The prognostic value of respiratory symptoms and performance status in ambulatory cancer patients and unsuspected pulmonary embolism; analysis of an international, prospective, observational cohort study

Author(s):  
Anthony Maraveyas ◽  
Noémie Kraaijpoel ◽  
George Bozas ◽  
Chao Huang ◽  
Isabelle Mahé ◽  
...  
2018 ◽  
Vol 29 ◽  
pp. viii234
Author(s):  
J.J. van Kleef ◽  
L.V. van de Poll-Franse ◽  
R.H. Verhoeven ◽  
M. Slingerland ◽  
J.P. Ruurda ◽  
...  

2018 ◽  
Vol 43 (1) ◽  
pp. 134-142 ◽  
Author(s):  
Saho Wada ◽  
Hironobu Inoguchi ◽  
Ryoichi Sadahiro ◽  
Yutaka J. Matsuoka ◽  
Yosuke Uchitomi ◽  
...  

2014 ◽  
Vol 146 (5) ◽  
pp. S-227-S-228
Author(s):  
Manuel Barreiro-de Acosta ◽  
Nicolau vallejo-Senra ◽  
Daniel De la Iglesia Garcia ◽  
Laura Uribarri-González ◽  
Iria Baston-Rey ◽  
...  

Author(s):  
Steve Goodacre ◽  
Ben Thomas ◽  
Laura Sutton ◽  
Matthew Bursnall ◽  
Ellen Lee ◽  
...  

AbstractObjectivesWe aimed to derive and validate a triage tool, based on clinical assessment alone, for predicting adverse outcome in acutely ill adults with suspected COVID-19 infection.MethodsWe undertook a mixed prospective and retrospective observational cohort study in 70 emergency departments across the United Kingdom (UK). We collected presenting data from 22445 people attending with suspected COVID-19 between 26 March 2020 and 28 May 2020. The primary outcome was death or organ support (respiratory, cardiovascular, or renal) by record review at 30 days. We split the cohort into derivation and validation sets, developed a clinical score based on the coefficients from multivariable analysis using the derivation set, and the estimated discriminant performance using the validation set.ResultsWe analysed 11773 derivation and 9118 validation cases. Multivariable analysis identified that age, sex, respiratory rate, systolic blood pressure, oxygen saturation/inspired oxygen ratio, performance status, consciousness, history of renal impairment, and respiratory distress were retained in analyses restricted to the ten or fewer predictors. We used findings from multivariable analysis and clinical judgement to develop a score based on the NEWS2 score, age, sex, and performance status. This had a c-statistic of 0.80 (95% confidence interval 0.79-0.81) in the validation cohort and predicted adverse outcome with sensitivity 0.98 (0.97-0.98) and specificity 0.34 (0.34-0.35) for scores above four points.ConclusionA clinical score based on NEWS2, age, sex, and performance status predicts adverse outcome with good discrimination in adults with suspected COVID-19 and can be used to support decision-making in emergency care.RegistrationISRCTN registry, ISRCTN28342533, http://www.isrctn.com/ISRCTN28342533


2019 ◽  
Vol 6 (3) ◽  
pp. 138
Author(s):  
Judith E. K. R. Hentzen ◽  
Laura Van Wijk ◽  
Carlijn I. Buis ◽  
Alain R. Viddeleer ◽  
Geertruida H. De Bock ◽  
...  

<p class="abstract"><strong>Background:</strong> Surgery-related muscle loss (SRML) occurs in at least one out of three cancer patients within one week after major surgery. Though, this important phenomenon has hardly been investigated.</p><p class="abstract"><strong>Methods:</strong> The MUSCLE POWER is a prospective, observational cohort study that investigates the presence, impact, and predictors for clinically relevant SRML in 178 cancer patients after major abdominal surgery using ultrasound measurements, squeeze and force measurements, and QoL questionnaires. Primary endpoint is the proportion of patients with clinically relevant SRML defined as ≥5% muscle loss within one week after surgery, measured by the cross-sectional area (CSA) of three different muscles: m. biceps brachii, m. rectus femoris, and m. vastus intermedius. Possible correlation with QoL and fatigue up to six months after surgery will be investigated. Daily physical activity during hospital stay will be monitored by a motility tracker, and protein intake will be monitored by a dietician. Possible predictors for clinically relevant SRML—consisting of age ≥65 years, preoperative diabetes, preoperative sarcopenia, major postoperative complications (Clavien-Dindo ≥III), insufficient physical activity, and insufficient postoperative protein intake—will be investigated with a multivariable logistic regression analyses with a backward stepwise approach. Variables with a <em>p</em>&lt;0.05 will be retrained in the final multivariable model.</p><p class="abstract"><strong>Discussion: </strong>The MUSCLE POWER investigates the presence and impact of clinically relevant SRML in cancer patients after major abdominal surgery. Crucial information regarding possible predictors for clinically relevant SRML can be used in future intervention studies to prevent postoperative muscle loss and subsequently improve postoperative outcome and QoL.</p><p><strong>Trial Registration: </strong>Medical Ethics Committee of the University Medical Center Groningen, the Netherlands (METc2018/361, version 3.0, January 21, 2019), and Netherlands Trial Register ([NTR], NTR NL7505, version 1.0, February 7, 2019).</p>


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