Risk factors for urethral gonorrhoea infection among heterosexual males in Melbourne, Australia: 2007–17

Background Since 2014 there has been an increase in gonorrhoea among heterosexuals in Australia. Sex with a partner from a country with high gonorrhoea prevalence has been identified as a risk factor for gonorrhoea in heterosexual females, but risk factors for heterosexual males remain unclear. This study determined risk factors for gonorrhoea among heterosexual males. Methods: Retrospective analysis was performed among heterosexual males attending Melbourne Sexual Health Centre (MSHC) between 1 January 2007 and 31 December 2017. Countries for overseas sexual partners were stratified as high-prevalence countries (HPC) or low-prevalence countries (LPC) based on the incidence of gonorrhoea. Results: The annual gonorrhoea positivity increased from 0.72% in 2007 to 1.33% in 2017 (Ptrend <0.001). Males attending MSHC as a contact of gonorrhoea had the highest odds of testing positive (adjusted odds ratio (aOR) 7.46; 95% confidence interval (CI) 4.46–12.49), followed by males identifying as Aboriginal and Torres Strait Islander (aOR 2.57; 95% CI 1.30–5.09), males who had injected drugs in the past 12 months (aOR 2.44; 95% CI 1.39–4.30) and males who had sex with a female from an HPC (aOR 2.18; 95% CI 1.77–2.68). Males aged ≥35 were at higher risk than those aged ≤24 years (aOR 1.44; 95% CI 1.14–1.82). Gonorrhoea positivity increased among males who had sex with females from an LPC (from 0.60% to 1.33%; Ptrend = 0.004) but remained the same over time among males who had sex with females from an HPC (2.14%; Ptrend = 0.143). Conclusions: There was an 80% increase in urethral gonorrhoea among heterosexual males between 2007 and 2017. Having sex with a female from an HPC is a significant risk factor for gonorrhoea. Gonorrhoea positivity among men having sex with a female from an HPC did not change over time, suggesting this risk factor has become less important.

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Community- versus hospital-acquired acute kidney injury in hospitalised COVID-19 patients

BMC Nephrology ◽

10.1186/s12882-021-02471-2 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jack S Bell ◽

Benjamin D James ◽

Saif Al-Chalabi ◽

Lynne Sykes ◽

Philip A Kalra ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Acute Kidney Injury ◽

Risk Factor ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Significant Risk ◽

Kidney Injury ◽

Significant Risk Factor ◽

Hospital Acquired

Abstract Background Acute kidney injury (AKI) is a recognised complication of coronavirus disease 2019 (COVID-19), yet the reported incidence varies widely and the associated risk factors are poorly understood. Methods Data was collected on all adult patients who returned a positive COVID-19 swab while hospitalised at a large UK teaching hospital between 1st March 2020 and 3rd June 2020. Patients were stratified into community- and hospital-acquired AKI based on the timing of AKI onset. Results Out of the 448 eligible patients with COVID-19, 118 (26.3 %) recorded an AKI during their admission. Significant independent risk factors for community-acquired AKI were chronic kidney disease (CKD), diabetes, clinical frailty score and admission C-reactive protein (CRP), systolic blood pressure and respiratory rate. Similar risk factors were significant for hospital-acquired AKI including CKD and trough systolic blood pressure, peak heart rate, peak CRP and trough lymphocytes during admission. In addition, invasive mechanical ventilation was the most significant risk factor for hospital-acquired AKI (adjusted odds ratio 9.1, p < 0.0001) while atrial fibrillation conferred a protective effect (adjusted odds ratio 0.29, p < 0.0209). Mortality was significantly higher for patients who had an AKI compared to those who didn’t have an AKI (54.3 % vs. 29.4 % respectively, p < 0.0001). On Cox regression, hospital-acquired AKI was significantly associated with mortality (adjusted hazard ratio 4.64, p < 0.0001) while community-acquired AKI was not. Conclusions AKI occurred in over a quarter of our hospitalised COVID-19 patients. Community- and hospital-acquired AKI have many shared risk factors which appear to converge on a pre-renal mechanism of injury. Hospital- but not community acquired AKI was a significant risk factor for death.

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Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1344 ◽

2020 ◽

pp. 1-7

Author(s):

Stephanie M. Cabral ◽

Katherine E. Goodman ◽

Natalia Blanco ◽

Surbhi Leekha ◽

Larry S. Magder ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Risk Adjustment ◽

Community Hospital ◽

Significant Risk ◽

Significant Risk Factor ◽

Bivariate Analysis ◽

Patient Admissions ◽

Clostridioides Difficile ◽

Risk Adjustment Model

Abstract Objective: To determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. Patients: All patients at least 18 years of age admitted to 3 hospitals in Maryland between January 1, 2016, and January 1, 2018. Methods: Comorbid conditions were assigned using the Elixhauser comorbidity index. Multivariable log-binomial regression was conducted for each hospital using significant covariates (P < .10) in a bivariate analysis. Standardized infection ratios (SIRs) were computed using current Centers for Disease Control and Prevention (CDC) risk adjustment methodology and with the addition of Elixhauser score and individual comorbidities. Results: At hospital 1, 314 of 48,057 patient admissions (0.65%) had a HO-CDI; 41 of 8,791 patient admissions (0.47%) at community hospital 2 had a HO-CDI; and 75 of 29,211 patient admissions (0.26%) at community hospital 3 had a HO-CDI. In multivariable regression, Elixhauser score was a significant risk factor for HO-CDI at all hospitals when controlling for age, antibiotic use, and antacid use. Abnormal leukocyte level at hospital admission was a significant risk factor at hospital 1 and hospital 2. When Elixhauser score was included in the risk adjustment model, it was statistically significant (P < .01). Compared with the current CDC SIR methodology, the SIR of hospital 1 decreased by 2%, whereas the SIRs of hospitals 2 and 3 increased by 2% and 6%, respectively, but the rankings did not change. Conclusions: Electronically available patient comorbidities are important risk factors for HO-CDI and may improve risk-adjustment methodology.

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Risk factors for hypertensive crisis in children with acute glomerulonephritis

Paediatrica Indonesiana ◽

10.14238/pi56.2.2016.101-6 ◽

2016 ◽

Vol 56 (2) ◽

pp. 101

Author(s):

Sherly Yuniarchan ◽

Risky Vitria Prasetyo ◽

Ninik Asmaningsih Soemyarso ◽

Mohammad Sjaifullah Noer

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Risk Factor ◽

Pediatric Population ◽

Hypertensive Crisis ◽

Significant Risk ◽

Significant Risk Factor ◽

P Value ◽

Acute Glomerulonephritis ◽

Female Ratio

Background Hypertensive crisis occurs in 1-4% of the hypertensive pediatric population, mostly due to acute glomerulonephritis (AGN). Some factors have been suggested to affect blood pressure (BP) in children, such as age, sex, race/ethnicity, obesity, and socioeconomic status, but little is known for risk factors for hypertensive crisis in AGN.Objective To analyze the risk factors for hypertensive crisis in children with AGN.Methods Retrospectively, we studied possible risk factors for hypertensive crisis in children with AGN at Dr. Soetomo Hospital from 2007 to 2011. Hypertensive crisis was defined as systolic BP ≥180 mmHg or diastolic BP ≥120 mmHg (for children ≥ 6 years of age); and systolic and/or diastolic BP >50% above the 95th percentile (for children aged <6 years). We evaluated the demographic and clinical characteristics as potential risk factors. Statistical analysis was done with Chi-square, Fisher’s exact, and logistic regression tests. Variables with P <0.25 in the univariable analysis were further analyzed by the multivariable logistic regression model. A P value of < 0.05 was considered statistically significant.Results There were 101 children included (mean age 9.7 (SD 2.17) years), with a male-to-female ratio of 2.7:1. Hypertensive crisis occurred in 42 (41.6%) children, of whom 8 had hypertensive urgency and 34 had hypertensive emergency. Proteinuria was seen in 53 children with AGN (52.5%) and was the significant risk factor for hypertensive crisis in our subjects (OR=2.75; 95%CI 1.16 to 6.52; P=0.021). Gender, clinical profiles, ethnicity, nutritional status, blood urea nitrogen (BUN), and glomerular filtration rate (GFR) were not significant risk factors for hypertensive crisis.Conclusion Proteinuria is the significant risk factor for hypertensive crisis in children with AGN.

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Risk factors for mortality in children with Wilms tumor

Paediatrica Indonesiana ◽

10.14238/pi56.4.2016.226-9 ◽

2016 ◽

Vol 56 (4) ◽

pp. 226

Author(s):

Yuni Purwanti ◽

Sutaryo Sutaryo ◽

Sri Mulatsih ◽

Pungky Ardani Kusuma

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Wilms Tumor ◽

Significant Risk ◽

Significant Risk Factor ◽

Stage Iii ◽

Control Group ◽

Case Group ◽

Chi Square ◽

Potential Risk Factors

Background Wilms tumor is the most common renal malignancy in children (95%) and one of the leading causes of death in children, with high mortality rates in developing countries. Identifying risk factors for mortality is important in order to provide early intervention to improve cure rates.Objective To identify risk factors for mortality in children with Wilms tumor.Methods We performed a case-control study of children (0-18 years of age) with Wilms tumor admitted to Dr. Sardjito Hospital between 2005 and 2012. The case group consisted of children who died of Wilms tumor, whereas the control group were children who survived. Data were collected from medical records. Statistical analyses using Chi-square and logistic regression tests were done to determine odds ratios and 95% CI of the potential risk factors for mortality from Wilms tumor.Results Thirty-five children with Wilms tumor were admitted to Dr. Sardjito Hospital during the study period. Nine (26%) children died and 26 survived. Stage ≥III was a significant risk factor for mortality in chidren with Wilms tumor (OR 62.8; 95%CI 5.6 to 70.5). Age ≥2 years (OR 1.4; 95%CI 0.1 to 14.3) and male sex (OR 1.2; 95%CI 0.1 to 10.8) were not significant risk factors for mortality.Conclusion Stage ≥III is a risk factor for mortality in children with Wilms tumor.

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Risk factors of childhood leukemia

Paediatrica Indonesiana ◽

10.14238/pi54.6.2014.358-64 ◽

2014 ◽

Vol 54 (6) ◽

pp. 358

Author(s):

Paulina K. Bangun ◽

Bidasari Lubis ◽

Sri Sofyani ◽

Nelly Rosdiana ◽

Olga R. Siregar

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Birth Weight ◽

Maternal Age ◽

Childhood Leukemia ◽

Significant Risk ◽

Significant Risk Factor ◽

High Birth Weight ◽

Parental Age ◽

Prenatal Risk Factors

Background The incidence of childhood leukemia has increasedannually. Recent studies have shown that childhood leukemia isinitiated in utero, and have focused on prenatal risk factors suchas birth weight and parental age. Exposure to pesticides andradiation, as well as parental smoking, breastfeeding, and thenumber of older siblings have also been sugges ted as risk factorsfor childhood leukemia.Objective To evaluate possible risk factors for childhood leukemia,including birth weight, parental age, and other risk factors.Methods This case-con trol study was conducted from October2011 to February 2012 in Haji Adam Malik Hospital, Medan .Case subjects were children aged below 18 years and diagnosedwith leukemia. Control subjects were children aged below 18years who were diagnosed with any non-cancerous acute illnessesin this hospital, and individually matched for age and gen der tothe case subject group. Patients and parents were asked to fill astructured questionnaire. Data was analyzed using conditionallogistic regression .Results A total of 140 subjects were eligible, with 70 subjects ineach group. Birth weight 2: 4000 g and maternal age 2:35 yearswere significant risk factors with OR 10.13 (95%CI 1.124 to 91.2 7)and OR 4.98 (95%CI 1.276 to 19.445), respectively. Paternal ageof 2:35 years was not a significant risk factor. Exposure to pesticideswas also noted as another significant risk factor (OR= 6.66; 95%CI2.021 to 21.966) .Conclusion High birth weight, advan ced maternal age, andexposure to pesticides are risk factors of childhood leukemia.

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Do all women attending urban sexual health services need testing for gonorrhoea?

Sexual Health ◽

10.1071/sh05029 ◽

2005 ◽

Vol 2 (4) ◽

pp. 259 ◽

Cited By ~ 4

Author(s):

Tim R. H. Read ◽

Marcus Y. Chen ◽

Catriona S. Bradshaw ◽

Sriyakantha Beneragama ◽

Christopher K. Fairley

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Sexual Health ◽

Medical Records ◽

Health Centre ◽

Identifiable Risk Factor ◽

Health Centres ◽

Health Services Need ◽

Low Prevalence ◽

Asymptomatic Women

Asymptomatic women are often screened for gonorrhoea at Australian sexual health centres. The medical records of all women diagnosed with gonorrhoea at the Melbourne Sexual Health Centre (MSHC) between January 2002 and December 2003 were audited and the database was examined for risk factors in all women tested in 2003. Fifteen cases of gonorrhoea were identified among women at MSHC, all had symptoms or an identifiable risk factor. Asymptomatic women without risk factors may not require screening for Neisseria gonorrhoeae in low prevalence populations.

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MON-585 Racial/Ethnic Contribution and Metabolic Factors of NAFLD/NASH in the US Population: Data from NNANES III

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1594 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Theodore C Friedman ◽

Magda Shaheen ◽

Dulcie Kermah ◽

Deyu Pan ◽

Katrina Schrode ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Liver Enzyme ◽

Significant Risk ◽

Significant Risk Factor ◽

Healthy Eating Index ◽

C Peptide ◽

The Us ◽

Race Ethnicity ◽

Racial Ethnic

Abstract Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver condition. It is manifested by hepatic steatosis (HS) that can progress to non-alcoholic steatohepatitis (NASH), and even liver failure. Interestingly, it is marked by racial/ethnic disparities, with a high prevalence in Hispanics. We aimed to identify the risk factors for these chronic conditions in the US. To this end, we analyzed data from NHANES III (1988-1994) using multiple or multinomial logistic regression considering the design and sample weight. HS was identified by ultrasound. NAFLD was defined as HS in the absence of viral hepatitis or excessive use of alcohol or hepatotoxic drugs. The NAFLD population was further divided into those with NASH (defined by the HAIR score), or with simple NAFLD. The prevalence of HS was 19.8%, 16.6%, and 27.9%; of NAFLD was 17.8%, 14.7%, and 25.5%; and of NASH was 3.2%, 2.5%, and 5.1% in non-Hispanic Whites, non-Hispanic Blacks and Hispanics, respectively. Race/ethnicity was a significant predictor of HS, NAFLD and NASH, with Hispanics having the highest odds for all conditions, and non-Hispanic Blacks having the lowest odds relative to Whites (p<0.05). Other significant risk factors for all three conditions were older age, higher BMI, abnormal levels of C-peptide, and elevated serum glucose and triglycerides (p<0.05). HOMA insulin resistance was associated with HS and NAFLD (p<0.05). While smoking status was not associated with HS (p>0.05), current smokers had lower odds of NAFLD & NASH than non-smokers (p<0.05). Elevation of the liver enzyme aspartate aminotransferase was a significant risk factor of HS, while elevation of the liver enzyme alanine transaminase was a significant risk factor of NAFLD. Elevation in the levels of both liver enzymes was predictive of NASH (p<0.05). Although we included physical activity relative to national recommendation variable and the Healthy Eating Index (a measure of diet quality) in our analyses, neither of these factors was a predictor of any of the liver conditions (p>0.05). Our results showed an independent association between race/ethnicity and HS, NAFLD, and NASH, whereby Hispanics had the highest odds for every condition relative to non-Hispanic Whites. Providers should consider the race/ethnicity of their patients when evaluating the risk for NAFLD and NASH, and also be aware of the other risk factors, such as BMI and levels of C-peptide, glucose, and triglycerides.

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Risk Factors and Outcomes of Revision Arthroscopic Posterior Shoulder Capsulolabral Repair in Contact Athletes

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00317 ◽

2019 ◽

Vol 7 (7_suppl5) ◽

pp. 2325967119S0031

Author(s):

Justin W. Arner ◽

Sachidhanand Jayakumar ◽

Dharmesh Vyas ◽

James P. Bradley

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Revision Surgery ◽

Significant Risk ◽

Return To Sport ◽

Significant Risk Factor ◽

Return To Play ◽

Bone Width ◽

Posterior Shoulder

Objectives: Risk factors and outcomes of revision arthroscopic posterior capsulolabral repairare currently not well defined in contact athletes.Evaluation of risk factors for contact athletes who require revision arthroscopic posterior unidirectional capsulolabral repair is needed. Methods: A total of 186 contact athletes’ shoulders that underwent arthroscopic posterior capsulolabral repair at minimum 2 year follow-up were reviewed. Those who required revision surgery were compared with those who did not. Parameters assessed included age, gender, labral and/or capsular injury, level of sport, and return to sport. Glenoid bone width, bone version, labral width, and labral version were also compared. Results: Eleven shoulders required revision surgery (5.9%) at mean 12.0 year follow-up. The only significant risk factor was glenoid bone width (revision=26.4 mm vs. non-revision=29.1 mm, p=0.005). Cartilage version (p=0.676), labral version (p=0.539), and bone version (p=0.791) were not significantly different between groups, nor was labral width (p=0.751). Gender (p=0.326), labral injury (p=0.349), capsule injury (p=0.683), and level of sport (p=0.381) were not significant factors for requiring revision surgery. Both return to sport at the same level (revision=16.7% vs. non-revision=72.1%, p<0.001) and overall return to sport (revision=50% vs. non-revision=93.7%, p<0.001) was significantly worse in the revision group. Of those who had revision surgery, 33.3% stated their original surgery was not worthwhile, which was significantly higher than the 4.5% in the non-revision group (p=0.041). Conclusion: Contact athletes underwent revision arthroscopic posterior capsulolabral repair at an incidence of 5.9% at 12 year follow-up. The only significant risk factor for requiring revision surgery was smaller glenoid bone width. Return to play was significantly worse in those who required revision surgery. This data is essential for patient selection, optimal treatment techniques, and patient education as posterior shoulder capsulolabral repair in contact athletes that require revision has not previously been evaluated.

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Incidence and risk factors of neonatal thrombocytopenia: a pr

Paediatrica Indonesiana ◽

10.14238/pi50.1.2010.31-7 ◽

2016 ◽

Vol 50 (1) ◽

pp. 31

Author(s):

Nila Kusumasari ◽

Rinawati Rohsiswatmo ◽

Djajadiman Gatot ◽

Darlan Darwis

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Necrotizing Enterocolitis ◽

Late Onset ◽

Significant Risk ◽

Significant Risk Factor ◽

Cross Sectional Study ◽

Cross Sectional ◽

Neonatal Thrombocytopenia ◽

Complete Blood Counts

Background Thrombocytopenia is the most common hematological abnormality in the neonatal period. Hemorrhagic manifestations are found in 10% cases of thrombocytopenia. Neonatal thrombocytopenia commonly assumed due to sepsis, despite many risk factors that may caused thrombocytopenia.Objective To obtain incidence and risk factors of neonatal thrombocytopenia.Methods A cross sectional study was conducted in April 2009. Complete blood counts investigation was performed before age of 24 hours, medical conditions and risk factors of mothers and subjects were noted, as well as hemorrhagic manifestations. Subjects with thrombocytopenia were followed for 2 weeks. The risk factors consisted of hypertension in pregnancy, pre-eclampsia, eclampsia, intrauterine growth retardation, gestational diabetes mellitus, perinatal infection, asphyxia, sepsis, and necrotizing enterocolitis.Results Neonatal thrombocytopenia was found 17 (12.1%) of 140 subjects, consisted of 88.2% early onset and 11.8% late onset. Significant risk factor of mother was pre-eclampsia (PR 3.97, 95%CI 1.70 to 9.25), while significant risk factors of neonates were asphyxia (PR 5.66, 95%CI 2.49 to 12.86), sepsis (PR 5.33, 95%CI 2.33-12.19) and necrotizing enterocolitis (p=0.014; PR 9.2 95% CI 5.17 to14.84). We found 29.4% hemorrhagic cases of neonatal thrombocytopenia (i.e.,. skin, gastrointestinal, intracranial hemorrhage).Conclusions The incidence of neonatal thrombocytopenia was 12.2%. Significant risk factor of mother that caused thrombocytopenia was pre-eclampsia, while risk factors of neonates were asphyxia, sepsis and necrotizing enterocolitis.[Paediatr Indones. 2010;50:31-7].

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Risk Factors for Silent Cerebral Infarcts in a Pediatric Sickle Cell Anemia (SCA) Cohort

Blood ◽

10.1182/blood.v112.11.2487.2487 ◽

2008 ◽

Vol 112 (11) ◽

pp. 2487-2487 ◽

Cited By ~ 1

Author(s):

Francoise Bernaudin ◽

Suzanne Verlhac ◽

Annie Kamdem ◽

Cécile Arnaud ◽

Lena Coïc ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Risk Factor ◽

Logistic Regression Analysis ◽

G6pd Deficiency ◽

Significant Risk ◽

Significant Risk Factor ◽

History Of ◽

Independent Risk Factors

Abstract Background Silent infarcts are associated with impaired cognitive functioning and have been shown to be predictors of stroke (Miller ST J Pediatr 2001). Until now, reported risk factors for silent infarcts were low pain event rate, history of seizures, high leukocyte count and Sen bS haplotype (Kinney TR Pediatrics 1999). Here, we seek to define the prevalence and risk factors of silent infarcts in the Créteil SCA pediatric cohort comprising patients assessed at least yearly by transcranial doppler (TCD) since 1992, and by MRI/MRA. Methods This study retrospectively analyzed data from the Créteil cohort stroke-free SS/Sb0 children (280; 134 F, 146 M), according to institutional review board. Time-averaged mean of maximum velocities higher than 200 cm/sec were considered as abnormal, resulting in initiation of a transfusion program (TP). A switch to hydroxyurea was proposed to patients with normalized velocities (< 170 cm/sec) and normal MRA on TP, although TP was re-initiated in case of abnormal velocities recurrence. Patients with “conditional” velocities (170–199 cm/sec) were assessed by TCD 4 times yearly. Alpha genes and beta-globin haplotypes were determined. Baseline biological parameters (G6PD activity; WBC, PMN, Reticulocytes, Platelets counts; Hemoglobin, Hematocrit, HbF, LDH levels; MCV; SpO2) were obtained a minimum of 3 months away from a transfusion, one month from a painful episode, after 12 months of age, before the first TCD, and always before therapy intensification. Results. Patients were followed for a total of 2139 patient-years. Alpha-Thal was present in 114/254 patients (45%) and 27/241 (11.2%) had G6PD deficiency. Beta genotype, available in 240 patients, was BaBa in 102 (42.5%), BeBe in 54 (22.5%), SeSe in 19 (7.9%) and “other” in 65 (27.1%); TCD was abnormal in 52 of 280 patients (18.6%). MRA showed stenoses in 30 of 226 evaluated patients (13.3%) while MRI demonstrated presence of silent infarcts in 81/280 patients (28.9%). Abnormal TCD (p<0.001), G6PD deficiency (p=0.008), high LDH (p=0.03), and low Hb (p=0.026) were significant risk factors for stenoses by univariate analysis while multivariate analysis retained only abnormal TCD as a significant risk factor for stenoses ([OR= 10.6, 95% CI (4.6–24.4)]; p<0.001). Univariate logistic regression analysis showed that the risk of silent infarcts was not related to alpha-Thal, beta genotype, abnormal TCD, WBC, PMN, platelets, reticulocyte counts, MCV, LDH level, HbF %, pain or ACS rates but was significantly associated with stenoses detected by MRA (p<0.001), gender (male; p=0.04), G6PD deficiency (p=0.05), low Hb (p=0.016) and Hct (p=0.012). Multivariate logistic regression analysis showed that gender ([OR= 2.1, 95% CI (1.03–4.27)]; p=0.042), low Hb ([OR= 1.4, 95% CI (1.0–1.1)]; p=0.05) and stenoses ([OR= 4.8, 95% CI (1.88–12.28)]; p=0.001) were all significant independent risk factors for silent infarcts. The presence of stenoses was the only significant risk factor for silent infarcts in patients with a history of abnormal TCD ([OR= 5.9, 95% CI (1.6–21.7)]; p=0.008). Conclusion We recently showed that G6PD deficiency, absence of alpha-Thal, and hemolysis are independent significant risk factors for abnormal TCD in stroke-free SCA patients (Bernaudin et al, Blood, 2008, in press). Here, we report that an abnormal TCD is the most significant risk factor for stenoses and, expanding previous studies, we demonstrate that stenoses, low Hb and gender are significant independent risk factors for silent infarcts.

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