scholarly journals The Association of Body Composition Parameters and Laboratory Markers With The Severity of Hypertriglyceridemia-Induced Pancreatitis

2020 ◽  
Author(s):  
Lifang Chen ◽  
Yingbao Huang ◽  
Huajun Yu ◽  
Kehua Pan ◽  
Zhao Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Composition ◽  
Logistic Regression ◽  
Adipose Tissue ◽  
Serum Albumin ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
The Third ◽  
Laboratory Markers ◽  
Low Serum

Abstract Background: Hypertriglyceridemia has arisen as the third leading cause of acute pancreatitis. This study aimed at exploring the association between the severity of hypertriglyceridemia-induced pancreatitis (HTGP) and computed tomography (CT)-based body composition parameters and laboratory markers.Methods: Clinical parameters were collected from 242 patients with HTGP between 2017 and 2020. Severity of HTGP was evaluated by original or modified CT severity index. Body composition parameters such as area and radiodensity of muscle, subcutaneous adipose tissue and visceral adipose tissue were calculated by CT at the third lumbar vertebra level. Parameters between mild and moderately severe to severe HTGP were compared. Uni-variate and multi-variate Logistic regression analyses were employed to assess the risk factors of the severity of HTGP.Results: Seventy patients with HTGP (28.9%) were mild. Body mass index, waist circumference and all CT-based body composition parameters differed between male and female patients. None was associated with the severity of HTGP, neither in the male nor in the female. Uni-variate and multi-variate Logistic regression analysis showed that low serum albumin (<35g/L) and high C-reactive protein (>90 mg/L) were risk factors of moderately severe to severe HTGP (P<0.001, OR=4.846, 95%CI=2.122-11.068; P<0.001, OR=4.230, 95%CI=2.050-8.727, respectively). Low serum albumin was also associated with pancreatic necrosis, longer hospital stay and higher scores of APACHE II, Ranson and Marshall in HTGP patients (all P<0.05).Conclusions: Low serum albumin and high C-reactive protein upon admission are associated with the severity of HTGP. However, none of the body composition parameters is associated with the severity of HTGP.

scholarly journals The association of parameters of body composition and laboratory markers with the severity of hypertriglyceridemia-induced pancreatitis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Lifang Chen ◽  
Yingbao Huang ◽  
Huajun Yu ◽  
Kehua Pan ◽  
Zhao Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Composition ◽  
Adipose Tissue ◽  
Serum Albumin ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Apolipoprotein A ◽  
Laboratory Markers ◽  
Subcutaneous Adipose ◽  
Low Serum

AbstractBackgroundHypertriglyceridemia has arisen as the third leading cause of acute pancreatitis. This study aimed at exploring the association between the severity of hypertriglyceridemia-induced pancreatitis (HTGP) and computed tomography (CT)-based body composition parameters and laboratory markers.MethodsLaboratory and clinical parameters were collected from 242 patients with HTGP between 2017 and 2020. Severity of HTGP was evaluated by original or modified CT severity index. Body composition parameters such as area and radiodensity of muscle, subcutaneous adipose tissue and visceral adipose tissue were calculated by CT at the level of third lumbar vertebra. Parameters were compared between mild and moderately severe to severe HTGP. Uni-variate and multi-variate Logistic regression analyses were employed to assess the risk factors of the severity of HTGP.ResultsSeventy patients (28.9%) presented with mild HTGP. Body mass index, waist circumference and all CT-based body composition parameters differed between male and female patients. None was associated with the severity of HTGP, neither in males nor in females. Receiver operating characteristic curves showed that areas under the curves of apolipoprotein A-I and albumin to predict the severity of HTGP were 0.786 and 0.759, respectively (allP < 0.001). Uni-variate and further multi-variate Logistic regression analysis confirmed that low serum albumin (< 35 g/L,P = 0.004, OR = 3.362, 95%CI = 1.492–8.823) and apolipoprotein A-I (< 1.1 g/L,P < 0.001, OR = 5.126, 95%CI = 2.348–11.195), as well as high C-reactive protein (> 90 mg/L,P = 0.005, OR = 3.061, 95%CI = 1.407–6.659) and lipase (P = 0.033, OR = 2.283, 95%CI = 1.070–4.873) were risk factors of moderately severe to severe HTGP. Levels of albumin, apolipoprotein A-I, C-reactive protein and lipase were also associated with the length of hospital stay (allP < 0.05). Besides, low serum albumin, low-density lipoprotein cholesterol and high radiodensity of subcutaneous adipose tissue were significant risk factors of pancreatic necrosis in patients with HTGP (allP < 0.05).ConclusionsLow serum albumin and apolipoprotein A-I, and high C-reactive protein and lipase upon admission were associated with a more severe type of HTGP and longer hospital stay for these patients. Albumin and apolipoprotein A-I may serve as novel biomarkers for the severity of HTGP. However, none of the body composition parameters was associated with the severity of HTGP.

P1593THE ASSOCIATION BETWEEN THE ANCLE-BRACHIAL INDEX AND MARKERS OF INFLAMATION IN CHRONIC HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Nevi Pasko ◽  
Ariana Strakosha ◽  
Arieta Dedej ◽  
Loredana Kapidani ◽  
Fjona Nasto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Serum Triglyceride ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Maintenance Hemodialysis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Arterial Complications ◽  
The Impact

Abstract Background and Aims Among hemodialysis patients, peripheral arterial disease (PAD) represents an important health care burden and has been associated with high mortality. The ancle-brachial index (ABI), is a reliable and noninvasive method used to asses PAD. The aim of this study was to evaluate the prevalence of PAD in patients undergoing chronic hemodialysis and the association with inflammation and malnutrition using serum C-reactive protein (CRP) and serum albumin as biomarkers. Method The study was conducted at different hemodialysis centers in patients receiving hemodialysis three times a week. We excluded patients with atrial fibrillation or who had been recently hospitalized. The ABI has been used as a diagnostic tool for PAD and measured before a hemodialysis session. A value of ABI less than 0.9 was considered abnormal. To better estimate the impact of malnutrition and inflammation we used the serum albumin, blood lipids values and serum C-reactive protein values defined by calculating the mean of the last three measurements. Results A total of 261 ESRD patients on maintenance hemodialysis were enrolled in the study. Mean age was 56.0 (±12) years, 58% were males, and 17.6% were diabetics. Mean time on hemodialysis was 5.9 (±6.7) years, with 24% of patients on dialysis for less than 3 years. Among our patients we found that the prevalence of PAD was 23.4%, of whom 58.1% were men. We found that age, diabetes, duration of hemodialysis, low serum albumin levels and high serum triglyceride levels were risk factors for PAD in hemodialysis patients. The multivariate analysis of our study has shown that a lower level of albumin and higher level of CRP were significantly associated with an ABI less than 0.9 (odds ratio, 4.54; 95% confidence interval, P = 0.017) after adjusting for demographic, clinical, biochemical and medication data. We did not find significant differences in serum calcium, phosphate or PTH levels between patients with PAD and those without it. Conclusion In conclusion, the present study showed high prevalence of PAD in patients on hemodialysis. The prevalence was higher in diabetics. Low albumin levels and C-reactive levels were independent risk factors of PAD. We found that early diagnosis and treatment of PAD could help to improve the quality of life of hemodialysed patients and postpone arterial complications in this group of patients.

scholarly journals Risk factors for clinical progression in patients with COVID-19: a retrospective study of electronic health record data in the United Kingdom

2020 ◽  
Author(s):  
Robert A Fletcher ◽  
Thomas Matcham ◽  
Marta Tibúrcio ◽  
Arseni Anisimovich ◽  
Stojan Jovanović ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Logistic Regression ◽  
Body Temperature ◽  
Blood Cell ◽  
Severe Disease ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Multivariable Logistic Regression ◽  
D Dimer

Background: The novel coronavirus disease 2019 (COVID-19) outbreak presents a significant threat to global health. A better understanding of patient clinical profiles is essential to drive efficient and timely health service strategies. In this study, we aimed to identify risk factors for a higher susceptibility to symptomatic presentation with COVID-19 and a transition to severe disease. Methods: We analysed data on 2756 patients admitted to Chelsea & Westminster Hospital NHS Foundation Trust between 1st January and 23rd April 2020. We compared differences in characteristics between patients designated positive for COVID-19 and patients designated negative on hospitalisation and derived a multivariable logistic regression model to identify risk factors for predicting risk of symptomatic COVID-19. For patients with COVID-19, we used univariable and multivariable logistic regression to identify risk factors associated with progression to severe disease defined by: 1) admission to the hospital AICU, 2) the need for mechanical ventilation, 3) in-hospital mortality, and 4) at least one measurement of elevated D-dimer (equal or superior to 1,000 ug/L) indicative of increased risk of venous thromboembolism. Results: The patient population consisted of 1148 COVID-19 positive and 1608 COVID-19 negative patients. Age, sex, self-reported ethnicity, C-reactive protein, white blood cell count, respiratory rate, body temperature, and systolic blood pressure formed the most parsimonious model for predicting risk of symptomatic COVID-19 at hospital admission. Among 1148 patients with COVID-19, 116 (10.1%) were admitted to the AICU, 71 (6.2%) required mechanical ventilation, 368 (32.1%) had at least one record of D-dimer levels ≥1,000 μg/L, and 118 patients died. In the multivariable logistic regression, age (OR = 0.953 per 1 year, 95% CI: 0.937-0.968) C-reactive protein (OR = 1.004 per 1 mg/L, 95% CI: 1.002-1.007), and white blood cell counts (OR = 1.059 per 109/L, 95% CI: 1.010-1.111) were found to be associated with admission to the AICU. Age (OR = 0.973 per 1 year, 95% CI: 0.955-0.990), C-reactive protein (OR = 1.003 per 1 mg/L, 95% CI: 1.000-1.006) and sodium (OR = 0.915 per 1 mmol/L, 0.868-0.962) were associated with mechanical ventilation. Age (OR = 1.023 per 1 year, 95% CI: 1.004-1.043), CRP (OR = 1.004 per 1 mg/L, 95% CI: 1.002-1.006), and body temperature (OR = 0.723 per 1oC, 95% CI: 0.541-0.958) were associated with elevated D-dimer. For mortality, we observed associations with age (OR = 1.060 per 1 year, 95% CI: 1.040-1.082), female sex (OR = 0.442, 95% CI: 0.442, 95% CI: 0.245-0.777), Asian ethnic background (OR = 2.237 vs White ethnic background, 95% CI: 1.111-4.510), C-reactive protein (OR = 1.004 per 1 mg/L, 95% CI: 1.001-1.006), sodium (OR = 1.038 per 1 mmol/L, 95% CI: 1.001-1.006), and respiratory rate (OR = 1.054 per 1 breath/min, 95% CI: 1.024-1.087). Conclusion: Our analysis suggests there are several demographic, clinical and laboratory findings associated with a symptomatic presentation of COVID-19. Moreover, significant associations between patient deterioration were found with age, sex and specific blood markers, chiefly C-reactive protein, and could help early identification of patients at risk of poorer prognosis. Further work is required to clarify the extent to which our observations are relevant beyond current settings.

Increased pretreatment C-reactive protein-to-albumin ratio predicts severe coronavirus disease 2019

2020 ◽  
Author(s):  
Xiaoyue Wang ◽  
Yan Xu ◽  
Huang Huang ◽  
Desheng Jiang ◽  
Chunlei Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Early Warning ◽  
Warning Signs ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Independent Risk Factors

Abstract Objective The aim of this study was to identify early warning signs for severe coronavirus disease 2019 (COVID-19). Methods We retrospectively analysed the clinical data of 90 patients with COVID-19 from Guanggu District of Hubei Women and Children Medical and Healthcare Center, comprising 60 mild cases and 30 severe cases. The demographic data, underlying diseases, clinical manifestations and laboratory blood test results were compared between the two groups. The cutoff values were determined by receiver operating characteristic curve analysis. Logistic regression analysis was performed to identify the independent risk factors for severe COVID-19. Results The patients with mild and severe COVID-19 had significant differences in terms of cancer incidence, age, pretreatment neutrophil-to-lymphocyte ratio (NLR), and pretreatment C-reactive protein-to-albumin ratio (CAR) ( P =0.000; P =0.008; P=0.000; P =0.000). The severity of COVID-19 was positively correlated with comorbid cancer, age, NLR, and CAR ( P <0.005). Multivariate logistic regression analysis showed that age, the NLR and the CAR were independent risk factors for severe COVID-19 (OR=1.086, P =0.008; OR=1.512, P =0.007; OR=17.652, P =0.001). Conclusion An increased CAR can serve as an early warning sign of severe COVID-19 in conjunction with the NLR and age.

scholarly journals C-Reactive Protein-to-Albumin Ratio Predicts Sepsis and Prognosis in Patients with Severe Burn Injury

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yaohua Yu ◽  
Weiwei Wu ◽  
Yanyan Dong ◽  
Jiliang Li
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Multivariate Logistic Regression Analysis ◽  
Severe Burn ◽  
C Reactive Protein ◽  
Multivariate Logistic Regression ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Severe Burns ◽  
Independent Risk Factors

Background. Sepsis is a leading cause of mortality among severe burns. This study was conducted to investigate the predictive role of C-reactive protein-to-albumin ratio (CAR) for sepsis and prognosis in severe burns. Methods. Patients with severe burn injuries from 2013 to 2017 were enrolled and divided into septic and nonseptic groups based on the presence of sepsis within 30 days postburn. Independent risk factors for sepsis were performed by the univariate and multivariate logistic regression analyses. The association between CAR level at admission and postburn 30-day mortality was designed via the Kaplan–Meier method. Results. Of all the 196 enrolled patients, 83 patients developed sepsis within 30 days postburn injury, with an incidence of 42.3%. TBSA percentage (OR: 1.65, 95% CI: 1.17-2.32, P = 0.014 ) and CAR at admission (OR: 2.25, 95% CI: 1.33-3.56, P = 0.009 ) were the two independent risk factors for sepsis in severe burns by the multivariate logistic regression analysis. A higher CAR level (≥1.66) at admission was associated with a lower postburn 30-day survival rate ( P = 0.005 ). Conclusions. The CAR level at admission was an independent risk factor for sepsis and prognosis in severe burns.

scholarly journals Survival analysis and risk factors in COVID-19 patients

2021 ◽  
pp. 1-15
Author(s):  
Wen Lu ◽  
Shuhui Yu ◽  
Hailing Liu ◽  
Lihua Suo ◽  
Kuanyin Tang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Platelet Count ◽  
Survival Analysis ◽  
Blood Cell ◽  
Serum Albumin ◽  
Protein Level ◽  
Lymphocyte Count ◽  
Clinical Characteristics ◽  
C Reactive Protein ◽  
Reactive Protein

ABSTRACT BACKGROUND: The aim of this study is to evaluate the clinical characteristics and outcomes in 2019 novel coronavirus patients and to help clinicians perform correct treatment and evaluate prognosis and guide the treatment. METHODS: 239 patients who were diagnosed with COVID-19 were included in this study. Patients were divided into the improvement group and the death group according to their outcome (improvement or death).Clinical characteristics and laboratory parameters were collected from medical records. Continuous variables were tested by independent sample T test, and categorical variables were analyzed by chi-square test or Fisher exact test. Cox proportional hazard regression model was used for survival analysis in death patients. The time-dependent AUC curves based on white blood cell count, lymphocyte count, white blood cell, lymphocyte count, neutrophil counts age, blood urea nitrogen and C-reactive protein were plotted. RESULTS: Efficacy evaluation indicated that 99 patients (41.4%) had deteriorated, and 140 patients (58.6%) had improved. Oxygen saturation, hemoglobin levels, infection-related indicators, lymphocyte and platelets counts, C-reactive protein, serum albumin, liver and kidney function and lactate dehydrogenase in improvement group were statistically significant between the improvement and death groups. Survival analysis revealed that comorbidities, lymphocyte counts, platelet count, serum albumin, C-reactive protein level and renal dysfunction may be risk factors in patients with COVID-19. CONCLUSION: Patients with comorbidities, lower lymphocyte counts in hemogram, platelet count and serum albumin, high C-reactive protein level and renal dysfunctionmay have higher risk to death. More attention should be givento risk management in the progression of COVID-19.

Risk Index Score for Bacteremia in Febrile Neutropenic Episodes in Children with Malignancies

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4654-4654
Author(s):  
Maria I Spasova ◽  
Janet G. Grudeva ◽  
Stefan S. Kostyanev ◽  
Evgeni D. Genev ◽  
Angelina A. Stoyanova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Antibiotic Therapy ◽  
Risk Group ◽  
Risk Index ◽  
Empiric Antibiotic Therapy ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Empiric Antibiotic ◽  
Risk Index Score

Abstract BACKGROUND: Nowadays febrile neutropenia is regarded as heterogeneous syndrome and adequate risk stratification of patients as a basis for tailoring empiric antibiotic therapy is attempted. We conducted this prospective study to determine risk factors for bacteremia in febrile neutropenic children that could be assessed in the first days from the onset of fever and based on logistic regression analysis to construct a risk index score for prediction of bacteremia. MATERIAL AND METHODS: We studied prospectively 199 consecutive episodes of febrile neutropenia for a 4-years period (2000 – 2004), occurring in 80 children with malignancies, treated by conventional chemotherapy. A standardized computer database with a set of variables for each febrile neutropenic episode was used. C-reactive protein was measured at the first fever and depending on its duration - on the 3-rd and 5-th day from the beginning of antibiotic therapy by immunoturbidimetric method. At the onset of fever and before initiation of antibiotic therapy blood cultures were drawn and injected directly into a culture bottle BACTEC Peds plus. RESULTS: By multivariate logistic regression analysis we determined 5 variables as independent risk factors for bacteremia: the underlying malignant disease (leukemia, NHL-gr.IV), chills, perianal cellulitis, presence of central venous catheter and degree of CRP rise ≥34.5 mg/L between the onset of fever and the 3rd day of empiric antibiotic therapy. This logistic regression model has sensitivity of 93%, specificity of 25%, negative predictive value of 89% and positive predictive value of 36% for the presence of bacteremia (Chi-square: 44, −2 log likelihood:200, Cox & Snell R square: 0.2). CONCLUSIONS: The present prospective study is characterized by prevalence of hematologic malignancies and relatively high frequency of bacteremia. We identified a low-risk group of 19.1%, comparable to the reported by other groups. Based on the statistical significance of serial measurement of C-reactive protein, which allows definite risk stratification of febrile neutropenic episodes on the 3rd day from the onset of fever, we would recommend sequential empiric antibiotic approach with switch to oral or even outpatient treatment in the low-risk group on the 3rd day.

scholarly journals Predictive Value of C-Reactive Protein for Early Postoperative Complications in Children After Hypospadias Surgery

2021 ◽  
Vol 9 ◽  
Author(s):  
Fengming Ji ◽  
Haoyu Tang ◽  
Chengchuang Wu ◽  
Li Chen ◽  
Huake Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Postoperative Complications ◽  
Predictive Value ◽  
Control Group ◽  
C Reactive Protein ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Reactive Protein ◽  
Urethral Defect

Background: This study explored the predictive value of postoperative C-reactive protein in children with hypospadias for postoperative complications and the risk factors.Methods: The clinical and follow-up data of 106 children with hypospadias who were treated with operations at Kunming Children's Hospital in 2020 were, respectively, analyzed. According to the occurrence of postoperative complications, the patients were divided into two groups: 25 patients with postoperative complications were the complications group, and 81 without postoperative complications were the control group. The baseline data, clinical characteristics, laboratory test indexes, and outcome of the two groups were collected. Receiver operating characteristic (ROC) was used to calculate the optimal cutoff value of C-reaction protein (CRP). Logistic regression was used to analyze the risk factors of hypospadias after surgery. A probability value (P) &lt; 0.05 was considered statistically significant.Results: According to the result of the ROC curve, the optimal cutoff value of CRP was 11.7 mg/L. Logistic regression showed that the length of urethral defect, the urethral material, the operative produce, and the postoperative CRP level were related to the occurrence of postoperative complications of patients with DCC. The length of the urethral defect and the CRP level were the independent risk factors of the prognosis of hypospadias patients. The CRP level was related to the occurrence of postoperative complications and fistula.Conclusions: Postoperative CRP level can be used as a reliable marker for predicting the prognosis of hypospadias patients.

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