scholarly journals The impact of nutritional risk factors and sarcopenia on survival in patients treated with pelvic exenteration for recurrent gynaecological malignancy: a retrospective cohort study

2021 ◽  
Author(s):  
Veronika Seebacher ◽  
Andrea Rockall ◽  
Marielle Nobbenhuis ◽  
S. Aslam Sohaib ◽  
Thomas Knogler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pelvic Exenteration ◽  
Prognostic Significance ◽  
Nutritional Risk ◽  
Moderate Risk ◽  
Gynaecological Malignancy ◽  
Royal Marsden Hospital ◽  
Muscle Attenuation ◽  
Gynaecological Malignancies ◽  
The Impact

Abstract Purpose The aim of the present study is to investigate the prognostic significance of nutritional risk factors and sarcopenia on the outcome of patients with recurrent gynaecological malignancies treated by pelvic exenteration. Methods We retrospectively evaluated muscle body composite measurements based on pre-operative CT scans, nutritional risk factors as assessed by a validated pre-operative questionnaire, and clinical–pathological parameters in 65 consecutive patients with recurrent gynaecological malignancies, excluding ovarian cancer, treated by pelvic exenteration at the Royal Marsden Hospital London. Predictive value for postoperative morbidity was investigated by logistic regression analyses. Relevant parameters were included in uni- and multivariate survival analyses. Results We found only (1) low muscle attenuation (MA)—an established factor for muscle depletion—and (2) moderate risk for malnutrition to be independently associated with shorter overall survival (p = 0.006 and p = 0.008, respectively). MA was significantly lower in overweight and obese patients (p = 0.04). Muscle body composite measurements were not predictive for post-operative morbidity. Conclusion The study suggests that pre-operative low MA and moderate risk for malnutrition are associated with shorter survival in patients with recurrent gynaecological malignancies treated with pelvic exenteration. Further studies are needed to validate these findings in larger cohorts.

scholarly journals Impact of nutritional risk factors on chronic non-communicable diseases

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
G Grosso
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Communicable Diseases ◽  
Nutritional Risk ◽  
Special Focus ◽  
High Systolic Blood Pressure ◽  
Non Communicable Diseases ◽  
Dietary Risk Factors ◽  
Dietary Risk ◽  
The Impact

Abstract Background modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention of chronic non-communicable diseases (NCD). Among various risk factors, poor nutrition quality has been identified as a leading determinant of NCD. Methods The Global Burden of Diseases (GBD) Study provided a comprehensive comparative risk assessment (CRA) of risk factor for NCD, quantifying the impact of behavioural, environmental and occupational, and metabolic risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. Special focus on nutritional risk factors will be dedicated, discussing the proportion of disease-specific burden attributable to each dietary risk factor and the level of intake associated with the lowest risk of mortality. Results In 2017, over 30 million deaths were attributable to risk factors. When ranked, high systolic blood pressure was the leading risk factor, accounting for more than 10 million deaths, followed by, high fasting plasma glucose, and high body-mass index. A total of 11 million deaths were attributable to dietary risk factors. High intake of sodium, low intake of whole grains, and low intake of fruits were the leading dietary risk factors for deaths globally. However, important differences between regions and outcome (i.e., cardiovascular disease vs. cancer) have been registered. Besides the major aforementioned factors, underrated dietary risk factors, such as low calcium intake, have been found important contributors to cancer burden in certain developed countries. Interpretation The combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in NCD at the global level. These data provide a comprehensive picture of the potential impact of suboptimal diet on NCD mortality and morbidity, highlighting the need for improving diet across nations.

Relationship between Hyperlipidemia, Cardiovascular Disease and Stroke: a Systematic Review

2020 ◽  
Vol 16 ◽  
Author(s):  
Aladeen Alloubani ◽  
Refat Nimer ◽  
Rama Samara
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Prognostic Significance ◽  
Vascular Diseases ◽  
Positive Association ◽  
Cholesterol Concentration ◽  
Lipid Lowering ◽  
Mortality And Morbidity ◽  
The Impact

Background:: Globally, dyslipidemia has been shown to be an independent predictor of many cardiovascular and cerebrovascular events, which lead to recent advocacy towards dyslipidemia prevention and control as a key risk factor and its prognostic significance to reduce the burden of stroke and myocardial infarction. Aim:: This study aimed to evaluate hyperlipidemia as a risk factor connected with stroke and CVD. Moreover, having identified this risk factor, the study evaluates how hyperlipidemia has been examined earlier and what can be done in the future. Methods:: All prospective studies concerning hyperlipidemia as risk factors for stroke and CVD were identified by a search of PubMed/MEDLINE and EMBASE databases with keywords hyperlipidemia, risk factors, stroke, and cardiovascular disease. Results:: The constant positive association between the incidence of coronary heart disease and cholesterol concentration of LDL is apparent in observational studies in different populations. Thus, the reduction of LDL cholesterol in those populations, particularly with regard to initial cholesterol concentrations, can reduce the risk of vascular diseases. However, the impact of using lipid-lowering drugs, such as statins, has been demonstrated in several studies as an important factor in decreasing the mortality and morbidity in rates of patients with stroke and CVD. Conclusion:: After reviewing all the research mentioned in this review, it can be confirmed that hyperlipidemia is a risk factor for stroke and correlated in patients with CVD.

scholarly journals The Prognostic Significance of the Preoperative Full Blood Count after Resection of Colorectal Liver Metastases

HPB Surgery ◽  
2009 ◽  
Vol 2009 ◽  
pp. 1-8 ◽  
Author(s):  
K. Dajani ◽  
D. A. O'Reilly ◽  
N. De Liguori Carino ◽  
P. Ghaneh ◽  
G. Poston ◽  
...  
Keyword(s):  
Risk Factors ◽  
Platelet Count ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Haematological Parameters ◽  
Full Blood Count ◽  
Free Survival ◽  
The Impact ◽  
Disease Free

Introduction. Increased preoperative platelet and neutrophil counts are risk factors for decreased survival in several different malignancies. Our aim was to investigate the relationship between overall or disease-free survival after resection of CRLM and the preoperative haematological parameters. Methods. We reviewed a cohort of 140 patients who underwent resection of CRLM with curative intent, utilising prospectively maintained databases. Patient demographics, operative details, FBC, CRP, INR, histopathology results, and survival data were examined. Kaplan-Meier survival and Cox regression analyses were used to determine the impact of all variables on survival. Results. 140 patients (96 males) with a median age of 67 years (range 33–82 years) underwent resection of CRLM. A significant correlation was exhibited between preoperative platelet count and neutrophil count (rho = 0.186, ). When modelled as continuous covariates in a Cox regression hazards, an increased preoperative platelet () and neutrophil counts () were significantly associated with overall survival. Of the haematological parameters assessed only preoperative platelet count showed a strong trend of association with disease free survival; however this failed to reach statistical significance (). Conclusions. Increased preoperative platelet and neutrophil counts are independent risk factors for decreased survival in patients undergoing resection of CRLM in our series of patients. These findings require validation in larger studies to determine their relationship with survival. Further research into the role of these cell types in tumour progression, particularly in the development and inhibition of angiogenesis, is warranted.

Determinants and prognostic relevance of aortic stiffness in patients with recent ST-elevation myocardial infarction

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
I Lechner ◽  
M Reindl ◽  
C Tiller ◽  
M Holzknecht ◽  
A Mayr ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Aortic Stiffness ◽  
Prognostic Significance ◽  
St Elevation Myocardial Infarction ◽  
Adjusted Analysis ◽  
St Elevation ◽  
The Impact

Abstract Background The association between aortic stiffness, cardiovascular risk factors and prognosis in patients with recent ST-elevation myocardial infarction (STEMI) is poorly understood. We analyzed the relationship between cardiovascular risk factors and arterial stiffening and assessed its prognostic significance in patients with recent STEMI. Methods We prospectively enrolled 408 consecutive patients who sustained a first STEMI and underwent primary percutaneous coronary intervention (PPCI). Aortic pulse wave velocity (PWV), a direct measure of aortic stiffness, was determined by the transit-time method using velocity-encoded, phase-contrast cardiac magnetic resonance imaging. Patient characteristics were acquired at baseline and major adverse cardiac and cerebrovascular events (MACCE) were assessed at 13 (interquartile range [IQR] 12–31) months. Cox regressionand logistic regression analysis were performed to explore predictors of PWV and MACCE. Results Median aortic PWV was 6.6 m/s (IQR 5.6–8.3m/s). In multivariable analysis, age (odds ratio [OR] 1.10, 95% confidence interval [CI], 1.08–1.14, p<0.001) and hypertension (OR 2.45, 95% CI, 1.53–3.91, p<0.001) were independently associated with increased PWV. Sex, diabetes, smoking status, dyslipidemia, and obesity were not significantly associated with PWV in adjusted analysis (all p>0.05). High PWV significantly and independently predicted occurrence of MACCE in adjusted analysis (hazard ratio [HR] 2.45, 95% CI 1.19–5.04, p=0.014). Conclusion In patients with recent STEMI, the impact of classical cardiovascular risk factors on aortic stiffness is mainly dependent on age and increased blood pressure. Increased aortic stiffness is associated with adverse clinical outcome post-STEMI, suggesting it as a relevant therapeutic target in this population. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – EU funding. Main funding source(s): Austrian Science Fund (FWF)Austrian Society of Cardiology Figure 1. Biorender.com

scholarly journals Determinants and prognostic relevance of aortic stiffness in patients with recent ST-elevation myocardial infarction

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
I Lechner ◽  
M Reindl ◽  
C Tiller ◽  
M Holzknecht ◽  
A Mayr ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Aortic Stiffness ◽  
Prognostic Significance ◽  
St Elevation Myocardial Infarction ◽  
Adjusted Analysis ◽  
St Elevation ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background The association between aortic stiffness, cardiovascular risk factors and prognosis in patients with recent ST-elevation myocardial infarction (STEMI) is poorly understood. Purpose We analyzed the relationship between cardiovascular risk factors and arterial stiffening and assessed its prognostic significance in patients with recent STEMI. Methods We prospectively enrolled 408 consecutive patients who sustained a first STEMI and underwent primary percutaneous coronary intervention (pPCI). Aortic pulse wave velocity (PWV), a direct measure of aortic stiffness, was determined by the transit-time method using velocity-encoded, phase-contrast cardiac magnetic resonance imaging. Patient characteristics were acquired at baseline and major adverse cardiac and cerebrovascular events (MACCE) were assessed at 13 (interquartile range [IQR] 12–31) months. Cox regression- and logistic regression analysis were performed to explore predictors of PWV and MACCE. Results Median aortic PWV was 6.6 m/s (IQR 5.6–8.3m/s). In multivariable analysis, age (odds ratio [OR] 1.10, 95% confidence interval [CI], 1.08–1.14, p < 0.001) and hypertension (OR 2.45, 95% CI, 1.53–3.91, p < 0.001) were independently associated with higher PWV. Gender, diabetes, smoking status, dyslipidemia, and obesity were not significantly associated with PWV in adjusted analysis (all p > 0.05). High PWV significantly and independently predicted occurrence of MACCE in adjusted analysis (hazard ratio [HR] 2.45, 95% CI 1.19–5.04, p = 0.014). Conclusion In patients with recent STEMI, the impact of classical cardiovascular risk factors on aortic stiffness is mainly dependent on age and increased blood pressure. Increased aortic stiffness is associated with adverse clinical outcome, suggesting it as a relevant therapeutic target in this population.

scholarly journals Disseminated intravascular coagulopathy in non-promyelocytic acute myeloid leukemia: Incidence, clinical and laboratory features and prognostic significance

2021 ◽  
Vol 2 (2) ◽  
pp. 99-109
Author(s):  
Mirjana Cvetković ◽  
Mirjana Mitrović
Keyword(s):  
Risk Factors ◽  
Negative Impact ◽  
Prognostic Significance ◽  
Early Death ◽  
Early Mortality ◽  
Older Age ◽  
Disseminated Intravascular Coagulopathy ◽  
Mortality Outcome ◽  
Intravascular Coagulopathy ◽  
The Impact

Introduction: Acute promyelocytic leukemia (APL) has the highest risk for overt disseminated intravascular coagulopathy (DIC), with reported incidence of DIC of up to 90%, as compared to 10-40% in other AML types. The influence of DIC on early death in non-APL AML patients has not been evaluated so far. Aim: The aim of our study was to analyze the incidence of DIC, its clinical and laboratory characteristics, and the impact on the survival and early death of patients with non-APL AML. Materials and methods: A total of 176 patients with non-APL AML, diagnosed and treated at the Clinic for Hematology of the Clinical Center of Serbia, between 2015 and 2020, were evaluated retrospectively. The diagnosis of DIC was made on the basis of ISTH (International Society on Thrombosis and Haemostasias) criteria. Results: The mean age of our patients was 53.8 ± 14.6 years, with 99/176 patients being men (56.2%). DIC was present in 74/176 patients (42.05%), who had a significant prevalence of the hemorrhagic syndrome (p = 0.01). The risk factors for overt DIC were the following: older age (p <0.01), comorbidities (p = 0.01), leukocytosis (p <0.001) and a high level of LDH (p <0.001). The FAB (French, American and British) type of non-APL AML, the cytogenetic risk group, and CD56 (cluster of differentiation) had no influence on overt DIC (p > 0.05). No difference was found in early mortality, outcome, and the survival of non-APL AML patients, with and without DIC (p > 0.05). Conclusion: Older age at diagnosis, comorbidities, leukocytosis, and high LDH concentrations are found to be adverse risk factors for overt DIC in non-APL AML patients. If treated promptly, with immediate, adequate and intensive use of blood derivates and components, DIC has no negative impact on early mortality, outcome, and survival.

scholarly journals Determinants and prognostic relevance of aortic stiffness in patients with recent ST-elevation myocardial infarction

2021 ◽  
Author(s):  
Ivan Lechner ◽  
Martin Reindl ◽  
Christina Tiller ◽  
Magdalena Holzknecht ◽  
Sarah Niederreiter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Aortic Stiffness ◽  
Prognostic Significance ◽  
St Elevation Myocardial Infarction ◽  
Adjusted Analysis ◽  
St Elevation ◽  
The Impact

AbstractThe association between aortic stiffness, cardiovascular risk factors and prognosis in patients with recent ST-elevation myocardial infarction (STEMI) is poorly understood. We analyzed the relationship between cardiovascular risk factors and arterial stiffening and assessed its prognostic significance in patients with recent STEMI. We prospectively enrolled 408 consecutive patients who sustained a first STEMI and underwent primary percutaneous coronary intervention (PPCI). Aortic pulse wave velocity (PWV), the most widely used measure of aortic stiffness, was determined by the transit-time method using velocity-encoded, phase-contrast cardiac magnetic resonance imaging. Patient characteristics were acquired at baseline and major adverse cardiac and cerebrovascular events (MACCE) were assessed at 13 [interquartile range (IQR) 12–31] months. Cox regression- and logistic regression analysis were performed to explore predictors of aortic stiffness and MACCE. Median aortic PWV was 6.6 m/s (IQR 5.6–8.3 m/s). In multivariable analysis, age [odds ratio (OR) 1.10, 95% confidence interval (CI), 1.08–1.14, p < 0.001] and hypertension (OR 2.45, 95% CI, 1.53–3.91, p < 0.001) were independently associated with increased PWV. Sex, diabetes, smoking status, dyslipidemia, and obesity were not significantly associated with PWV in adjusted analysis (all p > 0.05). High PWV significantly and independently predicted occurrence of MACCE in adjusted analysis [hazard ratio (HR) 2.45, 95% CI 1.19–5.04, p = 0.014]. In patients with recent STEMI, the impact of classical cardiovascular risk factors on aortic stiffness is mainly dependent on age and increased blood pressure. Increased aortic stiffness is associated with adverse clinical outcome post-STEMI, suggesting it as a relevant therapeutic target in this population. Trial (NCT04113356).

scholarly journals PREVALENCE AND FORECASTING OF ALIMENTARY RISK FACTORS AMONG PATIENTS WITH MYOCARDIAL INFARCTION

2019 ◽  
Vol 98 (8) ◽  
pp. 873-877
Author(s):  
A. V. Ivanenko ◽  
R. S. Goloschapov-Aksenov ◽  
Dmitry I. Kicha
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Prognostic Significance ◽  
Nutritional Risk ◽  
Control Group ◽  
Preventive Actions ◽  
High Incidence ◽  
Frequent Consumption ◽  
Specific Factors ◽  
And Control

Introduction. The high incidence of myocardial infarction (MI) in the population is largely determined by the significant prevalence of risk factors, including alimentaryones. Risk factors for MI are widely studied, however, forecasts of outcomes of MIare not associated with the prognostic significance of specific factors. Estimates have shown the prognostic significance of priority risk factors for myocardial infarction to remain virtually unexplored. Material and research methods. The object of the study was MI patients treated in hospital. The volume of the study was 162 MI patients (main group) and 140 practically healthy individuals (control group). The subject of the study was the calculation of prognostic coefficients (according to a special formula) based on the analysis of nutritional risk factors for myocardial infarction and an assessment of their prognosticity and prevalence. The sociological method-questioning of patients was applied. Results. The frequent consumption of salty and fatty foods, butter, a large amount of carbohydrate products, the presence of 2nd and 3rd degree obesity patients were establish to have the greatest prognostic value in MI patients. Monitoring highly predictive nutritional risk factors for MI allows identifying the priority preventive impacts, which, in addition, will not be passive, but active. The methodology for predicting the degree of risk of nutritional factors is confirmed in the context of comparative studies of experience and control groups. Conclusion. The identification of these nutritional risk factors in a patient visited the polyclinic allows attributing it to a risk group for the development of myocardial infarction with subsequent targeted laboratory and instrumental examination and registration with the dispensary. Assessment of the prevalence and prognostic significance of nutritional risk factors among MI patients provides opportunities for early detection of health abnormalities and the development of preventive actions.

Clinical and Seasonal Variations of Nutritional Risk Screening in Patients Scheduled for Rehabilitation after Heart Surgery

2013 ◽  
Vol 16 (6) ◽  
pp. 336
Author(s):  
Marko Boban ◽  
Viktor Persic ◽  
Zeljko Jovanovic ◽  
Niksa Drinkovic ◽  
Milan Milosevic ◽  
...  
Keyword(s):  
Weight Loss ◽  
Heart Surgery ◽  
Nutritional Risk ◽  
Risk Scores ◽  
Risk Screening ◽  
Climate Effects ◽  
Seasonal Climate ◽  
Nrs 2002 ◽  
The Impact ◽  
Nutritional Risk Screening

<p><b>Background:</b> Current knowledge on the pervasiveness of increased nutritional risk in cardiovascular diseases is limited. Our aim was to analyze the characteristics of nutritional risk screening in patients scheduled for rehabilitation after heart surgery. Prevalence and extent of nutritional risk were studied in connection with patients' characteristics and seasonal climate effects on weight loss dynamics.</p><p><b>Methods:</b> The cohort included 65 consecutive patients with an age range of 25-84 years, 2-6 months after surgical treatment for ischemic or valvular heart disease. Nutritional risk screening was appraised using a standardized NRS-2002 questionnaire. Groups were analyzed according to a timeline of rehabilitation according to the "cold" and "warm" seasons of the moderate Mediterranean climate in Opatija, Croatia.</p><p><b>Results:</b> Increased nutritional risk scores (NRS-2002) of >3 were found in 96% of studied patients. Mean NRS-2002 of patients was 5.0 � 1.0, with a percentage weight loss history of 11.7% � 2.2% (4.6-19.0). Risk was found to be more pronounced during the warmer season, with NRS-2002 scores of 5.3 � 0.7 versus 4.8 � 1.1 (<i>P</i> = 0.136) and greater loss of weight of 13.0% � 3.2% versus 10.6% � 3% (<i>P</i> = 0.005), respectively. Increased nutritional risk correlated significantly with creatinine concentrations (rho = 0.359; <i>P</i> = 0.034 versus 0.584; <i>P</i> = 0.001, respectively). Significant discordance in correlations was found between NRS-2002 and the decrease in left ventricle systolic function (rho correlation coefficient [rho-cc] = -0.428; <i>P</i> = 0.009), the increase in glucose concentrations (cc = 0.600; <i>P</i> < 0.001), and the decrease in erythrocyte counts (cc = -0.520; <i>P</i> = 0.001) during the colder season.</p><p><b>Conclusion:</b> Increased nutritional risk was found to be frequently expressed in the course of rehabilitation after heart surgery. Although seasonal climate effects influenced the weight loss dynamics, the impact on reproducibility of NRS-2002 was clinically less important. Further studies on the connection of nutritional risk with composited end points might offer improvements in overall quality of treatment.</p>

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