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.

Impact of Albumin-bilirubin (ALBI) score on the Prognostic Significance of Patients with Heart Failure:A Retrospective Cohort Study

2020 ◽  
Author(s):  
Su Han ◽  
Chuanhe Wang ◽  
Fei Tong ◽  
Ying Li ◽  
Zhichao Li ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Retrospective Cohort ◽  
Poor Prognosis ◽  
Prognostic Significance ◽  
Continuous Variable ◽  
The Other ◽  
Hospital Death ◽  
Net Reclassification Improvement ◽  
C Statistic ◽  
Integrated Discrimination Improvement

Abstract Objectives Liver dysfunction is prevalent in heart failure (HF) patients and it can bring a poor prognosis. Presently, albumin-bilirubin (ALBI) score has been designed as an effective and convenient scoring system for assessing liver function, but the correlation linking ALBI and in-hospital mortality in HF patients remains unclear.Methods and Results A total of 9749 patients with HF (from January 2013 to December 2018) was enrolled and retrospectively analyzed.
The main outcome is in-hospital death. We examined and analyzed ALBI as a continuous variable as well as according to 3 categories. Following adjustment for multivariable, patients which occurred in-hospital death was remarkably elevated in Tertile 3 group (ALBI>-2.27) (OR=1.670, 95% CI: 1.231~2.265, p=0.001), relative to the other two groups (Tertile 1: <-2.59; Tertile 2: -2.59~-2.27). When ALBI was inspected as a continuous variable, the incidence of HF patients with in-hospital death will increase by 8.2%. (For ALBI score per 0.1 score increasing, OR=1.082, 95% CI: 1.052~1.113, p<0.001). ALBI score for estimating in-hospital mortality under C-statistic was 0.650 (95% CI: 0.641~0.660, 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 estimation potential of NT-proBNP (NT-proBNP+ALBI vs NT-proBNP: C-statistic: z=1.990, p=0.0467; net reclassification improvement=0.4012, p<0.001; integrated discrimination improvement= 0.0082, p<0.001). Conclusions In patients with HF, ALBI score was an independent prognosticator of in-hospital death. The predictive significance of NT-proBNP +ALBI was superior to NT-proBNP, and ALBI score can enhance the estimation potential of NT-proBNP.

Cardiac rehabilitation and all-cause mortality in patients with heart failure: A retrospective cohort study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
B Buckley ◽  
S Harrison ◽  
E Fazio-Eynullayeva ◽  
P Underhill ◽  
R Sankaranarayanan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cohort Study ◽  
Propensity Score ◽  
Cardiac Rehabilitation ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Lower Odds ◽  
Patients With Heart Failure ◽  
All Cause Mortality

Abstract Funding Acknowledgements Type of funding sources: None. Background Despite the benefits of exercise training in the secondary prevention of cardiovascular disease, there are conflicting findings for the impact of exercise-based cardiac rehabilitation (CR) on mortality for patients with heart failure (HF). Methods A retrospective cohort study was conducted which utilised a global federated health research network. Patients with a diagnosis of HF were compared between those with and without an electronic medical record of exercise-based CR within 6-months of a HF diagnosis. Patients with HF undergoing exercise-based CR were propensity score matched to HF patients without exercise-based CR by age, sex, race, co-morbidities, medications, and procedures. We ascertained 2-year incidence of all-cause mortality, hospitalisation, stroke, and atrial fibrillation. Results Following propensity score matching, a total of 40,364 patients with HF were identified. Exercise-based CR was associated with 42% lower odds of all-cause mortality (odds ratio 0.58, 95% confidence interval (CI): 0.54-0.62), 26% lower odds of hospitalisation (0.74, 95% CI 0.71-0.77), 37% lower odds of incident stroke (0.63, 95% CI 0.51-0.79), and 53% lower odds of incident atrial fibrillation (0.47, 95% CI 0.4-0.55) compared to matched controls. The beneficial association of exercise-based CR on all-cause mortality was consistent across stratification for sex, older age, included comorbidities, and HF subtype (all P &lt; 0.0001), including patients with HFpEF (0.65, 95% CI 0.60-0.71). Conclusions Exercise-based CR was associated with lower odds of all-cause mortality, hospitalisations, incident stroke and incident atrial fibrillation at 2-years follow-up for patients with HF. The beneficial association of CR and lower mortality was consistent for patients with HFrEF and HFpEF.

scholarly journals Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e040729 ◽  
Author(s):  
Carlo Fumagalli ◽  
Renzo Rozzini ◽  
Matteo Vannini ◽  
Flaminia Coccia ◽  
Giulia Cesaroni ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hospital Mortality ◽  
Risk Score ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hospital Death ◽  
Clinical Risk Score ◽  
Cox Regression Analysis ◽  
Clinical Risk ◽  
Unit Increase

ObjectivesSeveral physiological abnormalities that develop during COVID-19 are associated with increased mortality. In the present study, we aimed to develop a clinical risk score to predict the in-hospital mortality in COVID-19 patients, based on a set of variables available soon after the hospitalisation triage.SettingRetrospective cohort study of 516 patients consecutively admitted for COVID-19 to two Italian tertiary hospitals located in Northern and Central Italy were collected from 22 February 2020 (date of first admission) to 10 April 2020.ParticipantsConsecutive patients≥18 years admitted for COVID-19.Main outcome measuresSimple clinical and laboratory findings readily available after triage were compared by patients’ survival status (‘dead’ vs ‘alive’), with the objective of identifying baseline variables associated with mortality. These were used to build a COVID-19 in-hospital mortality risk score (COVID-19MRS).ResultsMean age was 67±13 years (mean±SD), and 66.9% were male. Using Cox regression analysis, tertiles of increasing age (≥75, upper vs <62 years, lower: HR 7.92; p<0.001) and number of chronic diseases (≥4 vs 0–1: HR 2.09; p=0.007), respiratory rate (HR 1.04 per unit increase; p=0.001), PaO2/FiO2 (HR 0.995 per unit increase; p<0.001), serum creatinine (HR 1.34 per unit increase; p<0.001) and platelet count (HR 0.995 per unit increase; p=0.001) were predictors of mortality. All six predictors were used to build the COVID-19MRS (Area Under the Curve 0.90, 95% CI 0.87 to 0.93), which proved to be highly accurate in stratifying patients at low, intermediate and high risk of in-hospital death (p<0.001).ConclusionsThe COVID-19MRS is a rapid, operator-independent and inexpensive clinical tool that objectively predicts mortality in patients with COVID-19. The score could be helpful from triage to guide earlier assignment of COVID-19 patients to the most appropriate level of care.

scholarly journals Staphylococcus Aureus Bacteriuria as a Predictor of In-Hospital Mortality in Patients with Staphylococcus Aureus Bacteremia. Results of a Retrospective Cohort Study

2020 ◽  
Vol 9 (2) ◽  
pp. 508 ◽  
Author(s):  
Tobias Siegfried Kramer ◽  
Beate Schlosser ◽  
Désirée Gruhl ◽  
Michael Behnke ◽  
Frank Schwab ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
University Hospital ◽  
Hospital Death ◽  
Cox Regression Analysis

Staphylococcus aureus bloodstream infection (SA-BSI) is an infection with increasing morbidity and mortality. Concomitant Staphylococcus aureus bacteriuria (SABU) frequently occurs in patients with SA-BSI. It is considered as either a sign of exacerbation of SA-BSI or a primary source in terms of urosepsis. The clinical implications are still under investigation. In this study, we investigated the role of SABU in patients with SA-BSI and its effect on the patients’ mortality. We performed a retrospective cohort study that included all patients in our university hospital (Charité Universitätsmedizin Berlin) between 1 January 2014 and 31 March 2017. We included all patients with positive blood cultures for Staphylococcus aureus who had a urine culture 48 h before or after the first positive blood culture. We identified cases while using the microbiology database and collected additional demographic and clinical parameters, retrospectively, from patient files and charts. We conducted univariate analyses and multivariable Cox regression analysis to evaluate the risk factors for in-hospital mortality. 202 patients met the eligibility criteria. Overall, 55 patients (27.5%) died during their hospital stay. Cox regression showed SABU (OR 2.3), Pitt Bacteremia Score (OR 1.2), as well as moderate to severe liver disease (OR 2.1) to be independent risk factors for in-hospital mortality. Our data indicates that SABU in patients with concurrent SA-BSI is a prognostic marker for in-hospital death. Further studies are needed for evaluating implications for therapeutic optimization.

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.

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