scholarly journals Predictors of In-hospital Mortality In Patients With RT-PCR Confirmed Lassa Fever Infection Treated At A National Treatment Center, South West Nigeria

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Olatunde LO ◽  
Owhin S.O ◽  
Momoh A.J ◽  
Adebayo T.T. ◽  
Babatunde E ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Hospital Setting ◽  
Case Fatality ◽  
Lassa Fever ◽  
Standards Of Care ◽  
Inhospital Mortality ◽  
Rt Pcr ◽  
Case Record ◽  
Study Results ◽  
Elevated Creatinine

Background: Lassa fever (LF) infection is one of the viral hemorrhagic fever diseases found mainly in Sub-Saharan West Africa, including Nigeria. The case fatality rate is 60% among patients with Lassa fever complicated by AKI in one center study in Nigeria. Clinical and laboratory parameter has been documented as predictors of mortality among confirmed Lassa fever infected patients. Therefore, we decided to conduct similar study in our hospital to determine predictors of inhospital mortality among Lassa fever infected patients. Aim: This study was designed to determine the in-hospital clinical and laboratory predictors of outcome among RT-PCR (Real Time- Polymerase Chain Reaction) diagnosed Lassa fever patients. Methodology: This was a descriptive retrospective study involving the assessment of records of confirmed LF infected patients that were managed at the center from December 2019 to December 2020. 147 medical case record files of patients were retrieved for this study. Results: We found in our hospital setting, altered sensorium (p=0.001), seizures (p=0.001), bleeding diathesis (p=0.001), oliguria (p=0.001), elevated urea (p=0.001), elevated creatinine (p=0.001), hypoalbuminaemia (P=0.001), elevated SGOT (P=0.008) as significant predictors on in-hospital mortality. Conclusion: This study has helped us to identify the clinical parameters such as bleeding, central nervous system affectation, oliguria, tachycardia, tachypnea, hypoxaemia and laboratory parameters such as, elevated urea, elevated creatinine, hypoalbuminaemia as predictors of in-hospital mortality in RT-PCR confirmed Lassa fever patients. We believe early recognition of derangements of these parameters and with prompt intervention shall help to improve standards of care and outcome.

scholarly journals D-dimer Levels as Novel Biomarker Predictor for All-cause In-hospital Mortality Risk in COVID-19 Patients

2021 ◽  
Vol 2 (4) ◽  
pp. 14-19
Author(s):  
Nisa Amnifolia Niazta ◽  
Muchammad Dzikrul Haq Karimullah ◽  
William Sulistyono Putra ◽  
Norma Khairun Nisa ◽  
Phamella Esty Nuraini ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Case Fatality ◽  
Cross Sectional Study ◽  
Mortality Data ◽  
Inhospital Mortality ◽  
Rt Pcr ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Degrees Of Severity ◽  
D Dimer

Background : Coronavirus disease 2019 (COVID-19) has affected people all around the world in varying degrees of severity, causing death. The global case fatality rate (CFR) due to COVID-19 was 2.2 % as of January 1st, 2021. The CFR in the Kediri district is 7.7%, which is higher than the Nasional CFR of 3%. In COVID-19, we looked at high D-dimer as one of the predictors of in-hospital mortality. Objectives : The goal of this study was to find a link between D-dimer levels and all-cause in-hospital mortality in COVID-19 patients, as well as to define the best cut-off point. Methods : A single-center cross-sectional study was conducted. From March to December 2020, 185 COVID-19 patients treated at Kediri General Hospital who were confirmed positive by RT-PCR matched the eligibility criteria. The levels of D-dimer were divided into two groups: those above and those below the cutoff point. We 􏰏􏰚􏰏􏰦􏰗􏰱􏰋􏰕 􏰲 􏰩􏰞􏰊 􏰓􏰒 􏰐􏰓􏰝􏰚􏰊􏰌􏰳 􏰴􏰘􏰕􏰝􏰔􏰋􏰑 􏰵 􏰢􏰣􏰤 􏰶􏰟􏰷􏰔􏰦􏰳 􏰴􏰘􏰕􏰝􏰔􏰋􏰑 􏰵 􏰧 􏰶􏰟􏰷􏰔􏰦􏰳 􏰴􏰘􏰕􏰝􏰔􏰋􏰑 􏰵 􏰸 􏰶􏰟􏰷􏰔􏰦􏰳 􏰏􏰚􏰕 􏰴􏰘􏰕􏰝􏰔􏰋􏰑 􏰵 􏰲 􏰶􏰟􏰷􏰔􏰦􏰣 The primary endpoint was all-cause in-hospital mortality. Data were collected retrospectively and processed using SPSS version 25.0. Results : 􏰴􏰞􏰑􏰝􏰚􏰟 􏰜􏰓􏰌􏰐􏰝􏰊􏰏􏰦􏰝􏰱􏰏􏰊􏰝􏰓􏰚􏰳 􏰲􏰤 􏰐􏰏􏰊􏰝􏰋􏰚􏰊􏰌 􏰪􏰧􏰲􏰣􏰸􏰹􏰮 􏰎􏰋􏰑􏰋 􏰕􏰝􏰋􏰕􏰣 􏰺􏰦􏰋􏰻􏰏􏰊􏰋􏰕 􏰴􏰘􏰕􏰝􏰔􏰋􏰑 􏰵 􏰲 􏰶􏰟􏰷􏰔􏰦 􏰎􏰏􏰌 􏰌􏰊􏰏􏰊􏰝􏰌􏰊􏰝􏰩􏰏􏰦􏰦􏰗 significant associated with all-cause inhospital mortality (adjusted odds ratio [OR] 3.46; 95% confidence interval [CI] = 1.41 – 8.49, p = 0.007), with a sensitivity of 82.1% and a specificity of 42.2% ( area under curve [AUC] = 0.628; 95% CI = 0.527 – 0.728; p = 0.012). Conclusion : Elevated D-dimer levels were associated with all-cause in-hospital mortality. In our study, the 􏰓􏰐􏰊􏰝􏰔􏰏􏰦 􏰩􏰞􏰊 􏰓􏰒 􏰐􏰓􏰝􏰚􏰊 􏰴􏰘􏰕􏰝􏰔􏰋􏰑 􏰻􏰏􏰦􏰞􏰋 􏰎􏰏􏰌 􏰲 􏰶􏰟􏰷􏰔􏰦􏰣

An Updated Review on COVID-19

2020 ◽  
Vol 20 ◽  
Author(s):  
Mahmoud Ahmed Ebada ◽  
Ahmed Wadaa Allah ◽  
Eshak Bahbah ◽  
Ahmed Negida
Keyword(s):  
Screening Tool ◽  
Distress Syndrome ◽  
Reproduction Number ◽  
Case Fatality ◽  
Current Data ◽  
Future Research ◽  
Rt Pcr ◽  
Viral Structure ◽  
Discharge Criteria ◽  
Serology Testing

: Coronavirus Disease (COVID-19) pandemic has affected more than seven million individuals in 213 countries worldwide with a basic reproduction number ranging from 1.5 to 3.5 and an estimated case fatality rate ranging from 2% to 7%. A substantial proportion of COVID-19 patients are asymptomatic; however, symptomatic cases might present with fever, cough, and dyspnoea or severe symptoms up to acute respiratory distress syndrome. Currently, RNA RT-PCR is the screening tool, while bilateral chest CT is the confirmatory clinical diagnostic test. Several drugs have been repurposed to treat COVID-19, including chloroquine or hydroxychloroquine with or without azithromycin, lopinavir/ritonavir combination, remdesivir, favipiravir, tocilizumab, and EIDD-1931. Recently, Remdesivir gained FDA emergency approval based on promising early findings from the interim analysis of 1063 patients. The recently developed serology testing for SARSCoV-2 antibodies opened the door to evaluate the actual burden of the disease and to determine the rate of the population who have been previously infected (or developed immunity). This review article summarizes current data on the COVID-19 pandemic starting from the early outbreak, viral structure and origin, pathogenesis, diagnosis, treatment, discharge criteria, and future research.

scholarly journals COVID-19 and pregnancy – where are we now? A review

2020 ◽  
Vol 48 (5) ◽  
pp. 428-434 ◽  
Author(s):  
Aleksandra Rajewska ◽  
Wioletta Mikołajek-Bedner ◽  
Joanna Lebdowicz-Knul ◽  
Małgorzata Sokołowska ◽  
Sebastian Kwiatkowski ◽  
...  
Keyword(s):  
Case Fatality ◽  
Fetal Distress ◽  
Delivery Mode ◽  
Test Results ◽  
Rt Pcr ◽  
Third Trimester ◽  
The Third ◽  
Laboratory Test Results ◽  
Protective Antibodies ◽  
Polymerase Chain

AbstractThe new acute respiratory disease severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is highly contagious. It has caused many deaths, despite a relatively low general case fatality rate (CFR). The most common early manifestations of infection are fever, cough, fatigue and myalgia. The diagnosis is based on the exposure history, clinical manifestation, laboratory test results, chest computed tomography (CT) findings and a positive reverse transcription-polymerase chain reaction (RT-PCR) result for coronavirus disease 2019 (COVID-19). The effect of SARS-CoV-2 on pregnancy is not already clear. There is no evidence that pregnant women are more susceptible than the general population. In the third trimester, COVID-19 can cause premature rupture of membranes, premature labour and fetal distress. There are no data on complications of SARS-CoV-2 infection before the third trimester. COVID-19 infection is an indication for delivery if necessary to improve maternal oxygenation. Decision on delivery mode should be individualised. Vertical transmission of coronavirus from the pregnant woman to the fetus has not been proven. As the virus is absent in breast milk, the experts encourage breastfeeding for neonatal acquisition of protective antibodies.

scholarly journals Clinical correlates of anti-SARS-CoV-2 antibody profiles in Spanish COVID-19 patients from a high incidence region

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Robert Markewitz ◽  
Antje Torge ◽  
Klaus-Peter Wandinger ◽  
Daniela Pauli ◽  
Andre Franke ◽  
...  
Keyword(s):  
Case Fatality ◽  
Time Frame ◽  
Epidemic Outbreak ◽  
Sample Collection ◽  
Rt Pcr ◽  
High Incidence ◽  
Duration Of Hospitalization ◽  
Reasonable Time Frame ◽  
Support Treatment ◽  
Diagnostic And Prognostic Value

AbstractLaboratory testing for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) consists of two pillars: the detection of viral RNA via rt-PCR as the diagnostic gold standard in acute cases, and the detection of antibodies against SARS-CoV-2. However, concerning the latter, questions remain about their diagnostic and prognostic value and it is not clear whether all patients develop detectable antibodies. We examined sera from 347 Spanish COVID-19 patients, collected during the peak of the epidemic outbreak in Spain, for the presence of IgA and IgG antibodies against SARS-CoV-2 and evaluated possible associations with age, sex and disease severity (as measured by duration of hospitalization, kind of respiratory support, treatment in ICU and death). The presence and to some degree the levels of anti-SARS-CoV-2 antibodies depended mainly on the amount of time between onset of symptoms and the collection of serum. A subgroup of patients did not develop antibodies at the time of sample collection. Compared to the patients that did, no differences were found. The presence and level of antibodies was not associated with age, sex, duration of hospitalization, treatment in the ICU or death. The case-fatality rate increased exponentially with older age. Neither the presence, nor the levels of anti-SARS-CoV-2 antibodies served as prognostic markers in our cohort. This is discussed as a possible consequence of the timing of the sample collection. Age is the most important risk factor for an adverse outcome in our cohort. Some patients appear not to develop antibodies within a reasonable time frame. It is unclear, however, why that is, as these patients differ in no respect examined by us from those who developed antibodies.

scholarly journals Hospital beds and personal protective equipment planning for COVID-19 pandemic: A computer simulation approach

2020 ◽  
Author(s):  
Yiruo Lu ◽  
Yongpei Guan ◽  
Jennifer Fishe ◽  
Thanh Hogan ◽  
Xiang Zhong
Keyword(s):  
Computer Simulation ◽  
Personal Protective Equipment ◽  
Census Data ◽  
Discrete Event ◽  
Hospital Setting ◽  
Case Fatality ◽  
Protective Equipment ◽  
Simulation Approach ◽  
Number Of Patients ◽  
Hospital Resources

Abstract Health care systems are at the frontline to fight the COVID-19 pandemic. An emergent question for each hospital is how many general ward and intensive care unit beds are needed and how much personal protective equipment to be purchased. However, hospital pandemic preparedness has been hampered by a lack of sufficiently specific planning guidelines. In this paper, we developed a computer simulation approach to evaluating bed utilizations and the corresponding supply needs based on the operational considerations and constraints in individual hospitals. We built a data-driven SEIR model which is adaptive to control policies and can be utilized for regional forecast targeting a specific hospital’s catchment area. The forecast model was integrated into a discrete-event simulation which modeled the patient flow and the interaction with hospital resources. We tested the simulation model outputs against patient census data from UF Health Jacksonville, Jacksonville, FL. Simulation results were consistent with the observation that the hospital has ample bed resources to accommodate the regional COVID patients. After validation, the model was used to predict future bed utilizations given a spectrum of possible scenarios to advise bed planning and stockpiling decisions. Lastly, how to optimally allocate hospital resources to achieve the goal of reducing the case fatality rate while helping a maximum number of patients to recover was discussed. This decision support tool is tailored to a given hospital setting of interest and is generalizable to other hospitals to tackle the pandemic planning challenge.

scholarly journals Burden of arrhythmia in hospitalized patients with cannabis use related disorders: analysis of 2016-2018 national inpatient sample

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
H Thyagaturu ◽  
S Thangjui ◽  
B Shrestha ◽  
K Shah ◽  
R Naik ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Cardiac Arrhythmia ◽  
Case Reports ◽  
Cannabis Use ◽  
Categorical Variables ◽  
Cannabis Use Disorder ◽  
National Inpatient Sample ◽  
Income Status ◽  
Co Morbidity ◽  
Study Results

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cannabis is being more widely use as a recreational substance worldwide. There have been case reports and systematic review describing the association of cannabis use and cardiac arrhythmia (1). Purpose We sought out to measure the prevalence of different types of cardiac arrhythmia in hospitalizations associated with cannabis use disorder. Methods We queried January 2016 to December 2018 National Inpatient Sample (NIS) databases to identify adult (≥18 yrs) hospitalizations in the US with a diagnosis of cannabis use related disorders. Patients with an associated diagnosis of arrhythmias were also identified based on appropriate ICD-10 CM codes. We used the Chi-square test to evaluate the differences between binary or categorical variables, and Student’s t-test for continuous variables. Multivariate logistic regression was used in outcomes analysis to adjust for potential hospital and patient-level confounders (age, sex, race, diabetes, heart failure, chronic kidney disease, anemia, obesity, elixhauser co-morbidity index, hospital location, teaching status, bed size, income status and others). The discharge weights provided in the databases were used to calculate the national estimates. STATA 16.1 software was used to perform all statistical analysis. Results We identified 2,457,544 hospitalizations associated with cannabis use related disorders across three years. Of which, 187,825 (7.6%) were associated with any arrhythmia. We found that atrial fibrillation was the most associated arrhythmia. The complete list of types of arrhythmia and their prevalence are described in Figure-1. Patients with arrhythmia group were older (mean age 50.5 vs 38.3 yrs; P < 0.01) and had higher co-morbidity (% of >3 Elixhauser comorbidity score 94.1% vs 60.6%; P < 0.01). After adjusting for patient and hospital-level confounders, we observed arrhythmia group was associated with higher odds of in-hospital mortality compared to the group without arrhythmia [Odds Ratio (OR): 4.5 (4.09 – 5.00); P < 0.01]. We also observed statistically significant increase in hospitalization length of stay due to the status of any arrhythmia [5.7 vs 5.1 days; P < 0.01]. Conclusion The prevalence of Afib is high in hospitalizations associated with cannabis use. Hospitalizations associated with cannabis use disorder and any arrhythmia are associated with higher in-hospital mortality and LOS. Therefore, all electrocardiograms should be scrutinized in hospitalized cannabis users. However, further prospective studies are necessary to endorse our study results. Abstract Figure.

scholarly journals Evaluation of independent predictors of in-hospital mortality in patients with severe trauma

2019 ◽  
Vol 147 (7-8) ◽  
pp. 455-460
Author(s):  
Marija Milenkovic ◽  
Zaneta Terzioski ◽  
Adi Hadzibegovic ◽  
Jovana Stanisavljevic ◽  
Ksenija Petrovic ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Cox Regression ◽  
Arterial Oxygen Saturation ◽  
Area Under The Curve ◽  
Case Fatality ◽  
Scoring Systems ◽  
Severe Trauma ◽  
Arterial Oxygen ◽  
Emergency Center ◽  
Cox Regression Analysis

Introduction/Objective. The aim of this study was to determine independent predictors and the best trauma scoring system (REMS, RTS, GSC, SOFA, APPACHE II) of in-hospital mortality in patients with severe trauma at the Department of Emergency, Emergency Center, Clinical Center of Serbia, Belgrade. Methods. Longitudinal study included 208 consecutive patients with severe trauma. In order to determine independent survival contributors, univariate and multivariate Cox regression analyses were performed. The power of above-mentioned scoring systems (measured at admission to the Emergency center) to predict mortality was compared using the area under the curve (AUC). Results. There were 208 patients (159 male, 49 female), with the average age of 47.3 ? 20.7 years. Majority of patients were initially intubated (86.1%) on admission to the emergency department, and 59.6% patients were sedated before intubation. After finishing of diagnostic procedures, 17 patients were additionally intubated, and, at that time, 94.2% patients were on mechanic ventilation. The majority of patients was traumatized in a car crash (33.2%), followed by falls from height (26.4%) and as pedestrians (22.6%). Patients had an average of 24.7 ? 21.2 days spent in intensive care unit. The overall case-fatality ratio was 17/208 (8.2%). In Cox regression analysis only elevated heart rate (HR = 1.03, p = 0.012) and decreased arterial oxygen saturation (SpO2) (HR = 0.91, p = 0.033) singled out as independent contributors to in-hospital mortality of patients with severe trauma. REMS (AUC 0.72 ? 0.64) and SOFA (AUC 0.716 ? 0.067) scores were found fair and similar predictor of in-hospital mortality, while APACHE II (AUC 0.614 ? 0.062) and RTS (0.396 ? 0.068) were poor predictors. Conclusion. Results of this study showed an important role of REMS, which appears to provide balance between the predictive ability and the practical application, and components of REMS in prediction of outcome in patients with severe trauma and that HR and SpO2 are independent predictors of in-hospital mortality.

scholarly journals Accuracy of the Sequential Organ Failure Assessment Score for In-Hospital Mortality by Race and Relevance to Crisis Standards of Care

2021 ◽  
Vol 4 (6) ◽  
pp. e2113891
Author(s):  
William Dwight Miller ◽  
Xuan Han ◽  
Monica E. Peek ◽  
Deepshikha Charan Ashana ◽  
William F. Parker
Keyword(s):  
Hospital Mortality ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Standards Of Care ◽  
Assessment Score ◽  
Failure Assessment

scholarly journals Identification and Management of Sepsis in the Interventional Radiology Patient

2017 ◽  
Vol 1 ◽  
pp. 3
Author(s):  
Jacqueline Murtha ◽  
Vinit Khanna ◽  
Talia Sasson ◽  
Devang Butani
Keyword(s):  
United States ◽  
Health Care ◽  
Septic Shock ◽  
Interventional Radiology ◽  
Hospital Setting ◽  
The United States ◽  
Clinical Aspects ◽  
Inhospital Mortality ◽  
United States Population ◽  
Hospital Acquired

Sepsis is frequently encountered in the hospital setting and can be community-acquired, health-care-associated, or hospital-acquired. The annual incidence of sepsis in the United States population ranges from 300 to 1031 per 100,000 and is increasing by 13% annually. There is an associated inhospital mortality of 10% for sepsis and >40% for septic shock. Interventional radiology is frequently called on to treat patients with sepsis, and in rarer circumstances, interventional radiologists themselves may cause sepsis. Thus, it is essential for interventional radiologists to be able to identify and manage septic patients to reduce sepsis-related morbidity and mortality. The purpose of this paper is to outline procedures most likely to cause sepsis and delineate important clinical aspects of identifying and managing septic patients.

Abstract MP29: Patient Characteristics And Outcomes Associated With In-hospital Onset Of Acute Decompensated Heart Failure

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Corey A Kalbaugh ◽  
Patricia P Chang ◽  
Kunihiro Matsushita ◽  
Sunil K Agarwal ◽  
Melissa Caughey ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Mortality ◽  
Hospital Admission ◽  
Acute Decompensated Heart Failure ◽  
Case Fatality ◽  
Patient Characteristics ◽  
Decompensated Heart Failure ◽  
Hospital Length Of Stay ◽  
Smoking History ◽  
One Year

Introduction: There has been little focus on hospitalized acute decompensated heart failure (ADHF) that develops after admission, which may occur because of comorbid conditions, over-administration of fluid or post-surgical complications. Aims: To compare patient characteristics, case fatality, and hospital length of stay (LOS) associated with ADHF that develops after hospital admission as compared to those with ADHF at admission. Methods: Hospitalizations with possible ADHF were sampled, based on HF ICD codes, among those aged > 55 years from the four communities of the Atherosclerosis Risk in Communities Study (2005-2010). Medical records were abstracted with events classified by physician panel or computer classified. Case fatality was obtained through the National Death Index. We identified 4,503 (unweighted) events with definite/probable ADHF, after excluding those with unknown time of decompensation (n=81), hospital transfers (n=102), and race other than black or white (n=118). Demographic and clinical characteristics were compared by ADHF onset (at/after admission). Logistic regression was used to evaluate the association of ADHF onset with in-hospital mortality, and 28-days and one-year mortality, adjusted for demographics and comorbidity. Linear regression was used to evaluate the association of ADHF onset with log-transformed hospital LOS, adjusted for demographics. All analyses were weighted to account for the stratified sampling design. Results: Of 21,052 (weighted) ADHF events, 7.4% (n=1561) developed ADHF after admission. Patients with ADHF occurring after admission were older (mean: 79 vs. 75 years), and more likely white and female. Those with ADHF at admission were more likely to have a positive smoking history, COPD, and to be on dialysis. Presence of diabetes, hypertension and coronary artery disease were not significantly different between groups. In hospital mortality (16.5% vs. 6.3%; OR= 2.7, 95% CI=1.9-3.8) and 28-day mortality (23.9% vs. 10.1%; OR= 2.4, 95% CI=1.7-3.4) was higher among those who developed ADHF after admission. One-year case fatality was similar (39.4% vs. 33.6%; OR= 1.2, 95% CI=0.9-1.6). Unadjusted mean LOS was longer for those with ADHF occurring after admission (12.8 days, 95% CI=11.8-13.8) than those with ADHF at admission (7.2 days, 95% CI=6.8-7.6). The adjusted and geometric mean LOS was 1.3 days (95% CI=1.2-1.4) longer for those who developed ADHF after admission. Conclusion: Although patients with ADHF onset after admission were slightly older, differences in comorbidity do not indicate an easily identifiable subgroup for closer in-hospital monitoring. Development of ADHF after admission was associated with an alarmingly high early case fatality and longer hospital LOS compared to those with ADHF at hospital admission.

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