Publications by authors named "Wan-Chi Chan"
Background: End-stage kidney disease (ESKD) is commonly associated with critical limb-threatening ischemia (CLTI) and frailty. Yet there are no specific tools to predict outcomes of CLTI in ESKD, particularly those that incorporate frailty. We aimed to assess the utility of the medical record-based Hospital Frailty Risk (HFR) score in predicting outcomes of CLTI in ESKD.
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- - ESKD patients have a significant risk of bloodstream infections that can also lead to a higher chance of infections in cardiac devices (CIED).
- - A study of 15,515 ESKD patients with new CIEDs found a 4.8% infection rate, with factors like having a defibrillator and higher BMI increasing the risk.
- - Early lead extraction following a CIED infection is not commonly done but has been linked to better survival rates, with a notable difference in 3-year mortality between those who had the procedure and those who did not.
Patients with end-stage kidney disease (ESKD) on dialysis have an increased burden of coronary artery disease (CAD). This study assessed the trend and outcomes for coronary artery bypass surgery (CABG) in patients with ESKD and stable CAD. We conducted a longitudinal study using the United States Renal Data System of patients with ESKD and stable CAD who underwent CABG from the years 2009 to 2017.
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- * A study involving over 106,000 patients found that those with PAD had a high rate of major adverse limb events (MALE), and the presence of both CAD and CVD worsened outcomes significantly, increasing risks of mortality, heart attack, and stroke.
- * Overall findings indicate that patients in this high-risk population experience poor long-term outcomes, which deteriorate further as additional arterial diseases are present.
Background: Atherosclerotic cardiovascular disease is highly prevalent in patients with end-stage kidney disease (ESKD). Kidney transplant (KT) improves patient survival and cardiovascular outcomes. The impact of preexisting coronary artery disease (CAD) and peripheral artery disease (PAD) on posttransplant outcomes remains unclear.
View Article and Find Full Text PDFBackground: There is a paucity of data regarding epidemiology, temporal trends, and outcomes of patients with cardiogenic shock (CS) and end-stage renal disease (chronic kidney disease stage V on hemodialysis).
Methods: This is a retrospective cohort study using the United States Renal Data System database from January 1, 2006 to December 31, 2019. We analyzed trends of CS, percutaneous mechanical support (intraaortic balloon pump, percutaneous ventricular assist device [Impella and Tandemheart], and extracorporeal membrane oxygenation) utilization, index mortality, 30-day mortality, and 1-year all-cause mortality in end-stage renal disease patients.
Background: There is paucity of information on the incidence, clinical characteristics, admission trends, and outcomes of hypertensive crisis (HTN-C) in patients with end-stage kidney disease (ESKD) who are on maintenance dialysis.
Methods: We conducted a retrospective observational study of HTN-C admissions in patients with end-stage kidney disease using the United States Renal Data System. We identified patients with end-stage kidney disease aged ≥18 years on dialysis and were hospitalized for HTN-C from January 2006 to August 2015.
Background: The epidemiology and outcomes of hypertensive crisis (HTN-C) in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) have not been well studied. The objective of our study is to describe the incidence, clinical characteristics, and outcomes of emergency department (ED) visits for HTN-C in patients with CKD and ESRD.
Methods: We performed a secondary analysis of Nationwide Emergency Department Sample databases for years 2016-2018 by identifying adult patients presenting to ED with hypertension related conditions as primary diagnosis using appropriate diagnosis codes.
Emergency department use and hospital admissions among adult orthotopic heart transplant patients.
J Am Coll Emerg Physicians Open
June 2022
Objective: To study the demographics, clinical presentations, and outcomes of emergency department (ED) visits of patients with heart transplantation (HT) in the United States.
Methods: We performed a secondary analysis of the National Emergency Department Sample database from 2016 to 2018. All ED visits of patients with HT aged ≥ 18 years were identified using International Classification of Diseases, Tenth Revision codes.
Background: There is paucity of data regarding durable left ventricular assist device (LVAD) outcomes in patients with chronic kidney disease (CKD) stages 3-5 and CKD stage 5 on dialysis (end-stage renal disease [ESRD]).
Methods And Results: We conducted a retrospective study of Medicare beneficiaries with ESRD and a 5% sample of patients with CKD with an LVAD (2006-2018) to determine 1-year outcomes using the United States Renal Data System database. The LVAD implantation, comorbidities, and outcomes were identified using appropriate International Classification of Diseases, 9th and 10th edition codes.
Objectives: Cocaine use (CU) related chest pain (CP) is a common cause of emergency department (ED) visits in the United States. However, information on disposition and outcomes in these patients is scarce. We conducted a nationwide study to assess disposition from ED, hospitalization rates, in-hospital outcomes, and health care costs in patients with history of CU who presented to the ED with CP.
View Article and Find Full Text PDFBackground: There is a paucity of data on readmission rates and predictors of readmissions in cardiogenic shock patients after contemporary Extracorporeal Membrane Oxygenation (ECMO) use.
Methods: Using the Nationwide Readmission Database, we included adult patients (≥18 years old) hospitalized between January to November 2016-2018 for cardiogenic shock requiring ECMO support. Thirty-day readmission rates, associated variables, and predictors of readmission were assessed.
Article Synopsis
- The study investigates the prognostic significance of cardiopulmonary exercise testing (CPET) in patients with wild-type transthyretin cardiac amyloidosis (wtATTR) treated with tafamidis.
- A total of 33 patients (average age 82) were analyzed, with findings indicating that lower levels of peak oxygen consumption and peak circulatory power, along with a shorter exercise duration, were linked to poor outcomes, including mortality and the need for heart transplant.
- The results suggest that CPET measurements could help identify patients at higher risk for adverse events during tafamidis treatment, emphasizing the importance of exercise capacity in managing this condition.
We aimed to explore the diagnostic accuracy of various mediastinal measurements in determining acute nontraumatic thoracic aortic dissection with respect to posteroanterior (PA) and anteroposterior (AP) chest radiographs, which had received little attention so far. We retrospectively reviewed 100 patients (50 PA and 50 AP chest radiographs) with confirmed acute thoracic aortic dissection and 120 patients (60 PA and 60 AP chest radiographs) with confirmed normal aorta. Those who had prior history of trauma or aortic disease were excluded.
View Article and Find Full Text PDFObjective: To review the diagnostic power of various computed tomography (CT) signs in acute appendicitis, in particular those initially classified as inconclusive.
Materials And Methods: Retrospective review of 100 CT abdomen and pelvis studies with assessment of maximal luminal diameter, wall thickness and cross-sectional diameter of the appendix, periappendiceal inflammatory changes, and presence of appendicolith.
Results: All CT signs show statistically significant occurrences in acute appendicitis.