Predicting bacterial infection risk in patients with ANCA-associated vasculitis in southwest China: development of a new nomogram

Zhang, Naidan; Sun, Jiaxiang; Ji, Chaixia; Bao, Xiao; Yuan, Chengliang

doi:10.1007/s10067-022-06314-9

Cited by 4 publications

(2 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, significant differences in the results of previous studies evaluating PCT for the prediction of bacterial infections exist. One study showed that significantly elevated PCT levels (1.2 ~ 3.6 ng/mL) may be a biomarker for the diagnosis of Wegener’s granulomatous bacterial infections [ 44 ], and another study showed that PCT levels > 0.22 ng/mL hint at bacterial infection in patients with vasculitis [ 45 ]. This may be related to specific patient groups and different etiologies of infection.…”

Section: Discussionmentioning

confidence: 99%

Development and application of a risk nomogram for the prediction of risk of carbapenem-resistant Acinetobacter baumannii infections in neuro-intensive care unit: a mixed method study

Li,

Gao,

Diao

et al. 2024

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

Objective This study aimed to develop and apply a nomogram with good accuracy to predict the risk of CRAB infections in neuro-critically ill patients. In addition, the difficulties and expectations of application such a tool in clinical practice was investigated. Methods A mixed methods sequential explanatory study design was utilized. We first conducted a retrospective study to identify the risk factors for the development of CRAB infections in neuro-critically ill patients; and further develop and validate a nomogram predictive model. Then, based on the developed predictive tool, medical staff in the neuro-ICU were received an in-depth interview to investigate their opinions and barriers in using the prediction tool during clinical practice. The model development and validation is carried out by R. The transcripts of the interviews were analyzed by Maxqda. Results In our cohort, the occurrence of CRAB infections was 8.63% (47/544). Multivariate regression analysis showed that the length of neuro-ICU stay, male, diabetes, low red blood cell (RBC) count, high levels of procalcitonin (PCT), and number of antibiotics ≥ 2 were independent risk factors for CRAB infections in neuro-ICU patients. Our nomogram model demonstrated a good calibration and discrimination in both training and validation sets, with AUC values of 0.816 and 0.875. Additionally, the model demonstrated good clinical utility. The significant barriers identified in the interview include “skepticism about the accuracy of the model”, “delay in early prediction by the indicator of length of neuro-ICU stay”, and “lack of a proper protocol for clinical application”. Conclusions We established and validated a nomogram incorporating six easily accessed indicators during clinical practice (the length of neuro-ICU stay, male, diabetes, RBC, PCT level, and the number of antibiotics used) to predict the risk of CRAB infections in neuro-ICU patients. Medical staff are generally interested in using the tool to predict the risk of CRAB, however delivering clinical prediction tools in routine clinical practice remains challenging.

show abstract

Section: Discussionmentioning

confidence: 99%

Development and application of a risk nomogram for the prediction of risk of carbapenem-resistant Acinetobacter baumannii infections in neuro-intensive care unit: a mixed method study

Li,

Gao,

Diao

et al. 2024

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

show abstract

“…In the management of AAV patients, clinicians have always to deal with the delicate balance between avoiding disease recurrence and keeping a watchful eye on the clinical impact of immunosuppression, mostly based on the GC use [ 20 ]. In the front of the ongoing efforts of current pharmacological research to develop patient-tailored therapeutic approaches, other than non-specific immunosuppressive agents [ 22 ], the main risk for patients under life-long immunosuppression is that of infections and other concomitant diseases [ 23 ]. This condition leads to a growing need for pharmacological treatments, diagnostic tests, specialist visits, and hospitalizations with a significant economic burden for the National Health Systems (NHS) [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Profile, Healthcare Resource Consumption and Related Costs in ANCA-Associated Vasculitis Patients: A Real-World Analysis in Italy

Degli Esposti,

Dovizio,

Perrone

et al. 2023

Adv Ther

View full text Add to dashboard Cite

Introduction Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are rare autoimmune diseases triggering inflammation of small vessels. This real-world analysis was focused on the most common AAV forms, granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), to describe patients’ demographic and clinical characteristics, therapeutic management, disease progression, and the related economic burden. Methods A retrospective analysis was conducted on administrative databases of a representative sample of Italian healthcare entities, covering approximately 12 million residents. Between January 2010 and December 2020, adult GPA patients were identified by payment waiver code or hospitalization discharge diagnosis, and MPA patients by payment waiver code with or without hospitalization discharge diagnosis. Clinical outcomes were evaluated through AAV-related hospitalizations, renal failure onset, and mortality. Economic analysis included healthcare resource utilization deriving from drugs, hospitalizations, and outpatient specialist services. The related mean direct costs year/patient were also calculated in patients stratified by presence/absence of glucocorticoid therapy and type of inclusion criterion (hospitalization/payment waiver code). Results Overall, 859 AAV patients were divided into GPA ( n = 713; 83%) and MPA ( n = 146; 17%) cohorts. Outcome indicators highlighted a clinically worse phenotype associated with GPA compared to MPA. Cost analysis during follow-up showed tendentially increased expenditures in glucocorticoid-treated patients versus untreated (overall AAV: €8728 vs. €7911; GPA: €9292 vs. €9143; MPA: €5967 vs. €2390), mainly driven by drugs (AAV: €2404 vs. €874; GPA: €2510 vs. €878; MPA: €1881 vs. €854) and hospitalizations. Conclusion Among AAV forms, GPA resulted in a worse clinical picture, higher mortality, and increased costs. This is the first real-world pharmaco-economic analysis on AAV patients stratified by glucocorticoid use on disease management expenditures. In both GPA and MPA patients, glucocorticoid treatment resulted in higher healthcare costs, mostly attributable to medications, and then hospitalizations, confirming the clinical complexity and economic burden for management of patients with autoimmune diseases under chronic immunosuppression. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-023-02681-0.

show abstract

Characteristics and risk factors for infection in patients with ANCA-associated vasculitis: A systematic review and meta-analysis

Luo,

Liu,

Zhang

et al. 2025

Autoimmunity Reviews

View full text Add to dashboard Cite

Predicting bacterial infection risk in patients with ANCA-associated vasculitis in southwest China: development of a new nomogram

Cited by 4 publications

References 43 publications

Development and application of a risk nomogram for the prediction of risk of carbapenem-resistant Acinetobacter baumannii infections in neuro-intensive care unit: a mixed method study

Development and application of a risk nomogram for the prediction of risk of carbapenem-resistant Acinetobacter baumannii infections in neuro-intensive care unit: a mixed method study

Profile, Healthcare Resource Consumption and Related Costs in ANCA-Associated Vasculitis Patients: A Real-World Analysis in Italy

Characteristics and risk factors for infection in patients with ANCA-associated vasculitis: A systematic review and meta-analysis

Contact Info

Product

Resources

About