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Association between anemia and hematological indices with mortality among cardiac intensive care unit patients.

ABSTRACT: BACKGROUND:Anemia and elevated red cell distribution width (RDW) or mean corpuscular volume (MCV) are associated with an adverse prognosis in patients with cardiovascular disease and critical illness. Limited data exist regarding these associations in unselected cardiac intensive care unit (CICU) patients. METHODS:Retrospective cohort study of CICU patients between January 1, 2007, and December 31, 2015, with a hemoglobin (Hb) level measured at admission. Multivariable regression was performed to determine predictors of hospital mortality, and Kaplan-Meier analysis was used to determine post-discharge survival. RESULTS:We included 9644 patients with a mean age of 67.5?±?15.1 years, including 3604 (37.4%) females. The median (IQR) values of Hb, MCV and RDW were 12.2 g/dL (10.6, 13.7), 90.7 fL (87.3, 94.2) fL, and 14.1% (13.3, 15.8), respectively. Anemia (admission Hb??0.1), while admission RDW (adjusted OR 1.12 per 1%, 95% CI 1.07-1.18, p?

SUBMITTER: Rayes HA

PROVIDER: S-EPMC7224152 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Association between anemia and hematological indices with mortality among cardiac intensive care unit patients.

Rayes Hamza A HA Vallabhajosyula Saraschandra S Barsness Gregory W GW Anavekar Nandan S NS Go Ronald S RS Patnaik Mrinal S MS Kashani Kianoush B KB Jentzer Jacob C JC

Clinical research in cardiology : official journal of the German Cardiac Society 20190918 5

<h4>Background</h4>Anemia and elevated red cell distribution width (RDW) or mean corpuscular volume (MCV) are associated with an adverse prognosis in patients with cardiovascular disease and critical illness. Limited data exist regarding these associations in unselected cardiac intensive care unit (CICU) patients.<h4>Methods</h4>Retrospective cohort study of CICU patients between January 1, 2007, and December 31, 2015, with a hemoglobin (Hb) level measured at admission. Multivariable regression ...[more]

PMID: 31535171

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Project description:BackgroundThere has not been a well-accepted prognostic model to predict the mortality of aortic aneurysm patients in intensive care unit after open surgery repair. Otherwise, our previous study found that anion gap was a prognosis factor for aortic aneurysm patients. Therefore, we wanted to investigate the relationship between anion gap and mortality of aortic aneurysm patients in intensive care unit after open surgery repair.MethodsFrom Medical Information Mart for Intensive Care III, data of aortic aneurysm patients in intensive care unit after open surgery were enrolled. The primary clinical outcome was defined as death in intensive care unit. Univariate analysis was conducted to compare the baseline data in different groups stratified by clinical outcome or by anion gap level. Restricted cubic spline was drawn to find out the association between anion gap level and mortality. Subgroup analysis was then conducted to show the association in different level and was presented as frost plot. Multivariate regression models were built based on anion gap and were adjusted by admission information, severity score, complication, operation and laboratory indicators. Receiver operating characteristic curves were drawn to compare the prognosis ability of anion gap and simplified acute physiology score II. Decision curve analysis was finally conducted to indicate the net benefit of the models.ResultsA total of 405 aortic aneurysm patients were enrolled in this study and the in-intensive-care-unit (in-ICU) mortality was 6.9%. Univariate analysis showed that elevated anion gap was associated with high mortality (P value < 0.001), and restricted cubic spline analysis showed the positive correlation between anion gap and mortality. Receiver operating characteristic curve showed that the mortality predictive ability of anion gap approached that of simplified acute physiology score II and even performed better in predicting in-hospital mortality (P value < 0.05). Moreover, models based on anion gap showed that 1 mEq/L increase of anion gap improved up to 42.3% (95% confidence interval 28.5-59.8%) risk of death.ConclusionsThe level of serum anion gap was an important prognosis factor for aortic aneurysm mortality in intensive care unit after open surgery.

Dataset Information

Association between anemia and hematological indices with mortality among cardiac intensive care unit patients.

Publications

Association between anemia and hematological indices with mortality among cardiac intensive care unit patients.

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