Independent Predictors of In-Hospital Mortality in Elderly and Non-elderly Adult Patients Undergoing Emergency Admission for Hemorrhoids

Background The study explored determinants of mortality of admitted emergently patients with the primary diagnosis of hemorrhoids, during the years 2005-2014. Methods Demographics, clinical data, and outcomes were obtained from the National Inpatient Sample, 2005-2014, in elderly (65+ years) and non-elderly adult patients (18-64 years) with hemorrhoids who underwent emergency admission. Multivariable logistic regression model with backward elimination was used to identify predictors of mortality. Results 25 808 adult and 26 978 elderly patients were included. Female patients consisted of 42.5% and 59.3% in adult and elderly, respectively. 42 (.2%) adults died, of which 50% were female and 125 (.5%) elderly patients died, of which 60% were female. Mean (SD) age of the adult patients was 47.8 (11) years and in elderly patients was 78.7 (8) years. 82.2% and 85.7% had internal hemorrhoids in adult and elderly patients, respectively. 9326 (36.1%) adult and 7282 (27%) elderly patients underwent an operation. In the final multivariable logistic regression model for adult patients with operation, delayed operation and invasive diagnostic procedures increased the odds of mortality, whereas in elderly patients, delayed operation and frailty index were the risk factors of mortality. In both adults and elderly with no operation, increased hospital length of stay (HLOS) significantly increased the odds of mortality, and undergoing an invasive diagnostic procedure significantly decreased the odds of mortality. Conclusion In all operated patients, increased time to operation and undergoing an invasive diagnostic procedure were the risk factors for mortality. On the other hand, in non-operated emergency hemorrhoids patients, increased age and increased HLOS were the risk factors for mortality while undergoing an invasive diagnostic procedure decreased the odds of mortality.

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Risk Factors of Mortality in Patients Hospitalized With Chronic Duodenal Ulcers

The American Surgeon ◽

10.1177/00031348211054074 ◽

2022 ◽

pp. 000313482110540

Author(s):

Nicole Lin ◽

Abbas Smiley ◽

Manoj Goud ◽

Cynthia Lin ◽

Rifat Latifi1

Keyword(s):

Risk Factors ◽

Elderly Patients ◽

Diagnostic Procedure ◽

Protective Factor ◽

Emergency Admission ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Multivariable Logistic Regression Model ◽

Duodenal Ulcers ◽

Invasive Diagnostic Procedure

Background We aimed to identify risk factors of mortality in patients hospitalized with duodenal ulcers (DUs). Methods A National Inpatient Sample–based retrospective cohort study from 2005 to 2014 was conducted on patients undergoing emergency admission for chronic DUs. Demographics, clinical data, and outcomes were collected. Multivariable logistic regression model was applied to find the risk factors of mortality. Results 70 641 patients were included in this study, of which 30 525 (43%) were non-elderly (< 65 years) and 40 116 (57%) were elderly (65+ years) patients. 72% of non-elderly and 57% of elderly patients were males. Mortality rate of men vs women was similar in non-elderly group (1.9% vs 2%, respectively), whereas it significantly differed in elderly patients (4.5% vs 5.3%, respectively, P<.0001). Time to operation was 1.15 (1.83) days in survived vs 1.55 (3.86) days in deceased non-elderly patients ( P < .001). Time to operation was .85 (1.73) days in survived vs 1.79 (7.28) days in deceased elderly patients ( P < .001). In patients with operation, age, delayed operation, frailty, and presence of perforation were the main risk factors of mortality in both elderly and non-elderly patients. Invasive diagnostic procedure was shown as a protective factor in elderly patients. In the final model for patients with no operation, age, hospital length of stay, and frailty were the main risk factors of mortality in both elderly and non-elderly patients. Invasive diagnostic procedure was revealed as a protective factor in all patients as well. Conclusion Early operation in patients with DU requiring surgical intervention is essential to improve the outcomes.

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Delayed Operation as a Major Risk Factor for Mortality Among Elderly Patients with Ventral Hernia Admitted Emergently: An Analysis of 33,700 Elderly Patients

Surgical Technology Online ◽

10.52198/21.sti.39.hr1520 ◽

2021 ◽

Vol 39 ◽

Author(s):

Rifat Latifi ◽

◽

Lior Levy ◽

Medha Reddy ◽

Kenji Okumura ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Elderly Patients ◽

Intestinal Obstruction ◽

Regression Model ◽

Ventral Hernia ◽

Logistic Regression Model ◽

Multivariable Logistic Regression Model ◽

Multivariable Logistic Regression ◽

The Mean

Background: Elderly patients admitted emergently for ventral hernia may have high rates of complications, including morbidity and mortality. The goal of this study was to retrospectively assess risk factors for in-hospital mortality for elderly patients admitted emergently with a primary diagnosis of ventral hernia. Methods: Elderly patients with ventral hernia that required emergency admission were analyzed using the National Inpatient Sample database, 2005-2014. Demographics, clinical data, and outcomes were collected. The relationship between mortality and the predictors was assessed using a stratified analysis, multivariable logistic regression model, and multivariable generalized additive model. Results: A total of 33,700 elderly patients were analyzed. The mean (SD) age for males and females was 75 (7.25) and 76.25 (7.75) years, respectively (p<0.001). Approximately 70% of the patients were females. The mean (SD) hospital length of stay (HLOS) was 6.3 (6.5) and 11.6 (13.7) days in survived vs. deceased patients (p<0.001), respectively. Gangrene was present in 1.5% of survivors vs. 5.6% of deceased (p<0.001) patients. Intestinal obstruction was observed in 78% of survivors vs. 88% of deceased patients (p<0.001). Of the 8,554 cases managed non-operatively, 2.1% died. In contrast, in the 25,163 patients who were operated upon, the mortality rate was 2.9%. The mean (SD) HLOS was 7.39 (7.41) days in patients who had an operation vs. 3.82 (3.48) days in those who did not (p<0.0001). Time to operation was 1.12 (1.97) days in survivors vs. 1.81 (3.02) days in deceased patients (p<0.001). In the final multivariable logistic regression model for patients who underwent an operation, delayed operation, elderly male, frailty, invasive diagnostic procedures and presence of gangrene or obstruction were the main risk factors for mortality. In the final model for patients who did not have an operation, age, frailty, presence of gangrene or obstruction and HLOS were the main risk factors for mortality. Conclusion: A delayed operation in elderly males and frail patients with intestinal obstruction or gangrene admitted emergently due to ventral hernia significantly increases mortality in this setting.

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1244. Evaluation of Intraoperative Topical Vancomycin and the Incidence of Acute Kidney Injury

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1107 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S448-S448

Author(s):

Alison L Blackman ◽

Sabeen Ali ◽

Xin Gao ◽

Rosina Mesumbe ◽

Carly Cheng ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Logistic Regression ◽

Serum Creatinine ◽

Regression Model ◽

Logistic Regression Model ◽

Kidney Injury ◽

Topical Formulation ◽

Multivariable Logistic Regression Model ◽

Multivariable Logistic Regression

Abstract Background The use of intraoperative topical vancomycin (VAN) is a strategy aimed to prevent surgical site infections (SSI). Although there is evidence to support its efficacy in SSI prevention following orthopedic spine surgeries, data describing its safety, specifically acute kidney injury (AKI) risk, is limited. The purpose of this study was to determine the AKI incidence associated with intraoperative topical VAN. Methods This is a retrospective cohort study reviewing patient encounters where intraoperative topical VAN was administered from February 2018 to July 2018. All adult patients ( ≥18 years) that received topical VAN in the form of powder, beads, rods, paste, cement spacers, or unspecified topical routes were included. Patient encounters were excluded for AKI or renal replacement therapy (RRT) at baseline, ≤ 2 serum creatinine values drawn after surgery, and/or if irrigation was the only topical formulation given. The primary outcome was the percentage of patients who developed AKI after intraoperative topical VAN administration. AKI was defined as an increase in serum creatinine (SCr) ≥50% from baseline, an increase in SCr >0.5 from baseline, or0 if RRT was initiated after topical VAN was given. Secondary outcomes included analysis of AKI risk factors and SSI incidence. AKI risk factors were analyzed using a multivariable logistic regression model. Results A total of 589 patient encounters met study criteria. VAN powder was the most common formulation (40.9%), followed by unspecified topical routes (30.7%) and beads (9.9%%). Nonspinal orthopedic surgeries were the most common procedure performed 46.7%. The incidence of AKI was 8.7%. In a multivariable logistic regression model, AKI was associated with concomitant systemic VAN (OR 3.39, [3.39–6.22]) and total topical VAN dose. Each doubling of the topical dose was associated with increased odds of developing AKI (OR = 1.42, [1.08–1.86]). The incidence of SSI was 5.3%. Conclusion AKI rates associated with intraoperative topical VAN are comparable to that of systemic VAN. Total topical vancomycin dose and concomitant systemic VAN was associated with an increased AKI risk. Additional analysis is warranted to compare these patients to a similar population that did not receive topical VAN. Disclosures All authors: No reported disclosures.

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994. Risk for Viral Rebound in the Era of U=U; A CNICS Analysis

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1180 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S525-S526

Author(s):

Blake Hansen ◽

Tao Liu ◽

Lauri Bazerman ◽

Mari-Lynn Drainoni ◽

Fizza S Gillani ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Model ◽

Logistic Regression Model ◽

Viral Suppression ◽

Viral Rebound ◽

Research Support ◽

Multivariable Logistic Regression Model ◽

Multivariable Logistic Regression

Abstract Background The “Undetectable equals Untransmittable (U=U)” HIV prevention campaign is a cornerstone of HIV prevention. However, there are few recommendations to guide patients and providers in U=U implementation and limited data on risk factors for viral rebound among persons eligible for U=U. Methods We conducted a retrospective multi-center study using data from the CNICS HIV research network to identify risk factors for viral rebound among persons with established viral suppression [two viral loads (VL) and all VLs of < 200 copies/ul within a one-year period (U=U eligible)]. Demographics, patient-reported outcomes, and longitudinal clinical data from 21,359 persons with HIV were analyzed. To include missing data in the analysis, they were treated as a separate category. The primary outcome of viral rebound was defined as any VL > 200 copies/ul within two years after U=U eligibility. A univariable logistic regression model was conducted to identify predictors of viral rebound. Significant variables (p< 0.05) were included in a multivariable logistic regression model. Predictive values of individual variables were captured by adjusted odds ratios (aORs). Results From 2011-2019, 12,150 patients met criteria for U=U eligibility and had two years of follow up data. The median age was 46 (IQR: 38-53); 68% male; 51% were white, 39% black. 1544 (13%) experienced viral rebound during follow-up. Forest plot summaries of univariable and multivariable logistic regression models are in Figures 1&2. In multivariable analysis, Black race (aOR=1.56, p< 0.001); MSM-IDU risk (aOR=1.38, p=0.006); lower QoL score (aOR=1.49, p=0.005); poorer ART adherence (aOR=1.84, p< 0.001); duration of lifetime ART [aOR=1.47 (10+yrs), = 1.37 (5-10 yrs); and = 1.28 (2-5 yrs), p< 0.001]; use of InSTIs after eligibility (aOR=1.60, p< 0.001); current smoker (aOR=1.49, p< 0.001), current amphetamine (aOR=1.83, p< 0.001) or cocaine use (aOR=1.46, p=0.012), were associated with viral rebound. In both analyses, older age was protective against viral rebound. Figure 1. Summary of Univariate Logistic Regression Model Figure 2. Summary of Multivariable Logistic Regression Model Conclusion We identified multiple risk factors for viral rebound among PWH with viral suppression. Further research is needed to identify synergistic risk factors that increase probability of viral rebound to inform optimal implementation of U=U. Disclosures Edward Cachay, MD, MAS, Gilead (Consultant, Grant/Research Support)Merck Sciences (Grant/Research Support) Heidi Crane, MD, MPH, ViiV (Grant/Research Support) Benigno Rodriguez, MD, Gilead (Speaker’s Bureau)ViiV (Speaker’s Bureau)

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Risk Stratification for Organ/Space Surgical Site Infection in Advanced Digestive System Cancer

Frontiers in Oncology ◽

10.3389/fonc.2021.705335 ◽

2021 ◽

Vol 11 ◽

Author(s):

Chen Sun ◽

Hui Gao ◽

Yuelun Zhang ◽

Lijian Pei ◽

Yuguang Huang

Keyword(s):

Risk Factors ◽

Clinical Trial ◽

Logistic Regression ◽

Risk Stratification ◽

Surgical Site Infection ◽

Digestive System ◽

Logistic Regression Model ◽

Site Infection ◽

Multivariable Logistic Regression Model ◽

Digestive System Cancer

BackgroundOrgan/space surgical site infection (organ/space SSI) is a serious postoperative complication, closely related to a poor prognosis. Few studies have attempted to stratify the risk of organ/space SSI for patients with advanced digestive system cancer. This study aimed to identify a simple risk stratification for these patients based on perioperative factors.MethodsThe study was based on two randomized controlled trials (RCT) (NCT02715076, ChiCTR-IPR-17011099), including 839 patients undergoing elective radical resection of advanced digestive system cancer. The primary outcome was organ/space SSI within 30 days after surgery. Multivariable logistic regression model was used to identify risk factors. The risk of organ/space SSI stratified over those risk factors was compared using chi-square tests and the relative risk (RR) was estimated.ResultsAmong the 839 patients, 51 developed organ/space SSI (6.1%) within 30 days after surgery. According to the multivariable logistic regression model, 3 procedure types, including gastrectomy (OR=8.22, 95% CI: 2.71-24.87, P<0.001), colorectal resection (OR=8.65, 95% CI: 3.13-23.85, P<0.001) and pancreatoduodenectomy (OR=7.72, 95% CI: 2.95-20.21, P<0.001), as well as anaesthesia time > 4 h (OR=2.38, 95% CI: 1.08-5.27, P=0.032) and prolonged ICU stay (OR=4.10, 95% CI: 1.67-10.10, P=0.002), were risk factors for postoperative organ/space SSI. The number of risk factors was significantly associated with an increased risk of organ/space SSI (P<0.001), which was 2.8% in patients with 0-1 risk factor (RR=0.20, 95% CI: 0.11-0.35), 13.0% in patients with 2 risk factors (RR=3.64, 95% CI: 2.14-6.20) and 35.7% in patients with 3 risk factors (RR=6.41, 95% CI: 3.01-13.65).ConclusionThis study is a preliminary exploratory and provides a simple risk stratification to identify the risk of postoperative organ/space SSI for patients with advanced digestive system cancer. Further research is needed to validate and generalize the results in a wider population.Clinical Trial RegistrationClinicalTrials.gov, identifier NCT02715076; Chinese Clinical Trial Registry [https://www.chictr.org.cn/enindex.aspx], identifier ChiCTR-IPR-17011099.

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Risk Factors for Mortality in Patients with Ventral Hernia Admitted Emergently: An Analysis of 48,539 Adult Patients

Surgical Technology Online ◽

10.52198/21.sti.39.hr1497 ◽

2021 ◽

Vol 39 ◽

Author(s):

Abbas Smiley ◽

◽

Lior Levy ◽

Rifat Latifi ◽

◽

...

Keyword(s):

Risk Factors ◽

Regression Model ◽

Ventral Hernia ◽

Emergency Admission ◽

Total Sample ◽

Adult Patients ◽

Hospital Length Of Stay ◽

Multivariable Logistic Regression Model ◽

The Mean ◽

Male Sex

Background: More than 400,000 cases of ventral hernia (VH) are repaired each year in the U.S. This condition is a major problem with significant morbidly and mortality. The aim of this study was to evaluate independent predictors of in-hospital mortality for patients with a primary diagnosis of VH who were admitted emergently. Methods: Non-elderly adults (age 18-64 years) with ventral hernias that required emergency admission were analyzed using the National Inpatient Sample database, 2005-2014. Demographics, clinical data, and outcomes were collected. The relationships between mortality and predictors were assessed using a multivariable logistic regression model. Results: Overall, 48,539 patients were identified. The mean (SD) age for both males and females was 50 (9.6). Overall mortality was low (316 or 0.7%). Males accounted for 35% of the total sample and 45% of all mortalities (p<0.001). The mean (SD) hospital length of stay (HLOS) was 4.9 (6.3) and 12.3 (20.6) days in surviving and deceased patients (p<0.001), respectively. Approximately 1.1% of surviving and 6% of deceased patients had gangrene (p<0.001). Intestinal obstruction was observed in 70% of surviving and 83% of deceased patients (p<0.001). While a vast majority of the patients (40,602) were operated on, 8,023 patients were not; 0.7% and 0.4% died, respectively. The mean (SD) HLOS was 5.30 (6.99) days in patients who underwent an operation and 2.97 (2.96) days in those who did not (P<0.0001). Time to operation was 0.81 (1.92) days in surviving and 1.34 (2.42) days in deceased patients (p<0.001). In the final multivariable regression model for patients who underwent an operation, age, male sex, presence of gangrene or obstruction, and longer time to operation were the main risk factors for mortality. For patients who did not undergo an operation, only HLOS and presence of obstruction were the main risk factors for mortality. Conclusion: Male sex, presence of gangrene or obstruction at the presentation, and delayed operation were shown to be risk factors for mortality in adult patients with ventral hernia admitted emergently.

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A seroepidemiological survey of Mycobacterium avium subsp. paratuberculosis in sheep from North of Portugal

Pesquisa Veterinária Brasileira ◽

10.1590/s0100-736x2010001100001 ◽

2010 ◽

Vol 30 (11) ◽

pp. 903-908 ◽

Cited By ~ 4

Author(s):

Ana C Coelho ◽

Maria L Pinto ◽

Adosinda M Coelho ◽

Alfredo Aires ◽

Jorge Rodrigues

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Model ◽

Mycobacterium Avium ◽

Logistic Regression Model ◽

Mycobacterium Avium Subsp ◽

Univariable Analysis ◽

Multivariable Logistic Regression Model ◽

Multivariable Logistic Regression ◽

Mycobacterium Avium Subsp Paratuberculosis

The aim of this study was evaluate the risk factors for Mycobacterium avium subsp. paratuberculosis (Map) seroprevalence in sheep in the North of Portugal. The effects on seroprevalence of several variables such as individual characteristics, management practices, farm characteristics, animal health, and available veterinary services were evaluated. This information was then used in a multivariable logistic regression model in order to identify risk factors for Map seropositivity. Univariable analysis was used to screen the variables used in the logistic regression model. Variables that showed p values of <0.15 were retained for the multivariable analysis. Fifteen variables were associated with paratuberculosis in univariable analysis. The multivariable logistic regression model identified a number of variables as risk factors for seropositivity like sheep pure local and/or a cross of a local breed (OR=2.02), herd size with 31-60 head (OR=2.14), culling during the Spring-Summer season (OR=1.69) and the use of an anti-parasitic treatment such as Ivermectin as the only anti-parasitic medication (OR=5.60). Potential risk factors identified in this study support current recommendations for the control of paratuberculosis.

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A comprehensive, contemporary assessment of the association between hepatosteatosis and coronary artery calcium scoring

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.234 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

T Heseltine ◽

SW Murray ◽

RL Jones ◽

M Fisher ◽

B Ruzsics

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Coronary Artery ◽

Regression Model ◽

Coronary Artery Calcium ◽

Logistic Regression Model ◽

Prediction Models ◽

Multinomial Logistic Regression ◽

Cvd Risk ◽

Male Sex

Abstract Funding Acknowledgements Type of funding sources: None. onbehalf Liverpool Multiparametric Imaging Collaboration Background Coronary artery calcium (CAC) score is a well-established technique for stratifying an individual’s cardiovascular disease (CVD) risk. Several well-established registries have incorporated CAC scoring into CVD risk prediction models to enhance accuracy. Hepatosteatosis (HS) has been shown to be an independent predictor of CVD events and can be measured on non-contrast computed tomography (CT). We sought to undertake a contemporary, comprehensive assessment of the influence of HS on CAC score alongside traditional CVD risk factors. In patients with HS it may be beneficial to offer routine CAC screening to evaluate CVD risk to enhance opportunities for earlier primary prevention strategies. Methods We performed a retrospective, observational analysis at a high-volume cardiac CT centre analysing consecutive CT coronary angiography (CTCA) studies. All patients referred for investigation of chest pain over a 28-month period (June 2014 to November 2016) were included. Patients with established CVD were excluded. The cardiac findings were reported by a cardiologist and retrospectively analysed by two independent radiologists for the presence of HS. Those with CAC of zero and those with CAC greater than zero were compared for demographic and cardiac risks. A multivariate analysis comparing the risk factors was performed to adjust for the presence of established risk factors. A binomial logistic regression model was developed to assess the association between the presence of HS and increasing strata of CAC. Results In total there were 1499 patients referred for CTCA without prior evidence of CVD. The assessment of HS was completed in 1195 (79.7%) and CAC score was performed in 1103 (92.3%). There were 466 with CVD and 637 without CVD. The prevalence of HS was significantly higher in those with CVD versus those without CVD on CTCA (51.3% versus 39.9%, p = 0.007). Male sex (50.7% versus 36.1% p= <0.001), age (59.4 ± 13.7 versus 48.1 ± 13.6, p= <0.001) and diabetes (12.4% versus 6.9%, p = 0.04) were also significantly higher in the CAC group compared to the CAC score of zero. HS was associated with increasing strata of CAC score compared with CAC of zero (CAC score 1-100 OR1.47, p = 0.01, CAC score 101-400 OR:1.68, p = 0.02, CAC score >400 OR 1.42, p = 0.14). This association became non-significant in the highest strata of CAC score. Conclusion We found a significant association between the increasing age, male sex, diabetes and HS with the presence of CAC. HS was also associated with a more severe phenotype of CVD based on the multinomial logistic regression model. Although the association reduced for the highest strata of CAC (CAC score >400) this likely reflects the overall low numbers of patients within this group and is likely a type II error. Based on these findings it may be appropriate to offer routine CVD risk stratification techniques in all those diagnosed with HS.

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Risk factors on admission associated with hospital length of stay in patients with COVID-19: a retrospective cohort study

Scientific Reports ◽

10.1038/s41598-021-86853-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Anping Guo ◽

Jin Lu ◽

Haizhu Tan ◽

Zejian Kuang ◽

Ying Luo ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Liver Disease ◽

Length Of Stay ◽

Regression Model ◽

Logistic Regression Model ◽

Hospital Length ◽

Clinical Treatment ◽

Hospital Length Of Stay ◽

Female Sex

AbstractTreating patients with COVID-19 is expensive, thus it is essential to identify factors on admission associated with hospital length of stay (LOS) and provide a risk assessment for clinical treatment. To address this, we conduct a retrospective study, which involved patients with laboratory-confirmed COVID-19 infection in Hefei, China and being discharged between January 20 2020 and March 16 2020. Demographic information, clinical treatment, and laboratory data for the participants were extracted from medical records. A prolonged LOS was defined as equal to or greater than the median length of hospitable stay. The median LOS for the 75 patients was 17 days (IQR 13–22). We used univariable and multivariable logistic regressions to explore the risk factors associated with a prolonged hospital LOS. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated. The median age of the 75 patients was 47 years. Approximately 75% of the patients had mild or general disease. The univariate logistic regression model showed that female sex and having a fever on admission were significantly associated with longer duration of hospitalization. The multivariate logistic regression model enhances these associations. Odds of a prolonged LOS were associated with male sex (aOR 0.19, 95% CI 0.05–0.63, p = 0.01), having fever on admission (aOR 8.27, 95% CI 1.47–72.16, p = 0.028) and pre-existing chronic kidney or liver disease (aOR 13.73 95% CI 1.95–145.4, p = 0.015) as well as each 1-unit increase in creatinine level (aOR 0.94, 95% CI 0.9–0.98, p = 0.007). We also found that a prolonged LOS was associated with increased creatinine levels in patients with chronic kidney or liver disease (p < 0.001). In conclusion, female sex, fever, chronic kidney or liver disease before admission and increasing creatinine levels were associated with prolonged LOS in patients with COVID-19.

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Allogeneic Red Blood Cell Transfusion Rate and Risk Factors After Hemiarthroplasty in Elderly Patients With Femoral Neck Fracture

Frontiers in Physiology ◽

10.3389/fphys.2021.701467 ◽

2021 ◽

Vol 12 ◽

Author(s):

Rui Yue ◽

Minghui Yang ◽

Xiaohui Deng ◽

Ping Zhang

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Femoral Neck ◽

Elderly Patients ◽

Blood Cell ◽

Advanced Age ◽

Stepwise Logistic Regression ◽

Neck Fracture ◽

Low Bmi ◽

Multivariate Stepwise Logistic Regression

ObjectiveThis study aimed to determine the rate and risk factors of allogeneic red blood cell transfusions (ABT) after hemiarthroplasty (HA) in elderly patients with femoral neck fracture (FNF).MethodsThe subjects of the study were elderly patients (≥65 years old) who were admitted to the geriatric trauma orthopedics ward of Beijing Jishuitan Hospital between March 2018 and June 2019 for HA treatment due to an FNF. The perioperative data were collected retrospectively, and univariate and multivariate stepwise logistic regression analyses were performed to determine the post-operative ABT rate and its risk factors.ResultsThere were 445 patients in the study, of whom 177 (39.8%) received ABT after surgery. Multivariate stepwise logistic regression analysis showed that preoperative low hemoglobin (Hb), high intraoperative blood loss (IBL), advanced age, and a low body mass index (BMI) are independent risk factors of ABT after HA in elderly FNF patients.ConclusionABT after HA is a common phenomenon in elderly patients with FNF. Their post-operative ABT needs are related to preoperative low Hb, high IBL, advanced age, and low BMI. Therefore, ABT can be reduced by taking these factors into account. When the same patient had three risk factors (preoperative low hemoglobin, advanced age, and low BMI), the risk of ABT was very high (78.3%). Also, when patients have two risk factors of preoperative low hemoglobin and low BMI, the risk of ABT was also high (80.0%).

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