P3795Should we also screen for obstructive sleep apnea in patients presenting with excessive supraventricular ectopic activity?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Marinheiro ◽  
L Parreira ◽  
P Amador ◽  
D Mesquita ◽  
J Farinha ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Logistic Regression ◽  
Body Mass ◽  
Strong Evidence ◽  
Multivariate Logistic Regression Analysis ◽  
P Value ◽  
Ectopic Activity ◽  
Multivariate Logistic Regression ◽  
Obstructive Sleep

Abstract Background It is recommended to consider obstructive sleep apnoea (OSA) screening in atrial fibrillation (AF) patients with risk factors, due to the strong evidence of an association between these two entities. Excessive supraventricular ectopic activity (ESVEA) has been proposed to be a risk factor for AF. However, strong evidence between ESVEA and OSA has not been established. Objective We aimed to determine if ESVEA is associated with moderate to severe OSA since its treatment may prevent AF. Methods We studied patients who performed polysomnography and 24-hour Holter monitoring. Patients with atrial fibrillation were excluded. ESVEA was defined as more than 30 PACs per hour (frequent PACs) or runs of >4 consecutive PACs. The circadian pattern of PACs was also evaluated. Sleeping hours were used to define “nocturnal”. Moderate to severe OSA was defined when polyssonography demonstrated a apnoea/hypopnoea index (AHI) >15. We examined the association between ESVEA and moderate to severe OSA during wakefulness and sleep. Results We studied 290 patients [median age 65 (55–72) years, 62% males, body mass index (BMI) 30 (27–34)]. 112 (38%) had moderate to severe OSA. Median AHI was 11 (5–24) and mean oxygen saturation was 94% (92–95). Median PACs was 35 (9–117) and 29 patients (10%) had frequent PACs. Runs of >4PACs occurred in 114 patients (39%). Forty-three patients (15%) had predominant nocturnal PACs and 42 (14%) had nocturnal runs of PACs. Multivariate logistic regression analysis demonstrated only nocturnal PACs were associated with moderate to severe OSA (p=0.027) (table 1). Multivariate logistic regression Odds Ratio 95% Confidence Interval p-value Male gender 4.49 2.48–8.17 <0.001 Body mass index (kg/m2) 1.09 1.03–1.15 0.002 Nocturnal PACs 4.12 1.17–14.46 0.027 Variables not included in the model: age, number of PACs/h, frequent PACs (>30 PAcs/hour), runs of PACs (>4 consecutive PACs), nocturnal frequent PACs and nocturnal runs of PACs. Conclusion OSA screening in patients presenting with nocturnal PACs should be routinely considered, especially in male and obese. Treating moderate to severe OSA patients with CPAP has a potential benefit in preventing ESVEA and consequently AF.

scholarly journals Clinical variables of preoperative risk in thoracic surgery

2003 ◽  
Vol 121 (3) ◽  
pp. 107-110 ◽  
Author(s):  
Ivete Alonso Bredda Saad ◽  
Eduardo Mello De Capitani ◽  
Ivan Felizardo Contrera Toro ◽  
Lair Zambon
Keyword(s):  
Body Mass Index ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Thoracic Surgery ◽  
Body Mass ◽  
Multivariate Logistic Regression Analysis ◽  
Pulmonary Complications ◽  
Postoperative Pulmonary Complications ◽  
Multivariate Logistic Regression ◽  
Surgery Duration

CONTEXT: Pulmonary complications are the most common forms of postoperative morbidity in thoracic surgery, especially atelectasis and pneumonia. The first step in avoiding these complications during the postoperative period is to detect the patients that may develop them. OBJECTIVE: To identify risk variables leading to early postoperative pulmonary complications in thoracic surgery. DESIGN: Prospective study. SETTING: Hospital das Clínicas, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. PATIENTS: 145 patients submitted to elective surgery were classified as low, moderate and high risk for postoperative pulmonary complications using a risk assessment scale. PROCEDURES: The patients were followed up for 72 hours after the operation. Postoperative pulmonary complications were defined as atelectasis, pneumonia, tracheobronchitis, wheezing, prolonged intubation and/or prolonged mechanical ventilation. MAIN MEASUREMENTS: Univariate analysis was applied in order to study these independent variables: age, nutritional status, body mass index, respiratory disease, smoking habit, spirometry and surgery duration. Multivariate logistic regression analysis was performed in order to evaluate the relationship between independent and dependent variables. RESULTS: The incidence of postoperative complications was 18.6%. Multivariate logistic regression analysis showed that the variables increasing the chances of postoperative pulmonary complications were wheezing (odds ratio, OR = 6.2), body mass index (OR = 1.15), smoking (OR = 1.04) and surgery duration (OR = 1.007). CONCLUSION: Wheezing, body mass index, smoking and surgery duration increase the chances of postoperative pulmonary complications in thoracic surgery

Short-Term Outcomes Following Removal of Infected Hernia Mesh

2021 ◽  
pp. 000313482110241
Author(s):  
Christine Tung ◽  
Junko Ozao-Choy ◽  
Dennis Y. Kim ◽  
Christian de Virgilio ◽  
Ashkan Moazzez
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Logistic Regression ◽  
Body Mass ◽  
Smoking History ◽  
Multivariate Logistic Regression ◽  
Short Term ◽  
Mesh Removal ◽  
Mesh Placement ◽  
Infected Mesh

There are limited studies regarding outcomes of replacing an infected mesh with another mesh. We reviewed short-term outcomes following infected mesh removal and whether placement of new mesh is associated with worse outcomes. Patients who underwent hernia repair with infected mesh removal were identified from 2005 to 2018 American College of Surgeons-National Surgical Quality Improvement Program database. They were divided into new mesh (Mesh+) or no mesh (Mesh-) groups. Bivariate and multivariate logistic regression analyses were used to compare morbidity between the two groups and to identify associated risk factors. Of 1660 patients, 49.3% received new mesh, with higher morbidity in the Mesh+ (35.9% vs. 30.3%; P = .016), but without higher rates of surgical site infection (SSI) (21.3% vs. 19.7%; P = .465). Mesh+ had higher rates of acute kidney injury (1.3% vs. .4%; P = .028), UTI (3.1% vs. 1.3%, P = .014), ventilator dependence (4.9% vs. 2.4%; P = .006), and longer LOS (8.6 vs. 7 days, P < .001). Multivariate logistic regression showed new mesh placement (OR: 1.41; 95% CI: 1.07-1.85; P = .014), body mass index (OR: 1.02; 95% CI: 1.00-1.03; P = .022), and smoking (OR: 1.43; 95% CI: 1.05-1.95; P = .025) as risk factors independently associated with increased morbidity. New mesh placement at time of infected mesh removal is associated with increased morbidity but not with SSI. Body mass index and smoking history continue to contribute to postoperative morbidity during subsequent operations for complications.

scholarly journals Risk Factors for and Outcomes Associated with Clinical Isolates ofEscherichia coliandKlebsiellaSpecies Resistant to Extended-Spectrum Cephalosporins among Patients Admitted to Canadian Hospitals

2009 ◽  
Vol 20 (3) ◽  
pp. e43-e48 ◽  
Author(s):  
Marianna Ofner-Agostini ◽  
Andrew Simor ◽  
Michael Mulvey ◽  
Alison McGeer ◽  
Zahir Hirji ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Care Facility ◽  
P Value ◽  
Third Generation ◽  
Multivariate Logistic Regression ◽  
Extended Spectrum ◽  
Third Generation Cephalosporins

BACKGROUND: Clinical features associated with Gram-negative bacterial isolates with extended-spectrum beta-lactamase (ESBL)- and AmpC-mediated resistance identified in Canadian hospitals is largely unknown. The objective of the present study was to determine the demographics, risk factors and outcomes of patients with ESBL- or AmpC-mediated resistant organisms in Canadian hospitals.METHODS: Patients with clinical cultures ofEscherichia coliorKlebsiellaspecies were matched with patients with a similar organism but susceptible to third-generation cephalosporins. Molecular identification of the AmpC or ESBL was determined using a combination of polymerase chain reaction and sequence analysis. Univariate and multivariate logistic regression analysis was performed to identify variables associated with becoming a case.RESULTS: Eight Canadian hospitals identified 106 cases (ESBL/AmpC) and 106 controls. All risk factors identified in the univariate analysis as a predictor of being an ESBL/AmpC cases at the 0.20 P-value were included in the multivariate analysis. No significant differences in outcomes were observed (unfavourable responses 17% versus 15% and mortality rates 13% versus 7%, P not significant). Multivariate logistic regression found an association of becoming an ESBL/AmpC case with: previous admission to a nursing home (OR 8.28, P=0.01) or acute care facility (OR 1.96, P=0.03), length of stay before infection (OR 3.05, P=0.004), and previous use of first-generation cephalosporins (OR 2.38, P=0.02) or third-generation cephalosporins (OR 4.52, P=0.01). Appropriate antibiotics were more likely to be given to controls (27.0% versus 13.3%, P=0.05) and number of days to appropriate antibiotics was longer for cases (median 2.8 days versus 1.2 days, P=0.05).CONCLUSION: The importance of patient medical history, present admission and antibiotic use should be considered for allE coliorKlebsiellaspecies patients pending susceptibility testing results.

scholarly journals Influence of overweight on functional capacity of physically active older women

2020 ◽  
Vol 22 ◽  
Author(s):  
Akeline Santos de Almeida ◽  
Patrícia Almeida Fontes ◽  
Jamille Mendonça Reinaldo ◽  
Maria de Lourdes Feitosa Neta ◽  
Ricardo Aurélio Carvalho Sampaio ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Logistic Regression ◽  
Older Women ◽  
Body Mass ◽  
Functional Capacity ◽  
Negative Correlation ◽  
The Body ◽  
Lower Limbs ◽  
Multivariate Logistic Regression ◽  
Physically Active

Abstract Aging comprises a dynamic and progressive process, characterized by physiological and functional changes. Among these changes, increase in body fat is considered relevant, since it can leads to impaired physical fitness and augmented cardiometabolic risks. Considering this, the objective of this study was to evaluate the influence of overweight on functional capacity of physically active older women. A field survey was performed with 24 older women who practiced physical exercise. Participants were submitted to anamnesis, anthropometric measures (i.e., body mass and height); the Senior Fitness test; sit and reach flexibility test; and handgrip strength test. Pearson’s correlation test and multivariate logistic regression were used to verify the association between overweight and functional capacity. It was observed that hip flexibility (R=-0.494, p=0.014) and flexibility of the lower limbs (i.e., sit and reach test) showed negative correlation with the body mass index (R=-0.446, p=0.02); and after the multivariate logistic regression, negative correlation of lower limbs flexibility (B=-0,035, p=0,014) and the body mass index was observed. Thus, higher the body mass index among participants, lower hip flexibility they presented.

scholarly journals Atrial fibrillation and geriatric syndromes: an association beyond traditional risk factors

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
D J C P Cataneo ◽  
A P N R Navarrete ◽  
L A L O Lasses ◽  
J E C A Cossio
Keyword(s):  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Functional Disability ◽  
Multivariate Logistic Regression Analysis ◽  
Geriatric Syndromes ◽  
Multivariate Logistic Regression ◽  
Cross Sectional ◽  
Severe Cognitive Impairment

Abstract Objectives Atrial fibrillation (AF) is particularly frequent in nonagenarian patients, in whom geriatric syndromes (GS) are also often present and may interfere with treatment decision-making and impact prognosis. Previous work has identified an association between AF and GS in older adults; however, available data is limited for nonagenarian patients and other possibly associated factors. Therefore, this study aims to describe the association between AF and GS in nonagenarian patients. Methods This is a cross-sectional study of 205 nonagenarian patients followed in a third-level hospital's Geriatric Cardiology Clinic. Sociodemographic factors, comorbidities, and GS were investigated. To determine the association between AF and GS, multivariate logistic regression analyses were carried out, taking into account other correlations. Results The mean age of participants was 92.56 (SD 2.39) years; 124 (60.5%) were women. AF was present in 30.7% of participants. Most common GS were sarcopenia (77.6%), risk of malnutrition or malnutrition (69.8%), frailty (52.2%), depressive symptoms (45.9%), cognitive impairment (27.3%), and severe disability for activities of daily living (25.4%). In the multivariate logistic regression analysis, AF was independently associated with frailty (OR 2.57; CI 95% 1.32–5.01; p=0.006), malnutrition (OR 1.95; CI 95% 1.3–8, p=0.045), moderate to severe cognitive impairment (OR 2.15; CI 95% 1.11–4.14; p=0.023), and depressive symptoms (OR 5.84; CI 95% 1.16–4.12, p=0.016). Conclusions AF is independently associated with frailty, malnutrition, depressive symptoms, moderate to severe cognitive impairment and severe functional disability in nonagenarian patients. FUNDunding Acknowledgement Type of funding sources: None.

P1049Influence of body mass index on recurrence in atrial fibrillation patients after radiofrequency catheter ablation

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
S Calero Nunez ◽  
V M Hidalgo-Olivares ◽  
A De Leon-Ruiz ◽  
S Diaz-Lancha ◽  
L Exposito-Calamardo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Catheter Ablation ◽  
Body Mass ◽  
Left Atrial ◽  
Conflicts Of Interest ◽  
Left Atrial Size ◽  
Atrial Size ◽  
Obstructive Sleep ◽  
Significant Difference

Abstract Funding Acknowledgements No conflicts of interest INTRODUCTION  Evidence has shown that obesity, expressed as high body mass index (BMI), is associated with the development of atrial fibrillation(AF). However, the relationship between BMI and recurrence of AF after catheter ablation(CA) remains controversial. Understanding this relationship, may help in regard to patient(p) counseling and management before and after CA. Purpose To evaluate single center AF recurrences after pulmonary vein isolation according to BMI status. Secondary endpoints were to compare the influence of other comorbilitys such as pulmonar disease or obstructive sleep apnea(OSA) METHODS We included 114p with AF(54,5 ± 9,6 years; male 75,4%; paroxysmal 70,2%; persistent 29,8%) treated with first time radiofrequency ablation between 2013 and 2018. On the basis of the baseline BMI, patients were categorized into 2 groups: normal/overweigth (BMI &lt; 30kg/m2) and obese(BMI≥30kg/m2). RESULTS There was no significant difference between the majority of baseline characteristics of the groups (table 1), however patients with BMI≥30 were more likely to sufferd OSA(34% vs 8,2%:p = 0,001), to have larger left atrial (diameter &gt; 40mm: 70,5% vs 46,3%;p = 0,004), and persistent AF (43,4% vs 18%; p 0,004). During 12 months of follow-up AF recurred in 34p (29,8%), the freedom from AF was significantly higher in the BMI &lt; 30 group (48p(80%) vs 31(58,5%), p = 0,015). Multivariate analysis including variables of type of AF, OSA, BMI, left atrial size, ejection fraction, and hypertension demonstrated that BMI was the strongest predictor of being freedom from recurrent AF (OR = 0.35, 95% CI: 0,11–0,81, P = 0.014). A serious complication occurred in 6p(5,3%), with no relationship to BMI. CONCLUSION This study suggest that tight association between obesity and AF recurrence after ablation may be partly due to other concomitant conditions which in turn are more frequent in obese patients like OSA, left atrial size and presence of persistent AF. Abstract Table 1

scholarly journals Body Mass Index, Obstructive Sleep Apnea, and Outcomes of Catheter Ablation of Atrial Fibrillation

2008 ◽  
Vol 19 (7) ◽  
pp. 668-672 ◽  
Author(s):  
KRIT JONGNARANGSIN ◽  
AMAN CHUGH ◽  
ERIC GOOD ◽  
SIDDHARTH MUKERJI ◽  
SUJOYA DEY ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Catheter Ablation ◽  
Body Mass ◽  
Obstructive Sleep

scholarly journals Risk factors and prediction model construction of post-operative atrial fibrillation after thoracic surgery in Chinese patients

2021 ◽  
Author(s):  
Yunling Lin ◽  
Jianmin Sun ◽  
Xun Yuan ◽  
Hui Liu
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Thoracic Surgery ◽  
Prediction Model ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Chinese Patients ◽  
Multivariate Logistic Regression ◽  
Post Operative Atrial Fibrillation

IntroductionThe purpose of this study was to analyze the risk factors of post-operative atrial fibrillation (POAF) after thoracic surgery, and to build a predictive model for accurate preoperative identification of high-risk patients.Material and methodsIn this study, data of 2072 patients with pulmonary masses and esophageal cancer who attended our hospital in the period from January 1, 2017 to December 31, 2018 were analyzed retrospectively. According to whether AF occurred after the operation, the patients were divided into atrial fibrillation (AF) and non-AF (NAF) groups. The general information (age, sex, height, etc.), previous medical history (chronic lung disease, hypertension, etc.), medication history, preoperative ultrasound and cardiogram results, and preoperative and postoperative electrocardiogram (ECG) were collected. The operation mode, resection scope, histopathology and hospitalization were recorded. Univariate and multivariate logistic regression were used to screen out the risk factors of AF and establish a prediction model.ResultsThe incidence of POAF was 5.98%. Univariate analysis showed that sex, age, body mass index, left atrial diameter and operation organ were the risk factors of POAF. The above factors were included in the multivariate logistic regression analysis, and the results showed that male sex, age, anteroposterior diameter of left atrium and surgical organs were related to POAF. On this basis, a POAF prediction model was constructed, which had good discrimination and calibration. The area under the curve (AUC) is 0.784 with 95% CI: 0.746–0.822.ConclusionsThe prediction model of POAF based on the risk factors selected in this study can accurately predict the occurrence of AF after thoracic surgery.

scholarly journals Risk factors associated with pulmonary tuberculosis relapses in Cali, Colombia

Biomédica ◽  
2020 ◽  
Vol 40 (Supl. 1) ◽  
pp. 102-112
Author(s):  
Cindy Córdoba ◽  
Paola A. Buriticá ◽  
Robinson Pacheco ◽  
Anyela Mancilla ◽  
Augusto Valderrama-Aguirre ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Logistic Regression ◽  
Alcohol Consumption ◽  
Population Density ◽  
Pulmonary Tuberculosis ◽  
Body Mass ◽  
Multivariate Logistic Regression Analysis ◽  
The Body ◽  
Factors Associated

Introduction: Relapses in tuberculosis occur due to endogenous reactivations or exogenous reinfections and represent up to 27% of tuberculosis cases. Its importance lies in the risk of the appearance of multidrug-resistant Mycobacterium tuberculosis strains.According to the reports published in 2011 by the Colombian Instituto Nacional de Salud, there were 572 relapse cases reported in the country, i.e., a rate of 4.9%. Data of the tuberculosis control program from the Secretaría de Salud Municipal in Cali reported a relapse rate of 6%, higher than the national one, during 2013 and 2014.Objective: To determine the risk factors associated with relapse in patients with pulmonary tuberculosis in Cali.Materials and methods: We conducted an observational, analytical, and case-control study (1:1), which comprised 81 cases of pulmonary tuberculosis relapses detected in 2013 and 2014. Additionally, we collected data on socio-demographic and clinical variables, as well as lifestyle and health services, to identify the potential risk factors associated with tuberculosis relapses. We used logistic regression to identify the risk factors.Results: After adjustments for some variables, our multivariate logistic regression analysis showed that the body mass index (BMI) (OR=0.90, 95%CI: 0.81–0.99) and population density (OR=0.99, 95%CI: 0.98–1.00) were inversely associated with tuberculosis relapses. Alcohol consumption increased the likelihood of tuberculosis relapse (OR=5.56, 95%CI: 1.18–26.26).Conclusions: Body mass index and population density were inversely associated with pulmonary tuberculosis relapses in Cali. On the contrary, alcohol consumption increased the likelihood of tuberculosis relapses.

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