scholarly journals MO1049PROGRESSION OF CHRONIC KIDNEY DISEASE AND LONG-TERM MORTALITY IN PATIENTS HOSPITALIZED WITH TRICUSPID REGURGITATION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Saban Elitok ◽  
Anja Haase-Fielitz ◽  
Martin Ernst ◽  
Michael Haase
Keyword(s):  
Risk Factors ◽  
Hemoglobin Concentration ◽  
Ckd Progression ◽  
Survival Status ◽  
Independent Risk Factors ◽  
Index Hospital ◽  
The Impact ◽  
Long Term Mortality

Abstract Background and Aims Uremic toxins negatively affect the cardiovascular system resulting in significant morbidity and mortality. However, independent risk factors for chronic kidney disease (CKD) and that of worsening CKD have not been studied in patients with tricuspid regurgitation (TR), yet. Accordingly, in this study, we aimed to assess independent risk factors for the development of progressive CKD in patients with TR. Also, the impact of progressive CKD on long-term mortality was evaluated. Method This retrospective, single-center study comprised 444 consecutive patients with TR who were hospitalized between January 2010 and June 2017. We excluded patients with CKD stage 5. Demographic data, comorbidities, type of admission, medication, echocardiographic and laboratory parameters, and survival status were obtained from patient medical record from index hospital admission through discharge. For at least three years, serum creatinine concentrations and survival status were collected from outpatient medical record. We identified independent risk factors for CKD progression. Also, we assessed the impact of CKD progression and other variables on 3-year mortality using multivariable logistic regression analysis. For analysis of 3-year mortality, we grouped patients according to different combinations of their TR grade and presence or absence of CKD progression. Results Stage of CKD at hospital admission (odds ratio 0.34 [95% confidence interval 0.24-0.50], p < 0.001), baseline hemoglobin concentration (OR 0.72 [95% CI 0.57-0.92], p=0.006) and presence of diabetes type 2 (OR 1.81 [95% CI 1.08-3.03], p=0.024) were identified as independent risk factors for CKD progression. Progression of CKD during follow-up (OR 2.16 [95% CI 1.31-3.57], p=0.003), grade of TR and mitral regurgitation during index hospital stay and hemoglobin concentration at baseline were independent risk factors for 3-year mortality. Combination of TR grade and status of CKD progression showed a stepwise pattern for 3-year mortality (Figure 1). Patients with TR 1 and CKD progression had a similar 3-year mortality as patients with TR 2 or 3 but no CKD progression. In patients with TR 1, risk for 3-year mortality doubled if CKD progression occurred (OR 2.49 [95% CI 1.38-4.47], p=0.002). Conclusion Although retrospective studies cannot imply causal relationship, based on study findings, kidney follow-up especially in patients with mild TR may be advisable. If CKD progression can be prevented in patients with TR and if such kidney protection may reduce long-term mortality may be objective of future studies.

scholarly journals Independent risk factors for long-term mortality in patients with severe infection

Critical Care ◽  
2015 ◽  
Vol 19 (Suppl 1) ◽  
pp. P16
Author(s):  
J Francisco ◽  
I Aragão ◽  
T Cardoso
Keyword(s):  
Risk Factors ◽  
Severe Infection ◽  
Independent Risk Factors ◽  
Long Term Mortality

scholarly journals The impact of the recurrent laryngeal nerve injury on prognosis after McKeown esophagectomy for ESCC

2020 ◽  
Author(s):  
Rirong Qu ◽  
Dehao Tu ◽  
Wei Ping ◽  
Qi Wang ◽  
Ni Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Recurrent Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Term Survival ◽  
Laryngeal Nerve Injury ◽  
Independent Risk Factors ◽  
Mckeown Esophagectomy ◽  
The Impact

Abstract Background: The objective of this study was to assess the impact of the recurrent laryngeal nerve injury (RLNI) after esophagectomy on prognosis.Methods: Retrospectively collected data from 297 patients with esophageal squamous cell carcinoma who underwent McKeown esophagectomy at our department from April 2014 to May 2018, were analyzed.Results: RLNI occurred in 31.9% of the patients. Left-side RLNI occurred 2.8 times more often than right-side RLNI. Among the cases in which assessment of the vocal cords was continued, 8.4% involved permanent injury. There were no significant differences among clinicopathological data between patients with RLNI and without. Compared with patients without RLNI,patients with RNLI have longer operation time,more number of bronchoscopy suctions, longer postoperation hospital stay, and higher incidence of postoperative complications. T stage, N stage, RLN LN metastasis were independent risk factors for the prognosis, but RLNI is not independent risk factors for long-term survival. Conclusion: RLNI is a serious complication that will affect the short-term prognosis of patients and reduce the quality of life of patients. It should be avoided as much as possible during surgery, but it may not have negative impact on the long-term survival.

Abstract 19771: Persistent Thrombocytopenia after Myocardial Infarction is Associated with Increased Short- and Long-Term Mortality

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Anirudh Kumar ◽  
Salim Virani ◽  
Scott Bassett ◽  
Mahboob Alam ◽  
Ravi Hira ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Bleeding Complications ◽  
Group Differences ◽  
Long Term Outcomes ◽  
Post Discharge ◽  
Short And Long Term ◽  
The Impact ◽  
Long Term Mortality

Background: Thrombocytopenia (TCP) occurs commonly in patients hospitalized with acute myocardial infarction (AMI). It is unclear whether persistent TCP after discharge among AMI survivors is associated with worse outcomes. Methods: We examined the impact of persistent post-discharge TCP on outcomes in a registry of consecutive AMI patients hospitalized between January 2004 and December 2007. In-hospital (IH) TCP was defined by a nadir platelet count < 150 x 109/L. Resolved TCP was defined as IH TCP which resolved within 3 months after discharge while persistent TCP was defined as IH TCP which did not resolve within 3 months. Results: Of 842 patients hospitalized for a first AMI, we examined data on 617 hospital survivors who had follow-up within 3 months of discharge and documented long-term outcomes. Of those, 474 (76.8%) patients did not experience IH TCP while 42 (6.8%) and 101 (16.4%) had persistent and resolved TCP, respectively (Table). Patients with persistent TCP were older, had worse comorbidities, and were more likely to have TCP at baseline and discharge. There were no inter-group differences in infarct size, major bleeding complications, revascularization, or ejection fraction at discharge. Mortality following discharge was higher at all time-points among AMI patients with persistent TCP compared to patients with resolved or without IH TCP (Figure). Patients with resolved TCP had comparable mortality to those without IH TCP. Conclusion: Persistent TCP within 3 months after hospital discharge for AMI is associated with significantly increased short- and long-term mortality compared to patients with recovered TCP or without IH TCP.

Intradialytic Hypotension as an Independent Risk Factor for Long-Term Mortality in Maintaining Hemodialysis Patients: A 5-Year Follow-Up Cohort Study

2018 ◽  
Vol 45 (4) ◽  
pp. 320-326 ◽  
Author(s):  
Jinbo Yu ◽  
Zhonghua Liu ◽  
Bo Shen ◽  
Jie Teng ◽  
Jianzhou Zou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Mortality Rate ◽  
Independent Risk Factor ◽  
Left Ventricular ◽  
Intradialytic Hypotension ◽  
Ultrafiltration Rate ◽  
Long Term Mortality

Aims: This study aimed to assess risk factors of intradialytic hypotension (IDH) and the association of prognosis and IDH among maintenance hemodialysis (MHD) patients. Methods: Among 293 patients, 117 were identified with IDH (more than 4 hypotensive events during 3 months). The association between IDH and survival was evaluated. Results: The incidence of IDH was 39.9%. Age, ultrafiltration rate, N-terminal pro-B-type natriuretic peptide (NT-proBNP), albumin, β2-microglobulin (β2MG), and aortic root inside diameter (AoRD) were independently associated with IDH. During the 5-year follow-up, 84 patients died with a mortality rate 5.2 per 100 person-year. IDH-prone patients had a higher all-cause mortality rate. IDH and left ventricular mass index were independent risk factors for death (HR 1.655, 95% CI 1.061–2.580; HR 1.008, 95% CI 1.001–1.016). Conclusion: IDH is an independent risk factor for long-term mortality in MHD patients. Patients with older age, high ultrafiltration rate, high level of serum NT-proBNP and β2MG, hypoalbuminemia, and shorter AoRD are at high risk of IDH.

Risk factors for a first thrombotic event in antiphospholipid antibody carriers. A multicentre, retrospective follow-up study

2008 ◽  
Vol 68 (3) ◽  
pp. 397-399 ◽  
Author(s):  
A Ruffatti ◽  
T Del Ross ◽  
M Ciprian ◽  
M Nuzzo ◽  
M Rampudda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thrombotic Event ◽  
Multivariate Logistic Regression Analysis ◽  
Anticardiolipin Antibody ◽  
Primary Prophylaxis ◽  
Antiphospholipid Antibody ◽  
History Of ◽  
Independent Risk Factors

Objectives:To asses risk factors for a first thrombotic event in antiphospholipid antibody (aPL) positive carriers and evaluate the efficacy of prophylactic treatments.Methods:Recruitment criteria were age 18–65 years, no history of thrombosis, positivity for lupus anticoagulant and/or IgG/IgM anticardiolipin antibody (aCL) on ⩾2 occasions at least 6 weeks apart. Demographic, laboratory and clinical parameters were collected at enrolment and at the time of the thrombotic event.Results:370 patients/subjects (mean (SD) age 34 (9.9) years) were analysed retrospectively for a mean (SD) follow-up of 59.3 (45.5) months. Thirty patients (8.1%) developed a first thrombotic event during follow-up. Hypertension and medium/high levels of IgG aCL were identified by multivariate logistic regression analysis as independent risk factors for thrombosis. Thromboprophylaxis during high-risk and long-term periods was significantly protective.Conclusions:Hypertension or medium/high titres of IgG aCL are risk factors for a first thrombotic event in asymptomatic aPL carriers and primary prophylaxis is protective.

scholarly journals Long-term Risk of Advanced Neoplasia After Colonic Low-grade Dysplasia in Patients With Inflammatory Bowel Disease: A Nationwide Cohort Study

2019 ◽  
Vol 13 (12) ◽  
pp. 1485-1491 ◽  
Author(s):  
Michiel E De Jong ◽  
Sanne B Van Tilburg ◽  
Loes H C Nissen ◽  
Wietske Kievit ◽  
Iris D Nagtegaal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cumulative Incidence ◽  
Low Grade ◽  
Advanced Neoplasia ◽  
Inflammatory Bowel ◽  
Independent Risk Factors ◽  
Male Sex ◽  
Low Grade Dysplasia

AbstractBackground and AimsThe long-term risk of high-grade dysplasia [HGD] and colorectal cancer [CRC] following low-grade dysplasia [LGD] in inflammatory bowel disease [IBD] patients is relatively unknown. We aimed to determine the long-term cumulative incidence of advanced neoplasia [HGD and/or CRC], and to identify risk factors for advanced neoplasia in a nationwide IBD cohort with a history of LGD.MethodsThis is a nationwide cohort study using data from the Dutch National Pathology Registry [PALGA] to identify all IBD patients with LGD between 1991 and 2010 in the Netherlands. Follow-up data were collected until January 2016. We determined the cumulative incidence of advanced neoplasia and identified risk factors via multivariable Cox regression analysis.ResultsWe identified 4284 patients with colonic LGD with a median follow-up of 6.4 years after initial LGD diagnosis. The cumulative incidence of subsequent advanced neoplasia was 3.6, 8.5, 14.4 and 21.7%, after 1, 5, 10 and 15 years, respectively. The median time to develop advanced neoplasia after LGD was 3.6 years. Older age [≥ 55 years] at moment of LGD (hazard ratio [HR] 1.73, 95% confidence interval [CI] 1.44–2.06), male sex [HR 1.33, 95% CI 1.10–1.60], and follow-up at an academic [vs non-academic] medical centre [HR 1.37, 95% CI 1.07–1.76] were independent risk factors for advanced neoplasia following LGD.ConclusionsIn a large nationwide cohort with long-term follow-up of IBD patients with LGD, the cumulative incidence of advanced neoplasia was 21.7% after 15 years. Older age at LGD [≥55 years], male sex and follow-up by a tertiary IBD referral centre were independent risk factors for advanced neoplasia development after initial LGD.

Abstract 16287: Clinical Characteristics, Treatment and Long-term Mortality of Patients With Congenital Coronary Fistulas

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Miguel alejandro A Cutz ◽  
Manuel Gaxiola ◽  
Steaven Juarez
Keyword(s):  
Heart Failure ◽  
Coronary Artery ◽  
Pulmonary Artery ◽  
Clinical Characteristics ◽  
Phone Call ◽  
Smoking History ◽  
The Impact ◽  
Long Term Mortality

Introduction: Congenital coronary fistulas (CCF) are rare (0.002% in general population) however under-diagnosis is frequent. Patient and fistula characteristics vary among different populations, treatment is controversial and the impact in survival is not well established. Purpose: This study aimed to describe clinical characteristics, treatment received and long-term mortality among different options of treatment for CCF. Methods: We identified all cases of CCF diagnosed from January 2009 to January 2019 in a single center. Clinical data was obtained from medical records and mortality was assessed according to clinical checkups or by phone call. Long-term mortality was defined after at least one-year follow-up. Descriptive statistics were applied to all cases. Results: 22 cases of CCF were diagnosed, medium age was 53.6 years, 65% were male and 31% had smoking history. At presentation 36% had angina and 27% had dyspnea. Only 13.6% had no significant past medical history, 20% had another congenital anomaly associated, 13.6 % had chronic heart failure and 45.4% were associated to coronary artery disease (CAD), usually anterior descending artery (ADA) was affected. Most frequent origin of fistula was from the ADA in 42.3% of the cases and drainage was frequent to the pulmonary artery in 53.4%, 80% had a single fistula and 45% presented small fistulas. Overall mortality was 13.6% (n=3) with median follow-up of 3.6 (1-9.9) years. Among patients treated, 72.8% of the patients received medical treatment with a 12.5% rate of long-term mortality, however only one patient died from cardiovascular cause (worsening heart failure). None of the patients who received interventional treatment (N=3) died at long-term, 13.6% had coronary artery bypass grafting for CAD (none had fistula ligation), only one patient died several years later of neurological cause. Conclusions: The most common origin of CCF was from the ADA and the drainage was common to the pulmonary artery. Long term mortality is low in patients with CCF despite treatment received, only one patient in the entire cohort died of cardiac disease even when 55% had medium to large coronary fistula and 86.4% had previous cardiovascular disease. Further studies are needed to establish treatment guidelines.

Risk factors of long-term mortality in middle-aged women: a 27-year follow-up cohort

Climacteric ◽  
2018 ◽  
Vol 21 (6) ◽  
pp. 554-558 ◽  
Author(s):  
J. E. Blümel ◽  
S. Aedo ◽  
E. Arteaga ◽  
M. S. Vallejo
Keyword(s):  
Risk Factors ◽  
Middle Aged ◽  
Long Term Mortality
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