[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-436495-105":59,"doc-detail-436495-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","one-risk-factor-predicts-another-risk-factor-letter-to-the-editor","One risk factor predicts another risk factor - Letter to the editor","","Editor letter discussing an article on hemorrhagic complications after robotic-assisted partial nephrectomy. The writers acknowledge identified predictors such as type 2 diabetes, tumor size metrics, PAUDA, and operative factors, while noting that multivariate analysis leaves warm ischemic time >25 minutes as the significant risk factor. The letter questions how the 25-minute cutoff was derived, reviews clinical rationale for minimizing warm ischemia, and highlights concerns about statistical significance without clear clinical relevance.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/one-risk-factor-predicts-another-risk-factor-letter-to-the-editor/436495/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/one-risk-factor-predicts-another-risk-factor-letter-to-the-editor/436495.png","ImageObject",300,407,{"name":92,"@type":93},"Kyle","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Which risk factor is highlighted as significant after multivariate logistic regression?","Question",{"text":112,"@type":113},"The letter states that only warm ischemic time >25 minutes remains significant, with an odds ratio of 3.51 (95% CI: 1.28–9.59).","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why do the authors ask about the cutoff value of 25 minutes?",{"text":117,"@type":113},"They find the study interesting but question how the authors identified the 25-minute cutoff for warm ischemic time, especially given uncertainties for routine clinical practice.",{"name":119,"@type":110,"acceptedAnswer":120},"What limitation does the letter point out regarding existing studies?",{"text":121,"@type":113},"It notes that many literature reviews treat warm ischemic time as a surgical outcome and that statistical significance may not translate into clinical relevance, a limitation seen frequently across studies.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},436495,1790811286,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":81,"preview_page_count":4},3985741905716,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","J Chin MedAssoc  \nLetter to the editor  \nOne risk factor predicts another risk factor  \nYiu-Tai Lia, Wen-Hsun Changb,c,d,*  \naDepartment of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan, ROC; bDepartment of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; cDepartment of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; dFemale Cancer Foundation, Taipei, Taiwan, ROC  \nDear Editor,  \nThe following article entitled “Risk factors for hemorrhagic complications following robotic-assisted partial nephrectomy” published in the March issue of the Journal of the Chinese Medical Association seemed to be very interesting.1 Dr. Tsai et al’s1 group tried to investigate the risk factors associated with hemorrhagic complication in patients undergoing roboticassisted partial nephrectomy.1 The authors found that the type 2 diabetes mellitus (DM), Radius-scores tumor size, PAUDA (sum of the renal size plus renal sinus involvement), prolonged console time (>180 minutes), prolonged warm ischemic time (>25 minutes), and method of pedicle control were statistically significant risk factors in the prediction of hemorrhagic complication during robotic-assisted partial nephrectomy.1 After multivariate logistic regression analysis, the authors found that only the term“warm ischemic time >25 minutes” was the significant risk factor in the prediction of occurrence of hemorrhagic complication with an odds ratio (OR) of 3.51 (95% confidence interval [CI]: 1.28-9.59).1 Although the current study is interesting and many uncertainties of the clinical routine practice may not be clear and all are worthy of further explanation by authors.  \nAt first, we totally agree with the hemorrhage as a severe and life-threatened clinical condition not only during operation and postoperatively. Risk identification in patients who are candidates or arranged to undergo surgical treatment of their resectable diseases is of the critical importance, particularly for those patients facing the malignant diseases which need total and curative surgical resection.2 To avoid overtreatment and decompensation of residual organs and their function, minimally invasive surgery (MIS) and the far-advanced surgical instruments (the more powerful healed blood vessels system), and well-prepared works, such as transient blood occlusion, are frequently applied in modern surgical procedures to assist the process of the surgery in precise and uneventfully.3,4 Therefore, we highly appreciate Dr. Tsai et al’s1 work to identify the risk factor (warm ischemic time >25 minutes) associated with hemorrhagic complications intraoperatively and postoperatively. However, it is interesting to know how the authors identify the cutoff value of warm ischemic time by 25 minutes.  \nAdditionally, during the partial nephrectomy, transient occlusion of feeding vessels (renal artery) to the kidney is always  \n* Address correspondence. Miss. Wen-Hsun Chang, Department of Nursing, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, [ROC. E-mail address: whchang@vghtpe.gov.tw](ROC. E-mail address: whchang@vghtpe.gov.tw) (W.-H. Chang). Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2023) 86: 696.  \nReceived March 11, 2023; accepted March 13, 2023.  \ndoi: 10. 1097/JCMA.0000000000000931.  \nCopyright © 2023, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/))  \nneeded, contributing to the birth of term as “warm ischemic time” during the partial nephrectomy. In theory, the longer warm ischemic time results in more impairment of renal function.5 Therefore, many surgeons tried their best to shorten ","cbCaic4e0yoD9UY2","https://ap.wps.com/l/cbCaic4e0yoD9UY2","pdf",284342,"English","# Letter to the editor\n## Key findings and acknowledged significance\n## Questioning the 25-minute cutoff value\n## Clinical rationale and literature limitations","[{\"question\":\"Which risk factor is highlighted as significant after multivariate logistic regression?\",\"answer\":\"The letter states that only warm ischemic time \\u003e25 minutes remains significant, with an odds ratio of 3.51 (95% CI: 1.28–9.59).\"},{\"question\":\"Why do the authors ask about the cutoff value of 25 minutes?\",\"answer\":\"They find the study interesting but question how the authors identified the 25-minute cutoff for warm ischemic time, especially given uncertainties for routine clinical practice.\"},{\"question\":\"What limitation does the letter point out regarding existing studies?\",\"answer\":\"It notes that many literature reviews treat warm ischemic time as a surgical outcome and that statistical significance may not translate into clinical relevance, a limitation seen frequently across studies.\"}]","One risk factor predicts another risk factor - Letter to the editor | PDF",1790678180]