scholarly journals CHRONIC NEUROLOGICAL DISEASE AS AN INDEPENDENT RISK FACTOR FOR DEATH IN SEVERE COVID-19 CASES

2021 ◽  
Vol 20 (2) ◽  
pp. 224-227
Author(s):  
Elena Caires Silveira ◽  

COVID-19 is a multisystemic disease with a wild severity range, being some chronic diseases risk factors for unfavorable evolution. It has been suggested are chronic neurological diseases are associated to higher mortality in COVID-19 patients; such association however, has not been described enough. In this context, this study seeks to evaluate whether the presence of previous chronic neurological disease is a factor associated with higher mortality in hospitalized severe cases of COVID-19. For this, the association between those variables was investigated in 87,871 patients through univariate (risk ratio and χ2 test) and multivariate (Poisson regression) analysis. It was found that the mortality rate for patients presenting chronic neurological disease was 23% higher (),this being an independent and statistically significant association (RR = 1.23, 95% CI = 1.2-1.3; p-value < 0.001). Therefore, more studies are needed to better characterize this association.

2009 ◽  
Vol 32 (3) ◽  
pp. 173-179 ◽  
Author(s):  
Dejan Petrović ◽  
Radmila Obrenović ◽  
Biljana Stojimirović

Introduction Aortic valve calcification (AVC) accelerates development of aortic valve stenosis and cardiovascular complications. Hyperphosphatemia is one of the key risk factors for aortic valve calcification. Aim The aim of this study was to evaluate the prevalence of AVC in patients on regular hemodialysis and to assess the impact of different factors on its appearance. Method: The study investigated a total of 115 patients treated in the Hemodialysis Department of the Urology and Nephrology Clinic at the Kragujevac Clinical Center in Serbia. The variables investigated were: serum albumin, C-reactive protein (CRP), homocysteine, total cholesterol, LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), triglycerides (TG), Apolipoprotein A-I (Apo A-I), Apolipoprotein B (Apo B) and lipoprotein (a), calcium, phosphate and parathormone, and calcium-phosphorus product (Ca × P). Patients were evaluated by echocardiography for AVC. Statistical analysis included univariate and multivariate logistic regression analysis. Results Univariate regression analysis showed that serum phosphate levels and Ca × P are the most important risk factors for AVC (p<0.001). Multivariate logistic regression analysis revealed that hyperphosphatemia is an independent risk factor for AVC (p<0.001). Conclusion Hyperphosphatemia is an independent risk factor for aortic valve calcification.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e15171-e15171
Author(s):  
Kiyofumi Shimoji ◽  
Takeshi Masuda ◽  
Yu Nakanishi ◽  
Kakuhiro Yamaguchi ◽  
Shinjiro Sakamoto ◽  
...  

e15171 Background: Immune check point inhibitor (ICI) induced interstitial lung disease (ICI-ILD) is a clinically serious and life-threatening toxicity. Pre-existing ILD has been reported to be a risk factor for ICI-ILD in patients with non-small cell lung cancer (NSCLC). In addition, we have previously reported that interstitial lung abnormality (ILA) is also a risk factor for the ICI-ILD. Therefore, we investigated whether any patient characteristics, including ILA, were risk factors for ICI-ILD in patients with non-NSCLC cancers. Methods: Head and neck cancer, malignant melanoma, oral cavity cancer, renal cell carcinoma or gastric cancer patients who received anti PD-1 antibody (Nivolumab or Pembrolizumab) at Hiroshima University Hospital from December 2015 to May 2019 were enrolled. Information on patient characteristics before anti-PD-1 antibody administration, including chest CT findings and laboratory data, were obtained. Results: Two hundred patients were enrolled, and 20 (10%) developed ICI-ILD. Grade1 was observed in 15 patients, grade2 in 3, and grade3 and 5 in 1. There was no significant difference in the background factors between patients with and without ICI-ILD. On the other hand, the proportion of patients with ILA was significantly higher in the patients with ICI-ILD than those without (P < 0.01). Furthermore, univariate logistic regression analysis revealed ILA was the risk factor for ICI-ILD (p < 0.01), and multivariate logistic regression analysis showed that GGA or reticulation in ILA was an independent risk factor for ICI-ILD (p = 0.016, 0.011). Conclusions: Pre-existing ILA is a risk factor for ICI-ILD, and GGA or reticulation in ILA is an independent risk factor for ICI-ILD in patients with non-NSCLC cancers. Therefore, we should pay more attention to the development of ICI-ILD in patients with ILA, especially GGA or reticulation.


2021 ◽  
Vol 12 ◽  
Author(s):  
Luca Katzenmajer-Pump ◽  
Bernadett Frida Farkas ◽  
Balázs András Varga ◽  
Johan M. Jansma ◽  
Judit Balázs

Introduction: Suicide is one of the leading causes of death among adolescents. Although it is known that both perfectionism and attention-deficit/hyperactivity disorder (‘ADHD’) are important risk factors for suicide, there are no studies that have investigated the relationship between suicidal behavior and perfectionism among people with ADHD.Aim: The current study investigates the association between perfectionism and suicide in adolescents with ADHD.Method: Subjects included 88 adolescents with ADHD and 96 non-clinical control adolescents. We used the Multidimensional Perfectionism Scale to evaluate perfectionism as well as its separate traits, and the Mini International Neuropsychologic Interview Kid to evaluate psychiatric disorders and suicidal behavior. Differences between the groups were statistically evaluated using t-tests, a Poisson regression analysis with suicide as a discrete variable, and a logistic regression analysis with suicide as a binary variable.Results: Compared to the control group, the ADHD group showed a significantly lower level on the adaptive ‘Organization’ trait of perfectionism, but not on any other trait, and a significantly higher level of suicidal behavior.Logistic regression results indicated a significant association for perfectionism in general (OR = 0.93, p = 0.003), and for the ‘Personal Standards’ trait (OR: 0.82, p = 0.039).Poisson regression analysis also showed a significant association with perfectionism in general (IRR = 0.90; p &lt; 0.001) and with the ‘Personal standards’ trait model (IRR = 0.81, p = 0.019).Discussion: Our results indicate that a low level of perfectionism, in particular ‘Personal standards’, may be a risk factor for suicidal behavior in adolescents with ADHD. We recommend that psychoeducation and therapy of adolescents with ADHD should consider focusing on adaptive perfection as a possible risk factor for suicide as well.


2021 ◽  
Author(s):  
Yu Zhang ◽  
Huawu Yang ◽  
Dafang Zhan ◽  
Xiaoxiao Liu ◽  
Chenxin Xu ◽  
...  

Abstract The reasons for the influence of bariatric surgery (BS) on the early abnormal increase of liver enzymes and liver injury remain unclear. We found abnormal elevation of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in liver chemistry early after BS. To investigate the risk factors for early elevation of ALT and AST after BS, we performed a regression analysis of 177 patients who underwent BS at our center. Follow-up data before and after BS were collected and divided into two groups according to whether ALT and/or AST increased and exceeded the clinical threshold one month after BS. Logistic regression analysis was used, and independent risk factors were screened. Waist circumference (WC) before BS was an independent risk factor (P < 0.05) for increased ALT and AST after BS, but other factors (P > 0.05), such as sex, type of BS, or body mass index (BMI), were not. The cutoff of WC to predict abnormal elevation of ALT and AST after BS was 117.35 cm (sensitivity, 0.75; specificity, 0.62) and 113.65 cm (sensitivity, 0.88; specificity, 0.48), respectively. WC is an independent risk factor for early liver injury after BS. Long-term liver-related follow-up is necessary.


2021 ◽  
Vol 12 ◽  
pp. 232
Author(s):  
Masaru Honda ◽  
Hajime Maeda

Background: We routinely measured the exact chronic subdural hematoma (CSDH) volume during single burr hole surgery. To date, several risk factors have been reported for CSDH recurrence, including sex, hematoma volume and degree of midline shift calculated from computed tomography, use of anticoagulants or antiplatelet medications, and alcohol consumption habits. The aim of this study was to clarify whether hematoma volume, in conjunction with other factors, can predict recurrence. Methods: We retrospectively reviewed the clinical data of 194 consecutive patients with CSDH who underwent single burr hole surgery. The risk factors for recurrence were analyzed based on patients’ sex, age, bilaterality, existence of apparent trauma history, exact intraoperative hematoma volume, and various clinical factors, including preoperative anticoagulant/antiplatelet intake. Results: Recurrence occurred in 22 patients (11.3%). Multivariate logistic regression analysis revealed that intraoperative hematoma volume was an independent risk factor for CSDH recurrence (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.01–1.02, P < 0.001), in addition to sex (male) (OR 9.25; 95% CI, 1.00–84.8; P = 0.049) and diabetes mellitus (DM) (OR: 3.97, 95% CI, 1.34–11.7, P = 0.013). Based on receiver operating characteristics analysis, the cutoff value of the hematoma volume predicting CSDH recurrence was 150 ml (sensitivity and specificity of 72.7% and 72.1%, respectively; area under the curve: 0.7664, 95% CI: 0.654–0.879, P < 0.001). Of these, a hematoma volume ≥150 mL was the strongest independent risk factor for recurrence according to multiple regression (OR: 8.98, 95% CI: 2.73–29.6, P < 0.001) and Cox regression analysis (hazard ratio: 3.05, 95% CI: 1.18–7.87, log-rank P = 0.0046, P = 0.021). Follow-up periods after surgery were significantly longer for cases with recurrence than for non-recurrence cases (24.8 ± 11.5 vs. 15.9 ± 9.7 days), and the recurrence prediction cutoff value was 17 days, with a sensitivity and specificity of 83.1% and 68.2%, respectively (AUC: 0.7707, 95% CI: 0.6695–0.8720, P < 0.001). Conclusion: Intraoperative hematoma volume could be a predictive value for CSDH recurrence.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Onuki ◽  
M Shoji ◽  
M Kikuchi ◽  
T Asano ◽  
H Suzuki ◽  
...  

Abstract Background Insertable cardiac monitors (ICMs) allow for lengthy monitoring of cardiac rhythm and improve diagnostic yield in patients with unexplained syncope. In most cardiac syncope cases, sick sinus syndrome, atrioventricular block, and paroxysmal supraventricular tachycardia (SVT) are detected using ICMs. On the other hand, epileptic seizures are sometimes diagnosed as unexplained syncope because in these situations, the loss of consciousness is a similar manifestation. Thus, the population of patients with unexplained syncope monitored by ICMs includes epileptic patients. Clinical risk factors for bradycardia, SVT and epilepsy that necessitate therapy in patients with unexplained syncope are not well known. If these risks can be clarified, clinicians could provide more specific targeted monitoring. Purpose We aimed to identify these predictors. Methods We retrospectively reviewed medical records of consecutive patients who received ICMs to monitor unexplained syncope in three medical facilities. We performed Cox's stepwise logistic regression analysis to identify significant independent risk factors for bradycardia, SVT, and epilepsy. Results One hundred thirty-two patients received ICMs to monitor unexplained syncope. During the 17-month follow-up period, 19 patients (10 patients had sick sinus syndrome and 9 had atrioventricular block) needed pacemaker for bradycardia; 8 patients (3 had atrial flutter, 4 had atrial tachycardia, and 1 had paroxysmal atrial fibrillation) needed catheter ablation for SVT; and 9 patients needed antiepileptic agents from the neurologist.Stepwise logistic regression analysis indicated that syncope during effort (odds ratio [OR] = 3.41; 95% confidence interval [CI], 1.21 to 9.6; p=0.02) was an independent risk factor for bradycardia. Palpitation before syncope (OR = 9.46; 95% CI, 1.78 to 50.10; p=0.008) and history of atrial fibrillation (OR = 10.1; 95% CI, 1.96 to 52.45; p=0.006) were identified as significant independent prognostic factors for SVT. Syncope while supine (OR = 11.7; 95% CI, 1.72 to 79.7; p=0.01) or driving (OR = 15.6; 95% CI, 2.10 to 115.3; p=0.007) was an independent factor for epileptic seizure. Conclusions ICMs are useful devices for diagnosing unexplained syncope. Palpitation, atrial fibrillation and syncope during effort were independent risk factors for bradycardia and for SVT. Syncope while supine or driving was an independent risk factor for epilepsy. We should carefully follow up of patients with these risk factors. Funding Acknowledgement Type of funding source: None


2018 ◽  
Vol 5 ◽  
pp. 2333794X1775400 ◽  
Author(s):  
Fahmida Chowdhury ◽  
Probir Kumar Ghosh ◽  
K. M. Shahunja ◽  
Abu S. M. S. B. Shahid ◽  
Lubaba Shahrin ◽  
...  

Objectives. We sought to evaluate the admission and hospital risk factors for death in children with diarrhea requiring mechanical ventilation (MV). Methods. This was a retrospective study. We enrolled children aged 0 to 59 months admitted with diarrhea to the intensive care unit of the Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) between August 2009 and July 2013 and required MV. To evaluate the risk factors for death in MV, we compared the clinical and laboratory characteristics of the children requiring MV. We matched up to the clinical characteristics presented on admission and subsequently developed before MV during hospital stay with the survivors and deaths of children having MV. Results. Among 73 enrolled children, 58 (80%) died. Incidence of death in MV was higher among children having hyperkalemia ( P ≤ .001), hypoglycemia ( P ≤ .001), and metabolic acidosis ( P = .06) on admission and lower in children having tracheal isolates ( P ≤ .001) during hospitalization. After adjusting for covariates by using multivariate robust Poisson regression, children with hyperkalemia (incidence ratio = 1.34; P = .03; confidence interval = 1.02-1.76) on admission was the only independent risk factor for death of children with MV. Conclusion. Children with hyperkalemia on admission and subsequently requiring MV were more likely to die compared with those without hyperkalemia.


2020 ◽  
Author(s):  
Qiuxia Xie ◽  
Haoling Qin ◽  
Ling Lin ◽  
Jian Guan ◽  
Xuhui Zhou

Abstract Background: AAD refers to the blood flow into the middle membrane through the intimal rupture of the aorta. Hemorrhagic pulmonary sheath (HPS) is a common complication of Stanford-A AAD. The risk factors of HPS are remaining unclear Methods: In this study, we have probed the potential risk factors of HPS patients with acute Stanford A aortic dissection. 18 HPS patients with acute Stanford A aortic dissection were selected as the case group. The age difference ± 5 years and the same sex are set as the matching principles. 36 patients with acute Stanford-A type AD who did not detect HPS in the same period were matched according to the ratio of 1:2. Demographic data, treatment methods, AD-related disease history, clinical symptoms and Charlson comorbidity index (CCI) values of each patient were collected. Meanwhile, the values of the maximum diameter of ascending aorta (mm), aortic dissection range, and the main branch of the aorta, pleural effusion/blood, and pericardial effusion/blood were measured by two experienced cardiovascular radiological physicians. Univariate and multivariate conditional logistic regression analysis was used in this study. Results: CCI value and the branches of the brachiocephalic in the case group were significantly higher than those in the control group (p<0.05). Univariate conditional logistic regression analysis showed CCI and branches of the brachiocephalic were associated with HPS. Multivariate conditional logistic regression analysis suggested that branches of the brachiocephalic were an independent risk factor for HPS (OR=7.02, 95%CI=1.28-38.62, p=0.025). Conclusions: Branches of the brachiocephalic were an independent risk factor for HPS.


2020 ◽  
Author(s):  
Qiuxia Xie ◽  
Haoling Qin ◽  
Ling Lin ◽  
Jian Guan ◽  
Xuhui Zhou

Abstract Background: AAD refers to the blood flow into the middle membrane through the intimal rupture of the aorta. Hemorrhagic pulmonary sheath (HPS) is a common complication of Stanford-A AAD. The risk factors of HPS are remaining unclear Methods: In this study, we have probed the potential risk factors of HPS patients with acute Stanford A aortic dissection. 18 HPS patients with acute Stanford A aortic dissection were selected as the case group. The age difference ± 5 years and the same sex are set as the matching principles. 36 patients with acute Stanford-A type AD who did not detect HPS in the same period were matched according to the ratio of 1:2. Demographic data, treatment methods, AD-related disease history, clinical symptoms and Charlson comorbidity index (CCI) values of each patient were collected. Meanwhile, the values of the maximum diameter of ascending aorta (mm), aortic dissection range, and the main branch of the aorta, pleural effusion/blood, and pericardial effusion/blood were measured by two experienced cardiovascular radiological physicians. Univariate and multivariate conditional logistic regression analysis was used in this study. Results: CCI value and the branches of the brachiocephalic in the case group were significantly higher than those in the control group (p<0.05). Univariate conditional logistic regression analysis showed CCI and branches of the brachiocephalic were associated with HPS. Multivariate conditional logistic regression analysis suggested that branches of the brachiocephalic were an independent risk factor for HPS (OR=7.02, 95%CI=1.28-38.62, p=0.025). Conclusions: Branches of the brachiocephalic were an independent risk factor for HPS.


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