scholarly journals The Associations of Serum S100A9 with the Severity and Prognosis In Patients With Community-Acquired Pneumonia: A Retrospective Cohort Study

Author(s):  
Hong-Yan Liu ◽  
Hui-Xian Xiang ◽  
Ying Xiang ◽  
Zheng Xu ◽  
Chun-Mei Feng ◽  
...  

Abstract Background: Previous studies found that S100A9 may involve in the pathophysiology of community-acquired pneumonia (CAP). However, the role of S100A9 in the CAP was unclear. The goal was to explore the correlations of serum S100A9 with the severity and prognosis of CAP patients based on a retrospective cohort study.Methods: A total of 220 CAP patients and 110 control subjects were recruited. Demographic and clinical data were extracted. Serum S100A9 and inflammatory cytokines were measured.Results: Serum S100A9 was elevated in CAP patients on admission. Furthermore, serum S100A9 was gradually elevated parallelly with CAP severity scores. Inflammatory cytokines were increased and blood routine parameters were changed in CAP patients compared with control subjects. Correlation analysis found that serum S100A9 was positively associated with CAP severity scores, blood routine parameters (WBC, NLR and MON) and inflammatory cytokines. Furtherly, logistical regression demonstrated that there were positive associations between serum S100A9 and CAP severity scores. Besides, the prognosis of CAP was tracked. Serum higher S100A9 on the early stage was positively correlated with the death of risk and hospital stay among CAP patients. Conclusion: Serum S100A9 is positively correlated with the severity of CAP. On admission, serum higher S100A9 elevates the risk of death and hospital stay in CAP patients, suggesting that S100A9 may exert a certain function in the pathophysiology of CAP and regard as a serum diagnostic and managing biomarker for CAP.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hong-Yan Liu ◽  
Hui-Xian Xiang ◽  
Ying Xiang ◽  
Zheng Xu ◽  
Chun-Mei Feng ◽  
...  

Abstract Background Previous studies found that S100A9 may involve in the pathophysiology of community-acquired pneumonia (CAP). However, the role of S100A9 was unclear in the CAP. The goal was to explore the correlations of serum S100A9 with the severity and prognosis of CAP patients based on a prospective cohort study. Methods A total of 220 CAP patients and 110 control subjects were recruited. Demographic and clinical data were collected. Serum S100A9 and inflammatory cytokines were measured. Results Serum S100A9 was elevated in CAP patients on admission. Serum S100A9 was gradually elevated parallelly with CAP severity scores. Additionally, inflammatory cytokines were increased and blood routine parameters were changed in CAP patients compared with control subjects. Correlation analysis found that serum S100A9 was positively associated with CAP severity scores, blood routine parameters (WBC, NLR and MON) and inflammatory cytokines. Further, logistic regression analysis demonstrated that there were positive associations between serum S100A9 and CAP severity scores. Besides, the prognosis of CAP was tracked. Serum higher S100A9 on the early stage elevated the death of risk and hospital stay among CAP patients. Conclusion Serum S100A9 is positively correlated with the severity of CAP. On admission, serum higher S100A9 elevates the risk of death and hospital stay in CAP patients, suggesting that S100A9 may exert a certain role in the pathophysiology of CAP and regard as a serum diagnostic and managing biomarker for CAP.


2021 ◽  
Vol 8 ◽  
Author(s):  
Ling Zheng ◽  
Jun Fei ◽  
Chun-Mei Feng ◽  
Zheng Xu ◽  
Lin Fu ◽  
...  

Background: Many studies have identified the important role of 8-isoprostane (8-iso-PGF2α) in pulmonary diseases. However, the role of 8-iso-PGF2α in community-acquired pneumonia (CAP) remains unclear. Therefore, the main goal was to investigate the correlations of serum 8-iso-PGF2α with the severity and prognosis in CAP patients through a hospital-based retrospective cohort study.Methods: All 220 patients with CAP were enrolled. Demographic information and clinical data were collected. Levels of 8-iso-PGF2α and inflammatory cytokines were detected in serum using ELISA.Results: The levels of 8-iso-PGF2α were gradually increased in parallel with the CAP severity scores. Univariate and multivariate logistic regression analyses revealed a positive association between serum 8-iso-PGF2α and the CAP severity scores. Additionally, serum 8-iso-PGF2α levels were positively correlated with circulating inflammatory cytokines (CRP and TNFα). Serum 8-iso-PGF2α levels were increased in the patients with a longer hospital stay than those with a shorter hospital stay. Additionally, 20 patients died after hospitalization. Dead patients presented a higher serum 8-iso-PGF2α than surviving patients. A subsequent survival analysis revealed that higher serum 8-iso-PGF2α levels positively correlated with the risk of death in patients with CAP.Conclusions: Serum 8-iso-PGF2α levels on admission are positively associated with the severity of CAP patients. Elevated serum 8-iso-PGF2α on admission prolongs hospital stay and increases the risk of death in patients with CAP, indicating that 8-iso-PGF2α may be involved in the progression of CAP and serve as an early serum prognostic biomarker for CAP.


2021 ◽  
Vol 12 ◽  
Author(s):  
Jia-Le Wang ◽  
Xue Chen ◽  
Yi Xu ◽  
Yue-Xin Chen ◽  
Jing Wang ◽  
...  

BackgroundRecent evidences suggested that IL-37 may participate in the pathophysiology of community-acquired pneumonia (CAP). Nevertheless, its exact biological role was unknown. The objective of this study was to determine the associations of serum IL-37 with the severity and prognosis in CAP patients based on a retrospective cohort study.MethodsThe whole of 120 healthy subjects and 240 CAP patients were summoned. Peripheral blood was collected and IL-37 was detected using ELISA.ResultsSerum IL-37 was obviously decreased in CAP patients on admission. In addition, serum IL-37 was gradually decreased in parallel with CAP severity scores. Correlative analysis revealed that serum IL-37 was negatively associated with CAP severity scores and inflammatory cytokines. Further logistical regression found that reduction of serum IL-37 augmented the severity of CAP patients. Moreover, the follow-up research was performed in CAP patients. Serum lower IL-37 on admission prolonged the hospital stay in CAP patients. Serum IL-37 combination with PSI and CURB-65 had a stronger predictive capacity for death than IL-37 and CAP severity score alone in CAP patients.ConclusionThere are remarkably negative correlations between serum IL-37 with the severity and prognosis in CAP patients. Serum IL-37 on admission prolongs the hospital stay, demonstrating that IL-37 may involve in the process of CAP. Serum IL-37 may be regarded as a biomarker for diagnosis and prognosis for CAP patients.


Author(s):  
Barchín JL ◽  
Wikman-Jorgensen PE ◽  
Bello L ◽  
Pascual R

Introduction: Community-acquired pneumonia is a prevalent disease that is managed in heterogeneous ways. Clinical pathways have been proposed as one way to mitigate this variability, but few implementation experiences have been published. The primary objective of this study is to analyse the effects of implementing a standardised clinical pathway for community-acquired pneumonia on length of hospital stay. Methods: Retrospective cohort study comparing two equivalent time periods with and without a clinical pathway. We described patient characteristics in both periods and compared mean length of hospital stay, mortality, rate of complications, and readmissions within 30 days. Results: A total of 170 patients were included across both periods. Mean length of hospital stay in patients treated before implementation of the clinical pathway was 6.05 days versus 5.43 days afterward (p = 0.28). The segmented regression analysis showed a change in slope for the length of hospital stay (0.04) following implementation of the clinical pathway. The proportion of patients hospitalised for more than 6 days was 37.5% in the first period, compared to 29.6% in the second (p = 0.088). Multivariable analysis showed that nonadherence to the clinical pathway was associated with a hospital stay of longer than 6 days (p = 0.048). Mortality dropped from 10.5% to 4.7% after the clinical pathway was established (p = 0.12). The proportion of patients readmitted within 30 days due to CAP was 8.8% before the establishment of the clinical pathway and 0% afterwards (p = 0.006). Conclusion: A clinical pathway for managing community-acquired pneumonia was associated with a reduction in length of hospital stay and readmittance. There was a trend towards mortality reduction.


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Dong Hoon Shin ◽  
Jaehun Jung ◽  
Gi Hwan Bae

Background: Atrial fibrillation (AF) should be treated with anticoagulants to prevent stroke and systemic embolism. Resuming anticoagulation after intracerebral hemorrhage (ICH) poses a clinical conundrum. The absence of evidence-based guidelines to address this issue has led to wide variations in restarting anticoagulation after ICH. This study aimed to evaluate the risks and benefits of anticoagulation therapy on all-cause mortality, severe thromboembolism, and severe hemorrhage and compare the effect of novel direct oral anticoagulants (NOACs) with warfarin on post-ICH mortality in patients with AF. Methods: This retrospective cohort study was performed using health insurance claim data obtained between 2002 and 2017 from individuals with newly developed ICH with comorbid AF. We excluded participants aged < 40 years and those with traumatic ICH, subdural hemorrhage, or subarachnoid hemorrhage. The primary endpoint was all-cause mortality, and the secondary endpoints were severe thrombotic and hemorrhagic events. Anticoagulants, antiplatelet agents, and non-users were analyzed for survival with propensity score matching. Results: Among 6735 participants, 1743 (25.9%) and 1690 (25.1%) used anticoagulants and antiplatelet agents, respectively. Anticoagulant (HR, 0.321; 95% CI, 0.264-0.390; P < 0.0001) or antiplatelet users (HR, 0.393; 95% CI, 0.330-0.468; P < 0.0001) had a lower risk of all-cause mortality than non-users. However, there was no difference between the two drug users (HR, 1.183; 95% CI, 0.94-1.487; P = 0.152; reference: anticoagulant). The risk of acute thrombotic events, although not hemorrhagic events, was significantly lower in anticoagulant users than in antiplatelet users. In addition, anticoagulation between 6 to 8 weeks post-ICH showed a tendency of the lowest risk of death. Further, NOACs were associated with a lower risk of all-cause mortality than warfarin. Conclusions: Our results showed that in patients with AF, resuming anticoagulants between 6 and 8 weeks after ICH improved all-cause mortality, severe thromboembolism, and severe hemorrhage. Further, compared with warfarin, NOAC had additional benefits.


BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e038302
Author(s):  
Tao Tian ◽  
Changdong Guan ◽  
Lijian Gao ◽  
Lei Song ◽  
Jiansong Yuan ◽  
...  

ObjectivesThis study sought to investigate the relationship between occlusion length and long-term outcomes of patients with recanalised chronic total occlusion (CTO) lesion.DesignA retrospective cohort study.SettingFuwai Hospital, National Center for Cardiovascular Disease, Beijing, ChinaParticipantsConsecutive patients with successfully recanalised CTO were included from January 2010 to December 2013.Primary and secondary outcome measuresThe primary endpoint of the present study was a composite event of all-cause death and myocardial infarction (MI). The secondary endpoints included target lesion revascularisation (TLR) and target vessel revascularisation (TVR).ResultsA total of 1987 patients were included and 1801 (90.6%) subjects completed 5-year follow-up in this study. Based on occlusion length, the patients were divided equally into two groups: short (length <15 mm, n=957) and long (length ≥15 mm, n=1030) CTO group. Kaplan-Meier survival curve showed no significant difference in the risk of the composite primary endpoint between short and long CTO groups (p=0.242). Receiver operating characteristic curve analysis also established occlusion length ≥15 mm as a cut-off value for predicting TLR and TVR, with an area under the curve of 0.604 (95% CI: 0.569 to 0.638, p<0.001) and 0.605 (95% CI: 0.572 to 0.638; p<0.001). Kaplan-Meier analysis revealed that the risks for TLR (p=0.002) and TVR (p=0.002) were higher in a patient with long CTO lesion. Multivariate Cox analysis also identified long CTO lesion as an independent predictor of TLR (HR: 1.539, 95% CI: 1.033 to 2.293; p=0.034) and TVR (HR: 1.476, 95% CI: 1.012 to 2.151; p=0.043).ConclusionPatients with long CTO lesion did not show a higher risk of death and MI after recanalisation, but had higher risks of TLR and TVR. Lesion with occlusion length ≥15 mm should be under close surveillance for restenosis after recanalisation.


2020 ◽  
Vol 26 (11) ◽  
pp. 1186-1191
Author(s):  
Kuniaki Hirai ◽  
Akihiko Tanaka ◽  
Tetsuya Homma ◽  
Keisuke Kaneko ◽  
Kaho Akimoto ◽  
...  

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