1242. Evaluation of Risk Factors for Development of Total Hip Arthroplasty (THA) Surgical Site Infections (SSI)

Abstract Background THA is one of the most commonly performed surgeries for pathologic diseases of the hip. Multiple risk factors have been identified for SSI including: female gender, previous joint surgery, hematoma, joint dislocation, intraarticular glucocorticoid injection, rheumatoid arthritis, uncontrolled diabetes, anemia, malnutrition, and an immunosuppressed state. The objective of our study is to evaluate obesity (body mass index (BMI) >30) as an independent risk factor for THA SSI and identify other risk factors for SSI Methods A retrospective case–control (1:3) matched observation study was conducted from January 1, 2014–June 30, 2016. Patients with a THA SSI were identified using NHSN definitions and 3 controls were matched for sex and month of surgery for each SSI case. Patient information was extracted through chart review including BMI, revision surgery, chronic kidney disease (CKD), diabetes mellitus (DM), anemia, malnutrition, smoking, surgery duration, steroid use, pre-operative chlorhexidine (CHG) bathing and nasal povidone–iodine (PI) compliance. Multivariate analysis using a conditional logistic regression model was performed. Results Among 906 THA, 29 patients developed an SSI with 87 matched patients over the 2.5 years. The mean age in the SSI group was 61.0 years, and 37.9% were male. Mean age in the control group was 63.1, and 40.1% were male. In both groups, the most common indications for surgery were osteoarthritis followed by osteonecrosis and malignancy. Results of multivariate analysis identified five independent risk factors for SSI (see Table 1). Conclusion Obesity (BMI >30) was identified as an independent risk factor for THA SSI as well as CKD, steroid use and revision arthroplasty. While these risk factors are not easily modifiable, noncompliance with pre-operative CHG bathing and PI administration were also identified as significant SSI risk factor. These findings emphasize the importance of evaluating patients for SSI risk factors including obesity and improving compliance with all pre-operative SSI reduction measures. Disclosures All authors: No reported disclosures.

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Risk factors for post-bronchoscopy pneumonia: a case–control study

Scientific Reports ◽

10.1038/s41598-020-76998-z ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Yu Sato ◽

Kengo Murata ◽

Miake Yamamoto ◽

Tsukasa Ishiwata ◽

Miyako Kitazono-Saitoh ◽

...

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Risk Factor ◽

Independent Risk Factor ◽

Case Control Study ◽

Case Control ◽

Control Group ◽

Tracheobronchial Stenosis ◽

Control Study ◽

Age And Sex

AbstractThe bronchoscopy, though usually safe, is occasionally associated with complications, such as pneumonia. However, the use of prophylactic antibiotics is not recommended by the guidelines of the British Thoracic Society. Thus far there are few reports of the risk factors for post-bronchoscopy pneumonia; the purpose of this study was to evaluate these risk factors. We retrospectively collected data on patients in whom post-bronchoscopy pneumonia developed from the medical records of 2,265 patients who received 2666 diagnostic bronchoscopies at our institution between April 2006 and November 2011. Twice as many patients were enrolled in the control group as in the pneumonia group. The patients were matched for age and sex. In total, 37 patients (1.4%) had post-bronchoscopy pneumonia. Univariate analysis showed that a significantly larger proportion of patients in the pneumonia group had tracheobronchial stenosis (75.7% vs 18.9%, p < 0.01) and a final diagnosis of primary lung cancer (75.7% vs 43.2%, p < 0.01) than in the control group. The pneumonia group tended to have more patients with a history of smoking (83.8% vs 67.1%, p = 0.06) or bronchoalveolar lavage (BAL) (4.3% vs 14.9%, p = 0.14) than the control group. In multivariate analysis, we found that tracheobronchial stenosis remained an independent risk factor for post-bronchoscopy pneumonia (odds ratio: 7.8, 95%CI: 2.5–24.2). In conclusion, tracheobronchial stenosis was identified as an independent risk factor for post-bronchoscopy pneumonia by multivariate analysis in this age- and sex- matched case control study.

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Risk factors for peritoneal recurrence in serosa-negative gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.19 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 19-19 ◽

Cited By ~ 1

Author(s):

Hayato Omori ◽

Yuichiro Miki ◽

Wataru Takagi ◽

Fumiko Hirata ◽

Taichi Tatsubayashi ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Multivariate Analysis ◽

Risk Factor ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Independent Risk Factor ◽

Peritoneal Recurrence ◽

Node Metastasis ◽

Gastric Cancer Patients

19 Background: Peritoneal recurrence is often observed in gastric cancer patients without serosal invasion. It is difficult for pathologists to evaluate whether tumor cells penetrate serosa or not, because the subserosa layer is very thin. We evaluated the incidence and risk factors of peritoneal recurrence in serosa -negative gastric cancer patients to clarify the mechanism of peritoneal recurrence in these patients. Methods: A total of 1,745 gastric cancer patients underwent R0 resection from 2002 to 2009 were enrolled. The incidence of peritoneal recurrence according to tumor depth was analyzed. In serosa-nagative patients, the univariate and multivariate analysis were performed to identify the risk factors for peritoneal recurrence. Results: Peritoneal recurrence was observed in 64 (3.7 %) out of 1,745 patients. The incidence of peritoneal recurrence according to depth of tumor invasion was in 0 / 466 in T1a, 5 / 567 (0.88 %) in T1b, 4 / 187 (2.1 %) in T2, 31 / 360 (7.9 %) in T3, 20 / 108 (15.9 %) in T4a, and 4 / 12 (25 %) in T4b, respectively (p<0.001). As for the risk factor for peritoneal recurrence in T3 patients, histologically undifferentiated type, negative lymphatic invasion, scirrhous type, invasive infiltrating growth pattern were the significant factors identified by univariate analysis. Only the invasive infiltrating growth pattern (OR3.44 p0.038) was selected as significant independent risk factor for peritoneal recurrence by multivariate analysis. In T1b / T2 patients, massive lymph node metastasis (N3a, 3b), scirrhous type were the significant factor for peritoneal recurrence by univariate analysis. Only massive lymph node metastasis (OR25.1 p<0.001) was selected as the significant independent risk factor by multivariate analysis. Conclusions: The incidence of peritoneal recurrence increases in proportion to the tumor depth. Invasive infiltrating growth pattern was selected as an independent risk factor for peritoneal recurrence in T3 patients, while it was massive lymph node metastasis in T1b / T2 patients. The results suggest the possibility that microscopic serosal invasion in T3 tumor and lymphatic progression in T1b / T2 tumor may contribute to peritoneal recurrence in gastric cancer.

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Association of Abnormal Metatarsal Parabola With Second Metatarsophalangeal Joint Plantar Plate Pathology

Foot & Ankle International ◽

10.1177/1071100716674671 ◽

2016 ◽

Vol 38 (3) ◽

pp. 289-297 ◽

Cited By ~ 14

Author(s):

Adam E. Fleischer ◽

Erin E. Klein ◽

Maheen Ahmad ◽

Shivang Shah ◽

Fernanda Catena ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Conditional Logistic Regression ◽

Weight Bearing ◽

Metatarsophalangeal Joint ◽

Control Group ◽

X Rays ◽

Foot And Ankle ◽

Plantar Plate ◽

Second Metatarsal

Background: Plantar plate pathology is common, yet it is unclear whether, and to what extent, the length of the second metatarsal contributes to this problem. Methods: We conducted a retrospective case-control (1:2) study to examine radiographic risk factors for plantar plate tears. One hundred patients (age 55.7 ± 12.3 years) with plantar plate injuries and 200 healthy controls (age 56.3 ± 11.3 years) were included. Cases were defined as patients with nonacute, isolated, plantar plate pathology of the second metatarsophalangeal joint confirmed by intraoperative inspection at a single foot and ankle specialty practice from June 1, 2007, to January 31, 2014. Patients presenting for pain outside of the forefoot served as the control group. Controls were matched on age (±2 years), gender, and year of presentation. Weight-bearing foot x-rays were assessed for several predetermined angular relationships by a single rater. Conditional logistic regression was used to identify risk factors for plantar plate injury. Results: A long second metatarsal, defined as a metatarsal protrusion index less than −4 mm, was the only significant risk factor for plantar plate pathology in both the univariate and multivariable analyses (multivariate odds ratio 2.5 [95% confidence interval 1.8 to 3.3], P = .002). Conclusion: We found that a long second metatarsal was a risk factor for developing second metatarsophalangeal joint plantar plate tears. This knowledge may aid foot and ankle surgeons when contemplating the need for second metatarsal shortening osteotomies (eg, Weil osteotomy) during plantar plate surgery and when deciding on the amount of shortening for second metatarsal osteotomies. Level of Evidence: Level III, retrospective comparative study.

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Malignancy Risk Factors of Hydatidiform Mole

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v7i2.581 ◽

2019 ◽

pp. 146-151

Author(s):

Akbar N D Saputra ◽

Agustria Z Shaleh ◽

Patiyus Agustiansyah ◽

Theodorus Theodorus

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Risk Factor ◽

Hydatidiform Mole ◽

Blood Type ◽

Bivariate Analysis ◽

Control Group ◽

Fisher Exact Test ◽

Independent Variable ◽

Β Hcg

Abstract Objective: to determine risk factors inhydatidiform mole patients who will develop into Gestational Trophoblast Neoplasm (GTN) in Dr.Mohammad Hoesin Hospital Palembang Method: An observational analytical study with case control design was conducted in Department of Obstetrics and Gynecology in Dr. Mohammad Hoesin Hospital Palembang / Faculty of Medicine Sriwijaya University Palembang from January 2017 to August 2017. The frequency and distribution of data are described in tables. Bivariate analysis was done to determine correlation between independent variable and dependent variable using Chi Square/Fisher Exact test and multivariate analysis was used to know which independent variable has the biggest influence to the occurrence of Gestational TrophoblastNeoplasm (GTN) post evacuation of hydatidiform mole. Data analysis was done using SPSS version 21.0. Results: There were 45 patients who fulfilled inclusion criteria with control group and case group ratio 1 : 2 (15 cases and 30 controls). Statistical analysis showed a significant correlation between patient age, pre-evacuation β HCG level, parity, and histopathologic appearance with occurrence of Gestational Trophoblast Neoplasm (GTN) after evacuation of hydatidiform mole (p <0,05). From multivariate analysis, it was found that pre-evacuation β HCG levels ≥ 134,182.5 mIU/ml was a risk factor of Gestational Trophoblast Neoplasm (OR = 77.008, p value = 0.004). Conclusion: Pre-evacuation β HCG levels ≥ 134,182.5 mIU / ml is a risk factor for the occurrence of Gestational Trophoblast Neoplasm (GTN). Keywords: Hydatidiform mole, GTN, age, pre-evacuation β HCG level, parity, uterine size, blood type, hysthopathology feature

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Faktor risiko obesitas pada ibu rumah tangga miskin

Jurnal Gizi Klinik Indonesia ◽

10.22146/ijcn.15361 ◽

2012 ◽

Vol 9 (1) ◽

pp. 1

Author(s):

Digna Niken Purwaningrum ◽

Hamam Hadi ◽

I Made Alit Gunawan

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Logistic Regression ◽

Risk Factor ◽

Food Insecurity ◽

Energy Intake ◽

Conditional Logistic Regression ◽

Control Group ◽

Case Group ◽

Fat Intake

Background: Food insecurity is associated with allocation of income for high energy density food consumption that may cause obesity in poor family. In addition, low physical activity may lead to obesity, particularly in individual living in disadvantaged situation.Objective: To identify risk factors of obesity among poor housewives in Yogyakarta.Method: This was a case control study, case group was obese housewives and the control group was non obese housewives. The locations of the study were Bumijo and Pringgokusuman which have high population density. The samples were taken purposively. Each group consisted of 70 housewives (1:1) and were matched according to age. Mc.Nemar test and conditional logistic regression were used to identify the risk factors of obesity.Results: There was no difference in characteristics between the two groups. Food insecurity reached 91,43% in the control group, proportion of excessive energy intake reached 37.86% in the case group, higher than in control group (24.29%). Excessive fat intake in the case group reached 30% whereas in the control group was 28.57%. Low physical activity reached 40% in the case group, and 10% in the control group. The result of Mc.Nemar test showed that food insecurity, energy and fat intake had no significant association with obesity (p>0.05). While physical activity was associated with obesity (p=0.0001). The result of conditional logistic regression showed physical activity was dominant risk factor for obesity among poor housewives (R2=0.1916).Conclusion: Food security status was not a risk factor for obesity in poor families; energy intake and fat intake contributed to the prevalence of obesity though the influence was smaller than physical activity.

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Risk factors for unsuccessful removal of central venous access ports implanted in the forearm of adult oncologic patients

Japanese Journal of Radiology ◽

10.1007/s11604-021-01214-5 ◽

2021 ◽

Author(s):

Mitsuhiro Kinoshita ◽

Shoichiro Takao ◽

Junichiro Hiraoka ◽

Katsuya Takechi ◽

Yoko Akagawa ◽

...

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Risk Factor ◽

Independent Risk Factor ◽

Central Venous Access ◽

Univariate Analysis ◽

Venous Access ◽

Central Venous ◽

Significant Difference ◽

Oncologic Patients

Abstract Purpose To evaluate the risk factors for unsuccessful removal of a central venous access port (CV port) implanted in the forearm of adult oncologic patients. Materials and methods This study included 97 adult oncologic patients (51 males, 46 females; age range, 30–88 years; mean age, 63.7 years) in whom removal of a CV port implanted in the forearm was attempted at our hospital between January 2015 and May 2021. Gender, age at removal, body mass index, and diagnosis were examined as patient characteristics; and indwelling period, indwelling side, and indication for removal were examined as factors associated with removal of a CV port. These variables were compared between successful and unsuccessful cases using univariate analysis. Then, multivariate analysis was performed to identify independent risk factors for unsuccessful removal of a CV port using variables with a significant difference in the univariate analysis. A receiver-operating characteristics (ROC) curve was drawn for significant risk factors in the multivariate analysis and the Youden index was used to determine the optimum cut-off value for predicting unsuccessful removal of a CV port. Results Removal of CV ports was successful in 79 cases (81.4%), but unsuccessful in 18 cases (18.6%) due to fixation of the catheter to the vessel wall. Multivariate logistic regression analysis showed that the indwelling period (odds ratio 1.048; 95% confidence interval 1.026–1.070; P < 0.0001) was a significant independent risk factor for unsuccessful removal of a CV port. ROC analysis showed that the cut-off value for successful removal was 41 months, and 54% of cases with an indwelling period > 60 months had unsuccessful removal. Conclusion The indwelling period is an independent risk factor for unsuccessful removal of a CV port implanted in the forearm of adult oncologic patients, with a cut-off of 41 months.

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Study on Homocysteinemia as a Risk Factor of Ischemic Stroke

TAJ Journal of Teachers Association ◽

10.3329/taj.v34i1.54903 ◽

2021 ◽

Vol 34 (1) ◽

pp. 33-39

Author(s):

Md Amjad Hossain Pramanik ◽

Achinta Kumar Mallick ◽

Mukul Kumar Sarkar ◽

SM Emdadul Haque ◽

Md Raseul Kabir ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Ischemic Stroke ◽

Independent Risk Factor ◽

Homocysteine Level ◽

Control Group ◽

Age Group ◽

Healthy Individuals ◽

Serum Homocysteine ◽

And Control

Despite recent advances, only two-third of all strokes can be attributed to known causal risk factors. Homocysteine (tHcy), a sulfur-containing amino acid, is now considered to be an important risk factor for vascular diseases, along with the established risk factors like hyperlipidemia, hypertension, diabetes mellitus, and smoking. Elevated homocysteine levels play a causal role in the pathogenesis of atherosclerosis, thromboembolism and vascular endothelial dysfunction with an increased incidence of ischemic stroke. This study aimed to find out the association of hyperhomocysteinemia with ischemic stroke. A total of 100 subjects were included in this study, 50 were ischemic stroke patients enrolled as case, and 50 were normal healthy individuals enrolled as control. Serum homocysteine level was measured in both case and control groups. The comparison was made in both groups regarding other common risk factors like diabetes mellitus, hypertension, smoking, dyslipidemia, family history, etc. Among 100 patients, 50 had ischemic stroke and 50 were healthy individuals. In this study, out of all patients, abnormal serum homocysteine level was found in 32% of cases and 12% of controls. The mean (±SD) serum homocysteine level was found 16.50±13.86 μmole/L in cases and 9.46±3.49 μmole /L in the control group. Significant (p<0.05) difference was found between the case and the control. The incidence of hyperhomocysteinemia is higher in ischemic stroke cases than that in age-sex-matched healthy controls. In our study, serum homocysteine was high in both younger age group patients (16.65±14.55 μmole/L vs. 9.52±3.19 μmole/L) and older age group patients (16.33±9.87 vs. 9.35±3.97 μmole/L,) in case and control group respectively. Significant (p<0.05) difference was found between the case and the control. Multiple logistic regression analysis showed that abnormal serum homocysteine is an independent risk factor of ischemic stroke. So we conclude that hyperhomocysteinemia is an important and independent risk factor for the development of ischemic stroke. Hypertension and smoking are important contributory to elevated serum homocysteine. TAJ 2021; 34: No-1: 33-39

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Risk factors of hypothyroxinemia in premature infants

10.21203/rs.3.rs-449944/v1 ◽

2021 ◽

Author(s):

Aslan Yilmaz ◽

Yavuz Özer ◽

Nesrin Kaya ◽

Hande Turan ◽

Hazal Cansu Acar ◽

...

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Risk Factor ◽

Gestational Age ◽

Univariate Analysis ◽

Thyroid Stimulating Hormone ◽

Control Group ◽

Postnatal Life ◽

Thyroid Function Tests ◽

Retrospective Case

Abstract Background: Hypothyroxinemia is defined by low levels of thyroxine (T4) despite low or normal levels of thyroid-stimulating hormone (TSH). This study aimed to evaluate the risk factors associated with transient hypothyroxinemia (THOP) in premature newborn.Method: This is a single center, retrospective, case-control study. Premature newborns, between 24-34 weeks of gestation, hospitalised between January 2014-December 2019 in our Newborn Intensive Care Unit (NICU) were analyzed through their medical records. Thyroid function tests were routinely performed between the 10th and 20th days of postnatal life and were evaluated according to the gestational age references. Thirty six risk factors (prenatal and postnatal parameters, medical treatments, clinical diagnoses and applications in NICU) were searched in the patient group with THOP (n=71) and the control group with euthyroid prematures (n=73). The risk factors for THOP were identified by univariate analysis, followed by multivariate analysis. Results: Mean gestational ages of the study and the control groups were 29.7 ± 2.48 and 30.5 ± 2.30 weeks, respectively (p = 0.606). The birth weight, small for gestational age (SGA), intraventricular hemorrhage (IVH), congenital heart disease (CHD) were found to be the risk factors for THOP in the univariate analysis and CHD (p=0.033, odds ratio [OR]:3.7, 95% confidence interval [CI]: 1.1-12.3), BW (p=0.012, OR:0.998, 95% CI: 0.9-1.01) and SGA (p=0.006, OR:5.3, 95% CI: 1.6-17.71) were found to be an independent risk factor for THOP as a result of the multivariate analysis.Conclusıons: Although some treatment practices might have had direct effects on pituitary–thyroid axis, associated with the severity of the newborn clinical conditions, non of them was found to be a risk factor for THOP. However, preterm babies with CHD and SGA could have more risk for THOP.

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The Impact of Graft Nephrectomy on Subsequent Transplants: Multivariate Analysis of Risk Factors for Second Graft Loss and for Multiple Transplantations–A Single-Center Retrospective Study

ISRN Transplantation ◽

10.5402/2013/362571 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Emmanouil Giorgakis ◽

Asim Syed ◽

Hector Gonzalez

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Risk Factor ◽

Retrospective Study ◽

Independent Risk Factor ◽

Graft Loss ◽

Kaplan Meier ◽

Independent Risk Factors ◽

Allograft Loss ◽

The Impact

Introduction. The management of a failed primary allograft remains unclear and the evidence of the effect of transplantectomy to future transplants conflicting. Aim of this study is to review the impact of failed primary graft nephrectomy on future transplants. Materials/Methods. Retrospective study of 101 patients retransplanted in a single institution. Median follow-up was 68 months. Patients were divided into two groups; G1 (n=49) was the nephrectomy group; G2 (n=52) was the graft in situ group. The patients’ and second graft survival were analysed with the Kaplan-Meier method. The patients’ and transplant characteristics were analyzed with student’s t-test. The retransplant risk factors and the risk factors for multiple transplants were obtained via a logistic regression model. Results. The odds of second graft loss post-transplantectomy were high (OR = 5.24). Demographics, HLA mismatch and first graft rejection rates were similar among the two groups and did not affect the outcome. Transplantectomy accelerated the loss of a future failing graft. Multivariate analysis showed transplantectomy as independent risk factor for second allograft loss. Transplantectomy and younger age are significant independent risk factors for future multiple transplants. Conclusion. Transplantectomy of the failed primary graft is an independent risk factor for retransplant loss and for multiple renal transplants.

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Thrombocytopenia Is an Independent Risk Factor for the Prognosis of Thrombotic Microangiopathy in Chinese Patients With Systemic Lupus Erythematosus

Frontiers in Medicine ◽

10.3389/fmed.2021.772607 ◽

2021 ◽

Vol 8 ◽

Author(s):

Fan Yang ◽

Junwei Tian ◽

Linyi Peng ◽

Li Zhang ◽

Jia Liu ◽

...

Keyword(s):

Risk Factors ◽

Systemic Lupus Erythematosus ◽

Multivariate Analysis ◽

Risk Factor ◽

Platelet Count ◽

Lupus Erythematosus ◽

Thrombotic Microangiopathy ◽

Independent Risk Factor ◽

Chinese Patients ◽

Systemic Lupus

Objectives: This study aims to describe clinical characteristics and outcome of thrombotic microangiopathy (TMA) in Chinese patients with systemic lupus erythematosus (SLE), and investigate the risk factors.Methods: We conducted a retrospective single-center cohort and enrolled patients of TMA associated with SLE between January 2015 and December 2018. Demographic characteristics, clinical features, laboratory profiles, therapeutic strategies, and outcomes were collected. The risk factors of TMA in patients with SLE for mortality using multivariate analysis were estimated.Results: A total of 119 patients with a diagnosis of TMA were enrolled within the study period in our center, and SLE was found in 72 (60.5%) patients. The mean age was 29.2 ± 10.1 and 65 (92.3%) were women. Only 15 patients were found with definite causes, the other 57 cases remained with unclear reasons. Sixty-two patients got improved, while 10 patients died after treatment (mortality rate: 13.9%). Compared with the survival group, the deceased group had a higher prevalence of neuropsychiatric manifestations, infection with two or more sites, increased levels of C-reaction protein (CRP) and D-Dimer, and decreased platelet count. Multivariate analysis showed that the decrease of platelet count is the independent risk factor for in-hospital mortality for TMA in patients with SLE. The receiver operating characteristic (ROC) curve analysis displayed that a cutoff value of <18 × 109/L for platelet count could significantly increase the risk of death.Conclusions: Thrombotic microangiopathy often occurs in patients with active SLE with high mortality (13.9%), and thrombocytopenia, especially when the platelet count is lower than 18 × 109/L, is the risk factor for death.

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