Endocan, a Risk Factor for Developing Acute Respiratory Distress Syndrome among Severe Pneumonia Patients

Background. Severe pneumonia (SP) has been widely accepted as a major cause for acute respiratory distress syndrome (ARDS), and the development of ARDS is significantly associated with increased mortality. This study aimed to identify potential predictors for ARDS development in patients with SP. Methods. Eligible SP patients at admission from January 2013 to June 2017 were prospectively enrolled, and ARDS development within hospital stay was identified. Risk factors for ARDS development in SP patients were analyzed by univariate and multivariate logistic regression analysis. The receiver operating characteristic (ROC) curve analysis with the area under the curve (AUC) was performed for the predictive value of endocan for ARDS development. Results. A total of 145 SP patients were eventually enrolled into the final analysis, of which 37 developed ARDS during the hospital stay. Our final multivariate logistic regression analysis suggested plasma endocan expression as the only independent risk factor for ARDS development in SP patients (OR: 1.57, 95% CI: 1.14–2.25, P=0.021). ROC curve analysis of plasma endocan resulted in an AUC of 0.754, 95% CI of 0.642–0.866, a cutoff value of 11.6 ng/mL, a sensitivity of 78.7%, and a specificity of 70.3%, respectively (P<0.01). Conclusions. Endocan expression at ICU admission is a reliable predictive factor in predicting ARDS in patients with SP.

Download Full-text

Serum Irisin Predicts Mortality Risk in Acute Heart Failure Patients

Cellular Physiology and Biochemistry ◽

10.1159/000477867 ◽

2017 ◽

Vol 42 (2) ◽

pp. 615-622 ◽

Cited By ~ 12

Author(s):

Shutong Shen ◽

Rongrong Gao ◽

Yihua Bei ◽

Jin Li ◽

Haifeng Zhang ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Curve Analysis ◽

Multivariate Logistic Regression ◽

Roc Curve Analysis ◽

Kaplan Meier ◽

All Cause Mortality

Background/Aims: Irisin is a peptide hormone cleaved from a plasma membrane protein fibronectin type III domain containing protein 5 (FNDC5). Emerging studies have indicated association between serum irisin and many major chronic diseases including cardiovascular diseases. However, the role of serum irisin as a predictor for mortality risk in acute heart failure (AHF) patients is not clear. Methods: AHF patients were enrolled and serum was collected at the admission and all patients were followed up for 1 year. Enzyme-linked immunosorbent assay was used to measure serum irisin levels. To explore predictors for AHF mortality, the univariate and multivariate logistic regression analysis, and receiver-operator characteristic (ROC) curve analysis were used. To determine the role of serum irisin levels in predicting survival, Kaplan-Meier survival analysis was used. Results: In this study, 161 AHF patients were enrolled and serum irisin level was found to be significantly higher in patients deceased in 1-year follow-up. The univariate logistic regression analysis identified 18 variables associated with all-cause mortality in AHF patients, while the multivariate logistic regression analysis identified 2 variables namely blood urea nitrogen and serum irisin. ROC curve analysis indicated that blood urea nitrogen and the most commonly used biomarker, NT-pro-BNP, displayed poor prognostic value for AHF (AUCs ≤ 0.700) compared to serum irisin (AUC = 0.753). Kaplan-Meier survival analysis demonstrated that AHF patients with higher serum irisin had significantly higher mortality (P<0.001). Conclusion: Collectively, our study identified serum irisin as a predictive biomarker for 1-year all-cause mortality in AHF patients though large multicenter studies are highly needed.

Download Full-text

RELATIONSHIP BETWEEN CIGARETTE SMOKING AND NASOPHARYNGEAL CARCINOMA

INTERNATIONAL JOURNAL OF NASOPHARYNGEAL CARCINOMA (IJNPC) ◽

10.32734/ijnpc.v1i1.962 ◽

2019 ◽

Vol 1 (1) ◽

pp. 17-23

Author(s):

Ibrahim Irsan Nasution ◽

Ramsi Lutan ◽

Delfitri Munir ◽

Arlinda Sari Wahyuni

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Risk Factor ◽

Nasopharyngeal Carcinoma ◽

Cigarette Smoking ◽

Logistic Regression Analysis ◽

Significant Relationship ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Salted Fish

Introduciton Since then the pathogenesis of NPC has been intensively studied, specifically aimed at geography and racial variation. In recent years many environmental and biological factors have shown a risky relationship to the occurrence of NPC and the latest research results indicate the role of genetic and viral factors in the development of this disease Objectives Etiology of nasopharyngeal cancer (NPC) is multifactorial, and many of these factors overlap where one factor may occur together with other elements as a cause. Cigarette smoking is thought to also play a role in the development of NPC. Methods The study design was in case of control with an analytical approach during February-October 2007. To find out the relationship between Cigarette smoking NPC, a case-control study was conducted, with a sample of 96 patients with NPC as case and 96 people as a control. Case group and control samples were taken from RSUP H. Adam Malik Medan and RSU Dr. Pirngadi Medan. Results The majority of NPC patients are: Men (compared with women 2.84: 1), 50-59 years (29.2%), and farming (32.3%). The Batak ethnic is the largest ethnic group suffering from NPC 54 people (56.3%) and followed in the second place the most are Javanese (29.2%). The most histopathological type is WHO type 3 (38.6%). Most stages were III (58.4%), followed by stage IV (40.6%), stage II (1%), and there was none of stage I.In univariate logistic regression showed a significant relationship between smokers with consumption of cigarettes 11-20 cigarettes per day with OR=2.530 (p=0.021) with the occurrence of NPC. However, in the multivariate logistic regression analysis, the number of cigarettes per day did not show a significant relationship (p=0.587). The results of multivariate logistic regression analysis, nasopharyngeal carcinoma were significantly associated with people who had started smoking before the age of 20 years (p=0.000; OR 5.35 and CI 95% 2.290-12.499), consuming habits of salted fish before 10 years of age with sometimes frequency consumption of salted fish p=0.000; OR 7.766 (95% CI 2.937-20.538), often p=0.000; OR 16.515 (95% CI 5.3000-51.463), and the habit of using firewood p=0.014; OR 3.147 (95% CI 1.260-7.860). There was no significant relationship between the duration of cigarette smoking (p=0.293), a number of cigarettes (p=0.021) and the types of cigarettes smoked (p=0.081) with the incidence of NPC. Conclusion Cigarette smoking as a risk factor for NPC cannot act stand-alone as a risk factor, but there is a role for other factors that also influence as a risk factor.

Download Full-text

Delayed diagnosis of critical congenital heart defects predicting risk factors and survival rate in newborns in Beijing: a retrospective study

Journal of International Medical Research ◽

10.1177/03000605211028028 ◽

2021 ◽

Vol 49 (7) ◽

pp. 030006052110280

Author(s):

Wen Zhang ◽

Hong-Yan Xu ◽

Yan-Chun Zhang ◽

Kai-Bo Liu

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Risk Factor ◽

Retrospective Study ◽

Congenital Heart ◽

Heart Defects ◽

Delayed Diagnosis ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression

Objective To assess the prevalence and survival rate of newborns with a delayed diagnosis of critical congenital heart defects (CCHD) in Beijing. Methods This retrospective study analysed data from births between 2010 and 2017 from the Birth Defects Monitoring Network in Beijing. Newborns with CCHD were analysed according to seven categories. Statistical analyses were used to calculate the mortality rate within the first week (days 0–6) after live birth. Multivariate logistic regression analysis of survival was performed to analyse the potential risk factors for newborn mortality. Results A total of 1 773 935 perinatal newborns were screened in Beijing and 1851 newborns were diagnosed with CCHD, showing a prevalence of 10.43 per 10 000. Among the total 1851 CCHD patients, the majority (1692 of 1851; 91.41%) were identified through prenatal diagnosis, 104 of 1851 (5.62%) were diagnosed before obstetric discharge/transfer and 55 of 1851 (2.97%) were identified through delayed diagnosis. The prevalence of CCHD in newborns was 1.96 per 10 000 births. Multivariate logistic regression analysis of survival demonstrated that gestational age at delivery was the only risk factor for death within the first week after birth. Conclusions Within the first week after birth, gestational age was the only risk factor for death in newborns with CCHD.

Download Full-text

Association between Obesity and Chronic Periodontitis: A Cross-sectional Study

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1294 ◽

2013 ◽

Vol 14 (2) ◽

pp. 168-173 ◽

Cited By ~ 18

Author(s):

Ajay Reddy Palle ◽

CM Sanjeeva Kumar Reddy ◽

B Shiva Shankar ◽

Vemsi Gelli ◽

Jaradoddi Sudhakar ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Risk Factor ◽

Cardiovascular Diseases ◽

Chronic Periodontitis ◽

Multivariate Logistic Regression Analysis ◽

Cross Sectional Study ◽

Sectional Study ◽

Multivariate Logistic Regression ◽

Cross Sectional

ABSTRACT Aim Chronic periodontitis is multifactorial and numerous risk factors have been identified to contribute in the disease progression. Current study aimed to conduct a cross-sectional study in a population of patients with cardiovascular diseases in order to correlate the association between obesity [body mass index (BMI) and waist circumference (WC)] and periodontal disease parameters. Materials and methods The study was of a cross-sectional design and a total of 201 patients were examined after obtaining their informed consent. Subjects who had a history of cardiovascular diseases and under treatment were included in the study. Two indicators of obesity were used: BMI and WC. The following periodontal parameters were assessed: Probing depth, clinical attachment level. The oral hygiene status of the subjects was assessed by the oral hygiene index (OHI, simplified) given by John C Greene and Jack R Vermillion. The influence of the BMI and other confounding variables on periodontitis severity was assessed by multivariate logistic regression analysis. Data were analyzed using SPSS. Results Significant association was seen with low density lipoproteins (LDL) and severity of periodontitis (p < 0.005), triglyceride levels (TGL) and severity of periodontitis (p < 0.005), cholesterol and severity of periodontitis (p < 0.005), BMI and severity of periodontitis (p < 0.001), OHI and severity of periodontitis (p < 0.001). Significant association was seen with smoking and severity of periodontitis (p < 0.005), BMI and severity of periodontitis (p < 0.001), WC and severity of periodontitis (p < 0.001), cholesterol and severity of periodontitis (p < 0.001), OHI and severity of periodontitis (p < 0.001). Conclusion Obesity has been implicated as a risk factor for several conditions including cardiovascular disease, diabetes, etc. In our study the relation between measures of overall and abdominal obesity (BMI and WC) and periodontal disease showed significant association in the multivariate logistic regression analysis independent of other confounding factors. Clinical significance Obesity can act as a significant risk factor in progression of periodontitis. How to cite this article Palle AR, Reddy CMSK, Shankar BS, Gelli V, Sudhakar J, Reddy KKM. Association between Obesity and Chronic Periodontitis: A Cross-sectional Study. J Contemp Dent Pract 2013;14(2):168-173.

Download Full-text

Risk factors for carotid plaque progression after optimising the risk factor treatment: substudy results of the Atherosclerotic Plaque Characteristics Associated with a Progression Rate of the Plaque and a Risk of Stroke in Patients with the carotid Bifurcation Plaque Study (ANTIQUE)

Stroke and Vascular Neurology ◽

10.1136/svn-2021-001068 ◽

2021 ◽

pp. svn-2021-001068

Author(s):

David Školoudík ◽

Petra Kešnerová ◽

Tomáš Hrbáč ◽

David Netuka ◽

Jaroslav Vomáčka ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Risk Factor ◽

Logistic Regression Analysis ◽

Carotid Plaque ◽

Multivariate Logistic Regression Analysis ◽

Plaque Progression ◽

Multivariate Logistic Regression ◽

Factors Influencing

Background and aimCarotid plaque progression contributes to increasing stroke risk. The study aims to identify factors influencing carotid plaque thickness progression after changing the preventive treatment to the ‘treating arteries instead of risk factors’ strategy, that is, change in treatment depending on the progression of atherosclerosis.MethodsThe study participants who completed sonographic controls over the course of 3 years were enrolled to the analysis. Duplex sonography of cervical arteries was performed in 6-month intervals with measurement of carotid plaque thickness. Plaque thickness measurement error (σ) was set as 3 SD. Only evidently stable and progressive plaques (defined as plaque thickness difference between initial and final measurements of ˂σ and >2σ, respectively) were included to analysis. Univariate and multivariate logistic regression analysis was performed to identify factors influencing plaque progression.ResultsA total of 1391 patients (466 males, age 67.2±9.2 years) were enrolled in the study. Progressive plaque in at least one carotid artery was detected in 255 (18.3%) patients. Older age, male sex, greater plaque thickness, coronary heart disease, vascular surgery/stenting history and smoking were more frequently present in patients with progressive plaque (p˂0.05 in all cases). Multivariate logistic regression analysis identified only the plaque thickness (OR 1.850 for left side, 95% CI 1.398 to 2.449; and OR 1.376 for right side, 95% CI 1.070 to 1.770) as an independent factor influencing plaque progression.ConclusionCarotid plaque thickness corresponding to stenosis severity is the only independent risk factor for plaque thickness progression after optimising the prevention treatment.Trial registration numberNCT02360137.

Download Full-text

Apolipoprotein E Genotype and Cognitive Dysfunction after Noncardiac Surgery

Anesthesiology ◽

10.1097/00000542-200410000-00009 ◽

2004 ◽

Vol 101 (4) ◽

pp. 855-861 ◽

Cited By ~ 57

Author(s):

Hanne Abildstrom ◽

Michael Christiansen ◽

Volkert D. Siersma ◽

Lars S. Rasmussen ◽

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Risk Factor ◽

Apolipoprotein E ◽

Cognitive Dysfunction ◽

Logistic Regression Analysis ◽

Multivariate Logistic Regression Analysis ◽

Noncardiac Surgery ◽

Multivariate Logistic Regression ◽

Apolipoprotein E Genotype

Background Apolipoprotein E is important in recovery after neuronal damage. The epsilon4 allele of the apolipoprotein E gene has been shown as a risk factor for Alzheimer disease, poor outcome after cerebral injury, and accelerated cognitive decline with normal aging. The authors hypothesized that patients with the epsilon4 allele would have an increased risk of postoperative cognitive dysfunction (POCD) after noncardiac surgery. Methods In a multicenter study, a total of 976 patients aged 40 yr and older undergoing noncardiac surgery were tested preoperatively and 1 week and 3 months after surgery with a neuropsychological test battery comprising seven subtests. POCD was defined as a decline in test performance of more than 2 SD from the expected. Apolipoprotein E genotypes were determined by blood sample analysis at a central laboratory. Multivariate logistic regression analysis with POCD as the dependent variable assessed presence of the epsilon4 allele (yes/no) and other possible risk factors. Results The epsilon4 allele was found in 272 patients. One week after surgery, the incidence of POCD was 11.7% in patients with the epsilon4 allele and 9.9% in patients without the epsilon4 allele (P = 0.41). Three months later, POCD was found in 10.3% of patients with the epsilon4 allele and in 8.4% of patients without the epsilon4 allele (P = 0.40). Multivariate logistic regression analysis did not identify the epsilon4 allele as a risk factor at 1 week (P = 0.33) or 3 months (P = 0.57). Conclusions The authors were unable to show a significant association between apolipoprotein E genotype and POCD, but statistical power was limited because of a lower incidence of POCD than expected.

Download Full-text

Development and External Validation of a Nomogram for Early Predicting in-hospital Mortality of Patients with SARS-CoV-2 Pneumonia: A Two-Center, Retrospective Analysis

10.21203/rs.3.rs-27780/v1 ◽

2020 ◽

Author(s):

Miao Luo ◽

Junlin Lu ◽

Jing Liu ◽

Shuli Xia ◽

Shuang Wei

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Hospital Mortality ◽

External Validation ◽

Multivariate Logistic Regression Analysis ◽

Curve Analysis ◽

Multivariate Logistic Regression ◽

Factors Associated ◽

Death Cases

Abstract Background At present, the death cases with SARS-CoV-2 pneumonia are continuing to increase globally. However, the information on death cases and predictive methods are substantial lacking. We aimed to develop a nomogram, which was validated by both internal and external cohorts, for early predicting mortality in hospitalized patients with SARS-CoV-2 pneumonia.Methods We retrospectively collected data on 1,540 patients confirmed SARS-CoV-2 pneumonia from two hospitals. Multivariate logistic regression analysis was performed to examine factors associated with in-hospital mortality. We investigated the mortality related risk factors and their weights, thereafter designed and validated a predictive nomogram model to facilitate early discrimination of in-hospital death. We assessed the nomogram performance by examining calibration (calibration plots and Hosmer–Lemeshow calibration test) and discrimination (AUROC). We also plotted survival curves and decision curves to evaluate the clinical usefulness of the nomogram.Results In the 1,540 patients from two centers, 248 cases died (16.1%). In the predictive nomogram calculated by a multivariate logistic regression analysis, eight independent risk factors associated mortality included age ≥ 60 years (odd ratio(OR) = 2.840; 95%CI, 1.467–5.495; P = 0.002), respiratory rate ≥ 30 breaths per minute (OR = 3.308; 95%CI, 1.408–7.770; P = 0.006), neutrophil count ≥ 7 × 109/L (OR = 3.084; 95%CI, 1.667–5.707; P < 0.001), lymphocyte count ≤ 0.8 × 109/ L (OR = 4.688; 95%CI, 2.500-8.791; P < 0.001), d-dimer ≥ 1.5 µg/mL(OR = 2.159; 95%CI, 1.169–3.989; P = 0.014), lactate dehydrogenase ≥ 350U/L(OR = 4.385; 95%CI, 2.299–8.362; P < 0.001), procalcitonin ≥ 0.1 ng/mL(OR = 4.972; 95%CI, 2.537–9.746; P < 0.001), and presence of myocardial injury (OR = 2.289; 95%CI, 1.260–4.160; P = 0.007) on admission. Calibration curves showed good fitting of the nomogram model with no statistical significance (P = 0.740) by Hosmer-Lemeshow test. This predictive nomogram had better predictive ability than CURB-65 score in training set (AUROC = 0.956 vs 0.828,P < 0.001). The good predictive performance of the nomogram is suggested by calibration, discrimination, and survival curve analysis, whether in the training, internal or external validation set. The decision curve analysis showed that predicting mortality risk applying this nomogram would be better than having all patients or none patients.Conclusions This nomogram is a reliable prognostic method that can accurately and early predict in-hospital mortality in patients with SARS-CoV-2 pneumonia. It can guide clinicians to improve their abilities to evaluate patient prognosis, enhance patient stratification, make earlier and reasonable decisions.Trail registration: This is a retrospective observational study without a trial registration number.

Download Full-text

Efficacy of flurbiprofen axetil for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries

JA Clinical Reports ◽

10.1186/s40981-020-00403-x ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Atsushi Kotera

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Postoperative Pain ◽

Logistic Regression Analysis ◽

Pain Control ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Postoperative Pain Control ◽

Flurbiprofen Axetil ◽

Postanesthetic Shivering

Abstract Background Postanesthetic shivering is an unpleasant adverse event in surgical patients. A nonsteroidal anti-inflammatory drug has been reported to be useful in preventing postanesthetic shivering in several previous studies. The aim of this study was to evaluate the efficacy of flurbiprofen axetil being a prodrug of a nonsteroidal anti-inflammatory drug for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries. Method This study is a retrospective observational study. I collected data from patients undergoing gynecologic laparotomy surgeries performed between October 1, 2019, and September 30, 2020, at Kumamoto City Hospital. All the patients were managed with general anesthesia with or without epidural analgesia. The administration of intravenous 50 mg flurbiprofen axetil for postoperative pain control at the end of the surgery was left to the individual anesthesiologist. The patients were divided into two groups: those who had received intravenous flurbiprofen axetil (flurbiprofen group) and those who had not received intravenous flurbiprofen axetil (non-flurbiprofen group), and I compared the frequency of postanesthetic shivering between the two groups. Additionally, the factors presumably associated with postanesthetic shivering were collected from the medical charts. Intergroup differences were assessed with the χ2 test with Yates’ correlation for continuity category variables. The Student’s t test was used to test for differences in continuous variables. Furthermore, a multivariate logistic regression analysis was performed to elucidate the relationship between the administration of flurbiprofen axetil and the incidence of PAS. Results I retrospectively examined the cases of 141 patients aged 49 ± 13 (range 21-84) years old. The overall postanesthetic shivering rate was 21.3% (30 of the 141 patients). The frequency of postanesthetic shivering in the flurbiprofen group (n = 31) was 6.5%, which was significantly lower than that in the non-flurbiprofen group (n = 110), 25.5% (p value = 0.022). A multivariate logistic regression analysis showed that administration of flurbiprofen axetil was independently associated with a reduced incidence of postanesthetic shivering (odds ratio 0.12; 95% confidence interval, 0.02-0.66, p value = 0.015). Conclusions My result suggests that intraoperative 50 mg flurbiprofen axetil administration for postoperative pain control is useful to prevent postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries.

Download Full-text

The association between hypoglycemia and glycemic variability in elderly patients with type 2 diabetes: a prospective observational study

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00656-1 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Takahisa Handa ◽

Akinobu Nakamura ◽

Aika Miya ◽

Hiroshi Nomoto ◽

Hiraku Kameda ◽

...

Keyword(s):

Type 2 Diabetes ◽

Logistic Regression ◽

Regression Analysis ◽

Observational Study ◽

Elderly Patients ◽

Prospective Observational Study ◽

Multivariate Logistic Regression Analysis ◽

Glycemic Variability ◽

Multivariate Logistic Regression

Abstract Background This study aimed to explore predictive factors of time below target glucose range (TBR) ≥ 1% among patients’ characteristics and glycemic variability (GV) indices using continuous glucose monitoring data in elderly patients with type 2 diabetes. Methods We conducted a prospective observational study on 179 (71 female) Japanese outpatients with type 2 diabetes aged ≥ 65 years. The characteristics of the participants with TBR ≥ 1% were evaluated by multivariate logistic regression analysis. Receiver-operating characteristic (ROC) curve analyses of GV indices, comprising coefficient of variation (CV), standard deviation, and mean amplitude of glycemic excursions, were performed to identify the optimal index for the identification of patients with TBR ≥ 1%. Results In the multivariate logistic regression analysis, none of the clinical characteristics, including HbA1c and C-peptide index, were independent markers for TBR ≥ 1%, while all three GV indices showed significant associations with TBR ≥ 1%. Among the three GV indices, CV showed the best performance based on the area under the curve in the ROC curve analyses. Conclusions Among elderly patients with type 2 diabetes, CV reflected TBR ≥ 1% most appropriately among the GV indices examined. Trial registration UMIN-CTR: UMIN000029993. Registered 16 November 2017

Download Full-text

Risk factors for tissue expander infection in scar reconstruction: a retrospective cohort study of 2374 consecutive cases

Burns & Trauma ◽

10.1093/burnst/tkaa037 ◽

2020 ◽

Vol 8 ◽

Author(s):

Chen Dong ◽

Minhui Zhu ◽

Luguang Huang ◽

Wei Liu ◽

Hengxin Liu ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Treatment Failure ◽

Logistic Regression Analysis ◽

Disease Duration ◽

Multivariate Logistic Regression Analysis ◽

Tissue Expansion ◽

Multivariate Logistic Regression ◽

Hematoma Evacuation

Abstract Background Tissue expansion is used for scar reconstruction owing to its excellent clinical outcomes; however, the complications that emerge from tissue expansion hinder repair. Infection is considered a major complication of tissue expansion. This study aimed to analyze the perioperative risk factors for expander infection. Methods A large, retrospective, single-institution observational study was carried out over a 10-year period. The study enrolled consecutive patients who had undergone tissue expansion for scar reconstruction. Demographics, etiological data, expander-related characteristics and postoperative infection were assessed. Univariate and multivariate logistic regression analysis were performed to identify risk factors for expander infection. In addition, we conducted a sensitivity analysis for treatment failure caused by infection as an outcome. Results A total of 2374 expanders and 148 cases of expander infection were assessed. Treatment failure caused by infection occurred in 14 expanders. Multivariate logistic regression analysis identified that disease duration of ≤1 year (odds ratio (OR), 2.07; p < 0.001), larger volume of expander (200–400 ml vs <200 ml; OR, 1.74; p = 0.032; >400 ml vs <200 ml; OR, 1.76; p = 0.049), limb location (OR, 2.22; p = 0.023) and hematoma evacuation (OR, 2.17; p = 0.049) were associated with a high likelihood of expander infection. Disease duration of ≤1 year (OR, 3.88; p = 0.015) and hematoma evacuation (OR, 10.35; p = 0.001) were so related to high risk of treatment failure. Conclusions The rate of expander infection in patients undergoing scar reconstruction was 6.2%. Disease duration of <1 year, expander volume of >200 ml, limb location and postoperative hematoma evacuation were independent risk factors for expander infection.

Download Full-text