1477 Intra-hospital mortality of patients with severe head injury: a prospective cohort study of 754 patients from the Florianópolis trauma data bank

Introduction: Being infected with COVID-19 is associated with direct and indirect effects on the cardiopulmonary system and electrocardiography can aid in management of patients through rapid and early identification of these adversities. Objective: The present study was designed aiming to evaluate electrocardiographic changes and their correlation with the outcome of COVID-19 patients. Methods: This Prospective cohort study was carried out on COVID-19 cases admitted to the emergency department of an educational hospital, during late February and March 2020. Electrocardiographic characteristics of patients and their association with in-hospital mortality were investigated. Results: One hundred and nineteen cases with the mean age of 60.52±13.45 (range: 29-89) years were studied (65.5% male). Dysrhythmia was detected in 22 (18.4%) cases. T-wave inversion (28.6%), pulmonale P-wave (19.3%), left axis deviation (19.3%), and ST-segment depression (16.8%) were among the most frequently detected electrocardiographic abnormalities, respectively. Twelve (10.1%) cases died. There was a significant correlation between in-hospital mortality and history of diabetes mellitus (p=0.007), quick SOFA score > 2 (p<0.0001), premature ventricular contraction (PVC) (p=0.003), left axis deviation (LAD) (p=0.039), pulmonale P-wave (p<0.001), biphasic P-wave (p<0.001), inverted T-wave (p=0.002), ST-depression (p=0.027), and atrioventricular (AV) node block (p=0.002). Multivariate cox regression showed that history of diabetes mellitus, and presence of PVC and pulmonale P-wave were independent prognostic factors of mortality. Conclusions: Based on the findings of the present study, 18.4% of COVID-19 patients had presented with some kind of dysrhythmia and in addition to history of diabetes, presence of PVC and pulmonale P-wave were among the independent prognostic factors of mortality in COVID-19 patients.

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A prospective cohort study on hospital mortality due to Clostridium difficile infection

Infection ◽

10.1007/s15010-012-0258-1 ◽

2012 ◽

Vol 40 (5) ◽

pp. 479-484 ◽

Cited By ~ 32

Author(s):

J. M. Wenisch ◽

D. Schmid ◽

G. Tucek ◽

H.-W. Kuo ◽

F. Allerberger ◽

...

Keyword(s):

Cohort Study ◽

Clostridium Difficile ◽

Hospital Mortality ◽

Prospective Cohort Study ◽

Clostridium Difficile Infection ◽

Prospective Cohort

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G273 Accuracy of Physician Practice as Compared with Pecarn, Catch and Chalice Head Injury Clinical Decision Rules in Children. A Predict Prospective Cohort Study

10.1136/archdischild-2017-313087.267 ◽

2017 ◽

Cited By ~ 1

Author(s):

MD Lyttle ◽

M Borland ◽

N Phillips ◽

A Kochar ◽

JA Cheek ◽

...

Keyword(s):

Cohort Study ◽

Head Injury ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Decision Rules ◽

Clinical Decision ◽

Physician Practice ◽

Clinical Decision Rules

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The Association Between Dynamic Changes in Serum Presepsin Levels and Mortality in Immunocompromised Patients with Sepsis: A Prospective Cohort Study

10.21203/rs.3.rs-115066/v1 ◽

2020 ◽

Author(s):

Jongmin Lee ◽

Seo Hyun Kim ◽

Kyung Hoon Kim ◽

Na Ri Jeong ◽

Seok Chan Kim ◽

...

Keyword(s):

Septic Shock ◽

Cohort Study ◽

Hospital Mortality ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Area Under The Curve ◽

Immunocompromised Patients ◽

Dynamic Changes ◽

Saps 3 ◽

Sepsis And Septic Shock

Abstract Background: Presepsin is a subtype of soluble CD14 that is increased in the blood of septic patients. We investigated the role of dynamic changes in serum presepsin levels in critically ill, immunocompromised patients with sepsis.Methods: This is a prospective cohort study that included 119 adult patients who were admitted to the intensive care unit (ICU) between March 2019 and June 2020. Sepsis and septic shock were defined as Sepsis-3. Patients were classified into one of the following diagnostic groups: no sepsis, sepsis, and septic shock. Presepsin level was measured on day 1 and day 3 after ICU admission. The primary outcome was in-hospital mortality.Results: Of the 119 patients, sepsis was diagnosed in 40 patients (33.6%) and septic shock was diagnosed in 60 (50.4%) patients. The Simplified Acute Physiology Score (SAPS) 3 and Sequential Organ Failure Assessment score on day 1 were 75.5 ± 14.9 and 9.0 (6.5–11.5), respectively, and the overall hospital mortality was 44.5%. In 61 immunocompromised patients, presepsin levels on day 1 were higher in patients with sepsis than those in patients without sepsis (1203.0 [773.0–2484.0] vs. 753.0 [603.5–1092.0] ng/ml; P = 0.004). The area under the curve (AUC) of presepsin for diagnosing sepsis in immunocompromised patients was 0.87, which was comparable with that of procalcitonin (AUC, 0.892). Presepsin levels on day 3 were higher in patients who died in the hospital than in those who survived (1965.0 [1149.0–3423.0] vs. 933.0 [638.0–1571.0]; P = 0.001). In immunocompromised patients who died in the hospital, presepsin levels on day 3 were significantly higher than those on day 1 (P = 0.018). In the multivariate analysis, ΔPresepsin+ (ΔPresepsin concentrations [day3 – day1] > 0) alone was independently correlated with in-hospital mortality in immunocompromised patients (odds ratio, 6.22; 95% confidence interval, 1.33–29.06; P = 0.020).Conclusion: These findings suggest that dynamic changes in presepsin levels between day 1 and day 3 are associated with in-hospital mortality in patients with sepsis, especially in immunocompromised patients.

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Association between Malnutrition and Hospital Mortality and Duration of Intensive Care Unit Admission in the Critically Ill: A Prospective Cohort Study

10.20944/preprints201711.0066.v1 ◽

2017 ◽

Author(s):

Charles Chin Han Lew ◽

Gabriel Jun Yung Wong ◽

Ka Po Cheung ◽

Ai Ping Chua ◽

Mary Foong Fong Chong ◽

...

Keyword(s):

Intensive Care Unit ◽

Cohort Study ◽

Intensive Care ◽

Hospital Mortality ◽

Critically Ill ◽

Prospective Cohort Study ◽

Critically Ill Patients ◽

Prospective Cohort ◽

Unit Length ◽

Increased Risk

There is limited evidence for the association between malnutrition and hospital mortality as well as Intensive Care Unit length-of-stay (ICU-LOS) in critically ill patients. We aimed to examine the aforementioned associations by conducting a prospective cohort study in an ICU of a Singapore tertiary hospital. Between August 2015 and October 2016, all adult patients with ≥24 h of ICU-LOS were included. The 7-point Subjective Global Assessment (7-point SGA) was used to determine patients’ nutritional status within 48 hours of ICU admission. Multivariate analyses were conducted in two ways: 1) presence versus absence of malnutrition, and 2) dose-dependent association for each 1-point decrease in the 7-point SGA. There were 439 patients of which 28.0% were malnourished, and 29.6% died before hospital discharge. Malnutrition was associated with an increased risk of hospital mortality [adjusted-RR 1.39 (95%CI: 1.10–1.76)], and this risk increased with a greater degree of malnutrition [adjusted-RR 1.09 (95%CI: 1.01–1.18) for each 1-point decrease in the 7-point SGA]. No significant association was found between malnutrition and ICU-LOS. Conclusion: There was a clear association between malnutrition and higher hospital mortality in critically ill patients. The association between malnutrition and ICU-LOS could not be replicated and hence requires further evaluation.

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Accuracy of PECARN, CATCH, and CHALICE head injury decision rules in children: a prospective cohort study

The Lancet ◽

10.1016/s0140-6736(17)30555-x ◽

2017 ◽

Vol 389 (10087) ◽

pp. 2393-2402 ◽

Cited By ~ 88

Author(s):

Franz E Babl ◽

Meredith L Borland ◽

Natalie Phillips ◽

Amit Kochar ◽

Sarah Dalton ◽

...

Keyword(s):

Cohort Study ◽

Head Injury ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Decision Rules

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Burden, Clinical Outcomes and Predictors of Stroke in Hospital Mortality among Adult Patients Admitted to Stroke Unit of Jimma University Medical Center: Prospective Cohort Study

10.21203/rs.2.9228/v2 ◽

2019 ◽

Author(s):

Ginenus Fekadu ◽

Legese Chelkeba ◽

Ayantu Kebede

Keyword(s):

Cohort Study ◽

Hospital Mortality ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Stroke Unit ◽

Medical Center ◽

Female Ratio ◽

Hospital Arrival ◽

Time To Death ◽

Jimma University

Abstract Background: Global burden of stroke epidemiology is changing rapidly. Over the 1990–2013 period, there was a significant increase in the absolute number of deaths and incident events of stroke. The burden of ischemic and hemorrhagic stroke varies between regions and over time in Ethiopia. The paucity of data has limited research output and consequently the response to this burden in our country. Methods: Prospective cohort study was carried at stroke unit of Jimma University Medical Center (JUMC) from March 10- July 10, 2017. The outcome of interest was mortality and time to death. Data was analyzed using SPSS version 20. Multivariable Cox regression was used to identify the predictors of in hospital mortality and time to death from hospital arrival. Predictor variables with P< 0.05 were considered statistically significant. Results: A total of 116 eligible stroke patients were followed with the mean age of 55.1+14.0 years and males comprised of 73 (62.9%) with male: female ratio of 1.70:1. Stroke accounted for 16.5 % of total medical admissions and 23.6 % of the total cases of in hospital mortality. A total of 91 (78.4%) of patients were discharged being alive making in hospital mortality of rate of 25 (21.6%). The median time of in hospital mortality after admission and length of hospital stay of the patients was 4.38 days and 9.21 days, respectively. The prominent suspected immediate cause for in hospital mortality was increased intracranial pressure 17 (68.0%) followed by respiratory failure secondary to aspiration pneumonia 11 (44.0%). Brain edema (AHR: 6.27, 95% CI: 2.50-15.76), urine incontinence (AHR: 3.48, 95% CI: 1.48-8.17), National Institute of Health Stroke Scale (NIHSS) >13 during hospital arrival (AHR: 22.58, 95% CI: 2.95-172.56) and diagnosis of stroke clinically alone (AHR: 4.96, 95% CI: 1.96-12.54) were the independent predictors of in hospital mortality. Conclusions: The mortality of stroke in this set up was similar to other low- and middle-resource countries. There should be burning need to establish and strengthen the available stroke units which are well-equipped and staffed with intensive health care teams in different hospitals across the country.

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