scholarly journals Obesity and the Incidence of Bladder Injury and Urinary Retention Following Tension-Free Vaginal Tape Procedure: Retrospective Cohort Study

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Vladimir Revicky ◽  
Sambit Mukhopadhyay ◽  
Frances de Boer ◽  
Edward P. Morris

Background/Aims. Aim of the study was to establish an effect of obesity on the incidence of bladder injury or urinary retention following tension-free vaginal tape (TVT) procedure.Methods. This was a retrospective cohort study based at the Norfolk and Norwich University Hospital in the UK. Study population included 342 cases of TVT procedures. Incidence of bladder injury was 4.7% (16/342). Rate of urinary retention was 9% (31/342). Body mass index (BMI), age, type of analgesia, concomitant prolapse repair, and previous surgery were factors studied. Univariate analysis was performed to establish a relationship between BMI and complications, followed by a multivariable regression analysis to adjust for age, concomitant surgery, type of analgesia, and previous surgery.Results. Neither univariate analysis nor multivariate regression analysis revealed any statistically significant influence of obesity on the incidence of bladder injury or urinary retention. Unadjusted odds ratios and adjusted odds ratios for bladder injury and urinary retention by BMI groups were OR 1.7296 CI 0.4818–6.2097; OR 1.3745 CI 0.5718–3.3043 and adj. OR 2.885 CI 0.603–13.8; adj. OR 1.299 CI 0.502–3.365.Conclusion. Obesity does not appear to influence the rate of bladder injury or urinary retention following TVT procedure.

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S262-S262
Author(s):  
Kok Hoe Chan ◽  
Bhavik Patel ◽  
Iyad Farouji ◽  
Addi Suleiman ◽  
Jihad Slim

Abstract Background Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection can lead to many different cardiovascular complications, we were interested in studying prognostic markers in patients with atrial fibrillation/flutter (A. Fib/Flutter). Methods A retrospective cohort study of patients with confirmed COVID-19 and either with existing or new onset A. Fib/Flutter who were admitted to our hospital between March 15 and May 20, 2020. Demographic, outcome and laboratory data were extracted from the electronic medical record and compared between survivors and non-survivors. Univariate and multivariate logistic regression were employed to identify the prognostic markers associated with mortality in patients with A. Fib/Flutter Results The total number of confirmed COVID-19 patients during the study period was 350; 37 of them had existing or new onset A. Fib/Flutter. Twenty one (57%) expired, and 16 (43%) were discharged alive. The median age was 72 years old, ranged from 19 to 100 years old. Comorbidities were present in 33 (89%) patients, with hypertension (82%) being the most common, followed by diabetes (46%) and coronary artery disease (30%). New onset of atrial fibrillation was identified in 23 patients (70%), of whom 13 (57%) expired; 29 patients (78%) presented with atrial fibrillation with rapid ventricular response, and 2 patients (5%) with atrial flutter. Mechanical ventilation was required for 8 patients, of whom 6 expired. In univariate analysis, we found a significant difference in baseline ferritin (p=0.04), LDH (p=0.02), neutrophil-lymphocyte ratio (NLR) (p=0.05), neutrophil-monocyte ratio (NMR) (p=0.03) and platelet (p=0.015) between survivors and non-survivors. With multivariable logistic regression analysis, the only value that had an odds of survival was a low NLR (odds ratio 0.74; 95% confidence interval 0.53–0.93). Conclusion This retrospective cohort study of hospitalized patients with COVID-19 demonstrated an association of increase NLR as risk factors for death in COVID-19 patients with A. Fib/Flutter. A high NLR has been associated with increased incidence, severity and risk for stroke in atrial fibrillation patients but to our knowledge, we are first to demonstrate the utilization in mortality predictions in COVID-19 patients with A. Fib/Flutter. Disclosures Jihad Slim, MD, Abbvie (Speaker’s Bureau)Gilead (Speaker’s Bureau)Jansen (Speaker’s Bureau)Merck (Speaker’s Bureau)ViiV (Speaker’s Bureau)


2020 ◽  
Vol 6 (1) ◽  
pp. e000868
Author(s):  
Ricardo Lima Burigo ◽  
Robson Dias Scoz ◽  
Bruno Mazziotti de Oliveira Alves ◽  
Rubens Alexandre da Silva ◽  
Cesar Augusto Melo-Silva ◽  
...  

Background/AimDifferent authors have tried to correlate the peak isokinetic torque values with the incidence of soccer match injuries. However, due to the wide variety of assessment testing protocols, such an inference becomes difficult. This study aimed to verify the capacity of an isokinetic test to establish injury risk reference values for hamstring strain injuries.MethodsA retrospective cohort study based on isokinetic data and clinical records from the last 10 years was conducted in 582 Brazilian elite-professional soccer players, who were subjected to the same isokinetic test protocol, machine, and tester. A Multivariate Logistic Regression Analysis for Complex Data Sampling was used to generate injury risk statistical indexes.ResultsMultivariate regression analysis of both legs provided important data to identify the cut-off values of Concentric Peak Torque (181.82 Newton/*metres), Concentric Work (236.23 watts) and Concentric Power (130.11 joules).ConclusionsThe injury risk indexes indicate that an increase of just one Newton unit in CPT (Concentric Peak Torque) and CJ (Concentric Power) above those cut-off values, can reduce the risk of future injuries by 2% and 2.7%, respectively.


2021 ◽  
Vol 8 (1) ◽  
pp. e000514
Author(s):  
Adrienne K Joseph ◽  
Brandon Windsor ◽  
Linda S Hynan ◽  
Benjamin F Chong

ObjectiveEpidemiological studies have shown that discoid lupus erythematosus (DLE) has a higher incidence and prevalence in racial/ethnic minority groups, particularly Black individuals. The objective of this retrospective cohort study was to identify the differences in DLE lesion distribution and characteristics in Black individuals compared with non-Black individuals.Methods183 patients with DLE (112 Black patients and 71 non-Black patients) with a reported race/ethnicity and Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) scores were included in this retrospective cohort study. Univariate analysis was performed to determine significant differences in demographic data, clinical characteristics, DLE lesion distribution and DLE lesion characteristics in Black and non-Black patients with DLE. Multivariable logistic regression was preformed to determine significant predictors of DLE lesion location and characteristics.ResultsBlack patients with DLE had worse baseline CLASI damage scores compared with non-Black patients with DLE (median (IQR): 10.0 (6.0–14.5) vs 6.0 (3.0–10.0), p<0.001) and had 48.9 greater odds of dyspigmentation in any anatomical location (p<0.001). Black patients had 2.54 greater odds of having scalp involvement (p=0.015) and 1.97 greater odds of having ear involvement (p=0.032) compared with non-Black patients. Black patients also had greater odds of scalp dyspigmentation (OR=5.85, p<0.001), ear dyspigmentation (OR=2.89, p=0.001) and scarring alopecia (OR=3.00, p=0.001) compared with non-Black patients.ConclusionsSigns of disease damage, particularly ear dyspigmentation, scalp dyspigmentation and scarring alopecia, can more frequently affect Black patients with DLE. Recognising differences in clinical presentation of DLE among Black patients can assist future efforts with understanding biological, cultural, psychosocial and systemic factors that influence DLE presentation and outcomes in Black patients and may guide clinicians when counselling Black patients.


PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11650
Author(s):  
Wenpeng Li ◽  
Lexiang Zeng ◽  
Deping Han ◽  
Shanyi Zhang ◽  
Bingxi Lei ◽  
...  

Objective To develop and validate a preoperative index-based nomogram for the prediction of hypokalemia in patients with pituitary adenoma (PA). Methods This retrospective cohort study included 205 patients with PAs between January 2013 and April 2020 in the Sun Yat-sen Memorial Hospital, Guangzhou, China. The patients were randomly classified into either a training set (N = 143 patients) and a validation set (N = 62 patients) at a ratio of 7:3. Variables, which were identified by using the LASSO regression model were included for the construction of a nomogram, and a logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) in the training set. The area under the curve (AUC) was used to evaluate the performance of the nomogram for predicting hypokalemia. Multivariate logistic regression analysis with a restricted cubic spline analysis was conducted to identify a potential nonlinear association between the preoperative index and hypokalemia. Results The incidence of hypokalemia was 38.05%. Seven preoperative indices were identified for the construction of the nomogram: age, type of PA, weight, activated partial thromboplastin time, urea, eosinophil percentage, and plateletocrit. The AUCs of the nomogram for predicting hypokalemia were 0.856 (95% CI [0.796–0.915]) and 0.652 (95% CI [0.514–0.790]) in the training and validation sets, respectively. Restricted cubic splines demonstrated that there was no nonlinear association between hypokalemia and the selected variables. Conclusion In this study, we constructed a preoperative indices-based nomogram that can assess the risk of hypokalemia after the surgical treatment of pituitary adenomas. This nomogram may also help to identify high risk patients who require close monitoring of serum potassium.


2018 ◽  
Vol 11 (12) ◽  
pp. 950-956
Author(s):  
Thiago Silva Da Costa ◽  
Paulo José De Medeiros ◽  
Mauro José Costa Salles

Introduction: Surgical site infection (SSI) following hydrocelectomy is relatively uncommon, but it is one of the main post-operative problems. We aimed to describe the prevalence of SSI following hydrocelectomy among adult patients, and to assess predisposing risk factors for infection. Methodology: This retrospective cohort study was carried out at a university hospital and included hydrocelectomies performed between January 2007 and December 2014. Diagnosis of SSI was performed according to the Center for Diseases Control (CDC) guidelines. Multivariable logistic regression analysis was used to identify independent risk factors. Results: A total of 196 patients were included in the analysis. Overall, 30 patients were diagnosed with SSI (15.3%) and of these, 63.3% (19/30) were classified as having superficial SSI, while 36.7% (11/30) had deep SSI. The main signs and symptoms of infection were the presence of surgical wound secretion (70%) and inflammatory superficial signs such as hyperemia, edema and pain (60%). Among the 53 patients presenting chronic smoking habits, 26.4% (14⁄53) developed SSI, which was associated with a higher risk for SSI (odds ratio [OR] = 2.84, 95% confidence interval [CI] = 1.27 to 6.35, p < 0.01) in the univariate analysis. In the adjusted multivariable analysis, smoking habits were also statistically associated with SSI after hydrocelectomy (odds ratio [OR] = 2.84, 95% confidence interval [CI] = 1.30 to 6.24, p = 0.01). No pre-, intra-, or post-operative variable analyzed showed an independent association to SSI following hydrocelectomy. Conclusions: Smoking was the only independent modifiable risk factor for SSI in the multivariate analysis.


2019 ◽  
Vol 4 (5) ◽  
pp. e001715 ◽  
Author(s):  
Liana Macpherson ◽  
Morris Ogero ◽  
Samuel Akech ◽  
Jalemba Aluvaala ◽  
David Gathara ◽  
...  

IntroductionThere were almost 1 million deaths in children aged between 5 and 14 years in 2017, and pneumonia accounted for 11%. However, there are no validated guidelines for pneumonia management in older children and data to support their development are limited. We sought to understand risk factors for mortality among children aged 5–14 years hospitalised with pneumonia in district-level health facilities in Kenya.MethodsWe did a retrospective cohort study using data collected from an established clinical information network of 13 hospitals. We reviewed records for children aged 5–14 years admitted with pneumonia between 1 March 2014 and 28 February 2018. Individual clinical signs were examined for association with inpatient mortality using logistic regression. We used existing WHO criteria (intended for under 5s) to define levels of severity and examined their performance in identifying those at increased risk of death.Results1832 children were diagnosed with pneumonia and 145 (7.9%) died. Severe pallor was strongly associated with mortality (adjusted OR (aOR) 8.06, 95% CI 4.72 to 13.75) as were reduced consciousness, mild/moderate pallor, central cyanosis and older age (>9 years) (aOR >2). Comorbidities HIV and severe acute malnutrition were also associated with death (aOR 2.31, 95% CI 1.39 to 3.84 and aOR 1.89, 95% CI 1.12 to 3.21, respectively). The presence of clinical characteristics used by WHO to define severe pneumonia was associated with death in univariate analysis (OR 2.69). However, this combination of clinical characteristics was poor in discriminating those at risk of death (sensitivity: 0.56, specificity: 0.68, and area under the curve: 0.62).ConclusionChildren >5 years have high inpatient pneumonia mortality. These findings also suggest that the WHO criteria for classification of severity for children under 5 years do not appear to be a valid tool for risk assessment in this older age group, indicating the urgent need for evidence-based clinical guidelines for this neglected population.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Huiling Xu ◽  
Shumin Qiu ◽  
Xiaojing Chen ◽  
Suqin Zhu ◽  
Yan Sun ◽  
...  

Abstract Background There is no definitive evidence about the suitable timing to transfer blastocysts formed and cryopreserved on day 6 (D6 blastocysts) in frozen-thawed embryo transfer (FET) cycles. This study aimed to investigate the suitable timing to transfer D6 blastocysts in FET cycles and to identify factors affecting clinical pregnancy rate (CPR) and early miscarriage rate (EMR) in FET cycles with blastocysts. Methods This retrospective cohort study included 1788 FET cycles with blastocysts. There were 518 cycles with D6 blastocysts, and 1270 cycles with blastocysts formed and cryopreserved on day 5 (D5 blastocysts) (D5 group). According to the blastocyst transfer timing, the cycles with D6 blastocysts were divided into cycles with D6 blastocysts transferred on day 5 (D6-on-D5 group, 103 cycles) and cycles with D6 blastocysts transferred on day 6 (D6-on-D6 group, 415 cycles). The chi-square test, independent t-test or Mann-Whitney test, and logistic regression analysis were used for data analysis. Results The CPR and implantation rate (IR) were significantly higher in the D6-on-D5 group than in the D6-on-D6 group (55.3% vs. 37.3%, 44.8% vs. 32.6%, P < 0.01). The CPR and IR were significantly higher in the D5 group than in the D6-on-D5 group (66.0% vs. 55.3%, 62.1% vs. 44.8%, P < 0.05), and the EMR was significantly lower in the D5 group than in the D6-on-D5 group (11.2% vs. 21.1%, P < 0.05). Logistic regression analysis demonstrated that transfer D6 blastocysts on day 5, instead of day 6, could significantly increase the CPR (odds ratio[OR]: 2.031, 95% confidence interval (CI): 1.296–3.182, P = 0.002). FET cycles with D6 blastocysts transferred on day 5 had a higher EMR than those with D5 blastocysts (OR: 2.165, 95% CI: 1.040–4.506, P = 0.039). Hormone replacement therapy (HRT) cycles exhibited a higher EMR than natural cycles (OR: 1.953, 95% CI: 1.254–3.043, P = 0.003), while no difference was observed in the CPR (P > 0.05). Conclusions These results indicate that the suitable timing to transfer D6 blastocysts in FET cycles may be day 5, and D6 blastocyst transfer on day 6 in FET cycles should be avoided. D6 blastocysts transfer and HRT cycles may be associated with a higher EMR.


2020 ◽  
Vol 33 (6) ◽  
pp. 534-542
Author(s):  
Chami Im ◽  
Tak Kyu Oh ◽  
In-Ae Song

Abstract Background This study aimed to determine whether use of preoperative antihypertensive medication is associated with postoperative 90-day mortality in the hypertensive adult population that underwent elective noncardiac surgery. Methods In this retrospective cohort study, medical records of preoperative hypertensive patients who underwent noncardiac surgery at a single tertiary academic hospital from 2012 to 2018 were reviewed. Among the hypertensive patients, those prescribed to take antihypertensive medication continuously for more than 1 month before admission were defined as the HTN MED group; others were defined as the non-HTN MED group. Multiple imputation, propensity score (PS) matching, and logistic regression analysis were used for statistical analysis. Results Overall, 35,589 preoperative hypertensive adult patients (HTN MED group: 26,154 patients, non-HTN MED group: 9,435 patients) were included in the analysis. After PS matching, each group comprised 6,205 patients; thus, 12,410 patients were included in the final analysis. The odds for 90-day mortality of the HTN MED group in the PS-matched cohort were 41% lower (odds ratio: 0.59, 95% confidence interval: 0.41–0.85; P = 0.005) than those of the non-HTN MED group. Comparable results were obtained in the multivariable logistic regression analysis of the entire cohort (odds ratio: 0.54, 95% confidence interval: 0.41–0.72; P &lt; 0.001). Conclusions This study showed that the use of preoperative antihypertensive medication was associated with lower 90-day mortality among hypertensive patients who underwent noncardiac surgery. Therefore, preoperative screening and treatment with appropriate antihypertensive medication are important for hypertensive patients.


2021 ◽  
Author(s):  
Gaigai Li ◽  
Tongtao Fan ◽  
Xun Zhou ◽  
Xunrui Hou ◽  
Yuheng Luo ◽  
...  

Abstract Objective: To determine whether there is a link between serum albumin and mortality among participants in Japan older people.Methods: This is a single-center, retrospective cohort study analysis of 253 older patients with dysphagia from Japan, conducted from January 2014 and January 2017. The primary outcome was mortality. We performed Cox regression analysis to compare the mortality between the two groups (dividing by serum albumin=3g/dl).Results: A total of 253 patients were included in the analysis, of whom the number of serum albumin under 3g/dl was 93. The log-rank test showed a significantly longer mortality in the high group (serum albumin >=3g/dl) compared with the low group (median, 382 vs 176 days, P < 0.0001). Cox regression analysis showed that unadjusted HR for the high group relative to the low group was 0.40 (95% CI: 0.29–0.57; P <0.001). After adjustment 3 models in multivariable analyses, serum albumn was significantly associated with mortality. The adjusted HRs (95% CI) for total mortality rates were 0.46 (0.33~0.65) , 0.66 (0.44~0.99) and 0.64 (0.42~0.97), from model 2 to model 4.Conclusion: There is negative association between serum albumin and mortality in older people with dysphagia.


2020 ◽  
pp. 088506661990109 ◽  
Author(s):  
Tetsuro Maeda ◽  
Janvi Paralkar ◽  
Toshiki Kuno ◽  
Paru Patrawalla

Background: Lactate clearance has become important in the management of sepsis. However, factors unrelated to sepsis-induced hyperlactatemia, including β-2 adrenergic agonists, can interfere with lactate clearance. Objectives: To investigate the association of inhaled albuterol with lactate clearance in patients with sepsis. Methods: This was a single-center retrospective cohort study. Adult patients with sepsis diagnosed in the emergency department from May 2015 to May 2016 with initial lactate levels >2 mmol/L and serial lactate measurements 2 to 6 hours apart were included. Patients were divided into 2 groups based on whether they received inhaled albuterol between lactate measurements. The primary end point was lactate clearance of 10%. Secondary end points included intensive care unit (ICU) consultation and in-hospital mortality. A multivariate logistic regression analysis was performed to assess the effect of inhaled albuterol on lactate clearance. Results: Of 269 patients included, 58 (22%) received inhaled albuterol between lactate measurements. This group had a significantly higher prevalence of pulmonary disease and a lower initial lactate compared to those who did not receive inhaled albuterol. They had a significantly lower rate of lactate clearance (45% vs 77%, P < .001); however, ICU consultation (71% vs 57%, P = .066) and in-hospital mortality (19% vs 22%, P = .64) were not significantly different. A multivariate logistic regression analysis adjusting for age, sex, chronic kidney disease, cirrhosis, cancer, septic shock or severe sepsis, and the amount of intravenous fluids received showed that inhaled albuterol was independently associated with impaired lactate clearance (adjusted odds ratio: 0.26, 95% confidence interval: 0.14-0.50, P < .001). Conclusions: Inhaled albuterol in patients with sepsis was associated with impaired lactate clearance without an increase in ICU consultation or in-hospital mortality. Impaired lactate clearance in patients with sepsis who receive inhaled albuterol should be interpreted with caution.


Sign in / Sign up

Export Citation Format

Share Document