scholarly journals RISK FACTORS PREVENTING RETURN TO BASELINE ACTIVITY LEVEL AFTER BANKART REPAIR

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0005
Author(s):  
Julien T. Aoyama ◽  
Shawn Simmons ◽  
Tyrell Young-Hamilton ◽  
Molly Horn ◽  
Siddhi Ramesh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pediatric Population ◽  
Perioperative Risk ◽  
Activity Level ◽  
Bankart Repair ◽  
Continuous Variables ◽  
Chi Square ◽  
Factors Associated ◽  
Perioperative Risk Factors ◽  
Baseline Activity

Background As sports specialization continues to grow amongst youth, the prevalence of shoulder instability continues to increase. Bankart repair exists as a primary method to combat these issues, yet a third or more of patients experience recurrent instability following surgery. Currently most studies examining Bankart repair look at surgical technique (open vs arthroscopic) and the original treatment employed; however, there has been a lack of research examining whether demographic, injury history, and perioperative risk factors exist as well. The purpose of this prognostic study was to examine Bankart repair in the pediatric population and identify a wider range of risk factors associated with poor functional outcomes. Methods We conducted a retrospective review of all patients who received Bankart repair between 01/01/2010 and 12/31/2015 at the Children’s Hospital of Philadelphia. A range of demographic, injury history, clinical exam, operative, and perioperative variables were abstracted to identify risk factors associated with limited functional outcome as defined by inability to return to baseline sport or activity. Chi square analyses were used to find significant associations between dichotomous variables, and point-biserial analyses were used to find strength of correlations for continuous variables. Results 118 patients were included with an average age of 15.92 ±2.11 at the time of surgery. The mean OR time was 206.98 ±55.88 minutes. Point-biserial correlations for total OR time, BMI, and age with inability to return to baseline sport or activity were 0.32, .09, and .04 respectively. Chi square analyses found no significant associations for prior non-operative treatment, sulcus sign, and insurance type. For individuals who presented with prior instability, 92/119 (77.3%) with and 27/119 (22.7%) without, this was significantly associated with inability to return to baseline sport or activity (p = 0.04). For presence of a Hill Sachs Lesion 70/145 (48.2%) had a lesion, 75/145 (51.8%) did not, and this was significantly associated as well (p = 0.02). For injury type, 71/98 (72.4%) were contact, 27/98 (27.6%) were noncontact, and this was significantly associated as well (p = 0.01). Conclusion Many clinicians have informally found in practice that certain patient characteristics seem to be associated with poor outcomes after Bankart repair. Here we find that a history of prior instability, Hill Sachs lesion presence, and a contact injury mechanism are significantly associated with inability to return to baseline sport or activity post-operatively. The risk factors identified here can be categorized into injury history risk factors and perioperative risk factors. Clinicians can use these identified risk factors to better inform patients receiving Bankart repair of their likelihood of returning to baseline sport or activity.

Risk Factors for Opioid Use After Anterior Cruciate Ligament Reconstruction

2019 ◽  
Vol 47 (9) ◽  
pp. 2130-2137 ◽  
Author(s):  
Anita G. Rao ◽  
Priscilla H. Chan ◽  
Heather A. Prentice ◽  
Elizabeth W. Paxton ◽  
Tadashi T. Funahashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Perioperative Risk ◽  
Cruciate Ligament Reconstruction ◽  
Factors Associated ◽  
Perioperative Risk Factors ◽  
Anterior Cruciate

Background: The misuse of opioid medications has contributed to a significant national crisis affecting public health as well as patient morbidity and medical costs. After orthopaedic surgical procedures, patients may require prescription (Rx) opioid medication, which can fuel the opioid epidemic. Opioid Rx usage after anterior cruciate ligament reconstruction (ACLR) is not well characterized. Purpose: To determine baseline utilization of Rx opioids in patients undergoing ACLR and examine demographic, patient, and surgical factors associated with greater and prolonged postoperative opioid utilization. Study Design: Cohort study; Level of evidence, 3. Methods: Primary elective ACLRs were identified using Kaiser Permanente’s ACLR registry (2005-2015). We studied the association of perioperative risk factors on the number of dispensed opioid Rx in the early (0-90 days) and late (91-360 days) postoperative recovery periods using logistic regression. Results: Of 21,202 ACLRs, 25.5% used at least 1 opioid Rx in the 1-year preoperative period; 17.7% and 2.7% used ≥2 opioid Rx in the early and late recovery periods, respectively. Risk factors associated with greater opioid Rx in both the early and the late periods included the following: ≥2 preoperative opioid Rx, age ≥20 years, American Society of Anesthesiologists classification ≥3, other activity at the time of injury, chondroplasty, chronic pulmonary disease, and substance abuse. Risk factors associated with opioid Rx use during the early period only included the following: other race, acute injury, meniscal injury repair, multiligament injury, and dementia/psychosis. Risk factors associated with greater opioid Rx during the late period only included the following: 1 preoperative opioid Rx, female sex, body mass index ≥25 kg/m2, motor vehicle accident as the mechanism of injury, and hypertension. Conclusion: A quarter of ACLR patients had at least 1 opioid Rx before the procedure, but usage dropped to 2.7% toward the end of the postoperative year. We identified several perioperative risk factors for greater and prolonged opioid usage after ACLR.

Risk factors for diabetes mellitus and hypertension among artisans in Ogun state, Nigeria

2019 ◽  
Vol 50 (4) ◽  
pp. 695-710 ◽  
Author(s):  
Cathrine A. Oladoyinbo ◽  
Adenike Mercy Abiodun ◽  
Mariam Oluwatoyin Oyalowo ◽  
Irene Obaji ◽  
Abisola Margaret Oyelere ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Abdominal Obesity ◽  
Dietary Habits ◽  
Activity Level ◽  
Chi Square ◽  
Content Type ◽  
Factors Associated ◽  
Ogun State ◽  
Chi Square Analysis

Purpose This study was designed to assess the risk factors associated with hypertension (HTN) and diabetes among artisans in Ogun State, Nigeria. Evidences suggest increasing prevalence, incidences and morbidity of diabetes and HTN in Nigeria. However, the purpose of this study is to plan and prioritize effective intervention programs, there is need to provide data on the prevalence and risk factors for HTN and diabetes among local groups. Design/methodology/approach In total 300 apparently healthy artisans who have never been diagnosed of diabetes or HTN were randomly selected from five communities. A structured questionnaire was used in obtaining information on the personal characteristics of the respondents. An adapted dietary habit and lifestyle questionnaire were used to assess the dietary habits and lifestyle of the respondents. The WHO global activity questionnaire was adapted and used to gather information on the physical activity level of the respondents. Random blood glucose, blood pressure and anthropometric measurements were assessed using standard instruments. Chi-square (χ2), correlations and multinomial logistic regression analysis were performed to identify significant determinants of diabetes and HTN. Findings Mean age was 34.8 ± 9.9 and prevalence of diabetes and pre-diabetes were 1 and 4.7 per cent, respectively, while HTN and pre-HTN were 48.0 and 30.3 per cent, respectively. About half (55.7 per cent) of the respondents skip at least a meal daily and 31 per cent snack daily. Most (61.4 per cent) consume alcohol and 65.7 per cent engage in high physical activity. Abdominal obesity was significantly higher among women (p = 0.004). Using the chi-square analysis, age, abdominal obesity and educational status were factors found to be significantly associated with diabetes (p = 0.002; p = 0.007; p = 0.004) while age, gender, abdominal obesity and alcohol consumption had significant association with HTN. Although not statistically significant, respondents were 0.8, 1.0 and 1.1 times more likely to be diabetic with increasing body mass index, waist circumference (WC) and age (odd ratio (OR) = 0.78; confidence intervals (CI): 0.51-1.18; OR = 1.04; CI: 0.89-1.21; OR = 1.06; CI: 0.96-1.18, respectively). Abdominal obesity was significantly associated with HTN (OR = 1.08; CI: 1.03-1.13; p = 0.001). Also, older respondents were 1.1 times more likely of becoming hypertensive (OR = 1.07; CI: 1.02-1.11; p = 0.003). Increased risk of diabetes and HTN was found among respondents with increasing age and WC. Research limitations/implications This study was cross-sectional in design; it cannot be used to establish a cause-effect relationship between diabetes, HTN and the observed variables (anthropometric characteristics, dietary habits and lifestyle risk factors). Because of the few numbers (1 per cent) of respondents identified to be diabetic several important risk factors could not be included in the model. Practical implications An understanding of the risk factors associated with diabetes and HTN among sub-groups in the population will help to plan effective interventions targeted at specific groups. Originality/value The findings of this study show the associated risk factors for diabetes and HTN among artisans in Ogun State.

Perioperative Risk Factors Associated With Postoperative Unplanned Intubation After Lung Resection

2018 ◽  
Vol 32 (4) ◽  
pp. 1739-1746 ◽  
Author(s):  
Brittany N. Burton ◽  
Swapnil Khoche ◽  
Alison M. A’Court ◽  
Ulrich H. Schmidt ◽  
Rodney A. Gabriel
Keyword(s):  
Risk Factors ◽  
Lung Resection ◽  
Perioperative Risk ◽  
Factors Associated ◽  
Perioperative Risk Factors

scholarly journals Pre- and Perioperative Risk Factors of Post Hip Fracture Surgery Walking Failure in the Elderly

2019 ◽  
Vol 10 ◽  
pp. 215145931985346 ◽  
Author(s):  
YoungJi Ko
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Hip Fracture ◽  
Care Facility ◽  
Perioperative Risk ◽  
Factors Associated ◽  
Hip Fracture Surgery ◽  
Ambulatory Status ◽  
Perioperative Risk Factors ◽  
Fracture Surgery

Introduction: Osteoporotic hip fractures are a major problem. They increase mortality, morbidity, and functional decline. Recovery of ambulatory status is an essential prerequisite for older adults living in a normal environment. The main objective of this study was to investigate walking failure at 3 to 6 months after hip fracture surgery with the aim of identifying pre- and perioperative risk factors associated with it. Methods: A total of 120 participants (>65 years) were recruited following hip fracture surgery at a teaching hospital. Walking status was assessed on average 4.4 ± 1.3 months after hip fracture surgery and compared with prefracture walking status. The participants were divided into 2 groups according to walking status (group 1: ambulatory; group 2: nonambulatory) and risk factors associated with a failure to walk were determined using binominal logistic regression analysis. Results: The rate of recovery to prefracture ambulatory status was about 18.3% and 25% of participants could not walk at all. Risk factors for not being able to walk at all included poor prefracture ambulatory status and living at a long care facility as nonmodifiable factors, whereas a shorter length of stay before surgery and having a longer total hospitalization periods were modifiable factors. Conclusion: Walking recovery after hip fracture surgery was very poor at 3 to 6 months after hip fracture surgery. Based on our findings, older adults living in a long care facility should be provided their medical and functional needs through professional health-care providers and systematic health delivery systems. The therapeutic management for underlying diseases affecting surgery should precede unconditional early surgery. Older adults hospitalized during longer periods should be focused on their functional care.

scholarly journals Perioperative Risk Factors Associated with Pressure Ulcer in the Park Bench Position

2013 ◽  
Vol 33 (1) ◽  
pp. 075-083 ◽  
Author(s):  
Mine YOSHIMURA ◽  
Osamu NAGATA ◽  
Michihiro KOHNO ◽  
Takashi YAMASAKI ◽  
Tomoko MAE ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pressure Ulcer ◽  
Perioperative Risk ◽  
Factors Associated ◽  
Perioperative Risk Factors

scholarly journals Risk Factors Associated with Cognitive Decline after Cardiac Surgery: A Systematic Review

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Nikil Patel ◽  
Jatinder S. Minhas ◽  
Emma M. L. Chung
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Cognitive Decline ◽  
New Technologies ◽  
Perioperative Risk ◽  
Factors Associated ◽  
Perioperative Risk Factors ◽  
Postoperative Cognitive Decline

Modern day cardiac surgery evolved upon the advent of cardiopulmonary bypass machines (CPB) in the 1950s. Following this development, cardiac surgery in recent years has improved significantly. Despite such advances and the introduction of new technologies, neurological sequelae after cardiac surgery still exist. Ischaemic stroke, delirium, and cognitive impairment cause significant morbidity and mortality and unfortunately remain common complications. Postoperative cognitive decline (POCD) is believed to be associated with the presence of new ischaemic lesions originating from emboli entering the cerebral circulation during surgery. Cardiopulmonary bypass was thought to be the reason of POCD, but randomised controlled trials comparing with off-pump surgery show contradictory results. Attention has now turned to the growing evidence that perioperative risk factors, as well as patient-related risk factors, play an important role in early and late POCD. Clearly, identifying the mechanism of POCD is challenging. The purpose of this systematic review is to discuss the literature that has investigated patient and perioperative risk factors to better understand the magnitude of the risk factors associated with POCD after cardiac surgery.

Recipient and Perioperative Risk Factors Associated With Liver Transplant Graft Outcomes

2012 ◽  
Vol 44 (2) ◽  
pp. 505-508 ◽  
Author(s):  
Y. Sirivatanauksorn ◽  
V. Taweerutchana ◽  
S. Limsrichamrern ◽  
P. Kositamongkol ◽  
P. Mahawithitwong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplant ◽  
Perioperative Risk ◽  
Factors Associated ◽  
Perioperative Risk Factors
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