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14. The acute impact of baseline renal function and contrast medium volume/estimated glomerular filtration rate ratio on reduced renal function following endovascular abdominal aortic aneurysm repair.

Author

Beasley, Matthew, Broce, Mike, and Mousa, Albeir

Abstract

Objective: The aim of this study was to determine the acute impact of baseline serum creatinine, estimated glomerular filtration rate (eGFR), and contrast medium volume (CMV) on the incidence of reduced renal function (RRF) after endovascular abdominal aortic aneurysm repair (EVAR). We aimed to determine if the CMV/eGFR ratio was a predictor of RRF. Methods: This study is a retrospective review of EVAR patients in the Society for Vascular Surgery/Vascular Quality Initiative (SVS/VQI) from January 2015 to August 2020. Reduced renal function was defined as > 0.3 mg/dl (26.5 μmol/L), 50% increase from baseline, and temporary or permanent dialysis. Receiver operator characteristic (ROC) curve analyses were conducted for serum creatinine, eGFR, contrast volume, fluid volume, and CMV/eGFR ratio. Two data sets (training and test) were developed followed by multivariate analyses. Results: SVS/VQI data for EVAR contained 38,701 records, of which 30,539 were divided into training (n = 18,283; 60%) and test (n = 12,256; 40%) data sets. RRF rate for the training set was 3.6% (n = 667) and 3.4% (n = 420) for the test data. RRF patients included more females (29.4 vs 19.0%, p < 0.001), were older in age (75.6 + 8.4 vs 73.3 + 8.7 years), had more congestive heart failure (22.3 vs 12.2%, p < 0.001), and more COPD (42.0 vs 34.2%, p < 0.001). An ROC analysis revealed that eGRF, creatinine, contrast, intravenous fluid, and contrast medium volume (CMV)/eGFR ratio were all significantly (p < 0.05) correlated with RRF. The eGFR and CMV/eGFR ratio had the largest area under the curve, (0.26) and (0.65), respectively, while fluid had the lowest (0.54). Negative predictive values were 93.7 (CMV/eGFR), 93.9 (creatinine), 94.2 (eGFR), 92.8 (contrast), and 92.6 (intravenous fluid). Multivariate analysis of the training data set resulted in the CMV/eGFR ratio as an independent predictor of RRF (odds ratio, OR: 1.9 with 95% CI: 1.6, 2.2, p < 0.015). For the test data, the CMV/eGFR ratio was an independent predictor of RRF (OR: 1.8, CI: 1.4 to 2.2, p < 0.001) as well as several other variables. Conclusion: RRF after EVAR is a dreaded and potentially devastating complication. Baseline serum creatinine, eGFR, contrast medium volume, and the ratio (CMV/eGFR) were all significantly associated with RRF. The optimal cut-off value for the CMV/eGFR ratio, ≤ 2, provides an easy-to-use equation to provide a suggested contrast target based on initial renal function with caution applied for high-risk patients. [ABSTRACT FROM AUTHOR]

Published
2023
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25. Hydroxychloroquine in hospitalized COVID‐19 patients: Real world experience assessing mortality

Author

Annie, Frank H., Sirbu, Cristian, Frazier, Keely R., Broce, Mike, and Lucas, B. Daniel

Subjects
Male, hydroxychloroquine, Databases, Factual, coronavirus, SARS‐CoV‐2, Cohort Studies, COVID‐19, Original Research Articles, Humans, Original Research Article, Mortality, Aged, Retrospective Studies, azithromycin, Clinical Trials as Topic, antimalarial, Drug Repositioning, COVID-19, macrolide, Off-Label Use, Middle Aged, COVID-19 Drug Treatment, Hospitalization, Treatment Outcome, Female, severe acute respiratory syndrome coronavirus 2
Abstract

Hydroxychloroquine (HCQ) for coronavirus disease 2019 (COVID-19) is presently being used off-label or within a clinical trial.We investigated a multinational database of patients with COVID-19 with real-world data containing outcomes and their relationship to HCQ use. The primary outcome was all-cause mortality within 30 days of follow-up.This was a retrospective cohort study of patients receiving HCQ within 48 hours of hospital admission. Medications, preexisting conditions, clinical measures on admission, and outcomes were recorded.Among patients with a diagnosis of COVID-19 in our propensity-matched cohort, the mean ages ± SD were 62.3 ± 15.9 years (53.7% male) and 61.9 ± 16.0 years (53.0% male) in the HCQ and no-HCQ groups, respectively. There was no difference in overall 30-day mortality between the HCQ and no-HCQ groups (HCQ 13.1%, n=367; no HCQ 13.6%, n=367; odds ratio 0.95, 95% confidence interval 0.62-1.46) after propensity matching. Although statistically insignificant, the HCQ-azithromycin (AZ) group had an overall mortality rate of 14.6% (n=199) compared with propensity-matched no-HCQ-AZ cohort's rate of 12.1% (n=199, OR 1.24, 95% CI 0.70-2.22). Importantly, however, there was no trend in this cohort's overall mortality/arrhythmogenesis outcome (HCQ-AZ 17.1%, no HCQ-no AZ 17.1%; OR 1.0, 95% CI 0.6-1.7).We report from a large retrospective multinational database analysis of COVID-19 outcomes with HCQ and overall mortality in hospitalized patients. There was no statistically significant increase in mortality and mortality-arrhythmia with HCQ or HCQ-AZ.

Published
2020

32. Contributors

Author

Abou-Zamzam Jr., Ahmed M., Abularrage, Christopher J., AbuRahma, Ali F., AbuRahma, Zachary, Acher, Charles W., Acosta, Stefan, Adelman, Mark A., Akar, Ahmet Rüçhan, Aldailami, Hasan, Alimi Sr., Yves S., Arbabi, Cassra N., Arko III, Frank R., Armstrong, David G., Arnaoutakis, K. Dean J., Arora, Subodh, Arthurs, Zachary M., Ascher, Enrico, Avgerinos, Efthymios D., Azarbal, Amir F., Aziz, Faisal, Azizzadeh, Ali, Baba, Takeshi, Back, Martin, Baig, M. Shadman, Bailey, Charles J., Bailey, Christopher R., Ballast, Jocelyn K., Barnes, Geoffrey D., Bates, Mark C., Baumeister, Ruediger G.H., Beaulieu, Robert J., Bechara, Carlos F., Beck, Adam W., Belkin, Michael, Ben-Haim, Simona, Benjamin, Elizabeth R., Benjamin, Marshall E., Bernas, Michael J., Bismuth, Jean, Biteman, Benjamin R., Bivalacqua, Trinity J., Bjarnason, Haraldur, Björck, Martin, Black III, James H., Blankensteijn, Jan D., Blas, Joseph-Vincent V., Bose, Saideep, Bower, Thomas C., Bowling, Frank L., Brahmandam, Anand, Brewster, Luke, Brinster, Clayton J., Broce, Mike, Brody, Fredrick, Brooke, Benjamin S., Brown, Kellie R., Bush, Ruth L., Calligaro, Keith D., Campbell, John E., Carpenter, Jeffrey P., Carsten III, Christopher G., Cayne, Neal S., Chaer, Rabih A., Chang, Kevin Z., Chaturvedi, Shruti, Chauhan, Yusuf, Cheng, Charlie, Chinnadurai, Ponraj, Chou, Elizabeth, Clair, Daniel G., Clark, Ross M., Clouse, W. Darrin, Coleman, Dawn M., Colling, Meaghan E., Comerota, Anthony J., Conrad, Mark F., Conte, Michael S., Corriere, Matthew A., Dakour-Aridi, Hanaa, Dalman, Ronald L., Dalsing, Michael C., Dardik, Alan, Darling, R. Clement, III, Davies, Mark G., Davila, Victor J., Dawson, David L., Deery, Sarah E., Demetriades, Demetrios, P.M. de Vries, Jean-Paul, Diab, Kaled, Dillavou, Ellen D., DiMuzio, Paul, Dosluoglu, Hasan H., Dossabhoy, Shernaz S., Dougherty, Matthew J., Dryjski, Maciej L., Duncan, Audra A., Eagleton, Matthew J., Earnshaw, Jonothan J., Eberhardt, Robert T., Edwards, Jeffrey B., Edwards, Matthew S., Ehlert, Bryan A., Eidt, John F., Eldrup-Jorgensen, Jens, Eliason, Jonathan L., Elsayed, Nadin, Eskandari, Mark K., Eslami, Mohammad H., Farber, Alik, Farooqui, Emaad, Figueroa, C. Alberto, Fishman, Steven J., Flohr, Tanya R., Forbes, Thomas L., Fox, Charles, Freischlag, Julie A., Gandhi, Sagar S., Geary, Randolph L., Ghaffarian, Amir, Giuliano, Katherine, Glaudemans, Andor W.J.M., Gloviczki, Peter, Go, Michael R., Gober, Leah M., Goldman, Matthew P., Goodney, Philip P., Gowda, Mamatha, Grunebach, Holly, Guzman, Raul J., Hallett, John W., Hamdan, Allen D., Hansen, Kimberley J., Harris, Linda M., Hartung, Olivier, Haut, Elliott R., Hemingway, Jake F., Henke, Peter K., Hicks, Caitlin W., Hinchliffe, Robert J., Hingorani, Anil P., Ho, Karen J., Hohmann, Stephen E., Holscher, Courtenay M., Howell, Caronae, Hu, Yiyuan David, Humphries, Misty D., Hunter, Glenn C., Hurie, Justin, Iafrati, Mark D., Illig, Karl A., Inaba, Kenji, İnan, Mustafa Bahadır, Israel, Ora, Jacobowitz, Glenn R., Jaffer, Iqbal H., Jain, Krishna M., Jayaraj, Arjun, Johanning, Jason M., Johnson, Brad, Jordan Jr., William D., Kabbani, Loay S., Kabnick, Lowell S., Kalish, Jeffrey, Kalra, Manju, Kanthi, Yogendra, Kashyap, Vikram S., Kauffman, Paulo, Kauvar, David S., Kayssi, Ahmed, Kernodle, Amber B., Khan, Sikandar Z., Kiguchi, Misaki, Killeen, Amanda L., Kim, Gloria Y., Kim, Paul J., Kim, Tanner I., Kirkwood, Melissa L., Kleiss, Simone F., Knepper, Jordan, Kraiss, Larry W., Kwong, Jonathan M., Lajoie, Lidie, Lal, Brajesh K., Lala, Salim, LaMuraglia, Glenn M., Landry, Gregory J., Langford, John T., Laredo, James, Lawrence, Peter F., Lawson, Jeffrey H., Lavery, Lawrence A., Lee, Byung-Boong, Lee, Jason T., Lee, Young, Lely, Rutger J., Leong, Beatriz V., Levy, Elad l., Lewis, Anthony J., Li, Jing, Lillehei, Craig W., Lilly, Michael P., Lindsay, Thomas F., Lipsett, Pamela A., Lipsitz, Evan C., Litchfield, Terry F., Litt, Harold, Liu, James L., Liu, Zhao-Jun, Lohr, Joann M., Lugo, Joanelle, Lum, Ying Wei, Lurie, Fedor, Lynch, Thomas G., Ma, Kirsten F., Macsata, Robyn, Magee, Gregory A., Makaroun, Michel S., Malas, Mahmoud B., Maldonado, Thomas S., Malekpour, Fatemeh, Maleti, Oscar, Malka, Kimberly T., Mansour, M. Ashraf, Mansukhani, Neel A., Markovic, Jovan N., Marks, Natalie A., McCabe, Dominick J.H., McCarthy, Cullen K., McKinsey, James F., McLafferty, Robert B., McMurray, Robert C., McQuinn, Christopher W., Menard, Matthew T., Mendes, Bernardo C., Mills Sr., Joseph L., Milner, Ross, Modrall, J. Gregory, Mohebali, Jahan, Mokin, Maxim, Moneta, Gregory L., Money, Samuel R., Montross, Brittany C., Moore, Wesley S., Morasch, Mark, Morcos, Ramez, Mousa, Albeir Y., Muck, Patrick E., Myers, Daniel J., Myers, Stuart I., Nagarsheth, Khanjan H., Naoum, Joseph J., Naylor, A. Ross, Neville, Richard F., Nguyen, Bao-Ngoc, Nguyen, Louis L., Niklason, Laura E., Obi, Andrea, Ohki, Takao, Orion, Kristine C., Orlino, Jon P., Passman, Marc A., Patel, Rhusheet, Pearce, Benjamin J., Perler, Bruce A., Perry, Robert J.T., Pires, Paulo W., Plotkin, Anastasia, Powell, Richard J., Pruitt, Eric Yates, Puggioni, Alessandra, Quiñones-Baldrich, William J., Quiroga, Elina, Quiroz, Hallie, Raffetto, Joseph D., Raju, Seshadri, Recht, Matthew H., Reed, Amy B., Reilly, Brendon P., Reitz, Katherine M., Repella, Tana L., Rialon, Kristy L., Ricco, Jean-Baptiste, Rigberg, David A., Rios, Anthony L., Ritenour, Amber E., Robins, J. Eli, Rockman, Caron B., Rockson, Stanley G., Roddy, Sean P., Rogers, Lee C., Rohrer, Michael J., Rosenfeld, Ethan S., Ross, John R., Rossi, Peter J., Rowe, Vincent L., Roy, Rishi A., Russell, Todd E., Rzucidlo, Eva M., Sadek, Mikel, Salata, Konrad, Sam II, Albert D., Sarac, Timur P., Sarıcaoğlu, Mehmet Cahit, Satiani, Bhagwan, Schanzer, Andres, Schermerhorn, Marc L., Schlieder, Ian, Schneider, Joseph, Schneider, Peter A., Schwartz, Samuel, Scully, Rebecca E., Sen, Indrani, Shah, Samir K., Shames, Murray L., Shanmugam, Victoria K., Sharafuddin, Mel J., Sharma, Gaurav, Shepard, Alexander D., Shestopalov, Alexander, Shin, Laura, Shortell, Cynthia K., Sidawy, Anton N., Simons, Jessica P., Singh, Michael J., Singh, Niten, Siracuse, Jeffrey J., Slart, Riemer H.J.A., Smeds, Matthew R., Smith, Danielle C., Snow, Rachael, Soden, Peter A., Sorber, Rebecca A., Srivastava, Sunita D., Stanley, James C., Starnes, Benjamin W., Starr, Jean E., Stern, Jordan R., Sternbergh III, W. Charles, Stone, Patrick A., Stoner, Michael C., Sutzko, Danielle C., Tarpara, Anand, Taylor, Spence M., Thaveau, Fabien, Thompson, Jonathan R., Timaran, Carlos H., Tingen, Joseph S., Treffalls, John A., Troutman, Douglas A., Tsai, Lillian L., Tzeng, Edith, Ulloa, Jesus G., Upchurch Jr., Gilbert R., Valentine, R. James, Velazquez, Omaida C., Vo, Victoria, Vowels, Travis, Wakefield, Thomas W., Waqas, Muhammad, Wasan, Suman M., Wasse, Haimanot (Monnie), Weaver, Fred A., Weiss, Clifford R., Weitz, Jeffrey I., Westin, Gregory G., Williams, Carlin A., Williams, Timothy K., Williamson, Ashley J., Witte, Marlys H., Woelfel, Stephanie L., Wolosker, Nelson, Woo, Karen, Wynn, Martha, Yammine, Halim, Yan, Qi, Yeh, Chin-Chin C., Yoo, Taehwan, Yuo, Theodore H., Zarkowsky, Devin S., Zettervall, Sara L., and Zhou, Wei

Published
2023
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50. Serum creatinine stabilization following renal artery stenting

Author

Bates, Mark C., Campbell, John E., Broce, Mike, Lavigne, Philip S., and Riley, Mary A.

Subjects
Renal artery -- Physiological aspects, Stent (Surgery) -- Patient outcomes, Stent (Surgery) -- Physiological aspects, Stent (Surgery) -- Research, Angioplasty -- Patient outcomes, Angioplasty -- Physiological aspects, Angioplasty -- Research, Blood -- Analysis and chemistry, Blood -- Usage, Health
Published
2008

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