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Yan T, Ma Y, Wang Z, Lyu J, Wu S, Zhang C, Wei W, Zeng J, Ma Z, Xu K. Calcium administration appears not to benefit acute pancreatitis patients with hypocalcemia. J Hepatobiliary Pancreat Sci 2024; 31:273-283. [PMID: 38058277 DOI: 10.1002/jhbp.1397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 10/07/2023] [Accepted: 10/27/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE Hypocalcemia occurs commonly among patients with acute pancreatitis (AP) in the intensive care unit (ICU). Calcium therapy could be used to correct hypocalcemia and maintain calcium levels, but its impact on the prognosis has not been demonstrated. Our study aimed to determine whether calcium therapy could benefit the multiple outcomes of AP patients with hypocalcemia. METHODS We extracted 807 AP patients with hypocalcemia from the Beth Israel Deaconess Medical Center (MIMIC-IV) database and performed retrospective analyses. The outcomes were in-hospital, 28 days, ICU mortality, and the length of stay (LOS) in the hospital and ICU. We performed propensity matching (PSM) and inverse probability weighting (IPTW) to balance the baseline differences and conducted multivariate regression to investigate the impact of calcium therapy. RESULTS A total of 620 patients (76.8%) received calcium treatment (calcium group) during hospitalization, while 187 patients (non-calcium group) did not. Patients in the calcium group did not present significant survival differences between groups before and after matching. After including covariates, calcium administration had no association with patients' in-hospital (HR: 1.03, 95% Cl: 0.47-2.27, p = .942), 28 days and ICU mortality and was significantly associated with prolonged length of stay in the hospital (effect estimate: 6.18, 95% Cl: 3.27-9.09, p < .001) and ICU (effect estimate: 1.72, 95% Cl: 0.24-3.20, p < .001). Calcium therapy could not benefit patients in subgroups with exclusive parenteral infusion, early calcium therapy (<48 h), or various degrees of hypocalcemia. CONCLUSION AP patients with hypocalcemia could not benefit from calcium administration, which has no association with multiple mortality and is significantly associated with prolonged LOS in the hospital and ICU.
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Affiliation(s)
- Tianao Yan
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Pancreatic Disease Center of Xi'an Jiaotong University, Xi'an, China
| | - Yifei Ma
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Pancreatic Disease Center of Xi'an Jiaotong University, Xi'an, China
| | - Zheng Wang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Pancreatic Disease Center of Xi'an Jiaotong University, Xi'an, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shuai Wu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Pancreatic Disease Center of Xi'an Jiaotong University, Xi'an, China
| | - Chun Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Pancreatic Disease Center of Xi'an Jiaotong University, Xi'an, China
| | - Wanzhen Wei
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Pancreatic Disease Center of Xi'an Jiaotong University, Xi'an, China
| | - Jiahui Zeng
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Pancreatic Disease Center of Xi'an Jiaotong University, Xi'an, China
| | - Zhenhua Ma
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Pancreatic Disease Center of Xi'an Jiaotong University, Xi'an, China
| | - Kedong Xu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Pancreatic Disease Center of Xi'an Jiaotong University, Xi'an, China
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Wang N, Guo H, Jing Y, Song L, Chen H, Wang M, Gao L, Huang L, Song Y, Sun B, Cui W, Xu J. Development and Validation of Risk Prediction Models for Gestational Diabetes Mellitus Using Four Different Methods. Metabolites 2022; 12:1040. [PMID: 36355123 PMCID: PMC9697464 DOI: 10.3390/metabo12111040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/26/2022] [Accepted: 10/25/2022] [Indexed: 09/21/2023] Open
Abstract
Gestational diabetes mellitus (GDM), a common perinatal disease, is related to increased risks of maternal and neonatal adverse perinatal outcomes. We aimed to establish GDM risk prediction models that can be widely used in the first trimester using four different methods, including a score-scaled model derived from a meta-analysis using 42 studies, a logistic regression model, and two machine learning models (decision tree and random forest algorithms). The score-scaled model (seven variables) was established via a meta-analysis and a stratified cohort of 1075 Chinese pregnant women from the Northwest Women's and Children's Hospital (NWCH) and showed an area under the curve (AUC) of 0.772. The logistic regression model (seven variables) was established and validated using the above cohort and showed AUCs of 0.799 and 0.834 for the training and validation sets, respectively. Another two models were established using the decision tree (DT) and random forest (RF) algorithms and showed corresponding AUCs of 0.825 and 0.823 for the training set, and 0.816 and 0.827 for the validation set. The validation of the developed models suggested good performance in a cohort derived from another period. The score-scaled GDM prediction model, the logistic regression GDM prediction model, and the two machine learning GDM prediction models could be employed to identify pregnant women with a high risk of GDM using common clinical indicators, and interventions can be sought promptly.
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Affiliation(s)
- Ning Wang
- Department of Endocrinology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, China
- International Center for Obesity and Metabolic Disease Research of Xi’an Jiaotong University, Xi’an 710061, China
| | - Haonan Guo
- Department of Endocrinology and Second Department of Geriatrics, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
| | - Yingyu Jing
- Department of Endocrinology and Second Department of Geriatrics, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
| | - Lin Song
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China
| | - Huan Chen
- Department of Endocrinology and Second Department of Geriatrics, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
| | - Mengjun Wang
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China
- Department of Endocrinology, 521 Hospital of Norinco Group, Xi’an 710065, China
| | - Lei Gao
- Department of Endocrinology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, China
| | - Lili Huang
- Department of Medical Ultrasound, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, China
| | - Yanan Song
- Department of Endocrinology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, China
| | - Bo Sun
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China
| | - Wei Cui
- International Center for Obesity and Metabolic Disease Research of Xi’an Jiaotong University, Xi’an 710061, China
- Department of Endocrinology and Second Department of Geriatrics, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
| | - Jing Xu
- Department of Endocrinology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, China
- International Center for Obesity and Metabolic Disease Research of Xi’an Jiaotong University, Xi’an 710061, China
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Ullah H, Elakabawi K, Ke H, Ullah N, Ullah H, Shah SA, Khan HH, Khan MA, Guo N, Yuan Z. Predictors and 3-year outcomes of compromised left circumflex coronary artery after left main crossover stenting. Clin Cardiol 2021; 44:1377-1385. [PMID: 34269478 PMCID: PMC8495093 DOI: 10.1002/clc.23693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 06/18/2021] [Accepted: 07/05/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND There are few predictors of decreased fractional flow reserve (FFR) in the left circumflex coronary artery (LCx) after left main (LM) crossover stenting. OBJECTIVES We aimed to determine the predictors for low FFR at LCx and possible treatment strategies for compromised LCx, together with their long-term outcomes. METHODS Altogether, 563 patients who met the inclusion criteria were admitted to our hospital from February 2015 to November 2020 with significant distal LM bifurcation lesions. They underwent single-stent crossover percutaneous coronary intervention (PCI) under intravascular ultrasound (IVUS) guidance with further LCx intervention based on the measured FFR. RESULTS The patients showed significant angiographic LCx ostial affection post-LM stenting, but only 116 (20.6%) patients had FFR < 0.8. The three-year composite major adverse cardiac events (MACE) rates were comparable between the high and low FFR groups (16.8% vs. 15.5; p = 0.744). In a multivariate analysis, low FFR at the LCx was associated with post-stenting minimal luminal area (MLA) of LCx (odds ratio [OR]: 0.032, p < .001), post-stenting LCx plaque burden (OR: 1.166, p < .001), poststenting LM MLA (OR: 0.821, p = .038), and prestenting LCx MLA (OR: 0.371, p = .044). In the low FFR group, those with compromised LCx managed with drug-eluting balloon had the lowest three-year MACE rate (8.1%), as compared to either those undergoing kissing balloon inflation (KBI) (17.5%) or stenting (20.5%) (p = 0.299). CONCLUSION Unnecessary LCx interventions can be avoided with FFR-guided LCx intervention. Poststenting MLA and plaque burden of the LCx, and main vessel stent length are poststenting predictors of low FFR.
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Affiliation(s)
- Hameed Ullah
- Department of CardiologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Karim Elakabawi
- Department of CardiologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
- Department of CardiologyBenha UniversityEgypt
| | - Han Ke
- Department of CardiologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Najeeb Ullah
- Department of Data Science (FIT)University of MonashMolbourneAustralia
| | - Habib Ullah
- Department of CardiologyDow University of health sciencesKarachiPakistan
| | - Sardar Ali Shah
- Department of CardiologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | | | | | - Ning Guo
- Department of CardiologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Zuyi Yuan
- Department of CardiologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
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