scholarly journals Diabetes and Mortality Among 1.6 Million Adult Patients Screened for SARS-CoV-2 in Mexico

2020 ◽  
Author(s):  
Orison O. Woolcott ◽  
Juan P. Castilla-Bancayán
Keyword(s):  
Relative Risk ◽  
Chronic Renal Disease ◽  
Smoking Habit ◽  
Case Series ◽  
Hazard Ratio ◽  
Adult Patients ◽  
Epidemiological Surveillance ◽  
Risk Of Death ◽  
Case Series Study ◽  
Relative Risk Of Death

ABSTRACTBackgroundWhether diabetes is associated with COVID-19-related mortality remains unclear.MethodsIn this retrospective case-series study we examined the risk of death associated with self-reported diabetes in symptomatic adult patients with laboratory-confirmed COVID-19 who were identified through the System of Epidemiological Surveillance of Viral Respiratory Disease in Mexico from January 1 through November 4, 2020. Survival time was right-censored at 28 days of follow-up.ResultsAmong 757,210 patients with COVID-19 included in the study, 120,476 (16%) had diabetes and 80,616 died. Patients with diabetes had a 49% higher relative risk of death than those without diabetes (Cox proportional-hazard ratio; 1.49 (95% confidence interval [CI], 1.47-1.52), adjusting for age, sex, smoking habit, obesity, hypertension, immunodeficiency, and cardiovascular, pulmonary, and chronic renal disease. The relative risk of death associated with diabetes decreased with age (P=0.004). The hazard ratios were 1.66 (1.58-1.74) in outpatients and 1.14 (1.12-1.16) in hospitalized patients. The 28-day survival for inpatients with and without diabetes was, respectively, 73.5% and 85.2% for patients 20-39 years of age; 66.6% and 75.9% for patients 40-49 years of age; 59.4% and 66.5% for patients 50-59 years of age; 50.1% and 54.6% for patients 60-69 years of age; 42.7% and 44.6% for patients 70-79 years of age; and 38.4% and 39.0% for patients 80 years of age or older. In patients without COVID-19 (878,840), the adjusted hazard ratio for mortality was 1.78 (1.73-1.84).ConclusionIn symptomatic adult patients with COVID-19 in Mexico, diabetes was associated with higher mortality. This association decreased with age.

scholarly journals The effect of age on the association between diabetes and mortality in adult patients with COVID-19 in Mexico

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Orison O. Woolcott ◽  
Juan P. Castilla-Bancayán
Keyword(s):  
Respiratory Disease ◽  
Smoking Habit ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Adult Patients ◽  
Epidemiological Surveillance ◽  
Trend Test ◽  
Risk Of Death ◽  
Effect Of Age ◽  
Viral Respiratory

AbstractDiabetes is associated with severe COVID-19 and mortality. The aim of the present study was to determine the effect of age on the association between diabetes and mortality in patients with laboratory-confirmed COVID-19 in Mexico. This retrospective cohort study involved patients aged 20 years or older with symptoms of viral respiratory disease who were screened for SARS-CoV-2 infection across the System of Epidemiological Surveillance of Viral Respiratory Disease in Mexico from January 1 through November 4, 2020. Cox proportional-hazard regression was used to calculate the hazard ratio for 28-day mortality and its 95% confidence interval (CI). Among 757,210 patients with COVID-19 (outpatients and inpatients), 120,476 (16%) had diabetes and 80,616 died. Among 878,840 patients without COVID-19 (those who tested negative for SARS-CoV-2 infection), 88,235 (10.0%) had diabetes and 20,134 died. Among patients with COVID-19, diabetes was associated with a hazard ratio for death of 1.49 (95% CI 1.47–1.52), adjusting for age, sex, smoking habit, obesity, hypertension, immunodeficiency, and cardiovascular, pulmonary, and chronic renal disease. The strength of the association decreased with age (trend test: P = 0.004). For example, the adjusted hazard ratio for death was 3.12 (95% CI 2.86–3.40) for patients 20–39 years of age; in contrast, the adjusted hazard ratio of death for patients 80 years of age or older was 1.11 (95% CI 1.06–1.16). The adjusted hazard ratios were 1.66 (95% CI 1.58–1.74) in outpatients and 1.14 (95% CI 1.12–1.16) in inpatients. In hospitalized patients 80 years of age or older, no association was observed between diabetes and COVID-19-related mortality (adjusted hazard ratio: 1.03; 95% CI 0.98–1.08). Among patients without COVID-19, the adjusted hazard ratio for death was 1.78 (95% CI 1.73–1.84). In conclusion, in adult patients with COVID-19 in Mexico, the risk of death associated with diabetes decreased with age. No association between diabetes and mortality was observed among inpatients 80 years of age or older. Our findings should be verified in other populations.

Relative Risk of Death in Diabetic and Non Diabetic Dialysis PTS: A Useful Marker of a Cohort Features

1991 ◽  
pp. 455-457
Author(s):  
G. B. Piccoli ◽  
G. Beltrame ◽  
F. Bonello ◽  
M. Salomone ◽  
A. Pacitti ◽  
...  
Keyword(s):  
Relative Risk ◽  
Risk Of Death ◽  
Relative Risk Of Death

scholarly journals White Blood Cell and Platelet Dynamics Define Human Inflammatory Recovery

2021 ◽  
Author(s):  
Brody H Foy ◽  
Thor Sundt ◽  
Jonathan CT Carlson ◽  
Aaron D Aguirre ◽  
John M Higgins
Keyword(s):  
Relative Risk ◽  
Blood Cell ◽  
White Blood Cell ◽  
Tissue Damage ◽  
Inflammatory Responses ◽  
Good Prognosis ◽  
Adverse Outcomes ◽  
Acute Phase Reactants ◽  
Risk Of Death ◽  
Relative Risk Of Death

Inflammation is the physiologic reaction to cellular and tissue damage caused by pathologic processes including trauma, infection, and ischemia. Effective inflammatory responses integrate molecular and cellular functions to prevent further tissue damage, initiate repair, and restore homeostasis, while futile or dysfunctional responses allow escalating injury, delay recovery, and may hasten death. Elevation of white blood cell count (WBC) and altered levels of other acute phase reactants are cardinal signs of inflammation, but the dynamics of these changes and their resolution are not established. Patient responses appear to vary dramatically with no clearly defined signs of good prognosis, leaving physicians reliant on qualitative interpretations of laboratory trends. We studied the human acute inflammatory response to trauma, ischemia, and infection by tracking the longitudinal dynamics of cellular and serum markers in hospitalized patients. Unexpectedly, we identified a conserved pattern of recovery defined by co-regulation of WBC and platelet (PLT) populations. Across all inflammatory conditions studied, recovering patients followed a consistent WBC-PLT trajectory shape that is well-approximated by exponential WBC decay and delayed linear PLT growth. This recovery trajectory shape may represent a fundamental archetype of human physiologic response at the cellular population scale, and provides a generic approach for identifying high-risk patients: 32x relative risk of adverse outcomes for cardiac surgery patients, 9x relative risk of death for COVID-19, and 5x relative risk of death for myocardial infarction.

Reply to: Concerns about estimating relative risk of death associated with convalescent plasma for COVID-19

2022 ◽  
Author(s):  
Philippe Bégin ◽  
Jeannie Callum ◽  
Richard Cook ◽  
Erin Jamula ◽  
Yang Liu ◽  
...  
Keyword(s):  
Relative Risk ◽  
Risk Of Death ◽  
Relative Risk Of Death

scholarly journals Geografias da Diabetes Mellitus em Portugal: Como as Condições do Contexto Influenciam o Risco de Morrer

2014 ◽  
Vol 27 (3) ◽  
pp. 309 ◽  
Author(s):  
Paula Santana ◽  
Cláudia Costa ◽  
Adriana Loureiro ◽  
João Raposo ◽  
José Manuel Boavida
Keyword(s):  
Diabetes Mellitus ◽  
Relative Risk ◽  
Rural Areas ◽  
Public Health Problem ◽  
Standardized Mortality Ratio ◽  
Geographic Pattern ◽  
Bayesian Hierarchical ◽  
Risk Of Death ◽  
Mortality Ratio ◽  
Relative Risk Of Death

<strong>Introduction:</strong> Diabetes Mellitus is a public health problem that is on the increase throughout the world, including in Portugal. This paper aims to identify the changing geographic pattern of this cause of death in Portugal and its association with sociomaterial deprivation.<br /><strong>Material and Methods:</strong> This is a transversal ecological study of the deaths by Diabetes Mellitus in Portuguese municipalities in three periods (1989-1993, 1999-2003 and 2006-2010). It uses a Bayesian hierarchical model in order to obtain a smooth standardized mortality ratio and the relative risk of death by Diabetes Mellitus associated to sociomaterial deprivation.<br /><strong>Results:</strong> In 1989-1993, the highest smooth standardized mortality ratio values were found in coastal urban municipalities (80% of municipalities with smooth standardized mortality ratio ≥ 161, of which 60% are urban); in 2006-2010, the opposite was found, with the highest smooth standardized mortality ratio values occurring in rural areas in southern inland regions (76.9% of municipalities with smooth standardized mortality ratio ≥ 161, of which 69.2% are rural), particularly the Alentejo. The relative risk of death by Diabetes Mellitus increases with vulnerability associated to social and economic conditions in the area of residence, and is significant in the last two periods (relative risk: 1.00; IC95%: 0.98-1.02).<br /><strong>Discussion:</strong> Diabetes Mellitus presents a geographic pattern marked by coastal-inland and urban-rural asymmetry. However, this has been altering over the last twenty years. 48% of the population reside in municipalities where the smooth standardized mortality ratio has increased in the last twenty years, particularly in the rural areas of inland Portugal.<br /><strong>Conclusion: </strong>The highest smooth standardized mortality ratio are currently found in rural municipalities with the highest index of sociomaterial deprivation.<br /><strong>Keywords:</strong> Demography; Diabetes Mellitus/epidemiology; Diabetes Mellitus/mortality; Portugal; Socioeconomic Factors.

scholarly journals Antiepileptic drug use and mortality among community-dwelling persons with Alzheimer disease

Neurology ◽  
2020 ◽  
Vol 94 (20) ◽  
pp. e2099-e2108 ◽  
Author(s):  
Tatyana Sarycheva ◽  
Piia Lavikainen ◽  
Heidi Taipale ◽  
Jari Tiihonen ◽  
Antti Tanskanen ◽  
...  
Keyword(s):  
Relative Risk ◽  
Alzheimer Disease ◽  
Antiepileptic Drug ◽  
Cognitive Disorder ◽  
Careful Consideration ◽  
Community Dwelling ◽  
Risk Of Death ◽  
Vulnerable Patients ◽  
Relative Risk Of Death ◽  
First 90 Days

ObjectiveTo evaluate the risk of death in relation to incident antiepileptic drug (AED) use compared with nonuse in people with Alzheimer disease (AD) through the assessment in terms of duration of use, specific drugs, and main causes of death.MethodsThe MEDALZ (Medication Use and Alzheimer Disease) cohort study includes all Finnish persons who received a clinically verified AD diagnosis (n = 70,718) in 2005–2011. Incident AED users were identified with 1-year washout period. For each incident AED user (n = 5,638), 1 nonuser was matched according to sex, age, and time since AD diagnosis. Analyses were conducted with Cox proportional regression models and inverse probability of treatment weighting (IPTW).ResultsNearly 50% discontinued AEDs within 6 months. Compared with nonusers, AED users had an increased relative risk of death (IPTW hazard ratio [HR], 1.23; 95% confidence interval [CI], 1.12–1.36). This was mainly due to deaths from dementia (IPTW HR, 1.62; 95% CI, 1.42–1.86). There was no difference in cardiovascular and cerebrovascular deaths (IPTW HR, 0.98; 95% CI, 0.67–1.44). The overall mortality was highest during the first 90 days of AED use (IPTW HR, 2.40; 95% CI, 1.91–3.03). Among users of older AEDs, relative risk of death was greater compared to users of newer AEDs (IPTW HR, 1.79; 95% CI, 1.52–2.16).ConclusionIn older vulnerable patients with a cognitive disorder, careful consideration of AED initiation and close adverse events monitoring are needed.

Endoscopic Removal of Benign Forehead Tumors: Patient Satisfaction With Decision Making and Scar Outcomes

2017 ◽  
Vol 34 (4) ◽  
pp. 187-192 ◽  
Author(s):  
Jason E. Gilde ◽  
Barcleigh P. Landau ◽  
Christopher G. Tang ◽  
Charles W. Shih
Keyword(s):  
Decision Making ◽  
Patient Satisfaction ◽  
Operating Time ◽  
Case Series ◽  
Adult Patients ◽  
Endoscopic Approach ◽  
Endoscopic Removal ◽  
Retrospective Case ◽  
Kaiser Permanente ◽  
Case Series Study

The endoscopic approach is an alternative treatment to direct excision of benign forehead tumors. Prior publications describe the technique and outcomes. Our study assumes a quality improvement perspective, focusing on patient satisfaction with decision making and scar outcomes. This is a retrospective case series study of adult patients who underwent endoscopic removal of benign forehead tumors at Kaiser Permanente Oakland from 2006 to 2016. Data were collected pertaining to surgical outcomes, patient satisfaction using validated instruments. Thirty adult patients were included. Mean operating time was 60 minutes. Forehead tumors included osteomas and a variety of soft tissue lesions. Transient complications included hypoesthesia, seroma, and frontalis weakness. A recurrence of an epidermal inclusion cyst occurred. Patients reported nearly complete satisfaction with decision making and scar outcomes. Endoscopic removal of benign forehead tumors is a safe and effective treatment. Patient satisfaction with decision making and the scar is excellent. Further studies are needed to compare the endoscopic approach to direct excision. The surgeon should offer the endoscopic approach and appropriate counseling to the patient with a benign forehead tumor.

scholarly journals Positive fluid balance within the first 72 hours in the intensive care unit is associated with higher mortality in adult patients

2021 ◽  
Vol 10 (14) ◽  
pp. e498101422377
Author(s):  
Natália Linhares Ponte Aragão ◽  
Arnaldo Aires Peixoto Júnior ◽  
Carlos Augusto Ramos Feijó ◽  
Marina Parente Albuquerque ◽  
Francisco Albano de Meneses
Keyword(s):  
Fluid Balance ◽  
Adult Patients ◽  
Independent Factor ◽  
Risk Of Death ◽  
Icu Stay ◽  
Tertiary Teaching ◽  
Observational Cohort ◽  
Tertiary Teaching Hospital ◽  
Optimal Cutoff Point ◽  
Relative Risk Of Death

Objective: To identify the association between cumulative fluid balance in the first 72 hours of ICU stay and outcomes. Methodology: retrospective observational cohort with data analysis of adult patients hospitalized in an ICU of a tertiary teaching hospital. Results: a total of 86 patients who remained in the ICU for more than 72 hours were evaluated. The fluid balance in the first 72 hours was higher in the subgroup of patients who died in the ICU (5210.3 ± 2787.7 vs. 3017.4 ± 2847.2 mL, p = 0.004). The fluid balance in the first 72 hours was an independent factor directly associated with death in the ICU (OR: 1,000; p = 0.009). The area under the ROC curve was 0.7119 (95% CI: 0.58-0.84, p = 0.005). The optimal cutoff point for the fluid balance in the first 72 hours as a predictor of death in the ICU was + 3.900mL and the relative risk of death among those who presented a fluid balance higher than this value was 1.702 (95% CI: 1, 15-2.53, p = 0.009). Conclusion: an association was identified between the cumulative value in the fluid balance in the first 72 hours of ICU stay and the highest risk of death, which is an independent factor of the patient's severity at admission. 

scholarly journals Concerns about estimating relative risk of death associated with convalescent plasma for COVID-19

2022 ◽  
Author(s):  
Michael J. Joyner ◽  
Nigel S. Paneth ◽  
Jonathon W. Senefeld ◽  
DeLisa Fairweather ◽  
Katelyn A. Bruno ◽  
...  
Keyword(s):  
Relative Risk ◽  
Risk Of Death ◽  
Relative Risk Of Death
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