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ABSTRACT: Adequate transfer of passive immunity (TPI) is a cornerstone for a proper health status of calves. In the literature, there is limited information on the prevalence of failure of TPI in dairy-beef crossbred calves and its effect on morbidity, mortality, and ADG during the preweaning period. Therefore, this study aimed to evaluate the association between TPI with morbidity, mortality, and ADG in preweaning dairy-beef crossbred calves. A total of 1,055 newborn dairy-beef crossbred calves were enrolled upon arrival at a calf-raising facility in California from January to August 2021. Farm of origin, genetic breed group, sex, and BW were recorded upon arrival. Blood was collected at 24 ± 1 h after arrival to evaluate serum IgG concentration, serum total protein (TP), and packed cell volume. Morbidity (diarrhea and respiratory treatment records) and mortality were recorded daily until 60 d of life. Calves were grouped into 2 genetic breed groups: Holstein × Beef (Ho × Be, 49.6%) and Jersey × Beef crossbred calves (Je × Be, 50.4%). Descriptive statistics and Cox proportional hazard models were created to evaluate the association of TPI categories for serum IgG (TPI-IgG: poor:

Background: This study aimed to explore the correlation between hyperglycemia at intensive care unit (ICU) admission and the incidence of acute kidney injury (AKI) in patients after cardiac surgery. Methods: We conducted a retrospective cohort study, in which clinical data were extracted from the Medical Information Mart for Intensive Care (MIMIC)-IV database. Adults (≥18 years) in the database who were admitted to the cardiovascular intensive care unit after cardiac surgery were enrolled. The primary outcome was the incidence of AKI within 7 days following ICU admission. Secondary outcomes included ICU mortality, hospital mortality, ICU length of stay, and the 28-day and 90-day mortality. Multivariable Cox regression analysis was used to assess the association between ICU-admission hyperglycemia and AKI incidence within 7 days of ICU admission. Different adjustment strategies were used to adjust for potential confounders. Patients were divided into three groups according to their highest blood glucose levels recorded within 24 h of ICU admission: no hyperglycemia (

Summary: Background/aims: During the first outbreak of COVID-19 knowledge regarding nutritional status and target areas of the nutritional treatment to patients admitted to the hospitals with COVID-19 was limited. Therefore, the aim was 1) to describe baseline characteristics including nutritional status, nutritional risk, energy- and protein intake, nutritional route, and Nutrition Impact Symptoms (NIS) known to have an impact on the nutritional intake; 2) to compare these characteristics in patients who, respectively, survived or died within 30 days after discharge and 3) to describe nutritional aspects in the transition between hospitalisation and a home setting. Methods: This was an observational study. Patients admitted with COVID-19 in 2020 and referred to clinical dietitians were enrolled. Data on nutritional status, nutritional risk, NIS, nutritional treatment, grade of inflammation, 30-days mortality and readmissions rate and nutritional aspects after discharge were collected from the patient journal. Results: We included 81 patients, 41 (51%) male, median age 75 (IQR: 63–83). Patients were referred to the clinical dietitians at median day 4 (IQR: 3–8) of the hospital stay. The median BMI was 25 (IQR: 21–28) and 58 (83%) were at nutritional risk. Nutrition route was primarily oral (89%). The three most common NIS were; decreased appetite (88%), shortness of breath (55%), and early satiety (47%).At the 30 days follow-up 23 (28%) patients were deceased, of these 16 (70%) before discharge. The patients who died were older (median 82 vs. 72 y, P=0.002), and more were admitted from a care facility (48 vs. 17%, P=0.005). Further, among those who died fewer covered their energy requirement (25 vs. 43%, P=0.001), and protein requirement (23 vs. 34%, P=0.032). Also chewing- and swallowing problems were more prevalent in those who died (45 vs. 17%, P=0.048). There were no differences in nutritional status, nutritional risk, or nutritional route among the two groups. A total of 21 (26%) patients were readmitted within 30 days.At discharge only 11 (14%) patients had a nutritional discharge plan made by the clinical dietician. Up to one fifth still experienced NIS with early satiety (20%), chewing or swallowing problems (15%) and respiratory problems (15%) being the most frequent. Conclusions: Hospitalized patients with COVID-19 had several NIS, a high prevalence of nutritional risk and the majority had a nutritional intake below requirement. The mortality was high, especially during hospitalisation, and those patients that died had a lower intake of energy and protein and hence also coverage of requirement. Most patients were fed orally during hospitalisation. More than one fourth of the patients were readmitted within 30 days. Few patients had a nutritional discharge plan made by the dietitian and up till one fifth of the patients still suffered from NIS.Therefore, nutritional treatment is relevant in this group of patients.

Objectives: Acinetobacter baumannii (A. baumannii) nosocomial infections represent a serious hazard to public health, given high mortality rates and rapid spread of multidrug-resistance. The primary outcome of this study was to evaluate predictors of 14- and 30-d mortality in bloodstream infections (BSIs) due to both carbapenem-resistant and carbapenem-sensitive Acinetobacter. Secondary end points were to identify risk factors for BSIs due to carbapenem-resistant A. baumannii (CRAB) and to develop a predictive model for mortality in CRAB-related BSIs. Methods: Between 2019 and 2023, all consecutive hospitalized adult patients with bacteraemia due to A. baumannii were retrospectively enrolled at a single-centre. Results: One hundred twenty-six episodes of BSI caused by A. baumannii were recorded, 89.7% of which were due to CRAB. Recent burn injuries, older age, previous CRAB colonization, and antibiotics exposure were identified as risk factors for acquiring CRAB BSI. Overall, 14-d mortality was observed in 26.1% of the patients and 30-d mortality in 30.9% of the patients. On multivariate analysis, the Sequential Organ Failure Assessment (SOFA) score was associated with both 14- and 30-d mortality, whereas burn injuries correlated with 30-d survival. Concurrent coronavirus disease (COVID) was associated with mortality, although not reaching statistical figures. No major impact of receiving appropriate treatment was observed. Based on these findings, a multivariable model to predict mortality among patients with CRAB BSI was built and internally validated. Conclusions: A. baumannii BSIs are characterized by poor outcomes and limited therapeutic options. This study aimed to assist physicians in prompt identification of patients who are at greater risk of death, contributing to more informed clinical decision making.

Background: There exist few maximal oxygen uptake (VO2max) non-exercise-based prediction equations, fewer using machine learning (ML), and none specifically for older adults. Since direct measurement of VO2max is infeasible in large epidemiologic cohort studies, we sought to develop, validate, compare, and assess the transportability of several ML VO2max prediction algorithms. Methods: The Baltimore Longitudinal Study of Aging (BLSA) participants with valid VO2max tests were included (n = 1080). Least absolute shrinkage and selection operator, linear- and tree-boosted extreme gradient boosting, random forest, and support vector machine (SVM) algorithms were trained to predict VO2max values. We developed these algorithms for: (a) the overall BLSA, (b) by sex, (c) using all BLSA variables, and (d) variables common in aging cohorts. Finally, we quantified the associations between measured and predicted VO2max and mortality. Results: The age was 69.0 ± 10.4 years (mean ± SD) and the measured VO2max was 21.6 ± 5.9 mL/kg/min. Least absolute shrinkage and selection operator, linear- and tree-boosted extreme gradient boosting, random forest, and support vector machine yielded root mean squared errors of 3.4 mL/kg/min, 3.6 mL/kg/min, 3.4 mL/kg/min, 3.6 mL/kg/min, and 3.5 mL/kg/min, respectively. Incremental quartiles of measured VO2max showed an inverse gradient in mortality risk. Predicted VO2max variables yielded similar effect estimates but were not robust to adjustment. Conclusion: Measured VO2max is a strong predictor of mortality. Using ML can improve the accuracy of prediction as compared to simpler approaches but estimates of association with mortality remain sensitive to adjustment. Future studies should seek to reproduce these results so that VO2max, an important vital sign, can be more broadly studied as a modifiable target for promoting functional resiliency and healthy aging.

الملخص: أهداف البحث: بحثت دراسة الحالات والشواهد هذه في وضع وظائف الكريات البيضاء في فقر الدم المنجلي لتحديد الأمراض المناعية الأساسية للتشخيص المبكر والتخفيف من خطر العدوى البكتيرية المتزايدة في هذه الفئة من المرضى. طريقة البحث: تسعون مشاركا يضمون 24 هيموجلوبين-أ أ و22 هيموجلوبين-أ س و23 حالة ثابتة من هيموجلوبين-س س و21 حالة أزمة انسداد الأوعية الدموية هيموجلوبين-س س تم استقطابهم لهذه الدراسة. تم تصنيف الموضوعات أيضا إلى ست مجموعات، أي موضوعات هيموجلوبين-أ أ وموضوعات هيموجلوبين-أ س كمجموعات مراقبة، موضوعات هيموجلوبين-س س في حالة مستقرة، موضوعات هيموجلوبين-س س في حالة أزمة انسداد الأوعية الدموية، موضوعات هيموجلوبين-س س الخاضعة للأدوية، ومجموعة هيموجلوبين-س س التي تخضع للعلاج بالإضافة إلى مجموعة نقل الدم على التوالي. تم تقييم تحليل الدم، والرحلان الكهربائي للهيموجلوبين، ونسب الكريات البيضاء، والمقايسات الوظيفية للكريات البيضاء باستخدام الطرق القياسية، وتم تقييم مستويات انترليوكن-8 و إل-سيليكتن باستخدام إليزا. النتائج: تم زيادة إجمالي عدد الكريات البيضاء والوحيدات في مجموعات هيموجلوبين-س س مقارنة بمجموعات التحكم. ومع ذلك، كان لدى مجموعات هيموجلوبين-س س عدد أقل من الخلايا الليمفاوية مقارنة بالمجموعات الأخرى. تمت زيادة صلاحية كريات الدم البيضاء في مجموعات فقر الدم المنجلي، في حين تم تقليل أنشطة البلعمة والانفجار التنفسي التأكسدي في مجموعات فقر الدم المنجلي. لوحظت زيادة في مستويات انترليوكن-8 في جميع مجموعات فقر الدم المنجلي، ومع ذلك انخفضت مستويات إل-سيليكتن لـ هيموجلوبين-أ س الثابت و هيموجلوبين-أ س في مجموعات الأدوية مقارنة بالمجموعات الأخرى. تم العثور على نسبة العدلات إلى الخلايا اللمفاوية، ونسبة الخلايا الليمفاوية الوحيدة ونسبة الصفائح الدموية إلى الخلايا الليمفاوية لمجموعات فقر الدم المنجلي أعلى من مجموعات التحكم. الاستنتاجات: يشكل خلل أنشطة البلعمة والانفجار التنفسي التأكسدي لكريات الدم البيضاء في مجموعات مرض فقر الدم المنجلي، مما قد يزيد من قابليتها للإصابة بالعدوى وخطر الوفاة، خاصة أثناء حالة الأزمة. يمكن تصميم الأساليب العلاجية الجديدة خصيصا لتعزيز وظائف كريات الدم البيضاء هذه والتخفيف من خطر الإصابة المتزايد في مرض فقر الدم المنجلي. Abstract: Objectives: This case-control study investigated the mode of leukocyte function in sickle cell anemia (SCA) to delineate the underlying immunopathology for early diagnosis and mitigate the increased bacterial infection risk in this patient population. Method: In total, 90 participants comprising 24 hemoglobin (Hb)-AA, 22 Hb-AS, 23 steady state Hb-SS and 21 vaso-occlusive crisis state Hb-SS subjects were recruited for this study. The subjects were further divided into the following six groups: Hb-AA and Hb-AS subjects as control groups, Hb-SS subjects at steady state, Hb-SS subjects in a vaso-occlusive crisis state, Hb-SS subjects undergoing medication (Meds), and Hb-SS subjects undergoing medication plus blood transfusion (Meds/BT) group, respectively. Hematological analysis, Hb electrophoresis, leukocyte ratios, and leukocyte functional assays were assessed with standard methods, and interleukin 8 (IL-8) and L-selectin levels were evaluated using enzyme-linked immunosorbent assays. Results: Total leukocyte and monocyte counts were increased in the Hb-SS groups compared to the control groups. However, the Hb-SS groups had lower lymphocyte counts than the other groups (p

Background: The COVID-19 pandemic negatively impacted the collective American psyche. Socioeconomic hardships including social isolation led to an increase in firearm sales. Previous regional studies demonstrated increased penetrating trauma during the pandemic but it is unclear if trauma systems were prepared for this influx of penetrating injuries. This study aimed to confirm this increased penetrating trauma trend nationally and hypothesized penetrating trauma patients treated during the pandemic had a higher risk of complications and death, compared to pre-pandemic patients. Methods: The 2017–2020 Trauma Quality Improvement Program database was divided into pre-pandemic (2017–2019) and pandemic years (2020). Bivariate analyses and a multivariable logistic regression analyses were performed controlling for age, comorbidities, injuries, and vitals on arrival. Results: From 3,525,132 patients, 936,890 (26.6 %) presented during the pandemic. The pandemic patients had a higher rate of stab-wounds (4.8 % vs. 4.5 %, p > 0.001) and gunshot wounds (5.8 % vs. 4.6 %, p

Background/purpose: The optimal timing of vascular access (VA) creation for hemodialysis (HD) and whether this timing affects mortality and health-care utilization after HD initiation remain unclear. Thus, we conducted a population-based study to explore their association. Methods: We used Taiwan's National Health Insurance Research Database to analyze health-care outcomes and utilization in a cohort initiating HD during 2003–2013. We stratified patients by the following VA creation time points: >180, 91–180, 31–90, and ≤30 days before and ≤30 days after HD initiation and examined all-cause mortality, ambulatory care utilization/costs, hospital admission/costs, and total expenditure within 2 years after HD. Cox regression, Poisson regression, and general linear regression were used to analyze mortality, health-care utilization, and costs respectively. Results: We identified 77,205 patients who started HD during 2003–2013. Compared with the patients undergoing VA surgery >180 days before HD initiation, those undergoing VA surgery ≤30 days before HD initiation had the highest mortality—15.92 deaths per 100-person-years, crude hazard ratio (HR) 1.56, and adjusted HR 1.28, the highest hospital admissions rates— 2.72 admission per person-year, crude rate ratio (RR) 1.48 and adjusted RR 1.32, and thus the highest health-care costs— US$31,390 per person-year, 7% increase of costs and 6% increase with adjustment within the 2-year follow-up after HD initiation. Conclusion: Late VA creation for HD can increase all-cause mortality, hospitalization, and health-care costs within 2 years after HD initiation. Early preparation of VA has the potential to reduce post-HD mortality and healthcare expenses for the ESKD patients.

Risk of cardiovascular events is increased after COVID-19. However, information on cardiovascular risk trends after COVID-19 infection is lacking and estimates by sex are inconsistent. Our aim was to examine cardiovascular outcomes and mortality in a large cohort (164,346 participants) of SARS-CoV-2 positive individuals compared to non-positive individuals, stratified by sex. Data were obtained from the Spanish Health System’s electronic medical records. Selected individuals were ≥ 45 years old with/without a positive SARS-CoV-2 test in the period March-May 2020. Follow-up was obtained until January 31, 2021, for cardiovascular events (angina/myocardial infarction, arrhythmias, bypass/revascularization, heart failure, peripheral artery disease, stroke/transient ischemic attack, and thrombosis), and until March 31, 2021, for mortality. Individuals were matched by propensity score. Incidence of cardiovascular events and mortality was compared with accelerated failure time models. The effect of matching and of COVID-19 severity was assessed with sensitivity analyses. In the first 3 months of follow-up, SARS-CoV-2 positive individuals had a higher risk of mortality and of all cardiovascular events. From 4–12 months, there was increased risk of mortality in SARS-CoV-2 positive individuals overall, of heart failure in SARS-CoV-2 positive females (HR= 1.26 [1.11–1.42]), and of arrhythmias and thrombosis in SARS-CoV-2 positive males (HR= 1.29 [1.14–1.47] and HR= 1.35 [1.03–1.77], respectively). When COVID-19 patients admitted to the ICU were excluded, incidence of thrombosis was similar in males regardless of positive/non-positive SARS-CoV-2 status. In the full year of follow-up, increased incidence of heart failure and of arrhythmias and thrombosis was observed in SARS-CoV-2 positive females and males, respectively.

Background: A quality diet and an active lifestyle are both important cornerstones of cardiovascular disease (CVD) prevention. However, despite their interlinked effects on metabolic health, the 2 behaviors are rarely considered jointly, particularly within the context of CVD prevention. We examined the independent, interactive, and joint associations of diet and physical activity with CVD hospitalization, CVD mortality, and all-cause mortality. Methods: CVD-free Australian participants aged 45–74 years (n = 85,545) reported physical activity, diet, sociodemographic, and lifestyle characteristics at baseline (2006–2009) and follow-up (2012–2015), and data were linked to hospitalization and death registries (03/31/2019 for CVD hospitalization and all-cause mortality and 12/08/2017 for CVD mortality). Diet quality was categorized as low, medium, and high based on meeting dietary recommendations. Physical activity was operationalized as (a) total moderate-to-vigorous physical activity (MVPA) as per guidelines, and (b) the composition of MVPA as the ratio of vigorous-intensity physical activity (VPA) to total MVPA. We used a left-truncated cause-specific Cox proportional hazards model using time-varying covariates. Results: During a median of 10.7 years of follow-up, 6576 participants were admitted to the hospital for CVD and 6581 died from all causes (876 from CVD during 9.3 years). A high-quality diet was associated with a 17% lower risk of all-cause mortality than a low-quality diet, and the highest MVPA category (compared with the lowest) was associated with a 44% and 48% lower risk of CVD and all-cause mortality, respectively. Multiplicative interactions between diet and physical activity were non-significant. For all outcomes, the lowest risk combinations involved a high-quality diet and the highest MVPA categories. Accounting for total MVPA, some VPA was associated with further risk reduction of CVD hospitalization and all-cause mortality. Conclusion: For CVD prevention and longevity, one should adhere to both a healthy diet and an active lifestyle and incorporate some VPA when possible.

Background: We aimed to assess the utility of B-type natriuretic peptide (BNP) and 6-min walk test (6 MWT) together as predictors of re-hospitalization and mortality in acute decompensated heart failure (ADHF) patients. Methods: This prospective, observational, comparative study was conducted at a tertiary care center in India between October 2016 and March 2018. Patients (aged≥18 years) with ADHF and left ventricular systolic dysfunction were included in this study. The study group (N = 100 patients) consisted of patients undergoing a second BNP test along with the 6 MWT at the time of discharge and at 3-months of discharge. The control group (N = 100 patients) consisted of patients who did not undergo these tests at discharge and/or at 3-months of discharge. Study endpoints were re-hospitalization within 6-months, and in-patient and 6-month mortality. Results: Total 200 patients diagnosed with ADHF were enrolled. Mean age was 53.46 ± 10.12 years in the study group and 52.98 ± 9.88 years in the control group. ROC analysis of BNP level to predict re-hospitalization revealed AUC of 0.935 (p

Introduction: The incidence of STEMI and subsequent mortality has been reported to be higher in Indian populations compared to developed countries. However, there is limited data directly comparing contemporary primary percutaneous coronary intervention (pPCI) treatment strategies and clinical outcomes for STEMI patients between developed and developing countries. Materials and methods: We compared population demographics, procedural characteristics, times to reperfusion and mortality in STEMI patients treated with pPCI between two tertiary referral centers in India and Australia respectively over a 3-year period (1st Jan 2017–31st Dec 2019). Results: A total of 1293 STEMI presentations (896 Indian vs 397 Australian) were included. On average, Indian patients had lower median BMI than Australian patients (BMI 25.4 vs 27.8; p

Resumen: Antecedentes y objetivo: La endocarditis infecciosa presenta una mortalidad de 25%. La lesión renal aguda (LRA) se desarrolla en hasta 70% de los casos. El objetivo de presente estudio es determinar el impacto pronóstico de la LRA en la endocarditis y los factores asociados a la misma. Materiales y métodos: Estudio retrospectivo unicéntrico que incluyó a todos los pacientes ingresados por endocarditis entre 2015 y 2021. Basalmente se recogieron datos epidemiológicos y comorbilidades. Durante el ingreso, se recogieron datos de evolución de la función renal, variables asociadas con la propia infección y el desenlace de la misma. A través de modelos multivariables, se analizó la capacidad predictiva de la LRA en la mortalidad. Resultados: Se incluyó a 134 pacientes (63% varones, edad media 72 ± 15 años) de los que 94 (70%) presentaron una LRA (50% AKIN-1, 29% AKIN-2 y 21% AKIN-3). Los factores asociados a presentar una LRA fueron la edad, la hipertensión arterial, tener una enfermedad renal crónica, el FGe basal, padecer insuficiencia cardiaca y enfermedad vascular periférica. El único predictor independiente para presentar una LRA fue el FGe basal (OR 0,94, p = 0,001).Fallecieron 46 (34%) pacientes, de los que en 45 (98%) se desarrolló una LRA. A través de diversos modelos multivariantes ajustados, la LRA predijo independientemente la mortalidad. Asimismo, la pérdida de FGe (OR 1,054, p < 0,001) y el FGe basal (0,963, p = 0,012) se asociaron independientemente a fallecer durante la hospitalización. Conclusiones: El desarrollo de una LRA y su gravedad, es decir, la pérdida de FGe y la puntuación en la escala AKIN impactan en el pronóstico de una endocarditis infecciosa. Abstract: Introduction: Infective endocarditis presents a 25% mortality. Acute kidney injury (AKI) develops in up to 70% of the cases. The aim of this study is to evaluate the predictive value of AKI in mortality due to endocarditis and to assess its associated factors. Methods: Unicentric and retrospective study including all patients with in-hospital diagnosis of endocarditis between 2015 and 2021. Epidemiological data and comorbidities were collected at baseline. During admission, renal function parameters, infection-related variables and mortality were collected. Using adjusted multivariate models, LRA predictive value was determined. Results: One hundred and thirty-four patients (63% males, age 72±15 years) were included. Of them 94 (70%) developed AKI (50% AKIN-1, 29% AKIN-2 and 21% AKIN-3). Factors associated to AKI were age (p=0.03), hypertension (p=0.005), previous chronic kidney disease (p=0.001), heart failure (p=0.006), peripheral vascular disease (p=0.022) and glomerular filtration rate (GFR) at baseline (p

Objective: Breast cancer is the most frequently diagnosed cancer among women worldwide. Mortality-to-incidence ratio (MIR) is a marker that reflects the efficacy and availability of screening interventions and treatment outcomes. MIR can be used to influence public health strategy. The association between the MIRs for breast cancer among countries with different economic statuses and health expenditure is important yet has been investigated. This study was aimed to elucidate the association between the breast cancer MIRs and the human development and health expenditure among different countries. Materials and methods: Cancer incidence and mortality rates were obtained from the GLOBOCAN database. The MIRs were calculated by dividing the crude rate of mortality to the incidence. Associations among the MIR and variants of human development index (HDI) and current health expenditure (CHE) in 50 countries were estimated via linear regression. Results: Breast cancer had a higher incidence rate, but lower mortality rate, in developed countries (high HDI, CHE per capita, CHE/GDP), as compared with developing countries. Favorable MIRs were associated with a high HDI and high health expenditure countries (presented by high CHE per capita, and CHE/GDP) (both p

Background: Emerging evidence suggests that minimal acute kidney injury (stage 1 AKI) is associated with increased hospital mortality rates. However, for those who do not meet the AKI diagnostic criteria, whether a small increase in serum creatinine (SCr) levels is associated with an increased mortality rate in elderly patients is not known. Therefore, we aimed to investigate small elevations in SCr of

Background: When resuscitating patients with septic shock, cerebrovascular reactivity parameters are calculated by monitoring regional cerebral oxygen saturation (rSO2) using near-infrared spectroscopy to determine the optimal blood pressure. Here, we aimed to analyze the impact of cerebral autoregulation-directed optimal blood pressure management on the incidence of delirium and the prognosis of patients with septic shock. Methods: This prospective randomized controlled clinical study was conducted in the Xiangya Hospital of Central South University, China. Fifty-one patients with septic shock (December 2020–May 2022) were enrolled and randomly allocated to the experimental (n=26) or control group (n=25). Using the ICM+ software, we monitored the dynamic changes in rSO2 and mean arterial pressure (MAP) and calculated the cerebrovascular reactivity parameter tissue oxygen reactivity index to determine the optimal blood pressure to maintain normal cerebral autoregulation function during resuscitation in the experimental group. The control group was treated according to the Surviving Sepsis Campaign Guidelines. Differences in the incidence of delirium and 28-day mortality between the two groups were compared, and the risk factors were analyzed. Results: The 51 patients, including 39 male and 12 female, had a mean age of (57.0±14.9) years. The incidence of delirium was 40.1% (23/51), and the 28-day mortality rate was 29.4% (15/51). The mean MAP during the first 24 h of intensive care unit (ICU) admission was higher ([84.5±12.2] mmHg vs. [77.4±11.8] mmHg, P=0.040), and the incidence of delirium was lower (30.8% vs. 60.0%, P=0.036) in the experimental group than in the control group. The use of cerebral autoregulation-directed optimal blood pressure (odds ratio [OR]=0.090, 95% confidence interval [CI]: 0.009 to 0.923, P=0.043) and length of ICU stay (OR=1.473, 95% CI: 1.093 to 1.985, P=0.011) were risk factors for delirium during septic shock. Vasoactive drug dose (OR=8.445, 95% CI: 1.26 to 56.576, P=0.028) and partial pressure of oxygen (PaO2) (OR=0.958, 95% CI: 0.921 to 0.996, P=0.032) were the risk factors for 28-day mortality. Conclusions: The use of cerebral autoregulation-directed optimal blood pressure management during shock resuscitation reduces the incidence of delirium in patients with septic shock. Trial Registration: ClinicalTrials.gov ldentifer: NCT03879317

Background: Early evaluation of prognosis in cardiogenic shock (CS) is crucial for tailored treatment selection. Both lactate clearance and lactate levels are considered useful prognostic biomarkers in patients with CS. However, there is yet no literature comparing the 6-hour lactate clearance rate (Δ6Lac) with lactate levels measured at admission (L1) and after 6 h (L2) to predict 30-day mortality in CS. Methods: In this observational cohort study, 95 patients with CS were treated at Department of Intensive Care Unit, Yiwu Central Hospital between January 2020 and December 2022. Of these, 88 patients met the eligibility criteria. The lactate levels were measured after admission (L1) as the baseline lactate value, and were measured after 6 h (L2) following admission. The primary endpoint of the study was survival rate at 30 days. A receiver operating characteristic curve was used for data analysis. Univariate and multivariate Cox regression analyses were performed based on Δ6Lac. Kaplan–Meier (KM) survival curves were generated to compare the 30-day survival rates among L1, L2, and Δ6Lac. Results: The Δ6Lac model showed the highest area under the curve value (0.839), followed by the L2 (0.805) and L1 (0.668) models. The Δ6Lac model showed a sensitivity of 84.2% and specificity of 75.4%. The L1 and L2 models had sensitivities of 57.9% each and specificities of 89.9% and 98.6%, respectively. The cut-off values for Δ6Lac, L1, and L2 were 18.2%, 6.7 mmol/L, and 6.1 mmol/L, respectively. Univariate Cox regression analysis revealed a significant association between Δ6Lac and 30-day mortality. After adjusting for five models in multivariate Cox regression, Δ6Lac remained a significant risk factor for 30-day mortality in patients with CS. In our fifth multivariate Cox regression model, Δ6Lac remained a risk factor associated with 30-day mortality (hazard ratio [HR]=5.14, 95% confidence interval [CI]: 1.48 to 17.89, P=0.010) as well as L2 (HR=8.42, 95% CI: 1.26 to 56.22, P=0.028). The KM survival curve analysis revealed that L1 >6.7 mmol/L (HR=8.08, 95% CI: 3.23 to 20.20, P 6.1 mmol/L (HR=25.97, 95% CI: 9.76 to 69.15, P

Background: Cooking-related burn injuries are a public health problem, and may be even more likely to occur in countries that are experiencing a transition to cleaner cooking fuels like liquefied petroleum gas (LPG). The risk of burns from cooking with these newer fuels, and safety measures or training to prevent injuries, is not well documented. This study examines the burden of burn injuries and burn prevention education provided to consumer by LPG stove and cylinder vendors. Methods: A cross-sectional study was conducted among 100 burn patients admitted to Muhumbili National Hospital from February 2022 to January 2023 to assess cooking-related burns. Results: We found that among 377 patients with all burn injuries, 100 (26.5%) were cooking-related, with charcoal (51%) and LPG (35%) stoves being the most reported. Females (61%) were more affected than males (39%), and lower education levels were more likely to be associated with burn injuries. Of all burn patients admitted, 57 (15.1%) died. Among those who experienced a cooking-related burn, 7 (7%) died. Children were more affected (59%) by any cooking-related burn injuries, but adults were more likely to experience LPG-related burns (56%). Small cylinders with a burner placed directly over the cylinder as one unit, without a connecting hose, caused less injury than stoves using a larger cylinder with a rubber connecting hose. Conclusion: Safety measures for LPG stoves and fuels, including policies to increase awareness and prevent burn injuries, must be prioritized in countries like Tanzania that are transitioning from solid fuels to LPG fuels for cooking.

Background: Evidence on the health benefits of occupational physical activity (OPA) is inconclusive. We examined the associations of baseline OPA and OPA changes with all-cause, cardiovascular disease (CVD), and cancer mortality and survival times. Methods: This study included prospective and longitudinal data from the MJ Cohort, comprising adults over 18 years recruited in 1998–2016, 349,248 adults (177,314 women) with baseline OPA, of whom 105,715 (52,503 women) had 2 OPA measures at 6.3 ± 4.2 years (mean ± SD) apart. Exposures were baseline OPA, OPA changes, and baseline leisure-time physical activity. Results: Over a mean mortality follow-up of 16.2 ± 5.5 years for men and 16.4 ± 5.4 years for women, 11,696 deaths (2033 of CVD and 4631 of cancer causes) in men and 8980 deaths (1475 of CVD and 3689 of cancer causes) in women occurred. Combined moderately heavy/heavy baseline OPA was beneficially associated with all-cause mortality in men (multivariable-adjusted hazard ratio (HR) = 0.93, 95% confidence interval (95%CI): 0.89–0.98 compared to light OPA) and women (HR = 0.86, 95%CI: 0.79–0.93). Over a mean mortality follow-up of 12.5 ± 4.6 years for men and 12.6 ± 4.6 years for women, OPA decreases in men were detrimentally associated (HR = 1.16, 95%CI: 1.01–1.33) with all-cause mortality, while OPA increases in women were beneficially (HR = 0.83, 95%CI: 0.70–0.97) associated with the same outcome. Baseline or changes in OPA showed no associations with CVD or cancer mortality. Conclusion: Higher baseline OPA was beneficially associated with all-cause mortality risk in both men and women. Our longitudinal OPA analyses partly confirmed the prospective findings, with some discordance between sex groups.

The current study provides information on deep-water shrimps, Aristaeomorpha foliacea and Aristeus antennatus, which are trawled in the waters of the Mediterranean Sea off Damietta, Egypt, between January 2019 and December 2019. The catch comprised 62.68% of A. foliacea with a range from 16 to 65 mm in carapace length (CL) and 37.32% of A. antennatus with a range from 17 to 57 mm in CL. The overall sex ratio of females to males was 1.00:0.22 for A. foliacea and 1.00:0.47 for A. antennatus. Studying the length-weight relationship (LWR) revealed that A. foliacea and A. antennatus, females, males, and combined sexes, had negative allometric growth. Abdomen weight- total body weight relationship showed that A. antennatus had bigger mean abdomen weight indices than A. foliacea for females, males, and combined sexes. Age was studied based on the Bhattacharya length frequency method and four cohort age groups were predicted for A. antennatus and six cohort age groups for A. foliacea. The second cohort was the dominant age group for both species. For combined sexes, the von Bertalanffy growth parameters were K = 0.244, to = −0.072, and L∞ = 77.109 mm (CL) for A. foliacea, and K = 0.246, to = −0.689, and L∞ = 67.688 mm (CL) for A. antennatus. Total mortality (Z), natural mortality (M) and fishing mortality (F) were calculated as: Z = 0.670, M = 0.423, and F = 0.247 for A. foliacea, and Z = 1.295, M = 0.441, and F = 0.854 for A. antennatus. The exploitation ratio (E) revealed that the stock of A. foliacea was rationally exploited (E = 0.368) and the stock of A. antennatus was over-exploited (E = 0.659). At the current level of explotation, 39.23% of A. foliacea stock biomass and 15.35% of A. antennatus stock biomass were protected. Further studies are recommended to shed lights on the reproductive biology of these deep-water shrimp species.

1. Abstract: Objectives: Bipolar hemiarthroplasty is commonly performed to treat displaced femoral neck fractures in osteoporotic patients. This study aimed to assess the occurrence and outcomes of unplanned return visits to the emergency department (ED) within 90 days following bipolar hemiarthroplasty for displaced femoral neck fractures. Methods: The clinical data of 1322 consecutive patients who underwent bipolar hemiarthroplasty for osteoporotic femoral neck fractures at a tertiary medical center were analyzed. Data from the patients’ electronic medical records, including demographic information, comorbidities, and operative details, were collected. The risk factors and mortality rates were analyzed. Results: Within 90 days after surgery, 19.9% of patients returned to the ED. Surgery-related reasons accounted for 20.2% of the patient's returns. Older age, a high Charlson comorbidity index score, chronic kidney disease, and a history of cancer were identified as significant risk factors for unplanned ED visits. Patients with uncemented implants had a significantly greater risk of returning to the ED due to periprosthetic fractures than did those with cemented implants (P = 0.04). Patients who returned to the ED within 90 days had an almost fivefold greater 1-year mortality rate (15.2% vs 3.1%, P

Objectives: Postoperative atrial fibrillation (POAF) is the most common perioperative arrhythmia. The association of POAF with negative short-term outcomes after cardiac surgery is well understood; however, the association of POAF with long-term morbidity and mortality is not well described. We compared the risk of long-term clinical outcomes (up to 9 years postdischarge) in patients with and without POAF following open-chest cardiac surgery. Methods: This observational, retrospective cohort study used data from the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) Swedish Cardiac Surgery Registry and National Board of Health and Welfare. Patients aged 55 to 90 years who underwent open-chest coronary artery bypass and/or valvular surgery between 2010 and 2019 were included. Clinical outcomes were adjusted for differences in baseline demographics and clinical history using multivariable Cox regression. Results: A total of 30,870 patients with a mean age of 69.2 years were included in the study (no POAF, n = 20,734; POAF, n = 10,136). The median follow-up was 4.6 years. After adjustment, POAF was associated with a significantly higher risk of recurrent atrial fibrillation (hazard ratio [HR], 2.30; 95% CI, 2.21-2.41), heart failure (HR, 1.17; 95% CI, 1.10-1.25), chronic kidney disease (HR, 1.15; 95% CI, 1.07-1.24), all-cause mortality (HR, 1.11; 95% CI, 1.04-1.18), and cardiovascular mortality (HR, 1.16; 95% CI, 1.06-1.26). POAF was also associated with a numerically higher risk of ischemic stroke and major bleed, but these findings were not statistically significant after adjustment. Conclusions: These data provide further insight into the long-term clinical outcomes associated with POAF in patients undergoing cardiac surgery.

Acute pancreatitis (AP) is a sudden-onset inflammatory disease of the pancreas. The severity of AP is classified into mild, moderate, and severe categories based on the presence and persistence of organ failure. Severe acute pancreatitis (SAP) can be associated with significant morbidity and mortality. It requires early recognition for appropriate timely management. Prognostic scores for predicting SAP incorporating many clinical, laboratory, and radiological parameters have been developed in the past. However, all of these prognostic scores have low positive predictive value for SAP and some of these scores require >24 h for assessment. There is a need to develop biomarkers that can accurately identify patients at risk for SAP early in the course of the presentation. In this review, we aim to provide a summary of the most commonly utilized prognostic scores for AP and discuss future directions.

Background: As the group at high risk for sepsis is increasing with the aging of the population, physical activity (PA), which has beneficial effects on various diseases, needs to be considered as a personalized prevention strategy for sepsis without direct anti-sepsis drug. Purpose: To examine the association between the amount of PA (based on intensity, duration, and frequency) and the incidence rates of sepsis and mortality after sepsis. Methods: This was a large-scale, retrospective, longitudinal cohort study using data from the Korean National Health Insurance Service and the biennial general health screening program. The amount of PA self-reported at the time of the health screening was categorized as non-PA, mild (

الملخص: أهداف البحث: هدفت هذه الدراسة إلى تحليل تأثير 23 حالة مرضية مصاحبة على وفيات متلازمة الضائقة التنفسية الحادة المرتبطة بكوفيد، حصريا لدى الأشخاص الذين لديهم تاريخ من مرض السكري. طريقة البحث: تم استخدام دراسة رصدية وتحليلية ومقطعية للتحقيق في البيانات من 6723 خدمة صحية في البرازيل، تضم 5433 شخصا يعانون من مرض السكري. تم استخدام نماذج الانحدار اللوجستي المعدلة للعوامل الديموغرافية مثل العمر والجنس والعرق لتحليل العلاقة بين وفيات متلازمة الضائقة التنفسية الحادة المرتبطة بكوفيد والأمراض المصاحبة. النتائج: الأشخاص الذين لديهم اثنين، وثلاثة، وأربعة، وخمسة من الأمراض المصاحبة المتزامنة لديهم فرصة أكبر للوفاة. لقد حددنا أن مرضى السكري الذين يعانون من أمراض استقلابية مصاحبة، أو اضطرابات عصبية، أو كانوا مدخنين لديهم خطر وفاة أعلى متوقع بناء على متلازمة الضائقة التنفسية الحادة المرتبطة بكوفيد. الاستنتاجات: يلعب عدد الأمراض المصاحبة دورا حاسما في وفيات متلازمة الضائقة التنفسية الحادة المرتبطة بكوفيد لدى مرضى السكري، وخاصة أولئك الذين يعانون من التدخين والأمراض العصبية في وقت واحد. Abstract: Objectives: This study analyzed the influence of 23 comorbidities on COVID-associated acute distress respiratory syndrome (CARDS) mortality in people with a history of diabetes mellitus. Methods: An observational, analytical, cross sectional study was utilized to investigate data from 6723 health services in Brazil, comprising 5433 people with diabetes. Adjusted logistic regression models for demographic factors such as age, sex, and race were used to analyze the association between CARDS mortality and comorbidities. Results: Persons with two (p

Teratogenic and embryotoxic effect of diclofenac sodium (DS) on different developmental stages of the chick-embryos was investigated by examining different parameters such as its mortality rate, hatching, morphological measurements, weighing its internal organs and calculation of different indices. Experiment was divided into four trials with different dose (0.1 mL, 0.2 mL, 0.3 mL in groups A, B, and C, respectively and group D received 0.3 mL saline solution (0.9% NaCl) and group E remained un-injected) administration and observation. Results of first and second trial showed statistically (p0.05) when compared with the control groups. In trial 4, forelimb, hindlimb length, heart weight, CSI and HSI were statistically (p0.05). The mortality rate was increased with increase dose of DS and also affected the hatching. DS effect on chick embryos can be applied to humans because the early development of mammals and birds are closely related. So, it was concluded that DS should be used with caution during pregnancy especially during first trimester of pregnancy.

Liver injury in patients with COVID-19 infection may directly result from viral infection of liver cells, immune-mediated inflammation such as cytokine storm, and hypoxia resulting from pneumonia. Additionally, liver injury may occur due to drug toxicity and may lead to liver failure in critically ill COVID-19 patients. Given the significance of the liver and its vulnerability in COVID-19 patients, this study aimed to investigate the correlation of serum liver enzymes with the prognosis of hospitalized COVID-19 patients at Imam Khomeini Hospital in Urmia. This descriptive-analytical study involved hospitalized COVID-19 patients at Imam Khomeini Hospital in Urmia. Patient data were extracted from medical records and recorded in checklists, including demographic characteristics (age and gender), serum levels of Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST), and patient outcomes (recovery and mortality). Subsequently, the serum levels of AST and ALT in recovered and discharged patients were compared with those of deceased patients. The mean AST level was higher in deceased patients compared to recovered and discharged patients, and this difference was statistically significant (P

Introduction: Pulmonary embolism (PE) is a significant global cause of mortality, ranking third after myocardial infarction and stroke. ECG findings may play a valuable role in the prognostication of patients with PE, with various ECG abnormalities proving to be reasonable predictors of haemodynamic decompensation, cardiogenic shock, and even mortality. This study aims to assess the value of electrocardiography in predicting inpatient mortality in patients with acute pulmonary embolism, as diagnosed with computed tomography pulmonary angiogram. Method: This study was a cross sectional analysis based at Tygerberg Hospital, Cape Town, South Africa. Eligible patients were identified from all CT-PA performed between 1 January 2017 and 31 December 2019 (2 years). The ECGs were independently screened by two blinded emergency physicians for predetermined signs that are associated with right heart strain and higher pulmonary artery pressures, and these findings were analysed to in-hospital mortality. Results: Of the included 81 patients, 61 (75 %) were female. Of the 41 (51 %) patients with submassive PE and 8 (10 %) with massive PE, 7 (17 %) and 3 (38 %) suffered inpatient mortality (p = 0.023) respectively. Univariate ECG analysis revealed that complete right bundle branch block (OR, 8.6; 95 % CI, 1.1 to 69.9; p = 0.044) and right axis deviation (OR, 5.6; 95 % CI, 1.4 to 22.4; p = 0.015) were significant predictors of inpatient mortality. Conclusion: Early identification of patients with pulmonary embolism at higher risk of clinical deterioration and in-patient mortality remains a challenge. Even though no clinical finding or prediction tool in isolation can reliably predict outcomes in patients with pulmonary embolism, this study demonstrated two ECG findings at presentation that were associated with a higher likelihood of inpatient mortality. This single-centre observational study with a small sample precludes concrete conclusions and a large follow-up multi-centre study is advised.

Background: Septic shock is the progression of sepsis, defined as cardiovascular dysfunction during systemic infection, and it has a mortality rate of 40 %–80 %. Loss of vascular tone is an important pathophysiological feature of septic shock. Diastolic blood pressure (DBP) was reported to be associated with vascular tone. This study aimed to identify the associations of several hemodynamic indices, especially DBP, with outcome in pediatric septic shock to allow for timely interventions. Methods: Children with persistent catecholamine-resistant shock had a pulse index continuous cardiac output (PiCCO®) system implanted for invasive hemodynamic monitoring and were enrolled in the current study. Serial cardiac index, systemic vascular resistance index (SVRI), systolic blood pressure (SBP), mean arterial pressure (MAP), and DBP were recorded during the first 24 h following PiCCO® initiation. All hemodynamic parameters associated with 28-day mortality were further analyzed using receiver operating characteristic curve analysis. Results: Thirty-three children with persistent catecholamine-resistant shock were enrolled. The median age was 12 years and the youngest children were 5 years old. Univariate analysis noted that SVRI, SBP, MAP, and DBP were significantly higher, and shock index was significant lower, in survivors compared with non-survivors (p 0.75, indicating a good prediction for mortality. Conclusions: DBP correlated well with SVRI and it can serve as a predictor for mortality in pediatric septic shock. Furthermore, DBP was a superior discriminator of mortality when compared with SBP and MAP. A lower DBP was an independent hemodynamic factor associated with 28-day mortality.

Resumen: Introducción: La tasa de transferencia de moléculas pequeñas (PSTR) a través de la membrana peritoneal ha sido relacionada con un aumento en el riesgo de mortalidad en algunos estudios. Se ha observado en la literatura que aquellos pacientes con rápida difusión de solutos a través de la membrana peritoneal (transferencia alta/rápida) y probablemente aquellos con transferencia promedio alto caracterizado en la prueba de equilibrio peritoneal (PET) se asocian a una mayor mortalidad comparado con aquellos pacientes quienes tienen transferencia lenta. Sin embargo, algunos autores no han documentado este hecho. En el presente estudio queremos evaluar la relación (etiológica) entre las características de transferencia de la membrana peritoneal y mortalidad y supervivencia de la técnica en una población incidente en diálisis peritoneal en RTS Colombia durante los años 2007 a 2017 utilizando un modelo de riesgos competitivos. Materiales y métodos: Se realizó un estudio de cohortes retrospectivo en RTS Colombia en el periodo comprendido entre los años 2007 y 2017. En total fueron 8.170 pacientes incidentes mayores de 18 años, quienes tenían una prueba de equilibrio peritoneal (PET) entre los 28 y 180 días de inicio de terapia. Se evaluaron variables demográficas, clínicas y de laboratorio. Se analizó la relación (etiológica) entre el tipo de transferencia de la membrana peritoneal al inicio de la terapia y mortalidad global y la supervivencia de la técnica utilizando un modelo de riesgos competitivos (modelo de riesgo proporcional causa específico descrito por Royston-Lambert). Resultados: Los pacientes se clasificaron en cuatro categorías según el resultado de la PET: transferencia lento/bajo (16,0%), promedio bajo (35,4%), promedio alto (32,9%) y transferencia alto/rápido (15.7%). Durante el seguimiento, mediana de 730 días, fallecieron 3.025 (37,02%) pacientes, 1.079 (13,2%) fueron transferidos a hemodiálisis (HD) y 661 (8,1%) fueron trasplantados. En el análisis de riesgos competitivos, ajustado por edad, sexo, presencia de DM, HTA, IMC, función residual al inicio de la terapia, albúmina, hemoglobina, fósforo y terapia de inicio encontramos que el HR causa específico (HRce) para transferencia alto/rápido fue de 1,13 (IC 95% 0,98-1,30) p = 0,078, promedio alto 1,08 (IC 95% 0,96-1,22) p = 0,195, promedio bajo 1,09 (IC 95% 0,96-1,22) p = 0,156 comparados con el tipo de transferencia bajo. Para la supervivencia de la técnica, el HR causa-específico para transferencia alto/rápido de 1,22 (IC 95% 0,98-1,52) p = 0,66, promedio alto el HR fue de 1,10 (IC 95% 0,91-1,33) p = 0,296, promedio bajo HR de 1,03 (IC 95% 0,85-1,24) p = 0,733 comparados con el tipo de transferencia bajo/lento, ajustado por edad, sexo, DM, HTA, IMC, función renal residual, albúmina, fósforo, hemoglobina y terapia de inicio. Diferencias no significativas. Conclusiones: Al evaluar la relación etiológica entre el tipo de transferencia de membrana peritoneal y mortalidad global y supervivencia de la técnica utilizando un modelo de riesgos competitivos, no encontramos relación etiológica entre las características de transferencia de la membrana peritoneal de acuerdo con la clasificación dada por Twardowski evaluada al inicio de la terapia de diálisis peritoneal y la mortalidad global o en la supervivencia de la técnica en los modelos ajustados. Se hará posteriormente el análisis desde el modelo pronostico con el propósito de predecir el riesgo de mortalidad y sobrevida de la técnica utilizando el modelo de subdistribución de riesgos (Fine & Gray). Abstract: Introduction: In some studies, the peritoneal solute transfer rate (PSTR) through the peritoneal membrane has been related to an increased risk of mortality. It has been observed in the literature that those patients with rapid diffusion of solutes through the peritoneal membrane (high/fast transfer) and probably those with high average transfer characterized by the peritoneal equilibrium test (PET) are associated with higher mortality compared to those patients who have a slow transfer rate. However, some authors have not documented this fact. In the present study, we want to evaluate the (etiological) relationship between the characteristics of peritoneal membrane transfer and mortality and survival of the technique in an incident population on peritoneal dialysis in RTS Colombia during the years 2007 to 2017 using a competing risk model. Materials and methods: A retrospective cohort study was carried out at RTS Colombia in the period between 2007 and 2017. In total, there were 8170 incident patients older than 18 years, who had a PET between 28 and 180 days from the start of therapy. Demographic, clinical, and laboratory variables were evaluated. The (etiological) relationship between the type of peritoneal solute transfer rate at the start of therapy and overall mortality and technique survival were analyzed using a competing risk model (cause-specific proportional hazard model described by Royston-Lambert). Results: Patients were classified into four categories based on the PET result: slow/low transfer (16.0%), low average (35.4%), high average (32.9%), and high/fast transfer (15.7%). During follow-up, with a median of 730 days, 3025 (37.02%) patients died, 1079 (13.2%) were transferred to hemodialysis and 661 (8.1%) were transplanted. In the analysis of competing risks, adjusted for age, sex, presence of DM, HTA, body mass index, residual function, albumin, hemoglobin, phosphorus, and modality of PD at the start of therapy, we found cause-specific HR (HRce) for high/fast transfer was 1.13 (95% CI 0.98–1.30) P = .078, high average 1.08 (95% CI 0.96–1.22) P = .195, low average 1.09 (95% CI 0.96–1.22) P = .156 compared to the low/slow transfer rate. For technique survival, cause-specific HR for high/rapid transfer of 1.22 (95% CI 0.98–1.52) P = .66, high average HR was 1.10 (95% CI 0.91–1.33) P = .296, low average HR of 1.03 (95% CI 0.85–1.24) P = .733 compared with the low/slow transfer rate, adjusted for age, sex, DM, HTA, BMI, residual renal function, albumin, phosphorus, hemoglobin, and PD modality at start of therapy. Non-significant differences. Conclusions: When evaluating the etiological relationship between the type of peritoneal solute transfer rate and overall mortality and survival of the technique using a competing risk model, we found no etiological relationship between the characteristics of peritoneal membrane transfer according to the classification given by Twardowski assessed at the start of peritoneal dialysis therapy and overall mortality or technique survival in adjusted models. The analysis will then be made from the prognostic model with the purpose of predicting the risk of mortality and survival of the technique using the risk subdistribution model (Fine & Gray).

Background: Few population-based studies have evaluated the epidemiology of infective endocarditis (IE). Changes in population demographics and guidelines on IE may have affected both the incidence and outcomes of IE. Therefore, the aim of our study is to provide contemporary population-based epidemiological data of IE in Spain. Methods: Retrospective nationwide observational study using data from the Spanish National Health System Discharge Database. We included all patients hospitalized with IE from January 2000 to December 2019. Results: A total of 64,550 IE episodes were included. The incidence of IE rose from 5.25 cases/100,000 person-year in 2000 to 7.21 in 2019, with a 2% annual percentage change (95% CI 1.3–2.6). IE incidence was higher among those aged 85 or older (43.5 cases/100.000 person-years). Trends across the study period varied with sex and age.Patients with IE were progressively older (63.9 years in 2000–2004 to 70.0 in 2015–2019, p

Background: Acinetobacter baumannii, a common carbapenem-resistant gram-negative bacillus, usually causes nosocomial infections. Colistin has been used for carbapenem-resistant A. baumannii (CRAB) infections; however, only a few studies have evaluated colistin as a treatment option compared to appropriate controls. We investigated the effectiveness of colistin monotherapy in treating CRAB pneumonia compared to those treated without an active drug. Methods: Adult patients (≥ 18 years) with CRAB isolated from respiratory specimens were screened from September 2017 to August 2022. Only patients with pneumonia treated with colistin monotherapy (colistin group) were included and compared to those without any active antibiotics (no active antibiotics [NAA] group). The primary and secondary outcomes were 30-day all-cause mortality and acute kidney injury within 30 days. The inverse probability of the treatment-weighted Cox proportional hazard model was used to compare mortality between groups. Results: Among the 826 adult patients with CRAB in their respiratory specimens, 45 and 123 patients were included in the colistin and NAA groups, respectively. Most of the CRAB pneumonia (91.1%) cases were hospital-acquired pneumonia. The 30-day all-cause mortality rates in the colistin and NAA groups were 58.3% and 56.1%, respectively, and no difference was observed after adjustments (adjusted hazard ratio, 0.74; 95% CI, 0.47–1.17). The incidence of acute kidney injury was higher in the colistin group (65.3%) compared to the NAA group (39.0%) (P = 0.143). Conclusions: Colistin monotherapy did not significantly improve treatment outcomes for CRAB pneumonia. The development and evaluation of new antimicrobials for CRAB pneumonia should be advocated in clinical practice.

Background: The presence of frailty or delirium among patients hospitalized for acute decompensated heart failure (ADHF) is associated with increased mortality and prolonged hospital stay. Objectives: The purpose of this study was to assess the combined effect of frailty and delirium on in-hospital mortality and disposition at discharge among older adults hospitalized with ADHF. Methods: We conducted a retrospective observational study using Nationwide Inpatient Sample data from the Agency for Healthcare Research and Quality from 2016 to 2018. Patients aged 65 years or older with a diagnosis of ADHF (both with preserved and reduced left ventricular ejection fraction) were included. For analysis, we conducted a multivariable logistic regression analysis to determine OR for in-hospital mortality or nonhome discharge from delirium and frailty. Results: A total of 3,577,433 weighted number of hospitalizations with ADHF were included. Delirium, moderate frailty risk, and high frailty risk increased the OR for in-hospital mortality (3.74; 95% CI: 3.70-3.78, 4.02; 95% CI: 3.96-4.09, and 8.63; 95% CI: 8.47-8.78, respectively) and nonhome discharge (4.21; 95% CI: 4.18-4.25, 2.95; 95% CI: 2.94-2.97, and 8.86; 95% CI: 8.78-8.94, respectively). When the combination of delirium and frailty was assessed, compared to those without delirium and with low frailty risk, the OR of mortality among those with delirium and high frailty risk was the highest at 12.18 (95% CI: 11.89-12.48). For nonhome discharge, the OR was the highest among those with delirium and high frailty risk at 14.01 (95% CI: 13.77-14.26). Conclusions: Frailty and delirium, independently and in combination, led to higher odds of in-hospital mortality and nonhome disposition at discharge among patients hospitalized with ADHF.

Background: Iron metabolism disorders significantly increase the risk of diabetes and its related complications by inducing oxidative stress, inflammation, insulin resistance, and disturbances in glucose and lipid metabolism. However, whether dietary iron intake can influence progression of diabetes remains unclear. The present study aims to investigate the relationship between total iron, heme iron, and non-heme iron intake and diabetes, CVD, and all-cause mortality among men and women with diabetes in the U.S. population. Methods: A total of 4416 adults with diabetes(2415 men and 2001 women) from the NHANES 2003–2014 were enrolled. Dietary information was collected by 24-h dietary recall during two nonconsecutive days. Dietary total iron intake was measured based on the dietary survey. Dietary heme iron intake was calculated based on its proportion in dietary total iron intake from each food. non-heme iron is the difference between total iron and heme iron. Diabetes, CVD, and all-cause mortality status were identified as main outcomes. Cox models and RCS analysis were performed to estimate the hazard ratios and 95%CIs. Results: For men, the participants with a higher dietary heme iron intake were associated with higher risks of CVD (HRheme iron = 1.61,95%CI:1.03–2.51) and all-cause mortality (HRheme iron = 1.42,95%CI:1.10–1.83). For women, participants in the highest quartile of dietary total/heme/non-heme iron intake had a higher diabetes mortality risk ((HRtotal iron = 2.33,95%CI:1.24–4.38; HRheme iron = 1.87,95%CI:1.00–3.49; HRnon-heme iron = 2.28,95%CI:1.19–4.39), compared to those in the lowest quartile. Additionally, the dose–response curve for the relationship between dietary non-heme iron intake and CVD mortality followed a reverse J-shape in women with diabetes. Conclusions: Higher dietary heme iron intake was associated with an increased CVD mortality risk in both men and women with diabetes. Additionally, higher dietary total, heme, and non-heme iron intake was linked to an increased risk of diabetes mortality among women with diabetes. Therefore, women with diabetes should pay more attention on the overconsumption of any type of dietary iron.

This study aimed to examine acute effects of exposure to ambient air pollution on COVID-19 hospital admissions and mortality in the Netherlands. We hypothesized that exposure to increased air pollution in the preceding week might trigger an exacerbation of health of infected individuals.Associations between daily concentrations of particulate matter with an aerodynamic diameter ≤2.5 µm (PM2.5) and ≤10 µm (PM10), nitrogen dioxide (NO2), ozone (O3) and risk of hospital admissions and mortality due to COVID-19 from February to December 2020 was analyzed across all 352 Dutch municipalities grouped into 12 provinces. Time-series models were used to fit province-specific estimates, followed by meta-analyses to produce national estimates. Analyses were based on daily averages of PM2.5, PM10, NO2, and maximum 8-hour running average of O3 on a 1×1 km grid and averaged on municipality level by population weight. Models were adjusted for spatiotemporal confounders, including government policies in response to the number of COVID-19 infections. Since there were only few COVID-19 cases during the summertime when O3 levels were highest, associations between O3 and COVID-19 health outcomes were not further explored.We found associations between exposure to air pollution in the preceding week (average of lag 0-7 days) and COVID-19 hospital admissions and mortality. On a national level, an interquartile range increase in PM2.5, PM10 and NO2 exposure was associated with 11-12% increased mortality risk; the risk for hospital admissions was higher: 19-25%. Observed associations were more robust for PM than NO2 in two-pollutant models.Our results suggest that short-term exposure to PM2.5 and PM10 may increase the risk of COVID-19 mortality and hospital admission. This indicates that, consistent with previous studies on air pollution and respiratory infections, the population at risk of being hospitalized or dying of COVID-19 is extra vulnerable to the adverse effects of short-term air pollution exposure.

Purpose: The C-reactive protein (CRP) velocity (CRPv) is an indicator of the change in CRP over time. In individuals with sepsis, the second values of CRP and CRPv have been shown to have more importance than the first CRP value measured at admission. This study examined the importance of CRPv for mortality among individuals who were hospitalized in the intensive care unit (ICU). Methods: The study was conducted between January 2021 and December 2022. CRPv was calculated according to the change in the second CRP value compared to the first. Results: The median age of the patients was 79 years (interquartile range (IQR), 69–85 years), and 53.2 % were male. The in-hospital mortality rate was 45.5 %. The presence of diabetes increased the odds of mortality by 2.17 times (confidence interval (CI): 1.06–4.4, p=0.032). Each increase in CRPv by 1 mg/dl/hour increased the odds of mortality by 1.07 times (CI: 1.01–1.14, p=0.015), while each one-point increase in the Sequential Organ Failure Assessment (SOFA) score increased the odds of mortality by 1.21 times (CI: 1.07–1.35, p=0.002). The SOFA score had the highest area under the curve (AUC) value for in-hospital mortality (AUC = 0.699 p=7, its sensitivity in predicting mortality was 46.7 %, and its specificity was 85.1 %. The AUC value of CRPv in predicting mortality was 0.629 (p=0.006). When CRPv was >0.75, its sensitivity in predicting mortality was 68.2 %, and its specificity was 57 %. Conclusion: CRPv performed well in predicting mortality and had satisfactory discriminative ability. Additionally, diabetes, SOFA score, and CRPv elevation were significant risk factors for mortality.

Summary: Background: In chronic obstructive pulmonary disease (COPD), vascular alterations have been shown to contribute to hypoxia and pulmonary hypertension, but the independent contribution of small vessel abnormalities to mortality remains unclear. Methods: We quantified artery and vein dimensions on computed tomography (CT) down to 0.2 mm. Small vessel volumes (

Objective: The prognostic implication of phosphorus level in patients with coronary artery disease (CAD) remains controversial. We aimed to conduct a meta-analysis to evaluate the prognostic role of blood phosphorus level in CAD patients. Methods: We searched the PubMed, Web of Science, Scopus, and Embase databases until December 28, 2023, to identify prospective or retrospective longitudinal observational studies that examined the prognostic value of blood phosphorus level in CAD patients. Outcome measures included all-cause or cardiovascular mortality, heart failure, stroke, and major adverse cardiac events (MACEs). The prognostic value of blood phosphorus level was expressed by pooling the fully adjusted hazard ratios (HR) with 95 % confidence intervals (CI) for the hypophosphatemia or hyperphosphatemia compared to the reference normal phosphorus level. Results: Six studies involving 19,553 CAD patients were included. Meta-analysis showed that the hyperphosphatemia was significantly associated with higher risk of all-cause mortality (HR 1.39; 95 % CI 1.20–1.61), cardiovascular mortality (HR 1.37; 95 % CI 1.22–1.53), heart failure (HR 1.64; 95 % CI 1.44–1.87), and MACEs (HR 1.39; 95 % CI 1.03–1.88) but not stroke (HR 1.23; 95 % CI 0.79–1.92). However, non-significant association was found between hypophosphatemia and all-cause mortality (HR 1.21; 95 % CI 0.98–1.51), cardiovascular mortality (HR 1.07; 95 % CI 0.78–1.45), heart failure (HR 0.87; 95 % CI 0.72–1.05), stroke (HR 1.12; 95 % CI 0.76–1.67), and MACEs (HR 1.16; 95 % CI 0.99–1.36). Conclusions: Hyperphosphatemia, but not hypophosphatemia independently predicts all-cause mortality, cardiovascular mortality, heart failure, and MACEs in CAD patients.

Objective: To evaluate the independent, mediating, interactive, and associated effects of C-reactive protein (CRP) and Life's Essential 8 (LE8) on all-cause and cardiovascular mortality. Methods: Utilizing data from 10,043 participants in the NHANES 2005–2010, we employed Cox proportional hazards regression models and causal mediation analysis to investigate the joint and interactive effects of Life's Essential 8 (LE8) and C-reactive protein (CRP) on mortality risk. Results: During an average follow-up of 137.10 months, there were 1591 all-cause deaths and 485 cardiovascular deaths. Weighted linear regression showed that for patients with low cardiovascular health (CVH), the adjusted β was −0.22 (95 % CI: −0.27 to −0.17) for moderate cardiovascular health (CVH) and -0.36 (95 % CI: −0.43 to −0.30) for high cardiovascular health (CVH). Mediation analysis revealed that C-reactive protein (CRP) mediated 10.43 % of all-cause mortality and 9.20 % of cardiovascular mortality for moderate cardiovascular health (CVH) compared to low cardiovascular health (CVH), and 9.95 % and 8.32 % respectively for high cardiovascular health (CVH) compared to low cardiovascular health (CVH). No significant multiplicative or additive interactions between Life's Essential 8 (LE8) and C-reactive protein (CRP) were found in all-cause mortality or cardiovascular mortality. Individuals with high cardiovascular health (CVH) and the first quartile of C-reactive protein (CRP) had HRs of 0.30 (95 % CI 0.18–0.48) for all-cause mortality and 0.31 (95 % CI 0.13–0.74) for cardiovascular mortality compared to those with low cardiovascular health (CVH) and the fourth quartile of C-reactive protein (CRP). Conclusion: These findings suggest that CRP could significantly influence the relationship between cardiovascular health (CVH) and mortality. Interventions that target both lifestyle factors and CRP levels may improve cardiovascular health and potentially lower mortality risks.

Objectives: Persistent and significant swallowing impairment can occur in individuals with dementia. Determining prognosis and establishing realistic goals of care in this population is complex and comfort feeding may be recommended. This study aimed to establish evidence relating to patient outcomes following recommendation of comfort feeding to aid informed decision making. Design: A multi-centre, retrospective audit was conducted for a two-year period to establish the survival and readmission rates for hospitalised people with dementia, following recommendation of a comfort feeding plan. Setting: The study was conducted at three acute care hospitals in Adelaide, South Australia. Participants: A total of 163 participants were included, 90 male and 73 female, with a median age of 88 years. Measurements: Mortality within 30 and 90 days of admission and readmission rates within 30 days of discharge were calculated. Results: Forty-two percent of participants died during the admission during which a comfort feeding plan was recommended. Overall median survival time and one month survival was 13 days and 25%, respectively. Readmission rates were low (7.4% of those discharged). Comfort feeding recommendations aligned with dysphagia severity and those for whom Nil By Mouth (NBM) or ice chips only were recommended were at highest risk of dying in hospital, those recommended thickened fluids +/− ice chips were most likely to be alive 30 days after their original admission date. Conclusion: Dementia and comfort feeding were associated with high mortality rates, high rates of discharge to a supportive care facility and low readmission rates. Dysphagia severity associated with the consistency of fluids recommended.

The current understanding of the RSV-related mortality age distribution in low- and lower-middle-income countries (LMICs) relies on a limited number of disease incidence studies reporting wide age bands, and lacking specificity to Gavi-eligible countries. Understanding the age distribution of RSV-related deaths is crucial for the implementation of RSV interventions in LMICs that rely on support from Gavi. This study aims to provide the age profile of RSV mortality specifically in Gavi-eligible countries.Utilizing data from the RSV GOLD project, an ongoing global online mortality registry focusing on children under the age of 5 with laboratory-confirmed RSV infection, we employed two models (Complete Data Model and Prospective Data Model) to estimate the age profiles. To mitigate biases related to age group representation, we applied post-stratification weighting in our analysis.We included 423 pediatric deaths, including 145 from the community, under 2 years of age from 15 Gavi-eligible countries. Both models identified a peak age at 1 month and found that the majority of RSV-related mortality cases (59–77 %) from Gavi-eligible countries occur before 6 months of life. However, the models exhibited disparities in other age-related metrics. We present fitted age-at-time-of-death probability distributions to aid impact and cost-effectiveness studies.We expect that implementing infant RSV immunization strategies, such as maternal vaccination or infant immunoprophylaxis, will have high impact on RSV-related mortality in Gavi-eligible countries. The divergent results from the two models underscore the importance of carefully considering potential biases in retrospective and surveillance data when interpreting the age profile of RSV mortality cases in future research.

Objective: The aim was to predict the effectiveness of using frailty, defined by the frailty index (FI), for predicting recurrent pneumonia and death in patients 50 years and older with vascular cognitive impairment (VCI) during long-term hospitalization. Measurements: This retrospective cohort study was conducted at a teaching hospital in western China and included VCI patients aged ≥50 years undergoing long-term hospitalization. The relevant data were collected from the electronic medical record system. The FI was based on 31 parameters and groups were defined using a cutoff value (0.2) as robust (FI

Background: The COVID-19 pandemic has caused 14.83 million deaths globally. This systematic review and meta-analysis aimed to provide a pooled estimate of the overall mortality and morbidity of critically ill COVID-19 patients. Method: Four electronic databases, Medline/PubMed, the Cochrane Library, the WHO COVID-19 database, and the Web of Science, were used to identify relevant studies. Two authors independently screened the studies, evaluated the eligibility criteria and resolved discrepancies through discussion with the third author. The pooled effect size was computed using STATA software version 14. The Cochran Q test and I2 test were utilized to assess heterogeneity across the studies. Additionally, subgroup analysis, sensitivity analysis, and publication bias were evaluated. It is registered in Prospero with Prospero ID CRD42020212146. Results: A total of 1003 published articles were screened from various databases, and 24 studies involving a total of 142,291 critically ill COVID-19 participants were selected for inclusion in the review. Among the participants, 67 % were male, and the mean age was 63.43 + SD3.33 years. The mortality rate reported in the individual studies ranged from 4.5 % to 69.5 %. The findings from the analysis revealed that the overall pooled mortality rate was 34 % (95 % confidence interval: 31 %−37 %). Additionally, the findings showed that 62 % of critically ill COVID-19 patients required mechanical ventilation, while 68.7 % of these patients had chronic disease comorbidities. Conclusion: Critically ill COVID-19 patients face a high-risk risk of death, with an estimate of about one in three patients dying from the virus. Notably, a substantial portion of critically ill COVID-19 patients (62 %) require mechanical ventilation; surprisingly, more than two-thirds of patients with COVID-19 have chronic disease comorbidities, highlighting the importance of managing comorbidities in this population.

Summary: Background: Monitoring hepatitis B virus (HBV) and hepatitis C virus (HCV) liver-related morbidity and mortality is key to evaluate progress towards elimination targets. Methods: HBV and HCV notifications in NSW, Australia (1995–2022) were linked to hospital and mortality records. Temporal trends in decompensated cirrhosis (DC), hepatocellular carcinoma (HCC), and mortality were evaluated among people notified for HBV and HCV. Segmented Poisson regression models were used to assess the impact of the viral hepatitis elimination era (1 January 2015–31 December 2022) on advanced liver disease and mortality. Findings: During 1995–2022, there were 64,865 people with an HBV notification and 112,277 people with an HCV notification in NSW. Between 2002 and 2022, there were significant reductions in age-adjusted HBV- and HCV-related DC, HCC, and liver-related mortality. Among those with HBV, age-standardised incidence per 1000 person-years (py) in 2002, 2015, and 2022 was 3.08, 1.47, and 1.16 for DC (p

Introduction: Cervical cancer is a significant public health problem worldwide. The development of cervical neoplasms is associated with persistent infection by oncogenic subtypes of the HPV virus, which are responsible for around 70% of cervical cancers.A study carried out in Brazil between 2002 and 2021 recorded 133,429 deaths from cervical cancer.. Methodology: An observational, retrospective, cross-sectional, quantitative study was carried out using data collected by the Cancer Registry Service of the Haroldo Juaçaba Hospital/Ceará Cancer Institute (HHJ/ICC) over 22 years. Results: The sample consisted of 9096 women. The mean age was 51.4 ± 15.5, ranging from 15 to 100, with a median age of 60 years. Median overall survival was 59.77. The most frequent histological type was squamous cell carcinoma, with 8023 (88.2 %) cases. Around 25 % of patients (n = 2270) entered the service with stage 4A. The most common treatment was radiotherapy combined with chemotherapy (n = 3270, 35.9 %), followed by surgical removal (n = 1909, 21.0 %).In multivariate analysis, age (p = 0.019), race (p = 0.016), low level of education (p

Objective: Literature presents conflicting results on the pros and cons of pledget-reinforced sutures during surgical aortic valve replacement (SAVR). We aimed to investigate the effect of pledget-reinforced sutures versus sutures without pledgets during SAVR on different outcomes in a systematic review and meta-analysis. Methods: A literature search was performed in five different medical literature databases. Studies must include patients undergoing SAVR and must compare any pledget-reinforced with any suturing technique without pledgets. The primary outcome was paravalvular leakage (PVL), and secondary outcomes comprised thromboembolism, endocarditis, mortality, mean pressure gradient (MPG) and effective orifice area (EOA). Results were pooled using a random-effects model as risk ratios (RRs) or mean differences (MDs) for which the no pledgets group served as reference. Results: Nine observational studies met the inclusion criteria. The risk of bias was critical in seven studies, and high and moderate in two other. The pooled RR for moderate or greater PVL was 0.59 (95 % confidence interval [CI] 0.13, 2.73). The pooled RR for mortality at 30-days was 1.02 (95 % CI 0.48, 2.18) and during follow-up was 1.15 (95 % CI 0.67, 2.00). For MPG and EOA at 1-year follow-up, the pooled MDs were 0.60 mmHg (95 % CI −4.92, 6.11) and −0.03 cm2 (95 % CI −0.18, 0.12), respectively. Conclusions: Literature on the use of pledget-reinforced sutures during SAVR is at high risk of bias. Pooled results are inconclusive regarding superiority of either pledget-reinforced sutures or sutures without pledgets. Hence, there is no evidence to support or oppose the use of pledget-reinforced sutures.

Background: Infectious diseases remain a major global health concern, including in China, with an estimated >10 million cases of infectious disease in 2019. We describe the burden of site-specific infectious diseases among Chinese adults. Methods: From 2004 to 2008, the prospective China Kadoorie Biobank enrolled 512,726 adults aged 30-79 years from 10 diverse areas (5 rural, 5 urban) of China. During the 12 years of follow-up, 101,673 participants were hospitalized for any infectious disease. Descriptive analyses examined standardized incidence, mortality and case fatality of infections. Findings: The incidence of any infectious disease was 1856 per 100,000 person-years; respiratory tract infections (1069) were most common. The infectious disease mortality rate was 31.8 per 100,000 person-years (20.3 and 9.4 for respiratory and non-respiratory infections, respectively) and case fatality was 2.2% (2.6% and 1.6% for respiratory and non-respiratory infections, respectively). Infectious disease incidence and mortality rates were higher at older ages and in rural areas. There were no clear sex differences in infectious disease incidence rates, but mortality and case fatality rates were twice as high in men as in women. Interpretation: Infectious diseases were common in Chinese adults. The observed burden of, and disparities in, site-specific infections can inform targeted prevention efforts. Funding: Kadoorie Foundation, Wellcome Trust, MRC, BHF, CR-UK, MoST, NNSF.

Background: A one-time gait speed measurement predicts mortality risk. A framework for updating a clinician’s mortality risk perception with new information from each clinic visit is needed. We used joint modeling of longitudinal and survival data for dynamic prediction of mortality risk. Methods: We fit sex-stratified joint models to 20-meter (bi)annual longitudinal gait speed measured every 6 months and 14-year survival data from the Health, Aging and Body Composition Study allowing for non-linear fluctuations of gait speed and controlling for important covariates such as age, recent hospitalization, blood pressure, obesity, and comorbidities. Results: Participants (N = 3048) were 74 years old with gait speed 1.18 m/s. They were 42% Black, and 52% died over 14 years. Higher gait speed of 0.1 m/s was associated with 23% (95% confidence interval or CI = 20–25%) and 25% (CI = 21–28%) reductions in mortality risk in men and women; and a 0.05 m/s annualized slowing (slope) with 31% (CI = 13–51%) increase in men (all p < 0.05), with findings persisting after covariate adjustment. Distant gait speed history over a year prior contributed little for mortality risk prediction with mean change of only 1–2% in 5-year risk. Conclusion: The two most recent gait speeds appear sufficient to consider for mortality risk in the present initial analysis. More frequent gait speeds need to be considered in mortality risk prediction before definitive conclusions supporting real-world application.

Objectives: The red blood cell distribution width (RDW) and neutrophil to lymphocyte ratio (NLR) have been linked to poor prognosis in patients with ischaemic stroke. However, no study has yet evaluated the prognostic role of RDW and NLR, or their combined effect on reperfusion in patients with endovascularly-treated acute ischaemic stroke. This study therefore aimed to analyse the impact of RDW and NLR on poor functional outcomes and failed reperfusion following endovascular treatment in patients with acute anterior circulation ischaemic stroke. Methods: A total of 275 patients with acute anterior circulation ischaemic stroke treated endovascularly between 2015 and 2018 were enrolled in this study. The relationships between RDW, NLR, and poor outcomes were analysed using univariate and multivariate logistic regression models and receiver operating characteristic (ROC) curve analysis. The Youden Index was applied to determine the cut-off value. Results: Multivariate logistic regression analysis identified RDW (p = 0.015) and NLR (p = 0.015) as independent predictors of mortality at the 3rd month. ROC curve analysis of RDW revealed a cutoff value of 14.25 (p = 0.009) for poor clinical outcomes (modified Rankin scale [mRS] 3–6). Similarly, a cutoff value of 14.25 was found for mortality prediction (p = 0.003). The cutoff value for poor clinical outcome (mRS 3–6) in the NLR was determined as 5.93 (p = 0.003), whereas the cutoff value for mortality was set at 5.17 (p = 0.028). RDW also predicted failed reperfusion, with a cutoff value of 17.75 (p = 0.048). Conclusions: High RDW and NLR upon admission were identified as independent indicators of mortality in endovascularly treated acute anterior circulation ischemic stroke patients. Furthermore, the RDW could potentially predict failed reperfusion.