The Association between Cardiopulmonary Resuscitation in Out-of-Hospital Settings and Chest Injuries: A Retrospective Observational Study

AbstractObjectivesThe aim of this study was to assess the risk of cardiopulmonary resuscitation (CPR) performed in out-of-hospital settings for chest injuries in patients with out-of-hospital cardiac arrest (OHCA).MethodsThis retrospective, observational study was conducted in an emergency critical care medical center in Japan. Non-traumatic OHCA patients transferred to the hospital from April 2013 through August 2016 were analyzed. The outcome was defined by chest injuries related to CPR, which is composite of rib fractures, sternal fractures, and pneumothoraces. A multivariate logistic regression analysis was performed to assess the independent risk factors for chest injuries related to CPR. The threshold of out-of-hospital CPR duration that increased risk of chest injuries was also assessed.ResultsA total of 472 patients were identified, of whom 233 patients sustained chest injuries. The multivariate logistic regression model showed that the independent risk factors for chest injuries were age and out-of-hospital CPR duration (age: AOR=1.06 [95% CI, 1.04 to 1.07]; out-of-hospital CPR duration: AOR=1.03 [95% CI, 1.01 to 1.05]). In-hospital CPR duration was not an independent risk factor for chest injuries. When the duration of out-of-hospital CPR extended over 15 minutes, the likelihood of chest injuries increased; however, this association was not statistically significant.ConclusionsLong duration of out-of-hospital CPR was an independent risk factor for chest injuries, possibly due to the difficulty of maintaining adequate quality of CPR. Further investigations to assess the efficacy of alternative CPR devices are expected in cases requiring long transportation times.TakayamaW, KoguchiH, EndoA, OtomoY. The association between cardiopulmonary resuscitation in out-of-hospital settings and chest injuries: a retrospective observational study. Prehosp Disaster Med. 2018;33(2):171–175.

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Could remnant-like particle cholesterol become a risk factor in diabetic menopausal women with coronary artery disease? A cross-sectional study of single academic center in China

10.21203/rs.2.23149/v2 ◽

2020 ◽

Author(s):

Xunxun Feng ◽

Qianyun Guo ◽

Shu Zhou ◽

Tienan Sun ◽

Yuyang Liu ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Logistic Regression ◽

Risk Factor ◽

Independent Risk Factor ◽

Age Groups ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Menopausal Women ◽

Artery Disease

Abstract Background and aims It has been confirmed that remnant-like particle cholesterol (RLP-C) mediates the progression of coronary artery disease (CAD). Currently there is limited information on RLP-C in menopausal women. With the special status of diabetes mellitus (DM) combined with the special body changes of the menopausal women, the RLP-C is particularly important when studying the changes that occurred in response to CAD and its associated risk factors. This study discussed whether RLP-C could be an independent risk factor for menopausal women with CAD and DM. Methods The cohort consisted of 4753 menopausal women who had undergone coronary angiography. Subjects were separated into CAD and non-CAD groups, and univariate and multivariate logistic regression analysis of CAD risk factors were performed. All patients with a history of DM were divided into DM subgroups. Then, the univariate and multivariate logistic regression analysis of the risk factors of CAD and the comparison among age groups in the DM subgroup were performed. After age stratification of the DM group, the Kruskal-Wallis test was used to analyze the differences of various lipid indexes among age groups. Results The multivariate logistic regression showed that RLP-C was an independent risk factor for CAD in menopausal women (OR 1.232, 95%CI 1.070-1.419). In the DM subgroup, it was also found that RLP-C was an independent risk factor for CAD (OR 1.366, 95%CI 1.043-1.791). Kruskal-Wallis test analysis found that RLP-C had no significant difference among three groups (P>0.05). Conclusions RLP-C was proved to be an independent risk factor for menopausal women with CAD and DM.

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Clinical risk predictors for bradycardia, supraventricular tachycardia and epilepsy necessitating therapy in patients with unexplained syncope monitored by insertable cardiac monitor

European Heart Journal ◽

10.1093/ehjci/ehaa946.0709 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

T Onuki ◽

M Shoji ◽

M Kikuchi ◽

T Asano ◽

H Suzuki ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Logistic Regression ◽

Regression Analysis ◽

Risk Factor ◽

Independent Risk Factor ◽

Sick Sinus Syndrome ◽

Unexplained Syncope ◽

Independent Risk Factors

Abstract Background Insertable cardiac monitors (ICMs) allow for lengthy monitoring of cardiac rhythm and improve diagnostic yield in patients with unexplained syncope. In most cardiac syncope cases, sick sinus syndrome, atrioventricular block, and paroxysmal supraventricular tachycardia (SVT) are detected using ICMs. On the other hand, epileptic seizures are sometimes diagnosed as unexplained syncope because in these situations, the loss of consciousness is a similar manifestation. Thus, the population of patients with unexplained syncope monitored by ICMs includes epileptic patients. Clinical risk factors for bradycardia, SVT and epilepsy that necessitate therapy in patients with unexplained syncope are not well known. If these risks can be clarified, clinicians could provide more specific targeted monitoring. Purpose We aimed to identify these predictors. Methods We retrospectively reviewed medical records of consecutive patients who received ICMs to monitor unexplained syncope in three medical facilities. We performed Cox's stepwise logistic regression analysis to identify significant independent risk factors for bradycardia, SVT, and epilepsy. Results One hundred thirty-two patients received ICMs to monitor unexplained syncope. During the 17-month follow-up period, 19 patients (10 patients had sick sinus syndrome and 9 had atrioventricular block) needed pacemaker for bradycardia; 8 patients (3 had atrial flutter, 4 had atrial tachycardia, and 1 had paroxysmal atrial fibrillation) needed catheter ablation for SVT; and 9 patients needed antiepileptic agents from the neurologist.Stepwise logistic regression analysis indicated that syncope during effort (odds ratio [OR] = 3.41; 95% confidence interval [CI], 1.21 to 9.6; p=0.02) was an independent risk factor for bradycardia. Palpitation before syncope (OR = 9.46; 95% CI, 1.78 to 50.10; p=0.008) and history of atrial fibrillation (OR = 10.1; 95% CI, 1.96 to 52.45; p=0.006) were identified as significant independent prognostic factors for SVT. Syncope while supine (OR = 11.7; 95% CI, 1.72 to 79.7; p=0.01) or driving (OR = 15.6; 95% CI, 2.10 to 115.3; p=0.007) was an independent factor for epileptic seizure. Conclusions ICMs are useful devices for diagnosing unexplained syncope. Palpitation, atrial fibrillation and syncope during effort were independent risk factors for bradycardia and for SVT. Syncope while supine or driving was an independent risk factor for epilepsy. We should carefully follow up of patients with these risk factors. Funding Acknowledgement Type of funding source: None

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Could remnant lipoprotein cholesterol become a risk factor in diabetic menopausal women with coronary artery disease? A cross-sectional study of single academic center in China

10.21203/rs.2.23149/v1 ◽

2020 ◽

Author(s):

Xunxun Feng ◽

Qianyun Guo ◽

Shu Zhou ◽

Tienan Sun ◽

Yuyang Liu ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Risk Factor ◽

Independent Risk Factor ◽

Age Groups ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Remnant Lipoprotein ◽

Menopausal Women ◽

Artery Disease

Abstract Background and aimsIt had been confirmed that remnant lipoprotein cholesterol (RLP-C) mediates the progression of coronary artery disease (CAD). Currently there was limited information on RLP-C in menopausal women. With the special status of diabetes mellitus (DM) combined with the special body changes of the menopausal women, the RLP-C was particularly important when studying the changes that occurred in response to CAD and its associated risk factors. This study discussed whether RLP-C could be an independent risk factor for menopausal women with CAD and DM.MethodsThe cohort consisted of 4753 menopausal women who had undergone coronary angiography. Subjects were separated into CAD and non-CAD groups, and univariate and multivariate logistic regression analysis of CAD risk factors were performed. All patients with a history of DM were divided into DM subgroups. Then, the univariate and multivariate logistic regression analysis of the risk factors of CAD and the comparison among age groups in the DM subgroup were performed. After age stratification of the DM group, the Kruskal-Wallis test was used to analyze the differences of various lipid indexes among age groups. Results The univariate and multivariate logistic regression showed that RLP-C was an independent risk factor for CAD in menopausal women (OR 1.274, 95%CI 1.107-1.467, P=0.001). In the DM subgroup, it was also found that RLP-C was an independent risk factor for CAD (OR 1.243, 95%CI 1.078-1.433, P=0.003). Kruskal-Wallis test analysis found that RLP-C had no significant difference among three groups (P>0.05).ConclusionsRLP-C was proved to be an independent risk factor for menopausal women with CAD and DM.

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Risk Factor for Vital Signs Fluctuation during Colonoscopy under Conscious Sedation Consisting of Midazolam and Meperidine

Digestive Diseases ◽

10.1159/000481343 ◽

2017 ◽

Vol 36 (2) ◽

pp. 113-117 ◽

Cited By ~ 4

Author(s):

Shigeo Banno ◽

Motohiko Kato ◽

Yukie Sunata ◽

Yuichiro Hirai ◽

Yoko Kubosawa ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Multivariate Analysis ◽

Risk Factor ◽

Logistic Regression Model ◽

Conscious Sedation ◽

Vital Signs ◽

Multivariate Logistic Regression Model ◽

Multivariate Logistic Regression ◽

Independent Risk Factors

Background: Sedatives or analgesics are widely used to relieve a patient’s discomfort during colonoscopy (CS). Although cardiopulmonary adverse events are sometimes experienced during the examination, the risk factors for vital signs fluctuation (VSF) have not been fully elucidated. This study thus aimed to identify the risk factors for VSF during the examination, as well as to evaluate the frequency and the degree of VSF. Summary: A total of 755 consecutive subjects who received CS under endoscopist-administrated sedation using midazolam, meperidine, or combination of both were retrospectively analyzed. We assessed the distribution of vital signs during the procedure and frequency of VSF. To identify independent risk factors, we analyzed the association between VSF and subjects’ characteristics and procedure information using the multivariate logistic regression model. Consequently, VSF was observed in 17% of all; hypotension and oxygen desaturation was observed in 13 and 5%, respectively. However, we could achieve the purpose of all procedure and, no one required hospitalization or extension of hospital stay. Multivariate analysis revealed that age (OR 1.05 [95% CI 1.04–1.07]), being female (OR 1.78 [95% CI 1.19–2.70]), and use of midazolam (OR 5.06 [95% CI 3.18–8.08]) were independent risk factors for VSF.

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Hemmkörperentwicklung bei Hämophilie-Patienten nach Präparate wechsel

Hämostaseologie ◽

10.1055/s-0037-1619773 ◽

2012 ◽

Vol 32 (S 01) ◽

pp. S39-S42 ◽

Cited By ~ 1

Author(s):

S. Kocher ◽

G. Asmelash ◽

V. Makki ◽

S. Müller ◽

S. Krekeler ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Observational Study ◽

Retrospective Observational Study ◽

Frequent Change ◽

Patient Age ◽

Treatment Regimens ◽

Patient Âgé ◽

The Relationship ◽

Observation Period

SummaryThe retrospective observational study surveys the relationship between development of inhibitors in the treatment of haemophilia patients and risk factors such as changing FVIII products. A total of 119 patients were included in this study, 198 changes of FVIII products were evaluated. Results: During the observation period of 12 months none of the patients developed an inhibitor, which was temporally associated with a change of FVIII products. A frequent change of FVIII products didn’t lead to an increase in inhibitor risk. The change between plasmatic and recombinant preparations could not be confirmed as a risk factor. Furthermore, no correlation between treatment regimens, severity, patient age and comorbidities of the patients could be found.

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Clinical characteristics and prognosis in patients with premature coronary artery disease of different genders after intervention

European Heart Journal ◽

10.1093/ehjci/ehaa946.1315 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

X.F Tang ◽

Y Yao ◽

S.D Jia ◽

Y Liu ◽

B Xu ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Independent Risk Factor ◽

Coronary Intervention ◽

Premature Coronary Artery Disease ◽

Minor Bleeding ◽

Bleeding Events ◽

Cerebrovascular Events ◽

Independent Risk Factors ◽

Artery Disease

Abstract Objective To investigate the clinical characteristics and long-term prognosis of coronary intervention in patients with premature coronary artery disease (PCAD) between different genders. Methods From January 2013 to December 2013, 4 744 patients diagnosed as PCAD with percutaneous coronary intervention (PCI) in our hospital were enrolled. The general clinical data, laboratory results and interventional treatment data of all patients were collected, and the occurrence of major adverse cardio-cerebrovascular events (MACCE) within 2 years after PCI was followed up. Results Of the 4 744 patients undergoing PCI, 3 390 (71.5%) were males and 1 354 (28.5%) were females. The 2-year follow-up results showed that the incidence of BARC grade 1 hemorrhage in female patients was significantly higher than that in male patients (6.9% vs. 3.7%; P<0.001); however, there was no significant difference in the incidence of major adverse cardiovascular and cerebrovascular events (MACCE), all-cause death, cardiac death, recurrent myocardial infarction, revascularization (target vessel revascularization and target lesion revascularization), stent thrombosis, stroke and BARC grade 2–5 hemorrhage between the two groups (P>0.05). Multivariate COX regression analysis showed that gender was an independent risk factor for BARC grade 1 bleeding events in PCAD patients (HR=2.180, 95% CI: 1.392–3.416, P<0.001), but it was not an independent risk factor for MACCE and BARC grade 2–5 bleeding. Hyperlipidemia, preoperative SYNTAX score, multivessel lesions and NSTE-ACS were the independent risk factors for MACCE in PCAD patients with PCI (HR=1.289, 95% CI: 1.052–1.580, P=0.014; HR=1.030, 95% CI: 1.019–1.042, P<0.001; HR=1.758, 95% CI: 1.365–2.264, P<0.001; HR=1.264, 95% CI: 1.040–1.537, P=0.019); gender, hyperlipidemia, anticoagulant drugs like low molecular weight heparin or sulfonate were the independent risk factors for bleeding events (HR=1.579,95% CI 1.085–2. 297, P=0.017; HR=1.305, 95% CI 1.005–1.695, P=0.046; HR=1.321, 95% CI 1.002–1.741, P=0.048; HR=1.659, 95% CI 1.198–2.298, P=0.002). Conclusion The incidence of minor bleeding in women with PCAD is significantly higher than that in men; After adjusting for various risk factors, gender is an independent risk factor for minor bleeding events, but not an independent risk factor for MACCE in patients with PCAD. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Science and Technology Support Program of China

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Risk Factors for Aortic Valve Calcification in Patients on Regular Hemodialysis

The International Journal of Artificial Organs ◽

10.1177/039139880903200308 ◽

2009 ◽

Vol 32 (3) ◽

pp. 173-179 ◽

Cited By ~ 4

Author(s):

Dejan Petrović ◽

Radmila Obrenović ◽

Biljana Stojimirović

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Risk Factor ◽

Aortic Valve ◽

Independent Risk Factor ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Aortic Valve Calcification ◽

Valve Calcification ◽

Regular Hemodialysis

Introduction Aortic valve calcification (AVC) accelerates development of aortic valve stenosis and cardiovascular complications. Hyperphosphatemia is one of the key risk factors for aortic valve calcification. Aim The aim of this study was to evaluate the prevalence of AVC in patients on regular hemodialysis and to assess the impact of different factors on its appearance. Method: The study investigated a total of 115 patients treated in the Hemodialysis Department of the Urology and Nephrology Clinic at the Kragujevac Clinical Center in Serbia. The variables investigated were: serum albumin, C-reactive protein (CRP), homocysteine, total cholesterol, LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), triglycerides (TG), Apolipoprotein A-I (Apo A-I), Apolipoprotein B (Apo B) and lipoprotein (a), calcium, phosphate and parathormone, and calcium-phosphorus product (Ca × P). Patients were evaluated by echocardiography for AVC. Statistical analysis included univariate and multivariate logistic regression analysis. Results Univariate regression analysis showed that serum phosphate levels and Ca × P are the most important risk factors for AVC (p<0.001). Multivariate logistic regression analysis revealed that hyperphosphatemia is an independent risk factor for AVC (p<0.001). Conclusion Hyperphosphatemia is an independent risk factor for aortic valve calcification.

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Risk Factors and Neurologic Outcomes in Patients With Traumatic Brain Injury and Coagulopathy Within 72 Hours Post-operatively

10.21203/rs.3.rs-145018/v1 ◽

2021 ◽

Author(s):

Tao Chang ◽

Xigang Yan ◽

Chao Zhao ◽

Yufu Zhang ◽

Bao Wang ◽

...

Keyword(s):

Risk Factors ◽

Traumatic Brain Injury ◽

Logistic Regression ◽

Brain Injury ◽

Multivariate Logistic Regression ◽

Neurologic Outcomes ◽

Post Operative Period ◽

Duration Of Surgery ◽

Independent Risk Factors ◽

Time Of Admission

Abstract Background There are few studies on the development and effect of coagulopathy in patients with a traumatic brain injury (TBI) during the early post-operative period. We determined the risk factors and neurologic outcomes of in patients with a TBI and coagulopathy diagnosed by routine laboratory tests within 72 hours post-operatively. Methods The baseline characteristics, intra-operative management, and follow-up results of 462 patients with TBIs were obtained and retrospectively analyzed by multivariate logistic regression from January 2015 to June 2019. Coagulopathy was defined as an activated partial thromboplastin time > 40 seconds, international normalized ratio >1.4, or a platelet count < 100×109 /L.Results Multivariate logistic regression analysis revealed that the Glasgow Coma Scale (GCS) at the time of admission, Injury Severity Score (ISS) at the time of admission, pupil mydriasis, duration of surgery, intra-operative blood loss, and intra-operative crystalloid resuscitation were independent risk factors for patients who developed a coagulopathy post-operatively. There were statistical differences in mortality (p = 0.049), the Glasgow Outcome Scale-Extended (GCS-E; p = 0.024), and the modified Rankin Scale (p = 0.043) between patients with and without coagulopathy 1 week after surgery. Coagulopathy within 72 h after surgery revealed a trend for higher mortality at 1 week (66.7%), 3 months (71.4%), and 6 months (76.2%). Furthermore, coagulopathy and contusion expansion in the early post-operative period were independent risk factors for TBI mortality after surgery. Intra-operative crystalloid resuscitation had a substantial diagnostic accuracy in predicting coagulopathy within 72 h post-operatively (area under the curve [AUC] = 0.972).Conclusion Coagulopathy within 72 h post-operatively in patients with a TBI predicted worse disease progression and unfavorable neurologic outcomes. Hence, we should take practical and reasonable measures to manage these risk factors, which may protect patients with a TBI from post-operative coagulopathy.

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Middle Cerebral Artery-to-Uterine Artery Pulsatility Index Ratio Independently Predicts Adverse Perinatal Outcome in Pregnancies at Term

10.21203/rs.3.rs-51822/v1 ◽

2020 ◽

Author(s):

Sufen Zhou ◽

Hongyan Guo ◽

Heng Liu ◽

Mingqun Li

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Middle Cerebral Artery ◽

Perinatal Outcome ◽

Pulsatility Index ◽

Uterine Artery ◽

Regression Analyses ◽

Multivariate Logistic Regression ◽

Adverse Perinatal Outcome ◽

Independent Risk Factors

Abstract Background: This study aimed to investigate potential predictors, including cerebroplacental ratio (CPR), middle cerebral artery (MCA)/uterine artery pulsatility index (PI) ratio, for adverse perinatal outcome in pregnancies at term.Methods: This was an observational, prospective study of recruited pregnancies at term. An adverse perinatal outcome was set as the primary observational endpoint. The receiver operating characteristic (ROC) curve was plotted to investigate the predictive and cut-off values of risk factors for adverse perinatal outcome. Independent risk factors (maternal, neonatal, prenatal ultrasound and Doppler variables) for adverse perinatal outcome were evaluated by the univariate and multivariate logistic regression analyses.Results: A total of 392 pregnancies at term were included and 19.4% of them had suffered adverse perinatal outcome. CPR (OR: 0.42, 95%CI: 0.20-0.93, P=0.032) and MCA/uterine artery PI ratio (OR: 0.25, 95%CI: 0.16-0.42, P=0.032) were two independent risk factors for adverse perinatal outcome by univariate and multivariate logistic regression analyses.Conclusions: MCA/uterine artery PI ratio is a good predictor of adverse perinatal outcome in pregnancies at term.

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Aneurysm characteristics and risk of rebleeding after subarachnoid haemorrhage

European Stroke Journal ◽

10.1177/2396987318803502 ◽

2018 ◽

Vol 4 (2) ◽

pp. 153-159

Author(s):

Inez Koopman ◽

Jacoba P Greving ◽

Irene C van der Schaaf ◽

Albert van der Zwan ◽

Gabriel JE Rinkel ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Aspect Ratio ◽

Subarachnoid Haemorrhage ◽

Independent Risk Factor ◽

Irregular Shape ◽

Aneurysmal Subarachnoid Haemorrhage ◽

Aneurysm Size ◽

Aneurysm Treatment ◽

Independent Risk Factors

Introduction Knowledge of risk factors for rebleeding after aneurysmal subarachnoid haemorrhage can help tailoring ultra-early aneurysm treatment. Previous studies have identified aneurysm size and various patient-related risk factors for early (≤24 h) rebleeding, but it remains unknown if aneurysm configuration is also a risk factor. We investigated whether irregular shape, aspect- and bottleneck ratio of the aneurysm are independent risk factors for early rebleeding after aneurysmal subarachnoid haemorrhage. Patients and methods From a prospectively collected institutional database, we investigated data from consecutive aneurysmal subarachnoid haemorrhage patients who were admitted ≤24 h after onset between December 2009 and January 2015. The admission computed tomographic angiogram was used to assess aneurysm size and configuration. With Cox regression, we calculated stepwise-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for irregular shape, aspect ratio ≥1.6 mm and bottleneck ratio ≥1.6 mm. Results Of 409 included patients, 34 (8%) patients had in-hospital rebleeding ≤24 h after ictus. Irregular shape was an independent risk factor for rebleeding (HR: 3.9, 95% CI: 1.3–11.3) after adjustment for age, sex, PAASH score, aneurysm location, aneurysm size and aspect- and bottleneck ratio. Aspect ratio ≥1.6 mm (HR: 2.3, 95% CI: 0.8–6.5) and bottleneck ratio ≥1.6 mm (HR: 1.7, 95% CI: 0.8–3.6) were associated with an increased risk of rebleeding, but were not independent risk factors after multivariable adjustment. Conclusions Irregular shape is an independent risk factor for early rebleeding. However, since the majority of subarachnoid haemorrhage patients have an irregular aneurysm, additional risk factors have to be found for aneurysm treatment prioritisation.

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