scholarly journals Development of a predictive model for mortality in hospitalized patients with COVID-19

2021 ◽  
pp. 1-33
Author(s):  
Yuanyuan Niu ◽  
Zan Zhan ◽  
Jianfeng Li ◽  
Wei Shui ◽  
Changfeng Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Early Identification ◽  
Good Accuracy ◽  
Virus Disease ◽  
Fatal Outcome ◽  
Multivariable Analysis ◽  
Hospital Death ◽  
Factors Associated ◽  
Logistic Analysis ◽  
Failure Assessment

Abstract Introduction: Early identification of patients with novel corona virus disease 2019 (COVID-19) who may be at high mortality risk is of great importance. Methods: In this retrospective study, we included all patients with COVID-19 at Huanggang Central Hospital from January 23 to March 5, 2020. Data on clinical characteristics and outcomes were compared between survivors and non-survivors. Univariable and multivariable logistic regression were used to explore risk factors associated with in-hospital death. A nomogram was established based on the risk factors selected by multivariable analysis. Results: A total of 150 patients were enrolled, including 31 non-survivors and 119 survivors. The multivariable logistic analysis indicated that increasing the odds of in-hospital death associated with higher Sequential Organ Failure Assessment score (OR, 3.077; 95% CI: 1.848–5.122; P < 0.001), diabetes (OR, 10.474; 95% CI: 1.554–70.617; P = 0.016), and lactate dehydrogenase greater than 245 U/L (OR, 13.169; 95% CI: 2.934–59.105; P = 0.001) on admission. A nomogram was established based on the results of the multivariable analysis. The AUC of the nomogram was 0.970 (95% CI: 0.947–0.992), showing good accuracy in predicting the risk of in-hospital death. Conclusions: This finding would facilitate the early identification of patients with COVID-19 who have a high-risk for fatal outcome.

Risk factors associated with hepatitis B virus disease in different states of North Eastern India and their distribution

2016 ◽  
Vol 9 (4) ◽  
pp. 756-761
Author(s):  
Namrata Kumari ◽  
Priyanka Kashyap ◽  
Snigdha Saikia ◽  
Kangkana Kataki ◽  
Subhash Medhi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Virus Disease ◽  
Eastern India ◽  
Factors Associated ◽  
B Virus ◽  
North Eastern ◽  
North Eastern India

scholarly journals Characteristics, outcomes and risk factors for mortality of 522 167 patients hospitalised with COVID-19 in Brazil: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e049089
Author(s):  
Marcia C Castro ◽  
Susie Gurzenda ◽  
Eduardo Marques Macário ◽  
Giovanny Vinícius A França
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Proportional Hazards ◽  
Secondary Outcome ◽  
Hospital Death ◽  
Factors Associated ◽  
Icu Admission ◽  
Hospitalised Patients

ObjectiveTo provide a comprehensive description of demographic, clinical and radiographic characteristics; treatment and case outcomes; and risk factors associated with in-hospital death of patients hospitalised with COVID-19 in Brazil.DesignRetrospective cohort study of hospitalised patients diagnosed with COVID-19.SettingData from all hospitals across Brazil.Participants522 167 hospitalised patients in Brazil by 14 December 2020 with severe acute respiratory illness, and a confirmed diagnosis for COVID-19.Primary and secondary outcome measuresPrevalence of symptoms and comorbidities was compared by clinical outcomes and intensive care unit (ICU) admission status. Survival was assessed using Kaplan Meier survival estimates. Risk factors associated with in-hospital death were evaluated with multivariable Cox proportional hazards regression.ResultsOf the 522 167 patients included in this study, 56.7% were discharged, 0.002% died of other causes, 30.7% died of causes associated with COVID-19 and 10.2% remained hospitalised. The median age of patients was 61 years (IQR, 47–73), and of non-survivors 71 years (IQR, 60–80); 292 570 patients (56.0%) were men. At least one comorbidity was present in 64.5% of patients and in 76.8% of non-survivors. From illness onset, the median times to hospital and ICU admission were 6 days (IQR, 3–9) and 7 days (IQR, 3–10), respectively; 15 days (IQR, 9–24) to death and 15 days (IQR, 11–20) to hospital discharge. Risk factors for in-hospital death included old age, Black/Brown ethnoracial self-classification, ICU admission, being male, living in the North and Northeast regions and various comorbidities. Age had the highest HRs of 5.51 (95% CI: 4.91 to 6.18) for patients≥80, compared with those ≤20.ConclusionsCharacteristics of patients and risk factors for in-hospital mortality highlight inequities of COVID-19 outcomes in Brazil. As the pandemic continues to unfold, targeted policies that address those inequities are needed to mitigate the unequal burden of COVID-19.

scholarly journals Multivariable analysis to determine risk factors associated with early pregnancy loss in thoroughbred broodmares

2019 ◽  
Vol 124 ◽  
pp. 18-23 ◽  
Author(s):  
A.M. de Mestre ◽  
B.V. Rose ◽  
Y.M. Chang ◽  
D.C. Wathes ◽  
K.L.P. Verheyen
Keyword(s):  
Risk Factors ◽  
Early Pregnancy ◽  
Pregnancy Loss ◽  
Multivariable Analysis ◽  
Early Pregnancy Loss ◽  
Factors Associated

P0034IDENTIFICATION OF FACTORS ASSOCIATED WITH PROGRESSION, PROGNOSIS AND TOLVAPTAN INDICATION IN POLYCYSTIC KIDNEY DISEASE PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Myrto Kostopoulou ◽  
Michaela Louka ◽  
Stavros Fokas ◽  
Eirini Tigka ◽  
Angelos Drakopoulos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Disease ◽  
Polycystic Kidney Disease ◽  
Multivariable Analysis ◽  
Laboratory Data ◽  
Kidney Volume ◽  
Polycystic Kidney ◽  
Factors Associated ◽  
Affected Parent ◽  
Male Sex

Abstract Background and Aims The identification of possible risk factors for the progression of Autosomal Dominant Polycystic Kidney Disease (ADPKD) is an emerging field especially after the introduction of the first disease-specific treatment. The present study aims to explore the associations between epidemiological, clinical and imagining data in a large cohort of ADPKD patients. Method This study was from a single outpatient clinic following patients with ADPKD. Patients were included in the study if they had a recent Magnetic Resonance Imaging (MRI) for measurement of Total Kidney Volume (TKV), a validated biomarker for disease progression. For all patients, the Mayo Clinic Imagining Category (MCIC) and the respective prediction for End Stage Renal Disease (ESRD) were calculated. Patients eligible for tolvaptan treatment (MCIC 1C, 1D, 1E, age &lt; 55 years old and estimated-glomerular filtration rate (e-GFR) ≥ 25 ml/min) were identified. Characteristics including individual medical history, clinical and laboratory data were examined for possible associations with renal and imagining parameters using linear regression models. Results A total of 158 patients were included. Based on measurements of height-adjusted TKV (ht-TKV) and age, 5% of the patients were classified as 1A, 20% as 1B, 34% as 1C, 25% as 1D and 16% as 1E, MCIC. In multivariable analysis, patient’s age (p = 0.01), male sex (p &lt; 0.001), parent’s age at which ESRD was reached (adjusted for patient age) (p &lt; 0.001) and proteinuria (p = 0.04) were associated with ht-TKV. Parent’s age at ESRD differed significantly between the MCICs of the offspring (mean±(SD)), 70.83 (12.90) in 1A, 63.79 (11.39) in 1B, 57.32 (10.42) in 1C, 51.42 (9.18) in 1D and 47.94 (5.73) years old in 1E, (p &lt; 0.001). Similarly, there were significant differences in the presence and the age of hypertension onset (p =0.004 and p = 0.003, respectively). In 104 patients (50 females, 54 males) who were eligible for tolvaptan treatment age at ADPKD diagnosis, age at hypertension onset and parent’s age reaching at ESRD were all significantly lower (p &lt; 0.001 for all) when compared to non-eligible patients. Finally, factors associated with the prediction score of ESRD (e-GFR 10/ml/min) were hypertension, uric acid and the age at ESRD of the affected parent (p = 0.001, 0.02 and 0.01, respectively). Conclusion The age at which an affected parent had reached ESRD, as heritability estimator, was significantly associated with a worst phenotype, prognosis and tolvaptan indication. Early diagnosis of the disease, hypertension and its early onset, proteinuria and male sex are also possible risk factors for the progression of ADPKD.

scholarly journals Parental risk factors associated with congenital heart disease in a Thai population: multivariable analysis

2021 ◽  
Vol 15 (6) ◽  
pp. 267-276 ◽  
Author(s):  
Chayamon Suwansumrit ◽  
Worawan Jittham
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Cigarette Smoke ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Maternal Exposure ◽  
Factors Associated ◽  
History Of

Abstract Background Congenital heart diseases (CHDs) are the most common types of birth defects and contribute to a large proportion of infant morbidities and mortalities worldwide. These defects may require multiple surgical interventions impacting the infant's quality of life. Objectives To identify risk factors associated with CHD in a population of Thai children. Methods We conducted a case–control study of patients attending the Pediatric Clinic, Naresuan University Hospital, Thailand. We included data from pediatric patients diagnosed with CHDs as cases, and patients without cardiovascular abnormalities as controls. Risk data were collected from July 2019 to April 2020 using face-to-face interviews. Multiple logistic regression was used to analyze parental factors associated with CHDs. Results We included 249 cases classified into 2 groups according to severity and 304 patients as controls. For those less-severely affected (155 patients, 62.2%), ventricular septal defect (27.7%) was the most prevalent, whereas for those with severe CHDs, tetralogy of Fallot was the most prevalent (14.0%). There was no difference in sex distribution or maternal obstetric history between the groups. In multivariable analysis, a family history of CHDs (adjusted odds ratio [AOR] 4.67, 95% confidence interval (CI) 1.61–13.57, P = 0.005) and maternal exposure to second-hand cigarette smoke (AOR 1.58, 95% CI 1.03–2.42, P = 0.002) were identified as significant risk factors for CHDs. Conclusion A family history of CHDs and maternal exposure to second-hand cigarette smoke are associated with having offspring with CHDs in the population studied. These findings help us to encourage affected parents to obtain a fetal echocardiogram.

scholarly journals Association of AKI-D with Urinary Findings and Baseline eGFR in Hospitalized COVID-19 Patients

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0001612021
Author(s):  
Dipal M. Patel ◽  
Manali Phadke ◽  
Feng Dai ◽  
Michael Simonov ◽  
Neera K. Dahl ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Markers ◽  
Kidney Injury ◽  
Fold Increase ◽  
Patient Characteristics ◽  
Hospital Death ◽  
Health Records ◽  
Lower Odds ◽  
Factors Associated ◽  
Multiple Covariates

Background: Acute kidney injury (AKI) is common in patients hospitalized with coronavirus disease 2019 (COVID-19). Risk factors for AKI requiring dialysis (AKI-D) are not fully understood. We aimed to identify risk factors associated with AKI-D and AKI not requiring dialysis (AKI-ND). Methods: We reviewed electronic health records of 3186 patients aged > 18 years old hospitalized with COVID-19 across six hospitals. Patient characteristics, urinalysis findings, and inflammatory markers were analyzed for association with in-hospital AKI status (AKI-D, AKI-ND, or no AKI), and we subsequently evaluated mortality. Results: After adjustment for multiple covariates, higher baseline eGFR was associated with 30% lower odds of AKI-D and 11% lower odds of AKI-ND (OR 0.70, 95% CI 0.64-0.77 for AKI-D; OR 0.89, 95% CI 0.85-0.92 for AKI-ND). Patients with obesity and Latino patients had increased odds of AKI-D, whereas those with congestive heart failure or diabetes with complications had increased odds of AKI-ND. Females had lower odds of in-hospital AKI (OR 0.28, 95% CI 0.17-0.46 for AKI-D; OR 0.83, 95% CI 0.70-0.99 for AKI-ND). After adjustment for covariates and baseline eGFR, 1-4+ protein on initial urinalysis was associated with a 9-fold increase in odds of AKI-D (OR 9.00, 95% CI 2.16-37.38) and > 2-fold higher odds of AKI-ND (OR 2.28, 95% CI 1.66-3.13). 1-3+ blood and trace glucose on initial urinalysis were also associated with increased odds of both AKI-D and AKI-ND. AKI-D and AKI-ND were associated with in-hospital death (OR 2.64, 95% CI 1.13-6.17 for AKI-D; OR 2.44, 95% CI 1.77-3.35 for AKI-ND). Conclusions: Active urine sediments, even after adjustment for baseline kidney function, and reduced baseline eGFR are significantly associated with increased odds of AKI-D and AKI-ND. In-hospital AKI was associated with in-hospital death. These findings may help prognosticate patients hospitalized with COVID-19.

scholarly journals Monitoring Approach of Fatality Risk Factors for Patients with Severe Acute Pancreatitis Admitted to the Intensive Care Unit. A Retrospective, Monocentric Study

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2013
Author(s):  
Tudorel Mihoc ◽  
Cristi Tarta ◽  
Ciprian Duta ◽  
Raluca Lupusoru ◽  
Greta Dancu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Acute Pancreatitis ◽  
Intensive Care ◽  
Severe Acute Pancreatitis ◽  
Fatal Outcome ◽  
Factors Associated ◽  
Reactive Protein ◽  
Wide Range ◽  
Secondary Objective

Acute pancreatitis is an unpredictable disease affecting the pancreas and it is characterized by a wide range of symptoms and modified lab tests, thus there is a continuing struggle to classify this disease and to find risk factors associated with a worse outcome. The main objective of this study was to identify the risk factors associated with the fatal outcome of the intensive care unit’s patients diagnosed and admitted for severe acute pancreatitis, the secondary objective was to investigate the prediction value for the death of different inflammatory markers at the time of their admission to the hospital. This retrospective study included all the patients with a diagnosis of acute pancreatitis admitted to the Intensive Care Unit of the Emergency County Hospital Timisoara between 1 January 2016 and 31 May 2021. The study included 53 patients diagnosed with severe acute pancreatitis, out of which 21 (39.6%) survived and 32 (60.4%) died. For the neutrophils/lymphocytes ratio, a cut-off value of 12.4 was found. When analyzing age, we found out that age above 52 years old can predict mortality, and for the platelets/lymphocytes ratio, a cut-off value of 127 was found. Combining the three factors we get a new model for predicting mortality, with an increased performance, AUROC = 0.95, p < 0.001. Multiple persistent organ failure, age over 50, higher values of C reactive protein, and surgery were risk factors for death in the patients with severe acute pancreatitis admitted to the intensive care unit. The model design from the neutrophils/lymphocytes ratio, platelets/lymphocytes ratio, and age proved to be the best in predicting mortality in severe acute pancreatitis.

scholarly journals Nomogram for Prediction of fatal outcome in Patients with Severe COVID-19 Pneumonia: A Multicenter Study

2020 ◽  
Author(s):  
Yun Yang ◽  
Xiaofei Zhu ◽  
Jian Huang ◽  
Cui Chen ◽  
Yang Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Validation Cohort ◽  
Fatal Outcome ◽  
Treatment Strategies ◽  
Training Cohort ◽  
Factors Associated ◽  
Risk Of Death ◽  
High Risk Factors ◽  
Cox Analysis

Abstract Background & Aims: To develop an effective model of predicting fatal Outcome in the severe coronavirus disease 2019 (COVID-19) patients.Methods: Between February 20, 2020 and April 4, 2020, consecutive COVID-19 patients from three designated hospitals were enrolled in this study. Independent high- risk factors associated with death were analyzed using Cox proportional hazard model. A prognostic nomogram was constructed to predict the survival of severe COVID-19 patients.Results: There were 124 severe patients in the training cohort, and there were 71 and 76 severe patients in the two independent validation cohorts, respectively. Multivariate Cox analysis indicated that age ≥ 70 years (HR 1.184, 95% CI 1.061-1.321), Panting(breathing rate ≥ 30/min) (HR 3.300, 95% CI 2.509-6.286), lymphocyte count < 1.0 × 109/L (HR 2.283, 95% CI 1.779-3.267), and IL-6 >10pg/mL (HR 3.029, 95% CI 1.567-7.116) were independent high-risk factors associated with fatal outcome. We developed the nomogram for identifying survival of severe COVID-19 patients in the training cohort (AUC 0.900, [95% CI 0.841-0.960], sensitivity 95.5%, specificity 77.5%); in validation cohort 1 (AUC 0.862, [95% CI 0.763-0.961], sensitivity 92.9%, specificity 64.5%); in validation cohort 2 (AUC 0.811, [95% CI 0.698-0.924], sensitivity 77.3%, specificity 73.5%). The calibration curve for probability of death indicated a good consistence between prediction by the nomogram and the actual observation. Conclusions: This nomogram could help clinicians to identify severe patients who have high risk of death, and to develop more appropriate treatment strategies to reduce the mortality of severe patients.

scholarly journals Nomogram for Prediction of fatal outcome in Patients with Severe COVID-19: A Multicenter Study

2021 ◽  
Author(s):  
Yun Yang ◽  
Xiaofei Zhu ◽  
Jian Huang ◽  
Cui Chen ◽  
Yang Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Validation Cohort ◽  
Fatal Outcome ◽  
Treatment Strategies ◽  
Training Cohort ◽  
Factors Associated ◽  
Risk Of Death ◽  
High Risk Factors ◽  
Cox Analysis

Abstract Background & Aims: To develop an effective model of predicting fatalOutcome in the severe coronavirus disease 2019 (COVID-19) patients.Methods: Between February 20, 2020 and April 4, 2020, consecutive COVID-19 patients from three designated hospitals were enrolled in this study. Independent high- risk factors associated with death were analyzed using Cox proportional hazard model. A prognostic nomogram was constructed to predict the survival of severe COVID-19 patients.Results: There were 124 severe patients in the training cohort, and there were 71 and 76 severe patients in the two independent validation cohorts, respectively. Multivariate Cox analysis indicated that age ≥ 70 years (HR 1.184, 95% CI 1.061-1.321), Panting(breathing rate ≥ 30/min) (HR 3.300, 95% CI 2.509-6.286), lymphocyte count < 1.0 × 109/L (HR 2.283, 95% CI 1.779-3.267), and IL-6 >10pg/mL (HR 3.029, 95% CI 1.567-7.116) were independent high-risk factors associated with fatal outcome. We developed the nomogram for identifying survival of severe COVID-19 patients in the training cohort (AUC 0.900, [95% CI 0.841-0.960], sensitivity 95.5%, specificity 77.5%); in validation cohort 1 (AUC 0.811, [95% CI 0.763-0.961], sensitivity 77.3%, specificity 73.5); in validation cohort 2 (AUC 0.862, [95% CI 0.698-0.924], sensitivity 92.9%, specificity 64.5%). The calibration curve for probability of death indicated a good consistence between prediction by the nomogram and the actual observation. The prognosis of severe COVID-19 patients with high levels of interleukin-6 (IL-6) receiving tocilizumab was better than that of those patients without tocilizumab both in the training and validation cohorts, but without difference (p = 0.105 for training cohort, p = 0.133 for validation cohort 1, and p = 0.210 for validation cohort 2).Conclusions: This nomogram could help clinicians to identify severe patients who have high risk of death, and to develop more appropriate treatment strategies to reduce the mortality of severe patients. Tocilizumab may improve the prognosis of severe COVID-19 patients with high levels of IL-6.

scholarly journals Maternal Risk Factors Associated with Low Birth Weight in Indonesia

2018 ◽  
Vol 11 (1) ◽  
pp. 376-383 ◽  
Author(s):  
Issara Siramaneerat ◽  
Farid Agushybana ◽  
Yaowaluck Meebunmak
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Maternal Education ◽  
Pregnancy Complication ◽  
Maternal Risk Factors ◽  
Maternal Risk ◽  
Factors Associated ◽  
Logistic Analysis

Background: Low birth weight (LBW) is a major risk factor for death and disease in the fetus and newborn infant. However, the study about LBW and maternal risk factors involved in Indonesia is still limited. Objective: The present study attempted to examine the association of maternal risk factors including mother’s age, mother and husband education, mother and husband occupation and wealth, ANC visit, desired pregnancy and obstetric complication toward the occurrence of low birth weight infant across region and family wealthy. Methods: This study employed the data from the national survey of Indonesia Demographic and Health Survey (IDHS). The latest births from married women who gave birth within 2 years (2011 and 2012) preceding the IDHS were considered as sample selection. It was approximately 15,126 respondents. The predicted risks of low birth weight were estimated using multilevel logistic analysis. Results: Data were collected on 15,126 pregnant women who reported 10.2% were with LBW infants. When using the multilevel logistic analysis, the factors associated with LBW were maternal delivery-baby age, mother’s education, antenatal care and pregnancy complication at significant levels of 0.01. Conclusion: The prevalence of preterm infants in this study was quite high. Factors affecting LBW were maternal age, maternal education, ANC visits and pregnancy complication. The ANC visit of pregnant women is a potential and feasible activity to reduce the incidence of LBW.

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