Prognostic factor of the two-year mortality after revascularization in patients with critical limb ischemia

Vascular ◽  
2016 ◽  
Vol 25 (2) ◽  
pp. 123-129 ◽  
Author(s):  
Koichi Morisaki ◽  
Takuya Matsumoto ◽  
Yutaka Matsubara ◽  
Kentaro Inoue ◽  
Yukihiko Aoyagi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ejection Fraction ◽  
Serum Albumin ◽  
Critical Limb Ischemia ◽  
Serum Albumin Level ◽  
Limb Ischemia ◽  
Albumin Level ◽  
Surgical Revascularization ◽  
Hybrid Therapy

Purposes The aim of this study was to evaluate the risk factors for the two-year survival after revascularization of critical limb ischemia. Methods Between 2008 and 2012, 142 patients underwent revascularization. A retrospective analysis was performed to measure the risk factor. Results A total 85 patients underwent surgical revascularization, 31 patients underwent endovascular therapy while 26 patients underwent hybrid therapy. By multivariate analysis, the following variables were considered to be risk factors: ejection fraction <50 % (HR, 3.14; 95% CI, 1.22–7.95; P = 0.02), serum albumin level <2.5 g/dL (HR, 3.45; 95% CI, 1.01–11.7; P = 0.04) and nonambulatory status (HR, 4.11; 95% CI, 1.79–9.70; P < 0.01). The two-year survival rate of the patients with no risk factors was 85.5%, while the patients with at least one risk factor had an unfavorable prognosis (one; 56.7%, two; 45.4%). Conclusions The nonambulatory status, serum albumin level <2.5 g/dL and ejection fraction <50% were the risk factors for the two-year mortality after revascularization in critical limb ischemia patients. These risk factors may be useful for the treatment strategy of critical limb ischemia patients.

Pulmonary Hypertension in Peritoneal Dialysis Patients: Prevalence and Risk Factors

2009 ◽  
Vol 29 (2) ◽  
pp. 191-198 ◽  
Author(s):  
Aydin Ünal ◽  
Murat Sipahioglu ◽  
Fatih Oguz ◽  
Mehmet Kaya ◽  
Hamit Kucuk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Ejection Fraction ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Systolic Pulmonary Artery Pressure ◽  
Ventricular Ejection Fraction

Aim To investigate the prevalence of pulmonary arterial hypertension (PAH) and the possible contributing factors for PAH in patients receiving regular continuous ambulatory peritoneal dialysis (CAPD). Patients and Methods The study included 135 CAPD patients and 15 disease-free controls. Patients that had chronic obstructive pulmonary disease, severe mitral or aortic valve disease, connective tissue disease, history of pulmonary embolism, left ventricular ejection fraction <50%, or chest wall or parenchymal lung disease were excluded. All patients and controls were examined using echocardiography and bioelectrical impedance analysis. PAH was defined as systolic pulmonary artery pressure (PAP) >35 mmHg at rest. Results Mean systolic PAP was higher in the CAPD patients than in the controls (19.66 ± 11.66 vs 14.27 ± 4.55 mmHg, p = 0.001). PAH was detected in 17 (12.6%) of the 135 CAPD patients. Mean systolic PAP was significantly higher in patients with PAH than in those without PAH (42.00 ± 9.13 vs 16.44 ± 7.83 mmHg, p = 0.001). Serum albumin level and ejection fraction were lower in patients with PAH than in those without PAH ( p = 0.001 and 0.003 respectively). The ratio of extracellular water/total body water (ECW/TBW), which can reflect hydration status, was significantly higher in patients with PAH than in those without PAH ( p = 0.008). In the PD group, no patients were hypovolemic; 51 (37.8%) of the 135 PD patients were hypervolemic and 84 (62.2%) were normovolemic. Only 3 of the 17 patients with PAH were normovolemic; the rest were hypervolemic. Mean systolic PAP was significantly higher in hypervolemic PD patients (24.57 ± 14.19 mmHg) than in normovolemic PD patients (16.68 ± 7.61 mmHg) ( p = 0.001). PAP correlated with ECW/TBW ( r=0.317, p = 0.001) and left ventricular mass index (LVMI; r=0.286, p = 0.001). On the other hand, it inversely correlated with serum albumin level ( r = –0.281, p = 0.001), hemoglobin level ( r = –0.165, p = 0.044), and ejection fraction ( r = –0.263, p = 0.001). Serum albumin level, ECW/TBW, and LVMI were found in multivariate analysis to be independent risk factors for PAP. Conclusion PAH is a frequent cardiovascular complication in CAPD patients. Serum albumin level, hypervolemia, and LVMI are major risk factors for PAH. Therefore, strategies for treatment of hypervolemia, left ventricular hypertrophy, and hypoalbuminemia should be enhanced to prevent the development of PAH in CAPD patients.

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 Low Serum Albumin Level is Risk Factor for Patients with Percutaneous Endoscopic Gastrostomy

2010 ◽  
Vol 49 (21) ◽  
pp. 2283-2288 ◽  
Author(s):  
Naoyuki Tominaga ◽  
Ryo Shimoda ◽  
Ryuichi Iwakiri ◽  
Nanae Tsuruoka ◽  
Yasuhisa Sakata ◽  
...  
Keyword(s):  
Risk Factor ◽  
Serum Albumin ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Endoscopic Gastrostomy ◽  
Low Serum

scholarly journals A prospective cohort study of hypoalbuminemia as risk factor of wound healing in diabetic foot: a study from tertiary hospital in south India

2017 ◽  
Vol 4 (9) ◽  
pp. 3141
Author(s):  
Unnikrishnan Edakkepuram ◽  
Sheeja P. C. ◽  
Ellikunnel Vithon Gopi
Keyword(s):  
Wound Healing ◽  
Risk Factor ◽  
Cohort Study ◽  
Serum Albumin ◽  
Prospective Cohort Study ◽  
Diabetic Foot ◽  
Prospective Cohort ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Low Serum

Background: Diabetic foot ulcers is a major complication of diabetes mellitus, and precedes >80% of all diabetes related lower leg amputations. One of the risk factors in non-healing diabetic ulcer is low serum albumin level. The objectives of this study were to study the effect of low serum albumin level in patients with diabetic foot ulcer and to study the factors affecting wound healing in diabetic ulcer.Methods: Prospective cohort study in a tertiary hospital.Results: The mean age among study was 57.8 out of which 68.3% were males and 31.7% were females. 55% patients presented with slough over ulcer, 29.2% patients presented with healthy granulation and 15.8% patients presented with extensive wound infection. Among study group 50% patients had good glycaemic control and 50% patients had poor glycaemic control.Conclusions: Low serum albumin level is one of the attributable risk factor of non-healing ulcers in diabetic foot. Poor glycaemic status is also a risk factor for non-healing ulcer.

scholarly journals Analysis of risk factors and outcome in peritoneal dialysis patients with early-onset peritonitis: a multicentre, retrospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e029949 ◽  
Author(s):  
Xiaoyan Ma ◽  
Yingfeng Shi ◽  
Min Tao ◽  
Xiaolu Jiang ◽  
Yi Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Retrospective Cohort ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
First Episode ◽  
Lower Serum ◽  
Factors Associated ◽  
All Cause Mortality ◽  
Technique Failure

ObjectivesTo investigate the risk factors associated with early-onset peritonitis (EOP) and their influence on patients’ technique survival and mortality.Study designRetrospective, cohort study.SettingThree peritoneal dialysis (PD) units in Shanghai.ParticipantsPD patients from 1 June 2006 to 1 May 2018 were recruited and followed up until 31 December 2018. According to time-to-first episode of peritonitis, patients were divided into non-peritonitis (n=144), EOP (≤6 months, n=74) and late-onset peritonitis (LOP) (>6 months, n=139).Primary and secondary outcome measuresEOP was defined as the first episode of peritonitis occurring within 6 months after the initiation of PD. The outcomes were all-cause mortality and technique failure.ResultsOf the 357 patients, 74 (20.7%) patients developed their first episode of peritonitis within the first 6 months. Compared with the LOP group, the EOP group had older ages, more female patients, higher Charlson Comorbidity Index (CCI) score, lower serum albumin levels and renal function at the time of initiation of PD, and higher diabetes mellitus and peritonitis rates (p<0.05).Staphylococcuswas the most common Gram-positive organism in both EOP and LOP groups. The multivariate logistic regression analysis showed that factors associated with EOP included a higher CCI score (OR 1.285, p=0.011), lower serum albumin level (OR 0.924, p=0.016) and lower Kt/V (OR 0.600, p=0.018) at start of PD. In the Cox proportional-hazards model, EOP was more likely a predictor of technique failure (HR 1.801, p=0.051). There was no difference between EOP and LOP for all-cause mortality.ConclusionA higher CCI score and lower serum albumin level and Kt/V at PD initiation were significantly associated with EOP. EOP also predicted a high peritonitis rate and poor clinical outcome.

P0411PREDICTORS OF RENAL AND PATIENT OUTCOME IN PATIENTS WITH IDIOPATHIC MEMBRANOUS NEPHROPATHY: FROM KOGNET DATA

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ji-Young Choi ◽  
Ji Hye Kim ◽  
Ga Young Lee ◽  
Hee Won Noh ◽  
Soojee Jeon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Patient Outcome ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Patient Survival ◽  
Albumin Level ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression

Abstract Background and Aims Idiopathic membranous nephropathy (iMN) is a leading cause of nephrotic syndrome and one of the major causes of end-stage renal disease (ESRD). Various factors can affect renal and patient outcome in patients with iMN. In this study, we analyzed the predictors of renal and patient survival in patients with iMN. Method We analyzed 1,776 patients diagnosed with iMN in Korean GlomeruloNEphritis STudy (KoGNET), a retrospective database of patients with renal biopsy from 1979 to 2018 from 18 centers in Korea. Student t-test for continuous variables and Chi-square test for categorical variables were performed for analyses. Cox proportional hazard regression was used to determine risk factors affecting renal and patient survival. Results The mean age of patients was 53.0 ± 14.7 years old and 1,075 (60.5%) were male. At the time of renal biopsy, 755 (46.0%) and 266 (16.2%) had hypertension and diabetes, respectively. Serum albumin level was 2.7 ± 0.8 g/dL and 871 (49.0%) had nephrotic range of proteinuria. When analyzed by dividing over 65 and under, the hemoglobin and serum albumin level were lower, more patients showed nephrotic ranged proteinuria, and higher prevalence of comorbidities such as hypertension, diabetes, coronary heart disease and cerebrovascular disease in the group over 65 than in the group under 65. Median duration of follow-up was 88.0 (38.0 – 115.1) months. Complete or partial remission rates were 48.5%, 63.8%, and 68.0% at 6 months, 12months after biopsy, and last follow-up, respectively. In Cox proportional hazard regression, high hemoglobin [HR 0.66 (0.47 – 0.93), p=0.017], high serum albumin level [HR 0.41 (0.18 – 0.94), p=0.034], and high estimated GFR by CKD-EPI equation [HR 0.94 (0.91 – 0.96), p&lt;0.001] at biopsy were good predictors for renal outcome, whereas presence of cerebrovascular disease at biopsy [HR 6.45 (1.16 – 35.71), p=0.033] were poor prognostic factors for ESRD. Age 65 and older [HR 3.26 (1.53 – 6.95), p=0.002] and presence of hypertension at biopsy [HR 2.45 (1.09 – 5.54), p=0.031] were significant risk factors for patient survival in multivariate Cox proportional regression analysis. Conclusion High hemoglobin and serum albumin, and good renal function at biopsy were good predictors for renal survival. Older age and hypertension at biopsy were poor prognostic factors for patient survival in iMN patients. Prognostic information of outcomes in this study might be helpful to optimize management in iMN patients.

Postoperative serum albumin level is an independent risk factor for discontinuation of adjuvant chemotherapy for pancreatic cancer

Pancreatology ◽  
2013 ◽  
Vol 13 (4) ◽  
pp. S51
Author(s):  
Masaki Tanaka ◽  
Ippei Matsumoto ◽  
Makoto Shinzeki ◽  
Sadaki Asari ◽  
Tadahiro Goto ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Risk Factor ◽  
Adjuvant Chemotherapy ◽  
Serum Albumin ◽  
Independent Risk Factor ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Postoperative Serum

scholarly journals Serum Albumin Level < 32 g/l on Day 30 Can Predicts Higher Risk of Non-Relapse Mortality in Acute Lymphoblastic Leukemia Following Allogeneic Stem Cell Transplantation

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5930-5930
Author(s):  
Feras Alfraih ◽  
Vikas Gupta ◽  
John Kuruvilla ◽  
Jeffrey H. Lipton ◽  
Hans A. Messner ◽  
...  
Keyword(s):  
Risk Factor ◽  
Serum Albumin ◽  
Acute Gvhd ◽  
Serum Albumin Level ◽  
Lymphoblastic Leukemia ◽  
Chronic Gvhd ◽  
Group Versus ◽  
Albumin Level ◽  
Grade 3 ◽  
High Albumin

Introduction: It is extremely significant issue to predict hematopoietic stem cell transplant (HSCT) outcomes using a biomarker. In this study, we attempted to evaluate the impact of post-transplant serum albumin on outcomes in patients with acute lymphoblastic leukemia (ALL). Methods: 123 patients with ALL receiving HSCTs between 1999 and 2012 at our center were evaluated for post-transplant serum albumin levels and their correlation with transplant's outcome. The level of serum albumin was retrospectively retrieved in certain time point ± 3 days for following periods: 1 month pre HSCT and then weekly after transplantation for first 3 months. 100 patients had available serum albumin levels. The ROC analyses were used to determine the most statistically significant cutoff level of serum albumin level correlating with NRM at 1 year. The ROC analysis suggested the level of 32 g/l at 4 weeks post HSCT as the best cutoff level for further analysis. Thus patients were stratified into low versus high albumin level group according to that cutoff level. Results: Median age for all patients is 37 (range 17-61), 35% were female and related donors were 57%. Matched donors were 83%. 71% were in 1st complete remission. 37% were Philadelphia chromosome positive. GVHD prophylaxis was CSA/MTX 60%, CSA/MMF 22%. Conditioning regimen was myeloablative in 95%. 61% received peripheral blood stem cells. With a median follow-up among survivors of 60 months (range 21-100), 61% patients showed albumin level ³ 32g/l at day 30 while 39% showed dropped albumin level <32 g/l at day 30. The OS rate at 2 years was 61% in high albumin group versus 23% in low albumin group (p < 0.001). The NRM rate was 62% in high albumin group versus 17% in low albumin group (p < 0.001). However, no difference of relapse incidence was noted between the two groups. The cumulative incidence of overall acute GVHD, grades 2/4, grades 3/4 at day 120 and overall chronic GVHD at 2 years was 67%, 59%, 16% and 45% in high albumin group versus 72%, 70%, 49% and 39% in low albumin group, suggesting higher incidence of grade 3/4 acute GVHD in low albumin group vs high. In multivariate analysis, serum albumin level < 32 g/l at 4 weeks was confirmed as an independent adverse risk factor for NRM (p=0.04, HR 2.81) together with acute GVHD grades 3/4 (p 0.01, HR 3.79) and chronic GVHD (p²0.001, HR 0.21). For OS, albumin level was not confirmed as an independent risk factor, but acute GVHD grade 3/4 (p< 0.001, HR 3.36) and chronic GVHD (p <0.001, HR 0.008) were found to be independent factors. For relapse chronic GVHD grade 3-4 was the only independent prognostic factor (p <0.001, HR 0.27). Conclusion: The present study suggested that 1) serum albumin level less than 32 g/l at day 30 can predicts higher risk of non-relapse mortality and 2) dropped serum albumin might be affected by in part the occurrence of severe acute GVHD, and by independent mechanism of gut GVHD. Further study is strongly warranted to confirm the prognostic role of serum albumin level on transplant outcomes in a prospectively designed study. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Incidence and risk factors of peritoneal dialysis-related peritonitis in elderly patients: A retrospective clinical study

2020 ◽  
Vol 40 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Haishan Wu ◽  
Hongjian Ye ◽  
Rong Huang ◽  
Chunyan Yi ◽  
Juan Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Elderly Patients ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Advanced Age ◽  
Retrospective Clinical Study ◽  
Technique Failure ◽  
Related Mortality

Background: This study was to analyze the incidence, risk factors, and clinical outcomes of peritonitis in elderly continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: Incident patients undergone CAPD from 1 January 2006 to 30 June 2015 in our center were enrolled and divided into aged < 65 years and ≥ 65 years groups. Risk factors were evaluated using a logistic regression model, and outcome comparison was evaluated using a Cox proportional model. Results: Among 1953 patients, 111(33.2%) in elderly ( n = 334) and 470 (29.0%) in younger ( n = 1619) developed at least one episode of peritonitis. Comparing with younger patients, elderly ones had a higher peritonitis rate (0.203 vs. 0.145 episodes/patient-year, p < 0.05). The multivariate Cox regression showed that advanced age (hazard ratio (HR) = 1.06, 95% confidence interval (CI) = 1.01–1.11, p = 0.015), assistant-assisted peritoneal dialysis (PD; HR = 2.64, 95% CI = 1.23–5.64, p = 0.012), higher body mass index (BMI; HR = 1.11, 95% CI = 1.02–1.20, p = 0.010), and low serum albumin level (HR = 0.94, 95% CI = 0.90–0.98, p = 0.004) were associated with increased peritonitis risk in elderly patients. Compared with younger ones with peritonitis, elderly patients had an approximately fourfold increased risk of peritonitis-related mortality (odd ratio (OR) = 3.57, 95% CI = 1.38–9.28, p = 0.009). During the cohort, peritonitis was the risk factor associated with technique failure (HR = 3.19, 95% CI = 2.33–4.39, p < 0.001) in younger patient but not in the elderly population (HR = 1.82, 95% CI = 0.84–3.94, p = 0.132). Conclusions: Elderly PD patients had higher prevalence for peritonitis and peritonitis-related mortality. Advanced age, assistant-assisted PD, a higher BMI, and lower serum albumin level were independently associated with the first episode of peritonitis in elderly patients. However, peritonitis was not the predictor of death-censored technique failure in elderly ones.

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