Articles: mortality.
-
Editorial
Decoding Homelessness: Z-Codes and the Recognition of Homelessness as a Comorbid Condition.
There are an estimated 653,100 people across the United States experiencing homelessness. Homelessness is an important social determinant of health associated with increased morbidity and mortality. ⋯ Here, we review the historical purpose and utilization of codes to identify SDOH ("Z-codes"); describe how the recent CMS policy change elevates the importance of homelessness within medical care and impacts reimbursement; analyze the potential risks and benefits of this change to patients, clinicians, and health systems; and assess barriers to implementation. We conclude by calling for health systems to move beyond simply documenting homelessness to meaningfully addressing health inequities in PEH.
-
Anesthesia and analgesia · Nov 2024
The Association Between Perioperative Red Blood Cell Transfusions and 1-Year Mortality After Major Cancer Surgery: An International Multicenter Observational Study.
Packed red blood cell (pRBC) transfusions in patients undergoing surgery for cancer are given to treat anemia or acute hemorrhage. Evidence indicates that pRBC transfusions are associated with poor perioperative and oncological outcomes. The ARCA-1 (Perioperative Care in the Cancer Patient-1) study was designed to test the association between perioperative pRBC transfusions and postoperative morbidity and mortality in patients undergoing cancer surgery. The primary hypothesis of our study was that perioperative pRBC transfusions have a negative impact on postoperative morbidity and 1-year mortality. ⋯ This international, multicenter observational study showed that perioperative pRBC transfusion was associated with an increased mortality risk.
-
Anesthesia and analgesia · Nov 2024
Development and Validation of a Predictive Model for Maternal Cardiovascular Morbidity Events in Patients With Hypertensive Disorders of Pregnancy.
Hypertensive disorders of pregnancy (HDP) are a major contributor to maternal morbidity, mortality, and accelerated cardiovascular (CV) disease. Comorbid conditions are likely important predictors of CV risk in pregnant people. Currently, there is no way to predict which people with HDP are at risk of acute CV complications. We developed and validated a predictive model for all CV events and for heart failure, renal failure, and cerebrovascular events specifically after HDP. ⋯ Among individuals with HDP, our multilabel neural network model predicted CV events at delivery admission with good classification and events within 1 year of delivery with fair classification.
-
Cardiorespiratory fitness (CRF) is a stronger predictor of mortality than traditional risk factors and is a neglected vital sign of health. Enhanced fitness is a cornerstone in diabetes management and is most often delivered concurrently with pharmacological agents, which can have an opposing impact, as has been reported with metformin. Considering the rapid evolution of diabetes medications with improved cardiovascular outcomes, such as glucagon-like peptide-1 receptor agonists and sodium glucose cotransporter-2 inhibitors, it is of importance to consider the influence of these vis-a-vis effects on CRF. ⋯ Since CRF is a superior prognosticator for cardiovascular outcomes and both medications can cause lean muscle mass loss, the current review highlights the paucity of relevant interactive analysis.