Hemodialysis Patients with Pruritus and Insomnia Have Increased Risk of Death

2020 ◽  
Vol 49 (4) ◽  
pp. 419-425
Author(s):  
Olga Hilda Orasan ◽  
Flaviu Muresan ◽  
Augustin Mot ◽  
Adela Sitar Taut ◽  
Iulia Minciuna ◽  
...  
Keyword(s):  
Study Groups ◽  
Poor Quality ◽  
Exclusion Criteria ◽  
Reactive Protein ◽  
Risk Of Death ◽  
Survival Difference ◽  
Increased Risk ◽  
Laboratory Features ◽  
Impact On Survival

Background: Pruritus and insomnia are common disorders in hemodialysis (HD) patients, with a major clinical impact as they are associated with poor quality of life and increased mortality. Their coexistence and impact on survival in HD patients have rarely been investigated. Our aim is to investigate the survival of HD patients presenting either none, one, or both disorders and to compare certain features between these groups. Methods: After the inclusion/exclusion criteria, 170 patients treated by HD or online hemodiafiltration were assigned in 4 study groups depending on the presence of either, neither, or both pruritus and insomnia. We analyzed the survival difference between groups after 20 months, and we searched if there were significant differences in terms of clinical and laboratory features. Results: Survival at 20 months was lower in patients with both pruritus and insomnia. Patients with pruritus alone had a lower Kt/V than those with no complaints or insomnia alone. Those with no complaints had lower C-reactive protein and higher albumin levels than patients with insomnia alone or both conditions. Conclusion: Pruritus and insomnia should be actively investigated and correlated with some clinical and laboratory features as they have a significant impact on survival in HD patients.

scholarly journals Association of dyslipidemia with the severity and mortality of coronavirus disease 2019 (COVID-19): a meta-analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Yanli Liu ◽  
Yilong Pan ◽  
Yuyao Yin ◽  
Wenhao Chen ◽  
Xiaodong Li
Keyword(s):  
Fixed Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Risk Of Death ◽  
Potential Association ◽  
Increased Risk ◽  
Language Restriction ◽  
Newcastle Ottawa Scale

Abstract Background The numbers of confirmed cases of coronavirus disease 2019 (COVID-19) and COVID-19 related deaths are still increasing, so it is very important to determine the risk factors of COVID-19. Dyslipidemia is a common complication in patients with COVID-19, but the association of dyslipidemia with the severity and mortality of COVID-19 is still unclear. The aim of this study is to analyze the potential association of dyslipidemia with the severity and mortality of COVID-19. Methods We searched the PubMed, Embase, MEDLINE, and Cochrane Library databases for all relevant studies up to August 24, 2020. All the articles published were retrieved without language restriction. All analysis was performed using Stata 13.1 software and Mantel–Haenszel formula with fixed effects models was used to compare the differences between studies. The Newcastle Ottawa scale was used to assess the quality of the included studies. Results Twenty-eight studies involving 12,995 COVID-19 patients were included in the meta-analysis, which was consisted of 26 cohort studies and 2 case–control studies. Dyslipidemia was associated with the severity of COVID-19 (odds ratio [OR] = 1.27, 95% confidence interval [CI] 1.11–1.44, P = 0.038, I2 = 39.8%). Further, patients with dyslipidemia had a 2.13-fold increased risk of death compared to patients without dyslipidemia (95% CI 1.84–2.47, P = 0.001, I2 = 66.4%). Conclusions The results proved that dyslipidemia is associated with increased severity and mortality of COVID-19. Therefore, we should monitor blood lipids and administer active treatments in COVID-19 patients with dyslipidemia to reduce the severity and mortality.

Higher sRAGE Levels Predict Mortality in Frail Older Adults with Cardiovascular Disease

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Lee Butcher ◽  
Jose Antonio Carnicero ◽  
Karine Pérès ◽  
Marco Colpo ◽  
David Gomez Cabrero ◽  
...  
Keyword(s):  
Older Adults ◽  
Cox Regression ◽  
Population Based ◽  
Blood Levels ◽  
Roc Curve Analysis ◽  
Baseline Serum ◽  
Frailty Status ◽  
Risk Of Death ◽  
Survival Difference ◽  
Increased Risk

<b><i>Introduction:</i></b> The evidence that blood levels of the soluble receptor for advanced glycation end products (sRAGE) predict mortality in people with cardiovascular diseases (CVD) is inconsistent. To clarify this matter, we investigated if frailty status influences this association. <b><i>Methods:</i></b> We analysed data of 1,016 individuals (median age, 75 years) from 3 population-based European cohorts, enrolled in the FRAILOMIC project. Participants were stratified by history of CVD and frailty status. Mortality was recorded during 8 years of follow-up. <b><i>Results:</i></b> In adjusted Cox regression models, baseline serum sRAGE was positively associated with an increased risk of mortality in participants with CVD (HR 1.64, 95% CI 1.09–2.49, <i>p</i> = 0.019) but not in non-CVD. Within the CVD group, the risk of death was markedly enhanced in the frail subgroup (CVD-F, HR 1.97, 95% CI 1.18–3.29, <i>p</i> = 0.009), compared to the non-frail subgroup (CVD-NF, HR 1.50, 95% CI 0.71–3.15, <i>p</i> = 0.287). Kaplan-Meier analysis showed that the median survival time of CVD-F with high sRAGE (&#x3e;1,554 pg/mL) was 2.9 years shorter than that of CVD-F with low sRAGE, whereas no survival difference was seen for CVD-NF. Area under the ROC curve analysis demonstrated that for CVD-F, addition of sRAGE to the prediction model increased its prognostic value. <b><i>Conclusions:</i></b> Frailty status influences the relationship between sRAGE and mortality in older adults with CVD. sRAGE could be used as a prognostic marker of mortality for these individuals, particularly if they are also frail.

Fatigue: Has It Affected Your Compassion?

2017 ◽  
Vol 36 (5) ◽  
pp. 289-293
Author(s):  
Bobbi S. Greiner ◽  
Gail A. Poskey
Keyword(s):  
Risk Factors ◽  
Compassion Fatigue ◽  
Work Productivity ◽  
Signs And Symptoms ◽  
Poor Quality ◽  
Job Dissatisfaction ◽  
Job Turnover ◽  
Additional Stress ◽  
Increased Risk

AbstractCompassion fatigue is a concept used to describe how various stressors affect individuals who work in health care and other caregiving professions. The results of compassion fatigue may include decreased work productivity, poor quality of care, safety concerns, job dissatisfaction, and job turnover. The NICU professionals are at an increased risk for experiencing compassion fatigue because of the nature of working with critically ill infants, their families, and the additional stress of the workplace. The purpose of this article is for the NICU professional to understand compassion fatigue, identify the risk factors, recognize the signs and symptoms, and offer strategies to implement within the NICU environment.

The prognostic efficacy of beta2-microglobulin in acute pulmonary embolism

2017 ◽  
Vol 16 (2) ◽  
pp. 52-59
Author(s):  
Sotirios Kakavas ◽  
◽  
Aggeliki Papanikolaou ◽  
Evangelos Balis ◽  
Evgenios Metaxas ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Risk Of Death ◽  
Increased Risk ◽  
Preliminary Study ◽  
Wbc Count ◽  
A Prospective Study ◽  
Acute Pe

Our aim was to prospectively assess the prognostic value of beta2- microglobulin (b2-M) in patients with acute pulmonary embolism (PE). We conducted a prospective study of 109 patients admitted in a pulmonary clinic due to acute PE. A panel of inflammatory markers including b2-M white blood cell (WBC) count and C-reactive protein (CRP) was determined for each patient. In this preliminary study, baseline b2-M levels significantly correlated with the impairment of oxygenation and with all the parameters that are used for the early risk stratification of patients. In multivariate analysis, patients’ age and baseline b2-M levels were significantly associated with an increased risk of death. These findings require further prospective validation.

scholarly journals Vulnerability in the elderly

2021 ◽  
Vol 64 (3) ◽  
pp. 62-67
Author(s):  
Ana Popescu ◽  
◽  
Gabriela Soric ◽  
Victoria Federiuc ◽  
Vitalie Ojovanu ◽  
...  
Keyword(s):  
Genetic Factors ◽  
Functional Decline ◽  
The Elderly ◽  
Poor Quality ◽  
Important Target ◽  
Increased Risk ◽  
High Prevalence ◽  
Assessment Measures ◽  
Cognitive Problems

Background: Aging process involves an increased risk for the development of vulnerability, because senescence is a process characterized by a multitude of changes that influence the living conditions and health of the individuals. In geriatrics, the term “vulnerability” implies a multidimensional aspect, among which, multimorbidity, functional incapacity, socio-economic and cognitive problems in the elderly. The main objective of the article is to systematize data from the literature through the analysis of the concept and prevalence of vulnerability, assessed by the score Vulnerable Elders Survey-13 (VES-13) in the elderly. For this purpose, publications from the database GoogleSearch, PubMed, Hinari, etc. were analyzed. The information was systematized, highlighting the main aspects of the contemporary vision of the last 5 years.A series of studies (USA, Brazil, etc.) revealed a high prevalence of vulnerability in the elderly according to the VES-13 score, it was estimated in respondents aged > 65 years, between 40-50% of cases were vulnerable people, with a score ≥ 3 p. The vulnerability of the elderly results from different conditions, correlated with each other, especially biological, social and genetic factors. There was a functional decline between 13 and 24% of cases, especially in the elderly over 75 years, and an association with health problems, mobility and low autonomy in over 50% of cases, with a poor quality of life and increased risk of institutionalization. Conclusions: Vulnerability assessment measures are important for identifying older people at high risk of deteriorating health, which is an important target for interdisciplinary intervention.

Epidemiology

ESC CardioMed ◽  
2018 ◽  
pp. 2111-2116
Author(s):  
Darae Ko ◽  
Emelia Benjamin
Keyword(s):  
Structural Heart Disease ◽  
Evidence Base ◽  
Cardiovascular Complications ◽  
Poor Quality ◽  
European Ancestry ◽  
Public Health Burden ◽  
Risk Of Death ◽  
Increased Risk ◽  
History Of ◽  
Include Family History

Atrial fibrillation (AF) poses a substantial public health burden worldwide. About one in four adults over the age of 40 years are expected to develop AF during their lifetime. The risk for developing AF is higher in men compared to women. Globally, individuals of European ancestry appear to have a higher risk of AF onset than individuals from other racial/ethnic descents. Factors predisposing to AF include family history of AF, standard cardiovascular risk factors, and structural heart disease. Hypertension and obesity explain one-third of AF cases in high-income countries. AF can have devastating consequences including an increased risk of death; cardiovascular complications, such as stroke, systemic thromboembolism, heart failure, myocardial infarction, and sudden cardiac death; and non-cardiovascular complications, such as chronic kidney disease, cognitive impairment and dementia, and poor quality of life. There are major research opportunities to develop an evidence base to effectively prevent and manage AF and its outcomes.

Age, cancer site and gender associations with symptoms and problems in specialised palliative care: a large, nationwide, register-based study

2019 ◽  
pp. bmjspcare-2019-001880 ◽  
Author(s):  
Maiken Bang Hansen ◽  
Lone Ross ◽  
Morten Aagaard Petersen ◽  
Mogens Groenvold
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Physical Function ◽  
Cancer Diagnosis ◽  
Poor Quality ◽  
Cancer Site ◽  
Patients With Cancer ◽  
Increased Risk ◽  
And Gender

BackgroundPatients referred to specialised palliative care are troubled by symptoms/problems, but more knowledge is needed on the level and frequency of symptoms/problems. It is also uncertain how gender, age and cancer diagnosis, respectively, are associated with symptoms/problems.AimsTo describe symptoms/problems in patients with cancer at the start of specialised palliative care, and to study how age, gender and cancer diagnosis were associated with symptoms/problems.DesignA register-based study including data from the Danish Palliative Care Database.Setting/ParticipantsPatients with cancer who reported their symptoms/problems using the European Organisation for Research and Treatment of Cancer Quality of Life Questionaire-Core-15-Palliative Care (EORTC QLQ-C15-PAL) at the start of specialised palliative care were included. Ordinal logistic regression was performed to test if gender, age and cancer diagnosis were associated with each symptom/problem.Results31 771 patients with cancer were included in the study. The most prevalent and severe symptoms/problems were pain, appetite loss, fatigue, poor physical function and poor quality of life. Gender, age and cancer diagnosis were significantly associated with most symptoms/problems. The strongest associations between symptoms/problems and gender and age, respectively, were increased risk of nausea in women, as well as increased risk of poor physical function and reduced risk of sleeplessness and pain with increasing age. Patients with brain/central nervous system cancer had the lowest risk of symptoms but the highest risk of poor physical function.ConclusionAt the start of specialised palliative care, patients with cancer experience severe levels of symptoms, poor physical function and poor quality of life. Age, gender and diagnosis were significantly associated with most symptoms/problems, but the strength and direction of the associations differed across symptoms/problems.

scholarly journals 3420 Estradiol levels are elevated in older men with diffuse cutaneous SSc and are associated with decreased survival

2019 ◽  
Vol 3 (s1) ◽  
pp. 104-105
Author(s):  
DeAnna Baker Frost ◽  
Bethany Wolf ◽  
Christine Peoples ◽  
Jessica Fike ◽  
Katherine Silver ◽  
...  
Keyword(s):  
Cox Regression ◽  
Elevated Serum ◽  
High Serum ◽  
Organ Involvement ◽  
Healthy Controls ◽  
University Of Pittsburgh ◽  
Risk Of Death ◽  
Heart Involvement ◽  
Increased Risk ◽  
Impact On Survival

OBJECTIVES/SPECIFIC AIMS: Our objective was to examine serum E2 levels in dcSSc males in relation to disease characteristics (i.e autoanitbody profile and internal organ involvement) and its impact on survival. METHODS/STUDY POPULATION: We measured serum E2 levels in 83 dcSSc men >50 years old from the University of Pittsburgh Scleroderma Center and healthy controls of similar age. Using statistical modeling, we examined the associations between circulating E2 levels, internal organ involvement, autoantibody profiles, and survival. RESULTS/ANTICIPATED RESULTS: Male dcSSc patients had significantly higher serum E2 levels compared to healthy male controls and compared to dcSSc post-menopausal women of similar age. Male dcSSc patients with high serum E2 levels had significantly more heart involvement and worse survival. Using Cox regression modeling for risk of death, increasing serum E2 levels in anti-Scl-70 antibody positive dcSSc males were associated an increased risk of death. DISCUSSION/SIGNIFICANCE OF IMPACT: DcSSc male patients have higher levels of E2 compared to healthy controls and dcSSc postmenopausal women. Elevated serum E2 levels in dcSSc males >50 are associated with heart involvement and, if anti-Scl-70 antibody positive, worse survival. Our current study expands on our previous work, not only that that E2 exerts pro-fibrotic effects on skin, but also internal organ involvement, overall survival. These data suggest an important role of estrogen imbalance in SSc.

scholarly journals Treatment restrictions in patients with severe stroke are associated with an increased risk of death

2017 ◽  
Vol 2 (3) ◽  
pp. 244-249 ◽  
Author(s):  
Marjolein Geurts ◽  
Floor AS de Kort ◽  
Paul LM de Kort ◽  
Julia H van Tuijl ◽  
Ghislaine JMW van Thiel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Visual Analogue Scale ◽  
Functional Outcome ◽  
Analogue Scale ◽  
Modified Rankin Scale ◽  
Severe Stroke ◽  
Risk Of Death ◽  
Increased Risk ◽  
Treatment Restrictions

Introduction Treatment restrictions in the first 2 days after intracerebral haemorrhage have been independently associated with an increased risk of early death. It is unknown whether these restrictions also affect mortality if these are installed several days after stroke onset. Patients and methods Sixty patients with severe functional dependence at day 4 after ischaemic stroke or intracerebral haemorrhage were included in this prospective two-centre cohort study. The presence of treatment restrictions was assessed at the day of inclusion. Information about mortality, functional outcome (modified Rankin scale) score and quality of life (visual analogue scale) was recorded 6 months after stroke onset. Poor outcome was defined as modified Rankin scale >3. Satisfactory quality of life was defined as visual analogue scale ≥ 60. Results At 6 months, 30 patients had died, 19 survivors had a poor functional outcome and 9 patients had a poor quality of life. Treatment restrictions were independently associated with mortality at 6 months (adjusted relative risk, 1.30; 95% confidence interval, 1.06–1.59; p = 0.01), but not with functional outcome. Discussion Our findings were observed in 60 selected patients with severe stroke. Conclusion The instalment of treatment restrictions by itself may increase the risk of death after stroke, even if the first 4 days have passed. In future stroke studies, this potential confounder should be taken into account. Quality of life was satisfactory in the majority of the survivors, despite considerable disability.

scholarly journals Health-related quality of life as a predictor of mortality in patients on peritoneal dialysis

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Marília Pilotto de Oliveira ◽  
Luciana Kusumota ◽  
Vanderlei José Haas ◽  
Rita de Cássia Helú Mendonça Ribeiro ◽  
Sueli Marques ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Physical Functioning ◽  
Short Form ◽  
Health Related Quality ◽  
Risk Of Death ◽  
Increased Risk ◽  
Related Quality ◽  
Health Related

Objective: to characterize deaths that occurred, and the association between socio-demographic, clinical, laboratory variables and health-related quality of life and the outcome of death in patients on peritoneal dialysis, over a two year period after an initial assessment. Method: observational, prospective population study with 82 patients on peritoneal dialysis. The instruments used for the first stage of data collection were the mini-mental state examination, a sociodemographic, economic, clinical and laboratory questionnaire and the Kidney Disease and Quality of Life-Short Form. After two years, data for characterization and occurrence of death in the period were collected. The relative risk of death outcome was calculated through statistical analysis; the risk of death was estimated by the survival Kaplan-Meier curve, and determined predictors of death by the Cox Proportional Hazards Model. Results: of the 82 original participants, 23 had as an outcome death within two years. The increased risk for the outcome of death was associated with a lower mean score of health-related quality of life in the physical functioning domain. Conclusion: the worst health-related quality of life in the physical functioning domain, could be considered a predictor of death.

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