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Zhang T, Guan YZ, Liu H. Association of Acidemia With Short-Term Mortality of Acute Myocardial Infarction: A Retrospective Study Base on MIMIC-III Database. Clin Appl Thromb Hemost 2021; 26:1076029620950837. [PMID: 32862673 PMCID: PMC7466881 DOI: 10.1177/1076029620950837] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Acute myocardial infarction (AMI) is a leading cause of death and not a few of these patients are combined with acidemia. This study aimed to detect the association of acidemia with short-term mortality of AMI patients. A total of 972 AMI patients were selected from the Medical Information Mart for Intensive Care (MIMIC) III database for analysis. Propensity-score matching (PSM) was used to reduce the imbalance. Kaplan-Meier survival analysis was used to compare the mortality, and Cox-proportional hazards model was used to detect related factors associated with mortality. After PSM, a total of 345 non-acidemia patients and 345 matched acidemia patients were included. The non-acidemia patients had a significantly lower 30-day mortality (20.0% vs. 28.7%) and lower 90-day mortality (24.9% vs. 31.9%) than the acidemia patients (P < 0.001 for all). The severe-acidemia patients (PH < 7.25) had the highest 30-day mortality (52.6%) and 90-day mortality (53.9%) than non-acidemia patients and mild-acidemia (7.25 ≤ PH < 7.35) patients (P < 0.001). In Cox-proportional hazards model, acidemia was associated with improved 30-day mortality (HR = 1.518; 95%CI = 1.110-2.076, P = 0.009) and 90-day mortality (HR = 1.378; 95%CI = 1.034 -1.837, P = 0.029). These results suggest that severe acidemia is associated with improved 30-day mortality and 90-day mortality of AMI patients.
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Affiliation(s)
- Tang Zhang
- Department of Cardiology, The Second Affiliated Hospital, 74626Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | - Yao-Zong Guan
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, 74626Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | - Hao Liu
- Department of Cardiology, The Second Affiliated Hospital, 74626Guangxi Medical University, Nanning, Guangxi, People's Republic of China
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Ji Z, Hernández-Vázquez J, Domínguez-Zabaleta IM, Xia Z, Bellón-Cano JM, Gallo-González V, Ali-García I, Matesanz-Ruiz C, López-de-Andrés A, Jiménez-García R, Buendía-García MJ, Gómez-Sacristán Á, Girón-Matute WI, Puente-Maestu L, de Miguel-Díez J. Influence of Comorbidities on the Survival of COPD Patients According to Phenotypes. Int J Chron Obstruct Pulmon Dis 2020; 15:2759-2767. [PMID: 33154636 PMCID: PMC7608550 DOI: 10.2147/copd.s270770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/22/2020] [Indexed: 11/23/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) usually occurs alongside other conditions. Few studies on comorbidities have taken into account the phenotypes of COPD patients. The objective of this study is to evaluate the prevalence of comorbidities included in the Charlson index and their influence on the survival of patients with COPD, taking phenotypes into account. Methods An observational study was conducted on a group of 273 patients who had COPD and underwent spirometry in the first half of 2011, with a median prospective follow-up period of 68.15 months. The survival of these patients was analyzed according to the presence of various comorbidities. Results Of the 273 patients, 93 (34.1%) died within the follow-up period. An increased presence of chronic ischemic heart disease (CIHD), chronic heart failure (CHF), chronic kidney disease (CKD), and malignancy was found in deceased patients. All of these conditions shorten the survival of COPD patients globally; however, when considering phenotypes, only CHF influences the exacerbator with chronic bronchitis phenotype, CKD influences the non-exacerbator phenotype, and malignancy influences the positive bronchodilator test (BDT) and exacerbator with chronic bronchitis phenotypes. In the multivariate model, advanced age (hazard ratio, HR: 1.05; p=0.001), CHF (HR: 1.74; p=0.030), and the presence of malignancy (HR: 1.78; p=0.010) were observed as independent mortality risk factors. Conclusion The survival is shorter in the presence of CIHD in overall COPD patients and also CHF, CKD, and malignancy for certain phenotypes. It is important to pay attention to these comorbidities in the comprehensive care of COPD patients.
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Affiliation(s)
- Zichen Ji
- Pulmonology Service, Gregorio Marañón General University Hospital, Madrid, Spain.,Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| | | | | | - Ziyi Xia
- Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| | | | | | - Ismael Ali-García
- Pulmonology Section, Infanta Leonor University Hospital, Madrid, Spain
| | | | - Ana López-de-Andrés
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Rodrigo Jiménez-García
- Public Health and Maternal and Child Health Department, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| | | | | | - Walther Iván Girón-Matute
- Pulmonology Service, Gregorio Marañón General University Hospital, Madrid, Spain.,Faculty of Medicine, Complutense University of Madrid, Madrid, Spain.,Gregorio Marañón Health Research Institute, Madrid, Spain
| | - Luis Puente-Maestu
- Pulmonology Service, Gregorio Marañón General University Hospital, Madrid, Spain.,Faculty of Medicine, Complutense University of Madrid, Madrid, Spain.,Gregorio Marañón Health Research Institute, Madrid, Spain
| | - Javier de Miguel-Díez
- Pulmonology Service, Gregorio Marañón General University Hospital, Madrid, Spain.,Faculty of Medicine, Complutense University of Madrid, Madrid, Spain.,Gregorio Marañón Health Research Institute, Madrid, Spain
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