Obesity, glucose intolerance, advanced age, and lymphocytopenia are independent risk factors for oxygen requirement in Japanese patients with Coronavirus disease 2019 (COVID-19)

SummaryDue to the high risk of thrombocytopenia and haemorrhage, thrombotic complications have received little attention in patients with acute myeloid leukemia (AML). Furthermore, the predictive role of cytogenetics on venous thromboembolism (VTE) has largely been ignored. This study aimed to evaluate the incidence, risk factors, and prognostic aspects of VTE in AML. A total of 811 consecutive patients with AML were enrolled and analysed retrospectively. Cox time-dependent covariate regression analysis was used to identify the significant predictors of VTE development. To minimise potential confounding factors, we used propensity-score matching to compare overall survival between patients with and without VTE. The six-month and one-year cumulative incidences of VTE were 3.1 % (95 % confidence interval [CI], 2.0–4.7) and 3.9 % (95 % CI, 2.6–5.7), respectively. Of the 26 cases of VTE, 22 (85 %) developed within 6 months of leukemia diagnosis and 13 (50 %) were catheter-related. In multivariate analysis, advanced age (≥ 65 years) (hazard ratio [HR], 2.70; p = 0.03) and increasing cytogenetic risk (common HR, 1.84; p = 0.05) were independent predictors of VTE. There was no significant association between VTE development and decreased survival (p = 0.32 for matched analysis). Advanced age and increasing cytogenetic risk, well-known predictors for clinical outcome in AML, were also independent risk factors of VTE development. Our results suggest that VTE does not hold prognostic implications for AML.

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Factors affecting colistin nephrotoxicity: Advanced age and/or other factors?

10.22541/au.161846965.57392699/v1 ◽

2021 ◽

Author(s):

Tugba Arslan Gülen ◽

Ayfer Imre ◽

Uner Kayabas

Keyword(s):

Risk Factors ◽

General Population ◽

Serum Creatinine ◽

Serum Creatinine Level ◽

Creatinine Level ◽

Geriatric Patients ◽

Advanced Age ◽

Factors Affecting ◽

Factors Associated ◽

Independent Risk Factors

Introduction: The population is aging and older adults comprise the majority of patients in intensive care units. Colistin (COL) has been reintroduced to treat increasingly common resistant Gram-negative bacterial infections. Our study aims to investigate the factors affecting colistin nephrotoxicity in the general population and geriatric age group. Materials and Method: This retrospective study included 170 patients, 116 (68.2%) of which were in the geriatric group (age ≥65). Acute renal failure was evaluated using the RIFLE score. Firstly, factors associated with COL nephrotoxicity in the general population were investigated. Then, risk factors for COL nephrotoxicity were evaluated in the geriatric patient group. Results: Advanced age (odds ratio [OR]=1.043; 95% confidence interval [CI]: 1.018-1.068; p=0.001) and initial serum creatinine level (OR=23.122; 95% CI: 3.123-171.217; p=0.002) were found to be independent risk factors associated with nephrotoxicity. In the evaluation of the geriatric population-based on nephrotoxicity, the initial serum urea and creatinine levels, immunosuppression, and overall mortality rates were found to be statistically significant in the group with nephrotoxicity (p<0.05). Initial serum creatinine level (OR=22.48; 95% CI: 2.835-178.426; p=0.003) and concomitant nephrotoxic agent use (OR=2.516; 95% CI: 1.275-4.963; p=0.008) were independent risk factors associated with nephrotoxicity in geriatric patients. Conclusion: Advanced age was found to be a risk factor for COL nephrotoxicity. Caution should be exercised especially in geriatric patients who have initial serum creatinine levels close to the upper limit, concomitant use of nephrotoxic drugs should be avoided and if possible, evaluation should be made in terms of non-COL treatment options in these patients.

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Impact of Different Sarcopenia Stages on the Postoperative New Osteoporotic Vertebral Compression Fracture After Percutaneous Kyphoplasty

10.21203/rs.3.rs-141490/v1 ◽

2021 ◽

Author(s):

Chaowei Lin ◽

Minyu Zhu ◽

Kelun Huang ◽

Sheng Lu ◽

Honglin Teng

Keyword(s):

Risk Factors ◽

Vertebral Compression Fracture ◽

Univariate Analysis ◽

Compression Fracture ◽

Osteoporotic Vertebral Compression Fracture ◽

Advanced Age ◽

Percutaneous Kyphoplasty ◽

European Working ◽

Independent Risk Factors ◽

The Impact

Abstract PurposeThe purpose of this study was to evaluate the impact of different sarcopenia stages on osteoporotic vertebral compression refracture (OVCRF) and identify other risk factors of new osteoporotic vertebral compression fracture (OVCF).MethodsWe conducted a large, retrospective study of patients who underwent percutaneous kyphoplasty (PKP) for OVCF. Sarcopenia was staged as “presarcopenia”, “sarcopenia”, and “severe sarcopenia” according to the definition of the European Working Group on Sarcopenia in Older People. Univariate and multivariate analyses evaluating the risk factors for OVCRF were performed. ResultsA total of 329 patients were included, in which 20.4%, 13.1%, and 7.3% of the patients were identified as having “presarcopenia”, “sarcopenia”, and “severe sarcopenia” respectively. Advanced sarcopenia stage was associated with lower BMI, lower serum albumin level and higher NRS 2002 scores. Subsequent fractures developed in 72 (21.8 %) of 329 patients during the one year follow-up. In univariate analysis, female (p = 0.012), advanced age (≥ 75 years; p = 0.004), lower BMD (p =0.000), stage of sarcopenia (p = 0.009) were associated with OVCRFs. Multivariable analysis revealed that female (OR 6.325; 95% CI 2.176-18.368, p = 0.001), age (OR 1.863; 95% CI 1.002-3.464, p =0.049), lower BMD (OR 1.736; 95% CI 1.294-2.328, p = 0.000), sarcopenia (OR 2.536; 95% CI 1.130-5.692, p = 0.024) and severe sarcopenia (OR 4.579; 95% CI 1.615-12.968, p = 0.004) were independent risk factors of OVCRFs. ConclusionsSarcopenia and severe sarcopenia were independent risk factors for OVCRF, as well as low BMD, advanced age and female.

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Mortality rates and risk factors in 1412 Japanese patients with decompensated hepatitis C virus-related cirrhosis: a retrospective long-term cohort study

BMC Gastroenterology ◽

10.1186/s12876-021-01770-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Shunichiro Fujiyama ◽

Norio Akuta ◽

Hitomi Sezaki ◽

Mariko Kobayashi ◽

Yusuke Kawamura ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Survival Rates ◽

Japanese Patients ◽

Independent Risk Factors

Abstract Background Hepatitis C virus is the leading cause of liver cirrhosis and hepatocellular carcinoma in Japan. We aimed to examine the long-term (> 20 years) mortality and hepatocellular carcinoma rates and associated risk factors in 1412 Japanese patients with decompensated hepatitis C virus-related cirrhosis (Child–Pugh B or C). Methods Cumulative survival and hepatocellular carcinoma rates were determined using Kaplan–Meier analysis. Independent risk factors were identified by multivariate analysis. A two-tailed P-value of < 0.05 was considered significant. Results The patients were followed up for a median of 2 years (range 0.5–24.2 years). In total, 62.3%, 41.7%, 4.7%, and 68.3% of the patients had a history of hepatocellular carcinoma, ascites, hepatic encephalopathy, and esophageal varices, respectively. The 1-, 5-, 10-, and 20-year cumulative overall survival rates in the total cohort was 74.9%, 29.0%, 9.1%, and 1.4%, respectively. The 1-, 3-, 5-, and 10-year cumulative survival rates for patients without hepatocellular carcinoma were 93.1%, 54.4%, 18.2%, and 4.0%, respectively, and the corresponding cumulative post-decompensation hepatocellular carcinoma rates were 14.0%, 31.6%, 46.1%, and 66.2%, respectively. The independent risk factors for mortality were older age, Child–Pugh C cirrhosis, the presence of hepatocellular carcinoma, low estimated glomerular filtration rate, low serum sodium level, low platelet count, and high γ-glutamyl transferase and α-fetoprotein levels for all patients and older age, Child–Pugh C cirrhosis, and low estimated glomerular filtration rate for patients without hepatocellular carcinoma. Overall, 1035 patients (73.3%) died; the causes of death were liver failure with/without hepatocellular carcinoma, pneumonia, sepsis, cardiovascular disease, and non-hepatocellular carcinoma malignancies. The corresponding morality rates per person-year were 133.4, 59.9, 10.9, 10.6, 9.0, and 5.2, respectively. Conclusions Among Japanese patients with decompensated hepatitis C virus-related cirrhosis, hepatocellular carcinoma is associated with poor prognosis. Our results highlight the importance of managing liver-related events, including hepatocellular carcinoma, in these patients.

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Prevalence and Associated Metabolic Factors for Thyroid Nodules: A Cross-Sectional Study in Southwest of China with More Than 120 Thousand Populations

10.21203/rs.3.rs-436890/v1 ◽

2021 ◽

Author(s):

Li Xu ◽

Fanling Zeng ◽

Yutong Wang ◽

Ye Bai ◽

Xuefeng Shan ◽

...

Keyword(s):

Risk Factors ◽

Central Obesity ◽

Thyroid Nodules ◽

Health Management ◽

Female Gender ◽

Cross Sectional Study ◽

Advanced Age ◽

Metabolic Factors ◽

Cross Sectional ◽

Independent Risk Factors

Abstract Objective. To explore the prevalence and its associated metabolic factors of thyroid nodules (TNs) among subjects who participated in the physical examinations in Chongqing, China. Methods. The participants from the Health Management Center of JinShan Hospital of Chongqing Medical University, between September 2015 and May 2020, were included in this study. All of the participants underwent thyroid ultrasonography, anthropometric measurements, and serum examinations. Differences in the TNs prevalence were compared with the chi-square test or Wilcoxon rang-sum test. Multivariable logistic regression analyses were used to estimate the metabolic factors associated with TNs and multi thyroid nodules (MTNs). Results. Of the included 121702 participants, 41547 had TNs, and 20899 had MTNs, with the prevalence of 34.1% and 17.0%, respectively. Women had a significantly higher prevalence of TNs than men (40.6% vs. 29.8%; χ2 = 1517.33, P < 0.001), and TNs prevalence was gradually increased with age (P for trend < 0.001). Female gender, advanced age, and metabolic factors including central obesity, BMI,hypertension, diabetes and fatty liver were positively associated with TNs; hyperlipoidemia and hyperuricemia were not independent risk factors of TNs. While female gender, advanced age, central obesity, hypertension and diabetes were independent risk factors of MTNs. Conclusions. The prevalence of thyroid nodules was relatively high. The associated factors identified in this study could help the clinicians to detect the high-risk patients and make targeted screening strategies for the preventing of the occurrence of TNs.

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P3615The number of coronary risk factors and mortality in patients with acute myocardial infarction from Japanese nation-wide real-world database

European Heart Journal ◽

10.1093/eurheartj/ehz745.0474 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

H Mori ◽

K Nishihara ◽

S Honda ◽

S Kojima ◽

M Takegami ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Hospital Mortality ◽

Real World ◽

Japanese Patients ◽

Advanced Age ◽

Coronary Risk Factors ◽

Inverse Association ◽

Coronary Risk

Abstract Background Hypertension, diabetes, dyslipidemia and smoking are so-called coronary risk factors for coronary heart disease, which were established by extensive epidemiological research. However, in Japanese patients with acute myocardial infarction (AMI), the impact of number of coronary risk factors on in-hospital morality has not been elucidated. Methods The Japan Acute Myocardial Infarction Registry (JAMIR) is a nationwide real-world database integrated form 10 regional registries. We examined the association between number of coronary risk factors and in-hospital mortality from this JAMIR registry. Results The data were obtained from total of 20462 AMI patients (mean age, 68.8±13.3 years old; 15281 men, 5181 women). Figure 1 shows the prevalence of each coronary risk factors stratified by sex and decade. The prevalence of hypertension became higher with the advanced age while the prevalence of smoking became lower with the advanced age. Prevalence of diabetes and dyslipidemia were highest in middle age. Majority (76.9%) of the patients with AMI had at least 1 of these coronary risk factors and, 23.1% had none of them. Overall, except women under 50, number of coronary risk factor was relatively less in older age (Figure 2). In-hospital mortality by sex and decades was shown in figure 3. In-hospital mortality rates were 10.7%, 10.5%, 7.2%, 5.0% and 4.5% with 0, 1, 2, 3 and 4 risk factors, respectively (Figure 4A). After adjusting age and sex, there was an inverse association between the number of coronary risk factors and in-hospital mortality (adjusted odds ratio [1.68; 95% CI, 1.20–2.35] among individuals with 0 vs. 4 risk factors, Figure 4B). Conclusion In the present study of Japanese patients with AMI, who received modern medical treatment, in-hospital mortality was inversely related to the number of coronary risk factors. Acknowledgement/Funding Grant-in-Aid for Scientific Research

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Advanced age and increased CRP concentration are independent risk factors associated with Clostridioides difficile infection mortality

Scientific Reports ◽

10.1038/s41598-020-71466-0 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Agnieszka Bednarska ◽

Dominik Bursa ◽

Regina Podlasin ◽

Marcin Paciorek ◽

Agata Skrzat-Klapaczyńska ◽

...

Keyword(s):

Risk Factors ◽

Infectious Diseases ◽

Advanced Age ◽

Receiver Operating Curve ◽

Multivariate Logistic Regression Model ◽

Risk Of Death ◽

Clostridioides Difficile ◽

Increased Risk ◽

Clostridioides Difficile Infection ◽

Independent Risk Factors

Abstract Clostridioides difficile (C.difficile) is a Gram-positive, spore-forming, toxin-producing anaerobic bacillus, which is one of the most common causes of health-care-associated infection developed mainly by elderly patients. The objective of this study was to assess mortality among the patients of the Hospital for Infectious Diseases in Warsaw related to C.difficile infection. Analysis was conducted of 1638 records reporting the medical histories of patients hospitalized for the first time due to Clostridioides difficile infection (CDI) in the Hospital for Infectious Diseases in Warsaw from 2010 to 2017. The inclusion criteria were any (principal or secondary) discharge diagnosis code for CDI according to ICD-10 and being an adult (≥ 18 years). 108 out of 1638 (7%) of the patients died. The median age in this group was 83 years. The largest number of deaths (90%) occurred in the group of patients aged 65 years or older and 81–90 years old (53% of all the deaths). In the multivariate logistic regression model relevant only to the age groups, not to sepsis—age over 80 and over 90 were independent predictors of death, increasing the risk of death by 3.4 and 1.8 times, respectively. The result of the receiver operating curve (ROC) analysis determined the age of 77 years as the threshold value, indicating the increased risk of death (AUC 0.727, standard error 0.025, 95% CI 0.678–0.776, p < 0.0001). In addition, other quantitative variables, namely CRP, creatinine and leucocytes were studied and turned out to be independent death predictors as well. The diagnosis of sepsis increased the risk of death fourfold (OR = 4.042; 95% Cl 2.4–6.7; p < 0.001). Increased inflammatory parameters, namely CRP and white blood cell count, advanced age, particularly over the age of 80, as well as a diagnosis of sepsis are independent risk factors for death and could be used as predictive markers of poor outcome in CDI.

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Advanced Age, High β-CTX Levels, and Impaired Renal Function are Independent Risk Factors for All-Cause One-Year Mortality in Hip Fracture Patients

Calcified Tissue International ◽

10.1007/s00223-015-0070-x ◽

2015 ◽

Vol 98 (1) ◽

pp. 67-75 ◽

Cited By ~ 7

Author(s):

Tonko Gulin ◽

Ivan Kruljac ◽

Lora Kirigin ◽

Marcela Merc ◽

Marina Pavić ◽

...

Keyword(s):

Risk Factors ◽

Renal Function ◽

Hip Fracture ◽

Impaired Renal Function ◽

Advanced Age ◽

Independent Risk Factors ◽

One Year

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Prevalence and associated metabolic factors for thyroid nodules: a cross-sectional study in Southwest of China with more than 120 thousand populations

BMC Endocrine Disorders ◽

10.1186/s12902-021-00842-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Li Xu ◽

Fanling Zeng ◽

Yutong Wang ◽

Ye Bai ◽

Xuefeng Shan ◽

...

Keyword(s):

Risk Factors ◽

Central Obesity ◽

Thyroid Nodules ◽

Health Management ◽

Female Gender ◽

Advanced Age ◽

Metabolic Factors ◽

Cross Sectional ◽

Independent Risk Factors ◽

Obesity Hypertension

Abstract Objective To explore the prevalence and its associated metabolic factors of thyroid nodules (TNs) among subjects who participated in the physical examinations in Chongqing, China. Methods The participants from the Health Management Center of JinShan Hospital of Chongqing Medical University, between September 2015 and May 2020, were included in this study. All of the participants underwent thyroid ultrasonography, anthropometric measurements, and serum examinations. Differences in the TNs prevalence were compared with the chi-square test or Wilcoxon rang-sum test. Multivariable logistic regression analyses were used to estimate the metabolic factors associated with TNs and multiple thyroid nodules (MTNs). Results Of the included 121,702 participants, 41,547 had TNs, and 20,899 had MTNs, with the prevalence of 34.1 and 17.0 %, respectively. Women had a significantly higher prevalence of TNs than men (40.6 % vs. 29.8 %; χ2 = 1517.33, P < 0.001), and TNs prevalence was gradually increased with age (P for trend < 0.001). Female gender, advanced age, and metabolic factors including central obesity, hypertension, diabetes and fatty liver were positively associated with TNs; BMI, hyperlipoidemia and hyperuricemia were not independent risk factors of TNs. While female gender, advanced age, central obesity, hypertension and diabetes were independent risk factors of MTNs. Conclusions The prevalence of thyroid nodules was relatively high. The associated factors identified in this study could help the clinicians to detect the high-risk patients and make targeted screening strategies for the preventing of the occurrence of TNs.

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4-year recurrence risk factors after tension-free vaginal tape-obturator as a treatment of stress urinary incontinence

Clinical Journal of Obstetrics and Gynecology ◽

10.29328/journal.cjog.1001069 ◽

2020 ◽

Vol 3 (2) ◽

pp. 145-150

Author(s):

S De Miguel Manso ◽

E García García ◽

JA Gobernado Tejedor ◽

CE Badillo Bercebal ◽

D Viruega Cuaresma ◽

...

Keyword(s):

Risk Factors ◽

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Mixed Urinary Incontinence ◽

Advanced Age ◽

Mixed Incontinence ◽

Tension Free ◽

Tension Free Vaginal Tape ◽

Independent Risk Factors ◽

Vaginal Tape Obturator

Objectives: Tension-free vaginal tapes are the gold standard of the surgical treatment of stress urinary incontinence (SUI); however, long-term recurrence of SUI after this surgery has been a matter of problem. Here, we attempted to determine the incidence of its recurrence and to identify the risk factors of 4-year-recurrence of SUI after this surgery. Methods: Of all patients undergoing this surgery (n = 341, 2015-2019), 71 patients were met the study inclusion criteria. Of 71, SUI recurred in 8 patients, with the recurrence rate being 11.3%. The following three were identified to be independent risk factors: older age, history of delivery of macrosomic baby (>4 kg), and the presence of mixed urinary incontinence. The frequency of recurrence in cases with mixed incontinence amounted for 19.5%. Recurrence was 22 and 50% for women with macrosomic delivery once and more than twice, respectively. Conclusion: Advanced age, macrosomic delivery and mixed urinary incontinence have shown to be independent risk factors of recurrence of SUI after tension-free vaginal tape-obturator at 4 years. Key message: Stress urinary incontinence can recur so investigate possible risk factors is a priority. Our paper relates recurrence with: advanced age, fetal macrosomia and mixed incontinence.

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