scholarly journals Retrospective analysis of risk factors of hypotensive bradycardic events during shoulder arthroscopic surgery under interscalene blockade in the sitting position

2020 ◽  
Vol 73 (6) ◽  
pp. 542-549
Author(s):  
Taeha Ryu ◽  
Baek Jin Kim ◽  
Seong Jun Woo ◽  
So Young Lee ◽  
Jung A Lim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Odds Ratio ◽  
Arthroscopic Surgery ◽  
Sitting Position ◽  
Past Medical History ◽  
Frequent Adverse Event ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Independent Risk Factors

Background: Hypotensive bradycardic events (HBEs) are a frequent adverse event in patients who underwent shoulder arthroscopic surgery under interscalene block (ISB) in the sitting position. This retrospective study was conducted to investigate the independent risk factors of HBEs in shoulder arthroscopic surgery under ISB in the sitting position. Methods: A total of 2549 patients who underwent shoulder arthroscopic surgery under ISB and had complete clinical data were included in the study. The 357 patients who developed HBEs were included in the HBEs group, and the remaining 2192 in the non-HBEs group. The potential risk factors for HBEs, such as age, sex, past medical history, anesthetic characteristics, and intraoperative medications were collected and compared between the groups. Statistically significant variables were included in a logistic regression model to further evaluate the independent risk factors for HBEs in shoulder arthroscopic surgery under ISB. Results: The incidence of HBEs was 14.0% (357/2549). Logistic regression analysis revealed that the intraoperative use of hydralazine (odds ratio [OR] 4.2; 95% confidence interval [CI] 2.9–6.3), propofol (OR 2.1; 95% CI 1.3–3.6), and dexmedetomidine (OR 3.9; 95% CI 1.9–7.8) before HBEs were independent risk factors for HBEs in patients who received shoulder arthroscopic surgery under ISB. Conclusions: The intraoperative use of antihypertensives such as hydralazine and sedatives such as propofol or dexmedetomidine leads to increased risk of HBEs during shoulder arthroscopic surgery under ISB in the sitting position.

scholarly journals Positive Signs on Physical Examination Are Not Always Indications for Endotracheal Tube Intubation in Patients with Facial Burn

2020 ◽  
Author(s):  
Ruo-Yi Huang ◽  
Szu-Jen Chen ◽  
Yen-Chang Hsiao ◽  
Ling-Wei Kuo ◽  
Chien-Hung Liao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endotracheal Tube ◽  
Odds Ratio ◽  
Inhalation Injury ◽  
Burn Patients ◽  
Shortness Of Breath ◽  
Airway Protection ◽  
Increased Risk ◽  
Independent Risk Factors ◽  
Facial Burn

Abstract BackgroundAfter clinical evaluation in the emergency department (ED), facial burn patients are usually intubated to protect their airways. However, the possibility of unnecessary intubation or delayed intubation after admission exists. Objective criteria for the evaluation of inhalation injury and the need for airway protection in facial burn patients are needed.MethodsFacial burn patients between January 2013 and May 2016 were reviewed. Patients who were and were not intubated in the ED were compared. All intubated patients received routine bronchoscopy to evaluate whether they had inhalation injuries. Patients with and without confirmed inhalation injuries were compared. Multivariate logistic regression analysis was used to identify the independent risk factors for inhalation injuries in facial burn patients. The reasons for intubation in patients without inhalation injuries were also investigated.ResultsDuring the study period, 121 patients were intubated in the ED among a total of 335 facial burn patients. Only 73 (60.3%) patients were later confirmed to have inhalation injuries on bronchoscopy. The comparison between patients with and without inhalation injuries showed that shortness of breath (odds ratio=3.376, p=0.027) and high total body surface area (TBSA) (odds ratio=1.038, p=0.001) were independent risk factors for inhalation injury. Other physical signs (e.g., hoarseness, burned nostril hair, etc.), laboratory examinations and chest X-ray findings were not predictive of inhalation injury in facial burn patients. All patients with a TBSA over 60% were intubated in the ED even if they did not have inhalation injuries.ConclusionIn the management of facial burn patients, positive signs on conventional physical examinations may not always be predictive of inhalation injury and the need for endotracheal tube intubation in the ED. More attention should be paid to facial burn patients with shortness of breath and a high TBSA because they have an increased risk of inhalation injuries. Airway protection is needed in facial burn patients without inhalation injuries because of their associated injuries and treatment.

scholarly journals 1678. Evaluation of Sodium-Glucose Co-Transporter 2 Inhibitor Therapy and Other Potential Risk Factors for the Development of Bacteremia in Patients with Urosepsis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S824-S824
Author(s):  
Kelly Slaten ◽  
Adam Harnden ◽  
Johnathyn Britton ◽  
Elizabeth W Covington ◽  
William Johnson
Keyword(s):  
Risk Factors ◽  
Community Hospital ◽  
Sglt2 Inhibitor ◽  
Binary Logistic Regression ◽  
Sglt2 Inhibitors ◽  
Positive Urine Culture ◽  
Increased Risk ◽  
Positive Urine ◽  
Potential Risk Factors ◽  
Independent Risk Factors

Abstract Background Though sodium-glucose co-transporter 2 (SGLT2) inhibitors have been associated with an increased risk of urinary tract infection, it is unknown whether SGLT2 inhibitors increase the risk of urinary-source bacteremia. Early recognition of bacteremia risk factors in patients with urosepsis could allow rapid management to improve patient outcomes. The purpose of this study is to assess patients presenting with urosepsis and a positive urine culture to evaluate the impact of sodium-glucose co-transporter 2 (SGLT2) inhibitor receipt and other potential risk factors for developing bacteremia. Methods This was a single-center, retrospective, case-control study performed at a community hospital. Patients were included if they presented with a positive urine culture and met pre-specified criteria for urosepsis. Patients were categorized in one of two groups: bacteremia and non-bacteremia. The following patients were excluded: confirmed pregnancy, age less than 18 years, and/or a proven source of bacteremia outside the urogenital tract. The primary endpoint assessed the percentage of patients taking a SGLT2 inhibitor in the bacteremia versus non-bacteremia groups. Independent risk factors for bacteremia were assessed via binary logistic regression. Additional statistical analysis included chi-square for categorical data and Student’s t-test for continuous data. Results A total of 162 patients were analyzed in the study (n=81 in bacteremia and non-bacteremia groups). There was no difference in percentage of patients with or without bacteremia who received SGLT2 inhibitor therapy (p = 0.499). The following were identified as independent risk factors for bacteremia in the binary logistic regression analysis: temperature ≥ 100.4 degrees Fahrenheit (OR 4.1; 95% CI 1.5 – 11.4), bicarbonate level < 20 mmol/L (OR 11.4; 95% CI 3.1 – 41.5), and blood glucose level > 180 mg/dL (OR 3.9; 95% CI 1.3 – 11.6). Conclusion In this study of patients in a community hospital, SGLT2 inhibitors in the setting of patients with urosepsis and positive urine cultures did not increase the risk for bacteremia. Independent risk factors associated with an increased risk of bacteremia included temperature ≥ 100.4 degrees Fahrenheit, bicarbonate level < 20 mmol/L, and blood glucose level > 180 mg/dL. Disclosures All Authors: No reported disclosures

Risk Factors and Outcomes of Placenta Praevia in Lubumbashi, Democratic Republic of Congo

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Ndomba MM ◽  
◽  
Mukuku O ◽  
Tamubango HK ◽  
Biayi JM ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Perinatal Outcomes ◽  
Placenta Praevia ◽  
Republic Of Congo ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Independent Risk Factors

Introduction: Placenta Praevia (PP) is frequently associated with severe maternal bleeding leading to an increased risk for adverse outcome of mother and infant. This study aims to determine the prevalence, and to evaluate potential risk factors and respective outcomes of pregnancies with PP in Lubumbashi, Democratic Republic of Congo. Methods: Data were retrospectively collected from patients diagnosed with PP at 4 hospitals in Lubumbashi between January 2013 and December 2016. All women who gave birth to singleton infants were studied. Differences between women with PP and without PP were evaluated. Adjusted Odds Ratios (aOR) with 95% confidence intervals for risk factors, and adverse maternal and perinatal outcomes associated with PP were estimated in multivariable logistic regression. Results: The overall prevalence of PP was 1.49% (227/15,292). The following risk factors were independently associated with PP: multiparity ≥6 (aOR=2.36; 95% CI: 1.13-4.91), previous cesarean section (aOR=6.74; 95% CI: 2.99-15.18), and no antenatal care visit during pregnancy (aOR=7.15; 95% CI: 4.86-10.53). PP was significantly associated with adverse maternal outcomes such as delivery by cesarean section (aOR=3.09; 95% CI: 1.89- 5.06), maternal anemia (aOR=11.43; 95% CI: 6.20-21.06); and hospital stay of >4 days (aOR=2.02; 95% CI: 1.24-3.29). PP was also significantly associated with adverse perinatal outcomes such as Apgar scores of <7 at the 5th minute after birth (aOR=4.39; 95% CI: 2.62-7.36), low birth weight (aOR=4.10; 95% CI: 2.26-7.44), stillbirth (aOR=4.16; 95% CI: 1.39–12.46), and early neonatal death (aOR=5.72; 95% CI: 1.60–20.42). Conclusion: PP is associated with adverse maternal and perinatal outcomes, and multiple independent risk factors were identified. Therefore, detection and careful surveillance of these risk factors are important to ultimately improve maternal and perinatal outcomes.

scholarly journals Prevalence and Risk Factors ofToxoplasma gondiiin Fattening Pigs Farm from Yucatan, Mexico

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
A. Ortega-Pacheco ◽  
K. Y. Acosta Viana ◽  
E. Guzmán-Marín ◽  
J. C. Segura-Correa ◽  
M. Álvarez-Fleites ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Protective Factor ◽  
Herd Size ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Fattening Pigs

The objective of this study was to estimate the prevalence and identify risk factors associated with the presence ofToxoplasma gondiiin pig-fattening farms from Yucatan, Mexico. A cross-sectional study was conducted with a two-stage sampling. There were 429 pigs sampled from 39 farms randomly selected. Blood samples were collected to obtain DNA and serum. The presence of IgM and IgG antibodies was determined by indirect ELISA. Prevalence was estimated by diagnostic test. Potential risk factors to be included in a marginal logistic regression were tested by chi-square or Fisher. The prevalence of IgM and IgG was 92.5% (397/429) (CI 89.9–95.1%) and 95.8% (411/429) (CI 93.7–97.8%), respectively. Regarding PCR, a prevalence of 50.8% (218/429) (CI 45.9–55.6%) was found. The logistic regression showed an association with herd size and type of feeder (). The risk of a case in farms with ≤400 pigs was 27.9 times higher than in farms with >400 pigs. The manual feeder was a significant protective factor associated with the seropositive againstT. gondii. Results indicate a high circulation ofT. gondiiin pig-fattening farms from Yucatan, finding an increased risk of infection for those farms with less than 400 animals and automatic feeders.

Risk factors for odontoclastic resorptive lesions in cats

1999 ◽  
Vol 35 (3) ◽  
pp. 188-192 ◽  
Author(s):  
JM Scarlett ◽  
J Saidla ◽  
J Hess
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Cross Sectional Study ◽  
Demographic Characteristics ◽  
Sectional Study ◽  
Unconditional Logistic Regression ◽  
Cross Sectional ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
History Of

A cross-sectional study evaluating potential risk factors for odontoclastic resorptive lesions (ORL) in feline teeth was conducted. Owners of 32 cats with ORL and 27 cats without ORL were interviewed regarding their respective cat's demographic characteristics, diet, and medical and dental histories. Four factors were identified as significantly associated with ORL using unconditional logistic regression. A history of dental disease (gingivitis, calculus, or periodontal disease; odds ratio [OR], 4.5); city residence (OR, 4.4); and being an exclusively indoor cat (OR, 4.5) were associated with an increased risk for ORL. Consumption of commercial treats (OR, 0.3) appeared protective for ORL.

scholarly journals Relation between Cardiac Injury and Elevated Levels with Severe COVID-19 of Inflammatory Biomarkers in Patients

2020 ◽  
Author(s):  
Jing Li
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Cardiac Injury ◽  
High Sensitivity ◽  
Inflammatory Biomarkers ◽  
Health Crisis ◽  
Independent Risk Factors ◽  
The Relationship

Background: Since early December 2019, coronavirus disease 2019 (COVID-19) has emerged as a global pandemic and public health crisis. This study aims to explore the relationship between cardiac injury and inflammatory biomarkers in patients with severe COVID-19.Methods: We collected data on 91 patients with a confirmed diagnosis of severe COVID-19 from February 8 to March 31, 2020. Demographic characteristics, clinical data, and in-hospital outcomes were compared. The relationship between cardiac injury and inflammatory biomarkers was analyzed. Logistic regression was used to explore the independent risk factors for cardiac injury.Results: The mean age of all patients was 61 years ± 14 years. About half of the patients were male. Hypertension and coronary heart disease were more common in the cardiac injury group. The levels of inflammatory biomarkers in patients who experienced cardiac injury were generally higher than the levels of those without cardiac injury, including interleukin-6, interleukin-2 receptor (IL-2R), procalcitonin, and high-sensitivity C-reactive protein. There were positive correlations between the levels of high-sensitivity troponin I and N-terminal prohormone of brain natriuretic peptide and the levels of inflammatory biomarkers. Logistic regression shows that IL-2R (odds ratio 1.001, 95% confidence interval 1.000–1.002, P = 0.045) and comorbidities (odds ratio 4.909, 95% confidence interval 1.231–19.579, P = 0.024)are independent risk factors for cardiac injury in patients with severe COVID-19.Conclusion: High levels of inflammatory biomarkers are associated with higher risk of cardiac injury in patients withsevere COVID-19. IL-2R and comorbidities are predictors of cardiac injury.

scholarly journals Early and Late Postoperative Seizures in Meningioma Patients and Prediction by a Recent Scoring System

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 450
Author(s):  
Peter Baumgarten ◽  
Mana Sarlak ◽  
Daniel Monden ◽  
Andrea Spyrantis ◽  
Simon Bernatz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Tumor Volume ◽  
Total Risk ◽  
Increased Risk ◽  
Independent Risk Factors ◽  
Temporal Location ◽  
Meningioma Surgery ◽  
Impaired Quality

Seizures are among the most common symptoms of meningioma. This retrospective study sought to identify risk factors for early and late seizures in meningioma patients and to evaluate a modified STAMPE2 score. In 556 patients who underwent meningioma surgery, we correlated different risk factors with the occurrence of postoperative seizures. A modified STAMPE2 score was applied. Risk factors for preoperative seizures were edema (p = 0.039) and temporal location (p = 0.038). For postoperative seizures preoperative tumor size (p < 0.001), sensomotory deficit (p = 0.004) and sphenoid wing location (p = 0.032) were independent risk factors. In terms of postoperative status epilepticus; sphenoid wing location (p = 0.022), tumor volume (p = 0.045) and preoperative seizures (p < 0.001) were independent risk factors. Postoperative seizures lead to a KPS deterioration and thus an impaired quality of life (p < 0.001). Late seizures occurred in 43% of patients with postoperative seizures. The small sub-cohort of patients (2.7%) with a STAMPE2 score of more than six points had a significantly increased risk for seizures (p < 0.001, total risk 70%). We concluded that besides distinct risk factors, high scores of the modified STAMPE2 score could estimate the risk of postoperative seizures. However, it seems not transferable to our cohort

scholarly journals Nasal symptoms increase the risk of snoring and snoring increases the risk of nasal symptoms. A longitudinal population study

2021 ◽  
Author(s):  
Maria Värendh ◽  
Christer Janson ◽  
Caroline Bengtsson ◽  
Johan Hellgren ◽  
Mathias Holm ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Health ◽  
Smoking Status ◽  
Northern Europe ◽  
Nasal Breathing ◽  
Nasal Symptoms ◽  
Increased Risk ◽  
Study Population ◽  
Independent Risk Factors

Abstract Purpose Humans have a preference for nasal breathing during sleep. This 10-year prospective study aimed to determine if nasal symptoms can predict snoring and also if snoring can predict development of nasal symptoms. The hypothesis proposed is that nasal symptoms affect the risk of snoring 10 years later, whereas snoring does not increase the risk of developing nasal symptoms. Methods In the cohort study, Respiratory Health in Northern Europe (RHINE), a random population from Denmark, Estonia, Iceland, Norway, and Sweden, born between 1945 and 1973, was investigated by postal questionnaires in 1999–2001 (RHINE II, baseline) and in 2010–2012 (RHINE III, follow-up). The study population consisted of the participants who had answered questions on nasal symptoms such as nasal obstruction, discharge, and sneezing, and also snoring both at baseline and at follow-up (n = 10,112). Results Nasal symptoms were frequent, reported by 48% of the entire population at baseline, with snoring reported by 24%. Nasal symptoms at baseline increased the risk of snoring at follow-up (adj. OR 1.38; 95% CI 1.22–1.58) after adjusting for age, sex, BMI change between baseline and follow-up, and smoking status. Snoring at baseline was associated with an increased risk of developing nasal symptoms at follow-up (adj. OR 1.22; 95% CI 1.02–1.47). Conclusion Nasal symptoms are independent risk factors for development of snoring 10 years later, and surprisingly, snoring is a risk factor for the development of nasal symptoms.

scholarly journals Correlation between Potential Risk Factors and Pulmonary Embolism in Sarcoidosis Patients Timely Treated

2021 ◽  
Vol 10 (11) ◽  
pp. 2462
Author(s):  
Barbara Ruaro ◽  
Paola Confalonieri ◽  
Mario Santagiuliana ◽  
Barbara Wade ◽  
Elisa Baratella ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Potential Risk ◽  
Smoking Habit ◽  
Age At Diagnosis ◽  
Antiphospholipid Antibody ◽  
Increased Risk ◽  
Significant Difference ◽  
Antibody Positivity ◽  
Potential Risk Factors

Background. Some studies with inconclusive results have reported a link between sarcoidosis and an increased risk of pulmonary embolism (PE). This study aimed at assessing a possible correlation between potential risk factors and PE in sarcoidosis patients. Methods. A total of 256 sarcoidosis patients (84 males and 172 females; mean age at diagnosis 49 ± 13) were enrolled after giving written informed consent. Clinical evaluations, laboratory and radiology tests were performed to evaluate the presence of pulmonary embolism. Results. Fifteen sarcoidosis patients with PE (4 males and 11 females; mean age at diagnosis 50 ± 11), diagnosed by lung scintigraphy and 241 sarcoidosis patients without PE (80 males and 161 females; mean age at diagnosis 47 ± 13), were observed. There was a statistically significant increase of the presence of antiphospholipid antibodies in the sarcoidosis group with pulmonary embolism. There was no statistically significant difference between the two groups as to smoking habit, obesity or hereditary thrombophilia frequency (p > 0.05, respectively). Conclusions. This study demonstrates a significant correlation between the presence of antiphospholipid antibody positivity and the pulmonary embolism events in our sarcoidosis patients. Furthermore, we propose screening for these antibodies and monitoring, aimed at timely treatment.

Post-Bariatric Abdominoplasty: Analysis of 406 Cases With Focus on Risk Factors and Complications

2020 ◽  
Vol 41 (1) ◽  
pp. 59-71 ◽  
Author(s):  
Torsten Schlosshauer ◽  
Marcus Kiehlmann ◽  
Diana Jung ◽  
Robert Sader ◽  
Ulrich M Rieger
Keyword(s):  
Risk Factors ◽  
Wound Healing ◽  
Surgical Technique ◽  
Significant Risk ◽  
Level Of Evidence ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Wound Healing Problems ◽  
Bariatric Patients

Abstract Background Post-bariatric patients present a surgical challenge within abdominoplasty because of residual obesity and major comorbidities. In this study, we analyzed complications following abdominoplasty in post-bariatric patients and evaluated potential risk factors associated with these complications. Objectives The authors sought to determine the complications and risk factors following abdominoplasty in post-bariatric patients. Methods A retrospective study of patients who underwent abdominoplasty was performed from January 2009 to December 2018 at our institution. Variables analyzed were sex, age, body mass index (BMI), smoking, surgical technique, operative time, resection weight, drain output, and complications. Results A total of 406 patients were included in this study (320 female and 86 male) with a mean age of 44.4 years and a BMI of 30.6 kg/m2. Abdominoplasty techniques consisted of traditional (64.3%), fleur-de-lis technique (27.3%), and panniculectomy without umbilical displacement (8.4%). Overall complications recorded were 41.9%, the majority of these being wound-healing problems (32%). Minor and major complications were found in 29.1% and 12.8% of patients, respectively. A BMI value of ≥30 kg/m2 was associated with an increased risk for wound-healing problems (P = 0.001). The frequency of total complications was significantly related to age (P = 0.007), BMI (P = 0.004), and resection weight (P = 0.001). Abdominoplasty technique tended to influence total complications. Conclusions This study demonstrates in a fairly large sample of post-bariatric patients (n = 406) that abdominoplasty alone can be performed safely, with an acceptable complication rate. Age, BMI, and resection weight are shown to be significant risk factors for total complications. The role of surgical technique needs to be evaluated further. Level of Evidence: 4

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