scholarly journals Risk factors for postoperative meningitis after microsurgery for vestibular schwannoma

2019 ◽  
Author(s):  
Bowen Huang ◽  
Yanming Ren ◽  
Chenghong Wang ◽  
Zhigang Lan ◽  
Xuhui Hui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vestibular Schwannoma ◽  
Univariate Analysis ◽  
High Morbidity ◽  
Intraoperative Bleeding ◽  
Bleeding Volume ◽  
Independent Risk Factors ◽  
Postoperative Meningitis ◽  
Prolonged Hospital ◽  
Duration Of Operation

AbstractOBJECTIVEMeningitis after microsurgery for vestibular schwannoma (VS) is a severe complication and result in high morbidity. But few studies have focused on meningitis after VS surgery alone. The purpose of this study was to identify the risk factors for meningitis after VS surgery.METHODSWe undertook a retrospective analysis of all VS patients, who underwent microsurgery of VS and at least live for 7 days after surgery, between 1st June 2015 and 30st November 2018 at West China Hospital of Sichuan University. Univariate and multivariate analyses were performed to identify the risk factors for postoperative meningitis (POM).RESULTSWe collected 410 patients, 27 of whom had POM. Through univariate analysis, hydrocephalus (p=0. 018), Koos grade IV (p=0.04), The operative duration (> 3 hours p=0.03) and intraoperative bleeding volume (≥ 400ml p=0. 02) were significantly correlated to POM. Multivariate analysis showed that Koos grade IV (p=0.04; OR=3.19; 95% CI 1.032-3.190), operation duration (> 3 hours p=0.03 OR= 7.927; 95% CI 1.043-60.265), and intraoperative bleeding volume (≥ 400ml p=0.02; OR=2.551; 95% CI 1.112-5.850) are the independent influencing factors of POM.CONCLUSIONSKoos grade IV, the duration of operation, and the amount of bleeding were identified as independent risk factors for POM after microsurgery of VS. POM caused a prolonged hospital stay.

scholarly journals Analysis of Risk Factors for Severe Intraoperative Bleeding in Patients With Placenta Accreta Spectrum

2020 ◽  
Author(s):  
Yuanyuan Wang ◽  
Yadan Zhou ◽  
yangyu zhao ◽  
Lin Zeng
Keyword(s):  
Risk Factors ◽  
Placenta Accreta ◽  
Univariate Analysis ◽  
Severe Bleeding ◽  
Intraoperative Bleeding ◽  
Bleeding Volume ◽  
Imaging Characteristics ◽  
Peking University ◽  
Parity Number ◽  
Placenta Accreta Spectrum

Abstract Objective: To analyze relevant risk factors for severe postpartum hemorrhage in patients with placenta accreta spectrum to improve the ability to identify patients with high-risk for intraoperative bleeding and improve maternal outcomes. Methods: This study is a retrospective study. Placenta accreta patients who delivered by cesarean section at Peking University Third Hospital from September 2017 to December 2019 were selected and included, according to the amount of intraoperative bleeding, in the severe bleeding group (bleeding volume ≥ 2000 mL, 68 cases) and nonsevere bleeding group (bleeding volume <2000 mL, 99 cases). Univariate analysis and multivariate logistic regression were used to analyze the correlations between related risk factors or ultrasound imaging characteristics and the severity of bleeding during operation. Results: (1) There were statistically significant differences in gravity, parity, number of prior cesarean deliveries and placenta accreta ultrasound scores (p <0.05) between the two groups of patients. (2) Among the ultrasonographic indicators, the disappearance of the postplacental clear space, the emergence of cross-border blood vessels in the region of subplacental vascularity, interruption or disappearance of the bladder line, and the presence of the cervical blood sinus had the most significant correlation with hemorrhage during placenta accreta (p <0.05).

scholarly journals Evaluation of Risk Factors for Antibiotic Resistance in Patients with Nosocomial Infections Caused byPseudomonas aeruginosa

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Meliha Cagla Sonmezer ◽  
Gunay Ertem ◽  
Fatma Sebnem Erdinc ◽  
Esra Kaya Kilic ◽  
Necla Tulek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nosocomial Infection ◽  
Nosocomial Infections ◽  
Univariate Analysis ◽  
High Morbidity ◽  
Retrospective Case ◽  
Development Of Resistance ◽  
Independent Risk Factors ◽  
Imipenem Resistance ◽  
Control Study

Background.Pseudomonas aeruginosa(P. aeruginosa) is resistant to various antibiotics and can cause serious nosocomial infections with high morbidity and mortality. In this clinical study, we investigated the risk factors in patients who were diagnosed withP. aeruginosa-related nosocomial infection.Methods. A retrospective case control study including patients withP. aeruginosa-related nosocomial infection. Patients who were resistant to any of the six antibiotics (imipenem, meropenem, piperacillin-tazobactam, ciprofloxacin, amikacin, and ceftazidime) constituted the study group.Results. One hundred and twenty isolates were isolated. Various risk factors were detected for each antibiotic in the univariate analysis. In the multivariate analysis, previous cefazolin use was found as an independent risk factor for the development of imipenem resistance (OR = 3.33; CI 95% [1.11–10.0];p= 0.03), whereas previous cerebrovascular attack (OR = 3.57; CI 95% [1.31–9.76];p= 0.01) and previous meropenem use (OR = 4.13; CI 95% [1.21–14.07];p= 0.02) were independent factors for the development of meropenem resistance. For the development of resistance to ciprofloxacin, hospitalization in the neurology intensive care unit (OR = 4.24; CI 95% [1.5–11.98];p= 0.006) and mechanical ventilator application (OR = 11.7; CI 95% [2.24–61.45];p= 0.004) were independent risk factors.Conclusion. The meticulous application of contact measures can decrease the rate of nosocomial infections.

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.

scholarly journals Risk factors for postoperative meningitis after microsurgery for vestibular schwannoma

PLoS ONE ◽  
2019 ◽  
Vol 14 (7) ◽  
pp. e0217253 ◽  
Author(s):  
Bowen Huang ◽  
Yanming Ren ◽  
Chenghong Wang ◽  
Zhigang Lan ◽  
Xuhui Hui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vestibular Schwannoma ◽  
Postoperative Meningitis

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.

scholarly journals Developing a Risk Stratification Model for Surgical Site Infection after Abdominal Hysterectomy

2009 ◽  
Vol 30 (11) ◽  
pp. 1077-1083 ◽  
Author(s):  
Margaret A. Olsen ◽  
James Higham-Kessler ◽  
Deborah S. Yokoe ◽  
Anne M. Butler ◽  
Johanna Vostok ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Insurance ◽  
Blood Transfusion ◽  
Risk Stratification ◽  
Surgical Site Infection ◽  
Private Health Insurance ◽  
Abdominal Hysterectomy ◽  
Site Infection ◽  
Independent Risk Factors ◽  
Duration Of Operation

Objective.The incidence of surgical site infection (SSI) after hysterectomy ranges widely from 2% to 21%. A specific risk stratification index could help to predict more accurately the risk of incisional SSI following abdominal hysterectomy and would help determine the reasons for the wide range of reported SSI rates in individual studies. To increase our understanding of the risk factors needed to build a specific risk stratification index, we performed a retrospective multihospital analysis of risk factors for SSI after abdominal hysterectomy.Methods.Retrospective case-control study of 545 abdominal and 275 vaginal hysterectomies from July 1, 2003, to June 30, 2005, at 4 institutions. SSIs were defined by using Centers for Disease Control and Prevention/National Nosocomial Infections Surveillance criteria. Independent risk factors for abdominal hysterectomy were identified by using logistic regression.Results.There were 13 deep incisional, 53 superficial incisional, and 18 organ-space SSIs after abdominal hysterectomy and 14 organ-space SSIs after vaginal hysterectomy. Because risk factors for organ-space SSI were different according to univariate analysis, we focused further analyses on incisional SSI after abdominal hysterectomy. The maximum serum glucose level within 5 days after operation was highest in patients with deep incisional SSI, lower in patients with superficial incisional SSI, and lowest in uninfected patients (median, 189, 156, and 141 mg/dL, respectively; P = .005). Independent risk factors for incisional SSI included blood transfusion (odds ratio [OR], 2.4) and morbid obesity (body mass index [BMI], >35; OR, 5.7). Duration of operation greater than the 75th percentile (OR, 1.7), obesity (BMI, 30–35; OR, 3.0), and lack of private health insurance (OR, 1.7) were marginally associated with increased odds of SSI.Conclusions.Incisional SSI after abdominal hysterectomy was associated with increased BMI and blood transfusion. Longer duration of operation and lack of private health insurance were marginally associated with SSI.

Influence of Luminal Communication on Aortic Enlargement after Hemiarch Replacement for Acute Type A Aortic Dissection

2019 ◽  
Vol 68 (04) ◽  
pp. 294-300
Author(s):  
Gaku Uchino ◽  
Takeshi Yoshida ◽  
Bunpachi Kakii ◽  
Masato Furui
Keyword(s):  
Risk Factors ◽  
Growth Rate ◽  
Aortic Dissection ◽  
Univariate Analysis ◽  
Type A ◽  
Aortic Diameter ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Independent Risk Factors ◽  
Hemiarch Replacement

Background Aortic enlargement after hemiarch replacement (HAR) for acute type A aortic dissection (AAAD) is a serious problem. We reviewed our experience and analyzed the risk factors for aortic enlargement. Methods During April 2005 to December 2017, 364 patients underwent HAR for AAAD. Seventy-three patients fulfilled the inclusion criteria. We analyzed the change in aortic diameter, aortic growth rate, and major adverse aortic events (MAAEs) and their association with luminal communication of the aortic arch. Results Anastomotic communication, supra-aortic communication (SAC), and distal aortic communication were found in 34 (46.6%), 28 (38.4%), and 20 (27.4%) patients, respectively. The aortic growth rate was high because of the presence of SAC, distal aortic communication, and the number of coexisting aortic communication. Univariate analysis showed that the presence of SAC and an initial aortic diameter > 35 mm at 20 mm distal to the left subclavian artery and at the pulmonary artery bifurcation (PAB) were risk factors for MAAEs. Multivariate analysis showed that SAC and an initial aortic diameter > 35 mm at the PAB were independent risk factors for MAAEs. Conclusion SAC, distal aortic communication, and the number of coexisting aortic communication are significant risk factors for aortic enlargement after HAR for AAAD. SAC and an initial aortic diameter > 35 mm at the PAB are independent risk factors for MAAEs after this procedure.

Complications After Pancreaticoduodenectomy for Pancreatic Cancer: A Retrospective Study

2011 ◽  
Vol 96 (3) ◽  
pp. 220-227 ◽  
Author(s):  
Shiyan Ren ◽  
Peng Liu ◽  
Ningxin Zhou ◽  
Jiahong Dong ◽  
Rong Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Duct ◽  
Univariate Analysis ◽  
Postoperative Hemorrhage ◽  
Morbidity Rate ◽  
Surgical Time ◽  
Pancreatic Cancers ◽  
Duct Diameter ◽  
Independent Risk Factors ◽  
Abdominal Hemorrhage

Abstract Postoperative complications, such as pancreatic fistulae, after pancreaticoduodenectomy for pancreatic cancers are associated with surgical outcomes of patients with pancreatic cancers. A total of 160 patients with pancreatic cancers undergoing pancreaticoduodenectomy were retrospectively analyzed. Patients were grouped into a fistulae group (n  =  34) and a nonfistulae group (n  =  126). The fistulae group had a significantly higher morbidity rate than the nonfistulae group (P &lt; 0.0001), but hospital mortality was not different in both groups (P  =  0.481). There was a higher incidence of intra-abdominal hemorrhage in patients with pancreatic fistulae than in those without fistulae. Two patients in fistulae group underwent reoperation. Patients with pancreatic fistulae had significantly longer hospital stay than those without fistulae. Pancreatic duct diameter, smoking, years of tobaccos consumption, preoperative jaundice, and surgical hours were associated with risk of fistulae on univariate analysis. In a multivariate analysis, diameter of pancreatic duct, surgical hours, and preoperative jaundice were independent risk factors of pancreatic fistulae. Incidence of pancreatic fistulae after pancreaticoduodenectomy is significantly influenced by the size of pancreatic duct diameter, surgical time, and preoperative jaundice. Early postoperative hemorrhage could be cautiously prevented. The survival is not significantly impacted by pancreatic fistulae.

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