scholarly journals Older age and frailty are the chief predictors of mortality in COVID-19 patients admitted to an acute medical unit in a secondary care setting- A cohort study

2020 ◽  
Author(s):  
Rajkumar Chinnadurai ◽  
Onesi Ogedengbe ◽  
Priya Agarwal ◽  
Sally Money-Coomes ◽  
Ahmad Z Abdurrahman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Secondary Care ◽  
Clinical Characteristics ◽  
Care Setting ◽  
Older Age ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Secondary Care Setting ◽  
Group 2 ◽  
Group 1

Abstract Background There is a need for more observational studies across different clinical settings to better understand the epidemiology of the novel COVID-19 infection. Evidence on clinical characteristics of COVID-19 infection is scarce in secondary care settings in Western populations.Methods We describe the clinical characteristics of all consecutive COVID-19 positive patients (n=215) admitted to the acute medical unit at Fairfield General Hospital (secondary care setting) between 23 March 2020 and 30 April 2020 based on the outcome at discharge (group 1: alive or group 2: deceased). We investigated the risk factors that were associated with mortality using binary logistic regression analysis. Kaplan-Meir (KM) curves were generated by following the outcome in all patients until 12 May 2020. Results The median age of our cohort was 74 years with a predominance of Caucasians (87.4%) and males (62%). Of the 215 patients, 86 (40%) died. A higher proportion of patients who died were frail (group 2: 63 vs group 1: 37%, p<0.001), with a higher prevalence of cardiovascular disease (group 2: 58 vs group 1: 33%, p<0.001) and respiratory diseases (group 2: 38 vs group 1: 25 %, p=0.03). In the multivariate logistic regression models, older age (odds ratio (OR) 1.03; p=0.03), frailty (OR 5.1; p<0.001) and lower estimated glomerular filtration rate (eGFR) on admission (OR 0.98; p=0.01) were significant predictors of inpatient mortality. KM curves showed a significantly shorter survival time in the frail older patients. Conclusion Older age and frailty are chief risk factors associated with mortality in COVID-19 patients hospitalised to an acute medical unit at secondary care level. A holistic approach by incorporating these factors is warranted in the management of patients with COVID-19 infection.

scholarly journals Older age and frailty are the chief predictors of mortality in COVID-19 patients admitted to an acute medical unit in a secondary care setting- a cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Rajkumar Chinnadurai ◽  
Onesi Ogedengbe ◽  
Priya Agarwal ◽  
Sally Money-Coomes ◽  
Ahmad Z. Abdurrahman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Secondary Care ◽  
Clinical Characteristics ◽  
Care Setting ◽  
Older Age ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Secondary Care Setting ◽  
Group 2 ◽  
Group 1

Abstract Background There is a need for more observational studies across different clinical settings to better understand the epidemiology of the novel COVID-19 infection. Evidence on clinical characteristics of COVID-19 infection is scarce in secondary care settings in Western populations. Methods We describe the clinical characteristics of all consecutive COVID-19 positive patients (n = 215) admitted to the acute medical unit at Fairfield General Hospital (secondary care setting) between 23 March 2020 and 30 April 2020 based on the outcome at discharge (group 1: alive or group 2: deceased). We investigated the risk factors that were associated with mortality using binary logistic regression analysis. Kaplan-Meir (KM) curves were generated by following the outcome in all patients until 12 May 2020. Results The median age of our cohort was 74 years with a predominance of Caucasians (87.4%) and males (62%). Of the 215 patients, 86 (40%) died. A higher proportion of patients who died were frail (group 2: 63 vs group 1: 37%, p < 0.001), with a higher prevalence of cardiovascular disease (group 2: 58 vs group 1: 33%, p < 0.001) and respiratory diseases (group 2: 38 vs group 1: 25%, p = 0.03). In the multivariate logistic regression models, older age (odds ratio (OR) 1.03; p = 0.03), frailty (OR 5.1; p < 0.001) and lower estimated glomerular filtration rate (eGFR) on admission (OR 0.98; p = 0.01) were significant predictors of inpatient mortality. KM curves showed a significantly shorter survival time in the frail older patients. Conclusion Older age and frailty are chief risk factors associated with mortality in COVID-19 patients hospitalised to an acute medical unit at secondary care level. A holistic approach by incorporating these factors is warranted in the management of patients with COVID-19 infection.

scholarly journals Older age and frailty are the chief predictors of mortality in COVID-19 patients admitted to an acute medical unit in a secondary care setting- A cohort study

2020 ◽  
Author(s):  
Rajkumar Chinnadurai ◽  
Onesi Ogedengbe ◽  
Priya Agarwal ◽  
Sally Money-Coomes ◽  
Ahmad Z Abdurrahman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Secondary Care ◽  
Clinical Characteristics ◽  
Care Setting ◽  
Older Age ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Secondary Care Setting ◽  
Group 2 ◽  
Group 1

Abstract Background There is a need for more observational studies across different clinical settings to better understand the epidemiology of the novel COVID-19 infection. Evidence on clinical characteristics of COVID-19 infection is scarce in secondary care settings in Western populations.MethodsWe describe the clinical characteristics of all consecutive COVID-19 positive patients (n=215) admitted to the acute medical unit at Fairfield General Hospital (secondary care setting) between 23 March 2020 and 30 April 2020 based on the outcome at discharge (group 1: alive or group 2: deceased). We investigated the risk factors that were associated with mortality using binary logistic regression analysis. Kaplan-Meir (KM) curves were generated by following the outcome in all patients until 12 May 2020. ResultsThe median age of our cohort was 74 years with a predominance of Caucasians (87.4%) and males (62%). Of the 215 patients, 86 (40%) died. A higher proportion of patients who died were frail (group 2: 63 vs group 1: 37%, p<0.001), with a higher prevalence of cardiovascular disease (group 2: 58 vs group 1: 33%, p<0.001) and respiratory diseases (group 2: 38 vs group 1: 25 %, p=0.03). In the multivariate logistic regression models, older age (odds ratio (OR) 1.03; p=0.03), frailty (OR 5.1; p<0.001) and lower estimated glomerular filtration rate (eGFR) on admission (OR 0.98; p=0.01) were strong and independent predictors of inpatient mortality. KM curves showed a clear significantly shorter survival time in the frail older patients. ConclusionOlder age and frailty are strong and independent risk factors associated with mortality in COVID-19 patients hospitalised to an acute medical unit at secondary care level. A holistic approach by incorporating these factors is warranted in the management of patients with COVID-19 infection.

scholarly journals Older Age and Frailty are the Chief Predictors of Mortality in COVID-19 Patients Admitted to an Acute Medical Unit in a Secondary Care Setting- A Cohort Study

2020 ◽  
Author(s):  
Rajkumar Chinnadurai ◽  
Onesi Ogedengbe ◽  
Priya Agarwal ◽  
Sally Money-Coomes ◽  
Ahmad Z Abdurrahman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Secondary Care ◽  
Clinical Characteristics ◽  
Care Setting ◽  
Older Age ◽  
Binary Logistic Regression Analysis ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Secondary Care Setting

Abstract Background There is a need for more observational studies across different clinical settings to better understand the epidemiology of the novel COVID-19 infection. Evidence on clinical characteristics of COVID-19 infection is scarce in secondary care settings in Western populations.MethodsWe describe the clinical characteristics of all consecutive COVID-19 positive patients (n=215) admitted to the acute medical unit at Fairfield General Hospital (secondary care setting) between 23 March 2020 and 30 April 2020 based on the outcome at discharge (alive or deceased). We investigated the risk factors that were associated with mortality using binary logistic regression analysis. Kaplan-Meir (KM) charts were generated by following the outcome in all patients until 12 May 2020. ResultsThe median age of our cohort was 74 years with a predominance of Caucasians (87.4%) and males (62%). Of the 215 patients, 86 (40%) died. A higher proportion of patients who died were frail (63 vs 37%, p<0.001), with a higher prevalence of cardiovascular disease (50 vs 33%, p<0.001) and respiratory diseases (38 vs 25 %, p=0.034). In the multivariate logistic regression models, older age (odds ratio (OR) 1.03; p=0.03), frailty (OR 5.1; p<0.001) and lower estimated glomerular filtration rate (eGFR) on admission (OR 0.98; p=0.01) were strong and independent predictors of inpatient mortality. KM charts showed a clear difference in survival outcome in the frail older patients. ConclusionOlder age and frailty are strong and independent risk factors associated with mortality in COVID-19 patients hospitalised to an acute medical unit at secondary care level. A holistic approach by incorporating these factors is warranted in the management of patients with COVID-19 infection.

The significance of ultrasound biomicroscopy in the objective assessment of post-trabeculectomy bleb success

2021 ◽  
pp. 112067212199058
Author(s):  
Bediz Özen ◽  
Berna Yüce ◽  
Hakan Öztürk
Keyword(s):  
Risk Factors ◽  
Intraocular Pressure ◽  
Drug Use ◽  
Clinical Characteristics ◽  
Objective Assessment ◽  
Ultrasound Biomicroscopy ◽  
Potential Risk Factors ◽  
Group 2 ◽  
Antiglaucoma Drug ◽  
Group 1

Purpose: To compare clinical characteristics and ultrasound biomicroscopy (UBM) measurements of cases with functional and non-functional blebs, and to identify potential risk factors capable of affecting UBM parameters. Methods: Thirty-one patients aged 40–79 were included. Following trabeculectomy, cases were divided into two groups as those with functional bleb (Group 1, n = 20) and those with non-functional bleb (Group 2, n = 11). UBM was performed. Results: In Group 1 compared to Group 2, lower postoperative intraocular pressure (IOP) (12.1 ± 1.7 vs 27.2 ± 3.2 mmHg, p < 0.001), greater bleb height (1.0 ± 0.2 vs 0.5 ± 0.3 mm, p < 0.001), greater scleral route visibility [16/20 (80%) vs 4/11 (36.4%), p = 0.023] and lower bleb reflectivity (1.8 ± 0.2 vs 2.4 ± 0.4, p = 0.015) were observed. In Group 1, as postoperative IOP decreased, bleb height and scleral route visibility increased ( r = −0.387, p = 0.029 for bleb height; r = −0.374, p = 0.033 for scleral route), and bleb reflectivity decreased ( r = 0.359, p = 0.042). In Group 1, as duration of preoperative antiglaucoma drug use increased, bleb reflectivity increased ( r = 0.348, p = 0.046). Preoperative IOP and number of preoperative antiglaucoma drug use had no effect on UBM parameters in groups ( p > 0.05). Conclusion: UBM is useful in assessing bleb success. Lower bleb reflectivity, greater bleb height and greater scleral route visibility indicate that the bleb is functional. To the best of our knowledge, this is the first study investigating effects of preoperative IOP, number and duration of preoperative antiglaucoma drug use on UBM parameters. In cases with functional bleb, duration of preoperative drug use affects only bleb reflectivity, while postoperative IOP affects bleb height, scleral route visibility and bleb reflectivity.

Efficacy evaluation of the CEUS-LI-RADS-v2017 system in differential diagnosis of liver tumors

2019 ◽  
pp. 57-67
Author(s):  
A. N. Katrich ◽  
V. A. Porkhanov ◽  
N. S. Ryabin
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Liver Tumors ◽  
Morphological Data ◽  
Malignant Neoplasms ◽  
Diagnostic Efficiency ◽  
Efficacy Evaluation ◽  
General Group ◽  
Group 2 ◽  
Group 1

Objective: efficacy evaluation of the CEUS LI RADS v2017® system for differential diagnosis of liver tumors in patients with and without cirrhosis.Materials and methods. Retrospective analysis of diagnostic results of the 165 patients with liver tumors (177 nodules) was done. All patients underwent CEUS with results interpretation in accordance to the CEUS LIRADSv2017 ® criteria. Patients were divided into 2 groups based on clinical and morphological data. Group 1 included 62 patients with cirrhosis and/or CVH. Group 2 included 110 patients without risk factors for HCC.Results. Diagnostic efficiency of CEUS LI RADS v2017® for HCC identification was: group 1 – Se – 100%, Sp – 88%, Ac – 95.5%; group 2 – Se – 100%, Sp – 68.8%, Ac – 72.7%; general group Se – 100%, Sp – 72.2%, Ac – 81.4%. In the 2nd group, 21 out of 22 neoplasms, confirmed morphologically as FNH, we classified as LR 4. By applying benign character and specific contrasting patterns of FNG, they were transferred from LR 4 to LR 3. This allowed to increase sensitivity and specificity of differential diagnosis in group 2 (Se – 100%, Sp – 90.6%, Ac – 91.8%) and in general group (Se – 100%, Sp – 90.1%, Ac – 93.2%). Diagnostic efficiency of the criteria for non hepatocellular malignant neoplasms (LR M) was: group 1 – Se – 77.8%, Sp – 100%, Ac – 97%; group 2 – Se – 90%, Sp – 96.7%, Ac – 93.6%; general group- Se – 88.1%, Sp – 98.3%, Ac – 94.9%.Conclusion. Our study confirmed high accuracy of the CEUS LI RADS v2017® system in the differential diagnosis of focal liver tumors. Modification of the system (in particular, transfer of typical FNG forms from the LR 4 category) will make it possible to increase the accuracy of diagnostics by 20%. It will allow to use the LI RADS v2017® system for interpretation CEUS not only among patients with liver cirrhosis, but also in a general group without risk factors of GCC.

Prevalence of signs of dysphagia and associated risk factors in geriatric patients admitted to an acute medical unit

2021 ◽  
Vol 41 ◽  
pp. 208-216 ◽  
Author(s):  
Maria Dissing Olesen ◽  
Robert Mariusz Modlinski ◽  
Simon Hosbond Poulsen ◽  
Pernille Mølgaard Rosenvinge ◽  
Henrik Højgaard Rasmussen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Geriatric Patients ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Associated Risk Factors

Age and Left Ventricular Impairment Predict Reopening for Bleeding

2003 ◽  
Vol 11 (2) ◽  
pp. 147-152 ◽  
Author(s):  
Yongzhi Deng ◽  
Karen Byth ◽  
Hugh S Paterson
Keyword(s):  
Renal Failure ◽  
Coronary Artery ◽  
Chronic Renal Failure ◽  
Multiple Logistic Regression Analysis ◽  
Left Ventricular ◽  
Older Age ◽  
Redo Surgery ◽  
Prophylactic Measures ◽  
Group 2 ◽  
Group 1

Statistical analysis of data collected prospectively from all patients undergoing surgery under cardiopulmonary bypass from September 1994 to November 1998 (group 1) was performed to identify preoperative risk factors for reopening for bleeding. Multiple logistic regression analysis of 19 preoperative variables was carried out with reoperation for bleeding as the endpoint. The protocol for intraoperative use of aprotinin was then changed to include high-risk patients. Data collected from all subsequent patients from May 1999 to March 2002 (group 2) were analyzed. Subgroup analyses on primary isolated coronary artery surgery were also performed. Data were obtained from 1,946 patients aged 22 to 88 years (mean, 62.5 years). Older age, severe left ventricular impairment, redo surgery, and chronic renal failure were the independent predictors of reopening for bleeding in group 1. There were no independent predictors of reopening in group 2. Older age and chronic renal failure were the predictors of reexploration for bleeding in patients undergoing primary isolated coronary artery grafting. Prophylactic measures to prevent excessive bleeding should be used in elderly patients and those with severe left ventricular impairment, redo surgery, and chronic renal failure.

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