Early feeding after total laryngectomy results in shorter hospital stay without increased risk of complications: a retrospective case-control study

2015 ◽  
Vol 40 (6) ◽  
pp. 587-592 ◽  
Author(s):  
C.M.C. Serbanescu-Kele ◽  
G.B. Halmos ◽  
J. Wedman ◽  
B.F.A.M. van der Laan ◽  
B.E.C. Plaat
Keyword(s):  
Hospital Stay ◽  
Total Laryngectomy ◽  
Case Control Study ◽  
Case Control ◽  
Early Feeding ◽  
Retrospective Case ◽  
Increased Risk ◽  
Control Study

scholarly journals Suicide in Psychiatric Inpatients— A Case–Control Study

2020 ◽  
Vol 11 ◽  
Author(s):  
Eberhard A. Deisenhammer ◽  
Elisa-Marie Behrndt-Bauer ◽  
Georg Kemmler ◽  
Christian Haring ◽  
Carl Miller
Keyword(s):  
Logistic Regression ◽  
Hospital Stay ◽  
Attempted Suicide ◽  
Case Control Study ◽  
Psychiatric Inpatients ◽  
Case Control ◽  
Increased Risk ◽  
Inpatient Suicide ◽  
History Of ◽  
Control Study

Objective: Psychiatric inpatients constitute a population at considerably increased risk for suicide. Identifying those at imminent risk is still a challenging task for hospital staff. This retrospective case–control study focused on clinical risk factors related to the course of the hospital stay.Method: Inpatient suicide cases were identified by linking the Tyrol Suicide Register with the registers of three psychiatric hospitals in the state. Control subjects were patients who had also been hospitalized in the respective psychiatric unit but had not died by suicide. Matching variables included sex, age, hospital, diagnosis, and admission date. The study period comprised 7 years. Data were analyzed by the appropriate two-sample tests and by logistic regression.Results: A total of 30 inpatient suicide cases and 54 control patients were included. A number of factors differentiated cases from controls; after correction for multiple testing, the following retained significance: history of aborted suicide, history of attempted suicide, history of any suicidal behavior/threats, suicidal ideation continuing during hospitalization, no development of prospective plans, no improvement of mood during the hospital stay, and leaving ward without giving notice. Logistic regression identified the latter three variables and history of attempted suicide as highly significant predictors of inpatient suicide.Conclusions: Preventive measures during hospitalization include thorough assessment of suicidal features, an emphasis on the development of future perspectives, and a review of hospital regulations for patients who want to leave the ward.

Efficacy of small-volume gastrografin videofluoroscopic screening for detecting pharyngeal leaks following total laryngectomy

2020 ◽  
Vol 134 (4) ◽  
pp. 350-353
Author(s):  
M Narayan ◽  
S Limbachiya ◽  
D Balasubramanian ◽  
N Subramaniam ◽  
K Thankappan ◽  
...  
Keyword(s):  
Total Laryngectomy ◽  
Small Volume ◽  
Case Control Study ◽  
Case Control ◽  
Control Group ◽  
Study Group ◽  
Retrospective Case ◽  
Control Study ◽  
Pharyngocutaneous Fistulae

AbstractObjectivesPharyngocutaneous fistulae are dreaded complications following total laryngectomy. This paper presents our experience using 3–5 ml gastrografin to detect pharyngeal leaks following total laryngectomy, and compares post-operative videofluoroscopy with clinical follow-up findings in the detection of pharyngocutaneous fistulae.MethodsA retrospective case–control study was conducted of total laryngectomy patients. The control group (n = 85) was assessed clinically for development of pharyngocutaneous fistulae, while the study group (n = 52) underwent small-volume (3–5 ml) post-operative gastrografin videofluoroscopy.ResultsIn the control group, 24 of 85 patients (28 per cent) developed pharyngocutaneous fistulae, with 6 requiring surgical correction. In the study group, 24 of 52 patients (46 per cent) had videofluoroscopy-detected pharyngeal leaks; 4 patients (8 per cent) developed pharyngocutaneous fistulae, but all cases resolved following non-surgical management. Patients who underwent videofluoroscopy had a significantly lower risk of developing pharyngocutaneous fistulae; sensitivity and specificity in the detection of pharyngocutaneous fistulae were 58 per cent and 100 per cent respectively.ConclusionSmall-volume gastrografin videofluoroscopy reliably identified small pharyngeal leaks. Routine use in total laryngectomy combined with withholding feeds in cases of early leaks may prevent the development of pharyngocutaneous fistulae.

scholarly journals Neonatal Thrombocytopenia after Perinatal Asphyxia Treated with Hypothermia: A Retrospective Case Control Study

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
N. Boutaybi ◽  
F. Razenberg ◽  
V. E. H. J. Smits-Wintjens ◽  
E. W. van Zwet ◽  
M. Rijken ◽  
...  
Keyword(s):  
Platelet Count ◽  
Therapeutic Hypothermia ◽  
Case Control Study ◽  
Perinatal Asphyxia ◽  
Case Control ◽  
Control Group ◽  
Retrospective Case ◽  
Increased Risk ◽  
Hypothermia Group ◽  
Control Study

Our objective was to estimate the effect of therapeutic hypothermia on platelet count in neonates after perinatal asphyxia. We performed a retrospective case control study of all (near-) term neonates with perinatal asphyxia admitted between 2004 and 2012 to our neonatal intensive care unit. All neonates treated with therapeutic hypothermia were included in this study (hypothermia group) and compared with a historic control group of neonates with perinatal asphyxia treated before introduction of therapeutic hypothermia (2008). Primary outcome was thrombocytopenia during the first week after birth. Thrombocytopenia was found significantly more often in the hypothermia group than in the control group, 80% (43/54) versus 59% (27/46) (P=.02). The lowest mean platelet count in the hypothermia group and control group was97×109/Land125×109/L(P=.06), respectively, and was reached at a mean age of 4.1 days in the hypothermia group and 2.9 days in the control group (P<.001). The incidence of moderate/severe cerebral hemorrhage was 6% (3/47) in the hypothermia group versus 9% (3/35) in the control group (P=.64). In conclusion, neonates with perinatal asphyxia treated with therapeutic hypothermia are at increased risk of thrombocytopenia, without increased risk of cerebral hemorrhage.

scholarly journals Incidence and Risk of Severe Ileus After Orthopedic Surgery: A Case-Control Study

2019 ◽  
Vol 16 (S2) ◽  
pp. 272-279 ◽  
Author(s):  
Lisa A. Mandl ◽  
Mayu Sasaki ◽  
Jingyan Yang ◽  
Sara Choi ◽  
Kelianne Cummings ◽  
...  
Keyword(s):  
Orthopedic Surgery ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
International Classification Of Diseases ◽  
Case Control ◽  
Orthopedic Procedures ◽  
Retrospective Case ◽  
Full Diet ◽  
Increased Risk ◽  
Control Study

Abstract Background Post-operative ileus (POI) is common and can be associated with significant morbidity. Questions/Purposes We aimed to identify the incidence of and risk factors associated with severe post-operative ileus (SPOI) after elective orthopedic surgery. Methods We conducted a retrospective case–control study of patients undergoing elective orthopedic procedures at a single musculoskeletal specialty hospital. SPOI cases matched 1:2 to non-POI controls. International Classification of Diseases, Ninth Revision (ICD-9), codes were used to identify patients who were coded as having an episode of POI. After chart review, a subset was classified as clinical SPOI cases, based on set criteria. Regression models were constructed to identify variables associated with SPOI. Results Of 273 POI cases, 77 (28.2%) were classified as SPOI. Overall rates of SPOI were 2.74/1000 orthopedic discharges, with SPOI most common in spine surgeries (9.07/1000 spine procedure discharges). Hypothesis-generating multivariable conditional logistic regression suggested that, for hip and knee cases, not being on a full diet by post-operative day (POD) 2 posed an increased risk of SPOI. For spine cases, not being on a full diet on POD 2 and longer surgery times were associated with risk of SPOI. Conclusions In this retrospective case–control study, patients undergoing elective orthopedic procedures who had not progressed to full diet by POD 2 and spine patients with longer operative times were most at risk for SPOI. These data can be used clinically by peri-operative physicians to stratify patients according to risk.

scholarly journals Gastrointestinal endoscopy under sedation is associated with pneumonia in older inpatients—results of a retrospective case-control study

2017 ◽  
Vol 6 (3) ◽  
pp. 382-390
Author(s):  
Christopher M Kollmann ◽  
Wolff Schmiegel ◽  
Thorsten Brechmann
Keyword(s):  
Antibiotic Treatment ◽  
Gastrointestinal Endoscopy ◽  
Case Control Study ◽  
Invasive Procedure ◽  
Case Control ◽  
Advanced Age ◽  
Retrospective Case ◽  
Inflammatory Parameters ◽  
Increased Risk ◽  
Control Study

Background and aims Apparent aspiration is a notable adverse event during gastrointestinal endoscopy under sedation (GIES), but data about inapparent aspiration are scarce. Generally, particularly older patients are at higher risk of suffering from adverse events. Objective The objective of this article is to determine the risk of pneumonia, lower respiratory tract infection (LRI) and systemic inflammatory activation after GIES, especially in patients of at least 65 years. Methods The retrospective case-control study included 250 patients undergoing GIES and assigned age-, gender- and time of performance-matched controls without invasive procedure or sedation (ratio 1:1). Results On day 3 patients of advanced age presented with both pneumonia and LRI more often (2.6 vs. 0.0%, p = 0.041 and 7.8 vs. 2.5%, p = 0.034, respectively). In general, several inflammatory parameters increased significantly after GIES (i.e. white blood cell count (increase of ≥ 25%) 18.6 vs. 6.9%, p < 0.001), leading to more frequent antibiotic treatment (6.8 vs. 1.6%, p = 0.004). The effects were less pronounced on day 7. Conclusions Patients of advanced age carry an increased risk of pneumonia and LRI after GIES. Patients are generally more likely to feature inflammation and to receive antibiotic treatment.

Case-Control Study of Antibiotic Use and Subsequent Clostridium difficile–Associated Diarrhea in Hospitalized Patients

2008 ◽  
Vol 29 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Roger Baxter ◽  
G. Thomas Ray ◽  
Bruce H. Fireman
Keyword(s):  
Clostridium Difficile ◽  
Case Control Study ◽  
Gastrointestinal Disease ◽  
Healthcare Delivery ◽  
Case Control ◽  
Healthcare Delivery System ◽  
Retrospective Case ◽  
Increased Risk ◽  
And Control ◽  
Control Study

Objective.To determine which antibiotics increase or decrease the risk of Clostridium difficile-associated diarrhea (CDAD).Design.Retrospective case-control study.Setting.Nonprofit, integrated healthcare delivery system in Northern California.Patients.Study participants included patients with cases of hospital-acquired CDAD that occurred during the period from 1999 through 2005 (n = 1,142) and control patients (n = 3,351) matched for facility, calendar quarter during which hospitalization occurred, diagnosis related group for the index hospitalization, and length of hospital stay. All case and control patients had received antibiotics in the 60 days before the index date. For each antibiotic, the risk of CDAD was examined in relation to whether the patient received the antibiotic, after adjustment for use of other antibiotics, demographic characteristics, selected health conditions, and use of healthcare services.Results.The following antibiotics were associated with a significantly increased risk of acquiring CDAD: imipenem-cilastin (odds ratio [OR], 2.77), clindamycin (OR, 2.31), cefuroxime (OR, 2.16), moxifloxacin (OR, 1.88), ceftazidime (OR, 1.82), cefpodoxime (OR, 1.58), ceftizoxime (OR, 1.57), and ceftriaxone (OR, 1.49). Metronidazole and doxycycline were associated with a significantly reduced risk of CDAD (OR for metronidazole, 0.67; OR for doxycycline, 0.41). Other factors associated with an increased risk of CDAD were older age, longer hospital stays, use of proton pump inhibitors, prior gastrointestinal disease, and prior infection (not including C. difficile infection.)Conclusions.Some antibiotics appear to increase the risk of acquiring CDAD, notably clindamycin, third-generation cephalosporins, and carbapenems, whereas metronidazole and doxycycline appear to be protective, compared with other antibiotics.

scholarly journals An outbreak and case-control study of Salmonella Havana linked to alfalfa sprouts in South Australia, 2018

2019 ◽  
Vol 43 ◽  
Author(s):  
Stephen Harfield ◽  
Rebecca Beazley ◽  
Emma Denehy ◽  
Alessia Centofanti ◽  
Paul Dowsett ◽  
...  
Keyword(s):  
Case Control Study ◽  
South Australia ◽  
Case Control ◽  
Epidemiological Investigation ◽  
Retrospective Case ◽  
Trace Back ◽  
Increased Risk ◽  
Study Results ◽  
Alfalfa Sprouts ◽  
Control Study

An epidemiological investigation and a retrospective case-control study were conducted into an outbreak of Salmonella Havana in alfalfa sprouts, in Adelaide, Australia. In total, 31 cases of S. Havana were notified during June and July 2018 and linked to the outbreak. Eighteen cases and 54 unmatched controls were included in a case-control study. Results from the case-control study indicated an increased risk of illness linked to the consumption of alfalfa sprouts; this was supported by trace-back, sampling and environmental investigations. This outbreak of S. Havana was caused by consumption of alfalfa sprouts from one local sprouts producer. It is unclear as to when in the production of alfalfa sprouts the contamination occurred. However, contaminated seeds and poor pest control are the most likely causes. This investigation highlights the importance of ensuring that producers take appropriate action to minimise the likelihood of contamination and to comply with legislation and standards for primary production and food safety.

scholarly journals 791. Evaluation of NSAID Exposure as a Risk Factor for Clostridium difficile infection: A Propensity-Score-Matched Case-Control Study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S439-S439
Author(s):  
Adam M Ressler ◽  
Alieysa Patel ◽  
Krishna Rao
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Propensity Score ◽  
Case Control Study ◽  
Case Control ◽  
Comorbid Disease ◽  
Retrospective Case ◽  
Increased Risk ◽  
Study Population ◽  
Control Study

Abstract Background Exposure to certain medications, particularly antibiotics and proton pump inhibitors, has been associated with increased risk for Clostridium difficile infection (CDI). Studies have suggested an increased risk for CDI associated with exposure to certain non-steroidal anti-inflammatory drugs (NSAIDs). We conducted a retrospective case-control study to evaluate the risk for CDI associated with NSAID use. Methods The population included 1338 patients tested for CDI from February–December 2016 at the University of Michigan. NSAID use within 30 days of CDI testing was determined by chart review. Both scheduled and as-needed NSAID use met the definition for exposure, but aspirin use alone did not. Additional clinical data such as comorbid disease and baseline laboratory parameters were extracted through electronic query. A random forest model imputed missing data. A propensity score for NSAID use was developed via logistic regression and included gender, back pain, baseline serum creatinine, osteoarthritis, rheumatoid arthritis, serum albumin, and use of anticoagulant or antiplatelet medications. Cases were matched 1:1 with C. difficile negative controls by propensity score, with a matching caliper of 0.2 x standard deviation of the logit of the score. The final study population consisted of 1256 cases and their matched controls, however 6 cases could not be matched to controls as none had scores within the matching caliper. Conditional logistic regression was used to compare cases to controls. Results NSAID use was similar between the two groups on unadjusted analyses. The adjusted, multivariable model demonstrates that non-aspirin NSAID use is not a significant risk factor for CDI (P =.816), after adjustment for comorbid disease burden, age, and history of prior CDI (Table). Older age and prior CDI were independent risk factors for CDI (Table). Table Study population and modeling results Conclusion In this retrospective case-control study, non-aspirin NSAID use was not associated with an increased risk of CDI. To our knowledge, this is the first study of NSAID use as a risk factor for CDI that accounted for bias due to treatment assignment using a propensity score. Future studies should account for frequency or chronicity of NSAID use, which may affect the results. Disclosures Krishna Rao, MD, MS, Bio-K+ International, Inc. (Consultant)Merck and Co., Inc. (Research Grant or Support)Roche Molecular Systems, Inc. (Consultant)

scholarly journals Hyperglycemia: A bad prognostic factor for neonate.

2020 ◽  
Vol 27 (10) ◽  
pp. 2133-2137
Author(s):  
Muhammad Anwar ◽  
Muhammad Asghar Ali ◽  
Ali Hammad
Keyword(s):  
Birth Weight ◽  
Hospital Stay ◽  
Case Control Study ◽  
Length Of Hospital Stay ◽  
Case Control ◽  
P Value ◽  
Increased Risk ◽  
Study Participants ◽  
Study Setting ◽  
Control Study

Objectives: The study was aimed to find out morbidity and mortality associated with hyperglycemia among neonates at our setting. Study Design: Observational Case-Control study. Setting: Department of Neonatology, Civil Hospital, Bahawalpur. Period: From 1st July 2019 to 31st December 2019. Material & Methods: The study included 194 neonates (97 each for cases and controls). Data like age (days), gender and weight were noted for all while presence of morbidities like IVH, NEC or infections were also recorded. Outcome among study participants of both groups was noted in terms of length of hospital stay and discharged/expired. Results: Out of a total of 194 study participants, majority, 114 (58.8%) were male, 101 (52.1%) had age between 1 to 7 days, and 84 (43.3%) had birth weight below 1.5 kilograms. Significantly more neonates had morbidity. Significantly more cases, 57 (58.8%) expired in comparison to 38 (39.2%) controls (p value 0.006). Length of hospital stay was also significantly more prolonged among cases. Conclusion: Neonates having hyperglycemia not only are at significantly increased risk of having morbidities and mortality.

scholarly journals COVID-19 ASSOCIATED MUCORMYCOSIS: A CASE-CONTROL STUDY

2021 ◽  
Author(s):  
Dulari Gupta ◽  
Rahul Kulkarni ◽  
Shripad Pujari ◽  
Atul Mulay
Keyword(s):  
Risk Factors ◽  
Confidence Interval ◽  
Case Control Study ◽  
Tertiary Care ◽  
Multivariate Regression Analysis ◽  
Case Control ◽  
Retrospective Case ◽  
Time Period ◽  
Increased Risk ◽  
Control Study

Background: India has seen a surge in COVID-19 associated mucormycosis (CAM) cases during the second wave of the pandemic. We conducted a study to determine independent risk factors for CAM. Methods: We performed a retrospective case control study in a tertiary care private hospital in Pune, India. Fifty-two cases of CAM were compared with 166 concurrent controls randomly selected from the COVID-19 admissions during the same time period. Association of demographic factors, comorbidities, cumulative steroid dose used (calculated as dexamethasone equivalent), maximum respiratory support required, use of injectable/oral anticoagulation, and use of aspirin with CAM was assessed by univariate and multivariate logistic regression. Results: A total of 218 subjects (52 cases; 166 controls) were studied. Any diabetes (pre-existing diabetes and new onset diabetes during COVID-19) was noted in a significantly higher proportion of cases (73.1%, 45.8% P<0.001) and cumulative dexamethasone dose used in cases was significantly greater (97.72 mg vs 60 mg; P=0.016). In a multivariate regression analysis cumulate dexamethasone dose >120 mg (OR 9.03, confidence interval 1.75-46.59, P=0.009) and any diabetes (OR 4.78, confidence interval 1.46-15.65, P=0.01) were found to be risk factors for CAM. While use of anticoagulation (OR 0.01, confidence interval 0.00-0.09, P<0.001) and use of aspirin (OR 0.02, confidence interval 0.01-0.07, P<0.001) were found to be protective against CAM. Conclusion: Diabetes mellitus and cumulative dose of dexamethasone greater than 120 mg (or equivalent dose of other corticosteroid) were associated with an increased risk of CAM while use of aspirin and anticoagulation were associated with a lower risk.

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