Acute kidney injury in head and neck cancer patients treated with chemoradiation with cisplatin: A single-center cohort study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17559-e17559
Author(s):  
Esther Van Meerten ◽  
Catherine Owusuaa ◽  
Ewout Hoorn ◽  
Esther Oomen De Hoop
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Univariate Analysis ◽  
Kidney Injury ◽  
Tertiary Center ◽  
Kdigo Guidelines ◽  
Independent Risk Factors

e17559 Background: Patients with advanced head and neck cancer (HNC) are commonly treated with chemoradiation with concomitant cisplatin. Acute kidney injury (AKI) is considered a dose-limiting toxicity of cisplatin. We aim to describe the incidence and risk factors of AKI. Methods: In our tertiary center, we retrospectively identified 261 patients with advanced HNC and adequate renal function who were treated curatively from 2008 to 2015 using radiotherapy and concurrent three-weekly cisplatin. Outcome was the first AKI episode, defined according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines as a ≥50% rise in serum creatinine compared to baseline. Several potential predictors were investigated by means of logistic regression analyses. Results: In our cohort (mean age 58 ± 8 years, 74.3% male), a total of 102 (39.1%) patients developed AKI. Factors significantly associated with AKI in the univariate analysis were: age, alcohol consumption, excessive smoking, diabetes, hypertension, diuretic use, renin-angiotensin-aldosterone-system blockers, and administration of furosemide when indicated during first cisplatin cycle. In the multivariable model smoking 6-25 and > 25 cigarettes per day (OR 1.85; 95% CI 1.01-3.39 and OR 3.22; 95% CI 1.34-7.70, respectively), diabetes (OR 2.58; 95% CI, 1.01-6.61), furosemide (OR 2.39; 95% CI, 1.36-4.18) , and hypertension (OR 2.79; 95% CI, 1.52-5.12) remained independent risk factors for AKI. Conclusions: The identified risk factors smoking, diabetes, and hypertension may have caused pre-existing kidney damage and therefore have predisposed to AKI. Co-administration of furosemide with cisplatin is a potentially reversible risk factor for AKI.

scholarly journals PO-057 Predicting risk of Acute Kidney Injury in head and neck cancer patients receiving chemoradiotherapy

2019 ◽  
Vol 132 ◽  
pp. 30-31
Author(s):  
S. Gaito ◽  
V.R. Kota ◽  
A. Abravan ◽  
K. Garcez ◽  
L.W. Lee ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Kidney Injury

scholarly journals Venous Thromboembolism Risk in Head and Neck Cancer: Significance of the Preoperative Platelet-to-Lymphocyte Ratio

2017 ◽  
Author(s):  
Tristan Tham ◽  
Lauren Rahman ◽  
Christina Persaud ◽  
Peter Costantino
Keyword(s):  
Risk Factors ◽  
Head And Neck Cancer ◽  
Venous Thromboembolism ◽  
Head And Neck ◽  
Neck Cancer ◽  
Oral Presentation ◽  
Univariate Analysis ◽  
Major Surgery ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio

Abstract (250 limit)ObjectiveWe aimed to investigate the association between the preoperative platelet-to-lymphocyte ratio (PLR) and venous thromboembolism (VTE) in head and neck cancer (HNC) patients undergoing major surgery.Study DesignRetrospective cohort studySettingAcademic tertiary hospital from 2011 to 2017Subjects and MethodsPatients with confirmed HNC undergoing major surgery were included in this study. The preoperative PLR was recorded for all patients. Known VTE risk factors, including age, sex, smoking, BMI, prior VTE, and anticoagulation were also recorded. Risk factors were screened in univariate analysis using Wilcoxon’s rank sum test and χ2 test (Bonferroni corrected). Significant covariates were subsequently included in a multivariate regression model. Bootstrap techniques were used to obtain credible confidence intervals (CI).ResultsThere were 306 patients enrolled with 7 cases of VTE (6 DVTs and 1 PE). On univariate analysis, length of stay (p = 0.0026), length of surgery (p = 0.0029), and PLR (p = 0.0002) were founded to have significant associations with VTE. A Receiver Operator Characteristic (ROC) curve was constructed, that yielded an AUROC of 0.905 (95% CI: 0.82 - 0.98). Using an optimized cutoff, the multivariate model showed that length of surgery (β 95% CI: 0.0001 - 0.0006; p = 0.0056), and PLR (β 95% CI: 5.3256 - 5.3868; p < 0.0001) were significant independent predictors of VTE.ConclusionThis exploratory pilot study has shown that PLR offers a potentially accurate risk stratification measure as an adjunct to current tools in VTE risk prediction, without additional cost to health systems.Oral PresentationThis data was presented as an oral presentation at the Annual American Academy of Otolaryngology – Head and Neck Surgery (AAO-HNSF) Meeting, 13th September 2017

scholarly journals The PCT to Albumin Ratio Predicts Mortality in Patients With Acute Kidney Injury Caused by Abdominal Infection-Evoked Sepsis

2021 ◽  
Vol 8 ◽  
Author(s):  
Lijuan Chen ◽  
Xiaoli Wu ◽  
Haiyan Qin ◽  
Hongchao Zhu
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Poor Prognosis ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Survival Group ◽  
Abdominal Infection ◽  
The Poor ◽  
Independent Risk Factors

Purpose: Considerable evidence suggests that inflammation and malnutrition are common in patients with acute kidney injury (AKI) and correlated with mortality of various diseases. Despite this, few studies have reported the underlying predictive effects of inflammatory and nutritional markers in combination on the mortality of AKI patients. Herein, we aimed to explore the values of PCT and CRP as well as the ratios of PCT/Alb and CRP/Alb in the poor prognosis of patients with sepsis-induced AKI.Patients and Methods: A total of 171 patients with AKI, caused by abdominal infection-evoked sepsis, were retrospectively studied and divided into a survival group (107 cases) and a non-survival group (64 cases). Univariate analysis was used to compare the clinical data of the two groups. Multivariate logistic regression analysis was used to analyze the independent risk factors of poor prognosis in patients with sepsis-induced AKI. The ROC curve was used to evaluate the diagnostic value of PCT, CRP, PCT/Alb, and CRP/Alb in the poor prognosis of patients with sepsis-induced AKI.Results: Univariate analysis revealed that the values of PCT, CRP, CRP/Alb, and PCT/Alb were significantly different between AKI survival and non-survival groups, and further analysis found that PCT and PCT/Alb were independent risk factors for poor prognosis in patients with sepsis-induced AKI after adjusting with age and gender. Of note, the predictive accuracy (0.864 vs. 0.807), specificity (83.2 vs. 69.2), and sensitivity (79.7 vs. 76.6) of PCT/Alb were all higher than that of the simple PCT.Conclusions: The ratio of PCT to Alb is an independent risk factor possessing a robust and accurate risk assessment for the poor prognosis of patients with sepsis-induced AKI, and it offers the potential to improve the management of this type of disease and a lower resultant mortality.

Factors Influencing the Development of Pneumonia in Patients With Head and Neck Cancer: A Meta-analysis

2020 ◽  
pp. 019459982093801
Author(s):  
Priyanka D. Reddy ◽  
Flora Yan ◽  
Shaun A. Nguyen ◽  
Cherie-Ann O. Nathan
Keyword(s):  
Risk Factors ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Subdistribution Hazard ◽  
Hazard Ratios ◽  
Independent Risk Factors ◽  
Male Sex

Objective The aim of this study was to identify factors that are associated with the occurrence of pneumonia in patients with head and neck cancer (HNC) after treatment. Data Sources PubMed, Scopus, OVID, and Cochrane Library from inception to November 26, 2019. Review Methods A systematic review in accordance with the PRISMA guidelines and an assessment of bias were performed. Included studies reported on the risk factors of pneumonia development after HNC treatment via odds ratios and subdistribution hazard ratios from regression analysis. Results Fifteen studies were included, comprising 30,962 patients with a mean age of 70 years (range, 19-95 years). Of these, 71.6% are male. The results of our study indicate that the following were independent risk factors contributing to the development of pneumonia: male sex, habitual alcohol consumption, poor oral hygiene before treatment, pretreatment dysphagia, hypopharynx and nasopharynx tumor sites, use of radiotherapy with or without chemotherapy versus surgery alone, addition of chemotherapy to radiotherapy, reirradiation, neck dissection, increased duration of tracheotomy, and use of sedatives for sleeping. Conclusion Multiple patient-, tumor-, and treatment-specific risk factors were identified in predicting pneumonia. Recognition of these risk factors early on may help prevent or at least detect pneumonia in this vulnerable group of patients.

scholarly journals Proteinuria as an independent risk factor for contrast-induced acute kidney injury and mortality in patients with stroke undergoing cerebral angiography

2016 ◽  
Vol 9 (5) ◽  
pp. 445-448 ◽  
Author(s):  
Yiming Tao ◽  
Wei Dong ◽  
Zhilian Li ◽  
Yuanhan Chen ◽  
Huaban Liang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Risk Factor ◽  
Cerebral Angiography ◽  
Independent Risk Factor ◽  
Estimated Glomerular Filtration Rate ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Independent Risk Factors

BackgroundThe correlation between proteinuria and contrast-induced acute kidney injury (CI-AKI) in patients with cerebrovascular disease is still unknown.ObjectiveTo determine whether proteinuria is a risk factor for CI-AKI and death in patients with stroke undergoing cerebral angiography.MethodsData from 2015 patients with stroke undergoing cerebral angiography between January 2009 and December 2013 were retrospectively collected. Clinical parameters were obtained from the hospital's computerized database. All variables were analyzed by univariate analysis and multivariate logistic regression analysis.ResultsCI-AKI was seen in 85 patients (4.2%). After adjustment for potential confounding risk factors, patients with proteinuria had a fivefold higher risk of CI-AKI than patients without proteinuria (OR=5.74; 95% CI 2.23 to 14.83; p<0.001). Other independent risk factors for CI-AKI were estimated glomerular filtration rate <60 mL/min/1.73 m2, anemia, and a high National Institute of Health Stroke Scale score. Proteinuria did not increase in-hospital mortality (OR=1.25; 95% CI 0.49 to 3.17; p=0.639) but did increase 1-year mortality (HR=2.30, 95% CI 1.55 to 3.41, p<0.001).ConclusionsProteinuria is an independent risk factor for CI-AKI and 1-year mortality in patients with stroke undergoing cerebral angiography. More attention should be paid to the development of CI-AKI in patients with stroke with proteinuria.

The Risk Factors of Head and Neck Cancer and Their General Patterns in Australia: A Descriptive Review and Update

2014 ◽  
Vol 33 (1) ◽  
pp. 45-57 ◽  
Author(s):  
Jagtar Singh ◽  
Ramya Ramamoorthi ◽  
Siddhartha Baxi ◽  
Rama` Jayaraj ◽  
Mahiban Thomas
Keyword(s):  
Risk Factors ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer
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