Longitudinal Profile of Laboratory Parameters and Their Application in the Prediction for Fatal Outcome Among Patients Infected With SARS-CoV-2: A Retrospective Cohort Study

Abstract Background Patients with coronavirus disease 2019 (COVID-19) experience a wide clinical spectrum, with over 2% developing fatal outcome. The prognostic factors for fatal outcome remain sparsely investigated. Methods A retrospective cohort study was performed in a cohort of patients with confirmed COVID-19 in one designated hospital in Wuhan, China, from 17 January–5 March 2020. The laboratory parameters and a panel of cytokines were consecutively evaluated until patients’ discharge or death. The laboratory features that could be used to predict fatal outcome were identified. Results Consecutively collected data on 55 laboratory parameters and cytokines from 642 patients with COVID-19 were profiled along the entire disease course, based on which 3 clinical stages (acute stage, days 1–9; critical stage, days 10–15; and convalescence stage, day 15 to observation end) were determined. Laboratory findings based on 75 deceased and 357 discharged patients revealed that, at the acute stage, fatality could be predicted by older age and abnormal lactate dehydrogenase (LDH), urea, lymphocyte count, and procalcitonin (PCT) level. At the critical stage, the fatal outcome could be predicted by age and abnormal PCT, LDH, cholinesterase, lymphocyte count, and monocyte percentage. Interleukin 6 (IL-6) was remarkably elevated, with fatal cases having a more robust production than discharged cases across the whole observation period. LDH, PCT, lymphocytes, and IL-6 were considered highly important prognostic factors for COVID-19–related death. Conclusions The identification of predictors that were routinely tested might allow early identification of patients at high risk of death for early aggressive intervention.

Download Full-text

Clinicopathologic characteristics, laboratory parameters, treatment protocols, and outcomes of pancreatic cancer: a retrospective cohort study of 1433 patients in China

PeerJ ◽

10.7717/peerj.4893 ◽

2018 ◽

Vol 6 ◽

pp. e4893 ◽

Cited By ~ 6

Author(s):

Shuisheng Zhang ◽

Xiaozhun Huang ◽

Yuan Tian ◽

Saderbieke Aimaiti ◽

Jianwei Zhang ◽

...

Keyword(s):

Pancreatic Cancer ◽

Cohort Study ◽

Prognostic Factors ◽

Lymph Node ◽

Distant Metastasis ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Clinicopathologic Characteristics ◽

Treatment Protocols ◽

Laboratory Parameters

Objectives The prognosis of people with pancreatic cancer is extremely unfavorable. However, the prognostic factors remain largely undefined. We aimed to perform comprehensive analyses of clinicopathologic characteristics, laboratory parameters, and treatment protocols for exploring their role as prognostic factors of pancreatic cancer. Methods Patients diagnosed with pancreatic cancer and hospitalized at the China National Cancer Center between April 2006 and May 2016 were enrolled in this retrospective cohort study. Clinicopathologic characteristics, laboratory parameters, and treatment protocols were compared among patients at different stages of the disease. The association between these factors and overall survival (OS) was analyzed using the Kaplan–Meier method and Cox proportional hazards model. Results The present study included 1,433 consecutive patients with pancreatic cancer. Median OS was 10.6 months (95% confidence interval [CI] 9.8–11.3 months), with 1-, 3-, and 5-year survival rates of 43.7%, 14.8%, and 8.8%, respectively. Cox multivariate analysis findings identified the following factors as independent predictors of OS: gender (female vs male, hazard ratio 0.72, 95% CI [0.54–0.95]); elevated total bilirubin (TBil; 1.82, 1.34–2.47); elevated carbohydrate antigen 19-9 (CA19-9; 1.72, 1.17–2.54); tumor being located in pancreatic body and tail (1.52, 1.10–2.10); advanced T stage (T3-4 vs T1-2, 1.62, 1.15–2.27); lymph node metastasis (1.57, 1.20–2.07); distant metastasis (1.59, 1.12–2.27); the presence of surgical resection (0.53, 0.34–0.81); and the presence of systemic chemotherapy (0.62, 0.45–0.82). Conclusions Being male, elevated TBil and carcinoembryonic antigen, tumor being located in pancreatic body and tail, advanced T stage, lymph node and distant metastasis, the absence of surgical resection, and the absence of systematic chemotherapy were associated with worse OS in patients with pancreatic cancer.

Download Full-text

Cross-border healthcare and prognosis of HIV infection in the triple border Brazil-Paraguay-Argentina

Cadernos de Saúde Pública ◽

10.1590/0102-311x00184918 ◽

2019 ◽

Vol 35 (9) ◽

Author(s):

Ricardo Zaslavsky ◽

Barbara Niegia Garcia de Goulart ◽

Patricia Klarmann Ziegelmann

Keyword(s):

Cohort Study ◽

Prognostic Factors ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Rank Test ◽

Hiv Patients ◽

Term Care ◽

Risk Of Death ◽

Cross Border ◽

Significant Difference

Abstract: The act of crossing an international border for healthcare is a reality in border areas and the flow is in the direction of the city with more human and healthcare resources. Although several prognostic factors related to HIV+ patients are known, the prognostic value of this type of mobility for long term care is still neglected. This study compares the prognosis of HIV patients from three groups, one involved in regional mobility, another in cross-border mobility in search for healthcare and the reference group which is composed by patients living in the same city of the health facility. This is a retrospective cohort study using medical records from a healthcare service in Brazil. Following survival analysis with log-rank test and Cox proportional hazard models, overall survival had no significant difference between patients who were involved in regional (HR = 1.03; 95%CI: 0.69-1.54; p = 0.89) or international (HR = 1.07; 95%CI: 0.58-1.97; p = 0.83) mobility and those who were not. This lack of difference was kept when adjusted for known prognostic factors. In this retrospective cohort study, exposure to both regional and international migration did not have a significant association with the risk of death by any cause in crude or adjusted analyses for already known prognostic factors. This is the first study to consider the prognostic role of cross-border healthcare for HIV patients. Despite these findings, the need of monitoring the extent and the clinical and demographic characteristics of healthcare demand originated in the other side of the border and the use of these data for decision making in health management is emphasized.

Download Full-text

Abstract P609: Restarting Anticoagulant Therapy After Intracranial Hemorrhage With Atrial Fibrillation: A Nationwide Retrospective Cohort Study

Stroke ◽

10.1161/str.52.suppl_1.p609 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Dong Hoon Shin ◽

Jaehun Jung ◽

Gi Hwan Bae

Keyword(s):

Atrial Fibrillation ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Lower Risk ◽

Retrospective Cohort ◽

Antiplatelet Agents ◽

Risk Of Death ◽

Hemorrhagic Events ◽

All Cause Mortality ◽

Severe Hemorrhage

Background: Atrial fibrillation (AF) should be treated with anticoagulants to prevent stroke and systemic embolism. Resuming anticoagulation after intracerebral hemorrhage (ICH) poses a clinical conundrum. The absence of evidence-based guidelines to address this issue has led to wide variations in restarting anticoagulation after ICH. This study aimed to evaluate the risks and benefits of anticoagulation therapy on all-cause mortality, severe thromboembolism, and severe hemorrhage and compare the effect of novel direct oral anticoagulants (NOACs) with warfarin on post-ICH mortality in patients with AF. Methods: This retrospective cohort study was performed using health insurance claim data obtained between 2002 and 2017 from individuals with newly developed ICH with comorbid AF. We excluded participants aged < 40 years and those with traumatic ICH, subdural hemorrhage, or subarachnoid hemorrhage. The primary endpoint was all-cause mortality, and the secondary endpoints were severe thrombotic and hemorrhagic events. Anticoagulants, antiplatelet agents, and non-users were analyzed for survival with propensity score matching. Results: Among 6735 participants, 1743 (25.9%) and 1690 (25.1%) used anticoagulants and antiplatelet agents, respectively. Anticoagulant (HR, 0.321; 95% CI, 0.264-0.390; P < 0.0001) or antiplatelet users (HR, 0.393; 95% CI, 0.330-0.468; P < 0.0001) had a lower risk of all-cause mortality than non-users. However, there was no difference between the two drug users (HR, 1.183; 95% CI, 0.94-1.487; P = 0.152; reference: anticoagulant). The risk of acute thrombotic events, although not hemorrhagic events, was significantly lower in anticoagulant users than in antiplatelet users. In addition, anticoagulation between 6 to 8 weeks post-ICH showed a tendency of the lowest risk of death. Further, NOACs were associated with a lower risk of all-cause mortality than warfarin. Conclusions: Our results showed that in patients with AF, resuming anticoagulants between 6 and 8 weeks after ICH improved all-cause mortality, severe thromboembolism, and severe hemorrhage. Further, compared with warfarin, NOAC had additional benefits.

Download Full-text

Which prognostic factors are important for long-term outcomes in symptomatic obstructive colon cancer? A multi-institutional retrospective cohort study

Journal of Minimally Invasive Surgery ◽

10.7602/jmis.2021.24.3.128 ◽

2021 ◽

Vol 24 (3) ◽

pp. 128-138 ◽

Cited By ~ 1

Author(s):

Chang Hwan Kim ◽

Jung Hoon Bae ◽

Chul Seung Lee ◽

Seung-Rim Han ◽

In Kyu Lee ◽

...

Keyword(s):

Colon Cancer ◽

Cohort Study ◽

Prognostic Factors ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Long Term Outcomes

Download Full-text

Prognostic factors of Candida spp. bloodstream infection in adults: A nine-year retrospective cohort study across tertiary hospitals in Brazil and Spain

The Lancet Regional Health - Americas ◽

10.1016/j.lana.2021.100117 ◽

2021 ◽

pp. 100117

Author(s):

Caroline Agnelli ◽

Maricela Valerio ◽

Emilio Bouza ◽

Jesús Guinea ◽

Teresa Sukiennik ◽

...

Keyword(s):

Cohort Study ◽

Prognostic Factors ◽

Bloodstream Infection ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Candida Spp ◽

Tertiary Hospitals

Download Full-text

Management of patients with pulmonary mycobacteriosis in France: a multicenter retrospective cohort study

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01701-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Pascale Bemer ◽

Olivia Peuchant ◽

Hélène Guet-Revillet ◽

Julien Bador ◽

Charlotte Balavoine ◽

...

Keyword(s):

Cohort Study ◽

Prognostic Factors ◽

Mycobacterium Avium ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Cox Regression ◽

Nontuberculous Mycobacteria ◽

Great Variability ◽

Microbiological Characteristics ◽

Smear Negative

Abstract Background Recent studies report very low adherence of practitioners to ATS/IDSA recommendations for the treatment of nontuberculous mycobacteria pulmonary disease (NTM-PD), as well as a great variability of practices. Type of management could impact prognosis. Methods To evaluate management and prognosis of patients with NTM-PD cases with respect to ATS recommendations, we conducted a multicenter retrospective cohort study (18 sentinel sites distributed throughout France), over a period of six years. We collected clinical, radiological, microbiological characteristics, management and outcome of the patients (especially death or not). Results 477 patients with NTM-PD were included. Respiratory comorbidities were found in 68% of cases, tuberculosis sequelae in 31.4% of patients, and immunosuppression in 16.8% of cases. The three most common NTM species were Mycobacterium avium complex (60%), M. xenopi (20%) and M. kansasii (5.7%). Smear-positive was found in one third of NTM-PD. Nodulobronchiectatic forms were observed in 54.3% of cases, and cavitary forms in 19.1% of patients. Sixty-three percent of patients were treated, 72.4% of patients with smear-positive samples, and 57.5% of patients with smear-negative samples. Treatment was in adequacy with ATS guidelines in 73.5%. The 2-year mortality was 14.4%. In the Cox regression, treatment (HR = 0.51), age (HR = 1.02), and M. abscessus (3.19) appeared as the 3 significant independent prognostic factors. Conclusion These findings highlight the adequacy between French practices and the ATS/IDSA guidelines. Treatment was associated with a better survival.

Download Full-text

Retrospective cohort study of prognostic factors in patients with oral cavity and oropharyngeal squamous cell carcinoma

Head & Neck ◽

10.1002/hed.23914 ◽

2015 ◽

Vol 38 (4) ◽

pp. 536-541 ◽

Cited By ~ 14

Author(s):

José F. Carrillo ◽

Liliana C. Carrillo ◽

Ana Cano ◽

Margarita C. Ramirez-Ortega ◽

Jorge G. Chanona ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cohort Study ◽

Prognostic Factors ◽

Oral Cavity ◽

Cell Carcinoma ◽

Squamous Cell ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Oropharyngeal Squamous Cell Carcinoma

Download Full-text

Associations between depression and all-cause and cause-specific risk of death: A retrospective cohort study in the Veterans Health Administration

Journal of Psychosomatic Research ◽

10.1016/j.jpsychores.2015.01.014 ◽

2015 ◽

Vol 78 (4) ◽

pp. 324-331 ◽

Cited By ~ 34

Author(s):

Kara Zivin ◽

Matheos Yosef ◽

Erin M. Miller ◽

Marcia Valenstein ◽

Sonia Duffy ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Veterans Health Administration ◽

Veterans Health ◽

Health Administration ◽

Risk Of Death ◽

Specific Risk

Download Full-text

Prognostic significance of occlusion length in recanalized chronic total occlusion lesion: a retrospective cohort study with 5-year follow-up

BMJ Open ◽

10.1136/bmjopen-2020-038302 ◽

2020 ◽

Vol 10 (7) ◽

pp. e038302

Author(s):

Tao Tian ◽

Changdong Guan ◽

Lijian Gao ◽

Lei Song ◽

Jiansong Yuan ◽

...

Keyword(s):

Cohort Study ◽

Primary Endpoint ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Chronic Total Occlusion ◽

Secondary Outcome ◽

Total Occlusion ◽

Risk Of Death ◽

Kaplan Meier

ObjectivesThis study sought to investigate the relationship between occlusion length and long-term outcomes of patients with recanalised chronic total occlusion (CTO) lesion.DesignA retrospective cohort study.SettingFuwai Hospital, National Center for Cardiovascular Disease, Beijing, ChinaParticipantsConsecutive patients with successfully recanalised CTO were included from January 2010 to December 2013.Primary and secondary outcome measuresThe primary endpoint of the present study was a composite event of all-cause death and myocardial infarction (MI). The secondary endpoints included target lesion revascularisation (TLR) and target vessel revascularisation (TVR).ResultsA total of 1987 patients were included and 1801 (90.6%) subjects completed 5-year follow-up in this study. Based on occlusion length, the patients were divided equally into two groups: short (length <15 mm, n=957) and long (length ≥15 mm, n=1030) CTO group. Kaplan-Meier survival curve showed no significant difference in the risk of the composite primary endpoint between short and long CTO groups (p=0.242). Receiver operating characteristic curve analysis also established occlusion length ≥15 mm as a cut-off value for predicting TLR and TVR, with an area under the curve of 0.604 (95% CI: 0.569 to 0.638, p<0.001) and 0.605 (95% CI: 0.572 to 0.638; p<0.001). Kaplan-Meier analysis revealed that the risks for TLR (p=0.002) and TVR (p=0.002) were higher in a patient with long CTO lesion. Multivariate Cox analysis also identified long CTO lesion as an independent predictor of TLR (HR: 1.539, 95% CI: 1.033 to 2.293; p=0.034) and TVR (HR: 1.476, 95% CI: 1.012 to 2.151; p=0.043).ConclusionPatients with long CTO lesion did not show a higher risk of death and MI after recanalisation, but had higher risks of TLR and TVR. Lesion with occlusion length ≥15 mm should be under close surveillance for restenosis after recanalisation.

Download Full-text