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Predicting Mortality in Children With Pediatric Acute Respiratory Distress Syndrome: A Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology Study / Byron Enrique Piñeres Olave
Título : Predicting Mortality in Children With Pediatric Acute Respiratory Distress Syndrome: A Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology Study Tipo de documento : documento electrónico Autores : Byron Enrique Piñeres Olave, Fecha de publicación : 2020 Títulos uniformes : Critical Care Medicine Idioma : Inglés (eng) Palabras clave : mortality pediatric acute respiratory distress syndrome prediction risk stratification ventilator-free days Resumen : Objectives: Pediatric acute respiratory distress syndrome is heterogeneous, with a paucity of risk stratification tools to assist with trial design. We aimed to develop and validate mortality prediction models for patients with pediatric acute respiratory distress syndrome. Design: Leveraging additional data collection from a preplanned ancillary study (Version 1) of the multinational Pediatric Acute Respiratory Distress syndrome Incidence and Epidemiology study, we identified predictors of mortality. Separate models were built for the entire Version 1 cohort, for the cohort excluding neurologic deaths, for intubated subjects, and for intubated subjects excluding neurologic deaths. Models were externally validated in a cohort of intubated pediatric acute respiratory distress syndrome patients from the Children's Hospital of Philadelphia. Setting: The derivation cohort represented 100 centers worldwide; the validation cohort was from Children's Hospital of Philadelphia. Patients: There were 624 and 640 subjects in the derivation and validation cohorts, respectively. Interventions: None. Measurements and main results: The model for the full cohort included immunocompromised status, Pediatric Logistic Organ Dysfunction 2 score, day 0 vasopressor-inotrope score and fluid balance, and PaO2/FIO2 6 hours after pediatric acute respiratory distress syndrome onset. This model had good discrimination (area under the receiver operating characteristic curve 0.82), calibration, and internal validation. Models excluding neurologic deaths, for intubated subjects, and for intubated subjects excluding neurologic deaths also demonstrated good discrimination (all area under the receiver operating characteristic curve ≥ 0.84) and calibration. In the validation cohort, models for intubated pediatric acute respiratory distress syndrome (including and excluding neurologic deaths) had excellent discrimination (both area under the receiver operating characteristic curve ≥ 0.85), but poor calibration. After revision, the model for all intubated subjects remained miscalibrated, whereas the model excluding neurologic deaths showed perfect calibration. Mortality models also stratified ventilator-free days at 28 days in both derivation and validation cohorts. Conclusions: We describe predictive models for mortality in pediatric acute respiratory distress syndrome using readily available variables from day 0 of pediatric acute respiratory distress syndrome which outperform severity of illness scores and which demonstrate utility for composite outcomes such as ventilator-free days. Models can assist with risk stratification for clinical trials. Mención de responsabilidad : Nadir Yehya, Michael O Harhay, Margaret J Klein, Steven L Shein, Byron E Piñeres-Olave, Ledys Izquierdo, Anil Sapru, Guillaume Emeriaud, Philip C Spinella, Heidi R Flori, Mary K Dahmer, Aline B Maddux, Yolanda M Lopez-Fernandez, Bereketeab Haileselassie, Deyin Doreen Hsing, Ranjit S Chima, Amanda B Hassinger, Stacey L Valentine, Courtney M Rowan, Martin C J Kneyber, Lincoln S Smith, Robinder G Khemani, Neal J Thomas, on behalf of the Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology (PARDIE) V1 Investigators and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Referencia : Crit Care Med. 2020 Jun;48(6):e514-e522. DOI (Digital Object Identifier) : 10.1097/CCM.0000000000004345 PMID : 32271186 Derechos de uso : CC BY-NC-ND En línea : https://journals.lww.com/ccmjournal/FullText/2020/06000/Predicting_Mortality_in_ [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5113 Predicting Mortality in Children With Pediatric Acute Respiratory Distress Syndrome: A Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology Study [documento electrónico] / Byron Enrique Piñeres Olave, . - 2020.
Obra : Critical Care Medicine
Idioma : Inglés (eng)
Palabras clave : mortality pediatric acute respiratory distress syndrome prediction risk stratification ventilator-free days Resumen : Objectives: Pediatric acute respiratory distress syndrome is heterogeneous, with a paucity of risk stratification tools to assist with trial design. We aimed to develop and validate mortality prediction models for patients with pediatric acute respiratory distress syndrome. Design: Leveraging additional data collection from a preplanned ancillary study (Version 1) of the multinational Pediatric Acute Respiratory Distress syndrome Incidence and Epidemiology study, we identified predictors of mortality. Separate models were built for the entire Version 1 cohort, for the cohort excluding neurologic deaths, for intubated subjects, and for intubated subjects excluding neurologic deaths. Models were externally validated in a cohort of intubated pediatric acute respiratory distress syndrome patients from the Children's Hospital of Philadelphia. Setting: The derivation cohort represented 100 centers worldwide; the validation cohort was from Children's Hospital of Philadelphia. Patients: There were 624 and 640 subjects in the derivation and validation cohorts, respectively. Interventions: None. Measurements and main results: The model for the full cohort included immunocompromised status, Pediatric Logistic Organ Dysfunction 2 score, day 0 vasopressor-inotrope score and fluid balance, and PaO2/FIO2 6 hours after pediatric acute respiratory distress syndrome onset. This model had good discrimination (area under the receiver operating characteristic curve 0.82), calibration, and internal validation. Models excluding neurologic deaths, for intubated subjects, and for intubated subjects excluding neurologic deaths also demonstrated good discrimination (all area under the receiver operating characteristic curve ≥ 0.84) and calibration. In the validation cohort, models for intubated pediatric acute respiratory distress syndrome (including and excluding neurologic deaths) had excellent discrimination (both area under the receiver operating characteristic curve ≥ 0.85), but poor calibration. After revision, the model for all intubated subjects remained miscalibrated, whereas the model excluding neurologic deaths showed perfect calibration. Mortality models also stratified ventilator-free days at 28 days in both derivation and validation cohorts. Conclusions: We describe predictive models for mortality in pediatric acute respiratory distress syndrome using readily available variables from day 0 of pediatric acute respiratory distress syndrome which outperform severity of illness scores and which demonstrate utility for composite outcomes such as ventilator-free days. Models can assist with risk stratification for clinical trials. Mención de responsabilidad : Nadir Yehya, Michael O Harhay, Margaret J Klein, Steven L Shein, Byron E Piñeres-Olave, Ledys Izquierdo, Anil Sapru, Guillaume Emeriaud, Philip C Spinella, Heidi R Flori, Mary K Dahmer, Aline B Maddux, Yolanda M Lopez-Fernandez, Bereketeab Haileselassie, Deyin Doreen Hsing, Ranjit S Chima, Amanda B Hassinger, Stacey L Valentine, Courtney M Rowan, Martin C J Kneyber, Lincoln S Smith, Robinder G Khemani, Neal J Thomas, on behalf of the Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology (PARDIE) V1 Investigators and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Referencia : Crit Care Med. 2020 Jun;48(6):e514-e522. DOI (Digital Object Identifier) : 10.1097/CCM.0000000000004345 PMID : 32271186 Derechos de uso : CC BY-NC-ND En línea : https://journals.lww.com/ccmjournal/FullText/2020/06000/Predicting_Mortality_in_ [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5113 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001344 AC-2020-048 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
2020-048.pdfAdobe Acrobat PDF Results of Liver Transplantation for Hepatocellular Carcinoma in a Multicenter Latin American Cohort Study / Sergio Iván Hoyos Duque
Título : Results of Liver Transplantation for Hepatocellular Carcinoma in a Multicenter Latin American Cohort Study Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, Fecha de publicación : 2018 Títulos uniformes : Annals of Hepatology Idioma : Inglés (eng) Palabras clave : Liver cancer prediction candidate selection. Resumen : Background and aims: Heterogeneous data has been reported regarding liver transplantation (LT) for hepatocellular carcinoma (HCC) in Latin America. We aimed to describe treatment during waiting list, survival and recurrence of HCC after LT in a multicenter study from Latin America. Material and methods: Patients with HCC diagnosed prior to transplant (cHCC) and incidentally found in the explanted liver (iHCC) were included. Imaging-explanted features were compared in cHCC (non-discordant if pre and post-LT were within Milan, discordant if pre-LT was within and post-LT exceeding Milan). Results: Overall, 435 patients with cHCC and 92 with iHCC were included. At listing, 81% and 91% of cHCC patients were within Milan and San Francisco criteria (UCSF), respectively. Five-year survival and recurrence rates for cHCC within Milan, exceeding Milan/within UCSF and beyond UCSF were 71% and 16%; 66% and 26%; 46% and 55%, respectively. Locoregional treatment prior to LT was performed in 39% of cHCC within Milan, in 53% beyond Milan/within UCSF and in 83% exceeding UCSF (p 1,000 ng/mL 64%; p = 0.12). Discordant imaging-explanted data was observed in 29% of cHCC, showing lower survival HR 2.02 (CI 1.29; 3.15) and higher recurrence rates HR 2.34 when compared to AFP 1,000 ng/mL at listing was independently associated with a higher 5-year recurrence rate and a HR of 3.24 when compared to AFP Mención de responsabilidad : Federico Piñero, Paulo Costa, Yuri L Boteon, Sergio Hoyos Duque, Sebastian Marciano, Margarita Anders, Adriana Varón, Alina Zerega, Jaime Poniachik, Alejandro Soza, Martín Padilla Machaca, Josemaría Menéndez, Rodrigo Zapata, Mario Vilatoba, Linda Muñoz, Martín Maraschio, Martín Fauda, Lucas McCormack, Adrian Gadano, Ilka Sf Boin, Jose H Parente García, Marcelo Silva Referencia : Ann Hepatol. 2018 Mar 1;17(2):256-267. DOI (Digital Object Identifier) : 10.5604/01.3001.0010.8648 PMID : 29469048 En línea : https://linkinghub.elsevier.com/retrieve/pii/S1665268119301589 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4188 Results of Liver Transplantation for Hepatocellular Carcinoma in a Multicenter Latin American Cohort Study [documento electrónico] / Sergio Iván Hoyos Duque, . - 2018.
Obra : Annals of Hepatology
Idioma : Inglés (eng)
Palabras clave : Liver cancer prediction candidate selection. Resumen : Background and aims: Heterogeneous data has been reported regarding liver transplantation (LT) for hepatocellular carcinoma (HCC) in Latin America. We aimed to describe treatment during waiting list, survival and recurrence of HCC after LT in a multicenter study from Latin America. Material and methods: Patients with HCC diagnosed prior to transplant (cHCC) and incidentally found in the explanted liver (iHCC) were included. Imaging-explanted features were compared in cHCC (non-discordant if pre and post-LT were within Milan, discordant if pre-LT was within and post-LT exceeding Milan). Results: Overall, 435 patients with cHCC and 92 with iHCC were included. At listing, 81% and 91% of cHCC patients were within Milan and San Francisco criteria (UCSF), respectively. Five-year survival and recurrence rates for cHCC within Milan, exceeding Milan/within UCSF and beyond UCSF were 71% and 16%; 66% and 26%; 46% and 55%, respectively. Locoregional treatment prior to LT was performed in 39% of cHCC within Milan, in 53% beyond Milan/within UCSF and in 83% exceeding UCSF (p 1,000 ng/mL 64%; p = 0.12). Discordant imaging-explanted data was observed in 29% of cHCC, showing lower survival HR 2.02 (CI 1.29; 3.15) and higher recurrence rates HR 2.34 when compared to AFP 1,000 ng/mL at listing was independently associated with a higher 5-year recurrence rate and a HR of 3.24 when compared to AFP Mención de responsabilidad : Federico Piñero, Paulo Costa, Yuri L Boteon, Sergio Hoyos Duque, Sebastian Marciano, Margarita Anders, Adriana Varón, Alina Zerega, Jaime Poniachik, Alejandro Soza, Martín Padilla Machaca, Josemaría Menéndez, Rodrigo Zapata, Mario Vilatoba, Linda Muñoz, Martín Maraschio, Martín Fauda, Lucas McCormack, Adrian Gadano, Ilka Sf Boin, Jose H Parente García, Marcelo Silva Referencia : Ann Hepatol. 2018 Mar 1;17(2):256-267. DOI (Digital Object Identifier) : 10.5604/01.3001.0010.8648 PMID : 29469048 En línea : https://linkinghub.elsevier.com/retrieve/pii/S1665268119301589 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4188 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000802 AC-2018-089 Archivo digital Producción Científica Artículos científicos Disponible Liver transplantation for hepatocellular carcinoma: evaluation of the alpha-fetoprotein model in a multicenter cohort from Latin America / Sergio Iván Hoyos Duque
Título : Liver transplantation for hepatocellular carcinoma: evaluation of the alpha-fetoprotein model in a multicenter cohort from Latin America Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, Fecha de publicación : 2016 Títulos uniformes : Liver International Idioma : Inglés (eng) Palabras clave : Alpha-fetoprotein candidate selection liver cancer prediction Resumen : Background & Aims: The French alpha‐fetoprotein (AFP) model has recently shown superior results compared to Milan criteria (MC) for prediction of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) in European populations. The aim of this study was to explore the predictive capacity of the AFP model for HCC recurrence in a Latin American cohort. Methods: Three hundred twenty‐seven patients with HCC were included from a total of 2018 patients transplanted at 15 centres. Serum AFP and imaging data were both recorded at listing. Predictability was assessed by the Net Reclassification Improvement (NRI) method. Results: Overall, 82 and 79% of the patients were within MC and the AFP model respectively. NRI showed a superior predictability of the AFP model against MC. Patients with an AFP score >2 points had higher risk of recurrence at 5 years Hazard Ratio (HR) of 3.15 (P = 0.0001) and lower patient survival (HR = 1.51; P = 0.03). Among patients exceeding MC, a score ≤2 points identified a subgroup of patients with lower recurrence (5% vs 42%; P = 0.013) and higher survival rates (84% vs 45%; P = 0.038). In cases treated with bridging procedures, following restaging, a score >2 points identified a higher recurrence (HR 2.2, P = 0.12) and lower survival rate (HR 2.25, P = 0.03). A comparative analysis between HBV and non‐HBV patients showed that the AFP model performed better in non‐HBV patients. Conclusions: The AFP model could be useful in Latin‐American countries to better select patients for LT in subgroups presenting with extended criteria. However, particular attention should be focused on patients with HBV. Mención de responsabilidad : Federico Piñero, Matías Tisi Baña, Elaine Cristina de Ataide, Sergio Hoyos Duque, Sebastian Marciano, Adriana Varón, Margarita Anders, Alina Zerega, Josemaría Menéndez, Rodrigo Zapata, Linda Muñoz, Martín Padilla Machaca, Alejandro Soza, Lucas McCormack, Jaime Poniachik, Luis G Podestá, Adrian Gadano, Ilka S F Fatima Boin, Christophe Duvoux, Marcelo Silva, Latin American Liver Research, Education and Awareness Network LALREAN Referencia : Liver Int. 2016 Nov;36(11):1657-1667. DOI (Digital Object Identifier) : 10.1111/liv.13159 PMID : 27169841 En línea : https://onlinelibrary.wiley.com/doi/abs/10.1111/liv.13159 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3982 Liver transplantation for hepatocellular carcinoma: evaluation of the alpha-fetoprotein model in a multicenter cohort from Latin America [documento electrónico] / Sergio Iván Hoyos Duque, . - 2016.
Obra : Liver International
Idioma : Inglés (eng)
Palabras clave : Alpha-fetoprotein candidate selection liver cancer prediction Resumen : Background & Aims: The French alpha‐fetoprotein (AFP) model has recently shown superior results compared to Milan criteria (MC) for prediction of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) in European populations. The aim of this study was to explore the predictive capacity of the AFP model for HCC recurrence in a Latin American cohort. Methods: Three hundred twenty‐seven patients with HCC were included from a total of 2018 patients transplanted at 15 centres. Serum AFP and imaging data were both recorded at listing. Predictability was assessed by the Net Reclassification Improvement (NRI) method. Results: Overall, 82 and 79% of the patients were within MC and the AFP model respectively. NRI showed a superior predictability of the AFP model against MC. Patients with an AFP score >2 points had higher risk of recurrence at 5 years Hazard Ratio (HR) of 3.15 (P = 0.0001) and lower patient survival (HR = 1.51; P = 0.03). Among patients exceeding MC, a score ≤2 points identified a subgroup of patients with lower recurrence (5% vs 42%; P = 0.013) and higher survival rates (84% vs 45%; P = 0.038). In cases treated with bridging procedures, following restaging, a score >2 points identified a higher recurrence (HR 2.2, P = 0.12) and lower survival rate (HR 2.25, P = 0.03). A comparative analysis between HBV and non‐HBV patients showed that the AFP model performed better in non‐HBV patients. Conclusions: The AFP model could be useful in Latin‐American countries to better select patients for LT in subgroups presenting with extended criteria. However, particular attention should be focused on patients with HBV. Mención de responsabilidad : Federico Piñero, Matías Tisi Baña, Elaine Cristina de Ataide, Sergio Hoyos Duque, Sebastian Marciano, Adriana Varón, Margarita Anders, Alina Zerega, Josemaría Menéndez, Rodrigo Zapata, Linda Muñoz, Martín Padilla Machaca, Alejandro Soza, Lucas McCormack, Jaime Poniachik, Luis G Podestá, Adrian Gadano, Ilka S F Fatima Boin, Christophe Duvoux, Marcelo Silva, Latin American Liver Research, Education and Awareness Network LALREAN Referencia : Liver Int. 2016 Nov;36(11):1657-1667. DOI (Digital Object Identifier) : 10.1111/liv.13159 PMID : 27169841 En línea : https://onlinelibrary.wiley.com/doi/abs/10.1111/liv.13159 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3982 Reserva
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