Przeglądanie według Temat "mortality"

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Dynamika regionalnych nierówności w zdrowiu w Polsce
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2014) Łyszczarz, Błażej
Problematyka nierówności w stanie zdrowia stanowi jeden z najważniejszych obszarów badań i działań w obszarze współczesnej polityki zdrowotnej. Istotność problematyki nierówności w zdrowiu znajduje odzwierciedlenie w strategicznych dokumentach dotyczących polityki zdrowotnej, zarówno tych o charakterze krajowym, jak i międzynarodowym. Zgodnie ze stosowanym tu ujęciem prezentowanym przez Światową Organizację Zdrowia nierówności zdrowotne „odzwierciedlają niepotrzebne i możliwe do uniknięcia różnice w stanie zdrowia, które uważane są za niesprawiedliwe”. W opracowaniu podjęto próbę uchwycenia dynamiki regionalnych nierówności w zdrowiu w Polsce. Nierówności w zdrowiu zidentyfikowano na podstawie zróżnicowania standaryzowanych wskaźników umieralności w powiatach w podziale na wiek oraz płeć. Zastosowano dane dotyczące dwóch okresów: lat 1999–2001 oraz lat 2008–2010. Dynamikę nierówności w zdrowiu zidentyfikowano przy wykorzystaniu analizy sigma konwergencji oraz cech rozkładu badanej zmiennej. Wyniki badania wskazują, że nierówności w zdrowiu w Polsce, rozpatrywane z punktu widzenia różnic regionalnych, pogłębiły się między dwoma badanymi okresami. Sytuacja ta dotyczyła 5 z 6 analizowanych wskaźników umieralności. Tylko w przypadku kobiet w wieku 65 lat i więcej nie zaobserwowano pogłębiania się terytorialnych różnic w stanie zdrowia. Wyniki dają fragmentaryczny obraz nierówności zdrowotnych w Polsce. W badaniu skoncentrowano się tylko na pomiarze tych nierówności w ujęciu terytorialnym, nie przeanalizowano natomiast wpływu czynników społeczno-ekonomicznych na kształtowanie zróżnicowania w stanie zdrowia.
Effect of the prognostic nutritional index and systemic immuneinflammatory index in predicting short-term mortality in geriatric patients with SARS-CoV-2 infection
(Publishing Office of the University of Rzeszow, 2022-12) Özkan, Abuzer; İslam, Mehmet Muzaffer; Akça, Hatice Şeyma; Eroğlu, Serkan Emre; Gökhan, Aksel
Introduction and aim. We aimed to investigate whether systemic immune inflammatory index (SII) and prognostic nutritional index (PNI) were associated with short-term mortality in geriatric patients with SARS-CoV-2. Material and methods. Our study was designed retrospectively. The data of patients that presented to a single center. The primary outcome of the study was the diagnostic value of SII and PNI in predicting 28-day mortality in geriatric patients with SARS-CoV-2 pneumonia. Results. 272 geriatric patients with SARS-CoV-2 included. The median PNI was 42.5, and the median SII was 687.6 (430–1404.2). In univariant analysis, PNI and SII has a significant relationship with mortality (p<0.001 and p=0.008, Mann-Whitney U test). PNI had an area under the curve (AUC) value of 0.680, which was significantly higher than that of SII (AUC: 0.6). The odds ratio of PNI (>40.1) and SII (<1.267) for 30-day mortality were determined as 1.12 , and 1. Conclusion. In conclusion, the blood tests used to calculate PNI and SII are routinely included in complete blood count and biochemistry tests that can be performed in every hospital. According to the results of the current study, the mortality group had significantly higher SII values and significantly lower.
Hemodialysis dose and long-term COVID-19 outcomes – a retrospective cohort study
(Publishing Office of the University of Rzeszow, 2024-03) Stepanova, Natalia; Rysyev, Andriy; Snisar, Lyudmyla
Introduction and aim. Long-term outcomes of COVID-19 pose a global challenge, particularly impacting individuals with un derlying health conditions, including those who have undergone hemodialysis (HD). The study aimed to investigate the rela tionship between preexisting dialysis dose, measured by single pool Kt/V (spKt/V), and long-term outcomes of COVID-19 in patients undergoing HD. Material and methods. Demographic, clinical, and laboratory parameters following COVID-19 recovery, and long-term out comes, including the presence of COVID-19 sequelae, hospitalization, and all-cause mortality during a year after COVID-19 were retrospectively analyzed. Results. Out of the 195 patients included, there were 108 males (55.4%) and 87 females (44.6%), with a median age of 56 (44-63) years and a dialysis duration of 49 (31.3–85.2) months. Patients with spKt/V<1.4 had a significantly increased risk of long-term COVID-19 sequelae (HR 9.1, 95% CI: 3.4; 24.6), hospitalization (HR 7.6, 95% CI: 3.9; 14.6), and all-cause mortality (HR 8.5, 95% CI: 2.9; 25.8) within one year after COVID-19 recovery compared with those with spKt/V≥1.4. spKt/V cutoff point of ≤1.3 emerged as a significant risk factor for one-year hospitalization and mortality within our cohort. Conclusion. Suboptimal dialysis dose, as indicated by spKt/V < 1.4, is associated with adverse long-term COVID-19 outcomes in patients undergoing HD. Optimizing dialysis adequacy may mitigate these risks. Further research is needed to validate these f indings and explore interventions to improve outcomes in this vulnerable population.
Nonthyroidal illness syndrome as independent predictor of hospital mortality in the elderly hospitalized patients with COVID-19 pneumonia – single-center observation
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Młodożeniec, Aleksandra; Orłowska-Florek, Renata; Czarnożycka-Wróbel, Adrianna; Gargasz, Krzysztof; Gala-Błądzińska, Agnieszka
Introduction and aim. Elderly patients with COVID-19 are at increased risk for adverse outcomes. This study aims to evaluate the prevalence of nonthyroidal illness syndrome (NTIS) in hospitalized patients with COVID-19 pneumonia, its independent impact on patients’ survival. Furthermore, to investigate selected inflammatory biomarkers in those patients and to determine whether they predict mortality associated with the disease. Material and methods. In this single-centered, retrospective study, the medical records of 53 patients with confirmed SARSCoV- 2 infection who attended the provincial hospital between October 2020 and January 2021 were reviewed. Demographic data, laboratory values, comorbidities, treatments, and clinical outcomes were collected. We compared the data in survivor and non-survivor groups. Results. Of 393 adult patients with SARS-CoV-2 pneumonia, 53 (13,49%) met the inclusion criteria and were included. The median age was 72±12.2 years, 26 patients (49%) were men. The NTIS prevalence was 62.3% and showed a strong independent correlation with disease severity and mortality in COVID-19 patients (p=0.01). The interleukin-6, white blood cells, ferritin and neutrophil ratios also differed significantly statistically between survivors and non-survivors. Conclusion. NTIS and the lowering level of FT3 pose an independent prognostic marker of clinical deterioration and higher mortality in elderly patients with COVID-19.
Pelvic Exenteration: An Updated Mini-Review from 1948 to 2020
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2019) Unal, Ethem; Yıldız, Abdullah; Yuksekdag, Sema; Fırat, Aysun
Introduction. Pelvic exenteration (PE) is a curative or palliative radical surgical procedure applied for advanced or recurrent pelvic or perineal cancers. From 1948 to date, improvements in surgical techniques, including urinary conduits and pelvic reconstruction, have improved its morbidity and mortality. Aim. The present study reviews the evolution of PE, indications, complications and current results. Material and methods. Large case series and studies on PE were searched in PubMed, covering all years available, and recent applications of PE were reviewed. Results. Indications of PE are primary or locally advanced tumors (cervix. rectum. vulva. bladder), recurrence after radiotherapy (cervix), recurrence after primary resection (vulva, vagina, cervix, rectum) and palliative treatment for advanced tumors or pubic fistulas. Contraindication are distant metastases, involvement of iliac vessels, pelvic side-wall or para-aortic lymph nodes and invasion of sacrum proximal to S1/S2 or sciatic foramen. However, recent studies have reported more radical resections, including side-wall and vessels. Patient’s health condition and fitness are also important in decision-making. Conclusion. PE can be the last chance of cure or improving quality of life for advanced or locally recurrent pelvic cancers. 5-year survival rates with PE are better, but complications of such a radical surgery are still high, and should be improved.
Predictive value of blood urea nitrogen to serum albumin ratio in estimating in-hospital mortality in patients with upper gastrointestinal bleeding
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Kurt, Erdem; Kurt, Sebnem Zeynep Eke
Introduction and aim. The aim of this study was to examine the usability of blood urea nitrogen to serum albumin ratio (BAR) as a prognostic predictor of in-hospital mortality in patients with gastrointestinal (GI) bleeding. Material and methods. The electronic medical records of the patients who applied to the emergency department due to upper GI bleeding during the study period were reviewed. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate each discriminant cut-off value to estimate mortality. Results. The study included 225 patients. The median (IQR) age of the patients was 75.0 (68.0–84.0) and 94 (41.8%) were female. AUC was determined as 0.784±0.055 (95% CI, 0.677–0.892) for BAR (p<0.001) in terms of in-hospital mortality. The cut-off value of BAR for this outcome was calculated as 16.26. In this cut-off value, sensitivity was 71.43%, specificity 82.84%, positive predictive value (PPV) 30.00% and negative predictive value (NPV) 96.57%. Conclusion. BAR is a useful tool that can be used to predict the in-hospital mortality of patients with GI bleeding. Patients with GI bleeding with a BAR above 16.26 will require more aggressive and timely intervention.
The role of the hematological inflammatory index and systemic immuno-inflammation index in acute cholecystitis
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2022-12) Özdemir, Serdar; Altunok, İbrahim; Abuzer, Özkan; İslam, Mehmet Muzaffer; Algın, Abdullah; Eroğlu, Serkan Emre; Aksel, Gökhan
Introduction and aim. Acute cholecystitis is one of the most common hepatobiliary emergencies. We aimed to investigate the role of the initial hematological inflammatory index and systemic immuno-inflammation index in predicting short-term mortality in patients with acute cholecystitis. Material and methods. This study with a retrospective observational design was conducted at the emergency department of a tertiary teaching hospital. Patients admitted to our clinic between June 15, 2021, and March 15, 2022, according to the Tokyo criteria were included in the sample. The hematological inflammatory index and systemic immuno-inflammation index were calculated using the hematological test results of the patients evaluated at the emergency department. Survivor and non-survivor groups were formed according to all-cause 30-day mortality. The differences between survivor and non-survivor groups were investigated. Results. A total of 194 patients were included in the final analysis. The median age of the study population was 59 (25th–75th percentiles: 46.75–72) years. The rate of all cause-short-term mortality was 7.7. There were significant differences between the survivor and non-survivor groups in terms of the neutrophil count and the systemic immuno-inflammation index (p=0.007, 0.034, respectively; Mann-Whitney U test). No significant difference was found in the remaining laboratory parameters (lymphocyte count, platelet count, and hematological inflammatory index) (p=0.220, 0.489, 0.367 respectively; Mann-Whitney U test). Conclusion. The systemic immuno-inflammation index was determined to be significantly higher in the non-survivor group than in the survivor group among the patients with acute cholecystitis. However, there was no significant difference between these two groups in relation to the hematological inflammatory index.