scholarly journals Association between cardiovascular mortality and STOP-Bang questionnaire scores in a cohort of hospitalized patients: a prospective study

2021 ◽  
pp. e20210039
Author(s):  
Gabriel Valdivia1 ◽  
Alexia Schmidt1 ◽  
Bettina Schmidt1 ◽  
Francisca Rivera1 ◽  
Aileen Oñate2 ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Study Groups ◽  
Hospitalized Patients ◽  
Risk Of Mortality ◽  
Obstructive Sleep ◽  
Populations At Risk ◽  
Increased Risk ◽  
Obesity Hypertension ◽  
A Prospective Study ◽  
Score Risk

Objective: Obstructive sleep apnea (OSA) is associated with an increased risk of mortality and cardiometabolic diseases. The STOP-Bang questionnaire is a tool to screen populations at risk of OSA and prioritize complementary studies. Our objective was to evaluate the clinical utility of this questionnaire in identifying patients at an increased risk of mortality after discharge in a cohort of hospitalized patients. Methods: This was a prospective cohort study involving consecutive patients admitted to an internal medicine unit between May and June of 2017 who were reevaluated three years after discharge. At baseline, we collected data on comorbidities (hypertension, obesity, diabetes, and fasting lipid profile) and calculated STOP-Bang scores, defining the risk of OSA (0-2 score, no risk; = 3 score, risk of OSA; and = 5 score, risk of moderate-to-severe OSA), which determined the study groups. We also recorded data regarding all-cause and cardiovascular mortality at the end of the follow-up period. Results: The sample comprised 435 patients. Of those, 352 (80.9%) and 182 (41.8%) had STOP-Bang scores = 3 and = 5, respectively. When compared with the group with STOP-Bang scores of 0-2, the two groups showed higher prevalences of obesity, hypertension, diabetes, and dyslipidemia. Multivariate analysis showed an independent association between cardiovascular mortality and STOP-Bang score = 5 (adjusted hazard ratio = 3.12 [95% CI, 1.39-7.03]; p = 0.01). Additionally, previous coronary heart disease was also associated with cardiovascular mortality. Conclusions: In this cohort of hospitalized patients, STOP-Bang scores = 5 were able to identify patients at an increased risk of cardiovascular mortality three years after discharge.

scholarly journals Sudden death in patients with sleep apnea: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Emily S. Heilbrunn ◽  
Paddy Ssentongo ◽  
Vernon M. Chinchilli ◽  
Anna E. Ssentongo
Keyword(s):  
Sleep Apnea ◽  
Sudden Death ◽  
Cardiovascular Mortality ◽  
Meta Analysis ◽  
Cardiac Mortality ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
All Cause Mortality

AbstractBackgroundOver 1 billion individuals across the globe experience some form of sleep apnea, and this number is steadily rising. Obstructive sleep apnea (OSA) can negatively influence one’s quality of life and potentially increase the risk of mortality. However, this association between OSA and mortality has not been comprehensively and thoroughly explored. This meta-analysis was conducted to conclusively estimate the risk of death for all-cause mortality and cardiovascular mortality in OSA patients.Study Design4,613 articles from databases including PUBMED, OVID & Joana Briggs, and SCOPUS were comprehensively assessed by two reviewers (AES & ESH) for inclusion criteria. 28 total articles were included, with 22 of them being used for quantitative analysis. Pooled effects of all-cause mortality, cardiac mortality, and sudden death were calculated by utilizing the metaprop function in R Statistical Software and the random-effects model with appropriate 95% confidence intervals.ResultsAnalysis on 42,032 individuals revealed that those with OSA were twice as likely to die from cardiac mortality compared to those without sleep apnea (HR= 1.94, 95%CI 1.39-2.70). Likewise, individuals with OSA were 1.7 times as likely to die from all-cause sudden death compared to individuals without sleep apnea (HR= 1.74, 95%CI 1.40-2.10). There was a significant dose response relationship between severity of sleep apnea and incidence risk of death, where those with severe sleep apnea wereConclusionsIndividuals with obstructive sleep apnea are at an increased risk for all-cause mortality and cardiac mortality. Further research related to appropriate interventions and treatments are necessary in order to reduce this risk and optimize survival in this population.Key MessagesWhat is the key question?Are individuals with sleep apnea at an increased risk for cardiovascular mortality and sudden death?What is the bottom Line?Sleep apnea is associated with an increased risk of cardiovascular mortality and sudden death, with a dose response relationship, where those with severe sleep apnea are at the highest risk of mortality.Why read on?This is the first systematic review and meta-analyses to synthesize and quantify the risk of mortality in those with sleep apnea, highlighting important directions for future research.Prospero Registration IDCRD42020164941

scholarly journals Laparoscopic Roux-En-Y Gastric Bypass in Elderly Patients (60 Years or Older): A Meta-Analysis of Comparative Studies

2017 ◽  
Vol 107 (1) ◽  
pp. 6-13 ◽  
Author(s):  
S. Giordano ◽  
M. Victorzon
Keyword(s):  
Obstructive Sleep Apnea ◽  
Gastric Bypass ◽  
Confidence Interval ◽  
Excess Weight Loss ◽  
Meta Analysis ◽  
Younger Patients ◽  
Risk Of Mortality ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Remission Rates

Background and Aims: Elderly patient might experience an increased risk of complications after laparoscopic Roux-en-Y gastric bypass. We aimed to perform a meta-analysis of comparative studies on this issue in patients aged 60 years or older. Material and Methods: A systematic literature search was performed. Medline, Cochrane Library, Embase, Scopus, and Google Scholar were searched until July 2016 for studies on outcomes of laparoscopic Roux-en-Y gastric bypass in elderly versus younger patients. Primary outcomes were mortality and overall complications. Secondary outcomes were length of hospital stay, excess weight loss percentage, effect on diabetes, hypertension, hyperlipidemia and obstructive sleep apnea. Heterogeneity across the studies was evaluated by the I2 test, and a random effects model was used. Results were expressed as mean difference and risk ratio (RR). Results: Seven studies involving 3128 patients were retrieved and included in this study. A significantly increased risk of mortality and overall complications was observed among patients older than 60 years compared with younger ones (RR, 6.12; 95% confidence interval 1.08–34.83; p = 0.04; RR, 1.51; 95% confidence interval 1.07–2.11; p = 0.02). Particularly, elderly patients experienced 1% increased risk of mortality and 3% increased risk of overall complications. Length of stay, diabetes, and obstructive sleep apnea remission rates were similar among the groups. Excess weight loss percentage was significantly greater among younger patients (mean difference, −3.44; 95% confidence interval −5.20, −1.68; p < 0.001), as were hypertension (RR, 0.57; 95% confidence interval 0.42–0.76; p < 0.001) and hyperlipidemia (RR, 0.61; 95% confidence interval 0.45–0.83; p = 0.002) remission rates. Conclusion: Laparoscopic Roux-en-Y gastric bypass in patients older than 60 years may be a risky bariatric surgery operation due to higher complications and mortality and may not be as effective as in patients younger than 60 years. Thus, older patients should be carefully counseled before this procedure for individual risk–benefit assessment.

scholarly journals To jump or not to jump? A multicentre propensity-matched study of sequential vein grafting of the heart

2019 ◽  
Vol 29 (2) ◽  
pp. 201-208 ◽  
Author(s):  
Jens K Skov ◽  
Hans-Henrik Kimose ◽  
Jacob Greisen ◽  
Carl-Johan Jakobsen
Keyword(s):  
Artery Bypass ◽  
Postoperative Bleeding ◽  
Study Groups ◽  
Confidence Limits ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Early Graft ◽  
Matched Study ◽  
Early Graft Failure

AbstractOBJECTIVESIn this propensity-matched study we investigated the outcome after grafting with either a single vein or a sequential vein grafting strategy. Outcomes were primarily risk of reintervention and death in the short, intermediate and long term (10 years).MATERIALSIn the period from 2000 to 2016, data from 24 742 patients undergoing coronary artery bypass grafting were extracted from the Western Denmark Heart Registry, where data are registered perioperatively. We used a propensity-matched study in which the study groups were matched on parameters primarily from the EuroSCORE. The numbers of patients in both groups after matching were 3380.RESULTSSingle grafts resulted in significantly more postoperative bleeding and were more time-consuming. No differences were seen regarding in-hospital events such as stroke, acute myocardial infarction, dialysis or arrhythmias. After 30 days, patients in the jump graft group showed an increased rate of reintervention due to ischaemia after adjusting for confounding factors [hazard ratio (HR) 2.08, 95% confidence interval 1.01–4.34]. In addition, after adjusting for known confounders, sequential grafts were found to increase the risk of mortality at 6 months (HR 1.51, 95% confidence limits 1.07–2.11) and 5 years (HR 1.23, 95% confidence limits 1.04–1.46).CONCLUSIONSThis propensity-matched analysis suggested, although discretely, that a jump graft as a grafting strategy is associated with a slightly increased risk of mortality and early graft failure and that a single grafting strategy to the coronary arteries should be preferred when feasible.

scholarly journals Association between Serum Interleukin-6 Concentration and Mortality in Patients with Coronary Artery Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Dongfang Su ◽  
Zhongxia Li ◽  
Xinrui Li ◽  
Yuming Chen ◽  
Yuan Zhang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Mortality ◽  
Interleukin 6 ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Hazard Ratios ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Artery Disease

Objectives. To evaluate whether serum interleukin-6 (IL-6) is associated with increased risk of mortality in coronary artery disease (CAD) patients.Methods. We performed a prospective cohort study of 718 CAD patients from the Guangzhou Cardiovascular Disease Cohort (GCDC) study. Multivariable-adjusted Cox proportional hazards regression analyses were used to examine the association between serum IL-6 with all-cause and cardiovascular mortality.Results. During the 1663 person-years of followup, the cumulative all-cause mortality and cardiovascular mortality were 6.5% (n=47) and 3.3% (n=24), respectively. The mean length of followup was2.32±0.81years. In the multivariable analyses, a one-SD increment in log-transformed serum IL-6 was positively associated with an increased risk of all-cause and cardiovascular mortality, with hazard ratios (HR) of 2.93 (95% CI, 2.11–4.08) and 2.04 (95% CI, 1.34–3.68) within the patients combined and 2.98 (95% CI, 2.12–4.18) and 3.10 (95% CI, 1.98–4.85) within males, respectively. Patients in the highest serum IL-6 tertile versus the lowest tertile were at higher risk of all-cause and cardiovascular mortality, with HR of 17.12 (95% CI 3.11–71.76) and 8.68 (95% CI, 1.88–37.51), respectively.Conclusions. In hospitalized patients with CAD, serum IL-6 is significantly associated with all-cause and cardiovascular mortality.

Postoperative treatment of the patient with obstructive sleep apnea

2000 ◽  
Vol 122 (2) ◽  
pp. 233-236 ◽  
Author(s):  
Keith M. Ulnick ◽  
Richard F. Debo
Keyword(s):  
Intensive Care Unit ◽  
Obstructive Sleep Apnea ◽  
Intensive Care ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Study Groups ◽  
Postoperative Treatment ◽  
Arterial Oxygen ◽  
Obstructive Sleep ◽  
Increased Risk

>OBJECTIVE The postoperative management of patients with obstructive sleep apnea syndrome (OSAS) has been based primarily on the potential loss of the airway. Our hypothesis is that not all patients with OSAS require placement in the intensive care unit after surgery. METHODS We undertook a prospective, nonrandomized study (N = 38). Data included demographics, polysomnograms, body mass index (BMI), and postoperative course, including any complications within 72 hours. RESULTS The average respiratory disturbance index was 66, and the average BMI was 29. The average preoperative and postoperative maximal arterial oxygen desaturation values were 82% and 94%, respectively. Patients with BMIs less than 35 did not have desaturation values below 90%. No complications occurred. DISCUSSION Within the first 72 hours after surgery, no complications were observed in our study groups. Patients with BMIs greater than 35 were at increased risk for postoperative desaturations. The uncomplicated OSAS patient, one without significant comorbid factors, can be treated in a safe and prudent fashion outside of an intensive care unit.

scholarly journals Cardiovascular and all-cause mortality attributable to loneliness in older Swedish men and women.

2020 ◽  
Author(s):  
Masuma Novak ◽  
Margda waern ◽  
Lena Johansson ◽  
Anna Zettergren ◽  
Lina Ryden ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Cox Regression ◽  
Mortality Data ◽  
Men And Women ◽  
Face To Face ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Adjusted Model

Abstract Background. This study examined whether loneliness predicts cardiovascular- and all-cause mortality in older men and women. Methods. Baseline data from the Gothenburg H70 Birth Cohort Studies, collected during 2000 on 70-year-olds born 1930 and living in Gothenburg were used for analysis (n=524). Mortality data were analyzed until 2012 through Swedish national registers. Results. Perceived loneliness was reported by 17.1% of the men and 30.9% of the women in a face-to-face interview with mental health professional. A total of 142 participants died during the 12-year follow-up period, with 5 334 person-years at risk, corresponding to 26.6 deaths/1000 person-years. Cardiovascular disease accounted for 59.2% of all deaths. The cumulative rates/1000 person-years for cardiovascular mortality were 20.8 (men) and 11.5 (women), and for all-cause mortality 33.8 (men) and 20.5 (women), respectively. In Cox regression models, no significant increased risk of mortality was seen for men with loneliness compared to men without loneliness (cardiovascular mortality HR 1.52, 95% CI 0.78 - 2.96; all-cause HR 1.32, 95% CI 0.77 - 2.28). Increased risk of cardiovascular mortality was observed in women with loneliness compared to those without (HR 2.25 95% CI 1.14 - 4.45), and the risk remained significant in a multivariable-adjusted model (HR 2.42 95% CI 1.04 - 5.65). Conclusions. Loneliness was shown to be an independent predictor of cardiovascular mortality in women. We found no evidence to indicate that loneliness was associated with an increased risk of either cardiovascular- or all-cause mortality in men.

scholarly journals Efficacy and Safety of Hydroxychloroquine and Chloroquine for COVID-19: A systematic review

2020 ◽  
Author(s):  
Sonal Singh ◽  
Thomas J Moore
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Poor Quality ◽  
Hospitalized Patients ◽  
Efficacy And Safety ◽  
Treatment Benefits ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Newcastle Ottawa Scale

BACKGROUND: Hydroxychloroquine and chloroquine are widely used to treat hospitalized COVID-19 patients primarily based on antiviral activity in in vitro studies. Our objective was to systematically evaluate their efficacy and safety in hospitalized patients with COVID-19. METHODS: We systematically reviewed PubMed, ClinicalTrials.gov, and Medrxviv for studies of hydroxychloroquine and chloroquine in COVID-19 hospitalized patients on April 26, 2020. We evaluated the quality of trials and observational studies using the Jadad criteria and Newcastle Ottawa Scale, respectively. RESULTS: After a review of 175 citations, we included 5 clinical trials (total of 345 patients), 9 observational studies (n = 2529), and 6 additional studies (n = 775) reporting on the QT interval. Three studies reported treatment benefits including two studies reporting benefit on virologic outcomes, which was statistically significant in one study, and another reported significant improvement on cough symptoms. Three studies reported that treatment was potentially harmful, including an significantly increased risk of mortality in two studies and increased need for respiratory support in another. Eight studies were unable to detect improvements on virologic outcomes (n = 3) or pneumonia or transfer to ICU/death (n = 5). The proportion of participants with critical QTc intervals of ≥ 500 ms or an increase of ≥ 60 ms from baseline ranged from 8.3% to 36% (n = 8). One clinical trial and six observational studies were of good quality. The remaining studies were of poor quality. CONCLUSIONS: Our systematic review of reported clinical studies did not identify substantial evidence to support the efficacy of hydroxychloroquine or chloroquine in hospitalized COVID-19 patients and raises questions about potential harm from QT prolongation and increased mortality.

scholarly journals Cardiovascular and all-cause mortality attributable to loneliness in older Swedish men and women

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Masuma Novak ◽  
Margda Waern ◽  
Lena Johansson ◽  
Anna Zettergren ◽  
Lina Ryden ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Cox Regression ◽  
Mortality Data ◽  
Men And Women ◽  
Face To Face ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Adjusted Model

Abstract Background This study examined whether loneliness predicts cardiovascular- and all-cause mortality in older men and women. Methods Baseline data from the Gothenburg H70 Birth Cohort Studies, collected during 2000 on 70-year-olds born 1930 and living in Gothenburg were used for analysis (n = 524). Mortality data were analyzed until 2012 through Swedish national registers. Results Perceived loneliness was reported by 17.1% of the men and 30.9% of the women in a face-to-face interview with mental health professional. A total of 142 participants died during the 12-year follow-up period, with 5334 person-years at risk, corresponding to 26.6 deaths/1000 person-years. Cardiovascular disease accounted for 59.2% of all deaths. The cumulative rates/1000 person-years for cardiovascular mortality were 20.8 (men) and 11.5 (women), and for all-cause mortality 33.8 (men) and 20.5 (women), respectively. In Cox regression models, no significant increased risk of mortality was seen for men with loneliness compared to men without loneliness (cardiovascular mortality HR 1.52, 95% CI 0.78–2.96; all-cause HR 1.32, 95% CI 0.77–2.28). Increased risk of cardiovascular mortality was observed in women with loneliness compared to those without (HR 2.25 95% CI 1.14–4.45), and the risk remained significant in a multivariable-adjusted model (HR 2.42 95% CI 1.04–5.65). Conclusions Loneliness was shown to be an independent predictor of cardiovascular mortality in women. We found no evidence to indicate that loneliness was associated with an increased risk of either cardiovascular- or all-cause mortality in men.

Visual acuity and risk of overall, injury-related, and cardiovascular mortality: the Kangbuk Samsung Health Study

2021 ◽  
Author(s):  
So Young Han ◽  
Yoosoo Chang ◽  
Hocheol Shin ◽  
Chul Young Choi ◽  
Seungho Ryu
Keyword(s):  
Visual Acuity ◽  
Visual Impairment ◽  
Cardiovascular Mortality ◽  
Health Study ◽  
Normal Vision ◽  
Vital Status ◽  
Hazard Ratios ◽  
Risk Of Mortality ◽  
Increased Risk

Abstract Aims  The associations of visual impairment (VI) with cardio-metabolic risk factors have been reported but its association with cardiovascular mortality remains uncertain. Therefore, we evaluated the association of visual acuity (VA) with overall, injury-related, and cardiovascular mortality. Methods and results A cohort study was performed in 580 746 Korean adults (average age, 39.7 years) who were followed for a median of 8.1 years (maximum, 16 years). Presenting VA was measured by the Early Treatment Diabetic Retinopathy Study (ETDRS) chart. Visual acuity in the better vision eye was categorized as normal vision (≥0.8), lowered vision (0.5–0.8), mild visual impairment (VI) (0.3–0.5), or moderate to severe VI (&lt;0.3). Vital status and cause of death were ascertained through linkage to national death records. During 4 632 892.2 person-years of follow-up, 6585 overall deaths, 974 cardiovascular deaths, and 1163 injury-related deaths were identified. After adjustment for possible confounders, the multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for overall mortality among participants with lowered vision, minimal VI, and moderate to severe VI were 1.21 (1.13–1.29), 1.26 (1.15–1.37), and 1.54 (1.40–1.68), respectively, compared with those with normal vision. The corresponding HRs (95% CIs) for injury-related mortality were 1.12 (0.96–1.32), 0.98 (0.76–1.26), and 1.36 (1.04–1.79), respectively, and the corresponding HRs (95% CIs) for cardiovascular mortality were 1.32 (1.12–1.57), 1.43 (1.15–1.77), and 2.41 (1.94–2.99). Conclusion  In this large cohort of young and middle-aged individuals, VI was associated with increased risk of mortality especially due to cardiovascular disease.

Abstract 17216: Upright T Wave in Lead AVR and Risk of Mortality: A Systematic Review and Meta-Analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
laith A derbas ◽  
Raed Qarajeh ◽  
Anas Noman ◽  
Mohammed Al Amoodi ◽  
Ala Mohsen ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Risk Scores ◽  
Risk Of Death ◽  
T Wave ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Lead Avr

Background: Multiple observational studies have shown that positive T wave in lead AVR (PTAVR) on 12-lead electrocardiogram is associated with an increased risk of adverse outcomes including death. We sought to review the literature and conduct a meta-analysis to estimate the risk of mortality in patients with PTAVR. Methods: We searched multiple databases to investigate the association between PTAVR and risk of death. Studies that reported adjusted odds ratio (OR) or hazards ratio (HR) of the association between PTAVR and risk of death (all cause or cardiovascular mortality) were included. We used inverse variance approach to pool adjusted OR /HR and it’s 95 % confidence interval using a random effects model meta-analysis. Results: Out of 140 relevant studies, 17 studies were eligible. Twelve studies reported all-cause mortality and enrolled 4,122 patients, 1976 (47.9%) were males. PTAVR was associated with a significant increase in all-cause mortality, with a pooled adjusted OR 2.44, 95% CI [1.76-3.39], heterogeneity I 2 = 86%. Five studies reported cardiovascular mortality and enrolled 31,713 patients, 27,628 (87.1%) were males. PTAVR was associated with a significant increase in cardiovascular mortality, with a pooled adjusted OR 2.34, 95% CI [1.82-3.0], heterogeneity I 2 = 68%. Conclusion: Our findings suggest that PTAVR is significantly associated with a higher risk of death from any cause as well cardiovascular mortality. Lead AVR, an often neglected lead, should be carefully interpreted as it may provide important prognostic information. Further studies are warranted to examined the prognostic value of PTAVR in risk stratification when added to existing cardiovascular risk scores.

Sign in / Sign up

Export Citation Format

Share Document