Evaluation of Early Prognostic Factors of Mortality in Patients with Acute Pancreatitis: A Retrospective Study

Early and accurate assessment of severity in acute pancreatitis (AP) is of great importance to provide effective disease management and prevent mortality. In this study, we aim to evaluate early indicators that predict the mortality of AP. We retrospectively analyzed 24-hour clinical characteristics and laboratory data in 166 AP patients recruited between January 2014 and November 2015 in Baotou Central Hospital. In total, 18 patients did not survive the disease. Multivariate logistic regression showed that red cell distribution (RDW) (OR = 2.965, P=0.001) and creatinine (OR = 1.025, P=0.005) were early independent risk factors of AP mortality while albumin (OR = 0.920, P=0.032) levels reduced AP mortality. The corresponding optimal cut-off values were 14.45, 125.5, and 34.95, respectively. The positive predictive values of the AP mortality were 80.1%, 54.5%, and 69.5%. In combined measurement, the area under the curve of RDW, creatinine, and albumin was 0.964 (95% CI: 0.924 to 1.000, P<0.001). RDW ≥ 14.45%, creatinine ≥ 125.5 μmol/l, and albumin ≤ 34.95 g/l indicated a good predictive value for mortality in AP patients with a sensitivity of 100% and specificity of 64.2%. RDW, creatinine, and albumin may serve as early indicators for AP mortality which warrants further clinical investigation.

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Red Cell Distribution Width as a Novel Marker for Different Types of Atrial Fibrillation in Low and High Altitude

Cardiology Research and Practice ◽

10.1155/2019/6291964 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Kaiyue Han ◽

Xiaoling Su ◽

Jiang Liu ◽

Fengcai Yao ◽

FeiYan Lu

Keyword(s):

Atrial Fibrillation ◽

Regression Analysis ◽

High Altitude ◽

Multivariate Logistic Regression Analysis ◽

Red Cell ◽

Cell Distribution ◽

Multivariate Logistic Regression ◽

Distribution Width ◽

Different Types ◽

Low Altitude

Background. Increased red cell distribution width (RDW) can predict the incidence and mortality of cardiovascular diseases. However, there are limited data on the relationship between RDW and altitude and the subtype of atrial fibrillation (AF). We investigated the effects of altitude on RDW in patients with different types of AF. Methods. A total of 303 patients with nonvalvular AF were included. Of these, 156 lived in low altitude (77 paroxysmal AF, PAF; 79 persistent AF, PeAF) and 147 in high altitude (77 paroxysmal AF, PAF; 70 persistent AF, PeAF). In these groups, baseline characteristics, complete blood counts, serum biochemistry, and echocardiography were evaluated. Multivariate logistic regression analysis was conducted to determine the independent predictors of AF at the different altitudes. Results. In both low and high altitudes, RDW and left atrial diameter (LAD) were higher in AF than control subjects (P<0.05) and higher in persistent AF than paroxysmal AF (P<0.05). Compared with any groups (PAF group, PeAF group, or control group) of low-altitude, RDW and LAD were found higher in high-altitude corresponding groups. Multivariate logistic regression analysis demonstrated that RDW, mean corpuscular volume (MCV), and LAD levels independently associated with AF patients in low altitude (RDW, OR 1.687, 95% CI 1.021–2.789; P<0.05), while in high altitude, RDW, MCV, creatinine (Cr), and LAD were independent predictors for AF patients (RDW, OR 1.755, 95% CI 1.179–2.613; P<0.05). Conclusion. Elevated RDW levels may be an independent risk marker for nonvalvular AF, affected by type of AF and altitude.

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MO450ANEMIC PATIENTS WITH ELEVATED RED CELL DISTRIBUTION WIDTH (RDW) ARE LIKELY TO HAVE FASTER FUTURE CKD PROGRESSION

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab090.0012 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Hiroshi Tanaka

Keyword(s):

Blood Cells ◽

Laboratory Data ◽

Red Cell Distribution Width ◽

First Year ◽

Red Cell ◽

Cell Distribution ◽

Ckd Progression ◽

Distribution Width ◽

Annual Decline ◽

Egfr Decline

Abstract Background and Aims Elevation in red cell distribution width (RDW), a marker of size variance in red blood cells, recently has been reported to predict future cardiovascular event. RDW elevation has also been reported to be associated with faster CKD progression. It is not known whether the elevation of RDW is merely a sequela of, or truly a predictor of, the decline in kidney function. Method A hospital-wide study with all the laboratory data for a period of 4 years and 2 months was conducted. All the adult patients in whom an eGFR slope was obtained over 731 days or more with haemoglobin (Hb) measurements of at least twice over 731 days or more were included. Hb and RDW values were classified according to the timing of measurement: first-year measurements during the period vs last-year values. The effects of Hb and RDW on the annual decline in eGFR (mL/min/1.73m2/year) were analyzed. Statistical analysis was performed with R 3.6.0 on Ubuntu. Results A total of 4,611 patients (M:F = 2124:2487, age 18-105 (median 68) years) were included. The first-month Hb and RDW were 7.5 − 20.2 (median 13.6) g/dL and 10.5 − 34.6 (median 12.6). eGFR was 3.4 − 195 (median 69.3) mL/min/1.73m2. Patients with the highest tertile in the first-year RDW had significantly faster decline in eGFR than the rest (-1.74 vs -1.51, P=0.04), while patients with the highest tertile in the last-year RDW had virtually identical eGFR decline compared with the rest. Patients with higher RDW (>=median) and lower Hb (< median) had significantly faster decline in eGFR than the rest (-1.84±4.11 vs -1.47±2.95, P =0.002). Conclusion Anemic patients with elevated RDW are likely to have faster CKD progression in the future.

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Prognostic Value of Serum Creatinine in Severe Covid-19 Patients in Wuhan, China: A Retrospective Cohort Study

10.21203/rs.3.rs-33620/v1 ◽

2020 ◽

Author(s):

Wei-yun Zhang ◽

De-yu Xu ◽

Chang-guo Wang ◽

Ying-ying Liu ◽

Jian-an Huang ◽

...

Keyword(s):

Cohort Study ◽

Poor Prognosis ◽

Laboratory Data ◽

Kidney Injury ◽

Hospital Death ◽

Multivariate Logistic Regression ◽

Kaplan Meier ◽

Independent Risk Factors ◽

Study Laboratory ◽

Severe Type

Abstract Objectives: Although the respiratory and immune systems are the major targets of SARS-CoV-2, increasing evidence revealed that kidney injury was not rare in coronavirus disease 2019 (COVID-19). However, the incidences of kidney abnormalities were significantly different, from 0.5 to 75.4% in several reports. The association of kidney injury with prognosis remain controversial.Methods:In this retrospective single center cohort study, laboratory confirmedCOVID-19inpatients with severe type were enrolled. Demographic, clinicaland laboratory data were collected. Association ofserum creatinine (SCr)with 28-days mortality in severe COVID-19 patients was analyzed.Results:18.79% (48/304) patients died during the first 28-days of hospitalization.Non-survivors had a significantly higher SCr levels than survivors (109.27μmol/L vs. 69.99μmol/L, P <0.001). The 28-days mortality in high SCr group (>76μmol/L) was significantly higher than that in low SCr group (31.7% vs. 7.5%, P <0.001). Multivariate logistic regression revealed that the independent risk factors of 28-days outcome included age(OR: 2.95, 95%CI: 1.08-8.05), WBC (OR: 6.09, 95%CI: 2.27-6.39), lymphopenia (OR: 3.49, 95%CI: 1.55-7.92), IL-6 (OR: 4.44, 95%CI: 1.64-11.99) and SCr (OR: 2.69, 95%CI: 1.18-6.11). Kaplan-Meier analysis demonstrated the survival disadvantage in patients with high SCr levels (>76μmol/L). ROC curve showed the SCr cut-off value for predicting 28-days death was 77.5 μmol/L, with the sensitivity of 68.8% and speciality of 74.1%.Conclusion: SCr was associated with poor prognosis and might be an independent risk factor for in-hospital death. The cut-off value of SCr for prognosis prediction was 77.5 μmol/L, with the sensitivity of 68.8% and speciality of 74.1%.

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Nomogram for Predicting Persistent Organ Failure with Acute Pancreatitis in Pregnancy

10.21203/rs.3.rs-1223472/v1 ◽

2022 ◽

Author(s):

Chengcheng Sheng ◽

Zongxu Xu ◽

Jun Wang

Keyword(s):

Risk Factors ◽

Acute Pancreatitis ◽

Logistic Regression ◽

Regression Analysis ◽

Organ Failure ◽

Multivariate Logistic Regression Analysis ◽

Concordance Index ◽

Multivariate Logistic Regression ◽

Independent Risk Factors ◽

In Pregnancy

Abstract Background: Acute pancreatitis in pregnancy (APIP) with persistent organ failure (POF) poses a high risk of death for mother and fetus. This study sought to create a nomogram model for early prediction of POF with APIP patients.Methods: We conducted a cross-sectional study on APIP patients with organ failure (OF) between January 2012 and March 2021 in a university hospital. 131 patients were collected. Their clinical courses and pregnancy outcomes were obtained. Risk factors for POF were identified by univariate and multivariate logistic regression analysis. Prediction models with POF were built and nomogram was plotted. The performance of the nomogram was evaluated by using a bootstrapped-concordance index and calibration plots.Results: Hypertriglyceridemia was the most common etiology in this group of APIP patients, which accounted for 50% of transient organ failure (TOF) and 72.3% of POF. All in-hospital maternal death was in the POF group (P<0.05), which also had a significantly higher perinatal mortality rate than the TOF group (P<0.05). Univariate and multivariate logistic regression analysis determined that lactate dehydrogenase, triglycerides, serum creatinine, and procalcitonin were independent risk factors for predicting POF in APIP. A nomogram for POF was created by using the four indicators. The area under the curve was 0.875 (95% confidence interval 0.80–0.95). The nomogram had a bootstrapped-concordance index of 0.85 and was well-calibrated.Conclusions: Hypertriglyceridemia was the leading cause of organ failure-related APIP. Lactate dehydrogenase, triglycerides, serum creatinine, and procalcitonin were the independent risk factors of POF in APIP. Our nomogram model showed an effective prediction of POF with the four indicators in APIP patients.

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Risk Factors for Mortality in 220 Patients With COVID-19 in Wuhan, China: A Single-Center, Retrospective Study

Ear Nose & Throat Journal ◽

10.1177/0145561320972608 ◽

2020 ◽

pp. 014556132097260

Author(s):

Shuliang Zhou ◽

Sulin Mi ◽

Shuilian Luo ◽

Ying Wang ◽

Bin Ren ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Respiratory Rate ◽

Sofa Score ◽

Laboratory Data ◽

Older Age ◽

Univariable Analysis ◽

Multivariate Logistic Regression ◽

Failure Assessment ◽

Independent Risk Factors

Background: An outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 infection occurred in Wuhan, China, in December 2019. To date, the analysis of fatal cases and the risk factors for death have rarely been reported. Methods: In this study, 220 adult patients with confirmed and suspected COVID-19 were enrolled. Clinical characteristics, laboratory data, treatments, and complications were compared between 168 survivors and 52 nonsurvivors. Univariable analysis and multivariable logistic regression were used to investigate the risk factors for mortality. Results: A total of 220 patients (168 were discharged and 52 died in the hospital) were enrolled in the study. The median age of all patients was 59.5 (47.0-69.0) years, and the median age of patients who died was significantly older than that of patients who survived (70.5 vs 56.0 years, respectively; P < .001). According to multivariate logistic regression, older age (odds ratio: 1.09, 95% CI: 1.03-1.15; P = .001), initial Sequential Organ Failure Assessment (SOFA) score >2 (37.4, 9.4-148.0; P = .011), and respiratory rate >24 per minute (10.89, 1.47-80.67; P = .019) were independent risk factors for mortality. Conclusion: Clinical and laboratory parameters predicting poor prognosis including older age, baseline SOFA score >2, and respiratory rate >24 per minute were identified.

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Early indicators of severity and construction of a risk model for prognosis based upon laboratory parameters in patients with hemorrhagic fever with renal syndrome

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2014-0016 ◽

2014 ◽

Vol 0 (0) ◽

Cited By ~ 3

Author(s):

Hong Du ◽

Jing Li ◽

Hai-Tao Yu ◽

Wei Jiang ◽

Ye Zhang ◽

...

Keyword(s):

Risk Model ◽

Hemorrhagic Fever ◽

Acute Stage ◽

Predictive Values ◽

Laboratory Parameters ◽

Diagnostic Capability ◽

Independent Risk Factors ◽

Early Indicators

AbstractThe objective of this study was to explore the role of laboratory parameters as early indicators of severity and as effective predictors of prognosis in patients with hemorrhagic fever with renal syndrome (HFRS).A total of 356 patients were enrolled in this study and were divided into mild, moderate, severe and critical types according to the clinical classification of HFRS. The levels of 12 routinely tested laboratory parameters during the acute stage among the four types were compared. The predictive values of the laboratory parameters for prognosis were analyzed, and a risk model for prognosis based upon the parameters was constructed.The levels of white blood counts (WBC), platelets (PLT), aspartate aminotransferase (AST), albumin (ALB), blood urea nitrogen (BUN), serum creatinine (Scr), prothrombin time (PT) and activated partial thromboplastin time (APTT) demonstrated significant differences among the four types (p<0.001); WBC, AST, PT and fibrinogen (Fib) were major independent risk factors for death; WBC, AST, PT and Fib used in combination were better for predicting prognosis than single parameters used alone (p<0.001).Some routinely tested laboratory parameters can be beneficial as early indicators of severity of HFRS. Using a combination of WBC, AST, PT and Fib to predict the outcome in patients with HFRS exhibited acceptable diagnostic capability.

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