Post-Bariatric Abdominoplasty: Analysis of 406 Cases With Focus on Risk Factors and Complications

Abstract Background Post-bariatric patients present a surgical challenge within abdominoplasty because of residual obesity and major comorbidities. In this study, we analyzed complications following abdominoplasty in post-bariatric patients and evaluated potential risk factors associated with these complications. Objectives The authors sought to determine the complications and risk factors following abdominoplasty in post-bariatric patients. Methods A retrospective study of patients who underwent abdominoplasty was performed from January 2009 to December 2018 at our institution. Variables analyzed were sex, age, body mass index (BMI), smoking, surgical technique, operative time, resection weight, drain output, and complications. Results A total of 406 patients were included in this study (320 female and 86 male) with a mean age of 44.4 years and a BMI of 30.6 kg/m2. Abdominoplasty techniques consisted of traditional (64.3%), fleur-de-lis technique (27.3%), and panniculectomy without umbilical displacement (8.4%). Overall complications recorded were 41.9%, the majority of these being wound-healing problems (32%). Minor and major complications were found in 29.1% and 12.8% of patients, respectively. A BMI value of ≥30 kg/m2 was associated with an increased risk for wound-healing problems (P = 0.001). The frequency of total complications was significantly related to age (P = 0.007), BMI (P = 0.004), and resection weight (P = 0.001). Abdominoplasty technique tended to influence total complications. Conclusions This study demonstrates in a fairly large sample of post-bariatric patients (n = 406) that abdominoplasty alone can be performed safely, with an acceptable complication rate. Age, BMI, and resection weight are shown to be significant risk factors for total complications. The role of surgical technique needs to be evaluated further. Level of Evidence: 4

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Risk factors for surgical site infections in neurosurgery

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2019.0001 ◽

2019 ◽

Vol 101 (3) ◽

pp. 220-225 ◽

Cited By ~ 2

Author(s):

S Patel ◽

D Thompson ◽

S Innocent ◽

V Narbad ◽

R Selway ◽

...

Keyword(s):

Risk Factors ◽

Significant Risk ◽

Surgical Site Infections ◽

Reoperation Rate ◽

High Morbidity ◽

Clinical Notes ◽

Increased Risk ◽

Public Data ◽

Potential Risk Factors ◽

Risk Patients

Introduction Surgical site infections (SSIs) are of profound significance in neurosurgical departments, resulting in high morbidity and mortality. There are limited public data regarding the incidence of SSIs in neurosurgery. The aim of this study was to determine the rate of SSIs (particularly those requiring reoperation) over a seven-year period and identify factors leading to an increased risk. Methods An age matched retrospective analysis was undertaken of a series of 16,513 patients at a single centre. All patients who required reoperation for suspected SSIs within a 7-year period were identified. Exclusion criteria comprised absence of infective material intraoperatively and patients presenting with primary infections. Clinical notes were reviewed to confirm presence or absence of suspected risk factors. Results Of the 16,513 patients in the study, 1.20% required at least one further operation to treat a SSI. Wound leak (odds ratio [OR]: 27.41), dexamethasone use (OR: 3.55), instrumentation (OR: 2.74) and operative duration >180 minutes (OR: 1.85) were statistically significant risk factors for reoperation. Conclusions This is the first UK study of such a duration that has documented a SSI reoperation rate in a cohort of this size. Various risk factors are associated with the development of SSIs, making it essential to have robust auditing and monitoring of high risk patients to ensure excellent standards of healthcare. Departmental and public registers to record all SSIs may be beneficial, particularly for those treated solely by general practitioners, allowing units to address potential risk factors prior to surgical intervention.

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Cutaneous MCTs: Associations with Spay/Neuter Status, Breed, Body Size, and Phylogenetic Cluster

Journal of the American Animal Hospital Association ◽

10.5326/jaaha-ms-5621 ◽

2011 ◽

Vol 47 (3) ◽

pp. 210-216 ◽

Cited By ~ 45

Author(s):

Carrie R. White ◽

Ann E. Hohenhaus ◽

Jennifer Kelsey ◽

Elizabeth Procter-Gray

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Phylogenetic Cluster ◽

Mast Cell Tumor ◽

Increased Risk ◽

Potential Risk Factors ◽

Grade 3 ◽

Labrador Retrievers ◽

Control Study

Certain breeds are known to be overrepresented among mast cell tumor (MCT) patients, but other risk factors have not been evaluated. This study presents results from a case-control study of 252 dogs with grade 2 or grade 3 cutaneous MCT. Increased risk for MCT development was found in spayed females (adjusted odds ratio [OR], 4.11), boxers (adjusted OR, 6.09), Labrador retrievers (adjusted OR, 3.95), pugs (adjusted OR, 3.17), golden retrievers (adjusted OR, 2.12), the mastiff and terrier phylogenetic cluster (adjusted OR, 3.19), and breeds classified as large (adjusted OR, 2.10) or giant (adjusted OR, 5.44). Additional studies are needed to evaluate the role of these and other potential risk factors in MCT development.

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Risk factors and protective factors of depression in older people 65+. A systematic review

PLoS ONE ◽

10.1371/journal.pone.0251326 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0251326

Author(s):

Alexander Maier ◽

Steffi G. Riedel-Heller ◽

Alexander Pabst ◽

Melanie Luppa

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Older People ◽

Smoking Behavior ◽

Significant Risk ◽

Female Gender ◽

Assessment Tools ◽

Mobility Impairment ◽

Increased Risk ◽

Potential Risk Factors

Objectives Identifying risk factors of depression can provide a better understanding of the disorder in older people. However, to minimize bias due to the influence of confounders and to detect reverse influence, a focus on longitudinal studies using multivariate analysis is required. Design A systematic literature search was conducted by searching the databases MEDLINE, Cochrane, PsycINFO and Web of Science for all relevant articles published from January 2000 to the end of March 2020. The following inclusion criteria were used: prospective design, nationally or regionally representative sample, published in English or German, analyzed risk factors for depression of individuals 65+ identified by multivariate analysis, and provided validity of diagnostic instrument. All results of multivariate analysis were reported and summarized. Results Thirty articles were identified. Heterogeneous results were found for education, female gender, self-rated health, cognitive impairment and older age, although significant in several studies. Findings hinted at a protective quality of physical activity. In terms of physical health, chronic disease and difficulty initiating sleep homogeneously increased risk of depression. Mobility impairment resulted as a risk factor in three studies. IADL impairment and vision impairment were mostly identified as significant risk factors. Alcohol consumption and smoking behavior yielded heterogenous results. Psychosocial factors were assessed similarly in multiple studies and yielded heterogenous results. Limitations Research was limited to articles published in English or German. Length of follow up was not considered for the presentation of results. Adjustments for and inclusion of different variables in the studies may distort results. Conclusion Our findings demonstrate the necessity of refined, more comparable assessment tools for evaluating potential risk factors.

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Factors Associated with Revision Adenoidectomy

Otolaryngology ◽

10.1177/0194599811435971 ◽

2012 ◽

Vol 146 (6) ◽

pp. 984-990 ◽

Cited By ~ 30

Author(s):

Amy C. Dearking ◽

Brian D. Lahr ◽

Admire Kuchena ◽

Laura J. Orvidas

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Gastroesophageal Reflux Disease ◽

Surgical Technique ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Significant Risk ◽

Significant Risk Factor ◽

Historical Cohort ◽

Increased Risk

Objective. To determine whether patient factors (eg, indication for initial surgery, medical comorbidity, or age) are associated with adenoid regrowth and subsequent need for revision adenoidectomy and whether surgical factors (eg, surgical technique or level of surgeon’s training) are associated with adenoid regrowth and subsequent need for revision adenoidectomy. Study Design. Historical cohort study. Setting. Tertiary care academic medical center. Subjects and Methods. Children (≤18 years) who underwent adenoidectomy or adenotonsillectomy between 1980 and May 2009 were identified. Medical and surgical records were reviewed for sex, age at surgery, indication for surgery, training level of surgeon, surgical technique, and history of allergies, asthma, or gastroesophageal reflux disease. Results. Of 8245 surgical cases (53.8% male), 163 were revision adenoidectomies. Age at initial adenoidectomy was a significant factor for revision adenoidectomy, with younger ages associated with higher increased risk. Indication for adenoidectomy was also a significant risk factor; adjusted for age, patients with ear rather than infectious indications were about 10 times more likely to require revision. A diagnosis of gastroesophageal reflux disease was a significant risk factor (hazard ratio, 2.23; P = .002). Conclusion. Several risk factors are associated with revision adenoidectomy: young age at initial procedure, indication for adenoidectomy, and diagnosis of gastroesophageal reflux disease. Surgical technique, level of experience of the initial surgeon, and diagnosis of asthma or allergies were not significant risk factors for revision adenoidectomy.

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The Unique Associations of Academic Experiences With Depressive Symptoms in Emerging Adulthood

Emerging Adulthood ◽

10.1177/2167696816657233 ◽

2016 ◽

Vol 5 (1) ◽

pp. 75-80 ◽

Cited By ~ 5

Author(s):

Sarah E. Newcomb-Anjo ◽

Rosanne Villemaire-Krajden ◽

Katie Takefman ◽

Erin T. Barker

Keyword(s):

Risk Factors ◽

Depressive Symptoms ◽

University Students ◽

Emerging Adults ◽

Multiple Regression Model ◽

Academic Experiences ◽

Academic Experience ◽

Increased Risk ◽

Potential Risk Factors

Research has shown that university students are at increased risk of developing depression and related symptoms. The goal of the present study was to examine whether academic experiences relate to depressive symptoms in emerging adults, over and above a set of established depression risk factors. Participants ( N = 903), ages 18–25 years, completed a series of questionnaires about risk factors for depression, academic experiences, and depressive symptoms. Results of a hierarchical multiple regression model showed that features of the academic experience were associated with depressive symptoms, over and above the effects of established risk factors. In particular, perceived academic stress, disengagement from studies, and loneliness at university were significant predictors of depressive symptoms. This research highlights the role of subjective academic experiences as potential risk factors for depressive symptoms in university students.

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Risk factors for pregnancy-associated venous thromboembolism in Singapore

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0298 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Sandra Lynn Jaya-Bodestyne ◽

Lai Heng Lee ◽

Lay Kok Tan ◽

Kok Hian Tan ◽

Truls Østbye ◽

...

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Significant Risk ◽

International Classification Of Diseases ◽

Prospective Longitudinal Study ◽

Mortality And Morbidity ◽

Singapore General Hospital ◽

Increased Risk ◽

Potential Risk Factors ◽

Prospective Longitudinal

AbstractObjectivesPregnancy-associated venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), is associated with increased risk of maternal mortality and morbidity. This study aimed to assess potential risk factors for pregnancy-associated VTE.MethodsIn this case-control study, women with pregnancy-associated VTE were identified via International Classification of Diseases codes and included if they had been objectively diagnosed with VTE during pregnancy or within six weeks postpartum, from 2004 to 2016, at KK Women’s and Children’s Hospital or Singapore General Hospital in Singapore. Controls, i.e. pregnant women without VTE, were selected from a prospective longitudinal study. The odds ratio (OR) for VTE was computed for a range of maternal and obstetric factors.Results and conclusionsFrom 2004 to 2016, 89 cases of pregnancy-associated VTE and 926 controls were identifed and analysed using logistic regression. The most significant risk factors for pregnancy-associated VTE were smoking (OR 5.44, p=0.0002) and preterm delivery (OR 5.06, p=0.023). Malay race, multiparity, non-O blood group and caesarean section, were also identified to be of higher risk. These risk factors should be useful in the development of thromboprophylaxis strategies for pregnancy and the postpartum period, especially in Singapore.

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Correlation between Potential Risk Factors and Pulmonary Embolism in Sarcoidosis Patients Timely Treated

Journal of Clinical Medicine ◽

10.3390/jcm10112462 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2462

Author(s):

Barbara Ruaro ◽

Paola Confalonieri ◽

Mario Santagiuliana ◽

Barbara Wade ◽

Elisa Baratella ◽

...

Keyword(s):

Risk Factors ◽

Pulmonary Embolism ◽

Potential Risk ◽

Smoking Habit ◽

Age At Diagnosis ◽

Antiphospholipid Antibody ◽

Increased Risk ◽

Significant Difference ◽

Antibody Positivity ◽

Potential Risk Factors

Background. Some studies with inconclusive results have reported a link between sarcoidosis and an increased risk of pulmonary embolism (PE). This study aimed at assessing a possible correlation between potential risk factors and PE in sarcoidosis patients. Methods. A total of 256 sarcoidosis patients (84 males and 172 females; mean age at diagnosis 49 ± 13) were enrolled after giving written informed consent. Clinical evaluations, laboratory and radiology tests were performed to evaluate the presence of pulmonary embolism. Results. Fifteen sarcoidosis patients with PE (4 males and 11 females; mean age at diagnosis 50 ± 11), diagnosed by lung scintigraphy and 241 sarcoidosis patients without PE (80 males and 161 females; mean age at diagnosis 47 ± 13), were observed. There was a statistically significant increase of the presence of antiphospholipid antibodies in the sarcoidosis group with pulmonary embolism. There was no statistically significant difference between the two groups as to smoking habit, obesity or hereditary thrombophilia frequency (p > 0.05, respectively). Conclusions. This study demonstrates a significant correlation between the presence of antiphospholipid antibody positivity and the pulmonary embolism events in our sarcoidosis patients. Furthermore, we propose screening for these antibodies and monitoring, aimed at timely treatment.

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Influence of socio-economic status on Shiga toxin-producing Escherichia coli (STEC) infection incidence, risk factors and clinical features

Epidemiology and Infection ◽

10.1017/s0950268819000864 ◽

2019 ◽

Vol 147 ◽

Author(s):

N. L. Adams ◽

L. Byrne ◽

T. C. Rose ◽

G. K. Adak ◽

C. Jenkins ◽

...

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Shiga Toxin ◽

Economic Status ◽

Care Seeking ◽

Socio Economic Status ◽

Accident And Emergency ◽

Incidence Risk ◽

Potential Risk Factors

Abstract Shiga toxin-producing Escherichia coli (STEC) infection can cause serious illness including haemolytic uraemic syndrome. The role of socio-economic status (SES) in differential clinical presentation and exposure to potential risk factors amongst STEC cases has not previously been reported in England. We conducted an observational study using a dataset of all STEC cases identified in England, 2010–2015. Odds ratios for clinical characteristics of cases and foodborne, waterborne and environmental risk factors were estimated using logistic regression, stratified by SES, adjusting for baseline demographic factors. Incidence was higher in the highest SES group compared to the lowest (RR 1.54, 95% CI 1.19–2.00). Odds of Accident and Emergency attendance (OR 1.35, 95% CI 1.10–1.75) and hospitalisation (OR 1.71, 95% CI 1.36–2.15) because of illness were higher in the most disadvantaged compared to the least, suggesting potential lower ascertainment of milder cases or delayed care-seeking behaviour in disadvantaged groups. Advantaged individuals were significantly more likely to report salad/fruit/vegetable/herb consumption (OR 1.59, 95% CI 1.16–2.17), non-UK or UK travel (OR 1.76, 95% CI 1.40–2.27; OR 1.85, 95% CI 1.35–2.56) and environmental exposures (walking in a paddock, OR 1.82, 95% CI 1.22–2.70; soil contact, OR 1.52, 95% CI 2.13–1.09) suggesting other unmeasured risks, such as person-to-person transmission, could be more important in the most disadvantaged group.

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Post-thyroidectomy bleeding: analysis of risk factors from a national registry

British Journal of Surgery ◽

10.1093/bjs/znab015 ◽

2021 ◽

Author(s):

H E Doran ◽

S M Wiseman ◽

F F Palazzo ◽

D Chadwick ◽

S Aspinall

Keyword(s):

Risk Factors ◽

Total Thyroidectomy ◽

Thyroid Surgery ◽

Multivariable Analysis ◽

Significant Risk ◽

Bleeding Risk ◽

Redo Surgery ◽

Day Case ◽

Increased Risk ◽

Male Sex

Abstract Background Post-thyroidectomy haemorrhage occurs in 1–2 per cent of patients, one-quarter requiring bedside clot evacuation. Owing to the risk of life-threatening haemorrhage, previous British Association of Endocrine and Thyroid Surgeons (BAETS) guidance has been that day-case thyroidectomy could not be endorsed. This study aimed to review the best currently available UK data to evaluate a recent change in this recommendation. Methods The UK Registry of Endocrine and Thyroid Surgery was analysed to determine the incidence of and risk factors for post-thyroidectomy haemorrhage from 2004 to 2018. Results Reoperation for bleeding occurred in 1.2 per cent (449 of 39 014) of all thyroidectomies. In multivariable analysis male sex, increasing age, redo surgery, retrosternal goitre and total thyroidectomy were significantly correlated with an increased risk of reoperation for bleeding, and surgeon monthly thyroidectomy rate correlated with a decreased risk. Estimation of variation in bleeding risk from these predictors gave low pseudo-R2 values, suggesting that bleeding is unpredictable. Reoperation for bleeding occurred in 0.9 per cent (217 of 24 700) of hemithyroidectomies, with male sex, increasing age, decreasing surgeon volume and redo surgery being risk factors. The mortality rate following thyroidectomy was 0.1 per cent (23 of 38 740). In a multivariable model including reoperation for bleeding node dissection and age were significant risk factors for mortality. Conclusion The highest risk for bleeding occurred following total thyroidectomy in men, but overall bleeding was unpredictable. In hemithyroidectomy increasing surgeon thyroidectomy volume reduces bleeding risk. This analysis supports the revised BAETS recommendation to restrict day-case thyroid surgery to hemithyroidectomy performed by high-volume surgeons, with caution in the elderly, men, patients with retrosternal goitres, and those undergoing redo surgery.

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Combining Carcinoembryonic Antigen and Platelet to Lymphocyte Ratio to Predict Brain Metastasis of Resected Lung Adenocarcinoma Patients

BioMed Research International ◽

10.1155/2017/8076384 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Wei Wang ◽

Chao Bian ◽

Di Xia ◽

Jin-Xi He ◽

Ping Hai ◽

...

Keyword(s):

Risk Factors ◽

Brain Metastasis ◽

Lung Adenocarcinoma ◽

Carcinoembryonic Antigen ◽

Roc Curve ◽

Univariate Analysis ◽

Significant Risk ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Increased Risk

We aimed to evaluate the role of pretreatment carcinoembryonic antigen (CEA) and platelet to lymphocyte ratio (PLR) in predicting brain metastasis after radical surgery for lung adenocarcinoma patients. The records of 103 patients with completely resected lung adenocarcinoma between 2013 and 2014 were reviewed. Clinicopathologic characteristics of these patients were assessed in the Cox proportional hazards regression model. Brain metastasis occurred in 12 patients (11.6%). On univariate analysis, N2 stage (P = 0.013), stage III (P = 0.016), increased CEA level (P = 0.006), and higher PLR value (P = 0.020) before treatment were associated with an increased risk of developing brain metastasis. In multivariate model analysis, CEA above 5.2 ng/mL (P = 0.014) and PLR ≥ 120 (P = 0.036) remained as the risk factors for brain metastasis. The combination of CEA and PLR was superior to CEA or PLR alone in predicting brain metastasis according to the receiver operating characteristic (ROC) curve analysis (area under ROC curve, AUC 0.872 versus 0.784 versus 0.704). Pretreatment CEA and PLR are independent and significant risk factors for occurrence of brain metastasis in resected lung adenocarcinoma patients. Combining these two factors may improve the predictability of brain metastasis.

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