scholarly journals Musculoskeletal Disorders, Pain Medication and In-Hospital Mortality among Patients with COVID-19 in South Korea: A Population-Based Cohort Study

2021 ◽  
Vol 18 (13) ◽  
pp. 6804
Author(s):  
Tak-Kyu Oh ◽  
In-Ae Song ◽  
Joon Lee ◽  
Woosik Eom ◽  
Young-Tae Jeon
Keyword(s):  
South Korea ◽  
Hospital Mortality ◽  
Musculoskeletal Disorders ◽  
Multivariate Logistic Regression Analysis ◽  
Population Based ◽  
Pain Medication ◽  
Multivariate Logistic Regression ◽  
Lower Back ◽  
Inflammatory Drugs ◽  
Strong Opioids

We aimed to investigate whether comorbid musculoskeletal disorders (MSD)s and pain medication use was associated with in-hospital mortality among patients with coronavirus disease 2019 (COVID-19). Adult patients (≥20 years old) with a positive COVID-19 diagnosis until 5 June 2020 were included in this study, based on the National Health Insurance COVID-19 database in South Korea. MSDs included osteoarthritis, neck pain, lower back pain, rheumatoid arthritis, and others, while pain medication included paracetamol, gabapentin, pregabalin, glucocorticoid, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids (strong and weak opioids), and benzodiazepine. Primary endpoint was in-hospital mortality. A total of 7713 patients with COVID-19 were included, and in-hospital mortality was observed in 248 (3.2%) patients. In multivariate logistic regression analysis, no MSDs (p > 0.05) were significantly associated with in-hospital mortality. However, in-hospital mortality was 12.73 times higher in users of strong opioids (odds ratio: 12.73, 95% confidence interval: 2.44–16.64; p = 0.002), while use of paracetamol (p = 0.973), gabapentin or pregabalin (p = 0.424), glucocorticoid (p = 0.673), NSAIDs (p = 0.979), weak opioids (p = 0.876), and benzodiazepine (p = 0.324) was not associated with in-hospital mortality. In South Korea, underlying MSDs were not associated with increased in-hospital mortality among patients with COVID-19. However, use of strong opioids was significantly associated with increased in-hospital mortality among the patients.

scholarly journals Association of body temperature with in-hospital mortality among paediatric trauma patients: an analysis of a nationwide observational trauma database in Japan

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e033822
Author(s):  
Asami Okada ◽  
Yohei Okada ◽  
Hiromichi Narumiya ◽  
Wataru Ishii ◽  
Tetsuhisa Kitamura ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Body Temperature ◽  
Hospital Mortality ◽  
Multivariate Logistic Regression Analysis ◽  
Data Bank ◽  
Trauma Patients ◽  
Multivariate Logistic Regression ◽  
Hospital Arrival ◽  
Paediatric Trauma ◽  
Japan Trauma Data Bank

ObjectivesTo examine the association between body temperature (BT) on hospital arrival and in-hospital mortality among paediatric trauma patients.DesignA retrospective cohort study.SettingJapan Trauma Data Bank (JTDB, which is a nationwide, prospective, observational trauma registry with data from 235 hospitals).ParticipantsPaediatric trauma patients <16 years old who were transferred directly from the scene of injury to the hospital and registered in the JTDB from January 2004 to December 2017 were included. We excluded patients >16 years old and those who developed cardiac arrest before or on hospital arrival.Primary outcomeThe association between BT on hospital arrival and in-hospital mortality. We conducted multivariate logistic regression analyses to calculate the adjusted ORs, with their 95% CIs, of the association between BT and in-hospital mortality.ResultsA total of 9012 patients were included (median age: 9 years (IQR, 6.0–13.0 years), mortality: 2.5% (mortality number was 226 in total 9012 patients)). In the multivariate logistic regression analysis, the corresponding adjusted ORs of BT <36.0°C and BT ≥37.0°C, relative to a BT of 36°C–36.9°C, for in-hospital mortality were 2.83 (95% CI: 1.85 to 4.33) and 0.93 (95% CI: 0.53 to 1.63), respectively.ConclusionsIn paediatric patients with hypothermia (BT <36.0°C) on hospital arrival, a clear association with in-hospital mortality was observed; no such association was observed between higher BT values (≥37.0°C) and outcomes.

scholarly journals Clinical features and risk factors of postoperative in-hospital mortality following surgical repair of Stanford type A acute aortic dissection

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chen Ke ◽  
Hao Wu ◽  
Min Xi ◽  
Wei Shi ◽  
Qihong Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiopulmonary Bypass ◽  
Renal Insufficiency ◽  
Hospital Mortality ◽  
Acute Aortic Dissection ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Factors Affecting ◽  
Cardiopulmonary Bypass Time ◽  
The Mean

Abstract Background To investigate the clinical features of patients with Stanford type A acute aortic dissection (AAD) and analyze the risk factors affecting postoperative in-hospital mortality rate. Methods The demographic and clinical data were retrospectively collected and analyzed from 118 AAD patients admitted to the Affiliated Hospital of Hangzhou Normal University from June 2016 to April 2019. All patients underwent surgical treatment and were grouped into death and survival groups. The risk factors affecting postoperative in-hospital death were analyzed using multivariate logistic regression analysis. Results The male to female ratio in the patients was 3.8:1 and the mean age was 50.11 ± 9.91 years. The patient’s main comorbidities were hypertension (70.33%) and coronary heart disease (10.17%). The main symptoms included chest pain and back pain (72.89%). The highest incidence of complications was pericardial effusion (48.31%), followed by pleural effusion (22.88%). The mean systolic blood pressure, white blood cell count and D-dimer in the patients were over the ranges of normal people. The incidences of cardiac and renal insufficiency were 18.64% and 16.95% respectively, and the postoperative in-hospital mortality rate was 12.71%. Univariable analysis showed that age, renal insufficiency, cardiac insufficiency, D-dimer level, cardiopulmonary bypass time, operation time, blood transfusion volume and postoperative hemostasis were significant factors leading to the death (P < 0.05). Multivariate logistic regression analysis showed that age > 65, renal insufficiency, cardiopulmonary bypass time ≥ 250 min and postoperative hemostasis were independent risk factors for the death (P < 0.05). Conclusions AAD patients frequently have underlying diseases with pain as the main symptom. Age > 65 years, renal insufficiency, cardiopulmonary bypass time ≥ 250 min and postoperative hemostasis are significantly risk factors for postoperative mortality.

scholarly journals Comparison of Two Different Analgesic Prescription Strategies and Healthcare Systems: Slovenia vs. the Netherlands

2021 ◽  
Vol 2 ◽  
Author(s):  
Ajda Bedene ◽  
Anita Strmljan ◽  
Eveline L. A. van Dorp ◽  
Mitja Udovič ◽  
Willem M. Lijfering ◽  
...  
Keyword(s):  
The Netherlands ◽  
Medication Use ◽  
Pain Medication ◽  
Opioid Use ◽  
Pharmacy Claims ◽  
Frequent Use ◽  
Prescribing Practice ◽  
Inflammatory Drugs ◽  
Strong Opioids ◽  
Prescription Databases

Background: Prescribing practice of pain medication is changing in the Netherlands; opioids are used more often instead of nonsteroidal anti-inflammatory drugs (NSAIDs), therefore we aimed to compare the use of pain medication with Slovenia which has stringent prescribing rules for strong opioids.Methods: We conducted a cohort study into national prescription databases of the Netherlands and Slovenia covering pharmacy claims between January 1, 2013 and December 31, 2019. In the analysis about 17 million Dutch and 2 million Slovenian residents were included.Findings: The use of opioids and NSAIDs was higher in Slovenia than in the Netherlands. More frequent use of opioids in Slovenia could be almost entirely explained by weak opioids (about 6% of the population), whereas they were prescribed 50% less frequently in the Netherlands. The opioid use has increased by about 20% in the Netherlands (4.85 and 6.00% of the population in 2013 and 2018, respectively), and the majority of this increase could be explained by strong opioids (4.05% in 2018), specifically, by oxycodone whose use increased by more than 2-fold between 2013 and 2019. In comparison, oxycodone was seldomly used in Slovenia (about 0.3% of the population received a prescription in a year).Interpretation: When medication use is controlled by stringent prescribing rules, like for strong opioids in Slovenia, the use is lower as compared to when such rules do not exist.

Inhaled Albuterol Use and Impaired Lactate Clearance in Patients With Sepsis: A Retrospective Cohort Study

2020 ◽  
pp. 088506661990109 ◽  
Author(s):  
Tetsuro Maeda ◽  
Janvi Paralkar ◽  
Toshiki Kuno ◽  
Paru Patrawalla
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Logistic Regression Analysis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Multivariate Logistic Regression Analysis ◽  
Lactate Clearance ◽  
Multivariate Logistic Regression

Background: Lactate clearance has become important in the management of sepsis. However, factors unrelated to sepsis-induced hyperlactatemia, including β-2 adrenergic agonists, can interfere with lactate clearance. Objectives: To investigate the association of inhaled albuterol with lactate clearance in patients with sepsis. Methods: This was a single-center retrospective cohort study. Adult patients with sepsis diagnosed in the emergency department from May 2015 to May 2016 with initial lactate levels >2 mmol/L and serial lactate measurements 2 to 6 hours apart were included. Patients were divided into 2 groups based on whether they received inhaled albuterol between lactate measurements. The primary end point was lactate clearance of 10%. Secondary end points included intensive care unit (ICU) consultation and in-hospital mortality. A multivariate logistic regression analysis was performed to assess the effect of inhaled albuterol on lactate clearance. Results: Of 269 patients included, 58 (22%) received inhaled albuterol between lactate measurements. This group had a significantly higher prevalence of pulmonary disease and a lower initial lactate compared to those who did not receive inhaled albuterol. They had a significantly lower rate of lactate clearance (45% vs 77%, P < .001); however, ICU consultation (71% vs 57%, P = .066) and in-hospital mortality (19% vs 22%, P = .64) were not significantly different. A multivariate logistic regression analysis adjusting for age, sex, chronic kidney disease, cirrhosis, cancer, septic shock or severe sepsis, and the amount of intravenous fluids received showed that inhaled albuterol was independently associated with impaired lactate clearance (adjusted odds ratio: 0.26, 95% confidence interval: 0.14-0.50, P < .001). Conclusions: Inhaled albuterol in patients with sepsis was associated with impaired lactate clearance without an increase in ICU consultation or in-hospital mortality. Impaired lactate clearance in patients with sepsis who receive inhaled albuterol should be interpreted with caution.

scholarly journals Comparison of linezolid and daptomycin for the treatment of vancomycin-resistant enterococcal bacteremia

2019 ◽  
Vol 6 ◽  
pp. 204993611982896 ◽  
Author(s):  
Navaneeth Narayanan ◽  
Rena Rai ◽  
Parth Vaidya ◽  
Avani Desai ◽  
Tanaya Bhowmick ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Hospital Mortality ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Multivariate Logistic Regression Analysis ◽  
Clinical Failure ◽  
Multivariate Logistic Regression ◽  
Vancomycin Resistant ◽  
Secondary Outcomes ◽  
Enterococcal Bacteremia

Vancomycin-resistant enterococcal bacteremia (VRE-B) is a common nosocomial infection associated with significant morbidity and mortality. Daptomycin and linezolid are primary treatment options although definitive clinical data to assess comparative therapeutic effectiveness are lacking. This study assessed the outcomes of patients with VRE-B treated with linezolid or daptomycin. This was a single-center, retrospective cohort study evaluating adult patients with VRE-B treated with either daptomycin or linezolid admitted between January 2012 and August 2016 at a tertiary care, academic medical center. The primary outcome was clinical failure, a composite outcome defined as 14-day in-hospital mortality, microbiologic failure, or relapse of VRE-B. Secondary outcomes included 14-day in-hospital mortality, microbiologic failure, relapse of VRE-B, duration of VRE-B, and antibiotic failure. A multivariate logistic regression model was performed to adjust for potential confounding variables. A total of 93 patients were included ( n = 62 for linezolid and n = 31 for daptomycin). All blood isolates were Enterococcus faecium. Overall clinical failure was 55.9% and 14-day in-hospital mortality was 21.5%. There was a significantly higher rate of clinical failure in the daptomycin group as compared with the linezolid-treated patients (74.2% versus 46.8%; p = 0.01; respectively). In multivariate logistic regression analysis, there was a significantly higher odds of clinical failure for patients treated with daptomycin as compared with linezolid (adjusted odds ratio 2.89; 95% confidence interval 1.08–7.75) after adjusting for confounders. Secondary outcomes were not statistically significantly different between study groups. Standard-dose (6 mg/kg) daptomycin treatment was associated with a higher rate of clinical failure as compared with linezolid treatment.

Trends in extracorporeal membrane oxygenation treatment from 2005 to 2018 in South Korea

Perfusion ◽  
2021 ◽  
pp. 026765912110181
Author(s):  
Hyoung-Won Cho ◽  
In-Ae Song ◽  
Tak Kyu Oh
Keyword(s):  
Respiratory Failure ◽  
South Korea ◽  
Extracorporeal Membrane Oxygenation ◽  
Hospital Mortality ◽  
Population Based ◽  
Case Volume ◽  
Health Records ◽  
Membrane Oxygenation ◽  
Treatment Indications ◽  
Ecmo Treatment

Introduction: This study aimed to investigate trends in extracorporeal membrane oxygenation (ECMO) treatment during 2005–2018 and examine factors associated with in-hospital mortality. Methods: We conducted a population-based cohort study based on health records obtained from the National Health Insurance Service database in South Korea. All adult patients (⩾18 years old) who received ECMO treatment in the intensive care unit after hospitalization from 2005 to 2018 were enrolled. Results: We analyzed data for 21,129 adult ECMO patients from 128 hospitals. The prevalence of ECMO treatment gradually and continuously increased from 4 per 100,000 individuals (95% confidence interval [CI]: 3–4) in 2005 to 67.4 per 100,000 individuals (95% CI: 65–68) in 2018. There was a significant increase in ECMO treatment for acute respiratory distress syndrome (ARDS) or respiratory failure (from 2.5% during 2005–2008 to 14.5% during 2016–2018). The overall in-hospital and 30-day mortality rates of the patients were 48.4% and 53.5%, respectively. The in-hospital mortality rate was highest among patients with shock (62.1%) and lowest among ECMO patients with liver failure (21.6%). On multivariable logistic regression, a higher hospital case volume was associated with improvement in in-hospital mortality (p < 0.001). Conclusions: In South Korea, the prevalence of ECMO treatment has increased gradually and continuously between 2005 and 2018. There was a significant increase in the prevalence of ECMO treatment for ARDS or respiratory failure. Our results support that ECMO treatment indications have been expanding, and ECMO will become vital for treating critically ill patients in the future.

scholarly journals Later Onset of Hypertension Increased the Risk of Dementia in Mild Cognitive Impairment

2019 ◽  
Author(s):  
hongyun qin(Former Corresponding Author) ◽  
chengping Hu ◽  
ling Wang ◽  
yi Guo ◽  
Zhicheng Cao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Old Age ◽  
Pulse Pressure ◽  
Multivariate Logistic Regression Analysis ◽  
Population Based ◽  
Onset Age ◽  
Multivariate Logistic Regression ◽  
Hypertension Development

Abstract Objective To investigate the effect of hypertension development on the progression of MCI for middle aged and elderly people. Methods A population-based longitudinal cognition survey of people aged 55+ was conducted. The hypertension onset age was estimated by self-reported information and medical insurance card records. In order to study the effect of later onset of hypertension on dementia, the incidence of dementia was compared between the two groups. Results A total of 277 h ypertensive mild cognitive impairment (MCI) participants without dementia were followed for 6 years. Overall, 56 MCI participants (20.22%) progressed to dementia (MCIp). The proportion of MCIp participants in the old-age onset hypertension group (≥ 65 years) was higher than that of middle-age onset one (27.0% vs 15.4%; X 2 = 5.538, P = 0.019). And in the old-age onset hypertension group, the proportion of MCIp without diabetes mellitus was higher than those with diabetes mellitus (24.7% vs 12.6%; X 2 = 5.321, P = 0.021), and the proportion of MCIp with increased pulse pressure was higher than those without increased pulse pressure (33.3% vs 15.4%; X 2 = 3.902, P = 0.048). However, the multivariate logistic regression analysis showed that older age was the only risk for MCIp (OR=0.732, p=0.029). Conclusions These results suggest that, later onset hypertension was harmful to cognition even in cases where the level of blood pressure maintained at 130/80 mmHg with antihypertensive management.

scholarly journals Phyto-oestrogens and risk of prostate cancer in Scottish men

2007 ◽  
Vol 98 (2) ◽  
pp. 388-396 ◽  
Author(s):  
C. L. Heald ◽  
M. R. Ritchie ◽  
C. Bolton-Smith ◽  
M. S. Morton ◽  
F. E. Alexander
Keyword(s):  
Prostate Cancer ◽  
Case Control Study ◽  
Multivariate Logistic Regression Analysis ◽  
Prostate Cancer Risk ◽  
Population Based ◽  
Serum Concentrations ◽  
Multivariate Logistic Regression ◽  
Soy Foods ◽  
Inherited Susceptibility ◽  
Control Study

A population-based case–control study of diet, inherited susceptibility and prostate cancer was undertaken in the lowlands and central belt of Scotland to investigate the effect of phyto-oestrogen intake and serum concentrations on prostate cancer risk. A total of 433 cases and 483 controls aged 50–74 years were asked to complete a validated FFQ and provide a non-fasting blood sample. Multivariate logistic regression analysis found significant inverse associations with increased serum concentrations of enterolactone (adjusted OR 0·40, 95 % CI 0·22, 0·71] and with the consumption of soy foods (adjusted OR 0·52, 95 % CI 0·30, 0·91). However, no significant associations were observed for isoflavone intake or serum genistein, daidzein and equol. This study supports the hypotheses that soy foods and enterolactone metabolised from dietary lignans protect against prostate cancer in older Scottish men.

Diagnostic accuracy of time to first positivity of blood cultures for predicting severe clinical outcomes in children with pneumonia-related bacteremia

2020 ◽  
Vol 68 (7) ◽  
pp. 1241-1249
Author(s):  
Yin Zhang ◽  
Jilei Lin ◽  
Qingxia Shi ◽  
Chulin Li ◽  
Jingyue Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Early Recognition ◽  
Multivariate Logistic Regression Analysis ◽  
Blood Cultures ◽  
Lasso Regression ◽  
Multivariate Logistic Regression

Early recognition of severe clinical outcomes in children with pneumonia-related bacteremia is vitally important because of the high mortality. This study aims to explore risk factors for severe clinical outcomes in children with pneumonia-related bacteremia and evaluate the value of time to first positive blood cultures (TTFP) in predicting prognosis. Children with pneumonia-related bacteremia in Children’s Hospital of Chongqing Medical University were included (January 2013–May 2019), respectively. TTFP and clinical parameters were collected and analyzed. The area under the curve (AUC)-receiver operating characteristic was used to evaluate the discrimination ability of TTFP. Multivariate logistic regression tests were performed to evaluate the association between TTFP and severe clinical outcomes. A total of 242 children with pneumonia-related bacteremia were included. The least absolute shrinkage and selection operator (LASSO) regression analysis identified TTFP, serum albumin (ALB) and lactic dehydrogenase (LDH) as predictors of in-hospital mortality. Multivariate logistic regression analysis showed that shorter TTFP (OR 0.94; 95% CI 0.89 to 0.97; p<0.01), lower ALB level (OR 0.93; 95% CI 0.89 to 0.98; p<0.01) and higher LDH level (OR 1.001; 95% CI 1.000 to 1.001; p<0.01) were risk factors for in-hospital mortality in children with pneumonia-related bacteremia. AUC of TTFP for predicting in-hospital mortality was 0.748 (95% CI 0.668 to 0.829). Shorter TTFP (≤16 hours) was associated with in-hospital mortality and septic shock. TTFP plays an important role in predicting severe clinical outcomes in children with pneumonia-related bacteremia.

scholarly journals Later Onset of Hypertension Is Associated with Higher Risk of Dementia in Mild Cognitive Impairment

2019 ◽  
Author(s):  
hongyun qin ◽  
chengping Hu ◽  
ling Wang ◽  
yi Guo ◽  
Zhicheng Cao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Old Age ◽  
Pulse Pressure ◽  
Multivariate Logistic Regression Analysis ◽  
Population Based ◽  
Onset Age ◽  
Multivariate Logistic Regression ◽  
Hypertension Development

Abstract Objective To investigate the correlation between hypertension development and the progression of MCI for middle aged and elderly people. Methods A population-based longitudinal cognition survey of people aged 55+ was conducted. The hypertension onset age was estimated by self-reported information and medical insurance card records. In order to study the effect of later onset of hypertension on dementia, the incidence of dementia was compared between the two groups. Results A total of 277 hypertensive mild cognitive impairment (MCI) participants without dementia were followed for 6 years. Overall, 56 MCI participants (20.22%) progressed to dementia (MCIp). The proportion of MCIp participants in the old-age onset hypertension group (≥ 65 years) was higher than that of middle-age onset one (27.0% vs 15.4%; X2 = 5.538, P = 0.019). And in the old-age onset hypertension group, the proportion of MCIp without diabetes mellitus was higher than those with diabetes mellitus (24.7% vs 12.6%; X2 = 5.321, P = 0.021), and the proportion of MCIp with increased pulse pressure was higher than those without increased pulse pressure (33.3% vs 15.4%; X2 = 3.902, P = 0.048). However, the multivariate logistic regression analysis showed that older age was the only risk for MCIp (OR=0.732, p=0.029). Conclusions These results suggest that, individuals with later onset hypertension may have greater cognition decline, even in cases with blood pressure maintained at 130/80 mmHg with antihypertensive management.

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