Ruptured abdominal aortic aneurysm and quality of life.

This study was undertaken to examine the community hospital experience in managing ruptured abdominal aortic aneurysm, and to assess the quality of life in survivors of the abdominal aortic aneurysm procedure. Study parameters included a retrospective chart review with prospective follow-up at a 369-bed, university-affiliated, community teaching hospital. Eighty-one consecutive patients undergoing surgery for ruptured abdominal aortic aneurysm between 1991 and 2000 were included. Main outcome measures included mortality and quality of life, as assessed by the SF-36 health survey. The overall perioperative mortality rate was 34.6%, significantly less (p \u3c 0.005) than the 50% mortality rate reported in the literature. Predictor variables significantly related to mortality were age (p \u3c 0.002), preoperative creatinine (p \u3c 0.026), use of suprarenal clamp (p \u3c 0.0001), acute renal failure (p \u3c 0.0001), myocardial infarction (p \u3c 0.0001), respiratory failure (p \u3c 0.0001), and tobacco use (p \u3c 0.05). Multiple regression analysis found that three predictor variables--myocardial infarction, respiratory failure, and use of a suprarenal clamp--predicted 25% of the variability in mortality (p \u3c 0.0001). The quality-of-life analyses showed that the majority of the patients for whom follow-up data could be obtained (n = 26), reported the same or better quality of life compared to SF-36 norms for age-matched individuals. Results from this community hospital sample suggest that ruptured abdominal aortic aneurysm repair can be accomplished in this setting with an acceptable survival rate, and subsequent quality of life that meets or exceeds that of an age-matched sample

Multinational characterization of neurological phenotypes in patients hospitalized with COVID-19

International audienceAbstract Neurological complications worsen outcomes in COVID-19. To define the prevalence of neurological conditions among hospitalized patients with a positive SARS-CoV-2 reverse transcription polymerase chain reaction test in geographically diverse multinational populations during early pandemic, we used electronic health records (EHR) from 338 participating hospitals across 6 countries and 3 continents (January–September 2020) for a cross-sectional analysis. We assessed the frequency of International Classification of Disease code of neurological conditions by countries, healthcare systems, time before and after admission for COVID-19 and COVID-19 severity. Among 35,177 hospitalized patients with SARS-CoV-2 infection, there was an increase in the proportion with disorders of consciousness (5.8%, 95% confidence interval [CI] 3.7–7.8%, p FDR < 0.001) and unspecified disorders of the brain (8.1%, 5.7–10.5%, p FDR < 0.001) when compared to the pre-admission proportion. During hospitalization, the relative risk of disorders of consciousness (22%, 19–25%), cerebrovascular diseases (24%, 13–35%), nontraumatic intracranial hemorrhage (34%, 20–50%), encephalitis and/or myelitis (37%, 17–60%) and myopathy (72%, 67–77%) were higher for patients with severe COVID-19 when compared to those who never experienced severe COVID-19. Leveraging a multinational network to capture standardized EHR data, we highlighted the increased prevalence of central and peripheral neurological phenotypes in patients hospitalized with COVID-19, particularly among those with severe disease