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Many scoring systems for predicting the outcomes of patients with acute coronary syndrome (ACS) have been proposed. In some populations, a significant reduction in length of hospital stay may be achieved without compromising patient prognoses. However, the use of such scoring systems in clinical practice is limited. The aim of this study was to propose a universal list of predictors that can identify low-risk ACS patients who may be eligible for an earlier hospital discharge without increased short-term risk for major adverse cardiac events. A cohort of 1420 patients diagnosed with ACS were enrolled into a single-centre registry between October 2018 and December 2020. Clinical, laboratory, echocardiographic, and angiographic measurements were taken for each patient and entered into the study database. Using retrospective univariant analyses of patients treated with percutaneous coronary intervention (PCI) (n = 932), we compared each predictor to 30-day mortality rate using the Czech national registry of dead people. Eleven predictors correlate significantly with 30-day survival: age <80 years, ejection fraction >50%, no cardiopulmonary resuscitation, no mechanical ventilation needed, Killip class I at admission, haemoglobin levels >110 g/L while hospitalized, successful PCI procedure(s), no residual stenosis over 90%, Thrombolysis in Myocardial Infarction 3 flow after PCI, no left main stem disease, and no triple-vessel coronary artery disease. In all, presence of all predictors applies to 328 patients (35.2% of the cohort), who maintained a 100% survival rate at 30 days. A combination of clinical, echocardiographic, and angiographic findings provides valuable information for predicting the outcomes of patients with all types of ACS. We created a simple, useful tool for selecting low-risk patients eligible for early discharge.
- Klíčová slova
- Acute coronary syndrome, Early discharge, Low risk, Predictors, Prognosis,
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Alcoholic liver disease is a major cause of liver cirrhosis and the hepatorenal syndrome is a serious complication. Risk factors for hepatorenal syndrome (HRS) in alcoholic liver cirrhosis are not entirely explored. AIM: To assess the risk factors for hepatorenal syndrome in alcoholic liver cirrhosis. PATIENTS AND METHODS: Consecutive patients with alcoholic liver disease were followed for two months, development of renal failure, classified either as HRS or renal failure not fulfilling criteria of HRS, was the main outcome. RESULTS: Of 171 patients, 14 (8.2%) developed HRS and 13 (7.6%), renal failure not fulfilling the HRS criteria. A significant difference was found between patients with and without HRS in serum sodium (131.1±3.8 vs. 135.7±5.2; P = 0.003), creatinine, (94.1±26.8 vs. 80.3±20.2; P < 0.001), albumin (23.5±4.9 vs. 29.9±5.8; P < 0.001), INR (1.76±0.45 vs. 1.44±0.41; P < 0.001), bilirubin (252.3±179.4 vs. 91.2±101.0; P < 0.001), MELD (23±6 vs 15±5; P < 0.001) and MELD-Na score (27±5 vs. 18±6; P < 0.001). Multivariate analysis adjusted for sex and age showed that sodium together with creatinine are the strongest HRS predictors, followed by bilirubin with respective odds´ ratios (95% CI) of 1.041 (1.012-1.072) for creatinine, 0.870 (0.766-0.988) for serum sodium and 1.005 (1.001-1.010) for serum bilirubin. CONCLUSION: Serum levels of sodium, creatinine and bilirubin are important predictors of the hepatorenal syndrome.
- Klíčová slova
- alcohol, hepatorenal syndrome, liver cirrhosis, predictors,
- MeSH
- akutní poškození ledvin etiologie MeSH
- albuminy terapeutické užití MeSH
- alkoholická cirhóza jater komplikace MeSH
- analýza rozptylu MeSH
- antihypertenziva terapeutické užití MeSH
- hepatorenální syndrom diagnóza farmakoterapie etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lypresin analogy a deriváty terapeutické užití MeSH
- následné studie MeSH
- rizikové faktory MeSH
- terlipresin MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- albuminy MeSH
- antihypertenziva MeSH
- lypresin MeSH
- terlipresin MeSH
INTRODUCTION: The multifaceted benefits of breastfeeding for mothers and infants include enhanced neurodevelopment and immune function in preterm infants. However, more research is needed to understand the unique factors affecting breastfeeding practices in preterm infants. This study aimed to identify key social predictors of breastfeeding in preterm infants and assess the effectiveness of specific interventions on their feeding practices during the first six months postpartum. METHODS: A prospective, monocentric, longitudinal study involving a cohort of 201 preterm infants was executed at the Neonatology Department, Ceske Budejovice Hospital, Czech Republic, from January 2020 to January 2023. The STROBE guidelines were used. RESULTS: The study results elucidated a transition from breastfeeding to bottle feeding and formula within the infants' first six months. Notable social predictors of breastfeeding encompassed factors such as the number of children in the household, the mother's marital status, and the nature of housing. Certain interventions, including immediate skin-to-skin contact between mother and child, and initiation of nutritive feeding within the first half-hour post-birth, significantly influenced the probability of breastfeeding. CONCLUSIONS: The data underscored that social predictors and nursing interventions substantially shape the breastfeeding practices of preterm infants during the first six months postpartum. Inequities in health outcomes among premature infants can be effectively curbed through comprehensive care models that account for socioeconomic factors influencing breastfeeding.
- Klíčová slova
- breastfeeding, infant nutrition, interventions, longitudinal study, preterm infants, social predictors,
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: To undertake a large-scale clinical study of predictors of lithium (Li) response in bipolar I disorder (BD-I) and apply contemporary multivariate approaches to account for inter-relationships between putative predictors. METHODS: We used network analysis to estimate the number and strength of connections between potential predictors of good Li response (measured by a new scoring algorithm for the Retrospective Assessment of Response to Lithium Scale) in 900 individuals with BD-I recruited to the Consortium of Lithium Genetics. RESULTS: After accounting for co-associations between potential predictors, the most important factors associated with the good Li response phenotype were panic disorder, manic predominant polarity, manic first episode, age at onset between 15-32 years and family history of BD. Factors most strongly linked to poor outcome were comorbid obsessive-compulsive disorder, alcohol and/or substance misuse, and/or psychosis (symptoms or syndromes). CONCLUSIONS: Network analysis can offer important additional insights to prospective studies of predictors of Li treatment outcomes. It appears to especially help in further clarifying the role of family history of BD (i.e. its direct and indirect associations) and highlighting the positive and negative associations of different subtypes of anxiety disorders with Li response, particularly the little-known negative association between Li response and obsessive-compulsive disorder.
- Klíčová slova
- lithium response, network analysis, phenotype, predictors,
- MeSH
- bipolární porucha komplikace farmakoterapie MeSH
- dospělí MeSH
- komorbidita MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- obsedantně kompulzivní porucha komplikace MeSH
- prognóza MeSH
- prospektivní studie MeSH
- sloučeniny lithia terapeutické užití MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- sloučeniny lithia MeSH
BACKGROUND: The objective was to identify predictors of societal costs covering formal and informal care utilization by older home care clients in 11 European countries. METHODS: Societal costs of 1907 older clients receiving home care for 12 months from the Aged in Home care (AdHoc) study were estimated using the InterRAI Minimum Data Set for Home Care's (MDS-HC) resource use items. Predictors (medical, functional, and psychosocial domains) of societal costs were identified by performing univariate and multivariate generalized linear model analyses. RESULTS: Mean societal costs per participant were €36 442, ranging from €14 865 in Denmark to €78 836 in the United Kingdom. In the final multivariate model, country, being married, activities of daily living (ADL) dependency, cognitive impairment, limitations of going out, oral conditions, number of medications, arthritis, and cerebro vascular accident (CVA) were significantly associated with societal costs. CONCLUSIONS: Of the predictors, ADL dependency and limitations of going out may be modifiable. Developing interventions targeted at improving these conditions may create opportunities to curtail societal costs.
- Klíčová slova
- Minimum Data Set for Home Care, Predictors of costs, home care, older adults, societal costs,
- Publikační typ
- časopisecké články MeSH
There is a need to develop tools to predict individual weight loss maintenance and attrition prognosis. We aimed to identify predictors of weight loss maintenance outcome and attrition in subjects from eight European countries in the DiOGenes project. A total of 932 overweight/obese subjects (body mass index: 27-42 kg m(-2) ) were enrolled in an 8-week low-calorie diet (LCD). The 776 subjects (83%) who achieved at least 8% reduction in their initial body weight were randomized into five dietary arms varying in protein content and glycemic index for a 6-month weight maintenance period. Baseline characteristics, weight loss at weeks 1, 3 and 8 of LCD were assessed as predictors of weight loss maintenance and attrition using multivariate regression and correlation models. The multivariate model showed that the 6-month weight loss maintenance was predicted by: 7.889 - 0.343 × weight loss at week 3 + 1.505 × weight loss at week 8 + 2.422 × gender (0 = male and 1 = female gender) (R(2) = 51%, P = 0.0001). A greater weight loss at week 8 was associated with a lower attrition during the subsequent 6-month dietary intervention period (OR = 0.92, 95% CI: 0.88-0.97, P = 0.001). Furthermore, the men showed an increased likelihood for attrition during the dietary intervention period (OR = 1.54, 95% CI: 1.07-2.20, P = 0.02). A greater weight loss during 8 weeks of LCD and female gender predict better 6-month weight maintenance of weight loss, whereas the baseline characteristics did not predict outcome. Attrition could be strongly predicted by gender and weight loss during LCD.
- Klíčová slova
- attrition, gender, predictors, weight loss maintenance,
- Publikační typ
- časopisecké články MeSH
Livestock depredation by leopards is a pervasive issue across many Asian and African range countries, particularly in and around protected areas. Developing effective conflict mitigation strategies requires understanding the landscape features influencing livestock depredation. In this study, we investigated predictors associated with livestock depredation by leopards using 274 cases of leopard attacks on livestock that occurred between 2017 and 2020 in the Annapurna Conservation Area, Nepal. We also examined how livestock predation by leopards varied depending on the species, season, and time. A generalized linear model with binary logistic regression was used to test the statistical significance of variables associated with the presence and absence of conflict sites. The results revealed that the area of forest, agricultural land, length of rivers, slope, proximity to settlements and protected areas, and elevation significantly predicted the probability of leopard attacks on livestock. We also observed a significant increase in the incidence of leopard predation on livestock with decreasing slopes and rising elevations. The areas near human settlements and the protected areas faced a higher risk of leopard predation. The incidence of leopard predation on livestock varied significantly depending on the livestock species, season, and time. Goats were the most highly predated livestock, followed by sheep, cow/ox, and buffalo. A total of 289.11 km2 (or around 5% of the research area) was deemed to be at high risk for leopard predation on livestock. This study's comprehensive understanding of human-leopard conflicts provides valuable insights for planning and implementing measures to reduce damage caused by leopard populations throughout their range.
- Klíčová slova
- Annapurna Conservation Area, Landscape predictors, Livestock depredation,
- MeSH
- dobytek * MeSH
- ekosystém MeSH
- kozy MeSH
- lidé MeSH
- ovce MeSH
- Panthera * MeSH
- skot MeSH
- zachování přírodních zdrojů MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- skot MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Nepál MeSH
OBJECTIVE: To describe the burden and the predictors of genital warts (GWs) in Czech men and women. METHODS: A population-based cross-sectional study was conducted of 32 974 randomly selected health clinic attendees from all 14 regions of the Czech Republic. Information on GWs and lifestyle behaviour was collected using a questionnaire. RESULTS: Results revealed a 5.8% prevalence rate of self-reported GWs in the Czech population aged 16-55 years. There was an increase in the incidence of GWs in the years 2010-2013 when compared to lifetime incidence rates, from 205.4 (95% confidence interval (CI) 191.0-219.7) to 441.8 (95% CI 393.1-490.6) per 100 000 person-years. No significant differences were observed between genders. The strongest risk factors found for GWs were an infected sexual partner (adjusted odds ratio (OR) 114.3, 95% CI 78.9-165.4) and a high number of lifetime sexual partners (adjusted OR 3.36, 95% CI 2.72-4.17 for >14 partners vs. one partner). A novel finding was that 22.7% (95% CI 20.9-24.6%) of participants claimed that the pathology had disappeared spontaneously without medical assistance. CONCLUSIONS: The results provide baseline information for the development and monitoring of prevention strategies against GWs in the Czech Republic.
- Klíčová slova
- Genital warts, Human papillomavirus, Incidence, Prevalence, Risk predictors,
- MeSH
- dospělí MeSH
- incidence MeSH
- kondylomata akuminata epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- prevalence MeSH
- průřezové studie MeSH
- rizikové faktory MeSH
- sexuální partneři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) is one of the most significant inventions in cardiology, as it provides a viable minimally invasive treatment option for patients with aortic stenosis, the most common valvular disease in the developed world and one with a poor prognosis when left untreated. Using data available to date, this review aims to discuss and identify possible predictors of TAVI valve durability - an essential requirement for the device's wide-spread use, especially in younger patients. AREAS COVERED: This article explores the main causes of bioprosthetic valve dysfunction (BVD) based on pathophysiology and available data, and reviews possible predictors of BVD including prosthesis-related, procedure-related, and patient-related factors. An emphasis is made on affectable predictors, which could potentially be targeted with prevention management and improve valve durability. A literature search of online medical databases was conducted using relevant key words and dates; significant clinical trials were identified. A brief overview of important randomized controlled trials with mid to long-term follow-up is included in this article. EXPERT OPINION: Identifying modifiable predictors of valve dysfunction presents an opportunity to enhance and predict valve durability - a necessity as patients with longer life-expectancies are being considered for the procedure.
- Klíčová slova
- Aortic stenosis, bioprosthetic valve dysfunction, calcification, durability, predictors, prevention, structural valve deterioration, transcatheter aortic valve implantation,
- MeSH
- aortální chlopeň chirurgie MeSH
- aortální stenóza * chirurgie MeSH
- bioprotézy * MeSH
- lidé MeSH
- selhání protézy MeSH
- srdeční chlopně umělé * MeSH
- transkatetrální implantace aortální chlopně * škodlivé účinky metody MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
AIMS: This study aimed to investigate incidence and predictors of weaning failure and in-hospital death after successful weaning from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in patients with cardiogenic shock (CS). METHODS AND RESULTS: Overall, 685 patients with CS treated with VA-ECMO from 23 tertiary care centres in 7 countries were analysed (median age 57 [interquartile range 49-66] years, 542 [79.1%] male, median lactate 7.6 [interquartile range 4.1-12.7] mmol/L). The cause of CS was acute myocardial infarction in 438 (63.9%) patients, and 431 (62.9%) patients presented with cardiac arrest. A total of 410 patients (59.9%) were successfully weaned from VA-ECMO, whereas in 275 patients (40.1%) weaning failed (i.e. patients died on or within 48 h after VA-ECMO support). Of the successfully weaned patients, 150 (36.6%) died before hospital discharge. On multivariable logistic regression, predictors for both patient groups varied: age (per 10 years, odds ratio [OR] 1.49, 95% confidence interval [CI] 1.25-1.76; p < 0.001) and cardiac arrest before VA-ECMO implantation (OR 1.64, 95% CI 1.01-2.64; p = 0.04) were associated with weaning failure, whereas lactate clearance within 24 h after VA-ECMO initiation was associated with successful weaning (OR 0.21, 95% CI 0.1-0.44; p < 0.001). In-hospital death after successful weaning was more likely with higher age (per 10 years, OR 1.56, 95% CI 1.24-1.97; p < 0.001), renal replacement therapy (OR 2.56, 95% CI 1.4-4.68; p = 0.002) and bleeding events (OR 2.93, 95% CI 1.4-6.14; p = 0.004). CONCLUSION: Weaning from VA-ECMO fails in 40% of patients treated with VA-ECMO for CS. When successful, survival after VA-ECMO weaning mostly depends on age and the incidence of device- and shock-related complications.
- Klíčová slova
- Cardiogenic shock, Mechanical circulatory support, Mortality, Predictors, Veno‐arterial extracorporeal membrane oxygenation, Weaning,
- Publikační typ
- časopisecké články MeSH