scholarly journals Risk factors for postoperative nausea and vomiting after the removal of impacted third molars: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiroaki Hasegawa ◽  
Atsushi Abe ◽  
Hiroki Hayashi ◽  
Hiroshi Furuta ◽  
Takanori Ishihama

Abstract Background A better understanding of the risk factors for postoperative nausea and vomiting (PONV) could improve patient outcomes. This study aimed to analyze the risk factors for PONV and its onset after third molar impaction surgery, and to demonstrate the importance of controlling anesthesia-related factors regardless of patient-specific factors. Methods We included patients who reported nausea and vomiting within 12 h of extubation. Patients with incomplete data, those who could not communicate, and those with gastrointestinal disorders were excluded. We evaluated patient-specific risk factors, and the use of volatile anesthetics and intraoperative fentanyl anesthetic-related factors. Multiple logistic regression analysis was performed taking patient background factors into account. Results In total, 182 patients who underwent disimpaction of the third molar under general anesthesia between January 2017 and December 2018 at Nagoya Ekisaikai Hospital, were included. Approximately 12.6% (n = 23) patients experienced PONV, with no significant difference in terms of sex, smoking status, age, and body mass index compared to patients without PONV. Multiple logistic regression analysis revealed no interaction between fentanyl and volatile anesthetics. The major risk factor for PONV was the use of volatile anesthetics. Patients in whom anesthesia was maintained by volatile anesthetics were 13.35 times more likely to have PONV than those in whom total intravenous anesthesia was induced (P < 0.001). Conclusion Maintenance of anesthesia with volatile anesthetics is a risk factor for PONV.

2011 ◽  
Vol 114 (2) ◽  
pp. 491-496 ◽  
Author(s):  
Björn Latz ◽  
Christine Mordhorst ◽  
Thomas Kerz ◽  
Annette Schmidt ◽  
Astrid Schneider ◽  
...  

Object The purpose of this study was to assess the incidence and risk factors of postoperative nausea and vomiting (PONV) after craniotomy because most available data about PONV in neurosurgical patients are retrospective in nature or derive from small prospective studies. Methods Postoperative nausea and vomiting was prospectively assessed within 24 hours after surgery in 229 patients requiring supratentorial or infratentorial craniotomy. To rule out the relevance of the neurosurgical procedure itself to the development of PONV, the observed incidence of vomiting was compared with the rate of vomiting predicted with a surgery-independent risk score (Apfel postoperative vomiting score). Results The overall incidence of PONV after craniotomy was 47%. Logistic regression identified female sex as a risk factor for postoperative nausea (OR 4.25, 95% CI 2.3–7.8) and vomiting (OR 2.62, 95% CI 1.4–4.9). Both the incidence of nausea (OR 3.76, 95% CI 2.06–6.88) and vomiting (OR 4.48, 95% CI 2.4–8.37) were increased in patients not receiving steroids. Postoperative nausea and vomiting occurred after infratentorial as well as after supratentorial procedures. The observed incidence of vomiting within 24 hours after surgery was higher (49%) than would be predicted with the Apfel surgery-independent risk score (31%; p = 0.0004). Conclusions The overall incidence of PONV within 24 hours after craniotomy was approximately 50%. One possible reason is that intracranial surgeries pose an additional and independent risk factor for vomiting, especially in female patients. Patients undergoing craniotomy should be identified as high-risk patients for PONV.


2020 ◽  
Author(s):  
Mohammed Suleiman Obsa ◽  
Dinkisisa Chemeda Edosa ◽  
Zemenu Muluken Desalegn ◽  
Nega Desalegn Fanta ◽  
Sintayehu Mulugeta Tamiru ◽  
...  

Abstract Background Post-operative nausea and vomiting is the most frequent side effect of anesthesia. It affects 20 - 30% of all post-operative and 70%-80% high risk patients. Consequently, it is one of the most frequently observed adverse events associated with the provision of anesthesia. Thus this study is aimed to assess the incidence and associated factors of post-operative nausea and vomiting. Methods This cross-sectional study was conducted using a consecutive sampling method. Regular supervision and follow up were made. Data was entered in to Epi info version 7 software and transported to SPSS version 20 for analysis. Odd ratio and 95% confidence interval was computed. The findings of the study were reported using tables, figures and narration. Variables that were found to be candidate (p value < 0.25) on binary logistic regression entered into a multiple logistic regression analysis to identify independent predictors of post-operative nausea and vomiting. Results The results of this study indicated that the incidence of postoperative nausea and vomiting was 27.4% . Output of multiple logistic regression revealed that female sex (AOR = 4.065 (2.090 - 7.906), history of motion sickness (AOR = 2.836 (1.582 - 5.083), Gynecologic type of surgery (AOR = 3.782 (1.156 - 12.373), long duration of anaesthesia (> 60 min) (AOR = 2.974 (1.491 - 5.933) and administration of post-operative opioids (AOR = 2.333 (1.221 - 4.457) were considered as independent predictors of postoperative nausea and vomiting at P value < 0.05. Conclusion The present finding has shown that the overall incidence of postoperative nausea and vomiting is high 27.4% therefore provision of anti-emetic prophylaxis is reccomended.


2000 ◽  
Vol 21 (5) ◽  
pp. 319-323 ◽  
Author(s):  
Mathijs D. Kalmeijer ◽  
Ella van Nieuwland-Bollen ◽  
Diane Bogaers-Hofman ◽  
Gerard A.J. de Baere ◽  
Jan A.J.W. Kluytmans

AbstractObjective:To determine the relative importance of different risk factors for the development of surgical-site infections (SSIs) in orthopedic surgery with prosthetic implants.Design:In a cohort of 272 patients, the following possible risk factors were studied: age, gender, method of hair removal, duration of operation, surgeon, underlying illness, and nasal carriage of Staphylococcus aureus. Infections were recorded following the Centers for Disease Control criteria. The relation between risk factors and SSI was tested in univariate and multiple logistic regression analysis.Setting:Community hospital in Breda, The Netherlands.Results:18 (6.6%) of 272 patients experienced SSI: 11 superficial and 7 deep SSI. These infections led in three cases to removal of the prosthesis and caused 286 extra days in hospital. The main causative pathogen was S aureus. In multiple logistic regression analysis, the following factors were independent risk factors for the development of SSI: high-level nasal carriage of S aureus (P=.04), male gender (P=.005), and surgeon 1 (P=.006). The only independent risk factor for SSI with S aureus was high-level nasal carriage of S aureus (P=.002).Conclusion:High-level nasal carriage of S aureus was the most important and only significant independent risk factor for developing SSI with S aureus.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiuli Song ◽  
Yongjie Zhou ◽  
Wenwang Rao ◽  
Xiangyang Zhang

Abstract Background This study aimed to compare prevalence and risk factors of somatization (SOM) between health care workers and non-health care workers during COVID-19 outbreak in China. Methods From 14 February to 29 March 2020, an online survey was performed in both 605 health care workers and 1151 non-health care workers. Based on the somatization dimension score of the Symptom Checklist-90, participants were divided into non-SOM group and SOM group. Results Health care workers had higher prevalence rate of SOM (p < 0.001) than non-health care workers, with an OR of 1.70 (95% CI, 1.22–2.36, p = 0.002). Multiple logistic regression analysis revealed that in non-health care workers, the risk factors of SOM included other ethnicities, insomnia, and suicide, while in health care workers, the risk factors included working 6–8 h per day, and working ≥10 h per day during COVID-19 outbreak. Conclusions Our research suggests that both non-health care workers and health care workers have a relatively high prevalence of somatization. However, the related factors for somatization in both groups are significantly different, showing that medical service-related factors are associated with somatization in health care workers, while demographic and clinical factors are associated with somatization in non-health care workers.


2001 ◽  
Vol 45 (2) ◽  
pp. 160-166 ◽  
Author(s):  
P. Kranke ◽  
C. C. Apfel ◽  
T. Papenfuss ◽  
S. Rauch ◽  
U. Löbmann ◽  
...  

2017 ◽  
Vol 39 (4) ◽  
pp. 685-702 ◽  
Author(s):  
ANNE W. TAYLOR ◽  
RHIANNON PILKINGTON ◽  
ELEONORA DAL GRANDE ◽  
CONSTANCE KOURBELIS ◽  
HELEN BARRY

ABSTRACTBaby boomers who rent are often overlooked as an important sub-group. We aimed to assess the chronic conditions, risk factors, socio-economic factors and other health-related factors associated with renting in private or public housing. Data from telephone interviews conducted each month in South Australia between 2010 and 2015 were combined. Prevalence estimates were assessed for each risk factor and chronic condition by housing status. The association between housing status and variables of interest were analysed using logistic regression models adjusting for multiple covariates (age, gender, income, smoking, physical activity, area and year of data collection). Overall, 17.4 per cent of the 16,687 baby boomers interviewed were renting, either privately or using government-subsided housing. The health profile of renters (both private and public) was poorer overall, with renters more likely to have all of the chronic conditions and ten risk factors assessed. For public renters the relationships were maintained even after controlling for socio-economic and risk factor variables for all chronic diseases except osteoporosis. This research has provided empirical evidence of the considerable differences in health, socio-economic indicators and risk factors between baby boomers who rent and those who own, or are buying, their own homes.


2018 ◽  
Vol 159 (6) ◽  
pp. 1020-1027 ◽  
Author(s):  
Shekhar K. Gadkaree ◽  
Alexander Gelbard ◽  
Simon R. Best ◽  
Lee M. Akst ◽  
Martin Brodsky ◽  
...  

Objective To test the hypothesis that the etiologies of bilateral vocal fold mobility impairment (BLVFI), bilateral vocal fold paralysis (BVFP), and posterior glottis stenosis (PGS) have distinct clinical outcomes. To identify patient-specific and procedural factors that influence tracheostomy-free survival. Study Design Retrospective cohort study. Setting Johns Hopkins Medical Center from 2004 to 2015. Subjects and Methods Case series with chart review of 68 patients with PGS and 17 patients with BVFP. Multiple logistic regression analysis determined factors associated with airway prosthesis dependence at last follow-up and the procedural burden (defined as number of operative procedures per year). Results PGS comprised the majority of BLVFI (76%). PGS injury arose primarily after endotracheal intubation (91%), while BVFP most commonly was due to iatrogenic surgical injury to bilateral recurrent laryngeal nerves (88%, P < .001). Overall in BLVFI, 66% were tracheostomy free at last follow-up (62% in PGS, 82% in BVFP). Of those who underwent an operative intervention to be decannulated, 88% were decannulated (90% PGS, 80% BVFP). Patients with PGS required higher procedural burden to achieve decannulation compared with the BVFP cohort (3.1 ± 5.2 vs 0.71 ± 1.4, P = .002). In multivariate analysis of PGS, smoking was a risk factor for tracheostomy dependence ( P = .026). Conclusions BLVFI is primarily an iatrogenic complication. There are high rates of tracheostomy dependence in BLVFI, with procedural intervention needed for decannulation. Compared with BVFP, patients with PGS had a higher procedural burden overall and to achieve decannulation. Patients with PGS should be counseled that smoking, a modifiable risk factor, may increase the risk of tracheostomy dependence.


Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Tanya N Turan ◽  
Azhar Nizam ◽  
Michael J Lynn ◽  
Colin P Derdeyn ◽  
David Fiorella ◽  
...  

Purpose: SAMMPRIS is the first stroke prevention trial to include protocol-driven aggressive management of multiple vascular risk factors. We sought to determine the impact of this protocol on early risk factor control in the trial. Materials and Methods: SAMMPRIS randomized 451 patients with symptomatic 70%-99% intracranial stenosis to aggressive medical management or stenting plus aggressive medical management at 50 USA sites. For the primary risk factor targets (SBP < 140 mm/Hg (<130 if diabetic) and LDL < 70 mg/dL), the study neurologists follow medication titration algorithms and risk factor medications are provided to the patients. Secondary risk factors (diabetes, non-HDL, weight, exercise, and smoking cessation) are managed with assistance from the patient’s primary care physician and a lifestyle modification program (provided). Sites receive patient-specific recommendations and feedback to improve performance. Follow-up continues, but the 30-day data are final. We compared baseline to 30-day risk factor measures using paired t-tests for means and McNemar tests for percentages. Results: The differences in risk factor measures between baseline and 30 days are shown in Table 1. Conclusions: The SAMMPRIS protocol resulted in major improvements in controlling most risk factors within 30 days of enrollment, which may have contributed to the lower than expected 30 day stroke rate in the medical group (5.8%). However, the durability of this approach over time will be determined by additional follow-up.


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