ABSTRACT
BACKGROUND: The aim of our study was to evaluate the prognostic value of Charlson's weighted index of comorbidities (WIC) in patients with prolonged acute mechanical ventilation (PAMV, ventilator care ≥96 hours). METHODS: We retrospectively enrolled 299 Korean PAMV patients who were admitted in a medical intensive care unit (ICU) of a university-affiliated tertiary care hospital between 2008 and 2013. Survivors were defined as patients who survived for 60 days after ICU admission. RESULTS: The patients' mean age was 65.1±14.1 years and 70.6% were male. The mean ICU and hospital length of stay was 21.9±19.7 and 39.4±39.1 days, respectively. In addition, the 60-day mortality rate after ICU admission was 35.5%. The mean WIC was 2.3±1.8, with significant differences between nonsurvivors and survivors (2.7±2.1 vs. 2.1±1.7, p<0.05). The area under the curve of receiver-operating-characteristics curve for WIC was 0.593 (95% confidence interval [CI], 0.523–0.661; p<0.05). Based on Kaplan-Meier curves of 60-day survival, WIC ≥5 had statistically lower survival than WIC <5 (log-rank test, p<0.05). In a multivariate Cox proportional hazard model, WIC ≥5 was associated with poor prognosis (hazard ratio, 1.901; 95% CI, 1.140–3.171; p<0.05). The mortality rate of patients with WIC ≥5 was 54.2%. CONCLUSION: Our study showed a WIC score ≥5 might be helpful in predicting 60-day mortality in PAMV patients.
Subject(s)
Humans , Male , Comorbidity , Intensive Care Units , Length of Stay , Mortality , Prognosis , Proportional Hazards Models , Respiration, Artificial , Retrospective Studies , Survivors , Tertiary Healthcare , Ventilators, MechanicalABSTRACT
Rosai-Dorfman disease (RDD) is a benign proliferative histiocytic disorder of unknown etiology, which typically manifests as lymphadenopathy and systemic symptoms. Lymph node involvement is typical, but soft tissue RDD without nodal or systemic involvement is extremely rare. We report on a case of soft tissue RDD in a 16-year-old girl with a palpable mass on her buttock. It was firm, mobile, and discrete without tenderness. Excisional biopsy was performed, then RDD was confirmed histologically. RDD is a non-neoplastic disease that should be considered in the differential diagnosis of other soft tissue tumors. While the optimal treatment for extranodal RDD remains controversial, surgical excision is typically curative.
Subject(s)
Adolescent , Female , Humans , Biopsy , Buttocks , Diagnosis, Differential , Emperipolesis , Histiocytosis, Sinus , Lymph Nodes , Lymphatic DiseasesABSTRACT
Carcinoid tumors are low-grade malignant tumors arising from neuroendocrine cells. Primary renal carcinoid tumor is very rare due to the absence of neuroendocrine cells in the kidney and ureter. Therefore, little is known about the management and prognosis of renal carcinoid. Here, we report a case of a primary renal carcinoid tumor arising from a normal kidney in a 21-year-old man. He presented with a left renal mass, which was found accidentally. Abdominal computed tomography (CT) showed a 5.5 x 5.0-cm cystic mass with calcification. We suspected a cystic renal cell carcinoma and performed a laparoscopic radical nephrectomy. However, the histology revealed a well-differentiated neuroendocrine tumor. We concluded that it was a primary renal carcinoid tumor with no distant metastasis and did not administer chemotherapy or radiation therapy. He is recurrence-free after 8 months.