Adverse Outcomes and Mortality in Users of Non-Steroidal Anti-Inflammatory Drugs tested positive for SARS-CoV-2: A Danish Nationwide Cohort Study

Background Concerns over the safety of non-steroidal anti-inflammatory drug (NSAID) use during SARS-CoV-2 infection have been raised. Objectives To study whether use of NSAIDs is associated with adverse outcomes and mortality during SARS-CoV-2 infection. Design Population based cohort study Setting Danish administrative and health registries. Participants Individuals tested positive for SARS-CoV-2 during Feb 27, 2020 to Apr 29, 2020. Treated individuals (defined as a filled NSAID prescription up to 30 days before the SARS-CoV-2 test) were matched to up to 4 non-treated individuals on propensity scores based on age, sex, relevant comorbidities and prescription fills. Outcome measures The main outcome was 30-day mortality and treated individuals were compared to untreated individuals using risk ratios (RR) and risk differences (RD). Secondary outcomes included hospitalisation, intensive care unit (ICU) admission, mechanical ventilation and acute renal replacement therapy. Results A total of 9236 SARS-CoV-2 PCR positive individuals were eligible for inclusion. Of these, 248 (2.7%) had filled a prescription for NSAIDs and 535 (5.8%) died within 30 days. In the matched analyses, treatment with NSAIDs was not associated with 30-day mortality (RR 1.02, 95% CI 0.57 to 1.82; RD 0.1%, -3.5% to 3.7%), increased risk of hospitalisation (RR 1.16, 0.87 to 1.53; RD 3.3%, -3.4% to 10%), ICU-admission (RR 1.04, 0.54 to 2.02; RD 0.2%, -3.0% to 3.4%), mechanical ventilation (RR 1.14, 0.56 to 2.30; RD 0.5%, -2.5% to 3.6%), or renal replacement therapy (RR 0.86, 0.24 to 3.09; RD -0.2%, -2.0% to 1.6%). Conclusion Use of NSAIDs was not associated with 30-day mortality, hospitalisation, ICU-admission, mechanical ventilation or renal replacement therapy in Danish individuals tested positive for SARS-CoV-2. Registration: The European Union electronic Register of Post-Authorisation Studies, EUPAS-34734 (http://www.encepp.eu/encepp/viewResource.htm?id=34735)

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Association between Prolonged Intermittent Renal Replacement Therapy and All-Cause Mortality in COVID-19 Patients Undergoing Invasive Mechanical Ventilation: a Retrospective Cohort Study

10.1101/2020.03.16.20036780 ◽

2020 ◽

Cited By ~ 5

Author(s):

Yi Yang ◽

Jia Shi ◽

Shuwang Ge ◽

Shuiming Guo ◽

Xue Xing ◽

...

Keyword(s):

Mechanical Ventilation ◽

Cohort Study ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Invasive Mechanical Ventilation ◽

Risk Of Mortality ◽

Increased Risk ◽

Intermittent Renal Replacement Therapy

AbstractBackgroundFor the coronavirus disease 2019 (COVID-19), critically ill patients had a high mortality rate. We aimed to assess the association between prolonged intermittent renal replacement therapy (PIRRT) and mortality in patients with COVID-19 undergoing invasive mechanical ventilation.MethodsIn this retrospective cohort study, we included all patients with COVID-19 undergoing invasive mechanical ventilation from February 12nd to March 2nd, 2020. All patients were followed until death or March 28th, and all survivors were followed for at least 30 days.ResultsFor 36 hospitalized COVID-19 patients with invasive mechanical ventilation, the mean age was 69.4 (± 10.8) years, and 30 patients (83.3%) were men. Twenty-two (61.1%) patients received PIRRT (PIRRT group) and 14 cases (38.9%) were managed with conventional strategy (non-PIRRT group). There were no differences in age, sex, comorbidities, complications, treatments and most of the laboratory findings. During median follow-up period of 9.5 (interquartile range 4.3-33.5) days, 13 of 22 (59.1%) patients in the PIRRT group and 11 of 14 (78.6%) patients in the non-PIRRT group died. Kaplan-Meier analysis demonstrated prolonged survival in patients in the PIRRT group compared with that in the non-PIRRT group (P = 0.042). The association between PIRRT and a reduced risk of mortality remained significant in three different models, with adjusted hazard ratios varying from 0.332 to 0.398. Higher levels of IL-2 receptor, TNF-α, procalcitonin, prothrombin time, and NT-proBNP were significantly associated with an increased risk of mortality in patients with PIRRT.ConclusionPIRRT may be beneficial for the treatment of COVID-19 patients with invasive mechanical ventilation. Further prospective multicenter studies with larger sample sizes are required.

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Association between Prolonged Intermittent Renal Replacement Therapy and All-Cause Mortality in COVID-19 Patients Undergoing Invasive Mechanical Ventilation: A Retrospective Cohort Study

Blood Purification ◽

10.1159/000512099 ◽

2020 ◽

pp. 1-8

Author(s):

Yi Yang ◽

Jia Shi ◽

Shuwang Ge ◽

Shuiming Guo ◽

Xue Xing ◽

...

Keyword(s):

Mechanical Ventilation ◽

Cohort Study ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Invasive Mechanical Ventilation ◽

Risk Of Mortality ◽

Increased Risk ◽

Intermittent Renal Replacement Therapy

Background: The mortality rate of critically ill patients with coronavirus disease 2019 (COVID-19) was high. We aimed to assess the association between prolonged intermittent renal replacement therapy (PIRRT) and mortality in patients with COVID-19 undergoing invasive mechanical ventilation. Methods: This retrospective cohort study included all COVID-19 patients receiving invasive mechanical ventilation between February 12 and March 2, 2020. All patients were followed until death or March 28, and all survivors were followed for at least 30 days. Results: For 36 hospitalized COVID-19 patients receiving invasive mechanical ventilation, the mean age was 69.4 (±10.8) years, and 30 patients (83.3%) were men. Twenty-two (61.1%) patients received PIRRT (PIRRT group), and 14 cases (38.9%) were managed with conventional strategy (non-PIRRT group). There were no differences in age, sex, comorbidities, complications, treatments, and most of the laboratory findings. During the median follow-up period of 9.5 (interquartile range 4.3–33.5) days, 13 of 22 (59.1%) patients in the PIRRT group and 11 of 14 (78.6%) patients in the non-PIRRT group died. Kaplan-Meier analysis demonstrated prolonged survival in patients in the PIRRT group compared with that in the non-PIRRT group (p = 0.042). The association between PIRRT and a reduced risk of mortality remained significant in 3 different models, with adjusted hazard ratios varying from 0.332 to 0.398. Increased IL-2 receptor, TNF-α, procalcitonin, prothrombin time, and NT-proBNP levels were significantly associated with an increased risk of mortality in patients with PIRRT. Conclusion: PIRRT may be beneficial for the treatment of COVID-19 patients with invasive mechanical ventilation. Further prospective multicenter studies with larger sample sizes are required.

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Postoperative acute kidney injury requiring continuous renal replacement therapy and outcomes after coronary artery bypass grafting: a nationwide cohort study

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01704-7 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Tak Kyu Oh ◽

In-Ae Song

Keyword(s):

Cohort Study ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Cox Regression ◽

Artery Bypass ◽

Kidney Injury ◽

Population Based ◽

Bypass Grafting ◽

All Cause Mortality ◽

Postoperative Aki

Abstract Background Previous studies reported that patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) after cardiac surgery were at a higher risk of postoperative mortality. However, the impact of AKI and CRRT on long-term mortality has not yet been identified. Therefore, we investigated whether postoperative AKI requiring CRRT was associated with one-year all-cause mortality after coronary artery bypass grafting (CABG). Methods For this population-based cohort study, we analyzed data from the National Health Insurance Service database in South Korea. The cohort included all adult patients diagnosed with ischemic heart disease who underwent isolated CABG between January 2012 and December 2017. Results A total of 15,115 patients were included in the analysis, and 214 patients (1.4%) required CRRT for AKI after CABG during hospitalization. They received CRRT at 3.1 ± 8.5 days after CABG, for 3.1 ± 7.8 days. On multivariable Cox regression, the risk of 1-year all-cause mortality in patients who underwent CRRT was 7.69-fold higher. Additionally, on multivariable Cox regression, the 30-day and 90-day mortality after CABG in patients who underwent CRRT were 18.20-fold and 20.21-fold higher than the normal value, respectively. Newly diagnosed chronic kidney disease (CKD) requiring renal replacement therapy (RRT) 1 year after CABG in patients who underwent CRRT was 2.50-fold higher. In the generalized log-linear Poisson model, the length of hospital stay (LOS) in patients who underwent CRRT was 5% longer. Conclusions This population-based cohort study showed that postoperative AKI requiring CRRT was associated with a higher 1-year all-cause mortality after CABG. Furthermore, it was associated with a higher rate of 30-day and 90-day mortality, longer LOS, and higher rate of CKD requiring RRT 1 year after CABG. Our results suggest that CRRT-associated AKI after CABG may be associated with an increased risk of mortality; hence, there should be interventions in these patients after hospital discharge.

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MO458URINARY GROWTH DIFFERENTIATION FACTOR-15 (GDF15) LEVELS AS BIOMARKER OF ADVERSE OUTCOMES AND BIOPSY FINDINGS IN CHRONIC KIDNEY DISEASE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab090.0020 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Maria Vanessa Perez Gomez ◽

Elena Gomá-Garcés ◽

Maria Soledad Pizarro Sanchez ◽

Carolina Gracia-Iguacel ◽

Santiago Cano ◽

...

Keyword(s):

Diabetic Nephropathy ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Patient Survival ◽

Adverse Outcomes ◽

Diabetic Patients ◽

Growth Differentiation Factor 15 ◽

Differentiation Factor ◽

Increased Risk ◽

Serum And Urine

Abstract Background and Aims Growth differentiation factor-15 (GDF15) is a member of the TGF-β superfamily. Increased serum GDF15 has been associated with increased risk of CKD progression. However, no prior study had addressed the significance of urinary GDF15 in adult CKD. Method We have now assessed serum and urinary GDF15 in a prospective cohort of 84 patients who underwent kidney biopsy and then were followed for 29±17 months. Results There was a statistically significant correlation between serum and urine GDF15 values. However, while serum GDF15 values increased with decreasing glomerular filtration rate, urinary GDF15 did not. Immunohistochemistry located kidney GDF15 expression mainly to tubular cells and kidney GDF15 staining correlated with urinary GDF15 values. Urine GDF15 was significantly higher in patients with a histological diagnosis of diabetic nephropathy than in diabetic patients without diabetic nephropathy. This was not the case for serum GDF15. Both serum and urine GDF15 were associated with patient survival in multivariate models. However, when both urine and serum GDF15 were present in the model, lower urine GDF15 predicted patient survival [B coefficient (SEM) -0.395 (0.182) p 0.03], and higher urine GDF15 predicted a composite of mortality or renal replacement therapy [0.191 (0.06) p 0.002] while serum GDF15 was not predictive. Decision tree analysis yielded similar results. The AUC of the ROC for urine GDF15 as a predictor of mortality was 0.95 (95% CI 0.89-1.00, p <0.001). Conclusion In conclusion, urine GDF15 is associated with kidney histology patterns, mortality and need for renal replacement therapy in biopsied CKD patients.

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ASSOCIATION BETWEEN MORTALITY AND RENAL REPLACEMENT THERAPY AFTER CARDIAC SURGERY AMONG OCTOGENARIANS: A RETROSPECTIVE POPULATION-BASED COHORT STUDY

Canadian Journal of Cardiology ◽

10.1016/j.cjca.2015.07.393 ◽

2015 ◽

Vol 31 (10) ◽

pp. S184-S185

Author(s):

W. Wang ◽

R. MacArthur ◽

C.M. Norris ◽

R. Zibdawi ◽

M. Zibdawi ◽

...

Keyword(s):

Cardiac Surgery ◽

Cohort Study ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Population Based

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Healthcare costs in chronic kidney disease and renal replacement therapy: a population-based cohort study in Sweden

BMJ Open ◽

10.1136/bmjopen-2016-012062 ◽

2016 ◽

Vol 6 (10) ◽

pp. e012062 ◽

Cited By ~ 37

Author(s):

Jonas K Eriksson ◽

Martin Neovius ◽

Stefan H Jacobson ◽

Carl-Gustaf Elinder ◽

Britta Hylander

Keyword(s):

Chronic Kidney Disease ◽

Cohort Study ◽

Renal Replacement Therapy ◽

Kidney Disease ◽

Replacement Therapy ◽

Healthcare Costs ◽

Population Based

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Obstetrical, maternal and neonatal outcomes in pregnancies affected by muscular dystrophy

Journal of Perinatal Medicine ◽

10.1515/jpm-2017-0299 ◽

2018 ◽

Vol 46 (7) ◽

pp. 791-796 ◽

Cited By ~ 2

Author(s):

Adriano Petrangelo ◽

Eman Alshehri ◽

Nicholas Czuzoj-Shulman ◽

Haim A. Abenhaim

Keyword(s):

Cohort Study ◽

Muscular Dystrophy ◽

Large Population ◽

The United States ◽

Population Based ◽

Adverse Outcomes ◽

Neonatal Outcomes ◽

Increased Risk ◽

Maternal And Neonatal Outcomes ◽

Adverse Pregnancy

Abstract Objective: Pregnancies in women affected by a muscular dystrophy are at an increased risk of adverse maternal and neonatal outcomes due to the effect of the disease on the muscular, cardiac and respiratory systems. We sought to evaluate the risk of adverse outcomes within a large population-based cohort study. Methods: We used the data extracted from the Nationwide Inpatient Sample (NIS) to conduct a retrospective population-based cohort study consisting of over 12 million births that occurred in the United States between 1999 and 2013. Births to mothers with muscular dystrophy were identified using the International Classification of Diseases, Ninth Revision (ICD-9) codes and were compared with births to mothers with no maternal muscular dystrophy. Unconditional logistic regression analysis was used to evaluate the adjusted effect of muscular dystrophy on maternal and neonatal outcomes. Results: During the 14-year study period, there was an increasing trend in the incidence of muscular dystrophy, with a cumulative incidence of 7.26 in 100,000 births. Women with muscular dystrophy and their neonates were at a significantly increased risk of adverse pregnancy outcomes: specifically, an increased risk of preeclampsia, preterm premature rupture of membranes, preterm labor, venous thromboembolism, cardiac dysrhythmia, requiring a blood transfusion and giving birth by cesarean section. Neonates born to affected mothers were at a significantly higher risk of being born preterm, with a congenital malformation and suffering intrauterine growth restriction. Conclusion: The risk of several adverse maternal and neonatal outcomes is increased in pregnant women with muscular dystrophy. As such, additional surveillance in order to mitigate the risk of adverse outcomes is warranted in these pregnancies.

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Prognosis of Allogeneic Haematopoietic Stem Cell Recipients Admitted to the Intensive Care Unit: A Retrospective, Single-Centre Study

Acta Haematologica ◽

10.1159/000440937 ◽

2015 ◽

Vol 135 (2) ◽

pp. 72-78 ◽

Cited By ~ 5

Author(s):

Sidsel Christy Lindgaard ◽

Jonas Nielsen ◽

Anders Lindmark ◽

Henrik Sengeløv

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Stem Cell ◽

Intensive Care ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Scoring Systems ◽

University Hospital ◽

Haematopoietic Stem Cell ◽

Icu Admission

Background: Allogeneic haematopoietic stem cell transplantation (HSCT) is a procedure with inherent complications and intensive care may be necessary. We evaluated the short- and long-term outcomes of the HSCT recipients requiring admission to the intensive care unit (ICU). Methods: We retrospectively examined the outcome of 54 adult haematological HSCT recipients admitted to the ICU at the University Hospital Rigshospitalet between January 2007 and March 2012. Results: The overall in-ICU, in-hospital, 6-month and 1-year mortality rates were 46.3, 75.9, 79.6 and 86.5%, respectively. Mechanical ventilation had a statistically significant effect on in-ICU (p = 0.02), 6-month (p = 0.049) and 1-year (p = 0.014) mortality. Renal replacement therapy also had a statistically significant effect on in-hospital (p = 0.038) and 6-month (p = 0.026) mortality. Short ICU admissions, i.e. <10 days, had a statistically significant positive effect on in-hospital, 6-month and 1-year mortality (all p < 0.001). The SAPS II, APACHE II and SOFA scoring systems grossly underestimated the actual in-hospital mortality observed for these patients. Conclusion: The poor prognosis of critically ill HSCT recipients admitted to the ICU was confirmed in our study. Mechanical ventilation, renal replacement therapy and an ICU admission of ≥10 days were each risk factors for mortality in the first year after ICU admission.

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