scholarly journals PREEXISTING CHRONIC LIVER DISEASE AS AN INDEPENDENT RISK FACTOR REINTUBATION IN MECHANICALLY VENTILATED PATIENTS

CHEST Journal ◽  
2020 ◽  
Vol 158 (4) ◽  
pp. A611
Author(s):  
Muhammad Sameed ◽  
Muhammad Waleed ◽  
Jennie Zhang
Keyword(s):  
Risk Factor ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Independent Risk Factor ◽  
Chronic Liver ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilated Patients

scholarly journals Dual Effects of Large Spleen Volume After Splenectomy for the Patients With Chronic Liver Disease

2019 ◽  
Vol 104 (9-10) ◽  
pp. 412-422
Author(s):  
Akitoshi Matsuda ◽  
Naohisa Kuriyama ◽  
Shugo Mizuno ◽  
Masanobu Usui ◽  
Hiroyuki Sakurai ◽  
...  
Keyword(s):  
Risk Factor ◽  
Liver Disease ◽  
Liver Function ◽  
Chronic Liver Disease ◽  
Independent Risk Factor ◽  
Splenic Vein ◽  
Chronic Liver ◽  
Spleen Volume ◽  
Significant Independent Risk Factor ◽  
Volume Group

Background After splenectomy in patients with chronic liver disease, a large spleen was reported to be not only a risk factor of portal/splenic vein thrombosis (PSVT), but also a prediction for favorable improvement of liver function. This study aimed to evaluate the risk of PSVT and the improvement of liver function after splenectomy, with special attention to spleen volume (SV). Methods This studied included 50 patients who underwent splenectomy with diagnosed chronic liver disease between January 2005 and December 2017. After evaluation of risk factors for PSVT the cut-off value of SV for predicting PSVT was determined. According to the cut-off value of SV, 50 patients were divided into 2 groups: small-volume group (SVG) and large-volume group (LVG). Postoperative liver functions were compared between the 2 groups. Results Twenty-eight patients developed PSVT. Larger SV was the most significant independent risk factor for PSVT. The cut-off value of SV was 520 mL. Preoperatively, LVG had significantly higher total bilirubin, and MELD (model for end-stage liver disease) score, and had significantly higher rates of pancytopenia than SVG. Postoperatively, compared to SVG, platelet count, choline esterase, and total cholesterol in LVG were significantly increased. Conclusion After splenectomy in the patients with chronic liver disease, large SV is an independent risk factor for PSVT, with a clear benefit in improving liver function, if PSVT is properly diagnosed and managed.

The impact of diabetes on HCC.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4029-4029
Author(s):  
Suzanne Graef ◽  
Sarah Berhane ◽  
Mabel Joey Teng ◽  
Anna Skowronska ◽  
Philip James Johnson
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Independent Risk Factor ◽  
Chronic Liver ◽  
Diabetic Patients ◽  
Alcoholic Fatty Liver ◽  
Treatment Of Diabetes ◽  
The Impact

4029 Background: The incidence of hepatocellular carcinoma (HCC) in the UK has increased by 40% over the last 20 years, with a corresponding increase in mortality rate. The rising incidence of obesity and type II diabetes are believed to be contributing factors due to the association with non-alcoholic fatty liver and steatohepatitis. We aimed to examine if diabetes was as an independent risk factor for the development of HCC and to assess the impact of diabetes on overall survival (OS). Methods: Data from 724 patients with HCC and a control group comprising 340 patients with chronic liver disease were collected prospectively between 2007 and 2012. The odds ratio (OR) for HCC in diabetic versus non-diabetic patients was calculated. Univariate and multivariate analysis was performed using logistic regression. Cox proportional hazards analysis was used to estimate hazard ratio (HR) for death for HCC patients, with and without diabetes and for the impact of variation in diabetic treatments. Results: The prevalence of diabetes was 39% within the HCC population and 10.3% within the chronic liver disease group. Univariate analysis demonstrated increased risk of HCC associated with age, sex, diabetes, haemochromatosis, cirrhosis, alcohol abuse and Child’s score. In patients with diabetes OR for HCC was 5.74 (CI 3.9-8.3; p<0.001). Age, sex, cirrhosis, Child’s score, diabetes and diabetes treatment with insulin, retained significance as independent risk factors in multivariate analysis. There was no survival difference for HCC patients with and without diabetes. In diabetic patients with HCC, treatment of diabetes with metformin, compared against other diabetic treatment options, was associated with a significantly longer OS (31 versus 24 months, p = 0.016; HR 0.74, p = 0.027). Conclusions: This study has demonstrated that diabetes is an independent risk factor for the development of HCC in a high risk population and that treatment with insulin appears to confer further independent risk. Diabetes has no effect on survival following the development of HCC but treatment of diabetes with metformin is associated with prolonged survival. In considering the optimal treatment for diabetes in chronic liver disease the beneficial effects of metformin on OS, if HCC develops, should be taken into account.

388: CHRONIC LIVER DISEASE AN INDEPENDENT RISK FACTOR FOR PNEUMONIA SEVERITY AND MORBIDITY

2020 ◽  
Vol 48 (1) ◽  
pp. 176-176
Author(s):  
Muhammad Sameed ◽  
Minahil Tariq ◽  
Muhammad Waleed ◽  
Tariq Mahmood
Keyword(s):  
Risk Factor ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Independent Risk Factor ◽  
Chronic Liver ◽  
Pneumonia Severity

Lorazepam Is an Independent Risk Factor for Transitioning to Delirium in Intensive Care Unit Patients

2006 ◽  
Vol 104 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Pratik Pandharipande ◽  
Ayumi Shintani ◽  
Josh Peterson ◽  
Brenda Truman Pun ◽  
Grant R. Wilkinson ◽  
...  
Keyword(s):  
Risk Factor ◽  
Odds Ratio ◽  
Independent Risk Factor ◽  
A Priori ◽  
Dose Administration ◽  
P Values ◽  
Mechanically Ventilated ◽  
Analgesic Dose ◽  
Ventilated Patients ◽  
Relevant Covariates

Background Delirium has recently been shown as a predictor of death, increased cost, and longer duration of stay in ventilated patients. Sedative and analgesic medications relieve anxiety and pain but may contribute to patients' transitioning into delirium. Methods In this cohort study, the authors designed a priori an investigation to determine whether sedative and analgesic medications independently increased the probability of daily transition to delirium. Markov regression modeling (adjusting for 11 covariates) was used in the evaluation of 198 mechanically ventilated patients to determine the probability of daily transition to delirium as a function of sedative and analgesic dose administration during the previous 24 h. Results Lorazepam was an independent risk factor for daily transition to delirium (odds ratio, 1.2 [95% confidence interval, 1.1-1.4]; P = 0.003), whereas fentanyl, morphine, and propofol were associated with higher but not statistically significant odds ratios. Increasing age and Acute Physiology and Chronic Health Evaluation II scores were also independent predictors of transitioning to delirium (multivariable P values &lt; 0.05). Conclusions Lorazepam administration is an important and potentially modifiable risk factor for transitioning into delirium even after adjusting for relevant covariates.

scholarly journals Obesity Is the Most Common Risk Factor for Chronic Liver Disease

2019 ◽  
Vol 114 (11) ◽  
pp. 1744-1752 ◽  
Author(s):  
Rebecca Harris ◽  
Timothy R. Card ◽  
Toby Delahooke ◽  
Guruprasad P. Aithal ◽  
Indra N. Guha
Keyword(s):  
Risk Factor ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Common Risk Factor

scholarly journals The Risk Factors for Weaning Failure of Mechanically Ventilated Patients With COVID-19: A Retrospective Study in National Medical Team Work

2021 ◽  
Vol 8 ◽  
Author(s):  
Hua Zhao ◽  
Longxiang Su ◽  
Xin Ding ◽  
Huan Chen ◽  
Hongmin Zhang ◽  
...  
Keyword(s):  
Risk Factor ◽  
Protective Factors ◽  
Respiratory Mechanics ◽  
Team Work ◽  
Medical Team ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
National Medical ◽  
Weaning Failure ◽  
Ventilated Patients

Purpose: This study aimed to describe the clinical and laboratory characteristics and the parameters of the respiratory mechanics of mechanically ventilated patients with confirmed COVID-19 pneumonia and to clarify the risk or protective factors for weaning failure.Methods: Patients diagnosed with COVID-19 pneumonia were selected from the special intensive care unit (ICU) of the Sino-French New City Branch of Tong Ji Hospital, Wuhan, and treated by the National Medical Team Work. They were divided into successful weaning (SW) group (N = 15) and unsuccessful weaning (USW) group (N = 18) according to the prognosis. Information of these patients was analyzed.Results: There were 33 patients included in this study. Patients in the USW group were associated with a poor outcome; the 28-day mortality rate was higher than in the SW group (86.7 vs. 16.7% p &lt; 0.001). By comparison, we found that the initial plateau pressure (Pplat) and driving pressure (DP) of the USW group were higher and that compliance was lower than that of the SW group, but there was no difference between positive end-expiratory pressure (PEEP), partial pressure of carbon dioxide (PCO2), and the ratio of partial pressure arterial oxygen and fraction of inspired oxygen (P/F ratio). Comparing the worst respiratory mechanics parameters of the two groups, the results of the Pplat, DP, compliance, and PEEP were the same as the initial data. The PCO2 of the USW group was higher, while the P/F ratio was lower. A logistic regression analysis suggested that higher Pplat might be an independent risk factor and that higher compliance and lower DP might be protective factors for weaning failure of invasive mechanically ventilated patients with COVID-19 pneumonia.Conclusions: Patients with USW were associated with a poor outcome, higher Pplat might be a risk factor, and a higher compliance and a lower DP might be protective factors for the weaning failure of ventilated COVID-19 patients. Mechanical ventilation settings will affect the patient's prognosis.

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