Articles: mortality.
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Am. J. Respir. Crit. Care Med. · Jun 2024
The Lung Microbiome Predicts Mortality and Response to Azithromycin in Lung Transplant Patients with Chronic Rejection.
Rationale: Chronic lung allograft dysfunction (CLAD) is the leading cause of death after lung transplant, and azithromycin has variable efficacy in CLAD. The lung microbiome is a risk factor for developing CLAD, but the relationship between lung dysbiosis, pulmonary inflammation, and allograft dysfunction remains poorly understood. Whether lung microbiota predict outcomes or modify treatment response after CLAD is unknown. ⋯ Lung bacterial burden was positively associated with CLAD-associated cytokines, and ex vivo growth of P. aeruginosa was augmented in BAL fluid from transplant recipients with CLAD. Conclusions: In recipients of lung transplants with chronic rejection, increased lung bacterial burden is an independent risk factor for mortality and predicts clinical response to azithromycin. Lung bacterial dysbiosis is associated with alveolar inflammation and may be promoted by underlying lung allograft dysfunction.
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Multicenter Study
Impact of SARS-CoV-2 vaccine rollout on Hispanic and non-Hispanic admission and mortality trends: an interrupted time series analysis.
Challenges with SARS-CoV-2 vaccine prioritization, access, and hesitancy have influenced vaccination uptake. ⋯ SARS-CoV-2 vaccine rollout was associated with improved COVID-19 admission trends among non-Hispanic vs Hispanic patients. Vaccine rollout was not shown to influence mortality trends in either group, which were four times higher among Hispanic patients. Improved vaccine rollout may have reduced disparities in admission trends for Hispanic patients, but other factors influenced their mortality trends.
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Semin Respir Crit Care Med · Jun 2024
ReviewPulmonary Manifestations of Connective Tissue Diseases.
Systemic sclerosis is a multisystem connective tissue disease that is associated with substantial morbidity and mortality. Visceral organ involvement is common in patients with systemic sclerosis and occurs independently of skin manifestations. Pulmonary hypertension (PH) is an important and prevalent complication of systemic sclerosis. ⋯ The treatment of PAH associated with systemic sclerosis requires a multidisciplinary team including a PH specialist and a rheumatologist to optimize immunomodulatory and PAH-specific therapies. Several potential biomarkers have been identified and there are several promising PAH therapies on the horizon such as the novel fusion protein sotatercept. This chapter provides an overview of PH in systemic sclerosis, with a specific focus on group 1 PAH.
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Eur J Trauma Emerg Surg · Jun 2024
Multicenter Study Observational StudyEpidemiologic features and outcomes associated with caustic ingestion among adults admitted in intensive care unit from 2013 to 2019: a French national observational study.
Caustic ingestion is a potential life-threatening condition associated with high morbidity and mortality. Data on patients admitted to Intensive Care Unit (ICU) for severe caustic ingestion are lacking. We aimed to describing epidemiological features and outcomes of patients admitted to ICU for caustic ingestion in France. ⋯ ICU admission for severe caustic ingestion is associated with 9.8% mortality and 74% complications. Age > 40 years and SAPS 2 score were independently associated with mortality.
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Multicenter Study
Models predicting mortality risk of patients with burns to ≥ 50% of the total body surface.
Several models predicting mortality risk of burn patients have been proposed. However, models that consider all such patients may not well predict the mortality of patients with extensive burns. ⋯ For patients with burns to ≥ 50%of the TBSA, the Zhou et al. and FLAMES models demonstrate relatively high predictive ability for mortality. The new nomogram is sensitive, specific, and accurate, and will aid rapid clinical decision-making.