David Hajage

David Hajage
Hôpital La Pitié Salpêtrière (Groupe Hospitalier "La Pitié Salpêtrière - Charles Foix") · Département de Santé Publique

MD

About

204
Publications
24,882
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6,319
Citations
Citations since 2016
132 Research Items
5716 Citations
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201620172018201920202021202202004006008001,0001,2001,400
201620172018201920202021202202004006008001,0001,2001,400
201620172018201920202021202202004006008001,0001,2001,400

Publications

Publications (204)
Article
Full-text available
Background Trials comparing early and delayed strategies of renal replacement therapy in patients with severe acute kidney injury may have missed differences in survival as a result of mixing together patients at heterogeneous levels of risks. Our aim was to evaluate the heterogeneity of treatment effect on 60-day mortality from an early vs a delay...
Article
Full-text available
Background: Delaying time to prone positioning (PP) may be associated with higher mortality in acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19). We evaluated the use and the impact of early PP on clinical outcomes in intubated patients hospitalized in intensive care units (ICUs) for COVID-19. Methods: All int...
Article
Objective: The role of surgery in the treatment of malignant gliomas in the elderly is not settled. The authors conducted a randomized trial that compared tumor resection with biopsy only-both followed by standard therapy-in such patients. Methods: Patients ≥ 70 years of age with a Karnofsky Performance Scale (KPS) score ≥ 50 and presenting with...
Article
Rationale: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. Objectives: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohor...
Article
Full-text available
With the COVID-19 pandemic, documenting whether health care workers (HCWs) are at increased risk of SARS-CoV-2 contamination and identifying risk factors is of major concern. In this multicenter prospective cohort study, HCWs from frontline departments were included in March and April 2020 and followed for 3 months. SARS-CoV-2 serology was performe...
Article
Introduction Prédire le devenir des patients gravement malades hospitalisés en unité de soins intensifs (USI) et atteints de la maladie du coronavirus 19 (COVID-19) est un défi majeur pour éviter les séjours futiles et prolongés en USI. L'objectif de cette recherche était de développer des modèles de prédictifs de la survie à 90 jours applicable à...
Article
Introduction L’évaluation de l'effet d'un traitement à partir de données observationnelles est soumise à de multiples sources de biais. La définition puis l’émulation d'un essai cible dans ce contexte permet de réduire leur impact. Ici, nous utilisons cette approche afin d'estimer l'effet causal de l'administration du levosimendan (LVN) sur le temp...
Article
Introduction Les méthodes basées sur le score de propension (SP) sont largement utilisées dans les études observationnelles afin d’évaluer l'effet marginal d'un traitement. Lorsqu'on utilise une méthode basée sur le SP, une attention particulière doit être donnée à l'estimation de la variance de l'effet du traitement, qui doit tenir compte du fait...
Article
Full-text available
Objective: This study aimed to assess the impact of disease-modifying antirheumatic drugs (DMARDs) on 10-year outcomes in rheumatoid arthritis (RA). Methods: Patients with RA from the ESPOIR cohort with complete data on Disease Activity Score in 28 Joints (DAS28) and Health Assessment Questionnaire (HAQ) at 10 years (n=418) and complete radiogra...
Article
Objective We aimed to characterize the evolution of humoral immune response up to one year after SARS-CoV-2 infection in health care workers (HCWs) during the first wave of COVID-19 in Paris. Methods Serum samples from 92 HCWs were tested at month 0 (M0), M6 and M12 after SARS-CoV-2 infection for IgG targeting the nucleocapsid (N), IgG targeting t...
Article
Objective To assess whether meta-analyses include older randomized controlled trials (RCTs) and whether intervention effect differ between older and recent RCTs. Study design and setting In this meta-epidemiological study of 295 meta-analyses (2940 RCTs) published in 2017-2018, we evaluated the difference in intervention effects between older (ie,...
Article
Rationale: Dyspnea is a traumatic experience. Only limited information is available on dyspnea in intubated critically ill patients. Objectives: Our objectives were 1) to quantify the prevalence and severity of dyspnea; and 2) to evaluate the impact of dyspnea on ICU length of stay and post-traumatic stress disorder (PTSD) 90 days after ICU dischar...
Article
PurposePrevious studies support the potential efficacy of venovenous extracorporeal membrane oxygenation (vvECMO) for improving survival in severe acute respiratory distress syndrome (ARDS) cases. Prone positioning (PP) has been shown to improve the outcomes of moderate-to-severe ARDS patients. Few studies and no randomized controlled trials have e...
Article
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Background Vascular access for renal replacement therapy (RRT) is routine question in the intensive care unit. Randomized trials comparing jugular and femoral sites have shown similar rate of nosocomial events and catheter dysfunction. However, recent prospective observational data on RRT catheters use are scarce. We aimed to assess the site of RRT...
Article
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Background The COVID-19 pandemic is a heavy burden in terms of health care resources. Future decision-making policies require consistent data on the management and prognosis of the older patients (> 70 years old) with COVID-19 admitted in the intensive care unit (ICU). Methods Characteristics, management, and prognosis of critically ill old patien...
Article
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Rational To evaluate the respective impact of standard oxygen, high-flow nasal cannula (HFNC) and noninvasive ventilation (NIV) on oxygenation failure rate and mortality in COVID-19 patients admitted to intensive care units (ICUs). Methods Multicenter, prospective cohort study (COVID-ICU) in 137 hospitals in France, Belgium, and Switzerland. Demog...
Article
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Background Predicting outcomes of critically ill intensive care unit (ICU) patients with coronavirus-19 disease (COVID-19) is a major challenge to avoid futile, and prolonged ICU stays. Methods The objective was to develop predictive survival models for patients with COVID-19 after 1-to-2 weeks in ICU. Based on the COVID–ICU cohort, which prospect...
Article
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Background Patients infected with the severe acute respiratory syndrome coronavirus 2 (SARS-COV 2) and requiring intensive care unit (ICU) have a high incidence of hospital-acquired infections; however, data regarding hospital acquired bloodstream infections (BSI) are scarce. We aimed to investigate risk factors and outcome of BSI in critically ill...
Article
Objective Osteoporosis is underdiagnosed and undertreated, although severe complications of osteoporotic fractures, including vertebral fractures, are well known. This study sought to assess the feasibility and results of an opportunistic screening of vertebral fractures and osteoporosis in a large database of lumbar or abdominal CT scans. Materia...
Article
Background and Aims Patients with ulcerative colitis [UC] are at increased risk of colorectal cancer. Anti-tumour necrosis factor agents [anti-TNF] aim to reduce chronic colonic inflammation and may lower the risk of colorectal cancer [CRC], but the impact of anti-TNF exposure has not yet been assessed in population-based cohort studies. The aim of...
Preprint
Full-text available
Objective With the COVID-19 pandemic, documenting whether health care workers (HCWs) are at increased risk of SARS-CoV-2 contamination and identifying risk factors is of major concern. Methods In this multicenter prospective cohort study, HCWs from frontline departments were included in March and April 2020 and followed for 3 months. SARS-CoV-2 se...
Article
Full-text available
Background: Extracorporeal membrane oxygenation (ECMO) was frequently used to treat patients with severe coronavirus disease-2019 (COVID-19)-associated acute respiratory distress (ARDS) during the initial outbreak. Care of COVID-19 patients evolved markedly during the second part of 2020. Our objective was to compare the characteristics and outcom...
Preprint
Full-text available
Background Delaying time to prone positioning (PP) may be associated with higher mortality in acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19). We evaluated the use and the impact of early PP on clinical outcomes in intubated patients hospitalized in intensive care units (ICUs) for COVID-19. Methods All intubate...
Article
BACKGROUND The role of surgery for the treatment of malignant gliomas in patients 70 years of age or older is unsettled. We conducted a randomized trial that compared surgical resection of the tumor and biopsy only, both followed by standard therapy, in such patients. MATERIAL AND METHODS Patients aged 70 years and older, with a KPS of at least 50...
Article
Propensity score methods are widely used in observational studies for evaluating marginal treatment effects. The generalized propensity score (GPS) is an extension of the propensity score framework, historically developed in the case of binary exposures, for use with quantitative or continuous exposures. In this paper, we proposed variance estimato...
Article
Introduction Chez les patients hospitalisés en réanimation et présentant une insuffisance rénale aiguë, l’épuration extra-rénale (EER) peut être débutée soit précocement, soit selon une stratégie d’attente, c’est-à-dire seulement en cas d’apparition de complications métaboliques ou respiratoires mettant en jeu le pronostic vital. Plusieurs essais r...
Article
Objectives: To investigate whether intervention effect estimates for mortality differ between blinded and nonblinded randomized controlled trials conducted in critical care. We used a meta-epidemiological approach, comparing effect estimates between blinded and nonblinded randomized controlled trials for the same research question. Data sources:...
Article
Background Delaying renal replacement therapy (RRT) for some time in critically ill patients with severe acute kidney injury and no severe complication is safe and allows optimisation of the use of medical devices. Major uncertainty remains concerning the duration for which RRT can be postponed without risk. Our aim was to test the hypothesis that...
Preprint
Background: With the COVID-19 pandemic, documenting whether health care workers (HCWs) are at increased risk of SARS-CoV-2 contamination and identifying risk factors is of major concern. Methods: In this multicenter prospective cohort study, HCWs from frontline departments were included in March and April 2020 and followed for 3 months. SARS-CoV-2...
Article
Introduction L’essai français ToLEDO (Towards the Lowest Efficacious Dose) cherchait à comparer une stratégie de décroissance des bDMARDs (tocilizumab (TCZ) ou abatacept (ABA)) à une stratégie de maintien à pleine dose chez des patients ayant une polyarthrite rhumatoïde (PR) en rémission prolongée. La non infériorité n’a pas été démontrée pour le c...
Article
Introduction Une prise en charge précoce de la polyarthrite rhumatoïde (PR), visant à induire rapidement la rémission, est préconisée [1] ; cependant, le concept de fenêtre d’opportunité n’a jamais été démontré dans les études de vie réelle. L’objectif de ce travail était d’étudier l’impact de l’exposition aux traitements sur la progression radiolo...
Article
Introduction Les études portant sur les bénéfices et les risques de la corticothérapie au long cours dans la polyarthrite rhumatoïde (PR) ont apporté des résultats discordants ; ainsi, l’essai CareRA n’a pas mis en évidence de différence en termes de rémission entre les patients prenant ou non des corticoïdes en association au méthotrexate [1], tan...
Article
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Maternal nutritional and metabolic status influence fetal growth. This study investigated the contribution of gestational weight gain (GWG), gestational diabetes (GDM), and maternal obesity to birthweight and newborn body fat. It is a secondary analysis of a prospective study including 204 women with a pregestational body mass index (BMI) of 18.5–2...
Article
Full-text available
Purpose: To assess the effect of venovenous extracorporeal membrane oxygenation (ECMO) compared to conventional management in patients with severe acute respiratory distress syndrome (ARDS). Methods: We conducted a systematic review and individual patient data meta-analysis of randomised controlled trials (RCTs) performed after Jan 1, 2000 compa...
Article
Full-text available
Purpose: To describe acute respiratory distress syndrome (ARDS) severity, ventilation management, and the outcomes of ICU patients with laboratory-confirmed COVID-19 and to determine risk factors of 90-day mortality post-ICU admission. Methods: COVID-ICU is a multi-center, prospective cohort study conducted in 138 hospitals in France, Belgium, a...
Article
Aim: Periodic breathing is frequent in patients with severe heart failure. Apart from being an indicator of severity, periodic breathing has its own deleterious consequences (sleep-related oxygen desaturations, sleep fragmentation), which justifies attempts to correct it irrespective of the underlying disease. Animal models and human data suggest...
Article
Full-text available
Background: Lower limb arterial calcification is a frequent, underestimated but serious complication of diabetes. The DIACART study is a prospective cohort study designed to evaluate the determinants of the progression of lower limb arterial calcification in 198 patients with type 2 diabetes. Methods: Lower limb arterial calcification scores wer...
Article
Full-text available
Background Patients with COVID-19 who develop severe acute respiratory distress syndrome (ARDS) can have symptoms that rapidly evolve to profound hypoxaemia and death. The efficacy of extracorporeal membrane oxygenation (ECMO) for patients with severe ARDS in the context of COVID-19 is unclear. We aimed to establish the clinical characteristics and...
Article
Background Patients with sepsis-induced cardiomyopathy with cardiogenic shock have a high mortality. This study assessed venoarterial extracorporeal membrane oxygenation (VA-ECMO) support for sepsis-induced cardiogenic shock refractory to conventional treatments. Methods In this retrospective, multicentre, international cohort study, we compared o...
Article
Full-text available
Hip fracture (HF) in older patients is associated with a high six-month mortality rate. Several clinical conditions may affect outcome, including baseline characteristics, co-existing acute illnesses, perioperative factors, and postoperative complications. Our primary objective was to estimate the respective effect of these four domains on six-mont...
Preprint
Propensity score methods are widely used in observational studies for evaluating marginal treatment effects. The generalized propensity score (GPS) is an extension of the propensity score framework, historically developed in the case of binary exposures, for use with quantitative or continuous exposures. In this paper, we proposed variance esti-mat...
Article
Background and objectives Crowding is a frequent concern in the emergency department (ED). Laboratory point of care testing (POCT) has been proposed to decrease patients’ length of stay (LOS). Our objective was to determine whether an extended panel of POCT solutions could reduce LOS. Methods This was a single‐center, prospective, open‐label, cont...
Article
Full-text available
Background Long-term outcomes of awakened survivors of out-of-hospital cardiac arrest (OHCA) is poorly known. Research Question What are the month (M)-18 outcomes of survivors of out-of-hospital cardiac arrest (OHCA) who awakened during the first 2 weeks post-OHCA and their poor-outcome risk factors? Study Design and Methods: All OHCA survivors w...
Article
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Background: Data from non-randomized studies have suggested that hydroxychloroquine could be an effective therapeutic agent against Covid-19. Methods: We conducted an observational, retrospective cohort study involving hospitalized adult patients with confirmed, mild to severe Covid-19 in a French university hospital. Patients who received hydro...
Article
Objectives: Postcardiotomy cardiogenic shock occurs in 2-6% of patients undergoing cardiac surgery, and 1% of cardiac surgery patients will require mechanical circulatory support using venoarterial extracorporeal membrane oxygenation. Acute kidney injury is a frequent complication in this population and negatively impacts the survival. We aimed to...
Preprint
Full-text available
Background: Lower limb arterial calcification is a frequent, underestimated but serious diabetic complication. The DIACART study is a prospective cohort study designed to evaluate the determinants of lower limb arterial calcification progression in 198 patients with Type 2 Diabetes. Methods: Lower limb arterial calcification score was determined by...
Preprint
Full-text available
Background: Lower limb arterial calcification is a frequent, underestimated but serious complication of diabetes. The DIACART study is a prospective cohort study designed to evaluate the determinants of the progression of lower limb arterial calcification in 198 patients with type 2 diabetes. Methods: Lower limb arterial calcification scores were d...
Article
Background The timing of renal replacement therapy (RRT) for severe acute kidney injury is highly debated when no life-threatening complications are present. We assessed whether a strategy of delayed versus early RRT initiation affects 28-day survival in critically ill adults with severe acute kidney injury. Methods In this systematic review and i...
Article
Full-text available
Introduction: Caring for acute odontogenic cellulitis involves drainage, treatment of the tooth and the administration of antibiotic therapy (ANSM 2011). The emergence of bacterial resistance mechanisms has led to formulating actions to promote better use of antibiotics, but France stay one of the largest consumers in Europe. Objectives: Evaluate t...
Article
Full-text available
Background: The Artificial Kidney Initiation in Kidney Injury (AKIKI) trial showed that a delayed renal replacement therapy (RRT) strategy for severe acute kidney injury (AKI) in critically ill patients was safe and associated with major reduction in RRT initiation compared with an early strategy. The five criteria which mandated RRT initiation in...
Article
Full-text available
Importance The role of herpes simplex virus (HSV) reactivation on morbidity and mortality in patients in the intensive care unit requiring mechanical ventilation remains unknown. Objective To determine whether preemptive treatment with intravenous acyclovir reduces the duration of mechanical ventilation in patients with HSV oropharyngeal reactivat...
Article
Full-text available
Objectives Studies on the perioperative management of patients on direct oral anticoagulants (DOACs) receiving oral invasive procedures are sparse. Moreover, the recommendations of the scientific societies on DOACs are discordant, and the practices are highly variable. We conducted a survey of general and specialized dentists in France to compare t...