Rates and predictors of ACE inhibitor discontinuation subsequent to elevated serum creatinine: a retrospective cohort study

Introduction. Ischemic stroke is the third leading cause of mortality in low-income countries and the sixth in Ethiopia. The aim of this study was to determine the rate and predictors of in-hospital mortality due to ischemic stroke in Gondar University Hospital. Methods. The study was conducted from April 1, 2017, to May 15, 2017, at Gondar University Hospital. A census using retrospective cohort study design was conducted on medical records of adult patients with the diagnosis of ischemic stroke attending the medical inpatient ward of Gondar University Hospital between November 2012 and September 2016. Cox hazard regression was used to determine the predictors of in-hospital mortality. A two-sided statistical test at 5% level of significance was used. Results. The mean (±SD) duration of hospital stay was 11.55 (10.040) days. Of the total 208 patients, 26 (12.5%) patients died in the hospital. Cox regression revealed that only a decrease in renal function, particularly elevated serum creatinine (AHR=8.848, 95% CI: 1.616-67.437), was associated with a statistically significant increase of in-hospital mortality. The symptom onset-to-admission time varied greatly among patients and ranged from 1 hour to 168 hours. Conclusion. The in-hospital mortality associated with ischemic stroke was found to be high. Mainly, elevation in serum creatinine was highly associated with poorer outcomes in terms of in-hospital mortality. Much work should be done on improving the knowledge and awareness of the community regarding ischemic stroke and stroke in general to encourage early medical seeking behavior and reduce mortality and long-term disability.

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The Association of Low Admission Serum Creatinine with the Risk of Respiratory Failure Requiring Mechanical Ventilation: A Retrospective Cohort Study

Scientific Reports ◽

10.1038/s41598-019-55362-w ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 3

Author(s):

Charat Thongprayoon ◽

Wisit Cheungpasitporn ◽

Api Chewcharat ◽

Michael A. Mao ◽

Sorkko Thirunavukkarasu ◽

...

Keyword(s):

Mechanical Ventilation ◽

Cohort Study ◽

Respiratory Failure ◽

Serum Creatinine ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Reference Group ◽

Hospitalized Patients ◽

Tertiary Referral Hospital ◽

Time Of Admission

AbstractTo assess the association between low serum creatinine (SCr) value at admission and the risk of respiratory failure requiring mechanical ventilation in hospitalized patients. A retrospective cohort study was conducted at a tertiary referral hospital. All hospitalized adult patients from 2011 through 2013 who had an admission SCr value were included in this study. Patients who were mechanically ventilated at the time of admission were excluded. Admission creatinine was stratified into 7 groups: ≤0.4, 0.5–0.6, 0.7–0.8, 0.9–1.0, 1.1–1.2, 1.3–1.4, and ≥1.5 mg/dL. The primary outcome was the occurrence of respiratory failure requiring mechanical ventilation during hospitalization. Logistic regression analysis was used to assess the independent risk of respiratory failure based on various admission SCr, using SCr of 0.7–0.8 mg/dL as the reference group in the analysis of all patients and female subgroup and of 0.9–1.0 mg/dL in analysis of male subgroup. A total of 67,045 eligible patients, with the mean admission SCr of 1.0 ± 0.4 mg/dL, were studied. Of these patients, 799 (1.1%) had admission SCr of ≤0.4 mg/dL, and 2886 (4.3%) developed respiratory failure requiring mechanical ventilation during hospitalization. The U-curve relationship between admission SCr and respiratory failure during hospitalization was observed, with the nadir incidence of in-hospital respiratory failure in SCr of 0.7–0.8 mg/dL and increased in-hospital respiratory failure associated with both reduced and elevated admission SCr. After adjustment for confounders, very low admission SCr of ≤0.4 mg/dL was significantly associated with increased in-hospital respiratory failure (OR 3.11; 95% CI 2.33–4.17), exceeding the risk related to markedly elevated admission SCr of ≥1.5 mg/dL (OR 1.61; 95% CI 1.39–1.85). The association remained significant in the subgroup analysis of male and female patients. Low SCr value at admission is independently associated with increased in-hospital respiratory failure requiring mechanical ventilation in hospitalized patients.

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Increased hepatocellular carcinoma risk in chronic hepatitis B patients with persistently elevated serum total bile acid: a retrospective cohort study

Scientific Reports ◽

10.1038/srep38180 ◽

2016 ◽

Vol 6 (1) ◽

Cited By ~ 3

Author(s):

Haoliang Wang ◽

Xiaoyun Shang ◽

Xing Wan ◽

Xiaomei Xiang ◽

Qing Mao ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Chronic Hepatitis ◽

Cohort Study ◽

Bile Acid ◽

Hepatitis B ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Elevated Serum ◽

Total Bile Acid ◽

Carcinoma Risk

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Elevated serum alkaline phosphatase as a predictor of cognitive impairment in patients with acute ischaemic stroke: A retrospective cohort study

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2020.104104 ◽

2020 ◽

Vol 89 ◽

pp. 104104

Author(s):

He Jia ◽

Huimian Li ◽

Yanru Liu ◽

Chao Liu ◽

Mengzhou Xue

Keyword(s):

Alkaline Phosphatase ◽

Cohort Study ◽

Cognitive Impairment ◽

Ischaemic Stroke ◽

Acute Ischaemic Stroke ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Serum Alkaline Phosphatase ◽

Elevated Serum

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Serum creatinine as a predictor of mortality in patients readmitted to the intensive care unit after cardiac surgery: a retrospective cohort study in China

Journal of Thoracic Disease ◽

10.21037/jtd-20-3205 ◽

2021 ◽

Vol 13 (3) ◽

pp. 1728-1736

Author(s):

Jun Zhong ◽

Jian Gao ◽

Jing-Chao Luo ◽

Ji-Li Zheng ◽

Guo-Wei Tu ◽

...

Keyword(s):

Intensive Care Unit ◽

Cardiac Surgery ◽

Cohort Study ◽

Intensive Care ◽

Serum Creatinine ◽

Retrospective Cohort Study ◽

Retrospective Cohort

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Reno-protective effects of melatonin against vancomycin-related acute kidney injury in hospitalized patients: a retrospective cohort study

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00462-21 ◽

2021 ◽

Author(s):

Thomas S. Hong ◽

Kelsey Briscese ◽

Marshall Yuan ◽

Kiran Deshpande ◽

Lauren M. Aleksunes ◽

...

Keyword(s):

Oxidative Stress ◽

Acute Kidney Injury ◽

Logistic Regression ◽

Cohort Study ◽

Serum Creatinine ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Medical Center ◽

Kidney Injury ◽

Multivariable Logistic Regression

Background: Vancomycin is associated with nephrotoxicity and the mechanism may in part be related to oxidative stress. In vitro and preclinical studies suggest melatonin supplementation decreases oxidative stress. The objective of this study was to evaluate concomitant use of melatonin and vancomycin and the incidence of acute kidney injury (AKI). Methods: We performed a retrospective cohort study at a large community medical center. All consecutive patients admitted to the medical center between January 2016 and September 2020 who received vancomycin therapy alone or concomitantly with melatonin as part of ordinary care were considered for inclusion. The primary endpoint was the development of AKI defined as an absolute increase in serum creatinine of ≥ 0.3 mg/dL or a ≥ 50% increase in serum creatinine. All data were analyzed using descriptive statistics. A multivariable logistic regression was constructed to account for potential confounding variables. Results: A total of 303 adult patients meeting inclusion and exclusion criteria treated with vancomycin were identified, 101 of which received melatonin concomitantly. Overall baseline characteristics were similar between the two groups except for the incidence of bactremia/sepsis. After controlling for vancomycin area under the curve, baseline creatinine clearance, and intensive care unit admission in multivariable logistic regression, melatonin use was associated with a 63% decrease in AKI (odds ratio [OR], 0.37; 95% confidence interval [CI], 0.14 – 0.96; p =0.041). Conclusions: Melatonin use was associated with a significant reduction in vancomycin-related AKI. Although this was a retrospective study with a small sample size, given the magnitude of the difference seen, further large prospective studies are warranted.

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Serum 8-iso-PGF2α Predicts the Severity and Prognosis in Patients With Community-Acquired Pneumonia: A Retrospective Cohort Study

Frontiers in Medicine ◽

10.3389/fmed.2021.633442 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ling Zheng ◽

Jun Fei ◽

Chun-Mei Feng ◽

Zheng Xu ◽

Lin Fu ◽

...

Keyword(s):

Cohort Study ◽

Hospital Stay ◽

Inflammatory Cytokines ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Elevated Serum ◽

Community Acquired Pneumonia ◽

Risk Of Death ◽

Severity Scores

Background: Many studies have identified the important role of 8-isoprostane (8-iso-PGF2α) in pulmonary diseases. However, the role of 8-iso-PGF2α in community-acquired pneumonia (CAP) remains unclear. Therefore, the main goal was to investigate the correlations of serum 8-iso-PGF2α with the severity and prognosis in CAP patients through a hospital-based retrospective cohort study.Methods: All 220 patients with CAP were enrolled. Demographic information and clinical data were collected. Levels of 8-iso-PGF2α and inflammatory cytokines were detected in serum using ELISA.Results: The levels of 8-iso-PGF2α were gradually increased in parallel with the CAP severity scores. Univariate and multivariate logistic regression analyses revealed a positive association between serum 8-iso-PGF2α and the CAP severity scores. Additionally, serum 8-iso-PGF2α levels were positively correlated with circulating inflammatory cytokines (CRP and TNFα). Serum 8-iso-PGF2α levels were increased in the patients with a longer hospital stay than those with a shorter hospital stay. Additionally, 20 patients died after hospitalization. Dead patients presented a higher serum 8-iso-PGF2α than surviving patients. A subsequent survival analysis revealed that higher serum 8-iso-PGF2α levels positively correlated with the risk of death in patients with CAP.Conclusions: Serum 8-iso-PGF2α levels on admission are positively associated with the severity of CAP patients. Elevated serum 8-iso-PGF2α on admission prolongs hospital stay and increases the risk of death in patients with CAP, indicating that 8-iso-PGF2α may be involved in the progression of CAP and serve as an early serum prognostic biomarker for CAP.

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