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Pay L, Çetin T, Keskin K, Dereli Ş, Tezen O, Yumurtaş AÇ, Kolak Z, Eren S, Şaylık F, Çınar T, Hayıroğlu Mİ. Evaluation of Naples prognostic score to predict long-term mortality in patients with pulmonary embolism. Biomark Med 2024; 18:253-263. [PMID: 38487977 PMCID: PMC11216614 DOI: 10.2217/bmm-2023-0741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/20/2024] [Indexed: 06/26/2024] Open
Abstract
Background: The Naples prognostic score (NPS), which reflects the inflammatory and nutritional status of patients, is often used to determine prognosis in cancer patients. The aim of this study was to determine the long-term prognostic value of the NPS in acute pulmonary embolism (APE) patients. Methods: Two hundred thirty-nine patients diagnosed with APE were divided into two groups according to their NPS, and long-term mortality was compared. Results: The long-term mortality was observed in 38 patients out of 293 patients in the mean follow-up of 24 months. Multivariate analysis showed that NPS as a categorical parameter and NPS as a numeric parameter were independent predictors of long-term mortality. Conclusion: This study highlights that NPS may have the potential to predict long-term mortality in APE patients.
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Affiliation(s)
- Levent Pay
- Department of Cardiology, Ardahan State Hospital, Ardahan, 75000, Turkey
| | - Tuğba Çetin
- Department of Cardiology, Dr. Siyami Ersek Thoracic & Cardiovascular Surgery Training Hospital, Istanbul, 34668, Turkey
| | - Kıvanç Keskin
- Department of Cardiology, Dr. Siyami Ersek Thoracic & Cardiovascular Surgery Training Hospital, Istanbul, 34668, Turkey
| | - Şeyda Dereli
- Department of Cardiology, Dr. Siyami Ersek Thoracic & Cardiovascular Surgery Training Hospital, Istanbul, 34668, Turkey
| | - Ozan Tezen
- Department of Cardiology, Bayrampasa State Hospital, Istanbul, 34040, Turkey
| | - Ahmet Ç Yumurtaş
- Department of Cardiology, Kars Harakani State Hospital, Kars, 36200, Turkey
| | - Zeynep Kolak
- Department of Cardiology, Dr. Siyami Ersek Thoracic & Cardiovascular Surgery Training Hospital, Istanbul, 34668, Turkey
| | - Semih Eren
- Department of Cardiology, Dr. Siyami Ersek Thoracic & Cardiovascular Surgery Training Hospital, Istanbul, 34668, Turkey
| | - Faysal Şaylık
- Department of Cardiology, Van Education & Research Hospital, Van, 65300, Turkey
| | - Tufan Çınar
- Department of Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, MD 21201, USA
| | - Mert İ Hayıroğlu
- Department of Cardiology, Dr. Siyami Ersek Thoracic & Cardiovascular Surgery Training Hospital, Istanbul, 34668, Turkey
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Qiu J, Hao Y, Huang S, Wang T, He X, Wang W, Du D, Mao Y, Yuan Y. Serum Albumin for Short-Term Poor Prognosis in Patients With Acute Pulmonary Embolism: A Clinical Study Based on a Database. Angiology 2024:33197241226881. [PMID: 38193449 DOI: 10.1177/00033197241226881] [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: 01/10/2024]
Abstract
The relationship between serum albumin (ALB) and short-term prognosis in patients with acute pulmonary embolism (APE) remains unclear. We investigated the predictive value of ALB for short-term prognosis in APE patients using our hospital pulmonary embolism (PE) database (384 patients consecutively collected). Logistic regression analysis and nomograms were applied to construct the predictive model, and validation was assessed. A total of 340 APE patients were included, with a 30-day all-cause mortality rate of 8.5%. The incidence of hypoalbuminemia was 15.9%. The odds ratio (OR) for short-term mortality in patients with high ALB was 0.89 (0.886, 95% CI: 0.812-0.967). Additionally, we created a nomogram for individualized mortality risk prediction. Receiver operating characteristic (ROC) curve analysis showed that the diagnostic area under the curve (AUC) of ALB was 0.758 (95% CI 0.683-0.833), and the best cut-off value was 33.85 g/L. Optimal simplified Pulmonary Embolism Severity Index (sPESI) (ALB combined sPESI) AUC was 0.835 (95% CI 0.775-0.896). Baseline hypoalbuminemia may be an independent prognostic indicator of short-term mortality in patients with APE.
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Affiliation(s)
- Jiayong Qiu
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Yingying Hao
- Department of Radiation Oncology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Shenshen Huang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Tongsheng Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Xuegai He
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Wei Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Dan Du
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yimin Mao
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Yadong Yuan
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
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O’Hara A, Pozin J, Abourahma M, Gigstad R, Torres D, Knapp B, Kantarcioglu B, Fareed J, Darki A. Charlson and Elixhauser Comorbidity Indices for Prediction of Mortality and Hospital Readmission in Patients With Acute Pulmonary Embolism. Clin Appl Thromb Hemost 2024; 30:10760296241253844. [PMID: 38755956 PMCID: PMC11102695 DOI: 10.1177/10760296241253844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/17/2024] [Accepted: 04/20/2024] [Indexed: 05/18/2024] Open
Abstract
Several risk stratification systems aid clinicians in classifying pulmonary embolism (PE) severity and prognosis. We compared 2 clinical PE scoring systems, the PESI and sPESI scores, with 2 comorbidity indices, the Charlson Comorbidity Index (CCI) and the val Walraven Elixhauser Comorbidity Index (ECI), to determine the utility of each in predicting mortality and hospital readmission. Information was collected from 436 patients presenting with PE via retrospective chart review. The PESI, sPESI, CCI, and ECI scores were calculated for each patient. Multivariate analysis was used to determine each system's ability to predict in-hospital mortality, 90-day mortality, overall mortality, and all-cause hospital readmission. The impact of various demographic and clinical characteristics of each patient on these outcomes was also assessed. The PESI score was found to be an independent predictor of in-hospital mortality and 90-day mortality. The PESI score and the CCI were able to independently predict overall mortality. None of the 4 risk scores independently predicted hospital readmission. Other factors including hypoalbuminemia, serum BNP, coagulopathy, anemia, and diabetes were associated with increased mortality and readmission at various endpoints. The PESI score was the best tool for predicting mortality at any endpoint. The CCI may have utility in predicting long-term outcomes. Further work is needed to better determine the roles of the CCI and ECI in predicting patient outcomes in PE. The potential prognostic implications of low serum albumin and anemia at the time of PE also warrant further investigation.
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Affiliation(s)
- Alexander O’Hara
- Department of Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Jacob Pozin
- Department of Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Mohammed Abourahma
- Department of Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Ryan Gigstad
- Department of Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Danny Torres
- Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA
| | - Benji Knapp
- Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA
| | - Bulent Kantarcioglu
- Department of Pathology and Laboratory Medicine, Cardiovascular Research Institute, Loyola University Chicago, Health Sciences Division, Maywood, IL, USA
| | - Jawed Fareed
- Department of Pathology and Laboratory Medicine, Cardiovascular Research Institute, Loyola University Chicago, Health Sciences Division, Maywood, IL, USA
| | - Amir Darki
- Department of Cardiology, Loyola University Medical Center, Maywood, IL, USA
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Ding C, Zhang Z, Qiu J, Du D, Liu Z. Association of red blood cell distribution width to albumin ratio with the prognosis of acute severe pulmonary embolism: A cohort study. Medicine (Baltimore) 2023; 102:e36141. [PMID: 38013321 PMCID: PMC10681614 DOI: 10.1097/md.0000000000036141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/25/2023] [Indexed: 11/29/2023] Open
Abstract
Red blood cell distribution width (RDW) to human serum albumin (ALB) ratio (RDW/ALB Ratio, RAR) is a prognostic factor for adverse outcomes in different disease populations. However, the relationship between RAR and pulmonary embolism outcomes remains unclear. Therefore, this study set out to investigate the association between RAR and the risk of all-cause death in acute pulmonary embolism (APE) patients admitted to the intensive care unit (ICU). This is a retrospective study based on the MIMIC-IV database. The primary outcome was all-cause mortality among patients with APE (in-hospital and 1-year mortality). The relationship between RAR and all-cause mortality was assessed using Cox regression analysis. The survival curve was drawn to evaluate the predictive value of RAR for patient mortality. Correlations and threshold effects between RAR and all-cause mortality were analyzed using the generalized additive model (GAM). The study included 773 patients, and fully adjusted Cox regression models showed that RAR was associated with higher all-cause mortality in the hospital and one year later (all P < .05). In the GAM, the relationship between RAR and all-cause mortality was shown to be nonlinear, with a positive association between RAR and all-cause mortality in APE patients when RAR values were at low to moderate levels. This study revealed a significant association between RAR and the risk of all-cause day death in patients with pulmonary embolism. Higher RAR value was associated with increased in-hospital mortality and 1-year mortality.
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Affiliation(s)
- Chaowei Ding
- Department of Respiratory and Critical Care Medicine, Xiamen Humanity Hospital Fujian Medical University, Xiamen, Fujian, China
- Department of Respiratory and Critical Care Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Ziping Zhang
- Department of Respiratory and Critical Care Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Jiayong Qiu
- Department of Respiratory and Critical Care Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
- Department of Respiratory and Critical Care Medicine, the Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province, China
| | - Dan Du
- Department of Respiratory and Critical Care Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Zexin Liu
- Department of Respiratory and Critical Care Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
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Elshahaat HA, Zayed NE, Ateya MAM, Safwat M, El Hawary AT, Abozaid M. Role of serum biomarkers in predicting management strategies for acute pulmonary embolism. Heliyon 2023; 9:e21068. [PMID: 38027791 PMCID: PMC10651461 DOI: 10.1016/j.heliyon.2023.e21068] [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: 07/31/2023] [Revised: 09/06/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Background Acute pulmonary embolism (APE) is a condition that can be fatal. The severity of the disease influences therapeutic decisions, and mortality varies significantly depending on the condition's severity. Identification of patients with a high mortality risk is crucial. Since inflammation, hemostatic, and coagulation abnormalities are linked to APE, serum biomarkers may be helpful for prognostication. Aim To evaluate the significance of serum biomarkers in APE risk assessment and the suitability of these biomarkers for management and decision-making. Methods This study involved 60 adult patients with APE who were divided according to risk categorization. It was conducted in Chest, Cardiology and Internal Medicine department, Zagazig University Hospitals from December 2022 to May 2023. Several hematological biomarkers and their significance in APE risk assessment were measured with a comparison with the latest risk stratification methods which include haemodynamic measures and right ventricular (RV) dysfunction echocardiographic markers. Results Each risk group involved 20 patients (high, intermediate (10 were intermediate-high and 10 were intermediate-low) and low risk group). They were 34 females and 26 males with the mean ± SD of their age was 59.25 ± 13.06 years. Regarding hematological biomarkers, there were statistically significant differences as regards; lymphocytes, platelet to lymphocyte ratio (PLR), albumin, blood urea nitrogen (BUN), C-reactive protein (CRP) and D-dimer with highly statistically significant differences as regards; neutrophil to lymphocyte ratio (NLR), BUN to albumin (B/A) ratio, troponin I (TnI), and brain natriuretic peptide (BNP). TnI had the highest specificity and predictive value positive (PVP) and BNP had the highest sensitivity and predictive value negative (PVN) in predicting high risk groups. The Lymphocyte and NLR showed the lowest sensitivity and the albumin and B/A ratio had the lowest specificity. Regarding transthoracic echocardiography (TEE); there was a statistically significant increase regarding pulmonary artery systolic pressure (PASP) and a highly statistically significant increase regarding the right ventricle/left ventricle (RV/LV) ratio. There were statistically significant decreases regarding tricuspid annular plane systolic excursion (TAPSE) and peak systolic velocity of tricuspid annulus (S') among risk groups. Conclusion APE prognosis can be judged accurately by simultaneously measuring a few biomarkers along with haemodynamic variables and echocardiographic parameters of RV dysfunction.
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Affiliation(s)
| | - Niveen E. Zayed
- Chest Department, faculty of Medicine of Zagazig University, Zagazig, Egypt
| | | | - Mohamed Safwat
- Cardiology Department, Faculty of medicine of Zagazig University, Zagazig, Egypt
| | - Amr Talaat El Hawary
- Internal Medicine Department, Faculty of medicine of Zagazig University, Zagazig, Egypt
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Yadollahi M, Hosseinalipour H, Karajizadeh M, Alinaqi M, Fazeli P, Jowkar M, Jamali K, Yadollahi M. Investigating the prevalence of and predictive and risk factors for pulmonary embolism in patients with COVID-19 in Nemazee Teaching Hospital. Blood Res 2023; 58:127-132. [PMID: 37431097 PMCID: PMC10548293 DOI: 10.5045/br.2023.2023076] [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: 04/19/2023] [Revised: 06/14/2023] [Accepted: 06/29/2023] [Indexed: 07/12/2023] Open
Abstract
Background Pulmonary thromboembolism (PTE) is a significant contributing factor to vascular diseases. This study aimed to determine the prevalence of pulmonary thromboembolism and its predisposing factors in patients with COVID-19. Methods This cross-sectional study included 284 patients with COVID-19 who were admitted to Nemazee Teaching Hospital (Shiraz, Iran) between June and August 2021. All patients were diagnosed with COVID-19 by a physician based on clinical symptoms or positive polymerase chain reaction (PCR) test results. The collected data included demographic data and laboratory findings. Data were analyzed using the SPSS software. P≤0.05 was considered statistically significant. Results There was a significant difference in the mean age between the PTE group and non-PTE group (P=0.037). Moreover, the PTE group had a significantly higher prevalence of hypertension (36.7% vs. 21.8%, P=0.019), myocardial infarction (4.5% vs. 0%, P=0.006), and stroke (23.9% vs. 4.9%, P=0.0001). Direct bilirubin (P=0.03) and albumin (P=0.04) levels significantly differed between the PTE and non-PTE groups. Notably, there was a significant difference in the partial thromboplastin time (P=0.04) between the PTE and non-PTE groups. A regression analysis indicated that age (OR, 1.02; 95% CI, 1.00‒1.004; P=0.005), blood pressure (OR, 2.07; 95% CI, 1.12‒3.85; P=0.02), heart attack (OR, 1.02; 95% CI, 1.28‒6.06; P=0.009), and albumin level (OR, 0.39; 95% CI, 0.16‒0.97; P=0.04) were all independent predictors of PTE development. Conclusion Regression analysis revealed that age, blood pressure, heart attack, and albumin levels were independent predictors of PTE.
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Affiliation(s)
- Mahnaz Yadollahi
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hessam Hosseinalipour
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrdad Karajizadeh
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Muhammad Alinaqi
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pooria Fazeli
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Kazem Jamali
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Alsubhi YM, Alhadi AH, Hammudah AM, Alahmadi RA, Aljohani AM, Dubai SA, Susi AI, Almuwallad K, Alwasaidi TA. Comparison of laboratory biomarkers for the prediction of in-hospital mortality and severity of acute pulmonary embolism: A multi-center study. Saudi Med J 2023; 44:898-903. [PMID: 37717976 PMCID: PMC10505296 DOI: 10.15537/smj.2023.44.9.20230441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
OBJECTIVES To assess the specificity and sensitivity of prognostic biomarkers in individuals diagnosed with acute pulmonary embolism (PE). METHODS This study retrospectively enrolled 162 patients from the 741 patients who were hospitalized with acute PE and diagnosed using pulmonary computed tomography (CT) angiogram at 5 hospitals in Saudi Arabia between January 2015 and December 2019. Pulmonary embolism patients classified into survivor and non-survivor groups. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red cell distribution width (RDW) were all recorded and were compared between the groups. The evaluation of mortality prediction, sensitivity, and specificity was carried out by employing receiver operating characteristic curves. RESULTS The variables NLR and RDW exhibited a statistically significant correlation with increased mortality and disease severity. A total of 8 patients among the 162 patients died. At the cut-off value of 5.5, NLR was showed an association with all-cause mortality, demonstrating a sensitivity of 75% and a specificity of 82%. At the cut-off value of 18.15, RDW was found to be significantly associated with all-cause mortality, displaying a sensitivity of 63% and a specificity of 88%. CONCLUSION Multiple parameters have been implicated in the mortality and severity of PE. Our study revealed a statistically significant association between NLR, RDW, and PE mortality. These tests are easily accessible and may provide insights into the mortality associated with PE.
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Affiliation(s)
- Yasir M. Alsubhi
- From the Department of Medicine (Alsubhi, Hammudah, Alahmadi); from the Department of Critical Care (Almuwallad), King Fahad General Hospital, from the Department of Medicine (Alhadi); from the Division of Hematology (Alwasaidi), Prince Mohammed Bin Abdulaziz Hospital, Ministry of National Guard Health Affairs, from the Department of Preventive Medicine (Aljohani), Division of Infection Prevention and Control; from the Preventive Medicine Joint Program (Al Dubai), Post Graduate Studies, Ministry of Health, from the Department of Medicine (Alwasaidi), College of Medicine, Taibah University, Al-Madinah Al-Munawarah, and from the Department of Emergency Medicine (Susi), King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Ahmed H. Alhadi
- From the Department of Medicine (Alsubhi, Hammudah, Alahmadi); from the Department of Critical Care (Almuwallad), King Fahad General Hospital, from the Department of Medicine (Alhadi); from the Division of Hematology (Alwasaidi), Prince Mohammed Bin Abdulaziz Hospital, Ministry of National Guard Health Affairs, from the Department of Preventive Medicine (Aljohani), Division of Infection Prevention and Control; from the Preventive Medicine Joint Program (Al Dubai), Post Graduate Studies, Ministry of Health, from the Department of Medicine (Alwasaidi), College of Medicine, Taibah University, Al-Madinah Al-Munawarah, and from the Department of Emergency Medicine (Susi), King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Abdulaziz M. Hammudah
- From the Department of Medicine (Alsubhi, Hammudah, Alahmadi); from the Department of Critical Care (Almuwallad), King Fahad General Hospital, from the Department of Medicine (Alhadi); from the Division of Hematology (Alwasaidi), Prince Mohammed Bin Abdulaziz Hospital, Ministry of National Guard Health Affairs, from the Department of Preventive Medicine (Aljohani), Division of Infection Prevention and Control; from the Preventive Medicine Joint Program (Al Dubai), Post Graduate Studies, Ministry of Health, from the Department of Medicine (Alwasaidi), College of Medicine, Taibah University, Al-Madinah Al-Munawarah, and from the Department of Emergency Medicine (Susi), King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Riyadh A. Alahmadi
- From the Department of Medicine (Alsubhi, Hammudah, Alahmadi); from the Department of Critical Care (Almuwallad), King Fahad General Hospital, from the Department of Medicine (Alhadi); from the Division of Hematology (Alwasaidi), Prince Mohammed Bin Abdulaziz Hospital, Ministry of National Guard Health Affairs, from the Department of Preventive Medicine (Aljohani), Division of Infection Prevention and Control; from the Preventive Medicine Joint Program (Al Dubai), Post Graduate Studies, Ministry of Health, from the Department of Medicine (Alwasaidi), College of Medicine, Taibah University, Al-Madinah Al-Munawarah, and from the Department of Emergency Medicine (Susi), King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Azhar M. Aljohani
- From the Department of Medicine (Alsubhi, Hammudah, Alahmadi); from the Department of Critical Care (Almuwallad), King Fahad General Hospital, from the Department of Medicine (Alhadi); from the Division of Hematology (Alwasaidi), Prince Mohammed Bin Abdulaziz Hospital, Ministry of National Guard Health Affairs, from the Department of Preventive Medicine (Aljohani), Division of Infection Prevention and Control; from the Preventive Medicine Joint Program (Al Dubai), Post Graduate Studies, Ministry of Health, from the Department of Medicine (Alwasaidi), College of Medicine, Taibah University, Al-Madinah Al-Munawarah, and from the Department of Emergency Medicine (Susi), King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Sami Al Dubai
- From the Department of Medicine (Alsubhi, Hammudah, Alahmadi); from the Department of Critical Care (Almuwallad), King Fahad General Hospital, from the Department of Medicine (Alhadi); from the Division of Hematology (Alwasaidi), Prince Mohammed Bin Abdulaziz Hospital, Ministry of National Guard Health Affairs, from the Department of Preventive Medicine (Aljohani), Division of Infection Prevention and Control; from the Preventive Medicine Joint Program (Al Dubai), Post Graduate Studies, Ministry of Health, from the Department of Medicine (Alwasaidi), College of Medicine, Taibah University, Al-Madinah Al-Munawarah, and from the Department of Emergency Medicine (Susi), King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Abdulqader I. Susi
- From the Department of Medicine (Alsubhi, Hammudah, Alahmadi); from the Department of Critical Care (Almuwallad), King Fahad General Hospital, from the Department of Medicine (Alhadi); from the Division of Hematology (Alwasaidi), Prince Mohammed Bin Abdulaziz Hospital, Ministry of National Guard Health Affairs, from the Department of Preventive Medicine (Aljohani), Division of Infection Prevention and Control; from the Preventive Medicine Joint Program (Al Dubai), Post Graduate Studies, Ministry of Health, from the Department of Medicine (Alwasaidi), College of Medicine, Taibah University, Al-Madinah Al-Munawarah, and from the Department of Emergency Medicine (Susi), King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Kholoud Almuwallad
- From the Department of Medicine (Alsubhi, Hammudah, Alahmadi); from the Department of Critical Care (Almuwallad), King Fahad General Hospital, from the Department of Medicine (Alhadi); from the Division of Hematology (Alwasaidi), Prince Mohammed Bin Abdulaziz Hospital, Ministry of National Guard Health Affairs, from the Department of Preventive Medicine (Aljohani), Division of Infection Prevention and Control; from the Preventive Medicine Joint Program (Al Dubai), Post Graduate Studies, Ministry of Health, from the Department of Medicine (Alwasaidi), College of Medicine, Taibah University, Al-Madinah Al-Munawarah, and from the Department of Emergency Medicine (Susi), King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Turki A. Alwasaidi
- From the Department of Medicine (Alsubhi, Hammudah, Alahmadi); from the Department of Critical Care (Almuwallad), King Fahad General Hospital, from the Department of Medicine (Alhadi); from the Division of Hematology (Alwasaidi), Prince Mohammed Bin Abdulaziz Hospital, Ministry of National Guard Health Affairs, from the Department of Preventive Medicine (Aljohani), Division of Infection Prevention and Control; from the Preventive Medicine Joint Program (Al Dubai), Post Graduate Studies, Ministry of Health, from the Department of Medicine (Alwasaidi), College of Medicine, Taibah University, Al-Madinah Al-Munawarah, and from the Department of Emergency Medicine (Susi), King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
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Chervu N, Mabeza RM, Kronen E, Sakowitz S, Bakhtiyar SS, Hadaya J, Benharash P. Contemporary association of preoperative malnutrition and outcomes of hiatal hernia repairs in the United States. Surgery 2023:S0039-6060(23)00188-5. [PMID: 37217387 DOI: 10.1016/j.surg.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/05/2023] [Accepted: 04/09/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Hypoalbuminemia has been used as a surrogate for malnutrition and is associated with worse postoperative outcomes across major operations. Because patients with hiatal hernia often have inadequate caloric intake, we examined the association of serum albumin levels with outcomes after hiatal hernia repair. METHODS Adults undergoing elective and non-elective hiatal hernia repair via any approach were tabulated from the 2012 to 2019 National Surgical Quality Improvement Program. Patients were stratified into the Hypoalbuminemia cohort if serum albumin <3.5 mg/dL using restricted cubic spline analysis. Major adverse events were defined as a composite of all-cause mortality and major complications per the American College of Surgeons National Surgical Quality Improvement Program risk calculator. Entropy balancing was used to adjust for intergroup differences. Multivariable regression models were then constructed to assess the association of preoperative albumin with major adverse events, postoperative length of stay, and 30-day readmission. RESULTS Of 23,103 patients, 11.7% comprised the Hypoalbuminemia cohort. The Hypoalbuminemia group was older, less commonly of White race, and less likely to have an independent functional status than others. They were also more likely to undergo inpatient, non-elective surgery via laparotomy. After entropy balancing and adjustment, hypoalbuminemia remained associated with increased odds of major adverse events and multiple complications and longer adjusted postoperative length of stay. There was no significant difference in adjusted odds of readmission. CONCLUSION We used a quantitative methodology to establish a serum albumin threshold of 3.5 mg/dL associated with increased adjusted odds of major adverse events, increased postoperative length of stay, and postoperative complications after hiatal hernia repair. These results may guide preoperative nutrition supplementation.
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Affiliation(s)
- Nikhil Chervu
- Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, CA; Depatment of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Russyan Mark Mabeza
- Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, CA; David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Elsa Kronen
- Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, CA
| | - Sara Sakowitz
- Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, CA; David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Syed Shahyan Bakhtiyar
- Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, CA; Department of Surgery, University of Colorado, Aurora, CO
| | - Joseph Hadaya
- Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, CA; Depatment of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Peyman Benharash
- Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, CA; Depatment of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA.
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Su H, Shou Y, Fu Y, Zhao D, Heidari AA, Han Z, Wu P, Chen H, Chen Y. A new machine learning model for predicting severity prognosis in patients with pulmonary embolism: Study protocol from Wenzhou, China. Front Neuroinform 2022; 16:1052868. [PMID: 36590908 PMCID: PMC9802582 DOI: 10.3389/fninf.2022.1052868] [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: 09/24/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Pulmonary embolism (PE) is a common thrombotic disease and potentially deadly cardiovascular disorder. The ratio of clinical misdiagnosis and missed diagnosis of PE is very large because patients with PE are asymptomatic or non-specific. Methods Using the clinical data from the First Affiliated Hospital of Wenzhou Medical University (Wenzhou, China), we proposed a swarm intelligence algorithm-based kernel extreme learning machine model (SSACS-KELM) to recognize and discriminate the severity of the PE by patient's basic information and serum biomarkers. First, an enhanced method (SSACS) is presented by combining the salp swarm algorithm (SSA) with the cuckoo search (CS). Then, the SSACS algorithm is introduced into the KELM classifier to propose the SSACS-KELM model to improve the accuracy and stability of the traditional classifier. Results In the experiments, the benchmark optimization performance of SSACS is confirmed by comparing SSACS with five original classical methods and five high-performance improved algorithms through benchmark function experiments. Then, the overall adaptability and accuracy of the SSACS-KELM model are tested using eight public data sets. Further, to highlight the superiority of SSACS-KELM on PE datasets, this paper conducts comparison experiments with other classical classifiers, swarm intelligence algorithms, and feature selection approaches. Discussion The experimental results show that high D-dimer concentration, hypoalbuminemia, and other indicators are important for the diagnosis of PE. The classification results showed that the accuracy of the prediction model was 99.33%. It is expected to be a new and accurate method to distinguish the severity of PE.
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Affiliation(s)
- Hang Su
- College of Computer Science and Technology, Changchun Normal University, Changchun, Jilin, China
| | - Yeqi Shou
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yujie Fu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dong Zhao
- College of Computer Science and Technology, Changchun Normal University, Changchun, Jilin, China,*Correspondence: Dong Zhao,
| | - Ali Asghar Heidari
- School of Surveying and Geospatial Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Zhengyuan Han
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peiliang Wu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,Peiliang Wu,
| | - Huiling Chen
- College of Computer Science and Artificial Intelligence, Wenzhou University, Wenzhou, Zhejiang, China,Huiling Chen,
| | - Yanfan Chen
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,Yanfan Chen,
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Incidence and risk factors of preoperative deep vein thrombosis in patients with intertrochanteric fractures: a retrospective study. J Orthop Surg Res 2022; 17:375. [PMID: 35922845 PMCID: PMC9351110 DOI: 10.1186/s13018-022-03268-1] [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: 07/17/2021] [Accepted: 07/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The risk of perioperative complications remains high in patients with intertrochanteric fractures. Immobilization after injury may predispose these patients to deep vein thrombosis (DVT) while waiting for surgery. The aims of this study were to determine the incidence of preoperative DVT in patients with intertrochanteric fractures and identify independent risk factors. METHODS This retrospective study included patients with intertrochanteric fractures waiting for surgical interventions at our institution from June 2018 to December 2020. All patients received pharmacologic thromboprophylaxis after admission and ultrasound screening for DVT in both lower limbs before surgery. Demographic, clinical and laboratory data of these patients were collected to perform univariate analysis first. Subsequently, factors with a significant difference in univariate analysis were introduced into the multivariate logistic regression analysis to determine the independent risk factors for preoperative DVT. RESULTS A total of 266 patients were enrolled in this study. Seventy-one patients (26.7%) developed DVTs before surgery. The majority of DVTs were distal types (91.5%). There were 40 patients with DVTs only in the affected limb, 7 patients with DVTs only in the unaffected limb, and 24 patients with DVTs in both lower limbs. Advanced age, female, prolonged period from injury to admission, combined cranial trauma, shorter thrombin time, increased level of D-dimer and lower level of albumin proved to be the independent risk factors for preoperative DVT. CONCLUSIONS We observed a high incidence of preoperative DVT in patients with intertrochanteric fractures. Identification of patients at high risk may improve the prevention and treatment of preoperative DVT in this population.
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11
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Chlapoutakis S, Georgakopoulou V, Trakas N, Kouvelos G, Papalexis P, Damaskos C, Sklapani P, Grivas A, Gouveris P, Tryfonopoulos D, Tzovaras A, Ardavanis‑Loukeris G, Grouzi E, Spandidos D, Matsagkas M. Characteristics and outcomes of cancer patients who develop pulmonary embolism: A cross‑sectional study. Oncol Lett 2022; 23:168. [PMID: 35496573 PMCID: PMC9019772 DOI: 10.3892/ol.2022.13288] [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: 02/16/2022] [Accepted: 03/17/2022] [Indexed: 11/21/2022] Open
Abstract
Pulmonary embolism (PE), along with deep vein thrombosis, are collectively known as venous thromboembolism (VTE). Predisposing factors for PE include post-operative conditions, pregnancy, cancer and an advanced age; of note, a number of genetic mutations have been found to be associated with an increased risk of PE. The association between cancer and VTE is well-established, and cancer patients present a higher risk of a thrombotic event compared to the general population. In addition, PE is a significant cause of morbidity and mortality among cancer patients. The aim of the present study was to illustrate the clinical characteristics, laboratory findings, radiology features and outcomes of cancer patients who developed PE, collected from an anticancer hospital. For this purpose, adult cancer patients diagnosed with PE by imaging with computed tomography pulmonary angiography were enrolled. The following data were recorded: Demographics, comorbidities, type of cancer, time interval between cancer diagnosis and PE occurrence, the type of therapy received and the presence of metastases, clinical signs and symptoms, predisposing factors for PE development, laboratory data, radiological findings, electrocardiography findings, and the type of therapy received for PE and outcomes in a follow-up period of 6 months. In total, 60 cancer patients were enrolled. The majority of the cancer patients were males. The most common type of cancer observed was lung cancer. The majority of cases of PE occurred within the first year from the time of cancer diagnosis, while the majority of patients had already developed metastases. In addition, the majority of cancer patients had received chemotherapy over the past month, while they were not receiving anticoagulants and had central obstruction. A large proportion of patients had asymptomatic PE. The in-hospital mortality rate was 13.3% and no relapse or mortality were observed during the follow-up period. The present study demonstrates that elevated levels of lactic acid and an increased platelet count, as well as low serum levels of carcinoembryonic antigen, albumin and D-dimer, may be potential biomarkers for asymptomatic PE among cancer patients.
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Affiliation(s)
| | | | - Nikolaos Trakas
- Department of Biochemistry, Sismanogleio Hospital, 15126 Athens, Greece
| | - Georgios Kouvelos
- Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41334 Larissa, Greece
| | - Petros Papalexis
- Unit of Endocrinology, First Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Pagona Sklapani
- Department of Cytology, Mitera Hospital, 15123 Athens, Greece
| | - Anastasios Grivas
- Second Department of Medical Oncology, Agios Savvas Hospital, 11522 Athens, Greece
| | - Panagiotis Gouveris
- Second Department of Medical Oncology, Agios Savvas Hospital, 11522 Athens, Greece
| | | | - Alexandros Tzovaras
- First Department of Medical Oncology, Agios Savvas Hospital, 11522 Athens, Greece
| | | | - Elissavet Grouzi
- Department of Transfusion Service and Clinical Hemostasis, Agios Savvas Hospital, 11522 Athens, Greece
| | - Demetrios Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Miltiadis Matsagkas
- Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41334 Larissa, Greece
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12
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Boyuk F. The Predictor Potential Role of the Glucose to Potassium Ratio in the Diagnostic Differentiation of Massive and Non-Massive Pulmonary Embolism. Clin Appl Thromb Hemost 2022; 28:10760296221076146. [PMID: 35187962 PMCID: PMC8864281 DOI: 10.1177/10760296221076146] [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] [Indexed: 11/16/2022] Open
Abstract
Objective Acute pulmonary embolism (PE) is one of the main causes of death and has a
course as massive (MPE) or non-massive (NMPE). The study investigates the
indicator potential of Glucose to Potassium ratio (GPR) in the differential
diagnosis of MPE and NMPE. Materials and Methods The study was designed as a retrospective cross-sectional clinical cohort in
patients with PE. A total of 111 participants enrolled in the research
separating two groups: MPE (n:54) and NMPE (n:67). The GPR was calculated by
dividing serum glucose by potassium levels and its results were compared
with D-Dimer, Pulmonary Artery Pressure (PAP), and C-Reactive Protein Test
(CRP). Results D-Dimer was measured as 6.5 ± 5.7 µg/L in the MPE and found higher than the
NMPE (3.9 ± 5.2 µg/L) (P = .019). CRP (100 ± 83.5 to
30.9 ± 42.7 mg/L; P = .0001) and PAP (49.5 ± 11.9 to
34.8 ± 7.3 mmHg; P = .0001) were found increased in the
MPE. GPR strongly increased in the MPE (30.7 ± 7.5 to 24.9 ± 4.3;
P = .0003) in line with CRP, D-Dimer and PAP. GPR
showed a stronger diagnostic value (AUC: 0.733; P = .00001;
Sensitivity:72%; Spesifity:70%; Cut-off: 26.5). PAP and GPR showed
significant efficiency on occurrence of the MPE according to the binary
logistic regression. Conclusion The GPR, as a novel and cheap marker, can be useful for diagnostic
differentiation of MPE from NMPE, but weaker than PAP and better than
D-dimer. Type of Study and Level of Evidence Level-II, Retrospective clinical cohort study.
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Affiliation(s)
- Ferit Boyuk
- 147022Department of Cardiology, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
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13
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Meng X, Fu M, Wang J, Xu H. Effects of Recombinant Human Brain Natriuretic Peptide in Patients with Acute Pulmonary Embolism Complicated with Right Ventricular Dysfunction Who Underwent Catheter-Directed Therapy. Int Heart J 2022; 63:8-14. [DOI: 10.1536/ihj.21-086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | - Mingming Fu
- Department of Foreign Language, North Sichuan Medical College
| | | | - Hui Xu
- Department of Biochemistry and Molecular Biology, Jiamusi University
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14
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Yang R, Liu G, Deng C. Pulmonary embolism with chronic obstructive pulmonary disease. Chronic Dis Transl Med 2021; 7:149-156. [PMID: 34505015 PMCID: PMC8413125 DOI: 10.1016/j.cdtm.2021.04.001] [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: 11/19/2020] [Indexed: 11/15/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease. The incidence of COPD is growing annually in China, and it is a significant and growing public health burden. Multivariate analysis showed that COPD was one of the independent risk factors for the occurrence of pulmonary embolism (PE), and the incidence of PE was significantly higher in COPD patients than in normal subjects. However, PE is often overlooked in patients with acute exacerbation of COPD (AECOPD) because there are many similarities in clinical symptoms between PE and AECOPD, which are difficult to distinguish, resulting in the failure of timely treatment and poor prognosis. Therefore, it is of great significance to understand the clinical manifestations, diagnosis, and treatment of COPD combined with PE for making a more accurate diagnosis, providing timely and effective treatment, and improving the prognosis of such patients.
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Affiliation(s)
- Ruohan Yang
- Institute of Respiratory Disease, Fujian Medical University, Division of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, China
| | - Guiqing Liu
- The Hammersmith Hospital, London W12 0NN, United Kingdom
| | - Chaosheng Deng
- Institute of Respiratory Disease, Fujian Medical University, Division of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, China
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HOŞGÜN D, AYDEMİR S, ATEŞ C. Evaluation of factors affecting 90-day mortality in patients hospitalized due to pulmonary thromboembolism. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.925332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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16
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Gök G, Karadağ M, Çinar T, Nurkalem Z, Duman D. In-hospital and short-term predictors of mortality in patients with intermediate-high risk pulmonary embolism. J Cardiovasc Thorac Res 2021; 12:321-327. [PMID: 33510882 PMCID: PMC7828758 DOI: 10.34172/jcvtr.2020.51] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/13/2020] [Indexed: 12/28/2022] Open
Abstract
Introduction: The aim of this study was to evaluate the in-hospital and short-term predictive factors of mortality in intermediate-high risk acute pulmonary embolism (PE) patients with right ventricle (RV)dysfunction and myocardial injury.
Methods: In this retrospective study, the medical records of 187 patients with a diagnosis of intermediate high risk acute PE were evaluated. A contrast-enhanced multi-detector pulmonary angiography was used to confirm diagnosis in all cases. All-cause mortality was determined by obtaining both in hospital and 30 days follow-up data of patients from medical records.
Results: During the in-hospital stay (9.5±4.72 days), 7 patients died, resulting in an acute PE related in-hospital mortality of 3.2%. Admission heart rate (HR), (Odds ratio (OR), 1.028 95% Confidence interval (CI), 0.002-1.121; P = 0.048) and blood urea nitrogen (BUN) (OR, 1.028 95% CI, 0.002-1.016; P = 0.044) were found to be independent predictors for in-hospital mortality in a multi variate logistic regression analysis. In total, 32 patients (20.9%) died during 30 days follow-up.The presence of congestive heart failure (OR, 0.015, 95%CI, 0.001-0.211; P = 0.002) and dementia (OR, 0.029, 95%CI,0.002-0.516; P = 0.016) as well as low albumin level (OR, 0.049 95%CI, 0.006-0.383; P = 0.049) were associated with 30 days mortality.
Conclusion: HR and BUN were independent predictors of in-hospital mortality and the presence of congestive heart failure, dementia, and low albumin levels were associated with higher 30 days mortality.
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Affiliation(s)
- Gulay Gök
- Medipol University Faculty of Medicine, Department of Cardiology, Istanbul, Turkey
| | - Mehmet Karadağ
- Hatay Mustafa Kemal University Faculty of Medicine, Department of Biostatistics, Hatay, Turkey
| | - Tufan Çinar
- Health Sciences University, Sultan 2. Abdülhamid Han Training and Research Hospital, Department of Cardiology, İstanbul, Turkey
| | - Zekeriya Nurkalem
- Medipol University Faculty of Medicine, Department of Cardiology, Istanbul, Turkey
| | - Dursun Duman
- Medipol University Faculty of Medicine, Department of Cardiology, Istanbul, Turkey
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Gok M, Kurtul A. A novel marker for predicting severity of acute pulmonary embolism: systemic immune-inflammation index. SCAND CARDIOVASC J 2020; 55:91-96. [DOI: 10.1080/14017431.2020.1846774] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Murat Gok
- Cardiology Clinic, Edirne Sultan 1.Murat State Hospital, Edirne, Turkey
| | - Alparslan Kurtul
- Faculty of Medicine, Department of Cardiology, Hatay Mustafa Kemal University, Hatay, Turkey
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