scholarly journals Spectrum, risk factors, and outcomes of neurological and psychiatric complications of COVID-19: a UK-wide cross-sectional surveillance study

2021 ◽  
Author(s):  
Amy L Ross Russell ◽  
Marc Hardwick ◽  
Athavan Jeyanantham ◽  
Laura M White ◽  
Saumitro Deb ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Data ◽  
White Cell Count ◽  
Surveillance Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Wide Cross ◽  
Hospitalised Patients ◽  
Psychiatric Conditions ◽  
Frailty Score

Abstract SARS-CoV-2 is associated with new-onset neurological and psychiatric conditions. Detailed clinical data, including factors associated with recovery, are lacking, hampering prediction modelling and targeted therapeutic interventions. In a UK-wide cross-sectional surveillance study of adult hospitalised patients during the first COVID-19 wave, with multi-professional input from general and sub-specialty neurologists, psychiatrists, stroke physicians, and intensivists, we captured detailed data on demographics, risk factors, pre-COVID-19 Rockwood frailty score, comorbidities, neurological presentation and outcome. A priori clinical case definitions were used, with cross-specialty independent adjudication for discrepant cases. Multivariable logistic regression was performed using demographic and clinical variables, to determine the factors associated with outcome. A total of 267 cases were included. Cerebrovascular events were most frequently reported (131, 49%), followed by other central disorders (95, 36%) including delirium (28, 11%), central inflammatory (25, 9%), psychiatric (25, 9%), and other encephalopathies (17, 7%), including a severe encephalopathy (n = 13) not meeting delirium criteria; and peripheral nerve-disorders (41, 15%). Those with the severe encephalopathy, in comparison to delirium, were younger, had higher rates of admission to intensive care and a longer duration of ventilation. Compared to normative data during the equivalent time-period prior to the pandemic, cases of stroke in association with COVID-19 were younger and had a greater number of conventional, modifiable cerebrovascular risk factors. 27% of strokes occurred in patients <60 years. Relative to those >60 years old, the younger stroke patients presented with delayed onset from respiratory symptoms, higher rates of multi-vessel occlusion (31%) and systemic thrombotic events. Clinical outcomes varied between disease groups, with cerebrovascular disease conferring the worst prognosis, but this effect was less marked than the pre-morbid factors of older age and a higher pre-COVID-19 frailty score, and a high admission white cell count, which was independently associated with a poor outcome. In summary, this study describes the spectrum of neurological and psychiatric conditions associated with COVID-19. In addition, we identify a severe COVID-19 encephalopathy atypical for delirium, and a phenotype of COVID-19 associated stroke in younger adults with a tendency for multiple infarcts and systemic thromboses. These clinical data will be useful to inform mechanistic studies and stratification of patients in clinical trials.

Characteristics and risk factors associated with stroke subtypes among adult patients admitted to stroke unit of JUMC

2019 ◽  
Vol 15 ◽  
Author(s):  
Bekalu Getachew Gebreegziabher ◽  
Tesema Etefa Birhanu ◽  
Diriba Dereje Olana ◽  
Behailu Terefe Tesfaye
Keyword(s):  
Risk Factors ◽  
Stroke Unit ◽  
Medical Center ◽  
Data Entry ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Associated ◽  
Stroke Subtypes

Background: Stroke is a great public health problem in Ethiopia. According to reports, in-hospital stroke mortality was estimated to be 14.7% in Ethiopia. Despite this, in this country researches done on factors associated with stroke sub-types were inadequate. Objective: To assess the Characteristics and risk factors associated with stroke sub-types among patients admitted to JUMC. Methods and materials: A retrospective cross sectional study was conducted from May 2017 to May 2018 in stroke unit of Jimma University Medical Center. A total of 106 medical charts of patients diagnosed with stroke were reviewed. Checklist comprising of relevant variables was used to collect data. SPSS version 21 was employed for data entry and analysis. Chi-square test was used to point-out association and difference among stroke sub-types. The data was presented using text, tables and figures. Result: From a total of 106 patients, 67(63.2%) were men. The mean ± SD of age was 52.67±12.46 years, and no significant association was found. Of all the patients, 59(55.6%) had ischemic strokes and 47(44.4%) had hemorrhagic strokes. The most common risk factor in the patients was alcohol use with a prevalence of 69.9%. Of all the risk factors, only sex, cigarettes smoking and dyslipidemia were significantly associated to sub-types of stroke. Conclusion: Ischemic stroke was the most common subtype of stroke. Sex of patient, cigarette smoking and dyslipidemia are significantly associated with the two stroke subtypes.

scholarly journals Risk Factors of Inadequate Bowel Preparation for Screening Colonoscopy

2021 ◽  
Vol 10 (12) ◽  
pp. 2740
Author(s):  
Efrat L. Amitay ◽  
Tobias Niedermaier ◽  
Anton Gies ◽  
Michael Hoffmeister ◽  
Hermann Brenner
Keyword(s):  
Risk Factors ◽  
Bowel Preparation ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Screening Colonoscopy ◽  
Cross Sectional ◽  
Factors Associated ◽  
Screening Practice ◽  
Abdominal Symptoms ◽  
Inadequate Bowel Preparation

The success of a colonoscopy in detecting and removing pre-cancerous and cancerous lesions depends heavily on the quality of bowel preparation. Despite efforts, 20–44% of colonoscopy participants have an inadequate bowel preparation. We aimed to assess and compare risk factors for inadequate bowel preparation and for the presence of advanced colorectal neoplasms in routine screening practice. In this cross-sectional study, among 8125 participants of screening colonoscopy in Germany with a comprehensive assessment of sociodemographic factors, lifestyle and medical history, we examined factors associated with inadequate bowel preparation and with findings of advanced neoplasms using adjusted log-binomial regression models. Among the identified risk factors assessed, three factors were identified that were significantly associated with inadequate bowel preparation: age ≥ 70 years (adjusted prevalence ratios, aPR, 1.50 95%CI 1.31–1.71), smoking (aPR 1.29 95%CI 1.11–1.50) and abdominal symptoms (aPR 1.14 95%CI 1.02–1.27). The same risk factors were also associated with the prevalence of advanced neoplasms in our study (aPR 1.72, 1.62 and 1.44, respectively). The risk factors associated with inadequate bowel preparation in this study were also associated with a higher risk for advanced neoplasms. Inadequate bowel preparation for colonoscopy might lead to missed colorectal cancer (CRC) precursors and the late diagnosis of CRC. People at high risk of advanced neoplasms are in particular need of enhanced bowel preparation.

scholarly journals Characteristics, outcomes and risk factors for mortality of 522 167 patients hospitalised with COVID-19 in Brazil: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e049089
Author(s):  
Marcia C Castro ◽  
Susie Gurzenda ◽  
Eduardo Marques Macário ◽  
Giovanny Vinícius A França
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Proportional Hazards ◽  
Secondary Outcome ◽  
Hospital Death ◽  
Factors Associated ◽  
Icu Admission ◽  
Hospitalised Patients

ObjectiveTo provide a comprehensive description of demographic, clinical and radiographic characteristics; treatment and case outcomes; and risk factors associated with in-hospital death of patients hospitalised with COVID-19 in Brazil.DesignRetrospective cohort study of hospitalised patients diagnosed with COVID-19.SettingData from all hospitals across Brazil.Participants522 167 hospitalised patients in Brazil by 14 December 2020 with severe acute respiratory illness, and a confirmed diagnosis for COVID-19.Primary and secondary outcome measuresPrevalence of symptoms and comorbidities was compared by clinical outcomes and intensive care unit (ICU) admission status. Survival was assessed using Kaplan Meier survival estimates. Risk factors associated with in-hospital death were evaluated with multivariable Cox proportional hazards regression.ResultsOf the 522 167 patients included in this study, 56.7% were discharged, 0.002% died of other causes, 30.7% died of causes associated with COVID-19 and 10.2% remained hospitalised. The median age of patients was 61 years (IQR, 47–73), and of non-survivors 71 years (IQR, 60–80); 292 570 patients (56.0%) were men. At least one comorbidity was present in 64.5% of patients and in 76.8% of non-survivors. From illness onset, the median times to hospital and ICU admission were 6 days (IQR, 3–9) and 7 days (IQR, 3–10), respectively; 15 days (IQR, 9–24) to death and 15 days (IQR, 11–20) to hospital discharge. Risk factors for in-hospital death included old age, Black/Brown ethnoracial self-classification, ICU admission, being male, living in the North and Northeast regions and various comorbidities. Age had the highest HRs of 5.51 (95% CI: 4.91 to 6.18) for patients≥80, compared with those ≤20.ConclusionsCharacteristics of patients and risk factors for in-hospital mortality highlight inequities of COVID-19 outcomes in Brazil. As the pandemic continues to unfold, targeted policies that address those inequities are needed to mitigate the unequal burden of COVID-19.

scholarly journals Hierarchical disentanglement of contextual from compositional risk factors of diarrhoea among under-five children in low- and middle-income countries

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Adeniyi Francis Fagbamigbe ◽  
A. Olalekan Uthman ◽  
Latifat Ibisomi
Keyword(s):  
Risk Factors ◽  
National Level ◽  
Cross Sectional ◽  
Middle Income ◽  
Contextual Risk ◽  
Under Five ◽  
Factors Associated ◽  
Under Five Children ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractSeveral studies have documented the burden and risk factors associated with diarrhoea in low and middle-income countries (LMIC). To the best of our knowledge, the contextual and compositional factors associated with diarrhoea across LMIC were poorly operationalized, explored and understood in these studies. We investigated multilevel risk factors associated with diarrhoea among under-five children in LMIC. We analysed diarrhoea-related information of 796,150 under-five children (Level 1) nested within 63,378 neighbourhoods (Level 2) from 57 LMIC (Level 3) using the latest data from cross-sectional and nationally representative Demographic Health Survey conducted between 2010 and 2018. We used multivariable hierarchical Bayesian logistic regression models for data analysis. The overall prevalence of diarrhoea was 14.4% (95% confidence interval 14.2–14.7) ranging from 3.8% in Armenia to 31.4% in Yemen. The odds of diarrhoea was highest among male children, infants, having small birth weights, households in poorer wealth quintiles, children whose mothers had only primary education, and children who had no access to media. Children from neighbourhoods with high illiteracy [adjusted odds ratio (aOR) = 1.07, 95% credible interval (CrI) 1.04–1.10] rates were more likely to have diarrhoea. At the country-level, the odds of diarrhoea nearly doubled (aOR = 1.88, 95% CrI 1.23–2.83) and tripled (aOR = 2.66, 95% CrI 1.65–3.89) among children from countries with middle and lowest human development index respectively. Diarrhoea remains a major health challenge among under-five children in most LMIC. We identified diverse individual-level, community-level and national-level factors associated with the development of diarrhoea among under-five children in these countries and disentangled the associated contextual risk factors from the compositional risk factors. Our findings underscore the need to revitalize existing policies on child and maternal health and implement interventions to prevent diarrhoea at the individual-, community- and societal-levels. The current study showed how the drive to the attainment of SDGs 1, 2, 4, 6 and 10 will enhance the attainment of SDG 3.

scholarly journals Burnout Syndrome during Residency Training in Jordan: Prevalence, Risk Factors, and Implications

2021 ◽  
Vol 18 (4) ◽  
pp. 1557
Author(s):  
Abdullah Nimer ◽  
Suzan Naser ◽  
Nesrin Sultan ◽  
Rawand Said Alasad ◽  
Alexander Rabadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Working Hours ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Burnout Syndrome ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Factors Associated ◽  
Resident Physicians ◽  
Healthcare Professions

Burnout syndrome is common among healthcare professions, including resident physicians. We aimed to assess the prevalence of burnout among resident physicians in Jordan, and a secondary aim was to evaluate the risk factors associated with the development of burnout syndrome in those residents, including gender, working hours, psychological distress, training sector, and specialty. In this cross-sectional study, 481 residents were recruited utilizing multistage stratified sampling to represent the four major health sectors in Jordan. Data were collected using an online questionnaire, where the Copenhagen Burnout Inventory (CBI) was used to assess the prevalence of burnout. The prevalence, group differences, and predictors of burnout were statistically analyzed using STATA 15. Overall, 373 (77.5%) residents were found to have burnout. Factors associated with higher levels of burnout were psychological stress (β = 2.34, CI = [1.88–2.81]), longer working hours (β = 4.07, CI = [0.52–7.62], for 51–75 h a week, β = 7.27, CI = [2.86–11.69], for 76–100 h a week and β = 7.27, CI = [0.06–14.49], for >100 h a week), and obstetrics/gynecology residents (β = 9.66, CI = [3.59–15.73]). Conversely, medical sub-specialty residents, as well as private and university hospital residents, had lower burnout levels. We concluded that decreasing the workload on residents, offering psychological counseling, and promoting a safety culture for residents might help in mitigating burnout consequences.

scholarly journals A retrospective cross-sectional study for predicting 72-h mortality in patients with serum aspartate aminotransferase levels ≥ 3000 U/L

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kai Saito ◽  
Hitoshi Sugawara ◽  
Tamami Watanabe ◽  
Akira Ishii ◽  
Takahiko Fukuchi
Keyword(s):  
Risk Factors ◽  
Alkaline Phosphatase ◽  
Creatine Kinase ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sodium Potassium ◽  
Factors Associated ◽  
C Statistic ◽  
Serum Aspartate Aminotransferase

AbstractRisk factors associated with 72-h mortality in patients with extremely high serum aspartate aminotransferase levels (AST; ≥ 3000 U/L) are unknown. This single-centre, retrospective, case-controlled, cross-sectional study obtained data from medical records of adult patients treated at Saitama Medical Center, Japan, from 2005 to 2019. We conducted a multivariate logistic after adjusting for age, sex, height, weight, body mass index, Brinkman Index, vital signs, biochemical values, updated Charlson Comorbidity Index (CCI) score, CCI components, and underlying causes. A logistic regression model with selected validity risks and higher C-statistic for predicting 72-h mortality was established. During the 15-year period, 428 patients (133 non-survivors and 295 survivors [cases and controls by survival < 72 and ≥ 72 h, respectively]) with AST levels ≥ 3000 U/L were identified. The 72-h mortality rate was 133/428 (31.1%). The model used for predicting 72-h mortality through the assessment of alkaline phosphatase, creatine kinase, serum sodium, potassium, and phosphorus levels had a C-statistic value of 0.852 (sensitivity and specificity, 76.6%). The main independent risk factors associated with 72-h mortality among patients with AST levels ≥ 3000 U/L included higher serum values of alkaline phosphatase, creatine kinase, serum sodium, potassium, and phosphorus.

Activities and risk factors associated with fall-related injuries among US Army soldiers

2020 ◽  
pp. bmjmilitary-2020-001564
Author(s):  
Raina D Brooks ◽  
T Grier ◽  
B H Jones ◽  
M C Chervak
Keyword(s):  
Risk Factors ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Physically Active ◽  
Us Army ◽  
Factors Associated ◽  
Younger Age ◽  
Near Falls ◽  
Independent Risk Factors ◽  
Army Soldiers

IntroductionFalls/near falls are the second leading cause of hospitalisation and outpatient visits among US Army soldiers. While numerous studies have evaluated fall-related or near fall-related injuries among elderly adults, few have evaluated this association among young adults. The objective of this study is to describe the characteristics and risk factors associated with fall-related or near fall-related injuries among male US Army soldiers.MethodsThis is a cross-sectional study of male US Army Airborne Division soldiers (n=5187). Electronic surveys captured demographic, lifestyle, physical training (PT), fitness and injury data during spring/summer of 2016. Multiple logistic regression was used to identify independent risk factors of fall-related or near fall-related injuries, adjusting for potential confounders.ResultsPrimary findings indicated that activities and risk factors associated with fall-related or near fall-related injuries among soldiers included younger age (≤35 years), holding a job that required minimal lifting activities, slower 2-mile run times and not running during personal PT.ConclusionsThe findings from this study suggest that male US Army soldiers and other physically active men may benefit from (1) obtaining and/or maintaining higher aerobic endurance and muscular strength, and (2) training focused on preventing fall-related injuries during PT, road marching and sports/recreational activities. Moreover, prevention strategies and education should further target younger soldiers (≤35 years old), as younger age is not modifiable.

scholarly journals A cross sectional study to compare cardiac structure and diastolic function in adolescents and young adults with youth-onset type 1 and type 2 diabetes: The SEARCH for Diabetes in Youth Study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Amy S. Shah ◽  
Scott Isom ◽  
Dana Dabelea ◽  
Ralph D’Agostino ◽  
Lawrence M. Dolan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diastolic Function ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Factors Associated ◽  
Youth Study ◽  
Hispanic White ◽  
Diabetes In Youth

Abstract Aims To compare left ventricular structure (LV) and diastolic function in young adults with youth- onset diabetes by type, determine the prevalence of abnormal diastolic function by diabetes type using published values from age similar healthy controls, and examine the risk factors associated with diastolic function. Methods In a cross sectional analysis we compared LV structure and diastolic function from two dimensional echocardiogram in participants with type 1 (T1D) and type 2 diabetes (T2D) who participated in the SEARCH for Diabetes in Youth Study. Linear models were used to examine the risk factors associated with worse diastolic function. Results Of 479 participants studied, 258 had T1D (mean age 21.2 ± 5.2 years, 60.5% non-Hispanic white, 53.9% female) and 221 had T2D (mean age 24.8 ± 4.3 years, 24.4% non-Hispanic white, 73.8% female). Median diabetes duration was 11.6 years. Participants with T2D had greater LV mass index and worse diastolic function that persisted after adjustment for differences in risk factors compared with participants with T1D (all p < 0.05). Abnormal diastolic function, quantified using healthy controls, was pronounced in both groups but greater in those with T2D than T1D (T2D: 57.7% vs T1D: 47.2%, respectively), p < 0.05. Risk factors associated with worse diastolic function included older age at diabetes diagnosis, female sex, higher BP, heart rate and HbA1c and longer diabetes duration. Conclusions LV structure and diastolic function is worse in individuals with T2D compared to T1D. However, abnormal diastolic function in seen in both groups compared to published values from age similar healthy controls.

scholarly journals Prevalence and Risk Factors Associated With Hypertension in Hemophilia: Cross-Sectional Analysis of a National Discharge Register

2016 ◽  
Vol 23 (7) ◽  
pp. 871-875 ◽  
Author(s):  
Craig D. Seaman ◽  
Mariya Apostolova ◽  
Jonathan Yabes ◽  
Diane M. Comer ◽  
Margaret V. Ragni
Keyword(s):  
Risk Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
Cross Sectional Analysis ◽  
Sectional Analysis
Sign in / Sign up

Export Citation Format

Share Document