scholarly journals Epidemiology and Mortality Predictors for Severe Childhood Community-acquired Pneumonia in ICUs: A Case-control Study

2021 ◽  
Author(s):  
lu cao ◽  
zhuo li ◽  
zhaohua ji ◽  
yan zuo ◽  
jingwen wang
Keyword(s):  
Case Control Study ◽  
Age Groups ◽  
Severe Pneumonia ◽  
Case Control ◽  
Community Acquired Pneumonia ◽  
Hospital Death ◽  
Retrospective Case ◽  
Prophylactic Measures ◽  
Mortality Predictors ◽  
Control Study

Abstract Background: To identify the epidemiology and mortality predictors for severe childhood community-acquired pneumonia (CAP) and evaluate the influence of medications on clinical outcome in the real world.Methods: We performed a retrospective case-control study among children with severe CAP aged ≤5 years of age, separately comparing the detailed information between the in-hospital death cases and the survival cases in two different age groups. Multivariate regression model was used to figure out mortality predictors.Results: 945 children were recruited, including 604 infants and 341 young children. Overall 88 deaths occurred (9.3%). There was low adherence to guidelines in antimicrobials and carbapenems were widely served as initial empiric regimens, but the efficacy was not superior to the guidelines recommended. In multivariate analyses, very severe pneumonia (OR: 3.55; 95% CI: 1.39-9.09), lower birth weight (OR: 3.92; 95% CI: 1.50-10.23), severe underweight (OR: 4.72; 95% CI: 1.92-11.62), mechanical ventilation (OR: 5.06; 95% CI: 1.97-12.95；OR：14.43; 95% CI 3.31-62.96)，comorbidity including anemia (OR: 5.61; 95% CI: 2.36-13.35), neonatal asphyxia (OR: 6.03; 95% CI: 1.57-23.12), gastrointestinal hemorrhage (OR: 3.73; 95% CI: 1.21-11.48) and sedative-hypnotics ( OR: 4.32; 95% CI: 1.76-10.61; OR: 4.13; 95% CI：1.50-11.38) were independent risk factors for death, whereas a lower mortality was present in infants with probiotics (OR: 0.24; 95% CI: 0.10-0.54).Conclusions: Severe pneumonia remains a primary cause of death in children under 5 years of age. Clinical characteristics, comorbidity and medications are evidently associated with death. Importantly, we should pay particular attention to the identification of the mortality predictors and establish prophylactic measures to reduce the mortality.

scholarly journals Epidemiology and Mortality Predictors for Severe Childhood Pneumonia in ICUs: A Real-World Study in China

2020 ◽  
Author(s):  
lu cao ◽  
zhaohua ji ◽  
yan zuo ◽  
jingwen wang
Keyword(s):  
Real World ◽  
Age Groups ◽  
Severe Pneumonia ◽  
Hospital Death ◽  
Observation Study ◽  
Childhood Pneumonia ◽  
Prophylactic Measures ◽  
Sedative Hypnotics ◽  
Independent Risk Factors ◽  
Mortality Predictors

Abstract Background To identify the epidemiology and mortality predictors for severe childhood pneumonia and evaluate the influence of medications on clinical outcome in the real world.Methods We performed a retrospective observation study among children with severe pneumonia aged ≤ 5 years of age, separately comparing the detailed information between the in-hospital death cases and the survival cases in two different age groups. Multivariate regression model was used to figure out mortality predictors.Results 945 children were recruited, including 604 infants and 341 young children. Overall 88 deaths occurred (9.3%). There was low adherence to guidelines in antimicrobials and carbapenems were widely served as initial empiric regimens, but the efficacy was not superior to the guidelines recommended. In multivariate analyses, very severe pneumonia (OR: 3.55; 95% CI: 1.39–9.09), lower birth weight (OR: 3.92; 95% CI: 1.50-10.23), severe underweight (OR: 4.72; 95% CI: 1.92–11.62), mechanical ventilation (OR: 5.06; 95% CI: 1.97–12.95;OR: 14.43; 95% CI 3.31–62.96),comorbidity including anemia (OR: 5.61; 95% CI: 2.36–13.35), neonatal asphyxia (OR: 6.03; 95% CI: 1.57–23.12), gastrointestinal hemorrhage (OR: 3.73; 95% CI: 1.21–11.48) and sedative-hypnotics ( OR: 4.32; 95% CI: 1.76–10.61; OR: 4.13; 95% CI༚1.50-11.38) were independent risk factors for death, whereas a lower mortality was present in infants with probiotics (OR: 0.24; 95% CI: 0.10–0.54).Conclusions Severe pneumonia remains a primary cause of death in children under 5 years of age. Clinical characteristics, comorbidity and medications are evidently associated with death. Importantly, we should pay particular attention to the identification of the mortality predictors and establish prophylactic measures to reduce the mortality.

scholarly journals Clinical characteristics and survival analysis in critical and non-critical patients with COVID-19 in Wuhan, China: a single-center retrospective case control study

2020 ◽  
Author(s):  
Ran Tian ◽  
Wei Wu ◽  
Chunyao Wang ◽  
Haiyu Pang ◽  
Zhiyu Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Large Scale ◽  
Case Control Study ◽  
Case Control ◽  
Hospital Death ◽  
Single Center ◽  
Retrospective Case ◽  
Critical Patients ◽  
Qsofa Score ◽  
Control Study

Abstract Since the outbreak of COVID-19 in China at the end of 2019, the world has experienced a large-scale epidemic caused by the SARS-CoV-2. Epidemiological and clinical course of COVID-19 patients have been reported, but there have been few analyses about the characteristics, predictive risk factors and outcomes of critical patients. In this single-center retrospective case-control study, 90 adult inpatients hospitalized at Tongji Hospital (Wuhan, China) were included. Demographic, clinical, laboratory test and treatment data were obtained and compared between critical and non-critical patients. We found that compared with non-critical patients, the critical patients had higher SOFA score and qSOFA scores. Critical patients had lower lymphocyte and platelet count, elevated D-dimer, decreased fibrinogen, and elevated high-sensitivity C-reactive protein (hsCRP) and interleukin-6(IL-6). More critical patients received treatment including antibiotics, anticoagulation, corticosteroid and oxygen therapy than non-critical ones. Multivariable regression showed higher qSOFA score and elevation of IL-6 were related to critical patients. Antibiotic usage and anticoagulation were associated with decreased in-hospital mortality. And critical grouping contributed greatly to in-hospital death. Critical COVID-19 patients have a more severe clinical cours. qSOFA score and elevation of IL-6 are risk factors for critical condition. Non-critical grouping, positive antibiotic application and anticoagulation may be beneficial for patient survival.

Genetic variation in PTX3 is associated with susceptibility to community-acquired pneumonia in adults: a retrospective case control study

2020 ◽  
Author(s):  
Yingqi Xiao ◽  
Shiyi Bu ◽  
Tiantian Tang ◽  
Qiaojun Zeng ◽  
Biru Huang ◽  
...  
Keyword(s):  
Case Control Study ◽  
Haplotype Frequency ◽  
Case Control ◽  
Community Acquired Pneumonia ◽  
Control Group ◽  
Strong Linkage Disequilibrium ◽  
Retrospective Case ◽  
Acute Phase Reactants ◽  
And Control ◽  
Control Study

Abstract BackgroundEvidence indicates that single nucleoid polymorphisms (SNPs) of key molecules in innate immunity are related to clinical outcome of community-acquired pneumonia (CAP). Pentraxin 3 (PTX3) is a member of the acute-phase reactants superfamily and plays an important role against various diseases. The purpose of the current study was to assess the association between PTX 3 SNP and the risk of CAP.MethodsThis is a retrospective case-control study. Patients who were diagnosed with CAP between January 2018 to December 2019 in the Department of Pulmonary and Critical Care Medicine at Sun Yat-sen Memorial Hospital were included as CAP group. Then CAP cases were matched 1:1 by gender with non-infectious hospitalized patients during the same time. We detected the genotypes, allele frequencies and haplotype distributions of three SNPs within PTX3 gene (rs2305619, rs3816527, and rs1840680) by polymerase chain reaction sequencing in CAP group and control group, and compared their associations with the risk of CAP.ResultsThree SNPs in both groups were consist with Hardy-Weinberg equilibrium. A strong linkage disequilibrium was detected between any pair of rs2305619, rs3816527 and rs1840680 (|D’|≥0.85). There were no differences of rs2305619 and rs3816527 in genotypic distribution and haplotype frequency between CAP group and control group. However, we identified that SNP rs1840680 AA homozygote was associated with a lower risk of CAP in adults (OR, 0.32; 95% CI, 0.11-0.91; p = 0.03).ConclusionsOur findings suggested that PTX3 single nucleoid polymorphism was associated with the risk of CAP in adults.

scholarly journals Risk of early-onset dementia among persons with tinnitus: a retrospective case–control study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yen-Fu Cheng ◽  
Sudha Xirasagar ◽  
Tzong-Han Yang ◽  
Chuan-Song Wu ◽  
Yi-Wei Kao ◽  
...  
Keyword(s):  
Early Onset ◽  
Case Control Study ◽  
Age Groups ◽  
Case Control ◽  
Research Database ◽  
Retrospective Case ◽  
Early Onset Dementia ◽  
Increased Risk ◽  
Taiwan National Health Insurance ◽  
Control Study

AbstractHigher rates of poor cognitive performance are known to prevail among persons with tinnitus in all age groups. However, no study has explored the association between tinnitus and early-onset dementia. We hypothesize that tinnitus may precede or occur concurrently with subclinical or early onset dementia in adults younger than 65 years of age. This case–control study used data from the Taiwan National Health Insurance Research Database, identifying 1308 patients with early-onset dementia (dementia diagnosed before 65 years of age) and 1308 matched controls. We used multivariable logistic regressions to estimate odds ratios (ORs) for prior tinnitus among patients with dementia versus controls. Among total 2616 sample participants, the prevalence of prior tinnitus was 18%, 21.5% among cases and 14.5% among controls (p < 0.001). Multivariable logistic regression showed and adjusted OR for prior tinnitus of 1.6 for cases versus controls (95% CI: 1.3 ~ 2.0). After adjusting for sociodemographic characteristics and medical co-morbidities, patients with early-onset dementia had a 67% higher likelihood of having prior tinnitus (OR = 1.628; 95% CI = 1.321–2.006). Our findings showed that pre-existing tinnitus was associated with a 68% increased risk of developing early-onset dementia among young and middle-aged adults. The results call for greater awareness of tinnitus as a potential harbinger of future dementia in this population.

scholarly journals Clinical features, bacteriology of endotracheal aspirates and treatment outcomes of patients with chronic obstructive pulmonary disease and community-acquired pneumonia in an intensive care unit in Taiwan with an emphasis on eosinophilia versus non-eosinophilia: a retrospective case–control study

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e020341 ◽  
Author(s):  
Wei-Chang Huang ◽  
Ching-Hsiao Lee ◽  
Ming-Feng Wu ◽  
Chen-Cheng Huang ◽  
Cheng-Hui Hsu ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Case Control Study ◽  
Case Control ◽  
Community Acquired Pneumonia ◽  
Chronic Obstructive ◽  
Clinical Implications ◽  
Retrospective Case ◽  
Obstructive Pulmonary Disease ◽  
Icu Admission ◽  
Control Study

ObjectivesThe clinical implications of blood eosinophil level in patients with chronic obstructive pulmonary disease (COPD) and community-acquired pneumonia (CAP) requiring invasive mechanical ventilation (IMV) and intensive care unit (ICU) admission are still unknown. Thus, this study aimed to compare the features of such patients with and without blood eosinophilia.DesignThis was a retrospective case–control study.SettingAn ICU of a medical centre in central Taiwan.ParticipantsA total of 262 patients with COPD and CAP requiring IMV and ICU admission.ResultsOf all participants (n=262), 32 (12.2%) had an eosinophil percentage (EP) >2% and 169 (64.5%) had an absolute eosinophil count (AEC) >300 cells/µL. Regardless of whether 2% or 300 cells/µL was used as a cut-off value, the eosinophilia group were slightly older (years) (82.9±5.4 vs 78.1±9.1, p=0.000 and 79.2±8.4 vs 77.6±9.6, p=0.246, respectively), and had a higher forced expiratory volume in 1 s/forced vital capacity (%) (56.0±8.0 vs 51.3±11.6, p=0.005 and 53.1±11.2 vs 49.5±11.2, p=0.013, respectively), less severe spirometric classification (p=0.008 and p=0.001, respectively), and lower white cell count 109/L (8.8±3.2 vs 11.1±4.9, p=0.009 and 10.3±4.4 vs 11.8±5.3, p=0.017, respectively) than the non-eosinophilia group. The bacteriology of endotracheal aspirates showed thatPseudomonas aeruginosaand other gram-negative bacilli were the most common organisms in all study groups. Participants with an EP >2% had a shorter ICU length of stay (OR=12.13, p=0.001) than those with an EP ≤2%, while an AEC >300 cells/µL was not associated with any in-ICUoutcomes.ConclusionsThe results of this study have significant clinical implications and should be considered when making treatment decisions for the management of patients with COPD and CAP requiring IMV and ICU admission.

scholarly journals Clinical characteristics and survival analysis in critical and non-critical patients with COVID-19 in Wuhan, China: a single-center retrospective case control study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ran Tian ◽  
Wei Wu ◽  
Chunyao Wang ◽  
Haiyu Pang ◽  
Zhiyu Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Clinical Course ◽  
Case Control ◽  
Hospital Death ◽  
Single Center ◽  
Retrospective Case ◽  
Critical Patients ◽  
Qsofa Score ◽  
Control Study

Abstract Since the outbreak of COVID-19 in China at the end of 2019, the world has experienced a large-scale epidemic caused by the SARS-CoV-2. The epidemiological and clinical course of COVID-19 patients has been reported, but there have been few analyses about the characteristics, predictive risk factors, and outcomes of critical patients. In this single-center retrospective case–control study, 90 adult inpatients hospitalized at Tongji Hospital (Wuhan, China) were included. Demographic, clinical, laboratory tests, and treatment data were obtained and compared between critical and non-critical patients. We found that compared with non-critical patients, the critical patients had higher SOFA score and qSOFA scores. Critical patients had lower lymphocyte and platelet count, elevated D-dimer, decreased fibrinogen, and elevated high-sensitivity C-reactive protein (hsCRP), and interleukin-6(IL-6). More critical patients received treatment including antibiotics, anticoagulation, corticosteroid, and oxygen therapy than non-critical ones. Multivariable regression showed higher qSOFA score and elevation of IL-6 were related to critical patients. Antibiotic usage and anticoagulation were associated with decreased in-hospital mortality. And critical grouping contributed greatly to in-hospital death. Critical COVID-19 patients have a more severe clinical course. qSOFA score and elevation of IL-6 are risk factors for critical condition. Non-critical grouping, positive antibiotic application, and anticoagulation may be beneficial for patient survival.

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