scholarly journals Management of patients with pulmonary mycobacteriosis in France: a multicenter retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pascale Bemer ◽  
Olivia Peuchant ◽  
Hélène Guet-Revillet ◽  
Julien Bador ◽  
Charlotte Balavoine ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prognostic Factors ◽  
Mycobacterium Avium ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Nontuberculous Mycobacteria ◽  
Great Variability ◽  
Microbiological Characteristics ◽  
Smear Negative

Abstract Background Recent studies report very low adherence of practitioners to ATS/IDSA recommendations for the treatment of nontuberculous mycobacteria pulmonary disease (NTM-PD), as well as a great variability of practices. Type of management could impact prognosis. Methods To evaluate management and prognosis of patients with NTM-PD cases with respect to ATS recommendations, we conducted a multicenter retrospective cohort study (18 sentinel sites distributed throughout France), over a period of six years. We collected clinical, radiological, microbiological characteristics, management and outcome of the patients (especially death or not). Results 477 patients with NTM-PD were included. Respiratory comorbidities were found in 68% of cases, tuberculosis sequelae in 31.4% of patients, and immunosuppression in 16.8% of cases. The three most common NTM species were Mycobacterium avium complex (60%), M. xenopi (20%) and M. kansasii (5.7%). Smear-positive was found in one third of NTM-PD. Nodulobronchiectatic forms were observed in 54.3% of cases, and cavitary forms in 19.1% of patients. Sixty-three percent of patients were treated, 72.4% of patients with smear-positive samples, and 57.5% of patients with smear-negative samples. Treatment was in adequacy with ATS guidelines in 73.5%. The 2-year mortality was 14.4%. In the Cox regression, treatment (HR = 0.51), age (HR = 1.02), and M. abscessus (3.19) appeared as the 3 significant independent prognostic factors. Conclusion These findings highlight the adequacy between French practices and the ATS/IDSA guidelines. Treatment was associated with a better survival.

scholarly journals Survival Rates and Prognostic Factors of COVID-19 Patients: A Registry-Based Retrospective Cohort Study

2021 ◽  
Author(s):  
Fatemeh Shahbazi ◽  
Manoochehr Karami ◽  
Mohammd Mirzaei ◽  
Younes Mohamadi
Keyword(s):  
Cohort Study ◽  
Prognostic Factors ◽  
Survival Rate ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Survival Function ◽  
Western Iran ◽  
Co Morbidity ◽  
Modifiable Factors

Abstract Background: Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a newly identified coronavirus. Our knowledge about survival rate and prognostic factors of the disease is not established well. This study proposed to estimate the survival function of COVID-19 in western Iran.Methods: This retrospective cohort study was performed in Hamadan province, western Iran. The study included patients that referred to the provincial hospitals during 7 months period from February 20 to September 20, 2020. The follow up of each subject was calculated from the date of onset of respiratory symptoms to the date of death. Demographic and clinical data were extracted from patients’ medical records. Kaplan-Meier method, log-rank test, and Cox regression were used for the analysis of the data. Results: The overall 1, 5, 10, 20, 30 and 49-day survival rate were 99.57%, 95.61%, 91.15%, 87.34%, 86.91%, and 86.74% respectively. A significant association was observed between survival time with age, gender, history of traveling to contaminated areas, co-morbidity, malignancies, and chronic diseases, and hospital units.Conclusion: Educational programs and access to healthcare could be implemented as modifiable factors to reduce the mortality rate and burden of this disease in COVID-19 patients.

scholarly journals Clinical characteristics and outcome of influenza virus infection among adults hospitalized with severe COVID-19: a retrospective cohort study from Wuhan, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xunliang Tong ◽  
Xiaomao Xu ◽  
Guoyue Lv ◽  
He Wang ◽  
Anqi Cheng ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Cohort Study ◽  
Clinical Features ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Influenza Virus Infection ◽  
Chronic Respiratory Disease ◽  
Hospital Death ◽  
New City

Abstract Background Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that rapidly spreads worldwide and co-infection of COVID-19 and influenza may occur in some cases. We aimed to describe clinical features and outcomes of severe COVID-19 patients with co-infection of influenza virus. Methods Retrospective cohort study was performed and a total of 140 patients with severe COVID-19 were enrolled in designated wards of Sino-French New City Branch of Tongji Hospital between Feb 8th and March 15th in Wuhan city, Hubei province, China. The demographic, clinical features, laboratory indices, treatment and outcomes of these patients were collected. Results Of 140 severe COVID-19 hospitalized patients, including 73 patients (52.14%) with median age 62 years were influenza virus IgM-positive and 67 patients (47.86%) with median age 66 years were influenza virus IgM-negative. 76 (54.4%) of severe COVID-19 patients were males. Chronic comorbidities consisting mainly of hypertension (45.3%), diabetes (15.8%), chronic respiratory disease (7.2%), cardiovascular disease (5.8%), malignancy (4.3%) and chronic kidney disease (2.2%). Clinical features, including fever (≥38 °C), chill, cough, chest pain, dyspnea, diarrhea and fatigue or myalgia were collected. Fatigue or myalgia was less found in COVID-19 patients with IgM-positive (33.3% vs 50/7%, P = 0.0375). Higher proportion of prolonged activated partial thromboplastin time (APTT) > 42 s was observed in COVID-19 patients with influenza virus IgM-negative (43.8% vs 23.6%, P = 0.0127). Severe COVID-19 Patients with influenza virus IgM positive have a higher cumulative survivor rate than that of patients with influenza virus IgM negative (Log-rank P = 0.0308). Considering age is a potential confounding variable, difference in age was adjusted between different influenza virus IgM status groups, the HR was 0.29 (95% CI, 0.081–1.100). Similarly, difference in gender was adjusted as above, the HR was 0.262 (95% CI, 0.072–0.952) in the COX regression model. Conclusions Influenza virus IgM positive may be associated with decreasing in-hospital death.

scholarly journals Determinants of Survival Among HIV/AIDS Patients With The Second-Line Antiretroviral Therapy In Henan Province of China 

2021 ◽  
Author(s):  
Yantao Jin ◽  
Miao Zhang ◽  
Yan-min Ma ◽  
Hui-jun Guo ◽  
Peng-yu Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Retrospective Cohort Study ◽  
Highly Active Antiretroviral Therapy ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Second Line ◽  
Aids Patients ◽  
Cd4 Cell Count ◽  
Hiv Aids

Abstract Background: To estimate the survival and effectors of mortality among HIV/AIDS patients switch to second-line highly active antiretroviral therapy (ART) in rural China.Methods: A three years’ retrospective cohort study was conducted and HIV/AIDS patients switched to the second-line ART between January 2009 to December 2014 enrollment. The data collected from medical records and analysis using Kaplan-Meier statistics and COX regression models.Findings: A total of 2883 HIV/AIDS participants followed up for 8445 person-years, 183 (6.5%) died, 14(0.5%) lost follow-up and the mortality rate 2.17/100 person-years. After adjusting other confounding factors by multivariable COX regression, age older than 50 years (HR,3.37; 95%CI, 1.92-5.92), Traditional Chinese medicine therapy (HR,0.48; 95%CI, 0.33-0.71), CD4 cell count littler than 200 cells/μl (HR,2.97; 95%CI, 1.90-4.64), AST or ALT higher than 50 u/L (HR,1.55; 95%CI, 1.15-2.11) were each independently associated with mortality among HIV/AIDS patients switch to second-line ART.Conclusions: Our retrospective cohort study indicates that mortality among HIV/AIDS patients switch to second-line ART lower than most other studies. However, the limitations of a retrospective cohort could have biased the study, so prospective studies should be carried out to confirm our primary results. The result of our study suggest that Chinese therapy was potential treatment for HIV/AIDS patients.

scholarly journals Risk factors for mortality in hospitalized patients with COVID-19 from three hospitals in Peru: a retrospective cohort study

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 224
Author(s):  
Cristian Díaz-Vélez ◽  
Diego Urrunaga-Pastor ◽  
Anthony Romero-Cerdán ◽  
Eric Ricardo Peña-Sánchez ◽  
Jorge Luis Fernández Mogollon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Oxygen Saturation ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Vulnerable Groups ◽  
Vital Functions ◽  
The Mean

Background: Peru was one of the countries with the highest COVID-19 mortality worldwide during the first stage of the pandemic. It is then relevant to evaluate the risk factors for mortality in patients hospitalized for COVID-19 in three hospitals in Peru in 2020, from March to May, 2020.  Methods: We carried out a retrospective cohort study. The population consisted of patients from three Peruvian hospitals hospitalized for a diagnosis of COVID-19 during the March-May 2020 period. Independent sociodemographic variables, medical history, symptoms, vital functions, laboratory parameters and medical treatment were evaluated. In-hospital mortality was assessed as the outcome. We performed Cox regression models (crude and adjusted) to evaluate risk factors for in-hospital mortality. Hazard ratios (HR) with their respective 95% confidence intervals (95% CI) were calculated.  Results: We analyzed 493 hospitalized adults; 72.8% (n=359) were male and the mean age was 63.3 ± 14.4 years. COVID-19 symptoms appeared on average 7.9 ± 4.0 days before admission to the hospital, and the mean oxygen saturation on admission was 82.6 ± 13.8. While 67.6% (n=333) required intensive care unit admission, only 3.3% (n=16) were admitted to this unit, and 60.2% (n=297) of the sample died. In the adjusted regression analysis, it was found that being 60 years old or older (HR=1.57; 95% CI: 1.14-2.15), having two or more comorbidities (HR=1.53; 95% CI: 1.10-2.14), oxygen saturation between 85-80% (HR=2.52; 95% CI: 1.58-4.02), less than 80% (HR=4.59; 95% CI: 3.01-7.00), and being in the middle (HR=1.65; 95% CI: 1.15-2.39) and higher tertile (HR=2.18; 95% CI: 1.51-3.15) of the neutrophil-to-lymphocyte ratio, increased the risk of mortality.  Conclusions: The risk factors found agree with what has been described in the literature and allow the identification of vulnerable groups in whom monitoring and early identification of symptoms should be prioritized in order to reduce mortality.

scholarly journals Morbidity and mortality outcomes of COVID-19 patients with and without hypertension in Lagos, Nigeria: A retrospective cohort study

2020 ◽  
Author(s):  
Akin Osibogun ◽  
Akin Abayomi ◽  
Oluchi Kanma-Okafor ◽  
Jide Idris ◽  
Abimbola Bowale ◽  
...  
Keyword(s):  
Cohort Study ◽  
Critical Illness ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Outcome Data ◽  
Morbidity And Mortality ◽  
P Value ◽  
Hypertensive Patients ◽  
Increased Risk

Abstract Background: The current pandemic of coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown epidemiological and clinical characteristics that appear worsened in hypertensive patients. The morbidity and mortality of the disease among hypertensive patients in Africa have yet to be well described.Methods: In this retrospective cohort study all confirmed COVID-19 adult patients (≥18 years of age) in Lagos between February 27 to July 6 2020 were included. Demographic, clinical and outcome data were extracted from electronic medical records of patients admitted at the COVID-19 isolation centers in Lagos. Outcomes included dying, being discharged after recovery or being evacuated/transferred. Descriptive statistics considered proportions, means and medians. The Chi-square and Fisher’s exact tests were used in determining associations between variables. Kaplan–Meier survival analysis and Cox regression were performed to quantify the risk of worse outcomes among hypertensives with COVID-19 and adjust for confounders. P-value ≤0.05 was considered statistically significant.Results: A total of 2075 adults with COVID-19 were included in this study. The prevalence of hypertension, the most common comorbidity, was 17.8% followed by diabetes (7.2%) and asthma (2.0%). Overall mortality was 4.2% while mortality among the hypertensives was 13.7%. Severe symptoms and mortality were significantly higher among the hypertensives and survival rates were significantly lowered by the presence of an additional comorbidity to 50% from 91% for those with hypertension alone and from 98% for all other patients (P<0.001). After adjustment for confounders (age and sex), severe COVID-19and death were higher for hypertensives {severe/critical illness: HR=2.41, P=0.001, 95%CI=1.4–4.0, death: HR=2.30, P=0.001, 95%CI=1.2–4.6, for those with hypertension only} {severe/critical illness: HR=3.76, P=0.001, 95%CI=2.1–6.4, death: crude HR=6.63, P=0.001, 95%CI=3.4–1.6, for those with additional comorbidities}. Hypertension posed an increased risk of severe morbidity (approx. 4-fold) and death (approx. 7-fold) from COVID-19 in the presence of multiple comorbidities. Conclusion: The potential morbidity and mortality risks of hypertension especially with other comorbidities in COVID-19 could help direct efforts towards prevention and prognostication. This provides the rationale for improving preventive caution for people with hypertension and other comorbidities and prioritizing them for future antiviral interventions.

Retrospective cohort study of prognostic factors in patients with oral cavity and oropharyngeal squamous cell carcinoma

Head & Neck ◽  
2015 ◽  
Vol 38 (4) ◽  
pp. 536-541 ◽  
Author(s):  
José F. Carrillo ◽  
Liliana C. Carrillo ◽  
Ana Cano ◽  
Margarita C. Ramirez-Ortega ◽  
Jorge G. Chanona ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cohort Study ◽  
Prognostic Factors ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Oropharyngeal Squamous Cell Carcinoma

scholarly journals 1024. First Episode Infective Endocarditis in Persons Who Inject Drugs (PWIDs); A Retrospective Cohort Study

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S305-S305
Author(s):  
Laura Rodger ◽  
Dresden GlockerLauf ◽  
Esfandiar Shojaei ◽  
Adeel Sherazi ◽  
Brian Hallam ◽  
...  
Keyword(s):  
Cohort Study ◽  
Infective Endocarditis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
First Episode ◽  
Persons Who Inject Drugs ◽  
Cox Regression Analysis ◽  
Lower Survival ◽  
Valvular Surgery

Abstract Background Persons who inject drugs (PWID) represent a distinct demographic of patients with infective endocarditis (IE). Many centers do not perform valvular surgery on these patients due to concerns about poor outcomes. Methods Retrospective cohort study comparing PWID patients to non-PWID patients presenting between February 2007 and March 2016 in London, Ontario, among adult (&gt;18) inpatients with first episode IE. Results In 370 first episode IE cases, 53.9% occurred in PWIDs. PWID patients were younger (35.4 SD 10.0 vs. 59.4 SD 14.9) (P &lt; 0.001), more likely to have right-sided infection [125/202 (62%), vs. 16/168 (9.5%) (P &lt; 0.001)], and more often due to S. aureus (156/202 (77.3%) vs. 54/168 (32.1%), P &lt; 0.001). Myocardial and aortic root abscesses were less common in PWIDs [17/202 (8.4%) vs. 50/168 (30%) (P &lt; 0.01)]. There was no difference in the frequency of noncardiac complications. In total, 36.5% of patients were treated surgically with PWID patients less likely to undergo surgery [39/202 (19.3%) vs. 98/168 (58%) P &lt; 0.001]. Cox regression analysis identified the protective effect of cardiac surgery with regards to survival in all patients, with a hazard ratio of 0.49 (95% CI 0.31–0.76, P &lt; 0.001), as well as among PWIDs (HR 0.39, 95% CI 0.17–0.87, P = 0.02). Among all patients, lower survival was associated with older age (HR 1.03, 95% CI 1.00–1.05, P &lt; 0.001), injection drug use (HR 2.72, 95% CI 1.52–4.88, P &lt; 0.001), left-sided infection (HR 3.48, 95% CI 2.01–6.03, P &lt; 0.001), and bilateral infection (HR 3.19, 95% CI 1.45–7.01, P = 0.004). The lower survival of left-sided infection (HR 4.01, 95% CI 1.97–8.18, P &lt; 0.001) or bilateral infection (HR 6.94, 95% CI 2.39–20.2,P &lt; 0.001) was re-demonstrated in PWIDs. Conclusion This study identifies important clinical differences between PWIDs and nondrug users with respect to valve involvement, causative organism, complications, and management strategies. Our results highlight the important role of surgical treatment in a carefully selected PWID patient population. Disclosures All authors: No reported disclosures.

scholarly journals Clinicopathologic characteristics, laboratory parameters, treatment protocols, and outcomes of pancreatic cancer: a retrospective cohort study of 1433 patients in China

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e4893 ◽  
Author(s):  
Shuisheng Zhang ◽  
Xiaozhun Huang ◽  
Yuan Tian ◽  
Saderbieke Aimaiti ◽  
Jianwei Zhang ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cohort Study ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Distant Metastasis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Clinicopathologic Characteristics ◽  
Treatment Protocols ◽  
Laboratory Parameters

Objectives The prognosis of people with pancreatic cancer is extremely unfavorable. However, the prognostic factors remain largely undefined. We aimed to perform comprehensive analyses of clinicopathologic characteristics, laboratory parameters, and treatment protocols for exploring their role as prognostic factors of pancreatic cancer. Methods Patients diagnosed with pancreatic cancer and hospitalized at the China National Cancer Center between April 2006 and May 2016 were enrolled in this retrospective cohort study. Clinicopathologic characteristics, laboratory parameters, and treatment protocols were compared among patients at different stages of the disease. The association between these factors and overall survival (OS) was analyzed using the Kaplan–Meier method and Cox proportional hazards model. Results The present study included 1,433 consecutive patients with pancreatic cancer. Median OS was 10.6 months (95% confidence interval [CI] 9.8–11.3 months), with 1-, 3-, and 5-year survival rates of 43.7%, 14.8%, and 8.8%, respectively. Cox multivariate analysis findings identified the following factors as independent predictors of OS: gender (female vs male, hazard ratio 0.72, 95% CI [0.54–0.95]); elevated total bilirubin (TBil; 1.82, 1.34–2.47); elevated carbohydrate antigen 19-9 (CA19-9; 1.72, 1.17–2.54); tumor being located in pancreatic body and tail (1.52, 1.10–2.10); advanced T stage (T3-4 vs T1-2, 1.62, 1.15–2.27); lymph node metastasis (1.57, 1.20–2.07); distant metastasis (1.59, 1.12–2.27); the presence of surgical resection (0.53, 0.34–0.81); and the presence of systemic chemotherapy (0.62, 0.45–0.82). Conclusions Being male, elevated TBil and carcinoembryonic antigen, tumor being located in pancreatic body and tail, advanced T stage, lymph node and distant metastasis, the absence of surgical resection, and the absence of systematic chemotherapy were associated with worse OS in patients with pancreatic cancer.

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