scholarly journals Is sore throat an underreported and under-estimated quality indicator for endoscopic procedures? Results from a large prospective cohort

2020 ◽  
Vol 08 (10) ◽  
pp. E1398-E1404
Author(s):  
Katherine Kim ◽  
Srinivas Gaddam ◽  
John Verula ◽  
Ellis Lai ◽  
Ashley Dollentas ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Sore Throat ◽  
Univariate Analysis ◽  
Female Gender ◽  
Multivariate Logistic Regression Model ◽  
Endoscopic Procedures ◽  
Oral Airway ◽  
Post Procedure ◽  
Independent Risk Factors

Abstract Background and study aims Patients often develop sore throat after upper endoscopy procedures but there data are very limited on the magnitude of the problem. The aim of this study was to evaluate and identify independent risk factors of sore throat in patients undergoing endoscopy. Patients and methods Data were collected prospectively on consecutive outpatient endoscopy procedures performed at Cedars-Sinai Medical Center from October 2018 to February 2019. Procedure nurses collected pre-procedure, intra-procedure, and immediate post-procedure surveys including evaluation of sore throat (pain scale from 1 – 10). Significant univariate variables (P < 0.05) were entered into a multivariate logistic regression model. Results Data were collected on 715 patients. Four hundred seventy-two patients (mean age = 61 years, females = 53 %) were included in the analysis and 85 patients (18 %) experienced post-procedure sore throat. On univariate analysis, female gender, oral endoscopic ultrasound (EUS), oral double balloon enteroscopy (DBE), fellow involvement, throat suctioning, general anesthesia, oral airway, and prolonged procedure (> 30 minutes) were risk factors for sore throat (all P < 0.05). On the multivariate analysis, independent risk-factors for post-procedure sore throat were oral DBE (odds ratio [OR] 5.2), oral airway (OR 4.8), general anesthesia (OR 2.7), fellow involvement (OR 2.5), oral EUS (OR 2.4), and female gender (OR 2.0). Conclusions Contrary to popular belief, our study found that post-procedural sore throat is more common (18 %) than previously reported. Two types of endoscopic procedures, two anesthesia maneuvers, female gender, and fellow involvement were all independent risk factors. This is of particular concern for interventionalists who perform EUS and oral DBE as these patients are at higher risk for sore throat.

scholarly journals Incidence and risk factors for high-level BK viruria: a single center study in China

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Rui Xiong ◽  
Haimin Ye ◽  
Zhujing Liu ◽  
Xinchang Li
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Univariate Analysis ◽  
Bk Virus ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Single Center Study ◽  
History Of ◽  
Independent Risk Factors ◽  
High Level

Abstract Background BK virus allograft nephropathy is a serious complication after kidney transplantation, and the effect of pre-emptive intervention for high-level BK viruria has been verified, but protocols after kidney transplantation for early identification of high-level viruria are lacking. Methods This was a single-center study. The clinical data of the kidney transplant recipients and their donors in our center from January 1, 2015 to December 31, 2018, were collected. The patients were divided into the high-level BK viruria group (Group A) and a non-high-level BK viruria group (Group B) according to the qPCR results of BK virus DNA loads in urine samples. Significant variables were screened out by univariate analysis, and then the results were incorporated into a multivariate logistic regression model to analyze the independent risk factors for high-level BK viruria. Results A total of 262 recipients were included in the study. The incidence of high-level BK viruria was 13.4% (n = 35), and the median time of detection was 181 (range 91–1119) days. Univariate analysis showed that donor type ($$\chi^{2}$$ χ 2  = 21.770, P < 0.001), history of ATG/ATG-F application ($$\chi^{2}$$ χ 2  = 4.543, P = 0.033), acute rejection (AR) ($$\chi^{2}$$ χ 2  = 8.313, P = 0.004) and delayed graft function (DGF) ($$\chi^{2}$$ χ 2  = 21.170, P < 0.001) were related to high-level BK viruria. After the inclusion of the multivariate logistic regression model, the results showed deceased brain and cardiac donors (P = 0.032, OR = 3.927, 95% CI 1.122–13.746), AR (P = 0.022, OR = 4.709, 95% CI 1.253–17.697) and DGF (P = 0.001, OR = 6.682, 95% CI 2.288–19.518). Conclusions Donation by deceased brain and cardiac patients, history of AR and DGF were independent risk factors for high-level BK viruria after kidney transplantation.

scholarly journals Incidence and Risk Factors for High-level BK viruria -A Single Center Study in China

2020 ◽  
Author(s):  
Rui Xiong ◽  
Haimin Ye ◽  
Zhujing Liu ◽  
Xinchang Li
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Univariate Analysis ◽  
Bk Virus ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Single Center Study ◽  
History Of ◽  
Independent Risk Factors ◽  
High Level

Abstract Background BK virus allograft nephropathy (BKVAN) is a serious complication after kidney transplantation, and the effect of pre-emptive intervention for high-level BK viruria has been verified, but protocols after kidney transplantation for early identification of high-level viruria are lacking.Methods This was a single-center study. The clinical data of the kidney transplant recipients and their donors in our center from January 1, 2015 to December 31, 2018, were collected. The patients were divided into the high-level BK viruria group (Group A) and a non-high-level BK viruria group (Group B) according to the qPCR results of BK virus DNA loads in urine samples. Significant variables were screened out by univariate analysis, and then the results were incorporated into a multivariate logistic regression model to analyze the independent risk factors for high-level BK viruria.Results A total of 262 recipients were included in the study. The incidence of high-level BK viruria was 13.4% (n=35), and the median time of detection was 181 (range 91~1119) days. Univariate analysis showed that donor type ( =21.770, P < 0.001), history of ATG/ATG-F application ( =4.543, P=0.033), acute rejection (AR) ( =8.313, P=0.004) and delayed graft function (DGF) ( =21.170, P < 0.001) were related to high-level BK viruria. After the inclusion of the multivariate logistic regression model, the results showed deceased brain and cardiac donors (P=0.032, OR=3.927, 95% CI: 1.122~13.746), AR (P=0.022, OR=4.709, 95% CI: 1.253~17.697) and DGF (P=0.001, OR=6.682, 95% CI: 2.288~19.518).Conclusions Donation by deceased brain and cardiac patients, history of AR and DGF were independent risk factors for high-level BK viruria after kidney transplantation.

Risk factors for posttraumatic vasospasm

2011 ◽  
Vol 115 (3) ◽  
pp. 602-611 ◽  
Author(s):  
Kiarash Shahlaie ◽  
Krista Keachie ◽  
Irene M. Hutchins ◽  
Nancy Rudisill ◽  
Lori K. Madden ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Model ◽  
Potential Risk Factors ◽  
Severe Tbi ◽  
Independent Risk Factors ◽  
Clinically Significant ◽  
Underlying Mechanisms

Object Posttraumatic vasospasm (PTV) is an underrecognized cause of ischemic damage after severe traumatic brain injury (TBI) that independently predicts poor outcome. There are, however, no guidelines for PTV screening and management, partly due to limited understanding of its pathogenesis and risk factors. Methods A database review of 46 consecutive cases of severe TBI in pediatric and adult patients was conducted to identify risk factors for the development of PTV. Univariate analysis was performed to identify potential risk factors for PTV, which were subsequently analyzed using a multivariate logistic regression model to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results Fever on admission was an independent risk factor for development of PTV (OR 22.2, 95% CI 1.9–256.8), and patients with hypothermia on admission did not develop clinically significant vasospasm during their hospital stay. The presence of small parenchymal contusions was also an independent risk factor for PTV (OR 7.8, 95% CI 0.9–69.5), whereas the presence of subarachnoid hemorrhage or other patterns of intracranial injury were not. Other variables, such as age, sex, ethnicity, degree of TBI severity, or admission laboratory values, were not independent predictors for the development of clinically significant PTV. Conclusions Independent risk factors for PTV include parenchymal contusions and fever. These results suggest that diffuse mechanical injury and activation of inflammatory pathways may be underlying mechanisms for the development of PTV, and that a subset of patients with these risk factors may be an appropriate population for aggressive screening. Further studies are needed to determine if treatments targeting fever and inflammation may be effective in reducing the incidence of vasospasm following severe TBI.

scholarly journals Incidence and Risk Factors for High-level BK Viruria -A Single Center Study in China

2020 ◽  
Author(s):  
Rui Xiong ◽  
Haimin Ye ◽  
Zhujing Liu ◽  
Xinchang Li
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Logistic Regression Model ◽  
Univariate Analysis ◽  
Bk Virus ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
History Of ◽  
Independent Risk Factors ◽  
High Level

Abstract Background BK Virus Allograft Nephropathy (BKVAN) is a serious complication after kidney transplantation, and the effect of pre-emptive intervention for high-level BK viruria has been verified, but the protocols after kidney transplantation for early identification of high-level viruria is lacking.Methods This was a single-center respectively study. The clinical data of the kidney transplant recipients and their donors in our center from January 1, 2015 to December 31, 2018 were collected. According to the qPCR results of BK virus DNA loads in urine samples, the patients were divided into high-level BK Viruria Group (Group A) and none high-level BK Viruria Group (Group B). Significant variables were screened out by univariate analysis, and then the results were incorporated into multivariate logistic regression model to analyze the independent risk factors of high-level BK viruria.Results A total of 262 recipients were included in the study. The incidence of high-level BK viruria was 13.4% (n=35), and the median time of detection was 181(range 91~1119) days. Univariate analysis showed that the donor type ( =21.770, P < 0.001), history of ATG/ATG-F application ( =4.543, P=0.033), Acute Rejection (AR) ( =8.313, P=0.004) and Delayed Graft Function (DGF) ( =21.170, P < 0.001) were related with high-level BK viruria. After the inclusion of multivariate logistic regression model, the results showed that brain and cardiac deceased donors (P=0.032,OR=3.927, 95%CI:1.122~13.746), AR (P=0.022,OR=4.709, 95%CI:1.253~17.697) and DGF (P=0.001,OR=6.682, 95%CI:2.288~19.518).Conclusions Donation of Brain and Cardiac Deceased, history of AR, DGF were independent risk factors for high-level BK viruria after kidney transplantation.

scholarly journals Risk factors for cholesterol polyp formation in the gallbladder are closely related to lipid metabolism

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhihao Yu ◽  
Changlin Yang ◽  
Xuesong Bai ◽  
Guibin Yao ◽  
Xia Qian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Low Density Lipoprotein ◽  
Univariate Analysis ◽  
Density Lipoprotein ◽  
High Volume ◽  
Population Characteristics ◽  
Polyp Formation ◽  
Logistic Analysis ◽  
Cholesterol Polyp ◽  
Independent Risk Factors

Abstract Background The purpose of this study was to assess the risk factors for cholesterol polyp formation in the gallbladder. Methods This was a multicenter retrospective study based on pathology. From January 2016 to December 2019, patients who underwent cholecystectomy and non-polyp participants confirmed by continuous ultrasound follow-ups were reviewed. Patients in the cholesterol polyp group were recruited from three high-volume centers with a diagnosis of pathologically confirmed cholesterol polyps larger than 10 mm. Population characteristics and medical data were collected within 24 h of admission before surgery. The non-polyp group included participants from the hospital physical examination center database. They had at least two ultrasound examinations with an interval longer than 180 days. Data from the final follow-up of the non-polyp group were analyzed. The risk factors for cholesterol polyp formation were analyzed by comparing the two groups. Results A total of 4714 participants were recruited, including 376 cholesterol polyp patients and 4338 non-polyp participants. In univariate analysis, clinical risk factors for cholesterol polyps were age, male sex, higher body mass index (BMI), higher low-density lipoprotein (LDL), lower high-density lipoprotein (HDL), and higher aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. In multivariate logistic analysis, independent risk factors were age > 50 years (odds ratio [OR] = 3.02, 95% confidence interval [CI] 2.33–3.91, P < 0.001], LDL > 2.89 mmol/L (OR = 1.38, 95% CI 1.08–1.78, P = 0.011), lower HDL (OR = 1.78 95% CI 1.32–2.44, P < 0.001), AST > 40 IU/L (OR = 3.55, 95% CI 2.07–6.07, P < 0.001), and BMI > 25 kg/m 2 (OR = 1.32, 95% CI 1.01–1.72, P = 0.037). Conclusions Age, LDL, HDL, AST, and BMI are strong risk factors for cholesterol polyp formation. Older overweight patients with polyps, accompanied by abnormal lipid levels, are at high risk for cholesterol polyps.

scholarly journals Development of Predictive Nomograms for Clinical Use to Quantify the Risk of Amputation in Patients with Diabetic Foot Ulcer

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Bocheng Peng ◽  
Rui Min ◽  
Yiqin Liao ◽  
Aixi Yu
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Prediction Model ◽  
Predictive Factors ◽  
Diabetic Foot ◽  
Univariate Analysis ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Single Factor ◽  
Independent Risk Factors

Objective. To determine the novel proposed nomogram model accuracy in the prediction of the lower-extremity amputations (LEA) risk in diabetic foot ulcer (DFU). Methods and Materials. In this retrospective study, data of 125 patients with diabetic foot ulcer who met the research criteria in Zhongnan Hospital of Wuhan University from January 2015 to December 2019 were collected by filling in the clinical investigation case report form. Firstly, univariate analysis was used to find the primary predictive factors of amputation in patients with diabetic foot ulcer. Secondly, single factor and multiple factor logistic regression analysis were employed to screen the independent influencing factors of amputation introducing the primary predictive factors selected from the univariate analysis. Thirdly, the independent influencing factors were applied to build a prediction model of amputation risk in patients with diabetic foot ulcer by using R4.3; then, the nomogram was established according to the selected variables visually. Finally, the performance of the prediction model was evaluated and verified by receiver working characteristic (ROC) curve, corrected calibration curve, and clinical decision curve. Results. 7 primary predictive factors were selected by univariate analysis from 21 variables, including the course of diabetes, peripheral angiopathy of diabetic (PAD), glycosylated hemoglobin A1c (HbA1c), white blood cells (WBC), albumin (ALB), blood uric acid (BUA), and fibrinogen (FIB); single factor logistic regression analysis showed that albumin was a protective factor for amputation in patients with diabetic foot ulcer, and the other six factors were risk factors. Multivariate logical regression analysis illustrated that only five factors (the course of diabetes, PAD, HbA1c, WBC, and FIB) were independent risk factors for amputation in patients with diabetic foot ulcer. According to the area under curve (AUC) of ROC was 0.876 and corrected calibration curve of the nomogram displayed good fitting ability, the model established by these 5 independent risk factors exhibited good ability to predict the risk of amputation. The decision analysis curve (DCA) indicated that the nomogram model was more practical and accurate when the risk threshold was between 6% and 91%. Conclusion. Our novel proposed nomogram showed that the course of diabetes, PAD, HbA1c, WBC, and FIB are the independent risk factors of amputation in patients with DFU. This prediction model was well developed and behaved a great accurate value for LEA so as to provide a useful tool for screening LEA risk and preventing DFU from developing into amputation.

scholarly journals Factors Affecting Patients with Concurrent Deep Neck Infection and Acute Epiglottitis

Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 29
Author(s):  
Chia-Ying Ho ◽  
Yu-Chien Wang ◽  
Shy-Chyi Chin ◽  
Shih-Lung Chen
Keyword(s):  
Risk Factors ◽  
Airway Obstruction ◽  
Parapharyngeal Space ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Deep Neck Infection ◽  
Acute Epiglottitis ◽  
Neck Infection ◽  
Submandibular Space ◽  
Independent Risk Factors

Deep neck infection (DNI) is a serious disease of deep neck spaces that can lead to morbidities and mortality. Acute epiglottitis (AE) is a severe infection of the epiglottis, which can lead to airway obstruction. However, there have been no studies of risk factors in patients with concurrent DNI and AE. This study was performed to investigate this issue. A total of 502 subjects with DNI were enrolled in the study between June 2016 and August 2021. Among these patients, 30 had concurrent DNI and AE. The relevant clinical variables were assessed. In a univariate analysis, involvement of the parapharyngeal space (OR = 21.50, 95% CI: 2.905–158.7, p < 0.001) and involvement of the submandibular space (OR = 2.064, 95% CI: 0.961–4.434, p < 0.001) were significant risk factors for concurrent DNI and AE. In a multivariate analysis, involvement of the parapharyngeal space (OR = 23.69, 95% CI: 3.187–175.4, p = 0.002) and involvement of the submandibular space (OR = 2.465, 95% CI: 1.131–5.375, p < 0.023) were independent risk factors for patients with concurrent DNI and AE. There were no differences in pathogens, therapeutic managements (tracheostomy, intubation, surgical drainage), or hospital staying period between the 30 patients with concurrent DNI and AE and the 472 patients with DNI alone (all p > 0.05). However, we believe it is significant that DNI and AE are concurrent because both DNI and AE potentially cause airway obstruction, and concurrence of these two diseases make airway protection more difficult. The infections in critical spaces may cause the coincidence of these two diseases. Involvement of the parapharyngeal space and involvement of the submandibular space were independent risk factors associated with concurrent DNI and AE. There were no differences in pathogens between the concurrent DNI and AE group and the DNI alone group.

Incidence And Risk Factors For Postoperative Pneumonia Following Surgically Treated Hip Fracture In Geriatric Patients: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Yunxu Tian ◽  
Yanbin Zhu ◽  
Kexin Zhang ◽  
Miao Tian ◽  
Shuhui Qin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Geriatric Patients ◽  
Multivariate Analyses ◽  
Postoperative Pneumonia ◽  
Multivariate Logistic Regression Model ◽  
Preventive Strategy ◽  
Tertiary Referral Center ◽  
Independent Risk Factors ◽  
Clinical Conditions

Abstract Objective: Large sample investigations for risk factors for pneumonia in elderly patients after hip fracture surgeries are lacking. The purpose of this study is to determine the incidence and risk factors for postoperative pneumonia in geriatric patients following hip fracture operations.Methods: A retrospective study of incidence and risk factors in a tertiary referral center between 2016 and 2020 was conducted. Geriatric patients who developed postoperative pneumonia after surgeries of hip fracture during hospitalization stay were defined as cases and those without as controls. Multivariate logistic regression model was used to evaluate risk factors for postoperative pneumonia.Results: This study included 3147 patients, and 182 developed postoperative pneumonia, denoting the rate of 5.7%. In the multivariate analyses, age (OR, 1.04; 95% CI, 1.02–1.06), sex (males) (OR, 2.27; 95% CI, 1.64-3.13), respiratory disease (OR, 3.74; 95% CI, 2.32–6.04), heart disease (OR, 1.68; 95% CI, 1.14–2.47), cerebrovascular disease (OR, 1.58; 95% CI, 1.11–2.27), liver disease (OR, 2.61; 95% CI, 1.33–5.15), preoperative stay (OR, 1.08; 95% CI, 1.05–1.11) and general anesthesia (OR, 1.61; 95% CI, 1.15-2.27) were identified as independent risk factors for postoperative pneumonia.Conclusions: This study identified several risk factors for pneumonia in geriatric patients after hip fracture operations, providing a viable preventive strategy for optimizing clinical conditions for reductionof postoperative pneumonia.

scholarly journals Risk factors for a first thrombotic event in antiphospholipid antibody carriers: a prospective multicentre follow-up study

2011 ◽  
Vol 70 (6) ◽  
pp. 1083-1086 ◽  
Author(s):  
Amelia Ruffatti ◽  
Teresa Del Ross ◽  
Manuela Ciprian ◽  
Maria T Bertero ◽  
Sciascia Salvatore ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Univariate Analysis ◽  
Thrombotic Event ◽  
Multivariate Logistic Regression Analysis ◽  
Antiphospholipid Antibody ◽  
History Of ◽  
Ischaemic Attack ◽  
Independent Risk Factors

ObjectivesTo assess risk factors for a first thrombotic event in confirmed antiphospholipid (aPL) antibody carriers and to evaluate the efficacy of prophylactic treatments.MethodsInclusion criteria were age 18–65 years, no history of thrombosis and two consecutive positive aPL results. Demographic, laboratory and clinical parameters were collected at enrolment, once a year during the follow-up and at the time of the thrombotic event, whenever that occurred.Results258 subjects were prospectively observed between October 2004 and October 2008. The mean±SD follow-up was 35.0±11.9 months (range 1–48). A first thrombotic event (9 venous, 4 arterial and 1 transient ischaemic attack) occurred in 14 subjects (5.4%, annual incidence rate 1.86%). Hypertension and lupus anticoagulant (LA) were significantly predictive of thrombosis (both at p<0.05) and thromboprophylaxis was significantly protective during high-risk periods (p<0.05) according to univariate analysis. Hypertension and LA were identified by multivariate logistic regression analysis as independent risk factors for thrombosis (HR 3.8, 95% CI 1.3 to 11.1, p<0.05, and HR 3.9, 95% CI 1.1 to 14, p<0.05, respectively).ConclusionsHypertension and LA are independent risk factors for thrombosis in aPL carriers. Thromboprophylaxis in these subjects should probably be limited to high-risk situations.

Sexual behaviour of inmates with Chlamydia trachomatis infection in the prisons of Catalonia, Spain

Sexual Health ◽  
2012 ◽  
Vol 9 (2) ◽  
pp. 187 ◽  
Author(s):  
Evelin L. Corbeto ◽  
Dolors Carnicer-Pont ◽  
Rossie Lugo ◽  
Victoria Gonzalez ◽  
Elisabet Bascuñana ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chlamydia Trachomatis ◽  
High Mobility ◽  
Cross Sectional Study ◽  
Multivariate Logistic Regression Model ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Chlamydia Trachomatis Infection ◽  
High Risk Factors ◽  
Independent Risk Factors

Objective To determine the prevalence of Chlamydia trachomatis (CT) and high risk factors for acquisition in preventive prisoners in Catalonia. Methods: Cross-sectional study of a convenience sample of 478 prisoners aged between 18 and 35 years was analysed using real-time polymerase chain reaction. A standardized questionnaire was used to collect behavioural data. Significant differences were analysed in the descriptive study using Pearson’s χ2. The association between CT and its determinants was analysed using the Mantel–Haenszel test and a multivariate logistic regression model. Results: The overall prevalence of CT was 5.4%. The independent risk factors for infection by CT were as follows: foreign origin, having had concurrent sexual partners, and alcohol consumption. Conclusions: This is the first study performed in prisons of Catalonia that shows the prevalence of CT in young prisoners. The high mobility of young detainees could explain the similarity in prevalence obtained about young people in Catalonia. Systematic monitoring of CT infection in young preventive prisoners is important in order to prevent further problems in themselves and in the general population, since they become a ‘bridge population’ in sexually transmissible infection spreading.

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