A Novel Predictive Model for Anastomotic Leakage in Colorectal Cancer Using Auto-artificial Intelligence
Junichi Mazaki, Kenji Katsumata, Yuki Ohno, Ryutaro Udo, Tomoya Tago, Kenta Kasahara, Hiroshi Kuwabara, Masanobu Enomoto, Tetsuo Ishizaki, Yuichi Nagakawa, Akihiko Tsuchida
Abstract
<h3>Background</h3> Data describing cardiovascular outcomes in patients with COVID-19 and chronic kidney disease (CKD) are lacking. We compared cardiovascular outcomes of patients with and without COVID-19, stratified by CKD status. <h3>Methods</h3> This retrospective, multi-regional data-linkage study utilised individual patient-level data from two Scottish cohorts. All patients tested for SARS-CoV-2 in Cohort 1 between 01/02/2020 and 31/03/2021, and in Cohort 2 between 28/02/2020 and 08/02/2021, were included. <h3>Results</h3> Overall, 86 964 patients were tested for SARS-CoV-2. There were 36 904 patients (61±21 years, 58.1% women, 15.9% CKD, 10.1% COVID-19 positive) in Cohort 1 and 50 060 patients (63±20 years, 62.0% women, 16.4% CKD, 9.1% COVID-19 positive) in Cohort 2. In CKD patients, COVID-19 increased the risk of cardiovascular death by more than two-fold within 30 days (cause-specific hazard ratio [csHR] meta-estimate 2.34, 95% confidence interval [CI] 1.83–2.99), and by 57% at the end of follow-up (csHR meta-estimate 1.57, 95% CI 1.31–1.89). Similarly, the risk of all-cause death in COVID-19 positive <i>versus</i> negative CKD patients was greatest within 30 days (HR 4.53, 95% CI 3.97–5.16). Compared to patients without CKD, those with CKD had a higher risk of testing positive (11.5% <i>versus</i> 9.3%). Following a positive test, CKD patients had higher rates of cardiovascular death (11.1% <i>versus</i> 2.7%), cardiovascular complications, and cardiovascular hospitalisations (7.1% <i>versus</i> 3.3%) than those without CKD. <h3>Conclusions</h3> COVID-19 increases the risk of cardiovascular and all-cause death in CKD patients, especially in the short-term. CKD patients with COVID-19 are also at a disproportionate risk of cardiovascular complications than those without CKD.