scholarly journals The impact of blood type on the mortality of patients with severe abdominal trauma: a multicenter observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wataru Takayama ◽  
Akira Endo ◽  
Kiyoshi Murata ◽  
Kota Hoshino ◽  
Shiei Kim ◽  
...  
Keyword(s):  
Observational Study ◽  
Abdominal Trauma ◽  
Blood Type ◽  
Abbreviated Injury Scale ◽  
Trauma Outcomes ◽  
Multicenter Observational Study ◽  
Transfusion Volume ◽  
Type Of Injury ◽  
The Impact ◽  
The Relationship

AbstractFew studies have investigated the relationship between blood type and trauma outcomes according to the type of injury. We conducted a retrospective multicenter observational study in twelve emergency hospitals in Japan. Patients with isolated severe abdominal injury (abbreviated injury scale for the abdomen ≥ 3 and that for other organs < 3) that occurred between 2008 and 2018 were divided into four groups according to blood type. The association between blood type and mortality, ventilator-free days (VFD), and total transfusion volume were evaluated using univariate and multivariate regression models. A total of 920 patients were included, and were divided based on their blood type: O, 288 (31%); A, 345 (38%); B, 186 (20%); and AB, 101 (11%). Patients with type O had a higher in-hospital mortality rate than those of other blood types (22% vs. 13%, p < 0.001). This association was observed in multivariate analysis (adjusted odds ratio [95% confidence interval] = 1.48 [1.25–2.26], p = 0.012). Furthermore, type O was associated with significantly higher cause-specific mortalities, fewer VFD, and larger transfusion volumes. Blood type O was associated with significantly higher mortality and larger transfusion volumes in patients with isolated severe abdominal trauma.

The association of psychiatric and neurological comorbidities with outcomes in traumatic injury patients

2021 ◽  
pp. 009121742198914
Author(s):  
Jennifer Brady ◽  
R David Hayward ◽  
Elango Edhayan
Keyword(s):  
Length Of Stay ◽  
Psychiatric Illness ◽  
Traumatic Injury ◽  
Lower Mortality ◽  
Linear Modeling ◽  
Psychiatric Comorbidities ◽  
Trauma Outcomes ◽  
Hospital Stays ◽  
The Impact ◽  
The Relationship

Introduction Mental illness is a well-known risk factor for injury and injury recidivism. The impact of pre-existing psychiatric illness on trauma outcomes, however, has received less attention. Our study examines the relationship of pre-existing psychiatric illness on trauma outcomes including length of stay, cost, and mortality. Methods Patient data were obtained from the Healthcare Cost and Utilization Project’s State Inpatient Database. All patients admitted for trauma in the Detroit metropolitan area from 1/1/2006 to 12/31/2014 were included. The relationship between individual psychiatric comorbidities (depression, psychosis, and other neurological disorders) and outcomes were evaluated with logistic regression (mortality) and generalized linear modeling (length of stay and cost). Results Over 260,000 records were reviewed. Approximately one-third (29.9%) of patients had one or more psychiatric diagnoses. Patients with depression had longer hospital stays (RR = 1.12, p < 0.001) and higher costs (RR = 1.07, p < 0.001), but also lower mortality (OR = 0.69, p < 0.001). Patients with psychosis had longer stays (RR = 1.18, p < 0.001), higher costs (RR = 1.02, p = 0.002), and lower mortality (OR = 0.61, p < 0.001). Patients with other neurological comorbidities had higher mortality (OR = 1.23, p < 0.001), longer stays (RR = 1.29, p < 0.001), and higher costs (RR = 1.10, p < 0.001). Conclusion Patients with a psychiatric disorder required longer care and incurred greater costs, whereas mortality was higher for only those with a neurological disorder. Identifying patients’ psychiatric comorbidities at the time of admission for trauma may help optimize treatment. Addressing these conditions may help reduce the cost of trauma care.

scholarly journals The relationship between maximal expiratory pressure values and critical outcomes in mechanically ventilated patients: a post hoc analysis of an observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yann Combret ◽  
Guillaume Prieur ◽  
Roger Hilfiker ◽  
Francis-Edouard Gravier ◽  
Pauline Smondack ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Observational Study ◽  
Univariate Analysis ◽  
Premature Death ◽  
Extubation Failure ◽  
Short Term ◽  
Expiratory Muscle ◽  
Maximal Expiratory Pressure ◽  
The Impact ◽  
The Relationship

Abstract Background Little interest has been paid to expiratory muscle strength, and the impact of expiratory muscle weakness on critical outcomes is not known. Very few studies assessed the relationship between maximal expiratory pressure (MEP) and critical outcomes. The aim of this study was to investigate the relationship between MEP and critical outcomes. Methods This work was a secondary analysis of a prospective, observational study of adult patients who required mechanical ventilation for ≥ 24 h in an 18-bed ICU. MEP was assessed before extubation after a successful, spontaneous breathing trial. The relationships between MEP and extubation failure, and short-term (30 days) mortality, were investigated. Univariate logistic regressions were computed to investigate the relationship between MEP values and critical outcomes. Two multivariate analyses, with and without maximal inspiratory pressure (MIP), both adjusted using principal component analysis, were undertaken. Unadjusted and adjusted ROC curves were computed to compare the respective ability of MEP, MIP and the combination of both measures to discriminate patients with and without extubation failure or premature death. Results One hundred and twenty-four patients were included. Median age was 66 years (IQR 18) and median mechanical ventilation duration was 7 days (IQR 6). Extubation failure rate was 15% (18/124 patients) and the rate for 30-day mortality was 11% (14/124 patient). Higher MEP values were significantly associated with a lower risk of extubation failure in the univariate analysis [OR 0.96 95% CI (0.93–0.98)], but not with short-term mortality. MEP was independently linked with extubation failure when MIP was not included in the multivariate model, but not when it was included, despite limited collinearity between these variables. This study was not able to differentiate the respective abilities of MEP, MIP, and their combination to discriminate patients with extubation failure or premature death (adjusted AUC for the combination of MEP and MIP: 0.825 and 0.650 for extubation failure and premature death, respectively). Conclusions MEP is related to extubation failure. But, the results did not support its use as a substitute for MIP, since the relationship between MEP and critical outcomes was no longer significant when MIP was included. The use of MIP and MEP measurements combined did not reach higher discriminative capacities for critical outcomes that MEP or MIP alone. Trial Registration This study was retrospectively registered at https://clinicaltrials.gov/ct2/show/NCT02363231?cond=NCT02363231&draw=2&rank=1 (NCT02363231) in 13 February 2015

Intravenous immunoglobulins in the treatment of relapsing remitting multiple sclerosis - results of a retrospective multicenter observational study over five years

2005 ◽  
Vol 11 (5) ◽  
pp. 562-567 ◽  
Author(s):  
J Haas ◽  
M Maas-Enriquez ◽  
H P Hartung
Keyword(s):  
Observational Study ◽  
Intravenous Immunoglobulins ◽  
Ivig Treatment ◽  
Routine Practice ◽  
Consensus Recommendation ◽  
Multicenter Observational Study ◽  
First Line Therapy ◽  
Retrospective Data Analysis ◽  
Study Results ◽  
The Impact

Use of intravenous immunoglobulins (IVIG) has been recommended for treatment of RRMS if first line therapy with beta-interferon or glatiramer acetate is not tolerated, or if contraindications exist. This consensus recommendation is based on the demonstration of efficacy and tolerability of IVIG in four randomized controlled trials (RCTs). The impact of non-randomized observational trials on evidence-based recommendations for treatment is still under discussion. In order to evaluate the transferability of study results derived from RCTs into a routine practice setting, we carried out a retrospective data analysis on patients with RRMS who had been treated with IVIG during the last five years. Data sets from 308 out of 1122 screened patients were available for analysis. Treatment with IVIG resulted in a 69% reduction of the mean annual relapse rate (ARR) (calculated over two years) from 1.749±1.15 before IVIG treatment to 0.539±0.61 after start of IVIG treatment. Mean expanded disability status scale (EDSS) values remained stable throughout the observation period. The results of this observational study were similar to the results of previous RCTs with IVIG.

scholarly journals AI-based Analysis on Relationship between Genes and Personality

2021 ◽  
Vol 9 (6) ◽  
pp. 26-37
Author(s):  
Masayuki Kanazawa
Keyword(s):  
Target Gene ◽  
Single Gene ◽  
Biological Marker ◽  
Blood Type ◽  
Big Five Personality ◽  
Personality Test ◽  
The Subject ◽  
Abo Blood Type ◽  
The Impact ◽  
The Relationship

AI can be applied in various ways to the measurement of personality in psychology. Measuring the impact of a single gene on personality can be handled by AI technologies, at least technically, i.e., using supervised learning models of machine learning. The ABO blood type is a relatively easy biological marker to examine; therefore, people in many countries know their type, and its impact on the relationship with personality has been the subject of a large amount of research. In this study, we selected the ABO blood type as the target gene, examined its association with personality, and cross-checked the results with previous works. Two scales were used to measure personality: a) blood type personality traits extracted from previous studies, and b) the TIPI-J, a simplified version of the Big Five personality test. In the former, the AI was able to predict the respondents’ blood types with a higher probability than chance, while in the latter, the accuracy was within the range of chance. These obtained results were also discussed.

scholarly journals Impact of the day of the week on the discontinuation of broad-spectrum antibiotic prescriptions; a multi-centered observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hiroyuki Honda ◽  
Hideharu Hagiya ◽  
Tsukasa Higashionna ◽  
Yuto Haruki ◽  
Mai Haruki ◽  
...  
Keyword(s):  
Observational Study ◽  
Antimicrobial Stewardship ◽  
Broad Spectrum ◽  
Antibiotic Use ◽  
Antibiotic Administration ◽  
Multicenter Observational Study ◽  
Broad Spectrum Antibiotics ◽  
Admission Ward ◽  
Day Of The Week ◽  
The Impact

AbstractTo encourage and guide antimicrobial stewardship team (AST) activity and promote appropriate antibiotic use, we studied the impact of day of the week on the initiation and discontinuation of antibiotic administration. This was a multicenter observational study conducted at 8 Japanese hospitals from April 1 to September 30, 2019, targeting patients who underwent treatment with broad-spectrum antibiotics, such as anti-methicillin-resistant Staphylococcus aureus agents and anti-pseudomonal agents. We compared the weekly numbers of initiations and discontinuations of antibiotic prescription on each day of the week or on the days after a holiday. There was no statistical difference in the number of antibiotic initiations on both weekdays and the day after a holiday. However, antibiotic discontinuation was significantly higher from Tuesday onward than Monday and from the second day than the first day after a holiday. Similar trends were observed regardless of the categories of antibiotics, hospital and admission ward, and AST activity. This study suggests that broad-spectrum antibiotics tend to be continued during weekends and holidays and are most likely to be discontinued on Tuesday or the second day after a holiday. This was probably due to behavioral factors beyond medical indications, requiring further antimicrobial stewardship efforts in the future.

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