Incidence and Outcomes of Acute Transfusion Reactions in Hospitalized Patients in the United States

Introduction Acute transfusion reactions (ATRs) have a broad spectrum of presentations ranging from benign to life-threatening. Due to the rarity of these reactions, there is a paucity of data regarding their incidence and clinical outcomes. The objectives of this study were to determine the incidence of ATRs, its risk factors, and associated mortality. Methods: We reviewed the National Inpatient Sample (NIS) database 2014 for admissions where the patient (>=18 years old) was transfused blood products. The NIS is a large publicly available all-payer inpatient healthcare database designed to produce U.S. regional and national estimates of inpatient utilization, access, charges, quality, and outcomes. ATRs were identified using ICD-9 CM codes for transfusion-associated circulatory overload (TACO), transfusion-related acute lung injury (TRALI), febrile non-hemolytic transfusion reactions (FNHTR), acute infections, anaphylaxis, and acute hemolytic reaction. Pearson's chi-square and student's t-test were used to compare categorical and continuous variables between hospitalizations with versus without ATRs, respectively. Multivariate logistic regression analysis was done to determine the risk factors for common ATRs (TACO, TRALI, and FNHTR). A multivariate cox proportional model was built to compare the mortality of two study groups. A 2-sided p-value ≤ 0.05 was considered significant. Results: A total of 2,134,691 hospitalizations were associated with the transfusion of blood products. ATRs were documented in 0.2% of the hospitalizations (TACO 0.08%, TRALI 0.06%, FNHTR 0.09%, others 0.003%). The group that had ATRs was slightly younger (median age 67 vs 68 years, p=0.002), had the same proportion of females (58.3% vs 55.3%, p=0.055), less comorbidity score (28.7% vs 31.7% had Charlson Comorbidity Index >3, p=0.042) and more critically ill (17.8% vs 10.5% on mechanical ventilation, p<0.001) compared to group without ATRs. Hospitalizations with ATRs had longer median length of stay (7 vs 6 days, p<0.001) and higher median hospital cost ($64,399 vs $53,912, p<0.001) compared to without ATRs. The risk factors for common ATRs (odds ratio, OR) are mentioned in the table. ATRs were not associated with increased risk of mortality (combined HR 0.89 95%CI 0.71-1.12, p=0.321). Conclusions: Nationally, the incidence of ATRs is low in hospitalized patients and it is not associated with increased mortality. This large database analysis gives insight into the risk factors associated with different ATRs. Disclosures No relevant conflicts of interest to declare.

Download Full-text

The Risk Factors of the Venous Thromboembolism in Hospitalized Patients with Hematologic Malignancies in the United States: National Inpatient Sample Analysis, 2011-2015

Blood ◽

10.1182/blood-2018-99-115282 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 2310-2310

Author(s):

Veli Bakalov ◽

Amy Tang ◽

Amulya Yellala ◽

Robert B. Kaplan ◽

John Lister ◽

...

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Myeloid Leukemia ◽

Conflicts Of Interest ◽

Univariate Analysis ◽

Hematologic Malignancies ◽

The United States ◽

Hospitalized Patients ◽

Lymphocytic Leukemia ◽

P Value

Abstract Background. Hospital course of patients with hematologic malignancies associated with multiple complications, such as venous thromboembolism (VTE) which significantly affects morbidity and mortality. Compared to the general population patients with hematologic malignancies carry series of risk factors of VTE. Goals of this study were to describe demographic characteristics as well as define the risk factors of VTE in hospitalized patients with hematologic malignancies. Our study was focused on acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), Non-Hodgkin's lymphoma (NHL), Hodgkin's Disease (HD), multiple myeloma (MM). Methods. Cohort selection. The Nationwide Inpatient Sample (NIS) database from the Healthcare Cost and Utilization Project (HCUP) of the Agency for Healthcare Research and Quality (AHRQ) for the years 2011 to 2015 was queried for the analysis. We used International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and corresponding ICD-10-CM codes (for the period of 0ctober 1 - December 31, 2015) in order to identify patients with hematologic malignancies as a primary diagnosis for the hospitalization, and VTE as secondary diagnosis of the hospitalization. In order to determine comorbidities in selected population we used Clinical Classifications Software (CCS) in conjunction with ICD-9-CM codes. Statistical Analysis. Complex weights were used throughout all calculations, enabling appropriate national projections. Percentages in all tables and figures reflect national estimates. Chi-squared and independent t-tests were used for univariate analysis where appropriate. We performed logistic regression analyses to examine the association between risk factor and VTE. In our study p-value <0.05 was considered statistically significant. Data were analyzed using SAS v9.4 (SAS Institute, Cary, NC). Results. A total of 80,078 patients with hematologic malignancies were hospitalized from 2011 to 2015. Males represented 56.1% of the population, majority of the patients were white (69.5%), greater part of the patients were older than 35 years of age (35-65 42.6%, >65 48.8%) (Table 1). Main comorbidities during hospitalization were anemia (58.1%), followed by hypertension (49.1%), fluid disorders (40.1%) and coagulopathies (24.5%) (data not shown). Rate of VTE in all patients was 5.3% and was evenly distributed among genders and races. Rate of VTE was highest in patients with AML (6.6%) followed by ALL (6.1%), and NHL (6.0%), and lowest in patients with MM (3.49%) followed by CLL (3.31%), and CML (3.31%) (Table 2). The highest risk of VTE among patients with hematologic malignancies were in patients receiving chemotherapy (OR=1.684 95% CI=1.567-1.809) followed by infections such as pneumonia (OR 1.313 95% CI 1.201-1.436) and sepsis (OR=1.66 95% CI=1.524-1.621). Other comorbidities such as congestive heart failure, liver disease, coagulation disorders and acute renal failure were associated with significantly higher risk of VTE with OR varying from 1.1 to 1.2. (Table 3) Conclusions. In this retrospective large US inpatient database analysis, we found that average rates of VTE in patients with hematologic malignancies was 5.3% and was highest in patients with AML. Patients receiving chemotherapy had highest risk of developing VTE during hospitalization followed by patients with infections such as sepsis and pneumonia. Higher rates of VTE in patients receiving chemotherapy and patients with sepsis was previously described, however our findings indicate that rate of VTE remain high in these population. Findings of our study can be used for development of the appropriate antithrombotic prophylactic strategies in hospitalized patients with hematologic malignancies. Disclosures No relevant conflicts of interest to declare.

Download Full-text

Prevalence and Risk Factors for Mortality among COVID-19 Patients Hospitalized in Karachi City Pakistan

European Journal of Clinical Medicine ◽

10.24018/clinicmed.2021.2.3.46 ◽

2021 ◽

Vol 2 (3) ◽

pp. 66-71

Author(s):

Salman Imtiaz ◽

Ashar Alam ◽

Faiza Saeed ◽

Beena Salman ◽

Shoukat Memon ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Virus Disease ◽

Multivariate Logistic Regression Analysis ◽

Ethical Review ◽

P Value ◽

Age Group ◽

Continuous Variables

Background: Corona virus disease (Covid -19) is the most contagious form of the disease of present time. Therefore, the risk factors which proliferate the spread and hinders the better outcome should be identified. There is gross difference in the spread and outcome of covid 19 in different region of the world. There is need to identify these factors in different communities of the globe. Material and method: This is a retrospective observational cohort study of Covid -19 patients admitted during the study period. Institutional and ethical review board permission was taken prior to the study. Univariate and multivariate binary logistic regression was run and odds ratio with 95% confidence intervals were obtained. P value of ≤ 0.05 was considered significant. Outcome variables were recovery and death. Results: There were 840 patients admitted between the study duration, while 704 (83.8%) were included in our study. There were 491(69.7%) males and 213(30.3%) females. The mean age of the population was 54.6±15.5 years. All continuous variables were categorized according to binary outcome (recovered and death) of patients. In Logistic regression analysis we found that patients in age group of 51-65 years died 2.5 time more than patients of age ≤ 50 years. Similarly, the patients within age group of > 65 died 4.5 times higher than ≤ 50 years of age (p<0.001). Male patients died 1.5 times more than females. Among all comorbid conditions HTN had significant effect on death, they died 1.5 times more than normotensive patients. In multivariate logistic regression analysis, the age groups had same significant effect on death when adjusted with other parameters, while effect of gender vanished. Similarly, the effect of HTN was also abolished when other factors were included in analysis. Conclusion: We concluded that there is an urgent need of reevaluation of the traditional risk factors associated with viral epidemic and understanding the changing paradigm of epidemiology emerging out from this epidemic in both developed and developing counties. There is need of more data from developing world to elucidate the risk factors.

Download Full-text

2259. Predictors of Empiric Carbapenem Therapy in Complicated Intra-Abdominal Infections in the United States, 2013–2017: A Retrospective Cohort Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1937 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S773-S773

Author(s):

Marya Zilberberg ◽

Brian Nathanson ◽

Kenneth Lawrence ◽

Colby Johnson ◽

Kristen Ditch ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

The United States ◽

Generation Cephalosporin ◽

Hospitalized Patients ◽

P Value ◽

Multivariable Logistic Regression Model ◽

Abdominal Infections

Abstract Background Complicated intra-abdominal infections (cIAI) remain an important cause for hospitalization. Evidence-based guidelines recommend reserving broad-spectrum antibiotic coverage for high-risk cases in order to reduce overuse of certain antibiotic classes, particularly in the face of emerging carbapanem resistance. We examined the factors associated with use of empiric carbapenem treatment (ECT) among hospitalized patients with cIAI. Methods We performed a multicenter retrospective cohort study in the Premier database of approximately 180 hospitals, 2013–2017. Using an ICD-9/10 based algorithm including a requirement for a laparotomy/laparoscopy, we identified all adult patients hospitalized with cIAI and included those with a positive blood or abdominal culture. We derived and tested a multivariable logistic regression model to examine predictors of ECT. Results Among 321,317 hospitalized patients with cIAI, 4,453 (1.4%) were culture-positive, 1,185 (26.6%) of whom received ECT. Among those given ECT, >50% (682) had no risk factors for resistance, and in only 120 (10.1%) was an organism resistant to a third-generation cephalosporin (C3R extended spectrum β-lactamase [ESBL] phenotype) isolated. The top 5 variables associated with ECT use were: pre-cIAI anti-fungal therapy (OR 2.57, 95% CI 1.91, 3.45) urgent (vs. emergent) admission (OR 1.56, 95% CI 1.21, 2.01), corticosteroids (OR 1.50, 95% CI 1.13, 1.99), ICU admission (OR 1.46, 95% CI 1.17, 1.82), and presence of sepsis/septic shock (OR 1.43, 95% CI 1.18, 1.74). The model had a moderately good fit (c-statistic = 0.683; 95% CI (0.665, 0.700), Hosmer-Lemeshow P value = 0.411). Conclusion Among patients hospitalized with a cIAI, 26.6% received ECT despite >50% lacking risk factors for resistance, and an only 10% prevalence of C3R in this cohort. This suggests that there remains an opportunity for carbapanem-sparing strategies. Further stratification of the risk for resistance is needed among patients with markers of high illness severity, such as those identified in our model. Disclosures All authors: No reported disclosures.

Download Full-text

Unfavorable Outcomes Associated with Antithrombin Deficiency in Patients Required Mechanical Ventilation: A Nationwide Database Study

Blood ◽

10.1182/blood-2021-146404 ◽

2021 ◽

Vol 138 (Supplement 1) ◽

pp. 3029-3029

Author(s):

Tien-Chan Hsieh ◽

Guangchen Zou ◽

Gin Yi Lee ◽

Pramuditha Rajapakse ◽

Yee Hui Yeo

Keyword(s):

Mechanical Ventilation ◽

Young Adults ◽

Severe Sepsis ◽

Conflicts Of Interest ◽

Factor V Leiden ◽

Categorical Variables ◽

P Value ◽

Continuous Variables ◽

Antithrombin Deficiency ◽

Increased Risk

Abstract Background: Mechanical ventilation (MV) is associated with increased risk of venous thromboembolism (VTE). Together with other thrombosis risk factors such as hereditary thrombophilia (HT), VTE can lead to unfavorable outcomes. We aim to investigate the outcomes in various types of HT patients required mechanical ventilation (MV), which is relatively unknown. Methods: This was a retrospective study using National Inpatient Sample from the year 2016 to 2018. International Classification of Diseases 10 th Revision was used to identify various types of HT (antithrombin III deficiency [ATIII deficiency), Factor V Leiden, congenital protein C or S deficiency, prothrombin gene mutation, other congenital hyper-coagulopathy), VTE, MV, and other conditions or procedures. The cohort of interest was MV-associated adults (age at least 18-year-old). Primary outcome was mortality. Comorbidities were evaluated with Charlson Comorbidity Index (CCI). Continuous variables were compared using Welch two sample T-test. Categorical variables were analyzed with Pearson's Chi-squared test. The possible associated variables and confounders were adjusted with the generalized linear model. Results: Among 616,717 adult MV hospitalizations, 5,024 cases had at least one HT diagnosis. In HT subgroup, the patients were significantly younger (mean age 59.4 vs 61.7, p value <0.0001). The portion of female and Caucasian were higher in the HT subgroup (46.7% vs 44.5%, p value <0.002; 66.0% vs 63.3%, p value <0.0001). CCI was slightly higher in HT group (5.09 vs 4.94, p value <0.005). HT was independently associated with higher mortality (adjusted odds ratio [aOR]: 1.16; p value<0.000005) even after adjusted for VTE, myocardial infarction, ischemic stroke, and other comorbidities. HT patients had significantly higher risk of developing pulmonary embolism (PE) and deep vein thrombosis (DVT) (aOR: 2.86 and 2.09 respectively; both p value <0.0001). Among various types of HT, subgroup analysis revealed that only ATIII deficiency was associated with significantly higher mortality (aOR: 1.67, p value <0.0001). The odd of mortality in ATIII deficiency was higher in young adults and less prominent among older population (<40-year-old aOR: 2.81, p value <0.0001; >=65-year-old aOR: 1.53, p value <0.0001). ATIII deficiency patients also had higher risk of developing severe sepsis (aOR: 1.52, p value <0.0001). Conclusion: Among HT, only ATIII deficiency significantly increased the risk of mortality. The mortality odd was higher especially among young adults with ATIII deficiency. ATIII deficiency group also had higher odd of developing severe sepsis and VTE. Even though the other types of HT also had increased risk of VTE, they were not found to be associated with mortality in MV. It was unclear why only ATIII deficiency was associated with poor prognosis. Additional research needs to be done to fully investigate the underlying mechanism. Disclosures No relevant conflicts of interest to declare.

Download Full-text

Determinant of Hypertension, Obesity and Smoking on Stroke Events in Hospital Patients at Regional General Hospital of Rokan Hulu Riau District, 2018 (Epidemiology and Public Health)

Britain International of Exact Sciences (BIoEx) Journal ◽

10.33258/bioex.v2i1.173 ◽

2020 ◽

Vol 2 (1) ◽

pp. 384-389

Author(s):

Armaliza Permata Sari ◽

Rahayu Lubis ◽

Zulfendri

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

General Hospital ◽

Communicable Disease ◽

Hospitalized Patients ◽

Bivariate Analysis ◽

P Value ◽

A Value ◽

Increased Risk ◽

Regression Tests

Stroke is one of the most dominant non-communicable disease complications that can cause death and disability, the number of sufferers continues to increase. The number one cause of death stroke in Indonesia with a proportion of 15.4%. Many factors can cause a stroke, namely factors that can be modified and factors that cannot be modified. This study aims to determine the determinants of hypertension, obesity, smoking of the incidence of stroke in hospitalized patients at the Regional General Hospital of Rokan Hulu Regency, Riau. This type of research is an observational analytic study with a case-control study design with a total sample of 100 people (50 cases and 50 controls) with a ratio of 1: 1. Sampling was done by purposive sampling and using a questionnaire. The independent variables are hypertension, obesity, and smoking. Hypertension using a sphygmomanometer, Obesity using Body Mass Index (BMI) and smoking using a questionnaire. Data analysis was performed by bivariate analysis using simple logistic regression tests and multivariate analysis using multiple logistic regression tests. The results of bivariate analysis with risk factors for stroke events, the most dominant risk factors were hypertension with a value of p = 0.001 and (OR = 5.441, 95% Cl = 2,210-13,397), Obesity with a value of p = 0.026 and (OR = 1,712, 95% Cl = 0,690-4,244), and smoking with p value = 0,037 and (OR = 1,822, 95% Cl = 0,717-4,632). Hypertension is the most dominant risk factor for the incidence of stroke in hospitalized patients in Rokan Hulu District Hospital, while the increased risk of stroke with obesity and smoking is not statistically significant in this study.

Download Full-text

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

10.2196/preprints.23937 ◽

2020 ◽

Author(s):

Dr. Animesh Ray ◽

Dr. Komal Singh ◽

Souvick Chattopadhyay ◽

Farha Mehdi ◽

Dr. Gaurav Batra ◽

...

Keyword(s):

Tertiary Care ◽

Age Groups ◽

Hospitalized Patients ◽

North India ◽

P Value ◽

Care Hospital ◽

Igg Antibodies ◽

Igg Antibody ◽

Increased Risk ◽

Significant Difference

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)

Download Full-text

Examining the possible causal relationship between lung function, COPD and Alzheimer’s disease: a Mendelian randomisation study

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2020-000759 ◽

2021 ◽

Vol 8 (1) ◽

pp. e000759

Author(s):

Daniel Higbee ◽

Raquel Granell ◽

Esther Walton ◽

Roxanna Korologou-Linden ◽

George Davey Smith ◽

...

Keyword(s):

Risk Factors ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Lung Function ◽

Causal Relationship ◽

Mendelian Randomisation ◽

P Value ◽

Unmeasured Confounding ◽

Increased Risk ◽

Shared Risk

RationaleLarge retrospective case-control studies have reported an association between chronic obstructive pulmonary disease (COPD), reduced lung function and an increased risk of Alzheimer’s disease. However, it remains unclear if these diseases are causally linked, or due to shared risk factors. Conventional observational epidemiology suffers from unmeasured confounding and reverse causation. Additional analyses addressing causality are required.ObjectivesTo examine a causal relationship between COPD, lung function and Alzheimer’s disease.MethodsUsing two-sample Mendelian randomisation, we used single nucleotide polymorphisms (SNPs) identified in a genome wide association study (GWAS) for lung function as instrumental variables (exposure). Additionally, we used SNPs discovered in a GWAS for COPD in those with moderate to very severe obstruction. The effect of these SNPs on Alzheimer’s disease (outcome) was taken from a GWAS based on a sample of 24 807 patients and 55 058 controls.ResultsWe found minimal evidence for an effect of either lung function (OR: 1.02 per SD; 95% CI 0.91 to 1.13; p value 0.68) or liability for COPD on Alzheimer’s disease (OR: 0.97 per SD; 95% CI 0.92 to 1.03; p value 0.40).ConclusionNeither reduced lung function nor liability COPD are likely to be causally associated with an increased risk of Alzheimer’s, any observed association is likely due to unmeasured confounding. Scientific attention and health prevention policy may be better focused on overlapping risk factors, rather than attempts to reduce risk of Alzheimer’s disease by targeting impaired lung function or COPD directly.

Download Full-text

Abstract 090: Armenian Ethnicity: An Independent Risk Factor for Positive Exercise Treadmill Tests

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.10.suppl_3.090 ◽

2017 ◽

Vol 10 (suppl_3) ◽

Author(s):

Ara H Rostomian ◽

Daniel Sanchez ◽

Jonathan Soverow

Keyword(s):

Risk Factors ◽

Los Angeles ◽

Multivariate Logistic Regression Analysis ◽

Safety Net ◽

The United States ◽

World Health ◽

Limited Information ◽

Safety Net Hospital ◽

Exercise Treadmill ◽

History Of

Background: Several studies have examined the risk of cardiovascular disease (CVD) among larger racial and ethnic groups such as Hispanics and African-Americans in the United States, but limited information is available on smaller subgroups such as Armenians. According to the World Health Organization, Armenia ranks eighth in CVD rates among all countries however it is unclear if Armenian immigrants living in the US have the same high rates of disease. This study examined whether being of Armenian descent increased the risk of having a positive exercise treadmill test (ETT) among patients treated at a safety net hospital in Los Angeles County. Methods: Data on patients who received an ETT from 2008-2011 were used to conduct a retrospective analysis of the relationship between Armenian ethnicity and ETT result as a surrogate measure for CVD. A multivariate logistic regression analysis was used to estimate the odds ratios (OR) for having a positive ETT among Armenians relative to non-Armenians, adjusting for the following pre-specified covariates: gender, age, diabetes, hypertension, hyperlipidemia, smoking, family history of coronary artery disease (CAD), and patient history of CAD. Results: A total of 5,297 patients, ages 18 to 89, were included. Of these, 13% were Armenian and 46% were male, with an average age of 53 years. Armenians had higher odds of having a positive ETT than non-Armenians (Crude OR=1.30, p=0.037, CI:1.02,1.66). After adjusting for CV risk factors, Armenians were still significantly more likely to have a positive ETT than non-Armenians (OR=1.33, p=0.029, CI:1.03,1.71). CAD (OR 2.02, p<0.001, CI:1.38,2.96), and hyperlipidemia (OR=1.31, p=0.008, CI:1.07,1.60) were also significantly associated with a positive ETT. Conclusion: Armenians have a higher likelihood of having a positive ETT than non-Armenians. This relationship appears to be independent of traditional CV risk factors and suggests a role for cultural and/or genetic influences.

Download Full-text

The prevalence and risk factors of high-altitude pulmonary hypertension among native Tibetans in Sichuan Province, China

European Heart Journal ◽

10.1093/ehjci/ehaa946.2290 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

Q.L Gou ◽

R.F Shi ◽

X Zhang ◽

Q.T Meng ◽

X.R Li ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Pulmonary Hypertension ◽

High Altitude ◽

Multivariate Logistic Regression Analysis ◽

Sichuan Province ◽

Public Institution ◽

P Value ◽

Funding Source ◽

Cross Sectional

Abstract Background High-altitude pulmonary hypertension (HAPH) remains a concern due to its high mortality, however, studies evaluating its prevalence and risk factors are lacking. Objective To determine the prevalence of HAPH and its correlated factors among the highlanders living at 3200 metres above sea level in Ganzi Tibetan Automous Prefecture, Sichuan Province, China. Methods This was a single-center cross-sectional study involved 1129 subjects (mean age 46.6±14 years, 39% men). Native Tibetans with HAPH were defined as mean pulmonary artery pressure >30mmHg achieved from transthoracic echocardiography. Results The crude prevalence of HAPH was 6.2%, and was more prevalent in men compared to women (8.6% vs 4.6%, P=0.005). The elder was more likely to develop HAPH (OR: 5.308, 95% CI: 2.562–10.993). Highlanders with HAPH had more severe metabolic abnormalities (including elevated blood pressure, blood glucose, blood lipids, BMI, etc. P value<0.05) and significantly increased hemoglobin level (P=0.001). On multivariate logistic regression analysis, independent risk factors for HAPH were metabolic syndrome (OR: 3.128, 95% CI: 1.110–8.818), age (>60 years vs <40 years) (OR: 2.924, 95% CI: 1.282–6.669), and decreased SpO2 (OR: 1.072 per 1-unit decrease; 95% CI: 1.010–1.136). Conclusion It could be concluded that HAPH was prevalent among 6.2% native Tibetans in Sichuan Province, China. Increasing age, metabolic syndrome and decreased SpO2 were independent predisposing factors for HAPH Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): This study was funded by one Science and Technology Pillar Programs in Sichuan Province (Grant no. 2017SZ0008).

Download Full-text

Clinical profile and factors determining outcome of intramural very low birth weight babies in a tertiary care centre: a retrospective study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20170143 ◽

2017 ◽

Vol 5 (2) ◽

pp. 520

Author(s):

Devi Meenakshi K. ◽

Arasar Seeralar A. T. ◽

Srinivasan Padmanaban

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Birth Weight ◽

Low Birth Weight ◽

Logistic Regression Analysis ◽

Very Low Birth Weight ◽

Tertiary Care ◽

P Value ◽

Increased Risk

Background: Very low birth weight (VLBW) babies are at increased risk of a number of complications both immediate and late. Worldwide it has been observed that these babies contribute to a significant extent to neonatal mortality and morbidity. Aim of the study was to study the risk factors contributing to mortality in VLBW babies and to evaluate the morbidity pattern in these infants.Methods: A retrospective analysis of data retrieved from the case records of VLBW babies admitted in the NICU of Kilpauk Medical College between January 2015 to December 2015. Out of the 2360 intramural babies admitted during the study period, 99 babies were less than 1500 gms. The risk factors for these babies were analyzed for their association with the outcome. Data were statistically analyzed.Results: In present study, we found that sex of the baby, gestational age, obstetric score, birth asphyxia, pulmonary haemorrhage, ROP and presence of shock were found to be associated with increased mortality. By logistic regression analysis it was observed that birth weight of the baby (p value 0.002), duration of stay (p value 0.0006), presence of shock (p<0.0001), were the risk factors significantly associated with poor outcome.Conclusions: Among the maternal and neonatal factors analyzed in the study using logistic regression analysis, birth weight, duration of hospital stay and presence of shock were significantly related to poor outcome. Of these presence of shock was the single most important factor that predicted increased mortality.

Download Full-text