scholarly journals Risk Factors for Invasive Pulmonary Aspergillosis and Hospital Mortality in Acute-On-Chronic Liver Failure Patients: A Retrospective-Cohort Study

2013 ◽  
Vol 10 (12) ◽  
pp. 1625-1631 ◽  
Author(s):  
Jiajia Chen ◽  
Qing Yang ◽  
Jianrong Huang ◽  
Lanjuan Li
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Liver Failure ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Invasive Pulmonary Aspergillosis ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Pulmonary Aspergillosis

scholarly journals Infection deteriorating hepatitis B virus related acute-on-chronic liver failure: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xing-Ran Zhai ◽  
Jing-Jing Tong ◽  
Hong-Min Wang ◽  
Xiang Xu ◽  
Xiu-Ying Mu ◽  
...  
Keyword(s):  
Septic Shock ◽  
Cohort Study ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
B Virus

Abstract Background Infection is common in acute-on-chronic liver failure (ACLF), which may worsen the clinical condition and prognosis. However, the characteristics of infection and its influence on prognosis in hepatitis B virus related ACLF (HBV-ACLF) as defined by the European Association for the Study of the Liver (EASL) have not been clarified. We aimed to investigate the characteristics of infection and its influence on mortality in patients with HBV-ACLF defined by EASL in China. Methods We performed a retrospective cohort study in patients with HBV-ACLF defined by EASL in a single center from January 2015 to December 2017. These patients were divided into two groups with and without infection. The incidence, sites of infection, isolated strains, and risk factors associated with mortality were evaluated. Results A total of 289 patients were included, among them 185 (64.0%) were diagnosed with an infection. The most common type of infection was pneumonia (55.7%), followed by spontaneous bacterial peritonitis (47.6%) and others. The gram-negative bacteria were the most frequent (58.3%). Patients with one, two, and three or more infection sites had a gradually increasing incidence of sepsis (P < 0.01), septic shock (P < 0.001), and ACLF-3 (P < 0.05). Also, patients with infection isolated one, two, and three or more strains showed a growing incidence of sepsis (P < 0.01) and septic shock (P < 0.001). Patients with infection showed a significantly higher 28-day mortality than those without (P < 0.01), especially in patients with ACLF-3. Infection was identified as an independent risk factor for 28-day mortality in all HBV-ACLF patients. Pneumonia and sepsis were identified as independent predictors of 28-day mortality for patients with infection. Conclusions Infection is associated with severe clinical course and high mortality in HBV-ACLF defined by EASL. The increased number of infection sites or isolated strains was associated with the occurrence of sepsis and septic shock. Pneumonia and sepsis were independent predictors for mortality in HBV-ACLF patients with infection.

scholarly journals Infection deteriorating hepatitis B virus related acute-on-chronic liver failure: a retrospective cohort study

2020 ◽  
Author(s):  
Xing-Ran Zhai ◽  
Jing-Jing Tong ◽  
Hong-Min Wang ◽  
Xiang Xu ◽  
Xiu-Ying Mu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Infection Group ◽  
B Virus

Abstract Background: Infection is common in acute-on-chronic liver failure (ACLF), which may worsen the clinical condition and prognosis. However, the characteristics of infection and its influence on prognosis in hepatitis B virus related ACLF (HBV-ACLF) as defined by the European Association for the Study of the Liver (EASL) have not been clarified. We aimed to investigate the characteristics of infection and its influence on mortality in HBV-ACLF defined by EASL in China.Methods: We performed a retrospective cohort study with HBV-ACLF patients defined by EASL in a single center from January 2015 to December 2017. Patients were divided into an infection group and a non-infection group. The incidence, sites, strains of infection, and risk factors for mortality were evaluated. Results: A total of 289 patients were included, of which 185 (64.0%) were diagnosed with an infection. The most common was pneumonia (55.7%), followed by spontaneous bacterial peritonitis (47.6%) and others. The gram-negative bacteria were the most frequent (58.3%). Patients with one, two, and three or more infection sites had a gradually increasing incidence of sepsis (P<0.01), sepsis shock (P<0.001), and ACLF-3 (P<0.05). One, two, and three or more strains were isolated in 86, 16, and 18 patients, who showed a growing incidence of sepsis (P<0.01) and sepsis shock (P<0.001). Infection was identified as an independent risk factor for 28-day mortality in HBV-ACLF patients. Infected patients showed a significantly higher 28-day mortality than those without (P<0.01), especially in patients with ACLF-3. Pneumonia and sepsis were identified as independent predictors of 28-day mortality for infected patients.Conclusions: Infection is associated with severe clinical course and high mortality in HBV-ACLF defined by EASL. The increased incidence of sepsis and sepsis shock was associated with an increased number of infection sites and isolated strains. Pneumonia and sepsis were independent predictors affecting mortality in HBV-ACLF patients with infection.

scholarly journals Infection deteriorating hepatitis B virus related acute-on-chronic liver failure: a retrospective cohort study

2020 ◽  
Author(s):  
Xing-Ran Zhai ◽  
Jing-Jing Tong ◽  
Hong-Min Wang ◽  
Xiang Xu ◽  
Xiu-Ying Mu ◽  
...  
Keyword(s):  
Septic Shock ◽  
Cohort Study ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
B Virus

Abstract Background: Infection is common in acute-on-chronic liver failure (ACLF), which may worsen the clinical condition and prognosis. However, the characteristics of infection and its influence on prognosis in hepatitis B virus related ACLF (HBV-ACLF) as defined by the European Association for the Study of the Liver (EASL) have not been clarified. We aimed to investigate the characteristics of infection and its influence on mortality in patients with HBV-ACLF defined by EASL in China.Methods: We performed a retrospective cohort study in patients with HBV-ACLF defined by EASL in a single center from January 2015 to December 2017. These patients were divided into two groups with and without infection. The incidence, sites of infection, isolated strains, and risk factors associated with mortality were evaluated. Results: A total of 289 patients were included, among them 185 (64.0%) were diagnosed with an infection. The most common type of infection was pneumonia (55.7%), followed by spontaneous bacterial peritonitis (47.6%) and others. The gram-negative bacteria were the most frequent (58.3%). Patients with one, two, and three or more infection sites had a gradually increasing incidence of sepsis (P<0.01), septic shock (P<0.001), and ACLF-3 (P<0.05). Also, patients with infection isolated one, two, and three or more strains showed a growing incidence of sepsis (P<0.01) and septic shock (P<0.001). Patients with infection showed a significantly higher 28-day mortality than those without (P<0.01), especially in patients with ACLF-3. Infection was identified as an independent risk factor for 28-day mortality in all HBV-ACLF patients. Pneumonia and sepsis were identified as independent predictors of 28-day mortality for patients with infection.Conclusions: Infection is associated with severe clinical course and high mortality in HBV-ACLF defined by EASL. The increased number of infection sites or isolated strains was associated with the occurrence of sepsis and septic shock. Pneumonia and sepsis were independent predictors for mortality in HBV-ACLF patients with infection.

scholarly journals Proton pump inhibitors versus histamine-2 receptor blockers for stress ulcer prophylaxis in patients with sepsis: a retrospective cohort study

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110251
Author(s):  
Minqiang Huang ◽  
Ming Han ◽  
Wei Han ◽  
Lei Kuang
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Proton Pump ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Stress Ulcer ◽  
Increased Risk ◽  
Ulcer Prophylaxis

Objective We aimed to compare the efficacy and risks of proton pump inhibitor (PPI) versus histamine-2 receptor blocker (H2B) use for stress ulcer prophylaxis (SUP) in critically ill patients with sepsis and risk factors for gastrointestinal bleeding (GIB). Methods In this retrospective cohort study, we used the Medical Information Mart for Intensive Care III Clinical Database to identify critically ill adult patients with sepsis who had at least one risk factor for GIB and received either an H2B or PPI for ≥48 hours. Propensity score matching (PSM) was conducted to balance baseline characteristics. The primary outcome was in-hospital mortality. Results After 1:1 PSM, 1056 patients were included in the H2B and PPI groups. The PPI group had higher in-hospital mortality (23.8% vs. 17.5%), GIB (8.9% vs. 1.6%), and pneumonia (49.6% vs. 41.6%) rates than the H2B group. After adjusting for risk factors of GIB and pneumonia, PPI use was associated with a 1.28-times increased risk of in-hospital mortality, 5.89-times increased risk of GIB, and 1.32-times increased risk of pneumonia. Conclusions Among critically ill adult patients with sepsis at risk for GIB, SUP with PPIs was associated with higher in-hospital mortality and higher risk of GIB and pneumonia than H2Bs.

scholarly journals Risk factors for mortality in hospitalized patients with COVID-19 from three hospitals in Peru: a retrospective cohort study

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 224
Author(s):  
Cristian Díaz-Vélez ◽  
Diego Urrunaga-Pastor ◽  
Anthony Romero-Cerdán ◽  
Eric Ricardo Peña-Sánchez ◽  
Jorge Luis Fernández Mogollon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Oxygen Saturation ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Vulnerable Groups ◽  
Vital Functions ◽  
The Mean

Background: Peru was one of the countries with the highest COVID-19 mortality worldwide during the first stage of the pandemic. It is then relevant to evaluate the risk factors for mortality in patients hospitalized for COVID-19 in three hospitals in Peru in 2020, from March to May, 2020.  Methods: We carried out a retrospective cohort study. The population consisted of patients from three Peruvian hospitals hospitalized for a diagnosis of COVID-19 during the March-May 2020 period. Independent sociodemographic variables, medical history, symptoms, vital functions, laboratory parameters and medical treatment were evaluated. In-hospital mortality was assessed as the outcome. We performed Cox regression models (crude and adjusted) to evaluate risk factors for in-hospital mortality. Hazard ratios (HR) with their respective 95% confidence intervals (95% CI) were calculated.  Results: We analyzed 493 hospitalized adults; 72.8% (n=359) were male and the mean age was 63.3 ± 14.4 years. COVID-19 symptoms appeared on average 7.9 ± 4.0 days before admission to the hospital, and the mean oxygen saturation on admission was 82.6 ± 13.8. While 67.6% (n=333) required intensive care unit admission, only 3.3% (n=16) were admitted to this unit, and 60.2% (n=297) of the sample died. In the adjusted regression analysis, it was found that being 60 years old or older (HR=1.57; 95% CI: 1.14-2.15), having two or more comorbidities (HR=1.53; 95% CI: 1.10-2.14), oxygen saturation between 85-80% (HR=2.52; 95% CI: 1.58-4.02), less than 80% (HR=4.59; 95% CI: 3.01-7.00), and being in the middle (HR=1.65; 95% CI: 1.15-2.39) and higher tertile (HR=2.18; 95% CI: 1.51-3.15) of the neutrophil-to-lymphocyte ratio, increased the risk of mortality.  Conclusions: The risk factors found agree with what has been described in the literature and allow the identification of vulnerable groups in whom monitoring and early identification of symptoms should be prioritized in order to reduce mortality.

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