scholarly journals Effects of Ulinastatin on Postoperative Renal Function in Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass: a Prospective Cohort Study

2021 ◽  
Author(s):  
Hong Lv ◽  
Huanran Lv ◽  
Yuda Fei ◽  
Qian Li ◽  
Peng zhang ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cohort Study ◽  
Cardiopulmonary Bypass ◽  
Respiratory Failure ◽  
Hospital Mortality ◽  
Prospective Cohort ◽  
Adverse Outcomes ◽  
Control Group ◽  
New Onset

Abstract Background: Ulinastatin is a serine protease inhibitor with anti-inflammatory effects. Evidence for the effects of ulinastatin on renal outcomes remains sparse in patients receiving cardiac surgery with cardiopulmonary bypass (CPB).Methods: This prospective cohort study evaluated 413 patients aged 18–70 years who underwent cardiac surgery with CPB, from Aug 2008 to Jul 2019 in Fuwai Hospital, Beijing ,China. The ulinastatin group included 135 patients who received intravenous ulinastatin (1×106 U) after induction of anesthesia. The remaining 278 patients without ulinastatin served as the control group. The primary outcome was the rate of new-onset postoperative acute kidney injury (AKI). The secondary outcome was renal replacement therapy(RRT). Serum creatinine, plasma NGAL, and serum IL-6 levels were evaluated and the CSANGAL Score was calculated. In addition, in-hospital mortality, morbidity, adverse outcomes and 10-year follow-up the survival rate was analyzed.Results: Rate of new-onset AKI was significantly lower in the ulinastatin group than in the control group (20.00% vs. 32.40%, p=0.009). There was no significant difference of RRT between the two groups (0.00% vs. 2.16%, p=0.09). In-hospital mortality, morbidity, and adverse outcomes were comparable between the two groups except for a significantly lower incidence of respiratory failure in the ulinastatin group compared with the control group (0.76% vs. 5.40%, p=0.02). The 10-year follow-up survival rates did not differ significantly between the two groups.Conclusions: Ulinastatin significantly reduced postope rative AKI and respiratory failure in patients receiving cardiac surgery with CPB. But ulinastatin did not reduce ICU and hospital stay and mortality.Clinical trial registration: NCT01060189

Asthma and Immunoglobulin E Antibodies After Respiratory Syncytial Virus Bronchiolitis: A Prospective Cohort Study With Matched Controls

PEDIATRICS ◽  
1995 ◽  
Vol 95 (4) ◽  
pp. 500-505 ◽  
Author(s):  
N. Sigurs ◽  
R. Bjarnason ◽  
F. Sigurbergsson ◽  
B. Kjellman ◽  
B. Björkstén
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Respiratory Syncytial Virus ◽  
Prospective Cohort ◽  
Egg White ◽  
Control Group ◽  
Igg Antibodies ◽  
Ige Antibodies ◽  
Syncytial Virus

Objective. To study the occurrence of bronchial obstructive symptoms and immunoglobulin (Ig) E antibodies after respiratory syncytial virus (RSV) bronchiolitis in infancy. Previous studies of this subject have mostly been retrospective or without controls, or the controls have not been followed prospectively. Design. This was a prospective cohort study with matched controls. Participants. Forty-seven infants had experienced RSV bronchiolitis severe enough to cause hospitalization at a mean age of 3½ months. For each child with RSV infection, two controls were acquired from the local Child Health Center and matched for date of birth, sex, and residence. Only one control was obtained for one RSV child, and the control group thus contained 93 children. Methods. All the children underwent two follow-up examinations, the first one at a mean age of 1 year and the second at a mean age of 3 years. At the first follow-up, a skin-prick test against egg white was performed, and serum IgG antibodies against RSV were measured. At the second follow-up, serum IgE antibodies were measured using screening tests for common food and inhalant antibodies, and skin-prick tests against egg white, cat, birch, and mite allergen were performed. Hereditary and environmental factors (passive smoking, indoor furred animals) and duration of breast-feeding were recorded. Results. At the first follow-up, 89% in the RSV group and 27% in the control group had IgG antibodies against RSV (P < .001). At the second follow-up, asthma, defined as three episodes of bronchial obstruction verified by a physician, was found in 11 of 47 children (23%) in the RSV group and in 1 of 93 children (1%) in the control group (P < .001). A positive test for IgE antibodies was noted in 14 of 44 (32%) RSV children and in 8 of 92 (9%) children in the control group (P = .002). An analysis of risk factors for the development of asthma and IgE antibodies on the whole group of 140 children showed that RSV bronchiolitis was the most important risk factor, and a family history of atopy or asthma further increased the risk. Conclusions. Respiratory syncytial virus bronchiolitis during the first year of life apparently is an important risk factor for the development of asthma and sensitization to common allergens during the subsequent 2 years, particularly in children with heredity for atopy/asthma.

Mobilization within 24 hours of new-onset stroke enhances the rate of home discharge at 6-months follow-up: a prospective cohort study

2020 ◽  
pp. 1-10
Author(s):  
Tokio Kinoshita ◽  
Tatsuya Yoshikawa ◽  
Yukihide Nishimura ◽  
Yoshi-ichiro Kamijo ◽  
Hideki Arakawa ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Home Discharge ◽  
New Onset

scholarly journals Study protocol for resolution of organ injury in acute pancreatitis (RESORP): an observational prospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040200
Author(s):  
Ahmed E Sherif ◽  
Rory McFadyen ◽  
Julia Boyd ◽  
Chiara Ventre ◽  
Margaret Glenwright ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Acute Pancreatitis ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Observational Prospective Cohort Study ◽  
New Onset

IntroductionSurvivors of acute pancreatitis (AP) have shorter overall survival and increased incidence of new-onset cardiovascular, respiratory, liver and renal disease, diabetes mellitus and cancer compared with the general population, but the mechanisms that explain this are yet to be elucidated. Our aim is to characterise the precise nature and extent of organ dysfunction following an episode of AP.Methods and analysisThis is an observational prospective cohort study in a single centre comprising a University hospital with an acute and emergency receiving unit and clinical research facility. Participants will be adult patient admitted with AP. Participants will undergo assessment at recruitment, 3 months and 3 years. At each time point, multiple biochemical and/or physiological assessments to measure cardiovascular, respiratory, liver, renal and cognitive function, diabetes mellitus and quality of life. Recruitment was from 30 November 2017 to 31 May 2020; last follow-up measurements is due on 31 May 2023. The primary outcome measure is the incidence of new-onset type 3c diabetes mellitus during follow-up. Secondary outcome measures include: quality of life analyses (SF-36, Gastrointestinal Quality of Life Index); montreal cognitive assessment; organ system physiological performance; multiomics predictors of AP severity, detection of premature cellular senescence. In a nested cohort within the main cohort, individuals may also consent to multiparameter MRI scan, echocardiography, pulmonary function testing, cardiopulmonary exercise testing and pulse-wave analysis.Ethics and disseminationThis study has received the following approvals: UK IRAS Number 178615; South-east Scotland Research Ethics Committee number 16/SS/0065. Results will be made available to AP survivors, caregivers, funders and other researchers. Publications will be open-access.Trial registration numbersClinicalTrials.gov Registry (NCT03342716) and ISRCTN50581876; Pre-results.

scholarly journals Dementia Risk among Coronavirus Disease Survivors: A Nationwide Cohort Study in South Korea

2021 ◽  
Vol 11 (10) ◽  
pp. 1015
Author(s):  
Hye-Yoon Park ◽  
In-Ae Song ◽  
Tak-Kyu Oh
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
South Korea ◽  
Cox Regression ◽  
Control Group ◽  
Dementia Diagnosis ◽  
Dementia Risk ◽  
History Of ◽  
New Onset

We aimed to investigate whether coronavirus disease (COVID-19) survivors were at a higher risk of dementia diagnosis compared to controls at 6 months follow-up. Data pertaining to the period between 1 January and 4 June 2020, were extracted from the National Health Insurance Service (NHIS)-COVID-19 database in South Korea. Data on adults (≥20 years old) with no history of dementia, obtained from the NHIS-COVID-19 database, were included in the study. The endpoint of this study was the development of dementia, which was evaluated from 1 January to 1 December 2020. A total of 306,577 adults were included in the analysis, comprising 7133 COVID-19 survivors and 299,444 individuals in the control group. Among the subjects, new-onset dementia diagnosed in 2020 was recorded in 1.2% (3546 of 306,577). In the covariate-adjusted multivariable Cox regression model, the incidence of dementia among COVID-19 survivors was 1.39-fold higher (hazard ratio: 1.39, 95% confidence interval: 1.05–1.85; p = 0.023) than that in the control group. At approximately 6 months of follow-up, COVID-19 survivors were at a higher risk of dementia compared to other populations in South Korea.

scholarly journals Comparison of QSOFA and SIRS Scores for the Prediction of Adverse Outcomes of Secondary Peritonitis in a Tertiary Teaching Hospital in Uganda: a Prospective Cohort Study

2021 ◽  
Author(s):  
Emmanuel Nkonge ◽  
Olivia Kituuka ◽  
William Ocen
Keyword(s):  
Cohort Study ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Adverse Outcomes ◽  
Secondary Peritonitis ◽  
Mulago Hospital ◽  
Prolonged Hospital Stay ◽  
Prolonged Hospital

Abstract Background: SIRS and qSOFA are two ancillary scoring tools that have been used globally, inside and outside of ICU to predict adverse outcomes of infections such as secondary peritonitis. Mulago hospital uses SIRS outside the ICU to identify patients with secondary peritonitis, who are at risk of adverse outcomes. However it’s associated with delays in decision making given its partial reliance on laboratory parameters. In response to the practical limitations of SIRS, the sepsis-3 task force recommends qSOFA as a better tool, however its performance in patients with secondary peritonitis in comparison to that of SIRS has not been evaluated in Mulago hospital, Uganda.Objective: To compare the performance of qSOFA and SIRS scores in predicting adverse outcomes of secondary peritonitis in Mulago hospital, Uganda.Methods: This was a prospective cohort study of patients with clinically confirmed secondary peritonitis, from March 2018 to January 2019 at the A&E, Mulago hospital. QSOFA and SIRS scores were generated for each of the patient, with a score of ≥ 2 recorded as high risk, while a score of ≤ 2 recorded as low risk for the adverse outcome respectively. After surgery, patients were followed up until discharge or death. In-hospital mortality and prolonged hospital stay were the primary and secondary adverse outcomes, respectively. Sensitivity, specificity, PPV, NPV and accuracy at 95% confidence interval were calculated for each of the scores using STATA v.13Results: A total of 153 patients were enrolled. Of these, 151(M: F, 2.4:1) completed follow up and were analysed, 2 were excluded. Mortality rate was 11.9%. Fourty (26.5%) patients had a prolonged hospital stay. QSOFA predicted in-hospital mortality with AUROC of 0.52 versus 0.62, for SIRS. Similarly, qSOFA predicted prolonged hospital stay with AUROC of 0.54 versus 0.57, for SIRS.Conclusion: SIRS is superior to qSOFA in predicting both mortality and prolonged hospital stay among patients with secondary peritonitis. However, overall, both scores showed a poor discrimination for both adverse outcomes and therefore not ideal tools.

scholarly journals Do welfare benefit reassessments of people with mental health conditions lead to worse mental health? A prospective cohort study

2019 ◽  
Vol 66 (2) ◽  
pp. 136-149
Author(s):  
Ruth Stuart ◽  
Sanchika Campbell ◽  
Beatrice Osumili ◽  
Emily J Robinson ◽  
Mary Frost-Gaskin ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Health Service ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Exposed Group ◽  
Health Conditions ◽  
Control Group ◽  
Mental Health Conditions

Background: There have been cases of suicide following the Work Capability Assessment (WCA), a questionnaire and interview for those claiming benefits due to ill health or disability in the United Kingdom. Aims: To examine whether experiencing problems with welfare benefits, including WCA, among people with pre-existing mental health conditions was associated with poorer mental health and wellbeing and increased health service use and costs. Methods: A prospective cohort study of an exposed group ( n = 42) currently seeking help from a Benefits Advice Service in London and a control group ( n = 45) who had recently received advice from the same service. Questionnaires at baseline and 3-, 6- and 12-month follow-ups. Results: The exposed group had higher mean scores for anxiety ( p = .008) and depression ( p = .016) at baseline and the control group higher mean scores for wellbeing at baseline ( p = .034) and 12 months ( p = .035). However, loss to follow-up makes overall results difficult to interpret. The control group had higher incomes throughout the study, particularly at the 12-month follow-up ( p = .004), but the differences could have been accounted for by other factors. Health service costs were skewed by a few participants who used day-care services intensively or had inpatient stays. Over the study period the proportion of exposed participants engaged in benefits reassessment ranged from 50% to 88%, and 40% to 76% of controls. Conclusion: The hardship of living with financial insecurity and a mental health condition made it difficult for our participants to sustain involvement in a 12-month study and the frequency of benefit reviews meant that the experiences of our controls were similar to our exposed group. These limitations limit interpretation but confirm the relevance of our research. The control data raise the question of whether people with mental health conditions are being disproportionately reassessed.

scholarly journals P162: Patient-important outcomes in hyperglycemia after discharge from the emergency department: a prospective cohort study

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S114-S115
Author(s):  
J. W. Yan ◽  
L. Siddiqi ◽  
K. Van Aarsen ◽  
M. Columbus ◽  
K. M. Gushulak
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Healthcare Provider ◽  
Prospective Cohort Study ◽  
Burden Of Disease ◽  
Prospective Cohort ◽  
Tertiary Care ◽  
Adverse Outcomes ◽  
Post Discharge

Introduction: Hyperglycemic emergencies, including diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS), carry significant morbidity for individuals even after discharge. The objective of this study was to describe the patient-important outcomes and burden of disease for emergency department (ED) patients with hyperglycemia after discharge from hospital. Methods: This was a prospective cohort study of patients 18 years presenting to two tertiary care EDs (combined annual census 150,000 visits) with a discharge diagnosis of hyperglycemia, DKA or HHS over a 15-month period (Jul 2016-Oct 2017). During the ED visit, consent was obtained for a telephone follow-up call to determine patient-important outcomes. Trained research personnel collected data from medical records and completed a 14 day telephone follow-up using a standardized questionnaire to determine medication changes, missed days of school or work, and repeat admissions or visits to a healthcare provider. Descriptive statistics were used where appropriate to summarize the data. Results: Thus far, 172 patients have been enrolled in our study. Mean (SD) age is 53.9 (19.3) years and 97 (56.4%) are male. 65 (37.8%) patients were admitted from their initial ED visit. Of the 125 patients (72.7%) providing post-discharge outcomes, 75 (60.0%) required an adjustment to their diabetes medications or insulin. 21 (16.8%) patients missed days of school or work for a median (IQR) duration of 3.5 (1.3, 7.0) days. 85 (68.0%) saw another healthcare provider within a 14 day period, 45 (36.0%) saw their family physician, and 34 (27.2%) saw an internist or endocrinologist. 9 (7.2%) were seen again in the ED, 5 of these patients required admission to hospital. There was one death that occurred within the follow-up period. Conclusion: This prospective study builds on our previous retrospective work and demonstrates that visits for hyperglycemia carry a significant burden of disease beyond what may be seen in a single ED encounter. Further research will attempt to identify the factors that may be predictive of adverse outcomes in hyperglycemic patients presenting to the ED.

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