Post-pancreaticoduodenectomy hemorrhage risk factors, managements and outcomes

2014 ◽  
Vol 13 (5) ◽  
pp. 513-522 ◽  
Author(s):  
Jian Feng ◽  
Yong-Liang Chen ◽  
Jia-Hong Dong ◽  
Ming-Yi Chen ◽  
Shou-Wang Cai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hemorrhage Risk

scholarly journals Comparison of Survivors and Nonsurvivors of Diffuse Alveolar Hemorrhage: Risk Factors for In-hospital Death

2021 ◽  
Author(s):  
Swathi Sangli ◽  
Misbah Baqir ◽  
Jay Ryu
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Distress Syndrome ◽  
Signs And Symptoms ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Hospital Death ◽  
P Value ◽  
Steroid Use ◽  
Hemorrhage Risk

Abstract ObjectiveThe objective of this study was to identify the predictors of in-hospital mortality among patients with diffuse alveolar hemorrhage (DAH).Patients and MethodsWe conducted a retrospective review of 89 patients hospitalized for DAH at our institution between 2001 and 2017: 49 patients who died during hospitalization and 40 patients who survived were compared. We reviewed their presenting signs and symptoms, clinical course, radiologic and pathologic findings, along with medical management. We then performed univariate and multivariate analyses to identify the risk factors associated with in-hospital mortality.ResultsWe identified 12 factors to be associated with mortality when comparing survivor vs non-survivor cohorts: smoking (27 [67%] vs 21 [42%], p = 0.02), malignancy (7 [17%] vs 24 [49%], p = 0.002), interstitial lung disease (0 vs 7 [14%], p = 0.01), liver failure (1 [2%] vs 14 [28%], p = 0.001), autoimmune diseases (16 [40%] vs 4 [8%], p =0.0006), thrombocytopenia (3 [7%] vs 35 [71%], p <0.0001), ICU admission (23 [57%] vs 40 [85%], p=0.004), mean duration of ICU stay (3.5 days [± 6.7] vs 5.5 days [± 5.5], p = 0.4), steroid use (36 [90%] vs 31 [63%], p = 0.003), use of plasma exchange (6 [15%] vs 0, p = 0.005), use of mechanical ventilation (15 [37%] vs 36 [75%], p value = 0.0007) and development of acute respiratory distress syndrome (ARDS) (9 [22%] vs 37 [77%], p <0.0001), respectively. On multivariate analysis, thrombocytopenia (OR 52.08: 95% CI, 8.59-315.71; p <0.0001) and ARDS (OR 11.71: 95% CI, 2.60-52.67; p = 0.0013) were associated with higher odds of mortality in DAH while steroid use (OR 0.05: 95% CI, 0.007-0.39; p = 0.0004) was associated with a lower risk of in-hospital mortality in patients with DAH.ConclusionIn DAH, thrombocytopenia and ARDS were predictors of in-hospital mortality whereas the use of steroid was associated with a more favorable prognosis.

Mo1239 Inpatient-Onset Primary Esophageal Variceal Hemorrhage: Risk Factors and Mortality

2015 ◽  
Vol 148 (4) ◽  
pp. S-646
Author(s):  
Bradley Confer ◽  
Mohannad Dugum ◽  
Thimmaiah G. Theethira ◽  
Ibrahim A. Hanouneh ◽  
Rocio Lopez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Variceal Hemorrhage ◽  
Esophageal Variceal ◽  
Hemorrhage Risk

A benchmark approach to hemorrhage risk management of cavernous malformations

Neurology ◽  
2018 ◽  
Vol 90 (10) ◽  
pp. e856-e863 ◽  
Author(s):  
Sepide Kashefiolasl ◽  
Markus Bruder ◽  
Nina Brawanski ◽  
Eva Herrmann ◽  
Volker Seifert ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariable Analysis ◽  
Patient Characteristics ◽  
Young Age ◽  
Anatomical Location ◽  
Separate Analysis ◽  
Developmental Venous Anomaly ◽  
Cavernous Malformations ◽  
Risk Of Rupture ◽  
Hemorrhage Risk

ObjectiveDespite the low annual risk of hemorrhage associated with a cavernous malformation (CM) (0.6%–1.1% per year), the risk of rehemorrhage rate and severity of neurologic deficits is significantly higher; therefore, we aimed to evaluate the rupture risk of CMs depending on various factors.MethodsWe retrospectively analyzed medical records of all patients with CM admitted to our institution between 1999 and April 2016. Cavernoma volume, location of the lesion, existence of a developmental venous anomaly (DVA), number of cavernomas, and patient characteristics (sex, age, hypertension, and antithrombotic therapy) were assessed.ResultsOne hundred fifty-four patients with CM were included; 89 (58%) ruptured CMs were identified. In statistical univariable analysis, the existence of a DVA was significantly higher in the ruptured cavernoma group (p < 0.001; odds ratio [OR] 4.6). A multivariable analysis of all included independent risk factors designated young age (<45 years) (p < 0.05; OR 2.2), infratentorial location (p < 0.01; OR 2.9), and existence of a DVA (p < 0.0001; OR 4.7) with significantly higher risk of rupture in our patient cohort. A separate analysis of these anatomical locations, supratentorial vs infratentorial, indicated that the existence of a DVA (p < 0.01; OR 4.16) in ruptured supratentorial cases and CM volume (≥1 cm3) (p < 0.0001; OR 3.5) in ruptured infratentorial cases were significant independent predictors for hemorrhage.ConclusionsYoung age (<45 years), infratentorial location, and the presence of a DVA are associated with a higher hemorrhage risk. CM volume (≥1 cm3) and the existence of a DVA were independently in accordance with the anatomical location high risk factors for CM rupture.

Validation of Postpartum Hemorrhage Admission Risk Factor Stratification in a Large Obstetrics Population

2020 ◽  
Author(s):  
Halley Ruppel ◽  
Vincent X. Liu ◽  
Neeru R. Gupta ◽  
Lauren Soltesz ◽  
Gabriel J. Escobar
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
High Risk ◽  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Risk Group ◽  
Risk Groups ◽  
Low Risk ◽  
Hemorrhage Risk ◽  
Present On Admission

Abstract Objective This study aimed to evaluate the performance of the California Maternal Quality Care Collaborative (CMQCC) admission risk criteria for stratifying postpartum hemorrhage risk in a large obstetrics population. Study Design Using detailed electronic health record data, we classified 261,964 delivery hospitalizations from Kaiser Permanente Northern California hospitals between 2010 and 2017 into high-, medium-, and low-risk groups based on CMQCC criteria. We used logistic regression to assess associations between CMQCC risk groups and postpartum hemorrhage using two different postpartum hemorrhage definitions, standard postpartum hemorrhage (blood loss ≥1,000 mL) and severe postpartum hemorrhage (based on transfusion, laboratory, and blood loss data). Among the low-risk group, we also evaluated associations between additional present-on-admission factors and severe postpartum hemorrhage. Results Using the standard definition, postpartum hemorrhage occurred in approximately 5% of hospitalizations (n = 13,479), with a rate of 3.2, 10.5, and 10.2% in the low-, medium-, and high-risk groups. Severe postpartum hemorrhage occurred in 824 hospitalizations (0.3%), with a rate of 0.2, 0.5, and 1.3% in the low-, medium-, and high-risk groups. For either definition, the odds of postpartum hemorrhage were significantly higher in medium- and high-risk groups compared with the low-risk group. Over 40% of postpartum hemorrhages occurred in hospitalizations that were classified as low risk. Among the low-risk group, risk factors including hypertension and diabetes were associated with higher odds of severe postpartum hemorrhage. Conclusion We found that the CMQCC admission risk assessment criteria stratified women by increasing rates of severe postpartum hemorrhage in our sample, which enables early preparation for many postpartum hemorrhages. However, the CMQCC risk factors missed a substantial proportion of postpartum hemorrhages. Efforts to improve postpartum hemorrhage risk assessment using present-on-admission risk factors should consider inclusion of other nonobstetrical factors.

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