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Nosocomial bloodstream infection in patients caused by Staphylococcus aureus： drug susceptibility, outcome, and risk factors for hospital mortality

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Chinese Medical Journal 2012年第2期125卷 226-229页

作者： Chen Rong Yan Zhong-qiang Feng Dan Luo Yan-ping Wang Lei-li Shen Ding-xia Chinese Peoples Liberat Army Gen Hosp Dept Microbiol Beijing 100853 Peoples R China Chinese Peoples Liberat Army Gen Hosp Dept Hosp Infect Management Beijing 100853 Peoples R China Chinese Peoples Liberat Army Gen Hosp Dept Med Stat Beijing 100853 Peoples R China

Background Previous studies have different viewpoints about the clinical impact of methicillin resistance on mortality of hospital-acquired bloodstream infection （BSI） patients with Staphylococcus aureus （***）.The objective of this study was to investigate the mortality of hospital-acquired BSI with *** in a military hospital and analyze the risk factors for the hospital *** A retrospective cohort study was performed in patients admitted to the biggest military tertiary teaching hospital in China between January 2006 and May *** included patients had clinically significant nosocomial BSI with *** Logistic regression analysis was used to identify the risk factors for hospital mortality of patients with *** *** One hundred and eighteen patients of more than one year old were identified as clinically and microbiologically confirmed nosocomial bacteraemia due to ***,and 75 out of 118 patients were infected with methicillin-resistant *** （MRSA）.The overall mortality of nosocomial *** BSI was 28.0%.Methicillin resistance in *** bacteremia was associated with significant increase in the length of hospitalization and high proportion of inappropriate empirical antibiotic *** Logistic regression analysis,the severity of clinical manifestations （APACHE Ⅱ score）（odds ratio （OR） 1.22,95% confidence interval （CI） 1.12-1.34） and inadequacy of empirical antimicrobial therapy （OR 0.25,95% CI 0.09-0.69） remained as risk factors for hospital *** Nosocomial *** BSI was associated with high in-hospital *** resistance in *** has no significant impact on the outcome of patients with staphylococcal *** empirical antimicrobial therapy is very important to the prognosis.

关键词： Staphylococcus aureus bloodstream infection hospital mortality

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Chinese Medical Journal 2008年第12期121卷 1080-1084页

作者： TIAN Heng-li CHEN Shi-wen XU Tao HU Jin RONG Bo-ying WANG Gan GAO Wen-wei CHEN Hao Department of Neurosurgery Shanghai Sixth People's Hospital Shanghai Jiao Tong University Shanghai 200233 China

Background Acute subdural haematoma （ASDH） is a common traumatic brain injury with a relatively high mortality rate. However, few studies have examined the factors predicting the outcome of isolated traumatic ASDH. This clinical study examined the hospital mortality and analyzed the risk factors for mortality in patients treated surgically for isolated traumatic ASDH.Methods We collected 308 consecutive patients who underwent neurosurgery for isolated traumatic ASDH between January 1999 and December 2007 and used multivariate Logistic regression analysis to evaluate the influence of 11 clinical variables on hospital mortality.Results The overall hospital mortality was 21.75% （67/308）. Age （OR=1.807）, preoperative Glasgow Coma Score （OR=0.316）, brain herniation （OR=2.181） and the time from trauma to decompression （OR=1.815） were independent predictors of death, while no independent association was observed between hospital mortality and haematoma volume, midline shift, acute brain swelling or brain herniation duration, although these variables were correlated with hospital mortality in univariate analyses.Conclusions This study identified the risk factors for hospital mortality in patients who underwent surgical treatment for isolated traumatic ASDH. An increased risk of death occurs in patients who are over 50 years of age and have lower preoperative Glasgow Coma Scores, the presence of brain herniation and a long interval between trauma and decompression. The findings should help clinicians determine management criteria and improve survival.

关键词： acute subdural haematoma hospital mortality risk factors

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Relationship between time to positivity of blood culture with clinical characteristics and hospital mortality in patients with Escherichia coli bacteremia

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Chinese Medical Journal 2011年第3期124卷 330-334页

作者： BO Shi-ning BO Jian NING Yong-zhong ZHAO Yu LU Xiao-lin YANG Ji-yong ZHU Xi YAO Gai-qi Department of Intensive Care Unit Peking University Third Hospital Beijing 100083 China Department of Hematology Chinese People's Liberation Army General Hospital Beijing 100853 China Department of Microbiology Peking University Third Hospital Beijing 100083 China

Background Previous studies indicated that the time to positivity （TTP） of blood culture is a parameter correlating with degree of the bacteremia and outcome in patients with bloodstream infections caused by Escherichia coli （***/i）. The objective of this study was to further investigate the diagnostic and prognostic power of using TTP to predict E. coli *** A retrospective cohort study at two university hospitals was conducted. We retrieved all the medical records of those with E. coli bloodstream infection according to the records generated by their microbiology *** and multivariate analyses were applied to identify clinical factors correlating with fast bacterial growth and significant prognostic factors for hospital *** Medical records of 353 episodes of E. coli bacteremia diagnosed between January 1,2007 and December 31,2009 were retrieved in the investigation. Univariate analysis demonstrated that the TTP≤7 hours group is associated with higher incidence of active malignancies （41.7% vs. 27.2%, P=0.010）, neutropenia （30% vs.14.3%, P=0.007）, primary bacteremia （55.0% vs. 33.4%, P=0.002）, and poorer outcome （hospital mortality 43.3% vs.11.9%, P=0.000） than the TTP 〉7 hours group. Multivariate analysis revealed that the significant predictors of hospital mortality, in rank order from high to low, were TTP （for TTP 〈7 hours, odds ratio （OR）： 4.886; 95% confidence interval （CI）： 2.572-9.283; P=0.000）,neutropenia （OR： 2.800; 95% CI：1.428-5.490; P=0.003）, comedication of steroids or immunosuppressive agents （OR：2.670; 95% CI： 0.971-7.342; P=0.057）.Conclusions Incidence of malignancies, neutropenia and primary bacterernia correlates with fast bacterial growth in patients with E. coli bacteremia. The parameter of TTP has been identified as a variable of highest correlation to hospital mortality and therefore can be potentially utilized as a mortality prognostic marker.

关键词： Escherichia coli bacteremia hospital mortality

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hospitalizations and in-hospital mortality for inflammatory bowel disease in Brazil

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2022年第1期13卷 1-10页

作者： Ana Luiza Vilar Guedes Amanda Lopes Lorentz Larissa Fernandes de Almeida Rios Rios Beatriz Camara Freitas Adriano Gutemberg Neves Dias Ana Luísa Eckhard Uhlein Felipe Oliveira Vieira Neto Jobson Felipe Soares Jesus Túlio de SáNovaes Torres Raquel Rocha Vitor D Andrade Genoile Oliveira Santana Life Sciences Department State University of BahiaSalvador 41150-000BahiaBrazil Sciences of Nutrition Federal University of BahiaSalvador 40110-060BahiaBrazil Medicine Department Universidade Salvador(UNIFACS)Salvador 41820-021BahiaBrazil Medicine and Health Postgraduate Program Federal University of BahiaSalvador 40110-060BahiaBrazil

BACKGROUND Inflammatory bowel disease(IBD)is associated with complications,frequent hospitalizations,surgery and *** introduction of biologic drugs into the therapeutic arsenal in the last two decades,combined with an expansion of immunosuppressant therapy,has changed IBD management and may have altered the profile of hospitalizations and in-hospital mortality(IHM)due to *** To describe hospitalizations from 2008 to 2018 and to analyze IHM from 1998 to 2017 for IBD in *** This observational,retrospective,ecological study used secondary data on hospitalizations for IBD in Brazil for 2008-2018 to describe hospitalizations and for 1998-2017 to analyze *** data were obtained from the hospital Information System of the Brazilian Unified Health System and population data from demographic *** following variables were analyzed:Number of deaths and hospitalizations,length of hospital stay,financial costs of hospitalization,sex,age,ethnicity and type of hospital *** There was a reduction in the number of IBD hospitalizations,from 6975 admissions in 1998 to 4113 in 2017(trend:y=-0.1682x+342.8;R^(2)=0.8197;Phospitalization rate also decreased,from 3.60/100000 in 2000 to 2.17 in *** rates varied during the 20-year period,between 2.06 in 2017 and 3.64 in 2007,and did not follow a linear trend(y=-0.0005049x+2.617;R^(2)=0,00006;P=0.9741).IHM rates also varied between regions,increasing in all but the southeast,which showed a decreasing trend(y=-0.1122x+4.427;R^(2)=0,728;Phospitalization rate(1.15).The Midwest and South regions had the highest hospitalization rates(3.27 and 3.17,respectively).A higher IHM rate was observed for nonelective admissions(2.88),which accounted for 81%of IB

关键词： Inflammatory bowel disease Crohn’s disease Ulcerative colitis hospitalization hospital mortality hospital information systems Epidemiology

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Prediction of hospital mortality in intensive care unit patients from clinical and laboratory data: A machine learning approach

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World Journal of Critical Care Medicine 2022年第5期11卷 317-329页

作者： Elena Caires Silveira Soraya Mattos Pretti Bruna Almeida Santos Caio Fellipe Santos Correa Leonardo Madureira Silva Fabricio Freire de Melo Multidisciplinary Institute of Health Federal University of BahiaVitória da Conquista 45-029094Brazil

BACKGROUND Intensive care unit(ICU)patients demand continuous monitoring of several clinical and laboratory parameters that directly influence their medical progress and the staff’s *** data are vital in the assistance of these patients,being already used by several scoring *** this context,machine learning approaches have been used for medical predictions based on clinical data,which includes patient *** To develop a binary classifier for the outcome of death in ICU patients based on clinical and laboratory parameters,a set formed by 1087 instances and 50 variables from ICU patients admitted to the emergency department was obtained in the“WiDS(Women in Data Science)Datathon 2020:ICU mortality Prediction”*** For categorical variables,frequencies and risk ratios were *** variables were computed as means and standard deviations and Mann-Whitney U tests were *** then divided the data into a training(80%)and test(20%)*** training set was used to train a predictive model based on the Random Forest algorithm and the test set was used to evaluate the predictive effectiveness of the *** A statistically significant association was identified between need for intubation,as well predominant systemic cardiovascular involvement,and hospital death.A number of the numerical variables analyzed(for instance Glasgow Coma Score punctuations,mean arterial pressure,temperature,pH,and lactate,creatinine,albumin and bilirubin values)were also significantly associated with death *** proposed binary Random Forest classifier obtained on the test set(n=218)had an accuracy of 80.28%,sensitivity of 81.82%,specificity of 79.43%,positive predictive value of 73.26%,negative predictive value of 84.85%,F1 score of 0.74,and area under the curve score of *** predictive variables of the greatest importance were the maximum and minimum lactate values,adding up to a predictive importance of 15.54%.CONCLUSIO

关键词： hospital mortality Machine learning Patient outcome assessment Routinely collected health data Intensive care units Critical care outcomes

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Correlation of neutrophil to lymphocyte ratio to severity of coronary artery disease and in-hospital clinical outcomes in patients with acute coronary syndrome: A prospective observational study

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Journal of Acute Disease 2024年第1期13卷 14-19页

作者： Vinodhkumar Kandibendla GThiruvikrama Prakash Subash Chandra Bose Prafull Dhewle Department of Cardiology Prakriya HospitalsNagasandraBangloreIndia Department of Cardiology E.S.HospitalVillupuramTamil NaduIndia Department of Cardiology Government Medical CollegeAnanthapuramuAndhra PradeshIndia Department of Cardiology Shrikrishna Hrudayalaya HospitalNagpurMaharashtraIndia

Objective:To explore correlation of neutrophil-to-lymphocyte ratio(NLR)to severity of coronary artery disease(CAD)and in-hospital clinical outcomes in patients with acute coronary syndrome(ACS).Methods:In this prospective and observational study,we recruited 500 patients with *** all the eligible patients,demographic details were collected,and laboratory parameters were *** CAD severity was evaluated in terms of the number of involved *** NLR was calculated based on neutrophils and lymphocytes and the correlation of various risk factors and severity and outcome of CAD was ***:77.2%of Patients was male,and 52%of the patients aged between 55-70 *** on the type of ACS,396 out of 500 patients had ST-elevation myocardial *** ascending trend in the white blood cell levels and NLR value was noted as the severity of the ACS increased and the highest white blood cell levels and NLR was noted among classⅣ*** mean NLR value among the non-survivors were higher compared to the survivors(9.52±5.72 vs.4.76±2.36;Phospital mortality.

关键词： Acute coronary syndrome Coronary artery disease Coronary vessels hospital mortality Lymphocytes Neutrophils Prognosis Risk factors

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A New Coronavirus Estimation Global Score for Predicting mortality During hospitalization in Patients with COVID-19

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Cardiology Discovery 2022年第2期2卷 69-76页

作者： Hesong Zeng Xingwei He Wanjun Liu Jing Kan Liqun He Jinhe Zhao Cynthia Chen Junjie Zhang Shaoliang Chen Division of Cardiology Tongji HospitalTongji Medical CollegeHuazhong University of Science&TechnologyWuhanHubei 430030China Division of Cardiology Nanjing First HospitalNanjing Medical UniversityNanjingJiangsu 210006China Division of Cardiology Wuhan First HospitalWuhanHubei 430022China Division of Cardiology Tianyou Hospital affiliated to Wuhan University of Science&TechnologyWuhanHubei 430064China Mailman School of Public Health Columbia UniversityNew YorkNew York 10027USA College of Pharmacy Nanjing Medical UniversityNanjingJiangsu 210002China.

Objective:Coronavirus disease 2019(COVID-19)exists as a *** during hospitalization is multifactorial,and there is urgent need for a risk stratification model to predict in-hospital death among COVID-19 *** we aimed to construct a risk score system for early identification of COVID-19 patients at high probability of dying during in-hospital ***:In this retrospective analysis,a total of 821 confirmed COVID-19 patients from 3 centers were assigned to developmental(n=411,between January 14,2020 and February 11,2020)and validation(n=410,between February 14,2020 and March 13,2020)*** on demographic,symptomatic,and laboratory variables,a new Coronavirus estimation global(CORE-G)score for prediction of in-hospital death was established from the developmental group,and its performance was then evaluated in the validation ***:The CORE-G score consisted of 18 variables(5 demographics,2 symptoms,and 11 laboratory measurements)with a sum of 69.5 ***-of-fit tests indicated that the model performed well in the developmental group(H=3.210,P=0.880),and it was well validated in the validation group(H=6.948,P=0.542).The areas under the receiver operating characteristic curves were 0.955 in the developmental group(sensitivity,94.1%;specificity,83.4%)and 0.937 in the validation group(sensitivity,87.2%;specificity,84.2%).The mortality rate was not significantly different between the developmental(n=85,20.7%)and validation(n=94,22.9%,P=0.608)***:The CORE-G score provides an estimate of the risk of in-hospital *** is the first step toward the clinical use of the CORE-G score for predicting outcome in COVID-19 patients.

关键词： hospital mortality Coronavirus estimation global score COVID-19 Goodness-of-fit Receiver operating characteristics Risk stratification

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Acute Myocardial Infarction in Chinese Medicine hospitals in China from 2006 to 2013: An Analysis of 2311 Patients from hospital Data

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Chinese Journal of Integrative Medicine 2021年第5期27卷 323-329页

作者： LAI Xiao-lei LIU Hong-xu HU Xin TIAN Jing-feng SHANG Ju-ju LI Xiang ZHOU Qi XING Wen-long Department of Cardiovascular Beijing Hospital of Traditional Chinese MedicineCapital Medical UniversityBeijing 100010China Department of Rehabilitation Wangjing Hospital of China Academy of Chinese Medical SciencesBeijing 100102China

Objective:To assess the trends in characteristics,treatments,and outcomes of acute myocardial infarction(AMI)patients in tertiary Chinese medicine(CM)hospitals in China between 2006 and ***:This retrospective study was based on two nationwide epidemiological surveys of AMI in tertiary CM hospitals during 2 years(2006 and 2013).Patients admitted to the hospital for AMI were *** records were used as the data *** data were derived regarding baseline characteristics,treatments,and outcomes of patients to assess changes from 2006 to *** regression was used to analyze the relationship between prognosis,general influencing factors of disease,and various treatment ***:Totally 26 tertiary CM hospitals in 2006 and 29 tertiary CM hospitals in 2013(18 were repetitive)were surveyed.A total of 2,311 patients with AMI were enrolled(1,094 cases in 2006 and 1,217 cases in 2013).From 2006 to 2013,the mean age did not significantly change,but the proportion of patients younger than 65 years *** prevalence of risk factors such as hypertension,diabetes,and hyperlipidemia also *** increases were observed in primary percutaneous coronary intervention[20.48%(2006)vs.24.90%(2013)]and revascularization[36.11%(2006)vs.52.42%(2013)].In-hospital mortality decreased from 11.15%in 2006 to 10.60%in 2013.A mortality logistic regression analysis identified reperfusion therapy[odds ratio(OR),0.222;95%confidence interval(CI),0.106–0.464],Chinese patent medicines(OR,0.394;95%CI,0.213–0.727),and CM decoctions(OR,0.196;95%CI,0.109–0.353)as protective ***:Reperfusion and revascularization capabilities of tertiary CM hospitals have improved significantly,but in-hospital mortality has not significantly *** are needed to improve medical awareness of AMI and expand the use of CM to reduce in-hospital mortality in China.

关键词： myocardial infarct Chinese medicine traditional China hospital mortality

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Systematic review on the risk-benefit ratio of morphine for acute heart failure

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Journal of Acute Disease 2023年第3期12卷 89-95页

作者： Rushikesh S.Haridas Sheetal Shelke Girish Patrike Deepak Patil Sainath Dhumal Department of General Medicine Vilasrao Deshmukh Government Medical CollegeLaturIndia Department of Otorhinolaryngology MIMSR Medical CollegeLaturIndia Department of General Medicine Dr.Balasaheb Vikhe Patil Rural Medical CollegeLoniIndia Department of General Medicine MIMSR Medical CollegeLaturIndia

Objective:To evaluate morphine's risk-benefit profile in the treatment of acute heart ***:Different electronic databases,including PubMed,MEDLINE,Cochrane Library,and Google Scholar,as well as ***,were searched for articles published between 2012 and *** risk of bias in the present study was evaluated by employing randomized controlled trials(RCTs)checklist that assesses the effectiveness of new interventions through random assignment of participants to different treatment *** two-part tool was used to address the five specific domains such as selection bias,performance bias,detection bias,attrition bias,and selective reporting *** of the quality of diagnostic accuracy studies was conducted using the RevMan software(version 5.4),a quality assessment ***:A total of 13 studies were included in the present review,in which there were 5 retrospective studies,3 randomized-control studies,2 prospective studies,1 multicenter pharmacodynamics study,1 multicenter cardiac magnetic resonance imaging study,and 1 open-label,cross-over *** mortality of acute heart failure patients treated with morphine was higher compared to those without ***:Acute heart failure patients who do not receive morphine have a lower mortality rate compared to those who receive *** the adverse effects,including mortality associated with morphine,there is a pressing need for further research to explore alternative and effective treatment options in acute heart failure.

关键词： Acute heart failure hospital mortality Morphine Side-effects Invasive ventilation

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Incidence,prognosis,and risk factors of sepsis-induced cardiomyopathy

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World Journal of Clinical Cases 2021年第31期9卷 9452-9468页

作者： Yan-Wen Liang You-Feng Zhu Rui Zhang Min Zhang Xiao-Ling Ye Jian-Rui Wei Department of Intensive Care Unit Guangzhou Red Cross HospitalGuangzhou 510220Guangdong ProvinceChina Department of Geriatrics The Affiliated Hospital of Qingdao UniversityQingdao 270000Shandong ProvinceChina Guangzhou Women and Children’s Medical Center Guangzhou 510000Guangdong ProvinceChina

BACKGROUND At present,large-scale studies on the clinical characteristics of sepsis-induced cardiomyopathy(SIC)are *** To investigate the clinical characteristics of *** Based on the analysis of the MIMIC-III public database,we performed a largescale retrospective study involving sepsis patients who were admitted to the intensive care unit(ICU)and had no concomitant cardiac *** used propensity score matching analysis and multivariate logistic regression to ensure the robustness of the *** primary outcome was hospital mortality,and the secondary outcomes included the number of patients who received mechanical ventilation or renal replacement therapy during their hospital stay,the number of patients administered with vasopressors,the length of ICU stay,and the length of hospital *** In the present study,after screening 38605 patients,3530 patients with sepsis were included.A total of 997 patients met the SIC diagnostic criteria,and the incidence of SIC was 28.20%(95%confidence interval[CI]:26.80%-29.70%).Compared to patients in the non-SIC group,patients in the SIC group were of older age and had a higher Simplified Acute Physiology Score(SAPS)-Ⅰ score,SAPS-Ⅱ score,and Elixhauser comorbidity index(ECI).A total of 367(36.8%)of 997 patients in the SIC group and 818(32.3%)of 2533 patients in the non-SIC group died in the hospital,which resulted in a significant between-group difference(odds ratios=1.22,95%CI:1.05-1.42;P=0.011).For the secondary outcomes,more patients in the SIC group received mechanical ventilation and *** logistic regression analysis showed that age,male sex,ECI,hemoglobin level,diabetes,and mechanical ventilation use on the first day of ICU admission were risk factors for *** Compared with non-SIC patients,hospital mortality is higher in SIC patients.

关键词： Sepsis-induced cardiomyopathy Sepsis Septic shock Incidence hospital mortality MIMIC-Ⅲ

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