Characteristics of vomiting as a predictor of intracranial injury in pediatric minor head injury

CJEM ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 793-801
Author(s):  
Jessica A. Harper ◽  
Terry P. Klassen ◽  
Robert Balshaw ◽  
Justin Dyck ◽  
Martin H. Osmond ◽  
...  
Keyword(s):  
Risk Factors ◽  
Head Injury ◽  
High Risk ◽  
Skull Fracture ◽  
Minor Head Injury ◽  
Intracranial Injury ◽  
Altered Level ◽  
High Risk Factors ◽  
Recurrent Vomiting ◽  
Neurosurgical Intervention

ABSTRACTObjectivesVomiting is common in children after minor head injury. In previous research, isolated vomiting was not a significant predictor of intracranial injury after minor head injury; however, the significance of recurrent vomiting is unclear. This study aimed to determine the value of recurrent vomiting in predicting intracranial injury after pediatric minor head injury.MethodsThis secondary analysis of the CATCH2 prospective multicenter cohort study included participants (0–16 years) who presented to a pediatric emergency department (ED) within 24 hours of a minor head injury. ED physicians completed standardized clinical assessments. Recurrent vomiting was defined as ≥ four episodes. Intracranial injury was defined as acute intracranial injury on computed tomography scan. Predictors were examined using chi-squared tests and logistic regression models.ResultsA total of 855 (21.1%) of the 4,054 CATCH2 participants had recurrent vomiting, 197 (4.9%) had intracranial injury, and 23 (0.6%) required neurosurgical intervention. Children with recurrent vomiting were significantly more likely to have intracranial injury (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.7–3.1), and require neurosurgical intervention (OR, 3.5; 95% CI, 1.5–7.9). Recurrent vomiting remained a significant predictor of intracranial injury (OR, 2.8; 95% CI, 1.9–3.9) when controlling for other CATCH2 criteria. The probability of intracranial injury increased with number of vomiting episodes, especially when accompanied by other high-risk factors, including signs of a skull fracture, or irritability and Glasgow Coma Scale score < 15 at 2 hours postinjury. Timing of first vomiting episode, and age were not significant predictors.ConclusionsRecurrent vomiting (≥ four episodes) was a significant risk factor for intracranial injury in children after minor head injury. The probability of intracranial injury increased with the number of vomiting episodes and if accompanied by other high-risk factors, such as signs of a skull fracture or altered level of consciousness.

Association between maternal high-risk factors and anemia among women in Ethiopia

Nutrition ◽  
2021 ◽  
pp. 111404
Author(s):  
Noha Fadl ◽  
Gillian H Ice ◽  
Zelalem T Haile
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
High Risk Factors

Quantification of risk of recurrence associated with high risk factors in Stage II colon cancer: A retrospective study from a tertiary cancer institute in India

2021 ◽  
Vol 5 (1) ◽  
pp. 25
Author(s):  
LinuAbraham Jacob ◽  
Lalatendu Moharana ◽  
Lokanatha Dasappa ◽  
MC Suresh Babu ◽  
KN Lokesh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Colon Cancer ◽  
Retrospective Study ◽  
High Risk ◽  
Stage Ii ◽  
Risk Of Recurrence ◽  
High Risk Factors ◽  
Stage Ii Colon Cancer

Abstract 18634: Favorable Cardiovascular Health and the Compression of Morbidity: Findings From the Chicago Heart Detection Project in Industry Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Norrina B Allen ◽  
Lihui Zhao ◽  
Lei Liu ◽  
Martha Daviglus ◽  
Kiang Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Healthcare Costs ◽  
Cardiovascular Health ◽  
Heart Association ◽  
Baseline Risk ◽  
Compression Of Morbidity ◽  
High Risk Factors ◽  
Morbidity Score

Introduction: We sought to determine the association of CV health at younger ages with the proportion of life lived free of morbidity, the cumulative burden of morbidity, and average healthcare costs at older ages. Methods: The Chicago Heart Association (CHA) study is a longitudinal cohort of employed men and women aged 18-59 years at baseline exam in 1967-1973. Baseline risk factor levels included blood pressure, cholesterol, diabetes, BMI and smoking. Individuals were classified into one of four strata: favorable levels of all factors, 0 factors high but 1+ elevated, 1 high, and ≥2 high risk factors. Linked CMS/NDI data from 1984-2010 were used to determine morbidity in older age providing up to 40 years of follow-up. We included participants who were age 65+ between 1984 and 2010 and enrolled in Medicare FFS. All-cause morbidity was defined using the Gagne score. A CV morbidity score was defined as the sum of 4 CVDs including CHD (includes MI), PVD, cerebrovascular disease and CHF. Results: We included 25,390 participants (43% female, 90% White, mean age 44 at baseline); 6% had favorable levels, 19% had 1+ risk factors at elevated levels, 40% had 1 high risk factor and 35% had 2+ high risk factors. As compared to those with 2+ high risk factors, favorable CV health had lower levels of all-cause and CV morbidity from age 65-90 years, and a lower cumulative morbidity burden (p<0.001) translating to lower average annual healthcare costs ($15,905 vs $20,791 per year, p<0.001). Favorable CV health postponed the onset of all-cause morbidity by 4.5 years, the onset of CV morbidity by almost 7 years and extended life by almost 4 years resulting in a compression of morbidity on both the absolute and relative scale (see figure). Conclusion: Individuals in favorable CV health live a longer, healthier life and a greater proportion of life free of morbidity. These findings provide support for prevention efforts aimed at preserving cardiovascular health and reducing the burden of disease in older ages.

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