Inadequate pain relief with labor epidurals: a multivariate analysis of associated factors

The worldwide prevalence of maintenance hemodialysis continues to rise. An adequate delivery of hemodialysis dose as measured by Kt/V or urea reduction ratio is a crucial determinant of clinical outcome for chronic hemodialysis patients. The aim of this study was to assess the adequacy of hemodialysis and its associated factors among patients undergoing chronic hemodialysis in Dar es Salaam. This was a cross-sectional study done on patients undergoing chronic hemodialysis in four dialysis centers in Dar es Salaam. Sociodemographic information and treatment characteristics were collected. Urea reduction rate and single-pool Kt/V were calculated to determine the adequacy of hemodialysis. The data were analyzed and any associated factors for inadequate hemodialysis were determined using a chi-square test and a logistic regression analysis. A total of 143 patients participated in the study. Males represented 65.7% of the study population. The mean age (±SD) was 51.7 ± 1.2 years. Only 34.3% (based on urea reduction ratio (URR)) and 40.6% (based on Kt/V) of patients received adequate hemodialysis. The univariate analysis showed that males were more likely to have inadequate dialysis (65.6% versus 48.0%, p=0.048 based on Kt/V). Patients using hemodialyzers with dialyzer surface area less than 1.4 m2 received significantly less hemodialysis dose than those with more than 1.4 m2 (69.0% versus 41.2%, p=0.02, by URR) (62.7% versus 35.3%, p=0.03, by Kt/V criteria). Patients who had hemoglobin <10 g/dl received significantly inadequate hemodialysis dose as compared to patients with hemoglobin ≥10 g/dl by Kt/V criteria (69.8% versus 51.3%, p=0.03). None of the factors acquired significance in the multivariate analysis. The proportion of patients receiving an adequate hemodialysis dose is low (34.3% based on URR and 40.6% based on Kt/V). Male gender, dialyzer surface area of <1.4 m2, and hemoglobin level of <10 g/dl were associated with an inadequate delivered dose of hemodialysis in the univariate analysis but not in the multivariate analysis. This study can increase awareness about the importance of measuring hemodialysis adequacy and giving the correct hemodialysis dose to achieve the intended benefit.

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Mortality and Stroke Recurrence in a Rehabilitation Cohort of Patients with Cerebral Infarcts and Chagas Disease

European Neurology ◽

10.1159/000488033 ◽

2018 ◽

Vol 79 (3-4) ◽

pp. 177-184 ◽

Cited By ~ 3

Author(s):

Vinícius Viana Abreu Montanaro ◽

Thiago Falcão Hora ◽

Creuza Maria da Silva ◽

Carla Verônica de Viana Santos ◽

Maria Inacia Ruas Lima ◽

...

Keyword(s):

Multivariate Analysis ◽

Chagas Disease ◽

Associated Factors ◽

Protective Factor ◽

Bladder Dysfunction ◽

Cox Regression ◽

Cumulative Risk ◽

Population Characteristics ◽

Stroke Recurrence ◽

Cox Regression Analysis

Background: Chagas disease is related to ischemic stroke (IS), although few epidemiological studies have evaluated the associated mortality and recurrence. Our objective is to determine factors associated with mortality and recurrence of IS in patients with IS and Chagas disease. Methods: We retrospectively studied data obtained from electronic medical records of patients admitted at SARAH Hospitals across Brazil between 2009 and 2013. Using Cox regression analysis for mortality and logistic regression for recurrence, we assessed primary population characteristics and statistical associations between risk factors and outcomes. Results: We analyzed 279 patients who were followed up until 2016. The mean age at stroke onset was 61 with a 10% frequency of death. Multivariate analysis assessing mortality demonstrated that the associated factors were age at stroke (hazard ratio [HR] 1.04), initial modified Rankin Scale (mRS; HR 20.91), bladder dysfunction (HR 2.51), diabetes mellitus (DM; HR 3.64), and alcoholism (HR 3.37). Multivariate analysis assessing recurrence demonstrated that the associated factors were age at ictus (OR 0.96), cognitive deficit (OR 0.44), initial mRS (OR 1.84), cardioembolic etiology (OR 2.47), and female sex (OR 2.73). Conclusions: Cardiac conditions did not correlate with mortality or recurrence. Age was a protective factor against recurrence, probably due to cumulative risk of IS over time, while initial mRS was associated with both outcomes. Treating diseases such as DM and bladder dysfunction, and early treatment to reduce the initial mRS could potentially prevent both outcomes; also, establishing a correct etiological diagnosis is important.

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Adherence to antiretroviral therapy in children: a study of prevalence and associated factors

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2007001500010 ◽

2007 ◽

Vol 23 (suppl 3) ◽

pp. S424-S434 ◽

Cited By ~ 21

Author(s):

Neiva Isabel Raffo Wachholz ◽

Jair Ferreira

Keyword(s):

Multivariate Analysis ◽

Antiretroviral Therapy ◽

Educational Level ◽

Associated Factors ◽

Rio Grande ◽

Cross Sectional Study ◽

Rio Grande Do Sul ◽

Sectional Study ◽

Porto Alegre ◽

Cross Sectional

The survival of children with AIDS has increased considerably with the use of more effective antiretrovirals, but the benefits of this therapy are limited by the difficulty of adherence to the treatment. This cross-sectional study aimed to estimate the prevalence of non-adherence to antiretrovirals among children residents in Porto Alegre, Rio Grande do Sul State, Brazil, and identifying associated factors. There were 194 child caregivers interviewed. The technique utilized to evaluate adherence allowed the detection of lack of understanding of the prescribed antiretroviral regimens, as well as conscious loss of doses. Non-adherence was defined when the child had taken less than 80% of the prescribed medication during the 24h period prior to the interview. A general prevalence of non-adherence was 49.5%, which was higher than that estimated. The non-institutional caregivers had a prevalence rate of 55.7%, while the institutional caregivers had 22.2%. In multivariate analysis, the education of the caregiver was found to have a borderline association with the outcome. Institutionalized children and those taken care of by people with a higher educational level appeared to have more protection against non-adherence to antiretroviral therapy.

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Prevalence of postpartum depression and associated factors among postnatal care attendees in Debre Berhan, Ethiopia, 2018

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-02873-4 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 5

Author(s):

Abate Dargie Wubetu ◽

Nigus Alemnew Engidaw ◽

Kefyalew Dagne Gizachew

Keyword(s):

Social Support ◽

Multivariate Analysis ◽

Postpartum Depression ◽

Postpartum Period ◽

Postnatal Care ◽

Associated Factors ◽

Close Relative ◽

Debre Berhan ◽

Poor Social Support ◽

A Current

Abstract Background Postpartum depression explains various groups of depressive symptoms and syndromes that can take place during the first 6 weeks following birth. The postpartum period is a critical time where both mild and severe mood disorders can occur. The familiar forms are baby blues and postpartum depression. Understanding the prevalence and associated factors of postpartum depression is mandatory for early detection and treatment. Methods Institution based cross-sectional study was conducted from 1st May to June 30, 2018. The study participants were eligible women who came to Debre Berhan referral hospital and health centers for postnatal care and vaccination service. The Edinburgh postnatal depression scale was used to assess postpartum depression. A systematic random sampling technique was used to collect the data after determining the skip fraction (k = 2). The collected data were coded and entered into Epi-info version 7 and transported to SPSS version 20 for analysis. Both bivariate and multivariate binary logistic regression were done to identify associated factors. During bivariate analysis, variables with p-value < 0.05 were included in multivariate analysis. Odds ratios and their 95% confidence intervals were computed and variables with p-value less than 0.05 were considered to declare significantly associated factors (multivariate analysis). Results A total of 308 mothers who attended postpartum care we're included, which was a 100% response rate. The prevalence of postpartum depression was found to be 15.6% (95%CI = 11.7, 19.8). Being widowed/widower, having poor social support, having a current hospitalized child, and experienced a death of family member or close relative were significantly associated with postpartum depression. Conclusions The prevalence of postpartum depression was lower than most studies done in different areas. Major life events and traumas are associated with an increased risk of postpartum depression. Health professionals should be aware of the mother’s circumstances during the puerperium, they should initiate support to reduce the risk of depression in the postpartum period. Health care professionals working postpartum care clinics should give special attention to mothers who are widowed/widower, have poor social support, have a current hospitalized children, and experienced a death of family member or close relative.

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Factores de riesgo cardiovascular y evolución de pacientes con COVID-19 atendidos en un Hospital Nacional de Referencia de Lima, P

Revista Peruana de Investigación en Salud ◽

10.35839/repis.5.3.1071 ◽

2021 ◽

Vol 5 (3) ◽

pp. 195-200

Author(s):

Germán V. Valenzuela-Rodríguez ◽

Alfonso J. Rodriguez-Morales ◽

Roxana Mamani-Quiroz ◽

Ricardo Ayala-García ◽

Katherine Pérez ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Multivariate Analysis ◽

Cardiovascular Risk ◽

Arterial Hypertension ◽

Cardiovascular Risk Factors ◽

Associated Factors ◽

Myocardial Injury ◽

Bivariate Analysis ◽

Clinical Records

Introduction: Coronavirus disease 2019 (COVID-19) fatal outcomes have been associated with multiple cardiovascular risk factors. In new epidemic areas, such as Latin America, there is a lack of studies about this. Objectives: To evaluate demographic data, signs and symptoms during emergency arrival, prevalence of cardiovascular risk factors, laboratory and ECG findings and their influence in mortality, in a retrospective cohort of patients in a national reference hospital of Lima, Peru. Methods: Review the clinical records of the patients attended at Hospital Rebagliati Hospital during March 6th and April 30th, 2020, using rRT-PCR was used for the detection of the RNA of SARS-CoV-2 following the protocol Charité, Berlin, Germany, from nasopharyngeal swabs at the National Institute of Health. Bivariate analysis and multivariate analysis using logistic regression was done. Values of p < 0.05 were considered significant for all analyses. Results: One hundred six hospitalized patients were evaluated. The mean age of patients was 61.58 years (SD 16.81). Cardiovascular risk factors among them were hypertension (46.2%), diabetes (28.3%), and obesity (28.3%), among others. Fifty-six patients died (52.8%). Mortality associated factors at the multivariate analysis were arterial hypertension (OR=1.343, 95% 1.089-1.667), myocardial injury (OR=1.303, 95% 1.031-1.642), and mechanical ventilation (OR 1.262, 95% 1.034-1.665), as associated factors. Conclusion: Cardiovascular risk factors and cardiovascular signs or symptoms are common during emergency arrival in patients with COVID-19. Arterial hypertension, myocardial injury and mechanical ventilation were associated with mortality in multivariate analysis, as observed in other regions of the world.

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Assessment of Alcohol use Disorder and its Associated Factors among Alcohol users of Medical and Surgical Outpatients Attending a Specialized Hospital in Gondar, Ethiopia: A cross-sectional study

10.21203/rs.3.rs-35754/v2 ◽

2020 ◽

Author(s):

Demeke Demilew ◽

Berhanu Boru ◽

Getachew Tesfaw ◽

Habtamu Kerebih ◽

Endalamaw Salelew

Keyword(s):

Multivariate Analysis ◽

Alcohol Use ◽

Associated Factors ◽

Alcohol Use Disorder ◽

Alcohol Use Disorders ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

History Of ◽

Male Sex

Abstract Background: Alcohol use disorders increase the risk of physical harm, mental or social consequences for patients and others in the community. Studies on alcohol use disorder and associated factors among medical and surgical outpatients in Ethiopia are limited. Therefore, this study is meant to provide essential data on alcohol use disorders and associated factors among alcohol user medical and surgical outpatients for future interventions. Methods: An institution-based cross-sectional study was conducted using the systematic random sampling technique. Alcohol use disorders were assessed using the World Health Organization’s 10-item Alcohol Use Disorder Identification Test (AUDIT) questionnaire. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Bivariate and multivariate logistic regression analyses were performed, a P-value less than 0.05 were considered statistically significant in the multivariate analysis and the strength of association was measured using AOR at a 95% confidence interval.Results: The prevalence of alcohol use and use disorder were 322 (68.50%) and 111 (34.5%), respectively. In the multivariate analysis, male sex (AOR=3.33, 95%CI: 1.40, 7.93), history of mental illness (AOR=2.68, 95%CI: 1.12, 6.38), drinking for relaxation (AOR=1.88, 95%CI: 1.02, 3.48) and history of lifetime tobacco use (AOR=5.64, 95%CI: 1.95, 16.29) were significantly associated with the disorders. Conclusion: The prevalence of alcohol use disorders among medical and surgical outpatients was found to be high. Male sex, history of mental illness, alcohol for relaxation and tobacco smoking need more attention in the assessment of the outpatient departments.

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Inadequate pain relief with labor epidurals: a multivariate analysis of associated factors