A Cross-Sectional Study for Determining the Role of High-Sensitivity Cardiac Troponin T in Predicting 4-Month Mortality during the First Wave of the COVID-19 Pandemic.

Background: Positivity of cardiac troponins is common in hospitalized COVID-19 patients and may serve as an additional risk stratification tool in everyday clinical settings. Since patients with elevated troponins have a higher risk of in-hospital mortality, troponins have prognostic importance. As well as in-hospital mortality, high-sensitive troponin T may reflect 4-month mortality. We analyzed the relationship between cardiac troponin T levels and 4-month mortality of COVID-19. Materials and Methods: It was conducted as a retrospective cross-sectional study in Health Sciences University Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital Izmir, Turkey, with COVID-19 pneumonia patients during the first wave of the pandemic. We analyzed their comorbidities, C-reactive protein, ferritin, aspartate transaminase, alanine transaminase, cardiac troponin T, N-terminal-prohormone B-type-natriuretic peptide, international normalized ratio; duration of hospital stay, and survival status. Results: Factors associated with mortality were cardiac troponin T > 0.53 pg/dl (p = 0.009) and aspartate transaminase > 26.5 U/l (p = 0.012). The threshold for cardiac troponin T to predict 4-month mortality was 5.83pg/ml. Its sensitivity was 82.8% and its specificity was 66.4%. Conclusion: Cardiac troponin T and AST are indicators that can be used to predict 4-month mortality in addition to showing in-hospital mortality. The threshold for cardiac troponin T to predict 4-month all-cause mortality is 5.83pg/ml. The mortality difference persists at the beginning, middle, and end of the 4 months. Reference thresholds likely underestimate the true prognostic extent of cardiac injury and lower cutoff values may show mortality.

The impact of anemia on the mortality of COPD patients hospitalized for acute exacerbation resulting in respiratory failure.

Anemia increases mortality in patients with chronic obstructive pulmonary disease (COPD), but its effects on mortality and survival time for different levels of airflow limitation severity are unclear. Our goal was to investigate the effects of anemia on survival time and mortality in COPD patients with varying degrees of airflow limitation. We looked at 300 consecutive COPD patients in the past. Their demographic information, Charlson comorbidity index, previous early (30 days) and late (>30 days) hospitalizations, blood counts, and post-bronchodilator spirometric values were all recorded. They were contacted by phone to check on their vital status, and their mortality rates were calculated. Anemic patients had a mean overall survival time of 31.9 2.8 months and normal patients had a mean overall survival time of 41.7 2.1 months (p=0.001). Their 1-year and 2-year mortality rates are higher. Age, Charlson comorbidity index, BMI, FEV1%, anemia, MCV, hemoglobin, serum creatinin, and early and late hospitalizations all had an impact on mortality. BMI, anemia, and FEV1% remained risk factors for death. Anemic group 2 patients had a higher mortality rate than groups 3 and 4. Anemic patients in groups 2 and 4 had shorter survival times. Anemic COPD patients have higher 1-year and 2-year mortality rates. Mortality is affected by age, Charlson comorbidity index, BMI, FEV1%, anemia, MCV, hemoglobin, serum creatinin, and early and late hospitalizations. BMI, anemia, and FEV1% remained risk factors for death. Anemic group 2 patients have a higher mortality rate than groups 3 and 4. Anemic patients in groups 2 and 4 have shorter survival times.

Correlation of preoperative PET/computer tomography 18F-fluorodeoxyglucose uptake (maximum standardized uptake value) with prognosis in patients with operated lung cancer.

PURPOSE: The aim of this study was to investigate the correlation of preoperative 18F-fluorodeoxyglucose PET/computed tomography maximum standardized uptake value (SUVmax) in operated non-small cell lung cancer (NSCLC) cases with other prognostic parameters and survival. PATIENTS AND METHODS: NSCLC patients treated by surgical resection were imaged with PET within 60 days before surgery. RESULTS: Overall, 525 cases consecutive patients were retrospectively reviewed. The median value of SUVmax in a total of 525 cases was 12.1, and the mean was 13.3 ± 7.13. Logistic regression analysis performed to identify the variables that have an impact on SUVmax revealed that histology [hazard ratio (HR: 1.893; 95% CI; P = 0.001) and T status (HR: 8.991; 95% CI; P = 0.000) are correlated with SUVmax. Kaplan-Meier analysis revealed a mean survival of 73.7 ± 1.95 months and a median survival of 85.6 ± 6.03 months. In the group with an SUVmax value of less than 10, the mean survival was 81.9 ± 3.02 months (76.0-87.8), and in the group with SUVmax greater than 10.1, the mean survival was 68.6 ± 2.4 months (63.9-73.3) (P = 0.000). In the multivariate analysis, SUVmax, age, tumor histology, lymph node metastasis, comorbid diseases and complete/incomplete status of the resection were identified as the factors predictive of prognosis. CONCLUSION: It is seen that preoperative SUVmax is a parameter with prognostic significance at least as much as histopathology, age, complete/incomplete status of resection and lymph node involvement.

How does chronic obstructive pulmonary disease affect the survival of patients with stage 4 lung cancer?

BACKGROUND: Lung cancer risk is increased in COPD. However, it is not clear how COPD affects the course of lung cancer. AIM: To determine whether the overall survival of stage 4 lung cancer patients differ in various COPD stages. STUDY DESIGN: A cross-sectional retrospective study. METHODS: We screened lung cancer patients with ICD code: C34 and included stage 4 lung cancer patients with histological diagnosis and pulmonary function tests at admission in the study. Demographic data, stages, metastasis sites and number of metastases, performance status, pulmonary function tests, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages, arterial blood gasses and treatment methods were recorded on a standardised database. We checked their dates of death from national database. Data were evaluated with SPSS programme version 18. RESULTS: Out of 900 patients, 146 patients had stage 4 disease at the time of diagnosis and, 127 patients had COPD. There was a significant difference between survivals of stage 4 cancer patients with different COPD stages. As COPD stage increased, overall survival worsened (P = 0.037). Factors affecting survival were bone metastasis (P = 0.01, OR = 1.72), liver metastasis (P = 0.04, OR = 1.87), brain metastasis (P = 0.001, OR = 2.6), having N 2-3 disease (P = 0.01, OR = 1.79) and GOLD 4 COPD (P = 0.01, OR = 2.28). CONCLUSION: As COPD becomes more severe, overall survival rates of stage 4 patients worsen. Bone metastasis, liver metastasis, brain metastasis, having N2-3 disease and GOLD 4 COPD worsen the overall survival.