In-hospital mortality after hip arthroplasty in China

Aims There is an increasing demand for hip arthroplasty in China. We aimed to describe trends in in-hospital mortality after this procedure in China and to examine the potential risk factors. Patients and Methods We included 210 450 patients undergoing primary hip arthroplasty registered in the Hospital Quality Monitoring System in China between 2013 and 2016. In-hospital mortality after hip arthroplasty and its relation to potential risk factors were assessed using multivariable Poisson regression. Results During the study period, 626 inpatient deaths occurred within 30 days after hip arthroplasty. Mortality decreased from 2.9% in 2013 to 2.6% in 2016 (p for trend = 0.02). Compared with their counterparts, old age, male sex, and divorced or widowed patients had a higher rate of mortality (all p < 0.05). Risk ratio (RR) for mortality after arthroplasty for fracture was two-fold higher (RR 2.0, 95% confidence interval (CI) 1.5 to 2.6) than that for chronic disease. RRs for mortality were 3.3 (95% CI 2.7 to 3.9) and 8.2 (95% CI 6.5 to 10.4) for patients with Charlson Comorbidity Index (CCI) of 1 to 2 and CCI ≥ 3, respectively, compared with patients with CCI of 0. The rate of mortality varied according to geographical region, the lowest being in the East region (1.8%), followed by Beijing (2.1%), the North (2.9%), South-West (3.6%), South-Central (3.8%), North-East (4.1%), and North-West (5.2%) regions. Conclusion While in-hospital mortality after hip arthroplasty in China appears low and declined during the study period, discrepancies in mortality after this procedure exist according to sociodemographic factors. Healthcare resources should be allocated more to underdeveloped regions to further reduce mortality. Cite this article: Bone Joint J 2019;101-B:1209–1217

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Risk factors for poor outcome of patients with Coronavirus disease 2019 (COVID-19) in Albania

The Journal of Infection in Developing Countries ◽

10.3855/jidc.14592 ◽

2021 ◽

Vol 15 (09) ◽

pp. 1236-1243

Author(s):

Ergys Ramosaço ◽

Entela Kolovani ◽

Najada Çomo ◽

Nevila Gjermeni ◽

Vjollca Shpata ◽

...

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Lactate Dehydrogenase ◽

Hospital Mortality ◽

Potential Risk ◽

Chest Computed Tomography ◽

Poor Outcome ◽

Early Risk ◽

Potential Risk Factors ◽

D Dimer

Introduction: The study aims to identify potential risk factors for the poor outcome of hospitalized patients with SARS-CoV-2 infection in Albania. Methodology: A retrospective observational study on 133 consecutive hospitalized patients at “COVID 1” Hospital, University Hospital Center of Tirana. The study analyzed the correlation between potential risk factors and in-hospital mortality. Results: The study included 133 patients, 65.4% of the patients were male, age 60.46 ± 13.53 years. The mortality rate resulted in 22.6%. Univariate analysis revealed that early risk factors for mortality included: laboratory alterations on admission, such as lymphocytes count < 1.000/mm3 (OR = 3.30, 95% CI = 1.17-9.33), lactate dehydrogenase > 250 U/L (OR = 12.48, 95% CI = 1.62-95.78) and D dimer > 2 mg/L (OR = 4.72, 95% CI = 1.96-11.36); lung parenchymal involvement > 75% on chest computed tomography on admission (OR = 54.00, 95% CI = 11.89 – 245.11). Cox proportional hazard regression showed that independent risk factors for mortality were lung parenchymal involvement > 75% on chest computed tomography (HR = 8.31, 95%CI: 1.62-42.45) and occurrence of complications during hospital stay (OR = 10.28, 95% CI = 2.02-52.33). Conclusions: The risk of poor outcome can be predicted from the early stage of COVID 19 disease, using laboratory data and chest computed tomography. Among patients with COVID 19, lung parenchymal involvement and alterations > 75% on chest computed tomography on admission and laboratory findings, such as lymphocytopenia, and elevated lactate dehydrogenase and D dimer levels, turned out to be early risk factors for in-hospital mortality.

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Factors Associated with the Introduction of Mycobacterium avium spp. Paratuberculosis (MAP) into Dairy Herds in Galicia (North-West Spain): The Perception of Experts

Animals ◽

10.3390/ani11010166 ◽

2021 ◽

Vol 11 (1) ◽

pp. 166

Author(s):

Francisco Javier Villaamil ◽

Eduardo Yus ◽

Bibiana Benavides ◽

Alberto Allepuz ◽

Sebastián Jesús Moya ◽

...

Keyword(s):

Risk Factors ◽

Decision Tree ◽

Mycobacterium Avium ◽

Potential Risk ◽

North West ◽

Factors Associated ◽

Expert Opinions ◽

Potential Risk Factors ◽

Mycobacterium Avium Subsp Paratuberculosis ◽

Key Questions

This study aimed at quantifying expert opinions on the risk factors involved in Mycobacterium avium subsp. paratuberculosis (MAP) infection in dairy cattle herds. For this purpose, potential risk factors associated with the introduction of MAP into dairies were chosen based on a literature review and discussions with researchers and veterinarians. For each factor, a decision tree was developed, and key questions were included in each. Answers to these key questions led to different events within each decision tree. An expert opinion workshop was organized (following the recommendations of the OIE), and ordinal values ranging from 0 to 9 (i.e., a null to very high likelihood of infection) were assigned to each event. The potential risk factors were also incorporated into a structured questionnaire that was responded to by 93 farms where the sanitary status against MAP was known. Thereby, based on the values given by the experts and the information collected in the questionnaires, each farm was assigned a score based on their MAP entry risk. From these scores (contrast variable) and using a ROC curve, the cut-off that best discriminated MAP-positive and -negative farms was estimated. The most important risk factors for the introduction of MAP, according to expert opinions, involved purchase and grazing practices related to animals under six months of age. The scores obtained for each farm, also based on the expert opinions, allowed MAP positive/MAP negative farms to be discriminated with 68.8% sensitivity and 68.7% specificity. These data should be useful for focusing future training initiatives and improving risk-reduction strategies in the dairy industry.

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Seroprevalence and Associated Risk Factors of Rift Valley Fever in Domestic Small Ruminants in the North Region of Cameroon

Veterinary Medicine International ◽

10.1155/2019/8149897 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

R. Poueme ◽

F. Stoek ◽

N. Nloga ◽

J. Awah-Ndukum ◽

M. Rissmann ◽

...

Keyword(s):

Risk Factors ◽

Potential Risk ◽

Rift Valley ◽

Rift Valley Fever ◽

Small Ruminants ◽

Sub Saharan Africa ◽

Valley Fever ◽

Sheep And Goats ◽

The North ◽

Potential Risk Factors

Rift Valley fever (RVF) is a zoonotic vector borne infectious disease of major medical and veterinary importance particularly in sub-Saharan Africa. However, there is dearth of epidemiological knowledge of the disease in Cameroon. We conducted a cross-sectional study (January 2016–January 2017) to investigate the seroprevalence and potential risk factors of Rift Valley fever virus (RVFV) in sheep and goats in the North region of Cameroon. Stratified sampling approach was used to select herds where sera were collected from 680 randomly selected small ruminants (355 goats and 325 sheep) in eight localities (Kismatari, Lagdo, Pitoa, Garoua, Bocklé, Dembo, Poli and Touboro) within three administrative divisions (Bénoué, Mayo-Rey and Faro) in the North region. Anti-RVFV antibodies were detected using a competitive Enzyme-Linked Immunosorbent Assay (ELISA), while a capture ELISA was used for the detection of specific RVFV-Immunoglobulin M (Ig-M) antibodies. We evaluated the associated potential risk factors of RVF in small ruminants based on observations of animal-related intrinsic and extrinsic factors in combination with serological results. The results revealed that 3.4% (95% confidence interval (CI): 2.2–5.1%) of sampled animals and 24.6% (95% CI: 15.1–37.1%) of 65 sampled herds were seropositive for anti-RVFV antibodies and no difference in seropositivity between sheep and goats at individual animal as well as at herd levels was observed. Localities along hydrographic or large water banks such as Kismatari (OR: 14.333, (95% CI: 1.436–145.088)) and Pitoa (OR = 11.467 (95% CI: 1.249–50.306)) were significantly associated to RVFV antibody seroprevalence in a simple logistic regression. In addition, the multiple regression analysis showed that age and access to water points significantly influenced RVFV antibody seroprevalence in small ruminants. This study revealed that anti-RVFV antibodies are present in sheep and goats in the North region of Cameroon. It highlights the likely endemic circulation of RVFV in the considered localities despite the absence of clinical cases reported in animals or humans. Under these conditions, it is necessary to set up an early warning, surveillance and control strategy based on epizootic risk.

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TOTAL HIP ARTHROPLASTY

The Professional Medical Journal ◽

10.29309/tpmj/2011.18.02.2101 ◽

2011 ◽

Vol 18 (02) ◽

pp. 317-322

Author(s):

NABEEL DASTGIR ◽

A. SADDIQE ◽

J. P. MCCABE

Keyword(s):

Risk Factors ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Potential Risk ◽

Hip Dislocation ◽

Abduction Angle ◽

Total Hip ◽

Consecutive Period ◽

Potential Risk Factors ◽

Primary Total Hip Arthroplasty

Dislocation after total hip arthroplasty is part of spectrum ranging from neck impingement to subluxation before frank dislocation occurs. Objectives: To assess various parameters as potential risk factors for postoperative hip dislocation. Setting: Department of Orthopaedics in Merlin Park Regional Hospital, Galway Period: 5 years Study Design: Observational Material and Methods: In our study we reviewed 1096 patients who underwent primary total hip arthroplasty in a consecutive period of five years. We assessed various parameters as potential risk factors for dislocation. Results: During this period 16 (1.45 %) patients dislocated their hips. According to our study the Important factors that led to these dislocations were Retroverted cup (5 cases), trochanteric malunion/ avulsion (5 cases), Epilepsy (1 cases), Confusion/ Dementia (2 cases) Parkinsonism (2 cases). Abduction angle was found to be greater than 50 degrees in 8 cases. Conclusion: Familiarity with the risk factors assists in prevention and dictates aspects requiring further assessment, when dislocation occurs. Protection of the hip by bracing should be considered following revision surgery but is of questionable use in primary cases.

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Premature Arterial Disease Associated with Familial Antithrombin III Deficiency

Thrombosis and Haemostasis ◽

10.1055/s-0038-1645677 ◽

1990 ◽

Vol 63 (01) ◽

pp. 013-015 ◽

Cited By ~ 15

Author(s):

E J Johnson ◽

C R M Prentice ◽

L A Parapia

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Potential Risk ◽

Antithrombin Iii ◽

Arterial Disease ◽

Coagulation System ◽

Early Age ◽

Arterial Thromboembolism ◽

Potential Risk Factors ◽

Antithrombin Iii Deficiency

SummaryAntithrombin III (ATIII) deficiency is one of the few known abnormalities of the coagulation system known to predispose to venous thromboembolism but its relation to arterial disease is not established. We describe two related patients with this disorder, both of whom suffered arterial thrombotic events, at an early age. Both patients had other potential risk factors, though these would normally be considered unlikely to lead to such catastrophic events at such an age. Thrombosis due to ATIII deficiency is potentially preventable, and this diagnosis should be sought more frequently in patients with arterial thromboembolism, particularly if occurring at a young age. In addition, in patients with known ATIII deficiency, other risk factors for arterial disease should be eliminated, if possible. In particular, these patients should be counselled against smoking.

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