A predictive model for 28-day mortality after discharge in patients with sepsis associated with cerebrovascular disease.

BACKGROUND: The present study investigated the association between cerebrovascular diseases and sepsis, including its occurrence, progression, and impact on mortality. However, there is currently a lack of predictive models for 28-day mortality in patients with cerebrovascular disease associated with sepsis. OBJECTIVE: The objective of this study is to examine the mortality rate within 28 days after discharge in this population, while concurrently developing a corresponding predictive model. METHODS: The data for this retrospective cohort study were obtained from the MIMIC-IV database. Patients with sepsis and cerebrovascular disease in the ICU were included. Laboratory indicators, vital signs, and demographic data were collected within 24 hours of ICU admission. Mortality rates within 28 days after discharge were calculated based on patient death times. Logistic regression analysis was used to identify potential variables for a predictive model. A nomogram visualized the prediction model. The performance of the model was evaluated using ROC curves, Calibration plots, and DCA. RESULTS: The study enrolled a total of 2660 patients diagnosed with cerebrovascular disease complicated by sepsis, consisting of 1434 males (53.91%) with a median age of 70.97 (59.60, 80.73). Among this cohort of patients, a total of 751 fatalities occurred within 28 days following discharge. The multivariate regression analysis revealed that age, creatinine, arterial oxygen partial pressure (Pa O2), arterial carbon dioxide partial pressure (Pa CO2), respiratory rate, white blood cell (WBC) count, Body Mass Index (BMI), and race demonstrated potential predictive variables. The aforementioned model yielded an area under the ROC curve of 0.744, accompanied by a sensitivity of 66.2% and specificity of 71.2%. Furthermore, both calibration plots and DCA demonstrated robust performance in practical applications. CONCLUSION: The proposed prediction model allows clinicians to promptly assess the mortality risk in patients with cerebrovascular disease complicated by sepsis within 28 days after discharge, facilitating early intervention strategies. Consequently, clinicians can implement additional advantageous medical interventions for individuals with cerebrovascular disease and sepsis.

Icotinib and pemetrexed in treatment of lung adenocarcinoma and the effects on prognostic survival rate of patients.

Efficacy comparison of icotinib and pemetrexed in the treatment of lung adenocarcinoma and the effects on the prognostic survival rate of patients were investigated. A retrospective analysis was performed in 132 lung adenocarcinoma patients who were treated in the Affiliated Hospital of Weifang Medical University from July 2010 to July 2015. Among them, 69 patients were treated with icotinib (icotinib group), and 63 patients were treated with pemetrexed (pemetrexed group). In the icotinib group, 125 mg icotinib was orally administered continuously, 3 times a day, until progressive disease or intolerable adverse reactions occurred. In the pemetrexed group, 500 mg/m2 pemetrexed was intravenously dripped for a total of 4 cycles, 21 days for 1 cycle, until progressive disease or intolerable adverse reactions occurred. The efficacy, toxic and side effects, and survival rate of the two groups were evaluated. There was a statistically significant difference in toxic and side effects between the two groups of drugs after the treatment of lung adenocarcinoma (P<0.05). The median survival time of patients was 16 months in the icotinib group and 10 months in the pemetrexed group, with a statistically significant difference (P<0.05). The 1-year survival rate was higher in the icotinib group than that in the pemetrexed group (P<0.05). There was no difference in 2- and 3-year survival rates between the two groups (P>0.05). In conclusion, the clinical efficacy of icotinib is similar to that of pemetrexed in the treatment of lung adenocarcinoma, but icotinib has less adverse reactions, with better improvement in disease control.

Association of serum hepcidin levels with the presence and severity of obstructive sleep apnea syndrome.

BACKGROUND: Inflammation is thought to be involved in the pathogenesis of obstructive sleep apnea syndrome (OSAS). Hepcidin, a 25-kD peptide hormone produced by the liver, modulates acute inflammatory responses. This study aimed to determine the association of serum levels of hepcidin with the presence and severity of OSAS. MATERIAL/METHODS: We enrolled 184 patients with OSAS and 110 healthy subjects. Serum levels of hepcidin were evaluated using enzyme-linked immunosorbent assay (ELISA) method. RESULTS: OSAS patients had significantly higher serum hepcidin levels compared with healthy controls. Multivariable logistic regression analysis indicated that serum hepcidin levels were an independent determinant of the presence of OSAS (OR 1.224, 95% CI 1.159-1.292; P<0.001). Serum hepcidin levels were significantly elevated in severe OSAS patients compared with mild and moderate OSAS patients. Spearman correlation analysis revealed that serum hepcidin levels were correlated with the severity of OSAS. In addition, serum levels of hepcidin were correlated with apnea-hypopnea index (AHI) in patients with OSAS. CONCLUSIONS: Elevated serum hepcidin levels are associated with the presence and severity of OSAS.