Medical Journal Armed Forces India最新文献_第7页

Assessment of internal disaster and emergency preparedness in hospitals using the Hospital Safety Index tool 使用医院安全指数工具评估医院内部灾害和应急准备情况

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-07-01 DOI: 10.1016/j.mjafi.2024.08.011

Kushagra Patel , Pankaj Tomar , Neeraj Garg , Deepti Sahran , Urvashi M. Kapadia , Ashish Gupta

Background

While being vital infrastructure in circumstances of crisis, health and treatment facilities' equipment is at risk of destruction, and harm to healthcare structures may prevent medical services from being delivered. Enhancements could promote resilience, and assessing current facilities for internal disaster preparedness is crucial. An evaluation of three hospitals' internal emergency and disaster preparedness is presented in this paper.

Methods

Hospital safety and preparedness were assessed using the World Health Organization's (WHO) Second Edition of Hospital Safety Index (HSI) tool. The safety indices were determined by three modules: emergency and disaster management, non-structural, and structural. A safety rating, represented as a probability with a maximum value of one and a minimum value of zero, is determined by adding up the weighted results. Over three days, a multi-disciplinary team performed three hospital assessments through staff interviews and visual inspections.

Results

The study hospitals' safety indices were 0.90, 0.60, and 0.73; two were classified as Classification A, meaning they will probably be able to function in emergencies and disasters, and one was classified as Classification B, meaning that short-term intervention measures would be required to ensure the hospital's proper operation in the event of an internal disaster. This study has identified areas that must be prepared for internal disasters to increase resilience. These areas include (a) infrastructure, which has weaker protection, access, and physical security due to relatively old buildings; (b) critical systems, which have emergency response committees established by hospitals and can be improved by hospital staff receiving emergency response training; and (c) non-structural issues, which include the need to improve fuel storage, cupboard safety, shelf contents, and fitting protection.

Conclusion

Classification A applies to hospitals 1 and 3, whereas Classification B applies to Hospital 2. The HSI tool is a user-friendly, all-inclusive instrument offered by a reputable organisation that should be frequently used to evaluate the internal preparation of different hospitals for disasters.

背景保健和治疗设施的设备虽然在危机情况下是至关重要的基础设施，但它们面临被破坏的风险，对保健结构的损害可能使医疗服务无法提供。加强措施可以促进复原力，评估现有的内部备灾设施至关重要。本文对三家医院的内部应急备灾工作进行了评价。方法采用世界卫生组织（WHO）第二版医院安全指数（HSI）工具对医院的安全性和准备情况进行评估。安全指标由三个模块确定：应急和灾害管理、非结构和结构。安全等级表示为最大值为1，最小值为0的概率，通过将加权结果加起来确定。在三天时间里，一个多学科小组通过与工作人员面谈和目视检查进行了三次医院评估。结果研究医院的安全指数分别为0.90、0.60和0.73；其中两家医院被列为A类，这意味着它们可能能够在紧急情况和灾害中发挥作用；另一家医院被列为B类，这意味着在发生内部灾害时，需要采取短期干预措施，以确保医院正常运作。这项研究确定了必须为内部灾害做好准备以增强复原力的领域。这些领域包括(a)基础设施，由于建筑物相对陈旧，保护、进入和物理安全性较弱；(b)关键系统，由医院设立应急委员会，并可由接受应急培训的医院工作人员加以改进；(c)非结构性问题，包括需要改善燃料储存、橱柜安全、货架内容和配件保护。结论A级适用于医院1和医院3，B级适用于医院2。人类健康指数工具是一个用户友好的、包罗万象的工具，由一个信誉良好的组织提供，应经常用于评估不同医院应对灾害的内部准备工作。

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引用次数: 0

Fall-risk assessment in elderly pilgrims attending large religious congregation: A cross-sectional cohort study 参加大型宗教集会的老年朝圣者的跌倒风险评估：横断面队列研究

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-07-01 DOI: 10.1016/j.mjafi.2024.05.018

Vivek Aggarwal , V.K. Sashindran , P. Prashant , Nandini Sarkar , A.K. Yadav , V. Vasdev , Y. Uday

Background

Falls are an important geriatric syndrome with tremendous economic burden. The aim of this study was to find the prevalence of fall risk as assessed by digital sensor–based quantitative timed up and go (QTUG) device in elderly pilgrims attending Mahakumbh festival 2019.

Methods

An observational cross-sectional study done in elderly pilgrims attending the Kumbh Festival 2019. Combined fall risk and frailty assessment was estimated objectively using a digital sensor–based QTUG device. Details of age, body mass index (BMI), co-morbidities, and history of falls were also recorded. The association of fall and frailty assessment with gender, age, BMI, co-morbidities, and timed up and go (TUG) time was noted.

Results

In total, 370 elderly (aged >60 years) individuals were assessed. The mean age was 65.51 ± 5.22 years. The mean BMI was 25.17 ± 4.56 kg/m2. Previous falls history was seen in 40.12%. The mean combined fall risk and combined frailty risk was 51.79 ± 18.11% and 50.12 ± 18.55%, respectively. The mean TUG time was 16.16 ± 7.46 seconds. Age, female gender, and TUG time had significantly increased combined fall-risk percentage and combined frailty estimate (p: <0.0006, <0.0001, and <0.0001, respectively) and combined frailty percentage (p < 0.0001). BMI and age also had a significant correlation with combined frailty risk (p = 0.0018).

Conclusion

More than 50% of elderly Indians at Kumbh 2019 had a high combined fall risk and frailty estimate. The mean TUG time of elderly in our study was 16.16 seconds. There was a strong association between increased fall risk and female gender, age, and TUG time.

背景：跌倒是一种重要的老年综合征，具有巨大的经济负担。本研究的目的是通过基于数字传感器的定量定时起跳（QTUG）装置评估参加2019年马哈布节的老年朝圣者的跌倒风险发生率。方法对参加2019年大壶节的老年朝圣者进行观察性横断面研究。使用基于数字传感器的QTUG装置客观地评估跌倒风险和脆弱性。年龄、身体质量指数（BMI）、合并症和跌倒史的详细信息也被记录下来。注意到跌倒和虚弱评估与性别、年龄、BMI、合并症和拔腿时间（TUG）的关系。结果共评估老年人370例（60岁）。平均年龄65.51±5.22岁。平均BMI为25.17±4.56 kg/m2。以前的下跌历史为40.12%。平均联合跌倒风险为51.79±18.11%，联合衰弱风险为50.12±18.55%。平均TUG时间为16.16±7.46秒。年龄、女性性别和TUG时间显著增加了综合跌倒风险百分比和综合衰弱估计（p分别为<；0.0006、<；0.0001和<；0.0001）和综合衰弱百分比(p <；0.0001)。BMI和年龄也与综合虚弱风险有显著相关性（p = 0.0018）。在2019年大壶节上，超过50%的印度老年人有很高的跌倒风险和虚弱估计。本研究中老年人的平均TUG时间为16.16秒。女性性别、年龄和TUG时间与跌倒风险增加有很强的相关性。

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引用次数: 0

Cardiac arrest: A rare complication of tourniquet deflation 心脏骤停：止血带紧缩的罕见并发症

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-07-01 DOI: 10.1016/j.mjafi.2024.05.010

Saurabh Sud

引用次数: 0

Chatbot in anatomy learning and recapitulation: Prototype and review 用于解剖学习和复述的聊天机器人：原型与回顾

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-07-01 DOI: 10.1016/j.mjafi.2023.10.009

Nitya J. Waghray , Archana Rajasundaram , W.M.S. Johnson , Adarsh Waghray

The most frequently used phrase today is “chatbot.” A chatbot that will meet the demands of Indian medical graduates has to be developed, despite the fact that there are already a number of chatbots being utilized in the field of medical education. The authors have created a prototype of a chatbot designed specifically for anatomy education, with the goal of creating one that will meet the needs of the Indian educational system. The authors have created this review in order to gain a better grasp of the chatbot. Computer programs known as chatbots are created to mimic conversations with human users. To offer automated customer support, respond to frequently asked inquiries, or lead customers through a procedure, they can be linked to a variety of platforms, including websites, messaging apps, and mobile apps. To comprehend and react to user input, chatbots use machine learning and natural language processing (NLP) algorithms. They can be programmed to respond according to pre-written routines or to pick up new information from user interactions over time. By automating repetitive operations, chatbots can be helpful in a number of areas, including e-commerce, healthcare, and banking. They can also assist businesses in saving time and money. In the study of anatomy, chatbots can be employed to offer students individualized, interactive learning opportunities. They can be incorporated into educational software, mobile apps, and virtual reality settings to aid students in learning. Chatbots can be programmed to offer tests and quizzes, provide feedback on student performance, and offer explanations and illustrations to aid in the understanding of difficult concepts by students. Additionally, they can be utilized to offer interactive simulations of medical procedures and surgeries to students, enabling them to hone their skills in a secure setting. As a tool for medical students and healthcare workers, chatbots can also be utilized in medical education. They can help with diagnosis and treatment, and they can also offer instructions on how to utilize medical equipment. They can also provide information on anatomy and medical disorders.

今天最常用的短语是“聊天机器人”。尽管在医学教育领域已经有一些聊天机器人被使用，但必须开发一种满足印度医学毕业生需求的聊天机器人。作者创造了一个专门为解剖学教育设计的聊天机器人原型，其目标是创造一个满足印度教育系统需求的聊天机器人。作者创建这篇评论是为了更好地掌握聊天机器人。被称为聊天机器人的计算机程序被创造出来模仿与人类用户的对话。为了提供自动化的客户支持，响应常见问题，或引导客户完成流程，他们可以链接到各种平台，包括网站，消息应用程序和移动应用程序。为了理解和响应用户输入，聊天机器人使用机器学习和自然语言处理（NLP）算法。它们可以被编程为根据预先编写的例程做出响应，或者随着时间的推移从用户交互中获取新信息。通过自动化重复操作，聊天机器人可以在许多领域提供帮助，包括电子商务、医疗保健和银行业。他们还可以帮助企业节省时间和金钱。在解剖学的学习中，聊天机器人可以为学生提供个性化的互动学习机会。它们可以被整合到教育软件、移动应用程序和虚拟现实设置中，以帮助学生学习。聊天机器人可以被编程为提供测试和测验，对学生的表现提供反馈，并提供解释和插图，以帮助学生理解困难的概念。此外，它们还可以为学生提供医疗程序和手术的交互式模拟，使他们能够在安全的环境中磨练自己的技能。作为医学生和医护人员的工具，聊天机器人也可以用于医学教育。他们可以帮助诊断和治疗，他们也可以提供如何使用医疗设备的指导。它们还可以提供解剖学和医学疾病方面的信息。

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引用次数: 0

Annular pancreas in adulthood: Two compelling cases, including one with pyloric stenosis and chronic pancreatitis 成年后的环状胰腺：两个令人信服的病例，其中一人患有幽门狭窄和慢性胰腺炎

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-07-01 DOI: 10.1016/j.mjafi.2023.12.012

Vipan Kumar , Mohanasundaram Avudaiappan , Pardeep K. Sharma , Vikas Gupta

We report the infrequent occurrence of the annular pancreas (AP) in adults by presenting two remarkable cases. The first case involved an incidental discovery of an AP in a patient diagnosed with chronic pancreatitis. Surgical intervention was warranted due to gastric outlet obstruction resulting from pyloric stenosis. The patient underwent loop gastrojejunostomy (GJ) and duodenojejunostomy (DJ). The second case was evaluated for dyspeptic symptoms, and the AP was diagnosed on the contrast-enhanced abdomen CT. A bypass procedure in the form of loop DJ was performed to address the obstruction. These two cases underscore the distinctive presentations of AP and highlight the need for tailored strategies in their management.

我们报告罕见的发生环状胰腺（AP）在成人提出两个显着的情况下。第一个病例是在一个诊断为慢性胰腺炎的病人中偶然发现AP。由于幽门狭窄导致胃出口梗阻，手术干预是必要的。患者行胃空肠环状吻合术（GJ）和十二指肠空肠吻合术（DJ）。第二例评估消化不良症状，腹部增强CT诊断AP。以环路DJ的形式进行旁路手术以解决阻塞。这两个案例强调了AP的独特表现，并强调了在其管理中需要量身定制的策略。

引用次数: 0

To assess fall risk in the elderly OPD patients using conventional fall risk tool and Kinesis QTUG device: A comparative study 使用传统的跌倒风险工具和 Kinesis QTUG 设备评估门诊老年患者的跌倒风险：比较研究

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-07-01 DOI: 10.1016/j.mjafi.2024.03.003

Vivek Aggarwal , S. Shankar , Pradeep Behl , V. Vasdev , Y. Uday

Background

Falls are common among the elderly population and are usually multifactorial. Most of the falls are preventable if the risk factors are identified early and addressed. The primary objective was to assess the agreement between the fall-risk assessment as measured by the digital sensor–based Kinesis Quantitative Timed Up and Go (QTUG) device and conventional Fall Risk Assessment Tool (FRAT) in elderly Indian population.

Methods

The study was conducted in a tertiary care hospital of Western India. Conventional fall-risk assessment was done using the FRAT score and digital sensor–based fall risk was assessed using the Kinesis QTUG device. Agreement between both the fall-risk assessments was done using unweighted kappa.

Results

The mean age was 68.54 (±2.62) years with females constituting 53.3%. The mean timed-up-and-go test score was 20.33(±7.7) seconds. A total of 253 falls were noted for 147 elderly individuals. Combined fall risk using the Kinesis QTUG device showed that 59.56% (218/366) elderly patients had a high fall risk, whereas the FRAT score showed high fall risk in only 1.36% (5/366) elderly patients. There was a poor agreement between the two tools with unweighted kappa of 0.634.

Conclusions

Prevalence of falls in elderly in the last year was 40% in our study. There was a poor agreement in fall-risk estimate using the Kinesis QTUG device and FRAT score with an unweighted kappa value of 0.634.

背景：跌倒在老年人群中很常见，通常是多因素的。如果及早发现危险因素并加以处理，大多数跌倒是可以预防的。主要目的是评估基于数字传感器的kineesis定量定时起落（QTUG）装置测量的跌倒风险评估与传统的跌倒风险评估工具（FRAT）在印度老年人中的一致性。方法本研究在印度西部的一家三级医院进行。使用FRAT评分进行常规跌倒风险评估，使用kineesis QTUG装置评估基于数字传感器的跌倒风险。两种跌倒风险评估之间的一致性使用未加权kappa进行。结果患者平均年龄68.54（±2.62）岁，女性占53.3%。平均计时-出发测试分数为20.33（±7.7）秒。147名老年人共发生253次跌倒。结合Kinesis QTUG器械的跌倒风险评分显示，59.56%（218/366）的老年患者有较高的跌倒风险，而FRAT评分仅显示1.36%（5/366）的老年患者有较高的跌倒风险。两种工具之间的一致性较差，未加权kappa为0.634。结论近一年来老年人跌倒的发生率为40%。使用kineesis QTUG装置和FRAT评分进行跌倒风险评估的一致性较差，未加权kappa值为0.634。

{"title":"To assess fall risk in the elderly OPD patients using conventional fall risk tool and Kinesis QTUG device: A comparative study","authors":"Vivek Aggarwal , S. Shankar , Pradeep Behl , V. Vasdev , Y. Uday","doi":"10.1016/j.mjafi.2024.03.003","DOIUrl":"10.1016/j.mjafi.2024.03.003","url":null,"abstract":"<div><h3>Background</h3><div>Falls are common among the elderly population and are usually multifactorial. Most of the falls are preventable if the risk factors are identified early and addressed. The primary objective was to assess the agreement between the fall-risk assessment as measured by the digital sensor–based Kinesis Quantitative Timed Up and Go (QTUG) device and conventional Fall Risk Assessment Tool (FRAT) in elderly Indian population.</div></div><div><h3>Methods</h3><div>The study was conducted in a tertiary care hospital of Western India. Conventional fall-risk assessment was done using the FRAT score and digital sensor–based fall risk was assessed using the Kinesis QTUG device. Agreement between both the fall-risk assessments was done using unweighted kappa.</div></div><div><h3>Results</h3><div>The mean age was 68.54 (±2.62) years with females constituting 53.3%. The mean timed-up-and-go test score was 20.33(±7.7) seconds. A total of 253 falls were noted for 147 elderly individuals. Combined fall risk using the Kinesis QTUG device showed that 59.56% (218/366) elderly patients had a high fall risk, whereas the FRAT score showed high fall risk in only 1.36% (5/366) elderly patients. There was a poor agreement between the two tools with unweighted kappa of 0.634.</div></div><div><h3>Conclusions</h3><div>Prevalence of falls in elderly in the last year was 40% in our study. There was a poor agreement in fall-risk estimate using the Kinesis QTUG device and FRAT score with an unweighted kappa value of 0.634.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"81 ","pages":"Pages S96-S101"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141024891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Segmental spinal anesthesia with isobaric bupivacaine in lumbar fracture surgery for elderly patient with multiple comorbidities 等压布比卡因节段性脊柱麻醉在有多种合并症的老年患者腰椎骨折手术中的应用

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-07-01 DOI: 10.1016/j.mjafi.2024.10.002

Bhavna Sriramka, Diptimayee Mallik, Ranjita Acharya, Rajashree Devi

引用次数: 0

Pancreatico-Pleural Fistula: Revisiting a rare complication 胰胸膜瘘：回顾一个罕见的并发症

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-07-01 DOI: 10.1016/j.mjafi.2024.10.010

Supriya Adiody, Krishnanand Krishnakumar, T.K. Joseph, Fathima Kabir

引用次数: 0

Using Doppler duplex ultrasound to determine hemodynamic alterations in renal vasculature: Crucial pathophysiological event preceding renal dysfunction in decompensated cirrhosis 使用多普勒双工超声确定肾血管动力学改变：失代偿肝硬化肾功能障碍前的关键病理生理事件

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-07-01 DOI: 10.1016/j.mjafi.2024.08.008

Yashas Saipangallu , Alok Chandra , Yashvir Mathur , Priyank Dhiman , Manish Manrai , J. Muthukrishnan , Rajat Shukla , Sandeep Thareja , Saurabh Dawra

Background

Renal dysfunction is a watershed event in cirrhosis, often preceded by renal vasoconstriction. However, our reliability on elevated serum creatinine often delays interventions. Measurement of Renal Resistive Index (RI) and Renal Venous Stasis Index (RVSI) by Doppler ultrasound offers insight into renal vasoconstriction.

Methods

Fifty participants with decompensated cirrhosis with ascites and normal serum creatinine underwent renal Doppler ultrasound for the measurement of RI and RVSI. All patients were compliant with a salt-restricted diet. Individuals aged <18 years, hepatocellular carcinoma, non-cirrhosis-related ascites, pre-existing renal disease, obstructive uropathy, or history of nephrotoxic medication use were excluded. Statistical analyses, including Pearson correlation, regression analysis, and Chi-square/Fisher’s exact tests, were performed to assess the statistical significance between RI, RVSI, and renal parameters. Additionally, the association of RI with the model for end-stage liver disease sodium (MELD-Na) and Child-Turcotte-Pugh (CTP) scores was also assessed.

Results

Majority were males (88%), average CTP score was 11.7, mean MELD-Na score was 20.92, and mean serum creatinine was 1.05 mg/dL. Renal parameters had varying RI values among renal arteries, with the main right and left arteries at 0.615 [standard deviation (SD): 0.089] and 0.638 (SD: 0.083), respectively. RI and RVSI are significantly correlated with serum creatinine. Further, significant correlation between, RI, RVSI values noted with MELD-Na score even when serum creatinine values are normal.

Conclusion

Strong correlations between serum creatinine, RI, and MELD-Na scores hints at predictive clinical potential. Future research with larger cohorts and extended follow-up is required to gauge clinical utility and its impact on outcomes.

背景：肾功能障碍是肝硬化的分水岭事件，通常发生在肾血管收缩之前。然而，我们对血清肌酐升高的可靠性常常延迟干预。多普勒超声测量肾阻力指数（RI）和肾静脉停滞指数（RVSI）可以深入了解肾血管收缩。方法50例失代偿性肝硬化伴腹水，血清肌酐正常的患者行肾多普勒超声测量肾内积和RVSI。所有患者都遵循限盐饮食。排除年龄18岁、肝细胞癌、非肝硬化相关性腹水、既往肾病、梗阻性尿路病变或肾毒性药物使用史的患者。统计学分析包括Pearson相关分析、回归分析和卡方/Fisher精确检验，以评估RI、RVSI和肾脏参数之间的统计学意义。此外，还评估了RI与终末期肝病模型钠（MELD-Na）和child - turcote - pugh （CTP）评分的相关性。结果男性居多（88%），平均CTP评分为11.7，平均MELD-Na评分为20.92，平均血清肌酐为1.05 mg/dL。肾参数在肾动脉间的RI值各不相同，主要的右、左动脉分别为0.615[标准差（SD）： 0.089]和0.638 （SD: 0.083）。RI和RVSI与血清肌酐显著相关。此外，即使血清肌酐值正常，RVSI值与MELD-Na评分之间也存在显著相关性。结论血清肌酐、RI和MELD-Na评分之间存在较强的相关性，提示具有临床预测潜力。未来的研究需要更大的队列和延长的随访来衡量临床效用及其对结果的影响。

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引用次数: 0

Evaluation of lymph node ratios and log odds of positive nodes as prognostic indicators in primary organ malignancy 评价原发性器官恶性肿瘤中淋巴结比例和阳性淋巴结对数比值作为预后指标

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-07-01 DOI: 10.1016/j.mjafi.2024.08.012

Asaranti Kar , Silpa Ray , Pradeep Kumar Behera , Lity Mohanty , P.K. Das , Priyadarshini Biswal

Background

Staging of malignant tumours based on positive lymph node number and not taking into account the actual number of examined lymph nodes during surgery may lead to bias and fallacious results. The ratio of positive and resected lymph nodes (LNR) and log odds of positive nodes (LODDS) emerged as novel prognostic markers in deciding the future course of management better than the parameter pN in predicting cancer-specific survival. We aim to evaluate and compare the prognostic value of pN, LNR and LODDS in common primary organ malignancies like breast, head and neck, gastric and cervical cancers.

Methods

This was an ambidirectional observational study conducted from September 2018 to August 2021 with one year (from 2017 to 2018) for retrospective data collection archived from records. It included patients affected by breast, head and neck, gastric and cervical cancers and were followed up for a period of 3 years from the date of diagnosis to perform a holistic survival analysis. The sample was grouped by American Joint Committee on Cancer N stage, LNR and LODDS, and analysed using Kaplan–Meier and multivariate Cox proportional hazard models.

Results

The study included 202 breast cancer patients, 85 head and neck cancer patients, 100 gastric cancer patients and 52 cervical cancer patients. Multivariate Cox regressions analysis demonstrated a lower Akaike Information Criterion (AIC) value for LODDS and LNR followed by pN stage.

Conclusion

The novel indicators LNR and LODDS better predicted the biological behaviour irrespective of lymph node number and allowed clinicians to correctly stratify patients for better postoperative management.

基于阳性淋巴结数目而不考虑手术中检查淋巴结的实际数目的恶性肿瘤分期可能导致偏差和错误的结果。在预测癌症特异性生存方面，阳性和切除淋巴结的比率（LNR）和阳性淋巴结的对数赔率（LODDS）成为决定未来治疗过程的新预后指标，优于参数pN。我们的目的是评估和比较pN、LNR和LODDS在乳腺癌、头颈癌、胃癌和宫颈癌等常见原发器官恶性肿瘤中的预后价值。方法：本研究是一项双向观察性研究，于2018年9月至2021年8月进行，为期一年（2017年至2018年），回顾性收集记录数据。它包括患有乳腺癌、头颈癌、胃癌和宫颈癌的患者，从诊断之日起随访3年，进行整体生存分析。样本由美国癌症N分期、LNR和LODDS联合委员会分组，并使用Kaplan-Meier和多变量Cox比例风险模型进行分析。结果纳入202例乳腺癌患者，85例头颈癌患者，100例胃癌患者，52例宫颈癌患者。多变量Cox回归分析显示，LODDS和LNR的Akaike信息标准（AIC）值较低，其次是pN期。结论新颖的LNR和LODDS指标能更好地预测淋巴结数量无关的生物学行为，使临床医生能够正确地对患者进行分层，以便更好地进行术后管理。

{"title":"Evaluation of lymph node ratios and log odds of positive nodes as prognostic indicators in primary organ malignancy","authors":"Asaranti Kar , Silpa Ray , Pradeep Kumar Behera , Lity Mohanty , P.K. Das , Priyadarshini Biswal","doi":"10.1016/j.mjafi.2024.08.012","DOIUrl":"10.1016/j.mjafi.2024.08.012","url":null,"abstract":"<div><h3>Background</h3><div>Staging of malignant tumours based on positive lymph node number and not taking into account the actual number of examined lymph nodes during surgery may lead to bias and fallacious results. The ratio of positive and resected lymph nodes (LNR) and log odds of positive nodes (LODDS) emerged as novel prognostic markers in deciding the future course of management better than the parameter pN in predicting cancer-specific survival. We aim to evaluate and compare the prognostic value of pN, LNR and LODDS in common primary organ malignancies like breast, head and neck, gastric and cervical cancers.</div></div><div><h3>Methods</h3><div>This was an ambidirectional observational study conducted from September 2018 to August 2021 with one year (from 2017 to 2018) for retrospective data collection archived from records. It included patients affected by breast, head and neck, gastric and cervical cancers and were followed up for a period of 3 years from the date of diagnosis to perform a holistic survival analysis. The sample was grouped by American Joint Committee on Cancer N stage, LNR and LODDS, and analysed using Kaplan–Meier and multivariate Cox proportional hazard models.</div></div><div><h3>Results</h3><div>The study included 202 breast cancer patients, 85 head and neck cancer patients, 100 gastric cancer patients and 52 cervical cancer patients. Multivariate Cox regressions analysis demonstrated a lower Akaike Information Criterion (AIC) value for LODDS and LNR followed by pN stage.</div></div><div><h3>Conclusion</h3><div>The novel indicators LNR and LODDS better predicted the biological behaviour irrespective of lymph node number and allowed clinicians to correctly stratify patients for better postoperative management.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"81 ","pages":"Pages S126-S134"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0