Patient‐specific risk factors for positioning injuries

AORN Journal ◽  
2021 ◽  
Vol 113 (4) ◽  
Keyword(s):  
Risk Factors ◽  
Patient Specific ◽  
Specific Risk

scholarly journals Risk Factors for Failure in Conservatively Treated Osteoporotic Vertebral Fractures: A Systematic Review

2021 ◽  
pp. 219256822098227
Author(s):  
Max J. Scheyerer ◽  
Ulrich J. A. Spiegl ◽  
Sebastian Grueninger ◽  
Frank Hartmann ◽  
Sebastian Katscher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Treatment Failure ◽  
Patient Specific ◽  
Mineral Density ◽  
Radiographic Findings ◽  
Specific Risk ◽  
Fracture Development ◽  
Predict Treatment Failure

Study Design: Systematic review. Objectives: Osteoporosis is one of the most common diseases of the elderly, whereby vertebral body fractures are in many cases the first manifestation. Even today, the consequences for patients are underestimated. Therefore, early identification of therapy failures is essential. In this context, the aim of the present systematic review was to evaluate the current literature with respect to clinical and radiographic findings that might predict treatment failure. Methods: We conducted a comprehensive, systematic review of the literature according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) checklist and algorithm. Results: After the literature search, 724 potentially eligible investigations were identified. In total, 24 studies with 3044 participants and a mean follow-up of 11 months (range 6-27.5 months) were included. Patient-specific risk factors were age >73 years, bone mineral density with a t-score <−2.95, BMI >23 and a modified frailty index >2.5. The following radiological and fracture-specific risk factors could be identified: involvement of the posterior wall, initial height loss, midportion type fracture, development of an intravertebral cleft, fracture at the thoracolumbar junction, fracture involvement of both endplates, different morphological types of fractures, and specific MRI findings. Further, a correlation between sagittal spinal imbalance and treatment failure could be demonstrated. Conclusion: In conclusion, this systematic review identified various factors that predict treatment failure in conservatively treated osteoporotic fractures. In these cases, additional treatment options and surgical treatment strategies should be considered in addition to follow-up examinations.

Patient-specific risk factors of adverse drug events in adult inpatients - evidence detected using the Global Trigger Tool method

2014 ◽  
Vol 24 (3-4) ◽  
pp. 582-591 ◽  
Author(s):  
Marja Härkänen ◽  
Marjo Kervinen ◽  
Jouni Ahonen ◽  
Ari Voutilainen ◽  
Hannele Turunen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Drug Events ◽  
Patient Specific ◽  
Trigger Tool ◽  
Specific Risk ◽  
Global Trigger Tool

Gender as a Predictor of Complications in Endoscopic Sinus Surgery

2021 ◽  
pp. 000348942098741
Author(s):  
Rahul K. Sharma ◽  
Sonam Dodhia ◽  
Justin S. Golub ◽  
Jonathan B. Overdevest ◽  
David A. Gudis
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Endoscopic Sinus Surgery ◽  
Lower Risk ◽  
Sinus Surgery ◽  
Smoking History ◽  
Patient Specific ◽  
Specific Risk ◽  
Operative Complications ◽  
Post Operative Complications

Background: Understanding patient-specific risk factors for complications of functional endoscopic sinus surgery (ESS) is critical. Previous work has investigated such risk factors, but a population-based analysis has not been performed to date. Objectives: This study analyzes the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database to identify patient-specific risk factors associated with complications following ESS. Methods: A retrospective cohort study of patients who underwent ESS was conducted using the NSQIP database from 2011 to 2017. Patients were identified using CPT-codes for ESS procedures. The primary outcome analyzed was any postoperative complication. Simultaneous procedures with ESS were controlled for with regression analysis. Post-operative complications and 30-day readmission were evaluated using multivariate logistic regression controlling for age, gender, race, comorbidities (diabetes mellitus, hypertension, chronic obstructive pulmonary disease, congestive heart failure, renal failure, steroid use, and cancer history), smoking history, and intraoperative factors. Results: A total of 1279 patients who underwent ESS were identified. The average age of patients was 46.1 (SD = 16.8). Most patients (58.2%) had no major comorbidities. 594 (46.4%) patients had a tonsillectomy, adenoidectomy, or uvulopharyngoplasty at the same time as ESS. 101 (7.9%) patients experienced a complication post-operatively. 46 (3.6%) patients experienced a readmission postoperatively. The most common complication was reoperation (N = 40, 3.1%). Regression analysis revealed that gender was the only demographic factor associated with risk of post-operative complications, with women having a significantly lower risk than men (OR = 0.61, 95% CI 0.37-0.99, P = .046). Conclusions: ESS is typically performed on a relatively young and healthy population. Women have a significantly lower risk of complications after controlling for comorbidities. Further analysis of gender-specific differences in surgical outcomes should be evaluated to understand this phenomenon.

Risk Factors for Antibiotic Resistant Urinary Pathogens in Patients Discharged From the Emergency Department

2021 ◽  
pp. 001857872110468
Author(s):  
Stephanie L. Barré ◽  
Erin R. Weeda ◽  
Andrew J. Matuskowitz ◽  
Gregory A. Hall ◽  
Kyle A. Weant
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Antibiotic Use ◽  
Patient Specific ◽  
Lifetime History ◽  
Specific Risk ◽  
History Of ◽  
Inappropriate Antibiotics

Purpose: Urinary tract infections (UTIs) are one of the most common indications for antimicrobial use in the emergency department (ED). Appropriate empiric selection is crucial to ensure optimal care while limiting broad-spectrum antibiotic use. The primary objective of this study was to evaluate the relationship between patient-specific risk factors and drug resistant urinary pathogens in patients discharged from the ED and followed by Emergency Medicine Pharmacists (EMPs). Methods: This was a single-center, retrospective chart review of adult (≥18 years old) patients with positive urine cultures discharged from the ED. The association between risk factors and pathogen resistance to ≥1 classes of antibiotics was evaluated using multivariate logistic regression. Risk factors included the following: hospitalization within the previous 30 days, intravenous antibiotic use within 90 days, diabetes, clinical atherosclerotic cardiovascular disease, psychiatric disorder, dementia, current antibiotic use for any indication, previous lifetime history of UTIs, indwelling or intermittent catheterization, hemodialysis, previous lifetime history of a urologic procedure, urinary tract abnormality, immunosuppressive disease or medications, current residence in a nursing or rehabilitation facility, and history of a multidrug resistant organism (MDRO). Results: A total of 1018 patients were included. There was an increase in the odds of antibiotic resistance in patients with cystitis and ≥2 risk factors (Odds Ratio [OR] = 1.70, 95% CI = 1.24-2.32). In those with pyelonephritis, there was a non-significant increase in the odds of resistance for those with ≥2 risk factors (OR = 1.83, 95% CI = 0.98-3.42). Patients with pyelonephritis discharged on inappropriate antibiotics were more likely to return to the ED within 30 days ( P = .03). Conclusions: For patients with cystitis discharged from the ED, those with ≥2 patient-specific risk factors had significantly increased odds of antibiotic resistance. Patients with pyelonephritis, but not cystitis, who were discharged on inappropriate antibiotics were more likely to return to the ED within 30 days. In conjunction with an EMP culture follow-up program, the identification of risk factors for antimicrobial resistance can be used to design more patient-specific empiric antibiotic selections.

scholarly journals Modeling Patient-specific Risk Factors for Central Lung Tumor SBRT Planning

2018 ◽  
Vol 102 (3) ◽  
pp. S5-S6
Author(s):  
A. Modiri ◽  
S.R. Rice ◽  
C.A. Schonewolf ◽  
A.T. Berman ◽  
S.J. Feigenberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Tumor ◽  
Patient Specific ◽  
Specific Risk

scholarly journals Patient-specific risk profile associated with early-onset primary osteoarthritis of the shoulder: is it really primary?

2021 ◽  
Author(s):  
Fabian Plachel ◽  
Doruk Akgün ◽  
Jan-Philipp Imiolczyk ◽  
Marvin Minkus ◽  
Philipp Moroder
Keyword(s):  
Risk Factors ◽  
Early Onset ◽  
Young Patients ◽  
Risk Profile ◽  
Activity Level ◽  
Patient Specific ◽  
Healthy Controls ◽  
Specific Risk ◽  
Group A ◽  
Group B

Abstract Introduction Although age is considered to be the major risk factor of primary glenohumeral osteoarthritis (GOA), younger population may suffer from degenerative changes of the shoulder joint without evidence of any leading cause. The purpose of this study was to investigate the risk profile in young patients suffering from presumably primary GOA. Methods A consecutive group of 47 patients undergoing primary shoulder arthroplasty for early-onset GOA below the age of 60 years at time of surgery was retrospectively identified and prospectively evaluated. Patients with identifiable cause for GOA (secondary GOA) were excluded. The resulting 32 patients (mean age 52 ± 7 years; 17 male, 15 female) with primary GOA were matched by age (± 3 years) and gender to 32 healthy controls (mean age 53 ± 7 years; 17 male, 15 female). Demographic data and patient-related risk factors were assessed and compared among both groups to identify extrinsic risk factors for primary GOA. Patients were further subdivided into a group with concentric GOA (group A) and a group with eccentric GOA (group B) to perform a subgroup analysis. Results Patients had a significantly higher BMI (p = 0.017), were more likely to be smokers (p < 0.001) and to have systematic diseases such as hypertension (p = 0.007) and polyarthritis (p < 0.001) and a higher Shoulder Activity Level (SAL) (p < 0.001) when compared to healthy controls. Furthermore, group B had a significantly higher SAL not only compared to healthy controls but also to group A, including activities such as combat sport (p = 0.048) and weightlifting (p = 0.01). Conclusions Several patient-specific risk factors are associated with primary GOA in the young population, as well as highly shoulder demanding activities in the development of eccentric GOA. Consequently, a subset of young patients with eccentric primary GOA could in reality be secondary due to a muscular imbalance between internal and external rotators caused by improper weight training. Level of evidence III, Case–Control study

scholarly journals Patient-Specific Risk Factors and Clinical Correlates of Euglycemic Diabetic Ketoacidosis in Patients on Sodium-Glucose Co-Transporter-2 Inhibitors

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A473-A473
Author(s):  
Manoj Reddy Somagutta ◽  
Maria Kezia Lourdes L Pormento ◽  
Namrata Hange ◽  
Muhammad Adnan Khan ◽  
Molly S Jain ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Ketoacidosis ◽  
Autoimmune Diabetes ◽  
Patient Specific ◽  
Acid Decarboxylase ◽  
Type 2 Dm ◽  
Specific Risk ◽  
Gad 65 ◽  
Euglycemic Diabetic Ketoacidosis

Abstract Background: Sodium-Glucose Co-Transporter-2 Inhibitors (SGLT-2i) association with euglycemic diabetic ketoacidosis (EDKA) has been well reported. The underlying mechanism is mainly enhanced lipolysis and ketone bodies’ reabsorption. They also stimulate the pancreatic alpha cells and inhibit the beta cells, thereby causing an imbalance in glucagon/insulin levels, further contributing to lipolysis and ketogenesis. SGLT-2i were also found to cause EDKA in all types of diabetes, even uncovering undiagnosed Latent Autoimmune Diabetes of the Adult (LADA). Methods: Numerous electronic databases were systematically searched to identify patient-specific risk factors and clinical characteristics of EDKA in patients on SGLT-2i. The patient’s symptoms, clinical profile, laboratory results, and precipitants for EDKA were reviewed. Results: A total of 96 case reports identifying 116 patients with EDKA was fully reviewed. EDKA was twice prevalent in females (66.3%) than males (33.6%); median age was 52.15 ± 13.47, BMI was 29.3 ± 7.0. Among the 116 DKA events in SGLT-2i 92 (79.3%) were associated with Type-2 DM, 15 (12.9%) were Type-1 DM, 8 (6.9%) in LADA. Common symptoms were nausea (48.7%), vomiting (47%), and abdominal pain (28.2%). Canagliflozin was the most common SGLT-2i (40.5%), followed by Empagliflozin (29.3%) and Dapagliflozin (25.9%). The most common precipitant was surgery (17.2%), followed by infection (14.7%), fasting (11.2%), and Keto Diet (9.5%); others being reduced insulin use, alcoholism, and cancer. At presentation, average blood glucose was 196.8 ± 96.5, pH 7.1 ± 0.16, HCO3 8.7 ± 5.7 mmol/L, potassium 4.3 ± 1.03, anion-gap 24.2 ± 6.8 mmol/L, and the average HbA1C was 9.24 ± 2.08. Urine Ketones were positive in 81.89% of patients. 17 patients had pancreatic autoantibodies testing, and 7 were positive (41.2%) for glutamic acid decarboxylase-65 antibodies (anti-GAD-65). As a result, 7 patients were newly diagnosed with LADA who were previously misdiagnosed with type-2 DM. Conclusion: SGLT2i induced EDKA was found to be more predominant in females and type-2 DM. Diabetics should be educated on risk factors and consult physicians before commencing a dietary or exercise change. Physicians should be vigilant in diagnosing EDKA by thoughtful measurement of urine ketones and anti-GAD-65 testing can help diagnose underlying LADA.

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