scholarly journals Amputation Following Burn Injury

2019 ◽  
Vol 40 (4) ◽  
pp. 430-436
Author(s):  
Colleen N Bartley ◽  
Kenisha Atwell ◽  
Laura Purcell ◽  
Bruce Cairns ◽  
Anthony Charles
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Logistic Regression Model ◽  
Burn Injury ◽  
Burn Injuries ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Black Race ◽  
Burn Center

AbstractAmputation following burn injury is rare. Previous studies describe the risk of amputation after electrical burn injuries. Therefore, we describe the distribution of amputations and evaluate risk factors for amputation following burn injury at a large regional burn center. We conducted a retrospective analysis of patients ≥17 years admitted from January 2002 to December 2015. Patients who did and did not undergo an amputation procedure were compared. A multivariate logistic regression model was used to determine the risk factors for amputation. Amputations were further categorized by extremity location and type (major, minor) for comparison. Of the 8313 patients included for analysis, 1.4% had at least one amputation (n = 119). Amputees were older (46.7 ± 17.4 years) than nonamputees (42.6 ± 16.8 years; P = .009). The majority of amputees were white (47.9%) followed by black (39.5%) when compared with nonamputees (white: 57.1%, black: 27.3%; P = .012). The most common burn etiology for amputees was flame (41.2%) followed by electrical (23.5%) and other (21.9%). Black race (odds ratio [OR]: 2.29; 95% confidence interval [CI]: 1.22–4.30; P = .010), electric (OR: 13.54; 95% CI: 6.23–29.45; P < .001) and increased %TBSA (OR: 1.03; 95% CI: 1.02–1.05; P < .001) were associated with amputation. Burn etiology, the presence of preexisting comorbidities, black race, and increased %TBSA increase the odds of post burn injury. The role of race on the risk of amputation requires further study.

Purulent septic infections in patients with severe burn injuries. Etiology, prevalence, and risk factors

2020 ◽  
Vol 18 (3) ◽  
pp. 98-103
Author(s):  
Yu.Yu. Kutlaeva ◽  
◽  
A.A. Golubkova ◽  
V.A. Bagin ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Burn Injury ◽  
Venous Catheter ◽  
Severity Index ◽  
Burn Injuries ◽  
Burn Wound ◽  
Open Flame ◽  
Burn Center ◽  
Increased Risk ◽  
Epidemiological Characteristics

Objective. To assess epidemiological characteristics of purulent septic infections (PSIs) in the intensive care unit (ICU) of a burn center. Patients and methods. In this retrospective epidemiological study, we analyzed medical records of 399 patients with burn injuries and the results of laboratory testing (2,572 samples). The majority of ICU patients were men aged 30–39 years. Almost half of the patients were workers. Burns were primarily caused by an open flame and were mainly received at home. Of note, 45.4% of patients who had burns caused by an open flame also had respiratory tract lesions. More than half of the patients had deep burns. A total of 18.6% of patients (95% CI 14.8–22.7) died. Results. The incidence of PSIs in the ICU of the burn center was 533,8‰ (95% CI 483.5–583.6), which is 2.5 times higher than that in the official statistics (210,1‰ (95% CI 182.5–239.9)). More than half of PSIs (50.2% (95% CI 43.3–57.1)) were burn wound infections. Conclusion. The following factors were found to be associated with an increased risk of PSIs: burn area >40%, burn severity index >30, SOFA score >4, deep burns, surgery, stay in the ICU for >10 days, artificial ventilation for >1 day, and placement of a central venous catheter or an urinary catheter for >1 day. Most frequently, PSIs were caused by non-fermenting gram-negative bacteria such as Pseudomonas аeruginosa and Acinetobacter baumannii. Key words: burn injury, purulent septic infections, risk factors, infection control

Does radiation therapy increase late cardiac death in patients with left breast cancer?

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1127-1127
Author(s):  
Chi Lin ◽  
Kyle A. Denniston ◽  
Mary E. Charlton
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Logistic Regression ◽  
Radiation Therapy ◽  
Cardiac Death ◽  
Lower Risk ◽  
Logistic Regression Model ◽  
Left Breast ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression

1127 Background: The objective of this study was to evaluate the effect of external beam radiation therapy (RT) on late cardiac death (CD) in patients with left breast cancer. Methods: A total of 529,246 patients who were diagnosed with adenocarcinoma of the breast between 1983 and 2004 and survived ≥ 5 years were identified from the SEER database. After excluding patients who were male, had right breast cancer, received brachytherapy or had missing data, 163,894 patients remained. Examined risk factors for CD include age (≤49/50-59/60-69/70-100), race (white/non-white), stage (In situ/local/regional/distant), breast subsite (nipple and areola/inner quadrant/outer quadrant), diagnosis year (1983-1993/1994-2004), surgery status (none/less than mastectomy/mastectomy) and RT. Time to CD was evaluated using the Kaplan-Meier method. A multivariate logistic regression model was used to evaluate factors associated with the use of RT and the Cox Proportional Hazards model was used to evaluate risk factors for CD. Results: A multivariate logistic regression model revealed that patients who received RT tended to be younger, white, more recently diagnosed, have inner quadrant and more advanced disease and undergo less than mastectomy. Median overall survival for patients with RT was significantly longer than those without RT (263 vs. 226 months, Log-Rank p < .0001). RT group had a lower risk of CD than no-RT group (Log-Rank p < .0001). Median time to CD was not reached in either group. The probability of CD was increased with increasing age and stage, and decreased with more recent diagnosis year and after mastectomy. Cox model found RT to be associated with lower probability of CD (HR 0.66, 95% CI 0.62-0.70), after adjusting for age, stage, surgery status and diagnosis year. Race and breast subsite were not associated with CD. Conclusions: Patients with left breast cancer who survived ≥ 5 years and received RT had a lower risk of cardiac death than those who did not. The cause of this difference is unclear but suggests influence from an uninvestigated factor, potentially the increased use of cardiotoxic chemotherapy or other cardiovascular comorbidity in those patients not receiving RT. Continued study, accounting for such factors, is warranted.

scholarly journals Nationwide investigation of Shiga toxin-producingEscherichia coliamong cattle in Japan revealed the risk factors and potentially virulent subgroups

2017 ◽  
Vol 145 (8) ◽  
pp. 1557-1566 ◽  
Author(s):  
K. LEE ◽  
M. KUSUMOTO ◽  
T. IWATA ◽  
S. IYODA ◽  
M. AKIBA
Keyword(s):  
Risk Factors ◽  
Shiga Toxin ◽  
Odds Ratio ◽  
Severe Disease ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Fecal Shedding ◽  
Virulence Marker ◽  
Preventative Measures ◽  
Epidemiological Information

SUMMARYA nationwide study of Shiga toxin-producingEscherichia coli(STEC) was performed to determine the prevalence, characteristics and risk factors for fecal shedding of STEC among cattle in Japan. Information on rearing practices was also collected to identify risk factors for fecal shedding of STEC. STEC was isolated from 24·1% of samples (133/551) collected from 59·1% of farms (65/110). Bayesian clustering using the virulence marker profiles of the isolates subdivided the isolates into four genetically distinct groups, two of which corresponded toeae- orsaa-positive STEC, which can cause severe disease in human. Both STEC groups exhibited characteristic phylogeny and virulence marker profiles. It is noteworthy that the tellurite resistance gene was not detected in allsaa-positive STEC isolates, suggesting that the standard isolation method using tellurite might lead to an underestimation of the prevalence ofsaa-positive STEC. A multivariate logistic regression model using epidemiological information revealed a significantly (P< 0·01) high odds ratio on STEC fecal shedding in tie-stall housing and a low odds ratio in flat feed box and mechanical ventilation. Information on isolate characteristics of the two major pathotypes and risk factors in rearing practices will facilitate the development of preventative measures for STEC fecal shedding from cattle.

scholarly journals 282. Risk Factors for Mortality in Severe COVID-19 Patients Admitted to the Intensive Care Unit: A Retrospective Single-Center Study in Saudi Arabia

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S246-S247
Author(s):  
Sherif Khattab ◽  
Souad AlMuthree ◽  
Mohamed Bakry ◽  
Noha Ibraheem ◽  
Omar Alghamdi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Logistic Regression ◽  
Regression Model ◽  
Sofa Score ◽  
Logistic Regression Model ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Independent Risk Factors ◽  
Cox Proportional Hazard Regression

Abstract Background The first case of COVID-19 in the Kingdom of Saudi Arabia (KSA) was reported in March 2020. This study aims to describe the overall mortality in the ICU during the COVID-19 pandemic and to determine independent risk factors for overall survival & 29 days mortality. Methods This is a retrospective single-center study; data for adult patients admitted to the ICU with COVID-19 between 1st March 2020 to 31st December 2020 were extracted and reviewed. Overall survival was described using Kaplan-Meier curves with reporting of median overall survival and 29 days survival estimates. Multivariate analysis was performed using Cox proportional hazards model and multivariate logistic regression model. Figure 1. Study flow chart Table 1. Demographic characteristics categorized by Gender Results Eligible subjects were 209 (Figure 1) and subjects demographics are summarized in (Table1). Observed death events were 82 (39.2% of the total cohort), 61% of deaths reached at 2 weeks of ICU stay (n.= 50), median overall survival (OS) was reached at day 23, as shown in (Figure 2). The multivariate Cox proportional hazard regression analysis (Figure 3) showed elevated SOFA score [aHR= 1.10, P &lt; 0.001] and Vasopressors [aHR= 3.23, P= 0.002] as independent risk factors for overall ICU mortality. Independent protective factors were: Systemic corticosteroids use (P= 0.019), Insulin use (P= 0.026) and Liposomal Amphotericin B (LAMB) use (P= 0.019). For mortality at day 29, the multivariate logistic regression model (Figure. 4) showed elevated SOFA score (P= 0.005), any need for ventilation escalation after ICU admission (P= 0.014), Ribavirin use (P=0.016) and Vasopressors use ( P&lt; 0.001) as independent risk factors. Angiotensin-Converting Enzyme inhibitors (ACEi) use was a protective factor (P=0.025). Figure 2. Overall Survival (OS) for patients admitted to the ICU due to COVID-19 - Kaplan Meier (KM) Figure 3. Multivariate Cox proportional hazard regression model for factors associated with overall mortality in patients admitted to the ICU due to COVID-19 Figure 4. Multivariate logistic regression model for factors associated with 29 days mortality in patients admitted to the ICU due to COVID-19 Conclusion SOFA score and vasopressors are independent predictors for overall survival and 29-day mortality in the ICU. The need for ventilation escalation after ICU admission appeared to lead to poor prognosis in regard to 29-day mortality only. Systemic corticosteroids are lifesaving, further studies are required to confirm the observed clinical benefits with insulin, LAMB and ACEi use in the ICU and to investigate any hazardous impact of ribavirin on COVID-19 outcomes. Study limitations Residual confounding of other measured and/or unobserved factors cannot be ruled out. Disclosures Sherif Khattab, BPharm, Gilead Sciences (Employee, Shareholder) Mohamed Bakry, MBBCh, Gilead Sciences (Employee)Roche Pharma (Employee)

scholarly journals Colorectal Anastomosis Leak: Rate , Risk Factors and Outcome in a Tertiary Teaching Hospital, Addis Ababa Ethiopia, a Five Year Retrospective Study

1970 ◽  
Vol 29 (6) ◽  
Author(s):  
Gutema Wako ◽  
Henok Teshome ◽  
Engida Abebe
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Retrospective Study ◽  
Colorectal Surgery ◽  
Logistic Regression Model ◽  
Addis Ababa ◽  
Colorectal Anastomosis ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Anastomosis Leak

BACKGROUND: Anastomotic leakage is a morbid and potentially fatal complication of colorectal surgery. Determination of perioperative risk factors for colorectal anastomosis leak helps to identify patients requiring increased postoperative surveillance.METHODS: Institution based retrospective study was done to determine colorectal anastomosis leak rate and risk factors associated with it at a teaching hospital in Addis Ababa Ethiopia. Patients operated from January 2013 to December 2017 G.C were included. Univariate analysis followed by a multivariate logistic regression model was used to determine the influence of patient factors and operative events on postoperative anastomotic leakage.RESULTS: Inclusion criteria were met by 221 patients. Mean age of patients was 46.44(SD=19.1) with range of 1 to 85 years. Male accounted to 166 (74.8%) of the patients. Anastomotic leakage occurred in 12 (5.2%) of the patients. Mean time to diagnosis was 9.55 days (95% CI, 7.2-11.8) after surgery. Univariate analyses showed high preoperative level of creatinine, ASA score III and IV, emergency operation, operative time more than three hours, and malignant diseases were associated with colorectal anastomosisleak. Multivariate logistic regression model failed to show an association. Colorectal anastomosis leak increased the inpatient mortality rate by 50%. Median length of hospitalization in colorectal anastomosis leak group was 27.5 days, versus 7 days in patients without leak.CONCLUSION: Colorectal anastomosis leak remains common problem after colorectal surgery resulting significant post-operative mortality and morbidity. 

scholarly journals Incidence and Risk Factors for High-level BK Viruria -A Single Center Study in China

2020 ◽  
Author(s):  
Rui Xiong ◽  
Haimin Ye ◽  
Zhujing Liu ◽  
Xinchang Li
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Logistic Regression Model ◽  
Univariate Analysis ◽  
Bk Virus ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
History Of ◽  
Independent Risk Factors ◽  
High Level

Abstract Background BK Virus Allograft Nephropathy (BKVAN) is a serious complication after kidney transplantation, and the effect of pre-emptive intervention for high-level BK viruria has been verified, but the protocols after kidney transplantation for early identification of high-level viruria is lacking.Methods This was a single-center respectively study. The clinical data of the kidney transplant recipients and their donors in our center from January 1, 2015 to December 31, 2018 were collected. According to the qPCR results of BK virus DNA loads in urine samples, the patients were divided into high-level BK Viruria Group (Group A) and none high-level BK Viruria Group (Group B). Significant variables were screened out by univariate analysis, and then the results were incorporated into multivariate logistic regression model to analyze the independent risk factors of high-level BK viruria.Results A total of 262 recipients were included in the study. The incidence of high-level BK viruria was 13.4% (n=35), and the median time of detection was 181(range 91~1119) days. Univariate analysis showed that the donor type ( =21.770, P < 0.001), history of ATG/ATG-F application ( =4.543, P=0.033), Acute Rejection (AR) ( =8.313, P=0.004) and Delayed Graft Function (DGF) ( =21.170, P < 0.001) were related with high-level BK viruria. After the inclusion of multivariate logistic regression model, the results showed that brain and cardiac deceased donors (P=0.032,OR=3.927, 95%CI:1.122~13.746), AR (P=0.022,OR=4.709, 95%CI:1.253~17.697) and DGF (P=0.001,OR=6.682, 95%CI:2.288~19.518).Conclusions Donation of Brain and Cardiac Deceased, history of AR, DGF were independent risk factors for high-level BK viruria after kidney transplantation.

scholarly journals The biometric parameters of aniso-astigmatism and its risk factor in Chinese preschool children: the Nanjing Eye Study 

2020 ◽  
Author(s):  
Haohai Tong ◽  
Qingfeng Hao ◽  
Zijin Wang ◽  
Yue Wang ◽  
Rui Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Preschool Children ◽  
Logistic Regression Model ◽  
Multivariate Logistic Regression Model ◽  
Curvature Radius ◽  
Corneal Curvature ◽  
Multivariate Logistic Regression ◽  
Biometric Parameters ◽  
Term Delivery

Abstract Backgrounds: Aniso-astigmatism may hinder normal visual development in preschool children. Knowing its prevalence, biometric parameters and risk factors is fundamental to children eye care. The purpose of this study was to determine the biometric components of aniso-astigmatism and associated maternal risk factors in Chinese preschool children. Methods: In the population-based, prospective cohort Nanjing Eye Study, children were measured for noncycloplegic refractive error using an autorefractor and for biometric parameters using an optical low-coherent reflectometry. The difference of total astigmatism (TA) between both eyes was calculated using cylinder power (non-vectorial aniso-TA was defined as ≥1.00 Dioptre Cylinder [DC] between both eyes) and by vector analysis (vectorial aniso-TA was defined as a difference of ≥0.5 in J0 or J45 between both eyes which is equivalent to 1.00 DC). The prevalence of aniso-TA was presented. Interocular biometric parameters were compared between with vs. without aniso-astigmatism group. In addition, risk factors were determined using multivariate logistic regression model. Results: Of 1131 children (66.90±3.38 months, 53.31% male), the prevalence of non-vectorial aniso-TA was 1.95% (95% Confidence Interval (CI)=1.14%-2.75%), while the prevalence of vectorial aniso-TA was twice as common as non-vectorial aniso-TA, neither varying with sex or age. With aniso-TA eyes were more asymmetric in axial length and corneal curvature radius than without aniso-TA eyes. In multivariate logistic regression model, 5-min Apgar score less than 7 was significantly associated with higher risk of aniso-TA (vectorial aniso-TA: Odds Ratio (OR)=6.42, 95%CI=2.63-15.69, P<0.001; non-vectorial aniso-TA: OR=4.99, 95%CI=1.41-17.68, P=0.01）. Being twin or triple was significantly associated with higher risk of vectorial aniso-CA (OR=2.43, 95%CI=1.05-5.60, P=0.04). Pre-term delivery (OR=2.60, 95%CI=1.09-6.15, P=0.03) and post-term delivery (OR=3.61, 95%CI=1.31-9.96, P=0.01) were significantly associated with higher risk of vectorial aniso-CA. Conclusions: Both corneal curvature radius and axial length asymmetry were correlated with aniso-TA. Children with 5-min Apgar score<7 were more likely to have aniso-TA, while twin or triple, pre-term or post-term delivery were more likely to have vectorial aniso-CA.

scholarly journals Nomogram for Predicting the Postoperative Venous Thromboembolism in Spinal Metastasis Tumor: A Multicenter Retrospective Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Hao-ran Zhang ◽  
Ming-you Xu ◽  
Xiong-gang Yang ◽  
Feng Wang ◽  
Hao Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Venous Thromboembolism ◽  
Prediction Model ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Independent Risk Factors

IntroductionVenous thromboembolism can be divided into deep vein thrombosis and pulmonary embolism. These diseases are a major factor affecting the clinical prognosis of patients and can lead to the death of these patients. Unfortunately, the literature on the risk factors of venous thromboembolism after surgery for spine metastatic bone lesions are rare, and no predictive model has been established.MethodsWe retrospectively analyzed 411 cancer patients who underwent metastatic spinal tumor surgery at our institution between 2009 and 2019. The outcome variable of the current study is venous thromboembolism that occurred within 90 days of surgery. In order to identify the risk factors for venous thromboembolism, a univariate logistic regression analysis was performed first, and then variables significant at the P value less than 0.2 were included in a multivariate logistic regression analysis. Finally, a nomogram model was established using the independent risk factors.ResultsIn the multivariate logistic regression model, four independent risk factors for venous thromboembolism were further screened out, including preoperative Frankel score (OR=2.68, 95% CI 1.78-4.04, P=0.001), blood transfusion (OR=3.11, 95% CI 1.61-6.02, P=0.041), Charlson comorbidity index (OR=2.01, 95% CI 1.27-3.17, P=0.013; OR=2.29, 95% CI 1.25-4.20, P=0.017), and operative time (OR=1.36, 95% CI 1.14-1.63, P=0.001). On the basis of the four independent influencing factors screened out by multivariate logistic regression model, a nomogram prediction model was established. Both training sample and validation sample showed that the predicted probability of the nomogram had a strong correlation with the actual situation.ConclusionThe prediction model for postoperative VTE developed by our team provides clinicians with a simple method that can be used to calculate the VTE risk of patients at the bedside, and can help clinicians make evidence-based judgments on when to use intervention measures. In clinical practice, the simplicity of this predictive model has great practical value.

Correlation between plasma levels of Lp-PLA2, Hcy, CRP, Lp(a), AT-III, and TEG parameters and carotid atherosclerosis in patients with combined hypertension and cerebral infarction

2019 ◽  
Author(s):  
mingde ji ◽  
xueyan wang ◽  
xiaofei zhu ◽  
wanjian gu ◽  
meng zhuo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cerebral Infarction ◽  
Logistic Regression Model ◽  
Carotid Atherosclerosis ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Single Item ◽  
Factors Influencing ◽  
At Iii

Abstract Background: To observe the correlation between Lp-PLA2, Hcy, CRP, Lp(a), AT-III, and TEG parameters and carotid atherosclerosis with combined hypertension and cerebral infarction and evaluate their value in risk determination.Methods: Patients with primary hypertension were selected as subjects and divided into 2 groups based on cerebral infarction: simple hypertension group and hypertension combined with cerebral infarction group. The differences of Lp-PLA2, Hcy, CRP, Lp(a), AT-Ⅲ, and TEG were compared. Spearson correlation and multivariate logistic regression model were used to analyze the correlation. A ROC curve was used to analyse the value of a single item and their combination for the determination of carotid AS risk.Results: The levels of single item and CIMT in the hypertension combined with cerebral infarction group were higher, and the values of R, EPL, and LY30 were lower than corresponding indicators in the simple hypertension group. Furthermore, it was found that Lp-PLA2 and Hcy were risk factors. The AUC for Hcy and Lp-PLA2 for the determination the carotid AS risk were larger. Conclusions: The increase or decrease of Lp-PLA2, Hcy, and TEG were important factors influencing the development of carotid AS with combined hypertension and cerebral infarction. The levels of Lp-PLA2, Hcy, and TEG with combined hypertension and cerebral infarction were significantly different from those with simple hypertension and could be used as independent predictive factors for determining carotid AS risk.

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