Blood group AB and factor V Leiden as risk factors for pre-eclampsia: A population-based nested case-control study

Abstract Purpose Postoperative bleeding after thyroid surgery remains a potentially lethal complication. Outpatient thyroidectomy is an increasing trend in the high volume centers. There is a need to identify risk factors for postoperative bleeding in order to select proper patients for outpatient thyroidectomy. This study aimed to investigate this issue using a national population-based register. Material and method A nested case-control study on patients registered in the Swedish national register for endocrine surgery (SQRTPA) was performed. Patients with postoperative bleeding were matched 1:1 by age and gender to controls. Additional information on cases and controls was obtained from attending surgeons using a questionnaire. Risk factors for postoperative bleeding were evaluated with logistic regression and are presented as odds ratios (ORs) with 95% confidence intervals (CIs). The time of bleeding in relation to surgery was also investigated. Results There were 9494 operations, and 174 (1.8%) of them involved postoperative bleeding. In the whole cohort, patients with postoperative bleeding were older, 58 (46–69) vs. 49 (37–62) years, than patients without, p < 0.01. Male patients had a higher risk of bleeding, OR 2.18 (95% CI 1.58–2.99). In the case-control cohort, drain was an independent risk factor for bleeding, OR 1.64 (1.05–2.57). Two-thirds of patients bled within 6 h after surgery. The incidence of bleeding after 24 h was 10%. Conclusion High age, male gender, and drain are independent risk factors for bleeding after thyroid surgery. Even with careful patient selection, prolonged observation might be necessary in thyroid surgery.

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1396. Risk Factors for Brain Abscess: A Nationwide Population-based Nested Case–Control Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1260 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S507-S508

Author(s):

Jacob Bodilsen ◽

Michael Dalager-Pedersen ◽

Diederik van de Beek ◽

Matthijs C Brouwer ◽

Henrik Nielsen

Keyword(s):

Risk Factors ◽

Brain Abscess ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Population Attributable Fractions ◽

Attributable Fractions ◽

Nested Case Control ◽

Population Controls ◽

Control Study

Abstract Background Knowledge of risk factors for brain abscess is limited and relies on single-center cohorts without control groups. Methods We accessed nationwide medical registries to conduct a population-based nested case–control study of risk factors for brain abscess. We applied risk set sampling for selection of population controls (1:10) individually matched by age, sex, and area of residence. Conditional logistic regression was used to compute adjusted odds ratios (aOR) with 95% confidence intervals (CIs). Next, population attributable fractions were calculated. Results We identified 1,384 brain abscess patients in Denmark from 1982 through 2016 and 13,839 matched population controls. The median age was 50 years (interquartile range 33–63) and 37% were female. Cases often had a Charlson comorbidity score>2 (16%) compared with controls (3%). Adjusted ORs were: head trauma 2.15 (1.72–2.70), neurosurgery 19.3 (14.3–26.0), dental infection 4.61 (3.39–6.26) or surgery 2.57 (1.71–3.84), ear-nose-throat infection 3.81 (3.11–4.67) or surgery 2.85 (2.21–3.70), congenital heart disease 15.6 (9.57–25.4), diabetes mellitus 1.74 (1.33–2.29), alcohol abuse 2.22 (1.58–3.11), liver disease 2.37 (1.53–3.68), kidney disease 2.04 (1.30–3.20), and lung abscess or bronchiectasis 8.15 (3.59–18.5). The aORs were 4.12 (3.37–5.04) and 8.77 (5.66–13.6) for solid and hematological cancer, 12.0 (6.13–23.7) for HIV, and 5.71 (4.22–7.75) for immuno-modulating treatments. Risks were twice as high when risk factors were observed within 5 years before brain abscess. Population attributable fractions showed that neurosurgery (12%), solid cancer (11%), ear-nose-throat infections (7%) and immuno-modulating treatments (5%) were substantial contributors to occurrence of brain abscess. Conclusion Important risk factors included neurosurgery, cancer, ear-nose-throat infections and immuno-modulating treatments Disclosures All authors: No reported disclosures.

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