scholarly journals HsCRP Variation is the Main Risk Factor for Clinical Outcome in COVID-19 Hospitalized Young and Middle-Aged Patients

2020 ◽  
Author(s):  
Zhelong Liu ◽  
Danning Wu ◽  
Xia Han ◽  
Wangyan Jiang ◽  
Lin Qiu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Elderly Patients ◽  
Clinical Characteristics ◽  
The Elderly ◽  
Middle Aged ◽  
Aged Patients ◽  
Icu Admission ◽  
Discharged Patients ◽  
Independent Risk Factors

Abstract Background: The clinical characteristics and risk factors of clinical outcomes of COVID-19 in elderly and non-elderly patients show great difference. We are the first to explore the relationship between hsCRP variation and intensive care unit (ICU) admission in young and middle-aged COVID-19 patients compared with elderly patients.Methods: We included 273 hospitalized patients with confirmed COVID-19 from Tongji Hospital, Wuhan, China from Feb 10, 2020 to Mar 8, 2020. Clinical characteristics and risk factors of outcomes were compared between young and middle-aged patients with elderly patients.Results: Among young and middle-aged patients, hsCRP variation in those admitted to ICU was significantly higher than that in discharged patients. Among patients admitted to ICU, hsCRP variation showed significantly difference between young and middle-aged patients and elderly patients (median, 67.9 vs -10.2, P < 0.01). The hsCRP variation was an independent risk factor for ICU admission in young and middle-aged patients (OR = 1.068) and ROC curve revealed hsCRP variation significant for the prediction of ICU admission (AUC = 0.925) with 92.9% sensitivity and 95.5% specificity. Conclusion: HsCRP variation is the major independent risk factors for ICU admission in young and middle-aged COVID-19 inpatients, but not in the elderly patients.

scholarly journals Age characteristics of risk cardiovascular complications in women with left breast cancer with preserved ejection fraction at the stage of chemotherapy and radiotherapy

Kardiologiia ◽  
2019 ◽  
Vol 59 (7S) ◽  
pp. 23-30
Author(s):  
I. V. Vologdina ◽  
R. M. Zhabina
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Ejection Fraction ◽  
Elderly Patients ◽  
The Elderly ◽  
Cardiovascular Complications ◽  
Left Breast ◽  
Middle Aged ◽  
Aged Patients ◽  
Score Risk

Aim. A study of the risk factors for middle-aged and elderly women HER2neu with negative left breast cancer and a normal ejection fraction at the stage of chemoradiotherapy in everyday clinical practice. Matherial and methods. 61 women with left breast cancer without severe cardiovascular pathology were examined at the stage of doxorubicin therapy and 3D conformal radiation therapy. Group 1 comprised 32 patients of middle age (49.8 ± 4.5 years). Group 2 comprised 29 elderly patients (68.3 ± 3.6 years). In addition to Score risk assessment, additional factors, including psychosocial factors, were studied. All patients underwent ECG, echocardiography and 24-hour ECG monitoring. Anxiety levels were assessed using the HADS scale and scale CH. D. Spielberger –Yu.L. Khanin. The study was conducted before the start of treatment, after the completion of the doxorubicin course and after the completion of the course of radiotherapy. Results with discussion. In middle-aged patients, moderate Score risk was found in 21.9%, in the elderly at 58.6% (p = 0.0043, RR 2.68, 95% CI 1.301–5.520). A high Score risk was found in 15.6% of middle-aged patients and 41.4% of elderly patients (p = 0.0438, RR 2.648, 95% CI 1061–6.607). The most common risk factors in the patients studied in addition to age were heredity, overweight, hypercholesterolemia and diabetes mellitus. All examined patients had moderate reactive anxiety. Patients of middle age have moderate personal anxiety, in elderly patients high personal anxiety. After treatment with doxorubicin in a cumulative dose not exceeding 360 mg/m2 , a reduction in the ejection fraction below 50% was found in 6 middle-aged patients and 17.2% in elderly patients. Asymptomatic diastolic dysfunction was detected in 31.3% of middle-aged patients and 55.2% of the elderly. In patients of both groups, after arranging treatment, arrhythmia was detected. Conclusions. The obtained data indicate to the need for in-depth examination of middle-aged and especially elderly patients with left breast cancer with an assessment of risk factors and conducting an in-depth examination using Echocardiography, 24-hour ECG monitoring and psychological testing to prevent and early detection of cardiovascular complications.

scholarly journals Risk factors for cardiovascular complications in patients with left breast cancer in daily clinical practice

2020 ◽  
Vol 12 (2) ◽  
pp. 63-70
Author(s):  
Elena G. Poroshina ◽  
Irina V. Vologdina ◽  
Razifa M. Zhabina ◽  
Andrey A. Stanzhevsky ◽  
Larisa A. Krasilnikova
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Risk Factors ◽  
Elderly Patients ◽  
Healthy Lifestyle ◽  
The Elderly ◽  
Cardiovascular Complications ◽  
Left Breast ◽  
Middle Aged ◽  
Aged Patients

Purpose. Detection of adherence to a healthy lifestyle (HLS) and evaluation of behavioral risk factors for cardiovascular complications (CVC), including psychosocial, in patients with left breast cancer at the stage of chemoradiotherapy in daily clinical practice. Materials and methods. The patients were hospitalized for 3D conformal radiation therapy on the bed of the left breast with a total radiation dose (TRD) of 39 Gy (equivalent to 48 Gy of conventional fractionation). All the patients had a Madden mastectomy at the previous stages followed by doxorubicin therapy at a cumulative dose not exceeding 360 mg/m2. Determination of all components of a healthy lifestyle was carried out according to the data of interviewing the participants. The risk category of cardiovascular complications was assessed according to the SCORE scale. Additional characteristics including psychosocial factors were assessed. The examination included ECG and echocardiography. Results. At the initial examination, 58% of middle-aged patients and 74% of elderly patients showed comorbidity, while 18% of middle-aged patients and 29% of elderly patients had multiple comorbidities. Low adherence to healthy lifestyle in the patients was primarily associated with low physical activity due to the existing pain syndrome caused by both the tumor process itself and the surgical intervention. Physical activity in both groups was significantly lower than in the general population. High risk of CVC was significantly more common in the elderly patients. Systolic and diastolic dysfunction as a manifestation of cardiotoxicity after the previous stage of doxorubicin therapy were detected in middle-aged patients in 35.7% of the cases, in the elderly patients in 56.5% of the cases (HR 0.643, 95% CI 0.470-0.880). Psychosocial factors such as acute chronic stress and family problems were the most common. All the examined patients showed moderate reactive anxiety. The elderly patients showed a high level of personal anxiety. Conclusions. The obtained data suggest that in breast cancer patients, low adherence to HLS is primarily associated with low physical activity and unhealthy diet and to a much lesser extent smoking, which is of great importance in the formation of a healthy lifestyle in these patients in the future. In elderly patients, the study significantly more often identified risk factors such as obesity, high blood pressure, hypercholesterolemia and hyperglycemia. These patients revealed increased level of personal anxiety. This highlights the need for an expanded study of not only the main but also additional risk factors.

scholarly journals Prognosis and risk factors of ERCP pancreatitis in elderly

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Erhan Ergin ◽  
Nevin Oruç ◽  
Galip Ersöz ◽  
Oktay Tekeşin ◽  
Ömer Özütemiz
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Elderly Patients ◽  
Biochemical Analysis ◽  
Female Gender ◽  
The Elderly ◽  
Imaging Findings ◽  
Endoscopic Retrograde ◽  
Sphincter Oddi ◽  
Oddi Dysfunction

AbstractPost Endoscopic Retrograde Cholangiopancreatography (ERCP) pancreatitis is one of the most serious complications of ERCP. Our study aims to investigate the risk, predisposing factors and prognosis of pancreatitis after ERCP in elderly patients. Patients referred to the ERCP unit between April 2008 and 2012 and admitted to the hospital at least 1 day after the ERCP procedure were included to the study. Information including patient’s demographics, diagnosis, imaging findings, biochemical analysis, details of the ERCP procedure and complications were recorded. The severity of post ERCP pancreatitis (PEP) was determined by revised Atlanta Criteria as well as APACHE II and Ranson scores. A total of 2902 ERCP patients were evaluated and 988 were included to the study. Patients were divided into two groups as ≥ 65 years old (494 patients, 259 F, 235 M) and < 65 years old (494 patients, 274 F, 220 M). PEP was diagnosed in 4.3% of patients aged 65 years and older. The female gender was risk factors in elderly for PEP. The Sphincter Oddi Dysfunction (SOD) and Juxta papillary diverticula (JPD) were higher in elderly patients with PEP. Age did not increase the risk of PEP development. The most important post ERCP pancreatitis risk factor in the elderly is the female gender, while the risk is enhanced slightly by SOD and JPD.

Blood Transfusion is Associated with Infection and Increased Resource Utilization in Combat Casualties

2006 ◽  
Vol 72 (7) ◽  
pp. 619-626 ◽  
Author(s):  
James R. Dunne ◽  
Mark S Riddle ◽  
Janine Danko ◽  
Rich Hayden ◽  
Kyle Petersen
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Blood Transfusion ◽  
Resource Utilization ◽  
Independent Risk Factor ◽  
Study Cohort ◽  
Icu Admission ◽  
Independent Risk Factors ◽  
Combat Casualties ◽  
Injured Patients

Combat casualty care has made significant advances in recent years, including administration of blood products in far-forward locations. However, recent studies have shown blood transfusion to be a significant risk factor for infection and increased resource utilization in critically injured patients. We therefore sought to investigate the incidence of blood transfusion and its association with infection and resource utilization in combat casualties. Prospective data were collected and retrospectively reviewed on 210 critically injured patients admitted to the USNS Comfort over a 7-week period during the 2003 assault phase of Operation Iraqi Freedom. Patients were stratified by age, gender, and injury severity score (ISS). Multivariate regression analyses were used to assess blood transfusion and hematocrit (HCT) as independent risk factors for infection and intensive care unit (ICU) admission controlling for age, gender, and ISS. The study cohort had a mean age of 30 ± 2 years, a mean ISS of 14 ± 3, 84 per cent were male, and 88 per cent sustained penetrating trauma. Blood transfusion was required in 44 per cent (n = 93) of the study cohort. Transfused patients had a higher ISS (18 ± 4 vs. 10 ± 3, P < 0.01), a higher pulse rate (105 ± 4 vs. 93 ± 3, P < 0.0001), and a lower admission HCT (27 ± 1 vs. 33 ± 2, P < 0.0001) compared with patients not transfused. Patients receiving blood transfusion had an increased infection rate (69% vs. 18%, P < 0.0001), ICU admission rate (52% vs. 21%, P < 0.0001), and ICU length of stay (6.7 ± 2.1 days vs. 1.4 ± 0.5 days, P < 0.0001) compared with nontransfused patients. However, there was no significant difference in mortality between transfused and nontransfused patients. Multivariate binomial regression analysis identified blood transfusion and HCT as independent risk factors for infection (P < 0.01) and blood transfusion as an independent risk factor for ICU admission (P < 0.05). Combat casualties have a high incidence of blood transfusion. Blood transfusion is an independent risk factor for infection and increased resource utilization. Therefore, consideration should be given to the use of alternative blood substitutes and recombinant human erythropoietin in the treatment and management of combat casualties.

scholarly journals Clinical Characteristics and Risk Factors of Atrial Fibrillation in the Elderly

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Hong Li
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Regression Analysis ◽  
Clinical Characteristics ◽  
The Elderly ◽  
Spearman Correlation ◽  
Nonvalvular Atrial Fibrillation ◽  
Independent Risk Factors ◽  
Epidemiological Characteristics

Objective: To investigate the epidemiobgical characteristics of the elderly with atrial fibrillation (AF) in age, gender, the types of AF and relative causes. And To analyze the risk factors of persistent AF (PeAF), then use them to guide to prevent and treat for AF in the elderly.Methods: Collect the data of elderly patients with AF who were admitted to Liaoning People's Hospital from September 1, 2016 to September 30, 2017, and summarize the epidemiological characteristics of AF in the elderly. The risk factors for PeAF were analyzed by Spearman correlation analysis and mltivariate logistic regression analysis. Result: 1. In the elderly, the number of AF cases increase with age. The group of 75-84 years old was the largest part. The number of older females was larger than male in all ages. It was important to pay more attention to old woman with AF. 2.In the elderly, nonvalvular atrial fibrillation is popular. The top three causes of AF in the elderly were CHD, hypertension and heart failure. In the elderly, comorbidities were frequent, and the management was a major therapeutic objective. 3.CRP, 1eft atria diameter were the independent risk factors for PeAF in the elderly.

scholarly journals Assessment of risk factors and clinical characteristics of elderly patients with hypertensive encephalopathy against the background of hypertension

2015 ◽  
pp. 35-39
Author(s):  
V. V. Jaworski
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Cerebrovascular Disease ◽  
Detailed Analysis ◽  
Neurological Examination ◽  
Cognitive Functions ◽  
Clinical Characteristics ◽  
Basic Research ◽  
Hypertensive Encephalopathy ◽  
Middle Aged

The article presents the results of clinical and neurological examination of 105 elderly and middle- aged hipertenzivnoyu encephalopathy of II degree on a background of hypertension. The urgency of a detailed analysis of the patients to determine risk factors for cerebrovascular disease and basic research cognitive functions of patients.

scholarly journals Risk Factors Contributing to Higher Mortality Rates in Elderly Patients with Acute Traumatic Subdural Hematoma Sustained in a Fall: A Cross-Sectional Analysis Using Registered Trauma Data

2018 ◽  
Vol 15 (11) ◽  
pp. 2426 ◽  
Author(s):  
Ching-Hua Hsieh ◽  
Cheng-Shyuan Rau ◽  
Shao-Chun Wu ◽  
Hang-Tsung Liu ◽  
Chun-Ying Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Elderly Patients ◽  
Subdural Hematoma ◽  
Odds Ratio ◽  
The Elderly ◽  
Mortality Rates ◽  
Acute Subdural Hematoma ◽  
Hematoma Volume ◽  
Independent Risk Factors

Background: We aimed to explore the risk factors that contribute to the mortality of elderly trauma patients with acute subdural hematoma (SDH) resulting from a fall. Mortality rates of the elderly were compared to those of young adults. Methods: A total of 444 patients with acute traumatic subdural hematoma resulting from a fall, admitted to a level I trauma center from 1 January 2009 to 31 December 2016 were enrolled in this study. Patients were categorized into two groups: elderly patients (n = 279) and young adults (n = 165). The primary outcome of this study was patient mortality in hospital. The adjusted odds ratio (AOR) with 95% confidence interval (CI) for mortality was calculated according to gender and pre-existing comorbidities. Univariate and multivariate logistic regression analyses were performed to identify factors related to mortality in the elderly. Results: The odds ratio for mortality caused by falls in the elderly patients was four-fold higher than in the young adults, after adjusting for gender and pre-existing comorbidities. In addition, the presence of pre-existing coronary artery disease (OR 3.2, 95% CI 1.09–9.69, p = 0.035), end-stage renal disease (OR 4.6, 95% CI 1.48–14.13, p = 0.008), hematoma volume (OR 1.2, 95% CI 1.11–1.36, p < 0.001), injury severity score (OR 1.3, 95% CI 1.23–1.46, p < 0.001), and coagulopathy (OR 4.0, 95% CI 1.47–11.05, p = 0.007) were significant independent risk factors for mortality in patients with acute traumatic SDH resulting from a fall. Conclusions: In this study, we identified that pre-existing CAD, ESRD, hematoma volume, ISS, and coagulopathy were significant independent risk factors for mortality in patients with acute traumatic SDH. These results suggest that death following acute SDH is influenced both by the extent of neurological damage and the overall health of the patient at the time of injury.

scholarly journals Clinical Analysis of Hospital-acquired Bloodstream Infection in the Elderly

2019 ◽  
Vol 1 (01) ◽  
Author(s):  
Baojun Sun
Keyword(s):  
Risk Factors ◽  
Renal Insufficiency ◽  
Elderly Patients ◽  
Bloodstream Infection ◽  
Sofa Score ◽  
Chronic Renal Insufficiency ◽  
Bloodstream Infections ◽  
The Elderly ◽  
Independent Risk Factors ◽  
Hospital Acquired

Objective: This study was designed to get epidemiological characteristics, etiology characteristics, prognosis assessment and prognostic factors of hospital-acquired bloodstream infection (HABSI) in the elderly in Chinese PLA General Hospital and aimed at providing a reference for HABSI in the elderly on clinical diagnosis and treatment to improve the prognosis. Methods: The clinical data and pathology data of 210 cases of the elderly patients with HABSI from 2009 to 2012 in geriatric wards were retrospectively analyzed. Compare the clinical assessment effects of APACHE-II score, SAPS-II score and SOFA score to HABSI prognosis in the elderly by plotting the receiver operating characteristic curve. Use univariate and multivariate logistic regression analysis to get prognostic factors of HABSI in the elderly. Results: Univariate analysis of mortality: Day 1 apache -> 18 II score, lung infection, invasive ventilation, chronic hepatic insufficiency, chronic renal insufficiency, substantive organ malignant tumor, deep venipuncture, indwelling gastric tube indwelling ureter, complicated with shock and acquired bloodstream infections in the elderly patients with 7 days survival state association is significant. Day-1 SOFA score>7, chronic liver dysfunction, chronic renal insufficiency, concurrent shock, hemodialysis and 28-day survival status of patients with acquired bloodstream infection in elderly hospitals were significantly associated. Multivariate unconditioned logistic regression analysis related to death: Day-1APACHE-II score>18, parenchymal malignant tumors, and concurrent shock are independent risk factors for 7-day death in elderly patients with acquired bloodstream infection. Day-1 SOFA score>7, chronic renal insufficiency, and concurrent shock are independent risk factors for 28-day mortality in elderly patients with acquired bloodstream infection. Conclusion: The incidence of acquired bloodstream infections in the elderly was 1.37%. The 7-day and 28-day mortality rates were 8.10% and 22.38%, respectively. Concurrent shock is 26.7%. The 28-day mortality rate of concurrent shock patients was 48.21%. The best outcome score for the 7-day prognosis of elderly patients with acquired bloodstream infection was the Day-1APACHE-II score, followed by the Day-1 SOFA score. The best score for the 28-day prognostic assessment was the Day-1 SOFA score.

scholarly journals Clinical Analysis of Hospital-acquired Bloodstream Infection in the Elderly

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Baojun Sun
Keyword(s):  
Risk Factors ◽  
Renal Insufficiency ◽  
Elderly Patients ◽  
Bloodstream Infection ◽  
Sofa Score ◽  
Chronic Renal Insufficiency ◽  
Bloodstream Infections ◽  
The Elderly ◽  
Independent Risk Factors ◽  
Hospital Acquired

Objective: This study was designed to get epidemiological characteristics, etiology characteristics, prognosis assessment and prognostic factors of hospital-acquired bloodstream infection (HABSI) in the elderly in Chinese PLA General Hospital and aimed at providing a reference for HABSI in the elderly on clinical diagnosis and treatment to improve the prognosis. Methods: The clinical data and pathology data of 210 cases of the elderly patients with HABSI from 2009 to 2012 in geriatric wards were retrospectively analyzed. Compare the clinical assessment effects of APACHE-II score, SAPS-II score and SOFA score to HABSI prognosis in the elderly by plotting the receiver operating characteristic curve. Use univariate and multivariate logistic regression analysis to get prognostic factors of HABSI in the elderly. Results: Univariate analysis of mortality: Day 1 apache -> 18 II score, lung infection, invasive ventilation, chronic hepatic insufficiency, chronic renal insufficiency, substantive organ malignant tumor, deep venipuncture, indwelling gastric tube indwelling ureter, complicated with shock and acquired bloodstream infections in the elderly patients with 7 days survival state association is significant. Day-1 SOFA score>7, chronic liver dysfunction, chronic renal insufficiency, concurrent shock, hemodialysis and 28-day survival status of patients with acquired bloodstream infection in elderly hospitals were significantly associated. Multivariate unconditioned logistic regression analysis related to death: Day-1APACHE-II score>18, parenchymal malignant tumors, and concurrent shock are independent risk factors for 7-day death in elderly patients with acquired bloodstream infection. Day-1 SOFA score>7, chronic renal insufficiency, and concurrent shock are independent risk factors for 28-day mortality in elderly patients with acquired bloodstream infection. Conclusion: The incidence of acquired bloodstream infections in the elderly was 1.37%. The 7-day and 28-day mortality rates were 8.10% and 22.38%, respectively. Concurrent shock is 26.7%. The 28-day mortality rate of concurrent shock patients was 48.21%. The best outcome score for the 7-day prognosis of elderly patients with acquired bloodstream infection was the Day-1APACHE-II score, followed by the Day-1 SOFA score. The best score for the 28-day prognostic assessment was the Day-1 SOFA score.

scholarly journals Analysis of Effectiveness, Safety, and Bleeding Related to Rivaroxaban in Elderly Patients

2020 ◽  
Vol 26 ◽  
pp. 107602962092592
Author(s):  
Huimin Hou ◽  
Ang Li ◽  
Liping Zhang ◽  
Xiujiao Qin ◽  
Yanfang Jiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Multivariate Logistic Regression Analysis ◽  
The Elderly ◽  
Multivariate Logistic Regression ◽  
Bleeding Events ◽  
Old Patients ◽  
Daily Dose ◽  
Independent Risk Factors ◽  
Different Doses

This study explored the efficacy and safety of rivaroxaban in elderly patients, at different doses and age of patients, and analyzed risk factors of bleeding. A retrospective analysis was conducted of 299 patients aged 60 years or older who were admitted to the First Hospital of Jilin University between January 2016 and August 2018. It was found that the rate of bleeding events (but not embolism) significantly increased as the dose of oral rivaroxaban increased ( P < .001), and with age, especially in patients aged ≥80 years ( P = .001, both). The multivariate logistic regression analysis indicated that age (odds ratio [OR]: 2.963, 95% CI: 1.627-5.396) and the daily dose of rivaroxaban (OR: 2.325, 95% CI: 1.483-3.645) were independent risk factors for bleeding. The study determined that rivaroxaban anticoagulant therapy is effective in the elderly patients, but the risk of bleeding increases with age, and is a concern especially in the most old patients. The recommended daily dose of rivaroxaban is effective, but a lower dose is safer for the elderly patients.

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