The Relationship Between AKI in Patients With STEMI and Short-Term Mortality: A Propensity Score Matching Analysis

Acute myocardial infarction (AMI) in patients with acute kidney injury (AKI) is associated with poor long-term outcome. However, the short-term prognosis of AKI in patients with ST-elevation AMI (STEMI) needs to be explored further. We assessed this relationship between these patients and short-term mortality in relation to AKI and chronic kidney disease (CKD). All data were extracted from the Medical Information Mart for Intensive Care III database. The primary outcome was 28-day mortality. Kaplan-Meier curves, logistic regression models, and propensity score matching analysis were used to evaluate the associations between AKI in patients with STEMI and outcomes. A total of 1031 patients with STEMI met the inclusion criteria. For 28-day mortality, in the multivariable logistic regression models, the odds ratio (95% CI) of group 2 (AKI but no CKD) and group 3 (AKI in the presence of CKD) were 3.24 (1.46-7.18) and 4.57 (1.83-11.37), respectively, compared with group 1 (no AKI and no CKD). Comorbid AKI increased the risk of short-term mortality among patients with STEMI, especially for those with AKI in the presence of CKD.

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Biopsy in emergency gastroscopy does not increase the risk of rebleeding in patients with Forrest I acute nonvariceal upper gastrointestinal bleeding combined with suspected malignant gastric ulcer: a multicenter retrospective cohort study

BMC Gastroenterology ◽

10.1186/s12876-021-01836-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Quchuan Zhao ◽

Tianyu Chi

Keyword(s):

Logistic Regression ◽

Gastric Ulcer ◽

Cohort Study ◽

Propensity Score ◽

Propensity Score Matching ◽

Retrospective Cohort ◽

Regression Models ◽

Upper Gastrointestinal Bleeding ◽

Logistic Regression Models ◽

Upper Gastrointestinal

Abstract Background Few studies have reported whether a biopsy in emergency gastroscopy (EG) increased the risk of rebleeding in patients with Forrest I acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) combined with suspected malignant gastric ulcer (SMGU). This study aims to conduct a multicenter retrospective cohort study using propensity score matching to verify whether a biopsy in EG increases the risk of rebleeding in patients diagnosed with Forrest I ANVUGIB combined with SMGU. Methods Using the data for propensity-matched patients, logistic regression models were fitted using rebleeding as the dependent variable. Survival time was defined as the length of time the patient experienced from visiting the emergency department to rebleeding. We used the Kaplan–Meier (KM) method to analyze the 30-day survival of the patients with and without a biopsy after matching, and the log-rank test was performed to examine the differences in survival. Results With the use of propensity score matching, 308 patients who underwent a biopsy in EG were matched with 308 patients who did not. In the five logistic regression models, there were no significant group differences in the risk of rebleeding in patients with Forrest I ANVUGIB combined with SMGU between the biopsy and no-biopsy groups. The probability of survival was not significantly different between the no-biopsy and biopsy groups. Conclusions In this multicenter, retrospective propensity score matching cohort study, compared with patients without a biopsy, patients with a biopsy during EG had no increased risk of rebleeding, and there was no significant difference in the rate of rebleeding.

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Platelet Transfusion is Not Associated with the Better Outcomes of Patients with Sepsis-Induced Thrombocytopenia: A Propensity Score-Matching Analysis.

10.21203/rs.3.rs-313903/v1 ◽

2021 ◽

Author(s):

Aiming Zhou ◽

Shanshan Wu ◽

Qin Chen ◽

Lili Chen ◽

Jingye Pan

Keyword(s):

Propensity Score ◽

Propensity Score Matching ◽

Platelet Transfusion ◽

Medical Information ◽

Propensity Score Matching Analysis ◽

Kaplan Meier ◽

All Cause Mortality ◽

Short Term Mortality ◽

Mimic Iii ◽

Mortality Hazard Ratio

Abstract Background: The association of platelet transfusion and short-term mortality in patients with sepsis-induced thrombocytopenia remains unclear. Therefore, we intended to explore whether platelet transfusion could make a difference for patients with sepsis-induced thrombocytopenia.Methods: The study was based on the Medical Information Mart for Intensive Care (MIMIC) III database. Sepsis patients were divided into those with or without platelet transfusion (Platelet Transfusion group [PT group] and No Platelet Transfusion group [NPT group], respectively) during hospital stay. The primary outcome was 28-day all-cause mortality, and secondary outcomes were length of ICU stay (LOS-ICU) and survival days of 28. Propensity-score matching was used to reduce the imbalance. Results: We included 1733 patients: 296 patients in the PT group and 1437 patients in the NPT group. Overall, 655 patients died by day 28. After propensity score matching, 294 paired patients constituted each group. 28-day mortality did not decreased in PT patients comparing to NPT patients (120 [40.54%] vs. 535 [37.23%] deaths; P=0.29). LOS-ICU was similar between PT group and NPT group (5.84[2.68-11.78] vs. 4.94[2.18-12.72]; P=0.44). After confounders were adjusted for, it showed no difference between PT group and NPT group in 28-day mortality (hazard ratio [HR], 1.28;95% confidence interval [CI], [0.96, 1.17]; P=0.09) or lOS-ICU (odd ratio [OR], 0.09; 95%CI, [-1.45, 1.62]; P=0.91). Survival at 28 days showed no difference between the groups according to Kaplan-Meier survival estimates. After propensity score matching, platelet transfusion was also not associated with 28-mortality or LOS-ICU.Conclusions: In the propensity score-matched analysis, there is no evidence that platelet transfusion is beneficial for patients with sepsis-induced thrombocytopenia, neither 28-mortality nor LOS-ICU.

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Admission ECG changes predict short term-mortality after acute myocardial infarction less reliable in patients with diabetes

Scientific Reports ◽

10.1038/s41598-021-85674-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Timo Schmitz ◽

Christian Thilo ◽

Jakob Linseisen ◽

Margit Heier ◽

Annette Peters ◽

...

Keyword(s):

Myocardial Infarction ◽

Logistic Regression ◽

Regression Models ◽

Case Fatality ◽

Ecg Changes ◽

Day Case ◽

Short Term ◽

Logistic Regression Models ◽

Patients With Diabetes ◽

Short Term Mortality

AbstractPrior studies examined association between short-term mortality and certain changes in the admission ECG in acute myocardial infarction (AMI). Nevertheless, little is known about possible differences between patients with diabetes and without diabetes in this regard. So the aim of the study was to investigate the association between 28-day case fatality according to certain ECG changes comparing AMI cases with and without diabetes from the general population. From 2000 until 2017 a total of 9756 AMI cases was prospectively recorded in the study Area of Augsburg, Germany. Each case was assigned to one of the following groups according to admission ECG: ‘ST-elevation’, ‘ST-depression’, ‘only T-negativity’, ‘predominantly bundle branch block’, ‘unspecific changes’ and ‘normal ECG’ (the last two were put together for regression analyses). Multivariable adjusted logistic regression models were calculated to compare 28-day case-fatality between the ECG groups for the total sample and separately for diabetes and non-diabetes cases. For the non-diabetes group, the parsimonious logistic regression model revealed significantly better 28-day-outcome for the ‘normal ECG / unspecific changes’ group (OR: 0.47 [0.29–0.76]) compared to the reference group (STEMI). Contrary, in AMI cases with diabetes the category ‘normal ECG / unspecific changes’ was not significantly associated with lower short-term mortality (OR: 0.87 [0.49–1.54]). Neither of the other ECG groups was significantly associated with 28-day-mortality in the parsimonious logistic regression models. Consequently, the absence of AMI-typical changes in the admission ECG predicts favorable short-term mortality only in non-diabetic cases, but not so in patients with diabetes.

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Immigration, perceived discrimination and mental health: evidence from Venezuelan population living in Peru

Globalization and Health ◽

10.1186/s12992-020-00655-3 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Benoît Mougenot ◽

Elard Amaya ◽

Edward Mezones-Holguin ◽

Alfonso J. Rodriguez-Morales ◽

Báltica Cabieses

Keyword(s):

Mental Health ◽

Logistic Regression ◽

Propensity Score ◽

Propensity Score Matching ◽

Regression Models ◽

Mental Health Problems ◽

Perceived Discrimination ◽

Health Problems ◽

Logistic Regression Models ◽

Venezuelan Population

Abstract Background The association between international migration and mental health is conditioned to several factors, and discrimination may play a significant role. Currently, Peru is one of the principal Venezuelan migrant-receiving countries in Latin America. There are around one million Venezuelan refugees and migrants in the country. This study evaluates the association between self-perceived discrimination and mental health problems in Venezuelan population living in Peru. Method We analyzed data from the Venezuelan Population Residing in Peru Survey 2018, a nationally representative urban sample aimed at collecting information on several dimensions of Venezuelan population wellbeing. We applied logistic regression models to assess the association between self-perceived discrimination and mental health problems. Moreover, we applied the propensity score matching method as a robustness check of our results. Results Of 9487 Venezuelans surveyed, 6806 included complete information. From this sample, 6.3% reported mental health problems related to fear, anger, anxiety, or stress. Logistic regression models showed that Venezuelans who perceived being discriminated against had 2.4 higher odds of presenting mental health problems than their non-discriminated counterparts. Moreover, propensity score matching models showed that Venezuelans who perceived being discriminated against increased by 3.5 percentage points their probability of presenting mental health problems compared to their non-discriminated counterparts. Conclusions There is evidence that self-perceived discrimination is associated with mental health deterioration in Venezuelan migrants living in Peru. Our findings are relevant in the current geopolitical context and could be useful in the decision making processes in international health.

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