The Frequency of Unplanned Rehospitalization and Associated Factors in Gyneoncology Patients: A Retrospective Study

2016 ◽  
Vol 27 (1) ◽  
pp. 183-188 ◽  
Author(s):  
Gul Pinar ◽  
Ayse Akalin ◽  
Hulya Erbaba ◽  
Gokce Banu Acar ◽  
Filiz Avsar ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Patient Outcomes ◽  
Associated Factors ◽  
Gynecological Cancer ◽  
Short Interval ◽  
Multivariable Logistic Regression Model ◽  
Multivariable Logistic Regression ◽  
History Of ◽  
Associated Risk Factors ◽  
Health Care Strategies

ObjectiveIn this study, we aim to analyze rate and associated factors with unplanned rehospitalization in gynecological cancer patients.Materials and MethodsThe electronic database query (2007 to 2014) was used to evaluate rehospitalization rates within 90 days of index admission in patients with gynecological cancer. Multivariable logistic regression was used to identify factors associated with rehospitalization.ResultsMean patient age was 59.05 ± 11.96 years (minimum, 32 years; maximum, 85 years). A total of 152 patients’ data were evaluated. Seventy-three patients (48.0%) were rehospitalized within 90 days of discharge. The median length of index hospital stay (from 3 to 34 days) was 8.90 ± 6.03 days. The most common rehospitalization causes includes pain (24.6%), recurrence (21.9%), ascites (13.7%), surgical site infection (12.3%), acute reoperation (9.6%), thromboembolism (8.2%), renal failure (5.5%), ileus/obstruction (2.7%), and lymphedema (1.4%). In multivariable logistic regression model, difference was found between history of operation, receive chemotherapy, development of the complication during hospitalization comorbidities as well as multiparity variables, and rehospitalization (P < 0.05).ConclusionsUnplanned rehospitalization after discharge for gynecological cancer is common with significant associated risk factors and patient outcomes. Integrated multidisciplinary health care strategies, such as safe transition, communication, patient and family education, accurate medication reconciliation, and short-interval outpatient follow-up may help to prevent rehospitalization after discharge and improve patient outcomes.

Knowledge sharing practice and associated factors among healthcare providers at University of Gondar comprehensive specialized hospital in Amhara region, North West Ethiopian, 2020. (Preprint)

2020 ◽  
Author(s):  
Addisalem Workie
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Knowledge Sharing ◽  
Associated Factors ◽  
Logistic Regression Model ◽  
Healthcare Providers ◽  
Multivariable Logistic Regression Model ◽  
Multivariable Logistic Regression ◽  
Specialized Hospital ◽  
The Right

BACKGROUND In healthcare, information and knowledge needs of health care providers arise in the patient care process. However, the right information and knowledge at the right time and place to the right person is not reached so far yet. Thus, leads to miss diagnosis, wastage of medical resources and knowledge. OBJECTIVE The objective of this study was to assess knowledge sharing practice and associated factors among healthcare providers at University of Gondar comprehensive specialized hospital. METHODS Institutional based cross-sectional study design was conducted through stratified simple random sampling technique among 423 samples from February 24 up to March 27, 2020. Pretested, self administered questionnaire were used to collect the required data. Epi info version 7 and stata software version 15 were used for data entry, processing and analysis respectively. Descriptive statistics and multivariable logistic regression model were applied to describe the study objects and to assess knowledge sharing practice and its associated factors. P value ≤ 0.05 were considered as factors associated with knowledge sharing practice. RESULTS In this study, 423 respondents were participated. From those participants, the level of knowledge sharing practice among healthcare providers was 65.0% (95% CI: 60.46-69.56) with 100% response rate. In multivariable logistic regression model awareness AOR=2.44, 95% CI= [1.32-4.50], willingness AOR=1.96, 95% CI= [1.10-3.53], perceived loss of knowledge power AOR=0.192, 95% CI= [.12-.32], the availability of health information resource AOR=2.00, 95% CI= [1.56-5.38] and opportunity AOR=2.91, 95% CI= [1.71-4.95] were significantly associated with KSP. CONCLUSIONS Knowledge sharing practice of healthcare provider was 65.01% which is higher as compared with most studies conducted in Ethiopia. But, it needs further opportunity, resource allocation and supportive leadership to make it more beyond what exist right now.

scholarly journals Perinatal Depression and Associated Factors among Mothers in Southern Ethiopia: Evidence from Arba Minch Zuria Health and Demographic Surveillance Site

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Gebrekiros Gebremichael ◽  
Manaye Yihune ◽  
Dessalegn Ajema ◽  
Desta Haftu ◽  
Genet Gedamu
Keyword(s):  
Logistic Regression ◽  
Low Income ◽  
Associated Factors ◽  
Perinatal Depression ◽  
Smoking Status ◽  
Low Income Countries ◽  
Southern Ethiopia ◽  
Cross Sectional ◽  
Multivariable Logistic Regression ◽  
History Of

Background. Perinatal depression is a serious mental health problem that can negatively affect the lives of women and children. The adverse consequences of perinatal depression in high-income countries also occur in low-income countries. Objective. To assess the perinatal depression and associated factors among mothers in Southern Ethiopia. Methods. A community based cross-sectional study was conducted among selected 728 study participants in Arba Minch Zuria HDSS. A pretested questionnaire was used to collect the data. Data were analyzed using STATA version 12 software. Descriptive statistical methods were used to summarize the characteristics of the mothers. Bivariate and multivariable logistic regression was used for analysis. Results. The prevalence of perinatal depression among the study period was 26.7%. In the final multivariable logistic regression, monthly income AOR (95% C.I): 4.2 (1.9, 9.3), parity [AOR (95% C.I): 0.14 (0.03, 0.65)], pregnancy complications AOR (95% C.I): 5 (2.5, 10.4), husband smoking status [AOR (95% C.I): 4.12 (1.6, 10.6)], history of previous depression AOR (95% C.I): 2.7 (1.54, 4.8), and family history of psychiatric disorders were the independent factors associated with perinatal depression. Conclusion. The study showed a high prevalence of perinatal depression among pregnant mothers and mothers who have less than a one-year-old child.

Syphilis among men who have sex with men attending a large HIV clinic in Trinidad

2021 ◽  
pp. 095646242199719
Author(s):  
Robert Jeffrey Edwards ◽  
Isshad John ◽  
Selena Todd ◽  
Leon-Omari Lavia ◽  
David Musa ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Chart Review ◽  
Laboratory Data ◽  
Previous History ◽  
History Of ◽  
Review Study ◽  
Sex With Men ◽  
Associated Risk Factors ◽  
Living With Hiv ◽  
Age Range

A chart review study was conducted to determine the prevalence of syphilis and explore the associated risk factors among men who have sex with men (MSM) who attended a large HIV clinic in Trinidad during the period January–December 2019. Patients were routinely screened for syphilis annually, and demographic, clinical, and laboratory data were extracted from the medical records. Descriptive and bivariate analyses were performed, and factors significantly associated with a syphilis diagnosis were assessed using multivariate logistic regression. During the period, 218 MSM were seen, age range 19–67 years, and median age 34.0 years. The prevalence of syphilis was 41.3% (90/218), and 71.1% (64//90) of these infections were asymptomatic. Multivariate analysis using logistic regression showed that MSM living with HIV in the 30–34 years old-age group (OR, 4.32; 95% CI, 1.04–18.02), and those with a previous history of treated syphilis (OR, 10.18; 95% CI, 4.60–22.53) were more likely to be diagnosed with syphilis. The prevalence of syphilis is high among MSM attending the HIV clinic in Trinidad, and most of these infections were asymptomatic; hence, targeted and sustained interventions to reduce syphilis transmission are urgently required. Repeat episodes of syphilis may play a role in the transmission dynamics of syphilis in MSM.

scholarly journals Development of a new sternal dehiscence prediction scale for decision making in sternal closure techniques after cardiac surgery

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ehab Nooh ◽  
Colin Griesbach ◽  
Johannes Rösch ◽  
Michael Weyand ◽  
Frank Harig
Keyword(s):  
Logistic Regression ◽  
Risk Score ◽  
Characteristic Curve ◽  
Multivariable Analysis ◽  
Individual Risk ◽  
Dependent Diabetes Mellitus ◽  
Analysis Model ◽  
Multivariable Logistic Regression Model ◽  
Sternal Dehiscence ◽  
Multivariable Logistic Regression

Abstract Background After sternotomy, the spectrum for sternal osteosynthesis comprises standard wiring and more complex techniques, like titanium plating. The aim of this study is to develop a predictive risk score that evaluates the risk of sternum instability individually. The surgeon may then choose an appropriate sternal osteosynthesis technique that is risk- adjusted as well as cost-effective. Methods Data from 7.173 patients operated via sternotomy for all cardiovascular indications from 2008 until 2017 were retrospectively analyzed. Sternal dehiscence occurred in 2.5% of patients (n = 176). A multivariable analysis model examined pre- and intraoperative factors. A multivariable logistic regression model and a backward elimination based on the Akaike Information Criterion (AIC) a logistic model were selected. Results The model showed good sensitivity and specificity (area under the receiver-operating characteristic curve, AUC: 0.76) and several predictors of sternal instability could be evaluated. Multivariable logistic regression showed the highest Odds Ratios (OR) for reexploration (OR 6.6, confidence interval, CI [4.5–9.5], p < 0.001), obesity (body mass index, BMI > 35 kg/m2) (OR 4.23, [CI 2.4–7.3], p < 0.001), insulin-dependent diabetes mellitus (IDDM) (OR 2.2, CI [1.5–3.2], p = 0.01), smoking (OR 2.03, [CI 1.3–3.08], p = 0.001). After weighting the probability of sternum dehiscence with each factor, a risk score model was proposed scaling from − 1 to 5 points. This resulted in a risk score ranging up to 18 points, with an estimated risk for sternum complication up to 74%. Conclusions A weighted scoring system based on individual risk factors was specifically created to predict sternal dehiscence. High-scoring patients should receive additive closure techniques.

scholarly journals Assessment of Maternal Satisfaction and Associated Factors among Parturients Who Underwent Cesarean Delivery under Spinal Anesthesia at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2019

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Samuel Debas Bayable ◽  
Seid Adem Ahmed ◽  
Girmay Fitiwi Lema ◽  
Debas Yaregal Melesse
Keyword(s):  
Logistic Regression ◽  
Spinal Anesthesia ◽  
Cesarean Delivery ◽  
Associated Factors ◽  
Northwest Ethiopia ◽  
Anesthetic Technique ◽  
Spinal Block ◽  
Maternal Satisfaction ◽  
Cross Sectional ◽  
Multivariable Logistic Regression

Background. Spinal anesthesia is the most common anesthetic technique for cesarean delivery. Patient satisfaction is a subjective and complicated concept, involving physical, emotional, psychological, social, and cultural factors. Regular evaluation of maternal satisfaction related to anesthesia service is an important parameter to the required changes and expansion of high-quality care services. We aimed to assess maternal satisfaction and associated factors among parturients who underwent cesarean delivery under spinal anesthesia. Methods. Institutional-based cross-sectional study was conducted from February to May 2019. A total of 383 parturients were enrolled to assess maternal satisfaction using a 5-point Likert scale. Both bivariable and multivariable logistic regression analyses were done. Variables of p value ≤0.2 in the bivariable analysis were a candidate for multivariable logistic regression. A p value <0.05 was considered as significantly associated with maternal satisfaction at 95% CI. Results. This study revealed that 315 (82.3%) of the parturients were satisfied. Single spinal prick attempts (AOR = 2.08, 95% CI = 1.05–4.11), successful spinal block (AOR = 7.17, 95% CI = 3.33–15.43), less incidence of postdural puncture headache (AOR = 2.36, 95% CI = 1.33–4.20), and prophylactic antiemetic use (AOR = 0.35, 95% CI = 0.19–0.66) were positively associated with maternal satisfaction. Conclusions. The overall maternal satisfaction receiving spinal anesthesia was considerably low. Single spinal prink attempts, successful spinal block, and less incidence of postural puncture headache can increase maternal satisfaction. Therefore, effective perioperative management, skillful techniques, and using the small-gauge Quincke spinal needle (25–27 gauge) may increase the maternal satisfaction and quality of spinal anesthesia management.

scholarly journals Tocilizumab for patients with COVID-19 pneumonia. The single-arm TOCIVID-19 prospective trial

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Francesco Perrone ◽  
◽  
Maria Carmela Piccirillo ◽  
Paolo Antonio Ascierto ◽  
Carlo Salvarani ◽  
...  
Keyword(s):  
Logistic Regression ◽  
A Priori ◽  
Prospective Trial ◽  
Respiratory Support ◽  
Validation Dataset ◽  
Multivariable Logistic Regression Analysis ◽  
Phase 2 ◽  
Multivariable Logistic Regression Model ◽  
Intention To Treat ◽  
Multivariable Logistic Regression

Abstract Background Tocilizumab blocks pro-inflammatory activity of interleukin-6 (IL-6), involved in pathogenesis of pneumonia the most frequent cause of death in COVID-19 patients. Methods A multicenter, single-arm, hypothesis-driven trial was planned, according to a phase 2 design, to study the effect of tocilizumab on lethality rates at 14 and 30 days (co-primary endpoints, a priori expected rates being 20 and 35%, respectively). A further prospective cohort of patients, consecutively enrolled after the first cohort was accomplished, was used as a secondary validation dataset. The two cohorts were evaluated jointly in an exploratory multivariable logistic regression model to assess prognostic variables on survival. Results In the primary intention-to-treat (ITT) phase 2 population, 180/301 (59.8%) subjects received tocilizumab, and 67 deaths were observed overall. Lethality rates were equal to 18.4% (97.5% CI: 13.6–24.0, P = 0.52) and 22.4% (97.5% CI: 17.2–28.3, P < 0.001) at 14 and 30 days, respectively. Lethality rates were lower in the validation dataset, that included 920 patients. No signal of specific drug toxicity was reported. In the exploratory multivariable logistic regression analysis, older age and lower PaO2/FiO2 ratio negatively affected survival, while the concurrent use of steroids was associated with greater survival. A statistically significant interaction was found between tocilizumab and respiratory support, suggesting that tocilizumab might be more effective in patients not requiring mechanical respiratory support at baseline. Conclusions Tocilizumab reduced lethality rate at 30 days compared with null hypothesis, without significant toxicity. Possibly, this effect could be limited to patients not requiring mechanical respiratory support at baseline. Registration EudraCT (2020-001110-38); clinicaltrials.gov (NCT04317092).

scholarly journals 1244. Evaluation of Intraoperative Topical Vancomycin and the Incidence of Acute Kidney Injury

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S448-S448
Author(s):  
Alison L Blackman ◽  
Sabeen Ali ◽  
Xin Gao ◽  
Rosina Mesumbe ◽  
Carly Cheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Serum Creatinine ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Kidney Injury ◽  
Topical Formulation ◽  
Multivariable Logistic Regression Model ◽  
Multivariable Logistic Regression

Abstract Background The use of intraoperative topical vancomycin (VAN) is a strategy aimed to prevent surgical site infections (SSI). Although there is evidence to support its efficacy in SSI prevention following orthopedic spine surgeries, data describing its safety, specifically acute kidney injury (AKI) risk, is limited. The purpose of this study was to determine the AKI incidence associated with intraoperative topical VAN. Methods This is a retrospective cohort study reviewing patient encounters where intraoperative topical VAN was administered from February 2018 to July 2018. All adult patients ( ≥18 years) that received topical VAN in the form of powder, beads, rods, paste, cement spacers, or unspecified topical routes were included. Patient encounters were excluded for AKI or renal replacement therapy (RRT) at baseline, ≤ 2 serum creatinine values drawn after surgery, and/or if irrigation was the only topical formulation given. The primary outcome was the percentage of patients who developed AKI after intraoperative topical VAN administration. AKI was defined as an increase in serum creatinine (SCr) ≥50% from baseline, an increase in SCr >0.5 from baseline, or0 if RRT was initiated after topical VAN was given. Secondary outcomes included analysis of AKI risk factors and SSI incidence. AKI risk factors were analyzed using a multivariable logistic regression model. Results A total of 589 patient encounters met study criteria. VAN powder was the most common formulation (40.9%), followed by unspecified topical routes (30.7%) and beads (9.9%%). Nonspinal orthopedic surgeries were the most common procedure performed 46.7%. The incidence of AKI was 8.7%. In a multivariable logistic regression model, AKI was associated with concomitant systemic VAN (OR 3.39, [3.39–6.22]) and total topical VAN dose. Each doubling of the topical dose was associated with increased odds of developing AKI (OR = 1.42, [1.08–1.86]). The incidence of SSI was 5.3%. Conclusion AKI rates associated with intraoperative topical VAN are comparable to that of systemic VAN. Total topical vancomycin dose and concomitant systemic VAN was associated with an increased AKI risk. Additional analysis is warranted to compare these patients to a similar population that did not receive topical VAN. Disclosures All authors: No reported disclosures.

Surgical Thoracoabdominal Aortic Aneurysm Repair in a Non-High-Volume Institution

2020 ◽  
Author(s):  
Takashi Kunihara ◽  
Claudia Vukic ◽  
Fumihiro Sata ◽  
Hans-Jaochim Schäfers
Keyword(s):  
Spinal Cord ◽  
Logistic Regression ◽  
Aortic Aneurysm ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Left Ventricular ◽  
Multivariable Logistic Regression Model ◽  
Multivariable Logistic Regression ◽  
Cord Injury

Abstract Background Surgical thoracoabdominal aortic aneurysm (TAAA) repair remains challenging. Apart from mortality, spinal cord injury (SCI) is a dreaded complication. We analyzed our experience to identify predictors for SCI in a nonhigh-volume institution. Patients and Methods All patients who underwent TAAA repair between February 1996 and November 2016 (n = 182) were enrolled. Most were male (n = 121; 66.4%), median age was 68 years (range: 21–84). Elective operations were performed in 153 instances (84.1%). Our approach to minimize SCI includes distal aortic perfusion, mild hypothermia, identification of the Adamkiewicz artery, and sequential aortic clamping. Cerebrospinal fluid drainage was introduced in 2001 and liberal use of selective visceral perfusion in 2006. Results Early mortality was 12.1%; it was 8.5% after elective procedures. Reduced left ventricular function, nonelective setting, older age, and longer bypass time were identified as independent predictors for mortality in multivariable logistic regression model. Permanent SCI was observed in nine patients (4.9%), of whom seven (3.8%) developed paraplegia. In a multivariable logistic regression model for paraplegia, peripheral arterial disease (PAD), Crawford type II repair, smaller body surface area, and era before 2001 were identified as independent predictors, whereas only PAD was significant for SCI. The incidence of paraplegia was 13.8% in extensive repair out of the first 91 cases, whereas it was improved up to 2.7% thereafter. Conclusion Using an integrated approach, acceptable outcome of TAAA repair can be achieved, even in a nonhigh-volume center. PAD and extensive involvement of the aorta are strong independent predictors for spinal cord deficit after TAAA repair.

Common Correlates of Suicidal Ideation and Physical Assault Among Male and Female University Students in Hong Kong

2007 ◽  
Vol 22 (3) ◽  
pp. 290-303 ◽  
Author(s):  
Ko Ling Chan ◽  
Agnes Tiwari ◽  
W. C. Leung ◽  
Hesta W. Y. Ho ◽  
Catherine Cerulli
Keyword(s):  
Logistic Regression ◽  
Hong Kong ◽  
Suicidal Ideation ◽  
University Students ◽  
Partner Violence ◽  
Associated Factors ◽  
Physical Assault ◽  
Male And Female ◽  
Relationship Length ◽  
History Of

This study examined prevalence and correlates of suicidal ideation and dating partner violence in a cohort of 651 university students in social sciences classes at three universities in Hong Kong. A standard questionnaire was completed within one class period to examine the rates of occurrence of physical assault perpetration and suicidal ideation. Separate rates are presented for male and female perpetrators and for severe and overall levels of violence. The differences between subjects having suicidal ideation are compared using t tests. Logistic regression is used to predict the presence or absence of physical assault in the preceding year of reporting and suicidal ideation based on the variables such as Personal Relationship Profile, age, relationship length, and socioeconomic status. Results showed that 55% of suicidal persons had a history of violence, whereas 39% of violent people had a history of suicidal ideation. Logistic regression showed that physical assault shared a total of seven associated factors with suicidal ideation. Suicidal ideation seems to have no direct relation to physical and sexual assault, but they do share some common associated factors that are essential for the development of suicide prevention.

Beyond TILs: Predictors of pathologic complete response (pCR) in triple-negative breast cancer (TNBC) patients with moderate tumor-infiltrating lymphocytes (TIL) receiving neoadjuvant therapy.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 572-572
Author(s):  
Nour Abuhadra ◽  
Kenneth R. Hess ◽  
Jennifer Keating Litton ◽  
Gaiane M Rauch ◽  
Alastair Mark Thompson ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Neoadjuvant Therapy ◽  
Logistic Regression Model ◽  
Stage I ◽  
Multivariable Logistic Regression Model ◽  
Ki 67 ◽  
Early Stage Disease ◽  
Cut Points ◽  
Multivariable Logistic Regression

572 Background: Increased TIL in TNBC is associated with higher rates of pCR. High TIL is also associated with improved disease free survival and overall survival. The aim of this study is to identify data cut-points of pre-treatment low, moderate and high TIL count based on pCR and to identify clinical and pathological predictors of pCR in patients with moderate TIL. Methods: We evaluated the relationship between pCR and TIL in 180 patients with stage I-III TNBC enrolled in the ARTEMIS trial (NCT02276443). Recursive portioning was used to identify cut-points. Clinical and pathological variables such as age at diagnosis, stage, race, histology as well as Ki-67, vimentin, and androgen receptor (AR) by immunohistochemistry, were evaluated in pts with moderate TIL. A multivariable logistic regression model identified variables independently, significantly associated with pCR. Results: Four TIL groups were identified with pCR rates of 23%, 31%, 48% and 78% respectively (p < 0.0001) (Table A). In the two combined moderate TIL groups, 90 (97%) pts were evaluable for the multivariate model. Stage I-II disease, high Ki-67 and low AR were associated with increased probability of pCR (Table B). The multivariable logistic regression model area under the ROC curve was 0.78 (95% CI=0.68-0.88; p<0.0001). A model of computed risk score [ Stage I-II (score 2)+Ki-67≥ 50% (score 1)+AR<10% (score 1)] predicted a probability of 67% for pCR when all three variables were favorable (Table). Conclusions: Four TIL groups were identified. In pts with moderate TIL levels, early stage disease, high Ki-67 and low AR were associated with increased probability of pCR with neoadjuvant therapy. [Table: see text]

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