scholarly journals Risk of death in individuals hospitalized for COVID-19 with and without psychiatric disorders: an observational multicenter study in France

2022 ◽  
Author(s):  
Nicolas Hoertel ◽  
Marina Sánchez-Rico ◽  
Pedro de la Muela ◽  
Miriam Abellán ◽  
Carlos Blanco ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Multicenter Study ◽  
Risk Of Death

OVERVIEW OF THE BRAZILIAN OUTCOMES FROM FIRST MULTICENTRIC STUDY WITH USE FROM DATABASE CIBMTR. A PILOT STUDY.

JBMTCT ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. 55-62
Author(s):  
Cinthya Corrêa Da Silva ◽  
Leonardo Javier Arcuri ◽  
Anderson João Simione ◽  
Heliz Regina Alves Das Neves ◽  
Bruna Letícia Da Silva Santos Geraldo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pilot Study ◽  
Multicenter Study ◽  
Multicenter Studies ◽  
Acute Leukemias ◽  
Multicentric Study ◽  
Risk Of Death ◽  
Novel Drugs ◽  
Matched Sibling ◽  
Related Donor

To better understand the outcomes of HSCT in Brazil, we conducted a multicenter study using the CIBMTR database. Seven participating centers extracted their own data through the Data Back to Center tool. Main indications for HSCT-auto were MM(51%), NHL(18%) and HL(17%); Allogeneic, AML(24%), ALL(23%) and SAA(15%). For acute leukemias, risk of death was higher in the 18-40 years group (HR=1.18,p=0.022), 40-60(HR=1.19,p<0.001) and 60+(HR=1.39,p=0.007), compared with 0-18 years, in ALL (HR=1.05,p <0.001, compared with AML) and with partially-matched related donor (HR=1.59,p= 0.003, compared with matched sibling), while URD was not. HSCT in CR2+(HR=1.28,p=0.01) and relapse (HR=2.44,p< 0.001) were risk factors for death. 49%(95CI:44-52)52%(95CI:43-62)45%(95CI:39-51) and 55%(95CI:49-63), somewhat poorer than the CIBMTR: 62 and 70%, respectively.  Limited access to novel drugs for most centers and lack of molecular risk information are possible explanations for these differences. Further studies are necessary to better evaluate our findings and the DBtC tool enables multicenter studies.

Employment Outcomes After Vocational Training for People With Chronic Psychiatric Disorders: A Multicenter Study

2018 ◽  
Vol 72 (5) ◽  
pp. 7205195010p1 ◽  
Author(s):  
Hui-Ling Lee ◽  
Eric J. Hwang ◽  
Shang-Liang Wu ◽  
Wei-Mo Tu ◽  
Ming Hung Wang ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Multicenter Study ◽  
Vocational Training ◽  
Employment Outcomes

scholarly journals FRI0605-HPR MORTALITY AND SURVIVAL IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS IN ARGENTINA. A MULTICENTER STUDY ON BEHALF GESAR-LES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 908.2-908
Author(s):  
M. C. Bertolaccini ◽  
Y. Soria Curi ◽  
L. Gonzalez Lucero ◽  
G. V. Espasa ◽  
A. L. Barbaglia ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Multicenter Study ◽  
Lupus Erythematosus ◽  
Causes Of Death ◽  
Cox Regression ◽  
Renal Involvement ◽  
Systemic Lupus ◽  
Evolution Time ◽  
Risk Of Death ◽  
The Mean

Background:The mortality rate in patients with systemic lupus erythematosus (SLE) is 2–3 times higher than in the general population. However, survival in these patients has improved significantly and is currently 95% at 5 years according to different studies. Since the last 20 years, there are no new reports on this issue in Argentina.Objectives:To analyze the factors associated with mortality, survival and causes of death in patients with SLE.Methods:Longitudinal - multicenter study, in which 10 rheumatology centers of Argentina participated. Patients with SLE (ACR 1997 and / or SLICC 2012 criteria) with a minimum follow-up of 6 months monitored between January 2008 and December 2018 were included. Demographic, clinical, laboratory, therapeutic variables (treatments received during the evolution of the disease and within 60 days prior to death or last control); mortality, causes of death and survival at 5, 10 and 20 years were evaluated. Statistical analysis: descriptive statistics, Kaplan-Meier survival curves and Cox regression model.Results:Three hundred and eighty two patients were included; 90% women and 82% mestizos. The mean of evolution time of SLE was 4.1 ± 6.7 years. The mean age at the last control or death was 37.2 ± 12.7 years, SLEDAI 3.2 ± 4.2 and SLICC 1.2 ± 1.9.Mortality was 12% (95% CI [8-15]) and the causes of death were: Infections (27), cardiovascular disease (6), SLE activity (3), catastrophic antiphospholipid syndrome (2) and other causes (8). Using the variables associated with mortality in different Cox regression models, the variables that increased the risk of death significantly were: renal involvement (RR 3.3), cardiac involvement (RR 2.7), central nervous system involvement (RR 2.1), arterial thrombosis (RR 2.3), hyperlipemia (RR 2.4), number of infections (RR 1.2) and last SLEDAI (1.1).The time of HCQ use greater than 36 months decreased the risk of death in this cohort by 40% (p 0.03). Prednisone (maximum dose and time) was not associated with mortality (p NS). When analyzing the last treatment and adjusting it for final SLEDAI, HCQ was a mortality protection factor (RR 0.4) while the use of cyclophosphamide alone or associated with prednisone was a risk factor for death (RR 5.2).Significant differences were found when analyzing the causes of death according to the SLE evolution time (p 0.017): patients who died from infection had less evolution time (Me 2.25 years), than those who died due to cardiovascular causes (Me 10 years) or SLE activity (Me 15 years). In this cohort of patients, survival was 93% at 5 years, 88% at 10 years and 72% at 20 years.Conclusion:Mortality in this series of patients was 12% and infection was the leading cause of death. The use of HCQ for a period greater than 36 months, decreased the risk of death 40%.Disclosure of Interests:None declared

scholarly journals Lifetime experience of multiple common mental disorders and 19-year mortality: results from a Canadian population-based cohort

2019 ◽  
Vol 29 ◽  
Author(s):  
M. Kingsbury ◽  
E. Sucha ◽  
N. J. Horton ◽  
H. Sampasa-Kanyinga ◽  
J. M. Murphy ◽  
...  
Keyword(s):  
Major Depression ◽  
Alcohol Use ◽  
Mental Disorders ◽  
Panic Disorder ◽  
Psychiatric Disorders ◽  
Alcohol Use Disorders ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
The Impact

Abstract Aims To examine the impact of multiple psychiatric disorders over the lifetime on risk of mortality in the general population. Methods Data came from a random community-based sample of 1397 adults in Atlantic Canada, recruited in 1992. Major depression, dysthymia, panic disorder, generalised anxiety disorder and alcohol use disorders were assessed using the Diagnostic Interview Schedule (DIS). Vital status of participants through 2011 was determined using probabilistic linkages to the Canadian Mortality Database. Cox proportional hazard models with age at study entry as the time scale were used to investigate the relationship between DIS diagnoses and mortality, adjusted for participant education, smoking and obesity at baseline. Results Results suggested that mood and anxiety disorders rarely presented in isolation – the majority of participants experienced multiple psychiatric disorders over the lifetime. Elevated risk of death was found among men with both major depression and dysthymia (HR 2.56; 95% CI 1.12–5.89), depression and alcohol use disorders (HR 2.45; 95% CI 1.18–5.10) and among men and women who experienced both panic disorder and alcohol use disorders (HR 3.80; 95% CI 1.19–12.16). Conclusion The experience of multiple mental disorders over the lifetime is extremely common, and associated with increased risk of mortality, most notably among men. Clinicians should be aware of the importance of considering contemporaneous symptoms of multiple psychiatric conditions.

scholarly journals A Multicenter Study on the Prevalence of Psychiatric Disorders among New Referrals for Epilepsy in Japan

Epilepsia ◽  
2003 ◽  
Vol 44 (1) ◽  
pp. 107-114 ◽  
Author(s):  
Masato Matsuura ◽  
Yasunori Oana ◽  
Masaaki Kato ◽  
Akinori Kawana ◽  
Rumiko Kan ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Multicenter Study

scholarly journals Previous psychiatric disorders and antipsychotic drugs in COVID-19 patients: early findings on possible worse outcome

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M Scarpone ◽  
M Bergami ◽  
E Cenko ◽  
R Bugiardini ◽  
E Poluzzi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Angiotensin Converting Enzyme ◽  
Psychiatric Disorders ◽  
Antipsychotic Drugs ◽  
Adverse Outcomes ◽  
Therapeutic Management ◽  
Hospital Death ◽  
Converting Enzyme ◽  
Risk Of Death ◽  
Prior Use

Abstract Background There are a range of traditional risk factors for COVID-19, but it is not well established if there are also psychiatric related risk factors. These factors could increase angiotensin-converting enzyme 2 expression and potentiate COVID-19 cell entry. Purpose We aimed to assess if psychiatric disorders and antipsychotic treatments represent risk factors for COVID-19 worst outcomes. Methods We describe the demographics, symptoms, therapeutic management, and survival outcomes of COVID-19 in the population who were admitted in a single academic hospital in Northern Italy between March 1 and June 30, 2020. Patients were determined to have COVID-19 if they had a positive SARS-CoV-19 swab. We used logistic regression analyses to control for confounding by concomitant risk factors for COVID-19 and for therapeutic management of comorbidities including psychiatric disorders and antipsychotic related drugs. Results Among 609 patients, in-hospital death occurred in 120 (19.7%). A psychiatric disorder in the previous years was overrepresented (p&lt;0.0001) in non-survivors (35.5%) in comparison with survivors (22.1%). Age and a history of hypertension were as well, established (p&lt;0.005) risk factors for COVID-19 adverse outcomes: 80.6±11.4 vs 68±17.4 years and 70% vs 52% of people with hypertension in non-survivors vs survivors. Various pre-existing conditions were also associated (p&lt;0.001) with increased risk of death, such as stroke or transient ischemic attacks, chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD) (20% vs 8%, 35% vs 17%, and 24% vs 10%, respectively). We did not observe that prior use of angiotensin converting enzyme inhibitors or angiotensin receptor blockers were more prevalent in non-survivors compared with survivors. On the opposite, prior use of aspirin, P2Y receptor antagonists, and antipsychotic drugs was more common (p&lt;0.001) in non-survivors compared with their counterparts (36% vs 21%, 12% vs 5%, and 28% vs 10%, respectively). After multivariable adjustment, use of antipsychotic drugs was associated with higher risks of in-hospital death (OR: 2.27; 95% CI, 1.17–4.4). Other independent predictors of death were older age (OR: 2.8; 95% CI, 1.69–4.63), CKD (OR: 2.2; 95% CI, 1.21–4.03) and COPD (OR: 2.04; 95% CI, 1.22–3.42). Conclusions Antipsychotic drugs might be an independent risk factor for COVID-19 adverse outcomes. Although preliminary, our findings have implications for clinical services as they provide crucial information for understanding who is at greatest risk for COVID-19. FUNDunding Acknowledgement Type of funding sources: None.

Efficacy of deep sedation for patients with intractable electrical storm refractory to anti-arrhythmic drugs

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Martins ◽  
J.M Urien ◽  
N Barbarot ◽  
J.M Sellal ◽  
N Clementy ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Positive Impact ◽  
Deep Sedation ◽  
Therapeutic Option ◽  
Clinical Signs ◽  
Electrical Storm ◽  
Risk Of Death ◽  
Hospital Survival ◽  
Acute Response ◽  
And Control

Abstract Background Sympathetic overactivity is implicated in the initiation and maintenance of electrical storm (ES). Deep sedation has empirically been considered as an efficient therapeutic option to blunt sympathetic tone and control ES. Purpose The aim of this multicenter study was to determine the efficacy of deep sedation in patients presenting intractable ES refractory to anti-arrhythmic drugs. Methods Patients requiring deep sedation for refractory ES from January 1st 2007 to July 31st 2018 were retrospectively included in 13 centers. The primary endpoint was the rate of acute response to sedation, defined as ES termination within 15 minutes after deep sedation. Results Among the 116 patients, 55 (47.4%) had ES termination within 15 minutes and were considered “acute responders” to deep sedation. Clinical signs of congestive heart failure before deep sedation (OR=3.31, 95% CI:1.001–10.97, p=0.049) was the only independent predictor of non-acute response. Twenty-one non-acute responders (34.4%) had an extracorporeal membrane oxygenation (ECMO) implanted. Non-acute responders had a significantly lower in-hospital survival (Log-rank, p=0.010). ECMO implantation did not influence survival in non-acute responders to sedation. Acute response to deep sedation was an independent protector of in-hospital mortality, decreasing by 73% the risk of death (OR 0.27; 95% CI:0.10–0.70, p=0.008). Conclusion To the best of our knowledge, this multicenter study is the first analysis of the efficacy of deep sedation in patients with intractable ES refractory to anti-arrhythmic drugs, and demonstrating the positive impact of “acute response” on in-hospital survival. Funding Acknowledgement Type of funding source: None

What's in a model? Network models as tools instead of representations of what psychiatric disorders really are

2019 ◽  
Vol 42 ◽  
Author(s):  
Hanna M. van Loo ◽  
Jan-Willem Romeijn
Keyword(s):  
Psychiatric Disorders ◽  
Network Models ◽  
Model Network

AbstractNetwork models block reductionism about psychiatric disorders only if models are interpreted in a realist manner – that is, taken to represent “what psychiatric disorders really are.” A flexible and more instrumentalist view of models is needed to improve our understanding of the heterogeneity and multifactorial character of psychiatric disorders.

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