scholarly journals Postoperative anaemia might be a risk factor for postoperative delirium and prolonged hospital stay: A secondary analysis of a prospective cohort study

PLoS ONE ◽  
2020 ◽  
Vol 15 (2) ◽  
pp. e0229325 ◽  
Author(s):  
Julius Valentin Kunz ◽  
Claudia D. Spies ◽  
Anna Bichmann ◽  
Miriam Sieg ◽  
Anika Mueller
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Hospital Stay ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Postoperative Delirium ◽  
Secondary Analysis ◽  
Prolonged Hospital Stay ◽  
Prolonged Hospital

scholarly journals Comparison of QSOFA and SIRS Scores for the Prediction of Adverse Outcomes of Secondary Peritonitis in a Tertiary Teaching Hospital in Uganda: a Prospective Cohort Study

2021 ◽  
Author(s):  
Emmanuel Nkonge ◽  
Olivia Kituuka ◽  
William Ocen
Keyword(s):  
Cohort Study ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Adverse Outcomes ◽  
Secondary Peritonitis ◽  
Mulago Hospital ◽  
Prolonged Hospital Stay ◽  
Prolonged Hospital

Abstract Background: SIRS and qSOFA are two ancillary scoring tools that have been used globally, inside and outside of ICU to predict adverse outcomes of infections such as secondary peritonitis. Mulago hospital uses SIRS outside the ICU to identify patients with secondary peritonitis, who are at risk of adverse outcomes. However it’s associated with delays in decision making given its partial reliance on laboratory parameters. In response to the practical limitations of SIRS, the sepsis-3 task force recommends qSOFA as a better tool, however its performance in patients with secondary peritonitis in comparison to that of SIRS has not been evaluated in Mulago hospital, Uganda.Objective: To compare the performance of qSOFA and SIRS scores in predicting adverse outcomes of secondary peritonitis in Mulago hospital, Uganda.Methods: This was a prospective cohort study of patients with clinically confirmed secondary peritonitis, from March 2018 to January 2019 at the A&E, Mulago hospital. QSOFA and SIRS scores were generated for each of the patient, with a score of ≥ 2 recorded as high risk, while a score of ≤ 2 recorded as low risk for the adverse outcome respectively. After surgery, patients were followed up until discharge or death. In-hospital mortality and prolonged hospital stay were the primary and secondary adverse outcomes, respectively. Sensitivity, specificity, PPV, NPV and accuracy at 95% confidence interval were calculated for each of the scores using STATA v.13Results: A total of 153 patients were enrolled. Of these, 151(M: F, 2.4:1) completed follow up and were analysed, 2 were excluded. Mortality rate was 11.9%. Fourty (26.5%) patients had a prolonged hospital stay. QSOFA predicted in-hospital mortality with AUROC of 0.52 versus 0.62, for SIRS. Similarly, qSOFA predicted prolonged hospital stay with AUROC of 0.54 versus 0.57, for SIRS.Conclusion: SIRS is superior to qSOFA in predicting both mortality and prolonged hospital stay among patients with secondary peritonitis. However, overall, both scores showed a poor discrimination for both adverse outcomes and therefore not ideal tools.

scholarly journals Impact of antibiotics for children presenting to general practice with cough on adverse outcomes: secondary analysis from a multicentre prospective cohort study

2018 ◽  
Vol 68 (675) ◽  
pp. e682-e693 ◽  
Author(s):  
Niamh M Redmond ◽  
Sophie Turnbull ◽  
Beth Stuart ◽  
Hannah V Thornton ◽  
Hannah Christensen ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Respiratory Symptoms ◽  
Linear Models ◽  
Secondary Analysis ◽  
Adverse Outcomes ◽  
Antibiotic Prescribing ◽  
Acute Cough

BackgroundClinicians commonly prescribe antibiotics to prevent major adverse outcomes in children presenting in primary care with cough and respiratory symptoms, despite limited meaningful evidence of impact on these outcomes.AimTo estimate the effect of children’s antibiotic prescribing on adverse outcomes within 30 days of initial consultation.Design and settingSecondary analysis of 8320 children in a multicentre prospective cohort study, aged 3 months to <16 years, presenting in primary care across England with acute cough and other respiratory symptoms.MethodBaseline clinical characteristics and antibiotic prescribing data were collected, and generalised linear models were used to estimate the effect of antibiotic prescribing on adverse outcomes within 30 days (subsequent hospitalisations and reconsultation for deterioration), controlling for clustering and clinicians’ propensity to prescribe antibiotics.ResultsSixty-five (0.8%) children were hospitalised and 350 (4%) reconsulted for deterioration. Clinicians prescribed immediate and delayed antibiotics to 2313 (28%) and 771 (9%), respectively. Compared with no antibiotics, there was no clear evidence that antibiotics reduced hospitalisations (immediate antibiotic risk ratio [RR] 0.83, 95% confidence interval [CI] = 0.47 to 1.45; delayed RR 0.70, 95% CI = 0.26 to 1.90, overall P = 0.44). There was evidence that delayed (rather than immediate) antibiotics reduced reconsultations for deterioration (immediate RR 0.82, 95% CI = 0.65 to 1.07; delayed RR 0.55, 95% CI = 0.34 to 0.88, overall P = 0.024).ConclusionMost children presenting with acute cough and respiratory symptoms in primary care are not at risk of hospitalisation, and antibiotics may not reduce the risk. If an antibiotic is considered, a delayed antibiotic prescription may be preferable as it is likely to reduce reconsultation for deterioration.

scholarly journals Travel style is a major risk factor for diarrhoea in India: a prospective cohort study

2015 ◽  
Vol 21 (7) ◽  
pp. 676.e1-676.e4 ◽  
Author(s):  
V.M. Schindler ◽  
V.K. Jaeger ◽  
L. Held ◽  
C. Hatz ◽  
S. Bühler
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Major Risk Factor

scholarly journals Burden and consequence of birth defects in Nepal-evidence from prospective cohort study

2021 ◽  
Author(s):  
Prajwal Paudel ◽  
Avinash K Sunny ◽  
Rejina Gurung ◽  
Abhishek Gurung ◽  
Honey Malla ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Birth Defects ◽  
Prospective Cohort ◽  
Birth Defect ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Birth Asphyxia ◽  
Neonatal Infection

Abstract Background-Every year an estimated 7.9 million babies are born with birth defect. Of these babies, more than 3 million die and 3.2 million have disability. Improving nationwide information on prevalence of birth defect, risk factor and consequence is required for better resource allocation for prevention, management and rehabilitation. In this study, we assess the prevalence of birth defect, associated risk factors and consequences in Nepal.Method-This is a prospective cohort study conducted in 12 hospitals of Nepal for 18 months. All the women who delivered in the hospitals during the study period was enrolled. Independent researchers collected data on the social and demographic information using semi-structured questionnaire at the time of discharge and clinical events and birth outcome information from the clinical case note. Data were analyzed on the prevalence and type of birth defect. Logistic regression was done to assess the risk factor and consequences for birth defect. Results-Among the total 87,242 livebirths, the prevalence of birth defects was found to be 5.8 per 1000 live births. The commonly occurring birth defects were anencephaly (3.95%), cleft lip (2.77%), cleft lip and palate (6.13%), clubfeet (3.95%), eye abnormalities (3.95%) and meningomyelocele (3.36%). The odds of birth defect was higher among mothers with age <20 years (adjusted Odds ratio (aOR) 1.64; 95% CI, 1.18-2.28) and disadvantaged ethnicity (aOR 1.78; 95% CI, 1.46-2.18). The odds of birth asphyxia was twice fold higher among babies with birth defect (aOR 1.88; 95% CI, 1.41-2.51) in reference with babies without birth defect. The odds of neonatal infection was twice fold higher among babies with birth defect (aOR 1.82; 95% CI, 1.12-2.96) in reference with babies without birth defect. Babies with birth defect had three-fold risk of pre-discharge mortality (aOR 3.00; 95% CI, 1.93-4.69). Conclusion- Babies with birth defect have high risk for birth asphyxia, neonatal infection and pre-discharge mortality at birth. Further evaluation on the care provided to babies who have birth defect is warranted.

scholarly journals Risk Factors for the Occurrence and Protraction of Anterior Knee Pain in Children and Adolescents: a Prospective Cohort Study of 3 Years

2021 ◽  
Author(s):  
Manato Horii ◽  
Ryuichiro Akagi ◽  
Sho Takahashi ◽  
Shotaro Watanabe ◽  
Yuya Ogawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cohort Study ◽  
Children And Adolescents ◽  
Knee Pain ◽  
Prospective Cohort Study ◽  
Anterior Knee Pain ◽  
Prospective Cohort ◽  
Activity Level ◽  
Anterior Knee

Abstract Background: Anterior knee pain (AKP) is a common limitation to children’s participation in social and physical activities. Therefore, to prevent the occurrence and protraction of AKP, it is crucial to identify risk factors. The purpose of this study was to clarify the factors associated with the occurrence and protraction of AKP in children and adolescents. Method: A three-year prospective cohort study was conducted with children and adolescents aged 8–14 in Japan. We recorded the occurrence of AKP, heel buttock distance, straight leg raising angle (SLRA), dorsiflexion angle of the ankle joint, and the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS). Logistic regression analysis was performed to calculate the odds ratio (OR) for each predicted risk factor for the occurrence and protraction of AKP among subjects without AKP at baseline. Results: We recruited 1,254 children and adolescents for the present study, and 1,133 children and adolescents who did not have AKP at baseline were included in the analysis. Six to nine percent of the subjects developed AKP annually. A high HSS Pedi-FABS score significantly predicted AKP occurrence (in 2017, OR 1.07, 95% CI 1.02−1.12, p = 0.003; in 2018, OR 1.05, 95% CI 1.01−1.10, p = 0.025). Of the participants, 32.9% developed chronic AKP during the follow-up period. When 8-year-old was used as a reference age, 13-year-old subjects (right side, OR 2.37, 95% CI, 1.00−5.61, p = 0.05) and 14-year-old subjects (right side, OR 2.57, 95% CI, 1.00−6.60, p = 0.049; left side, OR 6.32; 95% CI 1.33−30.00, p = 0.020) were at a significantly higher risk of AKP protraction. Conclusions: This study showed that a greater physical activity level was a risk factor for the onset of anterior knee pain in childhood. In addition, one-third of the children and adolescents developed chronic knee pain, and elderly adolescents were at a higher risk of protraction.

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