scholarly journals Serum anion gap is associated with all-cause mortality among critically ill patients with congestive heart failure

2020 ◽  
Author(s):  
yiyang tang ◽  
wenchao lin ◽  
lihuang zha ◽  
xiaofang zeng ◽  
zhenghui liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Critically Ill ◽  
Subgroup Analysis ◽  
Critically Ill Patients ◽  
Demographic Data ◽  
Cox Proportional Hazards ◽  
Anion Gap ◽  
High Morbidity ◽  
All Cause Mortality

Background: Congestive heart failure (CHF) is a complex clinical syndrome, with high morbidity and mortality. Serum anion gap (SAG) has been known to be associated with the severity of various cardiovascular diseases. However, the role of SAG indicators in CHF is unclear. Methods and results: A retrospective analysis of data from MIMIC-III v1.4 was conducted in critically ill patients with CHF. Clinical information of each patient, including demographic data, comorbidities, vital signs, scores, and laboratory indicators, were successfully obtained. Cox proportional hazards models were performed to determine the relationship between SAG and mortality in CHF patient, the consistency of which was further verified by subgroup analysis. Results: A total of 7426 subjects met the inclusion criteria. In multivariate analysis, after adjusting for age, gender, ethnicity, and other potential confounders, higher SAG was significantly related to an increase in 30-day and 90-day all-cause mortality of critically ill patients with CHF compared with lower SAG (tertile3 vs tertile1: adjusted HR, 95% CI: 1.74, 1.46-2.08; 1.53, 1.32-1.77). In subgroup analysis, the association between SAG and all-cause mortality present similarities in most strata. Conclusion: SAG at admission can be a promising predictor of all-cause mortality in critically ill patients with CHF.

scholarly journals Serum Anion Gap Is Associated with All-Cause Mortality among Critically Ill Patients with Congestive Heart Failure

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Yiyang Tang ◽  
Wenchao Lin ◽  
Lihuang Zha ◽  
Xiaofang Zeng ◽  
Xiaoman Zeng ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Critically Ill ◽  
Subgroup Analysis ◽  
Critically Ill Patients ◽  
Demographic Data ◽  
Cox Proportional Hazards ◽  
Anion Gap ◽  
High Morbidity ◽  
All Cause Mortality

Background. Congestive heart failure (CHF) is a complex clinical syndrome, with high morbidity and mortality. Serum anion gap (SAG) is associated with the severity of various cardiovascular diseases. However, the role of SAG indicators in CHF is unclear. Methods and Results. A retrospective analysis of data from Multiparameter Intelligent Monitoring in Intensive Care III version 1.4 was conducted in critically ill patients with CHF. The clinical information of each patient, including demographic data, comorbidities, vital signs, scores, and laboratory indicators, were successfully obtained. Cox proportional hazards models were used to determine the relationship between SAG and mortality in patients with CHF, the consistency of which was further verified by subgroup analysis. Results. A total of 7426 subjects met the inclusion criteria. Multivariate analysis showed that after adjusting for age, gender, ethnicity, and other potential confounders, increased SAG was significantly related to an increase in 30- and 90-day all-cause mortalities of critically ill patients with CHF compared with decreased SAG (tertile 3 versus tertile 1: adjusted hazard ratio, 95% confidence interval: 1.74, 1.46–2.08; 1.53, 1.32–1.77). Subgroup analysis indicated that the association between SAG and all-cause mortality presented similarities in most strata. Conclusion. SAG at admission could be a promising predictor of all-cause mortality in critically ill patients with CHF.

scholarly journals Serum Anion Gap Predicts All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury: Analysis of the MIMIC-III Database

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Bihuan Cheng ◽  
Diwen Li ◽  
Yuqiang Gong ◽  
Binyu Ying ◽  
Benji Wang
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Cox Proportional Hazards ◽  
Anion Gap ◽  
Increased Risk ◽  
All Cause Mortality ◽  
The Relationship ◽  
Mimic Iii

Background. No epidemiological study has investigated the effect of anion gap (AG) on the prognosis of critically ill patients with acute kidney injury (AKI). Therefore, we aimed to determine the association between serum AG and all-cause mortality in these patients. Methods. From MIMIC III, we extracted demographics, vital signs, laboratory tests, comorbidities, and scoring systems from the first 24 h after patient ICU admission. A generalized additive model was used to identify a nonlinear association between anion gap and 30-day all-cause mortality. We also used the Cox proportional hazards models to measure the association between AG levels and 30-day, 90-day, and 365-day mortality in patients with AKI. Results. A total of 11,573 eligible subjects were extracted from the MIMIC-III. The relationship between AG levels and 30-day all-cause mortality in patients with AKI was nonlinear, with a U-shaped curve. In multivariate analysis, after adjusting for potential confounders, higher AG was a significant predictor of 30-day, 90-day, and 365-day all-cause mortality compared with lower AG (HR, 95% CI: 1.54, 1.33–1.75; 1.55, 1.38–1.73; 1.46, 1.31–1.60). Conclusions. The relationship between AG levels and 30-day all-cause mortality described a U-shaped curve. High-AG levels were associated with increased risk 30-day, 90-day, and 365-day all-cause mortality in critically ill patients with AKI.

scholarly journals 2117. Fluconazole vs. Echinocandins as Initial Therapy for Candidemia Caused by Fluconazole-Susceptible Species in the Era of Rapid Diagnostic Testing

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S716-S716
Author(s):  
Danya Roshdy ◽  
Tyler Ginn ◽  
Rupal K Jaffa ◽  
William E Anderson ◽  
Elizabeth Green ◽  
...  
Keyword(s):  
Blood Culture ◽  
Critically Ill ◽  
Positive Blood Culture ◽  
Subgroup Analysis ◽  
Critically Ill Patients ◽  
Diagnostic Testing ◽  
Initial Therapy ◽  
Clinical Failure ◽  
Rapid Diagnostic Testing ◽  
All Cause Mortality

Abstract Background Echinocandins (ECH) are recommended first-line for initial therapy (IT) of candidemia (CD) over fluconazole (FLU) due to their broad spectrum of activity. This recommendation was made prior to widespread implementation of rapid diagnostic testing (RDT), allowing prompt species identification and targeted therapy. The objective of this study was to compare clinical outcomes in patients with CD caused by FLU-susceptible species who received either FLU or ECH as IT. Methods This was a multicenter, retrospective cohort study of adults with CD caused by C. albicans, C. tropicalis, or C. parapsilosis. Patients who received FLU or ECH as IT for at least 48 hours from May 2012 to October 2018 were included. Patients who died within 48 hours of first positive blood culture were excluded. The primary endpoint was the rate of clinical failure (persistent CD for >72 hours, recurrent infection within 30 days, change in therapy, and all-cause mortality within 30 days). Secondary endpoints included 90-day all-cause mortality and time to culture clearance. A subgroup analysis in critically ill patients was conducted. Results Of the 371 patients evaluated, 128 met criteria for inclusion, 57 received FLU and 71 received ECH. Patients in the ECH group had a higher incidence of sepsis at the time of first positive blood culture (45.1% vs. 19.3%, P = 0.002). A line-associated source was more common in the ECH group (56.3%) vs. urinary source in the FLU group (21.1%). C. albicans was most common in both groups (63%). Clinical failure was similar in the FLU and ECH groups (38.6% vs. 35.2%, P = 0.69). 90-day mortality and time to culture clearance (1.6 vs. 1.5 days, P = 0.63) did not yield significant differences. In the subgroup analysis of critically ill patients, there was a trend suggesting higher rate of failure in patients who received FLU vs. an ECH (60.9% vs. 47.7%, P = 0.31), though underpowered to detect such a difference. Length of stay (LOS) was shorter in patients who received FLU (12 vs. 18 days, P = 0.018). Conclusion FLU as IT for FLU-susceptible CD may be a reasonable option in non-critically ill patients in the setting of RDT. This may lead to shorter LOS given the availability of an oral formulation. Additional prospective studies are needed to validate these conclusions. Disclosures All authors: No reported disclosures.

Serum anion gap at admission predicts all-cause mortality in critically ill patients with cerebral infarction: evidence from the MIMIC-III database

Biomarkers ◽  
2020 ◽  
Vol 25 (8) ◽  
pp. 725-732
Author(s):  
Xuefang Liu ◽  
Yanlin Feng ◽  
Xinyu Zhu ◽  
Ying Shi ◽  
Manting Lin ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Anion Gap ◽  
All Cause Mortality ◽  
Mimic Iii

In-Hospital Death of Critically Ill Patients Who Have Congestive Heart Failure: Does Size of Hospital Matter?

2010 ◽  
Vol 25 (2) ◽  
pp. 95-101
Author(s):  
Janet Dubord ◽  
Peter M. Dodek ◽  
Keith Chan ◽  
Sean P. Keenan ◽  
Stephen Marion ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Hospital Death

scholarly journals The Neutrophil Percentage-to-Albumin Ratio is Associated with All-Cause Mortality in Critically Ill Patients with Acute Myocardial Infarction

2021 ◽  
Author(s):  
Ya Lin ◽  
Yanhan Lin ◽  
Juanqing Yue ◽  
Qianqian Zou
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Medical Information ◽  
Cox Proportional Hazards ◽  
Albumin Ratio ◽  
Neutrophil Percentage ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Aim In this study, we evaluated the utility of neutrophil percentage-to-albumin ratio (NPAR) in predicting in critically ill patients with acute myocardial infarction (AMI). Methods the information of patients were collected from Medical Information Mart for Intensive Care III (MIMIC III) database. Admission NPAR was calculated as neutrophil percentage divided by serum albumin. The endpoints of this study were 30-day, 90-day, 180-day, and 365-day all-cause mortality. Cox proportional hazards models and subgroup analyses were used to determine the relationship between admission NPAR and these endpoints. Results 798 critically ill patients with AMI were enrolled in. After adjustments for age, race and gender, higher admission NPAR was associated with increased risk of 30-day, 90-day, 180-day, and 365-day all-cause mortality in critically ill patients with AMI. And after adjusting for possible confounding variables, two different trends have emerged. Stratified by tertiles, high admission NPAR was independently associated with 180-day and 365-day all-cause mortality in critically ill patients with AMI (tertile 3 vs. tertile 1: adjusted HR, 95%CI: 1.71,1.10-2.66, p<0.05;1.66,1.10-2.51, p<0.05). In other hand, stratified by quartiles, highest admission NPAR levels were independently associated with 90-day, 180-day and 365-day all-cause mortality (quartile 4 vs. quartile 1: adjusted HR, 95% CI: 2.36,1.32-4.23, p<0.05; 2.58,1.49-4.47, p<0.05; 2.61,1.56-4.37, p<0.05). ROC test showed that admission NPAR had a moderate ability to predict all-cause mortality of critically ill patients with AMI. No obvious interaction was found by subgroup analysis in most subgroups. Conclusions admission NPAR was an independent predictor for 180-day and 365-day all-cause mortality in critically ill patients with AMI.

scholarly journals Association of Systemic Immune-Inflammation Index With Short-Term Mortality of Congestive Heart Failure: A Retrospective Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Yiyang Tang ◽  
Xiaofang Zeng ◽  
Yilu Feng ◽  
Qin Chen ◽  
Zhenghui Liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Regression Analysis ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Readmission Rate ◽  
Short Term ◽  
Short Term Mortality ◽  
Immune Inflammation ◽  
High Level

Purpose: The present study aimed to clarify the potential predictive significance of Systemic immune-inflammation index (SII) in assessing the poor prognosis of critically ill patients with congestive heart failure (CHF).Methods: Detailed clinical data were extracted from the Multiparameter Intelligent Monitoring in Intensive Care III database after gaining access and building the local platform. The 30- and 90-day and hospital all-cause mortalities of the patient was the primary outcome, and the readmission rate and the occurrence of major cardiovascular adverse events (MACEs) were the secondary outcomes. the Cox proportional hazard model and Logistic regression analysis were selected to reveal the relationship between SII level and the research outcome. Further, the propensity score matching (PSM) analysis was performed to improve the reliability of results by reducing the imbalance across groups.Results: There were a total of 4,606 subjects who passed the screening process and entered the subsequent analysis. Multivariate regression analysis showed that after adjusting for possible confounders, including age, heart rate, and albumin, etc., the high level of SII was independently associated with 30- and 90-day and hospital mortalities (tertile 3 vs. tertile 1: HR, 95% CIs: 1.23, 1.04-1.45; 1.21, 1.06-1.39; 1.26, 1.05-1.50) and the incidence of MACEs (tertile 3 vs. tertile 1: OR, 95% CI: 1.39, 1.12-1.73) in critically ill patients with CHF, but no significant correlation was found between SII and the readmission rate. Consistently, patients with high SII level still presented a significantly higher short-term mortality than patients with low SII in the PSM subset.Conclusion: In critically ill patients with CHF, high level of SII could effectively predict high 30- and 90-day and hospital mortalities, as well as the high risk of occurrence of MACEs.

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