Risk of bleeding after thyroid surgery: matched pairs analysis

2011 ◽  
Vol 126 (3) ◽  
pp. 285-288 ◽  
Author(s):  
R P Morton ◽  
V Mak ◽  
D Moss ◽  
Z Ahmad ◽  
J Sevao
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Thyroid Surgery ◽  
Smoking Status ◽  
Matched Pairs ◽  
Current Smoking Status ◽  
Current Smoking ◽  
Factors Associated ◽  
Anaesthetic Care ◽  
Increased Risk

AbstractObjective:To identify those patients most at risk of developing a compressive post-operative haematoma following thyroid surgery.Method:Retrospective analysis of patients undergoing thyroid surgery. Factors associated with the group of patients who developed a post-operative haematoma were examined using a matched pairs, case–control design.Results:Following 355 thyroid operations, seven patients developed a post-operative haematoma requiring return to the operating theatre for bleeding control. A post-operative systolic blood pressure of greater than 150 mmHg, in the post-anaesthetic care unit, was the major significant factor identified by regression analysis (p = 0.002). Current smoking status was also a significant factor (p = 0.04).Conclusion:In our facility, a post-anaesthetic systolic blood pressure in excess of 150 mmHg was associated with an increased risk of haemorrhage following thyroid surgery.

scholarly journals Association Between Cigarette Smoking and Ovarian Reserve Among Women Seeking Fertility Care

2021 ◽  
Author(s):  
Islamiat Oladipupo ◽  
T'shura Ali ◽  
David W Hein ◽  
Kelly Pagidas ◽  
Henry Bohler ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Smoking Status ◽  
Effect Modification ◽  
Diminished Ovarian Reserve ◽  
Self Report ◽  
Tobacco Smoke Exposure ◽  
Heavy Smoking ◽  
Current Smoking Status ◽  
Current Smoking ◽  
Increased Risk

Abstract Background This study examined the association of smoking with ovarian reserve in a cross-sectional study of 207 women enrolled in the Louisville Tobacco Smoke Exposure, Genetic Susceptibility, and Infertility (LOUSSI) Study and assessed effect modification by NAT2 acetylator phenotype. Methods Information on current smoking status was collected using a structured questionnaire and confirmed by cotinine assay. Serum anti-Müllerian hormone (AMH) levels were used to assess ovarian reserve. Diminished ovarian reserve (DOR) was defined as AMH < 1ng/mL. Single nucleotide polymorphisms in the NAT2 gene, which metabolizes toxins found in cigarette smoke, were analyzed to determine NAT2 acetylator status. Linear and logistic regression were used to determine the effects of smoking on ovarian reserve and evaluate effect modification by NAT2. Regression analyses were stratified by polycystic ovary syndrome (PCOS) status and adjusted for age. Results Current smoking status, either passive or active, was not significantly associated with DOR. For dose-response assessed using self-report, the odds of DOR increased significantly for every additional cigarette currently smoked (odds ratio, OR:1.08; 95% confidence interval, 95%CI:1.01–1.15); additionally, every 1 pack-year increase in lifetime exposure was associated with an increased odds of DOR among women without PCOS (OR: 1.08 95%CI: 0.99–1.18). These trends appear to be driven by the heavy or long-term smokers. Effect modification by NAT2 genotype was not established. Conclusion A history of heavy smoking, but not current smoking status, may indicate increased risk of diminished ovarian reserve.

scholarly journals Determinants of cigarette smoking status in a national cohort of black and white adult ever smokers in the USA: a cross-sectional analysis of the REGARDS study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027175 ◽  
Author(s):  
Trisha M Parekh ◽  
Chengyi Wu ◽  
Leslie A McClure ◽  
Virginia J Howard ◽  
Mary Cushman ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Racial Differences ◽  
Smoking Status ◽  
Cross Sectional ◽  
Current Smoking Status ◽  
Current Smoking ◽  
Factors Associated ◽  
Cross Sectional Analysis ◽  
Regards Study ◽  
Sectional Analysis

ObjectivesWhile awareness of cigarette smoking’s harmful effects has increased, determinants associated with smoking status remain understudied, including potential racial differences. We aim to examine factors associated with former versus current smoking status and assess whether these associations differed by race.SettingWe performed a cross-sectional analysis using the population-based Reasons for Geographic and Racial Differences in Stroke(REGARDS)study.Outcome measuresLogistic regression was used to calculate the OR of former smoking status compared with current smoking status with risk factors of interest. Race interactions were tested using multiplicative interaction terms.Results16 463 participants reported smoking at least 100 cigarettes in their lifetime. Seventy-three per cent (n=12 067) self-reported former-smoker status. Physical activity (reference (REF) <3×/week; >3×/week: OR=1.26, 95% CI 1.11 to 1.43), adherence to Mediterranean diet (REF: low; medium: OR=1.46, 95% CI 1.27 to 1.67; high: OR=2.20, 95% CI 1.84 to 2.64), daily television viewing time (REF: >4 hours; <1 hour: OR=1.32, 95% CI 1.10 to 1.60) and abstinence from alcohol use (REF: heavy; none: OR=1.50, 95% CI 1.18 to 1.91) were associated with former-smoker status. Male sex, higher education and income $35 000–$74 000 (REF: <$20 000) were also associated with former-smoker status. Factors associated with lower odds of reporting former-smoker status were younger age (REF: ≥65 years; 45–64 years: OR=0.34, 95% CI 0.29 to 0.39), black race (OR=0.62, 95% CI 0.53 to 0.72) and single marital status (REF: married status; OR=0.66, 95% CI 0.51 to 0.87), being divorced (OR=0.60, 95% CI 0.50 to 0.72) or widowed (OR=0.70, 95% CI 0.57 to 0.85). Significant interactions were observed between race and alcohol use and dyslipidaemia, such that black participants had higher odds of reporting former-smoker status if they were abstinent from alcohol (OR=2.32, 95% CI 1.47 to 3.68) or had a history of dyslipidaemia (OR=1.31, 95% CI 1.06 to 1.62), whereas these relationships were not statistically significant in white participants.ConclusionEfforts to promote tobacco cessation should consist of targeted behavioural interventions that incorporate racial differences.

An observational study to determine the prevalence of alcohol use disorders in advanced cancer patients

2011 ◽  
Vol 26 (4) ◽  
pp. 360-367 ◽  
Author(s):  
Katherine Webber ◽  
Andrew N Davies
Keyword(s):  
Alcohol Use ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Alcohol Use Disorder ◽  
Smoking Status ◽  
Alcohol Use Disorders ◽  
Symptom Burden ◽  
Advanced Cancer Patients ◽  
Current Smoking Status ◽  
Current Smoking

Context: observational studies in North America suggest alcohol dependence is a common problem in advanced cancer patients and is associated with a high burden of physical and psychological symptoms. The prevalence of all types of alcohol use disorders, and the relationship between alcohol use disorders and symptoms, has not been studied. Objectives: this observational, cross-sectional study was designed to determine the prevalence of alcohol use disorders in patients with advanced cancer and establish if such patients have a higher symptom burden. Methods: sequential patients referred to the palliative medicine team at a United Kingdom cancer centre completed the Alcohol Use Disorders Identification Test, Hospital Anxiety and Depression Scale (HADS) and Memorial Symptom Assessment Scale-Short Form (MSAS-SF). Results: 120 patients participated in the study. Twenty-two (18%) patients screened positively for the presence of an alcohol use disorder. This study found no significant association between alcohol use disorders and the presence of anxiety ( P = 0.38) or depression ( P = 0.81) on the HADS or the global distress index subscale ( P = 0.142), physical symptom distress index subscale ( P = 0.734), or the psychological distress index subscale ( P = 0.154) on the MSAS-SF. Current smoking status was the only independent predictor for the presence of an alcohol use disorder ( P < 0.001). Seven (6%) patients screened positively for high-risk alcohol use disorders. Current smoking status ( P < 0.001) and male gender ( p < 0.001) were independent predictors of this problem. Conclusions: alcohol use disorders in this cohort of patients were not associated with a higher symptom burden, and the prevalence was lower than the general United Kingdom population.

Abstract 14652: Systolic Blood Pressure Trajectories and Cardiovascular Outcomes in SPRINT

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Charles A German ◽  
Tali Elfassy ◽  
Matthew J Singleton ◽  
Carlos J Rodriguez ◽  
Walter T Ambrosius ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Latent Class ◽  
Stable Group ◽  
Coronary Syndrome ◽  
Average Blood Pressure ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Over Time

Introduction: Blood pressure trajectories have been associated with cardiovascular disease (CVD) in observational studies. It is unclear whether these associations are independent of average blood pressure over time. Methods: We used data from SPRINT to identify systolic blood pressure (SBP) trajectories among a cohort of 8901 participants by incorporating SBP measures during the first 12 months of the trial post randomization. Trajectories were identified using latent class based modeling. Study outcomes included incident CVD, defined as myocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure, or death attributable to CVD, and all-cause mortality. Cox proportional hazards models were used to evaluate associations between SBP trajectories and our outcomes of interest. Results: Four distinct SBP trajectories were identified: ‘low decline’ (40%), ‘high decline’ (6%), ‘low stable’ (48%), and ‘high stable’ (5%) (Figure 1). Relative to the low decline group, the low stable group was associated with a 29% increased risk of CVD (HR: 1.29, 95%CI: 1.06-1.57) and the high stable group was associated with a 76% increased risk of all-cause mortality (HR: 1.76, 95%CI: 1.15-2.68) after baseline multivariable adjustment. Relative to the low stable group, the high stable group was associated with a 54% increased risk of all-cause mortality (HR: 1.54, 95%CI: 1.05-2.28). When adjusting for average blood pressure across the 12 month time period, there were no significant differences in outcomes. Conclusion: We identified 4 SBP trajectories using data from SPRINT and found differences in the risk of CVD and all-cause mortality after baseline adjustment. However, there were no differences in the risk of these outcomes after adjusting for average blood pressure over time. These results suggest that the pattern of blood pressure control may not be relevant as long as the target blood pressure is achieved.

scholarly journals Workload-indexed blood pressure response is superior to peak systolic blood pressure in predicting all-cause mortality

2019 ◽  
Vol 27 (9) ◽  
pp. 978-987 ◽  
Author(s):  
Kristofer Hedman ◽  
Nicholas Cauwenberghs ◽  
Jeffrey W Christle ◽  
Tatiana Kuznetsova ◽  
Francois Haddad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Exercise Testing ◽  
Lower Risk ◽  
Metabolic Equivalents ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Clinical Exercise Testing

Aims The association between peak systolic blood pressure (SBP) during exercise testing and outcome remains controversial, possibly due to the confounding effect of external workload (metabolic equivalents of task (METs)) on peak SBP as well as on survival. Indexing the increase in SBP to the increase in workload (SBP/MET-slope) could provide a more clinically relevant measure of the SBP response to exercise. We aimed to characterize the SBP/MET-slope in a large cohort referred for clinical exercise testing and to determine its relation to all-cause mortality. Methods and results Survival status for male Veterans who underwent a maximal treadmill exercise test between the years 1987 and 2007 were retrieved in 2018. We defined a subgroup of non-smoking 10-year survivors with fewer risk factors as a lower-risk reference group. Survival analyses for all-cause mortality were performed using Kaplan–Meier curves and Cox proportional hazard ratios (HRs (95% confidence interval)) adjusted for baseline age, test year, cardiovascular risk factors, medications and comorbidities. A total of 7542 subjects were followed over 18.4 (interquartile range 16.3) years. In lower-risk subjects ( n = 709), the median (95th percentile) of the SBP/MET-slope was 4.9 (10.0) mmHg/MET. Lower peak SBP (<210 mmHg) and higher SBP/MET-slope (>10 mmHg/MET) were both associated with 20% higher mortality (adjusted HRs 1.20 (1.08–1.32) and 1.20 (1.10–1.31), respectively). In subjects with high fitness, a SBP/MET-slope > 6.2 mmHg/MET was associated with a 27% higher risk of mortality (adjusted HR 1.27 (1.12–1.45)). Conclusion In contrast to peak SBP, having a higher SBP/MET-slope was associated with increased risk of mortality. This simple, novel metric can be considered in clinical exercise testing reports.

Contemplating to quit current smoking status: differences in behavioural and psychosocial patterns in a population-based cohort of current smokers

2005 ◽  
Vol 41 (1) ◽  
pp. 134-140 ◽  
Author(s):  
Karl-Heinz Ladwig ◽  
Jens Baumert ◽  
Hannelore Löwel ◽  
Angela Döring ◽  
Heinz-Erich Wichmann
Keyword(s):  
Smoking Status ◽  
Population Based ◽  
Current Smoking Status ◽  
Current Smoking ◽  
Status Differences

scholarly journals Depression and substance abuse and dependency in relation to current smoking status and frequency of smoking among nondaily and daily smokers

2013 ◽  
Vol 22 (6) ◽  
pp. 581-589 ◽  
Author(s):  
Carla J. Berg ◽  
Hefei Wen ◽  
Janet R. Cummings ◽  
Jasjit S. Ahluwalia ◽  
Benjamin G. Druss
Keyword(s):  
Substance Abuse ◽  
Smoking Status ◽  
Current Smoking Status ◽  
Current Smoking

scholarly journals Associations between pain and current smoking status among cancer patients

Pain ◽  
2011 ◽  
Vol 152 (1) ◽  
pp. 60-65 ◽  
Author(s):  
Joseph W. Ditre ◽  
Brian D. Gonzalez ◽  
Vani N. Simmons ◽  
Leigh Anne Faul ◽  
Thomas H. Brandon ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Smoking Status ◽  
Current Smoking Status ◽  
Current Smoking

Abstract MP33: Association Between Neurologic Outcomes and Temporal Profile of Systolic Blood Pressure Variability After Endovascular Thrombectomy

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Ayush Prasad ◽  
Jessica Kobsa ◽  
Sreeja Kodali ◽  
Cindy Khanh Nguyen ◽  
Darko Quispe Orozco ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Standard Deviation ◽  
Systolic Blood Pressure ◽  
Functional Outcome ◽  
Blood Pressure Variability ◽  
Treatment Strategies ◽  
Vessel Occlusion ◽  
Endovascular Thrombectomy ◽  
Increased Risk ◽  
Systolic Blood Pressure Variability

Introduction: Higher systolic blood pressure variability (BPV) after endovascular thrombectomy (EVT) has been associated with an increased risk of hemorrhagic transformation and worse functional outcomes. However, the time-varying behavior of BPV after EVT and its effects on functional outcome have not been well characterized. Methods: We analyzed data from an international cohort of patients with acute large-vessel occlusion stroke who underwent EVT at 11 centers across North America, Europe, and Asia. Repeated time-stamped blood pressure data were recorded for the first 72 hours after thrombectomy. Parameters of BPV were calculated in 12-hour epochs using five established methodologies: standard deviation (SD), coefficient of variation (CV), average real variability (ARV), successive variation (SV), and residual SD (rSD). Patients’ overall mean BPV was then used to assign patients into tertiles for regression analysis: low BPV, intermediate BPV, and high BPV. Functional outcome was measured with the modified Rankin Scale (mRS) at 90 days. Results: Of the 1,791 patients (age 69 ± 14, NIHSS 15 ± 6) included in our analysis, 1,085 (60.6%) had a poor 90-day outcome (mRS >3). Patients with poor outcome had significantly higher systolic BPV (p<0.05) measured as standard deviation (SBP SD) at each epoch (Figure 1B). Compared to patients with low BPV, those in the highest tertile group had significantly greater odds of a poor functional outcome after adjusting for age, sex, hypertension, NIHSS, ASPECT, tPA, time to reperfusion, and TICI score (OR 1.5; 95% CI 1.2-2; p=0.001). Patients in the highest tertile of BPV demonstrated time-dependent variability with the highest SBP SD during the first 24 hours after thrombectomy (Figure 1A). Conclusions: Higher BPV measured by SBP SD appears to be associated with poor 90-day outcome in EVT-treated stroke patients. Early treatment strategies targeting early high BPV warrant further prospective investigation.

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