Predictors of Mortality in COPD Exacerbation Cases Presenting to the Respiratory Intensive Care Unit

Abstract Background: Studies report high in-hospital mortality of chronic obstructive pulmonary disease (COPD) exacerbations especially for those who requiring intensive care unit (ICU) admission. Recognizing factors associated with mortality in those patients could reduce healthcare costs and improve end-of-life care. Methods: This retrospective cohort study included 384 patients with AECOPD admitted to the respiratory ICU (RICU) of a tertiary hospital in Beijing from Jan 1, 2011 to Dec 31, 2018. Patients demographic characteristic, blood test results and comorbidities were extracted from the electronic medical record system and compared between survivors and non-survivors. Results: We finally enrolled 384 AECOPD patients, 44 (11.5%) patients died in hospital and 340 (88.5%) were discharged. The most common comorbidity was respiratory failure (294 (76.6%)), followed by hypertension (214 (55.7%)), coronary heart disease (CHD, 115 (29.9%)) and chronic heart failure (CHF, (76 (19.8%)). Multiple logistic regression analysis revealed the independent risk factors associated with in-hospital mortality included lymphocytopenia, leukopenia combined with CHF and the requirement for invasive mechanical ventilation (IMV).Conclusions: The in-hospital mortality of patients with COPD exacerbation requiring RICU admission is high. Lymphocytes<0.8×109/L, leukopenia, requirement for IMV, combined with CHF could be identified as risk factors associated with increased mortality rates.

Download Full-text

Risk Factors for Intensive Care Unit Admission and In-hospital Mortality Among Hospitalized Adults Identified through the US Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET)

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1012 ◽

2020 ◽

Cited By ~ 31

Author(s):

Lindsay Kim ◽

Shikha Garg ◽

Alissa O’Halloran ◽

Michael Whitaker ◽

Huong Pham ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Hospital Mortality ◽

Invasive Mechanical Ventilation ◽

The United States ◽

Surveillance Network ◽

Factors Associated ◽

Icu Admission ◽

Male Sex

Abstract Background Currently, the United States has the largest number of reported coronavirus disease 2019 (COVID-19) cases and deaths globally. Using a geographically diverse surveillance network, we describe risk factors for severe outcomes among adults hospitalized with COVID-19. Methods We analyzed data from 2491 adults hospitalized with laboratory-confirmed COVID-19 between 1 March–2 May 2020, as identified through the Coronavirus Disease 2019–Associated Hospitalization Surveillance Network, which comprises 154 acute-care hospitals in 74 counties in 13 states. We used multivariable analyses to assess associations between age, sex, race and ethnicity, and underlying conditions with intensive care unit (ICU) admission and in-hospital mortality. Results The data show that 92% of patients had ≥1 underlying condition; 32% required ICU admission; 19% required invasive mechanical ventilation; and 17% died. Independent factors associated with ICU admission included ages 50–64, 65–74, 75–84, and ≥85 years versus 18–39 years (adjusted risk ratios [aRRs], 1.53, 1.65, 1.84, and 1.43, respectively); male sex (aRR, 1.34); obesity (aRR, 1.31); immunosuppression (aRR, 1.29); and diabetes (aRR, 1.13). Independent factors associated with in-hospital mortality included ages 50–64, 65–74, 75–84, and ≥ 85 years versus 18–39 years (aRRs, 3.11, 5.77, 7.67, and 10.98, respectively); male sex (aRR, 1.30); immunosuppression (aRR, 1.39); renal disease (aRR, 1.33); chronic lung disease (aRR 1.31); cardiovascular disease (aRR, 1.28); neurologic disorders (aRR, 1.25); and diabetes (aRR, 1.19). Conclusions In-hospital mortality increased markedly with increasing age. Aggressive implementation of prevention strategies, including social distancing and rigorous hand hygiene, may benefit the population as a whole, as well as those at highest risk for COVID-19–related complications.

Download Full-text

Predictors of mortality in COPD exacerbation cases presenting to the respiratory intensive care unit

Respiratory Research ◽

10.1186/s12931-021-01657-4 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Yang Cao ◽

Zhenzhen Xing ◽

Huanyu Long ◽

Yilin Huang ◽

Ping Zeng ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Intensive Care Unit ◽

Intensive Care ◽

Chronic Heart Failure ◽

Hospital Mortality ◽

Invasive Mechanical Ventilation ◽

Copd Exacerbation ◽

Factors Associated ◽

Respiratory Intensive Care Unit

Abstract Background Studies report high in-hospital mortality of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) especially for those requiring admission to an intensive care unit. Recognizing factors associated with mortality in these patients could reduce health care costs and improve end-of-life care. Methods This retrospective study included AECOPD patients admitted to the respiratory intensive care unit of a tertiary hospital in Beijing from Jan 1, 2011 to Dec 31, 2018. Patients demographic characteristics, blood test results and comorbidities were extracted from the electronic medical record system and compared between survivors and non-survivors. Results We finally enrolled 384 AECOPD patients: 44 (11.5%) patients died in hospital and 340 (88.5%) were discharged. The most common comorbidity was respiratory failure (294 (76.6%)), followed by hypertension (214 (55.7%)), coronary heart disease (115 (29.9%)) and chronic heart failure (76 (19.8%)). Multiple logistic regression analysis revealed that independent risk factors associated with in-hospital mortality included lymphocytopenia, leukopenia, chronic heart failure and requirement for invasive mechanical ventilation. Conclusions The in-hospital mortality of patients with acute COPD exacerbation requiring RICU admission is high. Lymphocytes < 0.8 × 109/L, leukopenia, requirement for invasive mechanical ventilation, and chronic heart failure were identified as risk factors associated with increased mortality rates.

Download Full-text

Risk Factors for Sepsis in the Neonatal Intensive Care Unit of a Tertiary Hospital in Mexico

Journal of Biomedical Research & Environmental Sciences ◽

10.37871/jbres1370 ◽

2021 ◽

Vol 2 (12) ◽

pp. 1183-1186

Author(s):

Ilse Lizeth Villegas-Velasquez ◽

Luz Irene Pascual-Mathey ◽

Olga Lidia Valenzuela-Limon ◽

Patricia Elisa Molina-Prior ◽

Jose Locia-Espinoza ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Gestational Age ◽

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

Tertiary Hospital ◽

Factors Associated ◽

Newborn Weight

Neonatal Sepsis (NS) is a systemic infection caused by bacteria, fungi, or viruses during the first month of life. Although various studies have identified the factors associated with NS, it is a public health problem due to its high morbidity and mortality. The study aimed to identify the risk factors associated with neonatal sepsis in the Neonatal Intensive Care Unit (NICU) of a tertiary hospital in Mexico. A case-control study was carried out using records of neonates (with sepsis 39 and without sepsis 39) from January to December 2017. The risk factors studied were the sociodemographic and clinical characteristics of the mother and clinics of the neonate. The data were analyzed using the Chi2 test, Fisher's exact test, Student's t-test, and the Odds Ratio (OR). The risk factors associated with NS were gestational age (OR 0.77, CI 95% = 0.64-0.91, p = 0.004), newborn weight (OR 0.45, CI95% = 0.23-0.86, p = 0.017) and days of hospital stay (OR 1.06, CI95% = 1.02-1.10, p = 0.0014). The mother's sociodemographic and clinical factors were not associated with NS. Risk factors associated with NS were gestational age, newborn weight, and days of hospital stay.

Download Full-text

Risk Factors Associated with Vancomycin-ResistantEnterococcusin Intensive Care Unit Settings in Saudi Arabia

Interdisciplinary Perspectives on Infectious Diseases ◽

10.1155/2013/369674 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 7

Author(s):

Mahmoud Shorman ◽

Jaffar A. Al-Tawfiq

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Saudi Arabia ◽

Intensive Care ◽

Antimicrobial Agents ◽

Multiorgan Failure ◽

Tertiary Hospital ◽

Oral Contrast ◽

Factors Associated ◽

Icu Admission

Background. Vancomycin-resistant enterococci (VRE) are significant nosocomial pathogens worldwide. There is one report about the epidemiology of VRE in Saudi Arabia.Objective. To determine the risk factors associated with VRE infection or colonization in intensive care unit (ICU) settings.Design. This is a descriptive, epidemiologic hospital-based case-control study of patients with VRE from February 2006 to March 2010 in ICU in a tertiary hospital in Saudi Arabia.Methods. Data were collected from hospital records of patients with VRE. The main outcome measure was the adjusted odds ratio estimates of potential risk factors for VRE.Results. Factors associated with VRE included ICU admission for multiorgan failure, chronic renal failure, prior use of antimicrobial agents in the past three months and before ICU admission, gastrointestinal oral contrast procedure, and hemodialysis. Being located in a high risk room (roommate of patients colonized or infected with VRE) was found to be protective.Conclusions. Factors associated with VRE acquisition are often complex and may be confounded by local variables.

Download Full-text

Risk factors for death of trauma patients admitted to an Intensive Care Unit

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.3482.3236 ◽

2020 ◽

Vol 28 ◽

Author(s):

Maicon Henrique Lentsck ◽

Rosana Rosseto de Oliveira ◽

Ligiana Pires Corona ◽

Thais Aidar de Freitas Mathias

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Medical Records ◽

Retrospective Cohort ◽

Prehospital Care ◽

Multiple Logistic Regression Analysis ◽

Trauma Patients ◽

Multiple Logistic Regression ◽

Factors Associated

Objective: To analyze the risk factors for death of trauma patients admitted to the intensive care unit (ICU). Method: Retrospective cohort study with data from medical records of adults hospitalized for trauma in a general intensive care unit. We included patients 18 years of age and older and admitted for injuries. The variables were grouped into levels in a hierarchical manner. The distal level included sociodemographic variables, hospitalization, cause of trauma and comorbidities; the intermediate, the characteristics of trauma and prehospital care; the proximal, the variables of prognostic indices, intensive admission, procedures and complications. Multiple logistic regression analysis was performed. Results: The risk factors associated with death at the distal level were age 60 years or older and comorbidities; at intermediate level, severity of trauma and proximal level, severe circulatory complications, vasoactive drug use, mechanical ventilation, renal dysfunction, failure to perform blood culture on admission and Acute Physiology and Chronic Health Evaluation II. Conclusion: The identified factors are useful to compose a clinical profile and to plan intensive care to avoid complications and deaths of traumatized patients.

Download Full-text

Association of Ventilator Type with Hospital Mortality in Critically Ill Patients with SARS-CoV2 Infection: A Retrospective Study.

10.21203/rs.3.rs-565958/v1 ◽

2021 ◽

Author(s):

Alexis FERRE ◽

Fabien Marquion ◽

Marc Delord ◽

Jean-Pierre Bédos ◽

Hugo Bellut ◽

...

Keyword(s):

Hospital Mortality ◽

Multivariate Regression ◽

Distress Syndrome ◽

Invasive Mechanical Ventilation ◽

Patient Characteristics ◽

Tertiary Hospital ◽

Prospective Data ◽

Factors Associated ◽

Kaplan Meier ◽

Patient Groups

Abstract Background: To evaluate the association between ventilator type and hospital mortality in patients with acute respiratory distress syndrome (ARDS) related to COVID-19 (SARS-CoV2 infection) during the first wave of the disease in France.Methods: We retrospectively included consecutive adults admitted to the intensive care unit (ICU) of a university-affiliated tertiary hospital for ARDS related to proven COVID-19, between March and May 2020. All patients were intubated. We compared two patient groups defined by whether an ICU ventilator or a less sophisticated ventilator such as a transport ventilator was used. Kaplan-Meier survival curves were plotted. Cox multivariate regression was performed to identify associations between patient characteristics and hospital mortality.Results: We included 82 patients (61 [74.4%] men) with a median age of 64 years [55–74], of whom 23 (28.1%) died before hospital discharge. By multivariate analysis, factors associated with in-hospital mortality were older age (HR, 1.06/year; 95%CI, 1.00–1.11; P=0.05) and diabetes mellitus (HR, 3.32; 95%CI, 1.13–9.76; P=0.03) but not ventilator type. Using non-ICU ventilator was associated neither with a longer duration of invasive mechanical ventilation (20 [12-36] vs. 25 [15-31] days; P=0.87) nor with a longer ICU stay (24 [14-40] vs. 27 [15-37] days; P=0.64).Conclusions: In patients with ARDS due to COVID-19, the use of non-ICU ventilators, such as transport ventilators, was not associated with worse outcomes. Although prospective data are needed to confirm our findings, this study suggests that transport ventilators may be valuable during COVID-19 surges that overwhelm ICU resources.

Download Full-text

Incidence, risk factors, clinical profile, and determinants (affecting outcome) of new onset acute kidney injury developing in critically Illpatients in pediatric intensive care unit of a tertiary hospital in middle India

Pediatric Review International Journal of Pediatric Research ◽

10.17511/ijpr.2019.i05.10 ◽

2019 ◽

Vol 6 (5) ◽

pp. 252-261

Author(s):

Dr. Badri Narayan Rao ◽

◽

Dr. Santosh Kumar Rathia ◽

Dr. Sharja Phuljhele ◽

Dr. Yogendra Kumar Verma ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Acute Kidney Injury ◽

Intensive Care ◽

Pediatric Intensive Care Unit ◽

Kidney Injury ◽

Pediatric Intensive Care ◽

Tertiary Hospital ◽

Incidence Risk ◽

New Onset

Download Full-text

Ethnicity and other COVID-19 death risk factors in Mexico

Archives of Medical Science ◽

10.5114/aoms.2020.101443 ◽

2020 ◽

Author(s):

Erwin Chiquete ◽

Jesus Alegre-Díaz ◽

Ana Ochoa-Guzmán ◽

Liz Nicole Toapanta-Yanchapaxi ◽

Carlos González-Carballo ◽

...

Keyword(s):

Risk Factors ◽

Proportional Hazards Model ◽

Invasive Mechanical Ventilation ◽

Significant Risk ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Chronic Obstructive ◽

Death Risk ◽

Factors Associated ◽

Risk Of Death

IntroductionPatients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may develop coronavirus disease 2019 (COVID-19). Risk factors associated with death vary among countries with different ethnic backgrounds. We aimed to describe the factors associated with death in Mexicans with confirmed COVID-19.Material and methodsWe analysed the Mexican Ministry of Health’s official database on people tested for SARS-CoV-2 infection by real-time reverse transcriptase–polymerase chain reaction (rtRT-PCR) of nasopharyngeal fluids. Bivariate analyses were performed to select characteristics potentially associated with death, to integrate a Cox-proportional hazards model.ResultsAs of May 18, 2020, a total of 177,133 persons (90,586 men and 86,551 women) in Mexico received rtRT-PCR testing for SARS-CoV-2. There were 5332 deaths among the 51,633 rtRT-PCR-confirmed cases (10.33%, 95% CI: 10.07–10.59%). The median time (interquartile range, IQR) from symptoms onset to death was nine days (5–13 days), and from hospital admission to death 4 days (2–8 days). The analysis by age groups revealed that the significant risk of death started gradually at the age of 40 years. Independent death risk factors were obesity, hypertension, male sex, indigenous ethnicity, diabetes, chronic kidney disease, immunosuppression, chronic obstructive pulmonary disease, age > 40 years, and the need for invasive mechanical ventilation (IMV). Only 1959 (3.8%) cases received IVM, of whom 1893 were admitted to the intensive care unit (96.6% of those who received IMV).ConclusionsIn Mexico, highly prevalent chronic diseases are risk factors for death among persons with COVID-19. Indigenous ethnicity is a poorly studied factor that needs more investigation.

Download Full-text