30-Day Postoperative Outcomes Following Transcervical Zenker’s Diverticulectomy in the Elderly: Analysis of the NSQIP Database

2020 ◽  
pp. 019459982097050
Author(s):  
Annie E. Moroco ◽  
Robert A. Saadi ◽  
Vijay A. Patel ◽  
Erik B. Lehman ◽  
John P. Gniady
Keyword(s):  
Postoperative Complications ◽  
Postoperative Complication ◽  
Odds Ratio ◽  
Smoking Status ◽  
The Elderly ◽  
Adverse Outcomes ◽  
Postoperative Outcomes ◽  
Improvement Program ◽  
Cross Sectional ◽  
History Of

Objective To compare the effect of patient factors, including age, on 30-day postoperative outcomes and complications for patients undergoing transcervical Zenker’s diverticulectomy. Study Design Retrospective cross-sectional analysis. Setting American College of Surgeons National Surgical Quality Improvement Program (NSQIP) Database. Methods Patients who underwent open Zenker’s diverticulectomy ( Current Procedural Terminology code 43130) were queried via the NSQIP (2006-2018). Outcomes analyzed include patient demographics, medical comorbidities, admission type, operative characteristics, length of admission, postoperative complication, readmission, and reoperation. Results A total of 614 patients were identified. Mean age at time of surgery was 71.1 years, with 13.4% older than 85 years. Outpatient procedures were performed in 29.8%. Postoperative complications occurred in 6.7%, with reoperation and readmission rates of 6.4% and 7.2%, respectively. A mortality rate of 0.3% was observed. Only smoking status (odds ratio, 2.94; P = .008) and history of congestive heart failure (odds ratio, 10.00; P = .014) were shown to have a significant effect on postoperative complications. Conclusion Smoking status confers a high risk for postoperative complication. Age was not an independent risk factor associated with adverse outcomes following open diverticulectomy, suggesting this procedure can be safely performed in patients with advanced age.

Postoperative Outcomes of Branchial Cleft Cyst Excision in Children and Adults: An NSQIP Analysis

2020 ◽  
Vol 162 (6) ◽  
pp. 959-968
Author(s):  
Annie E. Moroco ◽  
Robert A. Saadi ◽  
Vijay A. Patel ◽  
Erik B. Lehman ◽  
Meghan N. Wilson
Keyword(s):  
Postoperative Complications ◽  
Smoking Status ◽  
Pediatric Population ◽  
Branchial Cleft Cyst ◽  
Improvement Program ◽  
Cross Sectional ◽  
Perioperative Morbidity ◽  
Cyst Excision ◽  
Outpatient Procedures ◽  
Branchial Cleft

Objective Identify risk factors and perioperative morbidity for patients undergoing branchial cleft cyst (BCC) excision. Study Design Cross-sectional analysis. Setting American College of Surgeons National Surgical Quality Improvement Program adult and pediatric databases (NSQIP and NSQIP-P). Subject and Methods Patients who underwent BCC excision ( Current Procedural Terminology 42810, 42815) were queried via NSQIP (2005-2016) and NSQIP-P (2012-2016). Outcomes analyzed include patient demographics, medical comorbidities, admission type, operative characteristics, length of hospital stay, postoperative complications, and readmission. Results A total of 1775 children and 677 adults were identified. Mean age at time of surgery was 4.6 years for children and 38.6 years for adults. Outpatient procedures were performed in 87.1% of adults and 94.0% of children ( P < .001). Postoperative complications were uncommon, occurring in <1% of adults and 3.9% of children ( P < .001). Similarly, readmission occurred in 1.2% of adults and 1.1% of children. In adults, smoking status was shown to have a significant effect on postoperative complications (odds ratio, 6.25; P = .037). Age group did not have an effect on the complication rate in the pediatric population. Pediatric otolaryngologists had higher rates of postoperative complications ( P = .001), prolonged operative times ( P < .001), and fewer outpatient procedures ( P < .001). Conversely, in adults, otolaryngologists had fewer postoperative complications. Conclusion Postoperative complications following BCC excision are relatively uncommon, demonstrating procedural safety when performed at any age.

scholarly journals Analysis of the relationship between periodontitis and osteoporosis/fractures: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Seok-Jin Hong ◽  
Byoung-Eun Yang ◽  
Dae-Myoung Yoo ◽  
Sung-Jae Kim ◽  
Hyo-Geun Choi ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Bone Destruction ◽  
Epidemiological Data ◽  
Income Group ◽  
Cross Sectional Study ◽  
Inflammatory Factors ◽  
Sectional Study ◽  
Mineral Density ◽  
Cross Sectional ◽  
History Of

Abstract Background Chronic periodontitis is a multifactorial inflammatory disease resulting in patients exhibiting high levels of inflammatory factors causing systemic inflammatory bone destruction that may lead to osteoporosis development. The association between periodontitis and osteoporosis has been documented; however, the findings remain unclear. This study aimed to identify the association between periodontitis and osteoporosis using a cross-sectional study design and Korean Genome and Epidemiology Study (KoGES) health examinee data. Methods This cross-sectional study used epidemiological data from the KoGES during 2004–2016. Of 125,324 participants (age, 40–79 years), 9969 with periodontitis and 115,332 controls (without periodontitis) were selected. We analyzed the history of osteoporosis and fractures of all participants. All participants were examined according to age, sex, income group, obesity, smoking habits, alcohol consumption, and food intake. To analyze the odds ratio (OR) of periodontitis for those with osteoporosis and fractures, a logistic regression model was used. Results The adjusted odds ratio (aOR) of periodontitis for osteoporosis was 2.16 (95% confidence interval [CI], 2.01–2.31; P < 0.001). The aOR of periodontitis for any fracture was 1.54 (95% CI 1.46–1.62; P < 0.001). Conclusion Osteoporosis and fractures are associated with periodontitis. Performing regular oral hygiene and examinations of bone mineral density are recommended to prevent aggravation of osteoporosis and periodontitis.

Perioperative management after elective cardiac surgery: the predictive value of procalcitonin for infective and noninfective complications

2021 ◽  
Author(s):  
Alice Laudisio ◽  
Antonio Nenna ◽  
Marta Musarò ◽  
Silvia Angeletti ◽  
Francesco Nappi ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Complications ◽  
Predictive Value ◽  
Odds Ratio ◽  
Rate Ratio ◽  
Perioperative Management ◽  
Incidence Rate Ratio ◽  
Adverse Outcomes ◽  
Elective Cardiac Surgery ◽  
The Third

Objective: Procalcitonin (PCT) has been associated with adverse outcomes after cardiac surgery. Nevertheless, there is no consensus on thresholds and timing of PCT measurement to predict adverse outcomes. Materials & methods: A total of 960 patients undergoing elective cardiac surgery were retrospectively evaluated. PCT levels were measured from the first to the seventh postoperative day (POD). The onset of complications was recorded. Results: Complications occurred in 421 (44%) patients. PCT on the third POD was associated with the occurrence of any kind of complications (odds ratio: 1.06; p: 0.037), and noninfectious complications (odds ratio: 1.05; p: 0.035), after adjusting. PCT above the median value at the third POD (>0.33 μg/l) predicted postoperative complications (incidence rate ratio: 1.13; p = 0.035). Conclusion: PCT seems to predict postoperative complications in cardiac surgery. The determination at the third POD yields the greatest sensitivity and specificity.

HUBUNGAN TINGKAT PENGETAHUAN MENGENAI DIET HIPERTENSI TERHADAP KEJADIAN HIPERTENSI PADA LANSIA DI PUSKESMAS BALOI PERMAI BATAM KOTA

2020 ◽  
Vol 9 (1) ◽  
pp. 50-60
Author(s):  
Brain Guntoro ◽  
Kasih Purwati
Keyword(s):  
Public Health ◽  
Health Center ◽  
The Elderly ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Public Health Center ◽  
Chi Square Test ◽  
History Of ◽  
Level Of Knowledge

Hypertension is one of the number one causes of death and disability in the world. Hypertension contributes nearly 9.4 million deaths from cardiovascular disease each year. Hypertension can cause undesirable effects, it needs good handling, one of them is by doing a hypertension diet. To carry out a hypertension diet requires knowledge, lack of knowledge can increase risk factors for hypertension. This study aims to determine the relationship of the level of knowledge about hypertension diet to the incidence of hypertension in the elderly at the Baloi Permai Public Health Center Batam City. This research method is an analytic observational with a cross-sectional approach conducted at the Baloi Permai Public Health Center Batam City 2018. Sampling technique is a total sampling with a sample of 64 people in 2018 determined by inclusion and exclusion criteria. The results of the study were analyzed with frequency distribution and then tested with the Chi-square test. Based on the results of this study indicate that of the 64 respondents found elderly who have a good level of knowledge are 41 people (64.1%), 48 people (75.0%) have an age range between 60-70 years. 27 people (42.2%) elderly have the last high school education and 40 people (62.5%) have jobs as entrepreneurs. Elderly people who have normal blood pressure are 40 people (62.5%), and those affected by hypertension are 24 people (37.5%). The elderly who have a family history of hypertension is 21 people (32.8%) and those who do not have a history of hypertension are 43 people (67.2%). Chi-Square Test analysis results show the significance value p = 0.009. This number is significant because the p-value is smaller than the significance level (α) ≤ 5% (0.05), so H0 is rejected and Ha is accepted. Therefore it can be concluded that there is a significant relationship about the level of knowledge about the hypertension diet to the incidence of hypertension in the elderly. From the results of this study it was concluded that there was a relationship between the level of knowledge about the hypertension diet and the incidence of hypertension in the elderly at the Baloi Permai Public Health Center Batam City in 2016.

scholarly journals Comparison of Sarcopenia with Modified Frailty Index as a Predictor of Adverse Outcomes in Critically Ill Elderly Patients

2021 ◽  
pp. 200-206
Author(s):  
Shrirang Bhurchandi ◽  
Sachin Agrawal ◽  
Sunil Kumar ◽  
Sourya Acharya
Keyword(s):  
Elderly Patients ◽  
Critically Ill ◽  
Health Care Cost ◽  
Frailty Index ◽  
The Elderly ◽  
Time Frame ◽  
Adverse Outcomes ◽  
Cross Sectional ◽  
Parametric Data ◽  
Modified Frailty Index

Background: Ageing is a global fact affecting both developed and developing countries.It brings out various catabolic changes in body resulting in frailty(i.e. the person is not able to with stand minor stresses of the environment, due to reduced reserves in psychologicalreserve of several organ system).Thus causing a great burden of disease, dependence & health care cost. Sarcopenia is the leading component for frailty in the elderly population, but very few studies have been done in India for correlating frailty with sarcopenia. Aim: To compare sarcopenia with modified frailty index (MFI) as a predictor of adverse outcomes in critically ill elderly patients. Methodology: Cross-sectional study will be performed on all the critically ill geriatric subjects/patients coming to all the ICU's of AVBRH, Sawangi (M), Wardha who will satisfy various inclusion and exclusion criteria for selection and all standard parametric & non-parametric data will be assessed by using standard descriptive & inferential statistics. Expected Results: In our study, we are anticipating that the Modified frailty index to be a better predictor of adverse outcomes in terms of mortality as compared to sarcopenia in the critically ill elderly patients. Also, we are anticipating that sarcopenia to be the most important contributor of frailty in critically ill elderly patients and the prevalence of frailty will be high in critically ill elderly patients. Limitation: Due to limited time frame & resources we will not be able to follow up the patients.

scholarly journals Relationship between Periodontitis and Glaucoma: A Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Soo Hwan Byun ◽  
Dae Myoung Yoo ◽  
Minwook Chang ◽  
Hyo Geun Choi ◽  
Seok Jin Hong
Keyword(s):  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Epidemiological Data ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Epidemiology Study ◽  
Chi Square ◽  
Cross Sectional ◽  
History Of ◽  
And Control

The objective of this cross-sectional study was to evaluate the association between periodontitis and glaucoma. This prospective cohort study used epidemiological data from the Korean Genome and Epidemiology Study performed between 2004 and 2016. Among 173,209 participants, 9572 patients with periodontitis and 115,332 controls (nonperiodontitis) were selected. We analysed the history of glaucoma in periodontitis and control participants. The participants were interviewed regarding their history of hypertension, diabetes mellitus, hyperlipidaemia, periodontitis, glaucoma, smoking, and alcohol consumption by trained interviewers. A logistic regression model was created to analyse the odds ratio of having a history of glaucoma among patients with periodontitis. Two-tailed analyses using chi-square and independent t-tests were used for statistical analysis. The adjusted odds ratio of periodontitis as a risk factor for glaucoma was 3.44 (95% confidence interval = 2.99–3.97, p < 0.001 ). This study demonstrated that glaucoma was associated with periodontitis.

scholarly journals Nutritional Insufficiency as a Predictor for Adverse Outcomes in Adult Spinal Deformity Surgery

2017 ◽  
Vol 8 (2) ◽  
pp. 164-171 ◽  
Author(s):  
Kevin Phan ◽  
Jun S. Kim ◽  
Joshua Xu ◽  
John Di Capua ◽  
Nathan J. Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Postoperative Complications ◽  
Adult Spinal Deformity ◽  
Cohort Analysis ◽  
Adverse Outcomes ◽  
Red Blood Cell Transfusion ◽  
Improvement Program ◽  
Adult Deformity ◽  
Nutritional Insufficiency

Study Design: Retrospective analysis of prospectively collected data. Objective: The effect of malnutrition on outcomes after general surgery has been well reported in the literature. However, there is a paucity of data on the effect of malnutrition on postoperative complications during adult deformity surgery. The study attempts to explore and quantify the association between hypoalbuminemia and postoperative complications. Methods: A retrospective cohort analysis was performed on the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2010 to 2014. Patients (≥18 years of age) from the NSQIP database undergoing adult deformity surgery were separated into cohorts based serum albumin (<3.5 or >3.5 g/dL). Chi-square and multivariate logistic regression models were used to identify independent risk factors. Results: A total of 2236 patients met the inclusion criteria for the study, of which 2044 (91.4%) patients were nutritionally sufficient while 192 (8.6%) patients were nutritionally insufficient. Multivariate logistic regressions revealed nutritional insufficiency as a risk factors for mortality (odds ratio [OR] = 15.67, 95% confidence interval [CI] = 6.01-40.84, P < .0001), length of stay ≥5 days (OR = 2.22, 95% CI = 1.61-3.06, P < .0001), any complications (OR = 1.82, 95% CI = 1.31-2.51, P < .0001), pulmonary complications (OR = 2.29, 95% CI = 1.29-4.06, P = .005), renal complications (OR = 2.71, 95% CI = 1.05-7.00, P = .039), and intra-/postoperative red blood cell transfusion (OR = 1.52, 95% CI = 1.08-2.12, P = .015). Conclusions: This study demonstrates that preoperative hypoalbuminemia is a significant and independent risk factor for postoperative complications, 30-day mortality, and increased length of hospital in patients undergoing adult deformity surgery surgery. Nutritional status is a modifiable risk factor that can potentially improve surgical outcomes after adult deformity surgery.

scholarly journals Incontinence-associated dermatitis in elderly patients: prevalence and risk factors

2020 ◽  
Vol 73 (suppl 3) ◽  
Author(s):  
Mariana Ferreira ◽  
Luciana Abbade ◽  
Silvia Cristina Mangini Bocchi ◽  
Hélio Amante Miot ◽  
Paulo Villas Boas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Early Recognition ◽  
Statistical Significance ◽  
The Elderly ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Preventive Actions ◽  
Pressure Injury ◽  
High Level

ABSTRACT Objective: To determine the prevalence and risk factors for incontinence-associated dermatitis in the elderly. Method: Cross-sectional exploratory study carried out in public hospitals. The dermatitis prevalence and associations were obtained by calculating the ratio. The effect dimension was estimated by the odds ratio with a 95% confidence interval and statistical significance p <0.05. Results: 138 elderly people were included, with an average age of 77.2 years old (± 9.3); 69 (50%) had combined fecal and urinary incontinence. The dermatitis prevalence was 36.2% (50); 28% (14) had pressure injuries; 14% (7), candidiasis. Risk factors were: longer hospital stay (Odds Ratio = 5.8 [2.6-12.9]), obesity (Odds Ratio = 3.6 [1.2-10.4]), high level of dependence (Odds Ratio = 2.4 [1,1-5,0]) and high risk for pressure injury (Odds Ratio = 6.1 [1,4-26,9]). Conclusion: The study found a high prevalence of dermatitis associated with incontinence. The early recognition of risk factors favors effective preventive actions.

scholarly journals Symptom control among asthmatics with a clinically significant smoking history: a cross-sectional study in Finland

2020 ◽  
Author(s):  
Toni Kiljander ◽  
Tuija Poussa ◽  
Timo Helin ◽  
Antero Jaakkola ◽  
Kari Venho ◽  
...  
Keyword(s):  
Asthma Symptom ◽  
Smoking Status ◽  
Symptom Control ◽  
Cross Sectional Study ◽  
Smoking History ◽  
Sectional Study ◽  
Uncontrolled Asthma ◽  
Cross Sectional ◽  
History Of ◽  
Clinically Significant

Abstract Background Surprisingly little is known about asthma control among asthmatics who smoke. The aim of this cross-sectional study was to investigate asthma symptom control according to the GINA guidelines among asthmatics with a clinically significant smoking history. Methods One hundred ninety asthmatics from primary care in Finland were investigated. The patients were current or previous cigarette smokers with a history of 10 or more pack-years. They completed a questionnaire including questions on asthma symptoms and reliever use so that their level of asthma symptom control (well controlled, partly controlled, or uncontrolled) according to GINA could be determined. Results Sixty-six (34.7%) patients had their asthma well controlled, 81 (42.6%) had their asthma partly controlled, and 43 (22.6%) had uncontrolled asthma. Current smokers had uncontrolled asthma more often than ex-smokers, OR 2.54 (95% CI 1.25-5.14, p=0.01). Patients with moderate to severe asthma exacerbation during the previous year had uncontrolled asthma more often than patients without an exacerbation, OR 2.17 (95% CI 1.06-4.47, p=0.04), and patients with FEV1 < 80% of predicted had uncontrolled asthma more often than patients with FEV1 > 80% of predicted, OR 2.04 (95% CI 1.02-4.08, p=0.04). Conclusions Asthmatic patients with a clinically significant smoking history often do not have well controlled asthma. Poor asthma symptom control was associated with current smoking status, history of exacerbations and impaired lung function. Therefore, every attempt should be made to help asthmatics who smoke to quit smoking.

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