Risk factors for blood-contaminated cerebrospinal fluid collection in dogs

ObjectiveTo determine the risk factors for blood contamination during cerebrospinal fluid (CSF) collection in dogs.Study design and methodsThis is a prospective study of 170 CSF samples. Data collected included signalment of the patient, body condition score, site of CSF collection (cerebellomedullary cistern (CMC) or lumbar cistern (LC)), number of attempts, clinician expertise, final diagnosis, time of day, skull conformation and day of the week. Analysis of the CSF samples was then performed, and the presence of blood contamination (red blood cells >500/µl) was recorded. Logistic regression was used to quantify the association of potential risk factors of the procedure. Multivariate analysis was performed on the variables that were statistically significant.ResultsOf the 170 CSF samples, 53 per cent were collected from the CMC (n=90) and 47 per cent from the LC (n=80). Blood contamination was seen in 20 per cent (n=34) of the samples, 8.9 per cent (n=8) in CMC and 32.5 per cent (n=26) in LC samples. Increased odds of obtaining a contaminated CSF sample were associated with lower level of clinician expertise (odds ratio: 2.5; 95 per cent confidence interval: 0.9–6.7; P=0.046) and with LC versus CMC collection site (odds ratio: 8.1; 95 per cent confidence interval: 2.1–12.9; P=0.001).Clinical significanceThere is increased likelihood of blood contamination when collecting CSF from the LC compared with the CMC site. Increased clinician experience reduced the risk of CSF blood contamination, but none of the other variables examined significantly influenced this.

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Potential risk factors for Ebstein anomaly, National Birth Defects Prevention Study, 1997–2011

Cardiology in the Young ◽

10.1017/s1047951119000970 ◽

2019 ◽

Vol 29 (06) ◽

pp. 819-827 ◽

Cited By ~ 1

Author(s):

Karrie F. Downing ◽

Tiffany Riehle-Colarusso ◽

Suzanne M. Gilboa ◽

Angela E. Lin ◽

Matthew E. Oster ◽

...

Keyword(s):

Risk Factors ◽

Family History ◽

Confidence Interval ◽

Birth Defects ◽

Odds Ratio ◽

Paternal Age ◽

Prevention Study ◽

Ebstein Anomaly ◽

Potential Risk Factors ◽

History Of

AbstractBackground:Ebstein anomaly is a rare congenital heart defect (CHD) that, when severe, requires corrective surgery or other catheter-based intervention in the first year of life. Due to its rarity, risk factors for Ebstein anomaly remain largely unknown. Using national data, we examined 18 potential risk factors for Ebstein anomaly.Methods:Using 1997–2011 data from the National Birth Defects Prevention Study, a population-based case–control study, we calculated crude and adjusted odds ratios and 95% confidence intervals for paternal age, maternal socio-demographics, reproductive history, and modifiable risk factors, and infant characteristics reported by mothers of 135 Ebstein anomaly cases and 11,829 controls.Results:Mothers of Ebstein anomaly cases had 4.1 (95% confidence interval: 1.8, 9.5) times the odds of reporting a family history of CHD compared with mothers of controls. Ebstein anomaly was associated with maternal second-hand cigarette smoke exposure at home (odds ratio = 2.2 [95% confidence interval: 1.1, 4.4]), but not maternal cigarette smoking (odds ratio = 1.3 [95% confidence interval: 0.8, 2.1]). Odds were elevated, but the 95% confidence interval included 1.0, for maternal marijuana use (odds ratio = 1.8 [95% confidence interval: 0.9, 3.8]) and paternal age ≥40 years at delivery (odds ratio = 1.9 [95% confidence interval: 1.0, 3.5]).Conclusions:Maternal exposure to second-hand cigarette smoke at home and a family history of CHD were associated with elevated odds of Ebstein anomaly. Genetic analyses could clarify the potential heritability of Ebstein anomaly.

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Risk Factors for Early-onset, Ventilator-associated Pneumonia in Critical Care Patients

Anesthesiology ◽

10.1097/00000542-200009000-00011 ◽

2000 ◽

Vol 93 (3) ◽

pp. 638-645 ◽

Cited By ~ 55

Author(s):

Ozan Akça ◽

Kemalettin Koltka ◽

Serdar Uzel ◽

Nahit Çakar ◽

Kamil Pembeci ◽

...

Keyword(s):

Risk Factors ◽

Confidence Interval ◽

Glasgow Coma Score ◽

Early Onset ◽

Odds Ratio ◽

Late Onset ◽

Multidrug Resistant ◽

Ventilator Associated Pneumonia ◽

Clinical Criteria ◽

Potential Risk Factors

Background Ventilator-associated pneumonia is the leading nosocomial infection in critically ill patients. The frequency of ventilator-associated pneumonia caused by multidrug-resistant bacteria has increased in recent years, and these pathogens cause most of the deaths attributable to pneumonia. The authors, therefore, evaluated factors associated with selected multidrug-resistant ventilator-associated pneumonia in critical care patients. Methods The authors prospectively recorded potential risk factors at the time of intensive care unit admission. An endotracheal aspirate was obtained in all patients who met clinical criteria for pneumonia. Patients were considered to have ventilator-associated pneumonia only when they met the clinical criteria and aspirate culture was positive for bacteria 48 h or more after initiation of mechanical ventilation. Pediatric patients were excluded. Adult patients with ventilator-associated pneumonia were first grouped as "early-onset" (< 5 days) and "late-onset," determined by episodes of ventilator-associated pneumonia, and then, assigned to four groups based on the bacteria cultured from their tracheal aspirates: Pseudomonas aeruginosa, Acinetobacter baumanii, methicillin-resistant staphylococci, and all others. The first three bacteria were considered to be multidrug resistant, whereas the others were considered to be antibiotic susceptible. Potential risk factors were evaluated with use of univariate statistics and multivariate regression. Results Among 486 consecutive patients admitted during the study, 260 adults underwent mechanical ventilation for more than 48 h. Eighty-one patients (31%) experienced 99 episodes of ventilator-associated pneumonia, including Pseudomonas(33 episodes), methicillin-resistant staphylococci (17 episodes), Acinetobacter(9 episodes), and nonresistant bacteria (40 episodes). Sixty-six of these episodes were early onset and 33 episodes were late onset. Logistic regression analysis identified three factors significantly associated with early-onset ventilator-associated pneumonia caused by any one of the multidrug-resistant bacterial strains: emergency intubation (odds ratio, 6.4; 95% confidence interval, 2.0-20.2), aspiration (odds ratio, 12.7; 95% confidence interval, 2.4-64.6), and Glasgow coma score of 9 or less (odds ratio, 3.9; 95% confidence interval, 1.3-11.3). A. baumanii-related pneumonia cases were found to be significantly associated with two of these factors: aspiration (odds ratio, 14.2; 95% confidence interval, 1.5-133.8) and Glasgow coma score (odds ratio, 6.0; 95% confidence interval, 1.1-32.6). Conclusions The authors recommend that patients undergoing emergency intubation or aspiration or who have a Glasgow coma score of 9 or less be monitored especially closely for early-onset multidrug-resistant pneumonia. The occurrence of aspiration and a Glasgow coma score of 9 or less are especially associated with pneumonia caused by A. baumanii.

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Parental risk factors for congenital diaphragmatic hernia – a large German case-control study

BMC Pediatrics ◽

10.1186/s12887-021-02748-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Felicitas Schulz ◽

Ekkehart Jenetzky ◽

Nadine Zwink ◽

Charlotte Bendixen ◽

Florian Kipfmueller ◽

...

Keyword(s):

Risk Factors ◽

Confidence Interval ◽

Environmental Risk ◽

Odds Ratio ◽

Alcohol Intake ◽

Case Control Study ◽

Case Control ◽

Parental Risk Factors ◽

Healthy Control ◽

Control Study

Abstract Background Evidence for periconceptional or prenatal environmental risk factors for the development of congenital diaphragmatic hernia (CDH) is still scarce. Here, in a case-control study we investigated potential environmental risk factors in 199 CDH patients compared to 597 healthy control newborns. Methods The following data was collected: time of conception and birth, maternal BMI, parental risk factors such as smoking, alcohol or drug intake, use of hairspray, contact to animals and parental chronic diseases. CDH patients were born between 2001 and 2019, all healthy control newborns were born in 2011. Patients and control newborns were matched in the ratio of three to one. Results Presence of CDH was significantly associated with maternal periconceptional alcohol intake (odds ratio = 1.639, 95% confidence interval 1.101–2.440, p = 0.015) and maternal periconceptional use of hairspray (odds ratio = 2.072, 95% confidence interval 1.330–3.229, p = 0.001). Conclusion Our study suggests an association between CDH and periconceptional maternal alcohol intake and periconceptional maternal use of hairspray. Besides the identification of novel and confirmation of previously described parental risk factors, our study underlines the multifactorial background of isolated CDH.

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Age and multimorbidities as poor prognostic factors for COVID-19 in hemodialysis: a Lebanese national study

BMC Nephrology ◽

10.1186/s12882-021-02270-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Mabel Aoun ◽

Rabab Khalil ◽

Walid Mahfoud ◽

Haytham Fatfat ◽

Line Bou Khalil ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Coronary Artery Disease ◽

Confidence Interval ◽

Odds Ratio ◽

Death Rate ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

National Study ◽

Artery Disease

Abstract Background Hemodialysis patients with COVID-19 have been reported to be at higher risk for death than the general population. Several prognostic factors have been identified in the studies from Asian, European or American countries. This is the first national Lebanese study assessing the factors associated with SARS-CoV-2 mortality in hemodialysis patients. Methods This is an observational study that included all chronic hemodialysis patients in Lebanon who were tested positive for SARS-CoV-2 from 31st March to 1st November 2020. Data on demographics, comorbidities, admission to hospital and outcome were collected retrospectively from the patients’ medical records. A binary logistic regression analysis was performed to assess risk factors for mortality. Results A total of 231 patients were included. Mean age was 61.46 ± 13.99 years with a sex ratio of 128 males to 103 females. Around half of the patients were diabetics, 79.2% presented with fever. A total of 115 patients were admitted to the hospital, 59% of them within the first day of diagnosis. Hypoxia was the major reason for hospitalization. Death rate was 23.8% after a median duration of 6 (IQR, 2 to 10) days. Adjusted regression analysis showed a higher risk for death among older patients (odds ratio = 1.038; 95% confidence interval: 1.013, 1.065), patients with heart failure (odds ratio = 4.42; 95% confidence interval: 2.06, 9.49), coronary artery disease (odds ratio = 3.27; 95% confidence interval: 1.69, 6.30), multimorbidities (odds ratio = 1.593; 95% confidence interval: 1.247, 2.036), fever (odds ratio = 6.66; 95% confidence interval: 1.94, 27.81), CRP above 100 mg/L (odds ratio = 4.76; 95% confidence interval: 1.48, 15.30), and pneumonia (odds ratio = 19.18; 95% confidence interval: 6.47, 56.83). Conclusions This national study identified older age, coronary artery disease, heart failure, multimorbidities, fever and pneumonia as risk factors for death in patients with COVID-19 on chronic hemodialysis. The death rate was comparable to other countries and estimated at 23.8%.

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Subclinical atherosclerosis in children and adolescents with congenital heart disease

Cardiology in the Young ◽

10.1017/s1047951120004448 ◽

2020 ◽

pp. 1-8

Author(s):

Silvia M. Cardoso ◽

Michele Honicky ◽

Yara M. F. Moreno ◽

Luiz R. A. de Lima ◽

Matheus A. Pacheco ◽

...

Keyword(s):

Risk Factors ◽

Congenital Heart Disease ◽

Confidence Interval ◽

Odds Ratio ◽

Clinical Characteristics ◽

Congenital Heart ◽

Subclinical Atherosclerosis ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Media Thickness

Abstract Background: Subclinical atherosclerosis in childhood can be evaluated by carotid intima-media thickness, which is considered a surrogate marker for atherosclerotic disease in adulthood. The aims of this study were to evaluate carotid intima-media thickness and, to investigate associated factors. Methods: Cross-sectional study with children and adolescents with congenital heart disease (CHD). Socio-demographic and clinical characteristics were assessed. Subclinical atherosclerosis was evaluated by carotid intima-media thickness. Cardiovascular risk factors, such as physical activity, screen time, passive smoke, systolic and diastolic blood pressure, waist circumference, dietary intake, lipid parameters, glycaemia, and C-reactive protein, were also assessed. Factors associated with carotid intima-media thickness were analysed using multiple logistic regression. Results: The mean carotid intima-media thickness was 0.518 mm and 46.7% had subclinical atherosclerosis (carotid intima-media thickness ≥ 97th percentile). After adjusting for confounding factors, cyanotic CHD (odds ratio: 0.40; 95% confidence interval: 0.20; 0.78), cardiac surgery (odds ratio: 3.17; 95% confidence interval: 1.35; 7.48), and be hospitalised to treat infections (odds ratio: 1.92; 95% confidence interval: 1.04; 3.54) were associated with subclinical atherosclerosis. Conclusion: Clinical characteristics related to CHD were associated with subclinical atherosclerosis. This finding suggests that the presence of CHD itself is a risk factor for subclinical atherosclerosis. Therefore, the screen and control of modifiable cardiovascular risk factors should be made early and intensively to prevent atherosclerosis.

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Complications Following Decompressive Craniectomy

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0040-1721001 ◽

2021 ◽

Author(s):

Jan Mraček ◽

Jan Mork ◽

Jiri Dostal ◽

Radek Tupy ◽

Jolana Mrackova ◽

...

Keyword(s):

Risk Factors ◽

Decompressive Craniectomy ◽

Clinical Status ◽

Fluid Collection ◽

Epileptic Seizures ◽

Middle Cerebral Artery Infarction ◽

Temporal Muscle ◽

Life Saving ◽

Potential Risk Factors ◽

The Impact

Abstract Background Decompressive craniectomy (DC) has become the definitive surgical procedure to manage a medically intractable rise in intracranial pressure. DC is a life-saving procedure resulting in lower mortality but also higher rates of severe disability. Although technically straightforward, DC is accompanied by many complications. It has been reported that complications are associated with worse outcome. We reviewed a series of patients who underwent DC at our department to establish the incidence and types of complications. Methods We retrospectively evaluated the incidence of complications after DC performed in 135 patients during the time period from January 2013 to December 2018. Postoperative complications were evaluated using clinical status and CT during 6 months of follow-up. In addition, the impact of potential risk factors on the incidence of complications and the impact of complications on outcome were assessed. Results DC was performed in 135 patients, 93 of these for trauma, 22 for subarachnoid hemorrhage, 13 for malignant middle cerebral artery infarction, and 7 for intracerebral hemorrhage. Primary DC was performed in 120 patients and secondary DC in 15 patients. At least 1 complication occurred in each of 100 patients (74%), of which 22 patients (22%) were treated surgically. The following complications were found: edema or hematoma of the temporal muscle (34 times), extracerebral hematoma (33 times), extra-axial fluid collection (31 times), hemorrhagic progression of contusions (19 times), hydrocephalus (12 times), intraoperative malignant brain edema (10 times), temporal muscle atrophy (7 times), significant intraoperative blood loss (6 times), epileptic seizures (5 times), and skin necrosis (4 times). Trauma (p = 0.0006), coagulopathy (p = 0.0099), and primary DC (p = 0.0252) were identified as risk factors for complications. There was no significant impact of complications on outcome. Conclusions The incidence of complications following DC is high. However, we did not confirm a significant impact of complications on outcome. We emphasize that some phenomena are so frequent that they can be considered a consequence of primary injury or natural sequelae of the DC rather than its direct complication.

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Prevalence and Risk Factors for Salmonella and Campylobacter spp. Carcass Contamination in Turkeys Slaughtered in Quebec, Canada

Journal of Food Protection ◽

10.4315/0362-028x-70.6.1350 ◽

2007 ◽

Vol 70 (6) ◽

pp. 1350-1359 ◽

Cited By ~ 16

Author(s):

JULIE ARSENAULT ◽

ANN LETELLIER ◽

SYLVAIN QUESSY ◽

JEAN-PIERRE MORIN ◽

MARTINE BOULIANNE

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Confidence Interval ◽

Regression Models ◽

Meteorological Data ◽

Low Wind Speed ◽

Potential Risk Factors ◽

Estimate Prevalence ◽

Carcass Contamination ◽

Campylobacter Spp

An observational study was conducted to estimate prevalence and risk factors for carcass contamination by Salmonella and Campylobacter spp. in 60 lots of turkey slaughtered over 10 months in the province of Quebec, Canada. Carcass contamination was evaluated by the carcass rinse technique for about 30 birds per lot. Exposure to potential risk factors was evaluated with questionnaires, meteorological data, and cecal cultures. Multivariable binomial negative regression models were used for risk factor analysis. Prevalence of Salmonella-positive carcasses was 31.2% (95% confidence interval, 22.8 to 39.5%). Variables positively associated (P ≤ 0.05) with the proportion of lot-positive carcasses were ≥0.5% of carcass condemnation due to various pathologies, cecal samples positive for Salmonella, low wind speed during transportation, closure of lateral curtains of truck during transportation, and slaughtering on a weekday other than Monday. When only Salmonella-positive cecal culture lots were considered, the proportion of carcasses positive for Salmonella was significantly higher in lots exposed to a >5°C outside temperature variation during transportation, slaughtered on a weekday other than Monday, and in which ≥4% of carcasses had visible contamination. Prevalence of Campylobacter-positive carcasses was 36.9% (95% confidence interval, 27.6 to 46.3%). The proportion of positive carcasses was significantly higher in lots with Campylobacter-positive cecal cultures and lots undergoing ≥2 h of transit to slaughterhouse. For lots with Campylobacter-positive cecal cultures, variables significantly associated with an increased incidence of carcass contamination were ≥4% of carcasses with visible contamination, crating for ≥8 h before slaughtering, and no antimicrobials used during rearing.

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Retrospective analysis of risk factors of hypotensive bradycardic events during shoulder arthroscopic surgery under interscalene blockade in the sitting position

Korean Journal of Anesthesiology ◽

10.4097/kja.20035 ◽

2020 ◽

Vol 73 (6) ◽

pp. 542-549

Author(s):

Taeha Ryu ◽

Baek Jin Kim ◽

Seong Jun Woo ◽

So Young Lee ◽

Jung A Lim ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Odds Ratio ◽

Arthroscopic Surgery ◽

Sitting Position ◽

Past Medical History ◽

Frequent Adverse Event ◽

Increased Risk ◽

Potential Risk Factors ◽

Independent Risk Factors

Background: Hypotensive bradycardic events (HBEs) are a frequent adverse event in patients who underwent shoulder arthroscopic surgery under interscalene block (ISB) in the sitting position. This retrospective study was conducted to investigate the independent risk factors of HBEs in shoulder arthroscopic surgery under ISB in the sitting position. Methods: A total of 2549 patients who underwent shoulder arthroscopic surgery under ISB and had complete clinical data were included in the study. The 357 patients who developed HBEs were included in the HBEs group, and the remaining 2192 in the non-HBEs group. The potential risk factors for HBEs, such as age, sex, past medical history, anesthetic characteristics, and intraoperative medications were collected and compared between the groups. Statistically significant variables were included in a logistic regression model to further evaluate the independent risk factors for HBEs in shoulder arthroscopic surgery under ISB. Results: The incidence of HBEs was 14.0% (357/2549). Logistic regression analysis revealed that the intraoperative use of hydralazine (odds ratio [OR] 4.2; 95% confidence interval [CI] 2.9–6.3), propofol (OR 2.1; 95% CI 1.3–3.6), and dexmedetomidine (OR 3.9; 95% CI 1.9–7.8) before HBEs were independent risk factors for HBEs in patients who received shoulder arthroscopic surgery under ISB. Conclusions: The intraoperative use of antihypertensives such as hydralazine and sedatives such as propofol or dexmedetomidine leads to increased risk of HBEs during shoulder arthroscopic surgery under ISB in the sitting position.

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Prevalence and risk factors of Neospora caninum infection in ovine flocks of central-western Mexico

Acta Veterinaria Hungarica ◽

10.1556/004.2019.006 ◽

2019 ◽

Vol 67 (1) ◽

pp. 51-59 ◽

Cited By ~ 1

Author(s):

Jesús Manuel Romo-Gallegos ◽

Carlos Cruz-Vázquez ◽

Leticia Medina-Esparza ◽

Miguel Ramos-Parra ◽

Dora Romero-Salas

Keyword(s):

Risk Factors ◽

Confidence Interval ◽

Odds Ratio ◽

Animal Species ◽

Neospora Caninum ◽

Domestic Animal ◽

Caninum Infection ◽

Blood Samples ◽

Western Mexico ◽

The Mean

This study, carried out in 13 sheep flocks of central-western Mexico, aimed to identify the prevalence of anti-N. caninum antibodies, to develop a risk analysis of the infection and to estimate the prevalence of parasite DNA in blood. A total of 368 serum and blood samples were subjected to ELISA and PCR tests, respectively, and the association between the prevalence of antibodies and some management factors was estimated. The overall prevalence of anti-N. caninum antibodies was 13.5% [50/368; 95% confidence interval (CI) 10–17], ranging from 2.7 to 90% per flock, and 92% of the farms had seropositive animals. In ewes the prevalence was 14% (48/348, 95% CI 10–17) and in rams 10% (2/20; 95% CI 1– 33). The mean prevalence of Neospora DNA in blood was 27% (99/368, 95% CI 22–31), implying a range between 16 and 82%. In rams, the prevalence was 5% (1/20 95% CI 2–26), while in ewes it was 28% (98/348, 95% CI 23–33). The agreement between the tests was k = 0.19. The presence of other domestic animal species in the farms [odds ratio (OR) 4.4] and the consumption of placental debris, fetuses and stillborn lambs by dogs living in the farms (OR 5.8) were demonstrated to be risk factors.

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Perioperative complications in a paediatric cardiac surgery program with limited systemic resources

Cardiology in the Young ◽

10.1017/s1047951120002486 ◽

2020 ◽

Vol 30 (11) ◽

pp. 1659-1665

Author(s):

Igor V. Polivenok ◽

William M. Novick ◽

Aleksander V. Pyetkov ◽

Marcelo Cardarelli

Keyword(s):

Risk Factors ◽

Cardiac Surgery ◽

Confidence Interval ◽

Odds Ratio ◽

Operative Mortality ◽

Perioperative Complications ◽

Failure To Rescue ◽

Middle Income ◽

Paediatric Cardiac Surgery ◽

Complications Rate

AbstractBackground:The perioperative complications rate in paediatric cardiac surgery, as well as the failure-to-rescue impact, is less known in low- and middle-income countries.Aim:To evaluate perioperative complications rate, mortality related to complications, different patients’ demographics, and procedural risk factors for perioperative complication and post-operative death.Methods:Risk factors for perioperative complications and operative mortality were assessed in a retrospective single-centre study which included 296 consecutive children undergoing cardiac surgery.Results:Overall mortality was 5.7%. Seventy-three patients (24.7%) developed 145 perioperative complications and had 17 operative mortalities (23.3%). There was a strong association between the number of perioperative complications and mortality – 8.1% among patients with only 1 perioperative complication, 35.3% – with 2 perioperative complications, and 42.1% – with 3 or more perioperative complications (p = 0.007). Risk factors of perioperative complications were younger age (odds ratio 0.76; (95% confidence interval 0.61, 0.93), previous cardiac surgery (odds ratio 3.5; confidence interval 1.33, 9.20), extracardiac structural anomalies (odds ratio 3.03; confidence interval 1.27, 7.26), concomitant diseases (odds ratio 3.23; confidence interval 1.34, 7.72), and cardiopulmonary bypass (odds ratio 6.33; confidence interval 2.45, 16.4), whereas the total number of perioperative complications per patient was the only predictor of operative death (odds ratio 1.89; confidence interval 1.06, 3.37).Conclusions:In a program with limited systemic resources, failure-to-rescue is a major contributor to operative mortality in paediatric cardiac surgery. Despite the comparable crude mortality, the operative mortality among patients with perioperative complications in our series was significantly higher than in the developed world. A number of initiatives are needed in order to improve failure-to-rescue rates in low- and middle-income countries.

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