Medicine and Health Sciences Commons^™

Addressing Intimate Partner Violence (Ipv) Amongst Pregnant And Postpartum Individuals, Charlette E. Williams, Md, Elizabeth S. Hood, Bs, Julia F. Switzer, Md

Department of Obstetrics and Gynecology Posters

Goals of Project

1. Better recognition of Intimate Partner Violence (IPV) as it relates to our poor maternal morbidity and mortality statistics/outcomes
2. Better trauma-informed education surrounding recognition of red flag signs/symptoms for House Staff/Ob-Gyn rotation students
3. Better paring of patients with resources both in the clinic setting & postpartum

In-Hospital Mortality Trends After Surgery For Traumatic Thoracolumbar Injury: A National Inpatient Sample Database Study, Michael Mccurdy, Rajkishen Narayanan, Omar Tarawneh, Yunsoo Lee, Matthew Sherman, Teeto Ezeonu, Michael Carter, Jose A. Canseco, Alan S. Hilibrand, Alex R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder

Department of Orthopaedic Surgery Faculty Papers

INTRODUCTION: Given the increasing incidence of traumatic thoracolumbar injuries in recent years, studies have sought to investigate potential risk factors for outcomes in these patients.

RESEARCH QUESTION: The aim of this study was to investigate trends and risk factors for in-hospital mortality after fusion for traumatic thoracolumbar injury.

MATERIALS AND METHODS: Patients undergoing thoracolumbar fusion after traumatic injury were queried from the National Inpatient Sample (NIS) from 2012 to 2017. Analysis was performed to identify risk factors for inpatient mortality after surgery.

RESULTS: Patients in 2017 were on average older (51.0 vs. 48.5, P = 0.004), had more admitting diagnoses …

Racial Disparities Among Predicted Bronchopulmonary Dysplasia Risk Outcomes In Premature Infants Born <30 Weeks Gestation, Priyanka Patel, Andrew Ellefson, David A. Paul

Department of Pediatrics Faculty Papers

Background and Objective: There is extensive literature to support eliminating race-based risk stratification. The National Institute of Child Health and Human Development (NICHD) calculator, used to predict risk of bronchopulmonary dysplasia (BPD), includes race as a variable. We sought to investigate how utilizing race in determination of risk for BPD may lead to inequitable care.

Methods: The study included a retrospective cohort of infants born <30 weeks gestation between January 2016 and February 2022. The primary outcome was the difference in predictive risk of BPD for non-Hispanic Black compared to non-Hispanic White infants. The secondary outcome was the disparity in theoretical administration of post-natal corticosteroids when the calculator was applied to the cohort. Analysis included paired T-tests and Chi-Square.

Results: Of the 273 infants studied, 154 were non-Hispanic Black (56%). There was no difference between the groups in gestation or respiratory support on day of life (DOL) 14 or 28. …

Lower Versus Higher Oxygen Targets For Out-Of-Hospital Cardiac Arrest: A Systematic Review And Meta-Analysis, Xin Cheng, Yu Zhang, Haidong Deng, Yuning Feng, Weelic Chong, Yang Hai, Pengfei Hao, Jialing He, Tiangui Li, Liyuan Peng, Peng Wang, Yangchun Xiao, Fang Fang

Student Papers, Posters & Projects

BACKGROUND: Supplemental oxygen is commonly administered to patients after out-of-hospital cardiac arrest. However, the findings from studies on oxygen targeting for out-of-hospital cardiac arrest are inconclusive. Thus, we conducted a systematic review and meta-analysis to evaluate the impact of lower oxygen target compared with higher oxygen target on patients after out-of-hospital cardiac arrest.

METHODS: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, from inception to February 6, 2023, for randomized controlled trials comparing lower and higher oxygen target in adults (aged ≥ 18 years) after out-of-hospital cardiac arrest. We screened studies and extracted data independently. The primary …

Preoperative Hematocrit Levels And Postoperative Mortality In Patients Undergoing Craniotomy For Brain Tumors, Yangchun Xiao, Xin Cheng, Lu Jia, Yixin Tian, Jialing He, Miao He, Lvlin Chen, Pengfei Hao, Tiangui Li, Weelic Chong, Yang Hai, Chao You, Liyuan Peng, Fang Fang, Yu Zhang

Department of Medicine Faculty Papers

BACKGROUND: Abnormal hematocrit values, including anemia and polycythemia, are common in patients undergoing craniotomy, but the extent to which preoperative anemia or polycythemia independently increases the risk of mortality is unclear. This retrospective cohort study aimed to examine the association between preoperative anemia and polycythemia and postoperative mortality in patients who underwent craniotomy for brain tumor resection.

METHODS: We retrospectively analyzed data from 12,170 patients diagnosed with a brain tumor who underwent cranial surgery at West China Hospital between January 2011 and March 2021. The preoperative hematocrit value was defined as the last hematocrit value within 7 days before the …

The Impact Of Police Transport Of Patients With Penetrating Traumas On Mortality, Breanne Grove

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Introduction

• 2020: For people aged 1 to 44 in the U.S., firearm-related injuries ranked in the top five leading causes of death.¹
• 2022: 44,343 total gun violence deaths, 38,593 gun injuries & 646 mass shootings²
• 1987: Philadelphia became first U.S. municipality to allow police personnel to follow a “scoop and run” policy.^3,4 Necessity for police transport came from the lack of EMS availability when firearm homicide rates rose by 123%.⁵

Protein-Energy Malnutrition Is Associated With Worse Outcomes In Patients With Atrial Fibrillation: A Nationwide Analysis, Favour Markson, Emmanuel Akuna, Iriagbonse Asemota, Gabriel Areoye, Anoz Shahi, Praise Nwachukwu, Kenneth Ong

Einstein Health Papers

Protein–energy malnutrition (PEM), which leads to a reduced ability of tissues to regenerate and repair themselves, may exacerbate many chronic diseases, including atrial fibrillation (AF), which occurs as a response of the heart to chronic inflammation. However, population-based studies examining the association between PEM and the prevalence and health care burden of AF are lacking. The aim of this retrospective cohort study was to estimate the impact of PEM on the prevalence and clinical outcomes of hospitalization for AF. The National Inpatient Sample (NIS) 2016 and 2017 datasets were searched for data on hospitalized adult patients with AF as a …

Association Between Intraoperative Steroid And Postoperative Mortality In Patients Undergoing Craniotomy For Brain Tumor, Jialing He, Shuanghong He, Yu Zhang, Yixin Tian, Pengfei Hao, Tiangui Li, Yangchun Xiao, Liyuan Peng, Yuning Feng, Xin Cheng, Haidong Deng, Peng Wang, Weelic Chong, Yang Hai, Lvlin Chen, Chao You, Lu Jia, Dengkui Chen, Fang Fang

Department of Medical Oncology Faculty Papers

BACKGROUND: Despite the widespread use of intraoperative steroids in various neurological surgeries to reduce cerebral edema and other adverse symptoms, there is sparse evidence in the literature for the optimal and safe usage of intraoperative steroid administration in patients undergoing craniotomy for brain tumors. We aimed to investigate the effects of intraoperative steroid administration on postoperative 30-day mortality in patients undergoing craniotomy for brain tumors.

METHODS: Adult patients who underwent craniotomy for brain tumors between January 2011 to January 2020 were included at West China Hospital, Sichuan University in this retrospective cohort study. Stratified analysis based on the type of …

The Impact Of Covid-19 On Hospitalization Outcomes Of Patients With Acute Myocardial Infarction In The Usa, F.E. Markson, E. Akuna, C.Y. Lim, L. Khemani, A, Amanullah

Einstein Health Papers

Background/study objective: The effect of the COVID-19 pandemic affected health care delivery, as it led to variable outcomes in different disease states including cardiovascular diseases. In this study, we evaluated the impact of coexisting COVID-19 on Acute Myocardial Infarction (AMI). Design/setting: We analyzed discharge records of AMI patients from the National Inpatient Sample (NIS) in the year 2020.

Main outcome measures: Using propensity score matching, we assessed the impact of COVID-19 infection on the in-hospital outcomes of patients presenting with AMI.

Results: There were 1154 patients with concomitant COVID-19 infection and AMI who were matched with 109,990 patients with AMI …

Mortality In Asia Impairment Scale Grade A To D Patients With Odontoid Fracture And Magnetic Resonance Imaging Evidence Of Spinal Cord Injury, Bizhan Aarabi, Christopher J Neal, David S. Hersh, James S. Harrop, Michael G. Fehlings, Elizabeth G. Toups, James D. Guest, Beatrice Ugiliweneza, Noori Akhtar-Danesh, Shekar N. Kurpad, Robert G. Grossman

Department of Neurosurgery Faculty Papers

Odontoid fractures are common, often presenting in the elderly after a fall and infrequently associated with traumatic spinal cord injury (tSCI). The goal of this study was to analyze predictors of mortality and neurological outcome when odontoid fractures were associated with signal change on magnetic resonance imaging (MRI) at admission. Over an 18-year period (2001-2019), 33 patients with odontoid fractures and documented tSCI on MRI were identified. Mean age was 65.3 years (standard deviation [SD] = 17.2), and 21 patients were male. The mechanism of injury was falls in 25 patients, motor vehicle accidents in 5, and other causes in …

A Systematic Review Identifying Adverse Health Outcomes And Mortality Rates Associated With Telehealth, Fidelia Cascini, Ana Pantovic, Yazan A. Al-Ajlouni, Omar Al Ta'ani, Giovanna Failla, Andriy Melnyk, Paul Barach, Walter Ricciardi

College of Population Health Faculty Papers

Background: The literature supporting telehealth management is growing accelerated by the COVID-pandemic. We hypothesize that there are risks of adverse events associated with telehealth interventions.

Methods: A review of PubMed (including MEDLINE), Embase, ISI (Web of Science), VHL/GHL, Scopus, Science Direct, and PsycINFO was conducted for all adverse events associated with telehealth from January 1, 1960 to March 1, 2021. This systematic review and meta-analyses were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results: Of 5,144 citations 78 published studies met criteria for quality evaluation and underwent full text abstraction including the qualitative …

Association Between Acute Kidney Injury And Long-Term Mortality In Patients With Aneurysmal Subarachnoid Hemorrhage: A Retrospective Study, Yangchun Xiao, Jun Wan, Yu Zhang, Xing Wang, Hanwen Zhou, Han Lai, Weelic Chong, Yang Hai, L Dade Lunsford, Chao You, Shui Yu, Fang Fang

Department of Medical Oncology Faculty Papers

Background: Though acute kidney injury (AKI) in the context of aneurysmal subarachnoid hemorrhage (aSAH) worsens short-term outcomes, its impact on long-term survival is unknown.

Aim: We aimed to evaluate the association between long-term mortality and AKI during hospitalization for aSAH.

Methods: This was a retrospective study of patients who survived >12 months after aSAH. All patients were evaluated at West China Hospital, Sichuan University, between December 2013 and June 2019. The minimum follow-up time was over 1 year. the maximum follow-up time was about 7.3 years. AKI was defined by the KDIGO (The Kidney Disease Improving Global Outcomes) guidelines, which …

Angiotensin Blockade Therapy And Survival In Pancreatic Cancer: A Population Study, Scott W Keith, Vittorio Maio, Hwyda A Arafat, Matthew Alcusky, Thomas Karagiannis, Carol Rabinowitz, Harish Lavu, Daniel Z. Louis

College of Population Health Faculty Papers

Background: Pancreatic cancer (PC) is one of the most aggressive and challenging cancer types to effectively treat, ranking as the fourth-leading cause of cancer death in the United States. We investigated if exposures to angiotensin II receptor blockers (ARBs) or angiotensin I converting enzyme (ACE) inhibitors after PC diagnosis are associated with survival.

Methods: PC patients were identified by ICD-9 diagnosis and procedure codes among the 3.7 million adults living in the Emilia-Romagna Region from their administrative health care database containing patient data on demographics, hospital discharges, all-cause mortality, and outpatient pharmacy prescriptions. Cox modeling estimated covariate-adjusted mortality hazard ratios …

Case Report: Bilateral Emphysematous Pyelonephritis With Pneumatosis Intestinalis, Maria D'Amico, Joseph Izes, Akhil Das

Department of Urology Faculty Papers

Emphysematous pyelonephritis is a severe and rare gas producing infection in the renal parenchyma or collecting system. Diabetes mellitus is an established risk factor. Treatment options include antibiotics, minimally invasive management such as percutaneous drainage, or nephrectomy. This case report describes a 40-year-old female with newly diagnosed diabetes and cirrhosis who presented with left sided emphysematous pyelonephritis. After initial management with intravenous antibiotics and drainage of the collecting system, this patient's clinical condition worsened, and subsequent repeat imaging revealed bilateral emphysematous pyelonephritis as well as pneumatosis intestinalis.

Dysregulation Of Biomarkers Of Hemostatic Activation And Inflammatory Processes Are Associated With Adverse Outcomes In Pulmonary Embolism, Iman Darwish, Jawed Fareed, Yevgeniy Brailovsky, Debra Hoppensteadt, Brett Slajus, Emily Bontekoe, Frank De Stefano, Trent Reed, Amir Darki

Division of Cardiology Faculty Papers

Introduction: The pathophysiology of pulmonary embolism (PE) represents complex, multifactorial processes involving blood cells, vascular endothelium, and the activation of inflammatory pathways. Platelet (P), endothelial (E), and leukocyte (L)-selectin molecules may play an important role in PE pathophysiology. We aimed to profile the biomarkers of inflammation, including selectins in PE patients, and compare them to healthy individuals.

Materials and methods: 100 acute PE patients and 50 controls were included in this case control study. ELISA methods were used to quantify levels of selectins, inflammatory, and hemostatic biomarkers.

Results: In PE patients, levels of selectin molecules as compared to controls convey …

A Quasi-Experimental Study Of Medicaid Expansion And Urban Mortality In The American Northeast., Cyrus Ayubcha, Pedram Pouladvand, Soussan Ayubcha

Marcus Institute of Integrative Health Faculty Papers

Objectives: To investigate the association of state-level Medicaid expansion and non-elderly mortality rates from 1999 to 2018 in Northeastern urban settings.

Methods: This quasi-experimental study utilized a synthetic control method to assess the association of Medicaid expansion on non-elderly urban mortality rates [1999-2018]. Counties encompassing the largest cities in the Northeastern Megalopolis (Washington D.C., Baltimore, Philadelphia, New York City, and Boston) were selected as treatment units (n = 5 cities, 3,543,302 individuals in 2018). Cities in states without Medicaid expansion were utilized as control units (n = 17 cities, 12,713,768 individuals in 2018).

Results: Across all cities, there …

Covid-19 In Patients With Hematologic Malignancies: A Single Center Retrospective Study, Xuejun Wang, Adam Binder, Usama Gergis, Lindsay Wilde, Md

Department of Medical Oncology Faculty Papers

Initial studies that described the novel coronavirus (COVID-19) reported increased morbidity and mortality in patients with cancer. Of this group, patients with hematologic malignancies (HM) had the highest disease severity and death rates. Subsequent studies have attempted to better describe how COVID-19 affects patients with HM. However, these studies have yielded variable and often contradictory results. We present our single-institution experience with patients with HM who were diagnosed with COVID-19 from March 2020 to March 2021. We report 62 total cases with 10 patients who died during this time. The overall mortality was 16.1%. Mortality during the first two waves …

Active Implantable Cardioverter-Defibrillators In Continuous-Flow Left Ventricular Assist Device Recipients, Kuldeep Shah, Rahul Chaudhary, Mohit K. Turagam, Mahek Shah, Brijesh Patel, Gregg Lanier, Dhanunjaya Lakkireddy, Jalaj Garg

Division of Cardiology Faculty Papers

Introduction

Implantable cardioverter-defibrillator (ICD) in patients with heart failure with reduced ejection fraction reduces mortality secondary to malignant arrhythmias. Whether end-stage heart failure (HF) with continuous-flow left ventricular assist device (cf-LVAD) derive similar benefits remains controversial.

Methods

We performed a systematic literature review and meta-analysis of all published studies that examined the association between active ICDs and survival in advanced HF patients with cfLVAD. We searched PubMed, Medline, Embase, Ovid, and Cochrane for studies reporting the association between ICD and all-cause mortality in advanced HF patients with cfLVAD. Mantel-Haenszel risk ratio (RR) random-effects model was used to summarize data.

Results …

Automated Analysis Of Risk Factors For Postictal Generalized Eeg Suppression, Xiuhe Zhao, Laura Vilella, Liang Zhu, M R Sandhya Rani, Johnson P Hampson, Jaison Hampson, Norma J Hupp, Rup K Sainju, Daniel Friedman, Maromi Nei, Catherine Scott, Luke Allen, Brian K Gehlbach, Stephan Schuele, Ronald M Harper, Beate Diehl, Lisa M Bateman, Orrin Devinsky, George B Richerson, Guo-Qiang Zhang, Samden D Lhatoo, Nuria Lacuey

Department of Neurology Faculty Papers

Rationale: Currently, there is some ambiguity over the role of postictal generalized electro-encephalographic suppression (PGES) as a biomarker in sudden unexpected death in epilepsy (SUDEP). Visual analysis of PGES, known to be subjective, may account for this. In this study, we set out to perform an analysis of PGES presence and duration using a validated signal processing tool, specifically to examine the association between PGES and seizure features previously reported to be associated with visually analyzed PGES. Methods: This is a prospective, multicenter epilepsy monitoring study of autonomic and breathing biomarkers of SUDEP in adult patients with intractable epilepsy. We …

Declining Intensive Care Unit Mortality Of Covid-19: A Multi-Center Study, Sohaib Roomi, Syed Omar Shah, Waqas Ullah, Shan Abedin, Karyn L. Butler, Chiers, Kelly, Benjamin A. Kohl, Erika J. Yoo, Matthew Vibbert, Jack Jallo

Department of Surgery Faculty Papers

Background: Coronavirus disease 2019 (COVID-19) mortality has waned significantly over time; however, factors contributing towards this reduction largely remain unidentified. The purpose of this study was to evaluate the trend in mortality at our large tertiary academic health system and factors contributing to this trend. Methods: This is a retrospective cohort study of intensive care unit (ICU) patients diagnosed with COVID-19 between March and August 2020 admitted across 14 hospitals in the Philadelphia area. Collected data included demographics, comorbidities, admission risk of mortality score, laboratory values, medical interventions, survival outcomes, hospital and ICU length of stay (LOS) and discharge disposition. …

Skin Manifestations In Covid-19 Patients: Are They Indicators For Disease Severity? A Systematic Review, Parnian Jamshidi, Bahareh Hajikhani, Mehdi Mirsaeidi, Hassan Vahidnezhad, Masoud Dadashi, Mohammad Javad Nasiri

Department of Dermatology and Cutaneous Biology Faculty Papers

Introduction: Until now, there are several reports on cutaneous manifestations in COVID-19 patients. However, the link between skin manifestations and the severity of the disease remains debatable. We conducted a systematic review to evaluate the temporal relationship between different types of skin lesions and the severity of COVID-19. Methods: A systematic search was conducted for relevant studies published between January and July 2020 using Pubmed/Medline, Embase, and Web of knowledge. The following keywords were used: "SARS-CoV-2" or "COVID-19" or "new coronavirus" or "Wuhan Coronavirus" or "coronavirus disease 2019" and "skin disease" or "skin manifestation" or "cutaneous manifestation." Results: Out of …

Opioids And Sickle Cell Disease: From Opium To The Opioid Epidemic., Samir K. Ballas

Cardeza Foundation for Hematologic Research

Sickle cell disease (SCD) is an inherited disorder of hemoglobin structure. The clinical effects of the sickle gene are pleiotropic in nature causing multiple phenotypic expressions associated with the various complications of the disease. The hallmark of the disease is pain that could be acute, chronic, nociceptive, or neuropathic that could occur singly or in various combinations. The acute vaso-occlusive painful crisis (VOC) is the most common cause of admissions to the Emergency Department and/or the hospital. Although progress has been made in understanding the pathophysiology of SCD as well as in developing preventive and curative therapies, effective pain management …

Machine Learning Models For 6-Month Survival Prediction After Surgical Resection Of Glioblastoma, Jeffrey Gray, Lohit Velagapudi, Michael Baldassari, Bryan Sadler, David Vuong

Phase 1

Introduction: The role of surgical resection for the treatment of glioblastoma multiforme is well established. Survival analysis after resective surgery in the literature comprises mostly of traditional statistical models. Machine learning models offer powerful predictive and analytical capability for varied datasets and offer improved generalizability and scalability. We analyzed survival data of patients with glioblastoma with various machine learning algorithms and compared it to binary logistic regression.

Methods: We retrospectively identified cases of glioblastoma treated with surgical resection at our institution from 2012-2018. Feature scaling and one-hot encoding was used to better fit the models to the data and used …

Epidemiology Of Non-Alcoholic Fatty Liver Disease And Risk Of Hepatocellular Carcinoma Progression, Krishna Chaitanya Thandra, Adam Barsouk, Kalyan Saginala, John Sukumar Aluru, Prashanth Rawla, Alexander Barsouk

Kimmel Cancer Center Faculty Papers

Non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease worldwide. Its incidence has grown alongside the increasing global prevalence of type 2 diabetes, obesity, and metabolic syndrome. The risk of progression to hepatocellular carcinoma for nonalcoholic steatohepatitis patients over 5 years is 8%, and despite targeted and immunotherapy treatment advances, HCC maintains a bleak 5-year survival of 19%. NAFLD’s primary risk factors are components of metabolic syndrome as well as possible sleep disturbances. NAFLD is most common among men 50-60 years of age, though incidence in women catches up after menopause. In the US, Hispanics are …

Medical Therapy Vs Early Revascularization In Diabetics With Chronic Total Occlusions: A Meta-Analysis And Systematic Review, Muhammad Shayan Khan, Farhad Sami, Hemindermeet Singh, Waqas Ullah, Ma'en Al-Dabbas, Khalid Hamid Changal, Tanveer Mir, Zain Ali, Ameer Kabour

Abington Jefferson Health Papers

BACKGROUND: Management of chronic total occlusions (CTO) in diabetics is challenging, with a recent trend towards early revascularization [ER: Percutaneous coronary intervention (PCI) and bypass grafting] instead of optimal medical therapy (OMT). We hypothesize that ER improves morbidity and mortality outcomes in diabetic patients with CTOs as compared to OMT.

AIM: To determine the long term clinical outcomes and to compare morbidity and mortality between OMT and ER in diabetic patients with CTOs.

METHODS: Potentially relevant published clinical trials were identified in Medline, Embase, chemical abstracts and Biosis (from start of the databases till date) and pooled hazard ratios (HR) …

Impact Of Coronavirus Disease 2019 Pandemic On The Incidence And Management Of Out-Of-Hospital Cardiac Arrest In Patients Presenting With Acute Myocardial Infarction In England., Muhammad Rashid Hons, Chris P. Gale Hons, Nick Curzen Hons, Peter Ludman Hons, Mark De Belder Hons, Adam Timmis Hons, Mohamed O Mohamed Hons, Thomas F Lüscher Hons, Julian Hains Hons, Jianhua Wu, Ahmad Shoaib, Evangelos Kontopantelis, Chris Roebuck, Tom Denwood, John Deanfield, Mamas A. Mamas

Department of Medicine Faculty Papers

Background Studies have reported significant reduction in acute myocardial infarction-related hospitalizations during the coronavirus disease 2019 (COVID-19) pandemic. However, whether these trends are associated with increased incidence of out-of-hospital cardiac arrest (OHCA) in this population is unknown. Methods and Results Acute myocardial infarction hospitalizations with OHCA during the COVID-19 period (February 1-May 14, 2020) from the Myocardial Ischaemia National Audit Project and British Cardiovascular Intervention Society data sets were analyzed. Temporal trends were assessed using Poisson models with equivalent pre-COVID-19 period (February 1-May 14, 2019) as reference. Acute myocardial infarction hospitalizations during COVID-19 period were reduced by >50% (n=20 310 …

Management Of Acute Ischemic Stroke., Franziska Herpich, Fred Rincon

Department of Neurology Faculty Papers

OBJECTIVES: Concise "synthetic" review of the state of the art of management of acute ischemic stroke.

DATA SOURCES: Available literature on PubMed.

STUDY SELECTION: We selected landmark studies, recent clinical trials, observational studies, and professional guidelines on the management of stroke including the last 10 years.

DATA EXTRACTION: Eligible studies were identified and results leading to guideline recommendations were summarized.

DATA SYNTHESIS: Stroke mortality has been declining over the past 6 decades, and as a result, stroke has fallen from the second to the fifth leading cause of death in the United States. This trend may follow recent advances in …

Redefining Cardiac Biomarkers In Predicting Mortality Of Inpatients With Covid-19, Juan-Juan Qin, Xu Cheng, Feng Zhou, Fang Lei, Gauri Akolkar, Jingjing Cai, Xiao-Jing Zhang, Alice Blet, Jing Xie, Peng Zhang, Ye-Mao Liu, Zizhen Huang, Ling-Ping Zhao, Lijin Lin, Meng Xia, Ming-Ming Chen, Xiaohui Song, Liangjie Bai, Ze Chen, Xingyuan Zhang, Da Xiang, Jing Chen, Qingbo Xu, Xin-Liang Ma, Rhian M Touyz, Chen Gao, Haitao Wang, Liming Liu, Weiming Mao, Pengcheng Luo, Youqin Yan, Ping Ye, Manhua Chen, Guohua Chen, Lihua Zhu, Zhi-Gang She, Xiaodong Huang, Yufeng Yuan, Bing-Hong Zhang, Yibin Wang, Peter P Liu, Hongliang Li

Department of Emergency Medicine Faculty Papers

The prognostic power of circulating cardiac biomarkers, their utility, and pattern of release in coronavirus disease 2019 (COVID-19) patients have not been clearly defined. In this multicentered retrospective study, we enrolled 3219 patients with diagnosed COVID-19 admitted to 9 hospitals from December 31, 2019 to March 4, 2020, to estimate the associations and prognostic power of circulating cardiac injury markers with the poor outcomes of COVID-19. In the mixed-effects Cox model, after adjusting for age, sex, and comorbidities, the adjusted hazard ratio of 28-day mortality for hs-cTnI (high-sensitivity cardiac troponin I) was 7.12 ([95% CI, 4.60-11.03] P<0.001), (NT-pro)BNP (N-terminal pro-B-type natriuretic peptide or brain natriuretic peptide) was 5.11 ([95% CI, 3.50-7.47] P<0.001), CK (creatine phosphokinase)-MB was 4.86 ([95% CI, 3.33-7.09] P<0.001), MYO (myoglobin) was 4.50 ([95% CI, 3.18-6.36] P<0.001), and CK was 3.56 ([95% CI, 2.53-5.02] P<0.001). The cutoffs of those cardiac biomarkers for effective prognosis of 28-day mortality of COVID-19 were found to be much lower than for regular heart disease at about 19%-50% of the currently recommended thresholds. Patients with elevated cardiac injury markers above the newly established cutoffs were associated with significantly increased risk of COVID-19 death. In conclusion, cardiac biomarker elevations are significantly associated with 28-day death in patients with COVID-19. The prognostic cutoff values of these biomarkers might be much lower than the current reference standards. These findings can assist in better management of COVID-19 patients to improve outcomes. Importantly, the newly established cutoff levels of COVID-19-associated cardiac biomarkers may serve as useful criteria for the future prospective studies and clinical trials.

Use Of Advanced Statistical Techniques To Predict All-Cause Mortality In The Systolic Blood Pressure Intervention Trial, William Kostis, Javier Cabrera, Chun Pang Lin, John Kostis, Jennifer Wellings, Stavros Zinonos, Jeanne Dobrzynski, Daniel Blickstein

Department of Medicine Faculty Papers

Background: The Systolic Blood Pressure Intervention Trial (SPRINT) was conducted in patients with hypertension and additional risk for cardiovascular disease who were randomized to the intensive blood pressure group targeting systolic blood pressure (SBP) less than 120 mm Hg and to the standard group where the target was less than 140 mm Hg. Analyses were done in the matched group of participants with the same gender, same age (±2 years) and same SBP (±3 mm Hg) at three months of treatment regardless of initial randomization to intensive or standard group (shaded area in Figure 1). Methods and results: During 3.26 …

Does Preoperative Dipyridamole-Thallium Scanning Reduce 90-Day Cardiac Complications And 1-Year Mortality In Patients With Femoral Neck Fractures Undergoing Hemiarthroplasty?, Chin-Yi Liao, Timothy L. Tan, Yu-Der Lu, Cheng-Ta Wu, Mel S Lee, Feng-Chih Kuo

Rothman Institute Faculty Papers

BACKGROUND: This study aimed to evaluate the effect of dipyridamole-thallium scanning (DTS) on the rates of 90-day cardiac complications and 1-year mortality in patients with a femoral neck fracture treated with hemiarthroplasty.

METHODS: Between 2008 and 2015, 844 consecutive patients who underwent cemented or cementless hemiarthroplasty were identified from the database of a single level-one medical center. One-hundred and thirteen patients (13%) underwent DTS prior to surgery, and 731 patients (87%) did not. Patient characteristics, comorbidities, surgical variables, and length of the delay until surgery were recorded. A propensity score-matched cohort was utilized to reduce recruitment bias in a 1:3 …