Mortality Risk Assessment and Prognostication

Abstract Background Risk stratification is essential to assess mortality risk and guide treatment in patients with precapillary pulmonary hypertension (PH). We herein compared the accuracy of different currently used PH risk stratification tools and evaluated the significance of particular risk parameters. Methods We conducted a retrospective longitudinal observational cohort study evaluating seven different risk assessment approaches according to the current PH guidelines. A comprehensive assessment including multi-parametric risk stratification was performed at baseline and 4 yearly follow-up time-points. Multi-step Cox hazard analysis was used to analyse and refine risk prediction. Results Various available risk models effectively predicted mortality in patients with precapillary pulmonary hypertension. Right-heart catheter parameters were not essential for risk prediction. Contrary, non-invasive follow-up re-evaluations significantly improved the accuracy of risk estimations. A lack of accuracy of various risk models was found in the intermediate- and high-risk classes. For these patients, an additional evaluation step including assessment of age and right atrium area improved risk prediction significantly. Discussion Currently used abbreviated versions of the ESC/ERS risk assessment tool, as well as the REVEAL 2.0 and REVEAL Lite 2 based risk stratification, lack accuracy to predict mortality in intermediate- and high-risk precapillary pulmonary hypertension patients. An expanded non-invasive evaluation improves mortality risk prediction in these individuals.

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Absolute mortality risk assessment of COVID-19 patients: the Khorshid COVID Cohort (KCC) study

BMC Medical Research Methodology ◽

10.1186/s12874-021-01340-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hamid Reza Marateb ◽

Maja von Cube ◽

Ramin Sami ◽

Shaghayegh Haghjooy Javanmard ◽

Marjan Mansourian ◽

...

Keyword(s):

Risk Assessment ◽

Hospital Admission ◽

Mortality Risk ◽

Regression Models ◽

Assessment Method ◽

Point Of View ◽

Statistical Point ◽

Hazard Regression ◽

Risk Assessment Method ◽

Discharge From Hospital

Abstract Background Already at hospital admission, clinicians require simple tools to identify hospitalized COVID-19 patients at high risk of mortality. Such tools can significantly improve resource allocation and patient management within hospitals. From the statistical point of view, extended time-to-event models are required to account for competing risks (discharge from hospital) and censoring so that active cases can also contribute to the analysis. Methods We used the hospital-based open Khorshid COVID Cohort (KCC) study with 630 COVID-19 patients from Isfahan, Iran. Competing risk methods are used to develop a death risk chart based on the following variables, which can simply be measured at hospital admission: sex, age, hypertension, oxygen saturation, and Charlson Comorbidity Index. The area under the receiver operator curve was used to assess accuracy concerning discrimination between patients discharged alive and dead. Results Cause-specific hazard regression models show that these baseline variables are associated with both death, and discharge hazards. The risk chart reflects the combined results of the two cause-specific hazard regression models. The proposed risk assessment method had a very good accuracy (AUC = 0.872 [CI 95%: 0.835–0.910]). Conclusions This study aims to improve and validate a personalized mortality risk calculator based on hospitalized COVID-19 patients. The risk assessment of patient mortality provides physicians with additional guidance for making tough decisions.

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A Mortality Risk Assessment Approach on ICU Patients Clinical Medication Events Using Deep Learning

Computer Modeling in Engineering & Sciences ◽

10.32604/cmes.2021.014917 ◽

2021 ◽

Vol 128 (1) ◽

pp. 161-181

Author(s):

Dejia Shi ◽

Hanzhong Zheng

Keyword(s):

Risk Assessment ◽

Deep Learning ◽

Mortality Risk ◽

Icu Patients ◽

Assessment Approach

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Mortality risk assessment tool for CICU patients: Myocardial systolic fraction

International Journal of Cardiology ◽

10.1016/j.ijcard.2021.11.025 ◽

2021 ◽

Author(s):

Xiaoshang Zhang ◽

Dan Wu ◽

Suiyang Tong ◽

Chuanbin Cao

Keyword(s):

Risk Assessment ◽

Mortality Risk ◽

Assessment Tool ◽

Risk Assessment Tool

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Pre-operative mortality risk assessment in patients with continuous-flow left ventricular assist devices: Application of the HeartMate II risk score

The Journal of Heart and Lung Transplantation ◽

10.1016/j.healun.2014.02.011 ◽

2014 ◽

Vol 33 (7) ◽

pp. 675-681 ◽

Cited By ~ 24

Author(s):

Sunu S. Thomas ◽

Nadav Nahumi ◽

Jason Han ◽

Matthew Lippel ◽

Paolo Colombo ◽

...

Keyword(s):

Risk Assessment ◽

Mortality Risk ◽

Continuous Flow ◽

Operative Mortality ◽

Left Ventricular ◽

Ventricular Assist Devices ◽

Left Ventricular Assist Devices ◽

Heartmate Ii ◽

Ventricular Assist ◽

Left Ventricular Assist

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Posttransplant mortality risk assessment for adult-to-adult right-lobe living donor liver recipients with benign end-stage liver disease

Scandinavian Journal of Gastroenterology ◽

10.3109/00365521.2012.682089 ◽

2012 ◽

Vol 47 (7) ◽

pp. 842-852 ◽

Cited By ~ 2

Author(s):

Ming Zhang ◽

Fei Yin ◽

Bo Chen ◽

YouPing Li ◽

LuNan Yan ◽

...

Keyword(s):

Risk Assessment ◽

Liver Disease ◽

Mortality Risk ◽

Living Donor ◽

Donor Liver ◽

End Stage Liver Disease ◽

Right Lobe ◽

End Stage

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Screening-Level Risk Assessment of a Hydrogen Refueling Station that Uses Organic Hydride

Sustainability ◽

10.3390/su10124477 ◽

2018 ◽

Vol 10 (12) ◽

pp. 4477 ◽

Cited By ~ 6

Author(s):

Kiyotaka Tsunemi ◽

Kikuo Yoshida ◽

Takehiro Kihara ◽

Tei Saburi ◽

Kyoko Ono

Keyword(s):

Risk Assessment ◽

Mortality Risk ◽

Atmospheric Dispersion ◽

Acute Effect ◽

Heat Radiation ◽

Threshold Values ◽

Chemical Release ◽

Organic Hydride ◽

Level Of Concern ◽

Accident Scenarios

This study involves a screening-level risk assessment of the impairment of human health and life related to hydrogen explosion and chemical release during the operation of a hydrogen refueling station (HRS) that uses organic hydride. First, twenty-one accident scenarios were identified involving the leakage of hydrogen, toluene and methylcyclohexane (MCH) in the HRS. Next, the leakage frequency for each scenario was estimated using a hierarchical Bayesian model. Simulations were then performed of the blast-wave pressure and heat radiation after a hydrogen leak and of atmospheric dispersion of evaporated chemicals after leaks of liquid MCH and toluene. The consequences were estimated for each scenario according to leak size using the existing probit functions and threshold values. Finally, the risk due to explosion, heat radiation, and acute toxicity was estimated by multiplying the consequence by the leakage frequency. The results show that the mortality risk of explosion and acute effect is less than 10−6 per year, which is a negligible level of concern. However, the mortality risk of heat radiation in the scenarios involving hydrogen leakage from the pipe connected to the cylinders and compressors exceeds 10−4 per year inside the HRS, thereby requiring additional steps if a more-detailed risk assessment is needed.

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