Are there modifiable risk factors that may predict the occurrence of brachial plexus injury?

2014 ◽  
Vol 35 (5) ◽  
pp. 349-352 ◽  
Author(s):  
S Zuarez-Easton ◽  
N Zafran ◽  
G Garmi ◽  
Z Nachum ◽  
R Salim
Keyword(s):  
Risk Factors ◽  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Modifiable Risk Factors

scholarly journals Obstetrical brachial plexus injury: burden in a publicly funded, universal healthcare system

2016 ◽  
Vol 17 (2) ◽  
pp. 222-229 ◽  
Author(s):  
Christopher J. Coroneos ◽  
Sophocles H. Voineskos ◽  
Marie K. Coroneos ◽  
Noor Alolabi ◽  
Serge R. Goekjian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Practice ◽  
Brachial Plexus ◽  
Healthcare System ◽  
Quality Indicators ◽  
Brachial Plexus Injury ◽  
Shoulder Dystocia ◽  
Publicly Funded ◽  
Universal Healthcare ◽  
Universal Healthcare System

OBJECT The aim of this study was to determine the volume and timing of referrals for obstetrical brachial plexus injury (OBPI) to multidisciplinary centers in a national demographic sample. Secondarily, we aimed to measure the incidence and risk factors for OBPI in the sample. The burden of OBPI has not been investigated in a publicly funded system, and the timing and volume of referrals to multidisciplinary centers are unknown. The incidence and risk factors for OBPI have not been established in Canada. METHODS This is a retrospective cohort study. The authors used a demographic sample of all infants born in Canada, capturing all children born in a publicly funded, universal healthcare system. OBPI diagnoses and corresponding risk factors from 2004 to 2012 were identified and correlated with referrals to Canada’s 10 multidisciplinary OBPI centers. Quality indicators were approved by the Canadian OBPI Working Group’s guideline consensus group. The primary outcome was the timing of initial assessment at a multidisciplinary center, “good” if assessed by the time the patient was 1 month of age, “satisfactory” if by 3 months of age, and “poor” if thereafter. Joinpoint regression analysis was used to determine the OBPI incidence over the study period. Odds ratios were calculated to determine the strength of association for risk factors. RESULTS OBPI incidence was 1.24 per 1000 live births, and was consistent from 2004 to 2012. Potential biases underestimate the level of injury identification. The factors associated with a very strong risk for OBPI were humerus fracture, shoulder dystocia, and clavicle fracture. The majority (55%–60%) of OBPI patients identified at birth were not referred. Among those who were referred, the timing of assessment was “good” in 28%, “satisfactory” in 66%, and “poor” in 34%. CONCLUSIONS Shoulder dystocia was the strongest modifiable risk factor for OBPI. Most children with OBPI were not referred to multidisciplinary care. Of those who were referred, 72% were assessed later than the target quality indicator of 1 month that was established by the national guideline consensus group. A referral gap has been identified using quality indicators at clinically relevant time points; this gap should be addressed with the use of knowledge tools (e.g., a clinical practice guideline) to target variations in referral rates and clinical practice. Interventions should guide the referral process.

scholarly journals Frequency and Risk Factors for Prolonged Opioid Prescriptions After Surgery for Brachial Plexus Injury

2019 ◽  
Vol 44 (8) ◽  
pp. 662-668.e1 ◽  
Author(s):  
Christopher J. Dy ◽  
Kate Peacock ◽  
Margaret A. Olsen ◽  
Wilson Z. Ray ◽  
David M. Brogan
Keyword(s):  
Risk Factors ◽  
Brachial Plexus ◽  
Brachial Plexus Injury

Risk factors for clavicle fracture concurrent with brachial plexus injury

2015 ◽  
Vol 293 (4) ◽  
pp. 783-787 ◽  
Author(s):  
Ertugrul Karahanoglu ◽  
Taner Kasapoglu ◽  
Safak Ozdemirci ◽  
Erdem Fadıloglu ◽  
Aysegul Akyol ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Clavicle Fracture

scholarly journals Risk Factors at Birth for Permanent Obstetric Brachial Plexus Injury and Associated Osseous Deformities

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Rahul K. Nath ◽  
Nirupama Kumar ◽  
Meera B. Avila ◽  
Devin K. Nath ◽  
Sonya E. Melcher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Birth Weight ◽  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
The United States ◽  
Finger Movement ◽  
Average Birth Weight ◽  
Obstetric Brachial Plexus ◽  
Obstetric Brachial Plexus Injury

Purpose. To examine the most prevalent risk factors found in patients with permanent obstetric brachial plexus injury (OBPI) to identify better predictors of injury. Methods. A population-based study was performed on 241 OBPI patients who underwent surgical treatment at the Texas Nerve and Paralysis Institute. Results. Shoulder dystocia (97%) was the most prevalent risk factor. We found that 80% of the patients in this study were not macrosomic, and 43% weighed less than 4000 g at birth. The rate of instrument use was 41% , which is 4-fold higher than the 10% predicted for all vaginal deliveries in the United States. Posterior subluxation and glenoid version measurements in children with no finger movement at birth indicated a less severe shoulder deformity in comparison with those with finger movement. Conclusions. The average birth weight in this study was indistinguishable from the average birth weight reported for all brachial plexus injuries. Higher birth weight does not, therefore, affect the prognosis of brachial plexus injury. We found forceps/vacuum delivery to be an independent risk factor for OBPI, regardless of birth weight. Permanently injured patients with finger movement at birth develop more severe bony deformities of the shoulder than patients without finger movement.

Intrapartum risk factors for permanent brachial plexus injury

2003 ◽  
Vol 189 (3) ◽  
pp. 725-729 ◽  
Author(s):  
Sarah H Poggi ◽  
Shawn P Stallings ◽  
Alessandro Ghidini ◽  
Catherine Y Spong ◽  
Shad H Deering ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brachial Plexus ◽  
Brachial Plexus Injury
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