Short-Term Outcomes Following Removal of Infected Hernia Mesh

2021 ◽  
pp. 000313482110241
Author(s):  
Christine Tung ◽  
Junko Ozao-Choy ◽  
Dennis Y. Kim ◽  
Christian de Virgilio ◽  
Ashkan Moazzez
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Logistic Regression ◽  
Body Mass ◽  
Smoking History ◽  
Multivariate Logistic Regression ◽  
Short Term ◽  
Mesh Removal ◽  
Mesh Placement ◽  
Infected Mesh

There are limited studies regarding outcomes of replacing an infected mesh with another mesh. We reviewed short-term outcomes following infected mesh removal and whether placement of new mesh is associated with worse outcomes. Patients who underwent hernia repair with infected mesh removal were identified from 2005 to 2018 American College of Surgeons-National Surgical Quality Improvement Program database. They were divided into new mesh (Mesh+) or no mesh (Mesh-) groups. Bivariate and multivariate logistic regression analyses were used to compare morbidity between the two groups and to identify associated risk factors. Of 1660 patients, 49.3% received new mesh, with higher morbidity in the Mesh+ (35.9% vs. 30.3%; P = .016), but without higher rates of surgical site infection (SSI) (21.3% vs. 19.7%; P = .465). Mesh+ had higher rates of acute kidney injury (1.3% vs. .4%; P = .028), UTI (3.1% vs. 1.3%, P = .014), ventilator dependence (4.9% vs. 2.4%; P = .006), and longer LOS (8.6 vs. 7 days, P < .001). Multivariate logistic regression showed new mesh placement (OR: 1.41; 95% CI: 1.07-1.85; P = .014), body mass index (OR: 1.02; 95% CI: 1.00-1.03; P = .022), and smoking (OR: 1.43; 95% CI: 1.05-1.95; P = .025) as risk factors independently associated with increased morbidity. New mesh placement at time of infected mesh removal is associated with increased morbidity but not with SSI. Body mass index and smoking history continue to contribute to postoperative morbidity during subsequent operations for complications.

scholarly journals Influence of overweight on functional capacity of physically active older women

2020 ◽  
Vol 22 ◽  
Author(s):  
Akeline Santos de Almeida ◽  
Patrícia Almeida Fontes ◽  
Jamille Mendonça Reinaldo ◽  
Maria de Lourdes Feitosa Neta ◽  
Ricardo Aurélio Carvalho Sampaio ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Logistic Regression ◽  
Older Women ◽  
Body Mass ◽  
Functional Capacity ◽  
Negative Correlation ◽  
The Body ◽  
Lower Limbs ◽  
Multivariate Logistic Regression ◽  
Physically Active

Abstract Aging comprises a dynamic and progressive process, characterized by physiological and functional changes. Among these changes, increase in body fat is considered relevant, since it can leads to impaired physical fitness and augmented cardiometabolic risks. Considering this, the objective of this study was to evaluate the influence of overweight on functional capacity of physically active older women. A field survey was performed with 24 older women who practiced physical exercise. Participants were submitted to anamnesis, anthropometric measures (i.e., body mass and height); the Senior Fitness test; sit and reach flexibility test; and handgrip strength test. Pearson’s correlation test and multivariate logistic regression were used to verify the association between overweight and functional capacity. It was observed that hip flexibility (R=-0.494, p=0.014) and flexibility of the lower limbs (i.e., sit and reach test) showed negative correlation with the body mass index (R=-0.446, p=0.02); and after the multivariate logistic regression, negative correlation of lower limbs flexibility (B=-0,035, p=0,014) and the body mass index was observed. Thus, higher the body mass index among participants, lower hip flexibility they presented.

scholarly journals Early Prediction of Disease Progression in 2019 Novel Coronavirus Pneumonia Patients Outside Wuhan with CT and Clinical Characteristics

2020 ◽  
Author(s):  
Zhichao Feng ◽  
Qizhi Yu ◽  
Shanhu Yao ◽  
Lei Luo ◽  
Junhong Duan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Disease Progression ◽  
Severity Score ◽  
Clinical Characteristics ◽  
Lung Involvement ◽  
Multivariate Logistic Regression ◽  
Short Term ◽  
Progressive Group ◽  
Novel Coronavirus

AbstractObjectiveTo determine the predictive value of CT and clinical characteristics for short-term disease progression in patients with 2019 novel coronavirus pneumonia (NCP).Materials and Methods224 patients with confirmed 2019 novel coronavirus (COVID-19) infection outside Wuhan who had chest CT examinations were retrospectively screened. Clinical data were obtained from electronic medical records. CT images were reviewed and scored for lesion distribution, lobe and segment involvement, ground-glass opacities, consolidation, and interstitial thickening. All included patients with moderate NCP were observed for at least 14 days from admission to determine whether they exacerbated to severe NCP (progressive group) or not (stable group). CT and clinical characteristics between the two groups were compared, and multivariate logistic regression and sensitivity analyses were performed to identify the risk factors for developing severe NCP.ResultsA total of 141 patients with moderate NCP were included, of which 15 (10.6%) patients developed severe NCP during hospitalization and assigned to the progressive group. Multivariate logistic regression analysis showed that higher neutrophil-to-lymphocyte ratio (NLR) (odds ratio [OR] and 95% confidence interval [CI], 1.26 [1.04-1.53]; P = 0.018) and CT severity score (OR and 95% CI, 1.25 [1.08-1.46]; P = 0.004) on admission were independent predictors for progression to severe NCP, and sensitivity analysis confirmed the consistent results in nonimported patients but not in imported patients. However, no significant difference in lung involvement was found on CT between imported and nonimported patients (all P > 0.05). Patients who were admitted more than 4 days from symptom onset tended to have more severe lung involvement. Spearman correlation analysis showed the close association between CT severity score and inflammatory indexes (r = 0.17∼0.47, all P < 0.05).ConclusionCT severity score was associated with inflammatory levels and higher NLR and CT severity score on admission were independent risk factors for short-term progression in patients with NCP outside Wuhan. Furthermore, early admission and surveillance by CT should be recommended to improve clinical outcomes.

scholarly journals Evaluation of stability of deep venous thrombosis of the lower extremities using Doppler ultrasound

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094209
Author(s):  
Shefang Zhang ◽  
Wen Chu ◽  
Hua Wang ◽  
Yajun Liang ◽  
Yajuan Fan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Body Mass ◽  
Doppler Ultrasound ◽  
Area Under The Curve ◽  
Lower Extremities ◽  
Smoking History ◽  
D Dimer

Objective This study aimed to assess using Doppler ultrasound for analyzing stability of deep venous thrombosis (DVT) of the lower extremities. Methods Patients with DVT of the lower extremities who were treated from August 2017 to December 2019 were selected. The patients were divided into stable and unstable groups according to whether thrombus was collected in a filter. Related ultrasound and blood test results were analyzed and compared. Results A total of 126 patients with DVT of the lower extremities were included, of whom 74 were in the stable group and 52 were in the unstable group. There were significant differences in the prothrombin time (PT), and lipoprotein alpha, D-dimer, and triglyceride levels between the groups. D-dimer levels >2800 ug/L, smoking, history of venous thrombosis, PT >13.15 s, and body mass index >24.45 kg/m2 were independent risk factors for stability of DVT of the lower extremities. The area under the curve with combined detection of DVT was significantly higher than that for body mass index, PT, and D-dimer alone. Conclusion Doppler ultrasound may be reliable for analyzing the stability of DVT of the lower extremities. Related strategies targeting risk factors are required for reducing DVT of the lower extremities.

P3795Should we also screen for obstructive sleep apnea in patients presenting with excessive supraventricular ectopic activity?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Marinheiro ◽  
L Parreira ◽  
P Amador ◽  
D Mesquita ◽  
J Farinha ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Logistic Regression ◽  
Body Mass ◽  
Strong Evidence ◽  
Multivariate Logistic Regression Analysis ◽  
P Value ◽  
Ectopic Activity ◽  
Multivariate Logistic Regression ◽  
Obstructive Sleep

Abstract Background It is recommended to consider obstructive sleep apnoea (OSA) screening in atrial fibrillation (AF) patients with risk factors, due to the strong evidence of an association between these two entities. Excessive supraventricular ectopic activity (ESVEA) has been proposed to be a risk factor for AF. However, strong evidence between ESVEA and OSA has not been established. Objective We aimed to determine if ESVEA is associated with moderate to severe OSA since its treatment may prevent AF. Methods We studied patients who performed polysomnography and 24-hour Holter monitoring. Patients with atrial fibrillation were excluded. ESVEA was defined as more than 30 PACs per hour (frequent PACs) or runs of >4 consecutive PACs. The circadian pattern of PACs was also evaluated. Sleeping hours were used to define “nocturnal”. Moderate to severe OSA was defined when polyssonography demonstrated a apnoea/hypopnoea index (AHI) >15. We examined the association between ESVEA and moderate to severe OSA during wakefulness and sleep. Results We studied 290 patients [median age 65 (55–72) years, 62% males, body mass index (BMI) 30 (27–34)]. 112 (38%) had moderate to severe OSA. Median AHI was 11 (5–24) and mean oxygen saturation was 94% (92–95). Median PACs was 35 (9–117) and 29 patients (10%) had frequent PACs. Runs of >4PACs occurred in 114 patients (39%). Forty-three patients (15%) had predominant nocturnal PACs and 42 (14%) had nocturnal runs of PACs. Multivariate logistic regression analysis demonstrated only nocturnal PACs were associated with moderate to severe OSA (p=0.027) (table 1). Multivariate logistic regression Odds Ratio 95% Confidence Interval p-value Male gender 4.49 2.48–8.17 <0.001 Body mass index (kg/m2) 1.09 1.03–1.15 0.002 Nocturnal PACs 4.12 1.17–14.46 0.027 Variables not included in the model: age, number of PACs/h, frequent PACs (>30 PAcs/hour), runs of PACs (>4 consecutive PACs), nocturnal frequent PACs and nocturnal runs of PACs. Conclusion OSA screening in patients presenting with nocturnal PACs should be routinely considered, especially in male and obese. Treating moderate to severe OSA patients with CPAP has a potential benefit in preventing ESVEA and consequently AF.

scholarly journals Value of visceral fat area in normal body mass index (BMI) patients is a predictive factor for peritoneal metastasis in gastric cancer: A prospective study

2020 ◽  
Author(s):  
Chenchen Mao ◽  
Mingming Shi ◽  
Hui Chen ◽  
Libin Xu ◽  
He Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Body Mass Index ◽  
Logistic Regression ◽  
Body Mass ◽  
Peritoneal Metastasis ◽  
Visceral Fat ◽  
Visceral Fat Area ◽  
Cutoff Values ◽  
High Bmi

Abstract Background Although peritoneal metastasis (PM) is associated with poor prognosis in gastric cancer (GC) patients, it is difficult to discriminate preoperatively. Our previous study has demonstrated visceral fat area (VFA) is a better obesity index than body mass index (BMI) in predicting abdominal metastasis. Aim This study aimed to further explore the relationship between obesity and PM. Methods VFA was retrieved for 859 consecutive patients undergoing radical gastrectomy between January 1, 2009 and December 31, 2013. A receiver operating characteristic curve analysis was used to determine the BMI-specific cutoff values for VFA. Univariate and multivariate analyses evaluating the risk factors for PM at different BMI levels were performed. Results The optimal cutoff values for VFA were 67.28, 88.03, and 175.32 cm 2 for low, normal, and high BMI patients, respectively, and 18 (15.52%), 220 (40.15%), and 61 (31.28%) patients were classified as having high VFA in each group. Univariate logistic regression revealed that the association between high VFA and PM was not dependent on BMI (odds ratio [OR]=9.048, P=0.007 for low BMI, OR=3.827, P<0.001 for normal BMI, and OR=2.460, P=0.049 for high BMI). In multivariate logistic regression analysis, high VFA (OR=3.816, P<0.001) and vascular invasion (OR=1.951, P=0.039) were independent risk factors for PM only in the normal BMI group. Conclusions VFA only effectively predicted PM for GC patients with normal BMI, rather than those with low and high BMI. More attentions should be paid to those GC patients with high VFA and normal BMI.

scholarly journals Underweight increases the risk of pulmonary tuberculosis in adult

2017 ◽  
Vol 36 (1) ◽  
pp. 4
Author(s):  
Galuh Chandra Irawan ◽  
Ani Margawati ◽  
Ali Rosidi
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Logistic Regression ◽  
Risk Factor ◽  
Pulmonary Tuberculosis ◽  
Body Mass ◽  
Low Income ◽  
Smoking Behavior ◽  
Significant Risk ◽  
Low Body Mass Index

<p>Background<br />Tuberculosis (TB) is a leading cause of morbidity and mortality, especially in middle- and low-income countries. The risk of developing TB may be related to nutritional status. Socioeconomic and behavioral factors are also shown to increase the susceptibility to TB infection. The objective of this study was to determine nutritional factors as risk factors of pulmonary TB in adult.</p><p>Methods<br />This was an observational study of case control design. The study subjects were community members consisting of 19 adult cases of pulmonary tuberculosis and 38 controls. Data on nutritional intakes were obtained by semiquantitative food frequency questionnaire (FFQ), while smoking behavior, history of DM, body mass index, education, and income were obtained by structured interviews. The data were analyzed by independent t-test and logistic regression for calculation of the odds ratio (OR).</p><p>Results<br />The bivariate test showed that the adequacy levels for energy (OR=6.8; 95% CI: 1.51-30.54), protein (OR=5.1; 95% CI: 1.52-17.14), vitamin A (OR=4.2; 5% CI: 1.31-13.54), vitamin C (OR=3.8;95% CI: 1.21-12.36), selenium (OR=4.2; 95% CI: 1.34-13.58), body mass index (OR=4.4; 95% CI: 1.32-14.35) and smoking behavior (OR=3.7; 95% CI: 1.15-11.9), were significant risk factors for pulmonary tuberculosis. Multiple logistic regression test showed that low body mass index (&lt;18.5 kg/m2) (OR=6.0; 95% CI: 1.32-27.18) was a the most influential risk factor of pulmonary tuberculosis.</p><p>Conclusion<br />Low body mass index is the most influential risk factor for pulmonary tuberculosis incidence in adult. Nutrition profile in adult is an important determinant of TB incidence.</p>

Thirty-day mortality in traumatically brain-injured patients undergoing decompressive craniectomy

2013 ◽  
Vol 118 (6) ◽  
pp. 1329-1335 ◽  
Author(s):  
Yu-Hua Huang ◽  
Tao-Chen Lee ◽  
Tsung-Han Lee ◽  
Chen-Chieh Liao ◽  
Jason Sheehan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Decompressive Craniectomy ◽  
Multivariate Logistic Regression ◽  
Short Term ◽  
Brain Injured ◽  
Independent Risk Factors ◽  
Traumatically Brain Injured ◽  
Gcs Score ◽  
Injured Patients

Object Decompressive craniectomy is a life-saving measure for patients who have sustained traumatic brain injury (TBI), but patients undergoing this procedure may still die during an early phase of head injury. The aim of this study was to investigate the incidence, causes, and risk factors of 30-day mortality in traumatically brain-injured patients undergoing decompressive craniectomy. Methods The authors included 201 head-injured patients undergoing decompressive craniectomy in this 3-year retrospective study. The main outcome evaluated was 30-day mortality in patients who had undergone craniectomy after TBI. Demographic and clinical data, including information on death, were obtained for subsequent analysis. The authors identified differences between survivors and nonsurvivors in terms of clinical parameters; multivariate logistic regression was used to adjust for independent risk factors of short-term death. Results The 30-day mortality rate was 26.4% in traumatically brain-injured patients undergoing decompressive craniectomy. The majority of deaths following decompression resulted from uncontrollable brain swelling and extensive brain infarction, which accounted for 79.2% of mortality. In the multivariate logistic regression mode, the 2 independent risk factors for 30-day mortality were age (OR 1.035 [95% CI 1.006–1.064]; p = 0.018) and Glasgow Coma Scale (GCS) score before decompressive craniectomy (OR 0.769 [95% CI 0.597–0.990]; p = 0.041). Conclusions There is a high 30-day mortality rate in traumatically brain-injured patients undergoing decompressive craniectomy. Most of the deaths are attributed to ongoing brain damage, even after decompression. Risk factors of short-term death, including age and preoperative GCS score, are important in patient selection for decompressive craniectomy, and these factors should be considered together to ensure the highest chance of surviving TBI.

scholarly journals Risk factors associated with pulmonary tuberculosis relapses in Cali, Colombia

Biomédica ◽  
2020 ◽  
Vol 40 (Supl. 1) ◽  
pp. 102-112
Author(s):  
Cindy Córdoba ◽  
Paola A. Buriticá ◽  
Robinson Pacheco ◽  
Anyela Mancilla ◽  
Augusto Valderrama-Aguirre ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Logistic Regression ◽  
Alcohol Consumption ◽  
Population Density ◽  
Pulmonary Tuberculosis ◽  
Body Mass ◽  
Multivariate Logistic Regression Analysis ◽  
The Body ◽  
Factors Associated

Introduction: Relapses in tuberculosis occur due to endogenous reactivations or exogenous reinfections and represent up to 27% of tuberculosis cases. Its importance lies in the risk of the appearance of multidrug-resistant Mycobacterium tuberculosis strains.According to the reports published in 2011 by the Colombian Instituto Nacional de Salud, there were 572 relapse cases reported in the country, i.e., a rate of 4.9%. Data of the tuberculosis control program from the Secretaría de Salud Municipal in Cali reported a relapse rate of 6%, higher than the national one, during 2013 and 2014.Objective: To determine the risk factors associated with relapse in patients with pulmonary tuberculosis in Cali.Materials and methods: We conducted an observational, analytical, and case-control study (1:1), which comprised 81 cases of pulmonary tuberculosis relapses detected in 2013 and 2014. Additionally, we collected data on socio-demographic and clinical variables, as well as lifestyle and health services, to identify the potential risk factors associated with tuberculosis relapses. We used logistic regression to identify the risk factors.Results: After adjustments for some variables, our multivariate logistic regression analysis showed that the body mass index (BMI) (OR=0.90, 95%CI: 0.81–0.99) and population density (OR=0.99, 95%CI: 0.98–1.00) were inversely associated with tuberculosis relapses. Alcohol consumption increased the likelihood of tuberculosis relapse (OR=5.56, 95%CI: 1.18–26.26).Conclusions: Body mass index and population density were inversely associated with pulmonary tuberculosis relapses in Cali. On the contrary, alcohol consumption increased the likelihood of tuberculosis relapses.

scholarly journals Prevalence of Atypical Disorders and Associated Factors in Undergraduate Students of Prince of Songkla University, Songkhla, Thailand

2019 ◽  
Author(s):  
Orapan Fumaneeshoat
Keyword(s):  
Body Mass Index ◽  
Eating Disorders ◽  
Logistic Regression ◽  
Body Mass ◽  
Undergraduate Students ◽  
Eating Attitudes ◽  
Multivariate Logistic Regression ◽  
Attitudes And Behaviors ◽  
Prince Of Songkla University ◽  
And Behaviors

Objective: To quantify the prevalence of eating disorders and factors associated with eating disorders among undergraduate students in Prince of Songkla University, Hat Yai Campus.Material and Methods: This study was a cross sectional descriptive study using random sampling by proportionate accidental sampling. We used the Thai Eating Attitudes Test-26 (EAT-26) for collecting information about eating attitudes. Participants who had scores equal or higher than 12 (≥12) were assumed to have atypical eating attitudes and behaviors. We used the R and R studio program to analyze information. Multivariate logistic regression was used for correlation analysis.Results: In this study, we had completed questionnaires from 500 students (response rate 65.6%). The overall prevalence of atypical eating attitudes and behaviors in undergraduate students in Prince of Songkla University, Hat Yai Campus was 37.2%. We found that overweight body mass index (BMI) (BMI 23.00-24.99 kg/m2) and obesity BMI (≥25.00 kg/m2) were significantly more prevalent in students with atypical eating attitudes and behaviors than normal BMI (18.50-22.99 kg/m2), with odds ratios of 3.3 [95% confidence interval (CI)=1.8-6.2] and 3.7 (95% CI=1.9-6.9), respectively. However, multivariate logistic regression revealed no associations between atypical eating attitudes and behaviors, sex, target weight, biological disease, psychological disease, current medication(s) or faculty. Atypical eating attitudes and behaviors were significantly associated only with body mass index BMI. The overweight and obese BMI groups had significantly increased risks of 3.3 and 3.7 times of atypical eating attitudes and behaviors compared to the normal group, with 95% CIs of 1.8-6.2 and 1.9-6.9, respectively.Conclusion: From this study, overweight BMI and obesity BMI were significantly more prevalent in students with atypical eating attitudes and behaviors than normal BMI. BMI was the only factor significantly associated with atypical eating attitudes and behaviors.

scholarly journals Clinical variables of preoperative risk in thoracic surgery

2003 ◽  
Vol 121 (3) ◽  
pp. 107-110 ◽  
Author(s):  
Ivete Alonso Bredda Saad ◽  
Eduardo Mello De Capitani ◽  
Ivan Felizardo Contrera Toro ◽  
Lair Zambon
Keyword(s):  
Body Mass Index ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Thoracic Surgery ◽  
Body Mass ◽  
Multivariate Logistic Regression Analysis ◽  
Pulmonary Complications ◽  
Postoperative Pulmonary Complications ◽  
Multivariate Logistic Regression ◽  
Surgery Duration

CONTEXT: Pulmonary complications are the most common forms of postoperative morbidity in thoracic surgery, especially atelectasis and pneumonia. The first step in avoiding these complications during the postoperative period is to detect the patients that may develop them. OBJECTIVE: To identify risk variables leading to early postoperative pulmonary complications in thoracic surgery. DESIGN: Prospective study. SETTING: Hospital das Clínicas, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. PATIENTS: 145 patients submitted to elective surgery were classified as low, moderate and high risk for postoperative pulmonary complications using a risk assessment scale. PROCEDURES: The patients were followed up for 72 hours after the operation. Postoperative pulmonary complications were defined as atelectasis, pneumonia, tracheobronchitis, wheezing, prolonged intubation and/or prolonged mechanical ventilation. MAIN MEASUREMENTS: Univariate analysis was applied in order to study these independent variables: age, nutritional status, body mass index, respiratory disease, smoking habit, spirometry and surgery duration. Multivariate logistic regression analysis was performed in order to evaluate the relationship between independent and dependent variables. RESULTS: The incidence of postoperative complications was 18.6%. Multivariate logistic regression analysis showed that the variables increasing the chances of postoperative pulmonary complications were wheezing (odds ratio, OR = 6.2), body mass index (OR = 1.15), smoking (OR = 1.04) and surgery duration (OR = 1.007). CONCLUSION: Wheezing, body mass index, smoking and surgery duration increase the chances of postoperative pulmonary complications in thoracic surgery

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