Mortality Events In Patients Research Articles

Comparative effectiveness of dual antiplatelet therapy versus monotherapy in patients with ischemic stroke.

To compare the effectiveness of aspirin-clopidogrel dual antiplatelet therapy (DAPT) with aspirin or clopidogrel antiplatelet monotherapy (AM) in patients with ischemic stroke. It was a single-center, retrospective cross-sectional study of medical records of ischemic stroke patients admitted at King Abdulaziz University Hospital between January 2015 and October 2019. The primary endpoints were ischemic stroke recurrence, rehospitalization, and all-cause mortality between DAPT and AM. Kaplan-Meier and Cox proportional hazard analyses were employed in univariate and multivariate time-to-event analyses. The median time to recurrence of ischemic stroke was 15.0 months (95% confidence interval [CI], 8.586-23.01) for DAPT and 20.4 months (95% CI, 9.872-30.928) for the AM. The median survival time until all-cause mortality was 8.0 months (95% CI, 2.893-13.107) for DAPT and 14.1 months (95% CI, 8.173-19.97) for the AM. No statistically significant reductions in the instantaneous risks of recurrence (hazard ratio [HR], 1.27; 95% CI, 0.59-2.72; p=0.54), re-hospitalization (HR, 0.95; 95% CI, 0.59-1.48; p= 0.77), and mortality (HR, 1.04; 95% CI, 0.48-2.26; p=0.92) were found between the DAPT and AM groups. The DAPT was not superior to AM in reducing recurrence and mortality events in patients with ischemic stroke. Rehospitalization due to the sequelae of the composite of stroke, angina, and myocardial infarction was higher in the DAPT group.

Atenolol and mortality events in patients with chronic kidney disease: Analysis of data from the Japanese Adverse Drug Event Report database.

Atenolol and mortality events in patients with chronic kidney disease: Analysis of data from the Japanese Adverse Drug Event Report database.

D-Dimer, Disease Severity, and Deaths (3D-Study) in Patients with COVID-19: A Systematic Review and Meta-Analysis

Background: Hypercoagulability and the need for prioritizing coagulation markers for prognostic abilities have been highlighted in COVID-19. We aimed to quantify the associations of D-dimer with disease progression in patients with COVID-19. Methods: In this systematic review and meta-analysis, we searched electronic databases like PubMed and Web of Science, research repositories such as LitCovid, CDC, and WHO along with major journals. We included relevant studies that reported the prognostic information on D-dimer in association with disease severity, composite outcomes and mortality events in patients with COVID-19. Extracted data included author; country; study design; sample sizes; patient demographics; study duration; follow-up information; higher D-dimer events in different sub-groups of COVID-19; unadjusted and adjusted effect sizes (odds ratios and hazards ratios with 95% confidence interval levels). Quality assessment using QUIPS tool, and meta-analyses using random-effects model were conducted for pooled estimates. This study was registered with PROSPERO, CRD42020186661. Findings: We included 113 studies in our systematic review, of which 100 records (n=38,310) with D-dimer data) were considered for meta-analysis. Across 68 unadjusted (n=26,960) and 39 adjusted studies (n=15,653) reporting initial D-dimer, a significant association was found in patients with higher D-dimer for the risk of overall disease progression (uOR 3.15, 95% CI 2.41 to 4.14; aOR 1.64, 95% CI 1.29 to 2.10). This association remained significant in the sub-group analysis based on the outcome type: disease severity (unadjusted studies 40, uOR 3.30, 95% CI 2.67 to 4.04; adjusted studies 11, aOR 1.99, 95% CI 1.64 to 2.41), mortality (unadjusted studies 40, uOR 3.82, 95% CI 3.08 to 4.74; adjusted studies 22, aOR 1.36, 95% CI 1.19 to 1.54), and CEP (unadjusted studies 11, uOR 2.26, 95% CI 1.58 to 3.23; adjusted studies 9, aOR 1.67, 95% CI 1.37 to 2.03). The time-to-event outcomes were pooled across 19 unadjusted (n=9743) and 21 adjusted studies (n=13287); a strong association was found in patients with higher D-dimers for the risk of overall disease progression (uHR 1.41, 95% CI 1.10 to 1.81; aHR 1.10, 95% CI 1.02 to 1.20). The prognostic use of higher D-dimer was found to be promising for predicting overall disease progression (studies 68, sensitivity 0.59, specificity 0.62, DOR 4.92, AUC 0.75), severity (studies 32, sensitivity 0.55, specificity 0.56, DOR 3.49, AUC 0.69), and mortality outcomes (studies 32, sensitivity 0.64, specificity 0.66, DOR 7.20, AUC 0.79) in COVID-19. Interpretation: Our study showed that higher D-dimer levels provide prognostic information useful for clinicians to early assess COVID-19 patients at risk for disease progression and mortality outcomes. This study, recommending for rapid assessment of this coagulation marker, also support the ISTH guidelines for accurate D-dimer reporting in COVID-19.Funding Statement: There was no funding source for this study.Declaration of Interests: The authors declare no competing interests.

Obstruction after alcohol septal ablation is associated with cardiovascular mortality events

BackgroundLeft ventricular outflow tract obstruction (≥30 mm Hg at rest; LVOTO) is considered a possible risk of long-term outcomes in patients with hypertrophic cardiomyopathy (HCM). However, the influence of LVOTO...

Risk factors for cardiovascular disease and mortality events in adults with type 2 diabetes - a 10-year follow-up: Tehran Lipid and Glucose Study.

To identify risk factors for cardiovascular disease (CVD) and mortality events in patients with type 2 diabetes and to calculate their population attributable fraction among a representative Iranian population. A total of 1198 patients with type 2 diabetes (504 men and 694 women), aged ≥30years, without prevalent CVD, with a median follow-up of 10years were included in current study. To examine the association between risk factors and their outcomes, multivariate sex-adjusted Cox proportional hazard regression models were used. During the study, 281 and 172 participants experienced CVD and all-cause mortality events, respectively. Regarding CVD events, fasting plasma glucose (FPG) level of 7.22-<10mmol/L [hazard ratio (HR): 1.46, 95% CI 1.12-1.96], FPG level ≥10 mmol/L (HR 2.04, 1.53-2.72), hypertension (HR 1.65, 1.28-2.13), hypercholesterolaemia (HR 1.96, 1.40-2.75) and high waist to hip ratio (HR 1.30, 0.99-1.70; p = 0.051) were significant predictors, and corresponding population attributable fractions were 9.76, 17.84, 23.26, 41.63 and 14.76%, respectively. Considering all-cause mortality events, hypertension (HR 1.70, 1.23-2.36), FPG level ≥10 mmol/L (HR 2.31, 1.55-3.20) and smoking (HR 1.45, 1.03-2.04) were significant predictors, and corresponding population attributable fractions were 25.81, 20.88 and 11.18%, respectively. Meanwhile, being overweight or obese was associated with lower all-cause and CVD mortality events. Among modifiable risk factors in patients with type 2 diabetes, hypercholesterolaemia and central adiposity for CVD, smoking for mortality events and hypertension and poor glycaemic control for both outcomes need to be paid most attention by healthcare professionals. Copyright © 2016 John Wiley & Sons, Ltd.

Short-term postoperative mortality events in patients over 80 years of age with hip fracture: analysis at a single institution with limited medical resources

BackgroundLethal events represent the most important complication in the treatment of hip fracture in elderly patients. Despite the increasing chance for treatment of such conditions, few data regarding risk factors associated with lethal events have been determined for ordinary hospitals with limited medical and human resources, particularly in Japan. MethodsThe incidence of postoperative lethal events and related preoperative risk factors in extremely elderly patients (>80 years) with hip fracture were retrospectively analyzed in our hospital for the past 2 years. ResultsLethal events occurred in 11 (10.7%) of 103 patients within 3 months postoperatively. In both univariate and multivariate analyses, an elevated number of co-morbidities and preoperative respiratory dysfunction were identified as significant risk factors. Delay in surgery was not a risk factor for lethal events. ConclusionsA valid reason for delay is the need to stabilize concurrent medical conditions due to multiple co-morbidities in extremely elderly patients with hip fracture. Considering the limited resources and extreme age of the subjects, the mortality rate in the present study was quite acceptable. Patients, families of patients, and physicians should recognize the increased risk of mortality for patients with significant risk factors in the surgical treatment of hip fracture.