scholarly journals The Dialysis Sodium Gradient: A Modifiable Risk Factor for Fluid Overload

Nephron Extra ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Emilie Trinh ◽  
Catherine Weber
Keyword(s):  
Risk Factor ◽  
Fluid Overload ◽  
Modifiable Risk Factor ◽  
Sodium Gradient

Nonunion Rates in Hind- and Midfoot Arthrodesis in Current, Ex-, and Nonsmokers

2020 ◽  
pp. 107110072097126
Author(s):  
Jack Allport ◽  
Jayasree Ramaskandhan ◽  
Malik S. Siddique
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Relative Risk ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Smoking Status ◽  
Time Frame ◽  
Modifiable Risk Factor ◽  
Level Of Evidence ◽  
Significant Difference

Background: Nonunion rates in hind or midfoot arthrodesis have been reported as high as 41%. The most notable and readily modifiable risk factor that has been identified is smoking. In 2018, 14.4% of the UK population were active smokers. We examined the effect of smoking status on union rates for a large cohort of patients undergoing hind- or midfoot arthrodesis. Methods: In total, 381 consecutive primary joint arthrodeses were identified from a single surgeon’s logbook (analysis performed on a per joint basis, with a triple fusion reported as 3 separate joints). Patients were divided based on self-reported smoking status. Primary outcome was clinical union. Delayed union, infection, and the need for ultrasound bone stimulation were secondary outcomes. Results: Smoking prevalence was 14.0%, and 32.2% were ex-smokers. Groups were comparable for sex, diabetes, and body mass index. Smokers were younger and had fewer comorbidities. Nonunion rates were higher in smokers (relative risk, 5.81; 95% CI, 2.54-13.29; P < .001) with no statistically significant difference between ex-smokers and nonsmokers. Smokers had higher rates of infection ( P = .05) and bone stimulator use ( P < .001). Among smokers, there was a trend toward slower union with heavier smoking ( P = .004). Conclusion: This large retrospective cohort study confirmed previous evidence that smoking has a considerable negative effect on union in arthrodesis. The 5.81 relative risk in a modifiable risk factor is extremely high. Arthrodesis surgery should be undertaken with extreme caution in smokers. Our study shows that after cessation of smoking, the risk returns to normal, but we were unable to quantify the time frame. Level of Evidence: Level III, retrospective cohort study.

scholarly journals Failure to Medically Optimize Before Total Hip Arthroplasty: Which Modifiable Risk Factor Is the Most Dangerous?

2021 ◽  
Vol 10 ◽  
pp. 18-23
Author(s):  
Joseph M. Statz ◽  
Susan M. Odum ◽  
Nicholas R. Johnson ◽  
Jesse E. Otero
Keyword(s):  
Risk Factor ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Modifiable Risk Factor ◽  
Total Hip

Estimated fetal weight by ultrasound: a modifiable risk factor for cesarean delivery?

2012 ◽  
Vol 207 (4) ◽  
pp. 309.e1-309.e6 ◽  
Author(s):  
Sarah E. Little ◽  
Andrea G. Edlow ◽  
Ann M. Thomas ◽  
Nicole A. Smith
Keyword(s):  
Risk Factor ◽  
Cesarean Delivery ◽  
Fetal Weight ◽  
Modifiable Risk Factor ◽  
Estimated Fetal Weight

Abstract TP208: Sleep Disordered Breathing (SDB) - An Overlooked Modifiable Risk Factor in Acute Stroke Care

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Vishal Shah ◽  
Ashrai Gudlavalleti ◽  
Julius G Latorre
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Sleep Disordered Breathing ◽  
Modifiable Risk Factor ◽  
Inclusion Criteria ◽  
Risk Of Death ◽  
Disordered Breathing

Introduction: In patients with acute stroke, part of the acute management entails identifying the risk factors; modifiable or non modifiable. Early recognition of these factors is essential for optimizing therapeutic procedures, especially those with a known effective treatment. In this sense, Sleep Disordered Breathing (SDB) has also been suggested as a modifiable and independent risk factor for stroke as defined by international guidelines and some studies have demonstrated that patients with stroke and particularly Obstructive Sleep Apnea (OSA) have an increased risk of death or new vascular events. Pathogenesis of ischemic stroke in SDB is probably related to worsening of existing cardiovascular risk factors such as hypertension and hypoxia driven cardiac arrhythmia leading to higher prevalence of ischemic stroke in patients with sleep disordered breathing disease. Despite strong evidence linking SDB to ischemic stroke, evaluation for SDB is rarely performed in patients presenting with an acute ischemic stroke. Hypothesis: Evaluation of SDB is rarely performed in patients presenting with acute ischemic stroke. Methods: We performed a retrospective review of all patients above the age of 18 who were admitted to the acute stroke service at University Hospital July 2014 to December 2014. Demographic data, etiology of stroke as identified per TOAST criteria, modifiable risk factors, presenting NIHSS and frequency of testing for SDB and their results were collected. The data was consolidated and tabulated by using STATA version 14. Results: Total of 240 patients satisfied our inclusion criteria. Only 24 patients ie 10% of those who satisfied our inclusion criteria received evaluation for SDB. Out of those evaluated, 62.5% ie 15 patients out of 24 patients had findings concerning for significant desaturation. Only 2 providers out of 8 stroke physicians ie 25% tested for SDB in more than 5 patients. Conclusions: Our observations highlight the paucity in evaluation for SDB in acute ischemic stroke in a tertiary care setting. Being a modifiable risk factor, greater emphasis must be placed on evaluation for SDB in patients in patients with acute stroke. Education must be provided to all patients and providers regarding identification of these factors.

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