The impact of being in the COVID-19 pandemic on in-hospital mortality of non-infected patients aged 80 years and older with ST-elevation myocardial ınfarction

The COVID-19 outbreak in late 2019 was declared a pandemic by the World Health Organization(WHO)on March 12,2020.[1]As of the latest WHO data,COVID-19 has caused over 770 million cases and nearly 7 million deaths worldwide.[2]Hospitalizations due to COVID-19 are correlated with advanced age.[3,4]According to re-ports,individuals over the age of 65 account for 80%of COVID-19-related deaths.[3,4]This is primar-ily due to the increased burden of comorbidity with age.

Development and validation of a nomogram for predicting in-hospital mortality of intensive care unit patients with liver cirrhosis

BACKGROUND Liver cirrhosis patients admitted to intensive care unit(ICU)have a high mortality rate.AIM To establish and validate a nomogram for predicting in-hospital mortality of ICU patients with liver cirrhosis.METHODS We extracted demographic,etiological,vital sign,laboratory test,comorbidity,complication,treatment,and severity score data of liver cirrhosis patients from the Medical Information Mart for Intensive Care IV(MIMIC-IV)and electronic ICU(eICU)collaborative research database(eICU-CRD).Predictor selection and model building were based on the MIMIC-IV dataset.The variables selected through least absolute shrinkage and selection operator analysis were further screened through multivariate regression analysis to obtain final predictors.The final predictors were included in the multivariate logistic regression model,which was used to construct a nomogram.Finally,we conducted external validation using the eICU-CRD.The area under the receiver operating characteristic curve(AUC),decision curve,and calibration curve were used to assess the efficacy of the models.RESULTS Risk factors,including the mean respiratory rate,mean systolic blood pressure,mean heart rate,white blood cells,international normalized ratio,total bilirubin,age,invasive ventilation,vasopressor use,maximum stage of acute kidney injury,and sequential organ failure assessment score,were included in the multivariate logistic regression.The model achieved AUCs of 0.864 and 0.808 in the MIMIC-IV and eICU-CRD databases,respectively.The calibration curve also confirmed the predictive ability of the model,while the decision curve confirmed its clinical value.CONCLUSION The nomogram has high accuracy in predicting in-hospital mortality.Improving the included predictors may help improve the prognosis of patients.

Development and validation of an emergency bloodstream infection score for predicting in-hospital mortality in patients with community-acquired bloodstream infections

BACKGROUND:Community-acquired bloodstream infections(CABSIs)are common in the emergency departments,and some progress to sepsis and even lead to death.However,limited information is available regarding the prediction of patients with high risk of death.METHODS:The Emergency Bloodstream Infection Score(EBS)for CABSIs was developed to visualize the output of a logistic regression model and was validated by the area under the curve(AUC).The Mortality in Emergency Department Sepsis(MEDS),Pitt Bacteremia Score(PBS),Sequential Organ Failure Assessment(SOFA),quick Sequential Organ Failure Assessment(qSOFA),Charlson Comorbidity Index(CCI),and McCabe–Jackson Comorbid Classification(MJCC)for patients with CABSIs were computed to compare them with EBS in terms of the AUC and decision curve analysis(DCA).The net reclassification improvement(NRI)index and integrated discrimination improvement(IDI)index were compared between the SOFA and EBS.RESULTS:A total of 547 patients with CABSIs were included.The AUC(0.853)of the EBS was larger than those of the MEDS,PBS,SOFA,and qSOFA(all P<0.001).The NRI index of EBS in predicting the in-hospital mortality of CABSIs patients was 0.368(P=0.04),and the IDI index was 0.079(P=0.03).DCA showed that when the threshold probability was<0.1,the net benefit of the EBS model was higher than those of the other models.CONCLUSION:The EBS prognostic models were better than the SOFA,qSOFA,MEDS,and PBS models in predicting the in-hospital mortality of patients with CABSIs.

Comparison of Child-Pugh, MELD, MELD-Na, and ALBI Scores in Predicting In-Hospital Mortality in Patients with HCC

Background & Objectives: Hepatocellular carcinoma (HCC) leads to high morbidity and mortality. Various models have been proposed for predicting the outcome of patients with HCC. We aim to compare the prognostic abilities of Child-Pugh, MELD, MELD-Na, and ALBI scores for predicting in-hospital mortality of HCC. Methods: We enrolled patients diagnosed with liver cirrhosis and HCC from May 2017 through May 2018. We further divided eligible patients into hepatitis B virus (HBV), patients without ascites, and patients with ascites subgroups. Areas under the characteristic curves (AUCs) were analyzed. Results: A total of 495 patients were included in the study. We collected data on patients at admission. A majority of patients were infected with HBV (91.5%). None of them were complicated with hepatic encephalopathy. Only 14.9% of patients presented with ascites. In the whole population, AUCs with 95% confidence interval (CI) of Child-Pugh, ALBI, MELD, and MELD-Na scores in predicting in-hospital mortality were 0.889 (95% CI: 0.858 - 0.915), 0.849 (95% CI: 0.814 - 0.879), 0.669 (95% CI: 0.626 - 0.711), and 0.721 (95% CI: 0.679 - 0.760), respectively. In the patients without ascites subgroup, Child-Pugh showed better discriminatory ability than ALBI score in predicting in-hospital mortality (P = 0.0002), while there were no significant differences among other comparisons. Conclusions: Child-Pugh and ALBI may be useful predictors for predicting in-hospital mortality in whole patients, in patients with HBV infection, and in patients without ascites. In HCC patients with ascites, MELD-Na may be effective for predicting in-hospital mortality.

Shock Index,Modified Shock Index,and Age-Adjusted Shock Index in Predicting the In-Hospital Mortality in Patients with Heart Failure and Chronic Kidney Disease

Patients with heart failure(HF)often have a poor prognosis,with high morbidity and mortality.In the Chinese adult population,the prevalence of HF increased by 44%in the past 15 years,which was1.3%[1].HF is often associated with multiple organ disorders[2].

The Value of Prealbumin and its Combination with NT-proBNP for Predicting in-hospital Mortality in Patients with Heart Failure:Real-World Research Based on Propensity Score Matching

In recent years,extended life expectancies and lifestyle changes have markedly contributed to the increased incidence of heart failure(HF)worldwide[1].In China,while the age of patients with chronic HF has increased annually,the mortality rate has not decreased significantly[1].

Characteristics and in-hospital mortality of elderly patients with heart failure in Spanish hospitals

BACKGROUND The prevalence of heart failure(HF)increases with age,and it is one of the leading causes of hospitalization and death in older patients.However,there are little data on in-hospital mortality in patients with HF≥75 years in Spain.METHODS A retrospective analysis of the Spanish Minimum Basic Data Set was performed,including all HF episodes discharged from public hospitals in Spain between 2016 and 2019.Coding was performed using the International Classification of Diseases,10th Revision.Patients≥75 years with HF as the principal diagnosis were selected.We calculated:(1)the crude in-hospital mortality rate and its distribution according to age and sex;(2)the risk-standardized in-hospital mortality ratio;and(3)the association between in-hospital mortality and the availability of an intensive cardiac care unit(ICCU)in the hospital.RESULTS We included 354,792 HF episodes of patients over 75 years.The mean age was 85.2±5.5 years,and 59.2%of patients were women.The most frequent comorbidities were renal failure(46.1%),diabetes mellitus(35.5%),valvular disease(33.9%),cardiorespiratory failure(29.8%),and hypertension(26.9%).In-hospital mortality was 12.7%,and increased with age[odds ratio(OR)=1.07,95%CI:1.07–1.07,P<0.001]and was lower in women(OR=0.96,95%CI:0.92–0.97,P<0.001).The main predictors of mortality were the presence of cardiogenic shock(OR=19.5,95%CI:16.8–22.7,P<0.001),stroke(OR=3.5,95%CI:3.0–4.0,P<0.001)and advanced cancer(OR=2.6,95%CI:2.5–2.8,P<0.001).In hospitals with ICCU,the in-hospital risk-adjusted mortality tended to be lower(OR=0.85,95%CI:0.72–1.00,P=0.053).CONCLUSIONS In-hospital mortality in patients with HF≥75 years between 2016 and 2019 was 12.7%,higher in males and elderly patients.The main predictors of mortality were cardiogenic shock,stroke,and advanced cancer.There was a trend toward lower mortality in centers with an ICCU.

Triglyceride glucose index predicts in-hospital mortality in patients with ST-segment elevation myocardial infarction who underwent primary angiography

OBJECTIVES To assess the correlation between triglyceride glucose(TyG)index and in-hospital mortality in patients with ST-segment elevation myocardial infarction(STEMI).METHODS A total of 2190 patients with STEMI who underwent primary angiography within 12 h from symptom onset were selected from the prospective,nationwide,multicenter CAMI registry.TyG index was calculated with the formula:Ln[fasting triglycerides(mmol/L)×fasting glucose(mmol/L)/2].Patients were divided into three groups according to the tertiles of TyG index.The primary endpoint was in-hospital mortality.RESULTS Overall,46 patients died during hospitalization,in-hospital mortality was 1.5%,2.2%,2.6%for tertile 1,tertile 2,and tertile 3,respectively.However,TyG index was not significantly correlated with in-hospital mortality in single-variable logistic regression analysis.Nonetheless,after adjusting for age and sex,TyG index was significantly associated with higher mortality when regarded as a continuous variable(adjusted OR=1.75,95%CI:1.16-2.63)or categorical variable(tertile 3 vs.tertile 1:adjus-ted OR=2.50,95%CI:1.14-5.49).Furthermore,TyG index,either as a continuous variable(adjusted OR=2.54,95%CI:1.42-4.54)or categorical variable(tertile 3 vs.tertile 1:adjusted OR=3.57,95%CI:1.24-10.29),was an independent predictor of in-hospital mortality after adjusting for multiple confounders in multivariable logistic regression analysis.In subgroup analysis,the pro-gnostic effect of high TyG index was more significant in patients with body mass index<18.5 kg/m2(P interaction=0.006).CONCLUSIONS This study showed that TyG index was positively correlated with in-hospital mortality in STEMI patients who underwent primary angiography,especially in underweight patients.

Novel CABIN score outperforms other prognostic models in predicting in-hospital mortality after salvage transjugular intrahepatic portosystemic shunting

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is now established as the salvage procedure of choice in patients who have uncontrolled or severe recurrent variceal bleeding despite optimal medical and endoscopic treatment.AIM To analysis compared the performance of eight risk scores to predict in-hospital mortality after salvage TIPS(sTIPS)placement in patients with uncontrolled variceal bleeding after failed medical treatment and endoscopic intervention.METHODS Baseline risk scores for the Acute Physiology and Chronic Health Evaluation(APACHE)II,Bonn TIPS early mortality(BOTEM),Child-Pugh,Emory,FIPS,model for end-stage liver disease(MELD),MELD-Na,and a novel 5 category CABIN score incorporating Creatinine,Albumin,Bilirubin,INR and Na,were calculated before sTIPS.Concordance(C)statistics for predictive accuracy of inhospital mortality of the eight scores were compared using area under the receiver operating characteristic curve(AUROC)analysis.RESULTS Thirty-four patients(29 men,5 women),median age 52 years(range 31-80)received sTIPS for uncontrolled(11)or refractory(23)bleeding between August 1991 and November 2020.Salvage TIPS controlled bleeding in 32(94%)patients with recurrence in one.Ten(29%)patients died in hospital.All scoring systems had a significant association with in-hospital mortality(P<0.05)on multivariate analysis.Based on in-hospital survival AUROC,the CABIN(0.967),APACHE II(0.948)and Emory(0.942)scores had the best capability predicting mortality compared to FIPS(0.892),BOTEM(0.877),MELD Na(0.865),Child-Pugh(0.802)and MELD(0.792).CONCLUSION The novel CABIN score had the best prediction capability with statistical superiority over seven other risk scores.Despite sTIPS,hospital mortality remains high and can be predicted by CABIN category B or C or CABIN scores>10.Survival was 100%in CABIN A patients while mortality was 75%for CABIN B,87.5%for CABIN C,and 83%for CABIN scores>10.

Prognostic Value of Neutrophil to Lymphocyte Ratio for In-hospital Mortality in Elderly Patients with Acute Myocardial Infarction

Coronary artery disease （CAD） is a multifactorial disease in which inflammation plays a central role. This study aimed to investigate the association of inflammatory markers such as the neutrophil to lymphocyte ratio （NLR）, the Global Registry of Acute Coronary Events （GRACE） score with in-hospital mortality of elderly patients with acute myocardial infarction （AMI） in an attempt to explore the prognostic value of these indices for elderly AMI patients. One thousand consecutive CAD patients were divided into two groups based on age 60. The laboratory and clinical characteristics were assessed retrospectively by reviewing the medical records. The NLR and GRACE score were calculated. In the elderly （〉60 years）, patients with non-ST-elevation myocardial infarction （NSTEMI） and ST-elevation myocardial infarction （STEMI） had significantly higher NLR than did those with unstable angina （UA） and stable angina pectoris （SAP） （P〈0.01）. The NLR was considerably elevated in older AMI patients compared with their younger counterparts （〈60 years） （P〈0.05）. In elderly AMI patients, the NLR was considerably higher in the high-risk group than in both the low-risk and mediumrisk groups based on the GRACE score （P〈0.05 and P〈0.01, respectively）, and the NLR was positively correlated with the GRACE score （r=0.322, P〈0.001）. Either the NLR level or the GRACE score was significantly higher in the death group than in the surviving group （P〈0.05）. By curve receiver operator characteristic curve （ROC） analysis, the optimal cut-off levels of 9.41 for NLR and 174 for GRACE score predicted in-hospital death [ROC area under the curve （AUC） 0.771 and 0.787, respectively, P〈0.001]. It was concluded that an elevated NLR is a potential predictor of in-hospital mortality in elderly patients with AMI.

Comparison of different versions of the quick sequential organ failure assessment for predicting in-hospital mortality of sepsis patients:A retrospective observational study

BACKGROUND:The quick sequential organ failure assessment(qSOFA)is recommended to identify sepsis and predict sepsis mortality.However,some studies have recently shown its poor performance in sepsis mortality prediction.To enhance its effectiveness,researchers have developed various revised versions of the qSOFA by adding other parameters,such as the lactate-enhanced qSOFA(LqSOFA),the procalcitonin-enhanced qSOFA(PqSOFA),and the modified qSOFA(MqSOFA).This study aimed to compare the performance of these versions of the qSOFA in predicting sepsis mortality in the emergency department(ED).METHODS:This retrospective study analyzed data obtained from an electronic register system of adult patients with sepsis between January 1 and December 31,2019.Receiver operating characteristic(ROC)curve analyses were performed to determine the area under the curve(AUC),with sensitivity,specificity,and positive and negative predictive values calculated for the various scores.RESULTS:Among the 936 enrolled cases,there were 835 survivors and 101 deaths.The AUCs of the LqSOFA,MqSOFA,PqSOFA,and qSOFA were 0.740,0.731,0.712,and 0.705,respectively.The sensitivity of the LqSOFA,MqSOFA,PqSOFA,and qSOFA were 64.36%,51.40%,71.29%,and 39.60%,respectively.The specificity of the four scores were 70.78%,80.96%,61.68%,and 91.62%,respectively.The LqSOFA and MqSOFA were superior to the qSOFA in predicting in-hospital mortality.CONCLUSIONS:Among patients with sepsis in the ED,the performance of the PqSOFA was similar to that of the qSOFA and the values of the LqSOFA and MqSOFA in predicting in-hospital mortality were greater compared to qSOFA.As the added parameter of the MqSOFA was more convenient compared to the LqSOFA,the MqSOFA could be used as a candidate for the revised qSOFA to increase the performance of the early prediction of sepsis mortality.

Comprehensive Level One Trauma Center Could Lower In-hospital Mortality of Severe Trauma in China

Trauma is a major health and social problem in the US and China, It constitutes the main cause of death in people aged 45 or under in both countries112]. There is clear evidence from clinical studies that a large percentage of these deaths are needless and preventable if better treatment and prevention programs are available12-3].

High-density Lipoprotein Cholesterol and In-hospital Mortality in Patients with Acute Aortic Dissection

The association between high-density lipoprotein cholesterol（HDL-C） and mortality in patients with acute aortic dissection（AAD） is unclear. From January 2007 to January 2014, a total of 928 consecutive AAD patients who were admitted within 48 h after the onset of symptoms were enrolled in the study. Patients were divided into two groups according to whether serum HDL-C level was below the normal lower limit or not. The Cox proportional hazard regression model was used to identify the predictive value of HDL-C for in-hospital mortality in patients with AAD. As compared with normal HDL-C group（n=585）, low HDL-C group（n=343） had lower levels of systolic blood pressure and hemoglobin and higher levels of leukocyte, alanine aminotransferase, blood glucose, blood urea nitrogen, creatinine and urea acid. Low HDL-C group had significantly higher in-hospital mortality than normal HDL-C group（21.6% vs. 12.6%, log-rank=10.869, P=0.001）. After adjustment for baseline variables including demographics and biologic data, the increased risk of in-hospital mortality in low HDL-C group was substantially attenuated and showed no significant difference（adjusted hazard ratio, 1.23; 95% confidence interval, 0.86–1.77; P=0.259）. Low HDL-C is strongly but not independently associated with in-hospital mortality in patients with AAD.

Predictive value of SinoSCORE on in-hospital mortality and postoperative complications after coronary artery bypass surgery

Objective To evaluate the performance of the Sino System for Coronary Operative Risk Evaluation (SinoSCORE) on in hospital mortality and postoperative complications in patients undergoing coronary artery bypass grafting (CABG) in a single heart center. Methods From January 2007 to December 2008,clinical information of 201 consecutive patients undergoing isolated CABG in our hospital was collected. The SinoSCORE was used to

The Relationship Between Mean Platelet Volume and In-Hospital Mortality in Geriatric Patients with ST Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention

Objective:We planned to investigate the effect of mean platelet volume(MPV)on in-hospital mortality and coronary risk factors in geriatric patients with ST segment elevation myocardial infarction(STEMI)who underwent primary percutaneous coronary intervention(PCI).Methods:We enrolled 194 consecutive STEMI patients.The study population was divided into two groups on the basis of admission MPVs.The high-MPV group(n=49)included patients in the highest tertile(>8.9 fL),and the low-MPV group(n=145)included patients with a value in the lower two tertiles(≤8.9 fL).Clinical characteristics,in-hospital mortality,cardiovascular risk factors,and outcomes of primary PCI were analyzed.Results:The patients in the high-MPV group were older,more of them had three-vessel disease,and they had higher in-hospital mortality.Patients with in-hospital death were older,had higher Gensini score,creatinine concentration,and MPV,and had lower HDL cholesterol concentration.MPV,age,HDL cholesterol concentration,creatinine concentration,and Gensini score were found to be independent predictors of in-hospital death.Conclusion:These results suggest that high admission MPV levels are associated with increased in-hospital mortality in geriatric patients with STEMI undergoing primary PCI.

Factors related to early and rapid assessment of in-hospital mortality among older adult trauma patients in an earthquake

BACKGROUND:There is limited evidence for emergency physicians and emergency trauma surgeons regarding the determinants of early and rapid assessment of older adult in-hospital mortality due to earthquakes.This study explored factors related to the early and rapid assessment of the mortality among older adult earthquake trauma patients(OAETPs)and created a screening model.METHODS:Data on 7,308 OAETPs from the West China Earthquake Patients Database were analyzed retrospectively.The 35 variables that can be obtained rapidly on arrival at the hospital were collected.Least absolute shrinkage and selection operator(LASSO)regression analysis was performed.Then,the nomogram for assessing the mortality of OAETPs was constructed.RESULTS:We identified 10 independent mortality-related factors that contributed to the in-hospital mortality of OAETPs.The 10 factors included age(odds ratio[OR]=1.061,95%confidence interval[CI]:1.031-1.090),dementia(OR=5.146,95%CI:1.169-17.856),coronary heart disease(CHD;OR=23.441,95%CI:4.799-83.927),malignant tumor(OR=8.497,95%CI:3.583-17.967),deep vein thrombosis(DVT;OR=7.110,95%CI:1.369-27.168),chronic kidney disease(CKD;OR=11.783,95%CI:5.419-24.407),pulse rate(PR;OR=1.036,95%CI:1.022-1.048),mean artery pressure(MAP;OR=0.960,95%CI:0.945-0.975),Glasgow Coma Scale(GCS;OR=0.864,95%CI:0.760-0.972),and Triage Revised Trauma Score(T-RTS,OR=0.485,95%CI:0.351-0.696).CONCLUSION:The 10 mortality-related factors could be quickly obtained on hospital arrival and should be the focal point of future earthquake response strategies regarding hospitalized older adults with trauma.A nomogram was constructed based on the factors for screening OAETPs with a higher risk of in-hospital mortality.

Predictors of in-hospital mortality by logistic regression analysis among melioidosis patients in Northern Malaysia:A retrospective study

Objective:To identify the predictors of mortality among in-hospital melioidosis patients.Methods:A total of 453 patients in Hospital Sultanah Bahiyah,Kedah,and Hospital Tuanku Fauziah,Perlis with culture-confirmed melioidosis were retrospectively included in the study.Advanced multiple logistic regression was used to obtain the final model of predictors of mortality from melioidosis.The analysis was performed using STATA/SE 14.0.Results:A total of 50.11%(227/453)of the patients died at the hospital,and a majority(86.75%,393/453)of cases were bacteremic.The logistic regression estimated that the bacteremic type of melioidosis,low platelet count,abnormal white blood cell counts,and increased urea value were predictors of mortality.The results showed that bacteremic melioidosis increased the risk of death by 4.39 times(OR 4.39,95%CI 1.83-10.55,P=0.001)compared to non-bacteremic melioidosis.Based on laboratory test,the adjusted ORs from the final model showed that all three blood investigations were included as the associated factors of mortality for the disease[high white blood cell(>10×10^(9)/L):OR 2.43,95%CI1.41-4.17,P<0.001;low white blood cell(<4×10^(9)/L):OR 3.82,95%CI 1.09-13.34,P=0.036;low platelet(<100×10^(9)/L):OR 4.19,95%CI 1.89-9.30,P<0.001;high urea(>7800μmol/L):OR 5.53,95%CI 2.50-12.30,P<0.001;and low level of urea(<2500μmol/L):OR 3.52,95%CI 1.71-7.23,P=0.001].Conclusions:Routine blood investigations during a hospital admission can early identify predictors of mortality in melioidosis patients.

Chronic hepatitis-C infection in COVID-19 patients is associated with in-hospital mortality

BACKGROUND There is little evidence about the association of pre-existing hepatitis C infection(HCV)with outcomes in patients with coronavirus disease 2019(COVID-19).AIM To assess the prevalence of history of HCV among patients with COVID-19 and to study the relationship of in-hospital mortality in relation with other predictors of poor outcomes in the presence or absence of COVID-19 induced acute liver injury.METHODS In a retrospective single-center study design,1193 patients with COVID-19 infection were studied.Patients were then classified into those with and without a history of HCV,50(4.1%)and 1157(95.9%)respectively.RESULTS Multivariate cox-regression models showed that age,HCV,D-Dimer,and ferritin were the only predictors of in-hospital mortality.Acute liver injury and fibrosis score(Fib-4 score)were not different between both groups.Multivariate coxregression model for liver profile revealed that aspartate aminotransferase/alanine aminotransferase ratio,Fib-4 score,and HCV were predictors of inhospital mortality.After propensity score matching HCV was the only predictor of mortality in the multivariate cox-regression model.A model including HCV was found to add predictive value to clinical and laboratory parameters.CONCLUSION In patients with COVID-19,history of HCV infection leads to an accentuated severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)virulence,irrespective of baseline comorbidities,admission laboratory variables,or COVID-19-induced liver injury,which may be related to extrahepatic effects of HCV leading to enhanced ACE-2/TMPRSS mechanisms of SARS-CoV-2 viral entry,baseline cytokine-mediated pro-inflammation,and endothelial dysfunction.

Patterns of in-hospital mortality and bleeding complications following PCI for very elderly patients： insights from the Dartmouth Dynamic Registry

BackgroundVery 老病人(年龄 85 年) 是人口的一个很快增加的片断。作为一个组，他们经历跟随经皮的冠的干预(一种总线标准) 的在里面医院死亡和流血复杂并发症的高率。然而，在流血和死亡在之间的关系老 unknown.MethodsRetrospective 评论在 Dartmouth-Hitchcock 从 2000 ～ 2015 在 17,378 连续一种总线标准过程上被执行医学中心。在索引一种总线标准承认期间流血的发生(流血要求的输送，存取地点 hematoma > 5 厘米， pseudoaneurysm，和 retroperitoneal 流血)? 并且在里面医院死亡为四个年龄组被报导(< 65 年， 65-74 年， 75-84 年，和 85 年) 。承受了谁的流血复杂并发症和那些的病人的死亡被计算， multivariate 分析为在里面医院被执行死亡。最后，知道流血的预言者在病人年龄之间被比较 < 85 年和年龄 17,378 个病人学习了的 85 years.ResultsOf，(5.9%) 1019 经历了流血，(2.1%) 369 死了在里面医院追随者一种总线标准。流血和在里面医院死亡的发生与增加年龄 monotonically 增加了(死亡：0.94% ， 2.27% ， 4.24% 和 4.58% ；流血：3.96% ， 6.62% ， 10.68% 和 13.99% 好久 < 65， 65-74， 75-84 和 85 年，分别地) 。除了病人年龄 85 年，在 multivariate 分析上，流血为所有年龄组与增加的死亡被联系[机会比率(95% CI ) ：变老 < 65 年， 3.65 (1.99-6.74 ) ；年龄 65-74 年， 2.83 (1.62-4.94 ) ；年龄 75-84 年， 3.86 (2.56-5.82 ) ，年龄 85 年：1.39 (0.49-3.95 )] 有增加的 .ConclusionsBleeding 和死亡追随者一种总线标准增加变老。为老尽管有流血的高率，流血在里面医院死亡追随者一种总线标准不再是预兆的。

Prediction model of in-hospital mortality in elderly patients with acute heart failure based on retrospective study

学习是开发在老病人的在里面医院死亡是预兆的一个临床的风险模型的这的 ObjectivesThe 目的与尖锐的心就医了失败(AHF ) 从医院里的心病学部门的特别护理单位 60 岁以上的 .Methods2486 病人被分析。为在里面医院死亡的独立风险因素被二进制逻辑回归获得然后过去常建立风险预言分数系统(RPSS ) 。在接收装置操作符特征和 C 统计数值测试的曲线(AUC ) 下面的区域被采用估计 RPSS 的性能并且与指南心失败(GWTG-HF ) 与以前的 get 作比较 .ResultsBy 二进制代码逻辑回归分析，心率(或：1.043， 95% CI：1.030-1.057， P < 0.001 ) ，左室的喷射部分(或：0.918， 95% CI：0.833-0.966， P < 0.001 ) ， pH 价值(或：0.001， 95% CI：0.000-0.002， P < 0.001 ) ，肾的机能障碍(或：0.120， 95% CI：0.066-0.220， P < 0.001 ) 并且 NT 职业人员 BNP (或：3.463， 95% CI：1.870-6.413， P < 0.001 ) 是为老 AHF 病人的在里面医院死亡的独立风险因素。另外， RPSS，它是所有创作了上述参数，比 GWTG-THF 提供了更好的风险预言(AUC：0.873 对 0.818， P = 0.016 ).ConclusionsOur 风险预言模型， RPSS，在老病人为在里面医院死亡向好预言提供了 AHF。