scholarly journals Handgrip Strength Weakness and Asymmetry Together are Associated with Cardiovascular Outcomes in Elderly Outpatients: A Prospective Cohort Study

2022 ◽  
Author(s):  
Siyang Lin ◽  
Fang Wang ◽  
Yanjie Huang ◽  
Yin Yuan ◽  
Feng Huang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Handgrip Strength ◽  
Major Adverse Cardiovascular Event ◽  
Cardiovascular Outcomes ◽  
Complementary Information ◽  
Adverse Cardiovascular Event ◽  
Elderly Outpatients ◽  
Observational Cohort ◽  
Composite Endpoints

Abstract Background: The evaluations of handgrip strength (HGS) weakness and asymmetry have implications for the comprehensive geriatric assessment. The aim of this study was to investigate the association of HGS weakness and asymmetry on cardiovascular outcomes in elderly outpatients. Methods: This was a prospective observational cohort study of 364 geriatrics outpatients aged ≥ 60 years, in which all participants performed HGS tests at baseline. Patients with HGS < 28 kg for men and < 18 kg for women were diagnosed as HGS weakness, and HGS ratio < 0.90 or > 1.10 were diagnosed as HGS asymmetry. Primary outcomes defined as the major adverse cardiovascular event (MACE) and composite endpoints were assessed during 21-month median follow-up.Results: Among 364 participants, 155 (42.6%) demonstrated HGS weakness, and 160 (44.0%) demonstrated HGS asymmetry. HGS weakness was associated with MACE (HR: 2.763, 95%CI: 1.217-6.272) and composite endpoints (HR: 2.842, 95%CI: 1.399-5.774). However, no significant correlation between HGS asymmetry and cardiovascular outcomes was observed. Compared with the normal and symmetric HGS group, older adults with HGS weakness and asymmetry together had a higher risk of MACE (HR: 5.229, 95%CI: 1.559-17.542) and composite endpoints (HR: 4.002, 95%CI: 1.558-10.277). Conclusion: HGS weakness and asymmetry together may increase the risk of cardiovascular outcomes in elderly outpatients. HGS asymmetry offers complementary information to HGS weakness when making a comprehensive assessment of HGS.

scholarly journals Prevalence and Course of IgA and IgG Antibodies against SARS-CoV-2 in Healthcare Workers during the First Wave of the COVID-19 Outbreak in Germany: Interim Results from an Ongoing Observational Cohort Study

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 498
Author(s):  
Mark Reinwald ◽  
Peter Markus Deckert ◽  
Oliver Ritter ◽  
Henrike Andresen ◽  
Andreas G. Schreyer ◽  
...  
Keyword(s):  
Cohort Study ◽  
Healthcare Workers ◽  
Significant Proportion ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Observational Cohort Study ◽  
Igg Antibodies ◽  
University Hospitals ◽  
Observational Cohort

(1) Background: Healthcare workers (HCWs) are prone to intensified exposure to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in the ongoing pandemic. We prospectively analyzed the prevalence of antibodies against SARS-CoV-2 in HCWs at baseline and follow up with regard to clinical signs and symptoms in two university hospitals in Brandenburg, Germany. (2) Methods: Screening for anti-SARS-CoV-2 IgA and IgG antibodies was offered to HCWs at baseline and follow up two months thereafter in two hospitals of Brandenburg Medical School during the first wave of the COVID-19 pandemic in Germany in an ongoing observational cohort study. Medical history and signs and symptoms were recorded by questionnaires and analyzed. (3) Results: Baseline seroprevalence of anti-SARS-CoV-2 IgA was 11.7% and increased to 15% at follow up, whereas IgG seropositivity was 2.1% at baseline and 2.2% at follow up. The rate of asymptomatic seropositive cases was 39.5%. Symptoms were not associated with general seropositivity for anti-SARS-CoV-2; however, class switch from IgA to IgG was associated with increased symptom burden. (4) Conclusions: The seroprevalence of antibodies against SARS-CoV-2 was low in HCWs but higher compared to population data and increased over time. Screening for antibodies detected a significant proportion of seropositive participants cases without symptoms.

scholarly journals Neonatal Severe Hyperbilirubinemia Online Registry in Jiangsu Province: protocol for a multicentre, prospective, open, observational cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040797
Author(s):  
Qianqian Li ◽  
Xiaoyi Deng ◽  
Junmei Yan ◽  
Xiaofan Sun ◽  
Xiaoyue Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Observational Cohort Study ◽  
Jiangsu Province ◽  
Survival Status ◽  
Bilirubin Encephalopathy ◽  
Brainstem Response ◽  
Observational Cohort ◽  
Severe Hyperbilirubinemia

IntroductionSevere hyperbilirubinaemia in newborns can be easily complicated by acute bilirubin encephalopathy or even kernicterus, which could lead to neurological sequelae or death. However, there is no systematic study of the management of severe hyperbilirubinaemia in China. The Neonatal Severe Hyperbilirubinemia Online Registry study aims to investigate the management of jaundice before admission, risk factors and outcomes of severe hyperbilirubinaemia in a real-world setting in China.Methods and analysisThis is a prospective, multicentre, open, observational cohort study. From May 2020 to April 2023, more than 2000 patients with neonatal severe hyperbilirubinaemia from 13 tertiary hospitals in Jiangsu Province will join the study. Demographic data and treatment information will be collected from their clinical data. Management measures for jaundice before admission will be collected by the WeChat applet (called ‘Follow-up of jaundice’) after being provided by the patient’s guardian using a mobile phone. Follow-up data will include cranial MRI examination results, brainstem auditory-evoked potential or automatic auditory brainstem response, physical examination results and Griffiths Development Scales-Chinese at the corrected ages of 3–6 months and 1 and 2 years. Results and conclusions will be recorded using ‘Follow-up of jaundice.’ In-hospital outcomes, including severity of hyperbilirubinaemia (severe, extreme, hazardous), acute bilirubin encephalopathy (mild, moderate, severe) and survival status (death or survival), will be collected at discharge. Follow-up outcomes will include loss to follow-up, survival status and kernicterus (yes or no) at 2 years. The research will enhance our comprehensive knowledge of jaundice management before admission, risk factors and outcomes of severe hyperbilirubinaemia in China, which will ultimately help to reduce the incidence of neonatal severe hyperbilirubinaemia.Ethics and disseminationOur protocol has been approved by the Medical Ethics Committee of Nanjing Maternity and Child Health Care Hospital. We will present our findings at national conferences and peer-reviewed paediatrics journals.Trial registration numberNCT04251286.

scholarly journals Assessing Risk in Patients with Stable Coronary Disease: When Should We Intensify Care and Follow-Up? Results from a Meta-Analysis of Observational Studies of the COURAGE and FAME Era

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Umberto Barbero ◽  
Fabrizio D’Ascenzo ◽  
Freek Nijhoff ◽  
Claudio Moretti ◽  
Giuseppe Biondi-Zoccai ◽  
...  
Keyword(s):  
Stable Angina ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Stable Coronary Artery Disease ◽  
Random Effect ◽  
Composite Endpoint ◽  
Major Adverse Cardiovascular Event ◽  
Cardiac Events ◽  
Adverse Cardiovascular Event

Background. A large number of clinical and laboratory markers have been appraised to predict prognosis in patients with stable angina, but uncertainty remains regarding which variables are the best predictors of prognosis. Therefore, we performed a meta-analysis of studies in patients with stable angina to assess which variables predict prognosis.Methods. MEDLINE and PubMed were searched for eligible studies published up to 2015, reporting multivariate predictors of major adverse cardiac events (MACE, a composite endpoint of death, myocardial infarction, and revascularization) in patients with stable angina. Study features, patient characteristics, and prevalence and predictors of such events were abstracted and pooled with random-effect methods (95% CIs). Major adverse cardiovascular event (MACE) was the primary endpoint.Results. 42 studies (104,559 patients) were included. After a median follow-up of 57 months, cardiovascular events occurred in 7.8% of patients with MI in 6.2% of patients and need for repeat revascularization (both surgical and percutaneous) in 19.5% of patients. Male sex, reduced EF, diabetes, prior MI, and high C-reactive protein were the most powerful predictors of cardiovascular events.Conclusions. We show that simple and low-cost clinical features may help clinicians in identifying the most appropriate diagnostic and therapeutic approaches within the broad range of outpatients presenting with stable coronary artery disease.

scholarly journals One-year outcomes in a multicentre cohort study of incident rare diffuse parenchymal lung disease in children (ChILD)

Thorax ◽  
2019 ◽  
Vol 75 (2) ◽  
pp. 172-175 ◽  
Author(s):  
Steve Cunningham ◽  
Catriona Graham ◽  
Morag MacLean ◽  
Paul Aurora ◽  
Michael Ashworth ◽  
...  
Keyword(s):  
Cohort Study ◽  
Lung Disease ◽  
Low Oxygen ◽  
Child Survivors ◽  
Diffuse Parenchymal Lung Disease ◽  
Multicentre Cohort Study ◽  
Observational Cohort ◽  
One Year ◽  
First Time

We performed a prospective, observational, cohort study of children newly diagnosed with children’s interstitial lung disease (ChILD), with structured follow-up at 4, 8, 12 weeks and 6 and 12 months. 127 children, median age 0.9 (IQR 0.3–7.9) years had dyspnoea (68%, 69/102), tachypnoea (75%, 77/103) and low oxygen saturation (SpO2) median 92% (IQR 88–96). Death (n=20, 16%) was the most common in those <6 months of age with SpO2<94% and developmental/surfactant disorders. We report for the first time that ChILD survivors improved multiple clinical parameters within 8–12 weeks of diagnosis. These data can inform family discussions and support clinical trial measurements.

scholarly journals The Relationship between AKI and CKD in Patients with Type 2 Diabetes: An Observational Cohort Study

2020 ◽  
Vol 32 (1) ◽  
pp. 138-150 ◽  
Author(s):  
Simona Hapca ◽  
Moneeza K. Siddiqui ◽  
Ryan S.Y. Kwan ◽  
Michelle Lim ◽  
Shona Matthew ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Observational Studies ◽  
Observational Cohort Study ◽  
Patients With Diabetes ◽  
Observational Cohort ◽  
The Relationship ◽  
Egfr Slope

BackgroundThere are few observational studies evaluating the risk of AKI in people with type 2 diabetes, and even fewer simultaneously investigating AKI and CKD in this population. This limits understanding of the interplay between AKI and CKD in people with type 2 diabetes compared with the nondiabetic population.MethodsIn this retrospective, cohort study of participants with or without type 2 diabetes, we used electronic healthcare records to evaluate rates of AKI and various statistical methods to determine their relationship to CKD status and further renal function decline.ResultsWe followed the cohort of 16,700 participants (9417 with type 2 diabetes and 7283 controls without diabetes) for a median of 8.2 years. Those with diabetes were more likely than controls to develop AKI (48.6% versus 17.2%, respectively) and have preexisting CKD or CKD that developed during follow-up (46.3% versus 17.2%, respectively). In the absence of CKD, the AKI rate among people with diabetes was nearly five times that of controls (121.5 versus 24.6 per 1000 person-years). Among participants with CKD, AKI rate in people with diabetes was more than twice that of controls (384.8 versus 180.0 per 1000 person-years after CKD diagnostic date, and 109.3 versus 47.4 per 1000 person-years before CKD onset in those developing CKD after recruitment). Decline in eGFR slope before AKI episodes was steeper in people with diabetes versus controls. After AKI episodes, decline in eGFR slope became steeper in people without diabetes, but not among those with diabetes and preexisting CKD.ConclusionsPatients with diabetes have significantly higher rates of AKI compared with patients without diabetes, and this remains true for individuals with preexisting CKD.

scholarly journals Observational cohort study to investigate the unmet need and time waiting for referral for specialist opinion in adult asthma in England (UNTWIST asthma)

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031740
Author(s):  
John D Blakey ◽  
Alicia Gayle ◽  
Mariel G Slater ◽  
Gareth H Jones ◽  
Michael Baldwin
Keyword(s):  
Cohort Study ◽  
Waiting Time ◽  
Unmet Need ◽  
Observational Cohort Study ◽  
Clinical Practice Research Datalink ◽  
High Dose ◽  
Specialist Referral ◽  
Number Of Patients ◽  
Observational Cohort

ObjectivesThis study aimed to estimate how many patients with asthma in England met the referral eligibility criteria using national asthma guidelines, identify what proportion were referred and determine the average waiting time to referral.DesignThis is an observational cohort study.Setting/Data sourcesRoutinely collected healthcare data were provided by Clinical Practice Research Datalink records and Hospital Episode Statistics records from January 2007 to December 2015.ParticipantsPatients with asthma aged 18–80 years participated in this study.Main outcome measuresEligibility for referral by the British Thoracic Society/Scottish Intercollegiate Guidelines Network (BTS/SIGN) 2016 guidelines, determined after a 3-month pharmacological therapy exposure assessment, was classed by either ‘high-dose therapies’, ‘continuous or frequent use of oral steroids’ or ‘incident eligibility’ during follow-up (continuous oral corticosteroids for more than 3 months, or ≥800 µg/day inhaled corticosteroids/long-acting β2-agonist (or three controllers) and ≥2 asthma attacks/year).ResultsFrom the final cohort (n=23293), 19837 patients were eligible for specialist referral during follow-up based on the BTS/SIGN guideline recommendations. Among eligible patients without any previously recorded referral, 4% were referred during follow-up, with a median waiting time of 880 days (IQR=1428 days) between eligibility and referral.ConclusionsA large number of patients with asthma were eligible for specialist referral, of which a small proportion were referred, and many experienced a long waiting time before referral. The results indicate a major unmet need in asthma referral, which is a potential source of preventable harm and are likely to have implications regarding how services are organised to address this unmet need.

COMPASS criteria applied to a contemporary cohort of unselected patients with stable coronary artery diseases: insights from the START registry

2020 ◽  
Author(s):  
Leonardo De Luca ◽  
Dario Formigli ◽  
Jennifer Meessen ◽  
Massimo Uguccioni ◽  
Nicola Cosentino ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stable Coronary Artery Disease ◽  
Dual Therapy ◽  
Major Adverse Cardiovascular Event ◽  
Cardiovascular Outcomes ◽  
Adverse Cardiovascular Event ◽  
Exclusion Criteria ◽  
Absolute Increase ◽  
Artery Disease

Abstract Aims Recently, the cardiovascular outcomes for people using anticoagulation strategies (COMPASS) trial demonstrated that dual therapy reduced cardiovascular outcomes compared with aspirin alone in patients with stable atherosclerotic disease. Methods and results We sought to assess the proportion of patients eligible for the COMPASS trial and to compare the epidemiology and outcome of these patients with those without COMPASS inclusion or with any exclusion criteria in a contemporary, nationwide cohort of patients with stable coronary artery disease. Among the 4068 patients with detailed information allowing evaluation of eligibility, 1416 (34.8%) did not fulfil the inclusion criteria (COMPASS-Not-Included), 841 (20.7%) had exclusion criteria (COMPASS-Excluded), and the remaining 1811 (44.5%) were classified as COMPASS-Like. At 1 year, the incidence of major adverse cardiovascular event (MACE), a composite of cardiovascular death, myocardial infarction, and stroke, was 0.9% in the COMPASS-Not-Included and 2.0% in the COMPASS-Like (P = 0.01), and 5.0% in the COMPASS-Excluded group (P &lt; 0.0001 for all comparisons). Among the COMPASS-Like population, patients with multiple COMPASS enrichment criteria presented a significant increase in the risk of MACE (from 1.0% to 3.3% in those with 1 and ≥3 criteria, respectively; P = 0.012), and a modest absolute increase in major bleeding risk (from 0.2% to 0.4%, respectively; P = 0.46). Conclusion In a contemporary real-world cohort registry of stable coronary artery disease, most patients resulted as eligible for the COMPASS. These patients presented a considerable annual risk of MACE that consistently increases in the presence of multiple risk factors.

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