scholarly journals Autopsy and Statistical Evidence of Disturbed Hemostasis Progress in COVID-19: Medical Records from 407 Patients

2020 ◽  
Author(s):  
Tiebin Jiang ◽  
Bo Lv ◽  
Hongxia Liu ◽  
Shiwen He ◽  
Guogang Zhang ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Statistical Analysis ◽  
Medical Records ◽  
Activated Partial Thromboplastin Time ◽  
Statistical Tools ◽  
Multiple Organs ◽  
Autopsy Data ◽  
Discharge Status ◽  
Critical Patients ◽  
D Dimer

Abstract Background: The progression of coagulation in COVID-19 patients with confirmed discharge status and the combination of autopsy with complete hemostasis parameters have not been well studied. Objective : To clarify the thrombotic phenomena and hemostasis state in COVID-19 patients based on epidemiological statistics combining autopsy and statistical analysis. Methods: Using autopsy results from 9 patients with COVID-19 pneumonia and the medical records of 407 patients, including 39 deceased patients whose discharge status was certain, time-sequential changes in 11 relevant indices within mild, severe and critical infection throughout hospitalization according to the Chinese National Health Commission (NHC) guidelines were evaluated. Statistical tools were applied to calculate the importance of 11 indices and the correlation between those indices and the severity of COVID-19. Results: At the beginning of hospitalization, platelet (PLT) counts were significantly reduced in critically ill patients compared with severely or mildly ill patients. Blood glucose (GLU), prothrombin time (PT), activated partial thromboplastin time (APTT), and D-dimer levels in critical patients were increased compared with mild and severe patients during the entire admission period. The International Society on Thrombosis and Haemostasis (ISTH) disseminated intravascular coagulation (DIC) score was also high in critical patients. In the relatively late stage of nonsurvivors, the temporal changes in PLT count, PT, and D-dimer levels were significantly different from those in survivors. A random forest model indicated that the most important feature was PT followed by D-dimer, indicating their positive associations with disease severity. Autopsy data from 9 deceased patients also revealed DIC phenomena with prolonged PT, APTT, lower PLT count and thrombosis in multiple organs. Conclusions: Combining autopsy data, time-sequential changes and statistical methods to explore hemostasis-relevant indices among the different severities of the disease helps guide therapy and detect prognosis in COVID-19 infection.

scholarly journals Autopsy and statistical evidence of disturbed hemostasis progress in COVID-19: medical records from 407 patients

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Tiebin Jiang ◽  
Bo Lv ◽  
Hongxia Liu ◽  
Shiwen He ◽  
Guogang Zhang ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Statistical Analysis ◽  
Medical Records ◽  
Activated Partial Thromboplastin Time ◽  
Statistical Tools ◽  
Multiple Organs ◽  
Autopsy Data ◽  
Discharge Status ◽  
Critical Patients ◽  
D Dimer

Abstract Background The progression of coagulation in COVID-19 patients with confirmed discharge status and the combination of autopsy with complete hemostasis parameters have not been well studied. Objective To clarify the thrombotic phenomena and hemostasis state in COVID-19 patients based on epidemiological statistics combining autopsy and statistical analysis. Methods Using autopsy results from 9 patients with COVID-19 pneumonia and the medical records of 407 patients, including 39 deceased patients whose discharge status was certain, time-sequential changes in 11 relevant indices within mild, severe and critical infection throughout hospitalization according to the Chinese National Health Commission (NHC) guidelines were evaluated. Statistical tools were applied to calculate the importance of 11 indices and the correlation between those indices and the severity of COVID-19. Results At the beginning of hospitalization, platelet (PLT) counts were significantly reduced in critically ill patients compared with severely or mildly ill patients. Blood glucose (GLU), prothrombin time (PT), activated partial thromboplastin time (APTT), and D-dimer levels in critical patients were increased compared with mild and severe patients during the entire admission period. The International Society on Thrombosis and Haemostasis (ISTH) disseminated intravascular coagulation (DIC) score was also high in critical patients. In the relatively late stage of nonsurvivors, the temporal changes in PLT count, PT, and D-dimer levels were significantly different from those in survivors. A random forest model indicated that the most important feature was PT followed by D-dimer, indicating their positive associations with disease severity. Autopsy of deceased patients fulfilling diagnostic criteria for DIC revealed microthromboses in multiple organs. Conclusions Combining autopsy data, time-sequential changes and statistical methods to explore hemostasis-relevant indices among the different severities of the disease helps guide therapy and detect prognosis in COVID-19 infection.

scholarly journals Autopsy and Statistical Evidence of Disturbed Hemostasis Progress in COVID-19: Medical Records from 407 Patients

2021 ◽  
Author(s):  
Tiebin Jiang ◽  
Bo Lv ◽  
Hongxia Liu ◽  
Shiwen He ◽  
Guogang Zhang ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Statistical Analysis ◽  
Medical Records ◽  
Activated Partial Thromboplastin Time ◽  
Statistical Tools ◽  
Multiple Organs ◽  
Autopsy Data ◽  
Discharge Status ◽  
Critical Patients ◽  
D Dimer

Abstract Background: The progression of coagulation in COVID-19 patients with confirmed discharge status and the combination of autopsy with complete hemostasis parameters have not been well studied.Objective: To clarify the thrombotic phenomena and hemostasis state in COVID-19 patients based on epidemiological statistics combining autopsy and statistical analysis.Methods: Using autopsy results from 9 patients with COVID-19 pneumonia and the medical records of 407 patients, including 39 deceased patients whose discharge status was certain, time-sequential changes in 11 relevant indices within mild, severe and critical infection throughout hospitalization according to the Chinese National Health Commission (NHC) guidelines were evaluated. Statistical tools were applied to calculate the importance of 11 indices and the correlation between those indices and the severity of COVID-19.Results: At the beginning of hospitalization, platelet (PLT) counts were significantly reduced in critically ill patients compared with severely or mildly ill patients. Blood glucose (GLU), prothrombin time (PT), activated partial thromboplastin time (APTT), and D-dimer levels in critical patients were increased compared with mild and severe patients during the entire admission period. The International Society on Thrombosis and Haemostasis (ISTH) disseminated intravascular coagulation (DIC) score was also high in critical patients. In the relatively late stage of nonsurvivors, the temporal changes in PLT count, PT, and D-dimer levels were significantly different from those in survivors. A random forest model indicated that the most important feature was PT followed by D-dimer, indicating their positive associations with disease severity. Autopsy of deceased patients fulfilling diagnostic criteria for DIC revealed microthromboses in multiple organs.Conclusions: Combining autopsy data, time-sequential changes and statistical methods to explore hemostasis-relevant indices among the different severities of the disease helps guide therapy and detect prognosis in COVID-19 infection.

scholarly journals Autopsy and Informatics Analysis Evidence Disturbed Haemostasis Progress in COVID-19: Medical Records from 407 Patients

2020 ◽  
Author(s):  
Tiebin Jiang ◽  
Bo Lv ◽  
Hongxia Liu ◽  
Shiwen He ◽  
Guogang Zhang ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Random Forest ◽  
Medical Records ◽  
Activated Partial Thromboplastin Time ◽  
Multiple Organs ◽  
Autopsy Data ◽  
Discharge Status ◽  
Critical Patients ◽  
Informatics Tools ◽  
D Dimer

Abstract Background: The progress of coagulation in COVID-19 patients with confirmed discharge status (decease or discharge) and the combination of the autopsy with the complete coagulation parameters were not well studied.Objective: To clarify the thrombotic phenomena with coagulation progress in COVID-19 patients based on epidemiological statistics combining the autopsy and informatics analysis.Methods: Using 9 autopsy results with COVID-19 pneumonia and the medical records of 407 patients including 39 deceased ones whose discharge status was certain, time-sequential changes of 11 relevant indices within mild, severe and critical infection throughout hospitalization according to the Chinese National Health Commission (NHC) guidelines were evaluated. Informatics tools were applied to calculate the importance of 11 indices and the correlation between those indices and the severities of COVID-19.Results: At the beginning of the hospitalization, platelet (PLT) had a significant decrease in critically ill patients. Blood glucose (GLU), prothrombin time (PT), activated partial thromboplastin time (APTT), and D-dimer in critical patients were higher than those in mild and severe during the whole admission period. The International Society on Thrombosis and Haemostasis (ISTH) disseminated intravascular coagulation (DIC) score also showed the high DIC level in critical patients. At the relatively late stage of non-survivors, the temporal changes of PLT count, PT, and D-dimer were significantly different from survivors. A random forest model indicated that the most important feature was PT, followed by D-dimer, indicating their positive associations for the severities of disease. Autopsy data from 9 deceased patients also showed the DIC phenomena with prolonged PT, APTT, less PLT count and thrombosis in multiple organs.Conclusions: Combining autopsy data, time-sequential changes and informatics methods to explore the coagulation relevant indices among the different severities of the disease, helps guide the therapy and detect the prognosis in COVID-19 infection.

scholarly journals Autopsy and Informatics Analysis Evidence Coagulopathy Progress in COVID-19 Patients

2020 ◽  
Author(s):  
Tiebin Jiang ◽  
Bo Lv ◽  
Hongxia Liu ◽  
Shiwen He ◽  
Guogang Zhang ◽  
...  
Keyword(s):  
Random Forest ◽  
Medical Records ◽  
Dynamic Changes ◽  
The World ◽  
Autopsy Data ◽  
Progression Of Disease ◽  
Discharge Status ◽  
Critical Patients ◽  
Informatics Tools ◽  
D Dimer

Abstract Background The outbreak of COVID-19 around the world resulted in more than 480 thousand deaths. Objective To clarify the thrombotic phenomena with coagulation progress in COVID-19 patients based on epidemiological statistics combining the autopsy and informatics analysis. Methods Using 9 autopsy results with COVID-19 pneumonia and the medical records of 407 patients including 39 deceased ones whose discharge status was certain, time-sequential changes of 11 coagulation relevant indices within mild, severe and critical infection throughout hospitalization according to NHC guidelines were evaluated. Informatics tools were applied to calculate the importance and correlation between them and the progression of thrombosis. Results At the beginning of the hospitalization, PLT had a significant decrease in critically ill patients. GLU, PT, APTT, and D-dimer in critical patients were higher than those in mild and severe during the whole admission period. The ISTH DIC score also showed the continuous overt DIC in critical patients. At the late stage of non-survivors, the dynamic profiles of PLT, PT, and D-dimer were significantly different from survivors. A random forest model indicated that the most important feature was PT, followed by D-dimer, indicating their crucial roles for the progression of disease. Conclusions COVID-19 is constantly spreading wildly around the world, combining autopsy data, time-sequential profiles and informatics methods to explore the dynamic changes of coagulation relevant indices throughout the course of the disease deterioration, which helps guide the therapy and detect the prognosis in different level of COVID-19 infection.

scholarly journals Correlation between Hemostasis Profile and Sepsis Outcome

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Sisi Melansi ◽  
Eny Rahmawati ◽  
Susilawati Susilawati
Keyword(s):  
Cohort Study ◽  
Statistical Analysis ◽  
Treatment Period ◽  
Activated Partial Thromboplastin Time ◽  
Duration Of Treatment ◽  
Chi Square ◽  
Cytokine Activation ◽  
Cohort Study Design ◽  
Weak Negative Correlation ◽  
D Dimer

Sepsis is an organ dysfunction caused by infection. Excessive cytokine activation, which causes hemostasis disorder israted by Prothrombin Time (PT), activated Partial Thromboplastin Time (aPTT), fibrinogen, and D-dimer tests. Hemostasisdisorder can affect several sepsis outcomes (mortality and duration of treatment period). This study aimed to determine thecorrelation between hemostasis profile and sepsis outcome. This research was an analytical-observational withretrospective cohort study design with subjects consisting of 76 sepsis patients at Dr. Mohammad Hoesin Hospital,Palembang. The data were obtained by medical record observation and analyzed by Chi-Square and Spearman tests. From76 sepsis patients, 76.7% of subjects had normal PT; 88.2% had normal aPTT; 71.1% had elevated fibrinogen, and 100% hadelevated D-dimer. The patients' sepsis outcomes showed that 67.1% survived, and 32.9% has died, and the duration of thetreatment period without much differences is as long as ≤ 12 days and > 12 days. The statistical analysis showed that therewas no significant relationship between PT, mortality, duration of the treatment period (p=1.000; p=0.418), between aPTT,mortality, duration of the treatment period (p=0.709; p=0.480), between fibrinogen, mortality, duration of the treatmentperiod (p=0.350; p=1.000), and there was a weak negative correlation between D-dimer mortality and duration of thetreatment period (p=0.459; p=0.939). It could be concluded that there was no significant correlation between hemostasisprofile and sepsis outcome.

scholarly journals THE RISKS OF USING TRANEXAMIC ACID AND VITAMIN K FOR DECREASING PROTHROMBIN TIME AND ACTIVATED PARTIAL THROMBOPLASTIN TIME VALUES IN INTRACRANIAL HEMORRHAGIC PATIENTS AT RUMAH SAKIT UMUM PUSAT FATMAWATI JAKARTA

2017 ◽  
Vol 10 (17) ◽  
pp. 139
Author(s):  
Siti Zamilatul Azkiyah ◽  
Sudibyo Supardi ◽  
Retnosari Andrajati
Keyword(s):  
Statistical Analysis ◽  
Tranexamic Acid ◽  
Prothrombin Time ◽  
Vitamin K ◽  
Partial Thromboplastin Time ◽  
Medical Records ◽  
Vascular Malformations ◽  
Activated Partial Thromboplastin Time ◽  
Chi Squared ◽  
Threatening Condition

Objective: Intracranial hemorrhaging is a life-threatening condition that requires intensive treatment. Such hemorrhaging can happen spontaneously and may be caused by vascular malformations, trauma, or the administration of anticoagulant medications. The purpose of this study was to evaluate the risks of using tranexamic acid and Vitamin K for decreasing prothrombin time (PT) and activated partial thromboplastin time (aPTT) values in intracranial hemorrhagic patients.Methods: This study used a retrospective cohort design, and data were taken from patients’ medical records at the medical record installation of Rumah Sakit Umum Pusat Fatmawati in Jakarta. A total of 125 medical records were selected based on the inclusion criteria. The first group included patients receiving only tranexamic acid, and the second group consisted of patients receiving both tranexamic acid and Vitamin K.Results: Statistical analysis using Chi-squared testing for the first group showed a significant decrease in aPTT values, with p=0.000 (p<0.05), but there was no significant decrease in PT values, with p=0.314 (p<0.05). Statistical analysis using Chi-squared testing in the second group showed a significant decrease in aPTT values, with p=0.000 (p<0.05), and a significant decrease in PT values, with p=0.034 (p<0.05). Patients that used tranexamic acid and Vitamin K decreased the PT and aPTT values 2.7 times and 1, 6 times greater than patients without tranexamic acid and Vitamin K. Patients that used tranexamic acid decreased the PT and aPTT values 2.5 times and 1.2 times greater than patients without tranexamic acid.Conclusions: The combination of tranexamic acid and Vitamin K is potentially more effective in decreasing of hemorrhaging.

PENGARUH PEMBERIAN FRAKSI ETILASETAT KULIT UBI JALAR UNGU TERHADAP KADAR MALONDIALDEHID (MDA) SERUM MENCIT PUTIH JANTAN HIPERGLIKEMIA

2018 ◽  
Vol 8 (2) ◽  
pp. 144
Author(s):  
Ria Afrianti
Keyword(s):  
Blood Glucose ◽  
Statistical Analysis ◽  
Sweet Potato ◽  
Ethyl Acetate Fraction ◽  
Serum Levels ◽  
Negative Control ◽  
Control Group ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Purple Sweet Potato

This study aims to determine the effect giving of ethylacetate fraction of leather  purple sweet potato (Ipomoea batatas (L.) Lam, on levels of malondialdehyde (MDA) serum in mice hyperglicemia were induced with streptozocin dose of 50 mg/kgBW. Mice were divided into 5 groups, each group consisting of 3 tails, group I is a negative control, group II is a positive control, group III,IV and V is given ethylacetate fraction a dose of 100 mg/kgBW, 300 mg/kgBW, and 600 mg/kgBW. Ethyl Acetate Fraction leather purple sweet potato given orally for 15 days after the animal is declared hyperglicemia and measurement of blood glucose levels on 5, 10, and 15 day after giving test preparation in animal experiments. On the 16 day throughout the mice were taken serum levels measured malondialdehid. The statistical analysis results showed that giving of ethyl acetate fraction of leather purple sweet potato at a dose of 100 mg/kgBW, 300 mg/kgBW, and 600 mg/kgBW can lower blood glucose levels in mice hyperglycemia significantly (p<0.05). Malondialdehid levels on average in each group is 1.35 nmol/ml, 3.00 nmol/ml, 2.72 nmol/ml, 2.20 nmol/ml and 2.61 nmol/ml, the results of statistical analysis showed a decrease in melondialdehid serum levels were significantly (p<0.05), where a dose of 300 mg/kgBW is an effective dose for lowering blood glucose levels followed by decreased levels of malondialdehid which give effect approaching negative control.

scholarly journals ALLY in fighting COVID-19: magnitude of albumin decline and lymphopenia (ALLY) predict progression to critical disease

2021 ◽  
pp. jim-2020-001525
Author(s):  
Johanna S van Zyl ◽  
Amit Alam ◽  
Joost Felius ◽  
Ronnie M Youssef ◽  
Dipesh Bhakta ◽  
...  
Keyword(s):  
Medical Records ◽  
Resource Planning ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Disease Course ◽  
Risk Models ◽  
Simple Tool ◽  
Laboratory Results ◽  
Risk Of Disease ◽  
Critical Patients

The global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic leading to coronavirus disease 2019 (COVID-19) is straining hospitals. Judicious resource allocation is paramount but difficult due to the unpredictable disease course. Once hospitalized, discerning which patients may progress to critical disease would be valuable for resource planning. Medical records were reviewed for consecutive hospitalized patients with COVID-19 in a large healthcare system in Texas. The main outcome was progression to critical disease within 10 days from admission. Albumin trends from admission to 7 days were analyzed using mixed-effects models, and progression to critical disease was modeled by multivariable logistic regression of laboratory results. Risk models were evaluated in an independent group. Of 153 non-critical patients, 28 (18%) progressed to critical disease. The rate of decrease in mean baseline-corrected (Δ) albumin was −0.08 g/dL/day (95% CI −0.11 to −0.04; p<0.001) or four times faster, in those who progressed compared with those who did not progress. A model of Δ albumin combined with lymphocyte percentage predicting progression to critical disease was validated in 60 separate patients (sensitivity, 0.70; specificity, 0.74). ALLY (delta albumin and lymphocyte percentage) is a simple tool to identify patients with COVID-19 at higher risk of disease progression when: (1) a 0.9 g/dL or greater albumin drop from baseline within 5 days of admission or (2) baseline lymphocyte of ≤10% is observed. The ALLY tool identified >70% of hospitalized cases that progressed to critical COVID-19 disease. We recommend prospectively tracking albumin. This is a globally applicable tool for all healthcare systems.

Risks of Using Statistical Analysis Tools in Project Management Environments

2020 ◽  
Vol 7 (2) ◽  
pp. 1-19
Author(s):  
Brian J. Galli
Keyword(s):  
Risk Management ◽  
Project Management ◽  
Statistical Analysis ◽  
Common Type ◽  
Systematic Search ◽  
Statistical Tools ◽  
Early Stages ◽  
Analysis Tools ◽  
The Common ◽  
The Relationship

The purpose of this study is to examine the risks of using statistical tools in a project basis. A systematic search of certain academic databases has been conducted for this study. Statistical tools could be used in a project, and they should be properly planned and designed. Statistical tools include major activities, such as collecting and analyzing data, providing meaningful interpretation, and reporting findings. When dealing with statistical tools, there are several risks that may exist and impact the project either positively or negatively. This study covers a brief outline of the risk management, statistical tools, and the relationship between the two concepts. Finally, a discussion of the common type of risks that are initiated by using statistical analysis tools are provided, which could be planned, identified, and analyzed in the early stages of the project.

scholarly journals ASSESSMENT OF COAGULATION PROFILE IN PATIENTS WITH LIVER CIRRHOSIS AND ATRIAL FIBRILLATION

2021 ◽  
Vol 121 (1) ◽  
pp. 22-31
Author(s):  
Alіna Baylo ◽  
Vadym Shypulіn ◽  
Volodymyr Chernyavskyi ◽  
Luiza Parunyan
Keyword(s):  
Atrial Fibrillation ◽  
Liver Cirrhosis ◽  
Prothrombin Time ◽  
Partial Thromboplastin Time ◽  
International Normalized Ratio ◽  
Activated Partial Thromboplastin Time ◽  
Fibrinolytic System ◽  
Thrombin Time ◽  
Group I ◽  
D Dimer

The comorbid course of liver cirrhosis and atrial fibrillation causes higher levels of hospitalizations, mortality and ischemic stroke. According to current data, hemostasis in patients with liver cirrhosis is in a rebalanced dynamic state, but there are no data on the effect of atrial fibrillation on the hemostasis in patients with liver cirrhosis. Aims of the study. To assess abnormalities in primary, secondary haemostasis and fibrinolytic system in patients with liver cirrhosis and atrial fibrillation by using standard laboratory coagulation parameters and to investigate their changes depending on the stage of liver cirrhosis A, B, C according to Child-Pugh score. Materials and methods. A cross-sectional prospective study was conducted with the inclusion of 106 patients aged 42 to 83 years: group I (n = 70) - with liver cirrhosis and atrial fibrillation, II (n = 36) - with liver cirrhosis, which were distributed depending on the Child-Pugh score stages of cirrhosis and 20 healthy individuals. The levels of platelets, activated partial thromboplastin time, international normalized ratio, prothrombin time, thrombin time, fibrinogen, D-dimer were assessed on a Steellex M200 coagulometer. Statistical analysis (IBM SPSS Statistics) was performed. Results. The level of platelets in patients of group I was reduced by 37.4% (200 ± 8.33 vs. 274.7 ± 3.4; p,000.001), an activated partial thromboplastin time was prolonged by 38.6% (44.35 ± 1.39 vs. 32.01 ± 0.63, p˂0.001), prothrombin time was prolonged by 73.5% (19.4 ± 0.87 vs. 11.18 ± 0.53, p˂0.001), thrombin time was prolonged by 2.07 (25, 7 ± 1.31 vs. 12.4 ± 0.66, p˂0.001), the international normalized ratio was increased by 24.3% (1.38 ± 0.04 vs.1.11 ± 0.01, p˂0.001) compared to control. The fibrinogen level was 20.9% higher (4.17 ± 0.17 vs. 3.45 ± 0.11, p˂0.001) than in control group and was 83.7% higher (4.17 ± 0.17 vs. 2.27 ± 0.13, p˂0.001) than in group II. The D-dimer level was 83% higher than in control (675 ± 22.3 vs. 368.8 ± 21.85, p˂0.001) and 44% higher (675 ± 22.3 vs. 469 ± 37.18, p ˂0.001) compared with group II. Conclusions. In patients with liver cirrhosis and atrial fibrillation abnormalities of primary hemostasis are detected due to decrease of platelets on the background of portal hypertension. At the secondary stage of hemostasis indicators of external and internal coagulation mechanisms are prolonged due to the reduced synthesis of coagulation factors by the liver. Increased level of fibrinogen is determined at the stage of compensated and subcompensated cirrhosis with a gradual decrease at the stage of decompensation. The high activity of the fibrinolytic system is observed due to increase in the D-dimer levels, which may indicate a prothrombotic state in these patients.

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