scholarly journals Prosthetic complications of fixed dental prostheses supported by locking-taper implants: a retrospective study with a mean follow-up of 5 years

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wen mo Gao ◽  
Wei Geng ◽  
Chen chen Luo
Keyword(s):  
Bone Loss ◽  
Regression Model ◽  
Cox Regression ◽  
Marginal Bone Loss ◽  
Cox Regression Model ◽  
Fixed Dental Prosthesis ◽  
Single Crown ◽  
Prosthetic Complications ◽  
Free Rate

Abstract Background Restoration with locking-taper implants is a widely used methodology. However, conical connection systems such as locking-taper implant systems have rarely been examined. This study provides a retrospective investigation of locking-taper fixed restorations, mainly focusing on prosthetic complications. Methods Patients undergo treatment with conical connected implants from 2008 to 2010 were examined. Preparation of the implant sites was performed according to the standard procedures for the Bicon system. Bone healing took over 6 months, and the prosthetic procedure was initiated thereafter. Integrated abutment crowns or gold porcelain crowns were used, and the prosthesis type was a single crown or a fixed dental prosthesis. Once the crown was in place, its occlusion was thoroughly checked and adjusted, and then the crown was glazed or finely polished. The Kaplan–Meier method was used to calculate the cumulative complication-free rates for 5 and 10 years. Additionally, a Cox regression model was used to identify the factors that independently influenced the results. Implant survival and marginal bone loss were also investigated. Results A total of 392 patients who underwent 541 implants and 434 locking taper implant-based restorations from 2008 to 2010 were examined. The overall 5-year cumulative complication-free rate was 83.34%. The most common prosthetic complication was veneer chipping, with a frequency of 67.53%. According to the Cox regression model, the complication-free rate of integrated abutment crowns was significantly higher than that of gold porcelain crowns, that of molar regions was significantly higher than that of premolar regions, and that of females was significantly higher than that of males. Only three implant failures happened, and the mean marginal bone loss values at 1- year, 5-years and 10- years were 0.25 mm (95% CI ± 0.12), 0.40 mm (95% CI ± 0.03) and 0.51 mm (95% CI ± 0.05), respectively. Conclusion Veneer chipping was the most common complication with locking-taper implant-supported fixed restorations. The incidence of complications for IACs is significantly higher than that for GPCs. Age, location, and prosthesis type are not determinants of prosthetic complications. Besides, the long-term clinical effect of locking-taper implant can meet the clinical needs. The bone tissue level around the implant can maintain long-term stability.

scholarly journals Prosthetic complications of fixed dental prostheses supported by locking-taper implants: A retrospective study with a mean follow-up of 5 years.

2021 ◽  
Author(s):  
Wen Mo Gao ◽  
Wei Geng ◽  
Chen Chen Luo
Keyword(s):  
Retrospective Study ◽  
Bone Loss ◽  
Regression Model ◽  
Protective Factor ◽  
Cox Regression ◽  
Marginal Bone Loss ◽  
Cox Regression Model ◽  
Prosthetic Complications ◽  
Free Rate

Abstract Background: Restoration with locking-taper implants is a widely used methodology. However, relatively few have examined conical connection systems like locking-taper implant systems. This study provides a retrospective study of locking-taper fixed restorations, mainly focused on prosthetic complications.Methods: All patients who underwent conical connected implants from 2008–2010 were examined. Preparation of the implant sites was performed according to the standard procedures for the Bicon system. The bone healing took over 6 months, and the prosthetic procedure was initiated thereafter. Integrated abutment crowns or gold porcelain crowns were used, and the prosthesis type was a single crown or a fixed dental prosthesis. Once the crown was in place, its occlusion was thoroughly checked and adjusted, and then the crown was glazed or finely polished. The Kaplan-Meier method was used to calculate the cumulative complication-free rates for 5 and 10 years. Additionally, a Cox regression model was used to identify the factors that independently influenced the results. Implant survival and marginal bone loss were also investigated.Results: A total of 392 patients who underwent 541 implants and 434 locking taper implant-based restorations from 2008–2010 were examined. The overall 5-year cumulative complication-free rate was 83.34%. The most common prosthetic complication was veneer chipping, with a frequency of 67.53%. According to the Cox regression model, the complication-free rate of integrated abutment crowns was significantly higher than gold porcelain crowns, molar regions was significantly higher than premolar regions, and females was significantly higher than males. Only three implant failures happened, and a mean marginal bone loss at 1- year, 5-year and 10- year was 0.25mm（95%CI：±0.12）, 0.40mm （95%CI：±0.03）and 0.51mm（95%CI：±0.05）, respectively.Conclusion: Veneer chipping was the most common complication with locking-taper implants supported fixed restorations. According to the result of Cox regression model, gold porcelain crowns are a protective factor relative to integrated abutment crowns, male sex is a protective factor relative to female sex, and premolar prosthetics are a protective factor relative to molar prosthetics. The long-term clinical effect of locking-taper implant is stable, and the implant success rate can meet the clinical needs. The bone tissue level around the implant can maintain long-term stability.

scholarly journals FRI0181 ORGAN DAMAGE FREE SURVIVAL IN SOUTHERN CHINESE PATIENTS WITH ACTIVE LUPUS NEPHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 674.1-674
Author(s):  
C. C. Mok ◽  
C. S. Sin ◽  
K. C. Hau ◽  
T. H. Kwan
Keyword(s):  
Lupus Nephritis ◽  
Regression Model ◽  
Cox Regression ◽  
Organ Damage ◽  
Renal Survival ◽  
Cox Regression Model ◽  
Free Survival ◽  
Renal Response

Background:The goals of treatment of lupus nephritis (LN) are to induce remission, retard the progression of chronic kidney disease, prevent organ complications and ultimately reduce mortality. Previous cohort studies of LN have mainly focused on the risk of mortality and development of end stage renal failure (ESRF) (renal survival). The cumulative frequency of LN patients who survive without organ damage, which correlates better with the balance between treatment efficacy and toxicity, as well as quality of life, has not been well studied.Objectives:To study the organ damage free survival and its predictive factors in patients with active LN.Methods:Consecutive patients who fulfilled ≥4 ACR/SLICC criteria for SLE and with biopsy proven active LN between 2003 and 2018 were retrospectivey analyzed. Those with organ damage before LN onset were excluded. Data on renal parameters and treatment regimens were collected. Complete renal response (CR) was defined as normalization of serum creatinine (SCr), urine P/Cr (uPCR) <0.5 and inactive urinary sediments. Partial renal response (PR) was defined as ≥50% reduction in uPCR and <25% increase in SCr. Organ damage of SLE was assessed by the ACR/SLICC damage index (SDI). The cumulative risk of having any organ damage or mortality since LN was studied by Kaplan-Meier’s analysis. Factors associated with a poor outcome were studied by a forward stepwise Cox regression model, with entry of covariates with p<0.05 and removal with p>0.10.Results:273 LN patients were identified but 64 were excluded (organ damage before LN onset). 211 LN patients were studied (92% women; age at SLE 30.4±13.5 years; SLE duration at LN 1.9±3.1years). 47 (22%) patients had nephrotic syndrome and 60 (29%) were hypertensive. Histological LN classes was: III/IV±V (75.1%), I/II (7.8%) and pure V (17.1%) (histologic activity and chronicity score 7.0±4.2 and 1.8±1.5, respectively). Induction regimens were: prednisolone (33.1±17.5mg/day) in combination with intravenous cyclophosphamide (CYC) (21.4%; 1.0±0.2g per pulse), oral CYC (8.6%; 96.4±37.8mg/day), azathioprine (AZA) (14.3%; 78.6±25.2mg/day), mycophenolate mofetil (MMF) (22.8%; 1.9±0.43g/day) and tacrolimus (TAC) (17.1%; 4.3±1.1mg/day). After a follow-up of 8.6±5.4 years, 94(45%) patient developed organ damage (SDI≥1) and 21(10%) patients died. The commonest organ damage was renal (36.3%) and musculoskeletal (17.9%), and the causes of death were: infection (38.1%), malignancy (19.0%), cardiovascular events (9.5%) and ESRF complications (9.5%). At last visit, 114 (55%) patients survived without any organ damage. The cumulative organ damage free survival at 5, 10 and 15 years after renal biopsy was 73.5%, 59.6% and 48.3%, respectively. The 5, 10 and 15-year renal survival rate were 95.2%, 92.0% and 84.1% respectively. In a Cox regression model, nephritic relapse (HR 3.72[1.78-7.77]), proteinuric relapse (HR 2.30[1.07-4.95]) and older age (HR 1.89[1.05-3.37]) were associated with either organ damage or mortality, whereas CR (HR 0.25[0.12-0.50]) at month 12 were associated with organ damage free survival. Baseline SCr, uPCR and histological LN classes were not significantly associated with a poor outcome. Among patients with class III/IV LN, the long-term organ damage free survival were not significantly different in users of MMF (reference) from CYC (IV/oral) (HR 1.45[0.76- 2.75]) or TAC (HR 1.03[0.26-1.62]) as induction therapy.Conclusion:Organ damage free survival is achieved in 55% of patients with active LN upon 9 years of follow-up. CYC/MMF/TAC based induction regimens did not differ for the long-term outcome of LN. Targeting complete renal response and preventing renal relapses remain important goals of LN treatment.Acknowledgments:NILDisclosure of Interests:None declared

P2619Combined evaluation of nutrition screening indexes on long-term mortality in patients hospitalized for acute heart failure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Kenichiro ◽  
M Oguri ◽  
K Takahara ◽  
T Sumi ◽  
H Takahashi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Mass Index ◽  
Regression Model ◽  
Body Mass ◽  
Cox Regression ◽  
Cox Regression Model ◽  
Predictive Values ◽  
Conut Score ◽  
Long Term Mortality

Abstract Background Along with an aging society, the global burden of heart failure (HF) is evident in Japan. Recent reports showed that malnutrition is one of the frequent comorbidity in patients with HF, and this grievous issue is related to worsening prognosis in such subjects. There are many screening tools of nutrition risks, however, feasible indexes or strategies for evaluating nutrition risk in patients with HF remain to be identified definitively. Purpose The purpose of the present study was to examine the effectiveness of various nutrition indexes on 3-year mortality in hospitalized acute HF patients. Methods The study population comprised a total of 817 individuals who were hospitalized for acute HF between November 2009 and December 2015, and was followed up for 3 years. All the previously established objective nutritional indexes [The controlling nutritional status (CONUT) score, geriatric nutritional risk index (GNRI), and subjective global assessment (SGA)] were evaluated at the time of hospital admission. Malnutrition status of each index was defined as CONUT score ≥5, GNRI <91, or SGA (B and C), respectively. We evaluated combined predictive values of these indexes for 3-year mortality by Cox regression model, and calculated the net reclassification improvement (NRI) and the integrated discrimination improvement (IDI). Results The median age was 79 (interquartile range 70–85) years, and 55.7% of the subjects were male. The frequency of malnutrition was 18.1% in CONUT score, 31.9% in GNRI, and 25.9% in SGA. The rate of 3-year mortality was 32.2%. All indexes were related to the occurrence of 3-year mortality by univariate analyses (P<0.001). We examined combined predictive values by calculating multivariable-adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for associations of malnutrition by these 3 indexes and prognostic variables identified by multivariable Cox regression model (age, body mass index, systolic blood pressure, reduced eGFR, albumin, and prior HF hospitalization). Malnutrition of all 3 indexes (5.6% of the subjects) was associated with higher relative risk of 3-year mortality than well-nutrition (aHR 1.90; 95% CI 1.07–3.35, P=0.028), or malnutrition of any 1 index (aHR 1.95; 95% CI 1.18–3.21, P=0.009). Next, we individually included each value into a reference model (age, body mass index, reduced eGFR, albumin, prior HF hospitalization, and ischemic etiology by multivariable logistic regression analysis with P<0.05). SGA was superior according to comprehensive discrimination, calibration, and reclassification analysis (NRI 0.212, P=0.003; IDI 0.005, P=0.029). Similar analysis with other indexes (CONUT score or GNRI) revealed no improvement. Conclusion Our present results suggest that simultaneous addition of CONUT, GNRI, and SGA seems useful for predicting long-term mortality in acute HF. In addition, nutritional screening with SGA independently improves mortality risk stratification.

scholarly journals Does Implant-Abutment Interface affect Marginal Bone Levels around Implants?

2019 ◽  
Vol 13 (01) ◽  
pp. 047-052 ◽  
Author(s):  
Eser Elemek ◽  
Artun Urgancioglu ◽  
Janberd Dincer ◽  
Altug Cilingir
Keyword(s):  
Bone Loss ◽  
Dental Implants ◽  
Marginal Bone Loss ◽  
Single Crown ◽  
Implant Abutment ◽  
Different Types ◽  
Group A ◽  
Group B ◽  
Switch Group

Abstract Objective The use of dental implants with different types of surface roughness and implant-abutment interface has brought about a situation of marginal bone loss. Therefore, the aim of this study was to analyze and compare marginal bone levels of different types of osseointegrated dental implants with platform switch (Group A: Ankylos, Mannheim, Germany) and platform match (Group B: Dentsply Xive, Mannheim, Germany, and Group C: MIS Implant Technologies, Karmiel, Israel). Materials and Methods One hundred and seven patients (52 men and 55 women) with a mean age of 54.79 (standard deviation ± 12.35) years and a total of 321 dental implants (Group A, n = 198; Group B, n = 58; and Group C, n = 65) placed in a private practice between April 2006 and May 2015 were retrospectively analyzed. In addition to demographic information and implant characteristics, marginal bone levels were evaluated by Image J (Wayne Rasband, National Institute of Health, Maryland) program. Results The mean age of all patients was 54.79 ± 12.35 years, and 51.5% of them were women. Implants supporting fixed bridge were most commonly used in all groups (65%), whereas only 20% were restored with a single crown and 15% with overdentures. In total, 47.5% of all implants showed no marginal bone loss. Mean bone loss in Group A was significantly lower (0.81 ± 1.60 mm) as compared to Group B (1.58 ± 1.59 mm) and Group C (1.18 ± 1.36) (p < 0.005). Conclusion Among different types of dental implants, platform switch seems to preserve marginal bone levels and increase the long-term success of dental implants.

scholarly journals Long Term Outcome Prediction in Stemi/Nstemi Patients By Means of the Model Consisting of Simple Clinical Parameters

2021 ◽  
Vol 8 (3) ◽  
pp. 159-170
Author(s):  
Paweł Korczyc ◽  
Jędrzej Chrzanowski ◽  
Arkadiusz Stasiak ◽  
Joanna Stasiak ◽  
Andrzej Bissinger ◽  
...  
Keyword(s):  
Regression Model ◽  
Cox Regression ◽  
Everyday Practice ◽  
Syntax Score ◽  
Clinical Parameters ◽  
Observation Study ◽  
Cox Regression Model ◽  
Long Term Outcome ◽  
The Impact

Aim: Our study aimed to identify the clinical variables associated with long-term mortality after MI and to construct a simple, easy to use clinical practice model for the prediction of 5 year mortality after MI. Material and Methods: This is a prospective 5-year observation study of MI patients admitted to the Department of Cardiology at the Copernicus Memorial Hospital in Lodz in 2010 and 2011. The data were collected during hospitalization and again after a period of 1 and 5 years. A multi-factor multi-level Cox regression model was constructed to investigate the impact of clinical factors on long-term survival.results: 92 patients (39 STEMI, 53 NSTEMI) were included in the study and their data were used to construct a Cox regression model with satisfactory fit (R 2 =0.7945). Factors associated with a decrease in 5-year risk are: age (1.06, 95%CI: 1.01-1.11), SYNTAX score (1.05, 95%CI: 1.02-1.08), WBC level (1.16, 95%CI: 1.08-1.26), and glycemia at enrollment (1.01, 95%CI: 1.01-1.01). Higher values of HDL at enrollment were associated with a decrease in 5-year risk (HR=0.97, 95%CI: 0.93-0.99).conclusion: The model we created is a valuable tool that is useful and easy to employ in everyday practice for assessing the 5-year prognosis of patients after MI. What is new: The study presents the new model for prediction of 5-year mortality after myocardial infarction. This model is based on simple clinical parameters and may by applied in everyday practice.

P3529Prognostic impact of cohabitation status in hospitalized patients with acute heart failure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Kenichiro ◽  
M Oguri ◽  
K Takahara ◽  
H Takahashi ◽  
H Ishii ◽  
...  
Keyword(s):  
Heart Failure ◽  
Regression Model ◽  
Cox Regression ◽  
Interquartile Range ◽  
Living Alone ◽  
Left Ventricular Ejection ◽  
Cox Regression Model ◽  
Long Term Prognosis ◽  
Cohabitation Status

Abstract Background The prevalence of heart failure (HF) in the elderly is steadily increasing, therefore, the prudent care and treatment according to individual's characteristics, comorbidities, or prognosis, should be prerequisite. Although cohabitations status in each elderly patient is different, an association of this condition with long-term prognosis remains to be identified definitively in Japan. Purpose The purpose of the present study was to examine the prognostic impact of cohabitation status on 3-year mortality among hospitalized acute HF patients. Methods The study population comprised a total of 817 individuals who were hospitalized for acute HF between November 2009 and December 2015, and was followed up for 3 years. We classified patients into three groups (cohabitation with spouse, cohabitation with another generation, and living alone). We evaluated relative predictive values between these three groups for 3-year mortality by Cox regression model. Results The median age was 79 (interquartile range 70–85) years, and 55.7% of the subjects were male. Median length of hospital stay was 16 (interquartile range 11–23) days. The distribution of three groups was cohabitation with spouse (50.9%), cohabitation with another generation (28.5%), and living alone (20.6%). The overall rate of 3-year mortality was 32.2% (n=263), 31.5% (n=131) in cohabitation with spouse, 38.2% (n=89) in cohabitation with another generation, and 25.6% (n=43) in living alone. Cohabitation with another generation was significantly related to the occurrence of 3-year mortality by univariate analysis (P<0.001). Age (84 years vs. 77 years), the frequency of female (69.1% vs. 33.4%), left ventricular ejection fraction (52.7% vs. 47.5%) were significantly greater, whereas body mass index (21.2 vs. 22.6), smoking status (27.0% vs. 53.4%), ischemic etiology (27.5% vs. 35.6%), and the prevalence of type 2 diabetes mellitus (32.2% vs. 41.4%) and atrial fibrillation (20.6% vs. 29.8%) were significantly (P<0.05) smaller in cohabitation with another generation than others. The ratio of home return and optimal medical therapy were similar between the 2 groups. Cohabitation with another generation was associated with higher relative risk of 3-year mortality than living alone [Hazard Ratio (HR) 1.65; 95% Confidence Interval (CI) 1.15–2.38, P=0.007], or cohabitation with spouse (HR 1.46; 95% CI 1.12–1.92, P=0.006). Multivariable Cox regression model, with adjustment for age, albumin, brain natriuretic peptide, and prior HF hospitalization, revealed that cohabitation with another generation was no longer significant. Conclusion Our present results suggest that cohabitation status affected on long-term prognosis in patients with HF, especially cohabitation with another generation posed as worst predictor. We should pay more attention to social factors including cohabitation status in the clinical practice.

scholarly journals Atherosclerosis as a risk factor in the prognosis of the survival of patients with COPD

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
S Kotlyarov ◽  
A Kotlyarova
Keyword(s):  
Cardiovascular Diseases ◽  
Regression Model ◽  
Poor Prognosis ◽  
Roc Analysis ◽  
Cox Regression ◽  
Term Survival ◽  
Cox Regression Model ◽  
Kaplan Meier ◽  
History Of

Abstract Funding Acknowledgements Type of funding sources: None. Main funding source(s): no OnBehalf no Atherosclerosis is one of the key medical problems, as it contributes greatly to the structure of morbidity and mortality. Atherosclerosis rarely occurs in isolation, and is often combined with other diseases, including chronic obstructive pulmonary disease (COPD). The study of the significance of atherosclerosis and other key risk factors in the prognosis of COPD was carried out.  Materials and methods a study of the nature of the course of COPD for 15 years was carried out at three time control points (2005, 2008 and 2020). The presence of diseases associated with atherosclerosis in history, the severity of dyspnea according to the modified MRC scale and body mass index were taken into account. To assess the significance of the factors, a long-term survival analysis was performed using the Kaplan-Meier method. The statistical significance of the differences between the curves was assessed using the Log-rank test and the Breslow (Generalized Wilcoxon) and Tarone-Ware tests. To assess the influence of various factors and their combinations on long-term survival, a multivariate analysis was carried out using the Cox regression model (proportional hazards model).  Results and discussion The study included 170 men, with an average age of 60.09 ± 1.31 years. All patients smoked, the pack-years index was 43.78 ± 1.02. Of the 170 patients included in the study, 119 died by the third time point, which was 70%. The life expectancy of deceased patients averaged 70.48 ± 0.63 years. The main causes of death in patients with COPD are cardiovascular diseases caused by atherosclerosis, cancer, and respiratory failure. The most common cause of death in patients with COPD (68%) is diseases of the circulatory system associated with atherosclerosis. It was found that the presence of atherosclerosis in the anamnesis decreases the survival rate over a 15-year period. The graphs of the Kaplan-Meier survival curve depending on the presence of concomitant cardiovascular diseases in the anamnesis confirm the significance of the differences (p = 0.0194). It was also shown that an increase in the severity of dyspnea is associated with an increased risk of adverse outcomes (p &lt;0.001; ROC analysis, AUC = 0.737 ± 0.038). The analysis of survival using the construction of Kaplan-Meier curves showed that BMI &lt;21 is associated with a poor prognosis (p &lt;0.001; ROC analysis, AUC = 0.827 ± 0.043). The results of the Cox regression model showed that a history of atherosclerosis is a significant predictor of a poor prognosis in patients with COPD in a 15-year follow-up. It was shown that a history of atherosclerosis increases the risk of death in patients with COPD by 1.734 times.  Thus, concomitant cardiovascular diseases of atherosclerotic genesis, severe dyspnea and low body weight are a significant factor in the poor prognosis of COPD and should be taken into account when monitoring patients.

scholarly journals The significance of maternal asymptomatic bacteriuria during pregnancy on long-term offspring infectious hospitalizations

2021 ◽  
pp. 1-6
Author(s):  
Bluma Nae ◽  
Tamar Wainstock ◽  
Eyal Sheiner
Keyword(s):  
Regression Model ◽  
Cox Regression ◽  
Medical Center ◽  
Survival Curve ◽  
Cohort Analysis ◽  
Asymptomatic Bacteriuria ◽  
Population Based ◽  
Cox Regression Model ◽  
Kaplan Meier

Abstract Asymptomatic bacteriuria (ASB) is a well-acknowledged infectious entity during pregnancy; yet its long-term implications are not well investigated. The present study aimed to test the association between maternal ASB during pregnancy and long-term offspring infectious hospitalizations. A population-based cohort analysis was conducted, comparing the incidence of long-term infectious-related hospitalizations of offspring born to mothers who were diagnosed with ASB during pregnancy, and those who did not have ASB. The study was conducted at a tertiary medical center and included all singleton deliveries between the years 1991 and 2014. Infectious morbidities were based on a predefined set of International Classification of Disease-9 codes. A Kaplan−Meier survival curve compared cumulative infectious hospitalization incidence between the groups, and a Cox regression model was used to adjust for confounding variables. During the study period, 212,984 deliveries met inclusion criteria. Of them, 5378 (2.5%) were diagnosed with ASB. As compared to offspring of non-ASB mothers, total long-term infectious hospitalizations were significantly higher among children to mothers who were diagnosed with ASB (13.1% vs. 11.1%, OR = 1.2, 95% CI 1.11–1.30, P ≤ 0.001). Likewise, a Kaplan−Meier curve demonstrated higher cumulative incidence of infectious hospitalizations among children born to mothers with ASB (log rank, P = 0.006). In the Cox regression model, while controlling for maternal age, diabetes mellitus, ethnicity, hypertensive disorders, and gestational age, maternal ASB was noted as an independent risk factor for long-term infectious morbidity in the offspring (adjusted HR = 1.1, 95% CI 1.01–1.17, P = 0.042). ASB during pregnancy increases offspring susceptibility to long-term infectious hospitalizations.

scholarly journals 813. The Reduction of the acquisition rate of carbapenem resistant Acinetobacter baumannii after room privatization in the intensive care unit

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S448-S449
Author(s):  
Jongtak Jung ◽  
Pyoeng Gyun Choe ◽  
Chang Kyung Kang ◽  
Kyung Ho Song ◽  
Wan Beom Park ◽  
...  
Keyword(s):  
Regression Model ◽  
Acinetobacter Baumannii ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Intervention Group ◽  
Feeding Tube ◽  
Control Group ◽  
Cox Regression Model ◽  
Carbapenem Resistant ◽  
Hospital Acquired

Abstract Background Acinetobacter baumannii is one of the major pathogens of hospital-acquired infection recently and hospital outbreaks have been reported worldwide. On September 2017, New intensive care unit(ICU) with only single rooms, remodeling from old ICU with multibed bay rooms, was opened in an acute-care tertiary hospital in Seoul, Korea. We investigated the effect of room privatization in the ICU on the acquisition of carbapenem-resistant Acinetobacter baumannii(CRAB). Methods We retrospectively reviewed medical records of patients who admitted to the medical ICU in a tertiary care university-affiliated 1,800-bed hospital from 1 January 2015 to 1 January 2019. Patients admitted to the medical ICU before the remodeling of the ICU were designated as the control group, and those who admitted to the medical ICU after the remodeling were designated as the intervention group. Then we compared the acquisition rate of CRAB between the control and intervention groups. Patients colonized with CRAB or patients with CRAB identified in screening tests were excluded from the study population. The multivariable Cox regression model was performed using variables with p-values of less than 0.1 in the univariate analysis. Results A total of 1,105 cases admitted to the ICU during the study period were analyzed. CRAB was isolated from 110 cases in the control group(n=687), and 16 cases in the intervention group(n=418). In univariate analysis, room privatization, prior exposure to antibiotics (carbapenem, vancomycin, fluoroquinolone), mechanical ventilation, central venous catheter, tracheostomy, the presence of feeding tube(Levin tube or percutaneous gastrostomy) and the length of ICU stay were significant risk factors for the acquisition of CRAB (p&lt; 0.05). In the multivariable Cox regression model, the presence of feeding tube(Hazard ratio(HR) 4.815, 95% Confidence interval(CI) 1.94-11.96, p=0.001) and room privatization(HR 0.024, 95% CI 0.127-0.396, p=0.000) were independent risk factors. Table 1. Univariate analysis of Carbapenem-resistant Acinetobacter baumannii Table 2. Multivariable Cox regression model of the acquisition of Carbapenem-resistant Acinetobacter baumannii Conclusion In the present study, room privatization of the ICU was correlated with the reduction of CRAB acquisition independently. Remodeling of the ICU to the single room would be an efficient strategy for preventing the spreading of multidrug-resistant organisms and hospital-acquired infection. Disclosures All Authors: No reported disclosures

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