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Wang Q, Deng T, Xie Y, Lu H, Zhang T, Gao D. Association of α-HBDH levels with the severity and recurrence after acute ischemic stroke. Eur J Med Res 2024; 29:347. [PMID: 38926868 PMCID: PMC11201310 DOI: 10.1186/s40001-024-01944-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 06/19/2024] [Indexed: 06/28/2024] Open
Abstract
OBJECTIVE α-HBDH serves as a biomarker of myocardial damage and is implicated in adverse outcomes across various critical illnesses. Our study aimed to assess the correlation between α-HBDH levels, and severity and recurrence of acute ischemic stroke (AIS). METHODS We enrolled patients with mild-to-moderate AIS within 72 h of onset. Based on the baseline score of the National Institutes of Health Stroke Scale (bNIHSS) at registration, patients were categorized into mild (bNIHSS ≤ 4 points) and moderate AIS groups (4 < bNIHSS ≤ 10 points). Subsequently, based on the normal upper limit of α-HBDH, patients were divided into low-level α-HBDH (≤ 180 U/L) and high-level α-HBDH (> 180 U/L) groups. Multivariate logistic regression analysis and Cox proportional hazard regression analysis were employed to evaluate the relationship between α-HBDH levels and bNIHSS scores as well as the risk of recurrent AIS within 90 days. RESULTS We observed a significant association between higher baseline levels of α-HBDH and increased bNIHSS scores, indicating a more severe AIS (odds ratio = 24.449; 95% confidence interval [CI], 8.749-68.324; p < 0.01). Additionally, the risk of recurrent AIS within 90 days was 4.666 times higher in the high-level α-HBDH group compared to the low-level group (hazard ratio = 4.666; 95% CI, 2.481-8.777; p < 0.01). CONCLUSIONS The baseline level of α-HBDH is significantly correlated with the severity of AIS and the risk of recurrent AIS within 90 days.
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Affiliation(s)
- Qiang Wang
- Department of Neurology, Beijing Bo'ai Hospital, School of Rehabilitation Medicine, Capital Medical University, Beijing, 100068, China
| | - Ting Deng
- Department of Infectious Diseases, Beijing Bo'ai Hospital, School of Rehabilitation Medicine, Capital Medical University, Beijing, 100068, China
| | - Yuanyuan Xie
- Department of Emergency, Beijing Bo'ai Hospital, School of Rehabilitation Medicine, Capital Medical University, Beijing, 100068, China
| | - Haitao Lu
- Department of Neurology, Beijing Bo'ai Hospital, School of Rehabilitation Medicine, Capital Medical University, Beijing, 100068, China
| | - Tong Zhang
- Department of Neurology, Beijing Bo'ai Hospital, School of Rehabilitation Medicine, Capital Medical University, Beijing, 100068, China.
| | - Daiquan Gao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
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Jiang XT, Ding L, Huang X, Lei YP, Ke HJ, Xiong HF, Luo LY, He WH, Xia L, Lu NH, Zhu Y. Elevated CK-MB levels are associated with adverse clinical outcomes in acute pancreatitis: a propensity score-matched study. Front Med (Lausanne) 2023; 10:1256804. [PMID: 37746074 PMCID: PMC10514671 DOI: 10.3389/fmed.2023.1256804] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
Aim Cardiac injury, reflected by the measured concentrations of chemicals released from injured cardiac muscle, is common in acute pancreatitis (AP). However, there is no adequate evidence assessing the impact of cardiac injury on AP-related outcomes. Creatine kinase-myocardial band (CK-MB) mainly exists in the myocardium. Therefore, we sought to evaluate the relationship between the increase in CK-MB and the adverse clinical outcomes of AP. Methods This propensity score-matched study analyzed AP patients admitted to the Department of Gastroenterology in the First Affiliated Hospital of Nanchang University from June 2017 to July 2022. Propensity score matching and multivariate logistic regression analysis were used to explore the relationship between CK-MB elevation and AP outcome variables. Results A total of 5,944 patients were screened for eligibility, of whom 4,802 were ultimately enrolled. Overall, 896 (18.66%) of AP patients had elevated (>24 U/ml) CK-MB levels, and 895 (99.89%) were paired with controls using propensity score matching. The propensity score-matched cohort analysis demonstrated that mortality (OR, 5.87; 95% CI, 3.89-8.84; P < 0.001), severe acute pancreatitis (SAP) (OR, 2.74; 95% CI, 2.23-3.35; P < 0.001), and infected necrotizing pancreatitis (INP) (OR, 3.40; 95% CI, 2.34-4.94; P < 0.001) were more frequent in the elevated CK-MB (>24 U/ml) group than in the normal CK-MB (≤ 24 U/ml) group. Using the multivariate logistic regression analysis, elevated CK-MB levels were independently associated with increased mortality (OR, 2.753, 95% CI, 2.095-3.617, P < 0.001), SAP incidence (OR, 2.223, CI, 1.870-2.643, P < 0.001), and INP incidence (OR, 1.913, 95% CI, 1.467-2.494, P < 0.001). CK-MB elevation was an independent risk factor for adverse clinical outcomes in AP patients. Conclusion CK-MB elevation was significantly related to adverse outcomes in AP patients, which makes it a potentially useful laboratory parameter for predicting adverse clinical outcomes of AP.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Yin Zhu
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Yuan ZM, Wang LH, Chen C. Prognostic value of serum α-HBDH levels in patients with lung cancer. World J Surg Oncol 2023; 21:78. [PMID: 36872314 PMCID: PMC9987145 DOI: 10.1186/s12957-023-02965-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/27/2023] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND The purpose of our study is to investigate the expression level and prognostic value of serum α-hydroxybutyrate dehydrogenase (α-HBDH) in lung cancer (LC) patients. METHOD LC patients treated in the Department of Oncology, Shaanxi Provincial Cancer Hospital from January 2014 to December 2016 were included in this study, all of whom underwent serological detection of α-HBDH prior to admission, and were enrolled in follow-up 5-year survival. Comparing the differences between high group and normal groups based on α-HBDH and LDH expression via clinicopathological parameters and laboratory data. Univariate and multivariate regression and overall survival (OS) were analyzed to explore whether elevated α-HBDH was an independent risk factor for LC, compared to LDH. RESULTS Multivariate regression analysis showed that age (P = 0.018), liver metastasis (P = 0.011), α-HBDH (P = 0.015), and neutrophil-to-lymphocyte ratio (NLR) (P = 0.031) were independent prognostic factors affecting OS in LC patients. The overall diagnostic efficacy of α-HBDH (AUC = 0.887) was higher than that of LDH (AUC = 0.709) in the ROC curve. The sensitivity was significantly higher of α-HBDH (sensitivity: 76.06%, specificity: 94.87%) compared with LDH (sensitivity: 49.30%, specificity: 94.87%). The median of OS was more significant in the high-α-HBDH group (6.4 months) than in the normal-α-HBDH group (12.7 months) (P = 0.023). The median of OS was significant in the high-LDH (> 245 U/L) group at 5.8 months and 12.0 months in the normal-LDH (≤ 245 U/L) group (P = 0.068). CONCLUSIONS Elevated expression of α-HBDH may indicate a poor prognosis of LC patients. It has a higher sensitivity than LDH and can be used as a potential early biomarker and an independent risk factor predicting the prognosis of LC survival.
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Affiliation(s)
- Zhi-Min Yuan
- Department of Clinical Laboratory, Shaanxi Provincial Cancer Hospital, Xi'an, Shaanxi, China
| | - Long-Hao Wang
- Department of Otorhinolaryngology‑Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Cheng Chen
- Department of General Dentistry/Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xiwu Road 98# Xi'an, Shaanxi, 710004, China.
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Shi N, Zhang X, Zhu Y, Deng L, Li L, Zhu P, Xia L, Jin T, Ward T, Sztamary P, Cai W, Yao L, Yang X, Lin Z, Jiang K, Guo J, Yang X, Singh VK, Sutton R, Lu N, Windsor JA, He W, Huang W, Xia Q. Predicting persistent organ failure on admission in patients with acute pancreatitis: development and validation of a mobile nomogram. HPB (Oxford) 2022; 24:1907-1920. [PMID: 35750613 DOI: 10.1016/j.hpb.2022.05.1347] [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] [Received: 08/31/2021] [Revised: 01/15/2022] [Accepted: 05/31/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Early prediction of persistent organ failure (POF) is important for triage and timely treatment of patients with acute pancreatitis (AP). METHODS All AP patients were consecutively admitted within 48 h of symptom onset. A nomogram was developed to predict POF on admission using data from a retrospective training cohort, validated by two prospective cohorts. The clinical utility of the nomogram was defined by concordance index (C-index), decision curve analysis (DCA), and clinical impact curve (CIC), while the performance by post-test probability. RESULTS There were 816, 398, and 880 patients in the training, internal and external validation cohorts, respectively. Six independent predictors determined by logistic regression analysis were age, respiratory rate, albumin, lactate dehydrogenase, oxygen support, and pleural effusion and were included in the nomogram (web-based calculator: https://shina.shinyapps.io/DynNomapp/). This nomogram had reasonable predictive ability (C-indexes 0.88/0.91/0.81 for each cohort) and promising clinical utility (DCA and CIC). The nomogram had a positive likelihood ratio and post-test probability of developing POF in the training, internal and external validation cohorts of 4.26/31.7%, 7.89/39.1%, and 2.75/41%, respectively, superior or equal to other prognostic scores. CONCLUSIONS This nomogram can predict POF of AP patients and should be considered for clinical practice and trial allocation.
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Affiliation(s)
- Na Shi
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoxin Zhang
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yin Zhu
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Lihui Deng
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Lan Li
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ping Zhu
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Liang Xia
- Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Tao Jin
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Thomas Ward
- Liverpool Pancreatitis Research Group, Liverpool University Hospitals NHS Foundation Trust and Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Peter Sztamary
- Liverpool Pancreatitis Research Group, Liverpool University Hospitals NHS Foundation Trust and Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Wenhao Cai
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China; Liverpool Pancreatitis Research Group, Liverpool University Hospitals NHS Foundation Trust and Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Linbo Yao
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xinmin Yang
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ziqi Lin
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Kun Jiang
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jia Guo
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaonan Yang
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Vikesh K Singh
- Pancreatitis Center, Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, USA
| | - Robert Sutton
- Liverpool Pancreatitis Research Group, Liverpool University Hospitals NHS Foundation Trust and Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Nonghua Lu
- Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - John A Windsor
- Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Wenhua He
- Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, China.
| | - Wei Huang
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Qing Xia
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China.
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Limin Z, Alsamani R, Jianwei W, Yijun S, Dan W, Yuehong S, Ziwei L, Huiwen X, Dongzhi W, Xingquan Z, Guojun Z. The relationship of α-hydroxybutyrate dehydrogenase with 1-year outcomes in patients with intracerebral hemorrhage: A retrospective study. Front Neurol 2022; 13:906249. [PMID: 36330431 PMCID: PMC9623007 DOI: 10.3389/fneur.2022.906249] [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: 04/08/2022] [Accepted: 09/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background and aims Cardiac enzymes are recognized as a valuable tool for predicting the prognosis of various cardiovascular diseases. The prognostic value of alpha-hydroxybutyrate dehydrogenase (α-HBDH) in patients with intracerebral hemorrhage (ICH) was ambiguous and not evaluated. Methods Two hundred and thirteen Chinese patients with ICH participated in the study from December 2018 to December 2019. Laboratory routine tests and cardiac enzymes, including α-HBDH level, were examined and analyzed. All the patients were classified into two groups by the median value of α-HBDH: B1 <175.90 and B2 ≥175.90 U/L. The clinical outcomes included functional outcome (according to modified Rankin Scale (mRS) score ≥3), all-cause death, and recurrent cerebro-cardiovascular events 1 year after discharge. Associations between the α-HBDH and the outcomes were evaluated using logistic regression analysis. Univariate survival analysis was performed by the Kaplan-Meier method and log-rank test. Results Of the 213 patients, 117 had α-HBDH ≥175.90 U/L. Eighty-two patients had poor functional outcomes (mRS≥3). During the 1-year follow-up, a total of 20 patients died, and 15 of them had α-HBDH ≥175.90 U/L during the follow-up time. Moreover, 24 recurrent events were recorded. After adjusting confounding factors, α-HBDH (≥175.90) remained an indicator of poor outcome (mRS 3-6), all-cause death, and recurrent cerebro-cardiovascular events. The ORs for B2 vs. B1 were 4.78 (95% CI: 2.60 to 8.78, P = 0.001), 2.63 (95% CI: 0.80 to 8.59, P = 0.11), and 2.40 (95% CI: 0.82 to 7.02, P = 0.11) for poor functional outcomes with mRS ≥ 3, all-cause death, and recurrent cerebro-cardiovascular events, respectively. Conclusion Increased α-HBDH at admission was independently related to poor functional outcome and all-cause mortality in patients with ICH at 1-year follow-up.
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Affiliation(s)
- Zhang Limin
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
| | - Rasha Alsamani
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
| | - Wu Jianwei
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shi Yijun
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
| | - Wang Dan
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
| | - Sun Yuehong
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
| | - Liu Ziwei
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
| | - Xu Huiwen
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
| | - Wang Dongzhi
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
| | - Zhao Xingquan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhang Guojun
- Department of Clinical Diagnosis Laboratory of Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- NMPA Key Laboratory for Quality Control of In Vitro Diagnostics, Beijing, China
- Beijing Engineering Research Center of Immunological Reagents Clinical Research, Beijing, China
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Yang Y, Du S, Yuan W, Kou Y, Nie B. Prolonged activated partial thromboplastin time predicts poor short-term prognosis in patients with acute pancreatitis: A retrospective cohort study. Clin Transl Sci 2022; 15:2505-2513. [PMID: 35871496 PMCID: PMC9579392 DOI: 10.1111/cts.13378] [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: 04/10/2022] [Revised: 07/12/2022] [Accepted: 07/16/2022] [Indexed: 01/25/2023] Open
Abstract
It is unclear whether activated partial thromboplastin time (APTT) is predictive of survival in patients with acute pancreatitis (AP). Our study aimed to investigate the relationship between APTT and short-term prognosis in AP. From the Medical Information Mart for Intensive Care (MIMIC)-IV database, a total of 844 patients with AP were randomly divided into the training cohort (n = 591) and the validation cohort (n = 253) at a ratio of 7:3. Based on their APTT values, the patients were divided into the normal and high groups. The primary outcome of this study was 30- and 60-day survival. Kaplan-Meier survival analysis and Cox regression models were used to analyze associations between groups and outcomes. The training and validation cohort matched well on all parameters (p > 0.05). In terms of 30- and 60-day survival, Kaplan-Meier survival curves from both training and validation cohorts demonstrated a lower survival probability for patients in the high APTT group than the normal group (log-rank p < 0.05). In the training cohort, patients in the high APTT group had a statistically significantly higher risk of death than those in the normal group after controlling for possible confounders in Cox regression (p < 0.05). For the high APTT group, the hazard ratios (95% confidence interval [CI]) were 1.63 (95% CI 1.10, 2.61, p = 0.035) and 1.49 (95% CI 1.01, 2.38, p = 0.041), respectively. APTT performed as well as BISAP, Ranson, and APACHE II models in predicting 30- and 60-day survival in patients with AP. The results above have been verified in the validation cohort. Prolonged APTT in patients with AP may increase the risk of short-term death.
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Affiliation(s)
- Yuping Yang
- Department of Gastroenterology, The First Affiliated Hospital of Jinan UniversityJinan UniversityGuangzhouGuangdong ProvinceChina
| | - Shenshen Du
- Department of Gastroenterology, The First Affiliated Hospital of Jinan UniversityJinan UniversityGuangzhouGuangdong ProvinceChina
| | - Weinan Yuan
- Department of Gastroenterology, The First Affiliated Hospital of Jinan UniversityJinan UniversityGuangzhouGuangdong ProvinceChina
| | - Yanqi Kou
- Department of Gastroenterology, The First Affiliated Hospital of Jinan UniversityJinan UniversityGuangzhouGuangdong ProvinceChina
| | - Biao Nie
- Department of Gastroenterology, The First Affiliated Hospital of Jinan UniversityJinan UniversityGuangzhouGuangdong ProvinceChina
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Wang J, Liu QX, Teng DL, Ding YB, Lu GT, Gong WJ, Zhu QT, Han F, Xiao WM. Elevated serum ferritin levels are associated with severity and prognosis of severe acute pancreatitis: a preliminary cohort study. BMC Gastroenterol 2022; 22:408. [PMID: 36064328 PMCID: PMC9442953 DOI: 10.1186/s12876-022-02446-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 07/20/2022] [Indexed: 12/03/2022] Open
Abstract
Background Serum ferritin (SF), as an acute-phase response protein, is used to reflect the degree of oxidative stress and systemic inflammatory responses. This study was designed to assess the effect of elevated SF levels on the severity of acute pancreatitis (AP). Methods From January 2013 to December 2020, 200 consecutive patients with AP were retrospectively reviewed to analyze the relationships among the etiologies of pancreatitis, the severity of the disease and SF levels. The receiver operating characteristic (ROC) curve and logistic regression analysis were used to assess whether elevated SF levels could predict the onset of organ failure in AP. Results 92 (46%) had high SF levels (> 275 ng/ml). SF levels were not associated with the etiology of AP disease. Among patients with high SF levels, there was a significant increase in the proportion of patients with severe AP (23.1% vs. 76.9%) and a higher proportion of systemic inflammatory response scores (25.9% vs. 44.6%) in comparison to patients with normal SF levels. The area under the ROC curve for SF in predicting persistent organ failure was 0.812 [95% confidence interval 0.721–0.904]. Conclusions F concentrations were positively correlated with the severity of AP, and quantitative assessment of SF can predict disease severity and organ failure in patients with AP. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-022-02446-z.
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Affiliation(s)
- Jie Wang
- Department of Gastroenterology, Pancreatic Center, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China.,Yangzhou Key Laboratory of Pancreatic Disease, Institute of Digestive Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China
| | - Qing-Xie Liu
- Department of Gastroenterology, Pancreatic Center, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China.,Yangzhou Key Laboratory of Pancreatic Disease, Institute of Digestive Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China
| | - Dong-Ling Teng
- Department of Gastroenterology, Pancreatic Center, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China.,Yangzhou Key Laboratory of Pancreatic Disease, Institute of Digestive Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China
| | - Yan-Bing Ding
- Department of Gastroenterology, Pancreatic Center, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China.,Yangzhou Key Laboratory of Pancreatic Disease, Institute of Digestive Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China
| | - Guo-Tao Lu
- Department of Gastroenterology, Pancreatic Center, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China.,Yangzhou Key Laboratory of Pancreatic Disease, Institute of Digestive Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China
| | - Wei-Juan Gong
- Department of Gastroenterology, Pancreatic Center, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China.,Yangzhou Key Laboratory of Pancreatic Disease, Institute of Digestive Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China
| | - Qing-Tian Zhu
- Department of Gastroenterology, Pancreatic Center, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China. .,Yangzhou Key Laboratory of Pancreatic Disease, Institute of Digestive Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China.
| | - Fei Han
- Department of Gastroenterology, Pancreatic Center, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China. .,Yangzhou Key Laboratory of Pancreatic Disease, Institute of Digestive Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China.
| | - Wei-Ming Xiao
- Department of Gastroenterology, Pancreatic Center, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China. .,Yangzhou Key Laboratory of Pancreatic Disease, Institute of Digestive Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu, China.
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Lin H, Yu T, Xu R, Li X. Mean corpuscular hemoglobin predicts the length of hospital stay independent of severity classification in patients with acute pancreatitis. Open Med (Wars) 2022; 17:1449-1454. [PMID: 36128446 PMCID: PMC9449682 DOI: 10.1515/med-2022-0559] [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: 02/09/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/22/2022] Open
Abstract
Mean corpuscular hemoglobin (MCH) is a common blood routine test index. To explore the relationship between MCH and length of hospital stay in patients with acute pancreatitis (AP), we included 273 patients with AP without coronary heart disease, diabetes, hypertension and anemia in this study. All data were separated into three groups according to the length of hospital stay. Gender (p = 0.017) and severity classification (p < 0.001) were significantly correlated with length of hospital stay among three groups. Notably, MCH level was significant different among three groups (p = 0.009). Thus, all data were separated into two groups according to MCH level, and significant increases in the length of hospital stay were observed between two groups (p = 0.030). A positive correlation between length of hospital stay and MCH was observed (r = 0.172, p = 0.004). Multiple linear regression analysis showed that MCH was independent correlated with the length of hospital stay, no matter whether severity classification of AP was included (beta = 0.248, p < 0.001; beta = 0.212, p < 0.001). Our results demonstrated that the length of hospital stay was correlated with MCH level in patients with AP, and MCH level at admission may predict the length of hospital stay independent of severity classification in AP. These results may provide a potential evaluation basis for the management of patients with AP.
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Affiliation(s)
- Hao Lin
- Department of Clinical Science and Research, Zhongda Hospital, School of Medicine, Southeast University , Nanjing , 210009 , China
| | - Ting Yu
- Department of Gastroenterology, Zhongda Hospital, School of Medicine, Southeast University , Nanjing , China
| | - Rong Xu
- Department of Clinical Science and Research, Zhongda Hospital, School of Medicine, Southeast University , Nanjing , 210009 , China
| | - Xing Li
- Department of Quality Management, Zhongda Hospital, School of Medicine, Southeast University , Nanjing , China
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Yan Q, Sun YS, An R, Liu F, Fang Q, Wang Z, Xu T, Chen L, Du J. Application and progress of the detection technologies in hepatocellular carcinoma. Genes Dis 2022. [PMID: 37492708 PMCID: PMC10363596 DOI: 10.1016/j.gendis.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Hepatocellular carcinoma (HCC) has a very high incidence and fatality rate, and in most cases, it is already at an advanced stage when diagnosed. Therefore, early prevention and detection of HCC are two of the most effective strategies. However, the methods recommended in the practice guidelines for the detection of HCC cannot guarantee high sensitivity and specificity except for the liver biopsy, which is known as the "gold standard". In this review, we divided the detection of HCC into pre-treatment diagnosis and post-treatment monitoring, and found that in addition to the traditional imaging detection and liver biopsy, alpha fetoprotein (AFP), lens culinaris-agglutinin-reactive fraction of AFP (AFP-L3), protein induced by vitamin K absence or antagonist-II (PIVKA-II) and other biomarkers are excellent biomarkers for HCC, especially when they are combined together. Most notably, the emerging liquid biopsy shows great promise in detecting HCC. In addition, lactic dehydrogenase (LDH), suppressor of cytokine signaling (SOCS) and other relevant biomarkers may become promising biomarkers for HCC post-treatment monitoring. Through the detailed introduction of the diagnostic technology of HCC, we can have a detailed understanding of its development process and then obtain some enlightenment from the diagnosis, to improve the diagnostic rate of HCC and reduce its mortality.
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Wu M, Shi L, Zhang H, Liu H, Liu Y, Zhang W. Predictive value of arterial blood lactic acid concentration on the risk of all-cause death within 28 days of admission in patients with severe acute pancreatitis. Postgrad Med 2022; 134:210-216. [PMID: 35007467 DOI: 10.1080/00325481.2022.2027189] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ObjectiveTo evaluate the ability of arterial blood lactic acid concentration to predict death within 28 days of admission of patients with severe acute pancreatitis (SAP) in the intensive care unit (ICU).MethodsClinical data of 523 SAP patients in the MIMIC-IV database were retrospectively analyzed. Patients were divided into those who survived (n=461) and those who died (n=62) within 28 days of admission. The association between lactic acid concentration and all-cause death in SAP patients was determined by Cox regression analysis, Kaplan-Meier survival analysis and subgroup analysis. The ability of lactic acid concentration to predict the risk of all-cause death in SAP patients was determined by time-dependent receiver operating curve (ROC) analysis.ResultsArterial blood lactic acid concentration was significantly higher in the 62 patients who died within 28 days than in the 461 patients who survived (P <0.05). Adjusted multivariate Cox regression analysis showed that lactic acid concentration was a significant independent predictor on all-cause mortality within 28 days of admission for SAP (hazard ratio=1.22, 95% confidence interval 1.09-1.36, P <0.001), as did time-dependent ROC analysis (area under the ROC curve=0.741). Kaplan-Meier analysis showed that the rate of all-cause mortality within 28 days of admission was significantly higher in patients with high than low lactic acid concentration (P <0.0001). Subgroup analysis showed that there was no significant interaction between lactic acid concentration and other factors with all-cause death within 28 days of admission (all P >0.05).ConclusionArterial blood lactic acid concentration is an important independent predictor of all-cause mortality within 28 days of admission of SAP patients in the ICU.
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Affiliation(s)
- Menghuan Wu
- Department of Gastroenterology, The Affiliated Hospital of Jiangsu University, Zhenjiang 212000, China
| | - Liang Shi
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing 210000, China
| | - Hao Zhang
- Department of Emergency, The Affiliated Hospital of Jiangsu University, Zhenjiang 212000, Jiangsu, China
| | - Hanqiong Liu
- Department of Emergency, The Affiliated Hospital of Jiangsu University, Zhenjiang 212000, Jiangsu, China
| | - Yanru Liu
- Department of Emergency, The Affiliated Hospital of Jiangsu University, Zhenjiang 212000, Jiangsu, China
| | - Wei Zhang
- Department of Gastroenterology, The Affiliated Hospital of Jiangsu University, Zhenjiang 212000, China
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Zhang FJ, Huang GQ, Li J, Xu J, Li XM, Wang AM. Clinical Characteristics of Adult Hemophagocytic Lymphohistiocytosis in the Emergency Department. Int J Gen Med 2021; 14:4687-4694. [PMID: 34447263 PMCID: PMC8384344 DOI: 10.2147/ijgm.s326270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/11/2021] [Indexed: 01/01/2023] Open
Abstract
Purpose To determine the clinical manifestations and results of adult hemophagocytic lymphohistiocytosis (HLH) patients in our emergency department. Methods We retrospectively evaluated patients with HLH from 1 April 2018 to 31 December 2020. The clinical data of these patients (basic information, symptoms, vital signs, laboratory results, HLH diagnostic criteria, H Score, main treatments, outcomes) were collected. Results Thirty-three patients (23 males and 10 females; 40.55±18.78 years) with 34 clinical episodes (one male had two clinical episodes and died during the second episode) were enrolled. Twenty-five patients were placed in a “survivor” group, and nine patients were categorized into a “deceased” group. Fever, splenomegaly, hemoglobin <90 g/L and platelet count <100×109/L most commonly met the diagnostic standard for HLH. The H Score results in the survival group and deceased group was 212.4±37.18 and 252.1±40.95, respectively. Viral infection was the most common reason for HLH, followed by immune-system disease and cancer. Laboratory tests showed that deceased-group patients had multiple-organ dysfunction. Multivariate logistic regression showed that the lactate dehydrogenase (lactate dehydrogenase) level (P = 0.039; odds ratio, 0.999) was significantly related to death. Conclusion In the emergency department, HLH should be considered for critically ill patients with fever, splenomegaly, low hemoglobin and low platelet count. The H Score might be useful to diagnose HLH quickly. In our study, 26.47% of HLH patients died in the emergency department, and patients with a significantly increased lactate dehydrogenase level had a markedly increased risk of death.
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Affiliation(s)
- Fang-Jie Zhang
- Department of Emergency Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Guo-Qing Huang
- Department of Emergency Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Jia Li
- Department of Emergency Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Ji Xu
- Department of Emergency Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Xiang-Min Li
- Department of Emergency Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Ai-Min Wang
- Department of Emergency Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China
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