IMPACT OF ADDITIONAL ANTIBIOTICS ON IN-HOSPITAL MORTALITY IN PULMONARY TUBERCULOSIS COMPLICATED BY BACTERIAL PNEUMONIA: A PROPENSITY SCORE ANALYSIS

Respirology ◽  
2018 ◽  
Vol 23 ◽  
pp. 201-201
2021 ◽  
Author(s):  
Manuel Ponce-Alonso ◽  
Borja M Fernández-Félix ◽  
Ana Halperin ◽  
Mario Rodríguez-Domínguez ◽  
Ana M Sánchez-Díaz ◽  
...  

Abstract Purpose: Classically, men have been considered to have a higher incidence of infectious diseases, with controversy over the possibility that sex could condition the prognosis of the infection. The aim of the present work was to explore this assumption in patients admitted to the ICU with sepsis using a robust statistical analysis.Methods: Retrospective analysis (2006-2017) in patients with microbiologically confirmed bacteremia (n=440) by majoritarian bacterial pathogens. Risk of ICU and in-hospital mortality in males respect to females was compared by an univariant analysis and a propensity score correspondence analysis integrating their clinical characteristics. Results: Relevant differences were related to the infection source: urinary origin for females (28.7% vs 19.8%) and abdominopelvic surgery for males (8.8% vs 4.8%). Sepsis occurred more frequently in males (80.2% vs 76.1%) as well as in-hospital (48.0% vs 41.3%) and ICU (39.9% vs 36.5%) mortality. Escherichia coli was 2 times more frequent in survivors whereas Staphylococcus aureus was 3 times more frequent in deceased patients. Univariate analyses showed that males had a higher Charlson comorbidity index, a poorer McCabe prognostic score; however the propensity score in 296 patients demonstrated that females had higher risk of both ICU (OR 0.72; 95% CI 0.46 to 1.13), and in-hospital mortality (OR 0.84; 95% CI 0.55 to 1.30) but without statistical significance. Conclusion: Men with sepsis have worse clinical characteristics when admitted to the ICU, but sex has no influence on the prognosis of mortality. Our data contributes to help reduce the sex-dependent gap present in health care provision.


2011 ◽  
Vol 18 (11) ◽  
pp. 1208-1216 ◽  
Author(s):  
Kenneth E. Stewart ◽  
Linda D. Cowan ◽  
David M. Thompson ◽  
John C. Sacra ◽  
Roxie Albrecht

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Wulfran Bougouin ◽  
Kaci Slimani ◽  
Marie Renaudier ◽  
Yannick Binois ◽  
Marine Paul ◽  
...  

Backgound: Whether epinephrine or norepinephrine is preferable as the continuous intravenous vasopressor used to treat postresuscitation shock is unclear. Objectives: To compare outcomes of patients with postresuscitation shock after out-of-hospital cardiac arrest according to whether the continuous intravenous vasopressor used was epinephrine or norepinephrine. Methods: We conducted an observational multicenter study of consecutive patients managed in 2011-2018 for postresuscitation shock. The primary outcome was all-cause hospital mortality, and secondary outcomes were cardiovascular hospital mortality and unfavorable neurological outcome (Cerebral Performance Category 3 to 5). A multivariate regression analysis and a propensity score analysis were performed, as well as several sensitivity analyses. Results: Of the 766 patients included in five hospitals, 285 (37%) received epinephrine and 481 (63%) norepinephrine. All-cause hospital mortality was significantly higher in the epinephrine group (OR 2.6; 95%CI, 1.4-4.7; P =0.002). Cardiovascular hospital mortality was also higher with epinephrine (aOR 5.5; 95%CI 3.0-10.3; P <0.001), as was the proportion of patients with CPC of 3 to 5 at hospital discharge. Sensitivity analyses produced consistent results. The analysis involving adjustment on a propensity score to control for confounders showed similar findings (aOR 2.1; 95%CI 1.1-4.0; P =0.02). Conclusions: Among patients with postresuscitation shock after out-of-hospital cardiac arrest, use of epinephrine was associated with higher all-cause and cardiovascular-specific mortality, compared with norepinephrine infusion. A randomized controlled trial comparing the two vasopressors in this population is warranted.


2019 ◽  
Vol 25 (9) ◽  
pp. 714-719 ◽  
Author(s):  
Takamasa Kan ◽  
Kosaku Komiya ◽  
Kokoro Honjo ◽  
Sonoe Uchida ◽  
Akihiko Goto ◽  
...  

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J Song ◽  
X Bai ◽  
X Li ◽  
J Li ◽  
X Zheng

Abstract Background The effect of time of admission on clinical outcomes in patients with acute myocardial infarction (AMI) is still a matter of debate. Purpose To investigate the association between off-hours admission and in-hospital mortality in patients with ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). Methods We used a two-stage, random sampling method to create a nationally representative sample of patients with AMI in 167 Chinese hospitals in four years (2001, 2006, 2011, and 2015). Off-hours were defined as 20:00–07:59 and on-hours as 08:00–19:59. We used hierarchical logistic regression model to examine whether off-hour admissions were associated with in-hospital mortality and 7-day mortality. Inverse-probability weighting propensity score analysis was also conducted to assess the robustness of the results. Results We identified 25654 patients admitted with AMI (median age 67.0 years; 31.6% women), of whom 20133 (78.5%) were diagnosed as STEMI and 5521 (21.5%) as NSTEMI. There were 5368 (26.7%) admissions for STEMI, and 1356 (24.6%) for NSTEMI occurring during off-hours, respectively. After adjusting for case mix, year of admission, comorbidities, clinical presentation, and in-hospital treatments, a significant association was observed between off-hours admissions and in-hospital mortality among the patients with STEMI (adjusted OR 1.14; 95% CI 1.01 to 1.28). The magnitude of the association became greater in the secondary analysis with 7-day mortality as the outcome (adjusted OR 1.16; 95% CI 1.02 to 1.31). But among patients with NSTEMI, no significant association was observed for in-hospital and 7-day mortality. Propensity score analysis showed similar results to hierarchical logistic model for both outcomes in patients with STEMI and NSTEMI. Conclusion Off-hours admission with STEMI is associated with higher in-hospital mortality. Reducing the disparity of care of STEMI by the time of admission represents a potential opportunity for quality improvement in China. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): National Key Research and Development Program (2017YFC1310803, 2017YFC1310801) from the Ministry of Science and Technology of China


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