scholarly journals Use of Renin-Angiotensin System Blockers Increases Serum Potassium in Anuric Hemodialysis Patients

2018 ◽  
Vol 48 (2) ◽  
pp. 79-86 ◽  
Author(s):  
Ezio Movilli ◽  
Corrado Camerini ◽  
Paola Gaggia ◽  
Roberto Zubani ◽  
Giovanni Cancarini
Keyword(s):  
Blood Pressure ◽  
Serum Potassium ◽  
Hemodialysis Patients ◽  
K Value ◽  
Interdialytic Weight Gain ◽  
Increased Risk ◽  
Dialysis Vintage ◽  
Significant Difference ◽  
Severe Hyperkalemia ◽  
The Mean

Background: Angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) are increasingly used in uremic patients (pts). However, their effect on serum potassium (sK) concentrations in anuric pts on chronic hemodialysis treatment (HD) is controversial. The aim of the study was to evaluate sK before and after the start of ACEi/ARB therapy. Methods: In the period 1/1/2015 – 31/12/2015, 112 out of 240 prevalent HD pts on thrice weekly HD treatment followed at our institution started the ACEi/ARB therapy. The mean age was 67 ± 14 years, 67/112 were men, dialysis vintage was 6–212 months. In the 3 months before (PRE; N° 36 HD sessions) and after (POST; N° 36 HD sessions) the start of ACEi/ARB therapy, the following variables were evaluated in pre dialysis after the long interdialysis interval: sK (mean of 12 determinations; mmol/L), maximum sK (maximum K value observed during observations; sKmax; mmol/L), serum sodium (sNa; mmol/L), pre dialysis systolic blood pressure (SBP; mm Hg) and diastolic blood pressure (DBP; mm Hg), body weight (BW; Kg), interdialytic weight gain (IWG; Kg), Kt/V, serum bicarbonate concentrations (sBic; mmol/L), protein catabolic rate (PCRn; g/KgBW/day). SBP, DBP, IWG are the mean of the 24 HD sessions. Out of 112 patients, 102 were on antihypertensive therapy. The duration of HD and blood and dialysate flow rates were kept constant. Data are expressed as mean ± SD. Student t test for paired and unpaired data for normally distributed variables, Mann-Whitney test for medians, χ2 test for categorical data were employed to compare groups. A significant difference was defined as p < 0.05. Results: sK increased from 5.0 ± 0.4 mmol/L PRE to 5.7 ± 0.5 mmol/L POST (p < 0.0001). sKmax increased from 5.3 ± 0.5 mmol/L PRE to 6.2 ± 0.6 mmol/L POST (p < 0.0001). The percentage of pts with normal sK concentrations decreased from 82% PRE to 29% POST (p < 0.0001). Mild hyperkalemia increased from 18 to 52% (p < 0.001); in 31% of the patients, it was necessary to reduce the K dialysate concentration. None of the patients had severe hyperkalemia PRE, but 19% developed severe hyperkalemia POST (p < 0.0001) necessitating treatment withdrawal. Mean sK in these pts varied from 5.2 ± 0.3 mmol/L PRE to 6.5 ± 0.2 mmol/L at the moment of withdrawal (p < 0.0001) and sKmax from 5.5 ± mmol/L PRE to 6.9 ± 0.3 mmol/L (p< 0.0001). After withdrawal of ACEi/ARB, sK and sKmax concentrations decreased to basal levels within 1 month. There were no significant changes of BW, IWG, SBP, DBP, Na, Hb, Kt/V, sBic, and PCRn in both periods. Conclusions: ACEi/ARB therapy is associated with an increased risk of hyperkalemia in anuric hemodialysis patients. The proportion of patients with normal sK concentrations decreased from 82 to 29% and with mild hyperkalemia increased from 18 to 52%. Severe hyperkalemia necessitating the interruption of ACEi/ARB therapy developed in 19% of patients. This suggests great caution in the widest utilization of this class of drugs in HD patients.

Comparing the effects of cold compress and Xyla-p cream on hemodynamic changes in hemodialysis patients during venipuncture

2019 ◽  
Vol 17 (2) ◽  
Author(s):  
Ziba Ghoreyshi ◽  
Monireh Amerian ◽  
Farzaneh Amanpour ◽  
Reza Mohammadpourhodki ◽  
Hossein Ebrahimi
Keyword(s):  
Blood Pressure ◽  
Physiological State ◽  
Vital Signs ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Intermittent Hemodialysis ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
The Difference

AbstractBackgroundThe vital signs reflect the physiological state of patients in various clinical conditions. The purpose of this study was to compare the effects of cold compress and Xyla-P cream on hemodynamical changes during venipuncture in hemodialysis patients.Methods and MaterialIn this clinical trial study, 50 patients under hemodialysis were selected by simple random sampling. The patients were then randomly assigned to either Xyla-P cream, cold compress or placebo groups. The vital signs (blood pressure and pulse) were measured upon two intermittent hemodialysis sessions before and after venipuncture. Data were analyzed using repeated measures analysis of variance.ResultsThe mean alternation in systolic blood pressure was significantly different comparing the placebo and cold compress groups before and after intervention (p<0.001). However, the difference was not significant between the Xyla-P cream group and either placebo (p=0.402) or ice compress (p=0.698) groups. The difference of the mean diastolic blood pressure was significant comparing the placebo group with either the Xyla-P cream group (p=0.003) or cold compress group (p<0.001) before and after intervention. In addition, there was a significant difference in the mean number of heartbeats comparing the control group with either the Xyla-P cream group (p<0.001) or cold compress group (p<0.001) before and after the intervention.ConclusionsConsidering the beneficial effects of ice compress and the Xyla-P cream on reduction of cardiovascular parameters, it is recommended to use these methods in hemodialysis patients during venipuncture.

scholarly journals P1584FRAILTY IN MAINTENANCE HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Zauresh Amreyeva ◽  
Gulnar Chingayeva ◽  
Abay Shepetov ◽  
Assiya Kanatbayeva ◽  
Arina Yespotayeva
Keyword(s):  
Nutritional Status ◽  
Elderly Patients ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Measurement Tool ◽  
Frail Patients ◽  
Dialysis Vintage ◽  
Significant Difference ◽  
The Mean ◽  
Elderly Hemodialysis Patients

Abstract Background and Aims The population in Kazakhstan is rapidly aging, as a result the number of geriatric patients on maintenance hemodialysis (MHD) has been increasing. Frailty is prevalent in dialysis patients and is one of the common factors that can lead to increased morbidity and mortality. The primary objectives of this study were to evaluate the prevalence of frailty in elderly patients on MHD by using Edmonton Frailty Scale and assess their association with clinical and laboratory measurements. A secondary objective was to investigate the relationship between nutritional status and frailty. Method From July to September 2018, a total of 65 elderly patients undergoing HD in 7 dialysis facilities in Almaty, Kazakhstan were enrolled in this cross-sectional study. All participants were evaluated for the cognitive status through Mini-Mental State Examination (MMSE), nutritional status by using Mini Nutritional Assessment (MNA), Malnutrition-Inflammation Score (MIS), and anthropometric measurements (body mass index (BMI), triceps skinfold (TSF), mid-arm muscle circumference (MAMC)), functionality (Handgrip strength), as well biochemical data were collected from medical records. Frailty was defined in accordance with the Edmonton Frail scale (EFS). Results The study participants’ median age was 69 (range: 65–88) years old, and median dialysis vintage was 36 (IQR 15–60) months, 53.8% were female. The main comorbidities were hypertension (69.2%) and diabetes (35.4%). The prevalence of frailty assessed by the EFS was 23.1% (men: 13.3%; women: 86.7), 43.1% patients were non-frail (men: 64.3%; women: 35.7%), 33.8% patients were vulnerable (men: 45.5%; women: 54.5%). Based on MIS the prevalence of PEW was 73.8% and, according to MNA, the risk of malnutrition was detected in 47.7%, and 9.2% had malnutrition. No significant difference was observed between genders in the frequency of PEW. Mean body weight was 69.1±11.3kg, the mean BMI was slightly overweight 25.6±4.29kg/m2, while hand-grip strength was 21.33±3.36 in men and 15.5±5.51 in women, p=0.008, and it is lower than the normal population standard values. The frail patients group had a higher proportion of women 86.7% (p=0.001), worse nutritional status (93.3% and 86,7% had PEW evaluated by MIS (p=0.018) and MNA (p=0.035), respectively), more frequency of falls (p=0.01), anemia (p=0.038) when compared to group of non-frail and vulnerable patients. 66.7% of frail patients were widowed (p=0.005). The mean MMSE in this group of patients was 26.7±1.9. Conclusion The prevalence of frailty among elderly hemodialysis patients in this study was 23.1%, and we detected that 86.7% of them were female, as well PEW increased in frail patients. Also the study showed that protein-energy wasting is common among elderly hemodialysis patients. Its prevalence varies between 73.8% and 56.9% depending on the measurement tool used to evaluate the nutritional status. In our country with limited resources, EFS, MIS and MNA could help to follow elderly hemodialysis patients.

scholarly journals The Effect of Dialysis Solution Temperature and Stepwise Ultrafiltration Profile on Dialysis Adequacy and Pruritus in Hemodialysis Patients: A Quasi-experimental Study

2021 ◽  
Vol 9 (4) ◽  
Author(s):  
Abdolhamid Jamshidzehi ◽  
Fatemeh Kiyani ◽  
Salahuddin Boya ◽  
Hasan Askari ◽  
Farshid Saeedinezhad
Keyword(s):  
Standard Deviation ◽  
Hemodialysis Patients ◽  
Solution Temperature ◽  
Dialysis Adequacy ◽  
Dialysis Solution ◽  
Increased Risk ◽  
Significant Difference ◽  
Before And After ◽  
Quasi Experimental ◽  
The Mean

Background: Patients with renal insufficiency who receive hemodialysis should be continuously monitored to avoid possible complications, as they are at increased risk of several problems, including pruritus, as one of the most annoying problems. It seems that dialysis adequacy affects the pruritus of hemodialysis patients. Objective: The current study aimed to investigate the effect of dialysis solution temperature and stepwise ultrafiltration profile on dialysis adequacy and pruritus of hemodialysis patients. Methods: Following a single group quasi-experimental design, 34 eligible hemodialysis patients admitted to the hemodialysis ward of Zahedan Medical Center (Iran) in 2020 were recruited using the convenience sampling technique. All patients attended three standard dialysis sessions (at a temperature of 37°C) and three cold dialysis sessions (36°C) with a stepwise dialysis ultrafiltration profile. Dialysis adequacy was measured at the end of each session, and Yosipovitch’s Pruritus Severity Scale (PSS) was filled before and after each dialysis session. Data were summarized using descriptive statistics (i.e., frequency, mean, and standard deviation). Mean scores before and after dialysis were paired by t-test using SPSS version 22. Statistical significance was considered when P-value < 0.05. Results: The mean and standard deviation of dialysis adequacy in both standard dialysis and cold dialysis techniques with stepwise ultrafiltration profile were 1.18 ± 0.36 and 1.44 ± 0.48, respectively, indicating that dialysis adequacy of the cold dialysis method with stepwise ultrafiltration profile was significantly higher (P = 0.001). Besides, the mean pruritus scores in the standard dialysis and cold dialysis methods with stepwise ultrafiltration profile were -0.73 ± 0.80 and -1.73 ± 1.16, respectively, showing a significant difference (P = 0.001). Conclusions: Cold hemodialysis with a stepwise ultrafiltration profile can be used as a simple and low-cost technique to improve both dialysis adequacy and relieve pruritus in hemodialysis patients.

Elevation of pulse pressure in middle age is associated with the risk of dementia: data from a population-based cohort

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Kim ◽  
H Jung ◽  
P.S Yang ◽  
H.T Yu ◽  
T.H Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pulse Pressure ◽  
Middle Age ◽  
Population Based ◽  
Entire Cohort ◽  
Incident Dementia ◽  
Increased Risk ◽  
Diagnosis Of Dementia ◽  
History Of ◽  
The Mean

Abstract Aims Pulse pressure (PP) is a well-known risk factor for cardiovascular disease. However, the association between the PP and dementia is not well identified. This study aimed to determine the effect of PP on the risk of dementia development in different age subgroups using a longitudinal, population-based, and stroke-free cohort from the general population. Methods The association of PP with the development of incident dementia was assessed from January 1, 2005, to December 31, 2013, in 433,154 participants without a history of dementia or stroke from the Korea National Health Insurance Service-Health Screening cohort. The diagnosis of dementia was defined using the 10th revision of the International Classification of Disease codes. Results The mean age of the cohort was 55.7±9.2 years, 45.7% were women. Hypertension was 23.6%. The mean systolic and diastolic blood pressure of the entire cohort were 125.9±16.6 and 78.4±10.7 mmHg, respectively. Mean PP was 47.5±10.9 mmHg. In the middle-age group (40 to 50 year-old), increasing of 10 mmHg of PP was associated with incident dementia after adjusting mean blood pressure and clinical variables with a hazard ratio (HR) of 1.21 (95% confidence interval [CI]: 1.19–1.23, p&lt;0.001). The association was still significant even after censoring for stroke (HR: 1.16, 95% CI: 1.08–1.22, p&lt;0.001). In the older population, elevation of PP was not associated with dementia development (HR: 0.98, 95% CI: 0.95–1.01, p=0.247) Conclusion PP was associated with increased risk of dementia only in middle-aged population beyond that of mean arterial pressure. Funding Acknowledgement Type of funding source: None

MO570PULSE PRESSURE: A PREDICTOR OF CARDIOVASCULAR CALCIFICATION AND CARDIOVASCULAR MORTALITY IN HEMODIALYSIS PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Merita Rroji (Molla) ◽  
Saimir Seferi ◽  
Majlinda Cafka ◽  
Erjola Likaj ◽  
Vilma Cadri ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Abdominal Aorta ◽  
Cardiovascular Mortality ◽  
Pulse Pressure ◽  
Univariate Analysis ◽  
Hemodialysis Patients ◽  
Case Series Study ◽  
Increased Risk ◽  
Elevated Systolic Blood Pressure

Abstract Background and Aims The mortality rate is extremely high in chronic kidney disease (CKD), primarily due to the high prevalence of cardiovascular disease (CVD). Increased pulse pressure (PP), defined as the difference between inappropriately elevated systolic blood pressure (SBP) and reduced diastolic blood pressure (DBP) at any value of mean arterial pressure (MAP), is a surrogate measure of increased arterial stiffness of central elastic arteries (aorta and its major branches). CKD-MBD anomalies leading to calcification contribute to increased arterial stiffness and pulse pressure. This study aimed to evaluate the relationship of pulse pressure parameter with valve calcification and abdominal aortic calcification in hemodialysis patients and its impact on cardiovascular mortality. Method We performed a prospective case series study with 3 years follow- up. Plain X-ray images of the lateral lumbar spine from all subjects were studied to obtain images of the lower abdominal aorta using semiquantitative scores as described by Kauppila et al. Cardiac valve calcifications were evaluated by two-dimensional echocardiography with an HDI 5000 Sono CT echocardiographic machine with a 3.3-MHz multiphase array probe in subjects lying in the left decubitus position an according to the recommendations of the European Association of Echocardiography. The patient was evaluated as having vascular calcification if he had the presence of calcification in at least one of the site examined: a mitral valve, aortic valve or abdominal aorta. Results We studied 85 chronic stable hemodialysis patients. Mean age and meantime is therapy was 49.9±12.4 years and 51.5±28.7 months, respectively. Mean pulse pressure was 55.72±14.2 mmHg. Fifty-nine patients (69.4%) were identified with aortic abdominal calcification, and the mean Kauppila score was 4.91 ± 4.05. Sixty patients (70.5%) had at least one valve calcified, while thirty-three patients (38.8%) had both valves calcified. Univariate analysis revealed that every 1 mmHg increase in pulse pressure was associated with increased cardiovascular calcification risk p=0.020. In multivariate analysis, after adjustment for age, gender, diabetes mellitus, cholesterol, and triglyceride serum levels, the association also remained strong, where every increase of 1 mm Hg in pulse pressure was associated with increased risk for cardiovascular calcification (HR 1.02, 95% CI (1.00-1.03), p= 0.038). Besides, pulse pressure was an independent predictor for cardiovascular mortality (HR 1.03, 95% CI (1.02-1.05), p=0.002). Conclusion Pulse pressure may identify hemodialysis patients with subclinical cardiovascular calcification who need further evaluation. Wide pulse pressure is associated with increased cardiovascular mortality.

scholarly journals RELATIONSHIP BETWEEN INTERDIALYTIC WEIGHT GAIN AND PRE HEMODIALYSIS BLOOD PRESSURE IN HEMODIALYSIS PATIENTS

2020 ◽  
pp. 169-171
Author(s):  
M Manasa ◽  
Aravind Reddy. Gangula
Keyword(s):  
Blood Pressure ◽  
Weight Gain ◽  
Water Retention ◽  
Salt Intake ◽  
Hemodialysis Patients ◽  
Interdialytic Weight Gain ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Relationship ◽  
Esrd Patients

Interdialytic weight gain in patients with hemodialysis depends on fluid, salt intake in interdialytic period and compliance of dialysis patients. In end stage renal disease(ESRD) patients due to decreased and absent residual urine output there is salt and water retention in body which leads to interdialytic weight gain. Overhydration and IDWG is assumed to be the main cause of pre hemodialysis raised blood pressure(BP) in ESRD patients. Here the relationship between IDWG and pre HD blood pressure is studied in 40 hemodialysis patients. We recorded pre HD BP and IDWG in four subsequent hemodialysis sessions for each patient during the period of 2 weeks in patients who are on twice weekly hemodialysis. so, in total we studied 160 hemodialysis sessions. Mean of four pre HD BP is compared with mean of four IDWG for each patient. Then correlation between 40 mean IDWG and 40 mean pre HD BP is studied and also correlation between IDWG and pre HD blood pressure during 160 hemodidlysis sessions studied individually.

Abstract 240: Hypertension Prevalence and Management Among Adult Congenital Heart Disease Patients

Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
Joshua R Thomas ◽  
Ricky T Munoz ◽  
Mark D Fox ◽  
Angela T Yetman
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
Hypertension Prevalence ◽  
Significant Difference ◽  
Adult Congenital ◽  
The Mean

Background: Cardiovascular risk factors (CRFs) are poorly defined among the population of adults with congenital heart disease. In particular, the prevalence of pre-hypertension (pre-HTN) and hypertension (HTN) are currently unknown. Objective: To determine the prevalence of pre-HTN and HTN among adults with congenital heart disease; and to assess HTN control rates among different clinic types. Methods: A retrospective analysis of a cohort of adults with congenital heart disease (CHD) was conducted. Data regarding CHD patients' blood pressure (BP), medications, and provider specialty were analyzed. Results: The cohort consisted of 971 patients. The mean age was 30.4 years (SD = 10.4), with 51% male. Thirty-two percent had HTN (n = 304). There was no statistically significant difference in the prevalence of Pre-HTN and HTN by clinic type (i.e. specialty vs. non-specialty)( p = .225, p= .633 respectively). However, a statistically significant association exists between clinic type and HTN control rates χ 2 (1) = 3.185, p = .07 (Table 1). Those receiving care from a specialty clinic are 1.6 times more likely to have controlled HTN. Conclusions: Pre-HTN and HTN are common among adults with congenital heart disease. These CRFs are better managed in specialty clinics devoted to this population.

The Effect of Dhamma Practice on Depression Outcomes in Hemodialysis Patients

2021 ◽  
Vol 104 (1) ◽  
pp. 44-51
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Statistical Significance ◽  
Bodily Pain ◽  
Laboratory Data ◽  
Hemodialysis Patients ◽  
Study Results ◽  
Dialysis Vintage ◽  
Severity Of Depression

Background: Depression impairs the quality of life (QOL), increases risk of hospitalization and death in hemodialysis patients. Antidepressant medications can lead to more severe side effects. Dhamma practice by Chanting and Anapanasati meditation may relieve depressive symptoms in hemodialysis patients. Objective: To evaluate the effect of Dhamma practice on depression outcome and QOL in hemodialysis patients. Materials and Methods: The authors conducted a quasi-experimental research, a time series design. Patients who were hemodialyzed three times a week at Bhumirajanagarindra Kidney Institute Hospital were enrolled. Participants were trained to practice the Chanting with Anapanasati meditation for 35 minutes every hemodialysis session for six months. Comparison of depression scores, severity of depression, QOL, vital signs, laboratory data, and biomarkers (F2-isoprostanes) was made between the beginning and the end of the study. Results: Forty patients were eligible for participation in the present study. The average age was 63.7±13.1 years. Median dialysis vintage was 29.5 months. After Dhamma practice for six months, diastolic blood pressure was decreased significantly (p=0.015). Median depression score decreased from 9.5 to 4 (p<0.001). The proportion of depressive patients were decreased from 17.5% to 2.5%. The severity of depression trended to decrease, but without statistical significance. F2-isoprostanes was decreased significantly (p<0.001). Both physical aspects (role physical, bodily pain, and physical component scale) and mental aspects (vitality, role emotional, mental health, and mental component scale) of QOL were significantly improved. Conclusion: Dhamma practice by Chanting and Anapanassati meditation significantly decreased blood pressure, and depression, and improved QOL both physically and mentally, in hemodialysis patients. Keywords: Depression, Quality of life, Hemodialysis, Meditation, Buddhist chanting, Dhamma.

Abstract 17292: Does Morbid Obesity Worsens Outcomes in COVID-19?

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sohaib Roomi ◽  
Waqas Ullah ◽  
Nayab Nadeem ◽  
Rehan Saeed ◽  
Donald Haas ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Mechanical Ventilation ◽  
Hospital Mortality ◽  
Invasive Mechanical Ventilation ◽  
Multivariate Logistic Regression Analysis ◽  
Odds Ratios ◽  
Increased Risk ◽  
Significant Difference ◽  
The Mean ◽  
Mean Differences

Introduction: Given the high prevalence of obesity around the globe, patients with coronavirus disease 2019 (COVID-19) are at an increased risk of devastating complications. Hypothesis: We hypothesize that morbid obesity is independently associated with increased risk of in-hospital mortality, upgrade to intensive care unit, invasive mechanical ventilation(IVM), and acute renal failure necessitating dialysis. Methods: A retrospective cohort study was performed to determine the association of basal metabolic index (BMI) with the above-mentioned outcomes. Independent t-test and multivariate logistic regression analysis were performed to calculate mean differences and adjusted odds ratios (aOR) with its 95% confidence interval (CI), respectively. Results: A total of 176 patients with confirmed COVID-19 diagnosis were included. The mean age was 62.2 years, with 51% of male patients. The mean BMI for non-surviving patients was significantly higher compared to patients surviving on the 7th day of hospitalization (35 vs. 30 kg/m2, p=0.022) and patients with a higher BMI had higher in-hospital mortality (21% vs. 9%, OR 3.2, 95% CI 1.3-8.2, p=0.01) compared to patients with a normal BMI. Similarly, patients requiring IMV had a higher BMI (33 vs. 29, p=0.002) compared to non-intubated patients. aOR of patients needing IMV (56% vs. 28%, OR 3.3, 95% CI 1.6-7.0, p=0.002) and upgrade to ICU (46% vs. 28%, OR 2.2, 1.07-4.6, p=0.04) were significantly higher compared to patients with a lower BMI. There was no significant difference between the two groups in terms of the need for dialysis (5% vs. 13%, OR 3.8, 13% vs. 4%, 1.1-14.1, p=0.07). Adjusted odds ratios controlled for baseline comorbidities and medications mirrored the overall results, except for the need to upgrade to ICU. Conclusions: In patients with confirmed COVID-19, morbid obesity serves as an independent risk factor of high in-hospital mortality and the need for invasive mechanical ventilation.

Tear Rates of the Ipsilateral ACL Graft and the Contralateral Native ACL Are Similar following ACL Reconstruction

2020 ◽  
Author(s):  
Nadia Nastassia Ifran ◽  
Ying Ren Mok ◽  
Lingaraj Krishna
Keyword(s):  
Acl Reconstruction ◽  
Medical Records ◽  
Cruciate Ligament ◽  
Acl Graft ◽  
Increased Risk ◽  
Significant Difference ◽  
The Mean ◽  
Anterior Cruciate ◽  
Mean Time

AbstractThe aim of the study is to compare the tear rates of ipsilateral anterior cruciate ligament (ACL) grafts and the contralateral native ACL as well as to investigate the correlation of gender, age at time of surgery, and body mass index (BMI) with the occurrence of these injuries. The medical records of 751 patients who underwent ACL reconstruction surgery with follow-up periods of 2 to 7 years were retrospectively analyzed. Survival analyses of ipsilateral ACL grafts and contralateral native ACL were performed. Univariate and multivariate logistic regression analyses were performed to identify risk factors that were associated with these injuries. The tear rates of the ipsilateral ACL graft and contralateral ACL were 5.86 and 6.66%, respectively with no significant difference between groups (p = 0.998). The mean time of tears of the ipsilateral ACL and contralateral ACL was also similar (p = 0.977) at 2.64 and 2.78 years, respectively after surgery. Both the odds of sustaining an ipsilateral ACL graft and contralateral ACL tear were also significantly decreased by 0.10 (p = 0.003) and 0.14 (p = 0.000), respectively, for every 1-year increase in age at which the reconstruction was performed. However, graft type, gender, and BMI were not associated with an increased risk of these injuries. There was no difference between tear rates of ipsilateral ACL graft and contralateral ACL following ACL reconstruction. Patients who undergo ACL reconstruction at a young age are at an increased risk of both ipsilateral graft and contralateral ACL rupture after an ACL reconstruction. Patients who are young and more likely to return to competitive sports should be counselled of the risks and advised to not neglect the rehabilitation of the contralateral knee during the immediate and back to sports period of recovery. This is a Level III, retrospective cohort study.

Sign in / Sign up

Export Citation Format

Share Document