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  1. Article ; Online: Association Between Patient Race and Ethnicity and Outcomes With COVID-19: A Retrospective Analysis From a Large Mid-Atlantic Health System.

    Rao, Anirudh / Alnababteh, Muhtadi H / Avila-Quintero, Victor J / Flores, Jose M / Laing, Nina E / Boyd, David A / Yu, Jennifer / Ahmed, Naheed / Groninger, Hunter / Zaaqoq, Akram M

    Journal of intensive care medicine

    2023  Volume 38, Issue 5, Page(s) 472–478

    Abstract: Background: Members of racial and ethnic minority groups have been disproportionately impacted by coronavirus-2019 (COVID-19). The objective of the study is to describe associations between race and ethnicity on clinical outcomes such as need for ... ...

    Abstract Background: Members of racial and ethnic minority groups have been disproportionately impacted by coronavirus-2019 (COVID-19). The objective of the study is to describe associations between race and ethnicity on clinical outcomes such as need for mechanical ventilation and mortality.
    Methods: Retrospective cohort study of patients with severe COVID-19 infection admitted within a large, not-for-profit healthcare system in the mid-Atlantic region between March and July, 2020. Patient demographic data and clinical outcomes were abstracted from the electronic health record. Logistic regressions were performed to estimate associations between race and ethnicity and the clinical outcomes.
    Results: The study population (N  =  2931) was stratified into 1 of 3 subgroups: non-Hispanic White (n  =  466), non-Hispanic Black (n  =  1611), and Hispanic (n  =  654). The average age of White, Black, and Hispanic patients was 69  ±  17.06, 64  ±  15.9, and 50  ±  15.53 years old, respectively (
    Conclusion: Our analysis demonstrated that Hispanic patients were more likely require mechanical ventilation but had lower mortality when compared to White patients, with lower average age likely mediating this association. These findings emphasize the importance of outreach efforts to communities of color to increase prevention measures and vaccination uptake to reduce infection with COVID-19.
    MeSH term(s) Humans ; Black or African American ; COVID-19/therapy ; Ethnicity ; Minority Groups ; Retrospective Studies ; White People ; Hispanic or Latino
    Language English
    Publishing date 2023-01-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632828-3
    ISSN 1525-1489 ; 0885-0666
    ISSN (online) 1525-1489
    ISSN 0885-0666
    DOI 10.1177/08850666221149956
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  2. Article ; Online: A Multimodal Sepsis Quality-Improvement Initiative Including 24/7 Screening and a Dedicated Sepsis Response Team-Reduced Readmissions and Mortality.

    Alnababteh, Muhtadi H / Huang, Sean Shenghsiu / Ryan, Andrea / McGowan, Kevin M / Yohannes, Seife

    Critical care explorations

    2020  Volume 2, Issue 12, Page(s) e0251

    Abstract: Objectives: To evaluate if a hospitalwide sepsis performance improvement initiative improves compliance with the Centers for Medicare and Medicaid Services-mandated sepsis bundle interventions and patient outcomes.: Study design: Retrospective ... ...

    Abstract Objectives: To evaluate if a hospitalwide sepsis performance improvement initiative improves compliance with the Centers for Medicare and Medicaid Services-mandated sepsis bundle interventions and patient outcomes.
    Study design: Retrospective analysis comparing 6 months before and 14 months after intervention.
    Setting: Tertiary teaching hospital in Washington, DC.
    Subjects: Patients admitted with a diagnosis of sepsis to a tertiary hospital.
    Interventions: Implementation of a multimodal quality-improvement initiative.
    Measurements and main results: A total of 4,102 patients were diagnosed with sepsis, severe sepsis, or septic shock during the study period, 861 patients (21%) were diagnosed during a 6-month preintervention period, and 3,241 (79%) were diagnosed in a 13-month postintervention period. Adjusted for patient case-mix, the prevalence of simple sepsis increased by 12%, but it decreased for severe sepsis and septic shock by 5.3% and 6.9%, respectively. Compliance with all sepsis bundle interventions increased by 31.1 percentage points (
    Conclusions: After the implementation of multimodal sepsis performance initiatives, we observed a higher prevalence of sepsis secondary to screening but a lower prevalence of severe sepsis and septic shock, an improvement in compliance with the sepsis bundle interventions bundle, as well as reduction in hospital readmission and all- cause mortality rate.
    Language English
    Publishing date 2020-11-24
    Publishing country United States
    Document type Journal Article
    ISSN 2639-8028
    ISSN (online) 2639-8028
    DOI 10.1097/CCE.0000000000000251
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  3. Article ; Online: Assessing the need for transfer to the intensive care unit for Coronavirus-19 disease: Epidemiology and risk factors.

    Hashmi, Muhammad Daniyal / Alnababteh, Muhtadi / Vedantam, Karthik / Alunikummannil, Jojo / Oweis, Emil S / Shorr, Andrew F

    Respiratory medicine

    2020  Volume 174, Page(s) 106203

    Abstract: Background: Although many patients with coronavirus disease 2019 (Covid-19) require direct admission to the intensive care unit (ICU), some are sent after admission. Clinicians require an understanding of this phenomenon and various risk stratification ... ...

    Abstract Background: Although many patients with coronavirus disease 2019 (Covid-19) require direct admission to the intensive care unit (ICU), some are sent after admission. Clinicians require an understanding of this phenomenon and various risk stratification approaches for recognizing these subjects.
    Methods: We examined all Covid-19 patients sent initially to a ward who subsequently required care in the ICU. We examined the timing transfer and attempted to develop a risk score based on baseline variables to predict progressive disease. We evaluated the utility of the CURB-65 score at identifying the need for ICU transfer.
    Results: The cohort included 245 subjects (mean age 59.0 ± 14.2 years, 61.2% male) and 20% were eventually sent to the ICU. The median time to transfer was 2.5 days. Approximately 1/3rd of patients were not moved until day 4 or later and the main reason for transfer (79.2%) was worsening respiratory failure. A baseline absolute lymphocyte count (ALC) of ≤0.8 10
    Conclusion: Covid-19 patients admitted to general wards face a significant risk for deterioration necessitating ICU admission and respiratory failure can occur late in this disease. Neither baseline clinical factors nor the CURB-65 score perform well as screening tests to categorize these subjects as likely to progress to ICU care.
    MeSH term(s) COVID-19/complications ; COVID-19/epidemiology ; COVID-19/virology ; Comorbidity ; Female ; Ferritins/blood ; Hospitalization ; Humans ; Intensive Care Units/statistics & numerical data ; Lymphocyte Count/methods ; Male ; Middle Aged ; Pandemics/statistics & numerical data ; Patient Transfer/organization & administration ; Research Design/standards ; Research Design/statistics & numerical data ; Respiratory Insufficiency/epidemiology ; Respiratory Insufficiency/etiology ; Retrospective Studies ; Risk Assessment ; Risk Factors ; SARS-CoV-2/genetics ; Time Factors
    Chemical Substances Ferritins (9007-73-2)
    Keywords covid19
    Language English
    Publishing date 2020-10-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 1003348-8
    ISSN 1532-3064 ; 0954-6111
    ISSN (online) 1532-3064
    ISSN 0954-6111
    DOI 10.1016/j.rmed.2020.106203
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  4. Article ; Online: PREDICTING THE NEED FOR INVASIVE MECHANICAL VENTILATION IN PATIENTS WITH CORONAVIRUS DISEASE 2019

    Alnababteh, Muhtadi / Hashmi, Muhammad / Drescher, Gail / Vedantam, Karthik / Talish, Mishaal / Desai, Neerja / Oweis, Emil

    Chest

    Keywords covid19
    Publisher Elsevier; PMC
    Document type Article ; Online
    DOI 10.1016/j.chest.2020.09.009
    Database COVID19

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  5. Article ; Online: Renal sympathetic denervation in Sweden: a report from the Swedish registry for renal denervation.

    Sawalha, Yazan / Goncalves, Pedro / Alnababteh, Muhtadi / Emori, Seiji / Garcia-Garcia, Hector M

    Journal of hypertension

    2018  Volume 37, Issue 2, Page(s) 449

    MeSH term(s) Denervation ; Kidney ; Registries ; Sweden ; Sympathectomy
    Language English
    Publishing date 2018-12-21
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 605532-1
    ISSN 1473-5598 ; 0263-6352 ; 0952-1178
    ISSN (online) 1473-5598
    ISSN 0263-6352 ; 0952-1178
    DOI 10.1097/HJH.0000000000002011
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  6. Article ; Online: Cell-Free DNA Maps Tissue Injury and Correlates with Disease Severity in Lung Transplant Candidates.

    Balasubramanian, Shanti / Richert, Mary E / Kong, Hyesik / Fu, Sheng / Jang, Moon Kyoo / Andargie, Temesgen E / Keller, Michael B / Alnababteh, Muhtadi / Park, Woojin / Apalara, Zainab / Sun, Jian / Redekar, Neelam / Orens, Jonathan / Aryal, Shambhu / Bush, Errol L / Cantu, Edward / Diamond, Joshua / Shah, Pali / Yu, Kai /
    Nathan, Steven D / Agbor-Enoh, Sean

    American journal of respiratory and critical care medicine

    2023  Volume 209, Issue 6, Page(s) 727–737

    Abstract: Rationale: ...

    Abstract Rationale:
    MeSH term(s) Humans ; Prospective Studies ; Cell-Free Nucleic Acids ; Primary Graft Dysfunction ; Retrospective Studies ; Lung Transplantation ; Patient Acuity
    Chemical Substances Cell-Free Nucleic Acids
    Language English
    Publishing date 2023-12-20
    Publishing country United States
    Document type Multicenter Study ; Journal Article
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202306-1064OC
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  7. Article ; Online: The interplay of inflammation and coagulation in COVID-19 Patients receiving extracorporeal membrane oxygenation support.

    Zaaqoq, Akram / Sallam, Tariq / Merley, Caitlin / Galloway, Lan Anh / Desale, Sameer / Varghese, Jobin / Alnababteh, Muhtadi / Kriner, Eric / Kitahara, Hiroto / Shupp, Jeffrey / Dalton, Heidi / Molina, Ezequiel

    Perfusion

    2022  Volume 38, Issue 2, Page(s) 384–392

    Abstract: Objective: Bleeding and thrombosis are common complications during Extracorporeal Membrane Oxygenation (ECMO) support for COVID-19 patients. We sought to examine the relationship between inflammatory status, coagulation effects, and observed bleeding ... ...

    Abstract Objective: Bleeding and thrombosis are common complications during Extracorporeal Membrane Oxygenation (ECMO) support for COVID-19 patients. We sought to examine the relationship between inflammatory status, coagulation effects, and observed bleeding and thrombosis in patients receiving venovenous (VV) ECMO for COVID-19 respiratory failure.
    Study design: Cross-sectional cohort study.
    Settings: Quaternary care institution.
    Patients: The study period from April 1, 2020, to January 1, 2021, we included all patients with confirmed COVID-19 who received VV ECMO support.
    Intervention: None.
    Measurements and main results: Thirty-two patients were supported with VV ECMO during the study period, and 17 patients (53%) survived to hospital discharge. The ECMO nonsurvivors mean lactate dehydrogenase (LDH) levels were markedly elevated in comparison to survivors (1046 u/L [IQR = 509, 1305] vs 489 u/L [385 658],
    Conclusion: The correlation between inflammation and coagulation in the nonsurvivors supported with VV ECMO could indicate dysregulated inflammatory response and worse clinical outcomes.
    MeSH term(s) Humans ; COVID-19/complications ; COVID-19/therapy ; Extracorporeal Membrane Oxygenation/adverse effects ; Cross-Sectional Studies ; Retrospective Studies ; Inflammation/complications ; Hemorrhage/etiology ; Thrombosis/etiology
    Language English
    Publishing date 2022-01-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 645038-6
    ISSN 1477-111X ; 0267-6591
    ISSN (online) 1477-111X
    ISSN 0267-6591
    DOI 10.1177/02676591211057506
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  8. Article: Assessing the need for transfer to the intensive care unit for Coronavirus-19 disease: Epidemiology and risk factors

    Hashmi, Muhammad Daniyal / Alnababteh, Muhtadi / Vedantam, Karthik / Alunikummannil, Jojo / Oweis, Emil S / Shorr, Andrew F

    Respir Med

    Abstract: BACKGROUND: Although many patients with coronavirus disease 2019 (Covid-19) require direct admission to the intensive care unit (ICU), some are sent after admission. Clinicians require an understanding of this phenomenon and various risk stratification ... ...

    Abstract BACKGROUND: Although many patients with coronavirus disease 2019 (Covid-19) require direct admission to the intensive care unit (ICU), some are sent after admission. Clinicians require an understanding of this phenomenon and various risk stratification approaches for recognizing these subjects. METHODS: We examined all Covid-19 patients sent initially to a ward who subsequently required care in the ICU. We examined the timing transfer and attempted to develop a risk score based on baseline variables to predict progressive disease. We evaluated the utility of the CURB-65 score at identifying the need for ICU transfer. RESULTS: The cohort included 245 subjects (mean age 59.0 ± 14.2 years, 61.2% male) and 20% were eventually sent to the ICU. The median time to transfer was 2.5 days. Approximately 1/3rd of patients were not moved until day 4 or later and the main reason for transfer (79.2%) was worsening respiratory failure. A baseline absolute lymphocyte count (ALC) of ≤0.8 103/ml and a serum ferritin ≥1000 ng/ml were independently associated with ICU transfer. Co-morbid illnesses did not correlate with eventual ICU care. Neither a risk score based on a low ALC and/or high ferritin nor the CURB-65 score performed well at predicting need for transfer. CONCLUSION: Covid-19 patients admitted to general wards face a significant risk for deterioration necessitating ICU admission and respiratory failure can occur late in this disease. Neither baseline clinical factors nor the CURB-65 score perform well as screening tests to categorize these subjects as likely to progress to ICU care.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #894196
    Database COVID19

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  9. Article ; Online: Palliative Care for Patients on Extracorporeal Membrane Oxygenation for COVID-19 Infection.

    Rao, Anirudh / Zaaqoq, Akram M / Kang, In Guk / Vaughan, Erin M / Flores, Jose / Avila-Quintero, Victor J / Alnababteh, Muhtadi H / Kelemen, Anne M / Groninger, Hunter

    The American journal of hospice & palliative care

    2021  Volume 38, Issue 7, Page(s) 854–860

    Abstract: Background: Critically ill patients with COVID-19 infection on extracorporeal membrane oxygenation (ECMO) face high morbidity and mortality. Palliative care consultation may benefit these patients and their families. Prior to the pandemic, our ... ...

    Abstract Background: Critically ill patients with COVID-19 infection on extracorporeal membrane oxygenation (ECMO) face high morbidity and mortality. Palliative care consultation may benefit these patients and their families. Prior to the pandemic, our institution implemented a policy of automatic palliative care consultation for all patients on ECMO due to the high mortality, medical complexity, and psychosocial distress associated with these cases.
    Objectives: The main objective was to describe the role of the palliative care team for patients on ECMO for COVID-19 infection. The secondary objective was to describe the clinical outcomes for this cohort.
    Design: Case series.
    Settings/subjects: All patients age 18 or older infected by the novel coronavirus who required cannulation on ECMO from March through July of 2020, at an urban, academic medical center in the United States. Inter-disciplinary palliative care consultation occurred for all patients.
    Results: Twenty-three patients (median age 43 years [range 28-64], mean body mass index 34.9 kg/m2 [SD 9.2], 65% Hispanic ethnicity) were cannulated on ECMO. Eleven patients died during the hospitalization (48%). Patients older than 50 years of age demonstrated a trend toward increased odds of death compared to those younger than 50 years of age (OR 9.1,
    Conclusions: Here, we present one of the first studies describing the patient characteristics, outcomes, and palliative care actions for critically ill patients with COVID-19 on ECMO. Almost half of the patients in this cohort died during their hospitalization. Given the high morbidity and mortality of this condition, we recommend involvement of palliative care for patients/families with COVID-19 infection who are on ECMO. The impact of palliative care on patient and family outcomes, such as symptom control, satisfaction with communication, rates of anxiety, and grief experience merits further investigation.
    MeSH term(s) Adult ; COVID-19/therapy ; Extracorporeal Membrane Oxygenation ; Female ; Humans ; Male ; Middle Aged ; Palliative Care ; Pandemics
    Language English
    Publishing date 2021-03-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1074344-3
    ISSN 1938-2715 ; 1049-9091
    ISSN (online) 1938-2715
    ISSN 1049-9091
    DOI 10.1177/10499091211001009
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  10. Article ; Online: INVESTIGATING THE RELATIONSHIP BETWEEN RACE/ETHNICITY AND CLINICAL OUTCOMES IN COVID-19

    Alnababteh, Muhtadi / Drescher, Gail / Jayaram, Lakshmi / Kohli, Akshay / Hashmi, Muhammad / Hayat, Fatima / Chaturvedi, Mansi / Oweis, Emil / Zaaqoq, Akram

    Chest

    2020  Volume 158, Issue 4, Page(s) A2477–A2478

    Keywords Critical Care and Intensive Care Medicine ; Pulmonary and Respiratory Medicine ; Cardiology and Cardiovascular Medicine ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2020.09.054
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