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Prognostic value of estimated glomerular filtration rate and presence of proteinuria in type B aortic intramural hematoma

BACKGROUND: Although aggressive medical treatment is recommended in patients with type B aortic intramural hematoma (IMH), a variety of aortic events can occur during the later period. For early identification of these patients, the present study was aimed at evaluating the prognostic validity of es...

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Autores principales: Yang, Yang, Li, Weihao, Liu, Mingyuan, Zhang, Xiaoming, Li, Qingle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947484/
https://www.ncbi.nlm.nih.gov/pubmed/33717567
http://dx.doi.org/10.21037/jtd-20-2543
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author Yang, Yang
Li, Weihao
Liu, Mingyuan
Zhang, Xiaoming
Li, Qingle
author_facet Yang, Yang
Li, Weihao
Liu, Mingyuan
Zhang, Xiaoming
Li, Qingle
author_sort Yang, Yang
collection PubMed
description BACKGROUND: Although aggressive medical treatment is recommended in patients with type B aortic intramural hematoma (IMH), a variety of aortic events can occur during the later period. For early identification of these patients, the present study was aimed at evaluating the prognostic validity of estimated glomerular filtration rate (eGFR) and the presence of proteinuria in type B aortic IMH. METHODS: Data of 61 patients with type B IMH in Peking University People’s Hospital from January 2008 to December 2018 were retrospectively collected. The serum creatinine level and urine protein levels were measured at admission. And eGFR were calculated by the CKD-EPI equation. Adverse aortic-related events were defined as a composite of satisfaction of criteria for surgical conversion (with or without actual surgical intervention) and death from aortic rupture. RESULTS: Initial eGFR was significantly different between patients with adverse aortic-related events and those without (P=0.003). On multivariate analysis, eGFR <90 mL/min/1.73 m(2) (OR, 8.726; 95% CI: 1.711–46.144; P=0.009) and ULP (OR, 17.516; 95% CI: 3.322–92.258; P=0.001) were independent predictors of adverse aorta-related events. Furthermore, eGFR <90 mL/min/1.73 m(2) and proteinuria (+) (OR, 8.344; P=0.030) had significantly greater rates of aortic-related events. In addition, eGFR <90 mL/min/1.73 m(2) and proteinuria (+) had incremental prognostic value (C-statistic, 0.860, P=0.039) compared with ulcer-like projection (C-statistic, 0.815) alone. CONCLUSIONS: Initial eGFR and presence of proteinuria were able to provide incremental prognostic information in addition to ulcer-like projection in patients with type B aortic IMH.
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spelling pubmed-79474842021-03-12 Prognostic value of estimated glomerular filtration rate and presence of proteinuria in type B aortic intramural hematoma Yang, Yang Li, Weihao Liu, Mingyuan Zhang, Xiaoming Li, Qingle J Thorac Dis Original Article BACKGROUND: Although aggressive medical treatment is recommended in patients with type B aortic intramural hematoma (IMH), a variety of aortic events can occur during the later period. For early identification of these patients, the present study was aimed at evaluating the prognostic validity of estimated glomerular filtration rate (eGFR) and the presence of proteinuria in type B aortic IMH. METHODS: Data of 61 patients with type B IMH in Peking University People’s Hospital from January 2008 to December 2018 were retrospectively collected. The serum creatinine level and urine protein levels were measured at admission. And eGFR were calculated by the CKD-EPI equation. Adverse aortic-related events were defined as a composite of satisfaction of criteria for surgical conversion (with or without actual surgical intervention) and death from aortic rupture. RESULTS: Initial eGFR was significantly different between patients with adverse aortic-related events and those without (P=0.003). On multivariate analysis, eGFR <90 mL/min/1.73 m(2) (OR, 8.726; 95% CI: 1.711–46.144; P=0.009) and ULP (OR, 17.516; 95% CI: 3.322–92.258; P=0.001) were independent predictors of adverse aorta-related events. Furthermore, eGFR <90 mL/min/1.73 m(2) and proteinuria (+) (OR, 8.344; P=0.030) had significantly greater rates of aortic-related events. In addition, eGFR <90 mL/min/1.73 m(2) and proteinuria (+) had incremental prognostic value (C-statistic, 0.860, P=0.039) compared with ulcer-like projection (C-statistic, 0.815) alone. CONCLUSIONS: Initial eGFR and presence of proteinuria were able to provide incremental prognostic information in addition to ulcer-like projection in patients with type B aortic IMH. AME Publishing Company 2021-02 /pmc/articles/PMC7947484/ /pubmed/33717567 http://dx.doi.org/10.21037/jtd-20-2543 Text en 2021 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Yang, Yang
Li, Weihao
Liu, Mingyuan
Zhang, Xiaoming
Li, Qingle
Prognostic value of estimated glomerular filtration rate and presence of proteinuria in type B aortic intramural hematoma
title Prognostic value of estimated glomerular filtration rate and presence of proteinuria in type B aortic intramural hematoma
title_full Prognostic value of estimated glomerular filtration rate and presence of proteinuria in type B aortic intramural hematoma
title_fullStr Prognostic value of estimated glomerular filtration rate and presence of proteinuria in type B aortic intramural hematoma
title_full_unstemmed Prognostic value of estimated glomerular filtration rate and presence of proteinuria in type B aortic intramural hematoma
title_short Prognostic value of estimated glomerular filtration rate and presence of proteinuria in type B aortic intramural hematoma
title_sort prognostic value of estimated glomerular filtration rate and presence of proteinuria in type b aortic intramural hematoma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947484/
https://www.ncbi.nlm.nih.gov/pubmed/33717567
http://dx.doi.org/10.21037/jtd-20-2543
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