Efficacy evaluation of the CEUS-LI-RADS-v2017 system in differential diagnosis of liver tumors

2019 ◽  
pp. 57-67
Author(s):  
A. N. Katrich ◽  
V. A. Porkhanov ◽  
N. S. Ryabin
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Liver Tumors ◽  
Morphological Data ◽  
Malignant Neoplasms ◽  
Diagnostic Efficiency ◽  
Efficacy Evaluation ◽  
General Group ◽  
Group 2 ◽  
Group 1

Objective: efficacy evaluation of the CEUS LI RADS v2017® system for differential diagnosis of liver tumors in patients with and without cirrhosis.Materials and methods. Retrospective analysis of diagnostic results of the 165 patients with liver tumors (177 nodules) was done. All patients underwent CEUS with results interpretation in accordance to the CEUS LIRADSv2017 ® criteria. Patients were divided into 2 groups based on clinical and morphological data. Group 1 included 62 patients with cirrhosis and/or CVH. Group 2 included 110 patients without risk factors for HCC.Results. Diagnostic efficiency of CEUS LI RADS v2017® for HCC identification was: group 1 – Se – 100%, Sp – 88%, Ac – 95.5%; group 2 – Se – 100%, Sp – 68.8%, Ac – 72.7%; general group Se – 100%, Sp – 72.2%, Ac – 81.4%. In the 2nd group, 21 out of 22 neoplasms, confirmed morphologically as FNH, we classified as LR 4. By applying benign character and specific contrasting patterns of FNG, they were transferred from LR 4 to LR 3. This allowed to increase sensitivity and specificity of differential diagnosis in group 2 (Se – 100%, Sp – 90.6%, Ac – 91.8%) and in general group (Se – 100%, Sp – 90.1%, Ac – 93.2%). Diagnostic efficiency of the criteria for non hepatocellular malignant neoplasms (LR M) was: group 1 – Se – 77.8%, Sp – 100%, Ac – 97%; group 2 – Se – 90%, Sp – 96.7%, Ac – 93.6%; general group- Se – 88.1%, Sp – 98.3%, Ac – 94.9%.Conclusion. Our study confirmed high accuracy of the CEUS LI RADS v2017® system in the differential diagnosis of focal liver tumors. Modification of the system (in particular, transfer of typical FNG forms from the LR 4 category) will make it possible to increase the accuracy of diagnostics by 20%. It will allow to use the LI RADS v2017® system for interpretation CEUS not only among patients with liver cirrhosis, but also in a general group without risk factors of GCC.

scholarly journals Epidemiological study of the prevalence of cystitis in women of the Voronezh region

2021 ◽  
Vol 14 (2) ◽  
pp. 10-18
Author(s):  
O.I. Apolikhin ◽  
◽  
Florian Wagenlehner ◽  
D.A. Voytko ◽  
O.V. Zolotukhin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastrointestinal Tract ◽  
Epidemiological Study ◽  
Gastrointestinal Diseases ◽  
Study Group ◽  
General Group ◽  
Statistical Tool ◽  
Voronezh Region ◽  
History Of ◽  
Group 2

Introduction. The article is devoted to an epidemiological study of the prevalence of cystitis and risk factors for recurrence this disease. Materials and methods. The study is based on the data obtained during the screening survey of 1014 women in the age group of 18-80 years old, permanently residing in the Bobrovsky district of the Voronezh region. Based on the age of the subjects, 3 groups were formed: Group 1 (general group) - 1014 women, Group 2 (fertile age) - 551 women, Group 3 (postmenopausal age) - 463 women. To study the influence of risk factors on the development of cystitis, the following criteria were used: antibiotic therapy, sex life, urinary disorders, gastrointestinal tract (GIT) dysfunction, etc. The obtained material was processed using the computer program Statistics 10.0. 𝛘2 was used as a statistical tool. Results. Of the total number of women surveyed, 15.3% had risk factors according to the ORENUC classification system based on the clinical picture of UTI, anatomical level of UTI, the severity of infection, classification of risk factors and the availability of appropriate antimicrobial therapy. The largest number of risk factors was found in postmenopausal patients (p <0.05). It was found that despite the fact that most of the subjects were sexually active, the absence of sexual activity and the presence of one sexual partner did not affect the presence of a history of cystitis episode (p> 0.05), however, it was revealed that the history of cystitis was significantly associated with functions of the gastrointestinal tract (p<0.05). The use of tactics aimed at active detection of cystitis, by means of questionnaires, can increase the detection rate of cystitis by 10 times. Discussions. In our study, we did not find a large number of cases of recurrent cystitis, in contrast to previously published works, which cited figures from 10 to 30% of the number of women, however, by means of questionnaires, we managed to deduce the prevalence of cystitis in the studied region in women over 18 years old. which amounted to 17.4%. The figure obtained is consistent with data published in previously papers. Conclusions. TThis study has confirmed the previously published works indicating the relationship of cystitis with gastrointestinal diseases. In addition, we found that the prevalence of cystitis (having one or more episodes during a lifetime) in the study group was 17.4%. The annual incidence of cystitis in the study group was 3.2%, while according to official statistics in the region it does not exceed 0.4%. The latter fact indicates the need for further research and strengthening of sanitary and edu- cational work among the population (Internet, TV, radio, newspapers, etc.).

scholarly journals Factors associated with the risk subclinical carotid atherosclerosis in rotational shift workers in the Arctic

2021 ◽  
Vol 27 (1) ◽  
pp. 100-109
Author(s):  
N. P. Shurkevich ◽  
A. S. Vetoshkin ◽  
L. I. Gapon ◽  
S. M. Dyachkov ◽  
A. A. Simonyan
Keyword(s):  
Risk Factors ◽  
Total Cholesterol ◽  
Work Experience ◽  
Gas Production ◽  
The Arctic ◽  
Step Method ◽  
Shift Workers ◽  
Group 2 ◽  
Traditional Risk Factors ◽  
Group 1

Objective. To determine the most unfavorable predictors of atherosclerotic plaque (ASP) in carotid arteries (CA) in rotational shift workers in the Arctic using traditional risk factors, clinical and instrumental methods of research.Design and methods. In 2010–2012, we randomly selected 424 males aged 30–59 years from 1708 rotational shift workers at the medical unit of the gas production company “Gazprom dobycha Yamburg” (Yamburg settlement, 68ºN) and performed preventive medical examination. Subjects were divided into 2 groups according to blood pressure (BP) level. Group 1 included 294 patients with hypertension (HTN) of 1 or 2 stages > 140/90 mmHg and group 2 was comprised of 130 people with BP < 140/90 mmHg. The groups did not differ by age, total work experience in the Arctic and rotational shiftwork duration. Ultrasound examination of CA showed presence or absence of ASP and stenosis by NASCET method. In addition, we assessed traditional risk factors and performed 24-hour BP monitoring and blood tests including lipid spectrum, glucose level, creatinine.Results. ASP was found more often in subjects with HTN (group 1) than in people with normal BP in the same age group, 95 % CI 56–60 % vs 95 % CI 14–20 %, (p < 0,0001). The groups did not differ significantly in the nutritional habits (p = 0,067). At the same time, the rate of smoking (p = 0,039), low physical activity (p = 0,007), overweight (p < 0,0001) was significantly higher in group 1 compared to subjects with normal BP. According to multivariate analysis, three variables with the most significant predictors associated with ASP in CA with sensitivity 75,9 % were selected using step-by-step method: diastolic BP 24 (DBP24) (p < 0,0001), glucose (p = 0,017) and total cholesterol (p = 0,044). The linear function was obtained: F = –7,664 + 0,225 × Chol + 0,366 × Glu + 0,057 × DBP24, where the variable “Chol” is the level of total cholesterol in the blood in mmol/l; “Glu” — the level of blood glucose in mmol/l; “DBP24” — average 24-hour diastolic BP. Based on the model, we concluded that DBP24 increment by 1 mmHg increases the risk for developing ASB in CA by 5,9 %, OR = 1,059 (95 % CI: 1,033; 1,087); the increment in glucose and total cholesterol by 1 mmol/l increases the risk by 44,1 % and 25,2 %, respectively: OR = 1,441 (95 % CI: 1,084; 1,966), OR = 1,252 (95 % CI: 1,010; 1,565).Conclusions. Our data enable to determine the most unfavorable predictors of ASP in CA and can potentially serve as a guideline for early diagnosis and medical management to prevent cardiovascular diseases in rotational shift workers in the Arctic.

Abstract 53: Health Care Utilization and Cost among Type 2 Diabetes Mellitus (T2DM) Patients with Cardiovascular Disease (CVD) or Cardiovascular Disease Risk Factors

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
David M Kern ◽  
Stephanie DeVore ◽  
Jennifer Kim ◽  
Ying Wu ◽  
Ozgur Tunceli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Healthcare Utilization ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Care Utilization ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Group 2 ◽  
Group 1

CV events among T2DM patients are major contributors to high healthcare utilization and cost. Healthcare utilization and costs among T2DM patients with established CVD and CVD risk factors in a large US database were explored. T2DM patients aged ≥40 years were identified from the HealthCore Integrated Research Environment from 1/1/2007 to 4/30/2011 and followed from first T2DM diagnosis (index date) until loss of eligibility or death. Established CVD [Group 1] included patients with MI, stroke, peripheral vascular disease, coronary heart disease, congestive heart failure, or revascularization in the year prior to index. CVD risk [Group 2] included patients with older age (men ≥55 y, women ≥60 y) and prior diagnosis for either dyslipidemia or hypertension. Per person year (PPY) utilization and cost following T2DM diagnosis were calculated as the total number of events/cost divided by total number of person years of follow-up. There were 177,140 Group 1 (mean age: 68 y; 57% men) and 191,441 Group 2 (mean age: 66 y; 57% men) patients who met the selection criteria. During the 12, 24, 36, and 48 months following index, a higher proportion of Group 1 vs Group 2 patients had ≥1 inpatient visit (35%, 50%, 61%, 69% vs 16%, 27%, 36%, 44% respectively) and ≥1 ED visit (6.2%, 17%, 29%, 41% vs 2.9%, 9%, 18%, 28% respectively). T2DM patients have high healthcare utilization and costs. Those with established CVD have higher PPY event rates (Figure 1) and costs (Figure 2), compared with patients with CVD risk factors. Inpatient hospitalizations and outpatient visits are key cost drivers in this T2DM population.

scholarly journals Is low antiepileptic drug dose effective in long-term seizure-free patients?

2003 ◽  
Vol 61 (3A) ◽  
pp. 566-573 ◽  
Author(s):  
Tânia A.M.O. Cardoso ◽  
Fernando Cendes ◽  
Carlos A.M. Guerreiro
Keyword(s):  
Risk Factors ◽  
Antiepileptic Drug ◽  
Randomized Study ◽  
Drug Dose ◽  
University Hospital ◽  
Seizure Recurrence ◽  
Partial Group ◽  
Group 2 ◽  
Group 1

OBJECTIVE: To investigate the value of leaving seizure-free patients on low-dose medication. METHOD: This was an exploratory prospective randomized study conducted at our University Hospital. We evaluated the frequency of seizure recurrence and its risk factors following complete or partial antiepileptic drug (AED) withdrawal in seizure free patients for at least two years with focal, secondarily generalized and undetermined generalized epilepsies. For this reason, patients were divided into two groups: Group 1 (complete AED withdrawal), and Group 2 (partial AED withdrawal). Partial AED withdrawal was established as a reduction of 50% of the initial dose. Medication was tapered off slowly on both groups. Follow-up period was 24 months. RESULTS: Ninety-four patients were followed up: 45 were assigned to complete (Group 1) AED withdrawal and 49 to partial (Group 2) AED withdrawal. Seizure recurrence frequency after two years follow-up were 34.04% in group 1 and 32.69% in Group 2. Survival analysis showed that the probability of remaining seizure free at 6, 12, 18 and 24 months after randomization did not differ between the two groups (p = 0.8). Group 1: 0.89, 0.80, 0.71 and 0.69; group 2: 0.86, 0.82, 0.75 and 0.71. The analysis of risk factors for seizure recurrence showed that more than 10 seizures prior to seizure control was a significant predictive factor for recurrence after AED withdrawal (hazard ratio = 2.73). CONCLUSION: Leaving seizure free patients on low AED dose did not reduce the risk for seizure recurrence. That is, once the decision of AED withdrawal has been established, it should be complete.

scholarly journals The evaluation of ENA-78 and fibrinogen levels for the differential diagnosis of familial Mediterranean fever and acute appendicitis

2019 ◽  
Vol 43 (3) ◽  
pp. 141-147
Author(s):  
Murat Güzel ◽  
Recep Aktimur ◽  
Kadir Yıldırım ◽  
Sude Hatun Aktimur ◽  
Mehmet Hakan Taşkın ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Familial Mediterranean Fever ◽  
Acute Appendicitis ◽  
Acute Peritonitis ◽  
Significant Difference ◽  
Mediterranean Fever ◽  
Group 2 ◽  
Wbc Count ◽  
Higher Sensitivity ◽  
Group 1

Abstract Background Familial Mediterranean fever (FMF) is a disorder mainly present in the Mediterranean region, characterized by abdominal attacks that mimic acute peritonitis. Therefore, FMF might be confused with other conditions presenting with acute abdominal pain, particularly acute appendicitis (AA). We aimed to evaluate whether epithelial-derived neutrophil-activating peptide-78 (ENA-78) and fibrinogen levels and white blood cell (WBC) counts could be used as potential markers in the differential diagnosis of acute FMF attacks and AA. Methods The study involved three groups: patients with AA who underwent surgery (group 1, n = 30), patients with FMF attacks (group 2, n = 30), and patients with FMF who were attack-free (n = 30, controls), which included patients who were diagnosed as having FMF previously but had no attacks for a month. Results Significant differences were detected in the ENA-78 and fibrinogen levels between group 1 and group 2. No significant difference was found in the WBC count between group 1 and group 2. It was concluded that the WBC count was more sensitive (66%) for group 1, and fibrinogen showed higher sensitivity (86%) and specificity (96%) for group 2 compared with the other parameters. Conclusions We suggest that AA can be distinguished in patients with signs of peritonitis who were diagnosed as having FMF previously with the use of ENA-78 and fibrinogen levels; fibrinogen and ENA-78 might be helpful in discriminating between FMF attacks and AA.

scholarly journals Intestinal Obstruction due to Bezoar in Elderly Patients: Risk Factors and Treatment Results

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Fatih Altintoprak ◽  
Eyup Gemici ◽  
Yasin Alper Yildiz ◽  
Mustafa Yener Uzunoglu ◽  
Taner Kivilcim
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Surgical Technique ◽  
Abdominal Surgery ◽  
Elderly Patients ◽  
Intestinal Obstruction ◽  
History Of ◽  
Group 2 ◽  
Length Of Hospitalization ◽  
Group 1

Purpose. Bezoars are foreign particles from the accumulation of indigestible materials in the gastrointestinal system and a rare cause of mechanical intestinal obstruction. We aimed at investigating differences in risk factors for the development of intestinal obstruction associated with bezoar in elderly patients.Methods. Hospital records of patients who underwent surgery associated with phytobezoar between January 2004 and May 2016 were retrospectively evaluated. Patients were divided into two groups [<65 years (Group 1) and ≥65 years (Group 2)]. Data were examined regarding presence of comorbidity, history of abdominal surgery, operation time, bezoar site, surgical technique, length of hospitalization, morbidity, and mortality.Results. Of 121 patients enrolled, 48 (39.7%) were male and 73 (60.3%) were female (range: 24-86 years). Group 1 consisted of 69 patients aged < 65, while Group 2 consisted of 52 patients aged ≥ 65. Comorbidity was reported in 52 (42.9%) patients (mostly diabetes mellitus, 20.7%), while 60 patients (49.6%) had history of abdominal surgery (mostly peptic ulcer, 27.3%). No statistical differences were found between the two groups in terms of sex, bezoar site, surgical technique preferred, history of abdominal surgical intervention, pre- and postoperative CT examination, morbidity rates, and length of hospitalization. But, ratio of peptic ulcer operations history, presence of total comorbidity, and time of surgery decision was higher in Group 2 patients.Conclusion. In bezoar-related intestinal obstruction, duration and outcome of treatment are not affected by age distribution. Possibility of bezoar should primarily be considered in elderly patients with history of peptic ulcer operation.

VENTRICULOPERITONEAL SHUNTING AFTER ANEURYSMAL SUBARACHNOID HEMORRHAGE

Neurosurgery ◽  
2008 ◽  
Vol 62 (3) ◽  
pp. 618-627 ◽  
Author(s):  
Andrew S. Little ◽  
Joseph M. Zabramski ◽  
Madelon Peterson ◽  
Pamela W. Goslar ◽  
Scott D. Wait ◽  
...  
Keyword(s):  
Risk Factors ◽  
Subarachnoid Hemorrhage ◽  
Functional Status ◽  
Posthemorrhagic Hydrocephalus ◽  
Ventriculoperitoneal Shunting ◽  
Group 3 ◽  
Group 2 ◽  
Ventricle Size ◽  
Group 1

Abstract OBJECTIVE The goals of this study were to investigate the risk factors, indications, complications, and outcome for patients with ventriculoperitoneal shunts (VPSs) after subarachnoid hemorrhage and to define a subgroup eligible for future prospective studies designed to clarify indications for placement of a VPS. METHODS Clinical characteristics of 236 prospectively evaluated patients with subarachnoid hemorrhage and 6 months of follow-up were analyzed. Hydrocephalus was estimated by the relative bicaudate index (RBCI) measured on computed tomographic scans at the time of shunting. Patients were divided into three groups by ventricle size: Group 1 included 121 patients with small ventricles (RBCI &lt;1.0), Group 2 included 88 patients with borderline ventricle size (RBCI 1.0–1.4), and Group 3 included 27 patients with markedly enlarged ventricles (RBCI &gt;1.4). RESULTS Initially, 86 patients (36%) underwent ventriculoperitoneal shunting: 19 in Group 1 (16%), 43 in Group 2 (49%), and 24 in Group 3 (90%). Indications for placement of a VPS, risk factors, and outcome differed markedly by group. Four patients (3% of those not initially shunted) developed delayed hydrocephalus requiring a VPS, including one in Group 2 (2%). The 6-month shunt complication rate was 13%. Evaluation of patients in Group 2 indicated that functional status was an important factor in selecting candidates for shunting, and that patients receiving shunts and shunt-free patients demonstrated improvement in functional status during follow-up. CONCLUSION Although we currently use a proactive shunting paradigm for posthemorrhagic hydrocephalus, this report demonstrates that a conservative approach to patients with borderline ventricle size (i.e., RBCI of 1.0–1.4) and normal intracranial pressure should be evaluated in a prospective randomized trial.

Staged management of cardiac disease and concomitant early lung cancer: a 20-year single-center experience

2020 ◽  
Author(s):  
Jérémy Tricard ◽  
Daniel Milad ◽  
Anaëlle Chermat ◽  
Serge Simard ◽  
Yves Lacasse ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Overall Survival ◽  
Disease Free Survival ◽  
Free Survival ◽  
Cardiac Procedure ◽  
Independent Risk Factors ◽  
Group 2 ◽  
Disease Free ◽  
Group 1

Abstract OBJECTIVES The association of unstable heart disease and resectable lung cancer is rare. The impacts of staged management, cardiac surgery with cardiopulmonary bypass (CPB) versus angioplasty, on long-term survival and cancer recurrence remain debated. We report our experience using staged management. METHODS From 1997 to 2016, 107 patients were treated at the Quebec Heart and Lung Institute: 72 underwent cardiac surgery with CPB (group 1), 35 were treated with angioplasty (group 2), followed by oncological pulmonary resection. RESULTS Two postoperative deaths (3%) and 1 ischaemic heart complication (1%) were reported in group 1. One death (3%) was reported in group 2. Two-year overall survival was 82% (59/72) in group 1 and 80% (28/35) in group 2; 5-year overall survival was 62% (33/53) in group 1 and 63% (19/30) in group 2. Two-year disease-free survival in group 1 was 79% (57/72) and 77% (27/35) in group 2; 5-year disease-free survival was 58% (31/53) in group 1 and 60% (18/30) in group 2. The independent risk factors for death after thoracic surgery were transfusions (P = 0.004) and grade ≥3 complications (P = 0.034). Independent risk factors for recurrence included the cancer stage (P &lt; 0.001) and, paradoxically, a shorter delay between cardiac and lung procedures (P = 0.031). CONCLUSIONS When a staged management remains feasible after cardiac procedure, oncological outcomes of patients with cardiopathy and lung cancer are satisfactory. CPB does not seem to be deleterious. The delay between procedures should intuitively be as small as possible but not at the expense of good recovery after the cardiac procedure.

scholarly journals 353. A Comparison Study of Prevalence and Risk Factors for Nonalcoholic Fatty Liver Disease (NAFLD) and Nonalcoholic Steatohepatitis (NASH) by Transient Elastography (TE) in HIV-Infected Patients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S186-S186
Author(s):  
Sunny Choe ◽  
Hend Al-Saleh ◽  
James Fallon ◽  
Herbert Galang ◽  
Justin Mathew ◽  
...  
Keyword(s):  
Risk Factors ◽  
Transient Elastography ◽  
Medical Center ◽  
University Hospital ◽  
Lower Percentage ◽  
Strand Transfer ◽  
Nonalcoholic Fatty Liver ◽  
Virus Load ◽  
Group 2 ◽  
Group 1

Abstract Background There are limited data on the prevalence and risk factors of NAFLD and NASH in HIV-infected individuals receiving ART. A large study on this subject was presented at Glasgow 2018, from the University Hospital of Palermo (UHP). Methods We prospectively collected data on epidemiology, comorbidities, CD4, HIV virus load and ART from November 2017 to September 2018 in patients undergoing TE examination with Controlled Attenuation Parameter (CAP) in our HIV clinic at Saint Michael’s Medical Center in Newark, NJ. We used the same parameters to define NAFLD and fibrosis severity that were used for the UHP (CAP >248 dB/m and TE > 7.1 Kpa). We present comparative data between those 2 cohorts. Results We enrolled 624 consecutive HIV-infected individuals (group 1) their baseline epidemiologic characteristics were not significantly different from the UHP cohort (group 2) for age and sex. Prevalence of NAFLD was 51.6% in group 1compared with 42.7% in group 2, and the prevalence of significant fibrosis in those with NAFLD was 31% in group 1, and 23% in group 2. The main differences we found between those 2 cohorts were race: group 1, 68% black and group 2, 87% White, incidence of Diabetes mellitus was 20% in group 1, and 6% in group 2, despite the fact that BMI was not significantly higher in group 1. Other important differences were the mean time on ART, it was 5 years longer for group 1. Finally, there was a trend for a higher incidence of hypertension, a lower percentage of patients with Virus load < 20 c/mL, a lower mean CD4 count, and a higher percentage of integrase strand transfer inhibitors current users in group1. Conclusion NAFLD prevalence is alarming high in patients with HIV disease, it is of utmost importance to understand its natural history, in order to prevent the potentially severe consequences of NASH. Our study suggests that a longer duration on ART might correlate with higher incidence of NAFLD, which would suggest better monitoring of liver health with new ART. Disclosures All authors: No reported disclosures.

Carbapenem-Resistant Klebsiella pneumoniae Outbreak in a Neonatal Intensive Care Unit: Risk Factors for Mortality

2020 ◽  
Author(s):  
Meltem Bor ◽  
Ozkan Ilhan
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Congenital Anomalies ◽  
Neonatal Intensive Care ◽  
Carbapenem Resistant ◽  
Group 2 ◽  
Antifungal Use ◽  
Group 1

Abstract Aim The aim of our study was to determine the factors associated with mortality in neonates with carbapenem-resistant Klebsiella pneumoniae (CRKP). Material and methods This retrospective, single-center study was conducted in the Neonatal Intensive Care Unit of Harran University Faculty of Medicine between January 2017 and July 2018 who had CRKP growth in their blood, urine or cerebrospinal fluid cultures. The discharged group was designated as the control group (Group 1), whereas the group that faced mortality was classified as the case group (Group 2). The demographic data, clinical findings and laboratory and microbiological results of the two groups were compared to identify risk factors. Results A total of 58 patients (36 in Group 1 and 22 in Group 2) exhibited CRKP growth during the study period. Low birth weight (p = 0.039), previous antifungal (p = 0.002) or amikacin use (p = 0.040), congenital anomalies (p = 0.002), total parenteral nutrition (TPN) administration (p = 0.002), surgery (p = 0.035), thrombocytopenia (p = 0.007), low platelet mass index (p = 0.011), elevated C-reactive protein (p = 0.004), high carbapenem minimum inhibitory concentration (MIC) (p = 0.029) and high amikacin MIC (p = 0.019) were associated with mortality. In a multivariate regression analysis, previous antifungal use (p = 0.028), congenital anomalies (p = 0.032) and TPN use (p = 0.013) were independent factors in predicting mortality. Conclusion Previous antifungal use, congenital anomalies and TPN use were found to be independent risk factors for mortality in neonates with CRKP infection.

Sign in / Sign up

Export Citation Format

Share Document