Objective: In this study, we aimed to evaluate the death risk factors of patients included in the sepsis protocol bundle, using clinical data from qSOFA, SIRS, and comorbidities, as well as development of a mortality risk score.
Design: This retrospective cohort study was conducted between 2016 and 2021.
Setting: Two university hospitals in Brazil.
Participants: Patients with sepsis.
Interventions: Several clinical and laboratory data were collected focused on SIRS, qSOFA, and comorbidities.
Main Variable Of Interest: In-hospital mortality was the primary outcome variable. A mortality risk score was developed after logistic regression analysis.
Results: A total of 1,808 patients were included with a death rate of 36%. Ten variables remained independent factors related to death in multivariate analysis: temperature ≥38 °C (odds ratio [OR] = 0.65), previous sepsis (OR = 1.42), qSOFA ≥ 2 (OR = 1.43), leukocytes >12,000 or <4,000 cells/mm (OR = 1.61), encephalic vascular accident (OR = 1.88), age >60 years (OR = 1.93), cancer (OR = 2.2), length of hospital stay before sepsis >7 days (OR = 2.22,), dialysis (OR = 2.51), and cirrhosis (OR = 3.97). Considering the equation of the binary regression logistic analysis, the score presented an area under curve of 0.668, is not a potential model for death prediction.
Conclusions: Several risk factors are independently associated with mortality, allowing the development of a prediction score based on qSOFA, SIRS, and comorbidities data, however, the performance of this score is low.
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http://dx.doi.org/10.1016/j.medine.2024.03.005 | DOI Listing |
CNS Drugs
January 2025
Department of Cardiology, Second Affiliated Hospital of Dalian Medical University, Dalian, China.
Background: Early neurological deterioration (END) is associated with a poor prognosis in acute ischemic stroke (AIS). Effectively lowering low-density lipoprotein cholesterol (LDL-C) can improve the stability of atherosclerotic plaque and reduce post-stroke inflammation, which may be an effective means to lower the incidence of END. The objective of this study was to determine the preventive effects of evolocumab on END in patients with non-cardiogenic AIS.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China.
The neutrophil-to-lymphocyte ratio (NLR) may predict outcomes in end-stage liver disease, but its value after transjugular intrahepatic portosystemic shunt (TIPS) is unclear. This study explored the link between NLR and long-term outcomes in decompensated cirrhosis patients post-TIPS. We retrospectively analyzed 184 patients treated between January 2016 and December 2021, noting demographic data, lab results, and follow-up outcomes, including liver transplantation or death.
View Article and Find Full Text PDFBMC Cardiovasc Disord
January 2025
Department of Radiology, Qujing No.1 Hospital, Kirin District Garden Road no. 1, Qujing, 655099, China.
Background: Left ventricular (LV) myocardial contraction patterns can be assessed using LV mechanical dispersion (LVMD), a parameter closely associated with electrical activation patterns. Despite its potential clinical significance, limited research has been conducted on LVMD following myocardial infarction (MI). This study aims to evaluate the predictive value of cardiac magnetic resonance (CMR)-derived LVMD for adverse clinical outcomes and to explore its correlation with myocardial scar heterogeneity.
View Article and Find Full Text PDFTransplant Proc
January 2025
BioBizkaia Research Health Institute, Barakaldo, Bizkaia, Spain; Hepatobiliary Surgery and Liver Transplantation Unit, Cruces University Hospital, Bilbao, Spain. Electronic address:
Introduction: The hypothermic oxygenated perfusion (HOPE) system has been developed to improve the quality of previously considered suboptimal liver grafts, reduce complications, and increase the number of available donors. The aim of this study is to evaluate the results since its implementation in the liver transplant (LT) program at our center.
Materials And Methods: We conducted a retrospective descriptive analysis of all LTs with HOPE from August 2022 to November 2023 with a minimum follow-up of 3 months.
Lancet Public Health
January 2025
Department of Family Community Medicine, University of California, San Francisco, San Francisco, CA, USA.
Synthetic illicit drugs, such as nitazenes and fentanyls, are becoming commonplace in countries around the world, including in Europe, Australia, and Latin America, which raises concern for overdose crises like those seen in North America. An important dimension of the risk represented by synthetic drugs is the fact that they are increasingly packaged in counterfeit pill form. These pills-often indistinguishable from authentic pharmaceuticals-have substantially widened the scope of populations susceptible to synthetic drug overdose in North America (eg, among adolescents experimenting with pills or tourists from the USA seeking psychoactive medications from pharmacies in Mexico).
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