scholarly journals Determining the Incidence and Risk Factors for Central Venous Catheter Related Thrombosis in Children

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 419-419 ◽  
Author(s):  
Julie Jaffray ◽  
Char Witmer ◽  
Brian Vasquez ◽  
Rosa Diaz ◽  
Jemily Malvar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Interim Analysis ◽  
Male Gender ◽  
Multivariable Model ◽  
Insertion Technique ◽  
Central Venous ◽  
Children's Hospital ◽  
Pediatric Study ◽  
Children’S Hospital ◽  
History Of

Abstract Introduction: Venous thromboembolism (VTE) rates in children are increasing, largely due to the improved care of critically ill children and the placement of central venous catheters (CVCs). There is limited evidence regarding risk factors for CVC-associated thrombosis, and there are no guidelines for pediatric patients on choosing catheter type, insertion technique or consideration for prophylaxis. This study aims to be the first prospective, observational, multi-center, pediatric study to compare the VTE incidence between peripherally inserted central catheters (PICCs) and centrally inserted tunneled lines (TLs), as well as identify additional risk factors for CVC-associated thrombosis. Methods: This prospective, observational cohort study enrolled patients aged 6 months to <18 years from 3 large pediatric hospitals, Children's Hospital Los Angeles, Children's Hospital of Philadelphia and Texas Children's Hospital between September 2013 to April 2016 who either had a PICC or TL placed. Data regarding subject demographics and medical history (cancer, congenital heart disease, history of VTE, current infection, etc.) were collected via electronic medical record (EMR) review. Details specific to the CVC (reason for insertion, CVC size, number of lumens, brand and CVC material) and insertion technique (length of CVC, vein accessed, number of attempts) were also collected. Subjects were then prospectively monitored for the occurrence of a VTE and other CVC-related complications (infection, malfunction, use of tissue plasminogen activator) via EMR review for up to 6 months after their CVC was placed or after diagnosis of a VTE. Univariable and multivariable logistic regression was utilized to examine the association of patient and CVC characteristics on VTE incidence. All significant predictors (p < 0.10) in the univariable analyses were entered into a multivariable model where each predictor's contribution was assessed. Results: Interim analysis includes 789 subjects [53% male, median age 6 years (0.5, 18)] who had 883 CVCs placed (Table 1). PICCs were placed in 570 (65%) subjects and 313 (35%) had TLs placed. There were a total of 43 CVC-related VTEs (4.9%) and the majority, 37 (86%), were in subjects with PICCs. The median time to develop a PICC-associated VTE after placement was 37 days (1, 215). Twenty-four predictors were analyzed in separate logistic regression models. Univariable analysis of twenty-four possible predictors revealed a statistically significant increased risk of VTE incidence in subjects with a history of VTE with an odds ratio (OR) of 2.9 [95% confidence interval (CI), 1.3-6.6] or congenital heart disease OR=2.8 (CI 1.3-6.0), subjects with PICCs (vs. TLs) OR=3.8 (CI 1.6-9.1), multiple lumen CVCs (TL or PICC) OR=3.2 (CI 1.7-6.0) or in CVCs with a malfunction OR=2.1 (1.1-3.9). Male gender, on the other hand, was associated with a reduced risk of VTE OR=0.46 (0.2-0.9). Type of CVC (PICC vs. TL) OR=3.4 (CI 1.4-8.2), number of lumens OR=2.7 (CI 1.5-5.3), and history of VTE OR=2.8 (CI 1.2-6.5) remained significant positive predictors of VTE incidence in the setting of a multivariable model. Male gender remained to be inversely associated with VTE incidence (Table 2). Conclusions: This is the first prospective pediatric study comparing VTE incidence in PICCs versus TLs. This interim analysis of nearly 800 subjects revealed a significantly higher risk of VTE in subjects who have had a PICC placed versus a TL. Due to their ease of insertion, PICCs are being placed at increasing rates in some pediatric centers, thus this finding may be the leading factor for the increasing pediatric VTE incidence. Other significant risk factors for VTE were patients with multiple lumen CVCs and a history of VTE. For children who require a new CVC, practitioners should consider avoiding PICCs and multiple lumen CVCs if possible. Consideration should also be made to give prophylactic anticoagulation for children with a CVC and a history of VTE. Further analysis will be performed concerning the decreased VTE rate in male patients. The identification of these risk factors is the first step to creating CVC selection and insertion guidelines for all children to prevent VTE. Continued subject recruitment, with the recent addition of Nationwide Children's Hospital, is occurring to complete this evaluation. Disclosures Young: Biogen: Consultancy, Speakers Bureau; Novo Nordisk: Consultancy, Speakers Bureau; Kedrion: Consultancy; Baxter: Consultancy.

Children's Hospital-Acquired Thrombosis (CHAT) Registry: A Multi-Institutional Registry for Prospective Identification of Independent Risk Factors

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2597-2597 ◽  
Author(s):  
Arash Mahajerin ◽  
Julie Jaffray ◽  
Brian Vasquez ◽  
Neil A Goldenberg ◽  
Guy Young ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Scoring System ◽  
Laboratory Testing ◽  
Right Atrial ◽  
Central Venous ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Independent Risk Factors ◽  
Hospital Acquired

Abstract Background: Pediatric hospital-acquired venous thromboembolism (HA-VTE) incidence is rising and many centers are instituting pediatric-specific prophylaxis programs despite a lack of evidence-based risk stratification to reduce unnecessary thromboprophylaxis exposure. Objectives: The multi-institutional Children's Hospital-Acquired Thrombosis (CHAT) Registry via Research Electronic Data Capture (REDCap) can identify independent HA-VTE risk factors for prospective validation and creation of a risk-assessment scoring system. Methods: This IRB-approved, retrospective registry reveals HA-VTE risk factors from subjects aged 0-21 years with radiographically-validated VTE ≥ 48 hours after hospital admission, or after central venous line placement, at 5 pediatric hospitals from January 2012 - June 2015. Descriptive statistics summarize demographics, medical comorbidities, characteristics of the VTEs themselves and associated laboratory testing for 555 subjects. Further analyses are currently utilizing matched controls and logistic regression to identify specific odds ratios for independent risk factors. Results: The median time to VTE diagnosis was 9 days with interquartile range (IQR) of 5-18.5 days, 34% of VTE occurred in a critical care unit, and 36.8% of subjects had been hospitalized in the 30 days prior to the index hospitalization. 22.7% of VTE events were incidentally found. VTE distribution was: deep vein thromboses of arms/legs (79.6%), cerebral sinus venous thrombosis (7%), abdominal VTE (5%), pulmonary embolism (4.3%), and other (intra-cardiac and superior vena cava/right atrial junction - 5.5%) with overlap due to some subjects with multiple, separate, concurrent VTE events. Demographic characteristics revealed median age of 3.6 years (IQR: 0.4 - 13.6 years) at VTE diagnosis and slight male predominance (55%). 66.1% of subjects had significant past medical history (Table 1) and 7.2% were immobile at baseline. Evaluation of hospital course revealed a multitude of acquired putative risk factors for HA-VTE (Table 2). 70.8% of VTE were associated with a central venous catheter (CVC). Of CVC-related VTE, 70.5% were in the same vein as CVC, 20.1% were in a vein which previously held a CVC, 10.7% surrounded the CVC tip, 2.5% occurred in a vein where CVC placement was attempted but unsuccessful. 55% of subjects had at least one documented infection during hospitalization, 42% of subjects had surgery, 20.7% had a procedure involving intravascular instrumentation (defined as dialysis, plasmapheresis, cardiac catheterization, stent placement/removal, or coiling procedure), 5% of subjects underwent trauma prior to admission with 82% of trauma classified as "major", and 59.5% of subjects were intubated at some point during their admission. Regarding medications, 31.9% of subjects were on steroids at VTE diagnosis and an additional 13.2% of subjects received steroids in the 30 days prior to VTE diagnosis, 2.2% of subjects were on estrogen with all of these subjects having started estrogen within 6 months prior to VTE diagnosis, 4.1% of subjects received asparaginase prior to VTE, 1.6% of subjects received recombinant factor VIIa prior to VTE, and 0.4% of subjects received prothrombin complex concentrates prior to VTE. Laboratory testing of hospitalized patients revealed 43.2% of patients had a d-dimer level obtained at time of VTE and 96.5% of those patients had an elevated level. 48.3% of patients had at least one thrombophilia lab test ordered. 17.8% of subjects received VTE prophylaxis - 55% of which was pharmacologic anticoagulation. Conclusions: The CHAT registry results demonstrate a slight male predisposition and multiple associated chronic medical illnesses and acquired hospital course co-morbidities, particularly CVCs which were involved in the majority of events. Ongoing work includes incorporating additional institutions to reach a goal of 1000 cases and 2000 controls to identify independent risk factors for the development of a risk-assessment scoring system. Long-term goals include prospective validation of the scoring system to serve as the basis of identifying subjects for a future randomized clinical trial of risk-based prevention strategies. Such a trial would evaluate efficacy, safety, and cost-benefit of thromboprophylaxis in hospitalized children and help inform best practices. Disclosures Young: Novo Nordisk: Consultancy, Speakers Bureau; Kedrion: Consultancy; Baxter: Consultancy; Biogen: Consultancy, Speakers Bureau.

scholarly journals A184 INCIDENCE OF VENOUS THROMBOTIC EVENTS AND RISK FACTORS IN CHILDREN HOSPITALIZED WITH INFLAMMATORY BOWEL DISEASE: A RETROSPECTIVE, CASE-CONTROL STUDY

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 199-200
Author(s):  
Z Ding ◽  
M Sherlock ◽  
M Zachos
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Anticoagulation Therapy ◽  
Case Control ◽  
Central Venous ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Inflammatory Bowel ◽  
Control Study ◽  
Pediatric Ibd

Abstract Background Limited research has been published to describe the incidence of venous thromboembolism (VTE) and relevant risk factors in Canadian children with inflammatory bowel disease (IBD). Aims The present study aimed to investigate the incidence of VTE amongst hospitalized pediatric IBD patients over a 10-year period and identify risk factors for the development of VTE. Methods A retrospective, matched case-control study was performed at McMaster Children’s Hospital. Hospitalized pediatric patients with IBD (&lt;18 years old) from September 2009 to August 2020 were selected. Inpatient data was extracted from the medical record database, including baseline demographic data, thromboembolic events and potential risk factors for VTE. Results There were 890 hospitalizations of IBD patients during the study period. 15 (1.69%) were diagnosed with a VTE, including 4 males and 11 females (mean age 13.4±2.9 years old). 12 ulcerative colitis (UC) (80%) and 3 Crohn’s disease (CD) (20%) hospitalizations were comprised in the VTE group. There was a significant difference in VTE rate between females (2.7%) and males (0.8%) (P = 0.03). The VTE rate in the UC group (4.2%) was significantly higher than in the CD group (0.6%) (P = 0.001). The incidence of VTE amongst hospitalized IBD patients did not vary over the 10-year period (P = 0.496). Length of stay in hospital, albumin level and central venous catheter were shown to be significantly different, although they were not identified as independent risk factors (P &gt;0 .05). Of the 15 hospitalizations with VTE, 6/15 (40%) were superficial VTEs in the extremities and 9/15 (60%) had a deep vein thrombosis (DVT) including 6 in the extremities and 3 in the abdomen. VTEs were associated with a peripheral line in 7 patients and with a PICC line in 4 hospitalizations. 2 of 9 (22%) with extremity DVT developed symptomatic pulmonary embolism. An inherited thrombotic condition was identified in 2 of 15 with VTEs. 12/15 (80%) with VTEs were symptomatic and all VTE related symptoms happened in patients with extremity thrombosis and pulmonary embolism. 7 of 15 (47%) VTEs were treated with anticoagulation therapy for 1–6 months. VTE related symptoms and repeat imaging tests significantly improved, and no patient developed a bleeding complication as a result of treatment. Conclusions The VTE rate in pediatric IBD patients was relatively low at McMaster Children’s hospital. Children with VTE were disproportionately females with ulcerative colitis compared with children with no VTE. Central venous line insertion may be correlated with the risk for VTE in children with IBD. Most VTEs and related symptoms happened in patients with extremity thrombosis and secondary pulmonary embolus. Anticoagulation therapy in children with IBD with active disease appears to be safe. Funding Agencies Kids Dig Health Funding from McMaster Children’s Hospital, McMaster University

scholarly journals Risk factors associated with severe asthma exacerbations in children attending Alexandria University Children’s Hospital, Egypt

2018 ◽  
Vol 5 (12) ◽  
pp. 5019
Author(s):  
Ihab H. El Sawy ◽  
Reham M. Wagdy ◽  
Afaf G. Ibrahim ◽  
Suzy W. Ibrahim
Keyword(s):  
Risk Factors ◽  
Severe Asthma ◽  
Asthma Exacerbation ◽  
Mild Asthma ◽  
Factors Associated ◽  
Children's Hospital ◽  
Asthma Exacerbations ◽  
Severe Asthma Exacerbation ◽  
Children’S Hospital ◽  
History Of

Background: Severe asthma exacerbation is one of the common pediatric medical emergencies that necessitates hospital visits. The study aimed to identify risk factors associated with pediatric severe asthma exacerbations that might have the potential to guide the parents for early medical consultations and physicians at primary health care centers for proper management.Methods: A case-control study was conducted on over 100 asthmatic children below 12 years attending the Emergency Department of Alexandria University Children’s Hospital in acute exacerbation. Based on a modified pulmonary index score, the patients were allocated into 2 groups; study group (50 patients with severe asthma exacerbation) and control group (50 patients with mild asthma exacerbations). Demographic data, history of illness, alarming clinical signs, medications, and outcome of all participants were recorded.Results: Severe asthma exacerbations were more encountered among males, older age, and with a longer duration of asthma (X±SD=28.4±15.9 months) with significant differences when compared to controls. Comparing the studied groups revealed higher risk for severe asthma exacerbations mainly with; history of sudden onset of severe respiratory distress (Odds ratio “OR”=30.13, 95% CI, 13.78-66.69) and chronic steroid-dependent asthma (OR=14.46, 95% CI, 3.97-52.65). Cyanosis, lethargy, and inability to talk were alarming signs in patients with severe asthma exacerbation when compared to those with mild asthma exacerbation (p<0.05).Conclusions: Severe asthma exacerbation in children is still associated with many risk factors that may alert the patients’ caregivers and physicians prospectively for early proper management. 

scholarly journals 1130. Vancomycin Use in Pediatric Severe Sepsis at a Freestanding Children’s Hospital

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S401-S402 ◽  
Author(s):  
Shamim M Islam ◽  
Stacie M Yi ◽  
Anna Miller ◽  
Gurjot Sandhu ◽  
Amanda Hassinger
Keyword(s):  
Risk Factors ◽  
Severe Sepsis ◽  
Coagulase Negative Staphylococcus ◽  
Mandated Reporting ◽  
Children's Hospital ◽  
Prolonged Hospitalization ◽  
Age Related ◽  
Children’S Hospital ◽  
History Of ◽  
Mrsa Infection

Abstract Background Surviving Sepsis Campaign guidelines recommend antibiotics be administered within 1 hour of severe sepsis (SS) onset, but do not suggest which agents to give. Vancomycin (VAN) is often chosen as empiric therapy for severe sepsis (SS) in children without evidence of the prevalence or risk factors for infections requiring VAN. As VAN is associated with significant nephrotoxicity, this study was performed to measure the risk-benefit ratio of empiric VAN use in pediatric sepsis. Methods This was a retrospective study of children with SS between 1/1/2015 to 6/30/2018 at the Women and Children’s Hospital of Buffalo, as captured by billing data and sent to state Department of Health for mandated reporting. SS cases were assessed for risk factors for Gram-positive infections, including presence of a central venous line (CVL) or other invasive device; history of MRSA infection or nasal colonization within the last 2 years; skilled nursing facility (SNF) residence; and prolonged hospitalization of >1 month. Invasive infections for which vancomycin is an optimal agent, specifically culture-proven methicillin-resistant Staphylococcus aureus (MRSA), coagulase-negative Staphylococcus (CoNS), and ampicillin-resistant Enterococcus infections, were defined as vancomycin requiring (VAN-req). Acute kidney injury (AKI) was defined as having a serum Creatinine of twice normal per age-related reference values. Results Of 304 identified SS cases, 8.9% had VAN-req infections. VAN was empirically given to 58.2% of cases (177); 86.4% ultimately did not have VAN-req infections. 9.2% of all SS cases had AKI at SS onset; this included 15.8% of patients (28) receiving VAN, of which only 1 (3.6%) had a VAN-req infection. History of a past MRSA infection, prolonged hospitalization, SNF residence, and CVL presence were found to be independent risk factors for a VAN-req infection (Table 1). VAN-req infections in patients lacking these four risk factors was 3.1% (4/130). Conclusion VAN was given empirically in the majority of pediatric SS cases, but culture-proven infections requiring the drug were infrequent, especially in patients without specific risk factors. The use of empiric VAN for SS should be guided by well-defined criteria, as the drug’s potential risks are likely to outweigh any benefit in most patients. Disclosures All authors: No reported disclosures.

Risk Factors for Nonunion Following Ankle Arthrodesis: A Systematic Review and Meta-analysis

2021 ◽  
pp. 193864002199849
Author(s):  
Sumit Patel ◽  
Lauren Baker ◽  
Jose Perez ◽  
Ettore Vulcano ◽  
Jonathan Kaplan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Avascular Necrosis ◽  
Strong Evidence ◽  
Meta Analysis ◽  
Ankle Arthrodesis ◽  
Male Gender ◽  
Site Infection ◽  
Open Injury ◽  
History Of

Background Nonunion is a postoperative complication after ankle arthrodesis (AA), which leads to increased morbidity and revision rates. Previous studies have identified risk factors for nonunion following AA, but no meta-analysis has been performed to stratify risk factors based on strength of evidence. Methods Abstracts and full-text articles were screened by 2 independent reviewers. Relevant data were extracted from the included studies. Random effects meta-analyses were summarized as forest plots of individual study and pooled random effect results. Results Database search yielded 13 studies involving 987 patients were included, and 37 potential risk factors for nonunion. Meta-analysis found 5 significant risk factors for nonunion post-AA. Strong evidence supports male gender (OR: 1.96; 95% CI: 1.13-3.41), smoking (OR: 2.89; 95% CI: 1.23-6.76), and history of operative site infection prior to arthrodesis (OR: 2.40; 95% CI: 1.13-5.09) as predictors for nonunion following AA. There was moderate evidence supporting history of open injury (OR: 5.95; 95% CI: 2.31-15.38) and limited evidence for preoperative avascular necrosis (OR: 13.16; 95% CI: 2.17-79.61) as possible risk factors for nonunion. Conclusion The results of our meta-analysis suggest that male gender, smoking, and history of operative site infection have strong evidence and that history of open injury and avascular necrosis also have evidence as risk factors for nonunion. Surgeons should be cognizant of these risks when performing AA and closely follow up with patients with the aforementioned risk factors to ensure postoperative success. Levels of Evidence: Level V: Systematic review of cohort and case-control studies

scholarly journals A Retrospective Review of Hospital-Acquired Venous Thromboembolism at a Large Pediatric Tertiary Care Center

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3471-3471
Author(s):  
Marissa A. Just ◽  
Joanna Robles ◽  
Karan R. Kumar ◽  
Andrew Yazman ◽  
Jennifer A. Rothman ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Research Funding ◽  
Pediatric Patients ◽  
Central Venous ◽  
Vte Prophylaxis ◽  
Children's Hospital ◽  
Congenital Cardiac Disease ◽  
Children’S Hospital ◽  
Icd 10 ◽  
Hospital Acquired

Introduction: The incidence of venous thromboembolism (VTE) in hospitalized pediatric patients is increasing secondary to the growing medical complexity of pediatric patients and the increasing use of central venous catheters. Pediatric patients diagnosed with VTE have up to 2% mortality associated directly with their thromboses. While incidence, risk factor identification and preventive strategies are well established in hospitalized adults, this information is limited in the pediatric population. There are currently no standardized VTE risk screening tools or thromboprophylaxis guidelines for children at Duke Children's Hospital. The incidence of hospital acquired VTE (HA-VTE), as well as their associated risk factors were investigated in a retrospective review. Methods: Medical records of pediatric patients hospitalized at Duke Children's Hospital during June 2018 through November 2018 were reviewed. The EPIC SlicerDicer tool was used to identify patients with ICD-10 diagnoses codes related to thrombosis or treated with anticoagulants. Included patients were diagnosed with HA-VTE during their hospitalization or within 14 days of discharge. Data collected included demographics, thrombosis characteristics, family history, mobility, and acute or chronic co-morbid conditions. The characteristics of the study population were described by median (with 25th and 75th percentiles) for continuous variables and frequencies (with percentages) for binary or categorical variables. Results: Out of 4,176 total pediatric admissions to all units of Duke Children's Hospital (ages 0-18.99 years) during the inclusion timeframe, 33 VTE events were identified. The incidence of VTE events per 1000 patient days was 0.98. The complete patient and VTE event characteristics are listed in Tables 1 and 2. The median age of patients with VTE events was 0.4 years. Of the identified cohort, 73% had an associated central venous line (CVL). Neonates with congenital cardiac disease comprised the majority of the cohort. Other common patient characteristics observed in this cohort included impaired mobility, recent major surgery, and recent mechanical ventilation. Of the 33 VTE diagnoses, 70% received therapeutic anticoagulation with enoxaparin or unfractionated heparin. Only 2 patients (8%) received prophylactic anticoagulation prior to their diagnosis of VTE. Conclusions: The retrospective review of HA-VTE events at Duke Children's Hospital identified that the majority of the events occurred in neonates with congenital cardiac disease and the presence of CVLs. It was also noted that there was no standardization among the use of anticoagulation agents that were initiated for treatment of VTE. Furthermore, few patients received VTE prophylaxis during the hospitalization. A limitation of this review was that it was retrospective and the documentation of family history of thrombosis was inconsistent. It is also possible that several VTE events were missed due to inadequate ICD-10 coding. Based on the results of this review, there is a need to implement a risk stratification tool and develop standardized recommendations of VTE prophylaxis and treatments for pediatric patients admitted to Duke Children's Hospital. There is an additional quality improvement phase of this project and the goal is to implement a risk calculator that is based on information learned from the retrospective review. Ultimately, this risk calculator will help to decrease the incidence of VTE events at Duke Children's Hospital. Disclosures Rothman: Agios: Honoraria, Research Funding; Pfizer: Consultancy, Honoraria, Research Funding; Novartis: Honoraria, Research Funding.

scholarly journals Identification of risk factors for human immunodeficiency virus-1 infection in Khyber Pakhtunkhwa population: A case control study

2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Jamila Haider ◽  
Ghosia Lutfullah ◽  
Irshad Ur Rehman ◽  
Irfan Khattak
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Case Control Study ◽  
Case Control ◽  
Male Gender ◽  
Khyber Pakhtunkhwa ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Control Study ◽  
Human Immunodeficiency Virus 1

Objectives: The present study aims to identify the risk factors for Human Immunodeficiency Virus-1(HIV-1) infection in Khyber Pakhtunkhwa (KP) population by comparing HIV-antibody positive cases with HIV-antibody-negative controls. Methods: The study was designed at the Family Care Centre (FCC), Hayatabad Medical Centre (HMC) Peshawar from February 2015 to December 2016. A total of 280 individuals were selected randomly for the study as cases and control. Data was collected on a structured questionnaire with informed oral consent. The collected data was analysed statistically using SPSS version 20. Results: Out of 280 individuals, 56% were males, 44% were females, and 53.21% belonged to the urban areas. The literacy rate was 48.6%, and 75.4% were married. The statistical analysis of risk factors revealed the following factors as of significance value (p < 0.05). Family history of HIV (OR = 9.46), spouse status of HIV (OR=22.22), injection drug users (IDUs), migrants (OR=2.234), use of therapeutic injections (OR= 2.791), employment (OR=2.545), male gender (OR=2.35), tattooing (OR=7.667) and history of blood transfusion (OR= 2.69). Conclusion: The present study revealed spouse status of HIV, tattooing, migrants, IDUs, use of therapeutic injections, history of blood transfusion, male gender and employment as significant risk factors for HIV infection in the population of KP. doi: https://doi.org/10.12669/pjms.35.5.258 How to cite this:Haider J, Lutfullah G, Irshad ur Rehman, Khattak I. Identification of risk factors for human immunodeficiency virus-1 infection in Khyber Pakhtunkhwa population: A case control study. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.258 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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