The early mortality rate of people infected with coronavirus (COVID-2019) in Wuhan, China: Review of three retrospective studies

Abstract. Background: Multilevel peripheral arterial disease is frequently observed in patients with intermittent claudication or critical limb ischemia. This report evaluates the efficacy of one-stage hybrid revascularization in patients with multilevel arterial peripheral disease. Patients and methods: A retrospective analysis of a prospective database included all consecutive patients treated by a hybrid approach for a multilevel arterial peripheral disease. The primary outcome was the patency rate at 6 months and 1 year. Secondary outcomes were early and midterm complication rate, limb salvage and mortality rate. Statistical analysis, including a Kaplan-Meier estimate and univariate and multivariate Cox regression analyses were carried out with the primary, primary assisted and secondary patency, comparing the impact of various risk factors in pre- and post-operative treatments. Results: 64 patients were included in the study, with a mean follow-up time of 428 days (range: 4 − 1140). The technical success rate was 100 %. The primary, primary assisted and secondary patency rates at 1 year were 39 %, 66 % and 81 %, respectively. The limb-salvage rate was 94 %. The early mortality rate was 3.1 %. Early and midterm complication rates were 15.4 % and 6.4 %, respectively. The early mortality rate was 3.1 %. Conclusions: The hybrid approach is a major alternative in the treatment of peripheral arterial disease in multilevel disease and comorbid patients, with low complication and mortality rates and a high limb-salvage rate.

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Clinical Outcomes of Incidental Venous Thromboembolism in Cancer and Noncancer Patients: The SWIss Venous ThromboEmbolism Registry (SWIVTER)

Thrombosis and Haemostasis ◽

10.1055/s-0040-1720977 ◽

2020 ◽

Author(s):

David Spirk ◽

Tim Sebastian ◽

Stefano Barco ◽

Martin Banyai ◽

Jürg H. Beer ◽

...

Keyword(s):

Venous Thromboembolism ◽

Mortality Rate ◽

Recurrence Rate ◽

Anticoagulation Therapy ◽

Early Mortality ◽

Recurrence Rates ◽

Patients With Cancer ◽

Risk Of Death ◽

All Cause Mortality ◽

Baseline Characteristics

Abstract Objective In patients with cancer-associated venous thromboembolism (VTE), the risk of recurrence is similar after incidental and symptomatic events. It is unknown whether the same applies to incidental VTE not associated with cancer. Methods and Results We compared baseline characteristics, anticoagulation therapy, all-cause mortality, and VTE recurrence rates at 90 days between patients with incidental (n = 131; 52% without cancer) and symptomatic (n = 1,931) VTE included in the SWIss Venous ThromboEmbolism Registry (SWIVTER). After incidental VTE, 114 (87%) patients received anticoagulation therapy for at least 3 months. The mortality rate was 9.2% after incidental and 8.4% after symptomatic VTE for hazard ratio (HR) 1.10 (95% confidence interval [CI] 0.49–2.50). After adjustment for competing risk of death, recurrence rate was 3.1 versus 2.8%, respectively, for sub-HR 1.07 (95% CI 0.39–2.93). These results were consistent among cancer (mortality: 15.9% vs. 12.6%; HR 1.32, 95% CI 0.67–2.59; recurrence: 4.8% vs. 4.7%; HR 1.02, 95% CI 0.30–3.42) and noncancer patients (mortality: 2.9% vs. 2.1%; HR 1.37, 95% CI 0.33–5.73; recurrence: 1.5% vs. 2.3%; HR 0.63, 95% CI 0.09–4.58). Patients with incidental VTE who received anticoagulation therapy for at least 3 months had lower mortality (4% vs. 41%) and recurrence rate (1% vs. 18%) compared with those who did not. Conclusion In SWIVTER, more than half of incidental VTE events occurred in noncancer patients who often received anticoagulation therapy. Among noncancer patients, early mortality and recurrence rates were similar after incidental versus symptomatic VTE. Our findings suggest that anticoagulation therapy for incidental VTE may be beneficial regardless of the presence of cancer.

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Pneumomediastinum in COVID-19 disease: Outcomes and relation to the Macklin effect

Asian Cardiovascular and Thoracic Annals ◽

10.1177/02184923211010089 ◽

2021 ◽

pp. 021849232110100

Author(s):

João Brito ◽

Paulo Gregório ◽

Alessandro Mariani ◽

Paula D’ambrosio ◽

Mauro Filho ◽

...

Keyword(s):

Mortality Rate ◽

Retrospective Studies ◽

Underlying Mechanism ◽

Hemodynamic Instability ◽

Disease Course ◽

Lung Involvement ◽

Radiological Findings ◽

Disease Outcomes ◽

Macklin Effect ◽

Benign Course

Aim Pneumomediastinum (PM) is associated with several etiologies and mechanisms. Although it has been described more than 100 years ago, the literature is limited to small retrospective studies. This study aimed to follow patients with coronavirus disease (COVID-19) that developed PM during hospitalization and describe their clinical and radiological evolution. Methods A prospective cohort was developed with patients with PM, excluding those with aerodigestive trauma, inside a hospital COVID-19 dedicated hospital. Clinical variables including onset of symptoms, hemodynamic instability, associated complications, the need of interventions, and disease course were all recorded. Also, radiological findings such as the presence of the Macklin effect, extension of lung involvement by COVID-19, and characteristics of the PM were analyzed. Results Twenty-one patients with non-traumatic PM were followed, resulting in an overall incidence of 0.5% during the study period. Seven (33%) patients had associated pneumothorax and malignant/tension PM was observed in three (14%) cases. The Macklin effect could be found in 11 patients (52%) and the majority of them had more than 50% of lung involvement due to COVID-19. The mortality rate was 49%; however, no deaths were directly related to the PM. Conclusions PM incidence is probably increased in the severe acute respiratory syndrome caused by COVID-19, especially in those with greater involvement of the lungs, and the Macklin effect may be an important underlying mechanism of this complication. Usually, PM has a benign course, but complications like tension/malignant PM may occur requiring prompt detection and intervention.

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Early Mortality Rate of Atomic Bomb Survivors Based on House Reconstruction Survey

International Journal of Radiation Biology ◽

10.1080/09553009414550301 ◽

1994 ◽

Vol 65 (2) ◽

pp. 267-275

Author(s):

H. Mori ◽

T. Nakamura ◽

M. Mine ◽

H. Kondo ◽

Y. Okumura ◽

...

Keyword(s):

Mortality Rate ◽

Atomic Bomb ◽

Early Mortality ◽

Atomic Bomb Survivors

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Tetralogy of Fallot and abnormal coronary artery: use of a prosthetic conduit is outdated

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezz030 ◽

2019 ◽

Vol 56 (1) ◽

pp. 94-100 ◽

Cited By ~ 2

Author(s):

Margaux Pontailler ◽

Chloé Bernard ◽

Régis Gaudin ◽

Anne Moreau de Bellaing ◽

Mansour Mostefa Kara ◽

...

Keyword(s):

Coronary Artery ◽

Mortality Rate ◽

Tetralogy Of Fallot ◽

Pressure Ratio ◽

Pulmonary Stenosis ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Pulmonary Valve Replacement ◽

Early Mortality ◽

Abnormal Coronary Artery

AbstractOBJECTIVESRepair of tetralogy of Fallot (ToF) can be challenging in the presence of an abnormal coronary artery (CA) in 5–12% of cases. The aim of this study was to report our experience with ToF repair without the systematic use of a right ventricle-to-pulmonary artery (RV-PA) conduit.METHODSWe conducted a monocentric retrospective study from 2000 to 2016, including 943 patients with ToF who underwent biventricular repair, of whom 8% (n = 76) presented with an abnormal CA. Mean follow-up time was 50 months (1 month–18 years).RESULTSThe most frequent CA anomaly was the left descending artery arising from the right CA (n = 47, 61.8%). The median age at repair was 7.7 months (1.8 months–16 years). Thirteen patients (17%) required prior palliation, mostly systemic pulmonary shunts for anoxic spells in the neonatal period. Surgical repair allowed us to preserve the annulus in 40 patients (53%) by combining PA trunk plasty, commissurotomy and infundibulotomy under the abnormal CA. If the annulus had to be opened (n = 35, 46%), a transannular patch was inserted after a vertical incision of the PA trunk and extended obliquely on the RV over the anomalous crossing CA (with an infundibulotomy under the abnormal CA). Three patients (4%) required the insertion of an RV-PA conduit (1 valved tube and 2 RV-PA GORE-TEX tubes with annulus conservation). The early mortality rate was 4% (n = 3); none of the deaths was coronary related. Four patients (5%) required reoperation (2 early and 2 late reoperations) for residual pulmonary stenosis, 3 of whom had annulus preservation during the initial repair. The mean RV/left ventricle (LV) pressure ratio and an RV/LV pressure ratio >2/3 were identified as risk factors for right ventricular outflow tract (RVOT) reinterventions (P = 0.0026, P = 0.0085, respectively), RVOT reoperations (P = 0.0002 for both) and reoperation for RVOT residual stenosis (P = 0.0002, P = 0.0014, respectively). Two patients underwent pulmonary valve replacement. Freedom from late reoperation was 100% at 1 year, 97% at 5 years and 84% at 10 and 15 years.CONCLUSIONSRepair of ToF and abnormal CA can be performed without an RV-PA conduit, with an acceptable low reintervention rate. The high early mortality rate in this series remains a concern. If any doubt remains about the surgical relief of the RVOT obstruction, the RV/LV pressure ratio should always be measured in the operating room.

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Toxic Shock Syndrome Toxin 1-Producing Methicillin-Resistant Staphylococcus aureus of Clonal Complex 5, the New York/Japan Epidemic Clone, Causing a High Early-Mortality Rate in Patients with Bloodstream Infections

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01362-19 ◽

2019 ◽

Vol 63 (11) ◽

Cited By ~ 1

Author(s):

Dokyun Kim ◽

Jun Sung Hong ◽

Eun-Jeong Yoon ◽

Hyukmin Lee ◽

Young Ah Kim ◽

...

Keyword(s):

Risk Factors ◽

New York ◽

Staphylococcus Aureus ◽

Mortality Rate ◽

Clonal Complex ◽

Bloodstream Infections ◽

Early Mortality ◽

Epidemic Clone ◽

Methicillin Resistant ◽

Content Type

ABSTRACT This study was performed to evaluate the clinical impacts of putative risk factors in patients with Staphylococcus aureus bloodstream infections (BSIs) through a prospective, multicenter, observational study. All 567 patients with S. aureus BSIs that occurred during a 1-year period in six general hospitals were included in this study. Host- and pathogen-related variables were investigated to determine risk factors for the early mortality of patients with S. aureus BSIs. The all-cause mortality rate was 15.0% (85/567) during the 4-week follow-up period from the initial blood culture, and 76.5% (65/85) of the mortality cases occurred within the first 2 weeks. One-quarter (26.8%, 152/567) of the S. aureus blood isolates carried the tst-1 gene, and most (86.2%, 131/152) of them were identified to be clonal complex 5 agr type 2 methicillin-resistant S. aureus (MRSA) strains harboring staphylococcal cassette chromosome mec type II, belonging to the New York/Japan epidemic clone. A multivariable logistic regression showed that the tst-1 positivity of the causative S. aureus isolates was associated with an increased 2-week mortality rate both in patients with S. aureus BSIs (adjusted odds ratio [aOR], 1.62; 95% confidence interval [CI], 0.90 to 2.88) and in patients with MRSA BSIs (aOR, 2.61; 95% CI, 1.19 to 6.03). Two host-related factors, an increased Pitt bacteremia score and advanced age, as well as a pathogen-related factor, carriage of tst-1 by causative MRSA isolates, were risk factors for 2-week mortality in patients with BSIs. Careful management of patients with BSIs caused by the New York/Japan epidemic clone is needed to improve clinical outcomes.

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Results of a Multicenter Phase II Trial for Older Patients with c-Kit Positive Acute Myeloid Leukemia (AML) and High-Risk Myelodysplastic Syndrome (HR-MDS) Using Low-Dose Ara-C (LDAC) and Imatinib.

Blood ◽

10.1182/blood.v106.11.1853.1853 ◽

2005 ◽

Vol 106 (11) ◽

pp. 1853-1853

Author(s):

F. Heidel ◽

J. Cortes ◽

F. Ruecker ◽

M. Kaufmann ◽

W. Aulitzky ◽

...

Keyword(s):

Biological Activity ◽

Mortality Rate ◽

Supportive Care ◽

Phase Ii ◽

Older Patients ◽

Single Agent ◽

Early Mortality ◽

Hematologic Toxicity ◽

Myelosuppressive Chemotherapy

Abstract In international multicenter trials, the 5-year overall survival (OS) rate of AML patients older than age 55 ranges from 5–16%. A similar outcome is seen for relapsed/refractory AML patients. As only a minority of these patients appear to benefit from myelosuppressive chemotherapy, new approaches are clearly warranted. Over 70% of AML-patients show expression of the tyrosine kinase (TK) c-Kit on myeloid blasts. c-Kit is involved in activation of proliferation pathways and plays an anti-apoptotic role in normal and malignant hematopoiesis. Imatinib mesylate (IM) inhibits protein TKs including c-Kit, PDGFRs and Abl. Two former studies have investigated IM as a single agent in patients with c-Kit positive AML and HR-MDS suggesting biological activity of IM in a subset of AML patients (Cortes, Cancer 2003; Kindler, Blood 2002). LDAC has been used for MDS and AML to induce differentiation in AML blasts with partial response rates of approximately 30% but without improvement in OS. As synergy between IM and Ara-C has been reported in vitro we conducted a phase II study applying a combination of these two agents. 40 patients at 4 centers with a median age of 72 years (range: 42–82 years with 95% of patients >60 y) were enrolled into this study. They either were not eligible for myelosuppressive therapy or had relapsed/refractory disease. Previous therapy included supportive care only, biological agents or < 3 cycles chemotherapy. In median, c-kit positivity of AML blasts from patients included was 67%. 34 patients (85%) were included with AML and 6 patients (15%) with HR-MDS (including CMML). 38 patients were evaluable for this analysis. The overall rate of biological activity was 45% (17 of 38 patients): In 6/38 (16%) patients, a blast response (reduction >50% in PB) was observed while 8/38 patients showed stable disease over a minimum period of 2 months. The objective response rate was low with each 1 patient (3%) showing hematologic improvement, PR and CR, respectively. While more than one third of patients included had a short term course of LDAC/IM only (<4 weeks) due to disease associated morbidity or patient’s wish, 3 patients experienced long term progression-free survival of more than 250 days (up to 450 days). Analysis of non-hematologic toxicity revealed 2 patients with a grade III skin rash. Grade I-II toxicity, mainly nausea and loss of appetite occurred in one third of treated individuals. Patients over age 60 show a historical survival benefit of 2.5 months using myelosuppressive chemotherapy versus best supportive care and an early mortality rate of 25% within 6 weeks. Moreover, it has been pointed out that most of the ’benefit-time’ (>80%) is spent in hospital. Study medication offered in this trial was applied in an ambulatory setting with minimal hospitalization, an early mortality rate of 21% and a low toxicity rate. In conclusion, combination therapy of LDAC/IM does not appear to be inferior in comparison to myelosuppressive therapy in older AML patients. However, this trial shows that LDAC/IM does not improve substantially the clinical outcome of older patients with AML. Identification of molecular mechanisms for good and long-term responders will be part of further laboratory investigations.

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Early mortality rate (EMR) and complications in adults with acute myeloid leukemia (AML) in California.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.15_suppl.e13091 ◽

2016 ◽

Vol 34 (15_suppl) ◽

pp. e13091-e13091

Author(s):

Gwendolyn Ho ◽

Brian Andrew Jonas ◽

Qian Li ◽

Ann Brunson ◽

Theodore Wun ◽

...

Keyword(s):

Acute Myeloid Leukemia ◽

Mortality Rate ◽

Myeloid Leukemia ◽

Early Mortality ◽

Acute Myeloid

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Therapeutic leukapheresis in hyperleucocytic leukaemias: lack of correlation between degree of cytoreduction and early mortality rate

British Journal of Haematology ◽

10.1046/j.1365-2141.1997.1943011.x ◽

1997 ◽

Vol 98 (2) ◽

pp. 433-436 ◽

Cited By ~ 84

Author(s):

Pierluigi Porcu ◽

Constance F. Danielson ◽

Attilio Orazi ◽

Nyla A. Heerema ◽

Theodore G. Gabig ◽

...

Keyword(s):

Mortality Rate ◽

Early Mortality

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Impact of stroke unit in a public hospital on length of hospitalization and rate of early mortality of ischemic stroke patients

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20130120 ◽

2013 ◽

Vol 71 (10) ◽

pp. 774-779 ◽

Cited By ~ 7

Author(s):

Maria Sheila G. Rocha ◽

Ana Claudia F. Almeida ◽

Osorio Abath Neto ◽

Marianna P. R. Porto ◽

Sonia Maria D. Brucki

Keyword(s):

Mortality Rate ◽

Stroke Unit ◽

Public Hospital ◽

Unit Group ◽

Mortality Rates ◽

General Ward ◽

Early Mortality ◽

Stroke Patients ◽

Length Of Hospitalization ◽

Overall Mortality

We ascertained whether a public health stroke unit reduces the length of hospitalization, the rate of inpatient fatality, and the mortality rate 30 days after the stroke. Methods We compared a cohort of stroke patients managed on a general neurology/medical ward with a similar cohort of stroke patients managed in a str oke unit. The in-patient fatality rates and 30-day mortality rates were analyzed. Results 729 patients were managed in the general ward and 344 were treated at a comprehensive stroke unit. The in-patient fatality rates were 14.7% for the general ward group and 6.9% for the stroke unit group (p<0.001). The overall mortality rate 30 days after stroke was 20.9% for general ward patients and 14.2% for stroke unit patients (p=0.005). Conclusions We observed reduced in-patient fatalities and 30-day mortality rates in patients managed in the stroke unit. There was no impact on the length of hospitalization.

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