scholarly journals Identification of RAGE and OSM as New Prognosis Biomarkers of Severe Pneumonia

2022 ◽  
Vol 2022 ◽  
pp. 1-9
Author(s):  
Jing Lei ◽  
Li Wang ◽  
Qian Li ◽  
Lin Gao ◽  
Jing Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Poor Prognosis ◽  
Total Bilirubin ◽  
Oxygenation Index ◽  
Severe Pneumonia ◽  
Albumin Level ◽  
Significant Decline ◽  
Survival Group ◽  
Index Level

Objective. To investigate efficiency of RAGE and OSM as new prognosis biomarkers of severe pneumonia. Methods. Eligible patients were classified into hypoxemia and nonhypoxemia groups. Meanwhile, the same cohort was divided into survival and nonsurvival groups after a post-hospital stay of 30 days. We analyzed risk factors for the hypoxia and death among these patients. Results. Compared with nonsurvival group, significant increase was noticed in PH, lymphocyte, albumin and platelet level in survival group, while significant decline was noticed in neutrophils, RBC, hemoglobin, hematocrit, creatinine, total bilirubin, CRP, PCT, OSM, RAGE and neutrophils/lymphocyte level. Oxygenation index level was related to APACHE II, LIS, SOFA, NUTRIC score, WBC, neutrophils, lymphocyte, RAGE, and albumin level ( p < 0.05 ). LIS, SOFA, NUTRIC score, lac, lymphocyte, platelet, BUN, total bilirubin, PCT, and OSM levels were associated with mortality rate ( p < 0.05 ). Conclusions. RAGE and OSM may serve as a new biomarker for poor prognosis in pneumonia patients.

scholarly journals Identification of RAGE and OSM as new prognosis biomarkers of severe pneumonia

2020 ◽  
Author(s):  
Li Wang ◽  
Yan Tan ◽  
Jiangnan Zhao ◽  
Lin Gao ◽  
Jing Lei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Oxygenation Index ◽  
Severe Pneumonia ◽  
Final Analysis ◽  
Apache Ii Score ◽  
Reactive Protein ◽  
Related Risk ◽  
Diabetes Mellitus Status ◽  
Jinling Hospital ◽  
Risk Patients

Abstract BackgroundPatients with severe pneumonia complicated with hypoxic respiratory failure often associated with increased morbidity and mortality rates. It is critical to discover more sensitive and specific markers for early identification of such high risk patients thus specific and timely treatment can be adjusted.MethodsThis retrospective study was performed in the respiratory intensive care unit (RICU) of Nanjing First Hospital and Jinling Hospital, Nanjing Medical University. Clinical data of patients admitted to the RICU and diagnosed with pneumonia from January 2017 to October 2019 was retrospectively reviewed. The eligible patients were classified into hypoxemia and non hypoxemia groups according to oxygenation index of 250 mmHg. In the meantime, the same cohort was separated into survival and deceased groups after 30 days post hospital admission. The related risk factors in these two classifications were examined separately.ResultsA total of 828 patients were screened for eligibility, and eventually 130 patients with pneumonia were included in our final analysis. Among the patients, 16 passed away despite exhausting standard treatments. The comparison between hypoxemia and non hypoxemia groups suggested that gender, diabetes mellitus status, count of white blood cell(WBC), neutrophils, neutrophils/Lymphocyte, lactic acid, creatinine, D-dimer, procalcitonin (PCT), C-reactive protein (CRP), PH, Lymphocyte, albumin and RAGE were significantly different.ConclusionsPrevious studies have suggested that the APACHE II score, LIS, SOFA, Nutric scores, WBC, neutrophils, lymphocyte counts and albumin levels were independent risk factors for severe pneumonia. Our study indicated that RAGE should be a new biomarker to predict poor prognosis in pneumonia. In addition, we also showed that LIS, SOFA, lactate, lymphocyte, platelet, BUN, total bilirubin, and PCT levels before treatment were independent factors that associated with 30 days survival rate. In addition, we proposed that OSM should be considered as a new prognosis marker for pneumonia patients.

scholarly journals Acute kidney and liver injury could be the cause of death in patients with COVID-19

2021 ◽  
Author(s):  
Qutaiba Al Khames Aga ◽  
Kawthar Nassir ◽  
Hesham Al Mawla ◽  
Hassan Abbas ◽  
Jawad Rasheed ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Liver Injury ◽  
Poor Prognosis ◽  
Hepatic Injury ◽  
Total Bilirubin ◽  
Serum Bilirubin ◽  
Stage Iv ◽  
Liver Function Tests ◽  
Total Serum ◽  
Baseline Values

We evaluated the increase in the risk of developing acute kidney and hepatic injury. Moreover, we investigate the association between kidney and liver biomarkers with poor prognosis and mortality rate. Methods: This was a prospective cohort study of 397 adult patients with an average age of 48.03 ± 14.09 were diagnosed with COVID-19 of whom, 46 (11.59%) died in hospital. The upper values of the kidney and liver biomarkers were obtained from the recovered patients during the disease period and are compared to the data for dead patients at admission (Baseline) and one day before death. Results: At admission to the hospital, the baseline S.Cr, BUN, and eGFR were not significantly varied between recovered and dead patients. Furthermore, the baseline values for AST, ALT, and ALP were not significantly differed between both groups. Whereas, baseline value of total serum bilirubin was higher in died compared to the recovered patients. For dead patients, the day before death, 52.17% of the patients had progressed to stage III and stage IV AKI. S.Cr and BUN were significantly higher, and eGFR was lower compared to the recovered patients. All of the kidney and liver function tests were abnormally increased from baseline to the day before death. The AST, ALT, and total bilirubin one day before death were significantly higher compared to their baseline value. Conclusions: COVID-19 patients have a high risk for the development of AKI and liver injury that can be progressed to a chronic stage and increase the mortality rate.

scholarly journals Value of Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Red Blood Cell Distribution Width in Evaluating the Prognosis of Children with Severe Pneumonia

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Xuejiao Qi ◽  
Yihui Dong ◽  
Xiaojie Lin ◽  
Wencheng Xin
Keyword(s):  
Risk Factors ◽  
Severe Pneumonia ◽  
Apache Ii Score ◽  
Cell Distribution ◽  
Platelet To Lymphocyte Ratio ◽  
Survival Group ◽  
Distribution Width ◽  
Lymphocyte Ratio ◽  
Death Group ◽  
Red Blood Cell Distribution

Objective. To investigate the value of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and red blood cell distribution width (RDW) in evaluating the prognosis of children with severe pneumonia (SP). Methods. A retrospective analysis of the data of 91 children with SP admitted to our hospital from March 2018 to March 2021. According to the survival status after 28 days of treatment, all children were divided into the survival group (n = 59) and the death group (n = 32). The clinical data and laboratory indicators of the patients were recorded. Multivariate logistic regression was used to analyze the risk factors of prognosis, and the ROC curve was used to analyze the predictive value of each index. Results. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score and CURB-65 score of the death group were higher than those of the survival group ( P < 0.05 ). The RDW, NLR, PLR, and high-sensitivity C-reactive protein, procalcitonin blood lactic acid (Lac) of the death group, were higher than those of the survival group, and LYM was lower than the survival group ( P < 0.05 ). Multivariate regression analysis showed that APACHE II score, RDW, NLR, PLR, and Lac were all independent risk factors for poor prognosis in children with SP ( P < 0.05 ). The AUC of NLR, PLR, and RDW for evaluating the prognosis of children with SP were 0.798, 0.781, and 0.777, respectively. The sensitivity was 56.25%, 90.63%, and 56.25%, respectively, and the specificity was 89.83%, 55.93%, and 91.53%, respectively. The AUC of NLR, PLR, and RDW combined to evaluate the prognosis of children with SP was 0.943. When the best cut-off value was 0.8528, the sensitivity was 93.75%, and the specificity was 91.53%. Conclusion. NLR, PLR, and RDW have certain predictive value for the prognosis of children with SP; the combination of the three indicators has a higher value in evaluating the prognosis of children with SP, which can better guide the prognostic treatment.

scholarly journals Development a Nomogram to Predict Prognosis in Severe and Critically Ill Patients with COVID-19

2020 ◽  
Author(s):  
Weiping Tan ◽  
Ying Zhu ◽  
Hui Yi ◽  
Yingyu Lin ◽  
Yumei Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disease Severity ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Poor Prognosis ◽  
Total Bilirubin ◽  
Lung Involvement ◽  
Factors Associated ◽  
Independent Risk Factors ◽  
D Dimer

Abstract Background: The number of deaths caused by COVID-19 are on the rising worldwide. This study focused on severe and critically ill COVID-19, aim to explore independent risk factors associated with disease severity and to build a nomogram to predict patients’ prognosis.Methods: Patients with laboratory-confirmed COVID-19 admitted to the Union Hospital, Tongji Medical College and Hankou Hospital of Wuhan, China, from February 8th to April 6th, 2020. LASSO Regression and Multivariate Analysis were applied to screen independent factors. COX Nomogram was built to predict the 7-day, 14-day and 1-month survival probability.Results: A total of 115 severe [73 (63.5%)] and critically ill [42 (36.5%)] patients were included in this study, containing 93 (80.9%) survivors and 22 (19.1%) non-survivors. For disease severity, D-dimer [OR 6.33 (95%CI, 1.27-45.57], eosinophil percentage [OR 8.02 (95%CI, 1.82-45.04)], total bilirubin [OR 12.38 (95%CI, 1.24-223.65)] and lung involvement score [OR 1.22 (95%CI, 1.08-1.40)] were the independent factors associated with critical illness. Troponin [HR 9.02 (95%CI, 3.02, 26.97)] and total bilirubin [HR 3.16 (95%CI, 1.13, 8.85)] were the independent predictors for patients’ prognosis. Troponin≥26.2 ng/L and total bilirubin＞20 μmol/L were associated with poor prognosis. The nomogram based on the independent risk factors had a C-index of 0.92 (95%CI, 0.87, 0.98) for predicting survival probability. The survival nomogram validated in the critically ill patients had a C-index of 0.83 (95%CI: 0.75, 0.94).Conclusions: In conclusion, in severe and critically ill patients with COVID-19, D-dimer, eosinophil percentage, total bilirubin and lung involvement score were the independent risk factors associated with disease severity. The proposed survival nomogram accurately predicted prognosis. The survival analysis may suggest that early incidence of multiple organ dysfunction may be an important predictor of poor prognosis.

scholarly journals PROBLEMS OF THE TREATMENT OF PNEUMONIA CAUSED BY PSEUDOMONAS AERUGINOSA

2019 ◽  
Vol 42 (3) ◽  
pp. 78-83
Author(s):  
Mochonyi V. A. ◽  
Savchenko O. A. ◽  
Podsevakhina S. L. ◽  
Tkachenko O. V.
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Synergistic Effect ◽  
Poor Prognosis ◽  
Acquired Resistance ◽  
Severe Pneumonia ◽  
Natural Resistance ◽  
Beta Lactams ◽  
Pseudomonas Infection ◽  
High Level

Pseudomonas infection is one of the most problematic pathogens of pneumonia, because it has natural resistance to many antibiotics, is able to quickly form acquired resistance, often causes severe pneumonia with a poor prognosis. Analysis of the literature data showed that today P. Aeruginosa demonstrates resistance to all anti-pest control antibiotics, with the exception of polymyxin. The levels of resistance of P.Aeruginosa are very considerably depending on the region of the survey and the profile of the hospital, which requires monitoring the sensitivity of microorganisms in each department of the hospital. The data on the degree of resistance to P. Aeruginosa antibiotics in Ukraine are limited, but available local studies on this issue also show a high level of resistance of this microorganism to the main anti-pest antibiotics. In patients with pneumonia and risk factors for the involvement of Pseudomonas infection, most authors recommend combination antibiotic therapy, which has a synergistic effect on P. Aeruginosa, which allows, in most cases, to overcome the resistance of this microorganism. According to the literature, such synergism has been proven for the combination: beta-lactams (ceftazidime, cefepime, antipseudomonas carbapenems) + aminoglycosides (amikacin) or fluoroquinolones (ciprofloxacin or levofloxacin). The use of these drugs in the maximum allowable dose allows a higher degree of probability to achieve the eradication of P. Aeruginosa in patients with pneumonia and to improve the prognosis for this disease. Keywords: pneumonia, Pseudomonas Aeruginosa, resistance, treatment.

scholarly journals The PCT to Albumin Ratio Predicts Mortality in Patients With Acute Kidney Injury Caused by Abdominal Infection-Evoked Sepsis

2021 ◽  
Vol 8 ◽  
Author(s):  
Lijuan Chen ◽  
Xiaoli Wu ◽  
Haiyan Qin ◽  
Hongchao Zhu
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Poor Prognosis ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Survival Group ◽  
Abdominal Infection ◽  
The Poor ◽  
Independent Risk Factors

Purpose: Considerable evidence suggests that inflammation and malnutrition are common in patients with acute kidney injury (AKI) and correlated with mortality of various diseases. Despite this, few studies have reported the underlying predictive effects of inflammatory and nutritional markers in combination on the mortality of AKI patients. Herein, we aimed to explore the values of PCT and CRP as well as the ratios of PCT/Alb and CRP/Alb in the poor prognosis of patients with sepsis-induced AKI.Patients and Methods: A total of 171 patients with AKI, caused by abdominal infection-evoked sepsis, were retrospectively studied and divided into a survival group (107 cases) and a non-survival group (64 cases). Univariate analysis was used to compare the clinical data of the two groups. Multivariate logistic regression analysis was used to analyze the independent risk factors of poor prognosis in patients with sepsis-induced AKI. The ROC curve was used to evaluate the diagnostic value of PCT, CRP, PCT/Alb, and CRP/Alb in the poor prognosis of patients with sepsis-induced AKI.Results: Univariate analysis revealed that the values of PCT, CRP, CRP/Alb, and PCT/Alb were significantly different between AKI survival and non-survival groups, and further analysis found that PCT and PCT/Alb were independent risk factors for poor prognosis in patients with sepsis-induced AKI after adjusting with age and gender. Of note, the predictive accuracy (0.864 vs. 0.807), specificity (83.2 vs. 69.2), and sensitivity (79.7 vs. 76.6) of PCT/Alb were all higher than that of the simple PCT.Conclusions: The ratio of PCT to Alb is an independent risk factor possessing a robust and accurate risk assessment for the poor prognosis of patients with sepsis-induced AKI, and it offers the potential to improve the management of this type of disease and a lower resultant mortality.

scholarly journals The prevalence, risk factors and prognostic implications of dysphagia in elderly patients undergoing hip fracture surgery in Korea

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Seong-Eun Byun ◽  
Kyeu Back Kwon ◽  
Sang Ho Kim ◽  
Seung-Jae Lim
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Hip Fracture ◽  
Serum Albumin ◽  
Poor Prognosis ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Postoperative Pneumonia ◽  
Hip Fracture Surgery ◽  
Fracture Surgery

Abstract Background Dysphagia is prevalent in geriatric patients, such as elderly hip fracture patients, and is associated with a poor prognosis. This study investigated (1) the prevalence of dysphagia based on clinical screening and a video-fluoroscopic swallowing study (VFSS), (2) the risk factors of dysphagia, and (3) the prognostic implications of dysphagia in elderly patients (≥ 65 years) undergoing hip fracture surgery. Methods In this retrospective study, data from 393 female and 153 male patients ≥65 years of age who underwent surgery for a hip fracture between 2015 and 2018 were analysed. Patients who were considered at high risk of dysphagia after screening underwent a VFSS. To identify risk factors of dysphagia, demographic factors, the American Society of Anesthesiologists classification, past medical history, known risk factors of dysphagia, and factors associated with surgery were analysed using a binary logistic regression model. Odds ratios (ORs) of dysphagia for having poor prognosis including postoperative pneumonia, intensive care unit (ICU) admission, and death within 6 months after surgery were obtained by logistic regression. The association of postoperative pneumonia with poor prognosis was also analysed. Results Dysphagia was seen in 5.3% of hip fracture patients. In multivariate regression analysis, a serum albumin level < 3.5 g/dL was identified as a risk factor for dysphagia (OR [95%CI] = 3.13 [1.40, 7.01]). Dysphagia was identified as a risk factor for postoperative pneumonia in regression analysis after adjustment (OR [95%CI] = 3.12 [1.05, 9.27]). Postoperative pneumonia was significantly associated with ICU admission (OR [95% CI] = 4.56 [1.85, 11.28]) and death within 6 months after surgery (OR [95% CI] = 2.56 [1.03, 6.33]). Conclusions Dysphagia in elderly hip fracture surgery patients was associated with postoperative pneumonia, a risk factor for poor outcomes including ICU admission and death within 6 months after surgery. A serum albumin level < 3.5 g/dL was identified as a risk factor for dysphagia. Therefore, diagnostic testing should be performed to detect dysphagia, especially in patients with a low serum albumin level. Finally, particular care should be taken to prevent postoperative complications in patients with dysphagia.

scholarly journals The death risk factors of patients undergoing re-exploration for bleeding or tamponade after isolated off-pump coronary artery bypass grafting: a case–control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tongxiao Luan ◽  
Yingzhu Zhuang ◽  
Weihong Nie ◽  
Sumin Yang ◽  
Yuhui Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Mortality Rate ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Survival Group ◽  
Off Pump ◽  
Pump Coronary Artery Bypass ◽  
Death Group

Abstract Background The purpose of the study is to identify off-pump patients who are at higher risk of mortality after re-exploration for bleeding or tamponade. Methods We analyzed the data of 3256 consecutive patients undergoing isolated off-pump coronary artery bypass grafting (OPCABG) in our heart center from 2013 through 2020. Fifty-eight patients underwent re-exploration after OPCABG. The 58 patients were divided into death group and survival group according to their discharge status. Propensity score matching (PSM) was performed to analysis the risk factors of death. 15 pairs of cases of two groups were matched well. Results The mortality rate of patients underwent re-exploration after OPCABG for bleeding or tamponade was 27.59% (16/58). In the raw data, we found the patients in death group had higher body mass index (BMI) (P = 0.030), higher cardiac troponin T (cTnT) (P = 0.028) and higher incidence of heart failure before OPCABG (P = 0.003). After PSM, the levels of lactic acid before and after re-exploration (P = 0.028 and P < 0.001) were higher in death group. And the levels of creatinine (P = 0.002) and cTnT (P = 0.017) were higher in the death group after re-exploration. The death group had longer reoperation time (P = 0.010). In addition, the perioperative utilization rate of intra-aortic ballon pump (IABP) (P = 0.027), continuous renal replacement therapy (CRRT) (P < 0.001) and platelet transfusion (P = 0.017) were higher than survival group. Conclusions The mortality rate of patients undergoing re-exploration for bleeding or tamponade after isolated OPCABG is high. More attention should be paid to patients with above risk factors and appropriate measures should be taken in time.

scholarly journals Characteristics and Mortality Risk Factors of Influenza-Associated Encephalopathy/Encephalitis in Children in a Tertiary Pediatric Hospital in China, 2016-2019

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Yong-Ling S ◽  
◽  
Tian-Xiang Q ◽  
Wei-Qiang X ◽  
Su-Yun L ◽  
...  
Keyword(s):  
Risk Factors ◽  
Influenza Virus ◽  
Mortality Rate ◽  
Virus Type ◽  
Mortality Risk ◽  
Laboratory Tests ◽  
Brain Mri ◽  
Neurological Complications ◽  
Survival Group ◽  
Disturbance Of Consciousness

Objective: Seasonal influenza associated neurological complications had high mortality and morbidity rates in children. In this study, we aimed to investigate the clinical characteristics and mortality risk factors in children with influenza-associated encephalopathy. Methods: Retrospectively analyze the clinical data, laboratory tests, and imaging examinations of 68 children diagnosed with influenza-associated encephalopathy from January 2016 to December 2019 at Guangzhou Women and Children’s Medical Center, and the cases were divided into survival and non-survival groups by disease outcome and analyzed between two groups Results: Among the 68 children with influenza-associated encephalopathy, 40 were male, and 28 were female, aged from 3 months to 13 years, of which 66.18% (45/68) were under 5 years old. Pathogenetic tests showed that influenza virus type A accounted for 63.24% (43/68), and influenza virus type B accounted for 36.76% (25/68). Typical brain MRI changes in childhood influenza-associated encephalopathy were bilateral symmetrical lesions of the thalamus, basal ganglia, brainstem, and cerebellum. 68 patients had a mortality rate of 20.59% (14/68), with a significantly higher proportion of fever peak >39°C, Acute Disturbance Of Consciousness (ADOC), and cardiac arrest in the non-survival group than in the survival group (P<0.05). Laboratory tests showed significantly higher Alanine Aminotransferase (ALT), Aspartate Transaminase (AST), Creatinine Kinase (CK), and Lactate Dehydrogenase (LDH), Lactate, C-Reactive Protein (CRP), and CSF protein levels in the non-survival group compared with the survivor (P<0.05), and among them, elevated ALT, AST, LDH, and CSF protein were independent high-risk factors for death from influenzaassociated encephalopathy. Conclusions: Children under 5 years of age with influenza are prone to combine neurological complications and have a higher mortality rate. Significant elevations in ALT, AST, LDH, and CSF proteins predict death from influenzaassociated encephalopathy in children.

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