Risk factors for a poor outcome among children admitted with clinically severe pneumonia to a university hospital in Rabat, Morocco

Abstract Introduction Guadeloupe, a French West Indies island, has been fiercely affected by two large waves of COVID.Therapeutic approach was different between the two waves in the intensive care unit (ICU). We aimed to compare the two different periods in terms of characteristics and outcomes and to evaluate risk factors associated with 60-day mortality in our overall cohort. Methods All consecutive patients with laboratory confirmed COVID-19 pneumonia and requiring oxygen support admitted in our ICU unit of University Hospital of Guadeloupe were prospectively included. Patients were treated during the first wave with a combination of Hydroxychloroquine and Azithromycin and during the second wave with dexamethasone and reinforced anticoagulation. Results In our cohort, 187 patients were included, 31 during the first one and 156 during the second. Patients were mostly male (69%) with a median age of 64years old. Patients tend to be younger during the second wave and body mass index was higher (respectively 31 vs 27kg/m2, p=0.01). Overall mortality at Day 60 was high (45%) and not different between the two waves. Among patients under mechanical ventilation risk factors associated with death in a multivariate analysis were a high number of comorbidities, a high level of SOFA score and the delay of invasive mechanical ventilation (IMV) onset after admission in ICU (OR=1.6 (95% CI 1.2 – 2.4). Conclusion Although therapeutics approach evolve, COVID-19 severe pneumonia is still associated with a high mortality rate in ICU.

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Etiology and Risk Factors Determining Poor Outcome of Severe Pneumonia in Under–Five Children

The Indian Journal of Pediatrics ◽

10.1007/s12098-017-2514-y ◽

2017 ◽

Vol 85 (1) ◽

pp. 20-24 ◽

Cited By ~ 3

Author(s):

Suresh Kumar Jakhar ◽

Mukul Pandey ◽

Dheeraj Shah ◽

V. G. Ramachandran ◽

Rumpa Saha ◽

...

Keyword(s):

Risk Factors ◽

Severe Pneumonia ◽

Under Five ◽

Under Five Children ◽

Poor Outcome

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Preoperative bacterial culture can predict severe pneumonia in patients receiving esophagectomy

10.21203/rs.3.rs-944696/v1 ◽

2021 ◽

Author(s):

Akinao Kaneta ◽

Takahiro Sato ◽

Hiroshi Nakano ◽

Takuro Matsumoto ◽

Takeshi Tada ◽

...

Keyword(s):

Risk Factors ◽

Confidence Interval ◽

Odds Ratio ◽

Pathogenic Bacteria ◽

Bacterial Culture ◽

Severe Pneumonia ◽

Wilcoxon Test ◽

University Hospital ◽

Postoperative Pneumonia ◽

Categorical Variables

Abstract Background Postoperative pneumonia is one of the major complications after esophagectomy. The aim of this study was to determine whether bacterial cultures before esophagectomy could predict occurrence of postoperative pneumonia and help treatment strategies for postoperative pneumonia. Methods Sixty-nine patients who underwent subtotal esophagectomy at Fukushima Medical University hospital between January 2017 and May 2021 were included in this study. We collected sputum, oral and/or nasopharyngeal swabs for bacterial culture preoperatively from all patients and from those who were suspected of postoperative pulmonary infections. We compared cultured pathogenic bacteria obtained preoperatively and postoperatively from patients who developed postoperative pneumonia, and investigated their association with incidence of postoperative pneumonia. Fisher’s exact test was used to compare categorical variables between groups, and Wilcoxon test was used to compare continuous variables. Risk factors for postoperative pneumonia and severe pneumonia were analyzed using multivariate logistic regression models. Results Postoperative pneumonia occurred in 22 (31%) of the 69 patients, and 13 of the 22 patients were classified as with severe pneumonia. Multivariate analysis revealed that longer operative duration (for 30 minutes increase; odds ratio 1.27, 95% confidence interval 1.01–1.51, p=0.039) and positivity for preoperative bacterial culture (odds ratio 5.03, 95% confidence interval 1.31–19.2, p=0.018) were independent risk factors for severe postoperative pneumonia, but not for all incidence of postoperative pneumonia. Of note, in only 5 out of the 22 patients with pneumonia, the same pathogen species were detected preoperatively and after the onset of pneumonia. Conclusions In conclusion, our results implied that preoperative bacterial culture may be useful to predict severe postoperative pneumonia. However, it may not be useful in determining pathogenic bacteria responsible for postoperative pneumonia.

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Epidemiology of drowning incidents among children at Sultan Qaboos University Hospital Muscat, Oman

Oman Medical Journal ◽

10.5001/omj.2021.104 ◽

2021 ◽

Author(s):

Niranjan Lal Jeswani ◽

Muhammad Faisal Khilji ◽

Syed Rizvi ◽

Abdullah Al Reesi

Keyword(s):

Risk Factors ◽

Cardiopulmonary Resuscitation ◽

Univariate Analysis ◽

Cerebral Performance Category ◽

University Hospital ◽

Neurological Injury ◽

Swimming Ability ◽

Sultan Qaboos University ◽

Poor Outcome ◽

Adult Supervision

Objectives: To study the epidemiology of drowning among children cases reported at Sultan Qaboos University Hospital in Oman. Methods: We conducted a retrospective study of the patients who were presented at emergency department with the history of drowning over a period of 10 years from January 2008 to December 2017. Patients with age 1 to 18 years were included in the study. The data including demographics, timing and location of drowning, season, adult supervision, swimming ability, medical risk factors, duration of submersion, on spot resuscitation, emergency medicine department assessment, hospital management and outcome were collected from electronic hospital information system using a preformed proforma. Outcome was categorized into either full recovery, severe neurological injury or brain death based on the pediatric cerebral performance category (PCPC). A good outcome represents to a score of 1-3 points and PCPC 2 of 4-6 points corresponds to poor outcome. We calculated correlation for all variables with the outcome by using chi square and fisher exact tests. P value of <0.05 is taken as significant value. Results: A total of 74 patients were included in the study. Of them, 54 (73%) were male, children of less than six years of age were 47 (63.5%). More than 50% of drownings happened in outside swimming pool, 21 (28.4%) of patients were unsupervised during incident and 39 (52.7%) required cardiopulmonary resuscitation. Out of all studied subjects, 3 (4%) were brain dead and 2 (2.7%) developed severe neurological injury. On univariate analysis, the following variables were statistically significant (p<0.05) predicting the poor outcome like lack of adult supervision, duration of submersion >10 minutes, asystole, Glasgow Coma Scale <8, temperature <35c, PH <7, anion gap >20, blood glucose >10 mmol/L, abnormal chest x-ary findings, rewarming, cardiopulmonary resuscitation, intubation, inotrope support and pediatric intensive care unit admission. Conclusion: This study suggests that children especially male below 6 years of age without swimming ability need strict supervision next to body of water. Furthermore; preventive measures might include raising community awareness about the risk factors of drowning, commencing public CPR lessons and strict pool safety regulation by related authorities.

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Risk factors of poor outcome after surgical treatment of chronic constrictive pericarditis in a single-centre cohort

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0034-1367149 ◽

2014 ◽

Vol 62 (S 01) ◽

Author(s):

K. Penov ◽

C. Busch ◽

P.A. Amorim ◽

J. Garbade ◽

A. Rastan ◽

...

Keyword(s):

Risk Factors ◽

Surgical Treatment ◽

Constrictive Pericarditis ◽

Single Centre ◽

Poor Outcome

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Risk factors for poor outcome after ECMO treatment of low cardiac output after cardiac surgery

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-2007-967647 ◽

2007 ◽

Vol 55 (S 1) ◽

Author(s):

S Deiters ◽

H Welp ◽

J Graf ◽

A Löher ◽

S Schneider ◽

...

Keyword(s):

Risk Factors ◽

Cardiac Output ◽

Cardiac Surgery ◽

Low Cardiac Output ◽

Poor Outcome ◽

Ecmo Treatment

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Risk Factors and Outcome of Pretrem Labor in Pregnant Women Attending Zagazig Maternity University Hospital

Zagazig University Medical Journal ◽

10.21608/zumj.2020.22658.1699 ◽

2020 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Hassan Hassan Nassar ◽

Ali Ali ◽

Sherin Shazly ◽

Ahmed Mansour

Keyword(s):

Risk Factors ◽

Pregnant Women ◽

University Hospital

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Prevalence of and Risk Factors for Low Free Testosterone Levels in Japanese Men with Well-controlled Human Immunodeficiency Virus Infection

Current HIV Research ◽

10.2174/1570162x18666200720000344 ◽

2020 ◽

Vol 18 (5) ◽

pp. 381-386

Author(s):

Yusuke Yoshino ◽

Ichiro Koga ◽

Yoshitaka Wakabayashi ◽

Takatoshi Kitazawa ◽

Yasuo Ota

Keyword(s):

Risk Factors ◽

Human Immunodeficiency Virus ◽

Standard Deviation ◽

Hiv Infection ◽

Free Testosterone ◽

Serum Levels ◽

University Hospital ◽

Rapid Decline ◽

Total Testosterone ◽

Immunodeficiency Virus

Background: The change in the prevalence of hypogonadism with age in men with human immunodeficiency virus (HIV) infection is subject to debate. Objective: To address this issue, we diagnosed hypogonadism based on serum levels of free testosterone (fTST) rather than total testosterone which is thought to be an inaccurate indicator. We also determined the relationship between age and fTST levels and identified risk factors for hypogonadism in men with HIV infection. Method: We retrospectively reviewed fTST levels and associated clinical factors in 71 wellcontrolled HIV-infected men who were treated at Teikyo University Hospital between April 2015 and March 2016 and who had data available on serum fTST levels, measured >6 months after starting antiretroviral therapy. fTST was measured using radioimmunoassay on blood samples collected in the morning. Risk factors for hypogonadism were identified using Welch’s t-test and multiple regression analysis. Results: The men had a mean (± standard deviation) age of 47.4 ± 13.6 years, and mean (± standard deviation) serum fTST level of 13.0 ± 6.1 pg/mL. Fifteen (21.1%) men had hypogonadism based on a fTST <8.5 pg/mL. Serum fTST levels significantly decreased with age (−0.216 pg/mL/year). Older age and low hemoglobin levels were identified as risk factors for hypogonadism. Conclusion: The men in the study experienced a more rapid decline in fTST levels with age than men in the general population (−0.161 pg/mL/year). Serum fTST levels in men with HIV infection should be monitored, especially in older men and those with low hemoglobin levels.

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A-126 Clinical Utility of Risk Factors to Predict Self-reported Neurobehavioral Outcome Following Traumatic Brain Injury: PTSD, Sleep, Resilience, and Lifetime Blast Exposure

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa068.126 ◽

2020 ◽

Vol 35 (6) ◽

pp. 919-919

Author(s):

Lange R ◽

Lippa S ◽

Hungerford L ◽

Bailie J ◽

French L ◽

...

Keyword(s):

Risk Factors ◽

Traumatic Brain Injury ◽

Risk Factor ◽

Brain Injury ◽

Clinical Utility ◽

Poor Sleep ◽

Post Injury ◽

Poor Outcome ◽

Blast Exposure ◽

Neurobehavioral Outcome

Abstract Objective To examine the clinical utility of PTSD, Sleep, Resilience, and Lifetime Blast Exposure as ‘Risk Factors’ for predicting poor neurobehavioral outcome following traumatic brain injury (TBI). Methods Participants were 993 service members/veterans evaluated following an uncomplicated mild TBI (MTBI), moderate–severe TBI (ModSevTBI), or injury without TBI (Injured Controls; IC); divided into three cohorts: (1) < 12 months post-injury, n = 237 [107 MTBI, 71 ModSevTBI, 59 IC]; (2) 3-years post-injury, n = 370 [162 MTBI, 80 ModSevTBI, 128 IC]; and (3) 10-years post-injury, n = 386 [182 MTBI, 85 ModSevTBI, 119 IC]. Participants completed a 2-hour neurobehavioral test battery. Odds Ratios (OR) were calculated to determine whether the ‘Risk Factors’ could predict ‘Poor Outcome’ in each cohort separately. Sixteen Risk Factors were examined using all possible combinations of the four risk factor variables. Poor Outcome was defined as three or more low scores (< 1SD) on five TBI-QOL scales (e.g., Fatigue, Depression). Results In all cohorts, the vast majority of risk factor combinations resulted in ORs that were ‘clinically meaningful’ (ORs > 3.00; range = 3.15 to 32.63, all p’s < .001). Risk factor combinations with the highest ORs in each cohort were PTSD (Cohort 1 & 2, ORs = 17.76 and 25.31), PTSD+Sleep (Cohort 1 & 2, ORs = 18.44 and 21.18), PTSD+Sleep+Resilience (Cohort 1, 2, & 3, ORs = 13.56, 14.04, and 20.08), Resilience (Cohort 3, OR = 32.63), and PTSD+Resilience (Cohort 3, OR = 24.74). Conclusions Singularly, or in combination, PTSD, Poor Sleep, and Low Resilience were strong predictors of poor outcome following TBI of all severities and injury without TBI. These variables may be valuable risk factors for targeted early interventions following injury.

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