scholarly journals The characteristics of laboratory tests at admission and the risk factors for adverse clinical outcomes of severe and critical COVID-19 patients

2020 ◽  
Author(s):  
Liulin Wang ◽  
Xiaobin Cheng ◽  
Qiufen Dong ◽  
Chenliang Zhou ◽  
Yeming Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Blood Cell ◽  
White Blood Cell ◽  
Independent Risk Factor ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Blood Cell Count ◽  
Cox Proportional Hazard

Abstract Background Coronavirus disease 2019(COVID-19) is a worldwide pandemic.In this study, we aimed to evaluate the risk factors of death from severe and critical COVID-19 patients.Method A retrospective study of patients diagnosed with severe and critical COVID-19 from four hospitals in Wuhan, China, describing the clinical characteristics and laboratory results, and using Cox regression to study the risk factors was conducted.Results Four hundred and forty-six patients with COVID-19 showed a high case fatality rate(CFR)(20.2%). All patients required oxygen therapy, and 52(12%) patients required invasive mechanical ventilation,of which 50(96%) patients died.The univariate Cox proportional hazard model showed a white blood cell count of more than 10 × 10⁹/L(HR3.903,95%CI 2.413 to 6.313),patients’ risk of death significantly increased.The multivariate Cox proportional hazard model demonstrated that older age (HR 1.074, 95% CI 1.050 to 1.098) was an independent risk factor and high white blood cell count(HR 1.119, 95% CI 1.056 to 1.186)was a predictive factor for COVID-19 on admission.Conclusions COVID-19 is a new disease entity that carries significant risk of morbidity and CFR.Older age was an independent risk factor and high white blood cell was a predictive factor for COVID-19.

scholarly journals The Characteristics of Laboratory Tests at Admission and the Risk Factors for Adverse Clinical Outcomes of Severe and Critical COVID-19

2020 ◽  
Author(s):  
Liulin Wang ◽  
Xiaobin Cheng ◽  
Qiufen Dong ◽  
Chenliang Zhou ◽  
Yeming Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Proportional Hazard ◽  
Blood Cell Count ◽  
Patient Death ◽  
Cox Proportional Hazard ◽  
Independent Risk Factors

Abstract Background COVID-19 is a worldwide pandemic. In this study, we aimed to evaluate the risk of death from severe and critical COVID-19. Method A retrospective study of patients diagnosed with severe and critical COVID-19 from four hospitals , describing the clinical characteristics and laboratory results, and using Cox survival analysis to study the risk factors was conducted. Results Four hundred and forty-six patients with COVID-19 showed a high mortality rate (20.2%). All patients required oxygen therapy, and 52(12%) patients required invasive mechanical ventilation, of which 50(96%) patients died. The univariate Cox proportional hazard model showed a white blood cell count of more than 10 × 10⁹/L （HR4.3, 95% CI 2.8 to6.9）,which is a risk factor .The multivariate Cox proportional hazard model demonstrated that advanced age (HR 1.1, 95% CI 1.0 to 1.1) and high white blood cell count on admission (HR 1.1, 95% CI 1.0 to 1.2) were independent risk factors for patient death. Conclusions COVID-19 is a new disease entity that carries significant risk of morbidity and mortality.Advanced age and high white blood cell count were found to be independent risk factors for patient death.

scholarly journals Survival Analysis of Multiple Myeloma Cancer (MMC) Using the Cox-Proportional Hazard Model

2020 ◽  
Vol 5 (7) ◽  
Keyword(s):  
Risk Factors ◽  
Multiple Myeloma ◽  
Prognostic Factor ◽  
Blood Cells ◽  
White Blood Cells ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Survival Times ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard

Though multiple myeloma cancer (MMC) remains incurable, research into improving the therapeutic strategy has increased dramatically in recent years. But it is unclear if sustained improvements have been achieved. We studied the survival times of 48 patients diagnosed and treated with alkylating agents. The semi-parametric Cox proportional hazard model was employed to examine the survival probability taking into account the sixteen risk factors presumed to be contributing to the survival times. A careful and rigorous assessment of the risk factors based on the AIC of the stepwise selection technique revealed seven risk factors, and one interaction term are statistically significantly contributing to the survival times. They are blood urea nitrogen (BUN)/serum creatinine, white blood cells (WBC), Bence Jone protein in the urine (BJPU), fractures, proteinuria, gender, platelets, and the interaction of infections and serum calcium. The final Cox-PH model was well-validated and satisfied the key assumptions. The identified risk factors are rank according to the prognostic effect on the survival time based on the hazard ratio. Blood urea nitrogen (BUN)/serum creatinine was the greatest prognostic factor (most contributing factor, and highly negatively related to the MMC deaths or survival times), followed by white blood cells (WBC), and normal platelet was found to be the minimum prognostic factor (least contributing factor to MMC death or survival times). This study offers prognostic and therapeutic significance for further enhancement in the treatment strategy of the multiple myeloma cancer disease.

scholarly journals POS0466 RHEUMATOID ARTHRITIS PER SE IS NOT RISK FACTOR FOR CLINICAL FRACTURES: NINE-YEAR FINDINGS OF THE TOMORROW STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 465.1-465
Author(s):  
K. Mamoto ◽  
T. Koike ◽  
Y. Yamada ◽  
T. Okano ◽  
Y. Sugioka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Significant Risk ◽  
Thoracic Vertebrae ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Research Support ◽  
Cox Proportional Hazard ◽  
Increased Risk ◽  
Clinical Fractures

Background:Patients with rheumatoid arthritis (RA) who have sarcopenia and stiff or painful joints might be at increased risk of falls and fractures.Objectives:The present study aimed to prospectively identify the incidence of clinical fractures and associated risk factors in patients with RA in a cohort study named the TOMORROW (UMIN000003876) that started in 2010.Methods:We evaluated anthropometric parameters, bone mineral density (BMD), disease activity, RA medication at baseline and observed the incidence of clinical fractures during nine years in 202 patients with RA (mean age, 58.6 y; medication with biological agents, 54.9%) and 202 age- and sex-matched non-RA volunteers (mean age, 57.4 y). We compared the incidence of clinical fractures between patients with RA and controls for nine years, and analyzed the risk factors for fractures using Cox proportional hazard model.Results:The incidence of clinical fractures in RA patients was significantly higher compared to controls (27.5 vs 18.3%, p=0.04). However, Cox proportional hazard model, adjusted by age, sex, smoking and body mass index, revealed that low BMD at thoracic vertebrae (< 0.7 g/cm2) significantly associated to the incidence of clinical fractures (hazard ratio [HR], 1.86, p=0.02), but not RA morbidity (HR 1.47, p=0.10) (Table 1). Among patients with RA, low BMD at the thoracic vertebrae (< 0.7 g/cm2) was the most prominent risk factor for clinical fractures (HR, 2.66, p=0.02) (Table 1). Although the use of glucocorticoid (GC) at baseline (HR, 1.68, p=0.09) was not a significant risk factor for fractures, a mean GC dose (≥ 2 mg/day) at entry increased risk for clinical fractures in the patients (HR, 1.91, p=0.04) (Table 1).Conclusion:RA per se was not a risk factor for clinical fractures in this cohort. Low BMD at the thoracic vertebrae and the use of GC with even low dose at entry were apparently significant risk factors for the incidence of clinical fractures among patients with RA.Disclosure of Interests:Kenji Mamoto: None declared, Tatsuya Koike Grant/research support from: Takeda Pharmaceutical, Mitsubishi Tanabe Pharma Corporation,Chugai Pharmaceutical, Eisai, Abbott Japan, Teijin Pharma, Banyu Pharmaceutical and Ono Pharmaceutical, Yutaro Yamada: None declared, Tadashi Okano: None declared, Yuko Sugioka: None declared, Masahiro Tada: None declared, Kentaro Inui Speakers bureau: Daiichi Sankyo Co. Ltd., Mitsubishi Tanabe Pharma, Janssen Pharmaceutical K.K., Astellas Pharma Inc., Takeda Pharmaceutical Co. Ltd., Ono Pharmaceutical Co. Ltd., Abbvie GK, Pfizer Inc., Eisai Co.,Ltd., Chugai Pharmaceutical Co., Ltd., Grant/research support from: Janssen Pharmaceutical K.K., Astellas Pharma Inc., Sanofi K.K., Abbvie GK, Takeda Pharmaceutical Co. Ltd., QOL RD Co. Ltd., Mitsubishi Tanabe Pharma, Ono Pharmaceutical Co. Ltd., Eisai Co.,Ltd., Hiroaki Nakamura: None declared

scholarly journals Increased mortality associated with uncontrolled diabetes mellitus in patients with Pulmonary Cryptococcosis — a single U.S. cohort study

2021 ◽  
Author(s):  
Solana Archuleta ◽  
Amal A. Gharamti ◽  
Stefan Sillau ◽  
Paula Castellanos ◽  
Sindhu Chadalawada ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Case Control ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Pulmonary Cryptococcosis ◽  
Cox Proportional Hazard ◽  
Uncontrolled Diabetes ◽  
One Year

AbstractBackgroundDiabetes mellitus is an established risk factor for bacterial infections, but its role in Cryptococcosis is unclear. The study aimed to determine whether uncontrolled diabetes (HbA1c >7%) was an independent risk factor for mortality in cryptococcosis.MethodsA retrospective case-control study partially matched by age and gender was performed in patients tested for Cryptococcus infection at the University of Colorado Hospital from 2000-2019. A multivariable logistic regression model was used to identify mortality predictors. Cox proportional hazard model was used for survival analysis.ResultsWe identified 96 cases of Cryptococcosis and 125 controls. Among cases, cryptococcal meningitis (49.0%) and pneumonia (36.5%) constituted most infections. Cases with pulmonary cryptococcosis had a higher mortality at 10 weeks (50% vs 7%, p=0.006) and one year (66.7% vs 13.8%, p=0.005). Unadjusted Cox proportional hazard model found an increased rate of death for uncontrolled diabetes at 10-weeks (hazard ratio 8.4, CI: 1.4-50.8, p=0.02), and 1-year (hazard ratio 7.0, CI: 1.7-28.4, p=0.007) among pulmonary cryptococcosis cases. Multivariable analysis showed a significantly increased odds of 10-weeks (OR=4.3, CI: 1.1-16.5, p=0.035) and one-year (OR=5.9, CI: 2.2-15.8, p=0.014) mortality for uncontrolled diabetes among pulmonary cryptococcosis cases. After adjustment for gender, age, and case/control, for every 1% increase in HbA1c levels, the odds of pulmonary cryptococcosis mortality at one-year increased by 11% (OR = 1.6, CI 95%: 1.1-2.3, p= 0.006).ConclusionUncontrolled diabetes is associated with worse outcomes in pulmonary cryptococcosis, including a 4-fold and 6-fold increased odds of death at 10-weeks and 1-year, respectively. Glucose control interventions should be explored to improve clinical outcomes in patients with pulmonary cryptococcosis.

scholarly journals Delay of Detection Of COVID-19 Patients In Bangladesh; An Application To Cox Proportional Hazard Model

2020 ◽  
Author(s):  
Sujan Rudra ◽  
Shuva Das ◽  
Md. Ehsanul Hoque ◽  
Abul Kalam ◽  
Mohammad Arifur Rahman
Keyword(s):  
Risk Factors ◽  
Hazard Model ◽  
Laboratory Diagnosis ◽  
Cross Sectional Study ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Cox Proportional Hazard

Abstract Objective: To delineate the survival rate of the patients with coronavirus disease 2019 (COVID-19) who did the diagnostic tests lately after the development of symptoms. The aim is to determine the socio-demographic risk factors associated with the delay of the detection of COVID-19 patients. Methods: For this cross-sectional study, 300 patients were selected who were diagnosed as COVID-19 patients in the Molecular Biology Laboratory of Chittagong Medical College, Chattogram, Bangladesh. Data were collected from May to July 2020. Clinical characteristics were obtained from over phone interviews and laboratory diagnosis by Real-time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR). Cox proportional hazard model is applied to estimate risk factors affecting the delay of detection of COVID-19 patients.Result: Female mortality rate was 44.9% higher compared to males, graduates died 32% more than undergraduates, unmarried peoples’ death rate were 56% more than married and those who were in traveling irregularly and in contact with symptomatic patients, were 86% more died than non-travelers.Conclusion: Early diagnosis of COVID-19 can save a huge amount of lives and special attention should be emphasized on the significant explanatory variable.

scholarly journals Clinical Characteristics, Prognosis, and Nomogram for Esophageal Cancer Based on Adenosquamous Carcinoma: A SEER Database Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Haisheng Qian ◽  
Xiaofeng Ji ◽  
Chang Liu ◽  
Yini Dang ◽  
Xuan Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Clinical Characteristics ◽  
Adenosquamous Carcinoma ◽  
Hazard Model ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Seer Database ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard

Objective: Esophageal adenosquamous carcinoma (ASC) is a rare pathological type of cancer. Its clinical features and prognosis is poorly understood. The purpose of this study was to identify the characteristics of ASC patients and analyze the risk factors of esophageal carcinoma.Methods: Patients with esophageal cancer in the SEER database diagnosed from 1975–2016 were obtained. The epidemiology, clinical characteristics, and outcomes between these three groups were compared. The nomogram and online dynamic nomogram were constructed according to the Cox proportional hazard model.Results: The age-adjusted incidences of AC (1975–1999), AC (1999–2016), and ASC (1975–1989) increased over time (p &lt; 0.05). Age-adjusted incidences of SqCC (1986–2012) and ASC (1989–2016) decreased (p &lt; 0.05). Survival of patients with ASC was significantly worse when compared to AC and SqCC (ASC vs. AC, p &lt; 0.001, ASC vs. SqCC, p = 0.01). ASC, older age, black race, male, overlapping site, higher tumor grade, lymph node metastasis, and a higher summary stage or AJCC stage were considered to be risk factors for a poor survival in the multivariate Cox analysis. The ROC curves and AUC indicated that the model has a good discrimination ability (AUC were 0.774 for a 3-year OS and 0.782 for a 5-year OS). An online dynamic nomogram was built based on the Cox proportional hazard model for convenient clinical use.Conclusions: ASC is somewhat closer to AC rather than SqCC in terms of the demographics and tumor site, but has a worse OS than both AC and SqCC.

scholarly journals Delay of Detection Of COVID-19 Patients In Bangladesh; An Application To Cox Proportional Hazard Model

2020 ◽  
Author(s):  
Sujan Rudra ◽  
Shuva Das ◽  
Md. Ehsanul Hoque ◽  
Abul Kalam ◽  
Mohammad Arifur Rahman
Keyword(s):  
Risk Factors ◽  
Hazard Model ◽  
Laboratory Diagnosis ◽  
Cross Sectional Study ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Cox Proportional Hazard

Abstract Objective: To delineate the survival rate of the patients with coronavirus disease 2019 (COVID-19) who did the diagnostic tests lately after the development of symptoms. The aim is to determine the socio-demographic risk factors associated with the delay of the detection of COVID-19 patients. Methods: For this cross-sectional study, 300 patients were selected who were diagnosed as COVID-19 patients in the Molecular Biology Laboratory of Chittagong Medical College, Chattogram, Bangladesh. Data were collected from May to July 2020. Clinical characteristics were obtained from over phone interviews and laboratory diagnosis by Real-time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR). Cox proportional hazard model is applied to estimate risk factors affecting the delay of detection of COVID-19 patients.Result: Female mortality rate was 44.9% higher compared to males, graduates died 32% more than undergraduates, unmarried peoples’ death rate were 56% more than married and those who were in traveling irregularly and in contact with symptomatic patients, were 86% more died than non-travelers.Conclusion: Early diagnosis of COVID-19 can save a huge amount of lives and special attention should be emphasized on the significant explanatory variable.

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