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Ge J, Luo C, Lei M, Shi Z, Cheng X, Zhao M, Zhao Y, Song M, Ding W, Wang M, Cao W, Mao F, Han S, Xu Q, Wang J, Qin H, Wang L, Zhang Q. Association Between NT-proBNP and Prolonged Length of Stay in Hospital Among Preterm Infants Born at 28-31 Weeks' Gestation. Front Pediatr 2021; 9:783900. [PMID: 35141177 PMCID: PMC8819076 DOI: 10.3389/fped.2021.783900] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/07/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE In the early life of preterm infants, the relationship between heart function and length of hospitalization is unclear. This study aims to examine the association between serum NT-proBNP level on the 7th day (NT-proBNP7) after birth and length of hospitalization among preterm infants. METHODS A retrospective cohort study was conducted. Patients included 709 preterm infants born at 28-31 weeks' gestational age (GA) admitted to the NICU of the First Affiliated Hospital of Zhengzhou University between December 20, 2016, to April 31, 2021. Main outcome: Late discharge (postmenstrual age at discharge was in the fourth quartile (highest) among infants born at the same GA). Exposure factor: NT-proBNP7. RESULTS We observed increased prevalence ratios for late discharge among the tertile of logarithm of NT-proBNP7 level (LnNT-proBNP7) which was positive. Compared with the lowest tertile, infants in the highest tertile of LnNT-proBNP7 had an 8.4-fold increased probability of late discharge, and the results were consistent for the subgroups. Next, a non-linear (S-shaped) relationship between LnNT-proBNP7 and late discharge was observed, whose turning points were 7.5 and 9. The effect sizes and the confidence intervals on the left of the first turning point, between two turning points and on the right of the second turning point, were 0.6 (95% CI, 0.2-1.6), 5.0 (95% CI, 2.4-10.6), and 1.1 (95% CI, 0.2-6.1), respectively. In addition, the prevalence of BPD, NEC, nosocomial infection, or any of them was highest in the group of LnNT-proBNP7 ≥ 9, lowest in the group of LnNT-proBNP7 < 7.5. CONCLUSION Higher NT-proBNP7 levels were associated with longer hospitalization. The relationship between LnNT-proBNP7 and late discharge was S-shaped. LnNT-proBNP7 was positively related with late discharge when LnNT-proBNP7 was between 7.5 and 9.
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Affiliation(s)
- Jian Ge
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chenghan Luo
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengyuan Lei
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zanyang Shi
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan High Risk Newborn Clinical Treatment and Follow-Up Center, Zhengzhou, China.,Zhengzhou Key Laboratory for Prevention and Control of Developmental Disorders, Zhengzhou, China
| | - Xinru Cheng
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan High Risk Newborn Clinical Treatment and Follow-Up Center, Zhengzhou, China.,Zhengzhou Key Laboratory for Prevention and Control of Developmental Disorders, Zhengzhou, China
| | - Min Zhao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanting Zhao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Min Song
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenqian Ding
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengmeng Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenjun Cao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fengxia Mao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan High Risk Newborn Clinical Treatment and Follow-Up Center, Zhengzhou, China.,Zhengzhou Key Laboratory for Prevention and Control of Developmental Disorders, Zhengzhou, China
| | - Suge Han
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qianya Xu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junbo Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Haoqi Qin
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Li Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qian Zhang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan High Risk Newborn Clinical Treatment and Follow-Up Center, Zhengzhou, China.,Zhengzhou Key Laboratory for Prevention and Control of Developmental Disorders, Zhengzhou, China
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Massari F, Scicchitano P, Ciccone MM, Caldarola P, Aspromonte N, Iacoviello M, Barro S, Pantano I, Valle R. Bioimpedance vector analysis predicts hospital length of stay in acute heart failure. Nutrition 2018; 61:56-60. [PMID: 30703569 DOI: 10.1016/j.nut.2018.10.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/19/2018] [Accepted: 10/23/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Congestion in acute heart failure (AHF) affects survival curves and hospital length of stay (LOS). The evaluation of congestion, however, is not totally objective. The aim of this study was to verify the accuracy of bioelectrical impedance vector analysis (BIVA) in predicting the LOS in AHF patients. METHODS This is a retrospective study. A total of 706 patients (367 male; mean age: 78 ± 10 y) who had been admitted to hospital with an AHF event were enrolled. All underwent anthropometric and clinical evaluation, baseline transthoracic echocardiography, and biochemical and BIVA evaluations. RESULTS The comparison among the clinical characteristics of congestion, LOS, and hyperhydration status revealed that the higher the hydration status, the longer the LOS (from 7.36 d [interquartile range: 7.34-7.39 d] in normohydrated patients to 9.04 d [interquartile range: 8.85- 9.19 d] in severe hyperhydrated patients; P < 0.05). At univariate analysis, brain natriuretic peptide, blood urea nitrogen, New York Heart Association class, hemoglobin, hydration index, and peripheral edema all had a statistically significant influence on LOS. At multivariate analysis, only brain natriuretic peptide (P < 0.0001), blood urea nitrogen (P = 0.011), and hydration index (P < 0.0001) were significantly associated to LOS. CONCLUSIONS Congestion evaluated by BIVA is an independent predictor of length of total hospital stay in HF patients with acute decompensation. The quick and reliable detection of congestion permits the administration of target therapy for AHF, thus reducing LOS and treatment costs.
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Affiliation(s)
| | - Pietro Scicchitano
- Cardiology Section, F. Perinei Hospital, Altamura, Bari, Italy; Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
| | - Marco Matteo Ciccone
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | | | - Nadia Aspromonte
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart Agostino Gemelli Foundation, Rome, Italy
| | - Massimo Iacoviello
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Sabrina Barro
- Cardiology Department, Hospital of San Donà di Piave (Venezia), Italy
| | - Ivan Pantano
- Cardiology Department, Hospital of Chioggia, Chioggia (Venezia), Italy
| | - Roberto Valle
- Cardiology Department, Hospital of Chioggia, Chioggia (Venezia), Italy
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The Association Between Novel Biomarkers and 1-Year Readmission or Mortality After Cardiac Surgery. Ann Thorac Surg 2018; 106:1122-1128. [PMID: 29864407 DOI: 10.1016/j.athoracsur.2018.04.084] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 03/02/2018] [Accepted: 04/09/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Novel cardiac biomarkers including soluble suppression of tumorigenicity 2, galectin-3, and the N-terminal prohormone of brain natriuretic peptide may be associated with long-term adverse outcomes after cardiac surgery. We sought to measure the association between cardiac biomarker levels and 1-year hospital readmission or mortality. METHODS Plasma biomarkers from 1,047 patients discharged alive after isolated coronary artery bypass graft surgery from 8 medical centers were measured in a cohort from the Northern New England Cardiovascular Disease Study Group between 2004 and 2007. We evaluated the association between preoperative and postoperative biomarkers and 1-year readmission or mortality using Kaplan-Meier estimates and Cox proportional hazards modeling, adjusting for covariates used in The Society of Thoracic Surgeons 30-day readmission model. RESULTS The median follow-up time was 365 days. After adjustment for established risk factors, above-median levels of postoperative galectin-3 (median 10.35 ng/mL; hazard ratio, 1.40; 95% confidence interval, 1.08 to 1.80; p = 0.010) and N-terminal prohormone of brain natriuretic peptide (median = 15.21 ng/mL, hazard ratio, 1.42; 95% confidence interval, 1.07 to 1.87; p = 0.014) were each significantly associated with 1-year readmission or mortality. CONCLUSIONS In patients undergoing cardiac surgery, novel cardiac biomarkers were associated with readmission or mortality independent of established risk factors. Measurement of these biomarkers may improve our ability to identify patients at highest risk for readmission or mortality before discharge. This will also allow resource allocation accordingly, while implementing strategies for personalized medicine based on the biomarker profile of the patient.
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Metra M. December 2016 at a glance: cardiac metabolism, myocarditis, right ventricular function and prognostic markers. Eur J Heart Fail 2016; 18:1403-1404. [PMID: 27910286 DOI: 10.1002/ejhf.710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Marco Metra
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy
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Hunter BR, Pang PS. Contextual risk: a study of fish out of water. Eur J Heart Fail 2016; 18:1506-1507. [DOI: 10.1002/ejhf.658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 08/13/2016] [Accepted: 08/17/2016] [Indexed: 11/09/2022] Open
Affiliation(s)
- Benton R. Hunter
- Indiana University School of Medicine; Department of Emergency Medicine; Indianapolis IN USA
| | - Peter S. Pang
- Indiana University School of Medicine; Department of Emergency Medicine; Indianapolis IN USA
- Regenstrief Institute; Indiana University School of Medicine; Indianapolis IN USA
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