Short-term Predictor Research Articles

Suicidal Desire in Adolescents: An Examination of the Interpersonal Psychological Theory Using Daily Diaries

ABSTRACT Objective Despite decades of research, relatively little is known about short-term predictors of suicidal thoughts and behavior. Intensive longitudinal methods are increasingly applied to investigate near-term risk factors of suicidal thoughts in daily life. The aim of this study was to examine short-term predictors of daily-level suicidal thoughts in a high-risk adolescent sample using the interpersonal-psychological theory of suicidal behavior (IPTS) as a guiding framework; the theory proposes that interpersonal experiences of thwarted belongingness in combination with perceived burdensomeness lead to suicidal desire. Methods Seventy-eight adolescents hospitalized due to suicide risk responded to one survey/day for 28 days after discharge (n = 1621 unique observations). Multilevel models examined IPTS-informed predictors of same- and next-day suicidal urge intensity. Results Partial and time-dependent support for the theory was found. The hypothesized two-way interaction between burdensomeness and thwarted belongingness (either family or peer) was significantly associated with increasing same-day, but not next-day, suicidal ideation; specifically, greater belongingness attenuated adverse impact of burdensomeness. The only significant predictor of next-day ideation was higher previous-day burdensomeness. Baseline burdensomeness also emerged as a predictor of day-to-day suicidal ideation. Conclusion Using a theoretically informed model, this study offers an in-depth examination of short-term predictors of suicidal ideation among high-risk adolescents. Findings underscore the importance of fostering peer and family relationships in reducing suicidal thoughts in the post-discharge period. Results additionally suggest that both state- and trait-level burdensomeness have lasting influence on suicidal thoughts during this high-risk period. These findings could inform intervention efforts for high-risk youth.

Infective endocarditis: Epidemiology and prognosis

IntroductionInfective endocarditis (IE) is associated with high morbidity and mortality, despite advances in diagnosis and treatment. ObjectiveTo assess changes in the epidemiological profile of IE, to perform a time-trend analysis and to define short-term and long-term prognostic predictors of IE. MethodsRetrospective analysis of 173 patients admitted with a diagnosis of IE to a Portuguese level II Hospital between January 1998 and December 2013. The patients were divided into two groups according to the period of occurrence of the IE episode (1998-2007 vs. 2008-2013). The clinical event studied was the occurrence of death or the need for urgent surgery during hospitalization, and death in the follow-up period. Independent predictors of short-term and long-term prognosis were identified. ResultsIn the first portion of the study, IE occurred in younger individuals, often drug addicts, users of intravenous drugs and with gastrointestinal disease, human immunodeficiency virus and hepatitis B infection. In the second portion of the study, IE occurred more frequently in individuals of an older age with concomitant cardiovascular disease; enterococcus was isolated more frequently. The independent predictors of in-hospital death or need for urgent valve surgery were septic shock and the occurrence of peri-annular complications. The independent predictors of long-term mortality were age, chronic kidney disease and IE due to multidrug-resistant microorganisms. ConclusionDifferences were found in the epidemiological profile of IE during the study period. Referral for valve surgery increased slightly, but mortality remained high.

Deep learning analysis for energy consumption of shield tunneling machine drive system

Inaccurate estimation of energy from the shield driving system may result in serious energy loss and low tunneling efficiency. A deep learning network is developed in this study to optimize the energy consumption of cutterhead drives in a shield tunneling system. The proposed model, KCNN-LSTM, cooperates convolutional neural network (CNN) and long short-term memory predictor (LSTM) based on clustering algorithm to realize accurate energy consumption forecasts. First, geological conditions, shield operational parameters, and geometry are characterized and identified using a feature extraction strategy. The proposed model is used to decompose the energy consumption values and extract the sequential and implicit features of nonlinear interactions. The prediction is then applied to a real tunnel field case study. The modeling results are evaluated by comparing its performance with the reproduced Naïve predictor and other proven deep learning networks including recurrent neural network (RNN), CNN, and LSTM. The comparisons reveal that the proposed model outperforms the other conventional techniques in predictive accuracy. The KCNN-LSTM model provides an accurate and feasible tool for adjusting the energy consumption of cutterhead drives in shield tunneling.

Atrial Fibrillation Is Not an Independent Determinant of Mortality Among Critically Ill Acute Ischemic Stroke Patients: A Propensity Score-Matched Analysis From the MIMIC-IV Database.

Background/ObjectiveThis study was conducted to investigate the clinical characteristics and outcomes of patients with acute ischemic stroke and atrial fibrillation (AF) in intensive care units (ICUs).MethodsIn the Medical Information Mart for Intensive Care IV database, 1,662 patients with acute ischemic stroke were identified from 2008 to 2019. Of the 1,662 patients, 653 had AF. The clinical characteristics and outcomes of patients with and without AF were compared using propensity score matching (PSM). Furthermore, univariate and multivariate Cox regression analyzes were performed.ResultsOf the 1,662 patients, 39.2% had AF. The prevalence of AF in these patients increased in a stepwise manner with advanced age. Patients with AF were older and had higher Charlson Comorbidity Index, CHA2DS2-VASc Score, HAS-BLED score, and Acute Physiology Score III than those without AF. After PSM, 1,152 patients remained, comprising 576 matched pairs in both groups. In multivariate analysis, AF was not associated with higher ICU mortality [hazard ratio (HR), 0.95; 95% confidence interval (CI), 0.64–1.42] or in-hospital mortality (HR, 1.08; 95% CI, 0.79–1.47). In Kaplan–Meier analysis, no difference in ICU or in-hospital mortality was observed between patients with and without AF.ConclusionsAF could be associated with poor clinical characteristics and outcomes; however, it does not remain an independent short-term predictor of ICU and in-hospital mortality among patients with acute ischemic stroke after PSM with multivariate analysis.

Adaptive Ensemble Methods for Tampering Detection in Automotive Aftertreatment Systems

Control and diagnostic processes in modern vehicles incorporate nowadays a wide set of functionalities to preserve the vehicle’s health. Automotive vehicles contain embedded systems that must perform a diverse palette of tasks, ranging from less critical tasks (e.g, audio/video media control), to crucial ones, such as controlling the engine, fuel consumption, or the aftertreatment system. This paper identifies and addresses one emerging threat, namely, automotive tampering. Tampering denotes a procedure that changes the behavior of the system to gain financial or functional advantages, without damaging the system and without triggering the built-in safety features of the vehicle. Numerous studies show a growing number of tampered vehicles worldwide and considering that tampered vehicles contribute to air and atmosphere pollution, tampering remains a serious environmental threat. This paper proposes two ensemble-based approaches for tampering detection, both using Long Short-Term Memory neural network predictors, together with Cumulative Sum and Histogram distance-based detectors. Additionally, an Adaptive Majority Weighted Voting fusion methodology is proposed, that considers the historical decisions of the detectors. Experimental results are based on three unique datasets that incorporate a multitude of tampering scenarios. The results prove the efficiency of the proposed ensembles, with a 0% false alert rate and up to 100% detection rate, even when dealing with intelligent tamperers, and even in comparison with modern tampering detection solutions. Moreover, this paper offers resource consumption and scalability measurements on a reference embedded system, further demonstrating the integrability of the proposed techniques in a real embedded environment.

Short-term Outcome and Predictors of Survival Among Neonates With Moderate or Severe Hypoxic Ischemic Encephalopathy: Data From the Indian Neonatal Collaborative

Among term and late preterm infants, hypoxic ischemic encephalopathy (HIE) is an important cause of mortality, and neurologic morbidity among survivors. The primary objective was to study the incidence of survival to discharge among late preterm and term infants with moderate or severe HIE. Secondary objectives were to explore variation in the management of HIE across participating sites and to identify the predictors of survival. Indian Neonatal Collaborative (INNC), a network of 28 neonatal units in India. Retrospective cohort. Late preterm (34-36 weeks) and term (37-42 weeks) infants with moderate to severe HIE from 2018-2019. The primary outcome was survival to discharge (including discharged home and transfer to other hospital). A multivariate logistic regression model was constructed to identify the predictors of survival. Of 352 infants with moderate or severe HIE, 59% received therapeutic hypothermia. Survival to discharge among infants with moderate or severe HIE was 82%. Severe HIE (aOR 0.04; 95% CI 0.02-0.10), persistent pulmonary hypertension (PPHN) (aOR 0.22; 95% CI 0.08-0.61) and requirement of epinephrine during resuscitation (aOR 0.21; 95% CI 0.05-0.84) were independently associated with decreased odds of survival to discharge. Survival to discharge among infants with moderate or severe HIE was 82%. Severe HIE, requirement of epinephrine during resuscitation and PPHN decreased the odds of survival.

Short-Term Immunogenicity Profiles and Predictors for Suboptimal Immune Responses in Patients with End-Stage Kidney Disease Immunized with Inactivated SARS-CoV-2 Vaccine

IntroductionPatients with end-stage kidney disease (ESKD) are at risk of severe coronavirus disease and mortality. Immunogenicity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) inactivated whole-virus vaccine in patients with ESKD has never been explored.MethodsWe conducted a prospective cohort study of 60 patients with ESKD and 30 healthy controls. All participants received two doses of an inactivated whole-virus SARS-CoV-2 vaccine (Sinovac Biotech Ltd) 4 weeks apart. SARS-CoV-2-specific humoral and cell-mediated immune responses were investigated and referenced with healthy controls.ResultsAfter two doses, an anti-receptor-binding domain immunoglobulin G of 50 AU/ml or greater was present in 53 of 60 patients (88%) in the ESKD group and all participants (100%) in the control group (P = 0.05). The percentage of patients with ESKD and controls with neutralizing antibodies of 35% threshold or greater was 58% and 88%, respectively (P = 0.01). Furthermore, the proportion of patients with ESKD and S1-specific T cell response was comparable with controls (82% vs. 77%, P = 0.45). Old age, high ferritin level, and low absolute lymphocyte count were independently associated with poor humoral immune responses.ConclusionsPatients with ESKD could develop similar SARS-CoV-2-specific cell-mediated immune responses compared to healthy controls, although suboptimal humoral immune responses were observed following two doses of SARS-CoV-2 vaccination. Therefore, patients with ESKD and the abovementioned factors are at risk of generating inadequate humoral immune responses, and a vaccine strategy to elicit greater immunogenicity among these relatively immunocompromised patients is warranted. (Thai Clinical Trials Registry, TCTR20210226002).

Long-term efficacy, tolerability, and retention of brivaracetam in epilepsy treatment: A longitudinal multicenter study with up to 5years of follow-up.

This study was undertaken to evaluate the long-term efficacy, retention, and tolerability of add-on brivaracetam (BRV) in clinical practice. A multicenter, retrospective cohort study recruited all patients who initiated BRV between February and November 2016, with observation until February 2021. Long-term data for 262 patients (mean age = 40years, range = 5-81years, 129 men) were analyzed, including 227 (87%) diagnosed with focal epilepsy, 19 (7%) with genetic generalized epilepsy, and 16 (6%) with other or unclassified epilepsy syndromes. Only 26 (10%) patients had never received levetiracetam (LEV), whereas 133 (50.8%) were switched from LEV. The length of BRV exposure ranged from 1 day to 5years, with a median retention time of 1.6 years, resulting in a total BRV exposure time of 6829months (569years). The retention rate was 61.1% at 12 months, with a reported efficacy of 33.1% (79/239; 50% responder rate, 23 patients lost-to-follow-up), including 10.9% reported as seizure-free. The retention rate for the entire study period was 50.8%, and at last follow-up, 133 patients were receiving BRV at a mean dose of 222±104mg (median = 200, range = 25-400), including 52 (39.1%) who exceeded the recommended upper dose of 200mg. Fewer concomitant antiseizure medications and switching from LEV to BRV correlated with better short-term responses, but no investigated parameters correlated with positive long-term outcomes. BRV was discontinued in 63 (24%) patients due to insufficient efficacy, in 29 (11%) for psychobehavioral adverse events, in 25 (10%) for other adverse events, and in 24 (9%) for other reasons. BRV showed a clinically useful 50% responder rate of 33% at 12months and overall retention of >50%, despite 90% of included patients having previous LEV exposure. BRV was well tolerated; however, psychobehavioral adverse events occurred in one out of 10 patients. Although we identified short-term response and retention predictors, we could not identify significant predictors for long-term outcomes.

Frailty predicts short and long term outcomes of reperfusion treatment in acute stroke

Frailty is a important short and long term predictor of disability in the elderly and might influence the clinical outcome of acute treatment of stroke. Aim of the study was to evaluate whether frailty predicts short- and long term all-cause mortality and neurological recovery in old patients who underwent reperfusion acute treatment of stroke.

Characterization of COVID-19's Impact on Mobility and Short-Term Prediction of Public Transport Demand in a Mid-Size City in Spain.

COVID-19 has dramatically struck each section of our society: health, economy, employment, and mobility. This work presents a data-driven characterization of the impact of COVID-19 pandemic on public and private mobility in a mid-size city in Spain (Fuenlabrada). Our analysis used real data collected from the public transport smart card system and a Bluetooth traffic monitoring network, from February to September 2020, thus covering relevant phases of the pandemic. Our results show that, at the peak of the pandemic, public and private mobility dramatically decreased to and of their pre-COVID-19 values, after which the latter experienced a faster recovery. In addition, our analysis of daily patterns evidenced a clear change in the behavior of users towards mobility during the different phases of the pandemic. Based on these findings, we developed short-term predictors of future public transport demand to provide operators and mobility managers with accurate information to optimize their service and avoid crowded areas. Our prediction model achieved a high performance for pre- and post-state-of-alarm phases. Consequently, this work contributes to enlarging the knowledge about the impact of pandemic on mobility, providing a deep analysis about how it affected each transport mode in a mid-size city.

Do Patterns and Types of Negative Affect During Hospitalization Predict Short-Term Post-Discharge Suicidal Thoughts and Behaviors?

We still have little understanding of short-term predictors of suicidal thoughts and behaviors (STBs). Prior research links increased negative affect to STBs, but the vast majority of earlier work is limited by measuring negative affect at one time point and aiming to predict STBs months or years in the future. Recently, intensive longitudinal studies have shown that negative affect is associated with suicidal thoughts over relatively short, clinically useful time periods; however, the specific patterns and types of negative affect that predict STBs remain unclear. Using ecological momentary assessment (EMA) data from psychiatric inpatients hospitalized for suicide risk (N = 83), this study sought to test whether the patterns (means and variability) of two types of negative affect (anxiety/agitation and shame/self-hatred, which were derived from a larger EMA battery) during hospitalization predict STBs in the four weeks after discharge: an extremely high-risk time for suicidal behavior. The mean - but not the variability - of both anxiety/agitation and shame/self-hatred during hospitalization predicted the number of days with suicidal thoughts after discharge. The mean and the variability of shame/self-hatred - but not anxiety/agitation - predicted post-discharge suicide attempt. We discuss implications for assessment and treatment of suicidal individuals and propose key directions for future research.

Short Term Outcome and Predictors of Mortality Among Very Low Birth Weight Infants—A Descriptive Study: Correspondence

Short Term Outcome and Predictors of Mortality Among Very Low Birth Weight Infants—A Descriptive Study: Correspondence

Correlation between scores and outcome in Acute Coronary Syndrome patients

A proper analysis for the connection between baseline characteristics and the incidence of death and death-plus-myocardial (re)infarction at 30 days was done by [1]. The most important baseline features associated with death in analysis were age, heart rate, systolic blood pressure, ST-segment depression, signs of pump failure, and elevated levels of biomarkers. A risk estimation score was developed from this analysis [1].Over the last 10 years, multiple methods of risk stratification for ACS patients have been developed. Different scores are now available based on initial clinical history, ECG, and laboratory tests that enable early risk stratification on admission. Even among patients with ST-elevation myocardial infarction (STEMI), for whom initial therapeutic options are well defined, patient risk characteristics impact short and long term medical decision making [2].The TIMI risk score [3] is validated predictor of short term mortality.so we aimed to Correlate between TIMI score and in hospital outcomes in Acute Coronary Syndrome patients and concluded that the higher the TIMI score the higher adverse in hospital clinical cardiovascular outcomes.

Abatacept in rheumatoid arthritis-associated interstitial lung disease: short-term outcomes and predictors of progression

IntroductionInterstitial lung disease in rheumatoid arthritis (RA-ILD) is an extra-articular involvement that impairs the prognosis and for which there is still no well-coded treatment. The aim of this study was to evaluate abatacept (ABA) effectiveness and safety in patients with RA-ILD.MethodsRA-ILD patients who started ABA treatment were consecutively enrolled. Chest high-resolution computed tomography (HRCT), clinical, laboratory and respiratory function variables were collected at baseline and after 18 months of ABA treatment. HRCT abnormalities were evaluated using a computer-aided method (CaM). ABA response was established based on the change in the percentage of fibrosis evaluated at HRCT-CaM, dividing patients into “worsened” (progression ≥ 15%), “improved” (reduction ≥ 15%), and “stable” (changes within the 15% range). The multivariate regression model was used to assess the associations between RA characteristics and ABA response.ResultsForty-four patients (81% women, mean age 59.1 ± 8.0, mean disease duration of 7.5 ± 3.1 years) were studied. Five patients (11.4%) showed RA-ILD progression, 32 patients (72.6%) were considered stable, and 7 patients (16.0%) showed an RA-ILD improvement. The proportion of current smokers was significantly different between “worsened” patients, respect to those defined as "improved/stable” (p = 0.01). Current smoking habit (p = 0.005) and concomitant methotrexate treatment (p = 0.0078) were the two variables related to RA-ILD progression in multivariate regression analysis.ConclusionTreatment with ABA is associated with a RA-ILD stability or improvement in the 88.6% of patients. Current smoking habit and concomitant treatment with methotrexate are the modifiable factors associated with RA-ILD worsening.Key Points• Abatacept plays a favourable role in the control of RA-ILD, with a significant worsening in only 11.4% of patients during a 18-month follow-up period.• The predictive variables related to RA-ILD progression during abatacept therapy are the concomitant treatment with methotrexate and current smoking habit.

Remote and adjacent psychological predictors of early-adulthood resilience: Role of early-life trauma, extraversion, life-events, depression, and social-support.

Resilience is important for people to maintain mental health after negative life-events. However, its longitudinal psychological and social predictors are poorly revealed. Based on the ecological system theory model, the current study aimed to determine the longitudinal temporal mechanism underlying the development of early-adulthood resilience using long-term (early-life trauma and personality), medium-term and short-term (life-events, social support, and depression) psychosocial predictors. A total of 505 university students were recruited at baseline (T1), 433 of whom took part in a three-year longitudinal investigation (T2). The results showed that at T1 and T2, the resilience scores of individuals were identically high (72.98 and 73.21, respectively). Pearson correlation analysis showed that early-adulthood resilience was negatively correlated with early-life trauma, psychoticism and neuroticism, depression, ad life-events, and positively correlated with extraversion, social-support, and resilience. Regression and structural equation models showed that extraversion had a direct positive effect on T1 resilience through the mediation of T1 life-events, depression, and social-support, while childhood emotional neglect (EN) had indirect negative effect and extraversion had direct positive effect on T2 resilience through the mediation of T1 resilience, and T2 depression and social-support. In conclusion, this study is among the first to reveal the longitudinal temporal process of the development of early-adulthood resilience using remote and adjacent psychosocial predictors. The findings confirm that childhood EN and extraversion have a remote impact on early-adulthood resilience through recent and current depression and social-support. Our results imply that early-life trauma does not hinder the development of early-adulthood resilience in a linear trend.

The dynamics of doubt: Short-term fluctuations and predictors of doubts in personal goal pursuit.

An action crisis denotes an intrapsychic conflict in which a person feels torn between holding on to and letting go of a personal goal. It is characterized by the experience of goal-related doubts. To extend the existing understanding of action crises, we investigated the dynamics of doubts in daily life and addressed two questions: (1) To what extent do doubts with respect to a personal goal fluctuate in daily life? (2) In which situations do individuals primarily have doubts? In an experience sampling study (N = 254), we assessed doubts about a personal goal five times a day over 10 days. Our findings indicate that the level of doubt varies between individuals but also fluctuates within persons. Doubts increase in response to negative goal-related events and decrease in response to positive goal-related events. Individuals with higher (vs. lower) levels of action crisis have particularly high levels of doubt during goal-related (vs. -unrelated) activity. We discuss the implications of these findings for research on goal disengagement and point to the relevance of studying motivational parameters from a dynamic perspective.

Use of Ecological Momentary Assessment to Study Suicidal Thoughts and Behavior: a Systematic Review.

Ecological momentary assessment (EMA) is a recently introduced approach to patient evaluation that consists of asking patients questions in real time and in their usual habitat. This method seeks to contribute to suicide prevention by providing psychiatrists with detailed information about suicidal thoughts and behavior, how these fluctuate over short periods of time, and the short-term risk factors presented by patients. We conducted a systematic review of published research using EMA to study suicidal thoughts and behavior. Several systematic reviews of EMA in mental health have been conducted to date, and the literature contains numerous theoretical papers and compilations on EMA and suicide phenomena. To date, however, no systematic reviews have explored the use of this tool to study suicidal thoughts and behavior. We performed a systematic review of five databases (i.e., PubMed, Embase, Scopus, Web of Science, and PsycINFO) to identify studies on EMA and suicidal thoughts and behavior. An initial search revealed 544 articles. Following the study selection process, 35 studies were included in the review. Almost three-quarters of the studies were published in the last 4 years. The studies reviewed concluded that EMA was generally feasible and well accepted. EMA findings correlated well with the results of a retrospective assessment, though tended to over-represent symptom severity. Our review points to important aspects of suicidal thoughts and behavior, such as its wide fluctuation over short periods of time. Negative affect and disturbed sleep, among others, emerged as short-term predictors of suicidal thoughts and behavior. Therefore, EMA is a potentially useful tool in clinical practice, although not without drawbacks, such as participant fatigue with questionnaires and ethical concerns.

Short-Term Outcomes and Predictors of Effectiveness of Tocilizumab in Systemic Juvenile Idiopathic Arthritis: A Prospective Cohort Study.

Background: Systemic Juvenile Idiopathic Arthritis (sJIA) is a unique category of juvenile arthritis in which interleukin 6 plays a major pathogenic role. This study aimed to describe the therapeutic short-term outcomes among patients with sJIA starting tocilizumab (TCZ) therapy and to identify possible predictors of treatment response.Methods: We conducted a prospective observational study including 65 patients with sJIA meeting ILAR classification criteria with active disease despite conventional therapy that were treated by TCZ between August 2019 and October 2020 as the first-line biological therapy. Clinical and serological parameters were recorded at baseline and after 1 year of TCZ therapy.Results: After 1 year, 25% of the patients achieved minimal disease activity and 35% achieved clinically inactive disease. A significant reduction of the 10-joint juvenile arthritis disease activity score and acute phase reactants was also observed. Patients with younger age (≤7 years), shorter disease duration (≤3 years), lower disease activity, and higher serum ferritin and systemic manifestations showed more favorable results.Conclusion: Patients with sJIA showed favorable disease outcomes with TCZ treatment for 1 year, especially if the drugs were administered earlier in the disease course and in younger patients with a more pronounced inflammatory status. Our results may help to define the profile of patients with sJIA who are more likely to benefit from IL-6 blockade.

Intravenous thrombolysis in Chinese patients with mild acute ischemic stroke.

BackgroundMild stroke accounts for more than a half of all stroke patients, and short-term outcomes after treatment with intravenous (IV) recombinant tissue plasminogen activator (rtPA) have not been fully investigated in this group.MethodsOur study investigated short-term outcomes and predictors for a favorable functional outcome at discharge in mild stroke patients with IV rtPA. 6,752 mild stroke patients in the China Stroke Center Alliance with a clinical diagnosis of acute ischemic stroke, within 4.5 hours from symptom onset, with a baseline National Institutes of Health Stroke Scale score ≤5 and received rt-PA treatment were included in this retrospective analysis. Univariable and multivariable analyses were performed to identify factors independently associated with a favorable functional outcome.ResultsOnly 18.5% had an unfavorable functional outcome at discharge, 91.1% were discharged home, 89.9% could ambulate independently, 95.9% had a length of stay of 3 days or longer and 1.9% had sICH. A multivariable Logistic regression model identified that age >80 years [adjusted odds ratio (aOR): 1.57 (1.1–2.25)], diabetes mellitus [aOR: 1.35 (1.16–1.58)], 3–4.5 h time window [aOR: 1.43 (1.26–1.63)] and NIHSS score [3 vs. 0, aOR: 1.49 (1.05–2.11); 4 vs. 0, aOR: 2.36 (1.68–3.33); 5 vs. 0, aOR: 2.51 (1.77–3.56)] were independent risk factors for mRS >2 with hospital region, hospital level and hypertension as covariates.ConclusionsOur findings suggest that tPA is safe and effective in mild stroke patients with age ≤80 within the 3 hour time window and in those without diabetes mellitus, further studies are needed to confirm the findings.

Pulmonary hypertension with or without right ventricular failure as short-term prognostic predictors in patients with AHF

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Different registries have reported Right Ventricular Failure (RVF) as a predictor of IH mortality in patients with AHF. However, the association of different degrees of Pulmonary Hypertension (PH) associated with or without RVF as prognostic predictors of IH mortality and Rehospitalization (RH) at 60 days is not well stablished. Methods We included 394 consecutive patients from January 2012 to August 2020 with the primary diagnosis of AHF and different degrees of PH with or without RVF. IH mortality and RH after 60 days of patients with AHF and the presence of RVF with or without PH were evaluated and stratified by severity into mild, moderate and severe PH and forms of presentation of AHF. Univariate, bivariate and multivariate analysis was performed by logistic regression of the independent variables. The qualitative variables were analyzed by the chi square test and the quantitative variables by T Test. P was considered significant at values <0.05. Results The mean age was 74 years, 40% female, HBP 49%, dyslipidemia 52%, obesity 52%, type 2 DM 42%, smoking 28% and COPD 26%. 16% were de novo AHF and 84% with exacerbated CHF. Global RVF 6%. PH was present in 60%, being 24% mild, 25% moderate, 10% severe. The Left ventricular Ejection fraction (LVEF) mean was 52% (SD ± 15.1); Preserved 60%, Intermediate Range 18% and Reduced 22%. The IH mortality was 6.6% and the RH rate at 60 days was 21%. In the bivariate analysis for IH mortality, RVF was identified as an independent predictor of mortality (p = 0.001) nor for RH (p = 0.857). The different levels of PH were not identified as predictors of IH Mortality as well as RH. LVEF ranges did not show significant differences, nor in the forms of AHF presentation. The combined analysis of RVF or Left with different degrees of PHT did not show significant differences in IH mortality and RH.In the multivariate analysis by logistic regression for IH mortality, the presence of RVF maintained independence as a predictor variable (p = 0.004). Conclusion In our population of patients with AHF, the presence of RVF is a predictor of IH mortality regardless of the presence of PH, the PH and LVEF ranges. The presence of RVF was not associated with a higher rate of RH at 60 days.