scholarly journals Predicting Mechanical Ventilation For More Than 7 Days In The Emergency Department

2021 ◽  
Author(s):  
Jin Hui Paik ◽  
Jung-Soo Kim ◽  
Man-Jong Lee ◽  
Mi Hwa Park ◽  
Areum Durey ◽  
...  
Keyword(s):  
Emergency Department ◽  
Mechanical Ventilation ◽  
Underlying Disease ◽  
Test Results ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Factors Influencing ◽  
Laboratory Test Results ◽  
The Mean ◽  
Underlying Diseases

Abstract Background: The duration of mechanical ventilation (MV) required by patients admitted to the emergency department (ED) is difficult to predict. We investigated the duration of MV in ED-admitted patients, as well as their clinical progress.Methods: We investigated the duration of MV in adult patients (aged ≥18 years) who were attached to ventilators in our ED between January and December 2017. The patients were divided into two groups; MV <7 days and MV ≥7 days. The patients’ demographic characteristics, diagnoses, clinical features, and underlying diseases were compared between two groups.Results: The study comprised 282 patients including 142 in the MV <7 days group and 140 in the MV ≥7 days group. The MV ≥7 days group had more patients diagnosed with metabolic disorder, pneumonia, neurological disease, sepsis, and multiple trauma, and also had a greater proportion of patients with dementia or stroke as the underlying disease. The mean C-reactive protein level in the MV ≥7 days group was 6.4 mg/dL, which was higher than that in the MV <7 days group. The risk factors for requiring ≥7 days of MV were identified as a diagnosis of stroke as well as having the underlying diseases of cancer and stroke or dementia. Among the laboratory test results, pH, HCO3- , and albumin <3.5 g/dL were identified as factors influencing the duration of MV.Conclusions: MV for ≥7 days is predicted to be required for patients admitted for a stroke; those with underlying cancer or stroke; and those with adverse pH, HCO3-, and albumin blood test results.

scholarly journals Predicting Mechanical Ventilation for More Than 7 Days in the Emergency Department

2021 ◽  
Author(s):  
Jin Hui Paik ◽  
Jung-Soo Kim ◽  
Man-Jong Lee ◽  
Mi Hwa Park ◽  
Areum Durey ◽  
...  
Keyword(s):  
Emergency Department ◽  
Mechanical Ventilation ◽  
Underlying Disease ◽  
Test Results ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Factors Influencing ◽  
Laboratory Test Results ◽  
The Mean ◽  
Underlying Diseases

Abstract Background The duration of mechanical ventilation (MV) required by patients admitted to the emergency department (ED) is difficult to predict. We investigated the duration of MV in ED-admitted patients, as well as their clinical progress.Methods We investigated the duration of MV in adult patients (aged ≥18 years) who were attached to ventilators in our ED between January and December 2017. The patients were divided into two groups; MV <7 days and MV ≥7 days. The patients’ demographic characteristics, diagnoses, clinical features, and underlying diseases were compared between two groups.Results The study comprised 282 patients including 142 in the MV <7 days group and 140 in the MV ≥7 days group. The MV ≥7 days group had more patients diagnosed with metabolic disorder, pneumonia, neurological disease, sepsis, and multiple trauma, and also had a greater proportion of patients with dementia or stroke as the underlying disease. The mean C-reactive protein level in the MV ≥7 days group was 6.4 mg/dL, which was higher than that in the MV <7 days group. The risk factors for requiring ≥7 days of MV were identified as a diagnosis of stroke as well as having the underlying diseases of cancer and stroke or dementia. Among the laboratory test results, pH, HCO3- , and albumin <3.5 g/dL were identified as factors influencing the duration of MV.Conclusion MV for ≥7 days is predicted to be required for patients admitted for a stroke; those with underlying cancer or stroke; and those with adverse pH, HCO3-, and albumin blood test results.

scholarly journals Clinical and biochemical indexes of 11 COVID-19 patients and the genome sequence analysis of the tested SARS-CoV-2

2020 ◽  
Author(s):  
Zhikang Yu ◽  
Heming Wu ◽  
Qingyan Huang ◽  
Xuemin Guo ◽  
Zhixiong Zhong
Keyword(s):  
Test Results ◽  
Global Public Health ◽  
C Reactive Protein ◽  
Genome Sequences ◽  
Multiple Sequence ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Laboratory Test Results ◽  
Underlying Diseases ◽  
Genetic Form

Abstract BackgroundAt present, SARS-CoV-2 epidemic in the world rapidly spread. It is a serious global public health emergency.MethodsHere we described the clinical characteristics of 11 SARS-CoV-2 infected patients hospitalized in the Meizhou People's Hospital. And viral genome sequences of SARS-CoV-2 from these patients were analyzed.ResultsOf the 11 patients, six cases developed fever, nine cases developed cough, and two cases developed headache and chills. Four patients (36.4%) had underlying diseases. Pneumonia is the most common complication. The laboratory test results showed that there was no adult patients with increased LYM/LYM%. Most patients had normal total protein (TP) and albumin (ALB), but only two patients had decreased. Most patients had increased or normal levels of erythrocyte sedimentation rate (ESR), C reactive protein (CRP), activated partial thromboplastin time (APTT), fibrinogen (FIB), creatine kinase isoenzymes (CK-MB), and lactate dehydrogenase (LDH). Neutrophil (NEU) (r=0.664, P=0.026), CK-MB (r=0.655, P=0.029), blood urea nitrogen (BUN) (r=0.682, P=0.021) and SARS-CoV-2 virus cycle threshold (Ct) value were significantly correlated. Multiple sequence alignment (MSA) shows that we identified two different SNPs at positions 8781 and 28144, and have a completely linked genetic form of 8781C-28144T and 8781T-28144C.ConclusionsThe reports of these 11 cases in our hospital will provide useful information for the diagnosis, treatment and drug development of SARS-CoV-2.

scholarly journals Monocyte Distribution Widths for Early Sepsis Detection in Emergency Department and Comparison with C-reactive Protein and Procalcitonin

2020 ◽  
Author(s):  
Ala woo ◽  
Dong-Kyu Oh ◽  
Chan Jung Park ◽  
Sang-Bum Hong
Keyword(s):  
Emergency Department ◽  
Diagnostic Performance ◽  
Morphological Changes ◽  
White Blood Cells ◽  
Sepsis Group ◽  
C Reactive Protein ◽  
Distribution Width ◽  
Reactive Protein ◽  
Laboratory Test Results ◽  
Early Sepsis

Abstract Background: Monocyte undergo morphological changes in response to infection. Monocyte distribution width (MDW) reflects the morphological changes and increase in septic conditions. Currently, it has been suggested that MDW can act as an early biomarker of sepsis, but there are few reports on the comparison with conventional biomarkers such as C-reactive protein (CRP) and procalcitonin (PCT).Methods: Patients who visited the emergency department (ED) were screened and enrolled prospectively. Tests for complete blood count, MDW, CRP, and PCT were done. Diagnostic performance for sepsis was tested in terms of area under the curve (AUC) of receiver operating characteristic (ROC) curves, sensitivity, and specificity.Results: In total, 665 patients were screened, and 549 patients with validated laboratory test results were included for the analysis. The patients were categorized into three groups according to Sepsis-3 criteria: non-infection, infection, and sepsis. MDW was the highest in the sepsis group (median [Q1-Q3] 24.0 [20.8-27.8]). AUC [95%CI] for MDW, CRP, PCT, and white blood cells for sepsis were 0.71[0.67-0.75], 0.75[0.71-0.78], 0.76[0.72-0.79], and 0.61[0.57-0.65], respectively. With the optimal cut-off value from the cohort, the sensitivity was 85.6% with MDW (cut-off 19.8), 69.7% with CRP (4.0), and 76.6% with PCT (0.05). Combination of quick sequential organ failure score (qSOFA) with MDW and WBC improved the AUC (0.78[CI 0.74-0.82]) to a greater extent compared to qSOFA alone (0.67[CI 0.62-0.72]).Conclusions: MDW reflected comparable diagnostic performance with conventional diagnostic markers, implying that MDW could be an alternative biomarker and that the combination with qSOFA improves the diagnostic performance for early sepsis.

scholarly journals Improved Early Detection of Focal Brucellosis Complications with Anti-Brucella IgG

2020 ◽  
Vol 58 (10) ◽  
Author(s):  
Nannan Xu ◽  
Xiaomeng Dong ◽  
Yongyuan Yao ◽  
Yanyan Guan ◽  
Fengzhe Chen ◽  
...  
Keyword(s):  
Serological Test ◽  
Area Under The Curve ◽  
Positive Culture ◽  
Clinical Information ◽  
Acute Stage ◽  
Inflammatory Factors ◽  
Test Results ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Laboratory Test Results

ABSTRACT To evaluate the associations of inflammatory factors and serological test results with complicated brucellosis, we recruited 285 patients with a diagnosis of brucellosis between May 2016 and September 2019. The patients were subsequently classified into two groups according to the presence of complications. We collected demographic and clinical information and routine laboratory test results in addition to anti-Brucella IgG and IgM levels. Anti-Brucella IgG and IgM were uniformly tested using enzyme-linked immunosorbent assays (ELISAs) in this study. Among the 285 patients with brucellosis, 111 (38.95%) had complicated brucellosis. Osteoarthritis occurred more often in the subacute and chronic stages than in the acute stage (P = 0.002). Genital infection occurred more frequently in the acute stage than in the other stages (P = 0.023). Fever was not frequently observed in complicated cases (P < 0.001). The erythrocyte sedimentation rate (ESR) and the C-reactive protein (CRP) and anti-Brucella IgM and IgG levels were higher in complicated-brucellosis patients than in uncomplicated-brucellosis patients (P < 0.001). Anti-Brucella IgG, with an area under the curve of 0.885 (95% confidence interval [CI], 0.847 to 0.924), was the most robust indicator of complicated brucellosis. Positive culture, anti-Brucella IgM, the ESR, and CRP could be considered indicators, but their efficacy was weaker than that of IgG. In conclusion, a high ESR, high CRP, high anti-Brucella IgM and IgG levels, and positive culture were indicators of complicated brucellosis; among these, anti-Brucella IgG was the most robust biomarker.

scholarly journals Analysis of Mortality Factors in COVID-19 Patients; Systematic Review

2021 ◽  
Vol 2 (3) ◽  
pp. 1032-1042
Author(s):  
Yunita Liana ◽  
Pariyana ◽  
Mariana
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Laboratory Test ◽  
Neurological Disease ◽  
Test Results ◽  
C Reactive Protein ◽  
Mortality Factors ◽  
Reactive Protein ◽  
Laboratory Test Results ◽  
The Relationship

Abstract.   Coronavirus disease 2019 (COVID-19) is a highly contagious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. The increase in the number of COVID-19 cases is progressing quickly and has been spread between countries. As of October 14, 2020, there are 213 countries/regions around the world that have reported Covid-19 with a total of 38,002,699 confirmed cases of which 1,083,234 died. The purpose of this study was to determine the relationship between mortality factors and mortality in COVID-19 patients to predict the patient's prognosis. This research method is a systematic review through a literature review on mortality factors in COVID-19 patients Literature searches were accessed through internet searches using the Pubmed database based on the preferred reporting items for systemic review and meta-analysis (PRISMA). A systematic search was carried out on 18 October - 20 October 2020 with the keywords “COVID-19” AND “Death” OR “Decease” AND “Factor Associated”. There were 8 literature selected that met the inclusion and exclusion criteria. Based on the findings of the eight journals, mortality is old age, male, has a clinical condition of hypertension, obesity, diabetes, cardiovascular disease, lung disease, neurological disease, lymphophenia laboratory test results, hyperlactate dehydrogenase, increased procalcitonin, increased neutrophils, increased C-reactive protein, and increased D-dimer. All literature reported that a p value <0.05 was obtained from the analysis of the relationship between mortality factors and cases of death in COVID-19 patients. There is a significant relationship between mortality factors and the death of COVID-19 patients, where the mortality factors are elderly, male, have a clinical condition of hypertension, obesity, diabetes, cardiovascular disease, lung disease, neurological disease, lymphophenia laboratory test results, hyperlactate dehydrogenase, increase in procalcitonin, increase in neutrophils, increase in C-reactive protein, and increase in D-dimers in which the prognosis of patients who have mortality factors tends to be worse. Keywords: Mortality, Coronavirus, COVID-19

scholarly journals Evans Syndrome Associated with Hematological Malignancies: A Literature Review

2021 ◽  
Vol 9 (9) ◽  
Author(s):  
Motoharu Shibusawa
Keyword(s):  
Hematological Malignancies ◽  
Comprehensive Evaluation ◽  
Hematologic Malignancies ◽  
Underlying Disease ◽  
Clinical Findings ◽  
Test Results ◽  
Evans Syndrome ◽  
Laboratory Test Results ◽  
Underlying Diseases

Evans syndrome (ES) is a rare disorder in which the immune system produces antibodies that accidentally destroy red blood cells and platelets. The diagnosis of ES is made by the simultaneous presence of autoimmune hemolytic anemia and immune thrombocytopenia. However, the diagnosis of ES associated with hematologic malignancies necessitates a comprehensive evaluation of clinical course, clinical findings, and laboratory test results. Hematological malignancies are the most significant underlying diseases factors impacting ES and the prognosis, but there is no established standard therapy for autoimmune cytopenia associated with hematological malignancies. In ES associated with hematologic malignancies, achieving remission of the underlying disease seems to be the key to long-term remission.

scholarly journals Monocyte distribution width compared with C-reactive protein and procalcitonin for early sepsis detection in the emergency department

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250101
Author(s):  
A la Woo ◽  
Dong Kyu Oh ◽  
Chan-Jeoung Park ◽  
Sang-Bum Hong
Keyword(s):  
Emergency Department ◽  
Diagnostic Performance ◽  
Complete Blood Count ◽  
White Blood Cells ◽  
Sepsis Group ◽  
C Reactive Protein ◽  
Distribution Width ◽  
Reactive Protein ◽  
Laboratory Test Results ◽  
Early Sepsis

Purpose Monocyte distribution width (MDW) has been suggested as an early biomarker of sepsis, but few studies have compared MDW with conventional biomarkers, including C-reactive protein (CRP) and procalcitonin (PCT). This study evaluated MDW as a biomarker for sepsis and compared it with CRP and PCT. Materials and methods Patients aged 18–80 years who visited the emergency department were screened and prospectively enrolled in a tertiary medical center. Complete blood count, MDW, CRP, and PCT were examined. Diagnostic performance for sepsis was tested using the area under the curve (AUC) of receiver operating characteristic (ROC) curves, sensitivity, and specificity. Results In total, 665 patients were screened, and 549 patients with valid laboratory test results were included in the analysis. The patients were categorized into three groups according to the Sepsis-3 criteria: non-infection, infection, and sepsis. MDW showed the highest value in the sepsis group (median [interquartile range], 24.0 [20.8–27.8]). The AUC values for MDW, CRP, PCT, and white blood cells for predicting sepsis were 0.71 (95% confidence interval [CI], 0.67–0.75), 0.75 (95% CI, 0.71–0.78], 0.76 (95% CI, 0.72–0.79, and 0.61 (95% CI, 0.57–0.65), respectively. With the optimal cutoff value of the cohort, the sensitivity was 83.0% for MDW (cutoff, 19.8), 69.7% for CRP (cutoff, 4.0), and 76.6% for PCT (cutoff, 0.05). The combination of quick Sequential Organ Failure Assessment (qSOFA) with MDW improved the AUC (0.76; 95% CI, 0.72–0.80) to a greater extent than qSOFA alone (0.67; 95% CI, 0.62–0.72). Conclusions MDW reflected a diagnostic performance comparable to that of conventional diagnostic markers, implying that MDW is an alternative biomarker. The combination of MDW and qSOFA improves the diagnostic performance for early sepsis.

Hypermetabolism in the Initial Phase of Intensive Care Is Related to a Poor Outcome in Severe Sepsis Patients

2015 ◽  
Vol 66 (4) ◽  
pp. 188-195 ◽  
Author(s):  
Chao Wu ◽  
Xinying Wang ◽  
Wenkui Yu ◽  
Feng Tian ◽  
Sitong Liu ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Energy Expenditure ◽  
Clinical Outcome ◽  
Resting Energy Expenditure ◽  
Test Results ◽  
C Reactive Protein ◽  
Icu Patients ◽  
Reactive Protein ◽  
Laboratory Test Results ◽  
Resting Energy

Objective: To assess the incidence of hypermetabolism, defined as high resting energy expenditure, in severe sepsis ICU patients, and evaluate the suitability of excessive resting energy expenditure (REE) as a risk factor of their clinical outcome. Methods: In a single-center, prospective, six-month observational study in China, the measured REE (MREE) was estimated daily using indirect calorimetry (IC) for the first 5 days of ICU admission. The predicted REE (PREE) was determined using the Harris-Benedict equation. ICU severity criteria (APACHE II and SOFA scores), baseline and health characteristics, and laboratory test results, were compared between the hyper-metabolic (MREE/PREE ratio ≥1.3) and the normometabolic (MREE/PREE ratio <1.3) groups, and between the survivor and non-survivor groups, classified according to 28-day mortality. Results: Of the 62 included ICU patients (age, 57.1 ± 19.5 years), 34 patients (55%) were hypermetabolic. The 28-day mortality rate in the hypermetabolic and normometabolic groups was 35 and 18%, respectively (p < 0.001). The MREE/PREE ratio and C-reactive protein (CRP) plasma concentration were significantly higher in non-survivors than survivors (p = 0.017), and were significantly (p < 0.05) associated with 28-day mortality (ORMREE/ PREE = 1.018, 95% CI, 1.010-2.544, p = 0.031 and ORCRP = 1.010, 95% CI, 1.005-2.173, p = 0.025, respectively). Conclusion: In critical sepsis patients admitted to ICU, the MREE/PREE ratio may be a valuable evaluation index of the clinical outcome.

Clinical characteristics of inpatients with Coronavirus disease 2019 and acute ischemic stroke: from epidemiology to outcomes

2020 ◽  
Vol 17 ◽  
Author(s):  
Shiling Chen ◽  
Chao Pan ◽  
Ping Zhang ◽  
Yingxin Tang ◽  
Zhouping Tang
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Neurological Complication ◽  
Pathophysiological Mechanism ◽  
C Reactive Protein ◽  
Vessel Occlusion ◽  
Reactive Protein ◽  
Detailed Search ◽  
Underlying Diseases ◽  
Worse Prognosis

Abstract:: Acute Ischemic Stroke (AIS) is currently the most frequently reported neurological complication of Coronavirus disease 2019 (COVID-19). This article will elaborate on the clinical features of inpatients with COVID-19 and AIS and the pathophysiological mechanism of AIS under the background of COVID-19. Through a detailed search of relevant studies, we found that the incidence of AIS among COVID-19 patients varied from 0.9% to 4.6%, and AIS has been observed in many people without underlying diseases and cardiovascular risk factors as well as young people. The National Institute of Health Stroke Scale (NIHSS) score of COVID-19 patients with AIS was higher than historical AIS patients, and the proportion of large vessel occlusion (LVO) was about 64.2%. COVID-19 patients with AIS have commonly high levels of D-D dimer, fibrinogen, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), suggesting systemic hyperinflammatory and hypercoagulable state. The pooled mortality of COVID-19 patients with AIS was 38% and the mortality of LVO patients is higher (45.9%). Compared with COVID-19-negative AIS patients in the same period in 2020 and 2019, COVID- 19 patients with AIS had a worse prognosis.

scholarly journals Serum C-reactive protein metabolite (CRPM) is associated with incidence of contralateral knee osteoarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anne-Christine Bay-Jensen ◽  
Asger Bihlet ◽  
Inger Byrjalsen ◽  
Jeppe Ragnar Andersen ◽  
Bente Juhl Riis ◽  
...  
Keyword(s):  
Phase Iii ◽  
Response To Treatment ◽  
C Reactive Protein ◽  
Two Phase ◽  
Knee Oa ◽  
Reactive Protein ◽  
Inflammatory Phenotype ◽  
The Mean ◽  
Using Data

AbstractThe heterogeneous nature of osteoarthritis (OA) and the need to subtype patients is widely accepted in the field. The biomarker CRPM, a metabolite of C-reactive protein (CRP), is released to the circulation during inflammation. Blood CRPM levels have shown to be associated with disease activity and response to treatment in rheumatoid arthritis (RA). We investigated the level of blood CRPM in OA compared to RA using data from two phase III knee OA and two RA studies (N = 1591). Moreover, the association between CRPM levels and radiographic progression was investigated. The mean CRPM levels were significantly lower in OA (8.5 [95% CI 8.3–8.8] ng/mL, n = 781) compared to the RA patients (12.8 [9.5–16.0] ng/mL, n = 60); however, a significant subset of OA patients (31%) had CRPM levels (≥ 9 ng/mL) comparable to RA. Furthermore, OA patients (n = 152) with CRPM levels ≥ 9 ng/mL were more likely to develop contra-lateral knee OA assessed by X-ray over a two-year follow-up period with an odds ratio of 2.2 [1.0–4.7]. These data suggest that CRPM is a blood-based biochemical marker for early identification OA patients with an inflammatory phenotype.

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