scholarly journals Prognostic Factors of In-Hospital Mortality in Adult Patients With Aluminum Phosphide (ALP) Poisoning in Southern Iran (2014-2018)

2021 ◽  
Vol 11 (4) ◽  
pp. 34976-34976
Author(s):  
Mahdi Alibeigi ◽  
◽  
Razieh Sadat Mousavi-Roknabadi ◽  
Najmeh Ahmadzadeh Goli ◽  
Mehrdad Sharifi ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Body Temperature ◽  
Hospital Mortality ◽  
Sodium Bicarbonate ◽  
Study Groups ◽  
Cross Sectional Study ◽  
Adult Patients ◽  
Aluminum Phosphide ◽  
Cross Sectional ◽  
Southern Iran

Background: The suicide with aluminum phosphide, known as rice tablet, has increased significantly. This study aimed to investigate the epidemiology of Aluminum Phosphide (ALP) poisoning and determine the in-hospital mortality prognostic factors in adult people referring to ALP poisoning to one of the main poisoning centers in southern Iran. Methods: This retrospective cross-sectional study (March 21, 2014, to March 21, 2018) was conducted on all adult patients (>16 years) with ALP poisoning who were referred to Ali-Asghar Hospital (affiliated with Shiraz University of Medical Sciences). All data were extracted from the patients’ medical files. The patients were categorized into two groups of survived and non-survived. Univariate and multivariate logistic regression analyses were conducted to determine prognostic factors for in-hospital mortality, and Odds Ratios (ORs) were reported. Results: Totally, 97 patients were enrolled in this study. The patients’ Mean±SD age was 29.3±12.2 years. Both study groups (survived and non-survived) were matched in most demographic and poisoning characteristics. Nausea (62.9%) and vomiting (49.5%) were the most symptoms at the time of admission. Castor oil (66%), N-acetyl cysteine (56.7%), and magnesium sulfate (52.6%) were the most frequent treatment in these patients. The multivariate analysis showed that age (OR=1.12, 95%CI: 1.03-1.22), body temperature (OR=0.02, 95%CI: 0.01-0.48), resistant acidosis (OR=77.10, 95%CI: 5.05-1176.86), and taking sodium bicarbonate (OR=12.35, 95%CI: 1.25-122.10) were the prognostic factors of in-hospital mortality. Conclusion: The in-hospital mortality rate in patients with ALP poisoning was 29.9%. Age, illiteracy, body temperature, resistant acidosis, and taking sodium bicarbonate were the prognostic factors of in-hospital mortality in these patients.

Prognostic Factors in Adolescent and Adult Patients With Acute Lymphoblastic Leukemia With Two Protocols of Chemotherapy: A Cross-Sectional Study

2015 ◽  
Vol 15 (1) ◽  
pp. e7-e14 ◽  
Author(s):  
Edilson Diogenes Pinheiro Junior ◽  
Luis Fernando Pracchia ◽  
Beatriz Beitler de Mauriño ◽  
Gracia Aparecida Martinez ◽  
Pedro Enrique Dorlhiac-Llacer ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Cross Sectional Study ◽  
Adult Patients ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals In-hospital mortality risk factors in patients with ascites due to cirrhosis

2015 ◽  
Vol 61 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Miguel Hernan Vicco ◽  
Luz Rodeles ◽  
Franco Ferini ◽  
Ana Karina Long ◽  
Héctor Mario Musacchio
Keyword(s):  
Risk Factors ◽  
Portal Hypertension ◽  
Hospital Mortality ◽  
Prothrombin Time ◽  
Alcoholic Cirrhosis ◽  
Cross Sectional Study ◽  
Adult Patients ◽  
High Rate ◽  
Cross Sectional ◽  
Prolonged Prothrombin Time

Introduction: ascites is one of the most common complications of cirrhosis associated with a high rate of mortality. Although several scores have been developed in order to assess the prognosis of the disease, they were designed for predicting liver transplantation requirements and mortality in the short term, but not while in hospital. The aim of this study was to weigh risk factors for in-hospital mortality in adult patients with ascites due to alcoholic cirrhosis. Material and methods: we performed a cross-sectional study in 180 adult patients with diagnosis of cirrhosis with portal hypertension associated with high alcohol intake. The diagnosis of cirrhosis was made by liver echography and portal hypertension was defined by clinical features plus serum-ascites albumin gradient. Sampled individuals were subjected to complete clinical examination. Child Pugh and the MELD scores were applied in all the patients. Results: nineteen patients died while in-hospital. Mortality was associated with increased levels of serum white blood cell, urea, creatinine, prolonged prothrombin time, aspartate aminotransferase and alanine aminotransferase. We conducted a multiple binary logistic to predict in-hospital mortality which yielded that serum urea, creatinine and prothrombin time made a significant contribution to prediction with an OR 14 (95% CI 12.8 - 16.7 p = 0.03), 2 (95% CI 0.5 - 3.47, p = 0.04), and 2 (95% CI 1.03 - 2.31, p = 0.01) linearly-related. Conclusions: our results suggest that acute renal failure and prolonged prothrombin time are predictors of in-hospital mortality in patients with portal hypertension due to alcoholic cirrhosis.

scholarly journals Clinico-epidemiological Analysis of Adult Patients With Acute Poisoning

2021 ◽  
Vol 11 (3) ◽  
pp. 33533-33533
Author(s):  
Forogh Soltaninejad ◽  
◽  
Ghazal Beigi ◽  
Parastoo Golshiri ◽  
Nastaran Eizadi-Mood ◽  
...  
Keyword(s):  
Substance Dependence ◽  
Vital Signs ◽  
Study Groups ◽  
Cross Sectional Study ◽  
Acute Poisoning ◽  
Adult Patients ◽  
Cross Sectional ◽  
Self Mutilation ◽  
Significant Difference ◽  
Level Of Consciousness

Background: Patients with acute poisoning sometimes require hospitalization in the Intensive Care Unit (ICU). The correct admission of these patients has resulted to lower mortality. This study compared the characteristics of adult patients with acute poisoning who were admitted to the poisoning ward and the ICU. We also determined the relevant outcome predictive factors. Methods: This cross-sectional study was conducted on adult acutely poisoned patients who were admitted to the emergency room of Khorshid Hospital affiliated with Isfahan University of Medical Sciences from October 2018 to 2019. The clinico-epidemiological variables and outcomes were compared between adult patients hospitalized in the ward (n=100) and ICU (n=100). Binary logistic regression was used for predicting the outcome factors. Results: The Mean±SE age of the study patients in the ICU and ward were 36.6±1.62 (median: 34) and 34.20±1.19 years, (median: 33, P=0.23), respectively. There was no significant difference between the study groups respecting substance dependence, alcohol and drug abuse, disease history, and the type of exposure (P>0.05). However, self-mutilation, the kind of substance, the vital signs and level of consciousness at admission, and outcomes were significantly different between the research groups (P<0.05). Variables predicting outcomes (complication/death) were as follows: gender (male) (OR: 4.51; 95%CI: 1.51-13.42; P=0.007), the kind of substance (pesticides) (OR: 8.84; 95%CI: 1.78-44.07; P=0.008), time to admission (OR: 1.04; 95%CI: 1.02-1.08; P=0.002), hypotension (OR: 14.88; 95%CI: 3.01-71.58; P=0.001), and the place of hospitalization (ward) (OR: 2.85; 95%CI: 1.23-6.62; P=0.01). Conclusion: The self-mutilation, kind of substance, vital signs, level of consciousness at admission, and outcomes were significantly different between the study patients hospitalized in the ICU, compared to the ward. Gender (male), the kind of substance (pesticides), delayed arrival times, hypotension, and the place of hospitalization (ward) were essential factors for outcome (complication/death) prediction.

scholarly journals The Prognostic Factors of Aluminum Phosphide Poisoning in Urmia: A-five-years Cross-sectional Study

2021 ◽  
Vol 11 (2) ◽  
pp. 32663.1-32663.8
Author(s):  
Mohammad Majidi ◽  
◽  
Mohammad Jamalpour ◽  
Solmaz Nekoueifard ◽  
◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Treatment Outcomes ◽  
White Blood Cells ◽  
Cross Sectional Study ◽  
Clinical Findings ◽  
Sectional Study ◽  
Aluminum Phosphide ◽  
Cross Sectional ◽  
Significant Relationships ◽  
Aluminum Phosphide Poisoning

Background: Aluminum phosphide is a highly toxic fungicide. It causes such severe adverse effects as cardiac arrhythmias, metabolic acidosis, acute renal failure, shock, and even death. Therefore, this study investigated the prognostic factors of aluminum phosphide poisoning. Methods: In this cross-sectional study, all hospitalized patients due to aluminum phosphide poisoning admitted to the poisoning center at Taleghani Hospital, Urmia City, Iran, from 2015 to 2019 were evaluated. The demographics characteristics, clinical findings, and laboratory profiles were retrospectively studied by an investigator-made checklist and evaluated concerning the explored patients’ treatment outcomes. Then, the obtained data were analyzed by descriptive and analytical statistics using SPSS V. 16. Results: The present study investigated 134 patients (96 males & 38 females). The mortality rate was equal to 29.8% (22.4% males & 7.4% females) in the study patients. The research patients’ Mean±SD age was 28.6±11.5) years. The Mean±SD ingestion amount of aluminum phosphide was 1.48±1.06 g (min=0.2 g, max=15 g). Nausea and vomiting with 119 (88.8%), hypotension: 89 (66.4%), vertigo: 80 (59.7%), and sinus tachycardia: 74 (55.2%) were the most signs and symptoms in the study patients, respectively. Statistically significant relationships (P<0.05) were found between the patients’ treatment outcomes and white blood cells, direct bilirubin, Hco3, base excess, magnesium, Aspartate Aminotransferase, Alanine Aminotransferase, Blood Urea Nitrogen, creatinine, blood glucose, pH, prothrombin time, and the international normalized ratio. Furthermore, significant relationships were detected between the patients’ treatment outcomes and leukocytosis, hypokalemia, hyperglycemia, and hypoglycemia (P<0.05). Conclusion: Such prognostic factors as demographics characteristics, clinical findings, laboratory profiles, and electrolytes could be used as good indices of the severity of toxicity in patients; accordingly, such data are beneficial for the proper management of patients by healthcare providers. Therefore, prognostic factors should be considered in the diagnosis, treatment, and follow-up stages for these patients.

scholarly journals Processes of care and outcomes for homeless patients hospitalised for cardiovascular conditions at safety-net versus non-safety-net hospitals: cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e046959
Author(s):  
Atsushi Miyawaki ◽  
Dhruv Khullar ◽  
Yusuke Tsugawa
Keyword(s):  
Hospital Mortality ◽  
Health Outcomes ◽  
Care Delivery ◽  
Bypass Graft ◽  
Safety Net ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Homeless Adults ◽  
To Receive

ObjectivesEvidence suggests that homeless patients experience worse quality of care and poorer health outcomes across a range of medical conditions. It remains unclear, however, whether differences in care delivery at safety-net versus non-safety-net hospitals explain these disparities. We aimed to investigate whether homeless versus non-homeless adults hospitalised for cardiovascular conditions (acute myocardial infarction (AMI) and stroke) experience differences in care delivery and health outcomes at safety-net versus non-safety-net hospitals.DesignCross-sectional study.SettingData including all hospital admissions in four states (Florida, Massachusetts, Maryland, and New York) in 2014.ParticipantsWe analysed 167 105 adults aged 18 years or older hospitalised for cardiovascular conditions (age mean=64.5 years; 75 361 (45.1%) women; 2123 (1.3%) homeless hospitalisations) discharged from 348 hospitals.Outcome measuresRisk-adjusted diagnostic and therapeutic procedure and in-hospital mortality, after adjusting for patient characteristics and state and quarter fixed effects.ResultsAt safety-net hospitals, homeless adults hospitalised for AMI were less likely to receive coronary angiogram (adjusted OR (aOR), 0.42; 95% CI, 0.36 to 0.50; p<0.001), percutaneous coronary intervention (aOR, 0.52; 95% CI, 0.44 to 0.62; p<0.001) and coronary artery bypass graft (aOR, 0.43; 95% CI, 0.26 to 0.71; p<0.01) compared with non-homeless adults. Homeless patients treated for strokes at safety-net hospitals were less likely to receive cerebral arteriography (aOR, 0.23; 95% CI, 0.16 to 0.34; p<0.001), but were as likely to receive thrombolysis therapy. At non-safety-net hospitals, we found no evidence that the probability of receiving these procedures differed between homeless and non-homeless adults hospitalised for AMI or stroke. Finally, there were no differences in in-hospital mortality rates for homeless versus non-homeless patients at either safety-net or non-safety-net hospitals.ConclusionDisparities in receipt of diagnostic and therapeutic procedures for homeless patients with cardiovascular conditions were observed only at safety-net hospitals. However, we found no evidence that these differences influenced in-hospital mortality markedly.

scholarly journals Use of the first National Early Warning Score recorded within 24 hours of admission to estimate the risk of in-hospital mortality in unplanned COVID-19 patients: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043721
Author(s):  
Donald Richardson ◽  
Muhammad Faisal ◽  
Massimo Fiori ◽  
Kevin Beatson ◽  
Mohammed Mohammed
Keyword(s):  
Hospital Mortality ◽  
Early Warning ◽  
Absolute Risk ◽  
Cross Sectional Study ◽  
Early Warning Score ◽  
Cross Sectional ◽  
Risk Of Mortality ◽  
Baseline Mortality ◽  
Acute Hospitals ◽  
National Early Warning Score

ObjectivesAlthough the National Early Warning Score (NEWS) and its latest version NEWS2 are recommended for monitoring deterioration in patients admitted to hospital, little is known about their performance in COVID-19 patients. We aimed to compare the performance of the NEWS and NEWS2 in patients with COVID-19 versus those without during the first phase of the pandemic.DesignA retrospective cross-sectional study.SettingTwo acute hospitals (Scarborough and York) are combined into a single dataset and analysed collectively.ParticipantsAdult (≥18 years) non-elective admissions discharged between 11 March 2020 and 13 June 2020 with an index or on-admission NEWS2 electronically recorded within ±24 hours of admission to predict mortality at four time points (in-hospital, 24 hours, 48 hours and 72 hours) in COVID-19 versus non-COVID-19 admissions.ResultsOut of 6480 non-elective admissions, 620 (9.6%) had a diagnosis of COVID-19. They were older (73.3 vs 67.7 years), more often male (54.7% vs 50.1%), had higher index NEWS (4 vs 2.5) and NEWS2 (4.6 vs 2.8) scores and higher in-hospital mortality (32.1% vs 5.8%). The c-statistics for predicting in-hospital mortality in COVID-19 admissions was significantly lower using NEWS (0.64 vs 0.74) or NEWS2 (0.64 vs 0.74), however, these differences reduced at 72hours (NEWS: 0.75 vs 0.81; NEWS2: 0.71 vs 0.81), 48 hours (NEWS: 0.78 vs 0.81; NEWS2: 0.76 vs 0.82) and 24hours (NEWS: 0.84 vs 0.84; NEWS2: 0.86 vs 0.84). Increasing NEWS2 values reflected increased mortality, but for any given value the absolute risk was on average 24% higher (eg, NEWS2=5: 36% vs 9%).ConclusionsThe index or on-admission NEWS and NEWS2 offers lower discrimination for COVID-19 admissions versus non-COVID-19 admissions. The index NEWS2 was not proven to be better than the index NEWS. For each value of the index NEWS/NEWS2, COVID-19 admissions had a substantially higher risk of mortality than non-COVID-19 admissions which reflects the increased baseline mortality risk of COVID-19.

scholarly journals Risk factors for severe outcomes in people with diabetes hospitalised for COVID-19: a cross-sectional database study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e051237
Author(s):  
Emilio Ortega ◽  
Rosa Corcoy ◽  
Mònica Gratacòs ◽  
Francesc Xavier Cos Claramunt ◽  
Manel Mata-Cases ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Invasive Mechanical Ventilation ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Male Sex ◽  
Poor Outcomes ◽  
The Relationship

AimThis study’s objective was to assess the risk of severe in-hospital complications of patients admitted for COVID-19 and diabetes mellitus (DM).DesignThis was a cross-sectional study.SettingsWe used pseudonymised medical record data provided by six general hospitals from the HM Hospitales group in Spain.Outcome measuresMultiple logistic regression analyses were used to identify variables associated with mortality and the composite of mortality or invasive mechanical ventilation (IMV) in the overall population, and stratified for the presence or absence of DM. Spline analysis was conducted on the entire population to investigate the relationship between glucose levels at admission and outcomes.ResultsOverall, 1621 individuals without DM and 448 with DM were identified in the database. Patients with DM were on average 5.1 years older than those without. The overall in-hospital mortality was 18.6% (N=301), and was higher among patients with DM than those without (26.3% vs 11.3%; p<0.001). DM was independently associated with death, and death or IMV (OR=2.33, 95% CI: 1.7 to 3.1 and OR=2.11, 95% CI: 1.6 to 2.8, respectively; p<0.001). In subjects with DM, the only variables independently associated with both outcomes were age >65 years, male sex and pre-existing chronic kidney disease. We observed a non-linear relationship between blood glucose levels at admission and risk of in-hospital mortality and death or IMV. The highest probability for each outcome (around 50%) was at random glucose of around 550 mg/dL (30.6 mmol/L), and the risks flattened above this value.ConclusionThe results confirm the high burden associated with DM in patients hospitalised with COVID-19 infection, particularly among men, the elderly and those with impaired kidney function. Moreover, hyperglycaemia on admission was strongly associated with poor outcomes, suggesting that personalised optimisation could help to improve outcome during the hospital stay.

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