Infection After Endoscopic Dacryocystorhinostomy: Incidence and Implications

Background Endoscopic dacryocystorhinostomy (EN-DCR) is an increasingly common procedure performed by otolaryngologists. While EN-DCR has a high rate of success at relieving blockage of the lacrimal system, little is known regarding associated postoperative infection (POI) rates and risk factors. Objective The purpose of this study was to identify factors associated with the occurrence of postoperative orbital and rhinologic infection in a large cohort of patients undergoing EN-DCR. Methods A retrospective review of 582 patients who underwent EN-DCR was performed. All patients received antibiotic prophylaxis as a single intraoperative intravenous administration and a ten-day postoperative oral course. Clinical and demographic information was reviewed, including the occurrence of acute orbital or rhinologic infection within 30 days of surgery. Multivariable analysis was performed to identify risk factors associated with POI. Results Fifteen of 582 patients (2.6%) developed POI following EN-DCR. The most common POI was acute rhinosinusitis (10/15, 66.7%), followed by acute dacryocystitis (2/15, 13.3%), preseptal cellulitis (2/15,13.3%), and acute bacterial conjunctivitis (1/15, 6.7%). The majority of patients (464/582, 79.7%) underwent concurrent endoscopic sinus surgery (ESS). In most cases (302/464, 65.1%), ESS was performed to address comorbid rhinosinusitis, whereas 7.8% (36/464) of patients underwent surgery to enhance surgical access to the lacrimal sac. Patients who underwent concurrent ESS were less likely to develop POI (OR: 0.17, CI: 0.04-0.80, p < 0.05). Evidence of mucopurulence at surgery increased the likelihood of POI (OR: 6.24, CI: 1.51-25.84, p < 0.05). Conclusion Mucopurulence at the time of surgery significantly increased the risk of POI, whereas concurrent ESS, performed most commonly to address comorbid rhinosinusitis, significantly decreased the risk of POI. Awareness of risk factors for POI and appropriate surgical management of concurrent rhinosinusitis can lead to reduced infectious complications after EN-DCR.

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Multivariable analysis to determine risk factors associated with early pregnancy loss in thoroughbred broodmares

Theriogenology ◽

10.1016/j.theriogenology.2018.10.008 ◽

2019 ◽

Vol 124 ◽

pp. 18-23 ◽

Cited By ~ 9

Author(s):

A.M. de Mestre ◽

B.V. Rose ◽

Y.M. Chang ◽

D.C. Wathes ◽

K.L.P. Verheyen

Keyword(s):

Risk Factors ◽

Early Pregnancy ◽

Pregnancy Loss ◽

Multivariable Analysis ◽

Early Pregnancy Loss ◽

Factors Associated

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P0034IDENTIFICATION OF FACTORS ASSOCIATED WITH PROGRESSION, PROGNOSIS AND TOLVAPTAN INDICATION IN POLYCYSTIC KIDNEY DISEASE PATIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0034 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Myrto Kostopoulou ◽

Michaela Louka ◽

Stavros Fokas ◽

Eirini Tigka ◽

Angelos Drakopoulos ◽

...

Keyword(s):

Risk Factors ◽

Kidney Disease ◽

Polycystic Kidney Disease ◽

Multivariable Analysis ◽

Laboratory Data ◽

Kidney Volume ◽

Polycystic Kidney ◽

Factors Associated ◽

Affected Parent ◽

Male Sex

Abstract Background and Aims The identification of possible risk factors for the progression of Autosomal Dominant Polycystic Kidney Disease (ADPKD) is an emerging field especially after the introduction of the first disease-specific treatment. The present study aims to explore the associations between epidemiological, clinical and imagining data in a large cohort of ADPKD patients. Method This study was from a single outpatient clinic following patients with ADPKD. Patients were included in the study if they had a recent Magnetic Resonance Imaging (MRI) for measurement of Total Kidney Volume (TKV), a validated biomarker for disease progression. For all patients, the Mayo Clinic Imagining Category (MCIC) and the respective prediction for End Stage Renal Disease (ESRD) were calculated. Patients eligible for tolvaptan treatment (MCIC 1C, 1D, 1E, age < 55 years old and estimated-glomerular filtration rate (e-GFR) ≥ 25 ml/min) were identified. Characteristics including individual medical history, clinical and laboratory data were examined for possible associations with renal and imagining parameters using linear regression models. Results A total of 158 patients were included. Based on measurements of height-adjusted TKV (ht-TKV) and age, 5% of the patients were classified as 1A, 20% as 1B, 34% as 1C, 25% as 1D and 16% as 1E, MCIC. In multivariable analysis, patient’s age (p = 0.01), male sex (p < 0.001), parent’s age at which ESRD was reached (adjusted for patient age) (p < 0.001) and proteinuria (p = 0.04) were associated with ht-TKV. Parent’s age at ESRD differed significantly between the MCICs of the offspring (mean±(SD)), 70.83 (12.90) in 1A, 63.79 (11.39) in 1B, 57.32 (10.42) in 1C, 51.42 (9.18) in 1D and 47.94 (5.73) years old in 1E, (p < 0.001). Similarly, there were significant differences in the presence and the age of hypertension onset (p =0.004 and p = 0.003, respectively). In 104 patients (50 females, 54 males) who were eligible for tolvaptan treatment age at ADPKD diagnosis, age at hypertension onset and parent’s age reaching at ESRD were all significantly lower (p < 0.001 for all) when compared to non-eligible patients. Finally, factors associated with the prediction score of ESRD (e-GFR 10/ml/min) were hypertension, uric acid and the age at ESRD of the affected parent (p = 0.001, 0.02 and 0.01, respectively). Conclusion The age at which an affected parent had reached ESRD, as heritability estimator, was significantly associated with a worst phenotype, prognosis and tolvaptan indication. Early diagnosis of the disease, hypertension and its early onset, proteinuria and male sex are also possible risk factors for the progression of ADPKD.

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Potential risk factors associated with the development of synechiae following functional endoscopic sinus surgery

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-018-4936-1 ◽

2018 ◽

Vol 275 (5) ◽

pp. 1175-1181 ◽

Cited By ~ 2

Author(s):

Jamil Manji ◽

Al-Rahim R. Habib ◽

Ameen A. Amanian ◽

Saad Alsaleh ◽

Andrew Thamboo ◽

...

Keyword(s):

Risk Factors ◽

Potential Risk ◽

Endoscopic Sinus Surgery ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Factors Associated ◽

Potential Risk Factors

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Trastuzumab-Related Cardiotoxicity Among Older Patients With Breast Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2013.48.7884 ◽

2013 ◽

Vol 31 (33) ◽

pp. 4222-4228 ◽

Cited By ~ 134

Author(s):

Mariana Chavez-MacGregor ◽

Ning Zhang ◽

Thomas A. Buchholz ◽

Yufeng Zhang ◽

Jiangong Niu ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Cancer Patients ◽

Older Patients ◽

Cox Proportional Hazards ◽

Older Age ◽

Coding System ◽

Breast Cancer Patients ◽

Common Procedure ◽

Factors Associated

Purpose The use of trastuzumab in the adjuvant setting improves outcomes but is associated with cardiotoxicity manifested as congestive heart failure (CHF). The rates and risk factors associated with trastuzumab-related CHF among older patients are unknown. Patients and Methods Breast cancer patients at least 66 years old with full Medicare coverage, diagnosed with stage I-III breast cancer between 2005 and 2009, and treated with chemotherapy were identified in the SEER-Medicare and in the Texas Cancer Registry–Medicare databases. The rates and risk factors associated with CHF were evaluated. Chemotherapy, trastuzumab use, comorbidities, and CHF were identified using International Classification of Diseases, version 9, and Healthcare Common Procedure Coding System codes. Analyses included descriptive statistics and Cox proportional hazards models. Results In total, 9,535 patients were included, of whom 2,203 (23.1%) received trastuzumab. Median age of the entire cohort was 71 years old. Among trastuzumab users, the rate of CHF was 29.4% compared with 18.9% in nontrastuzumab users (P < .001). Trastuzumab users were more likely to develop CHF than nontrastuzumab users (hazard ratio [HR], 1.95; 95% CI, 1.75 to 2.17). Among trastuzumab-treated patients, older age (age > 80 years; HR, 1.53; 95% CI, 1.16 to 2.10), coronary artery disease (HR, 1.82; 95% CI, 1.34 to 2.48), hypertension (HR, 1.24; 95% CI, 1.02 to 1.50), and weekly trastuzumab administration (HR, 1.33; 95% CI, 1.05 to 1.68) increased the risk of CHF. Conclusion In this large cohort of older breast cancer patients, the rates of trastuzumb-related CHF are higher than those reported in clinical trials. Among patients treated with trastuzumab, those with cardiac comorbidities and older age may be at higher risk. Further studies need to confirm the role that the frequency of administration plays in the development of trastuzumab-related CHF.

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Parental risk factors associated with congenital heart disease in a Thai population: multivariable analysis

Asian Biomedicine ◽

10.2478/abm-2021-0033 ◽

2021 ◽

Vol 15 (6) ◽

pp. 267-276 ◽

Cited By ~ 1

Author(s):

Chayamon Suwansumrit ◽

Worawan Jittham

Keyword(s):

Risk Factors ◽

Family History ◽

Cigarette Smoke ◽

Congenital Heart ◽

Heart Diseases ◽

Multivariable Analysis ◽

Significant Risk ◽

Maternal Exposure ◽

Factors Associated ◽

History Of

Abstract Background Congenital heart diseases (CHDs) are the most common types of birth defects and contribute to a large proportion of infant morbidities and mortalities worldwide. These defects may require multiple surgical interventions impacting the infant's quality of life. Objectives To identify risk factors associated with CHD in a population of Thai children. Methods We conducted a case–control study of patients attending the Pediatric Clinic, Naresuan University Hospital, Thailand. We included data from pediatric patients diagnosed with CHDs as cases, and patients without cardiovascular abnormalities as controls. Risk data were collected from July 2019 to April 2020 using face-to-face interviews. Multiple logistic regression was used to analyze parental factors associated with CHDs. Results We included 249 cases classified into 2 groups according to severity and 304 patients as controls. For those less-severely affected (155 patients, 62.2%), ventricular septal defect (27.7%) was the most prevalent, whereas for those with severe CHDs, tetralogy of Fallot was the most prevalent (14.0%). There was no difference in sex distribution or maternal obstetric history between the groups. In multivariable analysis, a family history of CHDs (adjusted odds ratio [AOR] 4.67, 95% confidence interval (CI) 1.61–13.57, P = 0.005) and maternal exposure to second-hand cigarette smoke (AOR 1.58, 95% CI 1.03–2.42, P = 0.002) were identified as significant risk factors for CHDs. Conclusion A family history of CHDs and maternal exposure to second-hand cigarette smoke are associated with having offspring with CHDs in the population studied. These findings help us to encourage affected parents to obtain a fetal echocardiogram.

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Risk Factors Associated with Gastrointestinal Helminthic Infections among School Aged Children in Kurmi Local Government Area, Taraba State, Nigeria

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2021/v42i130432 ◽

2021 ◽

pp. 50-59

Author(s):

Vera Yafeh Akwa ◽

Waetsi Nya Yusufu ◽

Victor Ugochukwu Obisike ◽

Amina Ojochide Hassan

Keyword(s):

Risk Factors ◽

Parasitic Infection ◽

Hand Washing ◽

High Rate ◽

School Age Children ◽

Base Line ◽

School Age ◽

Factors Associated ◽

Helminthic Infections ◽

Significant Difference

One of the parasitic infection faced by school age children in developing countries is intestinal parasitic infection. This study was designed to determine risk factors associated with gastrointestinal helminthic infections among school age children. A total of 600 stool samples were randomly examined by direct smear method under microscope and formol-ether concentration technique. A structured questionnaire was used to collect data on socio-noneconomic status of the children’s parents and other variables. Of this, (n=252; 42%) were found to be infected with gastrointestinal helminths infections given a breakdown of male (n=148; 24.7%) and female (n=104; 17.3%). However, there was no significant difference in prevalence among the socio-economic status. Parent whose occupation was farmer (n=169; 28%) also recorded high rate of infection, the lowest prevalence was seen among civil servants (n=19; 3%). Parents with little or no knowledge of intestinal helminths were found to be statistically significant (n=199; 33.1%, p<0.02; α =0.02) The highest rate of infection was recorded among children who had dirty finger nails (n=232; 38.6%), followed by those who walked barefooted(28.2%),then open defecation (n=147; 24.6%), hand washing after defecation (n=195; 30,7%,), habit of eating raw/roasted meat (n=136; 22.3%), hand washing before meal (n=102; 17.02%) and keeping of dirty clothes and bed linens (n=180; 30%) . Such a relatively high prevalence rate of helminthic infection in the study area could be used as a base line for the concern bodies to launch de-worming intervention campaigns.

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Malnutrition Precipitated Measles Outbreak in Gewane District, Afar Regional State, Northeastern Ethiopia, 2016

10.21203/rs.3.rs-32423/v1 ◽

2020 ◽

Author(s):

Wolde Melese Ayele

Keyword(s):

Risk Factors ◽

Multivariable Analysis ◽

Clinical Signs ◽

Immunization Coverage ◽

Public Health Problem ◽

Binary Logistic Regression ◽

Developed Countries ◽

High Rate ◽

World Health ◽

Vaccination History

Abstract Background: Measles is a contagious viral and vaccine-preventable disease that is continuing a public health problem. It is occurring as an outbreak not only in developing but also in developed countries.Methods: A 1:2 ratios, unmatched case-control study was conducted from September 19/2016- October 08/2016 in Undufo Kebele, Gewane district, Northeastern Ethiopia. Both confirmed by laboratory and epidemiologically linked measles cases were involved. Controls were those who had no clinical signs of measles during the data collection period and residents of the same community where cases were identified. An interviewer-administered questionnaire was used to collect data. Nutritional status was measured using MUAC and the result decided based on the world health organization's nutritional categorization of children by MUAC. Data were entered into Epi-info 7 and analyzed using SPSS-21. Binary logistic regression was done to identify risk factors for measles infection with 95% confident level of Odds ratio.Result: Fifty cases and 100 controls have participated in this investigation. Four out of five samples collected were positive for measles IgM antibody. There were three deaths reported. There was no vaccination history of cases and controls. The majority of cases were female and between 6–15 years of age. In multivariable analysis, malnutrition (AOR = 3.21; 95%CI 1.871,6.334), and contact history (AOR = 12.24; 95%CI 6.992,28.121) increased the risk of contracting measles infection.Conclusion: children under 15-year age were more affected groups. The absence of vaccination in the area precipitated by a high rate of malnutrition was the main cause that aggravates the number of new infections. Contact history and malnutrition were the identified risk factors for measles infection. Therefore, increasing immunization coverage of more than 80%, and securing food security decrease the susceptibility of outbreak occurrence.

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Determinants and aetiologies of postpartum pyrexia; a retrospective analysis in a tertiary health facility in the Littoral Region of Cameroon.

10.21203/rs.2.17668/v2 ◽

2020 ◽

Author(s):

Yannick Lechedem Ngunyi ◽

Gregory Halle-Ekane ◽

Nicholas Tendongfor ◽

Etheldreda Leinyuy Mbivnjo ◽

Armel Evouna Mbarga ◽

...

Keyword(s):

Risk Factors ◽

Significant Risk ◽

Tertiary Hospital ◽

High Rate ◽

E Coli ◽

Factors Associated ◽

Littoral Region ◽

Perineal Tears ◽

Chi Squared ◽

Tract Infections

Abstract Background Postpartum febrile morbidity is relatively common, occurring in approximately 5–7% of births. Differentiating between potentially serious and benign causes of postpartum pyrexia (PP) is fundamental in curbing the mortality rate from sinister causes such as sepsis. The paucity of data on PP in Cameroon makes it difficult to access its actual burden. This study was aimed at determining the prevalence, risk factors and aetiologies of PP at a tertiary hospital in Douala, Cameroon. Methods This was a 2 – year hospital – based retrospective cohort study carried out at the Douala General Hospital (DGH), during which medical records of all postpartum admissions between January 1 st 2017 and December 31st 2018 were reviewed. The review consisted of collecting data on socio-demographic characteristics, clinical profile, investigations and final diagnoses. The collected data was analysed in SPSS 23.0. Chi-squared test was used to test the association between variables and a logistic regression analysis was fitted to identify risk factors associated to PP. Results A total of 1520 postpartum files were reviewed. The prevalence of PP was 8.82%. The most frequent causes of PP were: malaria (46.7%), urinary tract infections (18.7%), puerperal sepsis (17.9%) and pneumonia (8.7%). E. coli was the most (49.3%) cultured germ isolated in positive cultures. Onset of PP was more common (85%) within the first 3 days postpartum and malaria (60%) was the leading aetiology within this period. Five or more vaginal examinations prior to delivery (OR 59.151, 95% CI: 21.463-163.019; p<0.001), perineal tears (OR 45.157, 95% CI: 2.266-899.722; p<0.001), and duration of labour >18hours (OR 26.760, 95% CI: 7.100-100.862; p<0.001) were the most significant risk factors associated with PP. Conclusion Approximately 1 in every 12 postpartum cases in the DGH presents with PP . Malaria was the leading cause of PP at DGH especially for cases registered within 3 days postpartum. The risk factors identified were mostly associated to perinatal events, such as frequent vaginal examinations, perineal tears and prolonged labour. Efforts towards preventing identified risk factors thus becomes paramount in order to curb this high rate of PP in the DGH.

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Risk factors associated with early postoperative complications following laparoscopic total gastrectomy: Experience from the Chinese Laparoscopic Gastrointestinal Surgery Study (CLASS) group.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e15544 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e15544-e15544

Author(s):

Jingdong Liu ◽

Haojie Li ◽

Gang Zhao ◽

Zekuan Xu ◽

Guoxin Li ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Postoperative Complications ◽

Total Gastrectomy ◽

Multivariable Analysis ◽

Laparoscopic Total Gastrectomy ◽

Morbidity And Mortality ◽

Reconstruction Method ◽

Factors Associated ◽

Early Postoperative Complications

e15544 Background: The incidence rate of proximal gastric cancer has been rising steadily, and laparoscopic total gastrectomy (LTG) has been widely adopted. However, the safety of LTG still lacks solid evidence to prove. The aim of this study was to evaluate morbidity and mortality of LTG, and determine the risk factors associated with early postoperative complications. Methods: A retrospective multicenter study was carried out in China, and medical records of 109 gastric cancer patients receiving LTG during September 2014 and June 2016 were retrieved from the database. Patient characteristics, surgical outcomes, and postoperative morbidities and mortalities were analyzed. Results: Morbidity and mortality rates were 22.0% and 0% respectively. Pulmonary infection (13.8%, n = 15) was the most common complication. Most complications were grade II (15.5%, n = 17) according to the Clavien-Dindo classification. Multivariable analysis identified comorbidity, type of reconstruction method (TLTG) were independent risk factors of early postoperative complications. Comorbidity was the only independent risk factor of complications graded more than II. Diabetes mellitus was found correlated with surgical complication in subgroup analysis. Conclusions: LTG is safe and technically feasible in treating gastric cancer. Careful selection of patients without comorbidity and applying laparoscopy-assisted total gastrectomy instead of totally laparoscopic total gastrectomy may decrease postoperative complications.

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Perioperative Risk Factors Associated With Morbidity and Mortality Following Pediatric Inpatient Sinus Surgery

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489418805504 ◽

2018 ◽

Vol 128 (1) ◽

pp. 13-21 ◽

Cited By ~ 2

Author(s):

Brittany N. Burton ◽

Sapideh Gilani ◽

Milli Desai ◽

Robert Saddawi-Konefka ◽

Lindia Willies-Jacobo ◽

...

Keyword(s):

Risk Factors ◽

Adverse Events ◽

Confidence Interval ◽

Odds Ratio ◽

Acute Sinusitis ◽

Morbidity And Mortality ◽

Sinus Surgery ◽

Factors Associated ◽

Wide Range ◽

Comorbidity Burden

Objectives: Pediatric sinus surgery is indicated for a wide range of sinonasal and skull base pathologies, but it is most commonly performed for recalcitrant chronic rhinosinusitis or complicated acute sinusitis. The authors aim to report medical risk factors of morbidity and mortality following inpatient sinus surgery in the pediatric population. Methods: Using data from the Kids’ Inpatient Database from 2003 to 2012, patients with International Classification of Diseases, Ninth Revision, procedure codes for primary sinus surgery were identified. Mixed-effect multivariable logistic regression was used to identify risk factors of inpatient postoperative morbidity and mortality. Results: The final sample included a weighted estimate of 4965 pediatric patients. The rates of inpatient morbidity and mortality were 6% and 1%, respectively. Respiratory complications (2.5%) were the most prevalent postoperative adverse events. The most prevalent comorbidities were chronic sinusitis (59.8%), acute sinusitis (27.8%), and cystic fibrosis (26.4%). Compared with patients who did not experience any morbidity, patients with inpatient morbidity had higher rates of pneumonia, mycoses, and nasal or paranasal benign neoplasm ( P < .05). The odds of inpatient morbidity and mortality were highest for patients with leukemia (odds ratio, 2.74; 95% confidence interval, 1.59-4.72; P < .001) and mycoses (odds ratio, 15.84; 95% confidence interval, 6.45-38.89; P < .001), respectively. Conclusions: This study is the first to report the national comorbidity burden and risk factors for postoperative adverse events following inpatient sinus surgery. Knowledge of the comorbidities and independent factors associated with morbidity and mortality will help in directing preoperative optimization and counseling. Level of Evidence: 2c

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