scholarly journals Iron deficiency diagnosed using hepcidin on critical care discharge is an independent risk factor for death and poor quality of life at one year: an observational prospective study on 1161 patients

Critical Care ◽  
2018 ◽  
Vol 22 (1) ◽  
Author(s):  
Sigismond Lasocki ◽  
◽  
Thibaud Lefebvre ◽  
Claire Mayeur ◽  
Hervé Puy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Critical Care ◽  
Risk Factor ◽  
Iron Deficiency ◽  
Prospective Study ◽  
Independent Risk Factor ◽  
Poor Quality ◽  
Observational Prospective Study ◽  
One Year

Association Between Elevated Hemolysis at Diagnosis and Early Mortality and Risk of Thrombosis In Paroxysmal Nocturnal Hemoglobinuria (PNH) Patients with Cytopenia

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4241-4241 ◽  
Author(s):  
Jin Seok Kim ◽  
Jong Wook Lee ◽  
Sung-Soo Yoon ◽  
Je-Hwan Lee ◽  
Deog-Yeon Jo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factor ◽  
Abdominal Pain ◽  
Conflicts Of Interest ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Poor Quality ◽  
Severe Fatigue ◽  
Life Threatening

Abstract Abstract 4241 Introduction: PNH is a rare, progressive and life threatening disease driven by chronic hemolysis leading to thrombosis, renal impairment, pain, severe fatigue, poor quality of life and premature death. Thrombosis is the leading cause of death (accounting for 40–67% of PNH-related deaths) and was recently identified as a significant risk factor for mortality in Asian PNH patients. Abdominal pain is a common and distressing symptom in PNH and has also been found to be risk factor for thrombosis and mortality in PNH patients. In PNH patients with concomitant aplasia/cytopenias (PNH-cytopenia), the symptoms associated with hemolytic PNH (i.e., severe fatigue and anemia) may be attributed to a hypocellular marrow, potentially masking the life threatening risk of hemolysis-mediated thrombosis and abdominal pain. Here we evaluate the correlation of clinical risk factors with hemolytic symptoms in cytopenic PNH patients. Methods: We retrospectively analyzed medical charts of 286 PNH patients from the National Data Registry in South Korea to identify aplastic PNH patients with evidence of hemolytic symptoms at the time of diagnosis. We defined PNH-cytopenia patients with evidence of at least 2 of the following hematological values at diagnosis: Hgb <10 g/dL; ANC <1.5×109/L; thrombocytopenia <100×109/L. Hemolysis was defined as LDH °Ã1.5 fold above the upper limit of normal (ULN). Results: The median patient age was 37 years (range: 8 to 88 years) and median PNH duration was 7.8 years. At diagnosis, median PNH granulocyte clone was 49% and LDH was 3.9-fold above ULN. Median platelet count was 99×109/L and median ANC was 1.2×109/L, 21% with ANC <1.0×109/L. PNH-cytopenia was identified at diagnosis in 42% of PNH patients. PNH-cytopenic patients experienced a similar prevalence of hemolytic symptoms and mortality compared to PNH patients with no evidence of cytopenia (PNH) (see table below). Thrombosis was equally prevalent in PNH-cytopenia compared to PNH (12% vs18%; P=0.175). Abdominal pain was equally prevalent in PNH-cytopenia and PNH (52% vs 42%; P=0.112) and there was similar mortality between the 2 groups (13% vs 11%; P=0.631). There was a significantly higher prevalence of mortality (14% vs 4%; p=0.048), thrombosis (22% vs 4%; p=0.003) and abdominal pain (53% vs 32%; p=0.007) in patients with elevated hemolysis (°Ã LDH 1.5 above ULN) compared to patients without hemolysis. We found that 69% of PNH-cytopenia patients demonstrated elevated hemolysis at diagnosis. Thrombosis was identified in 17% of PNH-cytopenia patients with elevated hemolysis compared to 3% with no evidence of elevated LDH (p=0.051); abdominal pain (59% vs 32%; p= 0.012) and death (16% vs 3%; p=0.070) were higher in PNH-cytopenia patients with hemolysis compared to PNH-cytopenia patients without hemolysis. CONCULSION: These data demonstrate that the presence of hemolysis at diagnosis is associated with of life-threatening thrombosis, poor quality of life, and mortality in PNH patients. Despite the evidence of hypoplasia, PNH-cytopenia patients with hemolysis demonstrate a higher risk of life-threatening thrombosis, pain, and mortality. These data indicate that hemolysis is a potential risk factor for life- threatening complications independent of the presence of cytopenia in patients with PNH. Treatment for PNH patients with cytopenias should focus on both controlling hemolysis as well as improving hypoplasia. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Quality of Life After a Successful Femoropopliteal/Crural Reconstruction for Critical Leg Ischaemia—A One-year Prospective Study

EJVES Extra ◽  
2004 ◽  
Vol 8 (4) ◽  
pp. 95-97
Author(s):  
C. Wann-Hansson ◽  
R. Klevsgård ◽  
B. Risberg ◽  
I.R. Hallberg ◽  
A. Lundell
Keyword(s):  
Quality Of Life ◽  
Prospective Study ◽  
One Year

scholarly journals Quality of Life for Patients with Esophageal/Gastric Cardia Precursor Lesions or Cancer: A One-year Prospective Study

2015 ◽  
Vol 16 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Ying Wen ◽  
Xiong-Fei Pan ◽  
Wen-Zhi Huang ◽  
Zhi-Mei Zhao ◽  
Wen-Qiang Wei ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prospective Study ◽  
Gastric Cardia ◽  
Precursor Lesions ◽  
One Year

scholarly journals One Year Survival and Quality of Life in Patients Successfully Discharged From Neuro Critical Care Unit

2017 ◽  
Vol 15 (3) ◽  
pp. 249-258
Author(s):  
Maryam Poursadeghfard ◽  
Kamal Bastani ◽  
Tahereh Poursadeghfard ◽  
Sina Karamimagham ◽  
Sadegh Izadi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Critical Care ◽  
Critical Care Unit ◽  
One Year

Abstract 124: Recovery From Acute Myocardial Infarction in China: A Report From China PEACE Prospective Study of Acute Myocardial Infarction

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Yuan Lu ◽  
Jiamin Liu ◽  
Yongfei Wang ◽  
John Welsh ◽  
Haibo Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Prospective Study ◽  
Poor Quality ◽  
Chinese Patients ◽  
Important Improvement ◽  
Angina Frequency ◽  
Related Quality

Introduction: Despite a dramatic increase in the incidence of acute myocardial infarction (AMI) in China, little is known about patient’s health status in the year following discharge. We studied the change in angina frequency and angina-related quality of life at 1 year after AMI among Chinese patients. Methods: Among 3,336 patients admitted for AMI to 53 hospitals from December 2012 to May 2014 in the China PEACE Prospective Study of Acute Myocardial Infarction, Angina frequency and angina-related quality of life were assessed with the Seattle Angina Questionnaire (SAQ) at the time of hospitalization and 1 year later. Scores ranged from 0 to 100 points, with higher scores indicating fewer symptoms and better quality of life. We categorized both 1-year scores and changes in scores to support clinical interpretability. We considered a clinically poor outcome at 1 year to be an angina frequency score ≤ 60 (daily/weekly angina) or quality of life score ≤ 50 (poor/fair quality of life). A 1-year change in score ≥ 5 was improvement, a change between -5 and 5 was interpreted as no change, and ≤ -5 was interpreted as being significantly worse at 1 year than before the AMI. Results: Participants’ average age was 60.6 years (±11.9) and 22.8% were women. The response rate was about 75% and non-responders had similar characteristics compared with responders. At baseline, the mean scores were 86.3±21.9 for angina frequency and 66.7±24.0 for quality of life, with 16.3% having daily/weekly angina and 38.8% poor quality of life. One year later, 36.3% of patients had had a clinically important improvement in angina, 49.0% had no change, and 14.7% had worse symptoms. Similarly, 52.7% experienced a clinically important improvement in quality of life, 18.2% had no change, and 29.1% had worse quality of life. At 1 year after AMI, 5.5% of patients still had severe angina symptoms and 20.9% had poor quality of life. Conclusion: There is substantial variability in Chinese patients’ symptom and quality of life recovery after AMI and more work is needed to understand the causes of this variability and how best to improve symptoms and quality of life after AMI in China.

Abstract 278: The China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Prospective Study of Acute Myocardial Infarction: Study Design

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Jing Li ◽  
Rachel P Dreyer ◽  
Xi Li ◽  
Xue Du ◽  
Nicholas S Downing ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Risk Factor ◽  
Prospective Study ◽  
Patient Experience ◽  
Risk Factor Control

Background: The incidence of acute myocardial infarction (AMI) is growing rapidly in China, but there is limited information about the patient experience in the post-acute period. Specifically, long-term outcomes and patient-reported outcomes (PROs), including quality of life, symptoms and mood, after AMI, have not been systematically studied in China. Objectives: To conduct a nationwide prospective study following patients after AMI that 1) measures long-term clinical outcomes, PROs, cardiovascular risk factor control and adherence to medications for secondary prevention; and 2) identifies patient characteristics and hospital attributes that are associated with these outcomes. Methods: The China PEACE Prospective Study of AMI has recruited 4000 consecutive patients from 55 hospitals across China and is following them for 1-year. The first patient was enrolled in December 2012, and the last follow-up visit is scheduled for June 2015. After obtaining informed consent from patients, we abstracted details of their medical history, treatment, and in-hospital outcomes from medical charts. We conducted comprehensive baseline interviews characterizing patient demographics, risk factors, clinical presentation, and healthcare utilization. In addition, we used validated PRO instruments to measure quality of life, symptoms, mood, sleep, cognition and sexual activity. Follow-up interviews, measuring PROs, medication adherence and risk factor control were conducted at 1-, 6-, and 12-months after discharge. At these interviews, patients were asked to self-report major health events and to provide supporting materials (e.g., hospital discharge record for a readmission), which were subsequently validated by a National Coordinating Center. Blood and urine samples were obtained at baseline and 12-month follow-up, and stored for further biomarker analysis and genetic studies. To complement these patient-level data, we surveyed participating hospitals to characterize their facilities, processes and organizational learning culture. Together, these data will be used to identify factors associated with various outcomes following AMI. Conclusion: This study is uniquely positioned to generate new information regarding patient experience and determinants of outcomes after AMI in China.

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