scholarly journals Adherence to Attendance at Outpatient Clinic and Longterm Survival of Patients after Stroke in Outpatient Setting: the Data of REGION-M Registry

2021 ◽  
Vol 17 (3) ◽  
pp. 386-393
Author(s):  
S. Yu. Martsevich ◽  
S. N. Tolpygina ◽  
M. I. Chernysheva ◽  
A. V. Zagrebelny ◽  
V. P. Voronina ◽  
...  
Keyword(s):  
Relative Risk ◽  
Confidence Interval ◽  
Transient Ischemic Attack ◽  
Cerebral Circulation ◽  
Cerebral Stroke ◽  
Risk Of Death ◽  
Before And After ◽  
Moscow City ◽  
Relative Risk Of Death ◽  
Ischemic Attack

Aim. Assess the two-year survival rate of patients who have undergone acute cerebral circulation disorder, depending on their commitment to visiting the district polyclinic before and after discharge from the hospital.Material and methods. The outpatient part of the REGION-M register included 684 patients attached to the Moscow City Polyclinic №64, discharged from the Moscow City Clinical Hospital n.a. F.I. Inozemtsev of from 01.01.2012 to 04.30.2017 with a confirmed diagnosis of acute cerebral circulation disorder (cerebral stroke / transient ischemic attack).Results. Of the entire cohort, 83.2% of patients and 84.2% after hospital discharge attended the clinic during the year before the development of reference acute cerebral circulation disorder. Patients who attended the clinic before and after the reference stroke were older, more likely to have diabetes, comorbid disease and disability. For 22 months of follow-up, mortality was 28.8% (197 out of 684 people). Among those who applied and did not apply to the clinic before the reference acute cerebral circulation disorder, the difference in mortality tended to be reliable (27.4% versus 35.7%, p <0.1), while mortality was almost twice as low among patients who applied to the clinic at least 1 time after discharge (25.7%) than among patients who did not apply after discharge - 45.4%, p<0.0001. When adjusting for sex and age (the relative risk of death for them was 1.009, 95% confidence interval 1.005-1.01 2, p<0.0001 ), the statistical validity of reducing the risk of death was maintained when patients were committed to visiting the clinic after discharge - the relative risk of death 0.366 (95% confidence interval 0.269-0.500, p<0.0001 ).Conclusion. Lower mortality among those who visited the district polyclinic after undergoing stroke confirms the important role of medical observation in the posthospital period. At the same time, there is a reserve in improving the long-term prognosis of the lives of patients who have suffered a cerebral stroke or transient ischemic attack, due to greater coverage of patients with medical supervision in the clinic.

Relative Risk of Death in Diabetic and Non Diabetic Dialysis PTS: A Useful Marker of a Cohort Features

1991 ◽  
pp. 455-457
Author(s):  
G. B. Piccoli ◽  
G. Beltrame ◽  
F. Bonello ◽  
M. Salomone ◽  
A. Pacitti ◽  
...  
Keyword(s):  
Relative Risk ◽  
Risk Of Death ◽  
Relative Risk Of Death

scholarly journals White Blood Cell and Platelet Dynamics Define Human Inflammatory Recovery

2021 ◽  
Author(s):  
Brody H Foy ◽  
Thor Sundt ◽  
Jonathan CT Carlson ◽  
Aaron D Aguirre ◽  
John M Higgins
Keyword(s):  
Relative Risk ◽  
Blood Cell ◽  
White Blood Cell ◽  
Tissue Damage ◽  
Inflammatory Responses ◽  
Good Prognosis ◽  
Adverse Outcomes ◽  
Acute Phase Reactants ◽  
Risk Of Death ◽  
Relative Risk Of Death

Inflammation is the physiologic reaction to cellular and tissue damage caused by pathologic processes including trauma, infection, and ischemia. Effective inflammatory responses integrate molecular and cellular functions to prevent further tissue damage, initiate repair, and restore homeostasis, while futile or dysfunctional responses allow escalating injury, delay recovery, and may hasten death. Elevation of white blood cell count (WBC) and altered levels of other acute phase reactants are cardinal signs of inflammation, but the dynamics of these changes and their resolution are not established. Patient responses appear to vary dramatically with no clearly defined signs of good prognosis, leaving physicians reliant on qualitative interpretations of laboratory trends. We studied the human acute inflammatory response to trauma, ischemia, and infection by tracking the longitudinal dynamics of cellular and serum markers in hospitalized patients. Unexpectedly, we identified a conserved pattern of recovery defined by co-regulation of WBC and platelet (PLT) populations. Across all inflammatory conditions studied, recovering patients followed a consistent WBC-PLT trajectory shape that is well-approximated by exponential WBC decay and delayed linear PLT growth. This recovery trajectory shape may represent a fundamental archetype of human physiologic response at the cellular population scale, and provides a generic approach for identifying high-risk patients: 32x relative risk of adverse outcomes for cardiac surgery patients, 9x relative risk of death for COVID-19, and 5x relative risk of death for myocardial infarction.

Reply to: Concerns about estimating relative risk of death associated with convalescent plasma for COVID-19

2022 ◽  
Author(s):  
Philippe Bégin ◽  
Jeannie Callum ◽  
Richard Cook ◽  
Erin Jamula ◽  
Yang Liu ◽  
...  
Keyword(s):  
Relative Risk ◽  
Risk Of Death ◽  
Relative Risk Of Death

scholarly journals Apixaban versus No Anticoagulation in Patients Undergoing Long-Term Dialysis with Incident Atrial Fibrillation

2020 ◽  
Vol 15 (8) ◽  
pp. 1146-1154 ◽  
Author(s):  
Thomas A. Mavrakanas ◽  
Katherine Garlo ◽  
David M. Charytan
Keyword(s):  
Atrial Fibrillation ◽  
Confidence Interval ◽  
Transient Ischemic Attack ◽  
Lower Incidence ◽  
Primary Outcome ◽  
Hazard Ratio ◽  
Intracranial Bleeding ◽  
Nonvalvular Atrial Fibrillation ◽  
Maintenance Dialysis ◽  
Ischemic Attack

Background and objectivesThe relative efficacy and safety of apixaban compared with no anticoagulation have not been studied in patients on maintenance dialysis with atrial fibrillation. We aimed to determine whether apixaban is associated with better clinical outcomes compared with no anticoagulation in this population.Design, setting, participants, & measurementsThis retrospective cohort study used 2012–2015 US Renal Data System data. Patients on maintenance dialysis with incident, nonvalvular atrial fibrillation treated with apixaban (521 patients) were matched for relevant baseline characteristics with patients not treated with any anticoagulant agent (1561 patients) using a propensity score. The primary outcome was hospital admission for a new stroke (ischemic or hemorrhagic), transient ischemic attack, or systemic thromboembolism. The secondary outcome was fatal or intracranial bleeding. Competing risk survival models were used.ResultsCompared with no anticoagulation, apixaban was not associated with lower incidence of the primary outcome: hazard ratio, 1.24; 95% confidence interval, 0.69 to 2.23; P=0.47. A significantly higher incidence of fatal or intracranial bleeding was observed with apixaban compared with no treatment: hazard ratio, 2.74; 95% confidence interval, 1.37 to 5.47; P=0.004. A trend toward fewer ischemic but more hemorrhagic strokes was seen with apixaban compared with no treatment. No significant difference in the composite outcome of myocardial infarction or ischemic stroke was seen with apixaban compared with no treatment. Compared with no anticoagulation, a significantly higher rate of the primary outcome and a significantly higher incidence of fatal or intracranial bleeding and of hemorrhagic stroke were seen in the subgroup of patients treated with the standard apixaban dose (5 mg twice daily) but not in patients who received the reduced apixaban dose (2.5 mg twice daily).ConclusionsIn patients with kidney failure and nonvalvular atrial fibrillation, treatment with apixaban was not associated with a lower incidence of new stroke, transient ischemic attack, or systemic thromboembolism but was associated with a higher incidence of fatal or intracranial bleeding.PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_05_29_CJN11650919.mp3

scholarly journals Geografias da Diabetes Mellitus em Portugal: Como as Condições do Contexto Influenciam o Risco de Morrer

2014 ◽  
Vol 27 (3) ◽  
pp. 309 ◽  
Author(s):  
Paula Santana ◽  
Cláudia Costa ◽  
Adriana Loureiro ◽  
João Raposo ◽  
José Manuel Boavida
Keyword(s):  
Diabetes Mellitus ◽  
Relative Risk ◽  
Rural Areas ◽  
Public Health Problem ◽  
Standardized Mortality Ratio ◽  
Geographic Pattern ◽  
Bayesian Hierarchical ◽  
Risk Of Death ◽  
Mortality Ratio ◽  
Relative Risk Of Death

<strong>Introduction:</strong> Diabetes Mellitus is a public health problem that is on the increase throughout the world, including in Portugal. This paper aims to identify the changing geographic pattern of this cause of death in Portugal and its association with sociomaterial deprivation.<br /><strong>Material and Methods:</strong> This is a transversal ecological study of the deaths by Diabetes Mellitus in Portuguese municipalities in three periods (1989-1993, 1999-2003 and 2006-2010). It uses a Bayesian hierarchical model in order to obtain a smooth standardized mortality ratio and the relative risk of death by Diabetes Mellitus associated to sociomaterial deprivation.<br /><strong>Results:</strong> In 1989-1993, the highest smooth standardized mortality ratio values were found in coastal urban municipalities (80% of municipalities with smooth standardized mortality ratio ≥ 161, of which 60% are urban); in 2006-2010, the opposite was found, with the highest smooth standardized mortality ratio values occurring in rural areas in southern inland regions (76.9% of municipalities with smooth standardized mortality ratio ≥ 161, of which 69.2% are rural), particularly the Alentejo. The relative risk of death by Diabetes Mellitus increases with vulnerability associated to social and economic conditions in the area of residence, and is significant in the last two periods (relative risk: 1.00; IC95%: 0.98-1.02).<br /><strong>Discussion:</strong> Diabetes Mellitus presents a geographic pattern marked by coastal-inland and urban-rural asymmetry. However, this has been altering over the last twenty years. 48% of the population reside in municipalities where the smooth standardized mortality ratio has increased in the last twenty years, particularly in the rural areas of inland Portugal.<br /><strong>Conclusion: </strong>The highest smooth standardized mortality ratio are currently found in rural municipalities with the highest index of sociomaterial deprivation.<br /><strong>Keywords:</strong> Demography; Diabetes Mellitus/epidemiology; Diabetes Mellitus/mortality; Portugal; Socioeconomic Factors.

scholarly journals Antiepileptic drug use and mortality among community-dwelling persons with Alzheimer disease

Neurology ◽  
2020 ◽  
Vol 94 (20) ◽  
pp. e2099-e2108 ◽  
Author(s):  
Tatyana Sarycheva ◽  
Piia Lavikainen ◽  
Heidi Taipale ◽  
Jari Tiihonen ◽  
Antti Tanskanen ◽  
...  
Keyword(s):  
Relative Risk ◽  
Alzheimer Disease ◽  
Antiepileptic Drug ◽  
Cognitive Disorder ◽  
Careful Consideration ◽  
Community Dwelling ◽  
Risk Of Death ◽  
Vulnerable Patients ◽  
Relative Risk Of Death ◽  
First 90 Days

ObjectiveTo evaluate the risk of death in relation to incident antiepileptic drug (AED) use compared with nonuse in people with Alzheimer disease (AD) through the assessment in terms of duration of use, specific drugs, and main causes of death.MethodsThe MEDALZ (Medication Use and Alzheimer Disease) cohort study includes all Finnish persons who received a clinically verified AD diagnosis (n = 70,718) in 2005–2011. Incident AED users were identified with 1-year washout period. For each incident AED user (n = 5,638), 1 nonuser was matched according to sex, age, and time since AD diagnosis. Analyses were conducted with Cox proportional regression models and inverse probability of treatment weighting (IPTW).ResultsNearly 50% discontinued AEDs within 6 months. Compared with nonusers, AED users had an increased relative risk of death (IPTW hazard ratio [HR], 1.23; 95% confidence interval [CI], 1.12–1.36). This was mainly due to deaths from dementia (IPTW HR, 1.62; 95% CI, 1.42–1.86). There was no difference in cardiovascular and cerebrovascular deaths (IPTW HR, 0.98; 95% CI, 0.67–1.44). The overall mortality was highest during the first 90 days of AED use (IPTW HR, 2.40; 95% CI, 1.91–3.03). Among users of older AEDs, relative risk of death was greater compared to users of newer AEDs (IPTW HR, 1.79; 95% CI, 1.52–2.16).ConclusionIn older vulnerable patients with a cognitive disorder, careful consideration of AED initiation and close adverse events monitoring are needed.

PM236 Lyubertsy study on mortality rate in patients after cerebral stroke or transient ischemic attack (LIS-2). Design and medical treatment estimation before admission

Global Heart ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e110 ◽  
Author(s):  
Sergey Y. Martsevich ◽  
Natalia P. Kutishenko ◽  
Liubov Y. Drozdova ◽  
Moisey L. Ginzburg ◽  
Alexander Y. Suvorov ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Medical Treatment ◽  
Transient Ischemic Attack ◽  
Cerebral Stroke ◽  
Ischemic Attack

scholarly journals Concerns about estimating relative risk of death associated with convalescent plasma for COVID-19

2022 ◽  
Author(s):  
Michael J. Joyner ◽  
Nigel S. Paneth ◽  
Jonathon W. Senefeld ◽  
DeLisa Fairweather ◽  
Katelyn A. Bruno ◽  
...  
Keyword(s):  
Relative Risk ◽  
Risk Of Death ◽  
Relative Risk Of Death

Controlled trials of rG-CSF and CD11b-directed MAb during hyperoxia and E. coli pneumonia in rats

1996 ◽  
Vol 80 (6) ◽  
pp. 2066-2076 ◽  
Author(s):  
B. D. Freeman ◽  
R. Correa ◽  
W. Karzai ◽  
C. Natanson ◽  
M. Patterson ◽  
...  
Keyword(s):  
Relative Risk ◽  
Lung Injury ◽  
Neutrophil Function ◽  
Lung Damage ◽  
E Coli ◽  
Risk Of Death ◽  
Pathophysiological Role ◽  
O2 Concentration ◽  
Hyperoxic Lung Injury ◽  
Relative Risk Of Death

We studied the effects of inhibiting and augmenting neutrophil function by using an immunocompetent rat model of infectious and hyperoxic lung injury. After intrabronchial Escherichia coli challenge at all fractional inspired O2 (FIO2) values studied (FIO2 = 0.21, 0.60, and 0.95) and after lethal O2 exposure alone (FIO2 = 0.90), lung injury, as measured by histological and physiological changes, was reduced by a CD11b/CD18-directed monoclonal antibody (MAb 1B6, P < 0.05 vs. controls) but was increased by recombinant granulocyte colony-stimulating factor (rG-CSF; P < 0.05 vs. control; MAb 1B6 vs. rG-CSF, P < 0.004). Pulmonary neutrophil counts were reduced by MAb 1B6 (P < 0.04) and increased by rG-CSF (P < 0.0004) compared with control animals. However, despite antibiotics, MAb 1B6 and rG-CSF both significantly increased the relative risk of death, independent of O2 concentration, during E. coli pneumonia (1.74 [symbol: see text] 1.20 and 2.39 [symbol: see text] 1.19, respectively, each P < 0.01). During lethal hyperoxia, MAb 1B6 increased the relative risk of death (1.76 [symbol: see text] 1.28, P < 0.16), whereas rG-CSF had no effect on survival (0.97 [symbol: see text] 1.28, P = 0.89). Thus inhibition of neutrophil function attenuated and enhancement worsened lung injury in response to infectious and hyperoxic challenges, supporting a pathophysiological role of the neutrophil in these processes. However, it is problematic that MAb 1B6 therapy, despite preventing lung damage, ultimately worsened host defenses and survival. Furthermore, rG-CSF also adversely affected survival during infectious lung injury, demonstrating the inherent risks of inhibiting or augmenting neutrophil function in an immunocompetent host during infection.

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