scholarly journals Non-modifiable Risk Factors Associated with Sternoclavicular Joint Dislocations in the U.S. Military

2018 ◽  
Vol 183 (5-6) ◽  
pp. e188-e193 ◽  
Author(s):  
Baris Gun ◽  
Robert Dean ◽  
Beatrice Go ◽  
Catherine Richardson ◽  
Brian R Waterman
Keyword(s):  
Risk Factors ◽  
Air Force ◽  
Significant Risk ◽  
Sternoclavicular Joint ◽  
Modifiable Risk Factors ◽  
Age Group ◽  
Factors Associated ◽  
Adjusted Rate ◽  
Senior Enlisted ◽  
The U.S

Abstract INTRODUCTION Sternoclavicular joint (SCJ) dislocations, although uncommon, are observed in patients with ligamentous laxity as well as those who experience traumatic injuries. The incidence and epidemiology of this costly and debilitating injury to our relatively young and active military population have not previously been reported. The purpose of this study is to consider and quantify the non-modifiable risk factors associated with this injury. METHODS Using Defense Medical Epidemiological Database, first-time occurrences, from 2006 to 2015 for the ICD-9-CM code 839.61 (closed dislocation of the SCJ), were obtained and further categorized by gender, race, age, rank, and branch of service. Race was classified based on self-reporting of patients into White, Black, or other categories. Age was divided into the categories of less than 20 yr, 20–24 yr, 25–29 yr, 30–34 yr, 35–39 yr, and greater than 40 yr. Rank was categorized as junior enlisted (E-1 to E-4), senior enlisted (E-5 to E-9), junior officer (O-1 to O-3), and senior officer (O-4 to O-10). Branch of service includes Army, Navy, Air Force, and Marines. Multivariate data analysis was performed to obtain rate per 1,000 person-years as well as adjusted rate (adjusted for age group, gender, race, rank, and service) to isolate risk factors. RESULTS Between 2006 and 2015, 427 cases of closed SCJ dislocations occurred among an at-risk population of 13,772,342 person-years for an unadjusted incidence rate (IR) of 0.031 per 1,000 person-years. The annual unadjusted IR ranged from 0.017 in 2006 to 0.059 in 2014 with the greatest increase occurring between 2006 and 2007 representing 61% increase in the rate of injuries. Males were almost twice as likely to sustain these injuries compared with females (adjusted rate ratio 1.73; 95% confidence interval [CI] 1.23, 2.43). Age was not found to be a risk factor for the development of these injuries with IRs for each age group overlapping with 95% CI for all other age groups. Similarly, the other category for race was also not found to be a statistically significant risk factor. Junior Officers (adjusted rate 0.017; 95% CI 0.011, 0.025) were found least likely to suffer from these injuries with Junior Enlisted (0.034; 95% CI 0.030, 0.040) and Senior Enlisted (0.032; 95% CI 0.028, 0.037) most at risk. Being in the Navy (0.019; 95% CI 0.015, 0.025) was found to be most protective compared with Air Force (0.032; 95% CI 0.026, 0.039), Army (0.036; 95% CI 0.031, 0.041), and Marines (0.036; 95% CI 0.028, 0.045). DISCUSSION and CONCLUSION Annual unadjusted IR of SCJ dislocations readily increased from 2006 to 2014. Statistically significant risk factors, for suffering a closed SCJ dislocation, identified by our study, were male sex, enlisted rank, and branch of service other than Navy. Age and race were not found to have a statistically significant risk. These results can shed light on non-modifiable risk factors for dislocations of the SCJ and can be used in other studies to aid in reducing injury burden on the U.S. Military.

scholarly journals Evaluation of risk factors associated with stroke

2016 ◽  
Vol 48 (1-2) ◽  
pp. 24-27
Author(s):  
Md Saad Ahamed ◽  
Mir Mahfuzul Hoque Chowdhury ◽  
Poritosh Kumar Chowdhury ◽  
Md Altaf Hossain
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Past History ◽  
Reproductive Age ◽  
Modifiable Risk Factors ◽  
Age Group ◽  
Stroke Patients ◽  
College Hospital ◽  
Factors Associated ◽  
History Of

Stroke is the leading cause of adult disability and is the third commonest cause of death worldwide. It is a major cause of morbidity and mortality with disability and social dependence throughout the world. An observational, descriptive, cross-sectional study was conducted among purposively selected one hundred and seventy patients with stroke admitted at Kushtia Medical College Hospital, Kushtia from July 2014 to June 2015 to evaluate the different modifiable risk factors and their frequency among stroke patients. Stroke patients with more than 24 hours duration presenting within seven days of onset irrespective of age, sex and demographic profile were included in the study. After obtaining informed consent, patients who fulfilled the inclusion criteria were thoroughly evaluated for the presence of risk factors. Data were collected by investigators themselves. Out of 170 confirmed cases of stroke, 89 (52.35%) were male, while 81 (47.65%) were female. Mean age of the patients was 63.74 years with a standard deviation of 16.5 years. The highest incidence 43 (24.70%) of stroke was in the age group of 60 to 69 years. As many as 122 (71.76%) had ischaemic stroke, while 48 (28.24%) had haemorrhagic stroke. At least 119 (70.00%) cases were hypertensive. 41 (24.11%) cases had diabetes mellitus, 31 (18.23%) had hyperlipidaemia, 52 (30.6%) were smokers and 25 (14.70%) had past history of stroke. Among 81 female patients, 66 (81.48%) were in post-menopausal, whereas 15 (18.52%) were in the reproductive age group. Of them 5 (33.33%) had history of taking oral hormonal contraceptive. Hypertension, smoking, diabetes mellitus and hyperlipidaemia are the identified modifiable risk factors associated with stroke.Bang Med J (Khulna) 2015; 48 : 24-27

Renal Failure after Coronary Bypass Surgery and the Associated Risk Factors

2015 ◽  
Vol 18 (1) ◽  
pp. 006
Author(s):  
Hasan Reyhanoglu ◽  
Kaan Ozcan ◽  
Murat Erturk ◽  
Fatih İslamoglu ◽  
İsa Durmaz
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Renal Failure ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Significant Risk ◽  
High Morbidity ◽  
Factors Associated

<strong>Objective:</strong> We aimed to evaluate the risk factors associated with acute renal failure in patients who underwent coronary artery bypass surgery.<br /><strong>Methods:</strong> One hundred and six patients who developed renal failure after coronary artery bypass grafting (CABG) constituted the study group (RF group), while 110 patients who did not develop renal failure served as a control group <br />(C group). In addition, the RF group was divided into two subgroups: patients that were treated with conservative methods without the need for hemodialysis (NH group) and patients that required hemodialysis (HR group). Risk factors associated with renal failure were investigated.<br /><strong>Results:</strong> Among the 106 patients that developed renal failure (RF), 80 patients were treated with conservative methods without any need for hemodialysis (NH group); while <br />26 patients required hemodialysis in the postoperative period (HR group). The multivariate analysis showed that diabetes mellitus and the postoperative use of positive inotropes and adrenaline were significant risk factors associated with development of renal failure. In addition, carotid stenosis and postoperative use of adrenaline were found to be significant risk factors associated with hemodialysis-dependent renal failure (P &lt; .05). The mortality in the RF group was determined as 13.2%, while the mortality rate in patients who did not require hemodialysis and those who required hemodialysis was 6.2% and 34%, respectively.<br /><strong>Conclusion:</strong> Renal failure requiring hemodialysis after CABG often results in high morbidity and mortality. Factors affecting microcirculation and atherosclerosis, like diabetes mellitus, carotid artery stenosis, and postoperative vasopressor use remain the major risk factors for the development of renal failure.<br /><br />

scholarly journals Does Vancomycin Resistance Increase Mortality? Clinical Outcomes and Predictive Factors for Mortality in Patients with Enterococcus faecium Infections

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 105
Author(s):  
Jatapat Hemapanpairoa ◽  
Dhitiwat Changpradub ◽  
Sudaluck Thunyaharn ◽  
Wichai Santimaleeworagun
Keyword(s):  
Risk Factors ◽  
Clinical Outcomes ◽  
Proportional Hazards Model ◽  
Significant Risk ◽  
Vancomycin Resistance ◽  
Cox Proportional Hazards Model ◽  
Factors Associated ◽  
Joint Infections ◽  
Bone And Joint Infections ◽  
The Impact

The prevalence of enterococcal infection, especially E. faecium, is increasing, and the issue of the impact of vancomycin resistance on clinical outcomes is controversial. This study aimed to investigate the clinical outcomes of infection caused by E. faecium and determine the risk factors associated with mortality. This retrospective study was performed at the Phramongkutklao Hospital during the period from 2014 to 2018. One hundred and forty-five patients with E. faecium infections were enrolled. The 30-day and 90-day mortality rates of patients infected with vancomycin resistant (VR)-E. faecium vs. vancomycin susceptible (VS)-E. faecium were 57.7% vs. 38.7% and 69.2% vs. 47.1%, respectively. The median length of hospitalization was significantly longer in patients with VR-E. faecium infection. In logistic regression analysis, VR-E. faecium, Sequential Organ Failure Assessment (SOFA) scores, and bone and joint infections were significant risk factors associated with both 30-day and 90-day mortality. Moreover, Cox proportional hazards model showed that VR-E. faecium infection (HR 1.91; 95%CI 1.09–3.37), SOFA scores of 6–9 points (HR 2.69; 95%CI 1.15–6.29), SOFA scores ≥ 10 points (HR 3.71; 95%CI 1.70–8.13), and bone and joint infections (HR 0.08; 95%CI 0.01–0.62) were significant risk factors for mortality. In conclusion, the present study confirmed the impact of VR-E. faecium infection on mortality and hospitalization duration. Thus, the appropriate antibiotic regimen for VR-E. faecium infection, especially for severely ill patients, is an effective strategy for improving treatment outcomes.

scholarly journals Modifiable risk factors associated with sudden cardiac arrest within hemodialysis clinics

2011 ◽  
Vol 79 (2) ◽  
pp. 218-227 ◽  
Author(s):  
Patrick H. Pun ◽  
Ruediger W. Lehrich ◽  
Emily F. Honeycutt ◽  
Charles A. Herzog ◽  
John P. Middleton
Keyword(s):  
Risk Factors ◽  
Cardiac Arrest ◽  
Sudden Cardiac Arrest ◽  
Modifiable Risk Factors ◽  
Factors Associated

Abstract P614: Effect Sizes of Vascular Risk Factors for Stroke Occurrence by Age Among West Africans

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Mayowa Owolabi ◽  
FRED S SARFO ◽  
Onoja Akpa ◽  
Joshua Akinyemi ◽  
Albert Akpalu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Middle Age ◽  
Meat Consumption ◽  
The Elderly ◽  
Vascular Risk Factors ◽  
Effect Sizes ◽  
Modifiable Risk Factors ◽  
Age Group ◽  
Vascular Risk ◽  
Elderly Age

Background: Age is a non-modifiable risk factor for stroke occurrence due its influence on vascular risk factor acquisition. In sub-Saharan Africa, the effect sizes of vascular risk factors for stroke occurrence by age is unknown. Objective: To quantify the magnitude and direction of the effect sizes of key modifiable risk factors of stroke according to three age groups: <50years(young), 50-65 years(middle age) and >65 years(elderly) in West Africa. Methods: The Stroke Investigative Research and Educational Network (SIREN) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with evidence of an acute stroke. Controls were age-and-gender matched stroke-free adults. Detailed evaluations for vascular, lifestyle, stroke severity and outcomes were performed. We used conditional logistic regression to estimate adjusted odds ratios (aOR) of vascular risk factors of stroke. Results: Among 3,553 stroke cases, 813(22.9%) were young, 1441(40.6%) were middle-aged and 1299(36.6%) were elderly. Five modifiable risk factors were consistently associated with stroke occurrence regardless of age namely hypertension, dyslipidemia, diabetes mellitus, regular meat consumption and non-consumption of green vegetables. Among the 5 co-shared risk factors, the effect size, aOR(95%CI) of dyslipidemia, 4.13(2.64-6.46), was highest among the young age group, hypertension, 28.93(15.10-55.44) and non-consumption of vegetables 2.34(1.70-3.23) was highest among the middle-age group while diabetes, aOR of 3.50(2.48-4.95) and meat consumption, 2.40(1.76-3.26) were highest among the elderly age group. Additionally, among the young age group cigarette smoking and cardiac disease were associated with stroke. Furthermore, physical inactivity and salt intake were associated with stroke in the middle-age group while cardiac disease was associated with stroke in the elderly age group. Conclusions: Age has a profound influence on the profile, magnitude and direction of effect sizes of vascular risk factors for stroke occurrence among West Africans. Population-level prevention of stroke must target both co-shared dominant risk factors as well as factors that are unique to specific age bands in Africa.

Risk Factors Associated With Dengue Fever Outbreak in Taiz Governorate, Yemen, 2018: Case-control Study

2021 ◽  
Author(s):  
Abdulkareem Ali Hussein Nassar ◽  
Amr Abdulaziz Torbosh ◽  
Yassin Abdulmalik Mahyoub ◽  
Mohammed Abdullah Al Amad
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Case Control Study ◽  
Significant Risk ◽  
Case Fatality ◽  
Case Control ◽  
Case Definition ◽  
P Value ◽  
Factors Associated ◽  
Control Study

Abstract Background: Dengue Fever (DF) is a significant health problem in Yemen especially in the coastal areas. On November 6, 2018, Taiz governorates surveillance officer notified the Ministry of Public Health and Population on an increase in the number of suspected DF in Al Qahirah and Al Mudhaffar districts, Taiz governorate. On November 7, 2018, Field Epidemiology Training Program sent a team to perform an investigation. The aims were to confirm and describe the outbreak by person, place and time in Taiz governorate, and identify its risk factors.Methodology: Descriptive and case-control study (1:2 ratio) were conducted. WHO case definition was used to identify cases in Al Qahirah or Al Mudhaffar districts during August-November 2018. Control was selected from the same districts who did not suffer from DF. Predesigned questionnaire was used to collect data related to sociodemographic, behavioral and environmental characteristics. Bivariate and multivariate backward stepwise analyses were used. The adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were calculated. A P value < 0.05 was considered as the cut point for statistically significant. Epi info version 7.2 was used.Results: A total of 50 DF cases were found. Almost 52% were males and 76% were <30 years of age. The overall attack rate was 1/10,000 of the population. Case fatality rate was 4%. In multivariate analysis, not working (aOR = 26.6, 95% CI: 6.8–104.7), not using mosquito repellent (aOR = 13.9, 95% CI:1.4–136.8), wearing short sleeves/pants (aOR = 27.3, 95% CI: 4.8–156.8), poor sanitation (aOR = 5.4, 95% CI: 1.4–20.3), presence of outdoor trees (aOR = 13.2, 95% CI: 2.8–63.0) and houses without window nets (aOR = 15.7, 95% CI: 3.9–63.4) were statistically significant risk factors associated with DF outbreak. Eleven 11 (58%) of blood samples were positive for DF IgM.Conclusions: DF outbreak in Al Qahirah and Al Mudhaffar districts, Taiz governorate was confirmed. This study provides evidence-based information regarding the identified risk factors that contributed to the occurrence of this outbreak. Raising community awareness on the importance of personal protection measures and improving the sanitation services are strongly recommended.

A Model to Predict Central-Line–Associated Bloodstream Infection Among Patients With Peripherally Inserted Central Catheters: The MPC Score

2017 ◽  
Vol 38 (10) ◽  
pp. 1155-1166 ◽  
Author(s):  
Erica Herc ◽  
Payal Patel ◽  
Laraine L. Washer ◽  
Anna Conlon ◽  
Scott A. Flanders ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Model ◽  
Significant Risk ◽  
Hospital Medicine ◽  
Central Line ◽  
Cox Proportional Hazards Model ◽  
Operating Characteristics ◽  
Peripherally Inserted Central Catheters ◽  
Factors Associated ◽  
Central Catheters

BACKGROUNDPeripherally inserted central catheters (PICCs) are associated with central-line–associated bloodstream infections (CLABSIs). However, no tools to predict risk of PICC-CLABSI have been developed.OBJECTIVETo operationalize or prioritize CLABSI risk factors when making decisions regarding the use of PICCs using a risk model to estimate an individual’s risk of PICC-CLABSI prior to device placement.METHODSUsing data from the Michigan Hospital Medicine Safety consortium, patients that experienced PICC-CLABSI between January 2013 and October 2016 were identified. A Cox proportional hazards model with robust sandwich standard error estimates was then used to identify factors associated with PICC-CLABSI. Based on regression coefficients, points were assigned to each predictor and summed for each patient to create the Michigan PICC-CLABSI (MPC) score. The predictive performance of the score was assessed using time-dependent area-under-the-curve (AUC) values.RESULTSOf 23,088 patients that received PICCs during the study period, 249 patients (1.1%) developed a CLABSI. Significant risk factors associated with PICC-CLABSI included hematological cancer (3 points), CLABSI within 3 months of PICC insertion (2 points), multilumen PICC (2 points), solid cancers with ongoing chemotherapy (2 points), receipt of total parenteral nutrition (TPN) through the PICC (1 point), and presence of another central venous catheter (CVC) at the time of PICC placement (1 point). The MPC score was significantly associated with risk of CLABSI (P<.0001). For every point increase, the hazard ratio of CLABSI increased by 1.63 (95% confidence interval, 1.56–1.71). The area under the receiver-operating-characteristics curve was 0.67 to 0.77 for PICC dwell times of 6 to 40 days, which indicates good model calibration.CONCLUSIONThe MPC score offers a novel way to inform decisions regarding PICC use, surveillance of high-risk cohorts, and utility of blood cultures when PICC-CLABSI is suspected. Future studies validating the score are necessary.Infect Control Hosp Epidemiol2017;38:1155–1166

scholarly journals Factores de riesgo asociados a distocias del mecanismo del parto en gestantes primíparas atendidas en el Hospital Dr. Verdi Cevallos Balda

2020 ◽  
Vol 4 (2) ◽  
pp. 1
Author(s):  
Olga Katherine Veintimilla Chinga ◽  
María Alicia Fernanda Ledezma Hurtado ◽  
Dadier Marrero González ◽  
Lizeet López ◽  
Hugo Loor Lino
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Rural Areas ◽  
Overweight And Obesity ◽  
Modifiable Risk Factors ◽  
Maternal Complications ◽  
Factors Associated ◽  
Factores De Riesgo ◽  
Uterine Malformations ◽  
Delivery Mechanism

  Las distocias del mecanismo del parto en gestantes pueden generar consecuencias significativas tanto maternas como fetales y neonatales, existiendo diversos factores de riesgo asociados a dicha condición. La prevalencia de las distocias es variable para cada localidad, presentándose en el 0,3 % a de los casos. En este sentido, el objetivo de este trabajo fue determinar los principales factores de riesgo que se asocian a distocias del mecanismo del parto en gestantes primíparas atendidas en el Hospital Dr. Verdi Cevallos Balda. Se realizó un estudio descriptivo y retrospectivo, con 250 embarazadas atendidas en el periodo de enero 2018 a diciembre 2019. Las distocias de los mecanismos del parto en primíparas en el Hospital Dr. Verdi Cevallos se presentaron con más frecuencia en las edades entre los 20 y 34 años, con grado de instrucción secundaria, y de zonas rurales. Los principales factores de riesgos modificables asociados a distocias fueron los controles prenatales insuficientes, sobrepeso y obesidad de las gestantes; además de ganancia de peso inadecuada durante el embarazo, bajo peso fetal, duración prolongada de la primera fase del trabajo de parto e inducción del mismo. Los factores de riesgos no modificables identificados fueron la presentación de cara, estrechez pélvica, malformaciones uterinas, hipertensión arterial como enfermedad crónica asociada, talla materna menor a 140 cm y parto prolongado de más de 20 horas. Las complicaciones maternas tuvieron una alta incidencia y dentro de ellas, las cesáreas fueron las más frecuentes, mientras que el distress respiratorio fue la complicación neonatal más presentada.   Palabras clave: Distocia, factores de riesgo, peso elevado, malformaciones uterinas, complicaciones.   Abstract Dystocia of the delivery mechanism in pregnant women can generate significant maternal, fetal and neonatal consequences, with various risk factors associated with this condition. The prevalence of dystocia is variable for each locality, occurring in 0.3% of cases. In this sense, the objective of this study was to determine the main risk factors associated with dystocia in the delivery mechanism in primiparous pregnant women treated at the Dr. Verdi Cevallos Balda Hospital. A descriptive and retrospective study was carried out, with 250 pregnant women seen in the period from January 2018 to December 2019. Dystocia of the labor mechanisms in primiparous women at the Dr. Verdi Cevallos Hospital occurred more frequently in the ages between 20 and 34 years old, with a secondary education degree, and from rural areas. The main modifiable risk factors associated with dystocia were insufficient prenatal care, overweight and obesity in pregnant women; as well as inadequate weight gain during pregnancy, low fetal weight, prolonged duration of the first phase of labor and its induction. The non-modifiable risk factors identified were face presentation, pelvic narrowing, uterine malformations, arterial hypertension as an associated chronic disease, maternal height less than 140 cm and prolonged labor of more than 20 hours. Maternal complications had a high incidence and within them, caesarean sections were the most frequent, while respiratory distress was the most common neonatal complication.   Keywords: Dystocia, risk factors, high weight, uterine malformations, complications.

scholarly journals Ethnicity and other COVID-19 death risk factors in Mexico

2020 ◽  
Author(s):  
Erwin Chiquete ◽  
Jesus Alegre-Díaz ◽  
Ana Ochoa-Guzmán ◽  
Liz Nicole Toapanta-Yanchapaxi ◽  
Carlos González-Carballo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Proportional Hazards Model ◽  
Invasive Mechanical Ventilation ◽  
Significant Risk ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Chronic Obstructive ◽  
Death Risk ◽  
Factors Associated ◽  
Risk Of Death

IntroductionPatients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may develop coronavirus disease 2019 (COVID-19). Risk factors associated with death vary among countries with different ethnic backgrounds. We aimed to describe the factors associated with death in Mexicans with confirmed COVID-19.Material and methodsWe analysed the Mexican Ministry of Health’s official database on people tested for SARS-CoV-2 infection by real-time reverse transcriptase–polymerase chain reaction (rtRT-PCR) of nasopharyngeal fluids. Bivariate analyses were performed to select characteristics potentially associated with death, to integrate a Cox-proportional hazards model.ResultsAs of May 18, 2020, a total of 177,133 persons (90,586 men and 86,551 women) in Mexico received rtRT-PCR testing for SARS-CoV-2. There were 5332 deaths among the 51,633 rtRT-PCR-confirmed cases (10.33%, 95% CI: 10.07–10.59%). The median time (interquartile range, IQR) from symptoms onset to death was nine days (5–13 days), and from hospital admission to death 4 days (2–8 days). The analysis by age groups revealed that the significant risk of death started gradually at the age of 40 years. Independent death risk factors were obesity, hypertension, male sex, indigenous ethnicity, diabetes, chronic kidney disease, immunosuppression, chronic obstructive pulmonary disease, age > 40 years, and the need for invasive mechanical ventilation (IMV). Only 1959 (3.8%) cases received IVM, of whom 1893 were admitted to the intensive care unit (96.6% of those who received IMV).ConclusionsIn Mexico, highly prevalent chronic diseases are risk factors for death among persons with COVID-19. Indigenous ethnicity is a poorly studied factor that needs more investigation.

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