Blood albumin as a prognostic factor among unselected medically treated inpatients

2019 ◽  
Vol 13 (13) ◽  
pp. 1059-1069
Author(s):  
Krzysztof Tojek ◽  
Gabriel Kowalczyk ◽  
Beata Czerniak ◽  
Wioletta Banaś ◽  
Beata Szukay ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Lower Risk ◽  
Prognostic Value ◽  
Medical Documentation ◽  
Hospital Death ◽  
Prospective Analysis ◽  
Ideal Bodyweight ◽  
Unselected Population ◽  
Diagnostic Power ◽  
Blood Albumin

Aim: The aim of this study is to determine the prognostic value of blood albumin (BA) in an unselected population of inpatients. Materials & methods: We performed prospective analysis of the medical documentation of 7279 patients hospitalized between July 2014 and September 2017. Results: Individuals with BA ≥3.35 mg/dl had significantly lower risk of in-hospital death (odds ratio [OR]: 0.22; 95% CI: 0.19–0.27; p < 0.001) and 14-day readmission (OR: 0.64; 95% CI: 0.55–0.77; p < 0.0001). BA concentration was the strongest favorable factor predicting inpatient survival in a Cox hazard regression model (OR: 0.43; 95% CI: 0.36–0.50; p < 0.001), did not correlate with body mass index and actual-to-ideal bodyweight ratio and was strongly affected by numerous non-nutrient factors. Conclusion: BA concentration showed similar or better predictive and diagnostic power in relation to all-cause in-hospital mortality and 14-day readmission among inpatients than selected multifactorial scores.

scholarly journals Pre-diagnostic circulating concentrations of insulin-like growth factor-1 and risk of COVID-19 mortality: results from UK Biobank

2020 ◽  
Author(s):  
Xikang Fan ◽  
Cheng Yin ◽  
Jiayu Wang ◽  
Mingjia Yang ◽  
Hongxia Ma ◽  
...  
Keyword(s):  
Growth Factor ◽  
Odds Ratio ◽  
Lower Risk ◽  
Prospective Analysis ◽  
Insulin Like Growth Factor ◽  
Uk Biobank ◽  
Unconditional Logistic Regression ◽  
Endocrine Control ◽  
Risk Of Mortality ◽  
Death Data

Background: Coronavirus disease 2019 (COVID-19) deteriorates suddenly primarily due to excessive inflammatory injury, and insulin-like growth factor-1 (IGF-1) is implicated in endocrine control of the immune system. However, the effect of IGF-1 levels on COVID-19 prognosis remains unknown. Objective: To investigate the association between circulating IGF-1 concentrations and mortality risk among COVID-19 patients. Design: Prospective analysis. Setting: UK Biobank. Participants: 1425 COVID-19 patients who had pre-diagnostic serum IGF-1 measurements at baseline (2006-2010). Main outcome measures: COVID-19 mortality (available death data updated to 22 May 2020). Unconditional logistic regression was performed to estimate the odds ratio (OR) and 95% confidence intervals (CIs) of mortality across the IGF-1 quartiles. Results: Among 1425 COVID-19 patients, 365 deaths occurred due to COVID-19. Compared to the lowest quartile of IGF-1 concentrations, the highest quartile was associated with a 37% lower risk of mortality (OR: 0.63, 95% CI: 0.43-0.93, P-trend=0.03). The association was stronger in women and nonsmokers (both P-interaction=0.01). Conclusions: Higher IGF-1 concentrations are associated with a lower risk of COVID-19 mortality. Further studies are required to determine whether and how targeting IGF-1 pathway might improve COVID-19 prognosis.

scholarly journals Risk of Weight Loss in Adult Patients and the Effect of Staffing Registered Dietitians in Kaifukuki (Convalescent) Rehabilitation Wards: A Retrospective Analysis of a Nationwide Survey

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 753
Author(s):  
Shinta Nishioka ◽  
Yoji Kokura ◽  
Takatsugu Okamoto ◽  
Masako Takayama ◽  
Ichiro Miyai
Keyword(s):  
Weight Loss ◽  
Odds Ratio ◽  
Lower Risk ◽  
Nationwide Survey ◽  
Adult Patients ◽  
Weight Class ◽  
Registered Dietitians ◽  
Lower Odds ◽  
Nutrition Care ◽  
Class 1

There is scarce evidence regarding the risk of weight loss and the effect of having registered dietitians (RDs) on staff in rehabilitation wards on weight loss. We aimed to examine the effects of RDs in Kaifukuki (convalescent) rehabilitation wards (KRWs) on the prevention of weight loss in adult patients. Data from 2-year nationwide annual surveys on KRWs in Japan were retrospectively analysed. Weight loss was defined as loss of ≥5% weight during the KRW stay. Risk of weight loss in class 1 KRWs (obligated to provide nutrition care) was compared with that in class 2–6 KRWs (not obligated). Risk of weight loss in class 2–6 KRWs with RDs was compared to those without. Overall, 17.7% of 39,417 patients lost weight. Class 1 KRWs showed a lower risk of weight loss than class 2–6 KRWs (17.3% vs. 18.5%, p = 0.003). KRWs with RDs showed a significantly lower incidence of weight loss than those without RDs (16.1% vs. 18.8%, p = 0.015). Class 1 KRWs and exclusively staffed RDs were independently associated with lower odds of weight loss (odds ratio = 0.915 and 0.810, respectively). Approximately 18% of KRW patients lost weight, and having RDs on staff can lower the risk of weight loss.

scholarly journals Prognostic value of D-dimer for adverse outcomes in patients with infective endocarditis: an observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ying-Wen Lin ◽  
Mei Jiang ◽  
Xue-biao Wei ◽  
Jie-leng Huang ◽  
Zedazhong Su ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Infective Endocarditis ◽  
Adverse Events ◽  
Prognostic Value ◽  
Multivariable Analysis ◽  
Adverse Outcomes ◽  
Hospital Death ◽  
Large Sample Size ◽  
Cox Regression Analysis ◽  
D Dimer

Abstract Background Increased D-dimer levels have been shown to correlate with adverse outcomes in various clinical conditions. However, few studies with a large sample size have been performed thus far to evaluate the prognostic value of D-dimer in patients with infective endocarditis (IE). Methods 613 patients with IE were included in the study and categorized into two groups according to the cut-off of D-dimer determined by receiver operating characteristic (ROC) curve analysis for in-hospital death: > 3.5 mg/L (n = 89) and ≤ 3.5 mg/L (n = 524). Multivariable regression analysis was used to determine the association of D-dimer with in-hospital adverse events and six-month death. Results In-hospital death (22.5% vs. 7.3%), embolism (33.7% vs 18.2%), and stroke (29.2% vs 15.8%) were significantly higher in patients with D-dimer > 3.5 mg/L than in those with D-dimer ≤ 3.5 mg/L. Multivariable analysis showed that D-dimer was an independent risk factor for in-hospital adverse events (odds ratio = 1.11, 95% CI 1.03–1.19, P = 0.005). In addition, the Kaplan–Meier curve showed that the cumulative 6-month mortality was significantly higher in patients with D-dimer > 3.5 mg/L than in those with D-dimer ≤ 3.5 mg/L (log-rank test = 39.19, P < 0.0001). Multivariable Cox regression analysis showed that D-dimer remained a significant predictor for six-month death (HR 1.11, 95% CI 1.05–1.18, P < 0.001). Conclusions D-dimer is a reliable prognostic biomarker that independently associated with in-hospital adverse events and six-month mortality in patients with IE.

scholarly journals TET2 Mutation and High miR-22 Expression as Biomarkers to Predict Clinical Outcome in Myelodysplastic Syndrome Patients Treated with Hypomethylating Therapy

2021 ◽  
Vol 43 (2) ◽  
pp. 917-931
Author(s):  
Jina Yun ◽  
Young Sok Ji ◽  
Geum Ha Jang ◽  
Sung Hee Lim ◽  
Se Hyung Kim ◽  
...  
Keyword(s):  
Myelodysplastic Syndrome ◽  
Odds Ratio ◽  
Lower Risk ◽  
Genetic Mutations ◽  
Dna Hypermethylation ◽  
Leukemic Transformation ◽  
Mutation Status ◽  
Similar Tendency ◽  
Tet2 Mutation ◽  
Expression Status

Tet methylcytosine dioxygenase 2 (TET2) is one of the most frequently mutated genes in myelodysplastic syndrome (MDS). TET2 is known to involve a demethylation process, and the loss of TET2 is thought to cause DNA hypermethylation. Loss of TET2 function is known to be caused by genetic mutations and miRNA, such as miR-22. We analyzed 41 MDS patients receiving hypomethylating therapy (HMT) to assess whether TET2 mutation status and miR-22 expression status were associated with their clinical characteristics and treatment outcomes. Responsiveness to HMT was not affected by both TET2 mutation (odds ratio (OR) 0.900, p = 0.909) and high miR-22 expression (OR 1.548, p = 0.631). There was a tendency for TET2 mutation to be associated with lower-risk disease based on IPSS (Gamma = −0.674, p = 0.073), lower leukemic transformation (OR 0.170, p = 0.040) and longer survival (Hazard ratio 0.354, p = 0.059). Although high miR-22 expression also showed a similar tendency, this tendency was weaker than that of TET2 mutation. In summary, the loss of TET2 function, including both TET2 mutation and high miR-22 expression, was not a good biomarker for predicting the response to HMT but may be associated with lower-risk disease based on IPSS, lower leukemic transformation and longer survival.

Prognostic Value of Brain Magnetic Resonance Imaging in Neonatal Hypoxic-Ischemic Encephalopathy: A Meta-analysis

2017 ◽  
Vol 32 (13) ◽  
pp. 1065-1073 ◽  
Author(s):  
Iván Sánchez Fernández ◽  
J. Leon Morales-Quezada ◽  
Samuel Law ◽  
Paggie Kim
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Hypoxic Ischemic Encephalopathy ◽  
Resonance Imaging ◽  
Neonatal Brain ◽  
Ischemic Encephalopathy

Objective: To quantify the prognostic value of neonatal brain magnetic resonance imaging (MRI) in neonatal hypoxic-ischemic encephalopathy. Methods: Meta-analysis of studies with ≥35-week neonates with hypoxic-ischemic encephalopathy who underwent brain MRI within age 4 weeks and had neurodevelopmental follow-up for at least 12 months. Results: An abnormal neonatal brain MRI was more frequent among patients with unfavorable neurodevelopmental outcome: odds ratio = 18.2 (95% confidence interval: 9.4-34.9), P <.0001. The prognostic value of neonatal brain MRI in moderate hypoxic-ischemic encephalopathy had an odds ratio of 17.7 (95% confidence interval: 5.3-59.3) and in severe hypoxic-ischemic encephalopathy, the odds ratio was 125.0 (95% confidence interval: 2.0-7917.1). Therapeutic hypothermia did not change the prognostic value of neonatal brain MRI (odds ratio for hypothermia, 14.0 [95% confidence interval: 3.1-63.6], vs no hypothermia, 18.1 [95% confidence interval: 10.0-33.1], P = .7525). Conclusion: Neonatal brain MRI provides prognostic information on outcome beyond early infancy in hypoxic-ischemic encephalopathy and therapeutic hypothermia does not change its prognostic value.

Prospective analysis of safety and efficacy of medical cannabis in large unselected population of patients with cancer

2018 ◽  
Vol 49 ◽  
pp. 37-43 ◽  
Author(s):  
Lihi Bar-Lev Schleider ◽  
Raphael Mechoulam ◽  
Violeta Lederman ◽  
Mario Hilou ◽  
Ori Lencovsky ◽  
...  
Keyword(s):  
Prospective Analysis ◽  
Medical Cannabis ◽  
Safety And Efficacy ◽  
Patients With Cancer ◽  
Unselected Population

scholarly journals Admission blood glucose and in-hospital clinical outcome among patients with acute stroke in Inner Mongolia, China

2009 ◽  
Vol 32 (2) ◽  
pp. 151 ◽  
Author(s):  
Ning Wang ◽  
Dawei Qiao ◽  
Weijun Tong ◽  
Fengshan Zhang ◽  
Zhong Ju ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Blood Glucose ◽  
Acute Stroke ◽  
Inner Mongolia ◽  
Odds Ratio ◽  
Logistic Model ◽  
Hemorrhagic Stroke ◽  
Blood Glucose Concentration ◽  
Hospital Death ◽  
Stroke Patients

Purpose: There is still controversy about the association between admission blood glucose concentration and outcome of acute stroke. We studied the association between admission blood glucose and in-hospital death / dependency among acute stroke patients in Inner Mongolia, China. Methods: 2,178 acute ischemic and 1,760 hemorrhagic stroke patients in six hospitals were included in the study. Blood glucose and other study variables were collected within the first 24-hr of hospital admission. Clinical outcomes were evaluated by neurologists during hospitalization. The associations between admission blood glucose and the risk of in-hospital death/dependency were analyzed using a multiple logistic model. Results: There were associations between admission blood glucose and in-hospital death/dependency among patients with acute ischemic or hemorrhagic stroke. Compared with patients with blood glucose < 6.1mmol/L, multivariate-adjusted odds ratio (95% confidence interval) of death/dependency were 0.53 (0.23, 1.27), 2.22 (1.21, 4.11), 1.92 (1.12, 3.33) and 1.91 (1.00, 3.64) for ischemic stroke patients, and 0.93 (0.44, 1.96), 1.42 (0.65, 3.10), 1.98 (1.10, 3.55) and 2.93 (1.40, 6.11) for hemorrhagic stroke patients, with blood glucose 6.1-6.9, 7.0-7.7, 7.8-11.0 and ?11.1mmol/L, respectively. Conclusion: Increased admission blood glucose was associated with death/dependency among patients with acute hemorrhagic and ischemic stroke.

scholarly journals The protective association between statins use and adverse outcomes among COVID-19 patients: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Ronald Chow ◽  
James Im ◽  
Nicholas Chiu ◽  
Leonard Chiu ◽  
Rahul Aggarwal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Lower Risk ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Risk Of Mortality ◽  
Before And After ◽  
Statin Usage ◽  
Similar Risk ◽  
Ventilation Studies

ABSTRACTIntroductionStatins may reduce a cytokine storm, which has been hypothesized as a possible mechanism of severe COVID-19 pneumonia. The aim of this study was to conduct a systematic review and meta-analysis to report on adverse outcomes among COVID-19 patients by statin usage.MethodsLiteratures were searched from January 2019 to December 2020 to identify studies that reported the association between statin usage and adverse outcomes, including mortality, ICU admissions, and mechanical ventilation. Studies were meta-analyzed for mortality by the subgroups of ICU status and statin usage before and after COVID-19 hospitalization. Studies reporting an odds ratio (OR) and hazard ratio (HR) were analyzed separately.ResultsThirteen cohorts, reporting on 110,078 patients, were included in this meta-analysis. Individuals who used statins before their COVID-19 hospitalization showed a similar risk of mortality, compared to those who did not use statins (HR 0.80, 95% CI: 0.50, 1.28; OR 0.62, 95% CI: 0.38, 1.03). Patients who were administered statins after their COVID-19 diagnosis were at a lower risk of mortality (HR 0.53, 95% CI: 0.46, 0.61; OR 0.57, 95% CI: 0.43, 0.75). The use of statins did not reduce the mortality of COVID-19 patients admitted to the ICU (OR 0.65; 95% CI: 0.26, 1.64). Among non-ICU patients, statin users were at a lower risk of mortality relative to non-statin users (HR 0.53, 95% CI: 0.46, 0.62; OR 0.64, 95% CI: 0.46, 0.88).ConclusionPatients administered statins after COVID-19 diagnosis or non-ICU admitted patients were at lower risk of mortality relative to non-statin users.

scholarly journals Impacts of dialysis adequacy and intradialytic hypotension on changes in dialysis recovery time

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Murilo Guedes ◽  
Roberto Pecoits-Filho ◽  
Juliana El Ghoz Leme ◽  
Yue Jiao ◽  
Jochen G. Raimann ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Lower Risk ◽  
Recovery Time ◽  
First Year ◽  
Intradialytic Hypotension ◽  
Dialysis Adequacy ◽  
Dialysis Treatment ◽  
Fluid Removal ◽  
Lower Likelihood ◽  
Adjusted Logistic Regression

Abstract Background Dialysis recovery time (DRT) surveys capture the perceived time after HD to return to performing regular activities. Prior studies suggest the majority of HD patients report a DRT > 2 h. However, the profiles of and modifiable dialysis practices associated with changes in DRT relative to the start of dialysis are unknown. We hypothesized hemodialysis (HD) dose and rates of intradialytic hypotension (IDH) would associate with changes in DRT in the first years after initiating dialysis. Methods We analyzed data from adult HD patients who responded to a DRT survey ≤180 days from first date of dialysis (FDD) during 2014 to 2017. DRT survey was administered with annual KDQOL survey. DRT survey asks: “How long does it take you to be able to return to your normal activities after your dialysis treatment?” Answers are: < 0.5, 0.5-to-1, 1-to-2, 2-to-4, or > 4 h. An adjusted logistic regression model computed odds ratio for a change to a longer DRT (increase above DRT > 2 h) in reference to a change to a shorter DRT (decrease below DRT < 2 h, or from DRT > 4 h). Changes in DRT were calculated from incident (≤180 days FDD) to first prevalent (> 365-to- ≤ 545 days FDD) and second prevalent (> 730-to- ≤ 910 days FDD) years. Results Among 98,616 incident HD patients (age 62.6 ± 14.4 years, 57.8% male) who responded to DRT survey, a higher spKt/V in the incident period was associated with 13.5% (OR = 0.865; 95%CI 0.801-to-0.935) lower risk of a change to a longer DRT in the first-prevalent year. A higher number of HD treatments with IDH episodes per month in the incident period was associated with a 0.8% (OR = 1.008; 95%CI 1.001-to-1.015) and 1.6% (OR = 1.016; 95%CI 1.006-to-1.027) higher probability of a change to a longer DRT in the first- and second-prevalent years, respectively. Consistently, an increased in incidence of IDH episodes/months was associated to a change to a longer DRT over time. Conclusions Incident patients who had higher spKt/V and less sessions with IDH episodes had a lower likelihood of changing to a longer DRT in first year of HD. Dose optimization strategies with cardiac stability in fluid removal should be tested.

scholarly journals P1354 Prognostic value of the left ventricular longitudinal and circumferential function in patients with takotsubo syndrome during the acute phase

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Koshino ◽  
N Yamaguchi ◽  
T Oshima ◽  
K Hiroe ◽  
Y Ohta ◽  
...  
Keyword(s):  
Acute Phase ◽  
Prognostic Value ◽  
Laboratory Data ◽  
Left Ventricular ◽  
Hospital Death ◽  
Takotsubo Syndrome ◽  
Hemodynamic Assessment ◽  
Echocardiographic Examination ◽  
Severe Group ◽  
Fractional Shortening

Abstract Background Takotsubo syndrome is generally considered a benign disease with a reversible condition; however, hemodynamic and electrical instability during the acute phase exposes patients to the risk of serious adverse in-hospital events. The purpose of this study was to investigate the prognostic value of the left ventricular longitudinal and circumferential function in patients with TTS during the acute phase. Methods We divided the 27 patients with TTS (77.4 ± 10.2 years old, 21 females) into two groups; the severe group (SG) of 9 patients (in-hospital death, mechanical assist devices such as IABP or ECMO, oozing rupture) and non-severe group (NSG) of 18 patients. The echocardiographic examination on admission, catheter hemodynamic assessment, and laboratory data, and ST-T change in electrocardiogram were compared between two groups. Results There were no differences in age, laboratory data, electrocardiogram findings between the two groups. The LVEF was lower in SG (35.3 ± 6.1% vs. 45.9 ± 13.5%, p = 0.03). The index of Ballooning, the ratio of the systolic left ventricular diameter of ballooning segments to that of basal segments, was higher in SG (2.07 ± 0.61% vs.1.60 ± 0.32%, p = 0.016). The circumferential fractional shortening (CFS) of ballooning segments was lower in SG (4.6 ± 3.2% vs. 18.2 ± 8.2%, p = 0.00007), CFS of basal segments was not different between the two groups, and the ratio of CFS of ballooning segments to CFS of basal segments (CFS imbalance index) was lower in SG (5.60 ± 3.84 vs. 10.83 ± 3.92, p = 0.00003). The left ventricular longitudinal fractional shortening was lower in SG (0.12 ± 0.09 vs. 0.46 ± 0.19, p = 0.00003). The absolute value of GLS was lower in SG (7.6 ± 4.3% vs. 13.0 ± 3.6%, p = 0.002). In all three cases of in-hospital death, the CFS imbalance index was lower than 0.14. Conclusion In patients with TTS, left ventricular longitudinal and circumferential function could be related to serious adverse in-hospital events.

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