scholarly journals Morbidity predicting factors of penetrating colon injuries

2010 ◽  
Vol 57 (3) ◽  
pp. 55-58 ◽  
Author(s):  
A. Mickevicius ◽  
G. Valeikaite ◽  
A. Tamelis ◽  
Z. Saladzinskas ◽  
S. Svagzdys ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Postoperative Complications ◽  
Systolic Blood Pressure ◽  
Peritoneal Cavity ◽  
Primary Repair ◽  
Group Analysis ◽  
Fecal Contamination ◽  
Significant Risk ◽  
Fecal Diversion ◽  
Colon Injuries

THE AIM of this study was to analyze patients suffering from penetrating colon injuries management, clinical outcomes and factors, which predict higher morbidity and complications rate. METHODS: this was a retrospective analysis of prospectively collected data from patients with injured colon from 1995 to 2008. Age, time till operation, systolic blood pressure, part of injured colon, fecal contamination, PATI were registered. Monovariate and multivariate logistic regression was performed to determine higher morbidity predictive factors. RESULTS: 61 patients had penetrating colon injuries. Major fecal contamination of the peritoneal cavity and systolic blood pressure lower than 90 mmHg are independent factors determining the fecal diversion operation. Primary repair group analysis establish that major fecal contamination and systolic blood pressure lower than 90 mmHg OR=4,2 and 0,96 were significant risk factors, which have contributed to the development of postoperative complications. And systolic blood pressure lower than 90 mmHg and PATI 20 predict OR=0,05 and 2,61 higher morbidity. CONCLUSIONS: Fecal contamination of the peritoneal cavity and hypotension were determined to be crucial in choice of performing fecal diversion or primary repair. But the same criteria and PATI predict higher rate of postoperative complications and higher morbidity.

scholarly journals LO62: Systolic blood pressure is a strong predictive marker for TIA and mild stroke in younger patients

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S49
Author(s):  
C. Sedgwick ◽  
M. Bibok ◽  
N.S. Croteau ◽  
M.L. Lesperance ◽  
R. Balshaw ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Systolic Blood Pressure ◽  
Regression Model ◽  
Older Patients ◽  
Significant Risk ◽  
Younger Patients ◽  
Increased Risk ◽  
Age And Sex

Introduction: Age and systolic blood pressure (SBP) are important predictors of Acute Cerebrovascular Syndrome (ACVS). Yet, the effect of SBP is confounded by age, making its independent contribution to ACVS risk difficult to quantify. Here we use logistic regression to explore the role of SBP in younger and older ED patients. Methods: Data comprised 1019 ED patients (ACVS 70%, 30% non-ACVS) enrolled during a 28-month period of an ongoing prospective, observational, multi-site stroke biomarker study (SpecTRA). We used logistic regression to examine the effects of age, sex, and the age:SBP interaction as predictive markers of the diagnosis of ACVS. Results: Participants (53% male) ranged in age from 18 to 97 years (Q1=58, median=70, Q3=80). SBP ranged from 84 to 248 mmHg (Q1=137, median=154, Q3=174). In our initial regression model, age, sex, SBP and the age:SBP interaction were all significant (p<0.01). Using cubic regression splines for age, sbp and their interaction yields the same conclusion (p<0.01). To better understand the role of SBP in younger vs. older patients, we stratified the sample at the median age (70 years of age). In the younger group (n=510), participants were 55% male, 60% ACVS, and had SBP ranging from 91 to 236 mmHg (Q1=133, median=148, Q3=165). In the older group (n=509), participants were 51% male, 82% ACVS and had SBP ranging from 84 to 248 mmHg (Q1=143, median=159, Q3=179), a shift of approximately 10 mmHg between the groups. The logistic regression model was then fit separately to each group without the age:SBP interaction term. In the younger group, we found SBP to be highly significant (p<0.001), with an odds-ratio (OR) of 1.18 per 10 mmHg (95% CI: 1.10-1.29). In the older group, we found that SBP was not significant (p=0.91), with an OR of 1.00 per 10 mmHg (95% CI: 0.91-1.08). Age and sex were also significant risk factors in the younger group (each p<0.01), though not in the older group (both p>0.07). Conclusion: Our findings suggest that for ED patients suspected of ACVS, SBP is a clinically relevant predictor for younger patients, with higher SBP associated with an increased risk of ACVS, regardless of patient age and sex. SBP does not appear to be a strong predictor for patients over 70. ED physicians can leverage this finding by attributing greater importance to elevated SBP in younger patients than older patients when working toward a clinical suspicion of ACVS.

scholarly journals Pre-delivery hypotension after spinal anesthesia during cesarean section and its associated factors at Jigme Dorji Wangchuck National Referral Hospital, Bhutan

2021 ◽  
Vol 7 (1) ◽  
pp. 16-23
Author(s):  
Tenzin Yoezer ◽  
Karma Tenzin ◽  
Jampel Tshering ◽  
Yin Min Than ◽  
Kuenza P Wangmo
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cesarean Section ◽  
Systolic Blood Pressure ◽  
Spinal Anesthesia ◽  
Significant Risk ◽  
Referral Hospital ◽  
P Value ◽  
Fasting Duration ◽  
National Referral Hospital

Introduction: The current choice of anesthesia for the cesarean section is spinal anesthesia. However, hypotension is the major complication. If promptly not recognized and treated, it increases the morbidity and mortality of the mother and fetus. This study was conducted to evaluate the rate of pre-delivery hypotension and risk factors following spinal anesthesia for cesarean section at the National Referral Hospital in Bhutan. Methods: A cohort study was conducted from 1st October 2018 to 30th June 2019 on 350 women undergoing cesarean section under spinal anesthesia. Pre-delivery hypotension was defined as systolic blood pressure < 100 mm Hg. The association of factors for hypotension was tested using multivariable binary logistic regression using a forward stepwise model. A p-value < 0.05 was considered significant. Results: The rate of pre-delivery hypotension was 74.6 % (n=261). History of hypertension during pregnancy (Adjusted OR 0.25, [0.11-0.60], p=0.013), prophylaxis use of ephedrine (Adjusted OR 0.45, [0.22-0.92], p= 0.024) and ondansetron (Adjusted OR 0.43, [0.22-0.82], p= 0.010),longer preoperative fasting duration (Adjusted OR 1.12, [1.01-1.21], p=0.024,), sensory block level <= T4 (Adjusted OR 3.4, [1.8-6.4], p=<0.001) and baseline systolic blood pressure less than or equal to 120 mmHg (Adjusted OR 2.8, [1.5-5.1], p=0.001) were significant risk factors.  Conclusions: This study conduces that the rate of pre-delivery hypotension following spinal anesthesia in a cesarean section was high among women undergoing cesarean section. It is alarming as around two-third of women and fetus undergoing cesarean section under spinal anesthesia are at risk of consequences of hypotension. Most of the risk factors in the study are modifiable. The study suggests that if the anesthesia provider intervenes in managing the modifiable risk factors and treat hypotension promptly, it can help reduce the risk of women and fetus to spinal hypotension consequences.

scholarly journals Prevalence of hypertension and its significant correlates among Bangladeshi adults: a quantitative analysis from City Corporation Rangpur, Bangladesh

2019 ◽  
Vol 6 (9) ◽  
pp. 3748
Author(s):  
Sukanta Das ◽  
B. K. Chakravorti ◽  
Sahebul Islam
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Smoking Habit ◽  
Significant Risk ◽  
Medical Problem ◽  
Blood Pressure Reading ◽  
Categorical Variables ◽  
Chi Square ◽  
Pressure Reading

Background: Hypertension (HTN) is a common medical problem and the premier risk factor for cardiovascular disease. Hypertension is growing at a faster rate among all aged population. Therefore, this study aimed to investigate the prevalence of hypertension and to identify the significant risk factors of hypertension among the respondents.Methods: The sample of 1302 randomly selected respondents of various government offices at Rangpur City Corporation, Bangladesh are taken for this study. Hypertension was defined by the systolic blood pressure reading above 140 or the diastolic reading above 90 mmHg. Pre-hypertension was defined by the systolic blood pressure reading 120-139 or the diastolic reading 80-89 mmHg. Prevalence and risk factors of hypertension are presented as percentages. The significant association between the categorical variables is measured using Chi-square test.Results: It is found that the prevalence of hypertension and pre-hypertension (stage-1 HTN) among the respondents are 25% and 54%, respectively. Most of the respondents are in the pre-HTN stage, and at any time they may fall under hypertension. Respondent’s age, gender, residence, smoking habit, and physical activity are found as significant factors of hypertension.Conclusions: Reliable information about the prevalence of hypertension and its associated risk factors is very essential for growing awareness, treatment, and control of hypertension. Prevalence of hypertension is high among the study subjects. The male respondents who are at the higher age group, residing in the urban area, not taking regular physical exercise, and having smoking habit are found more prevalent cases of hypertension than the other counterparts.

scholarly journals Analysis of the Effects of Perioperative Nursing Intervention for Patients with Cerebrovascular Intervention

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Hongmei Kuang ◽  
Fengmei Xu ◽  
Baoyi Huang
Keyword(s):  
Blood Pressure ◽  
Postoperative Complications ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Nursing Intervention ◽  
Control Group ◽  
Observation Group ◽  
Low Back ◽  
Perioperative Nursing ◽  
Total Incidence

Objective: To explore the clinical application effects of perioperative nursing intervention in the treatment of patients with cerebrovascular intervention. Methods: 176 patients with cerebrovascular intervention in our hospital from October 2018 to March 2020 were selected and randomly divided into 2 groups, with 88 cases in the control group and 88 cases in the observation group. Comparative analysis of blood pressure and incidence of complications was performed. Results: During the operation, the systolic blood pressure of the observation group increased by (11.85±1.66) mmHg, and the diastolic blood pressure was (4.63±0.45) mmHg. The control group patients’ systolic blood pressure increased by (22.12±1.98) mmHg and the diastolic blood pressure was (8.36±3.69) mmHg, the two results were significantly different. The blood pressure of the patients in the control group fluctuated more; and the incidence of complications in the observation group is lower than that of the control group. The observation group’s incidence of hematoma, low back discomfort, dysuria, and insomnia and dreaminess was 2.27%, 2.27%, 1.14%, 0%, respectively, with total incidence of 5.68%; in the control group, the incidence of hematoma, low back discomfort, dysuria, insomnia and dreaminess were 6.81%, 5.68%, 3.41%, 4.55% respectively, total incidence being 20.45%. The difference between observation group and control group is obvious. Conclusion: Through perioperative nursing intervention, the recovery speed of patients can be improved, and the incidence of postoperative complications can be reduced. The mental state of the patient before the operation was adjusted, the emotions were calmed, the patient's compliance was improved, and the patient's resistive emotions were reduced. At the same time, if patients can get good nursing care after surgery, the probability of postoperative complications is reduced, so that patients have better results in surgery, and its clinical application is worthy of promotion.

Paradoxical Hypotension during Dobutamine Infusion for Myocardial Perfusion Scintigraphy

1998 ◽  
Vol 37 (08) ◽  
pp. 268-271
Author(s):  
B. Caner ◽  
E. Atalar ◽  
A. Karanfil ◽  
L. Tokgözoğlu ◽  
E. L. Ergün
Keyword(s):  
Blood Pressure ◽  
Myocardial Perfusion ◽  
Systolic Blood Pressure ◽  
Myocardial Perfusion Scintigraphy ◽  
Stress Test ◽  
Dobutamine Infusion ◽  
Perfusion Scintigraphy ◽  
Tilt Table ◽  
Study Results ◽  
Group A

Summary Aim: Dobutamine as a predominant beta-1 agonist increases heart rate and myocardial contractility and at sufficient high doses, it also increases systolic blood pressure. This study was undertaken to describe instances of paradoxical hypotension during dobutamine infusion for TI-201 myocardial perfusion SPECT study and the relationship between scintigraphic findings and hypotension occurred during dobutamine infusion. Methods: In 201 consecutive patients unable to perform adequate exercise, dobutamine TI-201 myocardial SPECT was performed. Dobutamine was infused starting from 10 μg/kg/min increasing to 40 μg/kg/min. Paradoxical hypotension was defined as a decrease in systolic blood pressure ≥ 20 mmHg compared with baseline study. Results: Paradoxical hypotension was observed in 40 patients (Group A) out of 201 (19.9%) while no significant change in systolic blood pressure was detected in the remaining 161 patients (Group B). Mean maximum fall in systolic blood pressure was 39 ± 18 mmHg (range: 20-90). In 33 of 40 patients (83%) with paradoxical hypotension, scintigraphy was normal compared to 131 (81%) of the remaining 161 patients. In patients of Group A, angiography, echocardiography and tilt table tests were performed in 13, 11 and 6 patients respectively. Nine of 13 angiographic evaluations (69%), 10 of 11 echocardiographic evaluations (91%), all of the tilt table tests were normal. Additionally, all of the patients of Group A were clinically followed up at least 6 months after the myocardial perfusion scintigraphy. None of the patients had a cardiac event except one patient during the follow-up period. Conclusion: Paradoxical hypotension during dobutamine infusion for myocardial scintigraphy is not an uncommon finding and up to 19.9% patients may develop such hypotension. To maximize test safety, precautions should be taken during dobutamine myocardial stress test, since remarkable decrease in systolic blood pressure may occur. Unlike hypotension occurring with exercise test, hypotension response to dobutamine is not always a marker for coronary artery disease.

INTERARM SYSTOLIC BLOOD PRESSURE DIFFERENCE IS ASSOCIATED WITH A HIGH PREVALENCE OF CARDIO VASCULAR DISEASES- A CROSS-SECTIONAL STUDY IN POLICE WORKER

2020 ◽  
Vol 4 (11) ◽  
Author(s):  
Somesh Raju ◽  
Rina Kumari ◽  
Sunita Tiwari ◽  
NS Verma
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Blood Sugar ◽  
Pressure Difference ◽  
Systolic Pressure ◽  
Working Environment ◽  
Vascular Events ◽  
Cross Sectional ◽  
Blood Pressure Difference ◽  
High Prevalence

Background: Interarm systolic blood pressure difference more than 10 mm of Hg is predictor of cardiovascular and metabolic risk. Despite of sufficient physical activity there is high prevalence of obesity in police personal because of stressful working environment. No studies have addressed the significance of interarm pressure difference among them. Therefore, the present study conducted to access the relation of interarm blood pressure difference with obesity in police personnel. Aims and Objective: To estimate the interarm pressure difference in police personal to see its association with their obesity. Material and Method: This cross-sectional observational study done on 245 police workers in PAC, Sitapur, India. Subjects having more than ten years of working experience were included in study. Anthropometric measurements of subject recorded by following standard protocol. Measurement of systolic pressure in both arm recorded simultaneously by mercury sphygmomanometer. Available data analyze and expressed in percentage, mean with SD and chi square test to see the significance of association. Results: According to anthropometric results of subjects 77.14 prcent subjects were having generalised obesity and 82.04 percent of subjects having abdominal obesity. 34.29 percent of subjects showed abnormally high (?10 mmHg) inter-arm systolic blood pressure difference. Both type of obesity showed positive association with blood sugar level but no association with interarm pressure difference. Conclusion: Interarm blood pressure difference is greater in individual having obesity or prolong duration of service. Such subjects are more susceptible to develop coronary artery disease or peripheral arterial disease in future. Early screening can help to detect the vascular events likely to occur in the future Keywords: Body mass index, Waist circumference, Interarm pressure difference, Random blood sugar

EFEKTIVITAS PEMBERIAN HYDROTHERAPI RENDAM KAKI PADA PENDERITA HIPERTENSI DI BANJAR SRI MANDALA, KELURAHAN DAUHWARU KABUPATEN JEMBRANA

2019 ◽  
Vol 10 (01) ◽  
pp. 33-44
Author(s):  
N.L.G. Sudaryati ◽  
I P. Sudiartawan ◽  
Dwi Mertha Adnyana
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Reduce Blood Pressure ◽  
Second Grade ◽  
Control Group ◽  
Hypertensive Patients ◽  
First Category

The aim of the study was to determine the effectiveness of giving hydrotherapi foot soak in hypertensive patients. The study was conducted with one group pretestposttest design without a control group by measuring blood pressure (pretest) before being given an intervention in the form of foot soak hydrotherm against 15 people with hypertension in Banjar Sri Mandala, Dauhwaru Village, Jembrana Subregency. Then do the blood pressure measurement again (posttest) after finishing the intervention. After the study was completed, the results showed that before the hydrotherapi foot bath intervention, there were 0% of patients classified as normal, 13.32% in prehypertension category, 60.08% in hypertension category I and 26.60% in hypertension category II. After the intervention was given, there were 13.32% of the patients classified as normal, 66.68% in the prehypertension category, 20.00% in the first category of hypertension and no patients belonging to the second grade hypertension category. There is a decrease of 20-30 mmHg for systolic blood pressure and 0-10 mmHg for diastolic blood pressure after intervention. Based on the results of the study it can be concluded that the hydrotherapi foot bath is effectively used to reduce blood pressure in hypertensive patients in the Banjar Sri Mandala, Dauhwaru Village, Jembrana District.

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