scholarly journals The Analysis of Etiology and Risk Factors for 192 Cases of Neonatal Sepsis

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Ting Xiao ◽  
Li-Ping Chen ◽  
Hui Liu ◽  
SiSi Xie ◽  
Yan Luo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Neonatal Sepsis ◽  
Univariate Analysis ◽  
Control Group ◽  
Bacterial Strains ◽  
Roc Curve Analysis ◽  
Soluble Cd14 ◽  
Independent Risk Factors ◽  
Pediatric Sepsis

This study aimed to investigate the etiology and risk factors of neonatal sepsis. A retrospective analysis was conducted on 192 patients with sepsis from August 2013 to March 2015. One hundred and six healthy neonates were used as the control group. Logistic regression was used to analyze the risk factors and ROC curve analysis performed in laboratory which indicated a significant correlation. The results of univariate analysis showed that postnatal age, body weight, and parity were significantly related to neonatal sepsis (P<0.5). Logistic regression analysis demonstrated that postnatal age and parity are independent risk factors for neonatal sepsis (OR were 1.176 and 0.692, resp., P<0.001). The maximum area underneath the curve (ROCAUC) of soluble CD14 (sCD14-ST), which was the most indicative biomarker of sepsis diagnostically, was 0.953 with sensitivity and specificity of 93.8% and 84.9%, respectively. Escherichia coli, Staphylococcus aureus, and Streptococcus agalactiae were the main bacterial strains causing neonatal sepsis, while postnatal age was an independent risk factor for the onset of disease. sCD14-ST could be a potential useful diagnostic marker for pediatric sepsis.

scholarly journals A Retrospective Study of Risk Factors for Symptomatic Anastomotic Leakage after Laparoscopic Anterior Resection of the Rectal Cancer without a Diverting Stoma

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Zhi-Jie Wang ◽  
Qian Liu
Keyword(s):  
Risk Factors ◽  
Anastomotic Leakage ◽  
Anterior Resection ◽  
Univariate Analysis ◽  
Control Group ◽  
Primary Malignancy ◽  
Laparoscopic Anterior Resection ◽  
Diverting Stoma ◽  
Independent Risk Factors ◽  
Intraoperative Chemotherapy

Background. Anastomotic leakage (AL) is a common and devastating postoperative issue for patients who have undergone anterior resection of rectal carcinoma and can lead to increased short-term morbidity and mortality. Moreover, it might be associated with a worse oncological prognosis of tumors. This study is aimed at exploring the risk factors for symptomatic AL after laparoscopic anterior resection (LAR) for rectal tumors without a preventive diverting stoma. Materials and Methods. This case control study retrospectively reviewed the data of 496 consecutive patients who underwent LAR of the rectum without a preventive diverting stoma at the Cancer Hospital, Chinese Academy of Medical Sciences between September 2016 and September 2017. All patients were divided into an AL group and a control group based on the occurrence of postoperative symptomatic AL. Factors regarding patient-related variables, operation-related variables, and tumor-related variables were collected and assessed between the two groups through univariate and multivariate logistic regression analyses to identify independent risk factors for AL. Results. In total, 18 (3.6%) patients developed postoperative symptomatic AL. Univariate analysis showed that a synchronous primary malignancy of the left hemicolon (P=0.047), intraoperative chemotherapy (P=0.003), and level of anastomosis (P=0.033) were significantly related with AL. Multivariate analysis was subsequently performed to adjust for confounding biases and confirmed that a synchronous primary malignancy of the left hemicolon (odds ratio (OR), 12.225; 95% confidence interval (CI), 1.764-84.702; P=0.011), intraoperative chemotherapy (OR, 3.931; 95% CI, 1.334-11.583; P=0.013), and level of anastomosis (OR, 3.224; 95% CI, 1.124-9.249; P=0.030) were independent risk factors for symptomatic AL for patients who received LAR for rectal neoplasms without a preventive diverting stoma. Conclusions. Synchronous primary malignancy of the left hemicolon, intraoperative chemotherapy, and a low anastomotic level can increase the risks of postoperative symptomatic AL after LAR of the rectum without a protective diverting stoma.

scholarly journals Pathophysiology and Risk Factors for Cholelithiasis in Patients with Crohn’s Disease

2019 ◽  
pp. S173-S182
Author(s):  
I. STURDIK ◽  
A. KRAJCOVICOVA ◽  
Y. JALALI ◽  
M. ADAMCOVA ◽  
M. TKACIK ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Parenteral Nutrition ◽  
Univariate Analysis ◽  
Abdominal Ultrasound ◽  
Control Group ◽  
Healthy Population ◽  
Retrospective Case ◽  
Independent Risk Factors

Cholelithiasis is more common in patients with Crohn’s disease (CD) than in the healthy population. The aim here was to examine risk factors for cholelithiasis in a cohort of CD patients and to compare the prevalence of cholelithiasis in a cohort of CD patients with that in a control group. This was a single-center retrospective case-control study. The cohort comprised all consecutive CD patients who underwent abdominal ultrasound from January 2007 to January 2018. The control group comprised age- and gender-matched non-CD patients referred for upper gastrointestinal tract dyspepsia. The study included 238 CD patients and 238 controls. The prevalence of cholelithiasis in the CD and control groups was 12.6 % and 9.2 %, respectively (risk ratio (RR), 1.36; p=0.24). Univariate analysis revealed that cholelithiasis was associated with multiple risk factors. Multivariate analysis identified age (OR, 1.077; 95 % CI, 1.043–1.112; p<0.001) and receipt of parenteral nutrition (OR, 1.812; 95 % CI, 1.131–2.903; p=0.013) as independent risk factors for cholelithiasis in CD patients. The prevalence of cholelithiasis in CD patients was higher than that in the control group; however, the difference was not statistically significant. Age and receipt of parenteral nutrition were independent risk factors for cholelithiasis in CD patients.

scholarly journals Risk factors of necrotizing enterocolitis in neonates with sepsis: A retrospective case-control study

2020 ◽  
Vol 34 ◽  
pp. 205873842096381
Author(s):  
Zheng-Li Wang ◽  
Yao An ◽  
Yu He ◽  
Xiao-Yu Hu ◽  
Lu Guo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Blood Cell ◽  
Necrotizing Enterocolitis ◽  
Red Blood Cell ◽  
Late Onset ◽  
Univariate Analysis ◽  
Red Blood Cell Transfusion ◽  
Control Group ◽  
Retrospective Case

Sepsis, a severe infectious disease in the neonatal period, is considered a risk factor for necrotizing enterocolitis (NEC). To investigate the specific risk factors for NEC in septic infants, septic infants admitted to our center from January 2010 to April 2018 were included. Septic neonates with proven NEC (Bell’s stage ⩾II) were enrolled in the NEC group, and those without NEC were enrolled in the control group. Demographics, clinical characteristics, and risk factors were compared between the two groups. Univariate and logistic regression analyses were used to evaluate the potential risk factors for NEC. A total of 610 septic neonates were included, of whom 78 (12.8%) had complicated NEC. The univariate analysis indicated that infants with NEC had a lower birth weight, a lower gestational age, and older age on admission than those without NEC ( P < 0.05). Higher rates of anemia, prolonged rupture of membranes (PROM) (⩾18 h), pregnancy-induced hypertension, late-onset sepsis (LOS), red blood cell transfusion and hypoalbuminemia were observed in the NEC group than in the non-NEC group (P<0.05). Logistic regression analysis revealed LOS ( P = 0.000), red blood cell transfusion ( P = 0.001) and hypoalbuminemia ( P = 0.001) were associated with the development of NEC. Among NEC infants, those who needed red blood cell transfusion had a longer hospitalization duration than those who did not need transfusion ( P < 0.05). LOS, red blood cell transfusion and hypoalbuminemia were independent risk factors for the development of NEC in infants with sepsis. Taking measures to reduce the occurrence of hypoproteinemia and severe anemia may help to reduce the occurrence of NEC in septic neonates.

scholarly journals Independent risk factors and the potential predictors of bladder cancer-related ischemic stroke

2020 ◽  
Vol 48 (4) ◽  
pp. 030006052091922
Author(s):  
Xuemei Quan ◽  
Qixiong Qin ◽  
Ya Chen ◽  
Yunfei Wei ◽  
Xianlong Xie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bladder Cancer ◽  
Ischemic Stroke ◽  
Univariate Analysis ◽  
Elevated Serum ◽  
Predictive Performance ◽  
Roc Curves ◽  
Control Group ◽  
Independent Risk Factors ◽  
D Dimer

Objective To investigate the independent risk factors and potential predictors of bladder cancer-related ischemic stroke (BCRIS). Methods This was a multi-center retrospective study including patients with active bladder cancer and acute ischemic stroke without traditional stroke risk factors (BCRIS group), and sex- and age-matched patients with active bladder cancer alone (control group). Data were collected between January 2006 and December 2018. Uni- and multivariate analyses were performed to identify independent risk factors for BCRIS. The predictive performance of these risk factors was assessed using receiver operating characteristic (ROC) curves. Results Records were retrospectively reviewed from 60 BCRIS patients and 120 bladder cancer controls. Univariate analysis revealed that serum D-dimer and carcinoembryonic antigen (CEA) levels and the platelet and neutrophil counts were significantly higher in BCRIS patients compared with controls. Multivariate analysis identified the three above-mentioned variables as independent risk factors for BCRIS. The product of all three factors gave the largest area under the ROC curve. Conclusions Elevated serum D-dimer and CEA levels and increased platelet count were independent risk factors for BCRIS, and the cut-off value based on the product of the three independent risk factors (≥2,640,745.29) could serve as a potential predictor of BCRIS.

scholarly journals The predictive value of PI-RADS v2 score in high-grade prostate cancer: a multicenter retrospective study

2020 ◽  
Author(s):  
Song Chen ◽  
Yun Yang ◽  
Tianchen Peng ◽  
Xi Yu ◽  
Haiqing Deng ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Logistic Regression ◽  
Prediction Model ◽  
Cross Validation ◽  
Prostate Volume ◽  
Univariate Analysis ◽  
High Grade ◽  
Independent Risk Factors ◽  
Leave One Out

Abstract Background: To explore the predictive value of PI-RADS v2 in high-grade prostate cancer and establish a prediction model combined with prostate cancer related biomarkers. Material and Methods: A total of 316 patients with newly discovered prostate cancer at Zhongnan Hospital of Wuhan University and Renmin Hospital of Wuhan University from December 2017 to August 2019 were enrolled in this study. The clinic information as age, tPSA, fPSA, prostate volume, Gleason score and PI-RADS v2 score have been collected. Univariate analysis was performed based on every variable to investigate the risk factors of high-grade prostate cancer. ROC curves were generated for the risk factors to distinguish the cut-off point. Logistic regression analyses were used to investigate the independent risk factors of high-grade prostate cancer. Nomogram prediction model was generated based on multivariate logistic regression analysis. The calibration curve, ROC curve, leave-one-out cross validation and independent external validation were performed to evaluate the discriminative ability, accuracy and stability of the nomogram prediction model. Results: Of 316 patients, a total of 187 patients were diagnosed as high-grade prostate cancer. Univariate analysis showed tPSA, fPSA, prostate volume, PSAD and PI-RADS v2 score were significantly different between the high- and low-grade prostate cancer patients. Univariate and multivariate logistic regression analyses showed only tPSA, prostate volume and PI-RADS v2 score were the independent risk factors of high-grade prostate cancer. The nomogram could predict the probability of high-grade prostate cancer, with a sensitivity of 79.4% and a specificity of 77.6%. The calibration curve displayed good agreement of the predicted probability with the actual observed probability. AUC of the ROC curve was 0.840 (0.797-0.884). Leave-one-out cross validation indicated the nomogram prediction model could classify 81.4% cases accurately. External data validation was performed with a sensitivity of 80.6% and a specificity of 77.3%, the Kappa value was 0.5755. Conclusions: PI-RADS v2 score had the value in predicting high-grade prostate cancer, the nomogram prediction model may help early diagnose the high risk prostate cancer.

scholarly journals Risk factors and prediction model of severe pertussis in infants < 12 months of age in Tianjin, China

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Cui Zhang ◽  
Yanmei Zong ◽  
Zhe Wang ◽  
Li Wang ◽  
Ying Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Protective Factor ◽  
Prediction Models ◽  
Univariate Analysis ◽  
Clinical Manifestations ◽  
Multivariate Logistic Regression Analysis ◽  
Severe Group ◽  
Common Group ◽  
Independent Risk Factors

Abstract Background To identify risk factors associated with the prognosis of pertussis in infants (< 12 months). Methods A retrospective study on infants hospitalized with pertussis January 2017 to June 2019. The infants were divided into two groups according to the severity of disease: severe pertussis and non-severe pertussis groups. We collected all case data from medical records including socio-demographics, clinical manifestations, and auxiliary examinations. Univariate analysis and Logistic regression were used. Results Finally, a total of 84 infants with severe pertussis and 586 infants with non-severe pertussis were admitted. The data of 75% of the cases (severe pertussis group, n = 63; non-severe pertussis group, n = 189) were randomly selected for univariate and multivariate logistic regression analysis. The results showed rural area [P = 0.002, OR = 6.831, 95% CI (2.013–23.175)], hospital stay (days) [P = 0.002, OR = 1.304, 95% CI (1.107–1.536)], fever [P = 0.040, OR = 2.965, 95% CI (1.050–8.375)], cyanosis [P = 0.008, OR = 3.799, 95% CI (1.419–10.174)], pulmonary rales [P = 0.021, OR = 4.022, 95% CI (1.228–13.168)], breathing heavily [P = 0.001, OR = 58.811, 95% CI (5.503–628.507)] and abnormal liver function [P < 0.001, OR = 9.164, 95% CI (2.840–29.565)] were independent risk factors, and higher birth weight [P = 0.006, OR = 0.380, 95% CI (0.191–0.755)] was protective factor for severe pertussis in infants. The sensitivity and specificity of logistic regression model for remaining 25% data of severe group and common group were 76.2% and 81.0%, respectively, and the consistency rate was 79.8%. Conclusions The findings indicated risk factor prediction models may be useful for the early identification of severe pertussis in infants.

scholarly journals Independent Risk Factors and The Long-term Outcomes for Postoperative Continuous Renal Replacement Treatment in Patients Who Underwent Emergency Surgery for Type A Acute Aortic Dissection

2020 ◽  
Author(s):  
Zhigang Wang ◽  
Min Ge ◽  
Tao Chen ◽  
Cheng Chen ◽  
Qiuyan Zong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Aortic Dissection ◽  
Emergency Surgery ◽  
Acute Aortic Dissection ◽  
Univariate Analysis ◽  
Binary Logistic Regression ◽  
Long Term Outcomes ◽  
Independent Risk Factors

Abstract Objective: The study objective was to investigate the incidence and risk factors of continuous renal replacement therapy (CRRT) in patients undergoing emergency surgery for type A acute aortic dissection (TA-AAD) and evaluate the perioperative and long-term outcomes. Methods: From January 2014 to December 2018, 712 consecutive patients were enrolled in the study. These patients were divided into two groups according to whether or not needed postoperative CRRT: the CRRT group vs the control group. Univariate analysis and binary logistic regression analysis were used to analyze the risk factors of CRRT. To avoid the selection bias and confounders, baseline characteristics were matched for propensity scores. Kaplan-Meier curves were generated to provide survival estimates at postoperative points in time. Results: Before propensity score matching, univariate analysis showed that there were significant differences in age, preoperative hypertension, pericardial effusion, preoperative serum creatinine (sCr), intraoperative need for combined coronary artery bypass grafting (CABG) or mitral valve or tricuspid valve surgery, cardiopulmonary bypass (CPB) time, extracorporeal circulation assistant time, aortic cross-clamp time, drainage volume 24 hours after surgery and ventilator time between two groups. All were higher in the CRRT group (P <0.05). These risk factors were included in binary logistic regression. It showed that preoperative sCr and CPB time were independent risk factors for CRRT patients undergoing surgery for TA-AAD. And there were significant differences regarding 30-day mortality (P <0.001) and long-term overall cumulative survival (P <0.001) with up to a 6-year follow-up. After propensity scoring, 29 pairs (58 patients) were successfully matched. Among these patients, the analysis showed that CPB time was still significantly longer in the CRRT group (P = 0.004), and the 30-day mortality rate was also higher in this group (44.8% vs 10.3%; P = 0.003). Conclusion: CRRT after TA-AAD is common and worsened short- and long- term mortality. The preoperative sCr and CPB time are independent risk factors for postoperative CRRT patients. Shorten the CPB time as much as possible is recommended to reduce the risk of CRRT after the operation.

scholarly journals Independent Risk Factors and The Long-term Outcomes for Postoperative Continuous Renal Replacement Treatment in Patients Who Underwent Emergency Surgery for Type A Acute Aortic Dissection

2020 ◽  
Author(s):  
Zhigang Wang ◽  
Min Ge ◽  
Tao Chen ◽  
Cheng Chen ◽  
Qiuyan Zong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Acute Aortic Dissection ◽  
Univariate Analysis ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Long Term Outcomes ◽  
Replacement Treatment ◽  
Independent Risk Factors

Abstract Objective: The study objective was to investigate the incidence and risk factors of continuous renal replacement treatment (CRRT) in patients undergoing emergency surgery for type A acute aortic dissection (TA-AAD) and evaluate the perioperative and long-term outcomes. Methods: From January 2014 to December 2018, 712 consecutive patients were enrolled in the study. These patients were divided into two groups according to whether or not needed severe postoperative acute kidney injury (AKI) requiring CRRT: the CRRT group vs the control group. Univariate analysis and binary logistic regression analysis were used to analyze the risk factors of CRRT. Significant variables by univariate analysis were included in binary logistic regression analysis. To avoid the selection bias and confounders, baseline characteristics were matched for propensity scores. One-to-one pair matching was performed using nearest neighbor matching without replacement within 0.02 standard deviations of the logit of the propensity score as caliper width. Kaplan-Meier curves were generated to provide survival estimates at postoperative points in time. Differences between the 2 groups were determined by log-rank tests. Results: Before propensity score matching, univariate analysis showed that there significant differences in age, preoperative hypertension, pericardial effusion, preoperative serum creatinine (sCr), intraoperative need for combined coronary artery bypass grafting (CABG) or mitral valve or tricuspid valve surgery, cardiopulmonary bypass (CPB) time, extracorporeal circulation assistant time, aortic cross-clamp time, drainage volume 24 hours after surgery and ventilator time between two groups. All were higher in the CRRT group (p<0.05). These risk factors were included in binary logistic regression. It showed that preoperative sCr (OR=1.008, 95% CI:1.002-1.014, P=0.005) and CPB time (OR=1.022, 95% CI:1.003-1.042, P=0.026) were independent risk factors for CRRT patients undergoing surgery for TA-AAD. And there were significant differences regarding 30-day mortality (P<0.001) and long-term overall cumulative survival (P<0.001) with up to a 6-year follow-up. After propensity scoring, 29 pairs (58 patients) were successfully matched. Among these patients, the analysis showed that CPB time was still significantly longer in the CRRT group (P = 0.004), and the 30-day mortality rate was also higher in this group (44.8% vs 10.3%; P = 0.003).Conclusion: CRRT after TA-AAD is common and worsened short- and long- term mortality. The preoperative sCr and CPB time are independent risk factors for postoperative CRRT patients. Shorten the CPB time as much as possible is recommended to reduce the risk of CRRT after the operation.

Factors and Predictive Model Associated With Perioperative Complications After Long Fusion in the Treatment of Adult Non-Degenerative Scoliosis

2020 ◽  
Author(s):  
Nan Wu ◽  
Zhen Zhang ◽  
Jiashen Shao ◽  
Shengru Wang ◽  
Ziquan Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Perioperative Complications ◽  
Posterior Instrumentation ◽  
Univariate Analysis ◽  
Vertical Axis ◽  
Degenerative Scoliosis ◽  
Predicted Probability ◽  
Related Risk ◽  
Independent Risk Factors

Abstract IntroductionAdult non-degenerative scoliosis accounts for 90% of spinal deformities in young adults. However, perioperative complications and related risk factors of long posterior instrumentation and fusion for the treatment of adult non-degenerative scoliosis have not been adequately studied.MethodsWe evaluated clinical and radiographical results from 180 patients with adult non-degenerative scoliosis who underwent long posterior instrumentation and fusion. Preoperative clinical data, intraoperative variables, and perioperative radiographic parameters were collected to analyze the risk factors for perioperative complications. Potential and independent risk factors for perioperative complications were evaluated by univariate analysis and logistic regression analysis.Results180 adult non-degenerative scoliosis patients were included in our study. There were 31 perioperative complications for 25 (13.9%) patients, 11 of which were cardiopulmonary-related complications, five of which were infection, six of which were neurological-related complications, three of which were gastrointestinal-related complications, and six of which were incision-related problems. The independent risk factors for development of perioperative complications included change in Cobb angle (odds ratio [OR]=1.058, 95% CI=1.011~1.108, P=0.015), change in central vertical axis (CVA) (OR=1.066, 95% CI=1.019-1.116, P=0.006) and red blood cell (RBC) transfusion (OR=5.631, 95% CI=1.676~18.924, P=0.005). The area under the receiver operating characteristic (ROC) curve based on predicted probability of the logistic regression was 0.746.ConclusionsBlood transfusion, Cobb change, and CVA change were independent risk factors for perioperative complications after long-segment posterior instrumentation and fusion in adult non-degenerative scoliosis patients.

Association of Intrapartum Risk Factors and Infant Clinical Indicators with Culture Confirmed Early Onset Neonatal Sepsis in a Secondary Care Rural Hospital in India

2020 ◽  
Author(s):  
Sumanth Gandra ◽  
Shravan K Ranga ◽  
D Taylor Hendrixson ◽  
Raghuprakash R Nayakanti ◽  
Jason G Newland ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Univariate Analysis ◽  
Individual Risk ◽  
Clinical Indicators ◽  
Acinetobacter Species ◽  
Backward Elimination ◽  
Culture Positive

Abstract Objective The aim of this study is to determine the association of intrapartum risk factors and infant clinical indicators using the National Institute for Health and Care Excellence (NICE) criteria with culture-positive early-onset neonatal sepsis (EONS) from a rural secondary healthcare facility where intrapartum prophylactic antibiotics are routinely administered to high-risk mothers. Methods A single-center prospective observational study was conducted between July 2017 and September 2018. All intramural neonates with at least one NICE criteria at less than 72 h of life, were included. Univariate logistic regression and multivariable logistic backward elimination analyses were conducted to investigate individual risk factors and predictive models for culture proven EONS. Results Of 236 newborns who were at risk for EONS by NICE criteria, 32 (13.8%) had positive blood cultures. Klebsiella species (n = 13, 39.4%) and Acinetobacter species (n = 11, 33.3%) were the most common isolated bacteria. In univariate analysis, the number of infant clinical indicators were associated with culture positive EONS (OR 1.36; 95% CI 1.01–1.81), but not the number of intrapartum risk factors (OR 0.76; 95% CI 0.4–1.29). The multivariate logistic regression with backward elimination procedure suggested that a model including absolute neutrophil count [adjusted OR (aOR) 0.81; 95% CI 0.72–0.92], C-reactive protein (aOR 1.24; 95% CI 1.08–1.43) and the number of clinical indicators (aOR 1.29; 95% CI 0.93–1.80) could be useful to predict culture positive EONS in our setting. Conclusion In this maternal and neonatal cohort, infant clinical indicators rather than intrapartum risk factors were associated with culture confirmed EONS.

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