scholarly journals The Impact of Graft Nephrectomy on Subsequent Transplants: Multivariate Analysis of Risk Factors for Second Graft Loss and for Multiple Transplantations–A Single-Center Retrospective Study

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Emmanouil Giorgakis ◽  
Asim Syed ◽  
Hector Gonzalez
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Retrospective Study ◽  
Independent Risk Factor ◽  
Graft Loss ◽  
Kaplan Meier ◽  
Independent Risk Factors ◽  
Allograft Loss ◽  
The Impact

Introduction. The management of a failed primary allograft remains unclear and the evidence of the effect of transplantectomy to future transplants conflicting. Aim of this study is to review the impact of failed primary graft nephrectomy on future transplants. Materials/Methods. Retrospective study of 101 patients retransplanted in a single institution. Median follow-up was 68 months. Patients were divided into two groups; G1 (n=49) was the nephrectomy group; G2 (n=52) was the graft in situ group. The patients’ and second graft survival were analysed with the Kaplan-Meier method. The patients’ and transplant characteristics were analyzed with student’s t-test. The retransplant risk factors and the risk factors for multiple transplants were obtained via a logistic regression model. Results. The odds of second graft loss post-transplantectomy were high (OR = 5.24). Demographics, HLA mismatch and first graft rejection rates were similar among the two groups and did not affect the outcome. Transplantectomy accelerated the loss of a future failing graft. Multivariate analysis showed transplantectomy as independent risk factor for second allograft loss. Transplantectomy and younger age are significant independent risk factors for future multiple transplants. Conclusion. Transplantectomy of the failed primary graft is an independent risk factor for retransplant loss and for multiple renal transplants.

scholarly journals Hyperbaric hyperoxemia as a risk factor for ventilator-acquired pneumonia?

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253198
Author(s):  
Morgan Caplan ◽  
Thibault Duburcq ◽  
Anne-Sophie Moreau ◽  
Julien Poissy ◽  
Saad Nseir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Radiological Criteria ◽  
Clinical Investigations ◽  
Independent Risk Factors ◽  
Hospital Transport ◽  
The Impact ◽  
The Relationship

Objectives Ventilator-acquired pneumonia (VAP) is the leading cause of serious associated infections in Intensive Care Units (ICU) and is associated with significant morbidity. The use of hyperbaric oxygen therapy (HBOT) in patients on mechanical ventilation may increase exposure to certain risk factors such as hyperoxemia and the need for multiple transfers. The aim of our study was to assess the relationship between HBOT and VAP. Method This retrospective observational study was performed from March 2017 to March 2018 in a 10-bed ICU using HBOT. All patients receiving mechanical ventilation (MV) for more than 48 hours were eligible. VAP was defined using clinical and radiological criteria. Data collection was carried out via digital medical records. Risk factors for VAP were determined by univariate and multivariate analysis. Results Forty-two (23%) of the 182 patients enrolled developed at least one episode of VAP. One hundred and twenty-four (68%) patients received HBOT. The incidence rate of VAP was 34 per 1000 ventilator days. The occurrence of VAP was significantly associated with immunosuppression (p<0.029), MV duration (5 [3–7] vs 8 [5–11.5] days, p<0.0001), length of stay (8 [5–13] vs 19.5 [13–32] days, p<0.0001), reintubation (p<0.0001), intra-hospital transport (p = 0.001), use of paralytic agents (p = 0.013), tracheotomy (p = 0.003) and prone position (p = 0.003). The use of HBOT was not associated with the occurrence of VAP. Multivariate analysis identified reintubation (OR: 8.3 [2.6–26.6]; p<0.0001), intra-hospital transport (OR: 3.5 [1.3–9.2]; p = 0.011) and the use of paralytic agents (OR: 3.3 [1.3–8.4]; p = 0.014) as independent risk factors for VAP. Conclusion Known risk factors for VAP are to be found within our ICU population. HBOT, however, is not an extra risk factor for VAP within this group. Further experimental and clinical investigations are needed to understand the impact of HBOT on the occurrence of VAP and on physiological microbiome.

Clinical characteristics and prognosis in patients with premature coronary artery disease of different genders after intervention

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
X.F Tang ◽  
Y Yao ◽  
S.D Jia ◽  
Y Liu ◽  
B Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Coronary Intervention ◽  
Premature Coronary Artery Disease ◽  
Minor Bleeding ◽  
Bleeding Events ◽  
Cerebrovascular Events ◽  
Independent Risk Factors ◽  
Artery Disease

Abstract Objective To investigate the clinical characteristics and long-term prognosis of coronary intervention in patients with premature coronary artery disease (PCAD) between different genders. Methods From January 2013 to December 2013, 4 744 patients diagnosed as PCAD with percutaneous coronary intervention (PCI) in our hospital were enrolled. The general clinical data, laboratory results and interventional treatment data of all patients were collected, and the occurrence of major adverse cardio-cerebrovascular events (MACCE) within 2 years after PCI was followed up. Results Of the 4 744 patients undergoing PCI, 3 390 (71.5%) were males and 1 354 (28.5%) were females. The 2-year follow-up results showed that the incidence of BARC grade 1 hemorrhage in female patients was significantly higher than that in male patients (6.9% vs. 3.7%; P&lt;0.001); however, there was no significant difference in the incidence of major adverse cardiovascular and cerebrovascular events (MACCE), all-cause death, cardiac death, recurrent myocardial infarction, revascularization (target vessel revascularization and target lesion revascularization), stent thrombosis, stroke and BARC grade 2–5 hemorrhage between the two groups (P&gt;0.05). Multivariate COX regression analysis showed that gender was an independent risk factor for BARC grade 1 bleeding events in PCAD patients (HR=2.180, 95% CI: 1.392–3.416, P&lt;0.001), but it was not an independent risk factor for MACCE and BARC grade 2–5 bleeding. Hyperlipidemia, preoperative SYNTAX score, multivessel lesions and NSTE-ACS were the independent risk factors for MACCE in PCAD patients with PCI (HR=1.289, 95% CI: 1.052–1.580, P=0.014; HR=1.030, 95% CI: 1.019–1.042, P&lt;0.001; HR=1.758, 95% CI: 1.365–2.264, P&lt;0.001; HR=1.264, 95% CI: 1.040–1.537, P=0.019); gender, hyperlipidemia, anticoagulant drugs like low molecular weight heparin or sulfonate were the independent risk factors for bleeding events (HR=1.579,95% CI 1.085–2. 297, P=0.017; HR=1.305, 95% CI 1.005–1.695, P=0.046; HR=1.321, 95% CI 1.002–1.741, P=0.048; HR=1.659, 95% CI 1.198–2.298, P=0.002). Conclusion The incidence of minor bleeding in women with PCAD is significantly higher than that in men; After adjusting for various risk factors, gender is an independent risk factor for minor bleeding events, but not an independent risk factor for MACCE in patients with PCAD. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Science and Technology Support Program of China

scholarly journals Risk factors for post-bronchoscopy pneumonia: a case–control study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yu Sato ◽  
Kengo Murata ◽  
Miake Yamamoto ◽  
Tsukasa Ishiwata ◽  
Miyako Kitazono-Saitoh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Case Control Study ◽  
Case Control ◽  
Control Group ◽  
Tracheobronchial Stenosis ◽  
Control Study ◽  
Age And Sex

AbstractThe bronchoscopy, though usually safe, is occasionally associated with complications, such as pneumonia. However, the use of prophylactic antibiotics is not recommended by the guidelines of the British Thoracic Society. Thus far there are few reports of the risk factors for post-bronchoscopy pneumonia; the purpose of this study was to evaluate these risk factors. We retrospectively collected data on patients in whom post-bronchoscopy pneumonia developed from the medical records of 2,265 patients who received 2666 diagnostic bronchoscopies at our institution between April 2006 and November 2011. Twice as many patients were enrolled in the control group as in the pneumonia group. The patients were matched for age and sex. In total, 37 patients (1.4%) had post-bronchoscopy pneumonia. Univariate analysis showed that a significantly larger proportion of patients in the pneumonia group had tracheobronchial stenosis (75.7% vs 18.9%, p < 0.01) and a final diagnosis of primary lung cancer (75.7% vs 43.2%, p < 0.01) than in the control group. The pneumonia group tended to have more patients with a history of smoking (83.8% vs 67.1%, p = 0.06) or bronchoalveolar lavage (BAL) (4.3% vs 14.9%, p = 0.14) than the control group. In multivariate analysis, we found that tracheobronchial stenosis remained an independent risk factor for post-bronchoscopy pneumonia (odds ratio: 7.8, 95%CI: 2.5–24.2). In conclusion, tracheobronchial stenosis was identified as an independent risk factor for post-bronchoscopy pneumonia by multivariate analysis in this age- and sex- matched case control study.

scholarly journals Aneurysm characteristics and risk of rebleeding after subarachnoid haemorrhage

2018 ◽  
Vol 4 (2) ◽  
pp. 153-159
Author(s):  
Inez Koopman ◽  
Jacoba P Greving ◽  
Irene C van der Schaaf ◽  
Albert van der Zwan ◽  
Gabriel JE Rinkel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Aspect Ratio ◽  
Subarachnoid Haemorrhage ◽  
Independent Risk Factor ◽  
Irregular Shape ◽  
Aneurysmal Subarachnoid Haemorrhage ◽  
Aneurysm Size ◽  
Aneurysm Treatment ◽  
Independent Risk Factors

Introduction Knowledge of risk factors for rebleeding after aneurysmal subarachnoid haemorrhage can help tailoring ultra-early aneurysm treatment. Previous studies have identified aneurysm size and various patient-related risk factors for early (≤24 h) rebleeding, but it remains unknown if aneurysm configuration is also a risk factor. We investigated whether irregular shape, aspect- and bottleneck ratio of the aneurysm are independent risk factors for early rebleeding after aneurysmal subarachnoid haemorrhage. Patients and methods From a prospectively collected institutional database, we investigated data from consecutive aneurysmal subarachnoid haemorrhage patients who were admitted ≤24 h after onset between December 2009 and January 2015. The admission computed tomographic angiogram was used to assess aneurysm size and configuration. With Cox regression, we calculated stepwise-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for irregular shape, aspect ratio ≥1.6 mm and bottleneck ratio ≥1.6 mm. Results Of 409 included patients, 34 (8%) patients had in-hospital rebleeding ≤24 h after ictus. Irregular shape was an independent risk factor for rebleeding (HR: 3.9, 95% CI: 1.3–11.3) after adjustment for age, sex, PAASH score, aneurysm location, aneurysm size and aspect- and bottleneck ratio. Aspect ratio ≥1.6 mm (HR: 2.3, 95% CI: 0.8–6.5) and bottleneck ratio ≥1.6 mm (HR: 1.7, 95% CI: 0.8–3.6) were associated with an increased risk of rebleeding, but were not independent risk factors after multivariable adjustment. Conclusions Irregular shape is an independent risk factor for early rebleeding. However, since the majority of subarachnoid haemorrhage patients have an irregular aneurysm, additional risk factors have to be found for aneurysm treatment prioritisation.

Advanced stage, elevated LDH, primary sites, but not adolescent (A) age (≥ 15 years) as risk factors for disease progression in childhood (C) and adolescent (A) mature B-NHL: Report of the FAB/LMB 96 international trial

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 10032-10032
Author(s):  
M. S. Cairo ◽  
R. Sposto ◽  
M. Gerrard ◽  
I. Waxman ◽  
S. Goldman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Risk Group ◽  
Significant Risk ◽  
High Risk Group ◽  
Stage Iii ◽  
Group A ◽  
Independent Risk Factors ◽  
Group B

10032 Background: We recently reported the results in C & A with low risk (group A), intermediate risk (group B) and high risk (group C) mature B-NHL treated on FAB/LMB 96 (Gerrard et al, Br J Haematol, 2008; Patte et al, Blood, 2007; Cairo et al, Blood, 2007, respectively). Adolescent age (15–21 yrs) has historically been considered to be an independent risk factor for poor outcome in subsets of mature B-NHL (Hochberg/Cairo et al, Br J Haematol, 2008; Burkhardt et al, Br J Haematol 2005; Cairo et al, Br J Haematol, 2003). Methods: We analyzed the EFS of all pts treated on FAB/LMB 96 and the following risk factors were significant in a univariate and Cox multivariate analysis: age (<15 vs ≥15 yrs), stage I/II vs III/IV, primary sites, LDH <2 vs ≥2 NL and histology (DLBCL vs BL/BLL). Results: 1111 pts (15%, 15–21 years) were treated with group A (N = 132), group B (N = 744), and group C (N = 235) therapy. Five year EFS (CI95) for all, A, B, C pts was 86% (84%,88%), 98% (93%, 100%), 87%% (84%, 89%), and 79%% (73%,84%), respectively. Age (≥15 yrs), LDH ≥2NL, stage III/IV, and BM+/CNS+ and histology were significant univariate risk factors for decreased EFS (P<0.045, <0.0001, <0.0001, <0.0001, and <0.0001 respectively). Multivariate analysis demonstrated age ≥15 yrs and DLBCL histology were no longer independent significant risk factors (p = .82 and 0.08, respectively), but LDH (RR 2.0, p = .001), stage III/IV (RR 3.8, p<0.001), and primary sites including PMBL (RR 4.0, p<.001) and BM+/CNS+ (RR 2.8, p<0.001) were independent significant risk factors for poorer outcome. Conclusions: With the use of modern short but intense FAB-LMB 96 therapy, adolescent age is no longer a poor risk factor in children with mature B-NHL. The independent risk factors identified in this study (stage, LDH, primary site) for decreased EFS in C & A mature B-NHL will form the basis of the next risk adapted international pediatric mature B-NHL trial. No significant financial relationships to disclose.

Risk factors for peritoneal recurrence in serosa-negative gastric cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 19-19 ◽  
Author(s):  
Hayato Omori ◽  
Yuichiro Miki ◽  
Wataru Takagi ◽  
Fumiko Hirata ◽  
Taichi Tatsubayashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Independent Risk Factor ◽  
Peritoneal Recurrence ◽  
Node Metastasis ◽  
Gastric Cancer Patients

19 Background: Peritoneal recurrence is often observed in gastric cancer patients without serosal invasion. It is difficult for pathologists to evaluate whether tumor cells penetrate serosa or not, because the subserosa layer is very thin. We evaluated the incidence and risk factors of peritoneal recurrence in serosa -negative gastric cancer patients to clarify the mechanism of peritoneal recurrence in these patients. Methods: A total of 1,745 gastric cancer patients underwent R0 resection from 2002 to 2009 were enrolled. The incidence of peritoneal recurrence according to tumor depth was analyzed. In serosa-nagative patients, the univariate and multivariate analysis were performed to identify the risk factors for peritoneal recurrence. Results: Peritoneal recurrence was observed in 64 (3.7 %) out of 1,745 patients. The incidence of peritoneal recurrence according to depth of tumor invasion was in 0 / 466 in T1a, 5 / 567 (0.88 %) in T1b, 4 / 187 (2.1 %) in T2, 31 / 360 (7.9 %) in T3, 20 / 108 (15.9 %) in T4a, and 4 / 12 (25 %) in T4b, respectively (p<0.001). As for the risk factor for peritoneal recurrence in T3 patients, histologically undifferentiated type, negative lymphatic invasion, scirrhous type, invasive infiltrating growth pattern were the significant factors identified by univariate analysis. Only the invasive infiltrating growth pattern (OR3.44 p0.038) was selected as significant independent risk factor for peritoneal recurrence by multivariate analysis. In T1b / T2 patients, massive lymph node metastasis (N3a, 3b), scirrhous type were the significant factor for peritoneal recurrence by univariate analysis. Only massive lymph node metastasis (OR25.1 p<0.001) was selected as the significant independent risk factor by multivariate analysis. Conclusions: The incidence of peritoneal recurrence increases in proportion to the tumor depth. Invasive infiltrating growth pattern was selected as an independent risk factor for peritoneal recurrence in T3 patients, while it was massive lymph node metastasis in T1b / T2 patients. The results suggest the possibility that microscopic serosal invasion in T3 tumor and lymphatic progression in T1b / T2 tumor may contribute to peritoneal recurrence in gastric cancer.

scholarly journals Risk factors for unsuccessful removal of central venous access ports implanted in the forearm of adult oncologic patients

2021 ◽  
Author(s):  
Mitsuhiro Kinoshita ◽  
Shoichiro Takao ◽  
Junichiro Hiraoka ◽  
Katsuya Takechi ◽  
Yoko Akagawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Central Venous Access ◽  
Univariate Analysis ◽  
Venous Access ◽  
Central Venous ◽  
Significant Difference ◽  
Oncologic Patients

Abstract Purpose To evaluate the risk factors for unsuccessful removal of a central venous access port (CV port) implanted in the forearm of adult oncologic patients. Materials and methods This study included 97 adult oncologic patients (51 males, 46 females; age range, 30–88 years; mean age, 63.7 years) in whom removal of a CV port implanted in the forearm was attempted at our hospital between January 2015 and May 2021. Gender, age at removal, body mass index, and diagnosis were examined as patient characteristics; and indwelling period, indwelling side, and indication for removal were examined as factors associated with removal of a CV port. These variables were compared between successful and unsuccessful cases using univariate analysis. Then, multivariate analysis was performed to identify independent risk factors for unsuccessful removal of a CV port using variables with a significant difference in the univariate analysis. A receiver-operating characteristics (ROC) curve was drawn for significant risk factors in the multivariate analysis and the Youden index was used to determine the optimum cut-off value for predicting unsuccessful removal of a CV port. Results Removal of CV ports was successful in 79 cases (81.4%), but unsuccessful in 18 cases (18.6%) due to fixation of the catheter to the vessel wall. Multivariate logistic regression analysis showed that the indwelling period (odds ratio 1.048; 95% confidence interval 1.026–1.070; P < 0.0001) was a significant independent risk factor for unsuccessful removal of a CV port. ROC analysis showed that the cut-off value for successful removal was 41 months, and 54% of cases with an indwelling period > 60 months had unsuccessful removal. Conclusion The indwelling period is an independent risk factor for unsuccessful removal of a CV port implanted in the forearm of adult oncologic patients, with a cut-off of 41 months.

scholarly journals Prognostic Factors of Colorectal Cancer: A Comparative Study on Patients With or Without Liver Metastasis

2021 ◽  
Vol 11 ◽  
Author(s):  
Honghua Peng ◽  
Guifeng Liu ◽  
Ying Bao ◽  
Xi Zhang ◽  
Lehong Zhou ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Risk Factor ◽  
Liver Metastasis ◽  
Adjuvant Therapy ◽  
Independent Risk Factor ◽  
Stage Iv ◽  
Genetic Alterations ◽  
Stage Ii ◽  
Independent Risk Factors

BackgroundRadical or palliative surgery with subsequent adjuvant therapy is the routine treatment for stage II/III colorectal cancer(CRC) and some stage IV CRC patients. This study aimed to clarify the prognostic clinicopathological and genetic factors for these patients.MethodsFifty-five stage II-IV CRC patients undergoing surgery and adjuvant therapy were recruited, including patients without liver metastasis(5 at stage II, 21 at stage III) and with liver metastasis(29 at stage IV). Genetic alterations of the primary cancer tissues were investigated by whole exome sequencing(WES). Patients were followed up to 1652 days(median at 788 days).ResultsThe mutational landscape of primary CRC tissue of patients with or without liver metastasis was largely similar, although the mutational frequency of TRIM77 and TCF7L2 was significantly higher in patients with liver metastasis. Several main driver gene co-mutations, such as TP53-APC, APC-KRAS, APC-FRG1, and exclusive mutations, such as TP53-CREBBP, were found in patients with liver metastasis, but not in patients without liver metastasis. No significant difference was found between the two groups in aberrant pathways. If stage II-IV patients were studied altogether, relapse status, SUPT20HL1 mutations, Amp27_21q22.3 and Del8_10q23.2 were independent risk factors(P&lt;0.05). If patients were divided into two groups by metastatic status, surgery types and Amp6_20q13.33 were independent risk factors for patients without liver metastasis(P&lt;0.05), while TRIM77 mutations were the only independent risk factor for patients with liver metastasis(P&lt;0.05).ConclusionsSurgery types and Amp6_20q13.33 were independent risk factors for CRC patients without liver metastasis, and TRIM77 mutations were the independent risk factor for CRC patients with liver metastasis.

Abstract 456: Increasing the Compression Velocity and Acceleration Improved the Quality of Simulated Chest Compression Under the Direction of Real Time Visual Feedback Device

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Yu Cao ◽  
Yarong He ◽  
Peng Yao
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Linear Regression ◽  
Real Time ◽  
Visual Feedback ◽  
Chest Compression ◽  
Independent Risk Factor ◽  
Baseline Test ◽  
Independent Risk Factors

Background: To investigate whether a real-time visual feedback device could improve the quality of chest compression (CC), and, if so, whether the mechanism is associated with dynamic indexes such as velocity and acceleration. Methods: A self-control trial of 2-minutes CC on a manikin by trained rescuers compared the quality of CC without or with a visual feedback device. Demographic characteristics were recorded and CC metrics for the two tests were computed. Multivariable linear regression analyses were performed to examine the impact of variables on rate of qualified chest compression (RQCC). Multivariable logistic regression was performed to determine independent risk factors for achieving qualified chest compression (QCC) in the second test. Results: A total of 159 participants (average age: 29.36±9.0 years, 80 (50.3%) men) were recruited. RQCC of the second test was significantly greater than that of the baseline test. Multivariable linear regression analysis showed that maximum compression velocity (V compression ) and maximum compression velocity (a compression ) were independent risk factors for RQCC for both tests. The mean V compression and a compression of the second test were significantly greater than those of the baseline test. However, V compression was the only independent risk factor predicting QCC achievement during the second test. ROC curve analysis showed the area under curve (AUC) was0.84,and the optimal cut-offvalue ofV compression was 39.48 cm/s. Conclusions: Increasing the V compression and a compression might improve the quality of simulated CC and should be recommended to improve QCC. Only V compression was an independent risk factor for achieving QCC during CC with a visual feedback device.

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