors of adverse outcome. Age at surgery, sex and the extent of colonic involvement did not influence outcome. Low complication and death rates should be expected for elective procedures in the elderly.

Age Factors↗

PubMed2006

Predictors of prison-based treatment outcomes: a comparison of men and women participants.

The purpose of this study was to examine differences between men and women entering prison-based therapeutic community (TC) treatment and to explore the relationship of those differences to posttreatment outcomes (i.e., aftercare participation and reincarceration rates). Extensive treatment-intake interview data for 4,386 women and 4,164 men from 16 prison-based TCs in California were compared using chi-square analyses and t-tests. Logistic regression analyses were then conducted separately for men and women to identify gender-specific factors associated with post-treatment outcomes. Prison intake data and treatment participation data come from a 5-year process and outcome evaluation of the California Department of Corrections' (CDC) Prison Treatment Expansion Initiative. The return-to-custody data came from the CDC's Offender Based Information System. Bivariate results showed that women were at a substantial disadvantage compared with their male counterparts with regard to histories of employment, substance abuse, psychological functioning, and sexual and physical abuse prior to incarceration. In contrast, men had more serious criminal justice involvement than women prior to incarceration. After controlling for these and other factors related to outcomes, regression findings showed that there were both similarities and differences with regard to gender-specific predictors of posttreatment outcomes. Time in treatment and motivation for treatment were similar predictors of aftercare participation for men and women. Psychological impairment was the strongest predictor of recidivism for both men and women. Substantial differences in background characteristics and the limited number of predictors related to posttreatment outcomes for women suggests the plausibility of gender-specific paths in the recovery process.

Adult↗

PubMed2002

Comparison of the predictive power of socio-economic variables, severity of injury and age on long-term outcome of traumatic brain injury: sample-specific variables versus factors as predictors.

The primary objective of this study was to measure the predictive power of pre-injury socio-economic status (SES), severity of injury and age variables on the very long-term outcomes of traumatic brain injury (TBI). By applying a within-subjects retroactive follow-up design and a factor analysis, the study also compared the relative power of sample-specific predictors to that of more commonly used variables and conceptually based factors. Seventy-six participants with severe TBI were evaluated at an average of 14 years post-injury with an extensive neuropsychological battery. The results show that pre-injury SES variables predict long-term cognitive, psychiatric, vocational, and social/familial functioning. Measures of severity of injury predict daily functioning, while age at injury fails to predict any of these variables. Sample-specific predictors were more powerful than more commonly used predictors. Implications regarding long-term clinically based and conceptually based prediction, and those regarding comparisons of predictors across samples are further discussed.

Activities of Daily Living↗

PubMed2005

Antecedents of emotion knowledge: Predictors of individual differences in young children.

Individual differences in emotion knowledge were examined among 188 4-year-old, predominantly African American children. Cognitive ability and negative emotionality, maternal characteristics (parenting, verbal intelligence, and depressive symptoms), environmental risk, and child sex were examined as predictors of emotion knowledge. Regression analyses indicated that cognitively skilled children who resided in relatively low risk environments with verbally intelligent mothers possessed greater emotion knowledge. Proximal (4-year) child cognitive ability was a stronger predictor than distal (2-year) cognitive ability. Positive parenting at 4 years was correlated with child emotion knowledge, but this relation disappeared when parenting was examined in the context of other predictors. These findings highlight the potential role of child cognitive ability, along with environmental risk and maternal verbal intelligence, in children's emotion knowledge and demonstrate the importance of examining a variety of predictors for their unique contribution to emotion knowledge.

Journal Article↗

PubMedDate not supplied

Perceived stress and coping resource availability as predictors of life satisfaction in young, middle-aged, and older adults.

Global satisfaction with life across three age groups (18 to 40 years, 41 to 65 years, and 66 years and above) was investigated. Multiple regressions were computed to examine the separate and joint effects of perceived stress and coping resource availability upon life satisfaction across the three age groups (N = 189). Age differences in perceived stress, coping resource availability, and life satisfaction, were also investigated. Results of this cross-sectional investigation indicated that self-appraisal measures of perceived stress and coping resource effectiveness served as moderate predictors of global life satisfaction, and that for the total sample the combined effects of perceived stress and coping resource effectiveness were better predictors of life satisfaction than either variable considered separately. Perceived stress was found to be a better predictor of life satisfaction for younger adults, and coping resource effectiveness was a better predictor of satisfaction with life for middle-aged and older adults. Significant age differences in life satisfaction, perceived stress, and coping resources were also found. The assessment of perceived stress and coping has important implications for life satisfaction among all age groups, and has particular significance to older adults. By identifying age differences in variables associated with satisfaction with life, more effective efforts can be made to promote physical and psychological well-being in late adulthood.

Adaptation, Psychological↗

PubMedDate not supplied

Mental health and number of illnesses are predictors of nutritional risk in elderly persons.

Data from a sample of elders (N = 240) in their 60s, 80s, and 100s indicated that nutritional risk was positively correlated with age (p < .05), ethnicity (p < .05), number of illnesses (p < .001), and poor mental health (p < .001). Regression analysis suggested that number of illnesses (p = .0001) and mental health (p = .0005) were the most significant predictors of nutritional risk and that these two variables explained 28.8% of the variance for the total sample. Somatic factors of mental health were significantly related to nutritional risk (p = .0001). Regression analyses for these age cohorts indicated that mental health was a highly significant predictor of nutritional risk for 80- to 89-year-olds (p = .004), particularly somatic aspects of mental health (p = .03). Although somatic factors were highly significant among centenarians (p = .005), overall mental health was not a predictor of nutritional risk in centenarians (p = .08). Number of illnesses was the primary predictor of nutritional risk among sexagenarians and octogenarians.

Aged↗

PubMed2002

Predictors of mental distress in early adulthood: a five-year follow-up of 709 high-school students.

Mental health risk factors in adolescence were examined as predictors of mental distress in early adulthood. A cohort of 709 Finnish adolescents was studied in 1990 (mean age 16.8) and in 1995. Trait anxiety, defence styles, life events, self-esteem and somatic symptoms were evaluated as predictors of high scores in the General Health Questionnaire in adulthood. Females (36%) were more likely to be distressed than males (23%). High trait anxiety and somatic symptom scores among adolescent females, and high immature defence style scores among males predicted mental distress. Males with low trait anxiety in adolescence had less distress. The results indicate trait anxiety as an important predictor of mental distress. Gender differences in other predictors suggest gender differences in coping.

Adaptation, Psychological↗

PubMed1998

Predictors of Attrition from an Outpatient Chemical Dependency Program.

This study investigated differences between completers and noncompleters of an intensive outpatient substance abuse treatment program to identify key predictors of attrition. Participants (n = 138) completed a comprehensive intake/assessment package that included the Addiction Severity Index as a precursor to participation in the program. Discriminant function analyses (DFA) suggested that ASI composite scores and severity ratings were not useful predictors. However, analysis of individual items was useful in identifying "red flags" as predictors for treatment attrition. The subsequent DFA identified the following variables as significant predictors: Hispanic ethnicity, absence of a professional skill, shorter time since last hospitalization, cocaine or cannabis use in the last 30 days, total number of family members with drug problems, presence of emotional abuse in last 30 days, concern with family problems, and number of family group meetings that family members attended. These red flags can serve the important function of providing clinicians with enough information to intervene early with patients at risk for treatment dropout.

Journal Article↗

PubMed1999

The relationship of Axis II personality disorders to other known predictors of addiction treatment outcome.

This study evaluated the prevalence of Axis II disorders in substance abuse patients and the relationship between Axis II psychopathology and two other known predictors of adverse addiction treatment outcomes, i.e., Axis I psychiatric comorbidity and illegal drug use, specifically cocaine. 232 patients with cocaine and/or alcohol dependence were admitted to either inpatient or outpatient addiction recovery programs at Carrier Foundation, a nonprofit, private-pay hospital in New Jersey. Axis II disorders were more prevalent in cocaine than alcohol dependence and in patients with Axis I psychiatric comorbidity. When all three predictors were evaluated in one prediction model, the combination of Axis I and II psychopathology was the best predictor of a return to substance use at one year post-treatment, compared to the three factors alone. These findings highlighted the importance of the interrelationship of the relative prognostic value of three known predictors of addiction treatment.

Adolescent↗

PubMedDate not supplied

First-ever stroke and outcome in patients admitted to Perugia Stroke Unit: predictors for death, dependency, and recurrence of stroke within the first three months.

Predictors of poor outcome after first-ever stroke within 3 months in consecutive patients admitted to our Stroke Unit were defined. Factors included age, sex, risk factors, occurrence of transient ischemic attacks, extension of cerebral infarction, presumed cause of stroke, clinical findings, and demographic characteristics. Multiple regression models were used to analyze predictors of mortality, dependency and stroke recurrence. A total of 435 patients with first-ever stroke were included. Of these, 358 patients had ischemic stroke and 77 hemorrhagic stroke. Three-month mortality rate was 20.5%. After the same period, 24.6% of survivors were dependent (mRS > or = 3) and 5.0% of patients had recurrent stroke. Age, the presence of atrial fibrillation, impaired consciousness on admission, and stroke severity were related to mortality. The presence of stroke due to an undetermined cause or small vessel disease was associated with lower mortality. Partial anterior circulation syndrome or lacunar syndrome were both related to better outcome. The best predictors for dependency after 3 months were age and stroke severity. The only variable identified as the best predictor for recurrence was the presence of diabetes mellitus.

Age Factors↗

PubMed2001

Predictors of pain 1 year post-spinal cord injury.

OBJECTIVE: To determine the predictive validity of demographic and medical characteristics to the subsequent development of pain 1 year post-spinal cord injury (SCI). DESIGN: Prospective longitudinal design using data from 18 Model Spinal Cord Injury Systems of Care. PARTICIPANTS: Adults 18 years or older with traumatic-onset SCI (n = 540) evaluated at 1 year postinjury. OUTCOME MEASURES: A single item from the Short Form-12 that assessed pain interference in day-to-day activities using a 5-point Likert scale. PREDICTOR VARIABLES: Demographic and medical characteristics, individual and total medical complications during rehabilitation, and insurance provider. RESULTS: Univariate analyses showed age, education, marital status, primary occupation at the time of injury, American Spinal Injury Association motor score, and sponsor of care to be related to pain interference 1 year post-SCI. Polychotomous logistic regression indicated that age and occupational status at the time of injury were the only significant unique predictors of pain interference. The youngest (aged 18-29 years) and oldest (aged 60 years and older) age groups reported the least amount of pain interference, whereas individuals unemployed at the time of injury were significantly more likely to report pain interference. None of the other predictor variables was significant. CONCLUSION: Age and occupational status appear to be important predictors of pain interference 1 year post-SCI. Future directions of study and limitations are discussed.

Adult↗

PubMed1997

Ethnocultural predictors of postpartum infant-care behaviours among immigrants in Canada.

OBJECTIVES: To determine, among immigrants, what ethnocultural variables predict postpartum infant-care behaviours over and above other maternal and infant characteristics. METHODS: We recruited a cohort of immigrant women on hospital postpartum units. Data on predictor variables were collected during face-to-face interviews in the early postpartum period. Follow-up telephone interviews occurred at 3 months postpartum to assess infant-care behaviours. We identified 411 women meeting our eligibility criteria, of these 77.3% agreed to participate and 94% received follow-up interviews. RESULTS: In the first stage of a multiple linear regression analysis, maternal and infant predictors accounted for 24.2% of the variance in the 'Infant-Care Behaviours' score. In the second stage of model building, ethnocultural variables explained an additional 5.8% of the variance. Separate analyses for recent immigrants (resident in Canada less than 3 years) and less recent immigrants (3 or more years) yielded some differences in predictors. Among recent immigrants, worries about the infant's health, mother's education and an interaction term (current immigration status by parity) were significant predictors, explaining 23% of the variance. Among less recent immigrants, worries about the baby's health, prenatal class attendance, marital status and official language comprehension ability explained 37.7% of the variance. CONCLUSIONS: Our results indicate that assessing ethnocultural characteristics, in addition to maternal and infant characteristics, improves the prediction of 'Infant-Care Behaviours' scores.

Adolescent↗

PubMed2004

Predictors of circadian sleep-wake rhythm maintenance in elders with dementia.

Minimal data exists to predict which elders with dementia in nursing homes will maintain circadian sleep-wake rhythms during senescence and which elders with dementia in nursing homes will experience sleep-wake rhythm deterioration. This circadian deterioration is one of the background factors identified in the Needs-driven Dementia-compromised Behavior Model. The objective of this study was to determine predictors of circadian sleep-wake rhythm maintenance in elders with dementia residing in nursing homes. This secondary analysis identifies predictors of maintaining circadian sleep-wake rhythm in a convenience sample of 171 elders with dementia residing in seven nursing homes in the Southern United States. An autocorrelogram of the circadian sleep-wake rhythm for each participant determined whether or not the rhythm had deteriorated. Using measures of depression, cognitive function, physical and psychosocial activity, medications, and sleep apnea, as well as demographic characteristics of the sample, logistic regression determined the best predictors of rhythm maintenance. The best predictors of circadian sleep-wake rhythm maintenance in elders with dementia residing in nursing homes were physical activity (p = 0.00) and psychosocial activity (p = 0.00). The interaction term between these variables was not significant (p = 0.24). These findings suggest that providing meaningful daytime physical and psychosocial activity may assist in maintaining circadian sleep-wake rhythmicity. Additional research is needed to determine if these interventions would improve circadian sleep-wake rhythm in elders with dementia residing in nursing homes.

Aged↗

PubMed2004

Psychological predictors of admission and discharge global assessment of functioning scale scores for geropsychiatric inpatients.

This study examined psychological predictors of Global Assessment of Functioning Scale scores (GAF) at intake and at discharge for geropsychiatric inpatients. A total of 301 predominantly male geropsychiatric inpatients were recruited from the Houston Veterans Affairs Medical Center. Path analysis was used to test a model proposing causal paths of psychological predictors (cognitive status, depression, agitation, general psychiatric status) to GAF scores on admission and discharge. At admission, all four psychological predictors had positive paths to the admission GAF scale scores but at discharge, only two (i.e., cognitive status and general psychiatric status) of the four psychological predictors had positive paths to the discharge GAF scale scores. The admission GAF scale scores also had a positive path to the discharge GAF scale scores. The overall functioning level of geropsychiatric inpatients may be predicted by measures which assess overall cognitive status and general psychiatric functioning during hospitalization. Results prompt consideration of a modified global scale specifically reflecting an older adult's activities during this period of life.

Activities of Daily Living↗

PubMed2003

Work characteristics and morbidity as predictors of self-perceived health status in Norwegian physicians.

AIMS: The purpose of this study was to assess whether work characteristics and morbidity are predictors of physical, psychological, and social functioning in physicians. METHODS: A cross-sectional study was undertaken of 1126 Norwegian physicians. For comparison of health status scores, the Short Form 36 questionnaire was used, adjusting for differences in age and gender where applicable. Somatic morbidity was classified on the basis of self-reported conditions and psychiatric morbidity with score on the 25-item Hopkins symptom checklist using a cut-off indicating clinical psychiatric disease. Multiple logistic regression analysis was used with SF-36 dimension score below/above the 10th percentile as the dependent variable. RESULTS: In the multivariate model, psychiatric comorbidity was a significant predictor in 7 of 8 dimensions of health status (odds ratio 0.17 to 0.49), and somatic comorbidity in 6 of 8 dimensions of health status (odds ratio 0.33 to 0.59). Working hours was a significant predictor of only one dimension of health status, general health, after adjustment for demographic and work-related variables. CONCLUSIONS: The most important predictors for most dimensions of health status among Norwegian physicians were the presence or absence of self-reported somatic or psychiatric morbidity, while working hours, choice of specialty, and position were less important.

Adult↗

PubMed2003

Predictors of susceptibility to smoking and ever smoking: a longitudinal study in a triethnic sample of adolescents.

This report describes a longitudinal study of the natural course of smoking initiation in a school-based, ethnically diverse (42% White, 37% African American, 20% Hispanic) sample of adolescents in grades 5, 8, and 12 who were followed prospectively for 1 year. A cohort of 659 students was identified who were never smokers at baseline and who completed questionnaires both at baseline and at 1-year follow-up. From this cohort, predictor variables were used to identify ethnic-specific risk factors for (a) "susceptibility to smoking" among the 509 students who were nonsusceptible, never smokers at baseline and (b) "ever smoking" among all 659 students who were never smokers at baseline (both susceptible and nonsusceptible). Logistic regression analyses revealed that parental and household influences (parental education, marital status, household smoking) were important predictors of ever smoking, but not of susceptibility to smoking, for African Americans. Hispanic adolescents were significantly influenced by environmental influences, namely smoking by other household members (ever smoking) and by peers (susceptibility and ever smoking), although peer pro-tobacco influences (friends who smoke or friends' approval of smoking) were important predictors of susceptibility to smoking or ever smoking for all three ethnic groups. Exposure to tobacco-related advertising was a risk factor for White (susceptibility and ever smoking) and African American (susceptibility only) adolescents but not for Hispanic adolescents. Inclusion of the susceptibility to smoking variable in the model predicting ever smoking substantially reduced the importance of other predictors in the model, suggesting that susceptibility to smoking was not an independent risk factor for ever smoking but rather a potential mediating variable. The results of this study offer important insights for designing ethnic-specific strategies for preventing smoking during adolescence.

Adolescent↗

PubMed2004

Independent predictors of cesarean delivery in women with diabetes.

OBJECTIVES: To identify independent risk factors for Cesarean delivery in women with pregnancy complicated by diabetes. METHODS: Retrospective analysis of pregnancies from 5735 diabetic women delivering liveborn infants. Maternal demographic, medical, obstetric historical factors and index pregnancy obstetric, glycemic and neonatal outcome parameters were evaluated for association with Cesarean delivery after a trial of labor. Individual risk factors were analyzed for association by chi2 and ANOVA. Independent predictors of Cesarean delivery and adjusted relative risk (RR) were identified by stepwise logistic regression. RESULTS: Trial of labor was permitted in 90.8% and 59.4% of women without (n = 4643) and with prior Cesarean delivery (n = 1092) and was successful in 85.2% and 56.9%, respectively. Eleven independent predictors were found. Five were related to obstetric history and maternal age: prior Cesarean delivery (RR 5.34, 95% CI 3.94-7.25), no prior live birth (RR 3.17, 95% CI 1.98-5.07), no prior vaginal delivery (RR 2.28, 95% CI 1.50-3.44), prior stillbirth (RR 1.71, 95% CI 1.09-2.68%) and maternal age > or = 35 years (RR 1.53, 95% CI 1.20-1.93). Two were related to the severity of diabetes at entry to diabetes care: requiring insulin (RR 1.53, 95% CI 1.20-1.93) and highest fasting plasma glucose level (RR 1.04, 95% CI 1.01-1.07). Two were related to obstetric factors: pre-eclampsia/hypertension (RR 2.56, 95% CI 2.00-3.27) and labor induction (RR 3.32, 95% CI 2.70-4.10). The remaining two were birth weight (per 250 g, RR 1.12, 95% CI 1.09-1.17) and pre-delivery body mass index (RR, 1.03, 95% CI 1.00-1.05). CONCLUSION: The majority of predictors were not modifiable, relating to obstetric history, maternal age and diabetes severity. Possible modifiable interventions to avoid/improve labor induction, and decrease birth weight and maternal weight gain might decrease risk of Cesarean delivery. Future studies must address these multiple predictors.

Adult↗