Articles: mortality.
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Acute kidney injury (AKI) is a common clinical problem which occurs in critically ill patients. Sepsis is now recognized as the most important contributing factor to AKI in this population. In clinical practice, certain studies have explored the urine neutrophil gelatinase-associated lipocalin (uNGAL) and the urine kidney injury molecule-1 (uKIM-1) as diagnostic and prognostic indices of AKI. ⋯ On the other hand, there was no statistical difference in event-free survival between patients with and without higher serum creatinine, creatinine clearance and uKIM-1 (data not shown). In conclusion, uNGAL may be a promising predictor for septic patients with AKI, resulting in a clear increase in 180-day mortality. Further clinical evaluation of uNGAL is underway.
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Knowledge of the association between body mass index (weight (kg)/height (m)(2)) and premature death in young adulthood is very limited, especially for specific causes of death. Using the US National Health Interview Survey linked mortality files, the authors examined the relation between body mass index and premature death from all causes, cardiovascular disease (CVD), and cancer among 112,328 persons aged 18-39 years who participated in the National Health Interview Survey in the years 1987, 1988, and 1990-1995. During an average of 16 years of follow-up (ending on December 31, 2006), there were 3,178 deaths: 573 from CVD and 733 from cancer. ⋯ In analyses restricted to participants who had never smoked, the hazard ratios for death from all causes were 1.07 (95% confidence interval (CI): 0.91, 1.26) for overweight participants, 1.41 (95% CI: 1.16, 1.73) for obese participants, and 2.46 (95% CI: 1.91, 3.16) for extremely obese participants, compared with those of normal weight. Monotonically increasing risks for excess body weight were also observed for deaths from cancer and CVD. The associations found in this young cohort were much stronger than those in middle-aged or older populations.
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Critical care medicine · Oct 2011
Multicenter Study Comparative StudyDefinition of mortality for trauma center performance evaluation: a comparative study.
Mortality is widely used as a performance indicator to evaluate the quality of trauma care, but there is no consensus on the most appropriate definition. Our objective was to evaluate the influence of the definition of mortality in terms of the place (in-hospital or postdischarge) and time (30 days and 3, 6, and 12 months) of death on the results of trauma center performance evaluations according to the patients' ages. ⋯ We observed an important variation in performance evaluation results across definitions of mortality, specifically in patients aged≥65 yrs. Half of the deaths among elders occurred later than 30 days following admission, including a significant number postdischarge. Results suggest that if performance evaluations include elderly patients, data on postdischarge mortality up to 6 months following admission are required.