scholarly journals Clinical Characteristics and Risk Factors for COVID-19-associated Candidemia

2021 ◽  
Author(s):  
Ali S Omrani ◽  
Junais Koleri ◽  
Fatma Ben Abid ◽  
Joanne Daghfel ◽  
Thasneem Odaippurath ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Regression Analysis ◽  
Intensive Care ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Conditional Logistic Regression ◽  
Conditional Logistic Regression Analysis ◽  
Failure Assessment ◽  
Candida Bloodstream Infection

Abstract Patients with COVID-19-associated candidemia (CAC) in an intensive care unit (ICU) were matched 1:2 with those without candidemia, based on ICU admission date and length of stay in ICU being at least equal to that before candidemia in the corresponding case. The incidence rate of CAC was 2.34 per 1,000 ICU days. Eighty cases could be matched to appropriate controls. In the multivariate conditional logistic regression analysis, age (P 0.001), and sequential organ failure assessment score (P 0.046) were the only risk factors independently associated with CAC. Tocilizumab and corticosteroids therapy were not independently associated with candidemia. Lay Summary In COVID-19 patients who need medical care in an intensive care unit, the risk of developing bloodstream Candida infection is higher in older patients and in those who have a more severe critical illness. Treatment with steroids or tocilizumab does not seem to affect the risk of candida bloodstream infection in these patients.

scholarly journals Clinical characteristics and risk factors for mortality in patients with coronavirus disease 2019 in intensive care unit: a single-center, retrospective, observational study in China

2020 ◽  
Author(s):  
Fangfang Sai ◽  
Xiaolei Liu ◽  
Lanyu Li ◽  
Yan Ye ◽  
Changqing Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Sofa Score ◽  
Lymphocyte Count ◽  
Clinical Characteristics ◽  
Study Cohort ◽  
Failure Assessment ◽  
Life Threatening

Abstract Background: Coronavirus disease 2019 (COVID-19) is a potentially life-threatening contagious disease which has spread all over the world. Risk factors for the clinical outcomes of COVID-19 pneumonia in intensive care unit (ICU) have not yet been well determined. Methods: In this retrospective, single-centered, observational study, we consecutively included 47 patients with confirmed COVID-19 who were admitted to the ICU of Leishenshan Hospital in Wuhan, China, from February 24 to April 5, 2020. Clinical characteristics and outcomes were collected and compared between survivors and non-survivors. Multivariable logistic regression was used to explore the risk factors associated with death in patients of COVID-19.Results: The study cohort included 47 adult patients with a median age of 70.55±12.52 years, and 30 (63.8%) patients were men. Totally 15 (31.9%) patients died. Compared with survivors, non-survivors were more likely to develop septic shock (6 [40%] patients vs 3 [9.4%] patients ), disseminated intravascular coagulation (3 [21.4%] vs 0), and had higher score of APACHE II (25.07±8.03 vs 15.56±5.95), CURB-65 (3[2-4] vs 2[1-3]), Sequential Organ Failure Assessment (SOFA) (7[5-9] vs 3[1-6]), higher level of D-dimer (5.74 [2.32-18] vs 2.05 [1.09-4.00] ) and neutrophil count (9.4[7.68-14.54] vs 5.32[3.85-9.34] ). SOFA score (OR 1.47, 1.01–2.13; p=0.0042) and lymphocyte count (OR 0.02, 0.00–0.86; p=0.042) on admission were independently risk factors for mortality. Patients with higher lymphocyte count (>0.63×109/L) and lower SOFA score ≤4 on admission had a significantly well prognosis than those with lower lymphocyte count (≤0.63×109/L) and higher SOFA score >4 in overall survival.Conclusions: Higher SOFA score and lower lymphocyte count on admission were associated with poor prognosis of patients with COVID-19 in ICU. Lymphocyte count may serve as a promising prognostic biomarker.

Characteristics of Adenocarcinoma of the Gallbladder Following Cholecystectomies in the Hispanic Population

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S64-S65
Author(s):  
David Gustafson ◽  
Osvaldo Padilla
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Incidental Finding ◽  
Conditional Logistic Regression ◽  
Gallbladder Disease ◽  
Predictor Variables ◽  
Wall Thickening ◽  
Conditional Logistic Regression Analysis

Abstract Introduction Gallbladder adenocarcinoma (GBC) is a rare malignancy. Frequency of incidental adenocarcinoma of the gallbladder in the literature is approximately 0.2% to 3%. Typically, GBC is the most common type and is discovered late, not until significant symptoms develop. Common symptoms include right upper quadrant pain, nausea, anorexia, and jaundice. A number of risk factors in the literature are noted for GBC. These risk factors are also more prevalent in Hispanic populations. This study sought to compare patients with incidental gallbladder adenocarcinomas (IGBC) to those with high preoperative suspicion for GBC. Predictor variables included age, sex, ethnicity, radiologic wall thickening, gross pathology characteristics (wall thickness, stone size, stone number, and tumor size), histologic grade, and staging. Methods Cases of GBC were retrospectively analyzed from 2009 through 2017, yielding 21 cases. Data were collected via Cerner EMR of predictor variables noted above. Statistical analysis utilized conditional logistic regression analysis. Results The majority of patients were female (n = 20) and Hispanic (n = 19). There were 14 IGBCs and 7 nonincidental GBCs. In contrast with previous research, exact conditional logistic regression analysis revealed no statistically significant findings. For every one-unit increase in AJCC TNM staging, there was a nonsignificant 73% reduction in odds (OR = 0.27) of an incidental finding of gallbladder carcinoma. Conclusion This study is important in that it attempts to expand existing literature regarding a rare type of cancer in a unique population, one particularly affected by gallbladder disease. Further studies are needed to increase predictive knowledge of this cancer. Longer studies are needed to examine how predictive power affects patient outcomes. This study reinforces the need for routine pathologic examination of cholecystectomy specimens for cholelithiasis.

Risk factors for poor outcome in older patients admitted in a surgical intensive care unit

2021 ◽  
Author(s):  
Emilie Occhiali ◽  
Pierre Prolange ◽  
Florence Cassiau ◽  
Frédéric Roca ◽  
Benoit Veber ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Older Patients ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Poor Outcome

Clinical characteristics, evolution, and treatment-related risk factors for mortality among immunosuppressed patients with influenza A (H1N1) virus admitted to the intensive care unit

2018 ◽  
Vol 48 ◽  
pp. 172-177 ◽  
Author(s):  
José Garnacho-Montero ◽  
Cristina León-Moya ◽  
Antonio Gutiérrez-Pizarraya ◽  
Angel Arenzana-Seisdedos ◽  
Loreto Vidaur ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Influenza A ◽  
Clinical Characteristics ◽  
H1n1 Virus ◽  
Related Risk ◽  
Influenza A H1n1 ◽  
Immunosuppressed Patients

scholarly journals Association of Adiponectin Gene Variations with Risk of Incident Myocardial Infarction and Ischemic Stroke: A Nested Case-Control Study

2006 ◽  
Vol 52 (11) ◽  
pp. 2021-2027 ◽  
Author(s):  
Hillary H Hegener ◽  
I-Min Lee ◽  
Nancy R Cook ◽  
Paul M Ridker ◽  
Robert YL Zee
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Conditional Logistic Regression ◽  
Adiponectin Gene ◽  
Conditional Logistic Regression Analysis ◽  
Caucasian Men ◽  
Potential Risk Factors

Abstract Background: Adiponectin (ADIPOQ) gene variations are associated with risk of cardiovascular disease in patients with diabetes. No prospective data are available, however, on the risk of atherothrombotic disorders in persons with ADIPOQ variations who do not have diabetes. Methods: From a group of DNA samples collected at baseline in a prospective cohort of 14 916 initially healthy American men, we assessed the presence of 5 ADIPOQ genetic variants (rs266729, rs182052, rs822396, rs2241766, and rs1501299) in samples from 600 Caucasian men who subsequently suffered an atherothrombotic event (incident myocardial infarction or ischemic stroke) and from 600 age- and smoking-matched Caucasian men who remained free of reported vascular disease during follow-up (controls). Results: Genotype distributions for the variations tested were in Hardy-Weinberg equilibrium. Marker-by-marker conditional logistic regression analysis, adjusted for potential risk factors, showed an association of rs266729 [recessive: odds ratio (OR), 0.26; 95% confidence interval (CI), 0.10–0.64; P = 0.004] and rs182052 (recessive: OR, 0.40; 95% CI, 0.21–0.76; P = 0.006) with decreased risk of ischemic stroke. These findings remained significant after Bonferroni correction. Haplotype-based (constituted by rs266729, rs182052, and rs822396) conditional logistic regression analysis, adjusted for the same potential risk factors, showed an association of haplotype G-A-G (OR, 0.28; 95% CI, 0.09–0.87; P = 0.03) with decreased risk of ischemic stroke. Prespecified analysis limited to participants without baseline diabetes showed similar significant findings. Conclusions: The present prospective investigation provides further evidence for a protective role of adiponectin gene variation in the risk of ischemic stroke that was independent of the presence of diabetes.

scholarly journals Influence of Tigecycline on Liver Function in Adult Patients in the Intensive Care Unit

2021 ◽  
Author(s):  
Jingnan Song ◽  
Pan Chen ◽  
Zhaoxia Tang ◽  
Yifan Zheng ◽  
Xiao Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Regression Analysis ◽  
Intensive Care ◽  
Liver Disease ◽  
Liver Injury ◽  
Liver Function ◽  
Adult Patients ◽  
Apache Ii Score ◽  
Cox Regression Analysis

Abstract Background There are few studies investigating TGC-associated hepatotoxicity in ICU patients, and the pathogenesis of hepatotoxicity and identification of risk factors are limited. Objectives To analyze the influence of tigecycline (TGC) on liver function in adult patients in the Intensive Care Unit to identify potential risk factors for tigecycline-induced liver injury (TILI). Methods Patients receiving tigecycline treatment in ICU during January 2019 to October 2020 were retrospectively enrolled. The liver function parameters before and after tigecycline treatment were collected, and risk factors associated with TILI was identified by logistic regression analysis. The probability of 28-day mortality was determined in Cox regression analysis. Results A total of 242 patients were enrolled, and TILI was identified in 24 patients (9.92%), of whom 75.0% had grade 1 liver injury, and 16.67%, 4.17%, 4.17% had grade 2 to 4 liver injury, respectively. The pattern of hepatotoxicity was hepatocellular in 16 patients (66.67%), cholestatic in 4 patients (16.67%), and mixed in 4 patients (16.67%). The median time from tigecycline start to symptoms was only 5 days (IQR, 3-7 days). Multivariate analysis identified tigecycline dose ≥ 200mg/day, longer course of treatment and preexisting liver disease tend to be independently associated with TILI. In addition, APACHE II score > 15, higher dose of tigecycline and TILI were independent risk factors of 28-day mortality, while longer course of tigecycline reduced this risk despite its association with TILI. Conclusions The maintenance dose and course of tigecycline, as well as liver disease is considered as risk factors of hepatotoxicity. 28-day mortality tended to be higher in TILI patients. The relationships among tigecycline dose and course, TILI and mortality should be further investigated.

scholarly journals Risk Factors and Outcomes of Acute Kidney Injury in Critically Ill Patients with Coronavirus Disease 2019

2020 ◽  
pp. 1-9
Author(s):  
Yichun Cheng ◽  
Nanhui Zhang ◽  
Ran Luo ◽  
Meng Zhang ◽  
Zhixiang Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
Stage 1

<b><i>Background:</i></b> Coronavirus disease 2019 (COVID-19) has emerged as a major global health threat with a great number of deaths worldwide. Acute kidney injury (AKI) is a common complication in patients admitted to the intensive care unit. We aimed to assess the incidence, risk factors and in-hospital outcomes of AKI in COVID-19 patients admitted to the intensive care unit. <b><i>Methods:</i></b> We conducted a retrospective observational study in the intensive care unit of Tongji Hospital, which was assigned responsibility for the treatments of severe COVID-19 patients by the Wuhan government. AKI was defined and staged based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Mild AKI was defined as stage 1, and severe AKI was defined as stage 2 or stage 3. Logistic regression analysis was used to evaluate AKI risk factors, and Cox proportional hazards model was used to assess the association between AKI and in-hospital mortality. <b><i>Results:</i></b> A total of 119 patients with COVID-19 were included in our study. The median patient age was 70 years (interquartile range, 59–77) and 61.3% were male. Fifty-one (42.8%) patients developed AKI during hospitalization, corresponding to 14.3% in stage 1, 28.6% in stage 2 and 18.5% in stage 3, respectively. Compared to patients without AKI, patients with AKI had a higher proportion of mechanical ventilation mortality and higher in-hospital mortality. A total of 97.1% of patients with severe AKI received mechanical ventilation and in-hospital mortality was up to 79.4%. Severe AKI was independently associated with high in-hospital mortality (OR: 1.82; 95% CI: 1.06–3.13). Logistic regression analysis demonstrated that high serum interleukin-8 (OR: 4.21; 95% CI: 1.23–14.38), interleukin-10 (OR: 3.32; 95% CI: 1.04–10.59) and interleukin-2 receptor (OR: 4.50; 95% CI: 0.73–6.78) were risk factors for severe AKI development. <b><i>Conclusions:</i></b> Severe AKI was associated with high in-hospital mortality, and inflammatory response may play a role in AKI development in critically ill patients with COVID-19.

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