scholarly journals Variation of Risk Factors for Cause-Specific Reintubation: A Preliminary Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Emi Fujii ◽  
Kazunori Fujino ◽  
Sachiko Tanaka-Mizuno ◽  
Yutaka Eguchi
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Respiratory Insufficiency ◽  
Large Scale ◽  
Multivariate Analyses ◽  
Propensity Score Analysis ◽  
Spontaneous Breathing Trial ◽  
Arterial Oxygen ◽  
Score Analysis ◽  
Inspired Oxygen

Unexpected reintubation may occur, even if the risk factors are considered and a spontaneous breathing trial is successful. Reintubation is thought to be caused by various factors. Several studies have investigated the risk factors of reintubation, but most did not classify reintubation by cause. We retrospectively classified patients undergoing reintubation at intensive care unit by cause (respiratory insufficiency vs. nonrespiratory insufficiency) to examine the cause-specific risk factors of reintubation. A total of 262 patients were included; reintubation within 48 hours after extubation was performed in 12 patients (reintubation rate, 4.5%). After classification by cause of reintubation, the pressure of arterial oxygen to fractional inspired oxygen concentration (P/F) ratio exhibited a significant association with reintubation only in the respiratory insufficiency group (odds ratio (OR) 0.989, 95% confidence interval (CI) 0.980 to 0.999, p=0.036, and OR 0.989, 95% CI 0.979 to 0.999, p=0.026, in the univariate and multivariate analyses, respectively). In the propensity score analysis, a P/F ratio ≤ 200 may be a risk factor for reintubation in the respiratory insufficiency group (OR 7.811, 95% CI 1.345 to 45.367, p=0.022). In the nonrespiratory insufficiency group, intubation duration was significantly related to reintubation (OR 1.165, 95% CI 1.012 to 1.342, p=0.033, and OR 1.163, 95% CI 1.004 to 1.348, p=0.044, in the univariate and multivariate analyses, respectively). In conclusion, a low P/F ratio at extubation may be a risk factor for reintubation due to respiratory insufficiency. In the nonrespiratory insufficiency group, intubation duration may be significantly related to reintubation. The risk factors for reintubation may differ by the cause of reintubation. Further large-scale randomized controlled trials are required.

scholarly journals Risk factor of pneumonia on toddler at puskesmas (public health center) I South Denpasar

2018 ◽  
Vol 6 (7) ◽  
pp. 2217
Author(s):  
Ethi Yudiastuti Kadek ◽  
Dewianti Ni Made
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Risk Factor ◽  
Health Center ◽  
Multivariate Analyses ◽  
Case Control ◽  
Research Data ◽  
Bivariate Analysis ◽  
Public Health Center ◽  
Emergency Fund

Background: The death of toddler due to pneumonia is still high because its risk factor still exist and has not been managed properly. United Nations International Children’s Emergency Fund (UNICEF) states that in 2011 there was 1.3 million deaths of children below five years old (toddler) and 14% of the number was caused by pneumonia.Methods: The design for this research was case control with 27 cases and 27 controls. The case was toddlers who were diagnosed with pneumonia by doctor of public health center (hereafter Puskesmas), aged 0-59 months and were recorded in the ill toddler register from January 1, 2016 until December 31, 2016, meanwhile control was healthy toddlers who were invited to Puskesmas during the research. Data was collected through interview, observation and measurement using questionnaire. Univariate, bivariate, multivariate analyses were performed using Stata SE 12.1.Results: Bivariate analysis showed that two years of breastfeeding and ARI frequency, as the risk factors of pneumonia on toddler. From bivariate analysis, it was found that the risk factor which was proven to be significant and increased pneumonia on toddler was OR ARI with the value of 5.67 (95% CI:1.16-27.82).Conclusions: ARI frequency as the risk factor of pneumonia on toddler at Puskesmas I South Denpasar.

scholarly journals Hemodialysis is a strong risk factor for post-endoscopic sphincterotomy bleeding in patients with choledocholithiasis

2018 ◽  
Vol 06 (05) ◽  
pp. E568-E574 ◽  
Author(s):  
So Nakaji ◽  
Nobuto Hirata ◽  
Hiroki Matsui ◽  
Toshiyasu Shiratori ◽  
Masayoshi Kobayashi ◽  
...  
Keyword(s):  
Risk Factor ◽  
Propensity Score ◽  
Endoscopic Sphincterotomy ◽  
Outcome Measure ◽  
Propensity Score Analysis ◽  
Univariate Analysis ◽  
Risk Difference ◽  
Secondary Outcome ◽  
Bleeding Rate ◽  
Score Analysis

Abstract Background and study aims Hemodialysis (HD) is considered one of the risk factors for post-endoscopic sphincterotomy (ES) bleeding. Therefore, we conducted a retrospective study to evaluate HD as a risk factor for post-ES bleeding in patients with choledocholithiasis. Patients and methods We used the post-ES bleeding rate as the main outcome measure. To evaluate the influence of HD on the risk of post-ES bleeding, logistic regression and propensity score analyses were conducted. In addition, univariate analysis-based comparisons of various clinical parameters (as secondary outcome measures) were performed between the patients in the HD and non-HD groups that experienced post-ES bleeding. Results A total of 1518 patients were enrolled. In the multivariate analysis, a platelet count of < 50,000, anticoagulant therapy, bleeding during ES, and HD were found to be significantly associated with post-ES bleeding (odds ratio [OR]: 35.30, 95 % confidence interval [CI]: 3.81 – 328.00; OR: 4.39, 95 % CI: 1.53 – 12.60; OR: 4.28, 95 % CI: 2.30 – 7.97; and OR: 13.30, 95 % CI: 5.78 – 30.80, respectively). Propensity score matching created 28 matched pairs. Propensity score analysis showed that the risk difference between the groups was 0.214 (95 % CI: 0.022 – 0.407). In a comparison between the patients in the HD and non-HD groups that suffered post-ES bleeding, it was found that the post-ES bleeding was significantly more severe in the HD group (p = 0.033), and massive blood transfusions and long periods of hospitalization were more frequently required in the HD group (p = 0.008 and p < 0.001, respectively). Conclusion HD is an independent risk factor for post-ES bleeding and makes post-ES bleeding more serious.

scholarly journals Intraoperative Fraction of Inspired Oxygen Is a Modifiable Risk Factor for Surgical Site Infection after Spinal Surgery

2009 ◽  
Vol 110 (3) ◽  
pp. 556-562 ◽  
Author(s):  
Lisa L. Maragakis ◽  
Sara E. Cosgrove ◽  
Elizabeth A. Martinez ◽  
Margaret G. Tucker ◽  
David B. Cohen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Spinal Surgery ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Modifiable Risk Factor ◽  
Care Hospital ◽  
Procedure Duration ◽  
Fraction Of Inspired Oxygen ◽  
Inspired Oxygen

Background Surgical site infections (SSI) after spinal surgery increase morbidity, mortality, length of hospital stay, and costs. Most previously identified risk factors for these infections, such as severity of illness and procedure duration, are not amenable to intervention. This study sought to identify modifiable risk factors associated with SSI after spinal surgery. Methods This is a case-control study including case identification and review of medical records. A total of 104 patients with SSI after spinal surgery were compared to 104 randomly selected control patients without SSI after spinal surgery in a 926-bed tertiary care hospital in Baltimore, Maryland, between April 1, 2001 and December 31, 2004. Results Multivariate analysis identified independent risk factors for SSI after spinal surgery including prolonged procedure duration (odds ratio [OR], 4.7; 95% confidence interval [95% CI], 1.6-14; P &lt; 0.001), American Society of Anesthesiologists score of 3 or greater (OR, 9.7; 95% CI, 3.7-25; P &lt; 0.001), lumbar-sacral operative level (OR, 2.9; 95% CI, 1.2-7.1; P = 0.02), posterior approach (OR, 3.5; 95% CI, 1.2-9.7; P = 0.02), instrumentation (OR, 2.5; 95% CI, 1.1-6.0; P = 0.03), obesity (OR, 4.0; 94% CI, 1.6-10; P &lt; 0.01), razor shaving before surgery (OR, 3.6; 95% CI, 1.2-11; P = 0.02), and intraoperative administered fraction of inspired oxygen of less than 50% (OR, 12; 94% CI, 4.5-33; P &lt; 0.001). Conclusions In addition to previously reported risk factors, this study identified intraoperative administered fraction of inspired oxygen of less than 50% as an independent, modifiable risk factor for SSI after spinal surgery. Intraoperative administration of at least 50% fraction of inspired oxygen should be tested prospectively as an intervention to prevent SSI after spinal surgery.

scholarly journals Previous obstetrical history does not impact short-term mid-urethral sling outcomes

2021 ◽  
Author(s):  
Ole Aleksander Dyrkorn ◽  
Anne Cathrine Staff ◽  
Sigurd Kulseng-Hanssen ◽  
Rune Svenningsen
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Urinary Incontinence ◽  
Multivariate Analyses ◽  
High Body Mass Index ◽  
Multivariate Logistic Regression Model ◽  
Failure Rates ◽  
Short Term ◽  
Nulliparous Women ◽  
Potential Impact

Abstract Introduction and hypothesis Pregnancy and delivery are known risk factors for stress and mixed urinary incontinence. The most common surgical treatment is mid-urethral sling (MUS) surgery. This study evaluated the potential impact of the obstetrical history on the short-term subjective and objective failure rates after MUS surgery. Methods A registry-based surgical cohort study using data from the Medical Birth Registry of Norway (MBRN) and the national Norwegian Female Incontinence Registry (NFIR). Data from 14,787 women that underwent MUS surgery from 1998 to 2016 with complete registrations in the MBRN were included. Outcomes were 6–12-month postoperative subjective and objective failure rates. The potential impact of obstetrical and constitutional factors on both outcomes was tested in a multivariate logistic regression model. Results Several obstetrical variables seemed to impact both outcomes in the univariate analyses. However, in the multivariate analyses, none of the obstetrical variables significantly impacted subjective failure, and only being nulliparous before MUS surgery remained a risk factor for objective failure [aOR 1.60, (95% CI 1.07–2.40), p = 0.022]. High body mass index at time of surgery, non-retropubic slings, high preoperative urgency symptom load, and surgical complications were all strong risk factors for poor outcomes in the multivariate analyses. Conclusion Although childbirth is considered a risk factor for developing stress urinary incontinence, childbirth does not appear to affect the result of MUS in parous women. Our results suggest that nulliparous women with SUI may have a different pathophysiology than SUI after childbirth.

scholarly journals Gout Augments the Risk of Cardiovascular Disease in Patients With Psoriasis: A Population-Based Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Zhiyong Chen ◽  
Yiwen Xu ◽  
Miao Chen ◽  
Ran Cui ◽  
Yu-Hsun Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Propensity Score Analysis ◽  
Population Based ◽  
Research Database ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Score Analysis ◽  
Increased Risk ◽  
Traditional Risk Factors ◽  
And Gender

ObjectivePatients with psoriasis (PsO) have a high frequency of concomitant gout and increased risk of cardiovascular diseases (CVD). We aimed to estimate the synergistic impact of gout on the risk of CVD in patients with PsO.MethodsA population-based cohort of patients registered in the National Health Insurance Research Database of Taiwan between 2000 and 2013 was stratified according to the presence of PsO and gout. Propensity score analysis was used to match age and gender at a ratio of 1:4. Cox proportional hazard models and subgroup analyses were used to estimate the hazard ratios (HRs) for CVD adjusted for traditional risk factors. The Kaplan–Meier method was used to plot the cumulative incidence curves.ResultsPatients with combined PsO and gout (n = 97), PsO alone (n = 388), gout alone (matched, n = 388) and matched controls (n = 388) were identified. Compared with the patients with PsO alone, the patients with combined PsO and gout had a significantly higher risk of CVD (relative risk 2.39, 95% CI 1.56 to 3.65). After adjustment for traditional risk factors, the risk of CVD was higher in patients with gout alone (HR 2.16, 95% CI 1.54 to 3.04) and in patients with combined PsO and gout (HR 2.72, 95% CI 1.73 to 4.28).ConclusionsGout augments the risk of CVD independently of traditional risk factors in patients with PsO.

Factors associated with long-term haemoptysis recurrence after transarterial embolisation for haemoptysis

2020 ◽  
Vol 24 (6) ◽  
pp. 606-611
Author(s):  
Y. Li ◽  
Z. Jia ◽  
S. Li ◽  
Y. Huang ◽  
X. Yuan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Multivariate Analyses ◽  
Fresh Blood ◽  
Factors Associated ◽  
Transarterial Embolisation ◽  
History Of ◽  
The Mean

OBJECTIVE: To assess factors associated with long-term haemoptysis recurrence after transarterial embolisation (TAE) for haemoptysis due to bronchiectasis.METHODS: Patients with haemoptysis due to bronchiectasis who underwent TAE between May 2010 and May 2019 were included in this retrospective study. Long-term haemoptysis recurrence was defined as the expectoration of >10 mL/day of fresh blood (for at least 1 day) 1 month after TAE. Univariate and multivariate analyses were performed to identify risk factors for long-term haemoptysis recurrence after TAE.RESULTS: A total of 197 patients (108 women; mean age, 61.0 ± 12.2 years) were included in the study. TAE was performed successfully in all patients. Side effects occurred in 43 (21.8%) patients, and all patients recovered uneventfully. During 37.6 ± 11.6 months of follow-up, long-term haemoptysis recurrence occurred in 41 (20.8%) patients; the mean interval between the TAE and haemoptysis recurrence was 21.4 ± 16.3 months. Long-term haemoptysis recurrence after TAE was associated with a history of haemoptysis (OR 3.483, 95% CI 1.373–8.836; P = 0.009).CONCLUSIONS: Approximately one fifth patients with bronchiectasis had long-term haemoptysis recurrence after TAE. Risk factor for long-term haemoptysis recurrence after TAE was a history of haemoptysis.

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