Mortality Risk
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Serkan Asil ◽  
Ender Murat ◽  
Hatice Taşkan ◽  
Veysel Özgür Barış ◽  
Suat Görmel ◽  

Introduction: The most important way to reduce CVD-related mortality is to apply appropriate treatment according to the risk status of the patients. For this purpose, the SCORE risk model is used in Europe. In addition to these risk models, some anthropometric measurements are known to be associated with CVD risk and risk factors. Objectives: This study aimed to investigate the association of these anthropometric measurements, especially neck circumference (NC), with the SCORE risk chart. Methods: This was planned as a cross-sectional study. The study population were classified according to their SCORE risk values. The relationship of NC and other anthropometric measurements with the total cardiovascular risk indicated by the SCORE risk was investigated. Results: A total of 232 patients were included in the study. The patients participating in the study were analysed in four groups according to the SCORE ten-year total cardiovascular mortality risk. As a result, the NC was statistically significantly lower among the SCORE low and moderate risk group than all other SCORE risk groups (low-high and very high 36(3)–38(4) (IQR) p: 0.026, 36(3)–39(4) (IQR) p < 0.001, 36(3)–40(4) (IQR) p < 0.001), (moderate-high and very high 38(4) vs. 39(4) (IQR) p: 0.02, 38(4) vs. 40(4) (IQR) p < 0.001, 39(4) vs. 40(4) (IQR) p > 0.05). NC was found to have the strongest correlation with SCORE than the other anthropometric measurements. Conclusions: Neck circumference correlates strongly with the SCORE risk model which shows the ten-year cardiovascular mortality risk and can be used in clinical practice to predict CVD risk.

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3596
Lorenz Borsche ◽  
Bernd Glauner ◽  
Julian von Mendel

Background: Much research shows that blood calcidiol (25(OH)D3) levels correlate strongly with SARS-CoV-2 infection severity. There is open discussion regarding whether low D3 is caused by the infection or if deficiency negatively affects immune defense. The aim of this study was to collect further evidence on this topic. Methods: Systematic literature search was performed to identify retrospective cohort as well as clinical studies on COVID-19 mortality rates versus D3 blood levels. Mortality rates from clinical studies were corrected for age, sex, and diabetes. Data were analyzed using correlation and linear regression. Results: One population study and seven clinical studies were identified, which reported D3 blood levels preinfection or on the day of hospital admission. The two independent datasets showed a negative Pearson correlation of D3 levels and mortality risk (r(17) = −0.4154, p = 0.0770/r(13) = −0.4886, p = 0.0646). For the combined data, median (IQR) D3 levels were 23.2 ng/mL (17.4–26.8), and a significant Pearson correlation was observed (r(32) = −0.3989, p = 0.0194). Regression suggested a theoretical point of zero mortality at approximately 50 ng/mL D3. Conclusions: The datasets provide strong evidence that low D3 is a predictor rather than just a side effect of the infection. Despite ongoing vaccinations, we recommend raising serum 25(OH)D levels to above 50 ng/mL to prevent or mitigate new outbreaks due to escape mutations or decreasing antibody activity.

2021 ◽  
pp. 000276422110509
David B. Feldman

Objective: The present study asks the question: What variables accounted for people’s tendencies to take steps to prepare for COVID-19 during the earliest stage of the pandemic? Data collection took place from March 6 to 11, 2020. In particular, the study examines variables that have been shown to predict health behavior in previous research outside the context of the present pandemic, including hope, optimism, perceived risk, fear, and mental health variables. Method: Participants (222 adults in 39 U.S. states) were recruited via Amazon Mechanical Turk. Online surveys included the Adult Hope Scale (AHS), Life Orientation Test (LOT-R), Health Anxiety Inventory (HAI), Depression, Anxiety, and Stress Scale (DASS-21), Impact of Events Scale (IES-R), and Positive and Negative Affect Schedule (PANAS). Also included were items inquiring about COVID-19 perceived mortality risk, fear/anxiety, and preparedness. Results and Conclusion: Participants were asked to imagine that COVID-19 had different hypothetical levels of mortality risk, ranging from 1 to 10 percent mortality (at the time of data collection, the WHO estimated actual mortality of the disease at approximately 3 percent). For each level, participants rated the degree to which they would be willing to take steps to prepare and protect themselves from the disease on a 7-point scale. Nearly 49 percent of participants said they would be relatively unlikely (i.e., provided a rating below the midpoint of the scale) to take steps to protect themselves if the mortality rate were at the 3 percent level. Stepwise multiple regression including the aforementioned predictors showed that three variables accounted for unique variance in participants’ levels of current preparedness: COVID-19 fear/anxiety, posttraumatic stress (as measured by the IES-R), and hope. Implications of these results are briefly discussed in the context of raising preparedness given that future public health crises are likely inevitable.

2021 ◽  
Vol 9 ◽  
Shisi Shen ◽  
Min Luo ◽  
Xuchen Meng ◽  
Ying Deng ◽  
Shuwen Cheng

Background: The adverse health effects of air pollutants are widely reported, and the elderly are susceptible to toxic environments. This study aimed to evaluate the association between use of solid fuels for cooking and mortality among the elderly.Methods: A total of 5,732 and 3,869 participants from the Chinese Longitudinal Healthy Longevity Survey were enrolled in two (2014 and 2018) and three surveys (2011, 2014, and 2018) of survey. Cooking fuel was divided into clean and solid fuel. Cox proportional hazards models were used to estimate the mortality hazard ratio (HR). Subgroup analyses were performed to assess the potential interaction effect.Results: Among the participants in the 2011–2018 survey, 53% reported using solid fuel. Such group was associated with a 9% increase in mortality risk relative to clean fuel users (HR = 1.09, 95% CI = 1.01–1.18). Among participants in the 2014–2018 survey, 339 reported a switch from solid to clean fuels and they were not at increased mortality risk relative to the 488 people that reported a stable use of clean fuels (HR = 1.14, 95% CI = 0.99–1.31) although the estimated HR was similar to the one for stable solid fuel users (HR = 1.19, 95%CI = 1.04–1.36 n = 509). Interaction and stratified analyses showed that solid fuel use had an impact on mortality in participants who were non-current smokers, had low dietary diversity scores, and were living in areas with high PM2.5 concentrations (&gt;50 μg/m3) and city population below 8 million (P for interaction &lt; 0.05). The association was robust in the three sensitivity analyses.Conclusion: The finding showed a clear association between solid fuel use and mortality among older Chinese, and an even stronger association between risk of mortality and solid fuel use among individuals exposed to high levels of PM2.5.

2021 ◽  
Vol 1 (10) ◽  
pp. e0000008
Isaac Lyatuu ◽  
Mirko S. Winkler ◽  
Georg Loss ◽  
Andrea Farnham ◽  
Dominik Dietler ◽  

We set up a mortality surveillance system around two of the largest gold mines in Tanzania between February 2019 and February 2020 to estimate the mortality impact of gold mines. Death circumstances were collected using a standardized verbal autopsy tool, and causes of death were assigned using the InSilicoVA algorithm. We compared cause-specific mortality fractions in mining communities with other subnational data as well as national estimates. Within mining communities, we estimated mortality risks of mining workers relative to other not working at mines. At the population level, mining communities had higher road-traffic injuries (RTI) (risk difference (RD): 3.1%, Confidence Interval (CI): 0.4%, 5.9%) and non-HIV infectious disease mortality (RD: 5.6%, CI: 0.8%, 10.3%), but lower burden of HIV mortality (RD: -5.9%, CI: -10.2%, -1.6%). Relative to non-miners living in the same communities, mining workers had over twice the mortality risk (relative risk (RR): 2.09, CI: 1.57, 2.79), with particularly large increases for death due to RTIs (RR: 14.26, CI: 4.95, 41.10) and other injuries (RR:10.10, CI: 3.40, 30.02). Our results shows that gold mines continue to be associated with a large mortality burden despite major efforts to ensure the safety in mining communities. Given that most of the additional mortality risk appears to be related to injuries programs targeting these specific risks seem most desirable.

2021 ◽  
Vol 8 ◽  
Jing-yan Li ◽  
Ren-qi Yao ◽  
Shuang-qing Liu ◽  
Yun-fei Zhang ◽  
Yong-ming Yao ◽  

Background: Sepsis can cause unpredictable harm, and early identification of risk for mortality may be conducive to clinical diagnosis. The present study proposes to assess the efficacy of the monocyte/high-density lipoprotein cholesterol ratio (MHR) combined with the neutrophil/lymphocyte ratio (NLR) on the day of admission in predictive efficacy in the 28-day mortality risk in critical patients with sepsis.Material and Methods: We administered observational and retrospective cohort research from a single center. The correlation of the clinical variables, together with the system severity scores of APACHE II and SOFA, are displayed by correlation analysis, and a Cox regression model could be performed to screen the independent risk factors and estimate the capacity of multiple markers in predicting 28-day mortality. The receiver operating characteristic (ROC) curve served as an applied method to output cutoff values for the diagnosis and prognostic risk, and the area under the ROC curve and net reclassification improvement index (NRI), as well as integrated discrimination improvement index (IDI) were employed to assess the feasibility of multiple parameters for predictive value in 28-day mortality of septic patients.Results: The study enrolled 274 eligible patients with sepsis. The correlation analysis indicated NLR and MHR were related to the sepsis severity. A multivariate Cox regression analysis indicated that NLR together with MHR displayed a close relation to death rate after adjusting for other potential confounders (NLR, HR = 1.404 [95% CI 1.170–1.684], P &lt; 0.001; MHR, HR = 1.217 [95% CI 1.112–1.331], P &lt; 0.001). The AUC of NLR, MHR, NLR_MHR was 0.827, 0.876, and 0.934, respectively. The addition on the biomarker NLR_MHR to the prediction model improved IDI by 18.5% and NRI by 37.8%.Conclusions: Our findings suggest that NLR and MHR trend to an elevated level in non-surviving patients with sepsis. Evaluation of NLR_MHR, an independent risk factor for increased mortality, might improve the predictive efficacy for 28-day mortality risk in septic patients.

2021 ◽  
Jarosław Królczyk ◽  
Anna Skalska ◽  
Karolina Piotrowicz ◽  
Małgorzata Mossakowska ◽  
Tomasz Grodzicki ◽  

AbstractTo assess the relationship between ankle-brachial index (ABI) and up to 10-year mortality in older individuals below and above the age of 80 years. In a multicenter survey of health status in the community dwelling subjects aged 55–59 and 65 + years in Poland, we assessed baseline medical history including risk-factors. We measured ABI, and serum creatinine, cholesterol, NT-proBNP, and interleukin-6 (IL-6) concentrations. We assessed mortality based on public registry. Between 2009 and 2019, 27.3% of 561 participants < 80 years, and 79.4% of 291 participants ≥ 80 years, died (p < 0.001); 67.8, 41.5, and 40.3% in the ABI groups < 0.9, 0.9–1.4, and > 1.4, respectively (p < 0.01). In the unadjusted Cox models, ABI was associated with mortality in the entire group, and < 80 years. In the entire group, analysis adjusted for age and sex showed mortality risk increased by 11% per year, and 50% with male sex. Mortality decreased by 37% per 1 unit ABI increase. In the group of people ≥ 80 years, only age was significantly associated with mortality (p < 0.001). In stepwise regression ABI < 0.9, male sex, active smoking, and NT-proBNP level were associated with risk of death < 80 years. In the ≥ 80 years old, mortality risk was associated with older age, and higher levels of IL-6, but not ABI. The ABI < 0.9 is associated with higher mortality in older people, but not among the oldest-old. In the oldest age group, age is the strongest predictor of death. In this age group, inflammageing is of importance.

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258706
Maxim Goncharov ◽  
Omar Asdrúbal Vilca Mejia ◽  
Camila Perez de Souza Arthur ◽  
Bianca Maria Maglia Orlandi ◽  
Alexandre Sousa ◽  

2021 ◽  
Vol 21 (1) ◽  
Tingting Shi ◽  
Ling Wang ◽  
Shuling Du ◽  
Huifeng Fan ◽  
Minghua Yu ◽  

Abstract Background Some children hospitalized for severe pertussis need intensive care; moreover, some children die because of deterioration alone or in combination with other complications. The purpose of this study was to identify the mortality risk factors among hospitalized children with severe pertussis. Methods This study evaluated the medical records of 144 hospitalized children with severe pertussis at the Guangzhou Women and Children’s Medical Centre between January 2016 and December 2019. Results The median age of patients was 2 months (IQR 1–4 months), with 90.3% of the patients aged < 6 months and 56.9% of the patients aged < 3 months. A total of 38 patients were admitted to intensive care unit (ICU), 13 patients died, and the mortality of severe pertussis was 34.2%, with patients younger than 6 weeks accounting for 76.9% of the deaths. On the multivariate analysis, the independent risk factors for death were WBC > 70.0 × 109/L (odds ratio [OR], 230.66; 95% confidence interval [CI], 5.16–10,319.09 P = 0.005) and pulmonary hypertension (PH) (OR 323.29; 95% CI 16.01–6529.42; P < 0.001). Conclusion Severe pertussis mainly occurred in children aged < 3 months. The mortality of severe pertussis was 34.2%, with patients younger than 6 weeks accounting for the majority of the deaths. We recommend the first dose of diphtheria-tetanus-pertussis (DTP) should be advanced to the age of 2 months or even 6 weeks. The presence of a WBC > 70.0 × 109/L and PH were the prognostic independent variables associated with death.

2021 ◽  
So Jeong Kim ◽  
Hye-Rin Kang ◽  
Chun Geun Lee ◽  
Seung Ho Choi ◽  
Yeon Wook Kim ◽  

Abstract Background: Surgical resection is recommended in all patients with pulmonary sclerosing pneumocytoma (PSP). However, no comparative study has demonstrated that surgical resection leads to improved outcomes. We aimed to compare all-cause mortality between patients with PSP who underwent surgery or did not and those without PSP.Methods: Participants aged ≥18 years who had pathologically diagnosed PSP between 2001 to 2018, at 3 hospitals were included. Randomly selected (up to 1:5) age-, sex-, and smoking status-matched controls were included. Mortality was compared using Kaplan–Meier estimates and Cox proportional hazards regression models. Literature review of studies reporting PSP was also conducted.Results: This study included 107 patients with PSP (surgery:non-surgery, 80:27) and 520 matched controls. There were no cases of lymph node or distant metastasis, recurrence, or mortality from PSP. No significant difference in all-cause mortality risk was observed between the PSP surgery, PSP non-surgery, and non-PSP groups (log rank test P=0.78) (PSP surgery vs. non-PSP: adjusted hazards ratio [aHR], 1.80; 95% confidence interval [CI], 0.22-14.6; PSP non-surgery vs. non-PSP: aHR, 0.77; 95% CI, 0.15-3.86; PSP surgery vs. PSP non-surgery: aHR, 2.35; 95% CI, 0.20-28.2). In the literature review, we identified 3,469 patients with PSP from 355 studies. Only 1.33% of these patients reported metastasis, recurrence, or death.Conclusion: All-cause mortality did not differ between patients with PSP and those without, irrespective of undergoing surgery. Our study and the literature review suggest that PSP has less impact on increased mortality risk.

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