Mo1354 Age Adjusted Charlson Comorbidity Index: A Prognostic Tool to Measure Disease Burden: Can We Use It in Acute Pancreatitis? A Retrospective Observational Study in Minority Populations

2015 ◽  
Vol 148 (4) ◽  
pp. S-681
Author(s):  
Suresh Kumar Nayudu ◽  
Sailaja Sakam ◽  
Naeem Abbas ◽  
Chaitanya Chandrala ◽  
Sridhar Chilimuri
Keyword(s):  
Acute Pancreatitis ◽  
Observational Study ◽  
Charlson Comorbidity Index ◽  
Disease Burden ◽  
Retrospective Observational Study ◽  
Minority Populations ◽  
Prognostic Tool ◽  
Comorbidity Index

Postoperative complications and 90-day mortality in radical cystectomy in high-risk patients: A monocentric retrospective observational study

2018 ◽  
Vol 85 (3) ◽  
pp. 111-117 ◽  
Author(s):  
Carlo Pavone ◽  
Luigi Candela ◽  
Dario Fontana ◽  
Alchiede Simonato
Keyword(s):  
High Risk ◽  
Postoperative Complications ◽  
Observational Study ◽  
Radical Cystectomy ◽  
Charlson Comorbidity Index ◽  
Odds Ratio ◽  
Retrospective Observational Study ◽  
High Risk Patients ◽  
Risk Patients ◽  
Comorbidity Index

Aim: Assessing the incidence of immediate postoperative complications and 90-day mortality in high-risk patients who have undergone radical cystectomy; evaluating the correlation between preoperative conditions and surgery outcomes. Materials and methods: This is a monocentric retrospective observational study in which data of 65 patients have been analyzed. High-risk criteria: (a) Age ≥75 years, (b) obesity, (c) age-adjusted Charlson Comorbidity Index ≥8, (d) anemic status, and (e) pT ≥3. More than 50% of patients had two or more “high-risk” indicators. Postoperative complications were assessed through Clavien–Dindo classification. Results: Average age of patients was 70.4 years, average age-adjusted Charlson Comorbidity Index was 5.8, and average body mass index was 27.5. In 28% of patients, no complications arose, while in 46% grades I–II complications according to Clavien–Dindo occurred, in 23% grades III–IV complications occurred, and in 3% of the patients, death arose in the immediate postoperative period (grade V). Overall, 90-day mortality rate after surgery was 12.3%. The age ≥75 years and an age-adjusted Charlson Comorbidity Index score ≥8 have shown to be risk factors for the onset of severe complications (odds ratio = 3.54, p = 0.028 and odds ratio = 4.7, p = 0.026), while preoperative anemic status was a risk factor for complications in general (odds ratio = 4.1, p = 0.015). No analyzed parameter was a predictor of 90-day mortality ( p > 0.05). Conclusion: Immediate postoperative complications and 90-day mortality in radical cystectomy in high-risk patients remain significant, but still in line with the data in the literature on comparable populations. Some of the preoperative parameters were able to predict the outcomes of the intervention with regard to the onset of complications but not to the 90-day mortality.

Sa1391 - Risk Factors for Walled-Off Necrosis Associated with Severe Acute Pancreatitis: A Multicenter Retrospective Observational Study

2018 ◽  
Vol 154 (6) ◽  
pp. S-289
Author(s):  
Satoshi Ikarashi ◽  
Kazunao Hayashi ◽  
Hirokazu Kawai ◽  
Junji Kohisa ◽  
Toshifumi Sato ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Observational Study ◽  
Severe Acute Pancreatitis ◽  
Retrospective Observational Study ◽  
Walled Off Necrosis

scholarly journals Derivation and validation of the ED-SAS score for very early prediction of mortality and morbidity with acute pancreatitis: a retrospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joseph Miller ◽  
Yiyang Wu ◽  
Rawan Safa ◽  
Georgiana Marusca ◽  
Sandeep Bhatti ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Observational Study ◽  
Primary Outcome ◽  
Validation Cohort ◽  
Scoring Systems ◽  
Retrospective Observational Study ◽  
Mortality And Morbidity ◽  
Derivation Cohort ◽  
C Statistic ◽  
Prediction Of Mortality

Abstract Background Existing scoring systems to predict mortality in acute pancreatitis may not be directly applicable to the emergency department (ED). The objective of this study was to derive and validate the ED-SAS, a simple scoring score using variables readily available in the ED to predict mortality in patients with acute pancreatitis. Methods This retrospective observational study was performed based on patient data collected from electronic health records across 2 independent health systems; 1 was used for the derivation cohort and the other for the validation cohort. Adult patients who were eligible presented to the ED, required hospital admission, and had a confirmed diagnosis of acute pancreatitis. Patients with chronic or recurrent episodes of pancreatitis were excluded. The primary outcome was 30-day mortality. Analyses tested and derived candidate variables to establish a prediction score, which was subsequently applied to the validation cohort to assess odds ratios for the primary and secondary outcomes. Results The derivation cohort included 599 patients, and the validation cohort 2011 patients. Thirty-day mortality was 4.2 and 3.9%, respectively. From the derivation cohort, 3 variables were established for use in the predictive scoring score: ≥2 systemic inflammatory response syndrome (SIRS) criteria, age > 60 years, and SpO2 < 96%. Summing the presence or absence of each variable yielded an ED-SAS score ranging from 0 to 3. In the validation cohort, the odds of 30-day mortality increased with each subsequent ED-SAS point: 4.4 (95% CI 1.8–10.8) for 1 point, 12.0 (95% CI 4.9–29.4) for 2 points, and 41.7 (95% CI 15.8–110.1) for 3 points (c-statistic = 0.77). Conclusion An ED-SAS score that incorporates SpO2, age, and SIRS measurements, all of which are available in the ED, provides a rapid method for predicting 30-day mortality in acute pancreatitis.

scholarly journals Derivation and Validation of the ED-SAS Score for Very Early Prediction of Mortality and Morbidity with Acute Pancreatitis: A Retrospective Observational Study

2020 ◽  
Author(s):  
Joseph Miller ◽  
Yiyang Wu ◽  
Rawan Safa ◽  
Georgiana Marusca ◽  
Sandeep Bhatti ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Observational Study ◽  
Validation Cohort ◽  
Scoring Systems ◽  
Retrospective Observational Study ◽  
Mortality And Morbidity ◽  
Derivation Cohort ◽  
C Statistic ◽  
Prediction Of Mortality ◽  
Level Data

Abstract Background: Existing scoring systems to predict mortality in acute pancreatitis may not be directly applicable to the emergency department (ED). The objective of this study was to derive and validate the ED-SAS, a simple scoring score using variables readily available in the ED to predict mortality in patients with acute pancreatitis. Methods: This retrospective observational study was performed based on patient level data collected from electronic health records across 2 independent health systems, one used for the derivation cohort and one for the validation cohort. Adult patients who were eligible presented to the ED, required hospital admission, and had a confirmed diagnosis of acute pancreatitis. Patients with chronic or recurrent episodes of pancreatitis were excluded. The primary outcome was 30-day mortality. Analyses tested and derived candidate variables to establish a prediction score and that was subsequently applied to the validation cohort to assess odds ratio for the primary and secondary outcomes. Results: The derivation cohort included 599 patients, and the validation cohort 2011 patients. Thirty-day mortality was 4.2% and 3.9% respectively. From the derivation cohort, 3 variables were established for use in the predictive scoring score: ≥2 systemic inflammatory response syndrome (SIRS) criteria, age >60 years, and SpO2 <96%. Summing the presence or absence of each variable yielded an ED-SAS score ranging from 0 to 3. In the validation cohort, the odds of 30-day mortality increased with each subsequent ED-SAS point: 4.4 (95% CI 1.8 – 10.8) for 1 point, 12.0 (95% CI 4.9 – 29.4) for 2 points, and 41.7 (95% CI 15.8 – 110.1) for 3 points (c-statistic = 0.77).Conclusion: An ED-SAS score that incorporates SpO2, age, and SIRS measurements provides a rapid method for predicting 30-day mortality in acute pancreatitis.

scholarly journals Myocardial Injury in COVID-19 Patients: Association with Inflammation, Coagulopathy and In-Hospital Prognosis

2021 ◽  
Vol 10 (10) ◽  
pp. 2096
Author(s):  
Victor Arévalos ◽  
Luis Ortega-Paz ◽  
Juan José Rodríguez-Arias ◽  
Margarita Calvo ◽  
Leticia Castrillo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Observational Study ◽  
Charlson Comorbidity Index ◽  
Myocardial Injury ◽  
Protective Factor ◽  
C Reactive Protein ◽  
Clinical Variables ◽  
Reactive Protein ◽  
Comorbidity Index ◽  
Adjusted Logistic Regression

The exact mechanisms leading to myocardial injury in the coronavirus disease 2019 (COVID-19) are still unknown. In this retrospective observational study, we include all consecutive COVID-19 patients admitted to our center. They were divided into two groups according to the presence of myocardial injury. Clinical variables, Charlson Comorbidity Index (CCI), C-reactive protein (CRP), CAC (COVID-19-associated coagulopathy), defined according to the ISTH score, treatment and in-hospital events were collected. Between March and April 2020, 331 COVID-19 patients were enrolled, 72 of them (21.8%) with myocardial injury. Patients with myocardial injury showed a higher CCI score (median (interquartile range), 5 (4–7) vs. 2 (1–4), p = 0.001), higher CRP values (18.3 (9.6–25.9) mg/dL vs. 12.0 (5.4–19.4) mg/dL, p ˂ 0.001) and CAC score (1 (0–2) vs. 0 (0–1), p = 0.001), and had lower use of any anticoagulant (57 patients (82.6%) vs. 229 patients (90.9%), p = 0.078), than those without. In the adjusted logistic regression, CRP, myocardial injury, CCI and CAC score were positive independent predictors of mortality, whereas anticoagulants resulted as a protective factor. Myocardial injury in COVID-19 patients is associated with inflammation and coagulopathy, resulting in a worse in-hospital prognosis. Treatment with anticoagulant agents may help to improve in-hospital outcomes.

scholarly journals Derivation and Validation of the ED-SAS Score for Very Early Prediction of Mortality and Morbidity with Acute Pancreatitis: A Retrospective Observational Study

2020 ◽  
Author(s):  
Joseph Miller ◽  
MD ◽  
Rawan Safa ◽  
Georgiana Marusca ◽  
BS Sandeep Bhatti ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Observational Study ◽  
Validation Cohort ◽  
Scoring Systems ◽  
Retrospective Observational Study ◽  
Mortality And Morbidity ◽  
Derivation Cohort ◽  
C Statistic ◽  
Prediction Of Mortality ◽  
Level Data

Abstract Background: Existing scoring systems to predict mortality in acute pancreatitis may not be directly applicable to the emergency department (ED). The objective of this study was to derive and validate the ED-SAS, a simple scoring score using variables readily available in the ED to predict mortality in patients with acute pancreatitis.Methods: This retrospective observational study was performed based on patient level data collected from electronic health records across 2 independent health systems, one used for the derivation cohort and one for the validation cohort. Adult patients who were eligible presented to the ED, required hospital admission, and had a confirmed diagnosis of acute pancreatitis. Patients with chronic or recurrent episodes of pancreatitis were excluded. The primary outcome was 30-day mortality. Analyses tested and derived candidate variables to establish a prediction score and that was subsequently applied to the validation cohort to assess odds ratio for the primary and secondary outcomes. Results: The derivation cohort included 599 patients, and the validation cohort 2011 patients. Thirty-day mortality was 4.2% and 3.9% respectively. From the derivation cohort, 3 variables were established for use in the predictive scoring score: ≥2 systemic inflammatory response syndrome (SIRS) criteria, age >60 years, and SpO2 <96%. Summing the presence or absence of each variable yielded an ED-SAS score ranging from 0 to 3. In the validation cohort, the odds of 30-day mortality increased with each subsequent ED-SAS point: 4.4 (95% CI 1.8 – 10.8) for 1 point, 12.0 (95% CI 4.9 – 29.4) for 2 points, and 41.7 (95% CI 15.8 – 110.1) for 3 points (c-statistic = 0.77).Conclusion: An ED-SAS score that incorporates SpO2, age, and SIRS measurements provides a rapid method for predicting 30-day mortality in acute pancreatitis.

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