scholarly journals Risk Factors Associated with Reoperation for Bleeding following Liver Transplantation

HPB Surgery ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Maxwell A. Thompson ◽  
David T. Redden ◽  
Lindsey Glueckert ◽  
A. Blair Smith ◽  
Jack H. Crawford ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Retrospective Study ◽  
Platelet Transfusion ◽  
Multivariable Analysis ◽  
Aminocaproic Acid ◽  
Meld Score ◽  
Single Institution ◽  
Factors Associated ◽  
Risk Of Death

Introduction. This study’s objective was to identify risk factors associated with reoperation for bleeding following liver transplantation (LTx). Methods. A retrospective study was performed at a single institution between 2001 and 2012. Operative reports were used to identify patients who underwent reoperation for bleeding within 2 weeks following LTx (operations for nonbleeding etiologies were excluded). Results. Reoperation for bleeding was observed in 101/928 (10.8%) of LTx patients. The following characteristics were associated with reoperation on multivariable analysis: recipient MELD score (OR 1.06/MELD unit, 95% CI 1.03, 1.09), number of platelets transfused (OR 0.73/platelet unit, 95% CI 0.58, 0.91), and aminocaproic acid utilization (OR 0.46, 95% CI 0.27, 0.80). LTx patients who underwent reoperation for bleeding had a longer ICU stay (5 days ± 7 versus 2 days ± 3, P<0.001) and hospitalization (18 days ± 9 versus 10 days ± 18, P<0.001). The risk of death increased in patients who underwent reoperation for bleeding (HR 1.89, 95% CI 1.26, 2.85). Conclusion. Reoperation for bleeding following LTx was associated with increased resource utilization and recipient mortality. A lower threshold for intraoperative platelet transfusion and antifibrinolytics, especially in patients with high lab-MELD score, may decrease the incidence of reoperation for bleeding following LTx.

scholarly journals Risk factors for nonvisualization of the sentinel lymph node on lymphoscintigraphy in breast cancer patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Youssef Chahid ◽  
Xinbo Qiu ◽  
Ewoudt M. W. van de Garde ◽  
Hein J. Verberne ◽  
Jan Booij
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Lymph Node ◽  
Retrospective Study ◽  
Sentinel Lymph Node ◽  
Cancer Patients ◽  
Multivariable Analysis ◽  
Tumor Location ◽  
Breast Cancer Patients ◽  
Factors Associated

Abstract Background Accurate sentinel lymph node (SLN) staging is essential for both prognosis and treatment in patients with breast cancer. However, the preoperative lymphoscintigraphy may fail to visualize the SLN in some patients. The purpose of this retrospective study was to identify risk factors associated with SLN nonvisualization on lymphoscintigraphy. For this single-center retrospective study, all data of lymphoscintigraphy of SLN procedures from March 2011 to April 2021 were collected and reviewed from the Amsterdam UMC database. Results A total of 1886 SLN procedures were included in this study. The SLN nonvisualization rate was 25.1% on lymphoscintigraphy at 4 h post-injection. The SLN nonvisualization rate decreased to 9.4% after reinjection. Multivariable analysis showed that age ≥ 70 years (P < 0.001; OR: 2.27; 95% CI: 1.46–3.53), BMI ≥ 30 kg/m2 (P = 0.031; OR: 1.48; 95% CI: 1.04–2.12) and nonpalpable tumors (P = 0.004; OR: 1.54; 95% CI: 1.15–2.07) were independent predictors of SLN nonvisualization. Tumor location, brand of radiopharmaceutical, injected dose and volume, experience of preparer and administrator were not associated with SLN nonvisualization. None of the patient, tumor or tracer characteristics were associated with SLN nonvisualization after radiotracer reinjection. Conclusions This study shows that risk factors for SLN nonvisualization in breast cancer patients during preoperative lymphoscintigraphy are age ≥ 70 years, BMI ≥ 30 kg/m2 and nonpalpable tumors. Our results support the notion that SLN lymphoscintigraphy is a very robust technique that does not depend on the experience of the preparer or administrator of the radiotracer.

Risk factors for nonvisualization of the sentinel lymph node on lymphoscintigraphy in breast cancer patients

2021 ◽  
Author(s):  
Youssef Chahid ◽  
Xinbo Qiu ◽  
Ewoudt M.W. van de Garde ◽  
Hein J. Verberne ◽  
Jan Booij
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Lymph Node ◽  
Retrospective Study ◽  
Sentinel Lymph Node ◽  
Cancer Patients ◽  
Multivariable Analysis ◽  
Tumor Location ◽  
Breast Cancer Patients ◽  
Factors Associated

Abstract BackgroundAccurate sentinel lymph node (SLN) staging is essential for both prognosis and treatment in patients with breast cancer. However, the preoperative lymphoscintigraphy may fail to visualize the SLN in some patients. The purpose of this retrospective study was to identify risk factors associated with SLN nonvisualization on lymphoscintigraphy. For this single-center retrospective study all data of lymphoscintigraphy of SLN procedures from March 2011 to April 2021 were collected and reviewed from the Amsterdam UMC database. ResultsA total of 1886 SLN procedures were included in this study. The SLN nonvisualization rate was 25.1% on lymphoscintigraphy at 4 hours post injection. The SLN nonvisualization rate decreased to 9.4% after reinjection. Multivariable analysis showed that age ≥70 years (P<0.001; OR: 2.27; 95% CI: 1.46–3.53), BMI ≥30 kg/m2 (P=0.031; OR: 1.48; 95% CI: 1.04–2.12), and nonpalpable tumors (P=0.004; OR: 1.54; 95% CI: 1.15–2.07) were independent predictors of SLN nonvisualization. Tumor location, brand of radiopharmaceutical, injected dose and volume, experience of preparer and administrator were not associated with SLN nonvisualization. None of the patient, tumor or tracer characteristics were associated with SLN nonvisualization after radiotracer reinjection.ConclusionsThis study shows that risk factors for SLN nonvisualization in breast cancer patients during preoperative lymphoscintigraphy are age ≥70 years, BMI ≥30 kg/m2, and nonpalpable tumors. Our results support the notion that SLN lymphoscintigraphy is a very robust technique, that does not depend on the experience of the preparer or administrator of the radiotracer.

scholarly journals Risk factors associated with the progression and metastases of hindgut neuroendocrine tumors: a retrospective study

BMC Cancer ◽  
2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Yoichiro Okubo ◽  
Rika Kasajima ◽  
Masaki Suzuki ◽  
Yohei Miyagi ◽  
Osamu Motohashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Neuroendocrine Tumors ◽  
Factors Associated

scholarly journals Factors associated with COVID-19 related hospitalisation, critical care admission and mortality using linked primary and secondary care data

2021 ◽  
Author(s):  
Lisa Cummins ◽  
Irene Ebyarimpa ◽  
Nathan Cheetham ◽  
Victoria Tzortziou Brown ◽  
Katie Brennan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Learning Disabilities ◽  
Secondary Care ◽  
Multivariate Logistic Regression Analysis ◽  
Additional Patient ◽  
Factors Associated ◽  
Icu Admission ◽  
Risk Of Death ◽  
North East ◽  
Increased Risk

AbstractBackgroundTo identify risk factors associated with increased risk of hospitalisation, intensive care unit (ICU) admission and mortality in inner North East London (NEL) during the first UK COVID-19 wave.MethodsMultivariate logistic regression analysis on linked primary and secondary care data from people aged 16 or older with confirmed COVID-19 infection between 01/02/2020-30/06/2020 determined odds ratios (OR), 95% confidence intervals (CI) and p-values for the association between demographic, deprivation and clinical factors with COVID-19 hospitalisation, ICU admission and mortality.ResultsOver the study period 1,781 people were diagnosed with COVID-19, of whom 1,195 (67%) were hospitalised, 152 (9%) admitted to ICU and 400 (23%) died. Results confirm previously identified risk factors: being male, or of Black or Asian ethnicity, or aged over 50. Obesity, type 2 diabetes and chronic kidney disease (CKD) increased the risk of hospitalisation. Obesity increased the risk of being admitted to ICU. Underlying CKD, stroke and dementia in-creased the risk of death. Having learning disabilities was strongly associated with increased risk of death (OR=4.75, 95%CI=(1.91,11.84), p=0.001). Having three or four co-morbidities increased the risk of hospitalisation (OR=2.34,95%CI=(1.55,3.54),p<0.001;OR=2.40, 95%CI=(1.55,3.73), p<0.001 respectively) and death (OR=2.61, 95%CI=(1.59,4.28), p<0.001;OR=4.07, 95% CI= (2.48,6.69), p<0.001 respectively).ConclusionsWe confirm that age, sex, ethnicity, obesity, CKD and diabetes are important determinants of risk of COVID-19 hospitalisation or death. For the first time, we also identify people with learning disabilities and multi-morbidity as additional patient cohorts that need to be actively protected during COVID-19 waves.

scholarly journals Risk factors associated with the severity of COVID-19 in a region of the Brazilian Amazon

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Daniele Melo Sardinha ◽  
Rosane do Socorro Pompeu de Loiola ◽  
Ana Lúcia da Silva Ferreira ◽  
Carmem Aliandra Freire de Sá ◽  
Yan Corrêa Rodrigues ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brazilian Amazon ◽  
The State ◽  
Metropolitan Region ◽  
Epidemiological Surveillance ◽  
Cross Sectional ◽  
Factors Associated ◽  
Risk Of Death ◽  
Increased Risk ◽  
Brazilian Amazon Region

AbstractThe Brazilian Northern region registered a high incidence of COVID-19 cases, particularly in the state of Pará. The present study investigated the risk factors associated with the severity of COVID-19 in a Brazilian Amazon region of 100,819 cases. An epidemiological, cross-sectional, analytical and demographic study, analyzing data on confirmed cases for COVID-19 available at the Brazilian Ministry of Health's surveillance platform, was conducted. Variables such as, municipalities of residence, age, gender, signs and symptoms, comorbidities were included and associated with COVID-19 cases and outcomes. The spatial distribution was performed using the ArcGIS program. A total of 100,819 cases were evaluated. Overall, patients had the mean age of 42.3 years, were female (51.2%) and with lethality reaching 4.79% of cases. Main symptoms included fever (66.5%), cough (61.9%) and sore throat (39.8%). Regarding comorbidities, most of the patients presented cardiovascular disease (5.1%) and diabetes (4.2%). Neurological disease increased risk of death by nearly 15 times, followed by obesity (5.16 times) and immunodeficiency (5.09 time). The municipalities with the highest incidence rate were Parauapebas, Canaã dos Carajás and Jacareacanga. Similarity between the Lower Amazon, Marajó and Southwest mesoregions of Pará state were observed concerning the highest morbidity rates. The obtained data demonstrated that the majority of cases occurred among young adults, females, with the classic influenza symptoms and chronic diseases. Finally, data suggest that the highest incidences were no longer in the metropolitan region of the state. The higher lethality rate than in Brazil may be associated with the greater impacts of the disease in this Amazonian population, or factors associated with fragile epidemiological surveillance in the notification of cases of cure.

scholarly journals Ethnicity and other COVID-19 death risk factors in Mexico

2020 ◽  
Author(s):  
Erwin Chiquete ◽  
Jesus Alegre-Díaz ◽  
Ana Ochoa-Guzmán ◽  
Liz Nicole Toapanta-Yanchapaxi ◽  
Carlos González-Carballo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Proportional Hazards Model ◽  
Invasive Mechanical Ventilation ◽  
Significant Risk ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Chronic Obstructive ◽  
Death Risk ◽  
Factors Associated ◽  
Risk Of Death

IntroductionPatients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may develop coronavirus disease 2019 (COVID-19). Risk factors associated with death vary among countries with different ethnic backgrounds. We aimed to describe the factors associated with death in Mexicans with confirmed COVID-19.Material and methodsWe analysed the Mexican Ministry of Health’s official database on people tested for SARS-CoV-2 infection by real-time reverse transcriptase–polymerase chain reaction (rtRT-PCR) of nasopharyngeal fluids. Bivariate analyses were performed to select characteristics potentially associated with death, to integrate a Cox-proportional hazards model.ResultsAs of May 18, 2020, a total of 177,133 persons (90,586 men and 86,551 women) in Mexico received rtRT-PCR testing for SARS-CoV-2. There were 5332 deaths among the 51,633 rtRT-PCR-confirmed cases (10.33%, 95% CI: 10.07–10.59%). The median time (interquartile range, IQR) from symptoms onset to death was nine days (5–13 days), and from hospital admission to death 4 days (2–8 days). The analysis by age groups revealed that the significant risk of death started gradually at the age of 40 years. Independent death risk factors were obesity, hypertension, male sex, indigenous ethnicity, diabetes, chronic kidney disease, immunosuppression, chronic obstructive pulmonary disease, age > 40 years, and the need for invasive mechanical ventilation (IMV). Only 1959 (3.8%) cases received IVM, of whom 1893 were admitted to the intensive care unit (96.6% of those who received IMV).ConclusionsIn Mexico, highly prevalent chronic diseases are risk factors for death among persons with COVID-19. Indigenous ethnicity is a poorly studied factor that needs more investigation.

scholarly journals Outcome of pinning in patients with slipped capital femoral epiphysis: risk factors associated with avascular necrosis, chondrolysis, and femoral impingement

2017 ◽  
Vol 46 (6) ◽  
pp. 2120-2127 ◽  
Author(s):  
Alexandru Ulici ◽  
Madalina Carp ◽  
Iulia Tevanov ◽  
Catalin Alexandru Nahoi ◽  
Alin Gabriel Sterian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Avascular Necrosis ◽  
Slipped Capital Femoral Epiphysis ◽  
Normal Weight ◽  
Single Centre ◽  
Factors Associated ◽  
Hip Impingement ◽  
Α Angle

Objective This study aimed to assess the principal risk factors that could lead to the most common long-term complications of slipped capital femoral epiphysis, such as avascular necrosis, chondrolysis, and hip impingement. Methods We conducted a single-centre, retrospective study and evaluated patients (70 patients, 81 hips) who were treated for slipped capital femoral epiphysis from 2010 to 2015 and who underwent pinning. We measured the severity of displacement radiologically using the Southwick angle. Postoperative radiographs were evaluated for the most frequent long-term complications of avascular necrosis (AVN), chondrolysis, and femoral acetabular impingement (FAI). Results We found seven cases of AVN, 14 cases of chondrolysis, and 31 hips had an α angle of 60°. Sex, ambulation, and symptoms did not affect development of these complications. Patients with a normal weight were almost two times more likely to develop FAI. Patients with moderate and severe slips had a similar percentage of AVN. In severe slips, 85.7% of patients had an α angle higher than 60°. Conclusions This study shows that severe slips have a higher risk of developing AVN and hip impingement. Every patient who suffers from SCFE (even the mildest forms) should be regularly checked for FAI.

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