Case control study of gastrointestinal complications after cardiopulmonary bypass heart surgery

Perfusion ◽  
2009 ◽  
Vol 24 (3) ◽  
pp. 173-178 ◽  
Author(s):  
Guowei Zhang ◽  
Naishi Wu ◽  
Hongyu Liu ◽  
Hang Lv ◽  
Zhifa Yao ◽  
...  

Background: Gastrointestinal complications (GIC) after cardiopulmonary bypass (CPB) surgery are rare, but, nevertheless, extremely dangerous.The identification of risks for GIC may be helpful in planning appropriate perioperative management strategies. The aim of the present study was to analyze perioperative factors of GIC in patients undergoing CPB surgery. Methods: We retrospectively analysed 206 patients who underwent GIC after cardiopulmonary bypass surgery from 2000 to 2007 and compared them with 206 matched control patients (matched for surgery, temperature, hemodilution and date). Univariate analysis and multiple logistic regression analysis were performed on 12 risk factors. Result: Sex and types of cardioplegia perfusate did not significantly influence the GIC after CPB surgery. Multiple logistic regression revealed that CPB time, preoperative serum creatinine (PSC) ≥ 179 mg/dL, emergency surgery, perfusion pressure ≤40mmHg, low cardiac output syndrome (LCOS), age ≥ 61, mechanical ventilation ≥96 h, New York Heart Association (NYHA) class III and IV were predictors of the occurrence of GIC after CPB surgery. Perfusion pressure and aprotinin administration were protective factors. Conclusion: Gastrointestinal complications after CPB surgery could be predictive in the presence of the above risk factors. This study suggests that GIC can be reduced by maintenance of higher perfusion pressure and shortening the time on CPB and ventilation.

Author(s):  
Nayani Radhakrishna ◽  
Ankur Khandelwal ◽  
Rajendra Singh Chouhan ◽  
Mihir Prakash Pandia ◽  
Sourav Burman ◽  
...  

Abstract Background Intraoperative aneurysmal rupture (IAR) is a catastrophic complication; however, its impact on neurological outcome is debatable. We studied the effects of IAR on intraoperative and postoperative complications and neurological outcome. Methods In this retrospective study, adult patients who underwent aneurysmal clipping over a period of 2 years were divided as follows: group R (with IAR) and group N (without IAR). Various perioperative parameters, intraoperative and postoperative complications were noted. Glasgow outcome scale (GOS) was noted at discharge from hospital and categorized as favorable (GOS IV and V) and unfavorable (GOS I, II and III). Collected data was statistically analyzed. Univariate and multiple logistic regression analyses were performed to identify predictors of IAR. A p value < 0.05 was considered significant. Results Thirty-two out of 195 (16.41%) patients suffered IAR, with majority involving anterior communicating artery aneurysm (46.88%). Duration of temporary clipping (p < 0.001), volume of blood loss, and fluid and blood transfusion were significantly more in group R. Postoperatively, significantly more patients in group R developed intracranial hematoma, cerebral infarct, and required prolonged ventilatory support (≥5 days). Unfavorable neurological outcome was observed more in group R (p = 0.013). In univariate analysis, blood loss > 500 mL, use of colloids, and duration of surgery > 5 hours were found to be associated with IAR. After multiple logistic regression analysis, only use of colloids and duration of surgery > 5 hours were the most predictive variables for IAR. Conclusions IAR is associated with serious intraoperative and postoperative complications and unfavorable neurological outcome.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saibin Wang ◽  
Renzhi Zhou ◽  
Siyao Zhu ◽  
Dan Yan

Abstract Background Therapeutic bronchoscopy is one of the effective methods in the treatment and management of malignant central airway stenosis (MCAS). However, restenosis after therapeutic bronchoscopy frequently occurs and severe restenosis (SR) can be life-threatening. Therefore, this study aimed at investigating the risk factors for SR after therapeutic bronchoscopy. Methods The data of 233 consecutive cases with MCAS who were subjected to therapeutic bronchoscopy between 2015 and 2020 at a tertiary hospital were collected. Patients were divided into SR group and non-SR during 6 months after therapeutic bronchoscopy. Multiple logistic regression analysis was performed to determine the risk factors for SR. Results SR during 6 months after therapeutic bronchoscopy occurred in 39.5% (92/233) of patients. The location and the initial degree of MCAS were associated with SR, as assessed by multiple logistic regression analysis (P < 0.05). The risk of SR after therapeutic bronchoscopy in the left main bronchus, right main bronchus, and right intermediate bronchus increased, compared to the risk when of MCAS was located in the trachea (OR (95% CI) of 8.821 (1.850-25.148), 6.583 (1.791–24.189), and 3.350 (0.831–13.511), respectively). In addition, the initial degree of MCAS was positively associated with an increased risk of SR (OR 1.020; 95% CI 1.006–1.035). Conclusions MCAS located in the left main bronchus, right main bronchus and right intermediate bronchus, as well as the higher initial degree of MCAS were independent risk factors for SR during 6 months after therapeutic bronchoscopy.


2020 ◽  
Vol 9 (2) ◽  
pp. 47-53
Author(s):  
Kashyap Dahal ◽  
A. Baral ◽  
K.K. Sah ◽  
J.R. Shrestha ◽  
A. Niraula ◽  
...  

Background and Aims: Cardiovascular disease (CVD) is the commonest cause of morbidity and mortality in patients with chronic kidney disease (CKD) due to increased prevalence of traditional and nontraditional CVD risk factors. Our study aimed to evaluate these risk factors in pre-dialysis Nepalese CKD patients. Methods: This was a cross-sectional study conducted in Department of Nephrology, Bir hospital. Total 100 consecutive pre-dialysis CKD patients were enrolled. Ten traditional and six nontraditional CVD risk factors were analyzed and compared between CKD stages. Descriptive statistics was used to illustrate the socio-demographic and clinical characteristics, chi square test for categorical variables and multiple logistic regression analysis was done to determine the risk factors of CVD in CKD patients. p-value<0.05 was considered to be statistically significant. Results: Mean patient age was 52.03}13.64 years with majority (60%) of the patients being male. Comparison of traditional risk factors in different stages depicted similar trend except for old age in Stage 3 CKD (p=0.002). Anemia (p<0.001), hyperphosphatemia (p=0.01), hyperparathyroidism (p<0.01) and cumulative nontraditional risk factors were significantly higher (p=0.01) in stage 5 CKD. The predicted CVD events by Framingham risk score showed high risk in 37% with no significant difference among the stages. Multiple logistic regression analysis showed increased body mass index, low serum albumin and increased serum phosphate as the three significant predictors for left ventricular hypertrophy. Conclusion: Our study shows that the CVD risk factors were prevailing along the various stages of CKD. The occurrence of non-traditional risk factors increased with increasing stage of CKD.


2021 ◽  
Author(s):  
Jun Zhou ◽  
Jiule Ding ◽  
Jie Chen ◽  
Liang Pan ◽  
Tingting Zha ◽  
...  

Abstract Objective To explore the association between quantitative classification of renal surface nodularity (qRSN) based on computed tomography (CT) imaging and early renal injury (ERI) in patients with aerial hypertension.Methods A total of 143 patients with a history of hypertension were retrospectively enrolled; clinical information (age, sex, hypertension grade, hypertension course, poorly controlled hypertension), laboratory tests and qRSN were collected or assessed. The subjects were divided into an ERI (n=60) or a control (CP, n=83) group according to ERI diagnosis based on the following criteria: cystatin C > 1.02 mg/L, creatinine ≤ 127 μmol/L, and urea nitrogen ≤ 8.3 mmol/L. Univariate analysis and multiple logistic regression were used to examine the association between ERI and qRSN. A receiver operating characteristic curve (ROC) was produced to compare multiple logistic regression models with or without qRSN for differing the ERI group from the control group.Results In univariate analysis, hypertension grade, poorly controlled hypertension, hypertension course, triglycerides (TG) and qRSN were related to ERI in patients with arterial hypertension (all P<0.1), with strong interrater agreement of qRSN. Multiple logistic regression analysis showed an area under the ROC curve of 0.705 in the model without qRSN and 0.789 in the model with qRSN, which was significantly different (Z=2.317, P=0.021).Conclusion CT imaging-based qRSN was associated with ERI in patients with arterial hypertension and may be an imaging biomarker of early renal injury.


2021 ◽  
Vol 20 (4) ◽  
Author(s):  
Abdul Hadi Said ◽  
Muhammad Addin Nur Hakim Azmi ◽  
Haziqah Mohd Hanapiah ◽  
Anis Wardati Abdullah ◽  
Mohd Shaiful Ehsan Shalihin

Introduction: Globally, depression is one of the serious problems reported among medical students. Various studies reported that the prevalence of depression among medical students was high due to multiple risk factors. Therefore, this study aimed to measure the prevalence of depression and its associated factors among medical students in International Islamic University Malaysia (IIUM). Materials and Methods: A cross-sectional study was conducted among 500 medical students in IIUM Kuantan. A validated self-reported questionnaire using Depression Anxiety Stress Score 21 was distributed during the second semester of the 2018/2019 session. Descriptive statistics were used to measure the prevalence of depression. Chi-square test, Fisher’s exact test, independent sample T-test, and multiple logistic regression were used to determine the association between risk factors and depression. Result: The prevalence of depression was 39% with 10.5% of them were having severe and extremely severe level of depression. Multiple logistic regression analysis showed regular physical activity (AOR=0.64, 95% CI: 0.42-0.98) and Tahajjud prayer practice (AOR: 0.76, 95% CI 0.66-0.88) are two protective factors against depression among medical students. Conclusion: About two out of every five IIUM medical students had depression. Regular physical activity and Tahajjud prayer practised may reduce the risk of depression and should be encouraged.


2020 ◽  
Vol 32 (S1) ◽  
pp. 167-167
Author(s):  
Kazuki Honda ◽  
Tomohisa Ishikawa ◽  
Ryuji Fukuhara ◽  
Seiji Yuki ◽  
Yusuke Miyagawa ◽  
...  

[Background]Sleep disturbance is a common symptom in elderly people. However, the associated risk factors have not been completely clarified. We examined possible risk factors associated with sleep disturbance in a community-based Japanese cohort study.[Methods]1521 community-dwelling individuals aged 65 years or older were selected from a consecutive series at a cohort study from 2016 to 2018 in Arao city, where located at south part of Japan. In this survey, the clinical valuables were collected as follows: age, sex, occupational status, education, lifestyle information, medical history, EuroQoL(EQ)-5D (a score of health-related quality of life [QOL]), Barthel index (a score of performance in activities of daily living), a score of Geriatric Depression Scale (GDS) and a score of Mini-Mental State Examination (MMSE). Sleep disturbance was assessed by the Pittsburgh Sleep Quality Index (when the global score was 6 or over, sleep disturbance was determined to be present). Multiple logistic regression analysis was used to examine the association between clinical valuables and sleep disturbance. This research was supported by AMED (Japan Agency for Medical Research and Development) under Grant Number JP18dk0207025h0003 and has been approved by the research ethics committee of Kumamoto University. Informed consent was obtained from all participants and their family members.[Results]Multiple logistic regression analysis revealed that Parkinson disease (Odds ratio[OR]=5.59), living alone (OR=1.93), liver disease (OR=1.89), hyperlipidemia (OR=1.36), higher score of GDS (OR=1.14), lower scores of both EQ-5D index (OR=1.11) and Barthel index (OR=1.03) were significantly associated as risk factors with sleep disturbance. Unexpectedly, lower score of MMSE was not a significant risk factor.[Conclusion]These results suggest that several physical illnesses, solitude, depressive symptoms and lower QOL, but not cognitive impairment, might be crucial risk factors associated with sleep disturbance in elderly population.


2021 ◽  
Vol 5 (2) ◽  
pp. 279
Author(s):  
Yuni Dwi Hastuti ◽  
Shofa Chasani ◽  
Muhammad Hasib Ardani

Patient safety is a global issue and a top priority in hospitals. Incidence of unexpected events varies significantly in Indonesia. Nurses’ compliance is an essential factor in the successful implementation of patient safety policies in hospitals. This study aimed to determine the factors influencing nurses’ compliance with patient safety policies in inpatient units of Dr. Kariadi general hospital, Semarang. This study employed a descriptive correlational design with a cross-sectional approach. The samples were 220 staff nurses recruited using a proportional random sampling technique. The data were collected using a questionnaire developed by the researchers and analyzed using the univariate analysis, Chi-Square test, and multivariate multiple logistic regression test. Results of the bivariate analysis showed that there were effects of supervision (p=0.038; OR=1.828), the character of authority figures (p=0.001; OR=2.648), and non-compliant colleagues (p=0.0001; OR=2.899) on nurses’ compliance with patient safety policies. However, gender (p=0.691), working environment (p=0.891), and contradictory orders (p=0.243) were found to have no effects on nurses’ compliance with patient safety policies. Results of multivariate analysis using a multiple logistic regression analysis showed that non-compliant colleagues were the most influential factor of nurses’ compliance with patient safety policies in the hospital. There were effects of supervision, the character of authority figures, and non-compliant colleagues on nurses’ compliance with patient safety policies. In contrast, gender, working environment, and contradictory orders showed no effects on nurses’ compliance. Non-compliant colleagues had the most effect on nurses’ compliance.


2020 ◽  
Author(s):  
Qianqian Ni ◽  
GuiZhi Cheng ◽  
An Chen ◽  
Seppo Heinonen

Abstract Background: The mental health of pregnant women, particularly those with elevated risks, has been an issue of global concern. Thus far, few studies have addressed mental health of pregnant women with threatened preterm labour (TPL). In the present study, we investigated self-perceived burden (SPB) and postpartum depression (PPD) among hospitalized pregnant women with TPL, exploring the association of SPB with PPD, and identifying other potential risk factors of early PPD. Methods: A self- reported survey conducted in the Obstetrics Department of Anhui Provincial Hospital, People’s Republic of China. Women hospitalized with TPL were approached one week after delivery. One hundred fifty women were recruited from January 2017 to December 2017. Self-Perceived Burden Scale (SPBS), Edinburgh Postnatal Depression Scale (EPDS), and Multidimensional Scale of Perceived Social Support (MSPSS) were the main measures. Descriptive statistics, Spearman's correlation, and multiple logistic regression were employed for data analysis.Results: SPB and PPD were commonly experienced by women hospitalized with TPL, and SPB was positively and significantly correlated with PPD. A multiple logistic regression analysis revealed that, for the women hospitalized with TPL during pregnancy, the emotional aspect of SPB (OR = 1.473, 95% CI = 1.141–1.903, p = 0.003), age (OR = 1.178, 95%CI = 1.056–1.314, p = 0.003), occupation (OR = 0.282, 95%CI = 0.095–0.023, p = 0.023), history of scarred uterus (OR = 0.163, 95%CI = 0.034–0.769, p = 0.022), delivery mode (OR = 5.974, 95%CI = 1.750–20.396, p = 0.004), and family support to women hospitalized with TPL during pregnancy (OR = 0.665, 95% CI = 0.498–0.887, p = 0.006) were the significant factors predicting early signs of PPD. Conclusion: This study indicated that SPB and PPD were prevalent mental issues among hospitalized women with TPL, and SPB, especially perceived emotional burden, is a strong predictor of PPD. Our study suggests the necessity of paying attention to mental health issues—especially SPB and PPD—among hospitalized women with TPL, as well as providing appropriate interventions at the prenatal stage to prevent adverse consequences. Perceiving support from family during pregnancy with high risk can help women in reducing the risk of PPD.


Author(s):  
Swapnajaswanth M. ◽  
Suryanarayana S. P. ◽  
Suman G. ◽  
Murthy N. S.

Background: Cervical cancer is an important public health problem worldwide; it is second most common cancer among women aged 15-44 years globally (Globocan 2012). The objective of the study was to study the association between select risk factors and carcinoma cervix among patients attending Kidwai Memorial Institute of Oncology, Bangalore.Methods: Hospital based case- control study was carried among newly diagnosed cases of cervical cancer, cases and apparently healthy controls were selected. Statistical analysis was performed using, Chi square test of significance, logistic regression were preformed.Results: Univariate analysis revealed the following variables as significant risk factors these were Age at consummation of marriage <18 years OR 5.9 (2.6-19.4), Age 1st pregnancy <18 years OR 3.4 (2.2-5.2), live births delivered >5 OR 2.9 (1.7-5.8), marital status other than those who were married OR 1.7 (1.2-2.6), education of study subject being uneducated OR 3.9 (2.9-5.7), not washing genitals after sex OR 2.8 (1.6-4.9), material used during menstruation other than sanitary pads OR 6 (3.1-11.7), sex during menstruation OR 3 (1.1-7.9), not washing of private parts daily OR 10.8 (6.4-18.2), not taking bath daily OR 4.4 (2.8-7), open air defecation 7.6 (5.4-11.7), tobacco use OR 3.3 (2.2-5.6), never use of any contraceptive OR 3.7 (1.0-8.3) were significant at 0.05 level. Following backward multiple logistic regression analysis the following variables were independently associated with the development of cancer cervix, these were, age at 1st pregnancy <18 years OR 2.2 (1.2-3.8), use of material other than sanitary pads OR 3 (1.3-6.5), having sex during menstruation OR 4.3 (1.2-15), not washing of private parts daily OR 5.5 (2.9-10.4), open air defecation OR 2.6 (1.4-4.7), attained significance at 0.05 level.Conclusions: The study has revealed that age at 1st pregnancy <18 years, use of material other than sanitary pads, having sex during menstruation, not washing of private parts daily, open air defecation, as an independent risk factor for the development of cancer cervix. It can be noted that all the risk factor mentioned above is highly amenable for primary prevention.


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