scholarly journals Incidence of Surgical Site Infection and Factors Associated among Cesarean Deliveries in Selected Government Hospitals in Addis Ababa, Ethiopia, 2019

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Hana Lijaemiro ◽  
Semarya Berhe Lemlem ◽  
Jembere Tesfaye Deressa
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Surgical Site Infection ◽  
Cesarean Delivery ◽  
Logistic Regression Analysis ◽  
Addis Ababa ◽  
Site Infection ◽  
Cesarean Deliveries ◽  
Government Hospitals ◽  
Bivariate Logistic Regression

Background. One-third to two-thirds of operated patients in low-income countries acquire surgical site infection, which is nine times higher when compared to high-resource countries. Identifying the incidence and risk factors that contribute to surgical site infection following cesarean delivery is a step ahead for preventing and reducing the problem. Nonetheless, the distribution of the problem in Addis Ababa, where the rate of cesarean delivery is relatively high compared to other parts of the country, is under investigation. Objective. The aim of this study is to assess the incidence of surgical site infection among cesarean deliveries and factors associated with it in selected governmental hospitals found in Addis Ababa, Ethiopia, in 2019. Method. A hospital-based prospective cohort study design was employed to follow 175 women, who gave birth by cesarean delivery in selected government hospitals in Addis Ababa, from March 11 to April 9, 2019. Convenience sampling method was used to select study units from the randomly selected hospitals. Descriptive statistics were run for determining the rate of cesarean delivery surgical site infection. Presence and degree of association between outcome and independent variables were computed through bivariate logistic regression analysis and factors that had p<0.2 significance level in the bivariate logistic regression analysis were considered in the multivariable logistic regression analysis. Result. From 166 participants who completed 30-day follow-up, 25 (15%) of the participants developed surgical site infection. Age, gestational age, duration of operation, and ≥5 vaginal examinations showed a significant association with the outcome variable with AOR (95% CI) of ((AOR = 1.504, 95% CI: (1.170 – 1.933, p=0.001))), ((AOR = 0.019, 95% CI: (0.001 – 0.291, p=0.004))), ((AOR = 1.108, 95% CI: (1.025 – 1.197, p=0.009))), and ((AOR = 13.076, 95% CI: (1.018 – 168.002, p=0.048))), respectively. Conclusion and recommendation. Surgical site infection rate is higher and certain associations lost due to small sample size. Further interventional studies with vast sample size are recommended.

scholarly journals Post-cesarean section surgical site infection and associated factors in East Gojjam zone primary hospitals, Amhara region, North West Ethiopia, 2020

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261951
Author(s):  
Hulubante Bizuayew ◽  
Haimanot Abebe ◽  
Getachew Mullu ◽  
Likinaw Bewuket ◽  
Daniel Tsega ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Logistic Regression Analysis ◽  
Multivariable Analysis ◽  
Outcome Variable ◽  
P Value ◽  
Multivariable Logistic Regression Analysis ◽  
Site Infection

Purpose Maternal surgical site infection after cesarean delivery is a clinical problem which contributes to significant morbidity and mortality. In Ethiopia admissions following cesarean section due to surgical site infection have been routine activities of health care institutions but there is limited scientific evidence on both the magnitude of the problem and factors associated with it making prevention mechanisms less effective. Therefore, this study aimed to assess magnitude and risk factors of post-cesarean section surgical site infection at primary hospitals of East Gojjam Zone, Northwest Ethiopia. Methods Institution-based cross sectional study with retrospective chart review was conducted from September 10–30 /2020 at 3 randomly selected primary hospitals of east Gojjam zone. The data were entered in Epi data version 3.1 and exported to Statistical Package for Social Science Software version 26. Post-cesarean section surgical site infection was measured based on disease classification and definition of the term by Center for Disease Control and Prevention. After checking for presence of multicollinarity, presence and degree of association of factors with outcome variable were computed through logistic regression analysis. Factors with P value ≤ 0.2 in bi-variable logistic regression analysis were included in the multivariable logistic regression analysis and those variables with P-value of <0.05 in multivariable analysis were considered statistically significant. Result From 622 medical records of women who underwent cesarean section, 77 (12.4%) of them developed surgical site infection. Rural residence [(AOR = 2.30, 95%CI: (1.29, 4.09)], duration of labor greater than 24hrs [(AOR = 3.48, 95%CI: (1.49, 8.09)], rupture of membrane>12hrs[(AOR = 4.61,95%CI:(2.34,9.09)], hypertension[(AOR = 3.14,95%CI:(1.29,7.59)] and preoperative Hematocrit ≤30%[(AOR = 3.22,95%CI:(1.25,8.31)] were factors significantly associated with post-cesarean section surgical site infections. Conclusion Magnitude of post-cesarean section surgical site infection was a significant problem in primary hospitals. Minimizing prolonged labor; minimize early rupture of membrane, properly managing patients with comorbidities like hypertension, strengthen prophylaxis and treatment for anemia during antenatal care and raising awareness for rural residents can reduce the problem. Zonal police makers should give emphasis to reduce its burden.

scholarly journals Post-cesarean section surgical site infection and associated factors in East Gojjam zone primary hospitals, Amhara region, North West Ethiopia, 2020

2021 ◽  
Author(s):  
Haimanot Geletie Abebe ◽  
Hulubante fetene bizuayew ◽  
Getachew Kassa Mullu ◽  
Likinaw Zeleke Bewuket ◽  
Daniel Tefera Tsega ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Logistic Regression Analysis ◽  
Multivariable Analysis ◽  
Outcome Variable ◽  
P Value ◽  
Multivariable Logistic Regression Analysis ◽  
Site Infection

Abstract Background Women after cesarean section have a five to twenty-times greater chance of getting an infection compared with women who give birth vaginally. Even though many efforts tried by the government and non-government organization in Ethiopia, a non-significant decline achieved and post cesarean section surgical site infection is still a problem. Scientific evidence on this is a step ahead for preventing and reducing post cesarean section surgical site infection. Therefore this study aimed to assess magnitude and risk factors of post cesarean section surgical site infection at primary hospitals of East Gojjam Zone, Northwest Ethiopia. Methods Institution based cross sectional study with retrospective chart review was conducted from September 10–30 /2020 at primary hospitals of east Gojjam zone. The data was entered in Epi data version3.1 and exported to Statistical Package for Social Science Software version 26. Presence and degree of association of factors with outcome variable were computed through logistic regression analysis. Factors with P value ≤ 0.2 in bi variable logistic regression analysis were included in the multivariable logistic regression analysis and those variables with P-value of < 0.05 in multivariable analysis were considered statistically significant. Result From 622 medical records of women who underwent cesarean section, 77 (12.4%) of them were developed surgical site infection. Rural residence [(AOR = 2.30, 95%CI :( 1.295, 4.098)], duration of labor greater than 24hrs [(AOR = 3.48, 95%CI :( 1.495, 8.086)], rupture of

Predictors of cranioplasty complications in stroke and trauma patients

2013 ◽  
Vol 118 (4) ◽  
pp. 757-762 ◽  
Author(s):  
Brian P. Walcott ◽  
Churl-Su Kwon ◽  
Sameer A. Sheth ◽  
Corey R. Fehnel ◽  
Robert M. Koffie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Surgical Site Infection ◽  
Logistic Regression Analysis ◽  
Therapeutic Indication ◽  
Patient Specific ◽  
Time Interval ◽  
Site Infection ◽  
Preservation Method

Object Decompressive craniectomy mandates subsequent cranioplasty. Complications of cranioplasty may be independent of the initial craniectomy, or they may be contingent upon the craniectomy. Authors of this study aimed to identify surgery- and patient-specific risk factors related to the development of surgical site infection and other complications following cranioplasty. Methods A consecutive cohort of patients of all ages and both sexes who had undergone cranioplasty following craniectomy for stroke or trauma at a single institution in the period from May 2004 to May 2012 was retrospectively established. Patients who had undergone craniectomy for infectious lesions or neoplasia were excluded. A logistic regression analysis was performed to model and predict determinants related to infection following cranioplasty. Results Two hundred thirty-nine patients met the study criteria. The overall rate of complication following cranioplasty was 23.85% (57 patients). Complications included, predominantly, surgical site infection, hydrocephalus, and new-onset seizures. Logistic regression analysis identified previous reoperation (OR 3.25, 95% CI 1.30–8.11, p = 0.01) and therapeutic indication for stroke (OR 2.45, 95% CI 1.11–5.39, p = 0.03) as significantly associated with the development of cranioplasty infection. Patient age, location of cranioplasty, presence of an intracranial device, bone flap preservation method, cranioplasty material, booking method, and time interval > 90 days between initial craniectomy and cranioplasty were not predictive of the development of cranioplasty infection. Conclusions Cranioplasty complications are common. Cranioplasty infection rates are predicted by reoperation following craniectomy and therapeutic indication (stroke). These variables may be associated with patient-centered risk factors that increase cranioplasty infection risk.

Surgical site infection risk following cesarean deliveries covered by Medicaid or private insurance

2019 ◽  
Vol 40 (6) ◽  
pp. 639-648 ◽  
Author(s):  
Sarah H. Yi ◽  
Kiran M. Perkins ◽  
Sophia V. Kazakova ◽  
Kelly M. Hatfield ◽  
David G. Kleinbaum ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Cesarean Delivery ◽  
Private Insurance ◽  
Site Infection ◽  
Cesarean Deliveries ◽  
Need To Evaluate ◽  
Study Population ◽  
Facility Level ◽  
Primary Payer

AbstractObjective:To compare risk of surgical site infection (SSI) following cesarean delivery between women covered by Medicaid and private health insurance.Study design:Retrospective cohort.Study population:Cesarean deliveries covered by Medicaid or private insurance and reported to the National Healthcare Safety Network (NHSN) and state inpatient discharge databases by hospitals in California (2011–2013).Methods:Deliveries reported to NHSN and state inpatient discharge databases were linked to identify SSIs in the 30 days following cesarean delivery, primary payer, and patient and procedure characteristics. Additional hospital-level characteristics were obtained from public databases. Relative risk of SSI by primary payer primary payer was assessed using multivariable logistic regression adjusting for patient, procedure, and hospital characteristics, accounting for facility-level clustering.Results:Of 291,757 cesarean deliveries included, 48% were covered by Medicaid. SSIs were detected following 1,055 deliveries covered by Medicaid (0.75%) and 955 deliveries covered by private insurance (0.63%) (unadjusted odds ratio, 1.2; 95% confidence interval [CI], 1.1–1.3; P < .0001). The adjusted odds of SSI following cesarean deliveries covered by Medicaid was 1.4 (95% CI, 1.2–1.6; P < .0001) times the odds of those covered by private insurance.Conclusions:In this, the largest and only multicenter study to investigate SSI risk following cesarean delivery by primary payer, Medicaid-insured women had a higher risk of infection than privately insured women. These findings suggest the need to evaluate and better characterize the quality of maternal healthcare for and needs of women covered by Medicaid to inform targeted infection prevention and policy.

scholarly journals Transepithelial photorefractive keratectomy for myopia: effect of age and keratometric values

2021 ◽  
Vol 14 (5) ◽  
pp. 744-749
Author(s):  
Amanda Nur Shinta Pertiwi ◽  
◽  
Agus Supartoto ◽  
Wasisdi Goenawan ◽  
Suhardjo Suhardjo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Older Age ◽  
Photorefractive Keratectomy ◽  
Bivariate Logistic Regression ◽  
Myopic Astigmatism ◽  
Effect Of Age ◽  
Preoperative Factors

AIM: To investigate demographic and preoperative factors increasing the risk of ametropia following transepithelial photorefractive keratectomy (transPRK) in myopia and myopic astigmatism. METHODS: This retrospective cohort study included myopic eyes (-0.50 to -8.75 D) with or without astigmatism (up to 3.50 D) enrolled at Dr. Yap Eye Hospital Yogyakarta. TransPRK was performed using Technolaz 217z100 excimer laser. Subjects were clustered into ametropia and emmetropia group based on uncorrected distance visual acuities (UDVA) 3mo post-operatively. Multiple preoperative and intraoperative parameters were analyzed using Logistic regression to obtain their effect on ametropia risk following transPRK. RESULTS: A total of 140 eyes of 87 consecutive subjects were studied. Prevalence of ametropia following transPRK was 20 (14.29%) eyes. Subjects in ametropia group were significantly older than the emmetropia group (31.80±14.23 vs 18.88±2.41, respectively; P&#x003C;0.001). Bivariate Logistic regression analysis showed that older age (OR=1.23), higher preoperative spherical equivalent (&#x003E;-6 D; OR=12.78), steeper anterior keratometric readings (Kmax&#x003E;45 D and mean K&#x003E;44 D; OR=4.28 and 4.35, respectively) increased the risk of ametropia following transPRK. Adjusted multivariate Logistic regression analysis showed that age was the strongest predictor for the incidence of ametropia following transPRK. Complications of transPRK were overcorrection, suspected posterior keratoectasia and accommodation insuffiency. CONCLUSION: Older age can be the strongest factor for increasing ametropia risk following transPRK. Cut-off points of Kmax and mean K at 45 and 44 D respectively are proposed as the predictors for ametropia following transPRK.

scholarly journals Association of cesarean birth with prevalence of functional constipation in toddlers at 3 years of age: results from the Japan Environment and Children’s Study (JECS)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mari Nakamura ◽  
Kenta Matsumura ◽  
Yoshiko Ohnuma ◽  
Taketoshi Yoshida ◽  
Akiko Tsuchida ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Cesarean Delivery ◽  
Logistic Regression Analysis ◽  
Subsequent Development ◽  
Functional Constipation ◽  
Birth Cohort Study ◽  
Delivery Mode ◽  
Odds Ratios ◽  
Old Japanese

Abstract Background The association between delivery mode and subsequent development of diseases is a growing area of research. Cesarean delivery affects the diversity of the microbiota in the infant gut, which may be associated with gastrointestinal disorders, including functional constipation, in infants. In this study, we investigated the association between delivery mode and prevalence of functional constipation in 3-year-old Japanese toddlers. Methods This study used data from the Japan Environment and Children’s Study, an ongoing nationwide birth cohort study. We analyzed 71,878 toddler–mother pairs. The presence of functional constipation was determined according to the Rome III diagnostic criteria. Odds ratios and 95% confidence intervals were calculated using logistic regression analysis. Results The prevalence of functional constipation in 3-year-old Japanese toddlers was estimated to be 12.3%. Logistic regression analysis revealed that the prevalence of functional constipation was higher in toddlers born by cesarean delivery (13.1%) compared with those born by vaginal delivery (12.1%), independent of 22 confounders (adjusted odds ratios = 1.064, 95% confidence interval = 1.004–1.128). Conclusions We determined the prevalence of functional constipation in 3-year-old Japanese toddlers and found that delivery mode was associated with the prevalence of functional constipation in Japanese toddlers.

ANALISIS HUBUNGAN SARANA, PENGETAHUAN, DAN SIKAP BIDAN PRAKTIK MANDIRI DENGAN KEPATUHAN MENJALANKAN STANDAR PELAYANAN ANTENATAL CARE DI KOTA PADANGSIDIMPUAN

2019 ◽  
Vol 2 (1) ◽  
pp. 27-33
Author(s):  
Megawati Sinambela ◽  
Evi Erianty Hasibuan
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Logistic Regression Analysis ◽  
Care Service ◽  
Multivariate Logistic Regression Analysis ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
The North

Antenatal care is a service provided to pregnant women to monitor, support maternal health and detect mothers whether normal or problematic pregnant women. According to the WHO, globally more than 70% of maternal deaths are caused by complications of pregnancy and childbirth such as hemorrhage, hypertension, sepsis, and abortion. Based on data obtained from the profile of the North Sumatra provincial health office in 2017, in the city of Padangsidimpuan in 2017 the coverage of ANC visits reached (76.58%) and had not reached the target in accordance with the 2017 Provincial Health Office strategy plan (95%). This type of research was an observational analytic study with a cross sectional design. The population in this study were independent practice midwives who were in the Padangsidimpuan, the sample in this study amounted to 102 respondents. The technique of collecting data used questionnaires and data analysis used univariate, bivariate and multivariate analysis with logistic regression analysis. Based on bivariate analysis showed that there was a relationship between facilities, knowledge and attitudes of independent midwives with compliance with the standards of antenatal care services with a value of p <0.05. The results of the study with multivariate logistic regression analysis showed that the factors associated with the compliance of independent midwives in carrying out antenatal care service standards were attitudes with values (p = 0.026).

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