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Biomedical subjects

Cristian Baicus

Publications and source records attributed to Cristian Baicus.

3 recordsLinked to original sources
PubMed2006

Does this patient have cancer? The assessment of age, anemia, and erythrocyte sedimentation rate in cancer as a cause of weight loss. A retrospective study based on a secondary care university hospital in Romania.

BACKGROUND: "Does this patient have cancer?" is a question frequently asked when confronted by patients with involuntary weight loss. The aim of this study was to assess the value of age, erythrocyte sedimentation rate (ESR), and anemia in the diagnosis of cancer as a cause of involuntary weight loss. METHODS: A retrospective study of 7850 patients admitted to the Department of Internal Medicine from January to September 2003 was performed. Especially selected were 431 patients with weight loss. Age, ESR, hemoglobin, and the discharge diagnosis were recorded. RESULTS: Twenty-four percent of the patients with involuntary weight loss had cancer. Age, ESR, and anemia were found not to be of value in the diagnosis of cancer (areas under the curve were 0.684, 0.690, and 0.766, respectively). When diagnostic tests for age, a high ESR, and anemia were used serially, the positive predictive value for a malignancy was 64% (CI: 27-90%); when the tests were utilized in parallel, the negative predictive value was 91% (CI: 85-100%). CONCLUSIONS: Any patient admitted to our Department of Internal Medicine for involuntary weight loss had a 24% probability of having a malignancy. Neither age, nor ESR, nor anemia, used separately as a multilevel, diagnostic test or combined serially or in parallel, could exclude or rule in the diagnosis of cancer. However, they could increase (from 24% to 64%) or decrease (from 24% to 9%) the probability of cancer.

Journal Article↗
PubMed2003

Fever of unknown origin-predictors of outcome. A prospective multicenter study on 164 patients.

BACKGROUND: To date, the studies that have been done on fever of unknown origin have mostly been descriptive. Therefore, we know the etiogical spectrum and how it has changed since 1966 for many regions of the world. However, we do not know if there are clinical or laboratory predictors of severe outcome. Being able to estimate the severity of the disease early on would allow one to determine how intensive the diagnostic work-up should be. METHODS: A multicenter cohort study was carried out on 164 consecutive patients who met the classic, modified criteria of fever of unknown origin. The study lasted 2 years (1997-1998) and included a follow-up period of another 2 years. The main outcome measured was the final diagnosis established at the end of follow-up. RESULTS: When the white cell count was abnormal, the relative risk for a serious disease was 1.49 (CI: 1.15-1.94; p=0.004), when anemia was present, the relative risk was 1.55 (CI: 1.21-1.98; p=0.003), and for high alanine aminotransferase (ALAT), bilirubin, or lactate dehydrogenase (LDH), the relative risks were 1.57 (CI: 1.21-2.02; p=0.010), 1.57 (CI: 1.18-2.08; p=0.007), and 3.43 (CI: 1.81-6.48; p=0.0002), respectively. In multivariate analysis, the odds ratios for serious diseases were 2.7 (CI: 1.17-6.4; p=0.02) for abnormal white cell count, 2.8 (CI: 1.14-7.16; p=0.02) for anemia, 4.3 (CI: 1.6-11.5; p=0.003) for high serum bilirubin, and 5.3 (1.5-18.6; p=0.009) for high serum ALAT. CONCLUSIONS: In patients having a fever of unknown origin, anemia, abnormal white cell count, and high ALAT and bilirubin are independent predictors of severe outcome.

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