15 results on '"Yue-qiang Fu"'
Search Results
2. Risk factors for mortality in pseudomonas aeruginosa bacteremia in children
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Jian Chen, Haixin Huang, Chengjun Liu, and Yue-qiang Fu
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bacteremia ,children ,mortality ,Pseudomonas aeruginosa ,Pediatrics ,RJ1-570 - Abstract
Background: The incidence of Pseudomonas aeruginosa (P. aeruginosa) bacteremia in children ranks third to fourth among gram-negative bacilli bacteremia, which is one of the main conditional pathogens in hospitals. This study aimed to identify the clinical characteristics and risk factors of 60-day in-hospital mortality in children with P. aeruginosa bacteremia. Methods: This retrospective study was conducted in a tertiary pediatric hospital between January 2015 and December 2021 including children with P. aeruginosa bacteremia. Kaplan–Meier survival analysis was used to investigate the time-to-event outcomes. Logistic regression was used to explore the independent risk factors for 60-day mortality. Results: Overall, 75 patients with P. aeruginosa bacteremia episodes were identified. Immunosuppression (52%) was the most common underlying condition, followed by neutropenia (50.7%) and hematological malignancies (48%). Among 75 patients with P. aeruginosa bacteremia, 25 (33.3%) had septic shock, 30 (40%) had respiratory failure, and 20 (26.7%) had liver function impairment. The 60-day in-hospital mortality was 17.3%. In multivariate analysis, independent risk factors for 60-day mortality were respiratory failure [odds ratio (OR) 39.329; 95% CI:3.212–481.48, P = 0.004) and liver function impairment (OR 17.925; 95% CI:2.909–139.178, P = 0.002). Conclusion: Respiratory failure and liver function impairment seem to be related to poor prognosis in children with P. aeruginosa bacteremia.
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- 2024
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3. Comparing outcomes between culture-positive and culture-negative septic shock in a PICU: A retrospective cohort study
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Haixin Huang, Jian Chen, Hongxing Dang, Chengjun Liu, and Yue-qiang Fu
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septic shock ,children ,culture negative ,culture positive ,mortality ,Pediatrics ,RJ1-570 - Abstract
BackgroundWe assessed the outcomes and characteristics of culture-negative septic shock (CNSS) and culture-positive septic shock (CPSS) in pediatric intensive care unit (PICU).MethodsWe performed a retrospective study on the data of children admitted to the PICU due to septic shock between January 2018 and December 2021. The primary outcome was in-hospital mortality. The secondary outcomes were the length of stay (LOS) of hospital, the need for mechanical ventilation (MV) and continue renal replacement therapy (CRRT).ResultsOverall, 238 patients were enrolled. 114 patients (47.9%) had positive cultures (60 blood samples, 41 sputum samples, 17 pus samples, and 19 others), 18 of whom were cultured positive at two sites, 1 at three sites, and 3 had two different types of bacteria at same site. The in-hospital mortality was 47.1%. There were no significant differences in the in-hospital mortality (47.6% vs. 46.5%, P = 0.866), PRISM-III score (10 vs. 12, P = 0.409), PIM-3 score (0.08 vs. 0.07, P = 0.845), pSOFA score (10 vs. 10, P = 0.677) or the need for MV (64.5% vs. 68.4%, P = 0.524) and CRRT (29.8% vs. 34.2%, P = 0.470) between the CNSS group and the CPSS group. The Procalcitonin (8.89 ng/ml vs. 28.39 ng/ml, P = 0.001) and C-reactive protein (28 mg/L vs. 58 mg/L, P = 0.001) levels were significantly lower in the CNSS group than in the CPSS group, while WBC count (9.03 × 109/L vs. 5.02 × 109/L, P = 0.002) and serum sodium (137 mmol/L vs. 132 mmol/L, P = 0.001) was significantly higher in CNSS. The LOS of hospital was significantly longer (16 days vs. 11 days, P = 0.011) in the CPSS group than in the CNSS group, while the LOS of PICU (5 days vs. 4 days, P = 0.094) stay was not significantly different.ConclusionCompared with children with CNSS, children with CPSS had higher PCT and CRP levels, but lower WBC count. Children with CPSS had longer LOS of hospital. However, positive or negative culture results were not associated with in-hospital mortality, the LOS of PICU, the need for MV or CRRT in children with septic shock.
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- 2022
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4. Relationship between admission coagulopathy and prognosis in children with traumatic brain injury: a retrospective study
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Cheng-yan You, Si-wei Lu, Yue-qiang Fu, and Feng Xu
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Children ,Activated partial thromboplastin time ,Fibrinogen ,Prognosis ,Traumatic brain injury ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background Coagulopathy in adult patients with traumatic brain injury (TBI) is strongly associated with unfavorable outcomes. However, few reports focus on pediatric TBI-associated coagulopathy. Methods We retrospectively identified children with Glasgow Coma Scale ≤ 13 in a tertiary pediatric hospital from April 2012 to December 2019 to evaluate the impact of admission coagulopathy on their prognosis. A classification and regression tree (CART) analysis using coagulation parameters was performed to stratify the death risk among patients. The importance of these parameters was examined by multivariate logistic regression analysis. Results A total of 281 children with moderate to severe TBI were enrolled. A receiver operating characteristic curve showed that activated partial thromboplastin time (APTT) and fibrinogen were effective predictors of in-hospital mortality. According to the CART analysis, APTT of 39.2 s was identified as the best discriminator, while 120 mg/dL fibrinogen was the second split in the subgroup of APTT ≤ 39.2 s. Patients were stratified into three groups, in which mortality was as follows: 4.5 % (APTT ≤ 39.2 s, fibrinogen > 120 mg/dL), 20.5 % (APTT ≤ 39.2 s and fibrinogen ≤ 120 mg/dL) and 60.8 % (APTT > 39.2 s). Furthermore, length-of-stay in the ICU and duration of mechanical ventilation were significantly prolonged in patients with deteriorated APTT or fibrinogen values. Multiple logistic regression analysis showed that APTT > 39.2 s and fibrinogen ≤ 120 mg/dL was independently associated with mortality in children with moderate to severe TBI. Conclusions We concluded that admission APTT > 39.2 s and fibrinogen ≤ 120 mg/dL were independently associated with mortality in children with moderate to severe TBI. Early identification and intervention of abnormal APTT and fibrinogen in pediatric TBI patients may be beneficial to their prognosis.
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- 2021
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5. Clinical Application Value of Pharmacokinetic Parameters of Vancomycin in Children Treated in the Pediatric Intensive Care Unit
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Bo Zhou, Wenyi Xiong, Ke Bai, Hongxing Dang, Jing Li, Feng Xu, Yue-qiang Fu, and Chengjun Liu
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nephrotoxicity ,children ,therapeutic drug monitoring ,pharmacokinetics/pharmacodynamics ,vancomycin ,Pediatrics ,RJ1-570 - Abstract
ObjectiveTo explore the efficacy and safety of vancomycin as measured by pharmacokinetic/pharmacodynamic parameters in children with severe infection in the Pediatric Intensive Care Unit (PICU) and to determine the appropriate threshold for avoiding nephrotoxicity.MethodsThe medical records of hospitalized children with severe infection treated with vancomycin in the PICU of a tertiary pediatric hospital from September 2018 to January 2021 were retrospectively collected. Univariate analysis was used to assess the correlation between vancomycin pharmacokinetic/pharmacodynamic parameters and therapeutic efficacy or vancomycin-related nephrotoxicity. Binary logistic regression was used to analyze the risk factors for vancomycin-related nephrotoxicity. The vancomycin area under the concentration-time curve over 24 h (AUC0–24) threshold was determined by receiver operating characteristic (ROC) curve analysis.ResultsOne hundred and 10 patients were included in this study. Seventy-six patients (69.1%) exhibited clinically effective response, while the rest exhibited clinically ineffective response. There were no significant differences in APACHE II score, steady-state trough concentration, peak concentration or AUC0–24 of vancomycin between the effective and ineffective groups. Among the 110 patients, vancomycin-related nephrotoxicity occurred in 15 patients (13.6%). Multivariate analysis showed that vancomycin treatment duration, trough concentration, and AUC0–24 were risk factors for vancomycin-related nephrotoxicity. The ROC curve indicated that AUC0–24 < 537.18 mg.h/L was a suitable cutoff point for predicting vancomycin-related nephrotoxicity.ConclusionNo significant correlations were found between the trough concentration or AUC0–24 of vancomycin and therapeutic efficacy when the daily dose of vancomycin was approximately 40 mg/kg d, while the trough concentration and AUC0–24 were both closely related to vancomycin-related nephrotoxicity. The combination of AUC0–24 and trough concentration for therapeutic drug monitoring may reduce the risk of nephrotoxicity.
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- 2022
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6. Effect of blood analysis and immune function on the prognosis of patients with COVID-19.
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Yue-Qiang Fu, Yue-Lin Sun, Si-Wei Lu, Yang Yang, Yi Wang, and Feng Xu
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Medicine ,Science - Abstract
IntroductionThis retrospective study investigated the implications of changes in blood parameters and cellular immune function in patients with Coronavirus Disease 2019 (COVID-19).MethodsRecords were reviewed of 85 patients admitted with COVID-19 between February 4 and 16, 2020. The primary outcome was in-hospital death.ResultsFourteen patients died. The baseline leukocyte count, neutrophil count and hemoglobin was significantly higher in non-survivors compared with survivors, while the reverse was true of lymphocyte count, platelet, PaO2/FiO2, CD3+ count and CD4+ count. The percentage of neutrophil count > 6.3×109/L in death group was significantly higher than that in survival group, and multivariate logistic regression showed neutrophil count > 6.3×109/L was independently associated with mortality. However, there were not significant difference in IgG, IgM, IgA, C3, C4 and the percentage of IgE > 100 IU/ml between the death group and survival group. Areas under the receiver operating characteristic curves of the following at baseline could significantly predict mortality: leukocyte, neutrophil, lymphocyte, CD3+ and CD4+ counts.ConclusionsFor hospitalized patients with COVID-19, lymphocyte, CD3+ and CD4+ counts that marked decrease suggest a poor outcome. Admission neutrophil count > 6.3 ×109/L is independently associated with mortality. At admission, leukocyte, neutrophil, lymphocyte, CD3+ and CD4+ counts should receive added attention.
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- 2020
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7. The impact of admission serum lactate on children with moderate to severe traumatic brain injury.
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Yue-Qiang Fu, Ke Bai, and Cheng-Jun Liu
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Medicine ,Science - Abstract
BackgroundLactate is used to evaluate the prognosis of adult patients with trauma. However, the prognostic significance of admission serum lactate in the setting of pediatric traumatic brain injury (TBI) is still unclear. We aim to investigate the impact of admission lactate on the outcome in children with moderate to severe TBI.MethodsThis retrospective study was conducted in a tertiary pediatric hospital between May 2012 and Jun 2018 included children with an admission Glasgow Coma Scale (GCS) of ≤13. Two hundred and thirteen patients were included in the analysis and 45 patients died in hospital.ResultsAdmission lactate and glucose were significantly higher in non-survivors than those in survivors (P < 0.05). Admission lactate was positively correlated with admission glucose and negatively correlated with GCS in all patients (n = 213), subgroup of isolated TBI (n = 112) and subgroup of GCS ≤ 8 (n = 133), respectively. AUCs of lactate could significantly predict the mortality and were higher than those of glucose in all patients, subgroup of isolated TBI and subgroup of GCS ≤ 8, respectively. Multivariate logistic regression showed that admission lactate (Adjusted OR = 1.189; 95% CI: 1.002-1.410; P = 0.047) was independently associated with mortality, while admission glucose (Adjusted OR = 1.077; 95% CI: 0.978-1.186; P = 0.133) wasn't an independent risk factor of death. Elevated admission lactate (> 2 mmol/L) was associated with death, reduced 14-day ventilation-free days, 14-day ICU-free days and 28-day hospital-free days.ConclusionsAdmission serum lactate can effectively predict the mortality of children with moderate to severe TBI. Elevated admission lactate is associated with death, reduced ventilator-free, ICU-free, and hospital-free days. Admission serum lactate could be used as a prognostic biomarker of mortality in children with moderate to severe TBI.
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- 2019
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8. Diagnosis and Management of 60 Children with Congenital Vascular Rings
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Guo-Qing Fang, Jing Li, Feng Xu, Yue-Qiang Fu, Ying-Fu Chen, Xiao-Juan Ji, He-Lin Zheng, and Si-Si Chen
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Medicine - Published
- 2015
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9. Comparing the clinical characteristics and outcomes of septic shock children with and without malignancies: a retrospective cohort study.
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Haixin Huang, Ruichen Zhang, Jian Chen, Hongxing Dang, Chengjun Liu, Siwei Lu, and Yue-qiang Fu
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SEPTIC shock ,MYCOSES ,BACTERIAL diseases ,CHILD mortality ,CHILDREN'S hospitals - Abstract
Objective: There is an amelioration in mortality rates of septic shock patients with malignancies over time, but it remains uncertain in children. Therefore, the authors endeavored to compare the clinical characteristics, treatment needs, and outcomes of septic shock children with or without malignancies. Methods: The authors retrospectively analyzed the data of children admitted to the PICU due to septic shock from January 2015 to December 2022 in a tertiary pediatric hospital. The main outcome was in-hospital mortality. Results: A total of 508 patients were enrolled. The proportion of Gram-negative bacteria and fungal infections in children with malignancies was significantly higher than those without malignancies. Septic shock children with malignancies had a longer length of stay (LOS) in the hospital (21 vs. 11 days, p<0.001). However, there were no statistically significant differences in the LOS of PICU (5 vs. 5 days, p = 0.591), in-hospital mortality (43.0 % vs. 49.4 %, p = 0.276), and 28-day mortality (49.2 % vs. 44.7 %, p = 0.452). The 28-day survival analysis (p = 0.314) also showed no significant differences. Conclusion: Although there are significant differences in the bacterial spectrum of infections, the septic shock children with or without malignancies showed a similar mortality rate. The septic shock children with malignancies had longer LOS of the hospital. [ABSTRACT FROM AUTHOR]
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- 2024
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10. Talaromyces Marneffei Infection in an HIV-Negative Child with a CARD9 Mutation in China: A Case Report and Review of the Literature
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Feng Xu, Si-wei Lu, Cheng-Jun Liu, Cheng-Yan You, Dan-Dan Pi, Yue-qiang Fu, and Fang Hu
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CARD9 mutation ,China ,medicine.medical_specialty ,Antifungal Agents ,Tuberculosis ,Veterinary (miscellaneous) ,HIV Infections ,Gene mutation ,HIV-negative ,medicine.disease_cause ,Applied Microbiology and Biotechnology ,Microbiology ,Medical microbiology ,Ascites ,Humans ,Medicine ,Child ,Genetic testing ,Mutation ,biology ,medicine.diagnostic_test ,business.industry ,Bone Marrow Smear ,Talaromyces marneffei ,medicine.disease ,CARD Signaling Adaptor Proteins ,Mycoses ,Talaromyces ,Immunology ,biology.protein ,Original Article ,medicine.symptom ,Antibody ,business ,Agronomy and Crop Science - Abstract
Background Talaromyces marneffei (T. marneffei) is a thermally dimorphic fungus causing systemic mycosis. Due to the atypical symptoms and diverse imaging findings, T. marneffei-infected patients may be misdiagnosed thus preventing timely antifungal therapy. Moreover, HIV-negative patients with T. marneffei infection may be congenitally immunocompromised because of the mutation of immune-related genes. Case presentation We describe a case of an HIV-negative child who developed disseminated T. marneffei infection in a nonendemic area. Chest CT showed similar imaging changes of miliary pulmonary tuberculosis, while there was no other evidence of tuberculosis infection, and empirical antituberculosis treatment was not effective. Lymphocyte subset analysis showed reduced natural killer cells, and the immunoglobulin profile showed low levels of IgM, C3 and C4. A bone marrow smear revealed T. marneffei infection, and ascites culture also proved T. marneffei infection. Despite antifungal treatment, the child died of multiple organ failure. Two gene mutations in caspase recruitment domain-containing protein 9 (CARD9) were detected, which had not been reported previously in T. marneffei-infected patients. Conclusions HIV-negative patients with CARD9 mutations may be potential hosts of T. marneffei. Abnormalities in the immunoglobin profile and lymphocyte subset may provide clues for immunocompromised patients, and further genetic testing is advised to identify gene mutations in HIV-negative patients with T. marneffei infection.
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- 2021
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11. Relationship between admission coagulopathy and prognosis in children with traumatic brain injury: a retrospective study
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Feng Xu, Cheng-Yan You, Yue-qiang Fu, and Si-wei Lu
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Male ,China ,medicine.medical_specialty ,Traumatic brain injury ,medicine.medical_treatment ,Critical Care and Intensive Care Medicine ,Logistic regression ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Brain Injuries, Traumatic ,medicine ,Coagulopathy ,Humans ,Hospital Mortality ,Children ,Blood Coagulation ,Original Research ,Retrospective Studies ,Mechanical ventilation ,Receiver operating characteristic ,medicine.diagnostic_test ,RC86-88.9 ,business.industry ,Glasgow Coma Scale ,Fibrinogen ,Infant ,Medical emergencies. Critical care. Intensive care. First aid ,030208 emergency & critical care medicine ,Retrospective cohort study ,Blood Coagulation Disorders ,Prognosis ,medicine.disease ,Hospitalization ,Survival Rate ,Activated partial thromboplastin time ,ROC Curve ,Child, Preschool ,Emergency Medicine ,Female ,Partial Thromboplastin Time ,business ,030217 neurology & neurosurgery ,circulatory and respiratory physiology ,Partial thromboplastin time - Abstract
Background Coagulopathy in adult patients with traumatic brain injury (TBI) is strongly associated with unfavorable outcomes. However, few reports focus on pediatric TBI-associated coagulopathy. Methods We retrospectively identified children with Glasgow Coma Scale ≤ 13 in a tertiary pediatric hospital from April 2012 to December 2019 to evaluate the impact of admission coagulopathy on their prognosis. A classification and regression tree (CART) analysis using coagulation parameters was performed to stratify the death risk among patients. The importance of these parameters was examined by multivariate logistic regression analysis. Results A total of 281 children with moderate to severe TBI were enrolled. A receiver operating characteristic curve showed that activated partial thromboplastin time (APTT) and fibrinogen were effective predictors of in-hospital mortality. According to the CART analysis, APTT of 39.2 s was identified as the best discriminator, while 120 mg/dL fibrinogen was the second split in the subgroup of APTT ≤ 39.2 s. Patients were stratified into three groups, in which mortality was as follows: 4.5 % (APTT ≤ 39.2 s, fibrinogen > 120 mg/dL), 20.5 % (APTT ≤ 39.2 s and fibrinogen ≤ 120 mg/dL) and 60.8 % (APTT > 39.2 s). Furthermore, length-of-stay in the ICU and duration of mechanical ventilation were significantly prolonged in patients with deteriorated APTT or fibrinogen values. Multiple logistic regression analysis showed that APTT > 39.2 s and fibrinogen ≤ 120 mg/dL was independently associated with mortality in children with moderate to severe TBI. Conclusions We concluded that admission APTT > 39.2 s and fibrinogen ≤ 120 mg/dL were independently associated with mortality in children with moderate to severe TBI. Early identification and intervention of abnormal APTT and fibrinogen in pediatric TBI patients may be beneficial to their prognosis.
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- 2021
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12. Characteristics of coagulation alteration in patients with COVID-19
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Hong chun Luo, Cheng yan You, Yue qiang Fu, and Si wei Lu
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Adult ,Male ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Fibrinogen ,Logistic regression ,Gastroenterology ,Fibrin ,D-Dimer ,Fibrin Fibrinogen Degradation Products ,03 medical and health sciences ,0302 clinical medicine ,Prothrombin time activity ,Internal medicine ,medicine ,Humans ,Hospital Mortality ,Blood Coagulation ,Aged ,Retrospective Studies ,Prothrombin time ,Aged, 80 and over ,medicine.diagnostic_test ,biology ,Receiver operating characteristic ,business.industry ,SARS-CoV-2 ,COVID-19 ,Retrospective cohort study ,Hematology ,General Medicine ,Middle Aged ,Death ,Oxygen ,Coagulation ,030220 oncology & carcinogenesis ,biology.protein ,Prothrombin Time ,Original Article ,Female ,business ,030215 immunology ,medicine.drug - Abstract
Abnormal blood coagulation often occurs in critically ill patients, which seriously affects their prognosis. This retrospective study investigated the implications of changes in blood coagulation in patients with coronavirus disease 2019 (COVID-19). Records were reviewed for patients admitted with COVID-19 between February 4 and 16, 2020. The primary outcome was in-hospital death. A total of 85 patients were included, of whom 12 died in the hospital. The admission prothrombin time (PT), international normalized ratio (INR), and levels of D-dimer and fibrin/fibrinogen degradation products (FDP) were significantly higher in non-survivors than in survivors, while the reverse was true for prothrombin time activity (PT-act) and PaO2/FiO2. Multivariate logistic regression showed that PT-act < 75% was independently associated with mortality. The area under the receiver operating characteristic curves for PT-act, D-dimer, and FDP at admission could significantly predict mortality. The AUCs for PT-act were larger than those for D-dimer and FDP; however, there was no significant difference. After 2 weeks of treatment, the coagulation parameters of the surviving patients improved. COVID-19 is often accompanied by abnormal coagulation. PT-act at admission is able to predict mortality in patients with COVID-19 as can D-dimer and FDP levels. PT-act < 75% is independently associated with mortality.
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- 2020
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13. Impact of blood analysis and immune function on the prognosis of patients with COVID-19
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Si-wei Lu, Feng Xu, Yi Wang, Yang Yang, Yue-Qiang Fu, and Yue-lin Sun
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medicine.medical_specialty ,biology ,Receiver operating characteristic ,business.industry ,Lymphocyte ,Retrospective cohort study ,Immunoglobulin E ,Gastroenterology ,Immune system ,medicine.anatomical_structure ,Internal medicine ,Absolute neutrophil count ,medicine ,biology.protein ,Platelet ,Hemoglobin ,business - Abstract
IntroductionThis retrospective study investigated the implications of changes in blood parameters and cellular immune function in patients with 2019-coronavirus infected disease (COVID-19).MethodsRecords were reviewed of 85 patients with COVID-19 between February 4 and 16, 2020. The primary outcome was in-hospital mortality at 28 days.ResultsFourteen patients died. The baseline leukocyte count, neutrophil count and hemoglobin was significantly higher in non-survivors compared with survivors, while the reverse was true of lymphocyte count, platelet, PaO2/FiO2, CD3+ count and CD4+ count. The percentage of neutrophil count > 6.3×109/L in death group was significantly higher than that in survival group, and multivariate logistic regression showed neutrophil count was independently associated with mortality. However, there were not significant difference in IgG, IgM, IgA, C3, C4 and the percentage of IgE > 100 IU/ml between the death group and survival group. Areas under the receiver operating characteristic curves of the following at baseline could significantly predict mortality: leukocyte, neutrophil, lymphocyte, CD3+ and CD4+ counts.ConclusionsFor patients with COVID-19, lymphocyte, CD3+ and CD4+ counts that marked decrease suggest a poor outcome. A high neutrophil count is independently associated with mortality. At admission, leukocyte, neutrophil, lymphocyte, CD3+ and CD4+ counts should receive added attention.
- Published
- 2020
- Full Text
- View/download PDF
14. The impact of admission serum lactate on children with moderate to severe traumatic brain injury
- Author
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Cheng-jun Liu, Ke Bai, and Yue-qiang Fu
- Subjects
Male ,Critical Care and Emergency Medicine ,Traumatic Brain Injury ,Epidemiology ,Biochemistry ,Pediatrics ,0302 clinical medicine ,Risk Factors ,Brain Injuries, Traumatic ,Medicine and Health Sciences ,Medicine ,Hospital Mortality ,Coma ,Child ,Trauma Medicine ,Multidisciplinary ,Organic Compounds ,Mortality rate ,Monosaccharides ,Hospitals ,Chemistry ,Intensive Care Units ,Neurology ,Child, Preschool ,Physical Sciences ,Lactates ,Female ,Serum lactate ,medicine.symptom ,Traumatic Injury ,Research Article ,Moderate to severe ,medicine.medical_specialty ,Traumatic brain injury ,Death Rates ,Science ,Carbohydrates ,03 medical and health sciences ,Population Metrics ,Internal medicine ,Humans ,Glasgow Coma Scale ,Hemoglobin ,Retrospective Studies ,Adult patients ,Population Biology ,business.industry ,Organic Chemistry ,Chemical Compounds ,Infant ,Biology and Life Sciences ,Proteins ,030208 emergency & critical care medicine ,Retrospective cohort study ,medicine.disease ,Health Care ,Glucose ,Logistic Models ,Health Care Facilities ,Medical Risk Factors ,business ,Neurotrauma ,030217 neurology & neurosurgery - Abstract
BackgroundLactate is used to evaluate the prognosis of adult patients with trauma. However, the prognostic significance of admission serum lactate in the setting of pediatric traumatic brain injury (TBI) is still unclear. We aim to investigate the impact of admission lactate on the outcome in children with moderate to severe TBI.MethodsThis retrospective study was conducted in a tertiary pediatric hospital between May 2012 and Jun 2018 included children with an admission Glasgow Coma Scale (GCS) of ≤13. Two hundred and thirteen patients were included in the analysis and 45 patients died in hospital.ResultsAdmission lactate and glucose were significantly higher in non-survivors than those in survivors (P < 0.05). Admission lactate was positively correlated with admission glucose and negatively correlated with GCS in all patients (n = 213), subgroup of isolated TBI (n = 112) and subgroup of GCS ≤ 8 (n = 133), respectively. AUCs of lactate could significantly predict the mortality and were higher than those of glucose in all patients, subgroup of isolated TBI and subgroup of GCS ≤ 8, respectively. Multivariate logistic regression showed that admission lactate (Adjusted OR = 1.189; 95% CI: 1.002-1.410; P = 0.047) was independently associated with mortality, while admission glucose (Adjusted OR = 1.077; 95% CI: 0.978-1.186; P = 0.133) wasn't an independent risk factor of death. Elevated admission lactate (> 2 mmol/L) was associated with death, reduced 14-day ventilation-free days, 14-day ICU-free days and 28-day hospital-free days.ConclusionsAdmission serum lactate can effectively predict the mortality of children with moderate to severe TBI. Elevated admission lactate is associated with death, reduced ventilator-free, ICU-free, and hospital-free days. Admission serum lactate could be used as a prognostic biomarker of mortality in children with moderate to severe TBI.
- Published
- 2019
15. Comparison of admission serum albumin and hemoglobin as predictors of outcome in children with moderate to severe traumatic brain injury: A retrospective study.
- Author
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Hong-chun Luo, Yue-qiang Fu, Cheng-yan You, Cheng-jun Liu, Feng Xu, Luo, Hong-Chun, Fu, Yue-Qiang, You, Cheng-Yan, Liu, Cheng-Jun, and Xu, Feng
- Published
- 2019
- Full Text
- View/download PDF
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