scholarly journals POS0141 ACTIVE SCREENING FOR GOUT IDENTIFIES A LARGER CARDIOVASCULAR POPULATION AT HIGH MORTALITY RISK

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 282.2-282
Author(s):  
S. Ruiz-Simón ◽  
I. Calabuig ◽  
M. Gomez-Garberi ◽  
M. Andrés
Keyword(s):  
High Mortality ◽  
Mortality Risk ◽  
Cardiovascular Events ◽  
Cox Regression ◽  
Field Studies ◽  
High Mortality Risk ◽  
Active Screening ◽  
Tertiary Centre ◽  
All Cause Mortality

Background:We have recently revealed by active screening that about a third of gout cases in the cardiovascular population is not registered in records [1], highlighting the value of field studies.Objectives:To assess whether gout screening in patients hospitalized for cardiovascular events may also help identify patients at higher risk of mortality after discharge.Methods:A retrospective cohort field study, carried out in 266 patients admitted for cardiovascular events in the Cardiology, Neurology and Vascular Surgery units of a tertiary centre in Spain. The presence of gout was established by records review and face-to-face interview, according to the 2015 ACR/EULAR criteria. The occurrence of mortality during follow-up and its causes were obtained from electronic medical records. The association between gout and subsequent mortality was tested using Cox regression models. Whether covariates affect the gout-associated mortality was also studied.Results:Of 266 patients recruited at baseline, 17 were excluded due to loss to follow-up (>6mo), leaving a final sample of 249 patients (93.6%). Thirty-six cases (14.5% of the sample) were classified as having gout: twenty-three (63.9%) had a previously registered diagnosis, while 13 (36.1%) had not and was established by the interview.After discharge, the mean follow-up was 19.9 months (SD ±8.6), with a mortality incidence of 21.6 deaths per 100 patient-years, 34.2% by cardiovascular causes.Gout significantly increased the risk of subsequent all-cause mortality, with a hazard ratio (HR) of 2.01 (95%CI 1.13 to 3.58). When the analysis was restricted to gout patients with registered diagnosis, the association remained significant (HR 2.89; 95%CI 1.54 to 5.41).The adjusted HR for all-cause mortality associated with gout was 1.86 (95% CI 1.01-3.40). Regarding the causes of death, both cardiovascular and non-cardiovascular were numerically increased.Secondary variables rising the mortality risk in those with gout were age (HR 1.07; 1.01 to 1.13) and coexistent renal disease (HR 4.70; 1.31 to 16.84), while gender, gout characteristics and traditional risk factors showed no impact.Conclusion:Gout was confirmed an independent predictor of subsequent all-cause mortality in patients admitted for cardiovascular events. Active screening for gout allowed identifying a larger population at high mortality risk, which may help tailor optimal management to minimize the cardiovascular impact.References:[1]Calabuig I, et al. Front Med (Lausanne). 2020 Sep 29;7:560.Disclosure of Interests:Silvia Ruiz-Simón: None declared, Irene Calabuig: None declared, Miguel Gomez-Garberi: None declared, Mariano Andrés Speakers bureau: Grunenthal, Menarini, Consultant of: Grunenthal, Grant/research support from: Grunenthal

scholarly journals Treatment experience of a patient with duodenal trauma

2020 ◽  
pp. 95-96
Author(s):  
A. K. Krekoten ◽  
A. A. Krekoten ◽  
V. N. Mutyl
Keyword(s):  
Small Intestine ◽  
High Mortality ◽  
Mortality Risk ◽  
Postoperative Period ◽  
Pancreatic Ducts ◽  
High Mortality Risk ◽  
Intraoperative Diagnosis ◽  
Short Loop ◽  
The Common

A case of combined duodenal trauma in the 11-year-old patient is described. Complications of pre-operative and intraoperative diagnosis as well as complicated postoperative period are emphasized to be a cause of high mortality risk in this pathology. The disconnection of proximal and distal parts of duodenum was performed; anastomoses were placed between the common bile and pancreatic ducts and small intestine, and gastroenteroanastomosis was performed on a short loop. Follow-up traced for 10 months: recovery.

scholarly journals Positive follow-up blood cultures identify high mortality risk among patients with Gram-negative bacteraemia

2020 ◽  
Vol 26 (7) ◽  
pp. 904-910 ◽  
Author(s):  
S.A. Maskarinec ◽  
L.P. Park ◽  
F. Ruffin ◽  
N.A. Turner ◽  
N. Patel ◽  
...  
Keyword(s):  
High Mortality ◽  
Mortality Risk ◽  
Blood Cultures ◽  
High Mortality Risk ◽  
Gram Negative

Association of Different Physical Activity Domains on All-Cause Mortality in Adults Participating in Primary Care in the Brazilian National Health System: 4-Year Follow-up

2017 ◽  
Vol 14 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Bruna C. Turi ◽  
Jamile S. Codogno ◽  
Romulo A. Fernandes ◽  
Xuemei Sui ◽  
Carl J. Lavie ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mortality Risk ◽  
Cox Regression ◽  
National Health System ◽  
Circulatory System ◽  
Cox Regression Analysis ◽  
Circulatory System Diseases ◽  
All Cause Mortality ◽  
Males And Females

Background:Evidence has shown that physical activity (PA) is associated with low mortality risk. However, data about reduced mortality due to PA are scarce in developing countries and the dose–response relationship between PA from different domains and all-cause mortality remains unclear. Thus, the aim of this study is to investigate the association of PA from different domains on all-cause mortality among Brazilian adults.Methods:679 males and females composed the study sample. Participants were divided into quartile groups according to PA from different domains (occupational, sports, and leisure-time). Medical records were used to identify the cause of the death. Cox regression analysis was performed to determine the independent associations of PA from different domains and all-cause mortality.Results:During the follow-up period, 59 participants died. The most prevalent cause of death was circulatory system diseases (n = 20; 33.9% [21.8%–45.9%]). Higher scores of occupational (HR= 0.45 [95% CI: 0.20–0.97]), sports (HR= 0.44 [95% CI: 0.20–0.95]) and overall PA (HR= 0.40 [95% CI: 0.17–0.90]) were associated with lower mortality, even after adjustment for confounders.Conclusions:The findings in this study showed the importance of being active in different domains to reduce mortality risk.

Outcome in biopsy-proven Lupus nephritis: Evaluation of biopsies from the Norwegian Kidney Biopsy Registry

Lupus ◽  
2017 ◽  
Vol 26 (8) ◽  
pp. 881-885 ◽  
Author(s):  
G E Norby ◽  
G Mjøen ◽  
R Bjørneklett ◽  
B E Vikse ◽  
H Holdaas ◽  
...  
Keyword(s):  
General Population ◽  
Lupus Nephritis ◽  
Confidence Interval ◽  
Cardiovascular Events ◽  
Causes Of Death ◽  
Cox Regression ◽  
Population Sample ◽  
All Cause Mortality ◽  
Class Iv

Objective To evaluate long-term mortality and end-stage renal disease (ESRD) in a cohort of Norwegian patients with biopsy-proven lupus nephritis (LN). Methods Renal biopsies were obtained from 178 patients with LN from 1988 until 2007. Mortality rate and death causes were provided by Statistics Norway and ESRD data were provided by the Norwegian Renal Registry. Risk factors for all-cause mortality were evaluated by Cox regression. Standardized mortality ratio (SMR) was compared to observed deaths in a matched general population sample. Results Mean age was 37.6 (±14.4) years, and median time of follow-up was 8.5 years (0–26.2). Thirty-six patients (20.2%) died during follow-up. The SMR for all-cause mortality was 5.6 (Confidence interval [CI] 3.7–7.5). In an adjusted multivariate analysis proliferative glomerulonephritis (LN class IV) was independently associated with all-cause mortality; hazard ratio (HR) 2.6 (Confidence interval [CI] 1.2–5.7 p = 0.017). Main causes of death were infections (47.2%) and cardiovascular events 8 (22.2%). Thirty-six patients (20.2%) reached ESRD. Conclusions Biopsy-proven LN is associated with increased mortality compared to the general population. LN class IV is associated with all-cause mortality. Infections and cardiovascular events were the most common causes of death. Patients with LN have a high incidence of ESRD.

scholarly journals Low serum klotho associated with all-cause mortality among a nationally representative sample of American adults

2021 ◽  
Author(s):  
Jacob K Kresovich ◽  
Catherine M Bulka
Keyword(s):  
Physical Activity ◽  
Mortality Risk ◽  
Representative Sample ◽  
Cox Regression ◽  
The United States ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Nationally Representative ◽  
Low Serum

Abstract α-Klotho (klotho) is a protein involved in suppressing oxidative stress and inflammation. In animal models, it is reported to underlie numerous aging phenotypes and longevity. Among a nationally representative sample of adults aged 40 to 79 in the United States, we investigated whether circulating concentrations of klotho is a marker of mortality risk. Serum klotho was measured by ELISA on 10,069 individuals enrolled in the National Health and Nutrition Examination Survey between 2007-2014. Mortality follow-up data based on the National Death Index were available through December 31, 2015. After a mean follow-up of 58 months (range: 1-108), 616 incident deaths occurred. Using survey-weighted Cox regression models adjusted for age, sex and survey cycle, low serum klotho concentration (< 666 pg/mL) was associated with a 31% higher risk of death (compared to klotho concentration > 985 pg/mL, HR: 1.31, 95% CI: 1.00, 1.71, P= 0.05). Associations were consistent for mortality caused by heart disease or cancer. Associations of klotho with all-cause mortality did not appear to differ by most participant characteristics. However, we observed effect modification by physical activity, such that low levels of serum klotho were more strongly associated with mortality among individuals who did not meet recommendation-based physical activity guidelines. Our findings suggest that, among the general population of American adults, circulating levels of klotho may serve as a marker of mortality risk.

scholarly journals Systolic blood pressure and all-cause mortality in normoglycemia, prediabetes, and diabetes

2020 ◽  
Author(s):  
Chao-lei Chen ◽  
Lin Liu ◽  
Jia-yi Huang ◽  
Yu-ling Yu ◽  
Kenneth Lo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Mortality Risk ◽  
Cox Regression ◽  
Reference Group ◽  
Diabetic Patients ◽  
Diabetes Status ◽  
All Cause Mortality ◽  
Glucose Status

Abstract Background The optimal blood pressure (BP) level for diabetic patients remains controversial, and population-based evidence on BP management for individuals with normoglycemia and prediabetes is insufficient. We aimed to investigate the associations between systolic blood pressure (SBP) and all-cause mortality among US adults with different glucose metabolism.Methods We used data from the 1999–2014 National Health and Nutrition Examination Survey (NHANES, n = 40,046) with comprehensive baseline examination and follow-up assessment. Restricted cubic spline was performed to examine dose-response relationship between continuous SBP and all-cause mortality. Cox regression models were used to estimate hazard ratios of all-cause mortality for SBP categories.Results Over 32,5450 person-years of follow-up (median 8.1 years), 4745 all-cause death (11.8%) were recorded, corresponding to an event rate of 14.58 per 1000 patient years. U-shaped associations between SBP and all-cause mortality were observed regardless of glucose status. The lowest mortality risk of optimal SBP (mmHg) by group was 115–120 (normoglycemia), 120–130 (prediabetes), and 125–135 (diabetes). Compared with the reference group, SBP < 100 mmHg was significantly associated with 49% (HR = 1.49, 95%CI: 1.13–1.96), 57% (1.57, 1.07–2.3), and 59% (1.59, 1.12–2.25) higher mortality risk in normoglycemia, prediabetes, and diabetes, respectively. The multivariable-adjusted HRs of all-cause mortality for SBP of 150–159 mmHg and ≥ 160 mmHg were 1.35 (1.08–1.70) and 1.61 (1.31–1.98), 1.44 (1.13–1.83) and 1.66 (1.33–2.08), and 1.29 (1.02–1.65) and 1.37 (1.09–1.72), respectively.Conclusions U-shaped relationships between SBP and all-cause mortality existed regardless of diabetes status. The optimal SBP range for the lowest mortality was gradually higher with worsening glucose status.

1444Metabolically healthy obesity (MHO) in the Malmo Diet Cancer Study - epidemiology and prospective risks

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Korduner ◽  
E Bachus ◽  
A Jujic ◽  
M Magnusson ◽  
P M Nilsson
Keyword(s):  
Mortality Risk ◽  
Cox Regression ◽  
University Hospital ◽  
Cross Sectional ◽  
Cox Regression Analysis ◽  
Cancer Study ◽  
All Cause Mortality ◽  
Prospective Risk ◽  
Morbidity Risk

Abstract Background/Aims Metabolically healthy obesity (MHO) is a controversial topic, since the underlying mechanisms and contributing factors behind this phenotype remain unclear. Here we aimed to investigate the characteristics of MHO, as well as prospective mortality risk. Method A cross-sectional analysis was carried out in a subsample of 3,812 obese subjects (BMI ≥30 kg/m2) selected from the Malmo Diet Cancer Study (MDCS) cohort (n=28,403). Subjects with MHO (n=1182; mean age 58±7 years) were defined by having no records of hospitalization in the national Swedish Hospital Discharge Register prior to the baseline examination, other than hospitalization due to normal deliveries or external injuries. MHO subjects were further compared to subjects with metabolically unhealthy obesity, MUO (n=2,630; mean age 60±7 years), and all non-obese individuals (n=24,591; mean age 58±8 years) in the cohort study. Moreover, prospective risk analyses for incident morbidity and mortality were carried out by Cox regression. Results Compared to MOU individuals (one-way ANOVA), MHO individuals were younger (58±7 years vs. 60±7 years, p=0.001) and more likely to be male (41.2% vs 37.1%, p=0.016). MHO individuals reported a significantly lower proportion of sedentary life style than MUO (17.4% vs. 21.9%, p=0.009), and were more likely to hold a university degree (13.4% vs. 9.4%, p=0.003). Furthermore, MHO individuals had significantly lower HbA1c (p=0.012), fasting plasma glucose (p=0.001) and triglyceride levels (p=0.011) as compared to their MOU counterparts. Cox-regression analysis adjusted for age, sex, smoking and blood pressure (follow-up time 20±6 years) showed both a significantly lower all-cause mortality risk for MHO individuals as compared to MUO (HR 0.74, 95% CI: 0.66–0.82; p=0.001), as well as lower total incident cardiovascular (CV) morbidity risk (HR 0.69, 95% CI: 0.60–0.80; p=0.001). Interestingly, when comparing MHO individuals to all non-obese individuals in the MDCS, there were no significant differences in neither mortality risk (p=0.9), nor incident CV morbidity risk (p=0.7). All-cause mortality risk Conclusion Compared to MUO individuals, MHO individuals presented with a higher level of education- and physical activity together with a more favorable lipid- and glucose profile. MHO individuals were at significantly lower prospective risk of total- and cardiovascular mortality during 20-years follow-up, as compared to MOU individuals. Notably, no significant differences could be seen in mortality and CV morbidity risks when comparing MHO subjects to all non-obese individuals in the total cohort. Acknowledgement/Funding The Research Council of Sweden and Skane University Hospital Funds and Foundations (Sweden)

scholarly journals Sleep duration and all-cause mortality in the elderly in China: a population-based cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yanfeng Ren ◽  
Maohua Miao ◽  
Wei Yuan ◽  
Jiangwei Sun
Keyword(s):  
Cohort Study ◽  
Sleep Duration ◽  
Dose Response ◽  
Cox Regression ◽  
Oldest Old ◽  
The Elderly ◽  
Response Analysis ◽  
Short Sleep Duration ◽  
All Cause Mortality

Abstract Background Although a U-shaped association between sleep duration and all-cause mortality has been found in general population, its association in the elderly adults, especially in the oldest-old, is rarely explored. Methods In present cohort study, we prospectively explore the association between sleep duration and all-cause mortality among 15,092 participants enrolled in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2005 to 2019. Sleep duration and death information was collected by using structured questionnaires. Cox regression model with sleep duration as a time-varying exposure was performed to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs). The dose-response association between them was explored via a restricted cubic spline function. Results During an average follow-up of 4.51 (standard deviation, SD: 3.62) years, 10,768 participants died during the follow-up period. The mean (SD) age of the participants was 89.26 (11.56) years old. Compared to individuals with moderate sleep duration (7–8 hours), individuals with long sleep duration (> 8 hours) had a significantly higher risk of all-cause mortality (HR: 1.13, 95%CI: 1.09–1.18), but not among individuals with short sleep duration (≤ 6 hours) (HR: 1.02, 95%CI: 0.96–1.09). Similar results were observed in subgroup analyses based on age and gender. In the dose-response analysis, a J-shaped association was observed. Conclusions Sleep duration was associated with all-cause mortality in a J-shaped pattern in the elderly population in China.

scholarly journals Vascular and Cardiac Prognostic Determinants in Patients with Gynecological Cancers: A Six-Year Follow-up Study

2021 ◽  
Vol 11 (13) ◽  
pp. 6091
Author(s):  
Pietro Scicchitano ◽  
Marco Tucci ◽  
Gabriella Ricci ◽  
Michele Gesualdo ◽  
Santa Carbonara ◽  
...  
Keyword(s):  
Brachial Artery ◽  
Cox Regression ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Controlled Study ◽  
Gynecological Cancers ◽  
Roc Curve Analysis ◽  
Cox Regression Analysis ◽  
All Cause Mortality

Background: The aim of this study was to assess the role of cardiac and vascular parameters as all-cause mortality determinants in patients suffering from gynecological cancers. Methods: This was an observational, prospective, non-randomized, and non-controlled study. Forty-seven consecutive patients (mean age: 58 ± 13 years) were enrolled after cancer staging. All patients underwent evaluation of vascular (common carotid intima-media thickness (mean C-IMT), flow-mediated dilation of the brachial artery (FMD), and antero-posterior diameter of the infrarenal abdominal aorta (APAO)) and cardiac function and morphology before cancer-related interventions. A 6-year follow-up was carried out to assess the overall survival of the whole population. Results: Twenty patients (42%) died by the time of the 6-year follow-up. The brachial artery FMD values were higher in the survivors than the non-survivors (9.71 ± 3.53% vs. 6.13 ± 2.62%, p < 0.001), as well as the LVEF (60.8 ± 3.0% vs. 57.8 ± 4.4%, p = 0.009). There were no differences in the mean C-IMT, APAO, and other echocardiographic parameters. ROC curve analysis identified a baseline LVEF < 57% and FMD value < 5.8% as the best cut-offs. Kaplan–Meier evaluation showed that the LVEF, tricuspid annular plane systolic excursion, and FMD were the best predictors of all-cause mortality, although only the LVEF and FMD were confirmed in multivariate Cox regression analysis. Conclusions: The LVEF and brachial artery FMD are independent prognostic determinants in patients with gynecological cancers.

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