Ten-year experience with standardized non-operating room anesthesia with Sevoflurane for MRI in children affected by neuropsychiatric disorders

Abstract Background Children require anesthesia for MRI to maintain immobility and reduce discomfort; clear indications about the best anesthesiologic management are lacking and each center developed its own protocol. Moreover, children with neuropsychiatric disorders more likely require sedation and are described in literature as more prone to general and respiratory complications. Aim of this study was to analyze the applicability of a sevoflurane-based approach, to describe general and respiratory complications and to identify risk factors in a pediatric neuropsychiatric population. Methods Retrospective cohort study, university Hospital (January 2007–December 2016). All the 1469 anesthesiologic records of children addressed from Neuropsychiatric Unit to undergo MRI under general anesthesia were analyzed; 12 patients equal or older than 18-year-old were excluded. We identified post-hoc nine macro-categories: static encephalopathies, metabolic/evolutive encephalopathies, epileptic encephalopathies, neuromuscular diseases, autistic spectrum disorders, migraine, psychiatric disorders, intellectual disabilities, others. A logistic regression model for events with low frequency (Firth’s penalized likelihood approach) was carried out to identify the mutually adjusted effect among endpoints (complications) and the independent variables chosen on the basis of statistical significance (univariate analysis, p ≤ 0.05) and clinical judgment. Results Of 1457 anesthesiologic records (age 4.0 (IQR 2.0 to 7.0) year-old, males 891 (61.2%), weight 17.0 (IQR 12.0 to 24.9) kg), 18 were cancelled for high anesthesiologic risk, 50 were cooperative, 1389 were anesthetized. A sevoflurane-based anesthesia was feasible in 92.3%; these patients required significantly less mechanical ventilation (8.6 vs. 16.2%; p = 0.012). Complications’ rate was low (6.2%; 3.1% respiratory). The risk for general complications increases with ASA score > 1 (OR 2.22, 95 CI% 1.30 to 3.77, p = 0.003), male sex (OR 1.73, 95% CI 1.07 to 2.81, p = 0.025), multi-drug anesthesia (OR 2.98, 95 CI% 1.26 to 7.06, p = 0.013). For respiratory complications, it increases with ASA score > 1 (OR 2.34, 95 CI% 1.19 to 4.73, p = 0.017), autumn-winter (OR 2.01, 95 CI% 1.06 to 3.78, p = 0.030), neuromuscular disorders (OR 3.18, 95 CI% 1.20 to 8.41, p = 0.020). We had no major complications compromising patients’ outcome or requiring admission to ICU. Conclusions Sevoflurane anesthesia is feasible and safe for children affected by neuropsychiatric disorders undergoing MRI. Specific risk factors for general and respiratory complications should be considered.

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Surgical site infection in a Greek general surgery department: who is at most risk?

Journal of Wound Care ◽

10.12968/jowc.2021.30.4.268 ◽

2021 ◽

Vol 30 (4) ◽

pp. 268-274

Author(s):

Anna Bekiari ◽

George Pappas-Gogos ◽

Dimitrios Dimopoulos ◽

Efthalia Priavali ◽

Konstantina Gartzonika ◽

...

Keyword(s):

Risk Factors ◽

General Surgery ◽

Risk Index ◽

Univariate Analysis ◽

University Hospital ◽

Candida Spp ◽

Asa Score ◽

Icu Stay ◽

Related Risk ◽

Starting Point

Objective: Surgical site infections (SSIs) are associated with protracted hospitalisation, antibiotics administration, and increased morbidity and mortality. This work investigated the incidence rate of SSIs in the Department of General Surgery at the University Hospital of Ioannina, Greece, the associated risk factors and pathogens responsible. Method: In this prospective cohort study, patients who underwent elective procedures under general anaesthesia were enrolled. Risk factors monitored included age, sex, body mass index, smoking, alcohol consumption, preoperative length of stay, chemoprophylaxis, intensive care unit (ICU) stay, American Society of Anesthesiology (ASA) score, and the National Nosocomial Infections Surveillance System (NNIS) basic SSI risk index. Results: Of the 1058 enrolled patients, 80 (7.6%) developed SSIs. Of the total cohort, 62.5% of patients received chemoprophylaxis for >24 hours. A total of 20 different pathogens, each with multiple strains (n=108 in total), were identified, 53 (49.5%) Gram-negative rods, 46 (42%) Gram-positive cocci, and nine (8.4%) fungi (Candida spp.). Escherichia coli was the prevalent microorganism (24.3%). SSI-related risk factors, as defined by univariate analysis, included: ICU stay, ASA score >2 (p<0.001), NNIS score >0, and wound classes II, III, and IV. Also, serum albumin levels <3.5g/dl were associated with increased rate of SSIs. The multivariate model identified an NNIS score of >0 and wound classes II, III, and IV as independent SSI-related risk factors. Conclusion: This study showed high SSI rates. Several factors were associated with increased SSI rates, as well as overuse of prophylactic antibiotics. The results of the present study could be a starting point for the introduction of a system for recording and actively monitoring SSIs in Greek hospitals, and implementation of specific guidelines according to risk factors.

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832. Assessment of Risk Factors Associated with Wide-resistance Gram-negative Bacteria Infections

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1021 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S457-S457

Author(s):

Henry Pablo Lopes Campos e Reis ◽

Ana Beatriz Ferreira Rodrigues ◽

Julio César Castro Silva ◽

Lia Pinheiro de Lima ◽

Talita Lima Quinaher ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Univariate Analysis ◽

Multidrug Resistant ◽

University Hospital ◽

Gram Negative Bacteria ◽

Multiresistant Pathogens ◽

Gram Negative ◽

Contact Isolation ◽

Bladder Catheter

Abstract Background Enterobacteria and multidrug-resistant non-fermenting Gram-negative bacilli present a challenge in the management of invasive infections, leading to mortality rates due to their limited therapeutic arsenal. The objective of this work was to analyze risk factors that may be associated with these infections, for a better situational mapping and assertive decision-making in a university hospital in Brazil. Methods The study was conducted between January and September 2019, with 167 patients in contact isolation at a university hospital in Brazil. Potential outcome-related variables for wide-resistance Gram-negative bacteria (BGN) infections were evaluated. Risk factors were identified from univariate statistical analysis using Fisher’s test. Results 51 (30.5%) out of 167 patients in contact isolation evolved with wide-resistance BGN infection. Risk factors in univariate analysis were age, hospital unit and previous use of invasive devices. Patients aged up to 59 years were more likely to progress to infection than those aged over 60 years (p 0.0274, OR 2.2, 95% CI 1.1-4.5). Those admitted to the oncohematology (p < 0.001, OR 32.5, Cl 9.1-116.3) and intensive care unit (p < 0.001, OR 28.0, Cl 3.5-225.9) units were more likely to develop this type of infection. The least likely were those admitted to a kidney transplant unit (p 0.0034, OR 15.33, Cl 1.8-131.0). Prior use of mechanical ventilation (p 0.0058, OR 12.2, Cl 2.0-76.1) and delayed bladder catheter (p 0.0266, OR 5.0, Cl 1.2-20.1) in patients with respiratory and urinary tract infection, respectively, were also reported as risk factors related to these infections. The gender of the patients was not significant for the study. Conclusion This study determined that variables such as age, hospitalization unit, use of mechanical ventilation and delayed bladder catheter could be considered important risk factors in triggering the infectious process by wide-resistant gram-negative bacteria. Thus, the analysis of these factors becomes a great foundation to prevent the development of multiresistant pathogens through prevention strategies, prophylaxis management and more targeted empirical therapies. Disclosures All Authors: No reported disclosures

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Which Factors Increase the Risk of Re-Operation after Meniscus Surgery in the Skeletally Immature?

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118s00064 ◽

2018 ◽

Vol 6 (7_suppl4) ◽

pp. 2325967118S0006

Author(s):

Neeraj M. Patel ◽

Surya Mundluru ◽

Nicholas Beck ◽

Theodore J. Ganley

Keyword(s):

Risk Factors ◽

Cruciate Ligament ◽

Statistical Significance ◽

Univariate Analysis ◽

Multivariate Model ◽

Skeletally Immature ◽

Initial Surgery ◽

Repeat Operation ◽

Operation Rate ◽

Meniscus Surgery

Objectives: The purpose of this study is to determine which factors heighten the risk for subsequent operations in skeletally immature patients undergoing meniscus surgery. Methods: A retrospective institutional database of 1,063 meniscus surgeries performed between 2000 and 2015 was reviewed. All procedures were performed in skeletally immature patients. Demographic and intra-operative information was recorded, as were concurrent injuries or operations and subsequent surgeries. Univariate analysis consisted of chi-square and independent-samples t-tests. Multivariate logistic regression was then performed to control for confounding factors. Results: The mean age at initial surgery was 13.4 years (standard deviation, SD, 2.2 years) and the average follow-up duration was 47 months (SD 54 months). Overall, 314 patients (29.5%) required repeat surgical intervention. 36% of all females required subsequent surgery compared to 26% of males (p<0.01). Discoid menisci underwent repeat operation more frequently than non-discoid menisci (35% vs. 27%, p=0.01). After accounting for confounders in a multivariate model, females had 2.2 times the odds of repeat surgery than males (95% CI 1.4-3.3, p<0.01) and each year of increasing age resulted in 1.3 times higher odds (95% CI 1.1 -1.4, p<0.01). The odds of subsequent surgeries were 4.2 times higher in those with flap tears (95% CI 1.8-9.7, p<0.01) and 2.9 times higher for discoid menisci (95% CI 1.4-6.0, p<0.01). Concomitant anterior cruciate ligament rupture or tibial spine fracture decreased the risk of needing additional surgeries in univariate analysis, but lost statistical significance in the multivariate model. Conclusion: Even when accounting for other factors in a multivariate model, female sex, increasing age, flap tears, and discoid meniscus were risk factors for subsequent procedures after meniscus surgery in skeletally immature patients. The re-operation rate in this population may be higher than previously reported. This study describes, for the first time, risk factors for repeat operations in skeletally immature patients undergoing meniscus surgery. These results can be used to counsel and monitor patients accordingly.

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Established the first clinical prediction model regarding the risk of hyperuricemia in IgA nephropathy

10.21203/rs.3.rs-888732/v1 ◽

2021 ◽

Author(s):

Yin-Hong Geng ◽

Zhe Zhang ◽

Jun-Jun Zhang ◽

Bo Huang ◽

Zui-Shuang Guo ◽

...

Keyword(s):

Risk Factors ◽

Iga Nephropathy ◽

Interstitial Fibrosis ◽

Characteristic Curve ◽

Univariate Analysis ◽

Curve Analysis ◽

University Hospital ◽

Prediction Ability ◽

Decision Curve Analysis ◽

Incidence Risk

Abstract Objective. To construct a novel nomogram model that predicts the risk of hyperuricemia incidence in IgA nephropathy (IgAN) . Methods. Demographic and clinicopathological characteristics of 1184 IgAN patients in the First Affiliated Hospital of Zhengzhou University Hospital were collected. Univariate analysis and multivariate logistic regression were used to screen out hyperuricemia risk factors. The risk factors were used to establish a predictive nomogram model. The performance of the nomogram model was evaluated using an area under the receiver operating characteristic curve (AUC), calibration plots, and a decision curve analysis. Results. Independent predictors for hyperuricemia incidence risk included sex, hypoalbuminemia, hypertriglyceridemia, blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), 24-hour urinaryprotein (24h TP), Gross and tubular atrophy/interstitial fibrosis (T). The nomogram model exhibited moderate prediction ability with an AUC of 0.834 ((95% CI 0.804–0.864)). The AUC from validation reached 0.787 (95% CI 0.736-0.839). The decision curve analysis displayed that the hyperuricemia risk nomogram was clinically applicable.Conclusion. Our novel and simple nomogram containing 8 factors may be useful in predicting hyperuricemia incidence risk in IgAN.

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Intestinal Microsporidiosis Among HIV/AIDS Patients Receiving Antiretroviral Therapy in Sana’a City, Yemen: First Report on Prevalence and Predictors

10.21203/rs.3.rs-684810/v1 ◽

2021 ◽

Author(s):

Kwkab A. R. Al-Barhami ◽

Rashad Abdul-Ghani ◽

Salah A. Al-Qobati

Keyword(s):

Risk Factors ◽

Antiretroviral Therapy ◽

Large Scale ◽

Statistical Significance ◽

Univariate Analysis ◽

Cell Counting ◽

Cd4 Cells ◽

Aids Patients ◽

Intestinal Microsporidiosis ◽

Hiv Aids

Abstract Background: Intestinal microsporidiosis is an opportunistic infection associated with persistent diarrhea among HIV/AIDS patients. In Yemen, however, its epidemiology is unknown. Therefore, this study determined its prevalence and predictors among HIV/AIDS patients receiving antiretroviral therapy (ART) in Sana'a city, Yemen.Methods: This cross-sectional study included 402 patients receiving ART at Al-Jomhori Educational Hospital in Sana'a from November 2019 to December 2020. Data about demographics, clinical characteristics and risk factors were collected using a pre-designed questionnaire. Stool samples were collected and examined for microsporidian spores using the Gram-chromotrope Kinyoun staining. Blood samples were also collected and used for CD4 cell counting by flow cytometry. Univariate analysis was used to test the association of patients’ characteristics and risk factors with intestinal microsporidiosis. Multivariable logistic regression was then used to identify the independent predictors of infection. Statistical significance was considered at P-values <0.05. Results: Intestinal microsporidiosis was prevalent among 14.2% (57/402) of HIV/AIDS patients but was not significantly associated with any of the studied demographics, source of drinking water, bathing and/or swimming outdoors, contact with soil, presence of domestic animals or indiscriminate defecation. However, it was significantly associated with diarrhea (OR=3.4, 95% CI: 1.7–6.6; P=0.001) and <200 CD4 cells/µl (OR=2.7, 95% CI: 1.5–5.0; P=0.001). The significant independent predictors of infection were <200 CD4 cells/µl (AOR=3.2, 95% CI: 1.5–6.9; P=0.003), not washing hands after contacting soil (AOR=2.5, 95% CI: 1.1–5.4; P=0.026) and before eating (AOR=3.1, 95% CI: 1.5–6.4; P=0.003), eating unwashed raw produce (AOR=2.5, 95% CI: 1.2–5.3; P=0.017) and absence of indoor latrines (AOR=6.2, 95% CI: 1.5–25.9; P=0.012).Conclusions: The prevalence of intestinal microsporidiosis among HIV/AIDS patients in Sana'a is high and comparable to that several other countries, being prevalent among approximately 14.0% of patients and significantly associated with diarrhea. It could be predicted among patients who have <200 CD4 cells/µl, poor hand hygiene after contacting soil and before eating, usually eat unwashed raw produce and do not possess indoor latrines. Large-scale studies on its epidemiology and predictors among HIV/AIDS patients across the country are warranted.

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The Prevalence of Health Care-Associated Infections and Risk Factors in a University Hospital

Medicina ◽

10.3390/medicina48080059 ◽

2012 ◽

Vol 48 (8) ◽

pp. 59 ◽

Cited By ~ 1

Author(s):

Greta Gailienė ◽

Zita Gierasimovič ◽

Daiva Petruševičienė ◽

Aušra Macijauskienė

Keyword(s):

Risk Factors ◽

Health Care ◽

Acute Care ◽

Prevalence Rate ◽

Antimicrobial Agents ◽

Univariate Analysis ◽

University Hospital ◽

Stepwise Logistic Regression ◽

Antimicrobial Use ◽

Health Care Associated Infections

The aim of the study was to evaluate the prevalence of health care-associated infections, risk factors, and antimicrobial use. Material and Methods. The study was carried out as a point-prevalence study in acute care wards, i.e., intensive care, surgical, and medical wards, at Vilnius University Hospital Santariškių Klinikos in April 2010. The study variables included the patient’s general data, indwelling devices, surgery, infection and its microbiological investigation, and antimicrobial use. All the variables that were logically related or had a P value of <0.25 in the univariate analysis were included in the stepwise logistic regression in order to study the factors potentially associated with health careassociated infections. Results. A total of 731 patients were surveyed. The overall prevalence rate of health care-associated infections was 3.8%. The prevalence of health care-associated infections differed by hospital wards (range 0.0%–19.2%). The lower respiratory tract (32.2%), urinary tract (28.5%), and surgical site infections (32.1%) were the most common health care-associated infections. Moreover, 89.3% of the cases of health care-associated infections were microbiologically investigated. Staphylococcus aureus (28.6%) and Escherichia coli (19.1%) were the most frequently isolated microorganisms. The use of one or more invasive devices was recorded in 332 patients (45.4%). Of the surveyed patients, 20.2% received antimicrobial agents. The most commonly prescribed antimicrobial agents were fluoroquinolones (21.1%), broad-spectrum penicillins (19.1%), and first- or second-generation cephalosporins (18.6%). Conclusions. The prevalence of health care-associated infections was found to be similar to the reported overall prevalence rate of health care-associated infections in acute care hospitals in Lithuania.

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Incidence and Risk Factors for Ventilator-Associated Pneumonia in Kathmandu University Hospital

Kathmandu University Medical Journal ◽

10.3126/kumj.v9i1.6258 ◽

2012 ◽

Vol 9 (1) ◽

pp. 28-31 ◽

Cited By ~ 3

Author(s):

S Ranjit ◽

B Bhattarai

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Univariate Analysis ◽

University Hospital ◽

Ventilator Associated Pneumonia ◽

Chi Square ◽

H2 Blockers ◽

Observational Cohort ◽

Level Of Significance

Background Ventilator associated pneumonia is a major cause of morbidity in the intensive care unit. Difficulties in identification of the risk factors, in diagnosing and in prevention, have intensified the problem. Objectives To measure the incidence of ventilator associated pneumonia in intensive care unit and to identify the risk factors associated. Methods A prospective observational cohort study of 69 patients who were mechanically ventilated for more than 48 hours were evaluated to find out the development of nosocomial pneumonia and presence or absence of risk factors. Data were subjected to univariate analysis using chi-square and t-test. Level of significance was set at 0.05. Results Twenty two (31.88%) out of 69 patients developed ventilator associated pneumonia, majority of them between four days to 14 days. Reintubation, invasive lines, H2 blockers and low PaO2/FiO2 were identified as major risk factors in our study. Enteral feeding via nasogastric tube and use of steroids was not associated with development of ventilator associated pneumonia. The patients with ventilator associated pneumonia had significantly longer duration of mechanical ventilation (18.88±7.7 days vs 7.36±4.19 days) and stay (29±17.8 days vs 9.22±5.14 days). The morality was similar for both the groups with or without ventilator associated pneumonia. ConclusionThe incidence of ventilator pneumonia is high. Patients requiring prolonged ventilation, re-intubation, more invasive lines and H2 blockers, are at high risk and need special attention towards prevention.http://dx.doi.org/10.3126/kumj.v9i1.6258 Kathmandu Univ Med J 2011;9(1):28-31

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Incidence and Risk Factors of Diabetic Foot Ulcer: A Population-Based Diabetic Foot Cohort (ADFC Study)—Two-Year Follow-Up Study

International Journal of Endocrinology ◽

10.1155/2018/7631659 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 18

Author(s):

Leila Yazdanpanah ◽

Hajieh Shahbazian ◽

Iraj Nazari ◽

Hamid Reza Arti ◽

Fatemeh Ahmadi ◽

...

Keyword(s):

Risk Factors ◽

Diabetic Foot ◽

Univariate Analysis ◽

Previous History ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Population Based ◽

University Hospital ◽

Foot Deformity ◽

History Of

Aim/Introduction. This study was carried out to assess the incidence and risk factors of diabetic foot ulcer (DFU). Materials and Methods. In this prospective cohort study in a university hospital, all the participants were examined and followed up for new DFU as final outcome for two years. To analyze the data, the variables were first evaluated with a univariate analysis. Then variables with P value < 0.2 were tested with a multivariate analysis, using backward-elimination multiple logistic regression. Results. Among 605 patients, 39 cases had DFU, so we followed up the remaining 566 patients without any present or history of DFU. A two-year cumulative incidence of diabetic foot ulcer was 5.62% (95% CI 3.89–8.02). After analysis, previous history of DFU or amputation [OR = 9.65, 95% CI (2.13–43.78), P value = 0.003], insulin usage [OR = 5.78, 95% CI (2.37–14.07), P value < 0.01], gender [OR = 3.23, 95% CI (1.33–7.83), P value = 0.01], distal neuropathy [OR = 3.37, 95% CI (1.40–8.09), P value = 0.007], and foot deformity [OR = 3.02, 95% CI (1.10–8.29), P value = 0.032] had a statistically significant relationship with DFU incidence. Conclusion. Our data showed that the average annual DFU incidence is about 2.8%. Independent risk factors of DFU development were previous history of DFU or amputation, insulin consumption, gender, distal neuropathy, and foot deformity. These findings provide support for a multifactorial etiology for DFU.

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Risk Factors Associated With Surgical Site Infection After Pediatric Posterior Spinal Fusion Procedure

Infection Control and Hospital Epidemiology ◽

10.1086/593952 ◽

2009 ◽

Vol 30 (2) ◽

pp. 109-116 ◽

Cited By ~ 85

Author(s):

W. Matthew Linam ◽

Peter A. Margolis ◽

Mary Allen Staat ◽

Maria T. Britto ◽

Richard Hornung ◽

...

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Antibiotic Prophylaxis ◽

Spinal Fusion ◽

Univariate Analysis ◽

Posterior Spinal Fusion ◽

Site Infection ◽

Fusion Procedure ◽

Factors Associated ◽

Asa Score

Objective.To identify risk factors associated with surgical site infection (SSI) after pediatric posterior spinal fusion procedure by examining characteristics related to the patient, the surgical procedure, and tissue hypoxia.Design.Retrospective case-control study nested in a hospital cohort study.Setting.A 475-bed, tertiary care children's hospital.Methods.All patients who underwent a spinal fusion procedure during the period from January 1995 through December 2006 were included. SSI cases were identified by means of prospective surveillance using National Nosocomial Infection Surveillance system definitions. Forty-four case patients who underwent a posterior spinal fusion procedure and developed an SSI were identified and evaluated. Each case patient was matched (on the basis of date of surgery, ± 3 months) to 3 control patients who underwent a posterior spinal fusion procedure but did not develop an SSI. Risk factors for SSI were evaluated by univariate analysis and multivariable conditional logistic regression. Odds ratios (ORs), with 95% confidence intervals (CIs) andPvalues, were calculated.Results.From 1995 to 2006, the mean annual rate of SSI after posterior spinal fusion procedure was 4.4% (range, 1.1%—6.7%). Significant risk factors associated with SSI in the univariate analysis included the following: a body mass index (BMI) greater than the 95th percentile (OR, 3.5 [95% CI, 1.5–8.3]); antibiotic prophylaxis with clindamycin, compared with other antibiotics (OR, 3.5 [95% CI, 1.2 10.0]); inappropriately low dose of antibiotic (OR, 2.6 [95% CI, 1.0–6.6]); and a longer duration of hypothermia (ie, a core body temperature of less than 35.5°C) during surgery (OR, 0.4 [95% CI, 0.2–0.9]). An American Society of Anesthesiologists (ASA) score of greater than 2, obesity (ie, a BMI greater than the 95th percentile), antibiotic prophylaxis with clindamycin, and hypothermia were statistically significant in the multivariable model.Conclusion.An ASA score greater than 2, obesity, and antibiotic prophylaxis with clindamycin were independent risk factors for SSI. Hypothermia during surgery appears to provide protection against SSI in this patient population.

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THE INCIDENCE AND RISK FACTORS OF CONTRAST INDUCED NEPHROPATHY IN PATIENTS UNDERGOING CORONARY ANGIOPLASTY.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i6.321 ◽

2019 ◽

Vol 3 (6) ◽

Author(s):

Mukesh Kumar Sharma ◽

Pradeep Kurmi ◽

Deepak Ameta ◽

Chandra Bhanu Chandan

Keyword(s):

Risk Factors ◽

Contrast Media ◽

Statistical Significance ◽

Univariate Analysis ◽

Kidney Injury ◽

Coronary Intervention ◽

Contrast Induced Nephropathy ◽

Absolute Increase ◽

Increased Risk ◽

Adequate Hydration

Background: Contrast induced nephropathy remains important cause of hospital-acquired acute kidney injury and affects between 2% of the general population to 50% of high-risk subgroups following coronary intervention. Objectives: To determine the incidence and to study the various risk factors associated with CIN. Patients and Methods: In our study, total of 212 patients (154 males and 58 females) who received non ionic iso osmolar contrast media during percutaneous transluminal coronary intervention (PCI) were included. We diagnosed CIN by a relative increase of >25% or an absolute increase of >0.5 mg/dl in serum creatinine levels two days after procedure. Results: The incidence of CIN in our study was 15.1%. In univariate analysis: age >75 years, hypertention diabetes mellitus (DM), heart failure, hypotension, CKD [creatinine >1.5mg/dl] and increased contrast volume were associated with increased risk of CIN whereas, gender, anemia and use of IABP failed to reach statistical significance. As the number of risk factor and/or volume of contrast increases, the incidence of CIN increases exponentially. Conclusion: Since there is no established treatment for CIN, all possible efforts should be taken to prevent it from occurring by identifying patients at risk. CIN is related with many risk factors, so whenever multiple risk factors are present in an individual patient, lowest dose of contrast should be used and adequate hydration should be given. Key Words: Contrast-induced nephropathy, Non ionic iso-osmolar contrast media, percutaneous coronary intervention.

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