Comparison of demographic variables related to 30-day readmission in cancers with similar risk factors: Analysis of 290,270 hospitalizations.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15596-e15596
Author(s):  
Suceil Sivsammye ◽  
Karthik Kailasam

e15596 Background: There has been increasing focus on reducing hospital readmissions which are an ongoing economic challenge. This study was targeted at cancer of the esophagus (CE), stomach (CS), and pancreas (CP) which share similar risk factors to identify if these patient subsets also share risk for hospital readmission. Methods: Data was extracted from Nationwide Inpatient Sample database, which approximates 20% of U.S. community hospitals. Patients with a diagnosis CE, CS, and CP were identified by Clinical Classification Software code 11, 12, and 17, respectively. Demographic parameters associated with high readmission rates were collected for patients readmitted within 30 days over 2009-2013. Chi-square test was used to asses differences between variables. Results: We identified a total of 290,270 hospitalizations over the 5-year period of which 26.2% were readmitted within 30 days. The total number of readmissions were comparable for CS (28.0%), CP (27.89%), and CE (26.81%). Patients 45 to 64 years (28.58%, p < 0.001), Medicaid insurances (33.4%, p < 0.001), and metropolitan areas (26.8%, p < 0.001) were associated with higher 30-day readmission rates amongst all three cancers. Males had higher readmission rates in CS (25.64%, p < 0.001) and CP (28.6%, p < 0.001) compared to females in CE (28.0%, p < 0.001). Lowest median income for zip code patients were readmitted more often in CS (26.2%, p < 0.001) vs. third median income in CP (27.78, p < 0.001) and fourth (highest) median income in CE (28.38 %, p < 0.001). The most common identified causes of readmission in all three cancers were complications of surgical procedures or medical care (8.51% ± 2.03%), and septicemia (6.5% ± 1.95%). Conclusions: Our analysis shows that some variables for readmission are similar however more studies are needed to further elucidate whether this is primarily due to analogous treatment techniques. If so interventions to limit readmissions related to these treatments should be taken. Differences in readmissions rate amongst income classes could be related to the ease of accessing the most endorsed treatments for each individual cancer, however further studies are needed to clarify this discrepancy.

2008 ◽  
Vol 19 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Carlos Estrela ◽  
Cláudio Rodrigues Leles ◽  
Augusto César Braz Hollanda ◽  
Marcelo Sampaio Moura ◽  
Jesus Djalma Pécora

The aim of this study was to assess the prevalence and risk factors of apical periodontitis in endodontically treated teeth in a selected population of Brazilian adults. A total of 1,372 periapical radiographs of endodontically treated teeth were analyzed based on the quality of root filling, status of coronal restoration and presence of posts associated with apical periodontitis (AP). Data were analyzed statistically using odds ratio, confidence intervals and chi-square test. The prevalence of AP with adequate endodontic treatment was low (16.5%). This percentage dropped to 12.1% in cases with adequate root filling and adequate coronal restoration. Teeth with adequate endodontic treatment and poor coronal restoration had an AP prevalence of 27.9%. AP increased to 71.7% in teeth with poor endodontic treatment associated with poor coronal restoration. When poor endodontic treatment was combined with adequate coronal restoration, AP prevalence was 61.8%. The prevalence of AP was low when associated with high technical quality of root canal treatment. Poor coronal restoration increased the risk of AP even when endodontic treatment was adequate (OR=2.80; 95%CI=1.87-4.22). The presence of intracanal posts had no influence on AP prevalence.


2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Hailegebriel Wondimu ◽  
Zelalem Addis ◽  
Feleke Moges ◽  
Yitayal Shiferaw

Background. Transfusion associated bacterial infection has remained more frequent with a sever risk of morbidity and mortality. This study assessed the bacteriological safety of blood collected for transfusion. Method. A cross-sectional study was conducted at University of Gondar hospital blood bank from December 2011 to June 2012. Bacterial isolation, identification, and antimicrobial susceptibility tests were done as per the standard procedure. Chi-square test and P value were used to assess associations between risk factors and the bacterial isolation rate. Results. Twenty-one (15.33%) blood units were found contaminated with bacteria, and 95.24% contamination was due to external sources. The commonly isolated bacteria were Staphylococcus aureus, Coagulase negative Staphylococci, Escherichia coli, Klebsiella species, Streptococci species, Enterobacter species, and Citrobacter species. All of the bacteria isolated were 100% sensitive to Gentamicin, Chloramphenicol, Amoxicillin, and Doxycycline. Multiple antimicrobial resistances were observed in 66.7% of the isolates. Not using glove by phlebotomist, touching disinfected phlebotomy site and double puncture at the same hand or both hands of a donor were found to be risk factors for bacterial contamination. Conclusion. Bacterial contamination of blood to be transfused is a common problem in the hospital. So attention should be given to activities performed at the blood bank for safe transfusion practices.


Author(s):  
T. G. Svetlichnaya ◽  
A. S. Mityagina ◽  
T. M. Burkova ◽  
N. M. Ogorelkova

Relevance. The high prevalence of tooth decay requires investigation of its risk factors. The aim was to study tooth decay risk factors among six-year-old children according to the level of dental health (based on parents’ assessment).Materials and methods. The research evaluated the dental health of six-year-olds and factors defining their oral health; The study surveyed 515 parents of six-year-old children from 7 kindergartens in Arkhangelsk. Pearson chi-square test assessed the differences in the frequency of tooth decay factors among six-year-old children according to the level of dental health. The accepted significance level was 0.05.Results. The Arkhangelsk parents evaluated the dental health of their six-year-olds as relatively favourable: good (41.2%) and satisfactory (46.6%). Only 9.5% of children had poor health. Children generally had good oral hygiene skills: 86.8% liked brushing their teeth; 60.2% squeezed the optimal amount of toothpaste on the toothbrush; 56.7% brushed their teeth twice a day. The dental literacy of parents was satisfactory: 67.0% purchased toothpaste for children; 90.8% considered necessary to treat primary teeth; 69.2% replaced toothbrush every three months; 59.7% visited a pediatric dentist twice a year. The children with poor dental health had insufficient oral hygiene skills: 46.9% did not like teeth cleaning; 51.1% brushed their teeth once a day. Their diet was not healthy: 100.0% did not eat hard food; 65.3% frequently consumed sweets. The parents  of children with poor dental health had low medical literacy and poor oral hygiene: 46.9% did not know that treatment of primary teeth was necessary; 42.9% considered the treatment of primary teeth as unnecessary; 32.6% purchased whatever toothpaste. The general negative trend is to use toothpaste without fluoride (68.1%).Conclusions. The results of the study demonstrated a significantly higher frequency of cariogenic factors in children with poor dental health.


2021 ◽  
Vol 23 (11) ◽  
pp. 381-401
Author(s):  
Umar Abdullahi Tawfiq ◽  
◽  
Shohaimi Shamarina ◽  
Syafinaz Amin Nordin ◽  
Mohd Noor Hisham Mohd Nadzir ◽  
...  

Typhoid is a life-threatening disease that has remained endemic in parts of Africa and Asia where its burden is elevated by the inefficiency of control efforts which have been hampered by lack of epidemiological data, among others. In Nigeria, such data is absent in most of the States like Gombe where the disease has been rife for a long time, hence, to bridge that knowledge gap, this study was set up to determine the host-associated risk factors for typhoid occurrence and recurrence in Gombe. A questionnaire that was designed and validated for this location was used to obtain data from 663 respondents using simple random sampling and analyzed using the Chi-square test for association and binomial logistic regression to obtain risk factors for typhoid occurrence and recurrence, respectively. The study revealed that occurrences were statistically significantly associated with the variables for vaccination (χ2 = 39.729, p < 0.01), having houseboy/girl (χ2 = 16.909, p < 0.01), typhoid patient at home (χ2 = 13.393, p < 0.01), hand washing before handling food (χ2 = 22.856, p < 0.01), consuming iced/frozen items (χ2 = 16.805, p < 0.01), boiling drinking water (χ2 = 49.633, p < 0.01), and eating commercially available foods/drinks (χ2 = 27.864, p < 0.01), while recurrences were statistically significantly predicted by „not sure of been vaccinated‟ (OR = 2.962, CI = 1.290 to 6.802, p < 0.01), „not having another typhoid patient at home‟ (OR = 1.799, CI = 0.998 to 3.244, p < 0.01), and „drinking unboiled water sometimes‟ (OR = 2.130, CI = 1.023 to 4.434, p < 0.01). It is believed that these findings will guide efforts by the Government for health interventions against typhoid in the study area, thus improving the quality of life for the population.


2021 ◽  
Author(s):  
Rong Xue ◽  
Ningdao Li ◽  
Zhurong Ji ◽  
Xingdong Cheng ◽  
Zhuqiu Zhang ◽  
...  

Abstract Background: Dysphagia is one of the most common complications after anterior cervical spine surgery. The study aimed to evaluate the risk factors for dysphagia after anterior cervical discectomy and fusion (ACDF) with the Zero-P Implant System by multidimensional analysis and investigated the predictive values of these risk factors for dysphagia. Methods: A retrospective analysis of 260 patients who underwent ACDF with the Zero-P Implant System and had at least 2 year of follow-up ware performed. All patients were divided into a non-dysphagia group and a dysphagia group. Sex, age, body mass index (BMI), intraoperative time, estimated blood loss, diabetes mellitus, hypertension, smoking, alcohol consumption, prevertebral soft-tissue thickness, the levels of surgery, O-C2 angle, C2–7 angle, T1 slope and segmental angle were analyzed. Chi-square test and logistic regression were performed to analyze the predictive value of each dimension for dysphagia. Results: In total, the non-dysphagia group comprised 170 patients and the dysphagia group comprised 90 patients. Chi-square test results indicated that number of operated levels, operation time dT1 slope, dO-C2 angle, dC2–7 angle, segmental angle and dPSTT were associated with a high incidence of dysphagia. Multivariate logistic regression analysis showed that number of operated levels, operation time, dC2–7 angle and dPSTT were significantly associated with postoperative dysphagia.Conclusions: Number of operated levels, operation time, dC2–7 angle and dPSTT were significantly associated with postoperative dysphagia. In additionally, sufficient preoperative preparation, evaluation combining with proficient and precise treatment measures are suggested to reduce the incidence of postoperative dysphagia when ACDF is performed.


2021 ◽  
Vol VI (I) ◽  
pp. 111-118
Author(s):  
Sameer Ul Khaliq Jan ◽  
Hamid Alam ◽  
Ayub Khan

The present study aims to analyze the causative factors which are responsible for the use of a stimulant drug methamphetamine which is commonly known as ice. For this purpose, data were collected from the two districts, i.e. Peshawar and Mardan, Khyber Pakhtunkhwa, Pakistan. A conceptual framework consists of Independent variable (ice use frequency) and dependent variables (risk factors). Data was collected through a structured questionnaire from a sample of 180 ice users by a snowball sampling technique. A Chi-square test was applied to examine the association between independent and dependent variables. The results reveal that a significant (p=0.05) association was found between various risk factors, i.e. easy availability, friends insistence, try out new experiences/curiosity, and use of ice for exam preparation with frequent use of ice. The study recommends that awareness may be created through educational, religious institution and media for the prevention and rehabilitation of ice addiction.


2020 ◽  
pp. 40-42
Author(s):  
Rajeev Ranjan Kumar ◽  
Shiv Kumar ◽  
Ravikirti Ravikirti ◽  
Debarshi Jana

Hypertension, its risk factors and complications is very poorly understood therefore it goes undiagnosed and untreated for a long time. The present study was undertaken to study the clinical profile of isolated systolic hypertension (systolic > 140 and diastolic ≤ 90 mmHg ) in elderly (above the age of 60 years)and to find out any other associated risk factors, any end organ complications, specially cardiac through electrocardiography and echocardiography and on kidney through creatinine clearance. The present cross-sectional study was undertaken on patients attending the outdoor department and indoor department of medicine. The study group comprised of 75 elderly patients who had isolated systolic hypertension (ISH). Using Chi square test correlation of age with stage of BP, association of risk factors with ISH and Stage III BP and ECG changes with LVH calculated. It concluded that ISH associated with risk factors has definite effect mainly on cardiac in terms of LV hypertrophy and on kidney in terms of reduced creatinine clearance and is an even better predictor of mortalityand morbidity than is diastolic blood pressure.


2021 ◽  
Vol 11 (5) ◽  
pp. 74-81
Author(s):  
Ayushi Rajkumar Jain ◽  
Doss Prakash ◽  
Sheetal Swamy

The alarming statistics of COVID-19 surges up in 2021 throwing an enormous burden on the healthcare system across the world. According to WHO reports on 14th April 2021, globally 136,996,364 confirmed COVID-19 cases are reported across the continents, including 2,951,832 deaths. The state of Maharashtra reported the maximum number of cases of India including high mortality rate. This study was conducted to identify and describe the relation of different predictors (Age, gender, duration of hospital stay, presence of co morbidities) of mortality among the COVID-19 deceased patients by retrospectively analyzing the medical case records of 121 patients from a dedicated COVID hospital at Aurangabad from July 2020 to December 2020. Chi-square test was performed to assess the association between causes of death with different cluster of variables and their significance. This study helps us to identify risk factors that show association between various predictors and mortality rate in COVID-19 patients. Out of 121 deaths, 96 (79%) were male, 61 (49.6%) were in age group between 60-79 years, ARDS was one of the major complication in the deceased patients accounting 29.8% and cardio respiratory arrest was the common cause of death among the deceased patients with 85%. It was also observed that mortality rate was very higher in the initial five days of hospitalization with critical care support. Our result findings provide clinical inferences for physicians to identify high-risk factors with COVID-19 at a very early stage. Key words: COVID-19, Mortality rate, Demographic predictors, Co-morbidities, Cardio respiratory arrest.


2020 ◽  
Vol 15 (2) ◽  
pp. 73
Author(s):  
Ikanov Safitri ◽  
R. Bambang Wirjatmadi

Physical fi tness is the ability of each individual to carry out various daily activities without feeling fatigue. Physical fi tness is useful as a supporting capacity for the physical activity of children therefore it is expected to improve their health and achievement. Factors that infl uence physical fi tness include genetics, age, gender, physical activity, nutritional status, food intake, haemoglobin level, resting time and smoking habits. The purpose of this study was to analyze the risk factors of physical fi tness among female students in Muhammadiyah 1 Ponorogo High School. This case control study included 50 female students and divided into 25 cases and 25 controls. Chi-Square test was used to analyze the relationships between variables. The results showed that there was an association between protein adequacy (p=0.023) OR = 11.3 and haemoglobin levels (p=0.049) OR = 9.3 with physical fi tness. While the adequacy of iron (p=0.345) did not associated with physical fi tness. Student with low protein adequacy and haemoglobin level have respectively 11.3 and 9.3 times higher risk of having low physical fi tness than student with good protein adequacy and haemoglobin level.


2020 ◽  
Vol 20 (1) ◽  
pp. 248-256
Author(s):  
Lenka Mařincová ◽  
Simona Šafaříková ◽  
Radka Cahlíková

Background: Over a few decades obesity has become a major global health problem. Its prevalence worldwide has more than doubled since 1980. The situation is expected to worsen in the future, especially in the developing countries that experience nutrition transition due to economic growth. It contributes to reduction in malnutrition which supports an increase in obesity prevalence. Objectives: The aim of this study was to analyse the predictors of obesity in the region of East Africa. Methods: Meta-analysis of existing studies was used in order to find the different risk factors and their significance in obesity development. Data extracted from 16 published academic research articles described the situation in East African countries. The significance of the effect of each variable was tested by means of an asymptotic chi-square test, or Fisher's exact (factorial) test and the risk ratios were calculated. Results: Based on the chi-square test and the risk ratios of the aggregated data, three risk factors were found to be significant in the development of obesity – gender, type of residence and socio-economic status. In East African countries, women are significantly more likely to be obese. Living in an urban area and socioeconomic status are also positively associated with obesity. Because of insufficient data three other risk factors did not prove to be of any significance – alcohol consumption, smoking and education level. Conclusion: Conclusions of this meta-analysis confirm world trends but we also found results that are not in line with them (e.g. education). This meta-analysis confirms the huge existing research gap concerning obesity predictors in the East African region. Keywords: Obesity; meta-analysis; East Africa. 


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