Pediatric Tracheostomy-Related Complications: ACross-sectional Analysis

2021 ◽  
pp. 019459982110465
Author(s):  
Micah Newton ◽  
Romaine F. Johnson ◽  
Erin Wynings ◽  
Hussein Jaffal ◽  
Stephen R. Chorney
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Logistic Regression Analysis ◽  
Reflux Disease ◽  
Pediatric Patients ◽  
Hospital Admissions ◽  
Multiple Logistic Regression Analysis ◽  
Sectional Analysis

Objective To determine the rate of tracheostomy-related complications in pediatric patients from nationally representative databases. Study Design Cross-sectional analysis. Setting 2016 Kids’ Inpatient Database and 2016 Nationwide Readmission Database. Methods All pediatric tracheostomy procedures were included. Complication type, admission outcomes, and readmission rates were recorded with a logistic regression analysis to determine patient characteristics associated with complications. Results An estimated 5309 tracheostomies were performed among pediatric patients in 2016, 8% (n = 432) of whom developed tracheostomy-related complications. This group was younger (4.7 vs 8.7 years, P < .001) and required longer hospital admissions (68.7 vs 33.2 days, P < .001) than children without tracheostomy-related complications. Mean costs ($459,324 vs $397,937, P < .001) and mean total charges ($1,573,964 vs $1,099,347, P < .001) were increased if a tracheostomy-related complication occurred. These events occurred more often in those with bronchopulmonary dysplasia (24% vs 12%, P < .001), heart disease (24% vs 12%, P = .001), gastroesophageal reflux disease (31% vs 19%, P < .001), short gestational age (24% vs 14%, P < .001), and subglottic stenosis (9.9% vs 5.4%, P = .001). The estimated 30-day readmission rate was 24% (SE, 1.7%) but did not increase after tracheostomy complications (27% vs 15%, P = .04). Tracheostomy-related complications were predicted by gastroesophageal reflux disease (odds ratio [OR], 1.50; 95% CI, 1.14-1.97; P = .004), younger age (OR, 1.12; 95% CI, 1.04-1.22; P = .002), and lengthier hospitalization (OR, 1.00; 95% CI, 1.00-1.01; P < .001) on multiple logistic regression analysis. Conclusion Tracheostomy-related complications occur in approximately 8% of pediatric patients and are higher in younger children or those with longer admission lengths. These data have implications for benchmarking standards of posttracheostomy complications across institutions.

scholarly journals Severity Scoring System to Predict the Necessity of Regular Transfusion among Patients with Hemoglobin H

2020 ◽  
Author(s):  
Duantida Songdej ◽  
Manunya Tandhansakul ◽  
Ampaiwan Chuansumrit ◽  
Nongnuch Sirachainan ◽  
Pimlak Charoenkwan ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Scoring System ◽  
Pediatric Patients ◽  
Transfusion Requirement ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Severity Scoring ◽  
Wide Range

Background: Hemoglobin H (HbH) is usually recognized as mild thalassemia. However, a wide range of clinical manifestations, from fatal hydrops fetalis to asymptomatic mild anemia, is observed. A severity scoring system to guide the management of patients with HbH is needed. Objective: To develop a scoring system to predict the necessity of regular transfusion among patients with HbH. Methods: Patients were classified into 2 groups according to transfusion requirement: severe among transfusion-dependent thalassemia (TDT) and nonsevere among nontransfusion-dependent thalassemia (NTDT). Clinical and hematological parameters associated with transfusion dependency were identified and β-coefficients of significant parameters from multiple logistic regression analysis were used to develop a scoring system. Results: A total of 247 pediatric patients (24 severe, 223 nonsevere) with a median age of 14.3 (IQR 9.9-18.4) years were included. Multiple logistic regression analysis revealed 3 significant parameters associated with regular transfusion requirement including 1) age at diagnosis <2 years, 2) spleen size ≥3 cm and 3) Hb at steady-state <8 g/dL. Coefficients of the respective parameters were used to define the scores as 1, 2 and 2, respectively. A total score of ≥3 was associated with regular transfusion requirement among severe HbH (sensitivity 88%, specificity 83%). The newly developed scoring system was validated in the second cohort of 134 pediatric patients with HbH treated at another center. The cut-off score ≥3 yielded comparable sensitivity and specificity for the prediction.

scholarly journals Prior Admissions as a Risk Factor for Readmission in Patients Surgically Treated for Femur Fractures: Implications for a Potential Hip Fracture Bundle

2021 ◽  
Vol 12 ◽  
pp. 215145932199616
Author(s):  
Robert Erlichman ◽  
Nicholas Kolodychuk ◽  
Joseph N. Gabra ◽  
Harshitha Dudipala ◽  
Brook Maxhimer ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Hip Fracture ◽  
Logistic Regression Analysis ◽  
Hip Fractures ◽  
Surgical Procedure ◽  
Hospital Admissions ◽  
Fracture Care ◽  
Increased Risk ◽  
Payment Models

Introduction: Hip fractures are a significant economic burden to our healthcare system. As there have been efforts made to create an alternative payment model for hip fracture care, it will be imperative to risk-stratify reimbursement for these medically comorbid patients. We hypothesized that patients readmitted to the hospital within 90 days would be more likely to have a recent previous hospital admission, prior to their injury. Patients with a recent prior admission could therefore be considered higher risk for readmission and increased cost. Methods: A retrospective chart review identified 598 patients who underwent surgical fixation of a hip or femur fracture. Data on readmissions within 90 days of surgical procedure and previous admissions in the year prior to injury resulting in surgical procedure were collected. Logistic regression analysis was used to determine if recent prior admission had increased risk of 90-day readmission. A subgroup analysis of geriatric hip fractures and of readmitted patients were also performed. Results: Having a prior admission within one year was significantly associated (p < 0.0001) for 90-day readmission. Specifically, logistic regression analysis revealed that a prior admission was significantly associated with 90-day readmission with an odds ratio of 7.2 (95% CI: 4.8-10.9). Discussion: This patient population has a high rate of prior hospital admissions, and these prior admissions were predictive of 90-day readmission. Alternative payment models that include penalties for readmissions or fail to apply robust risk stratification may unjustly penalize hospital systems which care for more medically complex patients. Conclusions: Hip fracture patients with a recent prior admission to the hospital are at an increased risk for 90-day readmission. This information should be considered as alternative payment models are developed for hip fracture care.

scholarly journals Association between obesity and chronic rhinosinusitis with nasal polyps: a national population-based study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e047230
Author(s):  
Jae-Sung Nam ◽  
Yun Ho Roh ◽  
Wasan Almazouq Fahad ◽  
Hae-Eun Noh ◽  
Jong-Gyun Ha ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Chronic Rhinosinusitis ◽  
Logistic Regression Analysis ◽  
Central Obesity ◽  
Nasal Polyps ◽  
Control Group ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

ObjectivesWe performed a cross-sectional analysis of data from the nationwide Korea National Health and Nutrition Examination Survey to evaluate the association between obesity and chronic rhinosinusitis with nasal polyps (CRSwNP) or without nasal polyp (CRSsNP).DesignRetrospective cross-sectional analysis of health survey data.SettingVoluntary survey of representative South Korean populations.ParticipantsIn total, 32 384 individuals aged 19 years or older with available data on CRS and obesity were included.Primary and secondary outcome measuresDiagnosis of CRSwNP or CRSsNP was performed by trained otolaryngologists through sinus endoscopy and surveys of medical history. General and central obesity was diagnosed using body mass index (BMI) and waist circumference (WC), respectively.MethodsA multivariate logistic regression analysis was used to clarify the association between CRSwNP or CRSsNP and obesity according to BMI and WC. Non-obese individuals were recruited as controls.ResultsThe prevalence of CRSwNP was higher in the general (OR, 1.438; 95% CI, 1.170 to 1.768; p<0.001) and central (OR, 1.251; 95% CI, 1.031 to 1.520; p=0.033) obesity groups than in the control group. Prevalence of CRSsNP was not correlated with obesity. In a logistic regression analysis, olfactory dysfunction (OR, 1.329; 95% CI, 1.137 to 1.553; p<0.001) and purulent discharge (OR, 1.383; 95% CI, 1.193 to 1.603; p<0.001) showed a higher incidence in the central obesity group than in the control group.ConclusionsWe demonstrated an association between CRSwNP and general and central obesity. Further investigations on the mechanism underlying this correlation are necessary for an improved understanding of the pathogenesis of CRSwNP.

scholarly journals Annual Disease Experience by Type and Correlations with Unmet Healthcare Needs among ROK Military Personnel

2020 ◽  
Vol 185 (7-8) ◽  
pp. e944-e951
Author(s):  
Hwi Jun Kim ◽  
Sarah So Yeon Oh ◽  
Dong Woo Choi ◽  
Sun Yeong Won ◽  
Hae Jung Kim ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Military Personnel ◽  
Private Insurance ◽  
Multiple Logistic Regression Analysis ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
Number Of Patients ◽  
Disease Experience

Abstract Introduction The National Statistical Yearbook of Defense 2018 issued by the Republic of Korea (ROK) Ministry of National Defense reported that the number of patients using military hospitals steadily increased from 2008 to 2017. However, in the outpatient clinic statistics for years 2015–2017 from the ROK Armed Forces Medical Command, the amount of medical care received from some medical departments, such as the infection medicine, surgery, and anesthesiology departments, decreased. Therefore, the purpose of this study was to observe the differences in incidence of military personnel’s unmet healthcare needs according to number of diseases by type. Materials and Methods The study used data from the Military Health Survey, which was conducted from 2014 to 2015 and included 5162 responses from ROK military personnel. The number of diseases by type and unmet healthcare needs were self-reported. A multiple logistic regression analysis was used to examine the validity of the annual disease experience by type and correlations with unmet healthcare needs. Results Of the 5162 military personnel, 25.2% experienced unmet healthcare needs, and the more people with the number of disease by type, the more likely they were to experience unmet healthcare needs (1: 13.4%, 2: 22.9%, 3: 29.2%, 4: 34.5%, 5: 41.4%). The logistic regression analysis also revealed significant differences (1 = REF, 2 odds ratio (OR) = 1.83, 95% confidence interval (CI): 1.50–2.24; 3 OR = 2.53, 95% CI: 2.05–3.11, 4 OR = 3.10, 95% CI = 2.49–3.85; ≥5 OR = 3.85, 95% CI = 3.08–4.81). In addition, subgroup analysis showed that female military personnel are more likely to experience unmet healthcare needs than are male military personnel. We have also confirmed that working areas and private insurance can affect unmet healthcare needs. Conclusion This study suggests that unmet healthcare needs are influenced by the number of disease by the type of ROK military personnel. It is therefore necessary to strive to reduce the number of military personnel who experience unmet healthcare needs through this data.

scholarly journals Prevalence of postural deviations and associated factors in children and adolescents: a cross-sectional study

2016 ◽  
Vol 29 (4) ◽  
pp. 777-786 ◽  
Author(s):  
Mariana Vieira Batistão ◽  
Roberta de Fátima Carreira Moreira ◽  
Helenice Jane Cote Gil Coury ◽  
Luis Ernesto Bueno Salasar ◽  
Tatiana de Oliveira Sato
Keyword(s):  
Physical Activity ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Associated Factors ◽  
Multiple Logistic Regression Analysis ◽  
Extrinsic Factors ◽  
Cross Sectional ◽  
Postural Changes ◽  
Intrinsic And Extrinsic Factors

Abstract Introduction: Postural deviations are frequent in childhood and may cause pain and functional impairment. Previously, only a few studies have examined the association between body posture and intrinsic and extrinsic factors. Objective: To assess the prevalence of postural changes in school children, and to determine, using multiple logistic regression analysis, whether factors such as age, gender, BMI, handedness and physical activity might explain these deviations. Methods: The posture of 288 students was assessed by observation. Subjects were aged between 6 and 15 years, 59.4% (n = 171) of which were female. The mean age was 10.6 (± 2.4) years. Mean body weight was 38.6 (± 12.7) kg and mean height was 1.5 (± 0.1) m. A digital scale, a tapeline, a plumb line and standardized forms were used to collect data. The data were analyzed descriptively using the chi-square test and logistic regression analysis (significance level of 5%). Results: We found the following deviations to be prevalent among schoolchildren: forward head posture, 53.5%, shoulder elevation, 74.3%, asymmetry of the iliac crests, 51.7%, valgus knees, 43.1%, thoracic hyperkyphosis, 30.2%, lumbar hyperlordosis, 37.2% and winged shoulder blades, 66.3%. The associated factors were age, gender, BMI and physical activity. Discussion: There was a high prevalence of postural deviations and the intrinsic and extrinsic factors partially explain the postural deviations. Conclusion: These findings contribute to the understanding of how and why these deviations develop, and to the implementation of preventive and rehabilitation programs, given that some of the associated factors are modifiable.

scholarly journals Analysis and Factors Associated with Measles in Larut, Matang and Selama Districts, Perak, Malaysia

2020 ◽  
Vol 27 (5) ◽  
pp. 130-140
Author(s):  
Asraf Ahmad Qamruddin ◽  
Reza Qamruddin ◽  
Ayu Malik
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Incidence Rate ◽  
Logistic Regression Analysis ◽  
Protective Factor ◽  
Multiple Logistic Regression Analysis ◽  
Prior History ◽  
Multiple Logistic Regression ◽  
Case Definitions ◽  
Factors Associated

Objectives: To determine the incidence rate of measles and the factors associated with confirmed measles cases in Larut, Matang and Selama districts. Methods: Cross-sectional analysis was carried out looking at all suspected and laboratoryconfirmed measles cases in Larut, Matang and Selama districts between 2015 and 2019. Multiple logistic regression analysis was used to determine the associated factors for laboratory-confirmed measles cases. Results: The incidence rate for suspected measles showed an increasing trend from 2015–2019. For laboratory-confirmed measles cases, the incidence rate showed more variation with an increase to 36.11 per million population in 2017 from 5.67 per million population in 2015. The incidence rate later decreased to 10.99 per million population in 2018 and increased again to 24.47 per million population in 2019. From multiple logistic regression analysis, cases that fulfilled the case definition of measles were more likely to be laboratory-confirmed measles. On the other hand, a prior history of measles immunisation was a protective factor. Conclusion: Measles incidence is increasing in trend. Any suspected measles cases that fulfilled the clinical case definitions need to be further investigated. Immunisation should be promoted as they are effective in preventing and eliminating measles.

scholarly journals Syrian mothers, why to accept or to refuse HPV vaccine for their teen girls

2018 ◽  
Vol 1 (1) ◽  
pp. 7-13
Author(s):  
Mohammed Al Saad ◽  
Saad Ahmed Ali Jadoo
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Hpv Vaccine ◽  
Multiple Logistic Regression Analysis ◽  
Univariate Analysis ◽  
Cluster Sampling ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Gynecological Examination

Background: Cervical cancer (CC) ranks the eighth most frequent cancer among Syrian women with crude incidence rates 1.4 per 100, 000 populations per year. This study aimed to test the acceptance of the human papillomavirus (HPV) vaccine among mothers of schoolgirls in sixth-grade class. Methods: A cross-sectional survey was conducted through a structured and self-administrated questionnaire. A total of 400 Syrian mothers of schoolgirls were selected randomly by the cluster sampling method in Aleppo city, Syria, in 2011. Significant variables from univariate analysis were included in an enter technique multiple logistic regression analysis. Results: The response rate was 86%. If the vaccine was free, 282 (81.7%) mothers would accept the vaccine for themselves and 236 (68.4%) for their daughters, respectively. However, the acceptance rate grossly decreased to 24.6% and 15.1%, respectively, if the vaccine was not provided free. The high cost of the HPV vaccine and lack of knowledge were the significant barriers for mothers' acceptance of the HPV vaccine. Protection of daughters and the trust with health authority were the main encouraging reasons to accept the HPV vaccine. Findings from logistic regression analysis revealed that the employed mothers (odds ratio = 2.4; 95% CI: 1.3–4.4), with a positive history of gynecological examination (OR = 2.1; 95% CI: 1.6–2.9) and having sound knowledge (OR = 2.4; 95% CI: 1.0–5.7) are independent factors related to the acceptance of the HPV vaccine for their daughters. Conclusion: The results from this study suggest that mothers from different cultural backgrounds, including Syrian mothers, are holding different beliefs on privacy and health that may affect their willingness to accept the HPV vaccine.

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