Study of factors associated with mortality and morbidity in blunt trauma abdomen

2019 ◽  
Vol 10 (1) ◽  
pp. 21-24
Author(s):  
Anil S Mundhe ◽  
◽  
Sudhir B Sasapardhi ◽  
Keyword(s):  
Blunt Trauma ◽  
Mortality And Morbidity ◽  
Factors Associated

scholarly journals Factors associated with hypertension in Pakistan: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246085
Author(s):  
Muhammad Riaz ◽  
Ghazala Shah ◽  
Muhammad Asif ◽  
Asma Shah ◽  
Kaustubh Adhikari ◽  
...  
Keyword(s):  
Public Health ◽  
Urban Areas ◽  
Health Workers ◽  
Health Concern ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Negatively Associated ◽  
Factors Associated ◽  
Health Related

Background High blood pressure is an important public health concern and the leading risk factor for global mortality and morbidity. To assess the implications of this condition, we aimed to review the existing literature and study the factors that are significantly associated with hypertension in the Pakistani population. Methods We conducted several electronic searches in PubMed, ISI Web of Science, PsycINFO, EMBASE, Scopus, Elsevier, and manually searched the citations of published articles on hypertension from May 2019 to August 2019. We included all studies that examined factors associated with hypertension regardless of the study design. To assess the quality of the research, we used the Newcastle-Ottawa Quality Assessment Scale. We also conducted meta-analyses using the DerSimonian & Laird random-effects model to collate results from at least three studies. Results We included 30 cross-sectional and 7 case-control studies (99,391 participants country-wide) in this review and found 13 (35.1%) to be high-quality studies. We identified 5 socio-demographic, 3 lifestyle, 3 health-related, and 4 psychological variables that were significantly associated with hypertension. Adults aged between 30–60 years who were married, living in urban areas with high incomes, used tobacco, had a family history of hypertension, and had comorbidities (overweight, obesity, diabetes, anxiety, stress, and anger management issues) were positively associated with hypertension. On the other hand, individuals having high education levels, normal physical activity, and unrestricted salt in their diet were negatively associated with hypertension. Conclusion We found several socio-demographic, lifestyle, health-related, and psychological factors that were significantly (positively and negatively) associated with hypertension. Our findings may help physicians and public health workers to identify high-risk groups and recommend appropriate prevention strategies. Further research is warranted to investigate these factors rigorously and collate global evidence on the same.

scholarly journals A Systematic Review of Risk Factors Associated with Near-Fatal and Fatal Asthma

2005 ◽  
Vol 12 (5) ◽  
pp. 265-270 ◽  
Author(s):  
GG Alvarez ◽  
M Schulzer ◽  
D Jung ◽  
JM FitzGerald
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Inhaled Corticosteroids ◽  
Respiratory Arrest ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Mortality And Morbidity ◽  
Factors Associated ◽  
Fatal Asthma ◽  
The Impact

BACKGROUND: Asthma mortality and morbidity continue to be a serious global problem. Systematic reviews provide an opportunity to review risk factors in detail.OBJECTIVE: To review all of the literature for risk factors associated with near-fatal asthma (NFA) and fatal asthma (FA).METHODS: A literature search from 1960 to January 2004 in MEDLINE and EMBASE was conducted. Studies were included based on the following criteria: NFA was defined as an asthma exacerbation resulting in respiratory arrest requiring mechanical ventilation or a partial pressure of CO2of at least 45 mmHg or asthma resulting in death (FA); the study reported the number of cases (NFA and/or FA) and asthmatic controls; there was explicit reporting of risk factors; cases that were adult and pediatric in nature; and all study types. Studies that included patients with chronic obstructive pulmonary disease were excluded.RESULTS: Four hundred and three articles were identified, of which 27 met the inclusion criteria. Increased use of medications such as beta-agonists via metered dose inhalers (OR=1.67, 95% CI 0.99 to 2.84, P=0.057) and nebulizers (OR=2.45, 95% CI 1.52 to 3.93, P=0.0002), oral steroids (OR=2.71, 95% CI 1.34 to 5.51, P=0.006) and oral theophylline (OR=2.02, 95% CI 1.03 to 3.98, P=0.04) and a history of hospital (OR=2.62, 95% CI 1.04 to 6.58, P=0.04) and/or intensive care unit (OR=5.14, 95% CI 1.91 to 13.86, P=0.001) admissions and mechanical ventilation (OR=6.69, 95% CI 2.80 to 15.97, P=0.0001) due to asthma were predictors of NFA and FA. Prior emergency department assessment did not confer a greater risk of NFA and FA (OR=1.13, 95% CI 0.43 to 2.92, P=0.810).The use of inhaled corticosteroids (ICS) measured in a dose-independent fashion (did the patient take ICS previously; yes or no) inferred equivocal risk of NFA and FA (OR=1.31, 95% CI 0.83 to 2.05, P=0.25). However, two studies measured the use of ICS in a dose-dependent fashion (ie, measured the number of prescriptions filled within the previous six to 12 months). Both studies showed a trend toward a protective effect against FA. One study showed that the premature cessation of ICS can hasten death.CONCLUSIONS: In the present study, risk factors of NFA and FA have been more accurately defined. Clinicians should identify patients with these characteristics to reduce their risk of NFA and FA. Further research should focus on quantifying the impact of risk factors on asthma deaths.

scholarly journals Factors Associated with Chest Tube Placement in Blunt Trauma Patients with an Occult Pneumothorax

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Michael Paplawski ◽  
Swapna Munnangi ◽  
Jody C. Digiacomo ◽  
Edwin Gonzalez ◽  
Ashley Modica ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Chest Tube ◽  
Rib Fractures ◽  
Tube Placement ◽  
Chest Tubes ◽  
Chest Tube Placement ◽  
X Ray ◽  
Factors Associated ◽  
Occult Pneumothorax ◽  
Chest X Ray

Background. An occult pneumothorax is identified by computed tomography but not visualized by a plain film chest X-ray. The optimal management remains unclear. Methods. A retrospective review of an urban level I trauma center’s trauma registry was conducted to identify patients with occult pneumothorax over a 2-year period. Factors predictive of chest tube placement were identified using univariate and multivariate logistic regression analysis. Results. A total of 131 patients were identified, of whom 100 were managed expectantly with an initial period of observation. Ultimately, 42 (32.0%) patients received chest tubes and 89 did not. The patients who received chest tubes had larger pneumothoraces at initial assessment, a higher incidence of rib fractures, and an increased average number of rib fractures, of which significantly more were displaced. Conclusions. Displaced rib fractures and moderate-sized pneumothoraces are significant factors associated with chest tube placement in a victim of blunt trauma with occult pneumothorax. The optimal timing for the first follow-up chest X-ray remains unclear.

scholarly journals A five years retrospective study of factors influencing outcome of major lower limb amputations

2020 ◽  
Vol 7 (8) ◽  
pp. 2553
Author(s):  
Sudhir Marahanumaiah ◽  
Sridhar Govindaiah
Keyword(s):  
Lower Extremity ◽  
Lower Limb ◽  
Mortality Rates ◽  
Age Group ◽  
Peripheral Vascular ◽  
Elderly Age ◽  
Mortality And Morbidity ◽  
Factors Associated ◽  
Tertiary Centre ◽  
Male Patients

Background: The word amputation is derived from Latin -Amputare - to cut away. The amputation is indicated when the limb is considered as dead limb/ deadly limb/ dead loss limb. Often cases are referred to tertiary centre late, resulting in complications which requires surgical management. Aim of the study was to compare the outcomes of major lower limb amputations and to identify risk factors associated with mortality and morbidity following major lower limb amputations.Methods: A retrospective observational study was done for 5 years between January 2014 to November 2019, comprising 276 patients undergoing major lower extremity amputations. Adult patients undergoing lower extremity amputations for ischemic, infected or gangrenous lower limb were included and patients who underwent amputations for trauma or tumours were excluded. The data regarding comorbidities, postoperative complications, outcome of major lower limb amputations were evaluated.Results: 276 patients underwent lower limb amputations (above knee amputations (AKA)-127, below knee amputations (BKA)-134, forefoot amputations-15). Male patients outnumbered females (6.7:1) and most of them were of elderly age group (mean age 60.56 years). The most common indications for amputations in our study were peripheral vascular disease (120), diabetes (87), necrotizing fasciitis (37). The 1 year mortality rates following lower limb amputations in our study were 14% (BKA) and 34% (AKA).Conclusions: Lower limb amputations are associated with high mortality rates. Mortality can be expected in both the early and the late postoperative periods and is most probably related to serious comorbidities, such as renal and heart disease, rather than the level of amputation.

scholarly journals Uterine Rupture - Risk Factors and Pregnancy Outcome in Bundelkhand Region

2021 ◽  
Vol 10 (27) ◽  
pp. 1961-1965
Author(s):  
Sheela Jain
Keyword(s):  
Risk Factors ◽  
Uterine Rupture ◽  
Fetal Mortality ◽  
Mortality And Morbidity ◽  
Factors Associated ◽  
Uterine Surgery ◽  
Grand Multiparity ◽  
Uterine Scar ◽  
Congenital Uterine Anomaly ◽  
Inter Pregnancy Interval

BACKGROUND Uterine rupture is defined as the tearing of the muscular wall of the uterus during pregnancy or labour.1 Often it occurs from the tearing of previous caesarean scar during labour.2 The other known risk factors for uterine rupture include, maternal age, height, body mass index (BMI), education, birth weight, gestational age, induction of labour, instrumental vaginal delivery, interpregnancy interval, congenital uterine anomaly, grand multiparity, previous uterine surgery, fetal macrosomia, fetal malposition, obstructed labour, uterine instrumentation, attempted forceps delivery, external version, and uterine trauma. 2-6This study was done to find out the prevailing risk factors associated with this grave condition in Bundelkhand region, so that mortality and morbidity associated with it could be prevented. METHODS We have studied 37 cases of uterine rupture, operated in our institution from Jan. 2018 to Oct. 2019. During this period a total of 2986 Caesarean sections (CS) were performed. Of these 37 cases, 5 were Nullipara (13.51 %), 16 primipara (31.25 %) and 16 were grand multipara (31.25 %). 24 cases (64.86 %) had previous uterine scar while 13 (35.13 %) had no scar. RESULTS In our study major risk factors for uterine rupture were found to be previous scars (64.68 %). Obstructive labour (23.07 %), malpresentation (7.69 %), grand multiparity (38.46 %) and prolong labour (30.76 %), were responsible for rupture in unscarred uterus. In all cases we first tried to repair the tear and only 9 (24.32 %) needed hysterectomy. In our study 28 patients (75.67 %) required only repair whereas 24.32 % cases needed hysterectomy. Maternal death was just 1 case (2.7 %) and (51.35 %) babies survived. CONCLUSIONS Majority of uterine rupture cases were found in women who had previous CS. So, first CS should be performed after very careful understanding of its indications. 2.7 % maternal mortality and 51.35 % delivery of live birth babies in our study proves that early detection and proper managing of the case can reduce maternal and fetal mortality in uterine rupture cases. KEY WORDS Uterine Rupture, Previous Scar, Inter-Pregnancy Interval

Prehospital Factors Associated With Cervical Spine Injury in Pediatric Blunt Trauma Patients

2020 ◽  
Author(s):  
Lorin R. Browne ◽  
Fahd A. Ahmad ◽  
Hamilton Schwartz ◽  
Michael Wallendorf ◽  
Nathan Kuppermann ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Blunt Trauma ◽  
Cervical Spine Injury ◽  
Spine Injury ◽  
Trauma Patients ◽  
Factors Associated

scholarly journals Risk Factors and Predictors of Mortality in Streptococcal Necrotizing Soft-tissue Infections: A Multicenter Prospective Study

2020 ◽  
Author(s):  
Trond Bruun ◽  
Eivind Rath ◽  
Martin Bruun Madsen ◽  
Oddvar Oppegaard ◽  
Michael Nekludov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Soft Tissue ◽  
Blunt Trauma ◽  
Gene Profiling ◽  
Soft Tissue Infections ◽  
Lasso Regression ◽  
Factors Associated ◽  
Necrotizing Soft Tissue Infections ◽  
The Impact

Abstract Background Necrotizing soft-tissue infections (NSTI) are life-threatening conditions often caused by β-hemolytic streptococci, group A Streptococcus (GAS) in particular. Optimal treatment is contentious. The INFECT cohort includes the largest set of prospectively enrolled streptococcal NSTI cases to date. Methods From the INFECT cohort of 409 adults admitted with NSTI to 5 clinical centers in Scandinavia, patients culture-positive for GAS or Streptococcus dysgalactiae (SD) were selected. Risk factors were identified by comparison with a cohort of nonnecrotizing streptococcal cellulitis. The impact of baseline factors and treatment on 90-day mortality was explored using Lasso regression. Whole-genome sequencing of bacterial isolates was used for emm typing and virulence gene profiling. Results The 126 GAS NSTI cases and 27 cases caused by SD constituted 31% and 7% of the whole NSTI cohort, respectively. When comparing to nonnecrotizing streptococcal cellulitis, streptococcal NSTI was associated to blunt trauma, absence of preexisting skin lesions, and a lower body mass index. Septic shock was significantly more frequent in GAS (65%) compared to SD (41%) and polymicrobial, nonstreptococcal NSTI (46%). Age, male sex, septic shock, and no administration of intravenous immunoglobulin (IVIG) were among factors associated with 90-day mortality. Predominant emm types were emm1, emm3, and emm28 in GAS and stG62647 in SD. Conclusions Streptococcal NSTI was associated with several risk factors, including blunt trauma. Septic shock was more frequent in NSTI caused by GAS than in cases due to SD. Factors associated with mortality in GAS NSTI included age, septic shock, and no administration of IVIG.

scholarly journals Overview and factors associated with pregnancies and abortions occurring in sex workers in Benin

2019 ◽  
Author(s):  
Gentiane Perrault Sullivan ◽  
Fernand Aimé Guédou ◽  
Georges Batona ◽  
Frédéric Kintin ◽  
Luc Béhanzin ◽  
...  
Keyword(s):  
Sex Work ◽  
Sex Workers ◽  
Work Practice ◽  
Work Place ◽  
Structural Factors ◽  
Cross Sectional ◽  
Safe Abortion ◽  
Mortality And Morbidity ◽  
Factors Associated ◽  
Unintended Pregnancies

Abstract INTRODUCTION The behavioural and structural factors related to sex work, place female sex workers (FSWs) at high risk of maternal mortality and morbidity (MMM), with a large portion due to unintended pregnancies and abortions. In the African context where MMM is high amongst the general population, understanding the frequency and determinants of pregnancy and abortion among FSWs is important in order to meet their sexual and reproductive health needs. METHODS Data from two Beninese cross-sectional surveys (2013 - 2016) were merged. We first performed exploratory univariate analyses to identify factors associated with pregnancy and abortion (p<0.20) using Generalized Estimating Equations with Poisson regression and robust variance. Multivariate analyses first included all the variables identified in the univariate models and backward selection (p≤0.05) was used to generate the final models. RESULTS Mean age was 31 years (N=866). The proportion of FSWs reporting at least one pregnancy during sex work was 16.4%, of whom 42.3% had more than one. Most pregnancies ended up with an abortion (67.6%). FSWs who lived with their boyfriend (adjusted proportion ratio (aPR) = 1.74, 95%CI: [1.1, 2.8]) and did not use condoms consistently with them (aPR=1.83, 95%CI: [1.1, 3.0]) had more pregnancies. CONCLUSION One FSW out of five had at least one pregnancy during her sex work practice. Most of those pregnancies, regardless of their origin, ended up with an abortion. Improving access to various forms of contraception and safe abortion is the key to reducing unwanted pregnancies and consequently, MMM among FSWs in Benin.

scholarly journals Factors Associated with Protection of Last Live Birth against Neonatal Tetanus among Mother Age 15-49 in Ethiopia: A Multilevel Analysis Using EDHS 2016

2020 ◽  
Author(s):  
Gebrezgiher Kalayu ◽  
Girmatsion Fisseha ◽  
Reda Shamie ◽  
Awtachew Berhe ◽  
Kebede Embaye
Keyword(s):  
Live Birth ◽  
Goodness Of Fit ◽  
Community Level ◽  
Contextual Effect ◽  
Neonatal Tetanus ◽  
P Value ◽  
Goodness Of Fit Test ◽  
Mortality And Morbidity ◽  
Factors Associated ◽  
The Individual

Abstract BackgroundEthiopia has the highest neonatal tetanus mortality and morbidity rates in the world due to low TT immunization coverage coupled with the high amount of deliveries taking place at home. This study aimed to identify individual and community-level factors associated with protections of last live birth against neonatal tetanus among mothers age 15–49 in Ethiopia.MethodsThe P-value of less than 0.05 in the final model was considered as statistically significant. The interclass correlation coefficient and proportional change in variance were used to quantify the magnitude of the general contextual effect. The relative goodness-of-fit test was conducted using Akaike's information criterion.ResultHome delivery (AOR = 0.83; 95% CI: 0.72, 0.96), at least one ANC visits (AOR = 12.35; 95% CI: 10.42, 14.62) and wealth index (poorer (AOR = 1.27, 95% CI: 1.04, 1.54) and richer (AOR = 1.53, 95% CI: 1.21, 1.93). were the individual factors that had an association with the utilization of protection of last live birth against neonatal tetanus.ConclusionsUtilization of protection of last live birth against neonatal tetanus is affected both by the individual and community level factors with high state variation.

Risk Factors for the Development of Nosocomial Pneumonia and Its Clinical Impact in Cardiac Surgery

2021 ◽  
Author(s):  
Ferdinand Jr Rivera Gerod ◽  
Edgar Ongjoco ◽  
Rod Castro ◽  
Armin Masbang ◽  
Elmer Casley Repotente ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Hospital Mortality ◽  
Nosocomial Pneumonia ◽  
Clinical Impact ◽  
Adult Patients ◽  
Mortality And Morbidity ◽  
Factors Associated ◽  
Prolonged Icu Stay

Abstract BackgroundThe development of nosocomial pneumonia after cardiac surgery is a significant post-operative complication that may lead to increased morbidity, mortality, and hospital cost. We aimed to identify risk factors associated with it and to determine its clinical impact in terms of in-hospital mortality and morbidity.MethodsThis is a retrospective cohort study conducted among all adult patients who underwent cardiac surgery from 2014-2019 in St. Luke’s Medical Center, Quezon City, Philippines. Baseline characteristics and possible risk factors for pneumonia were retrieved from medical records. Nosocomial pneumonia was based on the Centers for Disease Control and Prevention criteria. Clinical outcomes include in-hospital mortality and morbidity. Odds ratios from logistic regression was computed to determine risk factors associated with pneumonia using STATA 15.0.ResultsOut of 373 patients included in this study, 104 (28%) patients acquired pneumonia. Most surgeries were coronary artery bypass graft (CABG) (71.58%), followed by valve repair/replacement (29.76%). Neither age, sex, BMI, diabetes, LV dysfunction, renal dysfunction, COPD/asthma, urgency of surgery, surgical time, nor smoking showed association in the development of pneumonia. However, preoperative stay of >2 days was associated with 92.3% (95%CI 18–213%) increased odds of having pneumonia (p=.009). Also, every additional hour on mechanical ventilation conferred 0.8% (95%CI, 0.3–1%) greater odds of acquiring pneumonia (p=.003).Patients who developed pneumonia had 3.9 times odds of mortality (95%CI 1.51–9.89, p=.005), 3.8 times odds of prolonged hospitalization (95%CI 1.81–7.90,p<.001), 6.4 times odds of prolonged ICU stay (95%CI 3.59–11.35,p<.001), and 9.5 times odds of postoperative reintubation (95%CI 3.01–29.76,p<.001). ConclusionAmong adult patients undergoing cardiac surgeries, prolonged preoperative hospital stay and prolonged mechanical ventilation were both associated with an increased risk for nosocomial pneumonia. Those who developed pneumonia had worse outcomes with significantly increased in-hospital mortality, prolonged hospitalization, prolonged ICU stay, and increased postoperative re-intubation. Clinicians should therefore minimize delays in surgery to avoid unnecessary exposure to pathogenic organisms. Also, timely liberation from mechanical ventilation after surgery should be encouraged.

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