scholarly journals Prognostic factors of chronic pulmonary aspergillosis: A retrospective cohort of 264 patients from Japan

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249455
Author(s):  
Yuya Kimura ◽  
Yuka Sasaki ◽  
Junko Suzuki ◽  
Jun Suzuki ◽  
Hiroshi Igei ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Retrospective Cohort ◽  
Poor Prognosis ◽  
Survival Rates ◽  
Pulmonary Aspergillosis ◽  
Lower Serum ◽  
Proportional Analysis ◽  
The Poor ◽  
Chronic Pulmonary Aspergillosis ◽  
Male Sex

Background Chronic pulmonary aspergillosis (CPA) develops in various underlying pulmonary conditions. There is scarce data evaluating interstitial lung disease (ILD)/abnormalities (ILA) as such conditions, and it has not been explored much whether non-tuberculous mycobacterial pulmonary disease (NTM-PD) is a prognostic factor for mortality in CPA patients. Few reports had investigated prognostic factors of CPA including underlying pulmonary conditions. Objectives To explore prognostic factors of CPA including pulmonary conditions. Methods We conducted a retrospective cohort study of 264 CPA patients from a center for pulmonary aspergillosis in Japan. Results Survival rates were 78.7%, 61.0%, and 47.4% at 1, 3, and 5 years, respectively. Of 264 patients, 53 (20.1%) and 87 (33.1%) were complicated with ILA and NTM-PD. Several independent prognostic factors were identified by multivariate Cox proportional analysis: ILA (HR 1.76, 95%CI 1.06–2.92, p = 0.029), age (1.05, 1.02–1.08, p<0.001), male sex (2.48, 1.34–4.59, p = 0.004), body mass index of <18.5 kg/m2 (1,87, 1.20–2.90, p = 0.005), presence of aspergilloma (1.59, 1.04–2.45, p = 0.033), and lower serum albumin (0.56, 0.38–0.83, p = 0.004). NTM-PD was not associated with higher mortality (0.85, 0.52–1.38, p = 0.51). Conclusions The poor prognosis of CPA and several prognostic factors were revealed. Early diagnosis and intervention is required with reference to such factors.

scholarly journals Sepsis in the Emergency Room: Which are the Poor Prognostic Factors?

2021 ◽  
Vol 18 (1) ◽  
pp. 11-21
Author(s):  
Sebastian Dogaru ◽  
Caius Bogdan Teușdea ◽  
Florea Purcaru
Keyword(s):  
Prognostic Factors ◽  
Retrospective Cohort ◽  
Poor Prognosis ◽  
Clinical Care ◽  
Single Center ◽  
Specific Patient ◽  
The Poor ◽  
Huge Impact ◽  
The Impact ◽  
Single Center Observational Study

Abstract Background. Understanding the underlying cause of mortality in sepsis has broad implications for both trials design and clinical care. A one-size-fits-it-all treatment without considering underlying comorbidities and particularities of a specific patient may have a huge impact on prognosis. Materials and methods. We performed a retrospective, single center observational study of patients admitted in Emergency Department taking into account the suspicion of an infection, serious enough to produce a systemic inflammatory response syndrome. Of this population, we selected the septic patient (Sepsis-3 definition) and studied the impact of comorbidities on prognosis. Results. 125 patients were included. We found that institutionalized patient and respiratory insufficiency were the factors with the biggest impact on prognosis. Close to that, the age was a factor to be taken into account when discussing about prognosis. Other factors as malignancy, diabetes mellitus, cardiac and renal failure were not associated with ominous prognosis, although may have an impact. Two scores (MEDS and NEWS2) and a biomarker were also found to be useful when making a prognosis in such patients. Conclusions. In this retrospective cohort, the institutionalized patient and patients with with respiratory have poor prognosis, while in other diseases, MEDS, NEWS2 and presepsin were reliable prognostic factors.

scholarly journals Survival and prognostic factors in HIV-infected adults treated with Antiretroviral Therapy in a Malaysian referral hospital: A retrospective cohort study

2019 ◽  
Author(s):  
Lee Sing Chet ◽  
Siti Azrin Ab Hamid ◽  
Norsa'adah Bachok ◽  
Suresh Kumar Chidambaram
Keyword(s):  
Overall Survival ◽  
Cohort Study ◽  
Prognostic Factors ◽  
Antiretroviral Therapy ◽  
Haemoglobin Level ◽  
Retrospective Cohort ◽  
Survival Rates ◽  
Baseline Haemoglobin ◽  
History Of ◽  
Overall Survival Rates

Abstract Background: It is well established that antiretroviral therapy (ART) is beneficial in reducing the mortality among patients with human immunodeficiency virus (HIV). In Malaysia, there is lack of study and information regarding the overall survival rates and prognostic factors for survival in HIV-infected adults treated with ART. Therefore, this study aimed to assess and compare the survival rates as well as to identify the prognostic factors for survival among HIV adults in Malaysia.Methods: A retrospective cohort study was conducted by reviewing the medical records of HIV patients who started ART between year 2007 and 2016 at a tertiary referral hospital in Malaysia. ART-naive adults aged 15 years and above were included and those who were transferred out were excluded. After applying inclusion and exclusion criteria, there were 339 cases eligible in this study. Systematic sampling method was applied. Kaplan Meier survival curve and log-rank test were used to compare the overall survival rates. Cox proportional hazards regression was applied to determine the prognostic factors for survival.Results: The estimated overall survival rates were 95.9%, 93.8%, 90.4%, 84.9%, and 72.8% at 6 months, 1 year, 3 years, 5 years and 10 years, respectively. The overall survival rates were significantly different according to age group (p<0.001), employment status (p<0.001), transmission mode (p=0.003), and history of illicit drug use (p=0.017), baseline CD4 cell count (p<0.001), baseline haemoglobin level (p<0.001), tuberculosis co-infection (p<0.001), hepatitis co-infection (p=0.008), first NRTI (p<0.001) and history of defaults (p=0.021). Based on multiple Cox regression, patients who were anaemic had 3.76 times (95% CI: 1.97, 7.18; p<0.001) higher hazard of death than their non-anaemic counterparts. The hazard risk was 2.09 times (95% CI: 1.10, 3.96; p=0.024) higher among HIV patients co-infected with tuberculosis compared to those who were not. Conclusion: Overall survival rates were higher than low-income countries but lower than in high-income countries, and comparable with middle-income countries. Low baseline haemoglobin level and tuberculosis co-infection were strong prognostic factors for HIV survival

scholarly journals ALDH3B1 Is an Independent Prognostic Biomarker of Lung Adenocarcinoma

2020 ◽  
Vol 19 ◽  
pp. 153303382094601
Author(s):  
Hongmei Sun ◽  
Mingying Zhang ◽  
Li Li ◽  
Zongwen Huang
Keyword(s):  
Lung Cancer ◽  
Prognostic Factors ◽  
Propensity Score ◽  
Lung Adenocarcinoma ◽  
Propensity Score Matching ◽  
Aldehyde Dehydrogenase ◽  
Tumor Size ◽  
Poor Prognosis ◽  
Prognostic Biomarker ◽  
The Poor

Background: Lung cancer is the leading cause of cancer-related death, and adenocarcinoma is the most common type of lung cancer. Although emerging evidence implicates the role of several aldehyde dehydrogenases in cancer progression, the expression and clinical significance of aldehyde dehydrogenase 3B1 in lung adenocarcinoma has never been studied. Materials: In our study, the expression of aldehyde dehydrogenase 3B1 in 250 cases of lung adenocarcinoma was detected with immunohistochemistry, and the patients were further divided into subgroups with different aldehyde dehydrogenase 3B1 expression. Using real-time polymerase chain reaction, we investigated the aldehyde dehydrogenase 3B1 messenger RNA in 20 lung adenocarcinoma and paired normal lung tissues. With the χ2 test, we evaluated the clinical significance of aldehyde dehydrogenase 3B1 by analyzing its correlation with the clinicopathological factors. Propensity score matching was performed to balance the baseline of cohort. With univariate and multivariate analyses, we screened the prognostic factors of lung adenocarcinoma and identified the independent prognostic factors before and after the propensity score matching. Results: Aldehyde dehydrogenase 3B1 expression was significantly associated with the sex and age of patients, tumor size, and histological grade. High expression of aldehyde dehydrogenase 3B1 predicted the poor prognosis ( P = .003). Moreover, male patients ( P = .020), large tumor size ( P = .009), advanced T stage ( P = .001), positive lymphatic invasion ( P < .001), and advanced tumor–node–metastasis stage ( P < .001) were all the prognostic factors for unfavorable outcome. Aldehyde dehydrogenase 3B1 was an independent prognostic biomarker of lung adenocarcinoma, indicating the poor prognosis. In addition, after balancing the baseline characteristics by propensity score matching, we also demonstrated that aldehyde dehydrogenase 3B1 was an independent prognostic biomarker of lung adenocarcinoma ( P = .007). Conclusions: Aldehyde dehydrogenase 3B1 was an independent prognostic biomarker of lung adenocarcinoma, indicating the unfavorable prognosis. Postoperative detection of aldehyde dehydrogenase 3B1 would help stratify the high-risk patients with lung adenocarcinoma and guide individual treatment.

PS02.032: PRETREATMENT INFLAMMATORY STATUS INFLUENCES THE PROGNOSIS OF CT4B ESOPHAGEAL CARCINOMA PATIENTS UNDERGOING DEFINITIVE CHEMORADIOTHERAPY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 129-129
Author(s):  
Kotaro Sugawara ◽  
Koichi Yagi ◽  
Masato Nishida ◽  
Hiroharu Yamashita ◽  
Yasuyuki Seto
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Esophageal Carcinoma ◽  
Poor Prognosis ◽  
Conflicts Of Interest ◽  
Survival Rates ◽  
Clinical Staging ◽  
Definitive Chemoradiotherapy ◽  
Inflammatory Status ◽  
Overall Survival Rates

Abstract Background The outcome of definitive chemoradiotherapy (dCRT) for patients with cT4b esophageal carcinoma (EC) remains poor. Also, few studies focused on the prognostic factors in cT4b EC patients undergoing dCRT. Methods 80 patients undergoing dCRT for cT4b EC between 2006 and 2016 were retrospectively reviewed. All were in ECOG-PS 0–1. For evaluation of the pretreatment status, we employed demographic data, BMI, inflammatory marker (CRP), nutritional marker (Alb, prognostic nutritional index (PNI)) and tumor factors (clinical staging, pretreatment stenosis, tumor marker). Results There were 62 men with a mean age of 65 years (range, 41–83 years). 77 patients were squamous cell carcinoma, while 3 were adenocarcinoma. There were 12 (15%) patients with cM1 (lym) status. 36 (45.0%) patients had esophageal stenosis. 70 patients had cN + before dCRT, while 22 had cN + after dCRT. 30 patients (37.5%) had a CRP > 10 mg/l before dCRT, while 15 patients (18.8%) were in poor-nutritional status (PNI < 40). Of 80 patients, 1 patient gave up the treatment developing cerebral infarction. We analyzed survival in the 79 patients completing dCRT. Esophageal perforations were occurred in 5 (6.3%) patients. The 1- and 3-year overall survival rates were 59.8% and 38.3%, respectively. Salvage surgery was performed in 29 (36.3%) patients. R0 resection was achieved in 20 (69.0%) patients. Surgery-related death was developed in 3 patients. Pathological complete response was found in 10 (34.5%) patients. The 1- and 3-year overall survival rates of these 29 patients were 64.3% and 40.5%, respectively. Lastly, we evaluated prognostic factors in 79 patients. In univariable analysis, PNI < 40 (HR 2.43, 95% CI 1.19–4.63, P = 0.02), CRP ≥ 10 mg/l (HR 2.21, 95% CI 1.23–3.95, P = 0.01), pretreatment stenosis (HR 1.68, 95% CI 0.94–3.00, P = 0.08), cN + status after dCRT (HR 1.84, 95% CI 0.98–3.33, P = 0.06) were associated with poor prognosis. Subsequent multivariable Cox proportional hazards model revealed that CRP ≥ 10 mg/l (HR 2.00, 95% CI 1.03–3.81, P = 0.04) and cN + status after dCRT (HR 2.02, 95% CI 1.05–3.73, P = 0.03) were both independent risk factors for poor prognosis. Conclusion The outcome of dCRT for cT4b EC is acceptable. Pretreatment inflammatory status significantly influences the prognosis of patients undergoing dCRT. Disclosure All authors have declared no conflicts of interest.

Prognostic Factors for Mortality in Chronic Pulmonary Aspergillosis -Experience in Japan-

2021 ◽  
Author(s):  
Hitomi Hirano ◽  
Kenji Nemoto ◽  
Kai Kawashima ◽  
Hisayuki Oshima ◽  
Yuki Yabuuchi ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis

Poor Prognostic Factors after Repeat Hepatectomy for Recurrent Hepatocellular Carcinoma in the Modern Era

2012 ◽  
Vol 78 (4) ◽  
pp. 419-425 ◽  
Author(s):  
Eiji Tsujita ◽  
Yo-Ichi Yamashita ◽  
Kazuki Takeishi ◽  
Ayumi Matsuyama ◽  
Shin-Ichi Tsutsui ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Survival Rates ◽  
Repeat Hepatectomy ◽  
Recurrent Hepatocellular Carcinoma ◽  
The Poor ◽  
Estimated Blood Loss ◽  
Poor Outcomes ◽  
Overall Survival Rates

The purpose of this study was to determine the poor prognostic factors after repeat hepatectomy (Hx) in patients with recurrent hepatocellular carcinoma (HCC). Overall survival rates and clinicopathological variables in 112 patients with repeat Hx from 1992 to 2010 were compared with those in 531 patients who underwent a primary Hx. To clarify the poor prognosis factors after repeat Hx, survival data among 112 patients were univariately and multivariately analyzed. Overall survival after repeat Hx was similar for that of the patients who underwent a primary Hx. The mean age of repeat Hx group was significantly higher, and a well-preserved liver function was recognized than the primary Hx group. Multivariate analysis revealed that: 1) indocyanine green retention rate at 15 minutes; 2) disease-free interval; 3) tumor size; 4) portal vein invasion at primary Hx; 5) gender; and 6) estimated blood loss to be an independent and significant poor prognostic factors. The overall 3-year postrecurrence overall survival rates were 100, 91.3, 59.6, and 0 per cent at risk number (R) R0, R1/2, R3, R4, respectively ( P < 0.05). Repeat Hx provided a good compatible prognosis with primary Hx. In our findings, five risk factors to predict poor outcomes after repeat Hx were useful. Patients with recurrent HCC do not have universally poor outcomes, and our simple scoring system using five poor prognostic factors could serve to advise the prognosis and the potential benefit for patient selection about repeat Hx.

scholarly journals Nomograms predict survival outcome of Klatskin tumors patients

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8570
Author(s):  
Feng Qi ◽  
Bin Zhou ◽  
Jinglin Xia
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Intrahepatic Cholangiocarcinoma ◽  
Poor Prognosis ◽  
Survival Rates ◽  
Klatskin Tumor ◽  
Tumor Patients ◽  
Klatskin Tumors

Objective Klatskin tumors are rare, malignant tumors of the biliary system with a poor prognosis for patient survival. The current understanding of these tumors is limited to a small number of case reports or case series; therefore, we examined prognostic factors of this disease. Methods A population cohort study was conducted in patients selected from the Surveillance, Epidemiology, and End Results (SEER) database with a Klatskin tumor that was histologically diagnosed between 2004 to 2014. Propensity-matching (PSM) analysis was performed to determine the overall survival (OS) among those with a Klatskin tumor (KCC), intrahepatic cholangiocarcinoma (ICCA), or hepatocellular carcinoma (HCC). The nomogram was based on 317 eligible Klatskin tumor patients and its predictive accuracy and discriminatory ability were determined using the concordance index (C-index). Results Kaplan-Meier analysis showed that patients with Klatskin tumors had significantly worse overall survival rates (1-year OS = 26.2%, 2-year OS = 10.7%, 3-year OS = 3.4%) than those with intrahepatic cholangiocarcinoma (1-year OS = 62.2%, 2-year OS = 36.4%, 3-year OS = 19.1%, p < 0.001) or hepatocellular carcinoma (1-year OS = 72.4% , 2-year OS = 48.5%, 3-year OS = 36.2%, p < 0.001). A poor prognosis was also significantly associated with older age, higher grade, SEER historic stage, and lymph node metastasis. Local destruction of the tumor (HR = 0.635, 95% CI [0.421–0.956], p = 0.03) and surgery (HR = 0.434, 95% [CI 0.328–0.574], p < 0.001) were independent protective factors. Multivariate Cox analysis showed that older age, SEER historic stage, and lymph node metastases (HR = 1.468, 95% CI [1.008–2.139], p = 0.046) were independent prognostic factors of poor survival rates in Klatskin tumor patients, while cancer-directed surgery was an independent protective factor (HR = 0.555, 95% CI [0.316–0.977], p = 0.041). The prognostic and protective factors were included in the nomogram (C-index for survival = 0.651; 95% CI [0.607–0.695]). Conclusions The Klatskin tumor group had poorer rates of OS and cancer-specific survival than the ICCA and HCC groups. Early detection and diagnosis were associated with a higher rate of OS in Klatskin tumor patients.

Prognostic factors in patients with advanced renal carcinoma.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 391-391
Author(s):  
C. Muriel ◽  
E. Esteban ◽  
A. Astudillo ◽  
P. Martinez-Camblor ◽  
N. Corral ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Retrospective Cohort ◽  
Poor Prognosis ◽  
Renal Carcinoma ◽  
Good Prognosis ◽  
Biological Agents ◽  
Enhanced Expression ◽  
Favorable Prognostic Factor ◽  
Low Expression

391 Background: A retrospective cohort of 135 patients with advanced RCC treated with biological agents and/or cytokines (CK) was analysed between July 1996 and February 2010. Methods: The expression of several biomarkers by immunohistochemistry and 2 analytical variables: thrombocytosis and neutrophilia were analysed and were correlated with prognosis. Results: 67 patients were treated only with biological agents and 68 with CK (23 received also biological agents). The univariate statistical analysis showed that the enhanced expression of HIF-1alpha correlated with a poor prognosis in patients treated with sunitinib (PFS was 5.4 vs. 13.4 months in those with low expression, p=0.001). The overexpression of ACIX was associated to a better prognosis in patients that received biological agents (PFS was 18.3 vs. 5.2 months in those with decreased expression, p<0.001; OS was 32.1 vs. 7.8 months, p<0.001), including sunitinib (PFS was 16.8 vs. 5.5 months, p<0.001), sorafenib (PFS was 8 vs 3.5 months, p<0.001)) and CK (PFS was 6.3 vs. 2.7 months, p=0.003; OS was 32.9 vs. 5.9 months, p=0.001). Positive PTEN was related to a good prognosis in patients treated with sunitinib (PFS was 15.1 vs. 6.5 months, p=0.003) and CK (PFS was 7.5 vs. 3.8 months, p=0.037, OS was 13.7 vs 7.9 months, p=0.039). The increased expression of p21 was related to a poor prognosis in patients that received biological agents (PFS was 5.9 vs. 16.8 months with high expression, p=0.024), including sunitinib (PFS was 6.2 vs 18.9 months, p<0.001), sorafenib (PFS was 4 vs 9 months, p=0.013) and CK (PFS was 3.9 vs. 7.5 months, p<0.001). Thrombocytosis was related to a poor prognosis in patients treated with CK (PFS was 2.6 vs. 5.1 months p=0.017; OS was 5.9 vs. 14.3 months p=0.010). Neutrophilia was related to a poor prognosis in patients that received CK (PFS was 2.6 vs. 5.7 months, p=0.019; OS was 5.9 vs. 12.8 months, p=0.035). In the multivariate analysis, the overexpression of ACIX was a favorable prognostic factor independent of PFS with a HR of 0.107 (p<0.001) and OS with a HR of 0.055 (p<0.001). Conclusions: Our experience has suggested the utility of de HIF-1alpha, ACIX, PTEN, p21, thrombocytosis and neutrophilia as prognostic factors in patients with advanced RCC. ACIX has shown to be an independent prognostic factor. No significant financial relationships to disclose.

scholarly journals The Role of Serum miR-497 on the Predictive Index of Early Diagnosis and Poor Prognosis of Atherosclerosis Cerebral Infarction

2021 ◽  
Author(s):  
Zhiyong Cao ◽  
Han Wang ◽  
Xiangyang Zhu
Keyword(s):  
Prognostic Factors ◽  
Early Diagnosis ◽  
Cerebral Infarction ◽  
Poor Prognosis ◽  
Cox Regression ◽  
Survival Rates ◽  
Clinicopathological Parameters ◽  
Control Group ◽  
Predictive Index ◽  
Cox Regression Analysis

Background: Serum miR-497 can be used as a predictive index of the early diagnosis and poor prognosis of atherosclerosis cerebral infarction (ATCI). Methods: Overall, 135 ATCI patients, treated in The Second Affiliated Hospital of Nantong University, Nantong 226001, P.R.China from Apr 2012 to Jan 2015, were included in ATCI group. Whereas, 77 patients with non-atherosclerosis cerebral infarction were put in the control group. RT-qPCR was performed for detecting serum miR-497 expression, whose relationship with the patients’ clinicopathological parameters was analyzed. Receiver operating characteristic (ROC) curves were plotted to evaluate values of serum miR-497 for diagnosing ATCI patients and their 3-year and 5-year overall survival rates (OSRs). Cox regression analysis was conducted on prognostic factors of ATCI patients. Results: miR-497 remarkably rose in the serum of ATCI patients, and was correlated with histories of hypertension, smoking and diabetes mellitus (DM). Its areas under curves (AUCs) for diagnosing these pathological parameters were 0.803, 0.817 and 0.819, respectively. Its expression was higher in the serum of the patients with recurrence and poor prognoses. Its AUCs for predicting the two conditions were 0.924 and 0.937, respectively. The 3- and 5-year OSRs of patients with low expression were remarkably higher than those of patients with high expression. Conclusion: miR-497 and histories of hypertension, smoking and DM were independent prognostic factors affecting the 3-year OSR of ATCI patients. miR-497 expression rises in ATCI patients, so this miR is expected to become a serum diagnostic marker for ATCI.

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