scholarly journals Differences in mortality and suicidal behaviour between treated and never-treated people with schizophrenia in rural China

2009 ◽  
Vol 195 (2) ◽  
pp. 126-131 ◽  
Author(s):  
Mao-Sheng Ran ◽  
Cecilia Lai-Wan Chan ◽  
Eric Yu-Hai Chen ◽  
Wen-Jun Mao ◽  
Shi-Hui Hu ◽  
...  
Keyword(s):  
Suicidal Behaviour ◽  
Rural China ◽  
Middle Income ◽  
Follow Up Study ◽  
Duration Of Illness ◽  
All Cause Mortality ◽  
Mortality Ratio ◽  
Long Term Mortality

BackgroundMany people with schizophrenia remain untreated in the community. Long-term mortality and suicidal behaviour among never-treated individuals with schizophrenia in the community are unknown.AimsTo explore 10-year mortality and suicidal behaviour among never-treated individuals with schizophrenia.MethodWe used data from a 10-year prospective follow-up study (1994–2004) among people with schizophrenia in Xinjin County, Chengdu, China.ResultsThe mortality rate for never-treated individuals with schizophrenia was 2761 per 100 000 person-years during follow-up. There were no significant differences of rates of suicide and all-cause mortality between never-treated and treated individuals. The standardised mortality ratio (SMR) for never-treated people was 10.4 (95% CI 7.2–15.2) and for treated individuals 6.5 (95% CI 5.2–8.5). Compared with treated people, never-treated individuals were more likely to be older, poorer, have a longer duration of illness, marked symptoms and fewer family members.ConclusionsThe never-treated individuals have similar mortality to and a higher proportion of marked symptoms than treated people, which may reflect the poor outcome of the individuals without treatment. The higher rates of mortality, homelessness and never being treated among people with schizophrenia in low- and middle-income nations might challenge presumed wisdom about schizophrenia outcomes in these countries.

Blood pressure and long-term mortality in older patients: results of the Fiesole Misurata Follow-up Study

2020 ◽  
Vol 32 (10) ◽  
pp. 2057-2064
Author(s):  
Giulia Rivasi ◽  
Ersilia Lucenteforte ◽  
Giada Turrin ◽  
Daniela Balzi ◽  
Matteo Bulgaresi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Patients ◽  
Follow Up Study ◽  
Long Term Mortality

P0792FAT ATTENUATION INDEX OF CORONARY ARTERY IN COMPUTED TOMOGRAPHY ANGIOGRAPHY PREDICTS LONG-TERM OUTCOME IN CHRONIC KIDNEY DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Nam-Jun Cho ◽  
Soon hyo Kwon ◽  
Bo Da Nam ◽  
Kyoungin Choi
Keyword(s):  
Coronary Artery ◽  
Kidney Disease ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Adjusted Risk ◽  
Attenuation Index ◽  
All Cause Mortality ◽  
Long Term Mortality

Abstract Background and Aims Perivascular fat attenuation index (FAI) of coronary artery represents the degree of coronary inflammation. High coronary artery FAI in computed tomography angiography (CTA) is associated with increased all-cause and cardiac mortality in general population. However, the ability of the perivascular FAI using coronary CTA to predict long term outcome in chronic kidney disease (CKD) patients is unknown. Method This is a single center retrospective study. We analyzed coronary FAIs on CTA for CKD including patients with end stage renal disease (ESRD). The patients with percutaneous coronary intervention or coronary artery bypass graft were excluded. Mapping and analysis of perivascular FAI were performed around proximal three major coronary arteries. We assessed the prognostic value of FAI of CTA for long-term mortality (data from the Korean National Statistical Office) with Cox regression models, adjusted for age, sex, dialysis vintage, and clinical parameters. Results Between January 2012 and June 2018, 268 CKD patients were included. Mean age of this cohort was 64.5 ± 12.0 years, and 132 (49.3%) participants were men. 109 (44.7%) participants has diabetic kidney disease, and 179 (66.4%) participants were on hemodialysis. Median follow-up after coronary CTA was 29.2 (15.1 − 46.3) months. During follow-up, there were 43 (20.6%) deaths. The optimum cut-off value of FAI around the left anterior descending artery (LAD) was ascertained as -65.5 Hounsfield unit. The high perivascular FAI around the LAD was significantly associated with higher adjusted risk of all-cause mortality (hazard ratio, 2.15; 95% CI, 1.07–4.32). In ESRD subgroup, the high perivascular FAI group also has higher adjusted risk of all-cause mortality compared to low perivascular FAI group (hazard ratio, 2.43; 95% CI, 1.16–5.09). Conclusion The perivascular FAI around LAD predicts the long-term mortality in patients with CKD. This could provide the chance of early primary intervention in CKD patients.

Asymptomatic Females Are at Higher Risk for Perioperative TIA/Stroke and Males Are at Higher Risk for Long-Term Mortality after Carotid Artery Stenting: A Vascular Quality Initiative Analysis

2020 ◽  
Author(s):  
Young Erben ◽  
Yupeng Li ◽  
Joao A. Da Rocha-Franco ◽  
Rabih G. Tawk ◽  
Kevin M. Barrett ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Perioperative Period ◽  
Smoking History ◽  
Current Smoking ◽  
All Cause Mortality ◽  
Long Term Follow Up ◽  
Male Patients ◽  
Long Term Mortality

AbstractThe study aims to review the sex differences with respect to transient ischemic attack (TIA)/stroke and death in the perioperative period and on long-term follow-up among asymptomatic patients treated with carotid stenting (CAS) in the vascular quality initiative (VQI). All cases reported to VQI of asymptomatic CAS (ACAS) patients were reviewed. The primary end point was risk of TIA/stroke and death in the in-hospital perioperative period and in the long-term follow-up. The secondary end point was to evaluate predictors of in-hospital perioperative TIA/stroke and mortality on long-term follow-up after CAS. There were 22,079 CAS procedures captured from January 2005 to April 2019. There were 5,785 (62.7%) patients in the ACAS group. The rate of in-hospital TIA/stroke was higher in female patients (2.7 vs. 1.87%, p = 0.005) and the rate of death was not significant (0.03 vs. 0.07%, p = 0.66). On multivariable logistic regression analysis, prior/current smoking history (odds ratio = 0.58 [95% confidence interval or CI = 0.39–0.87]; p = 0.008) is a predictor of in-hospital TIA/stroke in females. The long-term all-cause mortality is significantly higher in male patients (26.9 vs. 15.7%, p < 0.001). On multivariable Cox-regression analysis, prior/current smoking history (hazard ratio or HR = 1.17 [95% CI = 1.01–1.34]; p = 0.03), coronary artery disease or CAD (HR = 1.15 [95% CI = 1.03–1.28]; p = 0.009), chronic obstructive pulmonary disease or COPD (HR = 1.73 [95% CI = 1.55–1.93]; p < 0.001), threat to life American Society of Anesthesiologists (ASA) class (HR = 2.3 [95% CI = 1.43–3.70]; p = 0.0006), moribund ASA class (HR = 5.66 [95% CI = 2.24–14.29]; p = 0.0003), and low hemoglobin levels (HR = 0.84 [95% CI = 0.82–0.86]; p < 0.001) are the predictors of long-term mortality. In asymptomatic carotid disease patients, women had higher rates of in-hospital perioperative TIA/stroke and a predictor of TIA/stroke is a prior/current history of smoking. Meanwhile, long-term all-cause mortality is higher for male patients compared with their female counterparts. Predictors of long-term mortality are prior/current smoking history, CAD, COPD, higher ASA classification of physical status, and low hemoglobin level. These data should be considered prior to offering CAS to asymptomatic female and male patients and careful risks versus benefits discussion should be offered to each individual patient.

scholarly journals Long-term mortality after massive, submassive, and low-risk pulmonary embolism

2019 ◽  
Vol 25 (2) ◽  
pp. 141-149 ◽  
Author(s):  
Rajesh Gupta ◽  
Zaid Ammari ◽  
Osama Dasa ◽  
Mohammed Ruzieh ◽  
Jordan J Burlen ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Mortality Rate ◽  
Tertiary Care ◽  
Low Risk ◽  
All Cause Mortality ◽  
Acute Pe ◽  
Long Term Mortality ◽  
Overall Mortality

Guidelines for management of normotensive patients with acute pulmonary embolism (PE) emphasize further risk stratification on the basis of right ventricular (RV) size and biomarkers of RV injury or strain; however, the prognostic importance of these factors on long-term mortality is not known. We performed a retrospective cohort study of subjects diagnosed with acute PE from 2010 to 2015 at a tertiary care academic medical center. The severity of initial PE presentation was categorized into three groups: massive, submassive, and low-risk PE. The primary endpoint of all-cause mortality was ascertained using the Centers for Disease Control National Death Index (CDC NDI). A total of 183 subjects were studied and their median follow-up was 4.1 years. The median age was 65 years. The 30-day mortality rate was 7.7% and the overall mortality rate through the end of follow-up was 40.4%. The overall mortality rates for massive, submassive, and low-risk PE were 71.4%, 44.5%, and 28.1%, respectively ( p < 0.001). Landmark analysis using a 30-day cutpoint demonstrated that subjects presenting with submassive PE compared with low-risk PE had increased mortality during both the short- and the long-term periods. The most frequent causes of death were malignancy, cardiac disease, respiratory disease, and PE. Independent predictors of all-cause mortality were cancer at baseline, age, white blood cell count, diabetes mellitus, liver disease, female sex, and initial presentation with massive PE. In conclusion, the diagnosis of acute PE was associated with substantial long-term mortality. The severity of initial PE presentation was associated with both short- and long-term mortality.

Expressed emotion in an 8 year follow-up

1997 ◽  
Vol 12 (3) ◽  
pp. 105-110 ◽  
Author(s):  
H Schulze Mönking ◽  
WP Hornung ◽  
K Stricker ◽  
G Buchkremer
Keyword(s):  
Global Assessment ◽  
Expressed Emotion ◽  
Causal Interpretation ◽  
Global Assessment Scale ◽  
Follow Up Study ◽  
Duration Of Illness ◽  
Living Together ◽  
Baseline Examination

SummaryThis study addresses the questions if and for which patients expressed emotion (EE) has a predictive validity in an 8 year follow-up study and if this is dependent on the residential form, especially on patients and relatives living together. Eight years after a baseline examination (Camberwell Family Interviews [CFI], global assessment scale [GAS], symptom score) 69 of 99 patients were reexamined. The number and duration of rehospitalizations as well as the symptom and GAS scores were recorded. These was no difference between outcome of high and low EE patients with a duration of illness of less than 4.5 years and for those living with partners. Patients from high EE parents with a longer duration of illness (> 4.5 years) at the outset of the study were significantly more often and longer in hospital. They had significantly higher symptom and GAS scores at the outset of the study and after 8 years. The EE effect was equal in the first and second 4 years of the follow-up and was independent from patients and parents living together. The results emphasize the significance of the EE index as a long-term predictor for the course of schizophrenic illness. The independence of the prediction from living together is an argument against a simple causal interpretation of the connection between EE and the course of schizophrenia.

scholarly journals Association of detected depression and undetected depressive symptoms with long-term mortality in a cohort of institutionalised older people

2016 ◽  
Vol 26 (2) ◽  
pp. 189-198 ◽  
Author(s):  
J. Damián ◽  
R. Pastor-Barriuso ◽  
E. Valderrama-Gama ◽  
J. de Pedro-Cuesta
Keyword(s):  
Depressive Symptoms ◽  
Nursing Homes ◽  
Life Expectancy ◽  
Hazard Ratio ◽  
Mortality Hazard ◽  
All Cause Mortality ◽  
Mortality Hazard Ratio ◽  
Long Term Mortality

Background.Studies on depression and mortality in nursing homes have shown inconclusive findings, and none has studied the role of detection. We sought to measure the association of depression with long-term all-cause mortality in institutionalised older people and evaluate a potential modification in the association by its detection status.Methods.We selected a stratified cluster sample of 591 residents aged 75 years or older (mean age 84.5 years) living in residential and nursing homes of Madrid, Spain, who were free of severe cognitive impairment at the 1998–1999 baseline interview. Mortality was ascertained until age 105 years or September 2013 (median/maximum follow-up 4.8/15.2 years) through linkage to the Spanish National Death Index. Detected depression was defined at baseline as a physician's diagnosis or antidepressant use, undetected depression as significant depressive symptoms (score of 4 or higher on the ten-item version of the Geriatric Depression Scale) without documented diagnosis or treatment, and no depression as the absence of diagnosis, treatment, and symptoms. Constant and age-dependent hazard ratios for mortality comparing detected and undetected depression with no depression were estimated using Cox models, and absolute years of life gained and lost using Weibull models.Results.The baseline prevalences of detected and undetected depression were 25.9 and 18.8%, respectively. A total of 499 participants died during 3575 person-years of follow-up. In models adjusted for age, sex, type of facility, number of chronic conditions, and functional dependency, overall depression was not associated with long-term all-cause mortality (hazard ratio 0.87, 95% confidence interval (CI): 0.70–1.08). However, compared with no depression, detected depression showed lower mortality (hazard ratio 0.63, 95% CI: 0.46–0.86), while undetected depression registered higher, not statistically significant, mortality (hazard ratio 1.35, 95% CI: 0.98–1.86). The median life expectancy increased by 1.8 years (95% CI: −3.1 to 6.7 years) in residents with detected depression and decreased by 6.3 years (95% CI: 2.6–10.1 years) in those undetected. Results were more marked in women than men and they were robust to the exclusion of antidepressants from the definition of depression and also to the use of a stricter cut-off for the presence of depressive symptoms.Conclusions.The long-term mortality risk associated with depression in nursing homes depends on its detection status, with better prognosis in residents with detected depression and worse in those undetected. The absolute impact of undetected depressive symptoms in terms of life expectancy can be prominent.

scholarly journals Long-term mortality predictors in pulmonary embolism

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
R Caldeira Da Rocha ◽  
R Fernandes ◽  
M Carrington ◽  
F Claudio ◽  
J Pais ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Troponin I ◽  
Cox Regression ◽  
Imaging Features ◽  
All Cause Mortality ◽  
History Of ◽  
Acute Pe ◽  
Long Term Mortality

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Acute Pulmonary embolism(PE)is a common and potentially fatal medical condition.In contemporary adult population,PE is associated with increased long-term mortality. Purpose Identify predictors of long-term all-cause mortality in patients(pts)admitted due to pulmonary embolism. Methods Retrospective single-center study of hospitalized pts with acute PE between 2015 and 2018.We evaluated comorbidities, admission(AD)presentation such as vitals(with hypotension defined as systolic blood pressure(SBP)&lt;90mmHg,and tachycardia as &gt;100ppm),lab analyses during in-hospital period,imaging features. Mortality(long-term &gt;3months)was also assessed using national registry of citizens.We performed uni and multivariate analysis to compare clinical characteristics of pts who died and who survived,using Cox regression and Kaplan-Meier methods.For the predictor age we assessed discrimination power and defined the best cut-off using area under the ROC curve(AUC)method. Results From 2015 to 2018,182 pts were admitted with diagnosis of pulmonary embolism,60% female with a mean age of 74 ± 13years old.Seventy-one(39%)pts died after a median follow-up of 26[10-41]months.Pts who died were older(80 ± 8 vs71 ± 14,p &lt; 0.001).The best cut-off value of age to predict mortality with 70%sensitivity and 61%specificity was 77years old(AUC 0.703;CI95% 0.63-0.78).Pts who died had more frequently history of neoplasia (21%vs 9%,p = 0.009).The remaining comorbidities were similar in both groups.Pts who did not survive were more frequently hypotensive(28% vs 13%, p = 0.008),had higher creatinine(1.1[0.8-1.4] vs 1.0[0.8-1.2], p = 0.002), lactate(2.3[1.8-2.8]vs 1.8[1.5-2.0],p = 0.007)and NT-proBNP(4694[1498-12300]vs2070[492-6660], p &lt; 0.001)at AD.Maximum troponin I (0.176[0.037-0.727]vs0.126[0.050-0.365]ng/mL,p = 0.012) was also higher than in pts who survived. After adjusting for history of neoplasia,ADcreatinine and maximum troponin I,we found that age (HR1.057;95%CI 1.01-1.11,p = 0.021),AD SBP &lt; 90(HR 2.215;95%CI 1.03-4.76,p = 0.041),lactate(HR 1.17;95%CI 1.01-1.36,p = 0.035)and NT-proBNP(HR 1.510;95%CI 1.250-1.780,p &lt; 0.001)were independent predictors of all-cause mortality. Conclusion In our cohort,the long-term all-cause mortality was 39%over a median  follow-up of 26[10-41]months.In patients with pulmonary embolism,aside from already identified age(especially when ≥70 years old)and NT-proBNP,lactate should also be considered when evaluating long-term prognosis. Furthermore,hypotension at admission increases by 2fold long-term mortality in patients who suffered acute PE.

Sign in / Sign up

Export Citation Format

Share Document