scholarly journals Risk Factors Associated with Major Complications after Ultrasound-Guided Percutaneous Renal Biopsy of Native Kidneys

2019 ◽  
Vol 45 (1) ◽  
pp. 122-130 ◽  
Author(s):  
Beatriz Pombas ◽  
Eva Rodríguez ◽  
Juan Sánchez ◽  
Aleksandar Radosevic ◽  
Javier Gimeno ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Blood Transfusion ◽  
Renal Biopsy ◽  
Categorical Variables ◽  
Ultrasound Guided ◽  
Factors Associated ◽  
Percutaneous Renal Biopsy ◽  
Major Complications ◽  
Increased Risk

Introduction: Percutaneous renal biopsy (PRB) of native kidneys is an important tool for diagnosis and management of renal disease. In this study, we analyzed the success, safety, and risk complications of PRB in our center. Methods: A retrospective review of ultrasound-guided PRB done at our institution from January 1998 to December 2017 was performed. Clinical and laboratory data were collected for 661 PRBs. Statistical analysis was performed using the Mann-Whitney U test for continuous variable and chi-square test for categorical variables. Multivariate analysis using logistic regression was performed to assess factors associated with increased risk of complications after PRB. Results: The median age was 56 (42–68) years old, the majority were male (64%) and white (82%). Ten glomeruli were present in 63.5% of PRBs. Overall, the rate of complications was 16.6%, where 15.1% of them were minor complications and 1.5% were major complications. Perinephritic hematoma accounted for the minor complication that occurred most frequently, whereas the need of a blood transfusion was the prevalent for major complications. By multivariate analysis, increased activated partial thromboplastin time (aPTT; OR 1.11, 95% CI 1.035–1.180) and prebiopsy lower hemoglobin (Hgb; OR 1.61, 95% CI 1.086–2.304) were identified as independent risk factors for major complications. In addition, older patients (OR 1.057, 95% CI 1.001–1.117) were identified as an independent risk factor for blood transfusion requirement. Conclusion: The current risk of complications after native PRB is low. Major complications are most common in case of increased aPTT and decreased Hgb baseline level.

scholarly journals Percutaneous renal biopsy of native kidneys: efficiency, safety and risk factors associated with major complications

2011 ◽  
Vol 5 ◽  
pp. 823-831 ◽  
Author(s):  
Abel Torres Muňoz ◽  
Rafael Valdez-Ortiz ◽  
Carlos González-Parra ◽  
Elvy Espinoza-Dávila ◽  
Luis E. Morales-Buenrostro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Biopsy ◽  
Factors Associated ◽  
Percutaneous Renal Biopsy ◽  
Major Complications

scholarly journals Life-Threatening Complications Following Percutaneous Ultrasound-Guided Renal Biopsy: a Rare Case Report

10.3823/2292 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Yuan-Hung Lo ◽  
Po-Jen Hsiao ◽  
Szu-Han Chiu ◽  
Kun-Lin Wu ◽  
Che-Fu Chang ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Hypovolemic Shock ◽  
Bleeding Complications ◽  
Ultrasound Guided ◽  
Basic Tool ◽  
Gross Hematuria ◽  
Percutaneous Renal Biopsy ◽  
Major Complications ◽  
Rare Case Report ◽  
Life Threatening

Ultrasound-guided percutaneous renal biopsy has been a basic tool for the diagnosis of kidney disease, but minor and major complications cannot be completely avoided. Major complications including gross hematuria, renal hematoma and arteriovenous fistula, and usually develop within 24 hours after renal biopsy. We present an educational case of female having major bleeding complications after renal biopsy with unusual clinical courses. The patient developed hypovolemic shock at 48 hours after renal biopsy along with perirenal hematoma and hemothorax.   The case highlight the need to remain the major complications in mind for physicians. Key words: Hemothorax, renal biopsy.

Septic Dermatitis of the Neonatal Scalp and Maternal Endomyometritis with Intrapartum Internal Fetal Monitoring

PEDIATRICS ◽  
1984 ◽  
Vol 74 (1) ◽  
pp. 81-85
Author(s):  
Marilyn M. Wagener ◽  
Russell Rule Rycheck ◽  
Robert B. Yee ◽  
Joanne F. McVay ◽  
Carol L. Buffenmyer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Significant Risk ◽  
Fetal Monitoring ◽  
Maternal Diabetes ◽  
Factors Associated ◽  
Increased Risk ◽  
Fetal Scalp ◽  
Pressure Catheter ◽  
Fetal Scalp Blood Sampling

During a 3-month period, 1,062 mother-infant pairs were studied for infections following internal fetal monitoring during labor. Six infants (0.56%) developed septic scalp dermatitis at the site of the spiral electrode application. Factors associated with septic scalp dermatitis included the number of vaginal examinations, the use of an intrauterine pressure catheter or of more than one spiral electrode, and fetal scalp blood sampling. Maternal diabetes and endomyometritis were also associated with an increased risk of scalp infection. The duration of spiral electrode use and duration of ruptured membranes were not significant risk factors. Endomyometritis was documented in 41 mothers, an overall incidence of 3.9%. In women whose babies were delivered by cesarean section, the incidence of endomyometritis was 28/117 (23.9%). Using multivariate analysis by logistic regression, endomyometritis was associated with the number of vaginal examinations during labor but not with the duration of internal monitoring, duration of labor, or duration of ruptured membranes.

scholarly journals Overweight is Associated With Increased Incidence of Minor Complications After Reduction Mammoplasty: A Retrospective Analysis of 453 Consecutive Cases

2018 ◽  
Vol 107 (3) ◽  
pp. 230-235 ◽  
Author(s):  
M. Sutinen ◽  
E. Eskelinen ◽  
M. Kääriäinen
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Multivariate Analysis ◽  
Retrospective Analysis ◽  
Body Mass ◽  
Significant Risk ◽  
Reduction Mammoplasty ◽  
Tertiary Referral Center ◽  
Major Complications ◽  
Increased Risk

Background and Aims: Reduction mammoplasty alleviates macromastia symptoms and improves quality of life. We investigated a large series of consecutive reduction mammoplasties to assess various risk factors for both minor and major complications after the procedure. Materials and Methods: A retrospective analysis of 453 consecutive reduction mammoplasties was performed between 2007 and 2010 at an academic tertiary referral center to evaluate risk factors and complications. Results: The incidence of minor and major complications was 40.5% and 8.8%, respectively. Patients with minor complications had both a significantly higher mean body mass index (30.2 vs 28.0) and sternal notch to nipple distance (33.9 vs 32.4 cm) than patients who recovered without complications (p < 0.001 for both comparisons), as well as more visits to the outpatient clinic (p < 0.001). In the multivariate analysis, body mass index was found to be the only significant risk factor for minor complications (p < 0.001). Furthermore, patients with body mass index higher than 27 had a 2.6-fold greater risk of minor complications (p < 0.001). An increase of one unit in body mass index increased the probability of minor complications by 14.1% (p < 0.001). 22 (4.9%) patients developed a hematoma requiring evacuation in the operating room. The mean body mass index of patients who developed a hematoma was 26.4, a value lower than that of patients without this complication (mean 29.0; p = 0.003). This finding was significant also in the multivariate analysis (p = 0.002). Conclusion: A higher body mass index was strongly associated with an increased risk of minor complications after reduction mammoplasty. It is important to inform obese patients about the increased risk of complications and to encourage them to lose weight before surgery.

scholarly journals Frequency, Timing, and Prediction of Major Bleeding Complications From Percutaneous Renal Biopsy

2020 ◽  
Vol 7 ◽  
pp. 205435812092352
Author(s):  
Melissa Schorr ◽  
Pavel S. Roshanov ◽  
Matthew A. Weir ◽  
Andrew A. House
Keyword(s):  
Retrospective Study ◽  
Blood Transfusion ◽  
Renal Biopsy ◽  
Major Bleeding ◽  
Bleeding Complications ◽  
Minor Bleeding ◽  
Risk Calculator ◽  
Ultrasound Guided ◽  
Percutaneous Renal Biopsy ◽  
C Statistic

Background and Objectives: The risk and timing of bleeding events following ultrasound-guided percutaneous renal biopsy are not clearly defined. Design setting, participants, and measurements: We performed a retrospective study of 617 consecutive adult patients who underwent kidney biopsy between 2012 and 2017 at a tertiary academic hospital in London, Canada. We assessed frequency and timing of minor (not requiring intervention) and major (requiring blood transfusion, surgery, or embolization) bleeds and developed a personalized risk calculator for these. Results: Bleeding occurred in 79 patients (12.8%; 95% confidence interval [CI]: 10.4%-15.7%). Minor bleeding occurred in 67 patients (10.9%; 95% CI: 8.6%-13.6%). Major bleeding occurred in 12 patients (1.9%; 95% CI: 1.1%-3.4%); 2 required embolization or surgery (0.3%; 95% CI: 0.09%-1.2%) and 10 required blood transfusion (1.6%; 95% CI: 0.9%-3.0%). Seventy-three of 79 events were identified immediately on post-procedure ultrasound (92.4% of cases; 95% CI: 84.4%-96.5%). Four of 617 patients experienced a minor event not detected immediately (0.6%; 95% CI: 0.3%-1.7%). Two patients (0.3%; 95% CI: 0.09%-1.2%) suffered a major complication that was not recognized immediately; both required blood transfusions only. There were no deaths or nephrectomies. A risk calculator using age, body mass index, platelet count, hemoglobin concentration, size of the target kidney, and whether the kidney is native, or an allograft predicted minor (C-statistic, 0.70) and major bleeding (C-statistic, 0.83). Conclusions: This retrospective study of 617 patients who had percutaneous ultrasound-guided renal biopsies supports the safety of short post-biopsy monitoring for most patients. A risk calculator can further personalize estimates of complication risk ( http://perioperativerisk.com/kbrc ).

Risk Factors for Hyperlactataemia in HIV-Infected Patients, Aquitaine Cohort, 1999–2003

2005 ◽  
Vol 16 (1) ◽  
pp. 63-67 ◽  
Author(s):  
Fabrice Bonnet ◽  
Eric Balestre ◽  
Elise Bernardin ◽  
Jean-Luc Pellegrin ◽  
Didier Neau ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Function ◽  
Multivariate Analysis ◽  
Serum Lactate ◽  
Cd4 Count ◽  
Plasma Lactate ◽  
Plasma Triglycerides ◽  
Factors Associated ◽  
Increased Risk ◽  
Over Time

The objectives of our study were to describe the characteristics of a subset of patients who had been prescribed serum lactate in clinical practice within a large cohort of HIV-infected patients and to determine the factors associated with hyperlactataemia. Hyperlactataemia (⩾T2 mmol/l) was found in 219 [29% (95% confidence interval: 25.3–31.7)] of the 768 HIV-infected participants. In multivariate analysis (logistical regression), an increased risk of hyperlactataemia was associated with increasing age, CD4 count <500/mm3, triglycerides >2.2 mmol/L, lipoatrophy and stavudine use. In a second model coding for the NRTI-based drug combinations, only those including stavudine were associated with an increased risk of hyperlactataemia. In a third model including exposure duration to NRTIs, we estimated a 20% increased risk of hyperlactataemia per year of exposure to didanosine or stavudine. The risk of hyperlactataemia could increase over time in patients treated with these drugs and is also closely associated with increased age, decreased CD4 count, lipodystrophy and increased plasma triglycerides. It could be proposed that patients having one or more of these risk factors undergo regular monitoring of plasma lactate and renal function to prevent lactic acidosis.

scholarly journals Predictors of perirenal haematoma post-percutaneous ultrasound-guided renal biopsy

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110583
Author(s):  
Shihao Xu ◽  
Bing Xiong ◽  
Saifeng Lin ◽  
Qiao Li ◽  
Lei Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Renal Biopsy ◽  
Real Time ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Ultrasound Guided ◽  
Factors Associated ◽  
A Prospective Study ◽  
Haematoma Formation

Objective To perform a prospective study to determine the risk factors associated with perirenal haematoma development after percutaneous renal biopsy (PRB). Methods This multivariate prospective study collected demographic and clinical data from all consecutive adult patients that underwent real-time ultrasound-guided PRB of native kidneys. All biopsies were performed by two well-trained ultrasound physicians using 16G biopsy needles. Routine renal ultrasounds were performed within 12–24 h after biopsies in order to observe post-biopsy perirenal haematoma formation. Patients were stratified based on the occurrence of post-biopsy haematoma development. Results This prospective study enrolled 218 patients and stratified them into a haematoma group ( n = 126) and a non-haematoma group ( n = 92). Binary logistic regression analysis identified female patients (odds ratio [OR] 1.990; 95% confidence interval [CI] 1.125, 3.521), patients with a body mass index (BMI) ≥28 kg/m2 (OR 2.660; 95% CI 1.097, 6.449) and patients with immediate post-biopsy active bleeding (IPAB) (OR 2.572; 95% CI 1.422, 4.655) as being more likely to have perirenal haematoma after real-time ultrasound guided PRB of native kidneys. Conclusion Female sex, a BMI ≥28 kg/m2 and IPAB were risk factors for perirenal haematoma after real-time ultrasound-guided PRB of native kidneys.

scholarly journals 1095. Investigation of Risk Factors Associated with Serious Bacterial, Viral and Invasive Fungal Infections in Hematologic Patients on Ibrutinib

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S576-S577
Author(s):  
Thomas Holowka ◽  
Harry Cheung ◽  
Maricar F Malinis ◽  
Sarah Perreault ◽  
Iris Isufi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fungal Infections ◽  
Antimicrobial Prophylaxis ◽  
Hematologic Malignancy ◽  
Invasive Fungal Infections ◽  
Risk Of Infection ◽  
Factors Associated ◽  
Serious Infection ◽  
Increased Risk ◽  
Serious Infections

Abstract Background Ibrutinib is a tyrosine kinase inhibitor used to treat hematologic malignancies that may increase the risk of serious infection including invasive fungal infections (IFI). In a study of 378 patients with hematologic malignancy on ibrutinib, serious infection and IFI occurred in 11% and 4% respectively (Varughese et al. Clin Infect Dis). The primary aims of our study were to determine the incidence of serious infection and associated risk factors in patients on ibrutinib. Methods We performed a retrospective analysis of patients with hematologic malignancy prescribed ibrutinib for ≥ 1 week at Yale New Haven Hospital from 2014 to 2019 to identify serious infections defined as those requiring inpatient management. We collected demographic, clinical and oncologic data. Chi-squared tests were used to determine factors associated with an increased risk of infection. Results A total of 254 patients received ibrutinib including 156 with CLL, 89 with NHL and 9 with other leukemias. Among these, 21 underwent HSCT, 9 complicated by GVHD. There were 51 (20%) patients with serious infections including 45 (17.7%) bacterial, 9 (3.5%) viral and 5 (2%) IFI (1 pulmonary cryptococcosis, 4 pulmonary aspergillosis). Anti-mold prophylaxis was prescribed to 7 (2.8%) patients, none of whom developed IFI. Risk factors associated with serious infection included ECOG score ≥ 2 (OR 4.6, p &lt; 0.001), concurrent steroid use (≥ 10 mg prednisone daily for ≥ 2 weeks; OR 3.0, p &lt; 0.001), neutropenia (OR 3.6, p &lt; 0.01), lymphopenia (OR 2.4, p &lt; 0.05) and maximum ibrutinib dose of 560 mg (OR 2, p &lt; 0.05). There was a dose dependent increase in infections based on number of chemotherapy regimens prior to ibrutinib initiation: 14.3% with 0, 19.7% with 1-2 and 28.7% with ≥ 3 prior treatments. Conclusion The incidence of serious infection in hematologic patients on ibrutinib was higher than previously reported (20% versus 11%) but the rate of IFI was lower (2% versus 4%). High ECOG score, leukopenia, steroids, and higher ibrutinib doses were associated with an increased risk for serious infection. Targeted antimicrobial prophylaxis should be considered for patients on ibrutinib with these risk factors. Improving functional status may also reduce the risk of infection in patients on ibrutinib. Disclosures All Authors: No reported disclosures

scholarly journals An Exploration of Heart Failure Risk in Breast Cancer Patients Receiving Anthracyclines with or without Trastuzumab in Thailand: A Retrospective Study

2021 ◽  
Vol 11 (3) ◽  
pp. 484-493
Author(s):  
Jukapun Yoodee ◽  
Aumkhae Sookprasert ◽  
Phitjira Sanguanboonyaphong ◽  
Suthan Chanthawong ◽  
Manit Seateaw ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cancer Patients ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Breast Cancer Patients ◽  
Ventricular Ejection Fraction ◽  
Factors Associated ◽  
Palliative Intent ◽  
Increased Risk

Anthracycline-based regimens with or without anti-human epidermal growth factor receptor (HER) 2 agents such as trastuzumab are effective in breast cancer treatment. Nevertheless, heart failure (HF) has become a significant side effect of these regimens. This study aimed to investigate the incidence and factors associated with HF in breast cancer patients treated with anthracyclines with or without trastuzumab. A retrospective cohort study was performed in patients with breast cancer who were treated with anthracyclines with or without trastuzumab between 1 January 2014 and 31 December 2018. The primary outcome was the incidence of HF. The secondary outcome was the risk factors associated with HF by using the univariable and multivariable cox-proportional hazard model. A total of 475 breast cancer patients were enrolled with a median follow-up time of 2.88 years (interquartile range (IQR), 1.59–3.93). The incidence of HF was 3.2%, corresponding to an incidence rate of 11.1 per 1000 person-years. The increased risk of HF was seen in patients receiving a combination of anthracycline and trastuzumab therapy, patients treated with radiotherapy or palliative-intent chemotherapy, and baseline left ventricular ejection fraction <65%, respectively. There were no statistically significant differences in other risk factors for HF, such as age, cardiovascular comorbidities, and cumulative doxorubicin dose. In conclusion, the incidence of HF was consistently high in patients receiving combination anthracyclines trastuzumab regimens. A reduced baseline left ventricular ejection fraction, radiotherapy, and palliative-intent chemotherapy were associated with an increased risk of HF. Intensive cardiac monitoring in breast cancer patients with an increased risk of HF should be advised to prevent undesired cardiac outcomes.

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