scholarly journals The effectiveness of BMI, calf circumference and mid-arm circumference in predicting subsequent mortality risk in elderly Taiwanese

2010 ◽  
Vol 105 (2) ◽  
pp. 275-281 ◽  
Author(s):  
Alan C. Tsai ◽  
Tsui-Lan Chang
Keyword(s):  
Mortality Risk ◽  
Relative Effectiveness ◽  
Calf Circumference ◽  
Measurement Scales ◽  
Health Measurement ◽  
Arm Circumference ◽  
Low Bmi ◽  
Long Term Mortality

BMI, mid-arm circumference (MAC) and calf circumference (CC) are anthropometric indicators often included in geriatric health measurement scales. However, their relative effectiveness in predicting long-term mortality risk has not been extensively examined. The present study aimed to evaluate the relative effectiveness of these anthropometrics in predicting long-term mortality risk in older adults. The study prospectively analysed the ability of these indicators in predicting 4-year follow-up mortality risk of a population-representative sample of 4191 men and women, 53 years of age or older in the ‘Survey of Health and Living Status of the Elderly in Taiwan’. Cox regression analyses were performed to evaluate the association of follow-up mortality risk with low ( < 21 kg/m2) or high ( ≥ 27 kg/m2) BMI, low MAC ( < 23·5/22 cm for men/women) and low CC ( < 30/27 cm) respectively, according to Taiwanese-specific cut-off points. Results showed that low CC and low MAC were more effective than low BMI in predicting follow-up mortality risk in 65–74-year-old elderly. But low CC and low BMI were more effective than low MAC in ≥ 75-year-old elderly, and low BMI was more effective than low MAC or low CC in 53–64-year-old persons. High BMI was not effective in predicting mortality risk in any of these age ranges. These results suggest that in elderly adults, CC is more effective than BMI in predicting long-term mortality risk. Thus, more consideration to CC and MAC in designing geriatric health or nutritional measurement scales is recommended.

scholarly journals Mid-Arm Circumference is an Independent Predictor of 30-Days Mortality in Patients with Decompensated Cirrhosis

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 73-73
Author(s):  
Camila Saueressig ◽  
Vivian Luft ◽  
Valesca Dall'Alba
Keyword(s):  
Nutritional Status ◽  
Mortality Risk ◽  
Decompensated Cirrhosis ◽  
Anthropometric Parameter ◽  
Total Period ◽  
Arm Circumference ◽  
Long Term Mortality ◽  
Overall Mortality

Abstract Objectives Malnutrition is common in cirrhosis and is associated with a worse prognosis. This study aimed to evaluate the nutritional status by mid-arm circumference (MAC) and the association between MAC and mortality in patients with decompensated cirrhosis. Methods This is a prospective cohort study performed with hospitalized decompensated cirrhotic patients. Nutritional status was assessed within 72 hours of admission, from April 2017 to April 2018. Patients with values of MAC ≤5th percentile were considered malnourished. Survival over time was estimated using Kaplan-Meier curves and significant predictors of 30-days and long-term mortality were identified using Cox proportional hazards models. Results One-hundred patients with an average age of 60.1 ± 10.3 years were evaluated. Of these, 63% were male. The presence of ascites was the most observed complication with a prevalence of 69%, followed by variceal bleeding in 24% and hepatic encephalopathy in 22%. The median of follow-up time of patients was 11.2 months (range, 2.4–21). Overall mortality was 60% and mortality in 30-days was 16%. Malnourished patients through MAC (30%) were significantly more likely to die in either follow-up of 30-days (Log-rank value: 0.008) and long-term mortality (Log-rank value: 0.001). The 30-days probabilities of survival were 70% in patients malnourished by MAC compared to 90% in patients with MAC values &gt; 5th percentile. In multivariate analysis, after adjustment for age and Child-Pugh score, patients with malnutrition had a higher risk of 30-days mortality (HR: 3.64; 95% CI 1.33–9.95; P = 0.012) and after total period of follow-up (HR: 2.21; 95% CI 1.30–3.73; P &lt; 0.001). Higher values of MAC were associated with a reduced overall mortality risk in 30-days and long-term of 15% and 8%, respectively. Conclusions Malnutrition, assessed by a simple bedside anthropometric parameter, can predict short-term and long-term follow-up mortality risk in patients with decompensated cirrhosis. Therefore, MAC may be an efficacious tool to assess nutritional status and identify patients with a high risk of mortality. Funding Sources This study was supported by a CAPES and FIPE/HCPA scholarship. The sources of funding were not involved in study design; in collection, analysis and interpretation of the data.

Abstract P075: Influence of Systemic Interleukin-6 on the Inverse Association between Your-Choice American Heart Diet and a 41-Year Mortality Risk from Coronary Heart Disease among Men

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Jun Dai ◽  
Anthony J Acton ◽  
Robert V Considine ◽  
Ruth E Krasnow ◽  
Terry Reed
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Systemic Inflammation ◽  
Mortality Risk ◽  
Interleukin 6 ◽  
Reactive Protein ◽  
Chd Risk ◽  
Long Term Mortality

Introduction: Whole diet evaluated using dietary pattern is associated with systemic inflammation and coronary heart disease (CHD). Systemic inflammation also contributes to CHD risk. Genetic factors explain variations in whole diet, systemic inflammation, and CHD. However, it is unknown whether systemic inflammation is a mechanism linking whole diet to the long-term mortality risk from coronary heart disease independent of genes. Hypothesis: Systemic inflammation measured as plasma interleukin-6 levels medicates the association between whole diet and long-term mortality risk from coronary heart disease independent of genes. Methods: From the National Heart, Lung, and Blood Institute Twin Study, we included 554 white, middle-aged, veteran male twins (105 monozygotic and 109 dizygotic twin pairs; 65 monozygotic and 61 dizygotic unpaired twins). The twins were not on antihypertensive medication and had diastolic blood pressure below 105 mmHg at baseline (1969-1973) and did not have suspected acute inflammation [plasma levels of interleukin-6 (IL-6) above 10 pg/mL or C-reactive protein above 30 mg/L)]. Usual dietary data at baseline were collected through nutritionist-administered dietary history interview. Your-Choice American Heart Diet (YCARD) score was devised to quantitatively evaluate whole diet. Plasma interleukin-6 and C-reactive protein levels were measured with ELISA. Data on vital status and death causes were collected through death certificates until Dec 31, 2010. A frailty survival model was used to estimate various associations: overall (equivalent to the association in the general population), within-pair (independent of genes and environment common to co-twins), and between-pair (indicating influence of the common factors). We controlled for total caloric intake and known CHD risk factors including body mass index and modified Framingham Risk Score. Results: There were 75 CHD deaths during a 41-year follow-up (median follow-up of 34 years). The adjusted overall association between YCARD score and the CHD mortality risk was negative [partial coefficient for a 10-unit increment in the YCARD score: βo (95% confidence interval (CI)): -0.13 (-0.24, -0.02); hazard ratio (95% CI): 0.88 (0.78, 0.98)]. The partial regression coefficient was -0.02 [95% CI (-0.23, 0.19)] for the within-pair effect of YCARD (βw) and -0.12 [95% CI (-0.26, 0)] for the between-pair effect of YCARD (βb) in relation to CHD mortality risk. Additional adjustment for IL-6 led to a 15.4% reduction in the βo, a 100% increment in the βw, and a 16.7% reduction in the βb. Conclusions: Systemic inflammation measured as interleukin-6 mediates the association between whole diet and long-term coronary heart mortality risk, which is largely through genetic and environmental factors shared between co-twins.

scholarly journals Repeated Measurements of Cardiac Troponin T and N-Terminal Pro-B-Type Natriuretic Peptide to Assess Long-Term Mortality Risk in Subjects with Osteoarthritis

Biomolecules ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 230
Author(s):  
Martin Rehm ◽  
Gisela Büchele ◽  
Rolf Erwin Brenner ◽  
Klaus-Peter Günther ◽  
Hermann Brenner ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Cardiac Troponin ◽  
Prognostic Value ◽  
Troponin T ◽  
Repeated Measurements ◽  
Cardiac Troponin T ◽  
One Year ◽  
Long Term Mortality

Osteoarthritis (OA) is associated with higher cardiovascular mortality risk. High-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are well-characterized prognostic cardiac markers. We aimed to describe the changes in biomarkers measured one year apart in a cohort of 347 subjects with OA who underwent hip or knee replacement surgery in 1995/1996 and to analyze the prognostic value of repeated measurements for long-term mortality. During a median follow-up of 19 years, 209 (60.2%) subjects died. Substantial changes in cardiac biomarkers, especially for NT-proBNP, and an independent prognostic value of NT-proBNP for long-term mortality were found for both baseline measurement concentration (hazard ratio (HR) 1.32, 95% confidence interval (CI) (1.13–1.55)) and follow-up measurement concentration (HR 1.39, 95% CI 1.18–1.64) (all HR per standard deviation increase after natural log-transformation). Baseline concentrations were correlated with follow-up concentrations of NT-proBNP and no longer showed prognostic value when included simultaneously in a single model (HR 1.08, 95% CI 0.86–1.37), whereas the estimate for the one-year measurement remained robust (HR 1.31, 95% CI 1.04–1.66). Therefore, no significant additional benefit of repeated NT-proBNP measurements was found in this cohort, facilitating the use of a single NT-proBNP measurement as a stable prognostic marker.

Is hypoglycaemia a marker for increased long-term mortality risk in patients with coronary artery disease? An 8-year follow-up

2004 ◽  
Vol 11 (2) ◽  
pp. 135-143 ◽  
Author(s):  
Enrique Z. Fisman ◽  
Michael Motro ◽  
Alexander Tenenbaum ◽  
Jonathan Leor ◽  
Valentina Boyko ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Mortality Risk ◽  
Artery Disease ◽  
Long Term Mortality

Early-onset delirium after spontaneous intracerebral hemorrhage

2021 ◽  
pp. 174749302110596
Author(s):  
Federico Marrama ◽  
Maéva Kyheng ◽  
Marco Pasi ◽  
Matthieu Pierre Rutgers ◽  
Solène Moulin ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Incidence Rate ◽  
Mortality Risk ◽  
Early Onset ◽  
Gray Model ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Long Term Mortality ◽  
New Onset

Objective This study aimed at identifying the incidence, predictors, and impact on long-term mortality and dementia of early-onset delirium in a cohort of patients with spontaneous intracerebral hemorrhage. Methods We prospectively recruited consecutive patients in the Prognosis of InTra-Cerebral Hemorrhage (PITCH) cohort and analyzed incidence rate of early-onset delirium (i.e. during the first seven days after intracerebral hemorrhage onset) with a competing risk model. We used a multivariable Fine-Gray model to identify baseline predictors, a Cox regression model to study its impact on the long-term mortality risk, and a Fine-Gray model adjusted for pre-specified confounders to analyze its impact on new-onset dementia. Results The study population consisted of 248 patients (mean age 70 years, 54% males). Early-onset delirium incidence rate was 29.8% (95% confidence interval (CI) 24.3–35.6). Multivariate analysis showed that pre-existing dementia (subhazard ratio (SHR) 2.08, 95%CI 1.32–3.32, p = 0.002), heavy alcohol intake (SHR 1.79, 95%CI 1.13–2.82, p = 0.013), and intracerebral hemorrhage lobar location (SHR 1.56, 95%CI 1.01–2.42, p = 0.049) independently predicted early-onset delirium. Median follow-up was 9.5 years. Early-onset delirium was associated with higher mortality rates during the first five years of follow-up (HR 1.52, 95%CI 1.00–2.31, p = 0.049), but did not predict new-onset dementia (SHR 1.31, 95%CI 0.60–2.87). Conclusion Early-onset delirium is a frequent complication after intracerebral hemorrhage; it is associated with markers of pre-existing brain vulnerability and with higher mortality risk, but not with higher dementia rates during long-term follow-up.

Antipsychotic medication and long-term mortality risk in patients with schizophrenia; a systematic review and meta-analysis

2017 ◽  
Vol 47 (13) ◽  
pp. 2217-2228 ◽  
Author(s):  
J. Vermeulen ◽  
G. van Rooijen ◽  
P. Doedens ◽  
E. Numminen ◽  
M. van Tricht ◽  
...  
Keyword(s):  
Antipsychotic Medication ◽  
Mortality Risk ◽  
Causes Of Death ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Cumulative Exposure ◽  
The Relationship ◽  
Long Term Mortality

Patients with schizophrenia have a higher mortality risk than patients suffering from any other psychiatric disorder. Previous research is inconclusive regarding the association of antipsychotic treatment with long-term mortality risk. To this aim, we systematically reviewed the literature and performed a meta-analysis on the relationship between long-term mortality and exposure to antipsychotic medication in patients with schizophrenia. The objectives were to (i) determine long-term mortality rates in patients with schizophrenia using any antipsychotic medication; (ii) compare these with mortality rates of patients using no antipsychotics; (iii) explore the relationship between cumulative exposure and mortality; and (iv) assess causes of death. We systematically searched the EMBASE, MEDLINE and PsycINFO databases for studies that reported on mortality and antipsychotic medication and that included adults with schizophrenia using a follow-up design of more than 1 year. A total of 20 studies fulfilled our inclusion criteria. These studies reported 23,353 deaths during 821,347 patient years in 133,929 unique patients. Mortality rates varied widely per study. Meta-analysis on a subgroup of four studies showed a consistent trend of an increased long-term mortality risk in schizophrenia patients who did not use antipsychotic medication during follow-up. We found a pooled risk ratio of 0.57 (LL:0.46 UL:0.76 p value <0.001) favouring any exposure to antipsychotics. Statiscal heterogeneity was found to be high (Q = 39.31, I2 = 92.37%, p value < 0.001). Reasons for the increased risk of death for patients with schizophrenia without antipsychotic medication require further research. Prospective validation studies, uniform measures of antipsychotic exposure and classified causes of death are commendable.

scholarly journals Long-term mortality risk in hospitalized patients with heart failure after myocardial infarction

2020 ◽  
Vol 25 (1) ◽  
pp. 14-18
Author(s):  
A. S. Galyavich ◽  
I. M. Mingalimova ◽  
Z. M. Galeeva ◽  
L. V. Baleeva
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Mortality Risk ◽  
Mortality Risks ◽  
Patients With Heart Failure ◽  
D Dimer ◽  
Long Term Mortality

Aim. Comparative assessment of laboratory and instrumental parameters of patients with heart failure (HF) after myocardial infarction at admission and discharge from the hospital to determine the long-term mortality risk.Material and methods. The clinical outcomes of 117 patients with stage II-III  (Strazhesko-Vasilenko Classification) heart failure (64 men and 53 women) were studied. All patients admitted to the hospital underwent laboratory and instrumental examination. The average follow-up for patients after discharge from the hospital was 3 years (12 to 44 months). The long-term mortality risks of HF patients were compared according to the examination data upon admission and discharge from the hospital.Results. The long-term mortality risk factors of HF patients at admission are the levels of pro-brain natriuretic peptide (proBNP) (risk 1,08, p=0,001), D-dimer (risk 1,062, p=0,018), urea (risk 1,048, p=0,016), creatinine (risk 1,006, p=0,016), alanine transaminase (risk 1,002, p=0,009). The long-term mortality risk factors of HF patients at discharge are urea (risk 1,141, p=0,001), N-terminal proBNP (risk 1,101, p=0,002), and the number of neutrophils (risk 1,064, p=0,002).Conclusion. There is a difference in risk factors for long-term mortality risk of HF patients at admission and discharge from the hospital.

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