Is there a mortality benefit in patients with COPD who take statins compared with those who do not?

Introduction Extensive research relying on Injury Severity Scores (ISS) reports a mortality benefit from routine non-selective thoracic CTs (an integral part of pan-computed tomography (pan-CT)s). Recent research suggests this mortality benefit may be artifact. We hypothesized that the use of pan-CTs inflates ISS categorization in patients, artificially affecting admission rates and apparent mortality benefit. Methods Eight hundred and eleven patients were identified with an ISS >15 with significant findings in the chest area. Patient charts were reviewed and scores were adjusted to exclude only occult injuries that did not affect treatment plan. Pearson chi-square tests and multivariable logistic regression were used to compare adjusted cases vs non-adjusted cases. Results After adjusting for inflation, 388 (47.8%) patients remained in the same ISS category, 378 (46.6%) were reclassified into 1 lower ISS category, and 45 (5.6%) patients were reclassified into 2 lower ISS categories. Patients reclassified by 1 category had a lower rate of mortality ( P < 0.001), lower median total hospital LOS ( P < .001), ICU days ( P < .001), and ventilator days ( P = 0.008), compared to those that remained in the same ISS category. Conclusion Injury Severity Score inflation artificially increases survival rate, perpetuating the increased use of pan-CTs. This artifact has been propagated by outdated mortality prediction calculation methods. Thus, prospective evaluations of algorithms for more selective CT scanning are warranted.

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Borderline trend towards long-term mortality benefit from drug eluting stents implantation in ST-elevation myocardial infarction patients in Poland-data from NRDES registry

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.25169 ◽

2013 ◽

Vol 83 (3) ◽

pp. 436-442 ◽

Cited By ~ 3

Author(s):

Zbigniew Siudak ◽

Artur Dziewierz ◽

Tomasz Rakowski ◽

Krzysztof Żmudka ◽

Jacek Legutko ◽

...

Keyword(s):

Myocardial Infarction ◽

St Elevation Myocardial Infarction ◽

Drug Eluting Stents ◽

Mortality Benefit ◽

Drug Eluting ◽

St Elevation ◽

Long Term Mortality

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A Meta-Analysis of Nutritional Supplementation for Management of Hospitalized Alcoholic Hepatitis

Canadian Journal of Gastroenterology ◽

10.1155/2012/945707 ◽

2012 ◽

Vol 26 (7) ◽

pp. 463-467 ◽

Cited By ~ 30

Author(s):

Ramy Antar ◽

Phil Wong ◽

Peter Ghali

Keyword(s):

Biochemical Parameters ◽

Meta Analysis ◽

Nutritional Therapy ◽

Pooled Analysis ◽

Nutritional Supplementation ◽

Mortality Benefit ◽

Randomized Controlled ◽

Balanced Diet ◽

Randomized Controlled Studies ◽

Diet Versus

BACKGROUND: Alcoholic liver disease (ALD) is associated with a high risk of morbidity and mortality. Malnutrition accompanies this condition and may be both a consequence of and contributor to the pathology. Many trials have investigated the benefits of providing supplemental nutrition in the management of patients with ALD. The present study is a meta-analysis of the available evidence.METHOD: A meta-analysis of randomized controlled studies comparing nutritional supplementation plus a normal hospital diet versus diet alone.RESULTS: Seven randomized controlled studies including 262 patients with ALD were identified. Pooled analysis revealed no statistical difference in mortality between groups given special nutritional therapy versus a normal balanced diet (OR 0.80 [95% CI 0.42 to 1.52]). In addition, nutrition did not significantly improve ascites (OR 1.29 [95% CI 0.52 to 3.20]) or any biochemical parameters. However, encephalopathy showed a significant improvement or resolution (OR 0.24 [95% CI 0.06 to 0.93]).CONCLUSION: Nutritional supplementation provided no mortality benefit in patients with ALD, and neither ascites nor biochemical parameters significantly improved. However, encephalopathy was significantly ameliorated and, therefore, nutritional supplementation should be encouraged in that setting.

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Is There a Mortality Benefit of Statin Use for Secondary Prevention of Coronary Artery Disease (CAD) in an Older Population? Insights from the Melbourne Interventional Group (MIG) Registry

Heart Lung and Circulation ◽

10.1016/j.hlc.2021.06.302 ◽

2021 ◽

Vol 30 ◽

pp. S231

Author(s):

D. Gayed ◽

D. Dinh ◽

D. Liang ◽

M. Tan ◽

E. Oquiel ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Secondary Prevention ◽

Mortality Benefit ◽

Older Population ◽

Artery Disease ◽

Interventional Group ◽

Statin Use

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Specialist pneumonia intervention nurse service improves pneumonia care and outcome

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2020-000863 ◽

2021 ◽

Vol 8 (1) ◽

pp. e000863

Author(s):

Robert C Free ◽

Matthew Richardson ◽

Camilla Pillay ◽

Kayleigh Hawkes ◽

Julie Skeemer ◽

...

Keyword(s):

Quality Improvement ◽

National Health Service ◽

Low Cost ◽

Community Acquired Pneumonia ◽

National Audit ◽

Mortality Benefit ◽

Model Of Care ◽

Spin Period ◽

National Health Service Trust ◽

Set Up

BackgroundA specialist pneumonia intervention nursing (SPIN) service was set up across a single National Health Service Trust in an effort to improve clinical outcomes. A quality improvement evaluation was performed to assess the outcomes associated with implementing the service before (2011–2013) and after (2014–2016) service implementation.ResultsThe SPIN service reviewed 38% of community-acquired pneumonia (CAP) admissions in 2014–2016. 82% of these admissions received antibiotic treatment in <4 hours (68.5% in the national audit). Compared with the pre-SPIN period, there was a significant reduction in both 30-day (OR=0.77 (0.70–0.85), p<0.0001) and in-hospital (OR=0.66 (0.60–0.73), p<0.0001) mortality after service implementation, with a review by the service showing the largest independent 30-day mortality benefit (HR=0.60 (0.53–0.67), p<0.0001). There was no change in length of stay (median 6 days).ConclusionImplementation of a SPIN service improved adherence to BTS guidelines and achieved significant reductions in CAP-associated mortality. This enhanced model of care is low cost, highly effective and readily adoptable in secondary care.

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Abstract TP165: Cardiac Screening Does not Improve One-year Mortality Among Patients With Cerebrovascular Disease

Stroke ◽

10.1161/str.47.suppl_1.tp165 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Jason J Sico ◽

Fitsum Baye ◽

Laura J Myers ◽

John Concato ◽

Linda S Williams ◽

...

Keyword(s):

High Risk ◽

Cerebrovascular Disease ◽

Stress Testing ◽

Cerebrovascular Event ◽

Mortality Benefit ◽

Cardiac Stress ◽

Cardiac Screening ◽

All Cause Mortality ◽

Cardiac Stress Testing ◽

One Year

Introduction: Guidelines recommend the use of cardiac stress testing to screen for occult coronary heart disease (CHD) among patients with ischemic stroke/TIA who have a ‘high risk’ Framingham Cardiac Risk score (FCRS). It is unclear whether implementation of this guideline confers a mortality benefit among patients with cerebrovascular disease. Hypothesis: We assessed the hypothesis that cardiac stress testing would be associated with lower odds of one-year all-cause mortality. Methods: Administrative data from a sample of 11,306 Veterans admitted to 134 Veterans Health Administration (VHA) facilities with a stroke or TIA in fiscal year 2011 were analyzed. Patients were excluded (n=6915) on the basis of: prior CHD history, receipt of cardiac stress testing within 18-months prior to cerebrovascular event, death within 90 days of discharge, being discharged to hospice, transferred to a non-VHA acute care facility, or missing/unknown race. A FCRS was calculated for each patient; a score of ≥ 20% was classified as ‘high risk’ of having CHD. Administrative data were used to identify whether cardiac stress testing was performed within 90-days after the cerebrovascular event. Logistic regression was used to assess whether cardiac stress testing was associated with one-year all-cause mortality. Results: Of the 4391 eligible patients, 62.8% (2759) had FCRS ≥ 20%, with 4.5% (n=123) of these patients receiving cardiac stress testing within 90 days of discharge. After adjusting for sociodemographic characteristics and medical comorbidities, FCRS ≥ 20% was associated with one-year mortality (aOR=2.18; CI 95 :1.59, 3.00), however, receipt of stress testing was not (aOR=0.59; CI 95 :0.26, 1.30). Conclusion: Cardiac screening did not confer a one-year all-cause mortality benefit among patients with cerebrovascular disease. Additional work is needed to assess outcomes among patients with cerebrovascular disease who are at ‘high risk’ for CHD.

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