scholarly journals Predictive value of lymphocyte‐to‐monocyte ratio in critically Ill patients with atrial fibrillation: A propensity score matching analysis

Author(s):  
Yue Yu ◽  
Suyu Wang ◽  
Pei Wang ◽  
Qiumeng Xu ◽  
Yufeng Zhang ◽  
...  
Critical Care ◽  
2012 ◽  
Vol 16 (3) ◽  
pp. R105 ◽  
Author(s):  
Francisco J González de Molina ◽  
Cristóbal León ◽  
Sergio Ruiz-Santana ◽  
Pedro Saavedra ◽  

2021 ◽  
Author(s):  
Yue Yu ◽  
Suyu Wang ◽  
Pei Wang ◽  
Qiumeng Xu ◽  
Yufeng Zhang ◽  
...  

Abstract Background Inflammation plays a key role in the initiation and progression of atrial fibrillation (AF). Lymphocyte-to-monocyte ratio (LMR) has been proved to be a reliable predictor of many inflammation-associated diseases, but little data are available on the relationship between LMR and AF. The present study aimed to evaluate the predictive value of LMR in predicting all-cause mortality among AF patients. Methods Data of patients diagnosed with AF were retrieved from the Medical Information Mart for Intensive Care-III (MIMIC-III) database. X-tile analysis was used to calculate the optimal cutoff value for LMR. The Cox proportional-hazards regression model was used to assess the association of LMR and 28-day, 90-day and 1-year mortality. Additionally, a propensity score matching (PSM) method was performed to minimize the impact of potential confounders. Results A total of 3,567 patients hospitalized with AF were enrolled in this study. The X-tile software indicated that the optimal cutoff value of LMR was 2.67. A total of 1,127 pairs were generated and all the covariates were well balanced after PSM. The Cox proportional-hazards model showed that patients with the low LMR (≤ 2.67) had a higher 1-year all-cause mortality than those with the high LMR (> 2.67) in the study cohort before PSM (HR = 1.640, 95% CI: 1.437–1.872, P < 0.001) and after PSM (HR = 1.279, 95% CI: 1.094–1.495, P = 0.002). The multivariable Cox regression analysis for 28-day and 90-day mortality yielded similar results. Conclusions The lower LMR (≤ 2.67) was associated with a higher risk of 28-day, 90-day, and 1-year all-cause mortality, which might serve as an independent prognostic predictor in AF patients.


2021 ◽  
Author(s):  
Yue Yu ◽  
Suyu Wang ◽  
Pei Wang ◽  
Qiumeng Xu ◽  
Yufeng Zhang ◽  
...  

Abstract Background Inflammation plays a key role in the initiation and progression of atrial fibrillation (AF). Lymphocyte-to-monocyte ratio (LMR) has been proved to be a reliable predictor of many inflammation-associated diseases, but little data are available on the relationship between LMR and AF. The present study aimed to evaluate the predictive value of LMR in predicting all-cause mortality among AF patients. Methods Data of patients diagnosed with AF were retrieved from the Medical Information Mart for Intensive Care-III (MIMIC-III) database. X-tile analysis was used to calculate the optimal cutoff value for LMR. The Cox proportional-hazards regression model was used to assess the association of LMR and 28-day, 90-day and 1-year mortality. Additionally, a propensity score matching (PSM) method was performed to minimize the impact of potential confounders. Results A total of 3,567 patients hospitalized with AF were enrolled in this study. The X-tile software indicated that the optimal cutoff value of LMR was 2.67. A total of 1,127 pairs were generated and all the covariates were well balanced after PSM. The Cox proportional-hazards model showed that patients with the low LMR (≤ 2.67) had a higher 1-year all-cause mortality than those with the high LMR (> 2.67) in the study cohort before PSM (HR = 1.640, 95% CI: 1.437–1.872, P < 0.001) and after PSM (HR = 1.279, 95% CI: 1.094–1.495, P = 0.002). The multivariable Cox regression analysis for 28-day and 90-day mortality yielded similar results. Conclusions The lower LMR (≤ 2.67) was associated with a higher risk of 28-day, 90-day, and 1-year all-cause mortality, which might serve as an independent prognostic predictor in AF patients.


2018 ◽  
Vol 33 (3) ◽  
pp. 46-56
Author(s):  
A. V. Evtushenko ◽  
V. V. Evtushenko ◽  
E. N. Pavlyukova ◽  
I. O. Kurlov ◽  
V. Kh. Vaizov ◽  
...  

The article is devoted to the evaluation of the results of clinical application of penetrating radiofrequency ablation techniques on atrial myocardium.Material and Methods. A total of 298 patients with valvular heart disease complicated with atrial fibrillation were operated. All operations were performed under cardiopulmonary bypass and cardioplegia. The main group consisted of 198 patients who were operated using penetrating technique radiofrequency exposure. The control group consisted of 100 patients who underwent surgery with the use of «classical» monopolar radiofrequency-ablation technique. Both groups did not significantly differ in any parameter before surgery, but to increase confidence in the results, pseudo-randomization was performed using the Propensity score matching technique.Results. Patients with previous heart surgery were excluded during the selection of candidates for the procedure because of the presence of adhesions in the pericardium that did not allow good visualization of the left atrium, sufficient to perform the procedure. Penetrating technique had significantly higher efficiency compared to the «classic» technique in the early and long-term postoperative periods. The efficiency was 93% in the early postoperative period and 88% in the long term. The efficacy of «classical» monopolar procedure was lower: 86 and 68%, respectively.


2021 ◽  
Author(s):  
Khalid Al Sulaiman ◽  
Ohoud Al Juhani ◽  
Hisham A. Badreldin ◽  
Khalid Bin Salah ◽  
Abdullah Al Harthi ◽  
...  

Abstract Background: Due to its supposed clinical efficacy, relative safety, and low cost, ascorbic acid represents an appealing option for clinicians to utilize in the context of a global health pandemic of COVID-19 patients.Objectives: The aim of this study was to evaluate the efficacy and safety of using ascorbic acid as adjunctive therapy in critically ill patients with COVID-19. Methods: This was a multi-center, non-interventional, retrospective cohort study. All critically ill adult patients admitted to ICU with a confirmed COVID-19 between March 1st to December 31st, 2020 were included in the final analysis. The study was conducted at two large governmental tertiary hospitals in Saudi Arabia. The purpose was to investigate the association between clinical outcomes with ascorbic acid use as an adjunctive therapy in COVID-19 after propensity score matching using baseline severity scores, systemic use of corticosteroids and study centers. Results: A 739 patients were included in this study; 296 patients were included after propensity score matching. There was no association between the administration of ascorbic acid and in-hospital mortality nor 30-day ICU mortality (OR (95%CI): 0.77 (0.476, 1.234), p-value=0.2738 and OR (95%CI): 0.73 (0.438 ,1.204), p-value=0.215 respectively). Using ascorbic acid was associated with lower incidence of thrombosis compared with the non-ascorbic acid group (6.1% vs. 13% respectively); OR (95%CI): 0.42 (0.184, 0.937), p-value=0.0342).Conclusion: Ascorbic acid use as an adjunctive therapy in COVID19 critically ill patients was not associated with mortality benefits; but associated with lower incidence of thrombosis. Further studies are required to confirm these findings.


2021 ◽  
Author(s):  
Khalid Al Sulaiman ◽  
Ohoud Al Juhani ◽  
Abdulrahman I Al Shaya ◽  
Abdullah Kharbosh ◽  
Raed Kensara ◽  
...  

Abstract Background: Zinc is a trace element that plays a role in stimulating innate and acquired immunity. The role of zinc in critically ill patients with COVID-19 remains unclear. This study aims to evaluate the efficacy and safety of zinc sulfate as adjunctive therapy in critically ill patients with COVID-19.Methods: Patients aged ≥ 18 years with a COVID-19 who were admitted to the intensive care unit (ICU) in two tertiary hospitals in Saudi Arabia were retrospectively assessed for zinc use, from 01 March 2020 until 31-December 2020. We assessed the association of zinc use as adjunctive therapy with the in-hospital and 30-day mortality after propensity score matching. Secondary outcomes included mechanical ventilation (MV) duration, ICU length of stay (LOS), hospital LOS, and complication (s) during ICU stay. Results: A total of 266 patients were included in this study after using propensity score matching. Zinc sulfate as adjunctive therapy during ICU stay was not associated with statistically significant reduction in 30-day mortality nor in-hospital mortality compared to those who did not receive zinc (HR= 0.65 CI = 0.41,1.01; p= 0.05 and HR= 0.67 CI = 0.45,1.00; p= 0.05; respectively). Moreover, MV duration (Beta coefficient 0.10 CI = -0.19,0.39; p= 0.48), ICU LOS (Beta coefficient 0.19 CI = -0.02,0.40; p=0.08) and hospital LOS (Beta coefficient 0.15 CI = -0.02,0.32; p=0.08) were not statistically significant between the two groups. Patients who received zinc have a higher odds of acute kidney injury (AKI) during ICU stay (OR= 1.80 CI = 1.08-3.0; p= 0.02). Conclusion: Zinc sulfate as adjunctive therapy in critically ill patients with COVID-19 may have survival benefit; however, was not statistically significant. Zinc use was linked with an increased risk of AKI development during ICU stay.


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