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American Journal of Gastroenterology ; 117(10 Supplement 2):S881-S883, 2022.
Article in English | EMBASE | ID: covidwho-2325441


Introduction: Intensive care outcomes in patients with cirrhosis are relatively poor. The comparison between outcomes, especially related to infections, remains unclear in those with and without cirrhosis. With the emergence of resistant and fungal organisms, the changes in infection profiles over time are important to analyze. The aim of this study is to determine the impact of cirrhosis and infections on inpatient death over time in a qSOFA-matched cohort of patients with and without cirrhosis. Method(s): Inpatients admitted to ICUs throughout 2015-2021 were analyzed. Patients with cirrhosis were matched 1:1 by age, gender, and admission qSOFA to patients without;COVID-positive patients were excluded. Admission demographics, labs, the reasons for ICU transfer, infections, and inpatient death or hospice referral were obtained for each patient. Comparisons were made between patients with and without cirrhosis and those who died/referred to hospice versus not. Logistic regression for death/hospice was performed. In patients with cirrhosis, the culture results were compared over the years. Result(s): 1669 patients;833 cirrhosis and 836 non-cirrhosis patients were included. Patients with cirrhosis had higher rates of infection, positive culture, abdominal infection, and bacteremia. They also had higher gram-positive and fungal infections with a higher rate of VRE. They showed a greater organ failure load, death, and hospice referral compared to patients without cirrhosis. Logistic regression showed that cirrhosis (OR 4.0, p< 0.0001), admission qSOFA (1.60, p< 0.0001), WBC (1.02, p=0.003), reasons for ICU (altered mental status 1.69, hypotension 1.79, renal support 2.77, respiratory failure 1.79, CVA 1.96, all p< 0.0001) with Infection (1.77, p< 0.0001, >1 microbe isolated 1.86, p=0.05) were risk factors for death/hospice. The infection trend in the cirrhosis group showed a significant decrease in positive cultures and gram-negative infections and an increase in fungal and gram-positive infections over time. Conclusion(s): Despite matching for demographics and qSOFA, patients with cirrhosis had higher risks of death and organ failures. They were more likely to develop gram-positive and fungal infections with multiple organisms and VRE. Time trends in cirrhosis showed lower rates of positive cultures and gram-negative infections and an increase in fungal and gram-positive infections over time, which should encourage re-evaluation of diagnostic and prophylactic strategies in cirrhosis-related infections. (Figure Presented).

22nd IEEE International Conference on Data Mining, ICDM 2022 ; 2022-November:1137-1142, 2022.
Article in English | Scopus | ID: covidwho-2275636
Managerial and Decision Economics ; 44(1):416-423, 2023.
Article in English | Scopus | ID: covidwho-2244063
Journal of Global Business and Trade ; 18(6):19-31, 2022.
Article in English | Scopus | ID: covidwho-2226463
Archives of Design Research ; 35(4):115-131, 2022.
Article in English | Scopus | ID: covidwho-2204049
Journal of the American College of Cardiology ; 80(12):B225-B226, 2022.
Article in English | Web of Science | ID: covidwho-2167597
Applied Chemistry for Engineering ; 33(4):444-450, 2022.
Article in Korean | Scopus | ID: covidwho-2025684
Managerial and Decision Economics ; 2022.
Article in English | Web of Science | ID: covidwho-1995550
Journal of System and Management Sciences ; 12(2):351-366, 2022.
Article in English | Scopus | ID: covidwho-1904187
Ann Surg Oncol ; 29(5): 2773-2783, 2022 May.
Article in English | MEDLINE | ID: covidwho-1779708


BACKGROUND: The purpose of this article is to summarize the opinions of the surgical oncology leaders from the Global Forum of Cancer Surgeons (GFCS) about the global impact of COVID-19 pandemic on cancer surgery. METHODS: A panel session (virtual) was held at the annual Society of Surgical Oncology 2021 International Conference on Surgical Cancer Care to address the impact of COVID-19 on cancer surgery globally. Following the virtual meeting, a questionnaire was sent to all the leaders to gather additional opinions. The input obtained from all the leaders was collated and analyzed to understand how cancer surgeons from across the world adapted in real-time to the impact of COVID-19 pandemic. RESULTS: The surgical oncology leaders noted that the COVID-19 pandemic led to severe disruptions in surgical cancer care across all domains of clinical care, education, and research. Several new changes/protocols associated with increased costs were implemented to deliver safe care. Leaders also noted that preexisting disparities in care were exacerbated, and the pandemic had a detrimental effect on well-being and financial status. CONCLUSIONS: The COVID-19 pandemic has led to severe disruptions in surgical cancer care globally. Leaders of the GFCS opined that new strategies need to be implemented to prepare for any future catastrophic events based on the lessons learned from the current events. The GFCS will embark on developing such a roadmap to ensure that surgical cancer care is preserved in the future regardless of any catastrophic global events.

COVID-19 , Neoplasms , Surgeons , Surgical Oncology , COVID-19/epidemiology , Humans , Neoplasms/surgery , Pandemics
JACC: Cardiovascular Interventions ; 15(4):S30, 2022.
Article in English | EMBASE | ID: covidwho-1757492