scholarly journals Effect of albumin-globulin score and albumin to globulin ratio on survival in patients with heart failure: a retrospective cohort study in China

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e022960 ◽  
Author(s):  
Kuan Li ◽  
Wanrong Fu ◽  
Yacong Bo ◽  
Yongjian Zhu
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Characteristic Curve ◽  
Serum Levels ◽  
Cox Regression Analysis ◽  
Patients With Heart Failure ◽  
Albumin To Globulin Ratio

ObjectiveTo investigate the combined effect of albumin (ALB) and globulin (GLB) on the overall survival (OS) of patients with heart failure (HF).DesignRetrospective cohort study.SettingA hospital.Participants404 patients first diagnosed with HF.MeasurementsSerum ALB and GLB were measured within 3 days after admission. The albumin to globulin ratio (AGR) was calculated as the ALB divided by the GLB. The receiver operating characteristic curve was used to calculate the cut-off points for ALB, GLB and AGR. Patients with low ALB levels (≤35.3 g/L) and high GLB levels (>27.0 g/L) were assigned an albumin-globulin score (AGS) of 2, those with only one of the two abnormalities were assigned an AGS of 1 and those with neither of the two abnormalities were assigned an AGS of 0.ResultsThe mean age of the 404 patients was 62.69±15.62, and 54.5% were male. 14 patients were lost to follow-up. 120 patients died from HF and 211 patients were readmitted to the hospital for worsening HF. Multivariate Cox regression analysis showed that higher AGR was significantly associated with favourable OS (HR, 0.61, 95% CI 0.38 to 0.98, p=0.040) but not AGS.ConclusionSerum levels of ALB and GLB are objective and easily measurable biomarkers which can be used in combination to predict the survival of patients with HF.

scholarly journals 1024. First Episode Infective Endocarditis in Persons Who Inject Drugs (PWIDs); A Retrospective Cohort Study

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S305-S305
Author(s):  
Laura Rodger ◽  
Dresden GlockerLauf ◽  
Esfandiar Shojaei ◽  
Adeel Sherazi ◽  
Brian Hallam ◽  
...  
Keyword(s):  
Cohort Study ◽  
Infective Endocarditis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
First Episode ◽  
Persons Who Inject Drugs ◽  
Cox Regression Analysis ◽  
Lower Survival ◽  
Valvular Surgery

Abstract Background Persons who inject drugs (PWID) represent a distinct demographic of patients with infective endocarditis (IE). Many centers do not perform valvular surgery on these patients due to concerns about poor outcomes. Methods Retrospective cohort study comparing PWID patients to non-PWID patients presenting between February 2007 and March 2016 in London, Ontario, among adult (>18) inpatients with first episode IE. Results In 370 first episode IE cases, 53.9% occurred in PWIDs. PWID patients were younger (35.4 SD 10.0 vs. 59.4 SD 14.9) (P < 0.001), more likely to have right-sided infection [125/202 (62%), vs. 16/168 (9.5%) (P < 0.001)], and more often due to S. aureus (156/202 (77.3%) vs. 54/168 (32.1%), P < 0.001). Myocardial and aortic root abscesses were less common in PWIDs [17/202 (8.4%) vs. 50/168 (30%) (P < 0.01)]. There was no difference in the frequency of noncardiac complications. In total, 36.5% of patients were treated surgically with PWID patients less likely to undergo surgery [39/202 (19.3%) vs. 98/168 (58%) P < 0.001]. Cox regression analysis identified the protective effect of cardiac surgery with regards to survival in all patients, with a hazard ratio of 0.49 (95% CI 0.31–0.76, P < 0.001), as well as among PWIDs (HR 0.39, 95% CI 0.17–0.87, P = 0.02). Among all patients, lower survival was associated with older age (HR 1.03, 95% CI 1.00–1.05, P < 0.001), injection drug use (HR 2.72, 95% CI 1.52–4.88, P < 0.001), left-sided infection (HR 3.48, 95% CI 2.01–6.03, P < 0.001), and bilateral infection (HR 3.19, 95% CI 1.45–7.01, P = 0.004). The lower survival of left-sided infection (HR 4.01, 95% CI 1.97–8.18, P < 0.001) or bilateral infection (HR 6.94, 95% CI 2.39–20.2,P < 0.001) was re-demonstrated in PWIDs. Conclusion This study identifies important clinical differences between PWIDs and nondrug users with respect to valve involvement, causative organism, complications, and management strategies. Our results highlight the important role of surgical treatment in a carefully selected PWID patient population. Disclosures All authors: No reported disclosures.

scholarly journals Prognostic impact of albumin-bilirubin score on the prediction of in-hospital mortality in patients with heart failure: a retrospective cohort study

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e049325
Author(s):  
Su Han ◽  
Chuanhe Wang ◽  
Fei Tong ◽  
Ying Li ◽  
Zhichao Li ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Continuous Variable ◽  
Hospital Death ◽  
Prognostic Impact ◽  
C Statistic ◽  
Patients With Heart Failure

ObjectivesLiver dysfunction is prevalent in patients with heart failure (HF) and can lead to poor prognosis. The albumin-bilirubin (ALBI) score is considered as an effective and convenient scoring system for assessing liver function. We analysed the correlation between ALBI and in-hospital mortality in patients with HF.DesignA retrospective cohort study.Setting and participantsA total of 9749 patients with HF (from January 2013 to December 2018) was enrolled and retrospectively analysed.Main outcome measuresThe main outcome is in-hospital mortality.ResultsALBI score was calculated using the formula (log10 bilirubin [umol/L] * 0.66) + (albumin [g/L] * −0.085), and analysed as a continuous variable as well as according to three categories. Following adjustment for multivariate analysis, patients which occurred in-hospital death was remarkably elevated in tertile 3 group (ALBI ≥2.27) (OR 1.671, 95% CI 1.228 to 2.274, p=0.001), relative to the other two groups (tertile 1: ≤2.59; tertile 2: −2.59 to −2.27). Considering ALBI score as a continuous variable, the in-hospital mortality among patients with HF increased by 8.2% for every 0.1-point increase in ALBI score (OR 1.082; 95% CI 1.052 to 1.114; p<0.001). The ALBI score for predicting in-hospital mortality under C-statistic was 0.650 (95% CI 0.641 to 0.660, p<0.001) and the cut-off value of ALBI score was −2.32 with a specificity of 0.630 and a sensitivity of 0.632. Moreover, ALBI score can enhance the predictive potential of NT-pro-BNP (NT-pro-BNP +ALBI vs NT-pro-BNP: C-statistic: z=1.990, p=0.0467; net reclassification improvement=0.4012, p<0.001; integrated discrimination improvement=0.0082, p<0.001).ConclusionsIn patients with HF, the ALBI score was an independent prognosticator of in-hospital mortality. The predictive significance of NT-proBNP +ALBI score was superior to NT-proBNP, and ALBI score can enhance the predictive potential of NT-proBNP.

scholarly journals Associated Factories and Time to Occurrence of Tuberculosis Among Children on HIV/AIDS Care in Assosa and Pawe General Hospitals North West Ethiopia: A Retrospective Cohort Study 2020

2020 ◽  
Author(s):  
Fassikaw kebede Bizuneh ◽  
Tadese Tollosa Daba ◽  
Belayneh Mengist Mitike ◽  
Tamrat sheawno Fikretsion ◽  
Belete Negese Negese
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Cox Model ◽  
Incidence Density ◽  
Human Immune Deficiency Virus ◽  
Cox Regression Analysis ◽  
Hiv Aids

Abstract Background: Tuberculosis (TB) incidence in peadtrics and children living with human immune-deficiency virus (HIV) is an emerging global concern. Although, the incidence of TB among adult HIV patients is exhaustively studied in Ethiopia, but among children on HIV/AIDS care is overlooked. Knowledge of the time when TB develops during successive follow up could be helpful for time relevant intervention strategies.Methods: health institution based retrospective cohort study conducted among 421 children on HIV/AIDS from 2009-2018. Time to develop TB was defined as time from enrollment for ART care until development of TB among children on ART. Proportional hazard assumption was checked for each variable and no variable was found with Schoenfeld test <0.05. Variables with P-value <0.25 at bivariate Cox regression analysis were entered into multivariable Cox model. Multivariable Cox regression model with 95%CI and AHR was used to identify significant predictor variables to develop TB at P< 0.05.Result: Totally 421 children were followed for a total of 662.5 Person Years of observation (PYO). The maximum and minimum follow up time on ART was 0.37 and 4.49 years, respectively. The median age of the children on ART at enrollment was 8 years (IQR=2-15). The Overall incidence density of tuberculosis in HIV infected children was 9.6/ 100 PYOs 95%CI (8.06-10.3). Tuberculosis occurrence among HIV infected children was significantly associated within TB history of contact AHR=3.7, 95%CI (2.89-7.2), not started on cotrimoxazole(CPT) AHR=2.4: 95%CI (1.84-4.74), incomplete vaccination AHR=2.4, 95%CI (1.32-4.5), sever stunting AHR =2.99:95%CI (1.2-7.81), having hemoglobin (Hgb) ≤10 mg/dl AHR = 4.02, 95%CI (2.01-8.1).Conclusion: More than 80% of TB incidences occurred during two years of follow up after ART started. So intensified screening of CPT& therapeutic feeding is highly recommended for all children.

scholarly journals Risk of pneumothorax in pneumoconiosis patients in Taiwan: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e054098
Author(s):  
Jo-Hui Pan ◽  
Chih-Hung Cheng ◽  
Chao-Ling Wang ◽  
Chia-Yen Dai ◽  
Chau-Chyun Sheu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Cumulative Incidence ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Secondary Outcome ◽  
Matched Cohort ◽  
Cox Regression Analysis ◽  
Control Subjects

ObjectivesThis study was conducted to explore the association between pneumoconiosis and pneumothorax.DesignRetrospective cohort study.SettingNationwide population-based study using the Taiwan National Health Insurance Database.ParticipantsA total of 2333 pneumoconiosis patients were identified (1935 patients for propensity score (PS)-matched cohort) and matched to 23 330 control subjects by age and sex (7740 subjects for PS-matched cohort).Primary and secondary outcome measuresThe incidence and the cumulative incidence of pneumothorax.ResultsBoth incidence and the cumulative incidence of pneumothorax were significantly higher in the pneumoconiosis patients as compared with the control subjects (p<0.0001). For multivariable Cox regression analysis adjusted for age, sex, residency, income level and other comorbidities, patients with pneumoconiosis exhibited a significantly higher risk of pneumothorax than those without pneumoconiosis (HR 3.05, 95% CI 2.18 to 4.28, p<0.0001). The male sex, heart disease, peripheral vascular disease, chronic pulmonary disease and connective tissue disease were risk factors for developing pneumothorax in pneumoconiosis patients.ConclusionsOur study revealed a higher risk of pneumothorax in pneumoconiosis patients and suggested potential risk factors in these patients. Clinicians should be aware about the risk of pneumothorax in pneumoconiosis patients.

Association Between Serum Albumin and Mortality in Older People With Dysphagia: a Retrospective Cohort Study

2021 ◽  
Author(s):  
Gaigai Li ◽  
Tongtao Fan ◽  
Xun Zhou ◽  
Xunrui Hou ◽  
Yuheng Luo ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cohort Study ◽  
Older People ◽  
Serum Albumin ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Total Mortality ◽  
High Group ◽  
Cox Regression Analysis

Abstract Objective: To determine whether there is a link between serum albumin and mortality among participants in Japan older people.Methods: This is a single-center, retrospective cohort study analysis of 253 older patients with dysphagia from Japan, conducted from January 2014 and January 2017. The primary outcome was mortality. We performed Cox regression analysis to compare the mortality between the two groups (dividing by serum albumin=3g/dl).Results: A total of 253 patients were included in the analysis, of whom the number of serum albumin under 3g/dl was 93. The log-rank test showed a significantly longer mortality in the high group (serum albumin >=3g/dl) compared with the low group (median, 382 vs 176 days, P < 0.0001). Cox regression analysis showed that unadjusted HR for the high group relative to the low group was 0.40 (95% CI: 0.29–0.57; P <0.001). After adjustment 3 models in multivariable analyses, serum albumn was significantly associated with mortality. The adjusted HRs (95% CI) for total mortality rates were 0.46 (0.33~0.65) , 0.66 (0.44~0.99) and 0.64 (0.42~0.97), from model 2 to model 4.Conclusion: There is negative association between serum albumin and mortality in older people with dysphagia.

scholarly journals AST/ALT ratio as a predictor of mortality and future exacerbations of PM/DM-ILD——a retrospective cohort study with 522 cases

2020 ◽  
Author(s):  
Renjiao Li ◽  
Wen-Jun Zhu ◽  
Faping Wang ◽  
Xiaoju Tang ◽  
Fengming Luo
Keyword(s):  
Mechanical Ventilation ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Low Cost ◽  
Cox Regression Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Hazard Ratios

Abstract ObjectiveTo assess the associations between aspartate transaminase/alanine transaminase ratio (DRR) and mortality in patients with Polymyositis/dermatomyositis associated interstitial lung disease (PM/DM-ILD).Patients and MethodsThis was a retrospective cohort study, which included 522 patients with PM/DM-ILD whose DRR on admission were tested at West China Hospital of Sichuan University during the period from January 1, 2008 to December 31, 2018. Cox regression models were used to estimate hazard ratios for mortality in four predefined DRR strata (≤ 0.91, 0.91–1.26, 1.26–1.73 and > 1.73), after adjusting for age, sex, DRR stratum, diagnosis, overlap syndrome, hemoglobin, platelet count, white blood cell count, the percentage of neutrophils, neutrophil/lymphocyte ratio, albumin, creatine kinase, uric acid/creatinine ratio, triglycerides or low density lipoprotein.ResultsHigher DRR (> 1.73) was an independent predictor of 1-year mortality in multivariate Cox regression analysis (hazard ratio 3.423, 95% CI 1.481–7.911, p = .004). Patients with higher DRR more often required use of mechanical ventilation and readmission for acute exacerbation of PM/DM-ILD at 1-year follow-up.ConclusionHigher DRR on admission for PM/DM-ILD patients are associated with increased mortality, risk of mechanical ventilation and hospitalization in 1-year follow-up. This low-cost, easy-to-obtain, rapidly measured biomarker may be useful in the identification of high-risk PM/DM-ILD patients that could benefit from intensive management.

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