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Background: The Harborview Risk Score (HRS) was recently proposed as scoring tool to predict 30-day mortality in patients with ruptured abdominal aortic aneurysms (rAAAs). The HRS assigns 1 point for each of the following preoperative characteristics: age > 76 years, pH < 7.2, creatinine level > 2 mg/dL (> 176.8 μmol/L), and systolic blood pressure < 70 mm Hg, resulting in scores from 0 to 4. The 30-day mortality risk increases with every point. Primarily, we aimed to validate the HRS for the first time in a Dutch study population. A second objective was to identify other clinically relevant predictors for 30-day mortality after repair of rAAA.
Methods: Retrospective data from patients who underwent open repair or endovascular aortic repair for a rAAA between January 2009 and February 2022 were reviewed. Patients were grouped by HRS category (score 0-4). The 30-day mortality rate was calculated for each HRS category. Determinants for 30-day mortality were tested for significance and validated for HRS.
Results: In total, data from 135 patients were included. Open repair was performed in 95 patients and 40 patients underwent endovascular aortic repair. Univariate logistic regression identified pH < 7.2, systolic blood pressure < 70 mm Hg, female sex, performance status, and increase per HRS unit as significant determinants for 30-day mortality. After adjusting for sex and performance status in the multivariate analysis, the association between the HRS per-unit increase and 30-day mortality remained significant (odds ratio 2.532 (95% confidence interval: 1.437-4.461)). The 30-day mortality rate for HRS score 0 was 15.2%, while for HRS score 3 and 4 the mortality was 80% and 100% respectively.
Conclusions: The Harborview Risk Score was validated in this single-center Dutch population. Results were concordant with data presented in earlier studies. Therefore, the HRS seems accurate and accessible as preoperative tool. For now, the HRS should guide as an insightful tool to indicate the chances of postoperative mortality during the preoperative conversations in the emergency room, rather than as a decision-making tool whether to operate or not. Our results suggest that female sex and performance status are also relevant predictors that should be assessed in other populations to improve preoperative scoring systems.
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http://dx.doi.org/10.1016/j.avsg.2023.12.086 | DOI Listing |
J Inflamm Res
December 2024
The Department of Emergency, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Background: The correlation between RAR is linked to negative outcomes in sepsis, but it remains uncertain if RAR is connected to prognosis in patients with sepsis-related NTIS. So we investigated it in this study.
Methods: Patients with sepsis-associated NTIS admitted to Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, between March 2013 and April 2017 were included in the study.
HPB (Oxford)
December 2024
Department of General Surgery, The First Affiliated Hospital, Henan University, Kaifeng, China; Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Naval Medical University), Shanghai, China. Electronic address:
Background: Intrahepatic and perihepatic abscess (IPHA) is a severe yet understudied complication that can occur after hepatectomy. This multicenter study aimed to elucidate the clinical features, risk factors, and outcomes of IPHA after hepatectomy for hepatocellular carcinoma (HCC), and to develop a novel prediction model for personalized risk assessment.
Methods: This was a multicenter cohort study of HCC patients who underwent curative-intent hepatectomy.
Diabetol Metab Syndr
December 2024
Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, NO.1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
Background: The stress hyperglycemia ratio (SHR) has been established as a predictor of unfavorable outcomes across various diseases. However, its relationship with prognosis in patients with cardiogenic shock (CS) remains unclear. This study aims to investigate the association between SHR and outcomes in CS patients.
View Article and Find Full Text PDFEur J Med Res
December 2024
Department of Clinical Research Laboratory, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, No.120 Gui Dan Road, Foshan, 528222, China.
Background: The role of inflammation and hypoproteinemia in influencing outcomes of critically ill patients has been widely recognized. However, there is a paucity of research on the prognostic value of the platelet-to-albumin ratio (PAR) in critically ill patients. Therefore, the aim of this study is to assess the prognostic significance of PAR in this population.
View Article and Find Full Text PDFJ Infect Dis
December 2024
The National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
Background: Current guidelines recommend combining a macrolide with a β-lactam antibiotic for the empirical treatment of moderate-to-high severity community-acquired pneumonia (CAP); however macrolide use is associated with potential adverse events and antimicrobial resistance.
Methods: We analysed electronic health data from 8,872 adults in Oxfordshire, UK, hospitalised with CAP between 01-January-2016 and 19-March-2024, who received either amoxicillin or co-amoxiclav as initial treatment. We examined the effects of adjunctive macrolides on 30-day all-cause mortality, time to hospital discharge, and changes in Sequential Organ Failure Assessment (SOFA) score, using inverse probability treatment weighting to address confounding by baseline severity.
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