The independent factors associated with oxygen therapy in COVID-19 patients under 65 years old

Background The number of hospitalized young coronavirus disease 2019 (COVID-19) patients has increased significantly. However, specific data about COVID-19 patients under 65 years old who are admitted to the hospital are scarce. Methods The COVID-19 patients under 65 years old who were admitted to the hospital in Sichuan Province, Renmin Hospital of Wuhan University, and Wuhan Red Cross Hospital were included in this study. Demographic information, laboratory data and clinical treatment courses were extracted from electronic medical records. Risk factors associated with oxygen therapy were explored. Results Eight hundred thirty-three COVID-19 patients under 65 years old were included. Of the included patients, 29.4% had one or more comorbidities. Oxygen therapy was required in 63.1% of these patients, and the mortality was 2.9% among the oxygen therapy patients. Fever (odds ratio [OR] 2.072, 95% confidence interval [CI] 1.312–3.271, p = 0.002), dyspnea (OR 2.522, 95% CI 1.213–5.243, p = 0.013), chest distress (OR 2.278, 95% CI 1.160–4.473, p = 0.017), elevated respiratory rate (OR 1.114, 95% CI 1.010–1.228, p = 0.031), and decreased albumin (OR 0.932, 95% CI 0.880–0.987, p = 0.016) and globulin levels (OR 0.929, 95% 0.881–0.980, p = 0.007) were independent factors related to oxygen therapy. Conclusions Oxygen therapy is highly required in COVID-19 patients under 65 years old who are admitted to the hospital, but the success rate is high. Respiratory failure-related symptoms, elevated respiratory rate, low albumin and globulin levels, and fever at admission are independent risk factors related to the requirement of oxygen.

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Risk factors associated with failure of high-flow nasal cannula oxygen therapy in patients with severe COVID-19 in Wuhan, China

10.21203/rs.3.rs-37538/v1 ◽

2020 ◽

Author(s):

Xiao-huan Ma ◽

Fang Yin ◽

Jie Zhang ◽

Meng-yun Peng ◽

Hong Guan ◽

...

Keyword(s):

Risk Factors ◽

Respiratory Failure ◽

Oxygen Therapy ◽

Laboratory Data ◽

Male Gender ◽

High Flow ◽

Binary Logistic Regression Analysis ◽

Hypoxemic Respiratory Failure ◽

Factors Associated ◽

Independent Risk Factors

Abstract Background Acute hypoxemic respiratory failure is prevalent in severe Coronavirus Disease 2019 (COVID-19). High-flow nasal canula (HFNC) is currently the most common ventilation strategy for COVID-19 patients with respiratory failure. This study is to analyze the risk factors associated with high-flow nasal canula (HFNC) oxygen therapy failure in patients with severe COVID-19.Methods: In this single-center, retrospective, observational study, we enrolled patients with confirmed severe COVID-19 admitted to Renmin Hospital of Wuhan university (Wuhan, China) from 1 February 2020 to 26 March 26 2020. Epidemiological, clinical, and laboratory data, and treatments and outcomes upon hospital admission, were obtained from electronic medical records. Sequential organ failure assessment (SOFA) scores were calculated.Results: Of 54 patients with severe COVID-19, HFNC was successful in 28 (51.9%) and unsuccessful in 26 (48.1%). HFNC failure was seen more commonly in patients aged ≥60 years and in men. In addition, compared with patients successfully treated with HFNC, patients with HFNC failure had the following characteristics: higher percentage of fatigue and anorexia as well as cardiovascular disease; increased time from onset to diagnosis and SOFA scores; elevated body temperature, respiratory rate, and heart rate; more complications including ARDS, septic shock, myocardial damage, and acute kidney injury; increased neutrophil counts and prothrombin time; and decreased arterial partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2) (all P < 0.05). However, binary logistic regression analysis showed that only male gender and PaO2/FiO2 were independent risk factors significantly associated with HFNC failure (both, P < 0.05). Conclusion: Patients with severe COVID-19 had a high HFNC treatment failure rate. Male gender and decreased PaO2/FiO2 were independent risk factors associated with HFNC failure in severe COVID-19 patients.

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Risk factors associated with failure of high-flow nasal cannula oxygen therapy in patients with severe COVID-19 in Wuhan, China

10.21203/rs.3.rs-41316/v2 ◽

2021 ◽

Author(s):

Xiao-Huan Ma ◽

Meng-Meng An ◽

Fang Yin ◽

Jie Zhang ◽

Meng-Yun Peng ◽

...

Keyword(s):

Risk Factors ◽

Respiratory Failure ◽

Oxygen Therapy ◽

Laboratory Data ◽

High Flow ◽

Binary Logistic Regression Analysis ◽

Hypoxemic Respiratory Failure ◽

Acute Hypoxemic Respiratory Failure ◽

Factors Associated ◽

Independent Risk Factors

Abstract Background: Acute hypoxemic respiratory failure is prevalent in severe Coronavirus Disease 2019 (COVID-19). High-flow nasal canula oxygen therapy (HFNC) is currently one of the most common ventilation strategies for COVID-19 patients with respiratory failure. This study is to analyze the risk factors associated with HFNC failure in patients with severe COVID-19.Methods: In this single-center, retrospective, observational study, we enrolled patients with confirmed severe COVID-19 admitted to Renmin Hospital of Wuhan university (Wuhan, China) from 1 February 2020 to 26 March 26 2020. Epidemiological, clinical, and laboratory data, and treatments and outcomes upon hospital admission, were obtained from electronic medical records. Sequential organ failure assessment (SOFA) scores were calculated.Results: Of 54 patients with severe COVID-19, HFNC was successful in 28 (51.9%) and unsuccessful in 26 (48.1%). HFNC failure was seen more commonly in patients aged ≥60 years and in men. In addition, compared with patients successfully treated with HFNC, patients with HFNC failure had the following characteristics: higher percentage of fatigue and anorexia as well as cardiovascular disease; increased time from onset to diagnosis and SOFA scores; elevated body temperature, respiratory rate, and heart rate; more complications including ARDS, septic shock, myocardial damage, and acute kidney injury; increased C-reactive protein, neutrophil counts and prothrombin time; and decreased arterial partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2) (all P < 0.05). However, binary logistic regression analysis showed that only male, PaO2/FiO2 and SOFA scores were independent risk factors significantly associated with HFNC failure (all P < 0.05). Conclusion: Patients with severe COVID-19 had a high HFNC treatment failure rate. Male, low PaO2/FiO2 and SOFA scores were independent risk factors associated with HFNC failure in severe COVID-19 patients. However, studies with larger sample sizes or multi-center studies are warranted.

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Effect of Instruction on Preventing Delayed Bleeding after Colorectal Polypectomy and Endoscopic Mucosal Resection

Journal of Clinical Medicine ◽

10.3390/jcm10050928 ◽

2021 ◽

Vol 10 (5) ◽

pp. 928

Author(s):

Takuya Okugawa ◽

Tadayuki Oshima ◽

Keisuke Nakai ◽

Hirotsugu Eda ◽

Akio Tamura ◽

...

Keyword(s):

Risk Factors ◽

Medical Records ◽

Colorectal Polyp ◽

Control Group ◽

Single Center ◽

Antithrombotic Agents ◽

Delayed Bleeding ◽

Factors Associated ◽

Independent Risk Factors ◽

Continuous Use

Background: The frequency of delayed bleeding after colorectal polypectomy has been reported as 0.6–2.8%. With the increasing performance of polypectomy under continuous use of antithrombotic agents, care is required regarding delayed post-polypectomy bleeding (DPPB). Better instruction to educate endoscopists is therefore needed. We aimed to evaluate the effect of instruction and factors associated with delayed bleeding after endoscopic colorectal polyp resection. Methods: This single-center, retrospective study was performed to assess instruction in checking complete hemostasis and risk factors for onset of DPPB. The incidence of delayed bleeding, comorbidities, and medications were evaluated from medical records. Characteristics of historical control patients and patients after instruction were compared. Results: A total of 3318 polyps in 1002 patients were evaluated. The control group comprised 1479 polyps in 458 patients and the after-instruction group comprised 1839 polyps in 544 patients. DPPB occurred in 1.1% of polyps in control, and 0.4% in after-instruction. Instruction significantly decreased delayed bleeding, particularly in cases with antithrombotic agents. Hot polypectomy, clip placement, and use of antithrombotic agents were significant independent risk factors for DPPB even after instruction. Conclusion: The rate of delayed bleeding significantly decreased after instruction to check for complete hemostasis. Even after instruction, delayed bleeding can still occur in cases with antithrombotic agents or hot polypectomy.

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Risk factors associated with failure of high-flow nasal cannula oxygen therapy in patients with severe COVID-19 in Wuhan, China

10.21203/rs.3.rs-41316/v1 ◽

2020 ◽

Author(s):

Xiao-huan Ma ◽

Fang Yin ◽

Jie Zhang ◽

Meng-yun Peng ◽

Hong Guan ◽

...

Keyword(s):

Risk Factors ◽

Laboratory Data ◽

Kidney Injury ◽

Myocardial Damage ◽

Binary Logistic Regression ◽

Male Gender ◽

Binary Logistic Regression Analysis ◽

Factors Associated ◽

Independent Risk Factors ◽

Fraction Of Inspired Oxygen

Abstract Methods: In this single-center, retrospective, observational study, we enrolled patients with confirmed severe COVID-19 admitted to Renmin Hospital of Wuhan university (Wuhan, China) from 1 February 2020 to 26 March 26 2020. Epidemiological, clinical, and laboratory data, and treatments and outcomes upon hospital admission, were obtained from electronic medical records. Sequential organ failure assessment (SOFA) scores were calculated.Results: Of 54 patients with severe COVID-19, HFNC was successful in 28 (51.9%) and unsuccessful in 26 (48.1%). HFNC failure was seen more commonly in patients aged ≥60 years and in men. In addition, compared with patients successfully treated with HFNC, patients with HFNC failure had the following characteristics: higher percentage of fatigue and anorexia as well as cardiovascular disease; increased time from onset to diagnosis and SOFA scores; elevated body temperature, respiratory rate, and heart rate; more complications including ARDS, septic shock, myocardial damage, and acute kidney injury; increased neutrophil counts and prothrombin time; and decreased arterial partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2) (all P < 0.05). However, binary logistic regression analysis showed that only male gender and PaO2/FiO2 were independent risk factors significantly associated with HFNC failure (both, P < 0.05). Conclusion: Patients with severe COVID-19 had a high HFNC treatment failure rate. Male gender and decreased PaO2/FiO2 were independent risk factors associated with HFNC failure in severe COVID-19 patients.

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Risk Factors for Mortality in 220 Patients With COVID-19 in Wuhan, China: A Single-Center, Retrospective Study

Ear Nose & Throat Journal ◽

10.1177/0145561320972608 ◽

2020 ◽

pp. 014556132097260

Author(s):

Shuliang Zhou ◽

Sulin Mi ◽

Shuilian Luo ◽

Ying Wang ◽

Bin Ren ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Respiratory Rate ◽

Sofa Score ◽

Laboratory Data ◽

Older Age ◽

Univariable Analysis ◽

Multivariate Logistic Regression ◽

Failure Assessment ◽

Independent Risk Factors

Background: An outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 infection occurred in Wuhan, China, in December 2019. To date, the analysis of fatal cases and the risk factors for death have rarely been reported. Methods: In this study, 220 adult patients with confirmed and suspected COVID-19 were enrolled. Clinical characteristics, laboratory data, treatments, and complications were compared between 168 survivors and 52 nonsurvivors. Univariable analysis and multivariable logistic regression were used to investigate the risk factors for mortality. Results: A total of 220 patients (168 were discharged and 52 died in the hospital) were enrolled in the study. The median age of all patients was 59.5 (47.0-69.0) years, and the median age of patients who died was significantly older than that of patients who survived (70.5 vs 56.0 years, respectively; P < .001). According to multivariate logistic regression, older age (odds ratio: 1.09, 95% CI: 1.03-1.15; P = .001), initial Sequential Organ Failure Assessment (SOFA) score >2 (37.4, 9.4-148.0; P = .011), and respiratory rate >24 per minute (10.89, 1.47-80.67; P = .019) were independent risk factors for mortality. Conclusion: Clinical and laboratory parameters predicting poor prognosis including older age, baseline SOFA score >2, and respiratory rate >24 per minute were identified.

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Renal Replacement Therapy and Concurrent Fluconazole Therapy Increase Linezolid-Related Thrombocytopenia Among Adult Patients

10.21203/rs.3.rs-532929/v1 ◽

2021 ◽

Author(s):

Yueh-chun Hsu ◽

Szu-ying Chen ◽

Yung-jun Hung ◽

Yu-wei Huang

Keyword(s):

Risk Factors ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Medical Records ◽

Laboratory Data ◽

Binary Logistic Regression ◽

Limited Information ◽

Demographic Information ◽

Significant Difference ◽

Fluconazole Therapy

Abstract Background: Linezolid, an antibiotic used against gram-positive pathogens, has been reported to be associated with thrombocytopenia. However, limited information is available on susceptibility to thrombocytopenia after linezolid usage. We aimed to investigate the risk factors for linezolid-associated thrombocytopenia. Methods: We conducted a retrospective cohort study of patients aged ≥ 18 years who received linezolid for ≥ 5 d during hospitalization in 2019. Demographic information, hospitalized information and laboratory data were extracted from electronic medical records. Thrombocytopenia was defined as a platelet count of <100,000 cells/mm3 or a reduction from baseline ≥ 25%. Binary logistic regression and survival analyses were used to evaluate the risk factors for linezolid-associated thrombocytopenia.Results: A total of 98 patients were enrolled. Thrombocytopenia occurred in 52 patients (53.1%), with a median first presentation 9 d after initiation of linezolid. There was no significant difference in the mortality or proportion of platelet transfusions between patients with and without thrombocytopenia. A higher risk of linezolid-associated thrombocytopenia was found in patients who received renal replacement therapy (RRT) (OR 4.8 [1.4-16.4]), concurrent fluconazole (OR 3.5 [1.2-9.8]), or a longer duration of linezolid treatment (OR 1.1 [1.0-1.1]). Patients who received RRT or concurrent fluconazole therapy had a shorter median time to develop thrombocytopenia (with vs. without RRT: 8 vs. 15 d; with vs. without fluconazole: 11 vs. 15 d). Those who simultaneously received RRT and fluconazole had the shortest median of time (6.5 d) and the highest risk of developing thrombocytopenia (87.5%).Conclusions: Patients who received RRT, concurrent fluconazole treatment, or a longer-duration linezolid had a higher risk of developing linezolid-associated thrombocytopenia.

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Activities and risk factors associated with fall-related injuries among US Army soldiers

BMJ Military Health ◽

10.1136/bmjmilitary-2020-001564 ◽

2020 ◽

pp. bmjmilitary-2020-001564

Author(s):

Raina D Brooks ◽

T Grier ◽

B H Jones ◽

M C Chervak

Keyword(s):

Risk Factors ◽

Cross Sectional Study ◽

Cross Sectional ◽

Physically Active ◽

Us Army ◽

Factors Associated ◽

Younger Age ◽

Near Falls ◽

Independent Risk Factors ◽

Army Soldiers

IntroductionFalls/near falls are the second leading cause of hospitalisation and outpatient visits among US Army soldiers. While numerous studies have evaluated fall-related or near fall-related injuries among elderly adults, few have evaluated this association among young adults. The objective of this study is to describe the characteristics and risk factors associated with fall-related or near fall-related injuries among male US Army soldiers.MethodsThis is a cross-sectional study of male US Army Airborne Division soldiers (n=5187). Electronic surveys captured demographic, lifestyle, physical training (PT), fitness and injury data during spring/summer of 2016. Multiple logistic regression was used to identify independent risk factors of fall-related or near fall-related injuries, adjusting for potential confounders.ResultsPrimary findings indicated that activities and risk factors associated with fall-related or near fall-related injuries among soldiers included younger age (≤35 years), holding a job that required minimal lifting activities, slower 2-mile run times and not running during personal PT.ConclusionsThe findings from this study suggest that male US Army soldiers and other physically active men may benefit from (1) obtaining and/or maintaining higher aerobic endurance and muscular strength, and (2) training focused on preventing fall-related injuries during PT, road marching and sports/recreational activities. Moreover, prevention strategies and education should further target younger soldiers (≤35 years old), as younger age is not modifiable.

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Acute kidney injury and other factors associated with mortality in hiv-infected patients

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.64.06.509 ◽

2018 ◽

Vol 64 (6) ◽

pp. 509-517

Author(s):

Geraldo Bezerra da Silva Junior ◽

Sérgio Luiz Arruda Parente Filho ◽

Douglas de Sousa Soares ◽

Rodrigo da Nóbrega de Alencar ◽

Tiago Tomaz Teles Peixoto ◽

...

Keyword(s):

Risk Factors ◽

Laboratory Data ◽

Kidney Injury ◽

Developed Countries ◽

Cross Sectional Study ◽

Cross Sectional ◽

Respiratory Impairment ◽

Factors Associated ◽

Disseminated Histoplasmosis ◽

Related Mortality

SUMMARY OBJECTIVE: HIV-related mortality is still high, especially in developed countries. The aim of this study is to investigate factors associated to death in HIV-infected patients. METHODS: This is a cross-sectional study with all HIV adult patients admitted to a tertiary infectious diseases hospital in Fortaleza, Northeast Brazil, from January 2013 to December 2014. Patients were divided into two groups: survivors and non-survivors. Demo-graphical, clinical and laboratory data were compared and a logistic regression was performed in order to investigate risk factors for death. P values ≤0.05 were considered statistically significant. RESULTS: A total of 200 patients with mean age of 39 years were including in the study, 69.5% males. Fifteen patients (7.5%) died. Non-survivors presented a higher percentage of males (93.3 vs. 67.3%, p = 0.037). Non-survivors presented AKI (73.3 vs. 10.3%, p < 0.001), liver dysfunction (33.3 vs. 11.5, p = 0.031), dyspnea (73.3 vs. 33.0%, p = 0.002) and disorientation (33.3 vs. 12.4%, p = 0.025) more frequently. Non-survivors also had higher levels of urea (73.8 ± 52.7vs. 36.1 ± 29.1 mg/dL, p < 0.001), creatinine (1.98 ± 1.65 vs. 1.05 ± 1.07 mg/dL, p < 0.001), aspartate aminotransferase (130.8 vs. 84.8 U/L, p = 0.03), alanine aminotransferase (115.6 vs. 85.4 U/L, p = 0.045) and lactate dehydrogenase (LDH) (1208 vs. 608 U/L, p = 0.012), as well as lower levels of bicarbonate (18.0 ± 4.7 vs. 21.6 ± 4.6 mEq/L, p = 0.016) and PCO2 (27.8 ± 7.7 vs. 33.0 ± 9.3 mmHg, p = 0.05). In multivariate analysis, disorientation (p = 0.035, OR = 5.523, 95%CI = 1.130 – 26.998), dyspnoea (p = 0.046, OR = 4.064, 95%CI = 1.028 – 16.073), AKI (p < 0.001, OR = 18.045, 95%CI = 4.308 – 75.596) and disseminated histoplasmosis (p = 0.016, OR = 12.696, 95%CI = 1.618 – 99.646) and LDH > 1000 U/L (p = 0.038, OR = 4.854, 95%CI = 1.093 – 21.739) were risk factors for death.]CONCLUSION: AKI and disseminated histoplasmosis (DH) were the main risk factors for death in the studied population. Neurologic and respiratory impairment as well as higher levels of LDH also increased mortality in HIV-infected patients.

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Physiological and psychological factors associated with onset of high-altitude headache in Chinese men upon acute high-altitude exposure at 3700 m

Cephalalgia ◽

10.1177/0333102416646761 ◽

2016 ◽

Vol 37 (4) ◽

pp. 336-347 ◽

Cited By ~ 7

Author(s):

Wen-Yun Guo ◽

Shi-Zhu Bian ◽

Ji-Hang Zhang ◽

Qian-ning Li ◽

Jie Yu ◽

...

Keyword(s):

Risk Factors ◽

High Altitude ◽

Mood State ◽

Physical Work ◽

Internal Diameter ◽

Physical Work Capacity ◽

P Values ◽

Factors Associated ◽

Diastolic Velocity ◽

Independent Risk Factors

Aim We aimed to identify clinical characteristics and risk factors associated with onset of high-altitude headache (HAH) after acute exposure at 3700 m. Method In two hours, 163 individuals ascended by plane to 3700 m. Demographic information, physiological and psychological measurements, cognitive function, physical work capacity tests and profile of mood states within one week prior to the departure and within 24 hours after arrival were examined. Results HAH patients featured significantly higher vertebral artery diastolic velocity (Vd), heart rate (HR) and pulmonary artery diameter. HAH was also associated with a more negative mood state, including scores for tension anxiety, depression, hostility, fatigue and confusion, as well as lower vigor (all p values <0.05). Furthermore, negative emotions were positively related to HAH severity. HAH slightly decreased cognitive functioning. HR, Vd, lack of vigor, confusion and self-reported anxiety (all p values <0.05) were independent risk factors for HAH. We have identified three independent baseline predictors for HAH including internal diameter of the left ventricle (LVD), Athens Insomnia Scale (AIS) and confusion score. Conclusions Higher HR, Vd, confusion and self-reported anxiety and insufficient vigor were independent risk factors for HAH. Furthermore, higher baseline LVD, AIS and confusion score are independent predictors of HAH.

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