scholarly journals Risk factors of pin tract infection during bone transport using unilateral external fixator in the treatment of bone defects

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kai Liu ◽  
Alimujiang Abulaiti ◽  
Yanshi Liu ◽  
Feiyu Cai ◽  
Peng Ren ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tract Infection ◽  
External Fixation ◽  
External Fixator ◽  
Significant Risk ◽  
Bone Transport ◽  
Living Environment ◽  
Chi Square ◽  
Clinical Appearance ◽  
Pin Tract Infection

Abstract Background The bone transport using the unilateral external fixator, one of the Ilizarov techniques, is widely practiced in lower limb reconstructive surgery. Pin tract infection (PTI), one of most common complication, has become the important postoperative problems which plague clinicians gradually. Methods A group of 130 patients who received bone transport surgery for tibia or femur defects using the unilateral external fixation (Orthofix limb reconstruction system, Verona, Italy) and met the inclusion criteria were selected for the study from 2015 to 2019. Regular pin tract care was performed twice a day, and the conditions of the pin tract were evaluated by the same observer using clinical appearance criteria. The Saw’s classification of PTI was used to assess the condition around screws. After the data were significant by the T-test or Pearson’s Chi-square test analyzed, odds ratios were calculated using logistic regression tests to describe factors associated with the diagnosis of PTI. Results Ninety-one males and thirty-nine females with a mean age of 43 years (range 28–58 years) were included in this cohort. 7816 observations were documented from 12 to 36 months, and 58 cases (44.6%) of PTI (thirty-nine cases in grade 1, 17 cases in grade 2, and 2 cases in grade 3). The top five risk factors were agricultural work (OR 1.86, CI 0.94–2.39), non-urban living (OR 1.75, CI 1.24–3.26), male (OR 1.71, CI 1.02–2.31), smoking (OR 1.53, CI 0.76–1.89), and diabetes (OR 1.26, CI 1.12–2.64). No long-term sequelae were observed at the latest clinical visit. Conclusion Occupation, gender, living environment (non-urban), smoking, and diabetes were the top five significant risk factors for PTI in the period of bone transport using unilateral external fixation. Awareness of predictable risk factors of PTI is beneficial to avoid or early detect the severe complications which can affect the effectiveness.

Complete ejection of a ring sequestrum 8 years after external fixation of the tibia

2020 ◽  
Vol 13 (3) ◽  
pp. e233196
Author(s):  
Isabella Regina Timmer ◽  
Benjamin Lucas Emmink ◽  
Loek Petrus Hendrikus Leenen ◽  
Geertje Anna Maria Govaert
Keyword(s):  
Tract Infection ◽  
External Fixation ◽  
External Fixator ◽  
Pin Tract Infection

On the day of scheduled debridement for a persistent pin tract infection, a 23-year old man presented himself carrying a small bony ring sequestrum that had spontaneously ejected from his tibial wound 1 week earlier. Eight years prior to presentation, he was treated for an open crural fracture which was stabilised with an external fixator. Revision of the operation notes revealed that the placement of this external fixator was performed without predrilling.

Venous Thromboembolism and High Grade Gliomas

1993 ◽  
Vol 70 (03) ◽  
pp. 393-396 ◽  
Author(s):  
Mandeep S Dhami ◽  
Robert D Bona ◽  
John A Calogero ◽  
Richard M Hellman
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Medical Center ◽  
Significant Risk ◽  
Bleeding Complications ◽  
Fisher Exact Test ◽  
High Grade ◽  
Chi Square ◽  
Exact Test ◽  
High Grade Gliomas

SummaryA retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation.We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.

scholarly journals Risk factors for hospital readmission following complicated urinary tract infection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tanya Babich ◽  
Noa Eliakim-Raz ◽  
Adi Turjeman ◽  
Miquel Pujol ◽  
Jordi Carratalà ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Medical Condition ◽  
Hospital Readmissions ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Complicated Urinary Tract Infection ◽  
Negative Influence

AbstractHospital readmissions following severe infections are a major economic burden on the health care system and have a negative influence on patients' quality of life. Understanding the risk factors for readmission, particularly the extent to which they could be prevented, is of a great importance. In this study we evaluated potentially preventable risk factors for 60-day readmission in patients surviving hospitalization for complicated urinary tract infection (cUTI). This was a multinational, multicentre retrospective cohort study conducted in Europe and the Middle East. Our cohort included survivors of hospitalization due to cUTI during the years 2013–2014. The primary outcome was 60-day readmission following index hospitalization. Patient characteristics that could have influenced readmission: demographics, infection presentation and management, microbiological and clinical data; were collected via computerized medical records from infection onset up to 60 days after hospital discharge. Overall, 742 patients were included. The cohort median age was 68 years (interquartile range, (IQR) 55–80) and 43.3% (321/742) of patients were males. The all-cause 60-day readmission rate was 20.1% (149/742) and more than half were readmitted for infection [57.1%, (80/140)]. Recurrent cUTI was the most frequent cause for readmission [46.4% (65/140)]. Statistically significant risk factors associated with 60-day readmission in multivariable analysis were: older age (odds ratio (OR) 1.02 for an one-year increment, confidence interval (CI) 1.005–1.03), diabetes mellitus (OR 1.63, 95% CI 1.04–2.55), cancer (OR 1.7, 95% CI 1.05–2.77), previous urinary tract infection (UTI) in the last year (OR 1.8, 95% CI: 1.14–2.83), insertion of an indwelling bladder catheter (OR 1.62, 95% CI 1.07–2.45) and insertion of percutaneous nephrostomy (OR 3.68, 95% CI 1.67–8.13). In conclusion, patients surviving hospitalization for cUTI are frequently re-hospitalized, mostly for recurrent urinary infections associated with a medical condition that necessitated urinary interventions. Interventions to avoid re-admissions should target these patients.

scholarly journals Prevalence of urinary tract infection and associated risk factors among women in Sindhupalchowk district, Nepal

2018 ◽  
Vol 5 (7) ◽  
pp. 2714 ◽  
Author(s):  
Leela Paudel ◽  
Naresh Manandhar ◽  
Saroj Sah ◽  
Sudesha Khadka ◽  
Samikshya Neupane ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Abdominal Pain ◽  
Urinary Tract ◽  
Tract Infection ◽  
Significant Risk ◽  
Lower Abdominal Pain ◽  
Common Symptom ◽  
High Power Field ◽  
Toilet Facility

Background: Urinary tract infection (UTI) occurs in all age groups, more common in women due to short urethra and its close proximity to anus and vagina. UTI is defined as “microscopic finding of >10 pus cells/high power field (40x) in urine”. The purpose of the study is to find the prevalence of UTI and its association with various risk factors.Methods: An analytical cross-sectional study on prevalence of UTI was done among 260 women aged 15 years and above. Convenient sampling technique was used. Semi-structured questionnaire was designed to collect the data and urine sample was collected for routine and microscopic examination at the time of interview. Collected urine was sent, within 3 hours of collection.Results: The mean age of the respondents was 36.43±16.17 years. The prevalence of UTI among women aged 15 years and above was 36.9%.The most common symptom was frequency of micturition (35%) followed by lower abdominal pain (38.46%). There was significant association between frequency of micturition, burning micturition and lower abdominal pain with occurrence of urinary tract infection. On urinalysis, 96 samples were positive for pus cell; one sample showed blood, 16 samples showed ca-oxalate and 57 samples showed protein which determines the type of UTI. Smoking [COR-2.15, C.I-(1.12, 4.09)] and unavailability of toilet facility [COR-0.27, C.I-(0.08, 0.93)] were the significant risk factors for occurrence of UTI.Conclusions: There was high prevalence of UTI among women aged 15 years and above and association between smoking and unavailability of toilet facility and UTI was significant.

scholarly journals External skeletal fixation of the tibial shaft fractures

2005 ◽  
Vol 62 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Sasa Milenkovic ◽  
Milorad Mitkovic ◽  
Mile Radenkovic
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Weight Bearing ◽  
Early Mobilization ◽  
Tibial Shaft ◽  
Closed Fracture ◽  
Early Weight Bearing ◽  
Shaft Fractures ◽  
Pin Tract Infection ◽  
Tibial Shaft Fractures

Aim. To present the possibility of a successful use of external skeletal fixation in treating the open and closed tibial shaft fractures with Mitkovic?s external fixator. Methods. External fixation was used in 115 patients with 118 fresh tibial shaft fractures, 82 males (71.3%) and 33 females (28.7%), average age 43.92 years (16?84). Open tibial shaft fractures were present in 37 (31.36%). All the fractures were treated with Mitkovic?s external fixator type M 20. Results. The results of external fixation were excellent or good in 94.07% of the cases, and bad in 5.08%. Pin tract infection appeared in 7 (5.93%) patients. In only 3 cases an external fixator was removed and treatment continued with the functional braces. Nonunion occurred in 6 (5.08%) patients, of which 4 were with open fractures (2 Gustilo type IIIB, 1 Gustilo type IIIA, 1 Gustilo type II) and 2 with the segment fractures. Compartment syndrome was observed in 1 (0.85%) patient with closed fracture. Malunion was found in 2 (1.69%) patients. Conclusion. External fixation of tibial shaft fractures is a simple and effective method to enable the safe healing of fractures, early mobilization of the patients, early weight-bearing, as well as early rehabilitation. Fixation of tibial shaft fractures was unilateral with convergent pins orientation, and there was also a possibility of compression and distraction.

scholarly journals Risk Factors for Nonunion in Arthroscopic and Open Ankle Arthrodesis

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0018
Author(s):  
William T. Davis ◽  
Bradley Alexander ◽  
Benjamin B. Cage ◽  
Elise M. Greco ◽  
Charles R. Sutherland ◽  
...  
Keyword(s):  
Risk Factors ◽  
External Fixation ◽  
Significant Risk ◽  
The United States ◽  
Ankle Arthrodesis ◽  
Open Group ◽  
Ankle Arthritis ◽  
Patient Factors ◽  
Tourniquet Time ◽  
Radiographic Union

Category: Ankle; Ankle Arthritis; Arthroscopy Introduction/Purpose: Ankle arthrodesis remains the most popular surgical treatment option for end-stage ankle arthritis (ESAA) among surgeons in the United States. The primary objective endpoint for judging failure versus success of any arthrodesis is radiographic union versus nonunion. Overall, reported union rates in the last two decades have been excellent; however, there does remain significant variation in results with conflicting evidence regarding both treatment and patient factors that are associated with nonunion. We present a relatively large case series of ankle arthrodeses from a single institution with a high-risk patient population with the goal of further clarifying the patient and treatment factors that lead to nonunion. Methods: We conducted a retrospective chart review of 118 patients who underwent primary open or arthroscopic ankle arthrodesis at our institution between November 2014 and April 2019. Revision arthrodesis and patients with a history of complex open fracture were excluded. A minimum 6-month postoperative followup was required. The patients were divided into arthroscopic and open arthrodesis cohorts. The primary outcome measure was radiographic union at 6 months. Patient factors including demographics, BMI, medical comorbidities, and smoking status were analyzed as predictors of nonunion. Likewise, treatment factors such as surgical approach, method of fixation, and tourniquet time were analyzed as predictors of nonunion. Results: Of the 43 individuals that underwent arthroscopic ankle arthrodesis seven progressed to nonunion (16.27%). Among those undergoing open ankle arthrodesis 6 patients out of 46 progressed to nonunion (13.04%). In the arthroscopic cohort, individuals with preoperative lower extremity infection had a significantly higher rate of nonunion compared to those without infection (50.00%, p=0.0447). The open group had two significant predictors of nonunion: use of external fixation and low tourniquet time. Individuals who underwent arthrodesis with the use of an external fixator had a 100% nonunion rate compared to 11.11% for those treated with screws and 0% for those treated with plate fixation (p=0.020). Individuals that had a total tourniquet time under 90 minutes had a non-union rate of 66.67% (p=0.0082). Conclusion: While it was unsurprising that preoperative infection was a significant risk factor for nonunion, it is interesting that this effect was only shown in the arthroscopic group and not the open group. This could have practice implications and warrants further study. Our findings also add to the body of evidence that external fixation is inferior to modern internal fixation techniques for achieving bony fusion. This result may also reflect the poor preoperative prognosis of those requiring external fixation. There remains little evidence that diabetes, smoking, or BMI are significant risk factors for nonunion in primary ankle arthrodesis. [Table: see text]

scholarly journals Risk factors for mortality in children with Wilms tumor

2016 ◽  
Vol 56 (4) ◽  
pp. 226
Author(s):  
Yuni Purwanti ◽  
Sutaryo Sutaryo ◽  
Sri Mulatsih ◽  
Pungky Ardani Kusuma
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Wilms Tumor ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Stage Iii ◽  
Control Group ◽  
Case Group ◽  
Chi Square ◽  
Potential Risk Factors

Background Wilms tumor is the most common renal malignancy in children (95%) and one of the leading causes of death in children, with high mortality rates in developing countries. Identifying risk factors for mortality is important in order to provide early intervention to improve cure rates.Objective To identify risk factors for mortality in children with Wilms tumor.Methods We performed a case-control study of children (0-18 years of age) with Wilms tumor admitted to Dr. Sardjito Hospital between 2005 and 2012. The case group consisted of children who died of Wilms tumor, whereas the control group were children who survived. Data were collected from medical records. Statistical analyses using Chi-square and logistic regression tests were done to determine odds ratios and 95% CI of the potential risk factors for mortality from Wilms tumor.Results Thirty-five children with Wilms tumor were admitted to Dr. Sardjito Hospital during the study period. Nine (26%) children died and 26 survived. Stage ≥III was a significant risk factor for mortality in chidren with Wilms tumor (OR 62.8; 95%CI 5.6 to 70.5). Age ≥2 years (OR 1.4; 95%CI 0.1 to 14.3) and male sex (OR 1.2; 95%CI 0.1 to 10.8) were not significant risk factors for mortality.Conclusion Stage ≥III is a risk factor for mortality in children with Wilms tumor. 

scholarly journals Risk factors for esophageal cancer in a low-incidence area of Brazil

2013 ◽  
Vol 131 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Orlando Milhomem Mota ◽  
Maria Paula Curado ◽  
José Carlos Oliveira ◽  
Edesio Martins ◽  
Daniela Medeiros Milhomem Cardoso
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Risk Factor ◽  
Rural Areas ◽  
Significant Risk ◽  
Oral Sex ◽  
Chi Square ◽  
Chi Square Test ◽  
Low Incidence ◽  
Control Study

CONTEXT AND OBJECTIVESEsophageal cancer is the eighth commonest type of cancer worldwide, occupying sixth place in terms of mortality. Smoking and alcohol use are known risk factors for this type of cancer. The aim here was to evaluate the risk factors for esophageal cancer in a low-incidence area.DESIGN AND SETTINGCase-control study in Goiânia, with 99 cases of esophageal cancer and 223 controls.METHODSThe variables were sociodemographic, dietary, occupational and lifestyle data. The sample was analyzed using the chi-square test, Mann-Whitney test and Mantel-Haenszel approach for multivariate analysis. Odds ratios (OR) were calculated with 5% significance and 95% confidence intervals.RESULTSThe risk of esophageal cancer was higher in patients ≥ 55 years (OR = 1.95; P < 0.001). Patients from rural areas were at greater risk of esophageal cancer (OR = 4.9; P < 0.001). Smoking was a risk factor among the cases (OR = 3.8; P < 0.001), as was exposure to woodstoves (OR = 4.42; P < 0.001). The practice of oral sex was not a risk factor (OR = 0.45; P = 0.04). Consumption of apples, pears, vegetables, cruciferous vegetables and fruit juices were protective against esophageal cancer.CONCLUSIONIn a region in which the incidence of esophageal cancer is low, the most significant risk factors were exposure to woodstoves, smoking and living in rural areas.

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