Hip Reconstruction in Nonambulatory Children With Cerebral Palsy: Identifying Risk Factors Associated With Postoperative Complications and Prolonged Length of Stay

2020 ◽  
Vol 40 (10) ◽  
pp. e972-e977 ◽  
Author(s):  
Jodie Shea ◽  
Kianna D. Nunally ◽  
Patricia E. Miller ◽  
Rachel Difazio ◽  
Travis H. Matheney ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Postoperative Complications ◽  
Length Of Stay ◽  
Hip Reconstruction ◽  
Prolonged Length ◽  
Factors Associated ◽  
Children With Cerebral Palsy

scholarly journals Early Outcomes After Surgical Management of Geriatric Patella Fractures

2021 ◽  
Vol 12 ◽  
pp. 215145932098769
Author(s):  
Jaclyn Kapilow ◽  
Junho Ahn ◽  
Kathryn Gallaway ◽  
Megan Sorich
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Length Of Stay ◽  
Geriatric Patients ◽  
The United States ◽  
Unplanned Readmission ◽  
Patella Fracture ◽  
Factors Associated ◽  
Prolonged Hospitalization ◽  
Patella Fractures

Objectives: To report the incidence and risk factors for prolonged hospitalization, discharge to a facility, and postoperative complications in geriatric patients who underwent surgery for patella fracture. Design: Retrospective database review. Setting: The American College of Surgeons—National Surgical Quality Improvement Program (NSQIP) collects data from 600 hospitals across the United States. Patients/Participants: NSQIP patients over 65 years of age with patella fractures. Intervention: Surgical fixation of patella fracture including extensor mechanism repair. Main Outcome Measurements: Prolonged hospitalization, discharge to a facility, and 30-day post-operative complications. Results: 1721 patients were included in the study. The average age was 74.9 years. 358 (20.8%) patients were male. 122 (7.1%) patients had a length of stay greater than 7 days. Factors associated with prolonged length of stay include pre-existing renal failure, need for emergent surgery, and time to surgery greater than 24 hours from admission. 640 patients (37.2%) of patients were discharged to a facility after surgery. Discharge to facility was associated with age >77 years, obesity, anemia, thrombocytopenia, pre-operative SIRS, and CCI > 0.5. Admission from home decreased the odds of discharge to a facility. The most common postoperative complications in this population were unplanned readmission (3.4%), unplanned reoperation (2.7%), surgical site infection (1.1%), mortality (1.0%), venous thromboembolism (0.8%), and wound dehiscence (0.2%). Complication rates increased with anemia and ASA class IV-V. Conclusions: Geriatric patients undergoing operative intervention for patella fractures are at high risk for prolonged hospitalization, discharge to facility, unplanned readmission or reoperation, and surgical site complications in the first 30 days following surgery. This study highlights modifiable and non-modifiable risk factors associated with adverse events. Early recognition of these factors can allow for close monitoring and multidisciplinary intervention in the perioperative period to improve outcomes. Level of Evidence: Prognostic level III.

Risk factors associated with epilepsy development in children with cerebral palsy

2019 ◽  
Vol 35 (7) ◽  
pp. 1181-1187 ◽  
Author(s):  
Elif Karatoprak ◽  
Gülhan Sözen ◽  
Sema Saltık
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Factors Associated ◽  
Children With Cerebral Palsy

Risk factors associated with low back pain in mothers of children with cerebral palsy

2007 ◽  
Vol 19 (4) ◽  
pp. 184-184
Author(s):  
Min Ye Jung ◽  
Keun Ho Lee ◽  
Eun Young Yoo ◽  
Joshua H. You
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Low Back Pain ◽  
Back Pain ◽  
Low Back ◽  
Factors Associated ◽  
Children With Cerebral Palsy

scholarly journals Risk Factors Associated With Perioperative Complications and Prolonged Length of Stay After Laparoscopic Adrenalectomy

JAMA Surgery ◽  
2018 ◽  
Vol 153 (11) ◽  
pp. 1036 ◽  
Author(s):  
Yufei Chen ◽  
Anouk Scholten ◽  
Kathryn Chomsky-Higgins ◽  
Iheoma Nwaogu ◽  
Jessica E. Gosnell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Laparoscopic Adrenalectomy ◽  
Perioperative Complications ◽  
Prolonged Length ◽  
Factors Associated

scholarly journals Factors Associated with Prolonged Length of Stay in Intensive Care Unit: Systematic Review and Meta-analysis

2021 ◽  
Vol 9 (1) ◽  
pp. 30
Author(s):  
Nashwa M. Radwan ◽  
Nagla E. Mahmoud ◽  
Amal H. Alfaifi ◽  
Khaled I. Alabdulkareem
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
English Language ◽  
Medical Condition ◽  
Severity Of Illness ◽  
Risk Of Bias ◽  
Prolonged Length ◽  
Factors Associated

Background: Prolonged length of Stay (PLOS) increases the risk of hospital-acquired infections and disrupts patient flowand access to care due to bed shortages. The extent to which PLOS is attributable to complications, patient characteristics, illness, or inefficienpractice style is unclear. Objectives: To determine risk factors associated with prolonged length of stay (PLOS) in intensive care unit. (ICU). Search methods: We searched the COCHRANE, MEDLINE, TRIP and EMBASE from 2010 till now. Selection criteria: We included all the studies published in English language from 2010 till now and investigated the PLOS in ICU after any medical condition. Data collection and analysis: Two authors independently assessed trials eligibility and risk of bias and extracted data. Review Manager 5.3 was utilized to manage the data. Main results: The review included 84719 participants from fourteen observational studies that had some degree of risk of bias and substantial heterogeneity. Post-operative sepsis/ septic shock and the severity of illness of the patients at hospital admission were the most common risk factors for PLOS (OR= 5.65, CI= 1.98, 16.08 and OR=3.95, CI= 1.67, 9.34 respectively), followed by emergency operation (OR= 2.68, CI= 1.56, 4.62), and comorbidities including renal failure and coronary heart disease (OR= 2.64, CI=1.26, 5.51 and OR=2.57, CI= 1.61, 4.10 respectively). Other variables associated with PLOS were respectively; pre-operative condition (OR=2.36, CI=1.28, 4.34), long term use of corticosteroids (OR= 2.03, CI= 1.81, 2.29 ), age >70 years (OR=1.89, CI=0.54, 2.32), operation duration >180 minutes (OR=1.86, CI=1.46, 2.38), most deprived condition (OR= 1.82, CI= 1.15, 2.89), diabetes (OR= 1.36, CI=1.18, 1.56), hypertension (OR=1.32, CI= 1.09, 1.62), smoking (OR=1.25, CI= 1.13, 1.39) and male sex (OR= 1.11, CI=1.06, 1.17). Authors conclusion: Identificationof risk factors associated with PLOS provides the opportunity for intervention to reduce the LOS and support efficient/optimause of hospital resources.

Identifying modifiable and non-modifiable risk factors associated with prolonged length of stay after hysterectomy for uterine cancer

2018 ◽  
Vol 149 (3) ◽  
pp. 545-553 ◽  
Author(s):  
Surbhi Agrawal ◽  
Ling Chen ◽  
Ana I. Tergas ◽  
June Y. Hou ◽  
Caryn M. St. Clair ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Uterine Cancer ◽  
Modifiable Risk Factors ◽  
Prolonged Length ◽  
Factors Associated

Risk factors associated with low back pain in mothers of children with cerebral palsy

2007 ◽  
Vol 19 (3) ◽  
pp. 93-98 ◽  
Author(s):  
Min Ye Jung ◽  
Keun Ho Lee ◽  
Eun Young Yoo ◽  
Joshua H. You
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Low Back Pain ◽  
Back Pain ◽  
Low Back ◽  
Factors Associated ◽  
Children With Cerebral Palsy

A Cross-sectional Study of the Clinical Profile of Children With Cerebral Palsy in Benin, a West African Low-Income Country

2019 ◽  
Vol 34 (13) ◽  
pp. 842-850
Author(s):  
Emmanuel Segnon Sogbossi ◽  
Damienne Houekpetodji ◽  
Toussaint G. Kpadonou ◽  
Yannick Bleyenheuft
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Low Income ◽  
Classification System ◽  
West African ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Common Cause ◽  
Low Income Country ◽  
Children With Cerebral Palsy

Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children’s mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school attendance. We recorded a high prevalence of intrapartum adverse events. Seventeen percent of children had postneonatal cerebral palsy, with cerebral malaria being the most common cause. Most children were severely affected (67.5% as bilateral spastic; 54.4% as GMFCS IV or V), but severity declined substantially with age. Only 23% of the children with cerebral palsy had attended school. Poor motor outcomes and comorbidities were associated with school nonattendance. These results suggest that intrapartum risk factors and postnatal cerebral malaria in infants are opportune targets for prevention of cerebral palsy in Sub-Saharan low-income countries.

scholarly journals Evaluation of risk factors for cerebral palsy

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Dina Salama Abd Elmagid ◽  
Hend Magdy
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Intracranial Hemorrhage ◽  
Cns Infection ◽  
Motor Impairments ◽  
Cerebrovascular Accidents ◽  
Common Causes ◽  
Children With Cerebral Palsy ◽  
Infant Brain ◽  
Cns Malformation

Abstract Background Cerebral palsy (CP) has been identified as one of the most important and common causes of childhood disabilities worldwide and is often accompanied by multiple comorbidities. CP is defined as a group of disorders of the development of movement and posture, causing activity limitation that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The objective of our study was to describe main clinical pattern and motor impairments of our patients, and to evaluate the presence of risk factors and if there is a relation to the type of cerebral palsy. Methods Children with cerebral palsy were retrospectively enrolled over 2 years from the neurology outpatient clinics. Cerebral palsy risk factors and motor impairments were determined through caregiver interviews, review of medical records, and direct physical examination. Results One thousand children with cerebral palsy were enrolled. Subjects were 64.4% male, with a median age of 2.5 years. The risk factors for cerebral palsy in our study were antenatal (21%), natal and post-natal (30.5%), post-neonatal (17.1%), and unidentified (31.4%). Antenatal as CNS malformation (26.6%), maternal DM (17.6%), prolonged rupture of membrane (11.9%), maternal hemorrhage (10.4%), and pre-eclampsia (4.7%). Natal and post-natal as hypoxic ischemic encephalopathy (28.5%), infection (16.3%), hyperbilirubinemia (12.7%), cerebrovascular accidents (8.8%), meconium aspiration (6.2%), and intracranial hemorrhage. Post-neonatal as CNS infection (34.5%), cerebrovascular accidents (28.6%), sepsis (23.9%), and intracranial hemorrhage (8.7%). Conclusions Cerebral palsy has different etiologies and risk factors. Further studies are necessary to determine optimal preventative strategies in these patients.

Higher-Than-Expected Rates of Distal Radioulnar Joint Fixation in Radial Shaft Fractures: Location of Fracture Matters

Hand ◽  
2021 ◽  
pp. 155894472110068
Author(s):  
Joanne Y. Zhang ◽  
Aneesh V. Samineni ◽  
David C. Sing ◽  
Alyssa Rothman ◽  
Andrew B. Stein
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Patient Characteristics ◽  
Distal Radioulnar Joint ◽  
Older Age ◽  
Radioulnar Joint ◽  
Factors Associated ◽  
Shaft Fractures ◽  
Male Sex ◽  
Preoperative Patient

Background: The purpose of this study was to evaluate rates of distal radioulnar joint (DRUJ) fixation based on location of the radial shaft fracture and risk factors associated with postoperative complications following radial shaft open reduction internal fixation (ORIF). Methods: Adult patients who underwent isolated radial shaft ORIF from 2014 to 2018 were identified from American College of Surgeons National Surgical Quality Improvement Program database and stratified by fracture location and by the presence or absence of DRUJ fixation. Preoperative patient characteristics and postoperative complications were compared to determine risk factors associated with DRUJ fixation. Results: We identified 1517 patients who underwent isolated radial shaft ORIF, of which 396 (26.1%) underwent DRUJ fixation. Preoperative patient characteristics and postoperative complications were similar between cohorts. Distal radioulnar joint fixation was performed in 50 (30.7%) of 163 distal radial shaft fractures, 191 (21.8%) of 875 midshaft fractures, and 3 (13.0%) of 23 proximal shaft fractures ( P = .025). Risk factors for patients readmitted include male sex (odds ratio [OR] = 12.76, P = .009) and older age (OR = 4.99, P = .035). Risk factors for patients with any postoperative complication include dependent functional status (OR = 6.78, P = .02), older age (50-69 vs <50) (OR = 2.73, P = .05), and American Society of Anesthesiologists (ASA) ≥3 (OR = 2.45, P = .047). Conclusions: The rate of DRUJ fixation in radial shaft ORIF exceeded previously reported rates of concomitant DRUJ injury, especially among distal radial shaft fractures. More distally located radial shaft fractures are significantly associated with higher rates of DRUJ fixation. Male sex is a risk factor for readmission, whereas dependent functional status, older age, and ASA ≥3 are risk factors for postoperative complications.

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