scholarly journals Retrospective Study of Postoperative Pulmonary Complications in Patients with Cervical Spine Pathology

2018 ◽  
Vol 05 (02) ◽  
pp. 98-104 ◽  
Author(s):  
Surya Kumar Dube ◽  
Mihir Prakash Pandia ◽  
Arvind Chaturvedi ◽  
Shailender Kumar
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Cervical Spine ◽  
Retrospective Study ◽  
Pulmonary Complications ◽  
Postoperative Pulmonary Complication ◽  
Care Hospital ◽  
Cervical Laminectomy ◽  
Independent Risk Factors ◽  
Postoperative Mechanical Ventilation

Abstract Background Postoperative pulmonary complication (PPC) after cervical spine surgery is known to increase patient morbidity and mortality as well as the hospital and intensive care unit (ICU) stay. However, studies addressing this issue are scarce in the current literature. The aim of this study was to find out the incidence and various factors associated with PPC in patients undergoing cervical spine surgeries. Materials and Methods It is a retrospective study in a tertiary care hospital. Two hundred and seven patients who underwent different cervical spinal surgeries were included in this study. Various perioperative data including demography, history of smoking, associated systemic illness, type and site of lesion, preoperative respiratory status, and signs of involvement of lower cranial nerves were collected. The incidence and the risk factors for PPC were found out. Statistical analysis was done using chi-square/Fisher's exact test/Student's t-test, followed by univariate and multiple logistic regression analysis. Results The incidence of PPC in our study was 39.6%. Various pulmonary complications observed were difficulty in breathing requiring some intervention (19.3%), pneumonia (5.3%), tracheobronchitis (3.9%), arterial desaturation (3.4%), reintubation (3.4%), atelectasis (1.3%), pleural effusion (0.97%), pneumothorax (0.97%), and acute respiratory distress syndrome (ARDS) (0.97%). Preoperative respiratory abnormality, cervical laminectomy and instrumentation surgery and postoperative mechanical ventilation of > 24 hours duration were found to be independent risk factors for occurrence of PPC. Conclusions The patients with cervical spinal cord pathology are at increased risk for PPC. Preoperative respiratory abnormality, postoperative mechanical ventilation of > 24-hour duration, and cervical laminectomy and instrumentation surgery are independent risk factors for PPC.

scholarly journals Age-Related Risk Factors and Complications of Patients With COVID-19: A Population-Based Retrospective Study

2022 ◽  
Vol 8 ◽  
Author(s):  
Han Zhang ◽  
Yingying Wu ◽  
Yuqing He ◽  
Xingyuan Liu ◽  
Mingqian Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Population Based ◽  
Male Gender ◽  
Poor Correlation ◽  
Age Related ◽  
Related Risk ◽  
Independent Risk Factors

Objective: To study the differences in clinical characteristics, risk factors, and complications across age-groups among the inpatients with the coronavirus disease 2019 (COVID-19).Methods: In this population-based retrospective study, we included all the positive hospitalized patients with COVID-19 at Wuhan City from December 29, 2019 to April 15, 2020, during the first pandemic wave. Multivariate logistic regression analyses were used to explore the risk factors for death from COVID-19. Canonical correlation analysis (CCA) was performed to study the associations between comorbidities and complications.Results: There are 36,358 patients in the final cohort, of whom 2,492 (6.85%) died. Greater age (odds ration [OR] = 1.061 [95% CI 1.057–1.065], p < 0.001), male gender (OR = 1.726 [95% CI 1.582–1.885], p < 0.001), alcohol consumption (OR = 1.558 [95% CI 1.355–1.786], p < 0.001), smoking (OR = 1.326 [95% CI 1.055–1.652], p = 0.014), hypertension (OR = 1.175 [95% CI 1.067–1.293], p = 0.001), diabetes (OR = 1.258 [95% CI 1.118–1.413], p < 0.001), cancer (OR = 1.86 [95% CI 1.507–2.279], p < 0.001), chronic kidney disease (CKD) (OR = 1.745 [95% CI 1.427–2.12], p < 0.001), and intracerebral hemorrhage (ICH) (OR = 1.96 [95% CI 1.323–2.846], p = 0.001) were independent risk factors for death from COVID-19. Patients aged 40–80 years make up the majority of the whole patients, and them had similar risk factors with the whole patients. For patients aged <40 years, only cancer (OR = 17.112 [95% CI 6.264–39.73], p < 0.001) and ICH (OR = 31.538 [95% CI 5.213–158.787], p < 0.001) were significantly associated with higher odds of death. For patients aged >80 years, only age (OR = 1.033 [95% CI 1.008–1.059], p = 0.01) and male gender (OR = 1.585 [95% CI 1.301–1.933], p < 0.001) were associated with higher odds of death. The incidence of most complications increases with age, but arrhythmias, gastrointestinal bleeding, and sepsis were more common in younger deceased patients with COVID-19, with only arrhythmia reaching statistical difference (p = 0.039). We found a relatively poor correlation between preexisting risk factors and complications.Conclusions: Coronavirus disease 2019 are disproportionally affected by age for its clinical manifestations, risk factors, complications, and outcomes. Prior complications have little effect on the incidence of extrapulmonary complications.

scholarly journals Incidence and Risk Factors for Severe Dehydration in Hospitalized Children in Ujjain, India

2020 ◽  
Author(s):  
Abhishek Sharma ◽  
Aditya Mathur ◽  
Cecilia Stålsby Lundborg ◽  
Ashish Pathak
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
World Health ◽  
Respiratory Pattern ◽  
Care Hospital ◽  
Severe Dehydration ◽  
Cross Sectional ◽  
Oral Rehydration ◽  
History Of ◽  
Independent Risk Factors

Diarrhoea contributes significantly in the under-five childhood morality and mortality worldwide. This cross-sectional study was carried out in a tertiary care hospital in Ujjain, India from July 2015 to June 2016. Consecutive children aged 1 month to 12 years having “some dehydration” and “dehydration” according to World Health Organization classification were eligible to be included in the study. Other signs and symptoms used to assess severe dehydration were capillary refill time, urine output, and abnormal respiratory pattern. A questionnaire was administered to identify risk factors for severe dehydration, which was the primary outcome. Multivariate logistic regression modeling was used to detect independent risk factors for severe dehydration. The study included 332 children, with mean ± standard deviation age of 25.62 ± 31.85 months; out of which, 70%(95% confidence interval [CI] 65 to 75) were diagnosed to have severe dehydration. The independent risk factors for severe dehydration were: child not exclusive breast fed in the first six months of life (AOR 5.67, 95%CI 2.51 to 12.78; p<0.001), history of not receiving oral rehydration solution before hospitalization (AOR 1.34, 95%CI 1.01 to 1.78; p=0.038), history of not receiving oral zinc before hospitalization (AOR 2.66, 95%CI 1.68 to 4.21; p<0.001) and living in overcrowded conditions (AOR 5.52, 95%CI 2.19 to 13.93; p<0.001). The study identified many risk factors associated with severe childhood dehydration; many of them are modifiable though known and effective public health interventions.

Profiling of the Risk Factors and Designing of a Model to Identify Ischemic Stroke in Patients with Non-Hodgkin Lymphoma: A Multicenter Retrospective Study

2020 ◽  
Vol 83 (1) ◽  
pp. 41-48
Author(s):  
Yunfei Wei ◽  
Qingqing Yang ◽  
Qixiong Qin ◽  
Ya Chen ◽  
Xuemei Quan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Retrospective Study ◽  
Hodgkin Lymphoma ◽  
Multiple Logistic Regression Analysis ◽  
Elevated Serum ◽  
Non Hodgkin Lymphoma ◽  
Independent Risk Factors ◽  
Identification Model ◽  
D Dimer

Background: The occurrence of ischemic stroke in patients with non-Hodgkin lymphoma (NHL) is not well understood. This study aimed to determine independent risk factors to identity ischemic stroke in non-Hodgkin lymphoma-associated ischemic stroke (NHLAIS) patients. Methods: This retrospective study was conducted on NHLAIS patients and age- and gender-matched NHL patients. We collected clinical data of patients in both groups and used multiple logistic regression analysis to identify independent risk factors for NHLAIS. A receiver operating characteristic (ROC) analysis was used to establish an identification model based on potential risk factors of NHLAIS. Results: Sixty-three NHLAIS patients and 63 NHL patients were enrolled. Stage III/IV (58/63, 92.1%) and multiple arterial infarcts (44/63, 69.8%) were common among NHLAIS patients. Notably, NHLAIS patients had higher levels of serum fibrinogen (FIB), D-dimer, and ferritin (SF) and prolonged thromboplastin time and prothrombin time (PT) compared with NHL patients (all p < 0.05). Elevated FIB, D-dimer, and SF and prolonged PT were independent risk factors for NHLAIS. The area under the ROC curve of the identification model of NHLAIS patients was largest compared to that of other risk factors (0.838, 95% confidence interval: 0.759–0.899) (p < 0.05). Conclusion: This study reveals that elevated serum FIB, D-dimer, and SF and prolonged PT are potential independent risk factors of NHLAIS. The identification model established in this study may help monitor NHL patients who are at high risk of developing NHLAIS.

scholarly journals P.091 Anterior surgical fixation for cervical spine flexion-distraction injuries

2017 ◽  
Vol 44 (S2) ◽  
pp. S36-S37
Author(s):  
AS Jack ◽  
G Choy ◽  
G Hardy St-Pierre ◽  
R Fox ◽  
A Nataraj
Keyword(s):  
Risk Factors ◽  
Cervical Spine ◽  
Failure Criteria ◽  
Posterior Fixation ◽  
Cervical Spine Injuries ◽  
Failure Data ◽  
Number Of Patients ◽  
Surgical Fixation ◽  
Independent Risk Factors ◽  
Anterior Posterior

Background: Optimal surgical management for flexion--distraction cervical spine injuries remains controversial with anterior, posterior, and circumferential fixation being accepted. Here, we examined risk factors for clinical and radiographic failure in patients with one segment cervical flexion-distraction injuries having undergone anterior surgical fixation. Methods: A retrospective review of 57 consecutive patients undergoing anterior fixation for cervical flexion-distraction injuries between 2008-2012 was performed. The primary outcome was the number of patients requiring additional surgical stabilization and/or radiographic failure. Data collected inlcuded age, gender, mechanism and level of injury, facet pattern injury, and vertebral endplate fracture. Results: Six patients failed clinically and/or radiographically (11%). Four patients (7%) required additional posterior fixation. Two patients identified met radiographic failure criteria, however had fused radiographically, were stable clinically, and no further treatment was pursued. Progressive kyphosis and translation correlated with need for revision (p<0.05 and p=0.02, respectively). No differences were identified for all other clinical and radiological factors assessed. Conclusions: This study supports the growing body of evidence for anterior fixation alone for flexion-distraction injuries. Findings suggest that measurements including segmental translation and kyphosis may predict radiographic failure and need for further surgical stabilization in some patients. Assessment for independent risk factors for anterior approach failure with a validated predictive scoring model should be considered.

Risk factors for recurrence of scabies: A retrospective study of scabies patients in a long-term care hospital

2011 ◽  
pp. no-no ◽  
Author(s):  
Kuniko MAKIGAMI ◽  
Noriko OHTAKI ◽  
Norihisa ISHII ◽  
Tetsuko TAMASHIRO ◽  
Sadao YOSHIDA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Long Term Care ◽  
Care Hospital ◽  
Term Care ◽  
Risk Factors For Recurrence

Safety of Biologic Agents in Elderly Patients with Rheumatoid Arthritis

2016 ◽  
Vol 43 (11) ◽  
pp. 1984-1988 ◽  
Author(s):  
Atsuko Murota ◽  
Yuko Kaneko ◽  
Kunihiro Yamaoka ◽  
Tsutomu Takeuchi
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Adverse Events ◽  
Elderly Patients ◽  
Young Patients ◽  
Pulmonary Complications ◽  
Biologic Agents ◽  
Treatment Withdrawal ◽  
Old Patients ◽  
Independent Risk Factors

Objective.To clarify the safety of biologics in elderly patients with rheumatoid arthritis.Methods.Biologics were analyzed for safety in relation to age in 309 patients.Results.Young (< 65 yrs old, n = 174), elderly (65–74 yrs old, n = 86), and older elderly patients (≥ 75 yrs old, n = 49) were enrolled. Although the incidence of adverse events causing treatment withdrawal was significantly higher in elderly and old elderly compared with young patients, no difference was found between elderly and older elderly patients. Pulmonary complications were independent risk factors.Conclusion.Old patients require special attention, although the safety of biologics in those ≥ 75 years old and 65–74 was comparable.

scholarly journals Risk Factors and Reasons for Treatment Abandonment for Patients With Esophageal Atresia: A Study From a Tertiary Care Hospital in Beijing, China

2021 ◽  
Vol 9 ◽  
Author(s):  
Shen Yang ◽  
Junmin Liao ◽  
Siqi Li ◽  
Kaiyun Hua ◽  
Peize Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Surgical Repair ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Unplanned Admission ◽  
Independent Risk Factors ◽  
Treatment Abandonment

Background: This study aims to identify the risk factors and reasons for treatment abandonment for patients with esophageal atresia (EA) in a tertiary care hospital in China.Methods: A retrospective study was conducted on 360 patients with EA admitted to Beijing Children's Hospital between January 1, 2007 and June 1, 2020. Medical records for treatment abandonment and non-treatment abandonment patients were compared. Univariate and multivariate logistic regression analyses were conducted to identify potential risk factors for treatment abandonment.Results: After the diagnosis of EA, parents of 107 patients refused surgical repair and discharged against medical advice, and 253 patients underwent surgical repair. Among these 253 patients, parents of 59 patients abandoned treatment after surgery; 52 patients were discharged in an unstable condition, and parents of seven patients abandoned resuscitation leading to death in the hospital. By comparing clinical characteristics between treatment abandonment before surgery (n = 107) and non-treatment abandonment (n = 253) groups, we found that mother's parity &gt;1, unplanned admission to intensive care unit before surgery, associated anomalies, and Gross type A/B were significant independent risk factors for treatment abandonment before surgery. Furthermore, birth weight &lt;2,545 g, being discharged from neonatal center/intensive care unit and other departments, unplanned admission to intensive care unit after surgery, operative time &gt;133 min, admission before 2016, pneumothorax, and anastomotic leakage were significant independent risk factors for treatment abandonment after surgery. The reasons for treatment abandonment included financial difficulties, multiple malformations with poor prognosis, belief of incurability and concerns about the prognosis of the diseases, postoperative complications, and extensive length of intensive care unit stay.Conclusions: Treatment abandonment of children with EA/TEF is still a common and serious problem in China. This study showed that EA/TEF patients in critical conditions, with associated anomalies, Gross type A/B, and who had occurrence of complications had high-risk for treatment abandonment.

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