Association between anemia and ICU outcomes.
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ABSTRACT:
SUBMITTER: Song X
PROVIDER: S-EPMC8318639 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Compare ICU outcomes and respiratory system mechanics in patients with and without acute kidney injury during invasive mechanical ventilation.DesignsRetrospective cohort study.SettingsICUs of the University of California, San Diego, from January 1, 2014, to November 30, 2016.PatientsFive groups of patients were compared based on the need for invasive mechanical ventilation, presence or absence of acute kidney injury per the Kidney Disease: Improving Global Outcomes criteria, and the temporal relationship between the development of acute kidney injury and initiation of invasive mechanical ventilation.InterventionsNone.Measurements and main resultsA total of 9,704 patients were included and 4,484 (46%) required invasive mechanical ventilation; 2,009 patients (45%) had acute kidney injury while being treated with invasive mechanical ventilation, and the mortality rate for these patients was 22.4% compared with 5% in those treated with invasive mechanical ventilation without acute kidney injury (p < 0.01). Adjusted hazard of mortality accounting for baseline disease severity was 1.58 (95% CI, 1.22-2.03; p < 0.001]. Patients with acute kidney injury during invasive mechanical ventilation had a significant increase in total ventilator days and length of ICU stay with the same comparison (both p < 0.01). Acute kidney injury during mechanical ventilation was also associated with significantly higher plateau pressures, lower respiratory system compliance, and higher driving pressures (all p < 0.01). These differences remained significant in patients with net negative cumulative fluid balance.ConclusionsAcute kidney injury during invasive mechanical ventilation is associated with increased ICU mortality, increased ventilator days, increased length of ICU stay, and impaired respiratory system mechanics. These results emphasize the need for investigations of ventilatory strategies in the setting of acute kidney injury, as well as mechanistic studies of crosstalk between the lung and kidney in the critically ill.
| S-EPMC9246080 | biostudies-literature
Project description:Anemia is commonly seen in preterm infants. It may reduce the capacity of hemoglobin to transport oxygen throughout the body and may result in tissue and organ dysfunction. This study aimed to investigate the effect of anemia on the development of bronchopulmonary dysplasia (BPD) in preterm infants. 243 infants who were admitted to BaYi Children's Hospital Affiliated to Clinical Medical College in Beijing Military General Hospital with gestational age (GA) less than 32 weeks from February, 2014 to February, 2015 were included in the study. Maternal and infant data were recorded. Multivarariate logistic regression analysis was performed to determine the association between anemia and BPD. Of 243 preterm infants, the incidence of anemia was higher in BPD patients than non-BPD patients (p < 0.001). Mean Hct in BPD patients was lower than non-BPD patients at different time points in 1d, 7d, 14d, and 21d. Controlling for other confounding factors, early anemia was associated with an increased risk of BPD. Number of transfusions is also a significant risk factor for BPD (p = 0.001). Therefore, prevention and treatment of early anemia is necessary and reducing number of transfusions may reduce the incidence of BPD in preterm infants.
| S-EPMC4776173 | biostudies-other
Project description:OBJECTIVE:To assess multiple Hb-based measures of anemia in hospitalized patients and test whether these are associated with fatigue. DESIGN:Prospective observational study. SETTING:Urban, academic medical center. PATIENTS:Hospitalized general medicine patients, age =50 years, with any Hb < 9 g/dL. MEASUREMENTS:Measures of anemia were created for each patient based on the Hb values from their hospitalization (mean, median, minimum, maximum, admission, and discharge). Fatigue was measured using the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue subscale. RESULTS:Seven hundred eighty-four patients participated. Minimum Hb was strongly associated with fatigue. Patients with a minimum Hb of < 8 g/dL had higher fatigue levels (mean FACIT [standard deviation] Hb < 7 g/dL: 25 [13], 7 g/ dL = Hb <8 g/dL: 25 [14] Hb =8 g/dL: 29 [14], P = 0.001) and were more likely to report high levels of fatigue (FACIT-Fatigue < 27) (56% vs 41%; P = 0.002). Mean Hb had a less robust association with fatigue than minimum Hb, and no other measure of Hb was associated with patients' fatigue levels. CONCLUSIONS:Minimum Hb is associated with fatigue while hospitalized and may help identify patients for interventions to address anemia-related fatigue.
| S-EPMC5896748 | biostudies-literature
Project description:The Illumina GoldenGate Genotyping Assay is a flexible, pre-optimized assay that uses a discriminatory DNA polymerase and ligase to interrogate 96 SNP loci simultaneously. This Assay utilizes the BeadArray Reader. Using this assay, we examined the distribution of the patients` genotypes to determine which genotype tends to have a better outcomes for cancer treatment.
2015-05-30 | GSE52072 | GEO
Project description:In school age children and adolescents, anemia might cause lower cognitive function and attention span, which in turn could diminish human capital accumulation. As children born in low-income households are more likely to be anemic, this may prevent many individuals from overcoming the intergenerational poverty traps. In this paper, we used data from the Mexican National Health and Nutrition Survey 2012 and focused on a sample of adolescents between 12 and 19 years of age to study the relationship between attending school without delay-our proxy for school performance-and anemia. We found a statistically significant association between the two variables. If this relationship is causal, the economic burden linked to the loss of school years could well exceed the costs associated with programs aimed at reducing the prevalence of anemia in vulnerable populations. Our results provide additional support to the existing literature on anemia as a significant barrier to school achievement.
| S-EPMC7084426 | biostudies-literature
Project description:Background: Human parvovirus B19 (B19V) can cause anemia in some patients, including those with compromised immunity system. There are a few studies on molecular epidemiology of B19V and its association with anemia in Iran. Therefore, the aim of this study was to determine the B19V DNA, IgM, IgG, genotyping, and viral load in HIV patients in different groups of pregnant women, general population, injection drug users (IDU), and Elite controllers. Also, the possible association of B19V with anemia was studied. Methods: In this case-control study, B19V DNA, anti-B19V IgM, anti-B19V IgG, viral load, and hemoglobin level were assessed in 113 HIV positive patients and 72 healthy controls. Also, CD4+ T cell counts and HIV load were measured in the patients' group. All statistical analyses were done using STATA 14.2 software (Stata Corporation, College Station, Texas, USA). P value < 0.05 was considered statistically significant. Results: Among HIV patients, 19 (16.8%) cases had B19V DNA, 3 (2.7%) had B19V IgM, and 7 (6.2%) had B19V IgG. In control group, the prevalence of B19V DNA, IgM, and IgG was 6 (8.33%), 7(9.7%), and 19 (26.4%), respectively. In subpopulations based on transmission routes, general population had the highest B19V IgG and DNA positivity prevalence and viral load level. There was no significant association between B19V antibodies and DNA with anemia. Conclusion: The results demonstrated that B19V infection cannot be considered as a high-risk factor for anemia in adult HIV patients. However, further studies are needed to determine the exact role of B19V infection in HIV patients.
| S-EPMC7137816 | biostudies-literature
Project description:Much remains unknown concerning the mechanism by which the splicing machinery pinpoints short exons within intronic sequences and how splicing factors are directed to their pre-mRNA targets. Part of the explanation probably lies in differences in chromatin organization between exons and introns. Proteomic, co-immunoprecipitation, and sedimentation analyses described here indicated that SF3B1, an essential splicing component of the U2 snRNP complex, is strongly associated with nucleosomes. ChIP-seq and RNA-seq analyses revealed that SF3B1 is specifically bound to nucleosomes located at exonic positions. SF3B1 binding is enriched at nucleosomes positioned over short exons flanked by long introns that are also characterized by differential GC content between exons and introns. Disruption of SF3B1 binding to such nucleosomes affected the splicing of these exons similarly to inhibition of SF3B1 expression. Our findings suggest that the association of SF3B1 with nucleosomes is functionally important for splice site recognition and that SF3B1 conveys splicing-relevant information embedded in chromatin structure. MNase-seq on Input and SF3B1 pull-down, mRNA-seq on control and SF3B1 si-RNA treated cells as well as on TSA (Trichostatin A) treated and untreated cells.
2015-04-22 | E-GEOD-65644 | biostudies-arrayexpress
Project description:OBJECTIVE:Many ICU patients do not require critical care interventions. Whether aggressive care environments increase risks to low-acuity patients is unknown. We evaluated whether ICU acuity was associated with outcomes of low mortality-risk patients. We hypothesized that admission to high-acuity ICUs would be associated with worse outcomes. This hypothesis was based on two possibilities: 1) high-acuity ICUs may have a culture of aggressive therapy that could lead to potentially avoidable complications and 2) high-acuity ICUs may focus attention toward the many sicker patients and away from the fewer low-risk patients. DESIGN:Retrospective cohort study. SETTING:Three hundred twenty-two ICUs in 199 hospitals in the Philips eICU database between 2010 and 2015. PATIENTS:Adult ICU patients at low risk of dying, defined as an Acute Physiology and Chronic Health Evaluation-IVa-predicted mortality of 3% or less. EXPOSURE:ICU acuity, defined as the mean Acute Physiology and Chronic Health Evaluation IVa score of all admitted patients in a calendar year, stratified into quartiles. MEASUREMENTS AND MAIN RESULTS:We used generalized estimating equations to test whether ICU acuity is independently associated with a primary outcome of ICU length of stay and secondary outcomes of hospital length of stay, hospital mortality, and discharge destination. The study included 381,997 low-risk patients. Mean ICU and hospital length of stay were 1.8?±?2.1 and 5.2?±?5.0 days, respectively. Mean Acute Physiology and Chronic Health Evaluation IVa-predicted hospital mortality was 1.6% ± 0.8%; actual hospital mortality was 0.7%. In adjusted analyses, admission to low-acuity ICUs was associated with worse outcomes compared with higher-acuity ICUs. Specifically, compared with the highest-acuity quartile, ICU length of stay in low-acuity ICUs was increased by 0.24 days; in medium-acuity ICUs by 0.16 days; and in high-acuity ICUs by 0.09 days (all p < 0.001). Similar patterns existed for hospital length of stay. Patients in lower-acuity ICUs had significantly higher hospital mortality (odds ratio, 1.28 [95% CI, 1.10-1.49] for low-; 1.24 [95% CI, 1.07-1.42] for medium-, and 1.14 [95% CI, 0.99-1.31] for high-acuity ICUs) and lower likelihood of discharge home (odds ratio, 0.86 [95% CI, 0.82-0.90] for low-, 0.88 [95% CI, 0.85-0.92] for medium-, and 0.95 [95% CI, 0.92-0.99] for high-acuity ICUs). CONCLUSIONS:Admission to high-acuity ICUs is associated with better outcomes among low mortality-risk patients. Future research should aim to understand factors that confer benefit to patients with different risk profiles.
| S-EPMC5828025 | biostudies-literature
Project description:Anemia is highly prevalent in India, especially in children. Exposure to ambient fine particulate matter (PM2.5) is a potential risk factor for anemia via. systemic inflammation. Using health data from the National Family and Health Survey 2015-2016, we examined the association between ambient PM2.5 exposure and anemia in children under five across India through district-level ecological and individual-level analyses.MethodsThe ecological analysis assessed average hemoglobin levels and anemia prevalence (hemoglobin < 11 g/dL considered anemic) by district using multiple linear regression models. The individual-level analysis assessed average individual hemoglobin level and anemia status (yes/no) using generalized linear mixed models to account for clustering by district. Ambient PM2.5 exposure data were derived from the Multiangle Imaging SpectroRadiometer (MISR) level 2 aerosol optical depth (AOD) data and averaged from birth date to date of interview.ResultsThe district-level ecological analysis found that, for every 10 μg m-3 increase in ambient PM2.5 exposure, average anemia prevalence increased by 1.90% (95% CI = 1.43, 2.36) and average hemoglobin decreased by 0.07 g/dL (95% CI = 0.09, 0.05). At the individual level, for every 10 μg m-3 increase in ambient PM2.5 exposure, average hemoglobin decreased by 0.14 g/dL (95% CI = 0.12, 0.16). The odds ratio associated with a 10-μg m-3 increase in ambient PM2.5 exposure was 1.09 (95% CI = 1.06, 1.11). There was evidence of effect modification by wealth index, maternal anemia status, and child BMI.ConclusionOur results suggest that ambient PM2.5 exposure could be linked to anemia in Indian children, although additional research on the underlying biologic mechanisms is needed. Future studies on this association should specifically consider interactions with dietary iron deficiency, maternal anemia status, and child BMI.Keywords: Anemia; Children; Ambient PM2.5 exposure; India; Association.
| S-EPMC7939416 | biostudies-literature
Project description:Background:The relationship between postoperative intensive care (ICU) admission following emergency general surgery (EGS) and emergency hospital readmission has not been widely investigated. Methods:Retrospective analysis of registry data for patients undergoing EGS in Scotland, 2005-2007. Exposure of interest was ICU admission status (direct from theatre; indirect after initial care on ward; no ICU admission). The primary outcome was emergency hospital readmission within 30 days of discharge. Results:Thirty-seven thousand one hundred seventy-three patients were included in the analysis. Overall emergency readmission rate was 8% (n?=?2983): 2756 (7.8%) in patients without postoperative ICU admission; 155 (12.1%) with direct ICU admission and 65 (14.7%) with indirect ICU admission. Indirect ICU admission was associated with increased hospital readmission rates (HR 1.24 [1.03, 1.49]; p?=?0.024) compared with direct ICU admission. ICU admission was associated with increased three-year readmission rates (p?=?0.006) and costs (p?<?0.001) compared with initial ward care. Conclusion:Indirect ICU admission is associated with increased emergency hospital readmission and healthcare costs for patients undergoing EGS.
| S-EPMC6820227 | biostudies-literature