scholarly journals Clinical Features of Patients with Home Isolation Sars-Cov-2 Infection: A Multicenter Retrospective Study in Southern Italy

Life ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 347
Author(s):  
Mariantonietta Pisaturo ◽  
Giulia De Angelis ◽  
Paolo Maggi ◽  
Vincenzo Sangiovanni ◽  
Fabio Numis ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Features ◽  
Charlson Comorbidity Index ◽  
Southern Italy ◽  
Severe Disease ◽  
Severe Infection ◽  
Home Management ◽  
Younger Age ◽  
Comorbidity Index ◽  
At Home

To describe epidemiological and clinical features of patients confirmed as having SARS-CoV-2 infection and managed in isolation at home. We performed a multicenter retrospective study enrolling all SARS-CoV-2-positive adults evaluated from 28 February to 31 May 2020 at one of nine COVID-19 Units in southern Italy: we included patients receiving care at home and those admitted to hospital. We defined patients with not-severe disease if they were asymptomatic or experienced a mild infection that did not need oxygen (O2) therapy and those with a severe infection if hospitalized and required O2 therapy. We enrolled 415 patients with SARS-CoV-2 infection: 77 were managed in isolation at home, 338 required hospital management. The 77 patients in home isolation were less frequently male than hospitalized patients (55% vs. 64%; <0.01) and were younger (median age 45 years (IQR:19) vs. 62 (IQR 22); p < 0.01), had a lower Charlson comorbidity index (median 0 (IQR2) vs. 6 (IQR 3); p < 0.01), and included fewer subjects with an underlying chronic disease (36% vs. 59%; p < 0.01). According to a binomial logistic regression analysis, a younger age (OR: 0.96 (95% IC: 0.94–0.98), p < 0.01) and a low Charlson comorbidity index (OR: 0.66 (95% IC: 0.54–0.83); p < 0.01) were independent factors associated with at-home management. The identification of subjects with SARS-CoV-2 infection who could be managed in home isolation is useful in clinical practice. A younger age and no comorbidities were identified as factors independently associated with home management.

scholarly journals Prognosis of COVID-19 Pneumonia Can Be Early Predicted Combining Age-Adjusted Charlson Comorbidity Index, CRB Score and Baseline Oxygen Saturation.

2021 ◽  
Author(s):  
Pilar Nuevo-Ortega ◽  
Carmen Reina-Artacho ◽  
Francisco Dominguez-Moreno ◽  
Victor Manuel Becerra-Muñoz ◽  
Luis Ruiz-Del-Fresno ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Charlson Comorbidity Index ◽  
Severe Disease ◽  
Hospital Environment ◽  
Severe Illness ◽  
Comorbidity Index ◽  
Clinical Tools ◽  
Discharge From Hospital ◽  
Statistical Criteria

Abstract Background: In potentially severe diseases in general and COVID-19 in particular, it is vital to early identify those patients who are going to develop complications. The last update of a recent living systematic review dedicated to predictive models in COVID-19,[1] critically appraises 145 models, 8 of them focused on prediction of severe disease and 23 on mortality. Unfortunately, in all 145 models, they found a risk of bias significant enough to finally "not recommend any for clinical use". Authors suggest concentrating on avoiding biases in sampling and prioritising the study of already identified predictive factors, rather than the identification of new ones that are often dependent on the database. Our objective is to develop a model to predict which patients with COVID-19 pneumonia are at high risk of developing severe illness or dying, using basic and validated clinical tools.Methods: prospective cohort of consecutive patients admitted in a teaching hospital during the “first wave” of the COVID-19 pandemic. Follow-up to discharge from hospital. Multiple logistic regression selecting variables according to clinical and statistical criteria. Results: 404 consecutive patients were evaluated, 392 (97%) completed follow-up. Mean age was 61 years; 59% were men. The median burden of comorbidity was 2 points in the Age-adjusted Charlson Comorbidity Index, CRB was abnormal in 18% of patients and basal oxygen saturation on admission lower than 90% in 18%. A model composed of Age-adjusted Charlson Comorbidity Index, CRB score and basal oxygen saturation can predict unfavorable evolution or death with an area under the ROC curve of 0.85 (95% CI: 0.80-0.89), and 0.90 (95% CI: 0.86 to 0.94), respectively.Conclusion: prognosis of COVID-19 pneumonia can be predicted in the out-of-hospital environment using two classic prognostic scales and a pocket pulse oximeter.

scholarly journals Surgery for elderly patients with resectable pancreatic cancer, a comparison with non-surgical treatments: a retrospective study outcomes of resectable pancreatic cancer

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hyeong Min Park ◽  
Sang-Jae Park ◽  
Sung-Sik Han ◽  
Seoung Hoon Kim
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Retrospective Study ◽  
Elderly Patients ◽  
Surgical Resection ◽  
Charlson Comorbidity Index ◽  
Resectable Pancreatic Cancer ◽  
Surgery Group ◽  
Comorbidity Index ◽  
High Charlson Comorbidity Index

Abstract Background We designed a retrospective study to compare prognostic outcomes based on whether or not surgical resection was performed in elderly patients aged(≥75 years) with resectable pancreatic cancer. Methods We retrospectively analyzed 49 patients with resectable pancreatic cancer (surgery group, resection was performed for 38 cases; no surgery group, resection was not performed for 11 cases) diagnosed from January 2003 to December 2014 at the National Cancer Center, Korea. Results There was no significant difference in demographics between the two groups. The surgery group showed significantly better overall survival after diagnosis than the no surgery group (2-year survival rate, 40.7% vs. 0%; log-rank test, p = 0.015). Multivariate analysis revealed that not having undergone surgical resection [hazard ratio (HR) 2.412, P = 0.022] and a high Charlson comorbidity index (HR 5.252, P = 0.014) were independent prognostic factors for poor overall survival in elderly patients with early stage pancreatic cancer. Conclusions In the present study, surgical resection resulted in better prognosis than non-surgical resection for elderly patients with resectable pancreatic cancer. Except for patients with a high Charlson comorbidity index, an aggressive surgical approach seems to be beneficial for elderly patients with resectable pancreatic cancer.

scholarly journals Clinical features and outcomes of new daily persistent headache in patients in China and comparison with medication-overuse headache: A double-center retrospective study

2020 ◽  
Author(s):  
Huanxian Liu ◽  
Ye Ran ◽  
Liang Dang ◽  
Ruirui Yang ◽  
Shuping Sun ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Features ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Mainland China ◽  
Clinical Information ◽  
Trigger Factors ◽  
Male Predominance ◽  
Younger Age ◽  
Persistent Headache

Abstract Background: This study examined the clinical features and outcomes of NDPH patients and comparison with medication-overuse headache (MOH) in mainland China.Methods: This retrospective study observed patients with NDPH and medication-overuse headache (MOH) visiting two outpatient clinics between November 2011 and December 2019. Clinical information was collected and all patients were followed by telephone.Results: The study recruited 73 NDPH and 638 MOH patients. The NDPH patients included 39 males (53.4%) and 34 females (46.6%), with an average age of 37.4 years and average headache duration of 10.6 years. Headache-precipitating factors included infection (15.1%) and stress (30.1%). Compared to MOH patients, NDPH patients had a male predominance (53.4% vs. 22.6%, p<0.001), younger age of CDH onset (26.7±12.3 vs. 41.4±11.3 years, p<0.001), and longer duration of CDH (10.6±11.8 vs. 6.1±6.2 years, p=0.023). Of the 62 NDPH patients followed up for 31 months, on average, therapeutic responses were more effective in NDPH patients with trigger factors than in those without trigger factors (71.4% vs. 32.4%; p = 0.002); the odds ratio (OR) of an effective outcome was 5.25 (1.73-17.84, p = 0.005).Conclusions: NDPH is significantly different from MOH, with a male predominance, younger age of CDH onset, and longer duration of CDH. The presence of trigger factors is an independent predictor of better treatment effect in NDPH patients.

scholarly journals Clinical features and outcomes of new daily persistent headache in patients in China and comparison with medication overuse headache: a double-center retrospective study

Pain medicine ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 10-20
Author(s):  
Huanxian Liu ◽  
Ye Ran ◽  
Liang Dang ◽  
Ruirui Yang ◽  
Shuping Sun ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Features ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Mainland China ◽  
Clinical Information ◽  
Trigger Factors ◽  
Male Predominance ◽  
Younger Age ◽  
Persistent Headache

Background: This study examined the clinical features and outcomes of NDPH patients and comparison with medication-overuse headache (MOH) in Mainland China. Methods: This retrospective study observed patients with NDPH and medication-overuse headache (MOH) visiting two outpatient clinics between November 2011 and December 2019. Clinical information was collected and all patients were followed by telephone. Results: The study recruited 73 NDPH and 638 MOH patients. The NDPH patients included 39 males (39/73, 53.4%) and 34 females (34/73, 46.6%), with an average age of 37.4 years and average headache duration of 10.6 years. Headache-precipitating factors included infection (11/73, 15.1%) and stress (22/73, 30.1%). Compared to MOH patients, NDPH patients had a male predominance (53.4% vs. 22.6%, p<0.001), younger age of CDH onset (26.7±12.3 vs. 41.4±11.3 years, p<0.001), and longer duration of CDH (10.6±11.8 vs. 6.1±6.2 years, p=0.023). In 62 NDPH patients followed up for 31 months, on average, therapeutic responses were more effective in NDPH patients with trigger factors than in those without trigger factors (71.4% vs. 32.4%; p = 0.002); the odds ratio (OR) of an effective outcome was 5.25 (1.73–17.84, p = 0.005). Conclusions: NDPH is significantly different from MOH, with a male predominance, younger age of CDH onset, and longer duration of CDH. The presence of trigger factors is an independent predictor of better treatment effect in NDPH patients.

Lateral patellar luxation in dogs: a retrospective study of 65 dogs

2014 ◽  
Vol 27 (02) ◽  
pp. 130-134 ◽  
Author(s):  
S. J. Butterworth ◽  
A. Miller ◽  
B. Keeley ◽  
S. Baines ◽  
W. M. McKee ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Features ◽  
Revision Surgery ◽  
Medical Records ◽  
Genu Valgum ◽  
Implant Removal ◽  
Large N ◽  
Younger Age ◽  
Small N ◽  
Multicentre Retrospective Study

SummaryTo report the signalment and clinical features of dogs with non-traumatic lateral patellar luxation and to report the complications and outcomes following surgery.A multicentre retrospective study was performed. Medical records were reviewed and the signalment, clinical features, and treatment of dogs presenting with lateral patellar luxation were recorded. In dogs treated surgically, the outcome and complications were investigated.Sixty-five dogs (95 stifles) were included; 39 were male and median age at presentation was 10 months. Breeds were classified as small (n = 6), medium (n = 23), large (n = 27), and giant (n = 9). Lateral patellar luxation was classified as grade I (n = 14), II (n = 41), III (n = 29), and IV (n = 11). Conformational abnormalities were noted in 34 stifles; genu valgum was the most common (n = 28). Higher-grade luxation was associated with a younger age at presentation (p = 0.032) and genu valgum (p = 0.01). Surgery was performed on 58 stifles, 22 of which sustained one or more complications; 16 complications were managed conservatively, four with implant removal and six with revision surgery. Surgeon-assessed outcome was good or excellent in 47 of the 51 dogs available for review.Non-traumatic lateral patellar luxation is a disease of predominantly medium and large breed dogs. It has several similar clinical features and can be surgically treated in a similar manner to medial patellar luxation with similar types of complications and outcomes expected.

scholarly journals 322. Risk Factors for COVID-19 Disease Severity Using Electronic-Health Records in a Real-World Cohort in the United States

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S266-S267
Author(s):  
Shemra Rizzo ◽  
Ryan Gan ◽  
Devika Chawla ◽  
Kelly Zalocusky ◽  
Xin Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Electronic Health Records ◽  
Confidence Intervals ◽  
Disease Severity ◽  
Charlson Comorbidity Index ◽  
Severe Disease ◽  
Older Age ◽  
Calendar Time ◽  
Health Records ◽  
Comorbidity Index

Abstract Background Over 32 million cases of COVID-19 have been reported in the US. Outcomes range from mild upper respiratory infection to hospitalization, acute respiratory failure, and death. We assessed risk factors associated with severe disease, defined as hospitalization within 21 days of diagnosis or death, using US electronic health records (EHR). Methods Patients in the Optum de-identified COVID-19 EHR database who were diagnosed with COVID-19 in 2020 were included in the analysis. Regularized multivariable logistic regression was used to identify risk factors for severe disease. Covariates included demographics, comorbidities, history of influenza vaccination, and calendar time. Results Of the 193,454 eligible patients, 36,043 (18.6%) were hospitalized within 21 days of COVID-19 diagnosis, and 6,397 (3.3%) died. Calendar time followed an inverse J-shaped relationship where severe disease rates rapidly declined in the first 25 weeks of the pandemic. BMI followed an asymmetric V-shaped relationship with highest rates of disease severity observed at the extremes. In the multivariable model, older age had the strongest association with disease severity (odds ratios and 95% confidence intervals of significant associations in Figure). Other risk factors were male sex, uninsured status, underweight and obese BMI, higher Charlson Comorbidity Index, and individual comorbidities including hypertension. Asthma and overweight BMI were not associated with disease severity. Blacks, Hispanics, and Asians experienced higher odds of disease severity compared to Whites. Figure. Significant associations (odds ratio and 95% confidence intervals) with COVID-19 severity (hospitalization or death), adjusted for geographical division. Reference and abbreviation categories: Charlson comorbidity index (CCI) = 0; Age = 18-30; Sex = Female; Race/Ethnicity = White; Insurance = Commercial; Body mass index (BMI) = 18.5-25; Calendar time = 0-25 weeks; Chronic obstructive pulmonary disease (COPD). Conclusion Odds of hospitalization or death have decreased since the start of the pandemic, with the steepest decline observed up to mid-August, possibly reflecting changes in both testing and treatment. Older age is the most important predictor of severe COVID-19. Obese and underweight, but not overweight, BMI were associated with increased odds of disease severity when compared to normal weight. Hypertension, despite not being included in many guidelines for vaccine prioritization, is a significant risk factor. Pronounced health disparities remain across race and ethnicity after accounting for comorbidities, with minorities experiencing higher disease severity. Disclosures Shemra Rizzo, PhD, F. Hoffmann-La Roche Ltd. (Shareholder)Genentech, Inc. (Employee) Ryan Gan, PhD, F. Hoffmann-La Roche Ltd (Shareholder)Genentech, Inc. (Employee) Devika Chawla, PhD MSPH, F. Hoffmann-La Roche Ltd. (Shareholder)Genentech, Inc. (Employee) Kelly Zalocusky, PhD, F. Hoffmann-La Roche Ltd. (Shareholder)Genentech, Inc. (Employee) Xin Chen, PhD, F. Hoffmann-La Roche Ltd. (Shareholder)Genentech, Inc. (Employee) Yifeng Chia, PhD, F. Hoffmann-La Roche Ltd (Shareholder)Genentech, Inc. (Employee)

scholarly journals Impact of Comorbidities on Survival Among Patients with Chronic Myeloid Leukaemia Using the Charlson Comorbidity Index: Retrospective study from Basra, Iraq

2019 ◽  
Vol 19 (3) ◽  
pp. 236
Author(s):  
Rafid A. Abood ◽  
Hasson M. Hasson ◽  
Asaad A. Khalaf ◽  
Elaf M. Saleh
Keyword(s):  
Retrospective Study ◽  
Chronic Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Chronic Diseases ◽  
Charlson Comorbidity Index ◽  
Kinase Inhibitors ◽  
Gastrointestinal Diseases ◽  
Female Ratio ◽  
Strong Negative Association ◽  
Comorbidity Index

Objectives: In chronic diseases, comorbidities are known to have a strong negative association with overall survival (OS). This study aimed to use the Charlson Comorbidity Index (CCI) to examine the effect of comorbidities on OS among patients with chronic myeloid leukaemia (CML) treated with tyrosine kinase inhibitors. Methods: This retrospective study was conducted between January 2006 and October 2016 and included 247 CML patients treated at the Basra Oncology & Haematology Centre, Basra, Iraq. Information from hospital records was used to calculate CCI scores and patients were divided into groups based on scores of 2–3 (CCI1 group) or ≥4 (CCI2 group). The OS was calculated using Kaplan-Meier curves. Results: There were 177 (71.7%) patients in the CCI1 group and 70 (28.3%) in the CCI2 group. Overall, patients in the CCI1 group were significantly younger compared to those in the CCI2 group (median age: 35 versus 60 years; P <0.001); however, the gender distribution was similar in both groups (male-to-female ratio of 1:1.06 versus 1:1.18, respectively; P = 0.683). Diabetes mellitus was the most common comorbidity (17%), followed by hypertension (12%) and gastrointestinal diseases (6%). There were no significant differences in mortality between the groups (9.6% versus 8.6%; P = 0.801). In total, 69.6% of all deaths were related to CML progression rather than to the presence of comorbidities. Conclusion: No significant correlation was found between CCI score and OS among CML patients in Basra. However, larger long-term prospective studies are needed to evaluate associations with median age at diagnosis and disease severity and to develop region-specific prognostic scales.Keywords: Comorbidity; Chronic Myeloid Leukemia; Mortality; Survival Analysis; Chronic Diseases; Iraq.

scholarly journals Etiologies and Clinical Characteristics of Patients with Macular Hole: A 8-Years Single-Center Retrospective Study

2021 ◽  
Author(s):  
Huifang Yue ◽  
Chenyu Liu ◽  
Yunda Zhang ◽  
Lijuan Zhang ◽  
Zhao Gao ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Correlation Analysis ◽  
Macular Hole ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Age Of Onset ◽  
Related Factors ◽  
Multivariate Correlation ◽  
Younger Age ◽  
Multivariate Correlation Analysis

Abstract Background: To investigate the etiologies and clinical characteristics of full-thickness macular hole (FTMH) patients at Shanxi eye hospital of North China. Methods: Patients diagnosed with FTMH and treated with surgery from 2012 to 2020 were included, and the etiologies and clinical features of different types of MHs were analysed in the 8-years cross sectional retrospective study. Multivariate correlation analysis was used to predict the related factors affecting baseline vision.Results: A total of 752 cases (776 eyes) were analysed. The top three causes of MH were idiopathic (IMH, 64.4%), myopic (MMH, 21.1%) and traumatic (TMH, 3.7%). Among these three causes’ groups, there were significant differences in sex distribution, age, and baseline BCVA. Female was predominated in IMH and MMH, while it was the opposite in TMH. The age of onset in IMH was older than MMH and TMH. The baseline Logarithm of the Minimum Angle of Resolution (logMAR) best-corrected visual acuity (BCVA) in IMH (Z=8.9, p<0.001) and Others group (Z=4.0, p<0.001) were significantly better than in MMH. In IMH, female patients had younger age, shorter axial length, and poorer baseline BCVA than male, while in MMH there were no significant differences between sexes. Multivariate correlation analysis showed that the smaller hole diameter of IMH, MMH without retinal detachment and younger age in TMH, may resulted in better baseline BCVA. Conclusions: The most common etiologies in MH were idiopathic, myopic and traumatic, which contributed to the different clinical features. Female was more common in IMH and MMH, and patients with MMH were 6.5 years earlier than IMH in onset. Therefore earlier monitoring fundus for female and people with high myopia is helpful for early detection and timely treatment.

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