Risk Factors of H-Type Hypertension in Tertiary Hospitals in Tibet and Inland

Aims: Thromboembolic events, including stroke, are typical complications of COVID-19. Whether arrhythmias, frequently described in severe COVID-19, are disease-specific and thus promote strokes is unclear. We investigated the occurrence of arrhythmias and stroke during rhythm monitoring in critically ill patients with COVID-19, compared with severe pneumonia of other origins.Methods and Results: This retrospective study included 120 critically ill patients requiring mechanical ventilation in three European tertiary hospitals, including n =60 COVID-19, matched according to risk factors for the occurrence of arrhythmias in n = 60 patients from a retrospective consecutive cohort of severe pneumonia of other origins. Arrhythmias, mainly atrial fibrillation (AF), were frequent in COVID-19. However, when compared with non-COVID-19, no difference was observed with respect to ventricular tachycardias (VT) and relevant bradyarrhythmias (VT 10.0 vs. 8.4 %, p = ns and asystole 5.0 vs. 3.3%, p = ns) with consequent similar rates of cardiopulmonary resuscitation (6.7 vs. 10.0%, p = ns). AF was even more common in non-COVID-19 (AF 18.3 vs. 43.3%, p = 0.003; newly onset AF 10.0 vs. 30.0%, p = 0.006), which resulted in a higher need for electrical cardioversion (6.7 vs. 20.0%, p = 0.029). Despite these findings and comparable rates of therapeutic anticoagulation (TAC), the incidence of stroke was higher in COVID-19 (6.7.% vs. 0.0, p = 0.042). These events also happened in the absence of AF (50%) and with TAC (50%).Conclusions: Arrhythmias were common in severe COVID-19, consisting mainly of AF, yet less frequent than in matched pneumonia of other origins. A contrasting higher incidence of stroke independent of arrhythmias also observed with TAC, seems to be an arrhythmia-unrelated disease-specific feature of COVID-19.

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Workplace Violence Against Healthcare Professionals in Thai Tertiary Hospitals

10.21203/rs.3.rs-910003/v1 ◽

2021 ◽

Author(s):

Sophida Kueanongkhun ◽

Siriwan Grisurapong ◽

Kitirat Techatraisak ◽

Thomas E. Guadamuz

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Workplace Violence ◽

Healthcare Workers ◽

Qualitative Data ◽

Physical Violence ◽

Chi Square ◽

Racial Harassment ◽

Tertiary Hospitals ◽

Chi Square Test

Abstract Background: Thailand lacks evidence of the current prevalence of workplace violence (WPV) at tertiary hospitals. This study aimed to examine the prevalence of, perpetrators of, and factors associated with WPV against healthcare workers in excellent tertiary hospitals in Thailand.Methods: This was a mixed-methods study. A questionnaire was individually administered by an interviewer to 220 healthcare workers using a tablet with an online platforms, and the completion rate was 100%. The study was conducted from July 2018 to March 2019. Pearson’s chi-square test was used to examine the variables related to any violence according to individual and work data. Odds ratios with 95% confidence intervals were used to assess risk factors for exposure to violence using a logistic regression model. Thirty participants provided additional qualitative data that were used for thematic analysis.Results: The findings revealed that in the past 12 months, 63.6% of the participants experienced violence at their workplaces. The most common type of violence reported was verbal violence (56.4%), followed by physical violence (24.1%), bullying (16.4%), sexual harassment (4.1%), and racial harassment (3.6%). Multivariable logistic regression revealed that the correlates of violence at hospitals included being male (OR = 4.28, 95% CI 1.50–12.19), working in an outpatient department (OR = 2.55, 95% CI 1.42–4.58), and having direct contact with clients (OR = 3.12, 95% CI 1.25–7.73). The qualitative data revealed 5 major themes.Conclusion: There is a high prevalence of violence against all healthcare workers at excellent tertiary hospitals in Thailand. Policymakers need to be aware of the roots and risk factors for all types of WPV. The results could also contribute to the development of appropriate policies, interventions for conflicts based on intergenerational gaps, reporting, investigation processes, preventive measures, and zero-tolerance protocols for all healthcare workers.

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684. Risk Stacking for Pneumococcal Disease in Costa Rica

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.691 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S247-S247

Author(s):

Jorge Chaverri-Murillo ◽

Manuel Ramírez-Cardoce ◽

José Castro-Cordero

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Costa Rica ◽

High Risk ◽

Pneumococcal Disease ◽

Heart Diseases ◽

High Risk Factor ◽

Tertiary Hospitals ◽

Risk Patients ◽

Culture Positive

Abstract Background The value of nontraditional high-risk factor stacking is not known in the Costa Rican population. We aim to describe risk factor stacking for pneumococcal disease (PD) in patients seeking care at Social Security Hospitals in Costa Rica Methods Descriptive study of adult patients with microbiological culture-positive Streptococcus pneumoniae disease seeking care at two tertiary hospitals in Costa Rica between years 2014 and 2016. Information on underlying comorbidities (nontraditional) and other risk factors for PD was analyzed and stalked for each age group (G1: <50, G2: 50–64, and G3: ≥65 y/o). Results We included 181 culture-positive patients. We found that patients in G1 predominantly stacked ≥2 risk factors (63%), the proportion of patients with ≥2 risk factor was similar to high-risk patients in G2 (33% vs. 38%). In G3, 18% didn’t stacked any other risk factor and 46% was on high-risk. Most frequent risk factors in G1/G2 were smoking and alcoholism, and in G3 chronic pulmonary and heart diseases. Conclusion We conclude that risk factor stacking is more relevant than high-risk conditions and PD also occurs in persons <50 y/o. We recommend that risk factor stacking should be considered in prevention strategies for PD. Disclosures All authors: No reported disclosures.

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Prevalence and risk factors of hepatitis D virus infection in patients with chronic hepatitis B infection attending the three main tertiary hospitals in Libya

Arab Journal of Gastroenterology ◽

10.1016/j.ajg.2017.11.003 ◽

2017 ◽

Vol 18 (4) ◽

pp. 216-219 ◽

Cited By ~ 4

Author(s):

Abdel-Naser Elzouki ◽

Saleh M. Bashir ◽

Omar Elahmer ◽

Islam Elzouki ◽

Fathi Alkhattali

Keyword(s):

Risk Factors ◽

Chronic Hepatitis ◽

Virus Infection ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Hepatitis B Infection ◽

Chronic Hepatitis B Infection ◽

Hepatitis D ◽

Hepatitis D Virus ◽

Tertiary Hospitals

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Risk factors for stillbirth and early neonatal death: a case-control study in tertiary hospitals in Addis Ababa, Ethiopia

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04025-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Eskinder Kebede ◽

Melani Kekulawala

Keyword(s):

Risk Factors ◽

Neonatal Death ◽

Maternal Education ◽

Case Control Study ◽

Addis Ababa ◽

Case Control ◽

Categorical Variables ◽

Early Neonatal Death ◽

Tertiary Hospitals ◽

Control Study

Abstract Background Ethiopia is a Sub-Saharan country that has made significant improvements in maternal mortality and under-five mortality over the past 15 years. However, the nation continues to have one of the highest rates of perinatal mortality in the entire world with current estimates at 33 deaths per 1000 live births. Methods This case-control study was conducted between October 2016 and May 2017 at Tikur Anbessa Hospital and Gandhi Memorial Hospital. All women who had a stillbirth or early neonatal death (i.e. death within 7 days) during this period willing to participate were included as cases. A systematic random sample of women delivering at the hospital were approached for recruitment as controls to generate a 2:1 ratio of controls to cases. Data on risk factors were retrieved from medical records including delivery records, and treatment charts. Statistical differences in background and social characteristics of cases and controls were determined by t-test and chi-squared (or fisher’s exact test) for quantitative and categorical variables respectively. Binary logistic regression analysis was completed to determine any associations between risk factors and stillbirth/early neonatal death. Results During the study period, 366 women delivering at the hospitals were enrolled as cases and 711 women delivering at the hospitals were enrolled as controls. Records from both hospitals indicated that the estimated stillbirth and neonatal mortality rates were 30.7 per 1000. Neonatal causes (43.4%) were the most common, followed by antepartum (32.5%) and intrapartum (24.5%). Risk factors for stillbirths and early neonatal death were low maternal education (aOR 1.747, 95%CI 1.098–2.780), previous stillbirth (aOR 9.447, 95%CI 6.245–14.289), previous preterm birth (aOR 3.620, 95%CI 2.363–5.546), and previous child with congenital abnormality (aOR 2.190, 95% 1.228–3.905), and antepartum hemorrhage during pregnancy (aOR 3.273, 95% 1.523–7.031). Conclusion Antepartum hemorrhaging is the only risk factor in our study amenable for direct intervention. Efforts should be maximized to improve patient education and antenatal and obstetric services. Moreover, the most significant cause of mortality was asphyxia-related causes. It is imperative that obstetric capacity in rehabilitation services are strengthened and for further studies to investigate the high burden of asphyxia at these tertiary hospitals to better tailor interventions.

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Early versus late acute kidney injury among patients with COVID-19—a multicenter study from Wuhan, China

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa288 ◽

2020 ◽

Vol 35 (12) ◽

pp. 2095-2102

Author(s):

Suyuan Peng ◽

Huai-Yu Wang ◽

Xiaoyu Sun ◽

Pengfei Li ◽

Zhanghui Ye ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Hospital Mortality ◽

Organ Dysfunction ◽

Clinical Features ◽

Kidney Injury ◽

Hazard Ratios ◽

Increased Risk ◽

Tertiary Hospitals ◽

History Of

Abstract Background Acute kidney injury (AKI) is an important complication of coronavirus disease 2019 (COVID-19), which could be caused by both systematic responses from multi-organ dysfunction and direct virus infection. While advanced evidence is needed regarding its clinical features and mechanisms. We aimed to describe two phenotypes of AKI as well as their risk factors and the association with mortality. Methods Consecutive hospitalized patients with COVID-19 in tertiary hospitals in Wuhan, China from 1 January 2020 to 23 March 2020 were included. Patients with AKI were classified as AKI-early and AKI-late according to the sequence of organ dysfunction (kidney as the first dysfunctional organ or not). Demographic and clinical features were compared between two AKI groups. Their risk factors and the associations with in-hospital mortality were analyzed. Results A total of 4020 cases with laboratory-confirmed COVID-19 were included and 285 (7.09%) of them were identified as AKI. Compared with patients with AKI-early, patients with AKI-late had significantly higher levels of systemic inflammatory markers. Both AKIs were associated with an increased risk of in-hospital mortality, with similar fully adjusted hazard ratios of 2.46 [95% confidence interval (CI) 1.35–4.49] for AKI-early and 3.09 (95% CI 2.17–4.40) for AKI-late. Only hypertension was independently associated with the risk of AKI-early. While age, history of chronic kidney disease and the levels of inflammatory biomarkers were associated with the risk of AKI-late. Conclusions AKI among patients with COVID-19 has two clinical phenotypes, which could be due to different mechanisms. Considering the increased risk for mortality for both phenotypes, monitoring for AKI should be emphasized during COVID-19.

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