scholarly journals Association of Blood Type on Clinical Outcomes in Black/African Americans Hospitalized for COVID-19 Infection

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 14-14
Author(s):  
Yan Cheng ◽  
Sharif Mohammed ◽  
Alexis Okoh ◽  
Ki (Steve) Lee ◽  
Corinne Raczek ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
African Americans ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
Type A ◽  
Blood Type ◽  
P Value ◽  
Single Center ◽  
Black African ◽  
O 31

Introduction: Early studies from Wuhan, China have reported an association between blood type and outcomes in COVID-19 infected patients. Conflicting reports in literature have investigated the protective role of blood type O against worst outcomes associated with COVID-19 infections. Approximately 50% of Black/African Americans (AA) have blood group O. Our study is the only study to date looking at the association between Black/AA and blood type. We aimed to determine the association between blood type and Black/AA patients hospitalized for COVID-19. Methods: We retrospectively reviewed data on patients with known blood type, who were admitted for COVID-19 at a single center between March and April 2020. We excluded other races in our study because only about 2% of the population was Caucasian and 8% representing other races, representing a small subset of patients under study whereas Black/AA represented about 90% of our hospitalized patients. Patients were stratified into 4 groups based on their ABO blood type. Baseline demographic, clinical characteristics and clinical course of the disease were compared. The primary end point was in-hospital mortality. Secondary endpoints included admission to the intensive care unit (ICU), acute kidney injury requiring hemodialysis and length of stay (LOS). Results: During the study period, a total of 256 patients were reviewed. Distribution of ABO type was as follows; A: (N=65) 25%, B: (N=62) 24%, AB: (N=9) 4%, O: (N=120) 47%. Compared to blood types A, B and O, AB patients were younger (mean; yrs. 63 vs. 63 vs. 62 vs. 43 yrs. p=0.0242). Blood type B patients were more likely to present with nausea, than groups A, AB, and O. (27% vs. 10% vs. 0% vs. 5%; p=0.017). All other characteristics including baseline inflammatory markers were comparable. There was no difference among groups regarding in-hospital mortality (A: 39% B: 29% AB: 33% O: 31% p value: 0.676) or admission to the ICU (A:31% B: 28% AB: 33% O: 34% p value: 0.840). The incidence of acute kidney injury requiring hemodialysis was higher in blood type A patients compared to B, AB, and O. (31% vs. 0% vs. 23% vs. 19%; p=0.046). In hospital LOS was comparable among all groups. Conclusions: In this single center analysis of black/AA patients admitted for COVID-19, there was no association between blood type and in-hospital mortality or admission to ICU. Blood type A patients had a higher propensity of kidney injury, but this did not translate into worse in-hospital survival. Disclosures Cohen: GBT: Speakers Bureau.

scholarly journals Acute kidney injury in hospitalized patients with COVID-19

2020 ◽  
Author(s):  
Joana Gameiro ◽  
José Agapito Fonseca ◽  
João Oliveira ◽  
Filipe Marques ◽  
João Bernardo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Multivariate Analysis ◽  
Kidney Disease ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
Hospitalized Patients ◽  
Single Center ◽  
Transient Aki ◽  
Worse Prognosis

Abstract Introduction: The incidence of AKI in coronavirus disease 2019 (COVID-19) patients ranges from 0.5 to 35% and has been associated with worse prognosis. The purpose of this study was to evaluate the incidence, severity, duration, risk factors and prognosis of AKI in hospitalized patients with COVID-19.Methods: We conducted a retrospective single-center analysis of 192 hospitalized COVID-19 patients from March to May of 2020. AKI was diagnosed using the Kidney Disease Improving Global Outcome (KDIGO) classification based on serum creatinine (SCr) criteria. Persistent and Transient AKI were defined according to the Acute Disease Quality Initiative (ADQI) workgroup definitions.Results: In this cohort of COVID-19 patients, 55.2% developed AKI (n=106). The majority of AKI patients had persistent AKI (n=64, 60.4%). Overall, in-hospital mortality was 18.2% (n=35) and was higher in AKI patients (28.3% vs 5.9%, p<0.001, unadjusted OR 6.03 (2.22-16.37), p<0.001). On a multivariate analysis, older age (adjusted OR 1.08 (95% CI 1.02-1.13), p=0.004), lower Hb level (adjusted OR 0.69 (95% CI 0.53-0.91), p=0.007) and acidemia at presentation (adjusted OR 5.53 (95% CI 1.70-18.63), p=0.005), duration of AKI (adjusted OR 7.91 for persistent AKI (95% CI 2.39-26.21), p=0.001) and severity of AKI (adjusted OR 2.30 per increase in KDIGO stage (95% CI 1.10-4.82), p=0.027) were independent predictors of mortality.Conclusion: AKI was frequent in hospitalized patients with COVID-19. Persistent AKI and higher severity of AKI were independent predictors of in-hospital mortality.

scholarly journals Acute Kidney Injury Can Predict In-Hospital Mortality in Elderly Patients with COVID-19 in the ICU: A Single-Center Study

2020 ◽  
Vol Volume 15 ◽  
pp. 2095-2107
Author(s):  
Qinglin Li ◽  
Tianyi Zhang ◽  
Fei Li ◽  
Zhi Mao ◽  
Hongjun Kang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Elderly Patients ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
Single Center ◽  
Single Center Study ◽  
Center Study

Weekend Versus Weekday Mortality for Thrombotic Thrombocytopenic Purpura (TTP) Related Hospitalizations in the United States: Data from the National Inpatient Sample

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4863-4863
Author(s):  
Smith Giri ◽  
Ranjan Pathak ◽  
Madan Raj Aryal ◽  
Paras Karmacharya ◽  
Michael G Martin
Keyword(s):  
United States ◽  
Acute Kidney Injury ◽  
Relative Risk ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
The United States ◽  
P Value ◽  
Adjusted Relative Risk ◽  
Hospital Type ◽  
Thrombocytopenic Purpura

Abstract Introduction: Previous research has shown that weekend hospital admissions are associated with an increased mortality in comparison to weekday admissions for a number of emergent conditions including myocardial infarction [Relative Risk (RR) 1.048; 95% confidence interval [CI], 1.022 to 1.076; P value <0.001], pulmonary embolism (RR 1.17, 95% CI 1.03 to 1.34, P value <0.01) and gastrointestinal hemorrhage (RR 1.17, 95% CI 1.03 to 1.34, P value <0.01) . Thrombotic Thrombocytopenic Purpura (TTP) is a hematological emergency with a significant morbidity and mortality if not recognized early. However, studies evaluating if a similar "weekend" effect exists in TTP are lacking. Methods: We used the Nationwide Inpatient Sample database to identify patients admitted with TTP in the United States using ICD 9 CM code 446.6 from 2009 to 2011. Baseline data for demographic variables, age, gender, race, hospital characteristics- region, hospital type (rural versus urban, teaching versus non-teaching), bed-size, insurance payer and comorbidities were derived for weekend and weekday admissions. Logistic regression analysis was used to calculate the adjusted relative risk of in-hospital mortality of weekend versus weekday admissions. Data analysis was done using STATA 13.0 (College Station, TX: StataCorp LP) Results: Of the 6634, estimated TTP related hospitalizations, 19.5 % were admitted on the weekends and 80.5 % admitted on the weekdays. The mean age was 48±0.5 years and 66.4 % were females. A higher in-hospital mortality rate was seen among weekend admissions as compared to weekday admissions (RR 1.32, 95% CI 1.30-1.33, p value <0.01). On multivariate analysis (table 1), weekend admission remained as an independent predictor of increased mortality (adjusted RR 1.16, 95% CI 1.15-1.17, P value <0.01) after adjusting for other confounders including age, gender, comorbidities, hospital type and size. Similarly, acute kidney injury (adjusted RR 3.41, 95% CI 3.34-3.43, P value <0.001), stroke (adjusted RR 5.46, 95% CI 5.31-5.62, P value <0.001), and sepsis (adjusted RR 6.57, 95% CI 6.40-6.75, Pvalue <0.001) were associated with significantly increased risk of mortality among patients with TTP (table 1). Conclusions: A significantly higher in-hospital mortality occurs among TTP patients admitted on the weekends as compared to weekdays. Future research should focus on identifying the underlying factors for this difference so that quality improvement measures could be taken to mitigate this difference. Table 1: Logistic Regression Analysis showing the adjusted relative risk (RR) of various patient and hospital characteristics in predicting in-hospital mortality for patients with TTP. Variable Adjusted RR 95% CI of Adjusted RR P value Weekend admission 1.16 1.15-1.17 <0.001 Pay - Medicare - Medicaid - Private including HMO - self-pay - no charge - other 1.0 1.33 1.19 1.63 1.36 2.02 .. 1.28-1.38 1.14-1.25 1.50-1.77 1.11-1.67 1.73-2.36 <0.001 <0.001 <0.001 <0.001 <0.001 Race - white - black - hispanic - asian or pacific islander - native american - other 1.0 1.01 0.93 1.13 1.05 1.07 0.98-1.03 0.89-0.97 1.07-1.19 0.94-1.16 1.02-1.13 0.47 0.003 <0.001 0.34 0.003 Region - Northeast -Midwest - South - West 1 0.92 1.05 0.97 0.86-0.98 0.99-1.11 0.91-1.04 0.01 0.06 0.48 Co-morbidities - smoking - obesity - dyslipidemia - hypertension - diabetes mellitus - peripheral vascular disease - coronary artery disease - acute kidney injury - chronic kidney disease - stroke - sepsis 0.90 0.78 0.60 0.68 0.99 1.32 1.06 3.41 1.10 5.46 6.57 0.88-0.92 0.76-0.79 0.59-0.61 0.67-0.69 0.97-1.00 1.29-1.34 1.05-1.07 3.34-3.43 1.08-1.11 5.31-5.62 6.40-6.75 <0.001 <0.001 <0.001 <0.001 0.12 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 Age 1.04 1.043-1.046 <0.001 Female 0.78 0.78-0.79 <0.001 Hospital Type - rural - urban non teaching - urban teaching 1.0 0.92 1.05 0.88-0.97 0.99-1.11 0.002 0.061 Bed size - small - medium - large 0.95 1.01 0.89-1.01 0.96-1.07 0.11 0.51 Disclosures No relevant conflicts of interest to declare.

scholarly journals MO384ERYTHROCYTURIAAT ADMISSION IS A PREDICTOR OF ACUTE KIDNEY INJURY AND IN-HOSPITAL MORTALITY IN HOSPITALIZED PATIENTS WITH COVID-19

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Yulia Khruleva ◽  
Elena Troitskaya ◽  
Marina Efremovtseva ◽  
Tapiwa Mubayazvamba ◽  
Zhanna Kobalava
Keyword(s):  
Acute Kidney Injury ◽  
Lung Injury ◽  
Hospital Mortality ◽  
Oral Anticoagulants ◽  
Clinical Signs ◽  
Kidney Injury ◽  
Hospitalized Patients ◽  
Adverse Outcomes ◽  
Common Finding ◽  
P Value

Abstract Background and Aims Acute kidney injury (AKI) is common among patients with coronavirus disease (COVID-19) and a major risk factor associated with mortality in hospitalized patients. Previously abnormal urine tests were reported to have a high incidence in COVID-19. We aimed to investigate the prevalence of urine tests changes and their impact on the outcomes in patients hospitalized with COVID-19. Method A retrospective analysis of the register of patients with COVID-19 was performed. COVID-19 was defined as the laboratory-confirmed infection and/or presence of the typical computer tomography (CT) picture with typical clinical signs. We excluded patients with re-hospitalizations, urinary tract infection, and single serum creatinine (SCr) measurement during hospitalization. Urine tests were performed within the first 24 h after hospitalization. Erythrocyturia was defined as the presence of &gt;3 red blood cells (RBC) per high-power field. Definition of acute kidney injury (AKI) was based on KDIGO criteria. Patients were identified as having in-hospital AKI, if AKI developed during hospitalization. P value &lt;0.05 was considered statistically significant. Results In final analysis we included 495 patients. Mean age was 64 [53;74], 51% (244) were males, mean Charlson index 3 [1;3], 66% with hypertension, 48% with obesity, 24% with diabetes mellitus (DM) and 6% with chronic kidney disease (CKD). 25% of patients were hospitalized in the intensive care unit (ICU), 17.8% (88) were treated with mechanical ventilation at some point during hospitalization. Patients were hospitalized on the 6±4 day of illness at mean. The mean length of stay was 11 [9;14] days, in the ICU - 4 [2;7] days. 19.4% patients died in hospital. The incidence of AKI was 22%, 47% patients had the 1st stage of AKI, 41% - the 2nd and 20% - the 3rd. In-hospital AKI was observed in 8.3% (41) of patients. Among discharged patients AKI was registered in 13%, of those who died in 60% (p&lt;0.0001). 52% (256) of patients had erythrocyturia and/or proteinuria and/or leukocyturia in urine test and admission: 35% of patients had proteinuria, 17% - hematuria and 19% - leukocyturia. The most prognostically significant associations of urinalysis changes were identified for erythrocyturia, which was present in 82 patients at admission, their mean RBC count in urine was 18.5 [7;52]. The presence of еrythrocyturia at admission was independent of age, gender, presence of hypertension, DM, obesity, blood test changes, pre-admission drug intake, included oral anticoagulants. Patients with erythrocyturia at admission had higher level of SCr at admission (101[83;140] vs 88[74;109] µmol/l, p=0.003), were more likely to develop AKI compared to patients without AKI (31.2% vs 12.4%, p&lt;0.001, respectively), had higher prevalence of in-hospital AKI (17% vs 6.5%, p=0.002) and more severe course of AKI (the 1st stage – 31% vs 54%, the 2nd - 43% vs 32%, the 3rd – 26% vs 14%, p=0.02). They also more often had CKD (13,4% vs 4.4%, p=0.001), more severe lung injury by CT scan during hospitalization (15.6% vs 5.5% with 75-90% lung injury, p=0.005, for the trend), were more frequently hospitalized in ICU (39% vs 22%, p=0.001), and had higher level of in-hospital mortality (32% vs 17%, p=0.002). Erythrocyturia at admission was predictor for development of in-hospital AKI (odds ratio (OR) 2.94 with a 95% confidence interval (CI) of 1.35 to 6.15, p=0.002) and in-hospital mortality (OR 2.28, 95% CI of 1.28 to 3.97, p=0.002). Conclusion Erythrocyturia at admission is a common finding in hospitalized patients with COVID-19, and is associated with severity of disease and adverse outcomes in this population.

scholarly journals Incidence, risk factors and clinical outcomes of acute kidney injury after heart transplantation: a retrospective single center study

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yi-Yao Jiang ◽  
Xiang-Rong Kong ◽  
Fen-Long Xue ◽  
Hong-Lei Chen ◽  
Wei Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Heart Transplantation ◽  
Urine Volume ◽  
Kidney Injury ◽  
Single Center ◽  
Term Survival ◽  
Long Term Survival

Abstract Objectives This study aimed to identify the incidence rate of Acute kidney injury (AKI) in our center and predict in-hospital mortality and long-term survival after heart transplantation (HTx). Methods This single-center, retrospective study from October 2009 and March 2020 analyzed the pre-, intra-, and postoperative characteristics of 95 patients who underwent HTx. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Risk factors were analyzed by multivariable logistic regression models. The log-rank test was used to compare long-term survival. Results Thirty-three (34.7%) patients developed AKI. The mortality in hospital in HTx patients with and without AKI were 21.21 and 6.45%, respectively (P < 0.05). Recipients in AKI who required renal replacement therapy (RRT) had a hospital mortality rate of 43.75% compared to 6.45% in those without AKI or RRT (P < 0.0001). A long cardiopulmonary bypass (CPB) time (OR:11.393, 95% CI: 2.183 to 59.465, P = 0.0039) was positively related to the occurrence of AKI. A high intraoperative urine volume (OR: 0.031, 95% CI: 0.005 to 0.212, P = 0.0004) was negatively correlated with AKI. AKI requiring RRT (OR, 11.348; 95% CI, 2.418–53.267, P = 0.002) was a risk factor for mortality in hospital. Overall survival in patients without AKI at 1 and 3 years was not different from that in patients with AKI (P = 0.096). Conclusions AKI is common after HTx. AKI requiring RRT could contribute powerful prognostic information to predict mortality in hospital. A long CPB time and low intraoperative urine volume are associated with the occurrence of AKI.

scholarly journals Efficacy of Using High-Dose Vitamin C, Thiamine, and Hydrocortisone in Sepsis and Septic Shock: A Retrospective Before-After Study

2021 ◽  
Author(s):  
Haytham Wali ◽  
William Malik ◽  
Juliane Mayette
Keyword(s):  
Septic Shock ◽  
Acute Kidney Injury ◽  
Vitamin C ◽  
Hospital Mortality ◽  
Multiorgan Failure ◽  
Kidney Injury ◽  
P Value ◽  
Permeability Barrier ◽  
High Dose ◽  
High Dose Vitamin

Abstract Background/Objective Sepsis can be associated with increased production of reactive oxygen species that deplete antioxidant molecules and increase the consumption of vitamin C, which correlates with multiorgan failure and death. Intravenous vitamin C may protect several microvascular functions, including capillary blood flow, microvascular permeability barrier, and arteriolar responsiveness to vasoconstrictors and vasodilators. This study was conducted to assess the practice of administering high-dose vitamin C in critically ill patients with sepsis or septic shock at our institution retrospectively.Methods We conducted an electronic health record (EHR)-based, retrospective, before-after study. The primary objective was to assess the efficacy of using a high-dose vitamin C regimen in decreasing hospital mortality. A two-sided P-value of < 0.05 was considered statistically significant.Results A total of 84 patient records were included in this study. Administration of high-dose vitamin C, thiamine, and hydrocortisone was associated with higher hospital mortality (64.3% versus 42.9%; P = 0.049), higher ICU mortality (59.5% versus 42.9%; P = 0.07), shorter ICU length of stay (three versus seven days; P = 0.53), higher incidence of acute kidney injury (61.9% versus 26.2%; P = 0.001), and a higher requirement for renal replacement therapy (76.9% versus 45.5%; P = 0.06).Conclusion Administration of high-dose vitamin C, thiamine, and hydrocortisone in critical care patients with sepsis or septic shock was associated with higher hospital mortality and higher incidence of acute kidney injury.

scholarly journals Incidence, Risk Factors and Clinical Outcomes of Acute Kidney Injury after Heart Transplantation: A Retrospective Single Center Study.

2020 ◽  
Author(s):  
Yiyao Jiang ◽  
Xiangrong Kong ◽  
Fenlong Xue ◽  
Honglei Chen ◽  
Wei Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Heart Transplantation ◽  
Urine Volume ◽  
Kidney Injury ◽  
Single Center ◽  
Term Survival ◽  
Long Term Survival

Abstract Objectives: This study aimed to identify the incidence rate of Acute kidney injury (AKI) in our center and predict in-hospital mortality and long-term survival after heart transplantation (HTx). Methods: This single-center, retrospective study from October 2009 and March 2020 analyzed the pre-, intra-, and postoperative characteristics of 95 patients who underwent HTx. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Risk factors were analyzed by multivariable logistic regression models. The log-rank test was used to compare long-term survival. Results: : Thirty-three (34.7%) patients developed AKI. The mortality in hospital in HTx patients with and without AKI were 21.21% and 6.45%, respectively (P<0.05). Recipients in AKI who required renal replacement therapy (RRT) had a hospital mortality rate of 43.75% compared to 6.45% in those without AKI or RRT (P<0.0001). A long cardiopulmonary bypass (CPB) time (OR:11.393, 95% CI: 2.183 to 59.465, P=0.0039) was positively related to the occurrence of AKI. A high intraoperative urine volume (OR: 0.031, 95% CI: 0.005 to 0.212, P=0.0004) was negatively correlated with AKI. AKI requiring RRT (OR, 11.348; 95% CI, 2.418-53.267, P=0.002) was a risk factor for mortality in hospital. Overall survival in patients without AKI at 1 and 3 years was not different from that in patients with AKI (P=0.096).Conclusions: AKI is common after HTx. AKI requiring RRT could contribute powerful prognostic information to predict mortality in hospital. A long CPB time and low intraoperative urine volume are associated with the occurrence of AKI.

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