321 Is Serum Bicarbonate Level Associated With Adverse Outcomes in Paediatric Patients?: A Retrospective Cohort Study

2015 ◽  
Vol 66 (4) ◽  
pp. S116
Author(s):  
D.G. Mainprize ◽  
N. Poonai ◽  
C. Travers ◽  
L. Wong ◽  
T. Tryphonopoulos ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Adverse Outcomes ◽  
Bicarbonate Level ◽  
Serum Bicarbonate ◽  
Paediatric Patients ◽  
Serum Bicarbonate Level

scholarly journals Factors associated with the time to return negative RT-PCR from COVID-19 in paediatric patients: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e052609
Author(s):  
Jianbo Shao ◽  
Hong Xu ◽  
Zhixi Liu ◽  
Xiaohua Ying ◽  
Hua Xu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Outcome Measures ◽  
Clinical Features ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Antiviral Drugs ◽  
Secondary Outcome ◽  
Rt Pcr ◽  
Factors Associated ◽  
Paediatric Patients

ObjectiveThis study aimed to describe the epidemiological and clinical features and potential factors related to the time to return negative reverse transcriptase (RT)-PCR in discharged paediatric patients with COVID-19.DesignRetrospective cohort study.SettingUnscheduled admissions to 12 tertiary hospitals in China.ParticipantsTwo hundred and thirty-three clinical charts of paediatric patients with confirmed diagnosis of COVID-19 admitted from 1 January 2020 to 17 April 2020.Primary and secondary outcome measuresPrimary outcome measures: factors associated with the time to return negative RT-PCR from COVID-19 in paediatric patients. Secondary outcome measures: epidemiological and clinical features and laboratory results in paediatric patients.ResultsThe median age of patients in our cohort was 7.50 (IQR: 2.92–12.17) years, and 133 (57.1%) patients were male. 42 (18.0%) patients were evaluated as asymptomatic, while 162 (69.5%) and 25 (10.7%) patients were classified as mild or moderate, respectively. In Cox regression analysis, longer time to negative RT-PCR was associated with the presence of confirmed infection in family members (HR (95% CI): 0.56 (0.41 to 0.79)). Paediatric patients with emesis symptom had a longer time to return negative (HR (95% CI): 0.33 (0.14 to 0.78)). During hospitalisation, the use of traditional Chinese medicine (TCM) and antiviral drugs at the same time is less conducive to return negative than antiviral drugs alone (HR (95% CI): 0.85 (0.64 to 1.13)).ConclusionsThe mode of transmission might be a critical factor determining the disease severity of COVID-19. Patients with emesis symptom, complications or confirmed infection in family members may have longer healing time than others. However, there were no significant favourable effects from TCM when the patients have received antiviral treatment.

scholarly journals Iron deficiency in 78 805 people admitted with heart failure across England: a retrospective cohort study

Open Heart ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e001153 ◽  
Author(s):  
James M Beattie ◽  
Rani Khatib ◽  
Ceri J Phillips ◽  
Simon G Williams
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Iron Deficiency ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Primary Diagnosis ◽  
Adverse Outcomes ◽  
Health Economy ◽  
Inpatient Mortality ◽  
Readmission Rates

ObjectivesIron deficiency (ID), with or without anaemia (IDA), is an important comorbidity in people with chronic heart failure (HF), but the prevalence and significance in those admitted with HF is uncertain. We assessed the prevalence of ID or IDA in adults (age ≥21 years) hospitalised with a primary diagnosis of HF, and examined key metrics associated with these secondary diagnoses.MethodsA retrospective cohort study of Hospital Episode Statistics describing all adults admitted to National Health Service (NHS) hospitals across England from April 2015 through March 2016 with primary diagnostic discharge coding as HF, with or without subsidiary coding for ID/IDA.Results78 805 adults were admitted to 177 NHS hospitals with primary coding as HF: 26 530 (33.7%) with secondary coding for ID/IDA, and 52 275 (66.3%) without. Proportionately more patients coded ID/IDA were admitted as emergencies (94.8% vs 87.6%; p<0.0001). Tending to be older and female, they required a longer length of stay (15.8 vs 12.2 days; p<0.0001), with higher per capita costs (£3623 vs £2918; p<0.0001), the cumulative excess expenditure being £21.5 million. HF-related (8.2% vs 5.2%; p<0.0001) and all-cause readmission rates (25.8% vs 17.7%; p<0.05) at ≤30 days were greater in those with ID/IDA against those without, and they manifested a small but statistically significant increased inpatient mortality (13.5% v 12.9%; p=0.009).ConclusionsFor adults admitted to hospitals in England, principally with acute HF, ID/IDA are significant comorbidities and associated with adverse outcomes, both for affected individuals, and the health economy.

Trauma and Pregnancy: Is Flow Cytometry Detection and Quantification of Fetal Red Blood Cells Useful? A Retrospective Cohort Study.

2021 ◽  
Author(s):  
Misgav Rottenstreich ◽  
Reut Meir ◽  
Itamar Glick ◽  
Heli Alexandrony ◽  
Alon D Schwarz ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
Cohort Study ◽  
Red Blood Cells ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Blood Cells ◽  
Retrospective Cohort ◽  
Neonatal Outcome ◽  
Adverse Outcomes ◽  
Minor Trauma

Abstract Purpose: To assess whether positive flow cytometry quantification of fetal red blood cells is associated with adverse outcomes in cases of trauma during pregnancy.Methods: A retrospective cohort study, at a single tertiary center between 2013 and 2019. All pregnant women with viable gestation involved in trauma who underwent flow cytometry were included. Flow cytometry was considered positive (≥0.03/≥30 ml). Composite adverse maternal and neonatal outcomes were compared between cases with positive and negative flow cytometry test. Univariate and multivariate logistic regression analysis were performed to assess the role of flow cytometry in predicting adverse outcomes. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated.Results: During the study 1023 women met inclusion and exclusion criteria. The mechanisms of injury were motor vehicle accident in 387 women (38%), falls in 367 (36%), direct abdominal trauma in 353 (35%) and in 14 women (1%) other mechanism of injury. Among the cohort, 119 women (11.6%) had positive flow cytometry (≥0.03/≥30 ml) with median result of 0.03 [0.03-0.04], while 904 women (88.4%) had negative flow cytometry test result (≤0.03/≤30 ml) with median result of 0.01 [0.01-0.02]. Composite adverse outcome occurred in 8% of the women, with no difference in the groups with vs. without positive flow cytometry (4.2% vs. 8.5%; p=0.1). Positive flow cytometry was not associated with any adverse maternal or neonatal outcome. This was confirmed on a multivariate analysis. Conclusions: Flow cytometry result is not related to adverse maternal and fetal/neonatal outcome of women involved in minor trauma during pregnancy. We suggest that flow cytometry should not be routinely assessed in pregnant women involved in minor trauma.

scholarly journals Nonsteroidal anti-inflammatory drug choice and adverse outcomes in clopidogrel users: A retrospective cohort study

PLoS ONE ◽  
2018 ◽  
Vol 13 (3) ◽  
pp. e0193800 ◽  
Author(s):  
Young Hee Nam ◽  
Colleen M. Brensinger ◽  
Warren B. Bilker ◽  
Charles E. Leonard ◽  
Scott E. Kasner ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Adverse Outcomes ◽  
Inflammatory Drug ◽  
Drug Choice ◽  
Anti Inflammatory

scholarly journals Adverse Outcomes After Noncardiac Surgery in Patients With Diabetes: A nationwide population-based retrospective cohort study

Diabetes Care ◽  
2013 ◽  
Vol 36 (10) ◽  
pp. 3216-3221 ◽  
Author(s):  
C.-C. Yeh ◽  
C.-C. Liao ◽  
Y.-C. Chang ◽  
L.-B. Jeng ◽  
H.-R. Yang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Population Based ◽  
Noncardiac Surgery ◽  
Adverse Outcomes ◽  
Patients With Diabetes

scholarly journals Association between primary care physician diagnostic knowledge and death, hospitalisation and emergency department visits following an outpatient visit at risk for diagnostic error: a retrospective cohort study using medicare claims

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041817
Author(s):  
Bradley M Gray ◽  
Jonathan L Vandergrift ◽  
Rozalina G McCoy ◽  
Rebecca S Lipner ◽  
Bruce E Landon
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Emergency Department ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Diagnostic Errors ◽  
Diagnostic Error ◽  
Adverse Outcomes ◽  
Ed Visits

ObjectiveDiagnostic error is a key healthcare concern and can result in substantial morbidity and mortality. Yet no study has investigated the relationship between adverse outcomes resulting from diagnostic errors and one potentially large contributor to these errors: deficiencies in diagnostic knowledge. Our objective was to measure that associations between diagnostic knowledge and adverse outcomes after visits to primary care physicians that were at risk for diagnostic errors.Setting/participants1410 US general internists who recently took their American Board of Internal Medicine Maintenance of Certification (ABIM-IM-MOC) exam treating 42 407 Medicare beneficiaries who experienced 48 632 ‘index’ outpatient visits for new problems at risk for diagnostic error because the presenting problem (eg, dizziness) was related to prespecified diagnostic error sensitive conditions (eg, stroke).Outcome measures90-day risk of all-cause death, and, for outcome conditions related to the index visits diagnosis, emergency department (ED) visits and hospitalisations.DesignUsing retrospective cohort study design, we related physician performance on ABIM-IM-MOC diagnostic exam questions to patient outcomes during the 90-day period following an index visit at risk for diagnostic error after controlling for practice characteristics, patient sociodemographic and baseline clinical characteristics.ResultsRates of 90-day adverse outcomes per 1000 index visits were 7 for death, 11 for hospitalisations and 14 for ED visits. Being seen by a physician in the top versus bottom third of diagnostic knowledge during an index visit for a new problem at risk for diagnostic error was associated with 2.9 fewer all-cause deaths (95% CI −5.0 to −0.7, p=0.008), 4.1 fewer hospitalisations (95% CI −6.9 to −1.2, p=0.006) and 4.9 fewer ED visits (95% CI −8.1% to −1.6%, p=0.003) per 1000 visits.ConclusionHigher diagnostic knowledge was associated with lower risk of adverse outcomes after visits for problems at heightened risk for diagnostic error.

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