Hospital Outcomes
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2021 ◽  
Vol 11 (1) ◽  
Israel Molina ◽  
Milena Soriano Marcolino ◽  
Magda Carvalho Pires ◽  
Lucas Emanuel Ferreira Ramos ◽  
Rafael Tavares Silva ◽  

AbstractChagas disease (CD) continues to be a major public health burden in Latina America. Information on the interplay between COVID-19 and CD is lacking. Our aim was to assess clinical characteristics and in-hospital outcomes of patients with CD and COVID-19, and to compare it to non-CD patients. Consecutive patients with confirmed COVID-19 were included from March to September 2020. Genetic matching for sex, age, hypertension, diabetes mellitus and hospital was performed in a 4:1 ratio. Of the 7018 patients who had confirmed COVID-19, 31 patients with CD and 124 matched controls were included (median age 72 (64–80) years-old, 44.5% were male). At baseline, heart failure (25.8% vs. 9.7%) and atrial fibrillation (29.0% vs. 5.6%) were more frequent in CD patients than in the controls (p < 0.05). C-reactive protein levels were lower in CD patients compared with the controls (55.5 [35.7, 85.0] vs. 94.3 [50.7, 167.5] mg/dL). In-hospital management, outcomes and complications were similar between the groups. In this large Brazilian COVID-19 Registry, CD patients had a higher prevalence of atrial fibrillation and chronic heart failure compared with non-CD controls, with no differences in-hospital outcomes. The lower C-reactive protein levels in CD patients require further investigation.

Danielle D. Strah ◽  
Katie A. Kowalek ◽  
Kevin Weinberger ◽  
Jenny Mendelson ◽  
Andrew W. Hoyer ◽  

Dimitrios Zikos ◽  
Olabisi Afolayan-Oloye

Grahya Guntur ◽  
Joseph J DuBose ◽  
Tiffany K Bee ◽  
Timothy Fabian ◽  
Jonathan Morrison ◽  

Background: Endovascular repair has emerged as a viable repair option for axillosubclavian arterial injuries in select patients; however, further study of contemporary outcomes is warranted. Methods: The American Association for the Surgery of Trauma (AAST) PROspective Observational Vascular Injury Treatment (PROOVIT) registry was used to identify patients with axillo-subclavian arterial injuries from 2013 – 2019. Demographics and outcomes were compared between patients undergoing endovascular repair versus open repair. Results: 167 patients were identified, with intervention required in 107 (64.1%). Among these, 24 patients underwent open damage control surgery (primary amputation = 3, ligation = 17, temporary vascular shunt = 4). The remaining 83 patients (91.6% male; mean age 26.0 ± 16) underwent either endovascular repair (36, 43.4%) or open repair (47, 56.6%). Patients managed with definitive endovascular or open repair had similar demographics and presentation, with the only exception that endovascular repair was more commonly employed for traumatic pseudoaneurysms (p=0.004). Endovascular repair was associated with lower 24-hour transfusion requirements (p=0.012), but otherwise the two groups were similar with regards to in-hospital outcomes. Conclusion: Endovascular repair is now employed in > 40% of axillo-subclavian arterial injuries undergoing repair at initial operation and is associated with lower 24 hour transfusion requirements, but otherwise outcomes are comparable to open repair.

2021 ◽  
Vol 21 (1) ◽  
Paterne Safari Mudekereza ◽  
Gauthier Bahizire Murhula ◽  
Charles Kachungunu ◽  
Amani Mudekereza ◽  
Fabrice Cikomola ◽  

Abstract Introduction Penetrating craniocerebral injuries (PCCI) are types of open head injuries caused by sharp objects or missiles, resulting in communication between the cranial cavity and the external environment. This condition is deemed to be more prevalent in armed conflict regions where both civilians and military are frequently assaulted on the head, but paradoxically their hospital outcomes are under-reported. We aimed to identify factors associated with poor hospital outcomes of patients with PCCI. Methods This was a retrospective series of patients admitted at the Regional Hospital of Bukavu, DRC, from 2010 to 2020. We retrieved medical records of patients with PCCI operated in the surgical departments. A multivariate logistic regression model was performed to find associations between patients’ admission clinico-radiological parameters and hospital outcomes. Poor outcome was defined as a Glasgow Outcomes Score below 4. Results The prevalence of PCCI was 9.1% (91/858 cases) among admitted TBI patients. More than one-third (36.2%) of patients were admitted with GCS < 13, and 40.6% of them were unstable hemodynamic. Hemiplegia was found in 23.1% on admission. Eight patients had an intracerebral hemorrhage. Among the 69 operated patients, complications, mainly infectious, occurred in half (50.7%) of patients. Poor hospital outcomes were observed in 30.4% and associated with an admission GCS < 13, hemodynamic instability, intracerebral hemorrhage, and hemiplegia (p < 0.05). Conclusion The hospital poor outcomes are observed when patients present with hemodynamic instability, an admission GCS < 13, intracerebral hemorrhage, and hemiplegia. There is a need for optimizing the initial care of patients with PCCI in armed conflict regions.

CHEST Journal ◽  
2021 ◽  
Vol 160 (4) ◽  
pp. A1831
karthik Gangu ◽  
Esha Sharma ◽  
aniesh bobba ◽  
Tarang Patel ◽  
Zachary Holliday

Paul M. Bourdillon ◽  
Craig S. Parzynski ◽  
Karl E. Minges ◽  
Jeptha P. Curtis ◽  
Nihar R. Desai

Rikinkumar Patel ◽  
Hema Mekala ◽  
Amit Chopra

CHEST Journal ◽  
2021 ◽  
Vol 160 (4) ◽  
pp. A1909
Viviana Reyes Pinzon ◽  
Genaro Velazquez ◽  
Catherine Weir ◽  
Parnia Khamooshi ◽  
Hafeez Shaka

Global Heart ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 63
Anubha Agarwal ◽  
Padinhare P. Mohanan ◽  
Dimple Kondal ◽  
Aashima Chopra ◽  
Abigail S. Baldridge ◽  

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