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Research article
Yong Peng
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9562-4622
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Background: The effect of short-term exposure to fine particulate matter (PM2.5) on the incidence of acute noncardiovascular critical illnesses (ANCIs) and clinical outcomes is unknown in patients with acute cardiovascular diseases.
Methods: We conducted a retrospective study in 2,337 admissions to an intensive cardiac care unit (ICCU) from June 2016 to May 2017. We used the 2-day average PM2.5 concentration before ICCU admission to estimate the individual exposure level, and patients were divided into 3 groups according to the concentration tertiles. Major ANCI was defined as the composite of acute respiratory failure, acute kidney injury, gastrointestinal hemorrhage, or sepsis. The primary endpoint was all-cause death or discharge against medical advice in extremely critical condition.
Results: More than 20 percent of admissions were complicated by major ANCI, and primary endpoints occurred in 7.6% of patients during their hospitalization. The association of short-term PM2.5 exposure levels with the incidence of acute respiratory failure (adjusted OR [odds ratio] =1.31, 95%CI [confidence interval]1.12-1.54) and acute kidney injury (adjusted OR=1.20, 95%CI 1.02-1.41) showed a significant trend. Additionally, there were numerically more cases of sepsis (adjusted OR=1.21, 95%CI 0.92-1.60) and gastrointestinal hemorrhage (adjusted OR=1.29, 95%CI 0.94-1.77) in patients with higher exposure levels. After further multivariable adjustment, short-term PM2.5 exposure levels were still significantly associated with the incidence of major ANCI (adjusted OR=1.32, 95%CI 1.12-1.56), as well as with in-hospital outcomes (adjusted OR=1.52, 95%CI 1.09-2.12).
Conclusion: Short-term PM2.5 exposure before ICCU admission was associated with an increased risk of incident major ANCI and worse in-hospital outcomes in patients receiving intensive cardiac care.
Keywords
Fine particulate matter, Acute noncardiovascular critical illness, Acute cardiac care, Prognosis
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CURRENT STATUS: Published
View the published article at BMC Public Health.
No community comments so far
Editorial decision: Accept
On 21 Apr, 2020
Review #2 received
Received 20 Apr, 2020
Reviewer #2 agreed
On 30 Mar, 2020
Review #1 received
Received 29 Mar, 2020
Reviewers invited
Invitations sent on 29 Mar, 2020
Reviewer #1 agreed
On 29 Mar, 2020
Editor assigned
On 08 Mar, 2020
Submission checks complete
On 07 Mar, 2020
Editor invited
On 07 Mar, 2020
Version 1
Posted 03 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 25 Feb, 2020
Review #2 received
Received 24 Feb, 2020
Review #1 received
Received 24 Feb, 2020
Reviewer #2 agreed
On 13 Feb, 2020
Editor assigned
On 06 Jan, 2020
Reviewers invited
Invitations sent on 06 Jan, 2020
Reviewer #1 agreed
On 06 Jan, 2020
Submission checks complete
On 31 Dec, 2019
Editor invited
On 30 Dec, 2019
First submitted
On 11 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
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A new preprint design is coming!
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See the published version of this preprint at BMC Public Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Yong Peng
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9562-4622
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Public Health.
No community comments so far
Editorial decision: Accept
On 21 Apr, 2020
Review #2 received
Received 20 Apr, 2020
Reviewer #2 agreed
On 30 Mar, 2020
Review #1 received
Received 29 Mar, 2020
Reviewers invited
Invitations sent on 29 Mar, 2020
Reviewer #1 agreed
On 29 Mar, 2020
Editor assigned
On 08 Mar, 2020
Submission checks complete
On 07 Mar, 2020
Editor invited
On 07 Mar, 2020
Version 1
Posted 03 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 25 Feb, 2020
Review #2 received
Received 24 Feb, 2020
Review #1 received
Received 24 Feb, 2020
Reviewer #2 agreed
On 13 Feb, 2020
Editor assigned
On 06 Jan, 2020
Reviewers invited
Invitations sent on 06 Jan, 2020
Reviewer #1 agreed
On 06 Jan, 2020
Submission checks complete
On 31 Dec, 2019
Editor invited
On 30 Dec, 2019
First submitted
On 11 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Public Health.
Background: The effect of short-term exposure to fine particulate matter (PM2.5) on the incidence of acute noncardiovascular critical illnesses (ANCIs) and clinical outcomes is unknown in patients with acute cardiovascular diseases.
Methods: We conducted a retrospective study in 2,337 admissions to an intensive cardiac care unit (ICCU) from June 2016 to May 2017. We used the 2-day average PM2.5 concentration before ICCU admission to estimate the individual exposure level, and patients were divided into 3 groups according to the concentration tertiles. Major ANCI was defined as the composite of acute respiratory failure, acute kidney injury, gastrointestinal hemorrhage, or sepsis. The primary endpoint was all-cause death or discharge against medical advice in extremely critical condition.
Results: More than 20 percent of admissions were complicated by major ANCI, and primary endpoints occurred in 7.6% of patients during their hospitalization. The association of short-term PM2.5 exposure levels with the incidence of acute respiratory failure (adjusted OR [odds ratio] =1.31, 95%CI [confidence interval]1.12-1.54) and acute kidney injury (adjusted OR=1.20, 95%CI 1.02-1.41) showed a significant trend. Additionally, there were numerically more cases of sepsis (adjusted OR=1.21, 95%CI 0.92-1.60) and gastrointestinal hemorrhage (adjusted OR=1.29, 95%CI 0.94-1.77) in patients with higher exposure levels. After further multivariable adjustment, short-term PM2.5 exposure levels were still significantly associated with the incidence of major ANCI (adjusted OR=1.32, 95%CI 1.12-1.56), as well as with in-hospital outcomes (adjusted OR=1.52, 95%CI 1.09-2.12).
Conclusion: Short-term PM2.5 exposure before ICCU admission was associated with an increased risk of incident major ANCI and worse in-hospital outcomes in patients receiving intensive cardiac care.
Figure 1
Figure 2
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