scholarly journals Is sleep apnoea a risk factor for Covid-19? Findings from a retrospective cohort study

2020 ◽  
Author(s):  
Thijs Feuth ◽  
Tarja Saaresranta ◽  
Antti Karlsson ◽  
Mika Valtonen ◽  
Ville Peltola ◽  
...  
Keyword(s):  
Critical Care ◽  
Risk Factor ◽  
Cohort Study ◽  
Oxygen Saturation ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Sleep Apnoea ◽  
Study Data ◽  
University Hospital ◽  
Obstructive Sleep

Background: In the early phase of the coronavirus disease-19 (Covid-19) pandemic, Southwest Finland remained relatively spared. By the 3rd of May 2020, a total of 28 patients have been admitted to the Turku University Hospital. In this paper, we explore baseline characteristics in order to identify risk for severe Covid-19 disease and critical care admission. Methods For this retrospective cohort study, data were derived from hospital records. Basic descriptive statistics were used to characterise patients, including medians, percentiles and frequencies. Differences were tested with Mann Whitney U-test and Pearson's chi-square test. Results Pre-existent obstructive sleep apnoea (OSA) was present in 29% of patients admitted in the hospital for Covid-19, none of them having severe OSA. Overall, other findings on admission were comparable with those reported elsewhere. C-reactive protein (CRP) and procalcitonin (PCT) were higher in patients who were eventually transferred to critical care in comparison to in those who were not (median CRP 187 mg/L versus 52 mg/L, p<0.005 and median PCT 0.46 versus 0.12, p=0.047). Moreover, there was a trend towards lower oxygen saturation on admission in ICU-patients (87% versus 93%, p=0.09). Discussion OSA was pre-existent in a disproportional large group of patients, which suggests that it is an important risk factor for severe Covid-19. Furthermore, we identified high CRP, PCT and possibly oxygen saturation as useful clinical measures to identify patients at risk for critical care.

scholarly journals Diabetes Mellitus as a Risk Factor for Drug Resistance Tuberculosis: A Retrospective Cohort Study at King Abdul Aziz University, Jeddah

2021 ◽  
pp. 136-145
Author(s):  
Sumyia Mehrin M. D. Abulkalam ◽  
Mai Kadi ◽  
Mahmoud A. Gaddoury ◽  
Wallaa Khalid Albishi
Keyword(s):  
Diabetes Mellitus ◽  
Drug Resistance ◽  
Risk Factor ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
University Hospital ◽  
P Value ◽  
Baseline Characteristic ◽  
Drug Resistant

Background: The association between tuberculosis (TB) and diabetes mellitus (DM) is re-emerging with the epidemic of type II diabetes. Both TB and DM were of the top 10 causes of death.[1] This study explores diabetes mellitus as a risk factor for developing the different antitubercular drug-resistant (DR) patterns among TB patients.  Methods: A retrospective cohort study has been conducted on all TB cases reported to the King Abdul Aziz University Hospital, Jeddah, between January 2012 to January 2021. All culture-confirmed and PCR-positive TB cases were included in this study. Categorical baseline characteristic of TB patient has been compared with DM status by using Fisher's exact and Pearson chi-square test. The univariable and multivariable logistic regression model was used to estimate the association between DM and different drug resistance patterns.  Results: Of the total 695 diagnosed TB patients, 92 (13.24%) are resistant to 1st line anti TB drugs. Among 92 DR-TB patients, 36 (39.13%) are diabetic. The percentage of different patterns of DR-TB with DM, in the case of mono DR (12.09%), poly DR (4.19%) MDR (0.547%). As a risk factor, DM has a significant association with DR-TB, mono drug-resistant, and pyrazinamide-resistant TB (P-value <0.05). The MDR and PDR separately do not show any significant association with DM, but for further analysis, it shows a significant association with DM when we combined.  Conclusion: Our study identified diabetes mellitus as a risk factor for developing DR-TB. Better management of DM and TB infection caring programs among DM patients might improve TB control and prevent DR-TB development in KSA.

scholarly journals Risk of obstructive sleep apnoea in patients with rheumatoid arthritis: a nationwide population-based retrospective cohort study

BMJ Open ◽  
2016 ◽  
Vol 6 (11) ◽  
pp. e013151 ◽  
Author(s):  
Te-Chun Shen ◽  
Liang-Wen Hang ◽  
Shinn-Jye Liang ◽  
Chien-Chung Huang ◽  
Cheng-Li Lin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Obstructive Sleep Apnoea ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Population Based ◽  
Sleep Apnoea ◽  
Obstructive Sleep

scholarly journals Incidence of indications for tonsillectomy and frequency of evidence-based surgery: a 12-year retrospective cohort study of primary care electronic records

2018 ◽  
Vol 69 (678) ◽  
pp. e33-e41 ◽  
Author(s):  
Dana Šumilo ◽  
Linda Nichols ◽  
Ronan Ryan ◽  
Tom Marshall
Keyword(s):  
Cohort Study ◽  
Electronic Medical Records ◽  
Retrospective Cohort Study ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Periodic Fever ◽  
Sleep Apnoea ◽  
Evidence Based ◽  
Research Database ◽  
Obstructive Sleep

BackgroundNeither the incidence of indications for childhood tonsillectomy nor the proportion of tonsillectomies that are evidence-based is known.AimTo determine the incidence of indications for tonsillectomy in UK children, and the proportion of tonsillectomies meeting evidence-based criteria.Design and settingA retrospective cohort study of electronic medical records of children aged 0–15 years registered with 739 UK general practices contributing to a research database.MethodChildren with recorded indications for tonsillectomy were identified from electronic medical records. Evidence-based indications included documented sore throats of sufficient frequency and severity (Paradise criteria); periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome (PFAPA); or tonsillar tumour. Other indications were considered non-evidence-based. The numbers of children subsequently undergoing tonsillectomy was then identified. The numbers with evidence-based and non-evidence-based indications for surgery among children who had undergone tonsillectomy were determined.ResultsThe authors included 1 630 807 children followed up for 7 200 159 person–years between 2005 and 2016. Incidence of evidence-based indications for tonsillectomy was 4.2 per 1000 person years; 13.6% (2144/15 760) underwent tonsillectomy. Incidence of childhood tonsillectomy was 2.5 per 1000 person years; 11.7% (2144/18 281) had evidence-based indications, almost all with Paradise criteria. The proportion of evidence-based tonsillectomies was unchanged over 12 years. Most childhood tonsillectomies followed non-evidence-based indications: five to six sore throats (12.4%) in 1 year, two to four sore throats (44.6%) in 1 year, sleep disordered breathing (12.3%), or obstructive sleep apnoea (3.9%).ConclusionIn the UK, few children with evidence-based indications undergo tonsillectomy and seven in eight of those who do (32 500 of 37 000 annually) are unlikely to benefit.

scholarly journals 0908 The Impact Of Adenotonsillectomy On Obstructive Sleep Apnea In Children With Trisomy 21: A Retrospective Cohort Study

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A345-A345
Author(s):  
J Platt ◽  
A Adeleye ◽  
A Nettel-Aguirre ◽  
A Chugh ◽  
W Yunker
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cohort Study ◽  
Sleep Apnea ◽  
Oxygen Saturation ◽  
Retrospective Cohort Study ◽  
Trisomy 21 ◽  
Retrospective Cohort ◽  
Complication Rates ◽  
Obstructive Sleep ◽  
The Impact

Abstract Introduction Obstructive sleep apnea (OSA) has a prevalence of 1 - 5.7% in the general pediatric population. In children with Trisomy 21 (T21), OSA is estimated to be much higher, at 30-60%. The medical consequences of untreated OSA may be significant, therefore it is worthwhile to explore treatment options. Adenotonsillectomy (AT) is often the first line treatment in children, including those with T21. However, success rates of AT in patients with T21 is more variable, and postoperative complications can be higher. The aim of this study was to determine the impact of AT on the apnea hypopnea index (AHI) in patients with Trisomy 21. Methods A retrospective cohort study was conducted by reviewing children with T21 and the following criteria: 1) 0 to 18 years of age, 2) AT completed between January 2010 to December 2015, 3) pre- and post-operative polysomnogram (PSG). Data extraction included demographics, details of PSG both prior to and after surgery including severity of sleep apnea and oxygen levels, type of surgery, and surgical complications. Results Our sample consisted of 64 subjects. Mean pre-operative AHI was 32.2, while mean post-operative AHI was 8.0, for a difference of 21.7 (p = 0.0001). Mean pre-operative oxygen saturation was 92.5, while mean post-operative oxygen saturation was 93.7, for a difference of 1.2 (p = 0.01). There were 10 post-operative emergency room visits (15.3%), 2 admissions to hospital (3.1%) and 2 repeat surgeries for post-operative bleeding (3.1%). Conclusion Preliminary findings of this study show a statistically significant improvement in OSA severity as determined by change in AHI and mean oxygen saturations post AT in children with T21. Complication rates were low. Further data collection and analysis is underway. Support None.

scholarly journals Endometriosis and the risk of ectopic pregnancy: 10-year retrospective cohort study

2019 ◽  
Vol 12 (1) ◽  
pp. 10-15
Author(s):  
Ally Saetta ◽  
Michael Magro ◽  
Reeba Oliver ◽  
Funlayo Odejinmi
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Ectopic Pregnancy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Primary Objective ◽  
University Hospital ◽  
Chi Square Analysis

Objective: Our primary objective is to give weight to the unanswered and recently heavily debated question, as to whether endometriosis is a statistically significant risk factor for ectopic pregnancy. Our study also provides information on the ethnicity, age and parity of each woman. We report the clinical presentation, the presence of other risk factors as well as intraoperative findings. Design: A retrospective cohort study. Settings: Whipps Cross University Hospital, Bart’s Health NHS Trust which is a district general University hospital in East London. Population: All women, over 10-year period (2005–2014), who were surgically treated for an ectopic pregnancy. Methods: In total, 800 patients were surgically managed. A total of 100 had incomplete data and were, therefore, excluded from analysis. The clinical details, demographics and operation notes were retrospectively analysed for 700 patients. Data were analysed using the student’s t test or chi-square analysis as appropriate. Results: In total, 37 women (5.3%) had endometriosis and 663 women (94.7%) had no evidence of endometriosis. Of the 37 patients, 24 had stage 1, 11 had stage 2 and 2 patients had stage 3 endometriosis. Conclusion: Our data support the theory that endometriosis is not a statistically significant occurrence in women with surgically managed ectopic pregnancy and is not risk factor for ectopic pregnancy.

scholarly journals P098 Predicting delays in or failure to initiate CPAP therapy: A retrospective cohort study

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A52-A53
Author(s):  
S Moore ◽  
B Duce ◽  
C Ellender ◽  
C Hukins
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Sleep Apnoea ◽  
Male Gender ◽  
Significant Feature ◽  
Cpap Therapy ◽  
Indigenous Status ◽  
Younger Age ◽  
Obstructive Sleep

Abstract Background Suboptimal CPAP usage is associated with negative outcomes and inefficient use of medical resources. Demographic and polysomnographic characteristics are well established predictors of poor adherence, however the literature regarding patients who fail to initiate treatment is limited. This audit aimed to identify features associated with the delayed commencement or failure to initiate CPAP therapy. Methods A single institution, retrospective cohort study was performed. The cohort comprised adults with obstructive sleep apnoea prescribed CPAP between 2017 and 2018. The demographic, clinical and polysomnographic features of this cohort were identified. Comparisons were conducted between patients who initiated therapy and those who did not, as well as between early and delayed initiators of treatment, which was defined as uptake after one month. Multiple logistic regression was performed with significance defined as a p&lt;0.05. Results 916 patients were identified. 38.2% of patients did not uptake prescribed CPAP, with male gender (p &lt; 0.001), younger age (p=0.007) and lower pressure (p=0.016) identified as prognostic factors. Socioeconomic disadvantage (p=0.774) and Epworth Sleepiness Scale (p=0.111) were not associated with failure to start treatment. Of the 61.8% of patients who initiated CPAP therapy, 33% exhibited a delayed start to therapy, with indigenous status a significant feature of this cohort (p=0.002). Discussion A large portion of patients displayed either delayed commencement or failure to initiate CPAP therapy. Younger age, male gender and lower prescribed pressures were identified as negative predictive factors. These characteristics, as well as delayed treatment experienced in the indigenous population, provide focus points for intervention.

Nonunion Rates in Hind- and Midfoot Arthrodesis in Current, Ex-, and Nonsmokers

2020 ◽  
pp. 107110072097126
Author(s):  
Jack Allport ◽  
Jayasree Ramaskandhan ◽  
Malik S. Siddique
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Relative Risk ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Smoking Status ◽  
Time Frame ◽  
Modifiable Risk Factor ◽  
Level Of Evidence ◽  
Significant Difference

Background: Nonunion rates in hind or midfoot arthrodesis have been reported as high as 41%. The most notable and readily modifiable risk factor that has been identified is smoking. In 2018, 14.4% of the UK population were active smokers. We examined the effect of smoking status on union rates for a large cohort of patients undergoing hind- or midfoot arthrodesis. Methods: In total, 381 consecutive primary joint arthrodeses were identified from a single surgeon’s logbook (analysis performed on a per joint basis, with a triple fusion reported as 3 separate joints). Patients were divided based on self-reported smoking status. Primary outcome was clinical union. Delayed union, infection, and the need for ultrasound bone stimulation were secondary outcomes. Results: Smoking prevalence was 14.0%, and 32.2% were ex-smokers. Groups were comparable for sex, diabetes, and body mass index. Smokers were younger and had fewer comorbidities. Nonunion rates were higher in smokers (relative risk, 5.81; 95% CI, 2.54-13.29; P < .001) with no statistically significant difference between ex-smokers and nonsmokers. Smokers had higher rates of infection ( P = .05) and bone stimulator use ( P < .001). Among smokers, there was a trend toward slower union with heavier smoking ( P = .004). Conclusion: This large retrospective cohort study confirmed previous evidence that smoking has a considerable negative effect on union in arthrodesis. The 5.81 relative risk in a modifiable risk factor is extremely high. Arthrodesis surgery should be undertaken with extreme caution in smokers. Our study shows that after cessation of smoking, the risk returns to normal, but we were unable to quantify the time frame. Level of Evidence: Level III, retrospective cohort study.

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