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Yang C, Yu Z, Peng B, Mao C, Li J, Cao Y. ALBI Grade Is Associated with Clinical Outcomes of Critically Ill Patients with AKI: A Cohort Study with Cox Regression and Propensity Score Matching. Mediators Inflamm 2024; 2024:1412709. [PMID: 39055134 PMCID: PMC11272401 DOI: 10.1155/2024/1412709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 04/21/2024] [Accepted: 06/25/2024] [Indexed: 07/27/2024] Open
Abstract
Background The albumin-bilirubin (ALBI) grade has surfaced as a viable substitute for assessing liver functional reserve in individuals afflicted with hepatocellular carcinoma (HCC). ALBI grade also demonstrates the capacity to stratify distinct patient subcohorts bearing disparate prognostic implications in not only HCC but also other inflammatory diseases like acute pancreatitis. However, the association between ALBI grade and clinical outcomes of acute kidney injury (AKI) remains mysterious. Methods The dataset was sourced from the Multiparameter Intelligent Monitoring in Intensive Care Database IV (MIMIC-IV) version 2.0. ALBI grade was calculated in a nomogram utilizing albumin and bilirubin. In order to ascertain the connection between ALBI grades and clinical outcomes of patients with AKI, Cox proportional hazards regression analysis was employed with in-hospital, 30- and 90-day mortality as end points, respectively. The Kaplan-Meier (K-M) curve was employed to gauge the cumulative incidence of mortality based on various ALBI grades. To explore potential nonlinear relationships, the Restricted Cubic Spline (RCS) approach was adopted. Furthermore, a subgroup analysis was conducted to validate the durability of the correlation between ALBI grade and in-hospital mortality. Furthermore, equilibrium of confounding variables was also achieved through the application of propensity score matching (PSM). Results The study encompassed a total of 12,518 patients (ALBI grade 1 : 2878, grade 2 : 6708, and grade 3 : 2932). Patients with heightened ALBI grades displayed a significant correlation with increased mortality in both univariate and various multivariate Cox regression models. RCS depicted a predominantly linear relationship. The robustness of the correlation was also affirmed across multifarious subpopulations through subgroup analysis. The association still remains after PSM. Conclusion Elevated ALBI grade was associated with worse clinical outcomes of critically ill patients with AKI.
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Affiliation(s)
- Chao Yang
- Department of UrologyAnhui Provincal Children's Hospital, Hefei, China
| | - Zhikang Yu
- Department of UrologyAnhui Provincal Children's Hospital, Hefei, China
| | - Bo Peng
- Department of UrologyAnhui Provincal Children's Hospital, Hefei, China
| | - Changkun Mao
- Department of UrologyAnhui Provincal Children's Hospital, Hefei, China
| | - Junting Li
- Department of UrologyAnhui Provincal Children's Hospital, Hefei, China
| | - Yongsheng Cao
- Department of UrologyAnhui Provincal Children's Hospital, Hefei, China
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Chen K, Yin Q, Guan J, Yang J, Ma Y, Hu Y, Chen C, Chen W. Association between the oxidative balance score and low muscle mass in middle-aged US adults. Front Nutr 2024; 11:1358231. [PMID: 38646107 PMCID: PMC11026710 DOI: 10.3389/fnut.2024.1358231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/25/2024] [Indexed: 04/23/2024] Open
Abstract
Background Oxidative Balance Score (OBS) is a tool for assessing the oxidative stress-related exposures of diet and lifestyle. The study aimed to investigate the association between OBS and low muscle mass. Methods Overall, 6,307 individuals over the age of 18 were assessed using data from the 2011 to 2018 National Health and Nutrition Examination Survey (NHANES). Weighted logistic regression and models were used, together with adjusted models. Results There was a negative relationship between OBS and low muscle mass [odds ratio (OR): 0.96, 95% confidence interval (CI): 0.94-0.97, p< 0.0001] using the first OBS level as reference. The values (all 95% CI) were 0.745 (0.527-1.054) for the second level, 0.650 (0.456-0.927) for the third level, and 0.326 (0.206-0.514) for the fourth level (P for trend <0.0001). Independent links with low muscle mass were found for diet and lifestyle factors. A restricted cubic spline model indicated a non-linear association between OBS and low muscle mass risk (P for non-linearity<0.05). In addition, the inflection points of the nonlinear curves for the relationship between OBS and risk of low muscle mass were 20. Conclusion OBS and low muscle mass were found to be significantly negatively correlated. By modulating oxidative balance, a healthy lifestyle and antioxidant rich diet could be a preventive strategy for low muscle mass.
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Affiliation(s)
- Kun Chen
- Department of Thoracic Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Qiang Yin
- Department of Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Jiangan Guan
- Department of Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Jingwen Yang
- Department of Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Yuan Ma
- Department of Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Yu Hu
- Department of Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Chan Chen
- Department of Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
| | - Wenwen Chen
- Department of Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
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Xia X, Tan S, Zeng R, Ouyang C, Huang X. Lactate dehydrogenase to albumin ratio is associated with in-hospital mortality in patients with acute heart failure: Data from the MIMIC-III database. Open Med (Wars) 2024; 19:20240901. [PMID: 38584822 PMCID: PMC10996934 DOI: 10.1515/med-2024-0901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 04/09/2024] Open
Abstract
The effect of the lactate dehydrogenase to albumin ratio (LAR) on the survival of patients with acute heart failure (AHF) is unclear. We aimed to analyze the impact of LAR on survival in patients with AHF. We retrieved eligible patients for our study from the Monitoring in Intensive Care Database III. For each patient in our study, we gathered clinical data and demographic information. We conducted multivariate logistic regression modeling and smooth curve fitting to assess whether the LAR score could be used as an independent indicator for predicting the prognosis of AHF patients. A total of 2,177 patients were extracted from the database. Survivors had an average age of 69.88, whereas nonsurvivors had an average age of 71.95. The survivor group had a mean LAR ratio of 13.44, and the nonsurvivor group had a value of 17.38. LAR and in-hospital mortality had a nearly linear correlation, according to smooth curve fitting (P < 0.001). According to multivariate logistic regression, the LAR may be an independent risk factor in predicting the prognosis of patients with AHF (odd ratio = 1.09; P < 0.001). The LAR ratio is an independent risk factor associated with increased in-hospital mortality rates in patients with AHF.
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Affiliation(s)
- Xiangjun Xia
- Department of Cardiology, Yiyang Central Hospital, Yiyang, 410215, Hunan, China
- Hunan Province Clinical Medical Technology Demonstration Base for Complex Coronary Lesions, Yiyang, Hunan, China
| | - Suisai Tan
- Department of Vascular Surgery, Yiyang Central Hospital, Yiyang, 410215, Hunan, China
| | - Runhong Zeng
- Department of Cardiology, Yiyang Central Hospital, Yiyang, 410215, Hunan, China
| | - Can Ouyang
- The Traditional Chinese Medical Hospital of Xiangtan County, Xiangtan, Hunan, China
| | - Xiabin Huang
- The Traditional Chinese Medical Hospital of Xiangtan County, Xiangtan, Hunan, China
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Chen JH, Zhang LW, Lin ZJ, Chen XF, Chen LC, Wang CX, Lin KY, Guo YS. The Association Between the Albumin-Bilirubin Score and Contrast-Associated Acute Kidney Injury in Patients Undergoing Elective Percutaneous Coronary Intervention. Angiology 2024:33197241228051. [PMID: 38227840 DOI: 10.1177/00033197241228051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
The albumin-bilirubin (ALBI) score is considered an effective and convenient scoring system for assessing liver function. We hypothesized that the ALBI score was predictive of contrast-associated acute kidney injury (CA-AKI) and long-term mortality in patients undergoing elective percutaneous coronary intervention (PCI). We retrospectively observed 5629 patients undergoing elective PCI. Contrast-associated acute kidney injury is defined as a 50% or 0.3 mg/dl increase in baseline serum creatinine levels within 48 h of contrast exposure. The incidence of CA-AKI was 6.2% (n = 350). After adjusting for potential confounding factors, multivariate analysis showed that the ALBI score was an independent predictor of CA-AKI (P = .002). A restricted cubic spline analysis confirmed approximately linear relationships between the ALBI score and risks of CA-AKI. Furthermore, at a median follow-up of 2.8 years, multivariate Cox regression analysis indicated that the ALBI score was an independent risk factor for long-term mortality (P < .001). The ALBI score was closely related to the occurrence of CA-AKI and long-term mortality in patients who underwent elective PCI. This score might be useful for risk stratification in high-risk patient groups to predict CA-AKI.
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Affiliation(s)
- Jun-Han Chen
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Center for Geriatrics, Fujian Provincial Clinical Research Center for Severe Acute Cardiovascular Diseases, Fuzhou, China
- Fujian Heart Failure Center Alliance, Fuzhou, China
| | - Li-Wei Zhang
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Center for Geriatrics, Fujian Provincial Clinical Research Center for Severe Acute Cardiovascular Diseases, Fuzhou, China
- Fujian Heart Failure Center Alliance, Fuzhou, China
| | - Zhi-Jie Lin
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Center for Geriatrics, Fujian Provincial Clinical Research Center for Severe Acute Cardiovascular Diseases, Fuzhou, China
- Fujian Heart Failure Center Alliance, Fuzhou, China
| | - Xiao-Fang Chen
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Center for Geriatrics, Fujian Provincial Clinical Research Center for Severe Acute Cardiovascular Diseases, Fuzhou, China
- Fujian Heart Failure Center Alliance, Fuzhou, China
| | - Li-Chuan Chen
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Center for Geriatrics, Fujian Provincial Clinical Research Center for Severe Acute Cardiovascular Diseases, Fuzhou, China
- Fujian Heart Failure Center Alliance, Fuzhou, China
| | - Chang-Xi Wang
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Center for Geriatrics, Fujian Provincial Clinical Research Center for Severe Acute Cardiovascular Diseases, Fuzhou, China
- Fujian Heart Failure Center Alliance, Fuzhou, China
| | - Kai-Yang Lin
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Center for Geriatrics, Fujian Provincial Clinical Research Center for Severe Acute Cardiovascular Diseases, Fuzhou, China
- Fujian Heart Failure Center Alliance, Fuzhou, China
| | - Yan-Song Guo
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Center for Geriatrics, Fujian Provincial Clinical Research Center for Severe Acute Cardiovascular Diseases, Fuzhou, China
- Fujian Heart Failure Center Alliance, Fuzhou, China
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Kuo PJ, Rau CS, Tsai CH, Chou SE, Su WT, Hsu SY, Hsieh CH. Evaluation of the Easy Albumin-Bilirubin Score as a Prognostic Tool for Mortality in Adult Trauma Patients in the Intensive Care Unit: A Retrospective Study. Diagnostics (Basel) 2023; 13:3450. [PMID: 37998586 PMCID: PMC10670548 DOI: 10.3390/diagnostics13223450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023] Open
Abstract
The easy albumin-bilirubin (EZ-ALBI) score is derived using the following equation: total bilirubin (mg/dL) - 9 × albumin (g/dL). This study aimed to determine whether the EZ-ALBI score predicted mortality risk in adult trauma patients in an intensive care unit (ICU). Data from a hospital's trauma database were retrospectively evaluated for 1083 adult trauma ICU patients (139 deaths and 944 survivors) between 1 January 2016 and 31 December 2021. Patients were classified based on the ideal EZ-ALBI cut-off of -26.5, which was determined via receiver operating characteristic curve analysis. The deceased patients' EZ-ALBI scores were higher than those of the surviving patients (-26.8 ± 6.5 vs. -30.3 ± 5.9, p = 0.001). Multivariate logistic analysis revealed that, in addition to age, the presence of end-stage renal disease, Glasgow Coma Scale scores, and injury severity scores, the EZ-ALBI score is an independent risk factor for mortality (odds ratio (OR), 1.10; 95% confidence interval (CI): 1.06-1.14; p = 0.001)). Compared with patients with EZ-ALBI scores < -26.5, those with scores ≥ -26.5 had a 2.1-fold higher adjusted mortality rate (adjusted OR, 2.14; 95% CI: 1.43-3.19, p = 0.001). In conclusion, the EZ-ALBI score is a substantial and independent predictor of mortality and can be screened to stratify mortality risk in adult trauma ICU patients.
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Affiliation(s)
- Pao-Jen Kuo
- Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Cheng-Shyuan Rau
- Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Ching-Hua Tsai
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-H.T.); (S.-E.C.); (W.-T.S.); (S.-Y.H.)
| | - Sheng-En Chou
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-H.T.); (S.-E.C.); (W.-T.S.); (S.-Y.H.)
| | - Wei-Ti Su
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-H.T.); (S.-E.C.); (W.-T.S.); (S.-Y.H.)
| | - Shiun-Yuan Hsu
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-H.T.); (S.-E.C.); (W.-T.S.); (S.-Y.H.)
| | - Ching-Hua Hsieh
- Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
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Zavrtanik H, Cosola D, Badovinac D, Hadžialjević B, Horvat G, Plevel D, Bogoni S, Tarchi P, de Manzini N, Tomažič A. Predictive value of preoperative albumin-bilirubin score and other risk factors for short-term outcomes after open pancreatoduodenectomy. World J Clin Cases 2023; 11:6051-6065. [PMID: 37731561 PMCID: PMC10507555 DOI: 10.12998/wjcc.v11.i26.6051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/25/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Pancreatoduodenectomy represents a complex procedure involving extensive organ resection and multiple alimentary reconstructions. It is still associated with high morbidity, even in high-volume centres. Prediction tools including preoperative patient-related factors to preoperatively identify patients at high risk for postoperative complications could enable tailored perioperative management and improve patient outcomes. AIM To evaluate the clinical significance of preoperative albumin-bilirubin score and other risk factors in relation to short-term postoperative outcomes in patients after open pancreatoduodenectomy. METHODS This retrospective study included all patients who underwent open pancreatic head resection (pylorus-preserving pancreatoduodenectomy or Whipple resection) for various pathologies during a five-year period (2017-2021) in a tertiary care setting at University Medical Centre Ljubljana, Slovenia and Cattinara Hospital, Trieste, Italy. Short-term postoperative outcomes, namely, postoperative complications, postoperative pancreatic fistula, reoperation, and mortality, were evaluated in association with albumin-bilirubin score and other risk factors. Multiple logistic regression models were built to identify risk factors associated with these short-term postoperative outcomes. RESULTS Data from 347 patients were collected. Postoperative complications, major postoperative complications, postoperative pancreatic fistula, reoperation, and mortality were observed in 52.7%, 22.2%, 23.9%, 21.3%, and 5.2% of patients, respectively. There was no statistically significant association between the albumin-bilirubin score and any of these short-term postoperative complications based on univariate analysis. When controlling for other predictor variables in a logistic regression model, soft pancreatic texture was statistically significantly associated with postoperative complications [odds ratio (OR): 2.09; 95% confidence interval (95%CI): 1.19-3.67]; male gender (OR: 2.12; 95%CI: 1.15-3.93), soft pancreatic texture (OR: 3.06; 95%CI: 1.56-5.97), and blood loss (OR: 1.07; 95%CI: 1.00-1.14) were statistically significantly associated with major postoperative complications; soft pancreatic texture was statistically significantly associated with the development of postoperative pancreatic fistula (OR: 5.11; 95%CI: 2.38-10.95); male gender (OR: 1.97; 95%CI: 1.01-3.83), soft pancreatic texture (OR: 2.95; 95%CI: 1.42-6.11), blood loss (OR: 1.08; 95%CI: 1.01-1.16), and resection due to duodenal carcinoma (OR: 6.58; 95%CI: 1.20-36.15) were statistically significantly associated with reoperation. CONCLUSION The albumin-bilirubin score failed to predict short-term postoperative outcomes in patients undergoing pancreatoduodenectomy. However, other risk factors seem to influence postoperative outcomes, including male sex, soft pancreatic texture, blood loss, and resection due to duodenal carcinoma.
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Affiliation(s)
- Hana Zavrtanik
- Department of Abdominal Surgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
| | - Davide Cosola
- Clinica Chirurgica, Azienda Sanitaria Universitaria Giuliano Isontina, Cattinara Hospital, Trieste 34149, Italy
| | - David Badovinac
- Department of Abdominal Surgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
| | - Benjamin Hadžialjević
- Department of Abdominal Surgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
| | - Gašper Horvat
- Department of Abdominal Surgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
| | - Danaja Plevel
- Department of Abdominal Surgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
| | - Selene Bogoni
- Clinica Chirurgica, Azienda Sanitaria Universitaria Giuliano Isontina, Cattinara Hospital, Trieste 34149, Italy
| | - Paola Tarchi
- Clinica Chirurgica, Azienda Sanitaria Universitaria Giuliano Isontina, Cattinara Hospital, Trieste 34149, Italy
| | - Nicolò de Manzini
- Clinica Chirurgica, Azienda Sanitaria Universitaria Giuliano Isontina, Cattinara Hospital, Trieste 34149, Italy
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste 34149, Italy
| | - Aleš Tomažič
- Department of Abdominal Surgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana 1000, Slovenia
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Shi L, Zhang D. Association of Dietary Inflammation Index and Helicobacter pylori Immunoglobulin G Seropositivity in US Adults: A Population-Based Study. Mediators Inflamm 2023; 2023:8880428. [PMID: 37545737 PMCID: PMC10403320 DOI: 10.1155/2023/8880428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 08/08/2023] Open
Abstract
Background Dietary patterns play important role in Helicobacter pylori (H. pylori) infection. We aimed to investigate the potential relationship between Dietary Inflammation Index (DII) and H. pylori infection in US adults. Methods This cross-sectional study was based on National Health and Nutrition Examination Survey (1999-2000). Individuals aged ≥20 years who provided a 24 hr dietary intake history and underwent H. pylori testing were included in the analysis. Multivariate weighted logistic regression analysis, smooth curve fitting, and subgroup analysis were used to investigate the relationship between DII and H. pylori infection. Subgroup analyses were based on demographic and clinical variables. Results There were 4,000 individuals enrolled in our final analysis. The overall mean age was 45.92 years and 46.77% were males. The overall prevalence of H. pylori infection in the study population was 45.9%. The smooth curve fitting analysis indicated a near-linear relationship between DII and H. pylori. In multivariate weighted logistic regression analysis, the odds ratio (OR) of DII is 1.17 (95% confidence interval (CI), 1.09-1.27) for H. pylori infection. In subgroup analysis, DII still increased the risk of H. pylori infection independently. Conclusions The increased DII levels were associated with an increased risk of H. pylori infection among US adults. Further studies are needed to elucidate the exact mechanisms of DII and H. pylori infection.
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Affiliation(s)
- Lin Shi
- Department of Gastroenterology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Dan Zhang
- Department of Nephrology, Affiliated Hospital of Xuzhou Medical University, 99 West Huai-hai Road, Xuzhou 221002, Jiangsu, China
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Shi L, Zhang L, Zhang D, Chen Z. Association between systemic immune-inflammation index and low muscle mass in US adults: a cross-sectional study. BMC Public Health 2023; 23:1416. [PMID: 37488531 PMCID: PMC10367418 DOI: 10.1186/s12889-023-16338-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/18/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Chronic inflammatory responses have been reported to be associated with low muscle mass and systemic immune-inflammation index(SII) is a novel indicator of inflammation. The purpose of our study was to clarify the relationship between SII and low muscle mass. METHODS This study was a cross-sectional study based on National Health and Nutrition Examination Survey (2011-2018). SII was calculated as the platelet count × neutrophil count/lymphocyte count. Appendicular skeletal muscle index was used to define low muscle mass. The individuals were divided into four groups by the quartile of SII (Q1-Q4). Multivariate weighted logistic regression analysis, smooth curve fitting and subgroup analysis were used to investigate the relationship between SII and sarcopenia. Subgroup analysis were based on demographic and clinical variables. RESULTS There were 10,367 individuals enrolled in our final analysis. The overall mean age was 39.39 years and 49.17% were males. The overall prevalence of low muscle mass in the study population was 8.77%. The smooth curve fitting analysis indicated a near-linear relationship between SII and low muscle mass. In multivariate weighted logistic regression analysis, the odds ratio (OR) of Q4 is 1.28 (95% CI, 1.16-1.40) for low muscle mass when compared to lowest quartile of the SII. In subgroup analysis, SII still increased the risk of low muscle mass independently. CONCLUSION The increased SII levels were associated with an increased risk of low muscle mass in a large population. Our study increased the understanding between inflammation and low muscle mass. Anti-inflammation therapy may be important for low muscle mass.
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Affiliation(s)
- Lin Shi
- Department of Gastroenterology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Liang Zhang
- Department of Gastrointestinal Surgery, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical College, Xuzhou, Jiangsu, China
| | - Dan Zhang
- Department of Nephrology, Affiliated Hospital of Xuzhou Medical University, 99 West Huai-hai Road, Xuzhou, 221002, Jiangsu, China
| | - Zhuo Chen
- Department of Gastroenterology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, China.
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Cheng W, Duan L, Xu J, Shu Y, Qiu H, Yin G. Prognostic value of the albumin-bilirubin score in patients with non-Hodgkin lymphoma-associated hemophagocytic lymphohistiocytosis. Front Immunol 2023; 14:1162320. [PMID: 37266439 PMCID: PMC10229876 DOI: 10.3389/fimmu.2023.1162320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/09/2023] [Indexed: 06/03/2023] Open
Abstract
Secondary hemophagocytic lymphohistiocytosis (sHLH) is a rare life-threatening systemic disease. This study aimed to assess the prognostic value of pretreatment albumin-bilirubin (ALBI). We retrospectively analyzed 168 non-Hodgkin lymphoma-associated secondary hemophagocytic lymphohistiocytosis (NHL-sHLH) patients with hepatic injuries. Multivariable logistic/Cox models and restricted cubic spline models were conducted to evaluate the relationships between the ALBI score and short- and long-term survival. Among 168 adult NHL-sHLH patients, 82 (48.8%) patients died within 30 days after admission, and 144 (85.7%) patients died during the follow-up period. Multivariable logistic/Cox regression model indicated that ALBI grade could be an independent risk factor for predicting the prognosis of patients with 30-day mortality and overall survival (odds ratios [OR]30 days 5.37, 95% confidence interval 2.41-12.64, P < 0.001; hazard ratios [HR]OS 1.52, 95% confidence interval 1.06-2.18, P = 0.023), respectively. The restricted cubic spline curve displayed a linear and positive relationship between the ALBI score and risk of mortality (P for nonlinearity =0.503). Furthermore, receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for predicting mortality by integrative analysis of the ALBI score and ferritin was significantly improved compared to the ALBI score (AUC 30 days: 0.820 vs 0.693, P = 0.001; AUC1 year: 0.754 vs 0.681, P = 0.043) or ferritin (AUC30 days: 0.820 vs 0.724, P = 0.005; AUC1 year: 0.754 vs 0.658, P = 0.031) alone. The ALBI score could be a useful indicator of short and long-term survival for NHL-sHLH patients with hepatic injuries.
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Affiliation(s)
- Wanying Cheng
- Department of Geriatric Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
- Department of Hematology, Wuxi People’s Hospital, Nanjing Medical University, Wuxi, China
| | - Limin Duan
- Department of Geriatric Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Ji Xu
- Department of Geriatric Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Yongqian Shu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Hongxia Qiu
- Department of Geriatric Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Guangli Yin
- Department of Geriatric Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
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Wei Y, Guo J. High Triglyceride-Glucose Index Is Associated with Poor Prognosis in Patients with Acute Pancreatitis. Dig Dis Sci 2023; 68:978-987. [PMID: 35731427 DOI: 10.1007/s10620-022-07567-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 05/16/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND Acute pancreatitis (AP) is a common gastrointestinal disease worldwide. Severe acute pancreatitis (SAP) is characterized as persistent organ failure with a mortality rate as high as 20-30%. Early assessment of the severity and screening out possible SAP is of great significance. Given that there is still a lack of both convenient and practical tools for evaluating SAP, we conducted this study to explore the association between TyG index and acute pancreatitis prognosis. METHODS A total of 353 in-patients diagnosed with acute pancreatitis in the Second Hospital of Shandong University were retrospectively enrolled from January 2018 to November 2021 in this study. According to the Atlanta Classification, they were divided into two groups based on the AP severity. Demographic information and clinical materials were retrospectively collected. The TyG index calculation formula is as follows: ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. Statistical analyses were performed using SPSS software (IBM version 22.0) and Medcalc software. Multivariable logistic regression analyses were used to investigate independent predictors for SAP. ROC curve was plotted to assess the predictive ability and cutoffs of TyG index. RESULTS A total of 353 AP patients were respectively enrolled in this study, of which 47 suffered from SAP. Compared with the non-SAP group, TyG index was significantly higher in the SAP group (10.44 ± 1.55 vs 9.33 ± 1.44, P < 0.001). Multivariate logistic regression analysis showed that TyG index was an independent risk factor for SAP (OR 1.835, 95% CI 1.380-2.442 P < 0.001), with a cutoff of 8.76 for non-HTG/AAP and 11.81 for HTG/AAP by ROC curve. TyG index of patients who suffered from SIRS, OF, APFC, and ANC was higher than those without (P < 0.05). CONCLUSIONS The triglyceride-glucose index is an independent risk factor for SAP. High TyG index is closely related to SAP and AP-related complications.
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Affiliation(s)
- Yimin Wei
- Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Jianqiang Guo
- Department of Gastroenterology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, China.
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Chou SE, Rau CS, Su WT, Tsai CH, Hsu SY, Hsieh CH. The Association of Albumin-Bilirubin (ALBI) Grade with Mortality Risk in Trauma Patients with Liver Injuries. Risk Manag Healthc Policy 2023; 16:279-286. [PMID: 36875171 PMCID: PMC9975765 DOI: 10.2147/rmhp.s397210] [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: 11/11/2022] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction The albumin-bilirubin (ALBI) grade objectively assesses liver function with better performance than the Child-Pugh and end-stage liver disease scores. However, the evidence is lacking on the ALBI grade in trauma cases. This study aimed to identify the association between the ALBI grade and mortality outcomes in trauma patients with liver injury. Methods Data from 259 patients with traumatic liver injury at a level I trauma center between January 1, 2009, and December 31, 2021 were retrospectively analyzed. Independent risk factors for predicting mortality were identified using multiple logistic regression analysis. Participants were characterized by ALBI score into grade 1 (≤ -2.60, n = 50), grade 2 (-2.60 < and ≤ -1.39, n = 180), and grade 3 (> -1.39, n = 29). Results Compared to survival (n = 239), death (n = 20) was associated with a significantly lower ALBI score (2.8±0.4 vs 3.4±0.7, p < 0.001). The ALBI score was a significant independent risk factor for mortality (OR, 2.79; 95% CI, 1.27-8.05; p = 0.038). Compared with grade 1 patients, grade 3 patients had a significantly higher mortality rate (24.1% vs 0.0%, p < 0.001) and a longer hospital stay (37.5 days vs 13.5 days, p < 0.001). Discussion This study showed that ALBI grade is a significant independent risk factor and an useful clinical tool to discover liver injury patients who are more susceptible to death.
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Affiliation(s)
- Sheng-En Chou
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Shyuan Rau
- Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wei-Ti Su
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ching-Hua Tsai
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shiun-Yuan Hsu
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ching-Hua Hsieh
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Wang Q, Chen Y, Huang P, Su D, Gao F, Fu X, Fu B. The Clinical Characteristics and Outcome of Elderly Patients With Acute Pancreatitis. Pancreas 2022; 51:1284-1291. [PMID: 37099768 DOI: 10.1097/mpa.0000000000002192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
OBJECTIVES This study aimed to identify the risk factors for the progression of acute pancreatitis (AP) to severe acute pancreatitis (SAP) and death in elderly patients. METHODS This was a single-center retrospective study conducted in a tertiary teaching hospital. Data on patient demographics, comorbidities, duration of hospitalization, complications, interventions, and mortality rates were collected. RESULTS Between January 2010 and January 2021, 2084 elderly patients with AP were included in this study. The mean age of the patients was 70.0 years (standard deviation, 7.1 years). Among them, 324 (15.5%) had SAP and 105 died (5.0%). The 90-day mortality rate in the SAP group was significantly higher than that in the AP group (P < 0.0001). Multivariate regression analysis revealed that trauma, hypertension, and smoking were risk factors for SAP. After multivariate adjustment, acute respiratory distress syndrome, acute kidney injury, sepsis, organ perforation, and abdominal hemorrhage were associated with higher 90-day mortality. CONCLUSIONS Traumatic pancreatitis, hypertension, and smoking are independent risk factors for SAP in elderly patients. Acute respiratory distress syndrome, acute kidney injury, sepsis, organ perforation, and abdominal hemorrhage are independent risk factors for death in elderly patients with AP.
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Muacevic A, Adler JR. Prognostic Significance of the Red Cell Distribution Width/Albumin Ratio in the Prediction of the Severity of Acute Biliary Pancreatitis: A Preliminary Report. Cureus 2022; 14:e30183. [PMID: 36238420 PMCID: PMC9552954 DOI: 10.7759/cureus.30183] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2022] [Indexed: 11/19/2022] Open
Abstract
Objective Acute pancreatitis (AP) is a common inflammatory disease that should be considered in the etiology of patients presenting to the emergency department with abdominal pain. AP manifests with a clinical picture that can lead to organ failure and even death; therefore, early diagnosis and treatment are essential. In this study, we aimed to evaluate the red cell distribution width (RDW)/albumin ratio (RAR), which, we consider, can be used to determine the clinical course of acute biliary pancreatitis (ABP). Material and method The study included 166 patients with ABP. The patient's demographic information, blood values at the time of the first presentation to the emergency department, and radiological results were recorded by screening them retrospectively. Using the Atlanta criteria, the cases were classified into mild, moderately severe, and severe AP groups (MAP, MSAP, and SAP, respectively) and compared. Results Of the patients, 121 (72.9%) patients had MAP, 40 (24.1%) had MSAP, and five (3%) had SAP. There was no statistically significant difference between the three groups regarding gender and age. The SAP group had significantly higher median values for the length of hospital stay [19 (4-31) days], white blood cell (WBC) count [20.4 x109/L (9.1-23.3 x109/L)], and creatinine (Cre) [1.4 mg/dL (0.7-3.4 mg/dL)] (p<0.001, p=0.003, and p=0.014, respectively). The RDW and albumin values of all the groups were within normal ranges. RAR was higher in the SAP group but did not statistically significantly different between the groups. In the receiver operating characteristic (ROC) analysis of RAR, the area under the curve (AUC) value was determined as 0.75, sensitivity as 80%, specificity as 70.2%, and positive likelihood ratio as 2.1 (p=0.05). Conclusion It is considered that RAR may be a helpful method in determining the course of ABP attacks, but there is a need for studies with a larger series, including all pancreatitis cases.
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Toyoda H, Johnson PJ. The ALBI score: From liver function in patients with HCC to a general measure of liver function. JHEP Rep 2022; 4:100557. [PMID: 36124124 PMCID: PMC9482109 DOI: 10.1016/j.jhepr.2022.100557] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 01/27/2023] Open
Abstract
The (albumin-bilirubin) ‘ALBI’ score is an index of ‘liver function’ that was recently developed to assess prognosis in patients with hepatocellular carcinoma, irrespective of the degree of underlying liver fibrosis. Other measures of liver function, such as model for end-stage liver disease (MELD) and Child-Pugh score, which were introduced for specific clinical scenarios, have seen their use extended to other areas of hepatology. In the case of ALBI, its application has been increasingly extended to chronic liver disease in general and in some instances to non-liver diseases where it has proven remarkably accurate in terms of prognosis. With respect to chronic liver disease, numerous publications have shown that ALBI is highly prognostic in patients with all types and stages of chronic liver disease. Outside of liver disease, ALBI has been reported as being of prognostic value in conditions ranging from chronic heart failure to brain tumours. Whilst in several of these reports, explanations for the relationship of liver function to a clinical condition have been proposed, it has to be acknowledged that the specificity of ALBI for liver function has not been clearly demonstrated. Nonetheless, and similar to the MELD and Child-Pugh scores, the lack of any mechanistic basis for ALBI’s clinical utility does not preclude it from being clinically useful in certain situations. Why albumin and bilirubin levels, or a combination thereof, are prognostic in so many different diseases should be studied in the future.
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Affiliation(s)
- Hidenori Toyoda
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Philip J Johnson
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
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Construction of a Nomogram Model for Predicting Pleural Effusion Secondary to Severe Acute Pancreatitis. Emerg Med Int 2022; 2022:4199209. [PMID: 35345495 PMCID: PMC8957464 DOI: 10.1155/2022/4199209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/20/2022] [Indexed: 01/30/2023] Open
Abstract
Background This study aims to investigate the risk factors of pleural effusion (PE) secondary to severe acute pancreatitis (SAP) and to build a nomogram model. Methods The clinical parameters of SAP patients admitted to the emergency department of the First Affiliated Hospital of Bengbu Medical College from January 2019 to August 2021 were retrospectively collected. The independence risk factors of PE secondary to SAP were analyzed by univariate analysis and multivariate logistic regression analysis. A nomogram risk prediction model was established and validated through the area under the ROC curve. Result Two hundred twenty-two SAP patients were included for analysis, of which 65 patients experienced secondary PE. The incidence of PE secondary to SAP was 29.28% (65/222). Logistic regression analysis showed that serum albumin (ALB) (OR = 0.830, 95% CI: 0.736∼0.936), fibrinogen (FIB) (OR = 4.573, 95% CI: 1.795∼11.648), C-reactive protein (CRP) (OR = 1.046, 95% CI: 1.009∼1.083), acute physiology, chronic health score system (APACHE-II) score (OR = 1.484, 95% CI: 1.106∼1.990), and sequential organ failure score (SOFA) (OR = 43.038, 95% CI: 2.030∼4.548) were independent risk factors for PE secondary to SAP (P < 0.05) and entered into the nomogram. The nomogram showed robust discrimination with an index of concordance of 0.755 and an area under the receiver operating characteristic curve of 0.837 (95% CI: 0.779∼0.894). Conclusion We developed a nomogram model for PE secondary to SAP with ALB, FIB, CRP, APACHE-II scores, and SOFA scores. The nomogram model showed good discrimination and consistency, and it can better predict the risk of PE secondary to SAP.
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Shi L, Zhang S. Identification of Subclasses of Decompensated Cirrhotic Patients with Acute Kidney Injury with Different Responses to Fluid Input. Dig Dis 2022; 41:296-303. [PMID: 35301271 DOI: 10.1159/000524028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 03/07/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Acute kidney injury is a heterogeneous disease in decompensated cirrhotic patients. The aims of our study were to detect subphenotypes of cirrhotic patients with acute kidney injury (AKI) and explore clinical traits in patients with different subclasses. METHODS All enrolled patients were identified from a clinical database. Clinical and laboratory variables were used to perform latent profile analysis (LPA). Clinical traits in each class were compared. A multivariable logistic regression model and a Cox model were used to explore the independent association of fluid input and mortality outcome. RESULTS A total of 439 AKI patients with decompensated cirrhosis were enrolled in our study, including 113 patients in profile 1 and 326 patients in profile 2, by the LPA model. Profile 1 had higher mortality (61.1%) than profile 2 (36.81%). Moreover, profile 1 had a higher MELD score (median 39, interquartile range 34-43) than profile 2 (p < 0.001). Higher cumulative fluid input in the first 24 h for profile 1 was associated with an increased risk of hospital mortality (odds ratio 1.33, 95% CI: 1.02-1.75) and 90-day mortality (hazard ratio 1.39, 95% CI: 1.08-1.78). CONCLUSIONS In this study, two distinct subclasses of decompensated cirrhotic patients with AKI were identified, with different clinical outcomes and fluid input responses.
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Affiliation(s)
- Lin Shi
- Department of Gastroenterology, Xuzhou Central Hospital, Xuzhou, China
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Formanchuk T, Shaprinskiy V, Formanchuk A. Clinical and simple laboratory data associated with fatal outcomes in patients with acute pancreatitis. ACTA FACULTATIS MEDICAE NAISSENSIS 2022. [DOI: 10.5937/afmnai39-32308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Aims. The aim of the study was to evaluate the association of mortality in acute pancreatitis with clinical and simple laboratory data received on the day of admission. Patients and methods. In our retrospective study, the clinical and laboratory parameters of 99 patients with moderate and severe acute pancreatitis were analyzed. All patients were divided into two groups: deceased and survivors. Results. We did not find a significant difference in age and gender distribution between the comparison groups. However, a significant predominance of alcoholic etiology of acute pancreatitis, early hospitalization (up to 6 hours from the onset of the disease) of patients, and the number of necrotizing infected type in the deceased group were found. Concomitant pathology did not significantly differ in comparison groups. In patients from the deceased group, the total number of all complications was significantly higher than in the group of survivors-21 (100%) and 42 (53.8%) (p = 0.0001), respecting. Among the laboratory parameters determined on the day of admission, in the deceased group, there was a significant increase in stabs to 19.8 ± 9.8 and ESR, AST to 225.3 ± 47.5 U/L, urea to 11.2 ± 7.7 mmol/L, and creatinine to 173.6 ± 26.1 mmol/L. Conclusion. The alcoholic genesis of acute pancreatitis, necrotizing infected type of inflammation of the pancreas, presence of late complications, and comorbidities were significantly higher in the deceased group. The levels of stabs, ESR, AST, urea, and creatinine determined on the admission significantly dominated in the deceased group, which requires further study for the prediction of mortality of acute pancreatitis.
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Liu W, Du JJ, Li ZH, Zhang XY, Zuo HD. Liver injury associated with acute pancreatitis: The current status of clinical evaluation and involved mechanisms. World J Clin Cases 2021; 9:10418-10429. [PMID: 35004974 PMCID: PMC8686151 DOI: 10.12998/wjcc.v9.i34.10418] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/16/2021] [Accepted: 09/16/2021] [Indexed: 02/06/2023] Open
Abstract
Acute pancreatitis (AP) is a very common acute disease, and the mortality rate of severe AP (SAP) is between 15% and 35%. The main causes of death are multiple organ dysfunction syndrome and infections. The mortality rate of patients with SAP related to liver failure is as high as 83%, and approximately 5% of the SAP patients have fulminant liver failure. Liver function is closely related to the progression and prognosis of AP. In this review, we aim to elaborate on the clinical manifestations and mechanism of liver injury in patients with AP.
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Affiliation(s)
- Wei Liu
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Juan-Juan Du
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Zeng-Hui Li
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Xin-Yu Zhang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Hou-Dong Zuo
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
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Yan Y, Qiao L, Hua Y, Shao S, Zhang N, Wu M, Liu L, Zhou K, Liu X, Wang C. Predictive value of Albumin-Bilirubin grade for intravenous immunoglobulin resistance in a large cohort of patients with Kawasaki disease: a prospective study. Pediatr Rheumatol Online J 2021; 19:147. [PMID: 34563210 PMCID: PMC8467146 DOI: 10.1186/s12969-021-00638-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 09/06/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Intravenous immunoglobulin (IVIG) resistance prediction is one of the primary clinical issues and study hotspots in KD. This study aimed to prospectively investigate the value of albumin-bilirubin grade (ALBI) in predicting IVIG resistance in KD and to assess whether ALBI has more predictive value or accuracy than either ALB or TBil alone in predicting IVIG resistance. METHODS A total of 823 patients with KD were prospectively enrolled. The clinical and laboratory data were compared between the IVIG-response group (n = 708) and the IVIG-resistance group (n = 115). Multivariate logistic regression analysis was performed to identify the independent risk factors for IVIG resistance. Receiver operating characteristic (ROC) curves analysis was applied to assess the validity of ALBI, ALB, and TBil in predicting IVIG resistance. RESULTS ALBI was significantly higher in patients with IVIG resistance and was identified as an independent risk factor for IVIG resistance in KD. The parameter of ALBI ≥ - 2.57 (AUC: 0.705, 95 %CI: 0.672-0.736), ALB ≤ 33.0 g/L (AUC: 0.659, 95 %CI: 0.626-0.692), and TBil ≥ 16.0µmol/L (AUC: 0.626, 95 %CI: 0.592-0.659), produced a sensitivity, specificity, PPV, and NPV of 0.617, 0.657, 0.226 and 0.914; 0.374, 0.850, 0.289 and 0.893; 0.269, 0.941, 0.425 and 0.888, respectively. CONCLUSIONS A higher ALBI was an independent risk factor for IVIG resistance in KD. It yielded better predictive ability than ALB and TBil alone for initial IVIG resistance.
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Affiliation(s)
- Yu Yan
- grid.13291.380000 0001 0807 1581Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan China ,grid.13291.380000 0001 0807 1581West China Medical School of Sichuan University, 610041 Chengdu, Sichuan China
| | - Lina Qiao
- grid.13291.380000 0001 0807 1581Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan 610041 Chengdu, China ,grid.13291.380000 0001 0807 1581Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Yimin Hua
- grid.13291.380000 0001 0807 1581Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan 610041 Chengdu, China ,grid.13291.380000 0001 0807 1581Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan China ,grid.13291.380000 0001 0807 1581The Cardiac development and early intervention unit, West China Second University Hospital, West China Institute of Women and Children’s Health, Sichuan University, 610041 Chengdu, Sichuan China
| | - Shuran Shao
- grid.13291.380000 0001 0807 1581Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan China ,grid.13291.380000 0001 0807 1581West China Medical School of Sichuan University, 610041 Chengdu, Sichuan China
| | - Nanjun Zhang
- grid.13291.380000 0001 0807 1581Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan China ,grid.13291.380000 0001 0807 1581West China Medical School of Sichuan University, 610041 Chengdu, Sichuan China
| | - Mei Wu
- grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan 610041 Chengdu, China ,grid.13291.380000 0001 0807 1581Department of Pediatrics, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Lei Liu
- grid.13291.380000 0001 0807 1581Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan China ,grid.13291.380000 0001 0807 1581West China Medical School of Sichuan University, 610041 Chengdu, Sichuan China
| | - Kaiyu Zhou
- grid.13291.380000 0001 0807 1581Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan 610041 Chengdu, China ,grid.13291.380000 0001 0807 1581Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan China ,grid.13291.380000 0001 0807 1581The Cardiac development and early intervention unit, West China Second University Hospital, West China Institute of Women and Children’s Health, Sichuan University, 610041 Chengdu, Sichuan China
| | - Xiaoliang Liu
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, 610041, Chengdu, Sichuan, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan, 610041, Chengdu, China. .,Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, 610041, Chengdu, Sichuan, China. .,Dept. of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, 3rd section, South Renmin Road, 610041, Chengdu, China.
| | - Chuan Wang
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, 610041, Chengdu, Sichuan, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan, 610041, Chengdu, China. .,Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, West China Second University Hospital, Sichuan University, 610041, Chengdu, Sichuan, China. .,The Cardiac development and early intervention unit, West China Second University Hospital, West China Institute of Women and Children's Health, Sichuan University, 610041, Chengdu, Sichuan, China. .,Dept. of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, 3rd section, South Renmin Road, 610041, Chengdu, China.
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Chen Y, Tang S, Wang Y. Prognostic Value of Glucose-to-Lymphocyte Ratio in Critically Ill Patients with Acute Pancreatitis. Int J Gen Med 2021; 14:5449-5460. [PMID: 34526812 PMCID: PMC8436258 DOI: 10.2147/ijgm.s327123] [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] [Received: 07/08/2021] [Accepted: 08/16/2021] [Indexed: 12/21/2022] Open
Abstract
Background Glucose metabolism and systemic inflammation have been associated with prognosis in acute pancreatitis (AP) patients. However, the possible value as a prognostic marker of the glucose-to-lymphocyte ratio (GLR) has not been evaluated in critically ill patients with AP. Methods This study included 1,133 critically ill patients with AP from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database, who were randomly divided into the training cohort (n=806) and the validation cohort (n=327) at a ratio of 7:3. X-tile software was used to determine the optimal cut-off values for GLR. Area under the curve (AUC) analysis was performed to compare the performance between GLR and other blood-based inflammatory biomarkers. Univariate and multivariate Cox regression analyses were applied to select prognostic factors associated with in-hospital mortality. A nomogram model was developed based on the identified prognostic factors and the validation cohort was used to further validate the nomogram. Results The optimal cut-off value for GLR was 0.9. The ROC analyses showed that the discrimination abilities of GLR were better than other blood-based inflammatory biomarkers. Multivariate Cox regression analysis demonstrated that age, platelet, albumin, bilirubin, Sequential Organ Failure Assessment (SOFA) score, and GLR are independent predictors of poor overall survival in the training cohort and were incorporated into the nomogram for in-hospital mortality as independent factors. The nomogram exhibited better discrimination with C-indexes in the training cohort and the validation cohort of 0.886 (95% CI=0.849–0.922) and 0.841 (95% CI=0.767–0.915), respectively. The calibration plot revealed an adequate fit of the nomogram for predicting the risk of in-hospital mortality in both sets. Conclusion As an easily available biomarker, GLR can independently predict the in-hospital mortality of critically ill patients with AP. The nomogram combining GLR with other significant features exerted favorable predictive performance for in-hospital mortality.
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Affiliation(s)
- Yongjun Chen
- Department of Gastroenterology, Qianjiang Central Hospital of Chongqing Municipality, Chongqing, 409000, People's Republic of China
| | - Shangjun Tang
- Department of Gastroenterology, Qianjiang Central Hospital of Chongqing Municipality, Chongqing, 409000, People's Republic of China
| | - Yumei Wang
- Department of Gastroenterology, Qianjiang Central Hospital of Chongqing Municipality, Chongqing, 409000, People's Republic of China
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Abstract
Introduction: Acute pancreatitis (AP) is a common gastrointestinal disease with a wide spectrum of severity and morbidity. Developed in 1974, the Ranson score was the first scoring system to prognosticate AP. Over the past decades, while the Ranson score remains widely used, it was identified to have certain limitations, such as having low predictive power. It has also been criticized for its 48-hour requirement for computation of the final score, which has been argued to potentially delay management. With advancements in our understanding of AP, is the Ranson score still relevant as an effective prognostication system for AP?Areas covered: This review summarizes the available evidence comparing Ranson score with other conventional and novel scoring systems, in terms of prognostic accuracy, benefits, limitations and clinical applicability. It also evaluates the effectiveness of Ranson score with regard to the Revised Atlanta Classification.Expert opinion: The Ranson score consistently exhibits comparable prognostic accuracy to other newer scoring systems, and the 48-hour timeframe for computing the full Ranson score is an inherent strength, not a weakness. These aspects, coupled with relative ease of use, practicality and universality of the score, advocate for the continued relevance of the Ranson score in modern clinical practice.
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Affiliation(s)
- Yuki Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Vishal G Shelat
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- FRCS (General Surgery), FEBS (HPB Surgery), Hepato-Pancreatico-BiliarySurgery, Department of Surgery, Tan Tock Seng Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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22
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Wu Q, Wang J, Qin M, Yang H, Liang Z, Tang G. Accuracy of conventional and novel scoring systems in predicting severity and outcomes of acute pancreatitis: a retrospective study. Lipids Health Dis 2021; 20:41. [PMID: 33906658 PMCID: PMC8080352 DOI: 10.1186/s12944-021-01470-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/20/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Recently, several novel scoring systems have been developed to evaluate the severity and outcomes of acute pancreatitis. This study aimed to compare the effectiveness of novel and conventional scoring systems in predicting the severity and outcomes of acute pancreatitis. METHODS Patients treated between January 2003 and August 2020 were reviewed. The Ranson score (RS), Glasgow score (GS), bedside index of severity in acute pancreatitis (BISAP), pancreatic activity scoring system (PASS), and Chinese simple scoring system (CSSS) were determined within 48 h after admission. Multivariate logistic regression was used for severity, mortality, and organ failure prediction. Optimum cutoffs were identified using receiver operating characteristic curve analysis. RESULTS A total of 1848 patients were included. The areas under the curve (AUCs) of RS, GS, BISAP, PASS, and CSSS for severity prediction were 0.861, 0.865, 0.829, 0.778, and 0.816, respectively. The corresponding AUCs for mortality prediction were 0.693, 0.736, 0.789, 0.858, and 0.759. The corresponding AUCs for acute respiratory distress syndrome prediction were 0.745, 0.784, 0.834, 0.936, and 0.820. Finally, the corresponding AUCs for acute renal failure prediction were 0.707, 0.734, 0.781, 0.868, and 0.816. CONCLUSIONS RS and GS predicted severity better than they predicted mortality and organ failure, while PASS predicted mortality and organ failure better. BISAP and CSSS performed equally well in severity and outcome predictions.
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Affiliation(s)
- Qing Wu
- Department of Gastroenterology, the Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jie Wang
- Department of Gastroenterology, the Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Mengbin Qin
- Department of Gastroenterology, the Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Huiying Yang
- Department of Gastroenterology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zhihai Liang
- Department of Gastroenterology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Guodu Tang
- Department of Gastroenterology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China.
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