scholarly journals Risk factors for hydrocephalus following fourth ventricle tumor surgery: A retrospective analysis of 121 patients

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241853
Author(s):  
Tengyun Chen ◽  
Yanming Ren ◽  
Chenghong Wang ◽  
Bowen Huang ◽  
Zhigang Lan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Retrospective Analysis ◽  
Fourth Ventricle ◽  
Univariate Analysis ◽  
Tumor Resection ◽  
Tumor Location ◽  
Subtotal Resection ◽  
Independent Risk Factors ◽  
Postoperative Hydrocephalus

Background and aim Most patients who present with a fourth ventricle tumor have concurrent hydrocephalus, and some demonstrate persistent hydrocephalus after tumor resection. There is still no consensus on the management of hydrocephalus in patients with fourth ventricle tumor after surgery. The purpose of this study was to identify the factors that predispose to postoperative hydrocephalus and the need for a postoperative cerebrospinal fluid (CSF) diversion procedure. Materials and methods We performed a retrospective analysis of patients who underwent surgery of the fourth ventricle tumor between January 2013 and December 2018 at the Department of Neurosurgery in West China Hospital of Sichuan University. The characteristics of patients and the tumor location, tumor size, tumor histology, and preventive external ventricular drainage (EVD) that were potentially correlated with CSF circulation were evaluated in univariate and multivariate analysis. Results A total of 121 patients were enrolled in our study; 16 (12.9%) patients underwent postoperative CSF drainage. Univariate analysis revealed that superior extension (p = 0.004), preoperative hydrocephalus (p<0.001), and subtotal resection (p<0.001) were significantly associated with postoperative hydrocephalus. Multivariate analysis revealed that superior extension (p = 0.013; OR = 44.761; 95% CI 2.235–896.310) and subtotal resection (p = 0.005; OR = 0.087; 95% CI 0.016–0.473) were independent risk factors for postoperative hydrocephalus after resection of fourth ventricle tumor. Conclusion Superior tumor extension (into the aqueduct) and failed total resection of tumor were identified as independent risk factors for postoperative hydrocephalus in patients with fourth ventricle tumor.

Treatment with Granulocyte Colony-Stimulating Factor after Allogeneic Transplantation Increases the Risk of Hepatic Veno-Occlusive Disease and Death: A Retrospective Analysis of 440 Cases at a Single Center.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1753-1753
Author(s):  
Miwa Sakai ◽  
Kazuteru Ohashi ◽  
Takeshi Kobayashi ◽  
Takuya Yamashita ◽  
Hideki Akiyama ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Retrospective Analysis ◽  
Univariate Analysis ◽  
Allogeneic Transplantation ◽  
Occlusive Disease ◽  
Clinical Effects ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Stimulating Factor

Abstract Hepatic veno-occlusive disease (VOD) is one of the most serious complications of hematopoietic stem cell transplantation (HSCT). Various factors have been identified as increasing the risk of hepatic VOD; history of liver dysfunction, elevated AST level, transplant from an HLA-mismatched or unrelated donor, and abdominal irradiation, but few of them have been associated with a significantly increased risk. A recent study showed a newly association between the use of granulocyte colony-stimulating factor (G-CSF) and subsequent higher incidence of VOD. The present analysis was performed to elucidate the clinical effects of G-CSF on the incidence of hepatic VOD and survival after HSCT in a large group of patients at a single institution. We retrospectively reviewed 440 patients (264 males, 176 females; median age 35, range 0–67) with hematological diseases who underwent allogeneic transplantation between September 1986 and December 2003. G-CSF was given basically according to the primary diseases and type of transplant, and a total of 230 patients with lymphoid malignancy received G-CSF shortly after transplantation, while G-CSF was not administered in remaining 210 patients with myeloid malignancy. A diagnosis of VOD was made according to the McDonald’s criteria and 47 patients (11.0%) were eventually diagnosed with VOD. Hepatic VOD occurred in 33 of 230 patients (14%) in the patients with G-CSF versus 14 of 210 patients (6%) in the non G-CSF group. Several possible risk factors based on the previous studies, including the use of G-CSF, were counted on an initial univariate analysis and cumulated significant factors further analyzed for their potential value for VOD development in multivariate analysis. By univariate analysis, the HLA disparity, performance status before transplantation, febrile episode during conditioning therapy and the use of G-CSF were significantly related to the incidence of VOD. A multivariate analysis with logistic regression again identified the use of G-CSF as the factor that significantly influenced the occurrence of VOD, in addition to the former three independent variables. Our analysis of risk factors in this series confirmed some other published studies but differed for other factors. Surprisingly,the administration of G-CSF may have an adverse impact on the subsequent survival after transplantation. Patient survival probability was statistically different (p=0.0063) between two groups, as analyzed by the Kaplan-Meier plot: the ten year survival rate was 50±4% in the G-CSF group and 64±4% in the non G-CSF group (p=0.0063). There were a total of 98 deaths in the G-CSF group compared with 70 deaths in the non G-CSF group. Although relapse and GVHD were the most common cause of death in both groups, death due to hepatic failure/VOD/TMA was observed 10% in the G-CSF group versus 4% in the non G-CSF group. Our data based on retrospective analysis should be interpreted with some caution, but they have suggested that G-CSF might be involved in VOD development and also adversely affected the outcome. Although underlying mechanism how G-CSF adversely effect on survival should be multifactorial, it is possible that G-CSF could activate the coagulation system and therefore induce thrombotic events including VOD. Thus, this putative mechanism of G-CSF towards a prothrombotic tendency warrants a further clarification, and the use of G-CSF should be carefully assessed in transplant recipients.

Conjunctival melanoma: Risk factors for recurrent or new tumor in 540 patients at a single ocular oncology center

2020 ◽  
pp. 112067212097039
Author(s):  
Sarangdev Vaidya ◽  
Lauren A Dalvin ◽  
Antonio Yaghy ◽  
Richard Pacheco ◽  
Jerry A Shields ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Univariate Analysis ◽  
Tumor Location ◽  
Tumor Formation ◽  
Older Age ◽  
Conjunctival Melanoma ◽  
Secondary Tumor ◽  
Unit Increase ◽  
History Of

Purpose: To investigate risk factors for recurrent or new tumor in patients with conjunctival melanoma. Methods: Retrospective review of patients with conjunctival melanoma managed on the Ocular Oncology Service, Wills Eye Hospital from 1974 to 2019. Results: There were 540 patients with mean follow-up of 57.6 months, of whom 176 (33%) had recurrent or new tumor formation. Risk factors for recurrent or new tumor on univariate analysis included presentation at older age (OR: 1.02 [1.01–1.03] per 1-year increase in age, p = 0.002), history of prior conjunctival surgery (OR: 1.62 [1.05–2.49], p = 0.03), worse visual acuity at presentation (OR: 1.76 [1.04–2.98] per 1 log-unit increase, p = 0.04), more advanced AJCC clinical T-subcategory (OR: 1.08 [1.02–1.14] per 1 subcategory increase, p = 0.01), tumor primary location in tarsal conjunctiva (OR: 1.80 [1.09–2.98], p = 0.02), and secondary tumor involvement of the fornix (OR: 1.68 [1.06–2.65], p = 0.03), and eyelid (OR: 1.92 [1.07–3.43], p = 0.03). Risk factors on multivariate analysis using all demographics, clinical features, and tumor location included presentation at older age (OR: 1.02 [1.00–1.03], p = 0.01), history of prior conjunctival surgery (OR: 1.84 [1.16–2.94], p = 0.01), and more advanced AJCC clinical T-subcategory (OR: 1.07 [1.01–1.13] per one subcategory increase, p = 0.03). Conclusion: On multivariate analysis, the strongest predictors of recurrent or new tumor formation following treatment of conjunctival melanoma included older age, history of prior conjunctival surgery, and advanced AJCC T-subcategory. These results suggest that earlier detection and the first surgery in conjunctival melanoma management are critical for prevention of recurrent or new tumor, and we recommend prompt referral to an experienced surgeon.

scholarly journals Risk Factors for Severe 30-d Complications After Minimally Invasive Radical Cystectomy With Ileal Conduit

2020 ◽  
Author(s):  
Ming Xiao ◽  
Zhaohui Zhong ◽  
Jiannan Ren ◽  
Wei Xiong
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Radical Cystectomy ◽  
Ileal Conduit ◽  
Univariate Analysis ◽  
Comprehensive Complication Index ◽  
Estimated Blood Loss ◽  
Independent Risk Factors

Abstract Background: To investigate the risk factors for severe complications within 30 days in patients receiving minimally invasive radical cystectomy with ileal conduit(MIRCIC).Methods: 270 consecutive patients who underwent MIRCIC between January 1, 2013 and August 1, 2020 were included. All complications were graded according to the Clavien-Dindo classification(CDC). The comprehensive complication index(CCI) for all complications in each patient was calculated. CDC ≥ Ⅲ or CCI > 33.7 were considered to be severe complications. Univariate and multivariate analysis were conducted by SPSS26.Results: A total of 691 complications were collected from 236 patients and the corresponding overall complications rate was 87.41% (236/270). Patients with CDC ≥ Ⅲ accounted for 23.70% and the incidence of CCI > 33.7 was 22.96%. For the highest CDC grade ≥ Ⅲ, in univariate analysis, the following seven variants were enrolled in a multivariate analysis: BMI (P=0.010), baseline albumin(P=0.065), pT (P=0.082), pN (P=0.026), pTNM (P=0.016), intraoperative blood transfusion (P=0.031), estimated blood loss (P=0.001). In multivariate analysis, BMI ≥ 30kg/m2 (P=0.012) and estimated blood loss ≥ 400ml (P=0.005) were the independent risk factors of CDC ≥ Ⅲ. Hydronephrosis (P=0.050), BMI (P=0.006), pT (P=0.004), pN (P=0.019), pTNM (P=0.000), operative time (P=0.030), estimated blood loss (P=0.001) were the relevant factors in CCI > 33.7. However, BMI ≥ 30kg/m2 (P=0.004) and estimated blood loss (P=0.002) were the independent risk factors of CCI > 33.7.Conclusion: BMI ≥ 30kg/m2 and estimated blood loss ≥ 400ml were found to be independent predictors of 30-d severe complications (CDC ≥ Ⅲ or CCI > 33.7) in patients who underwent MIRCIC.

scholarly journals Predictors of hydrocephalus after lateral ventricular tumor resection

2021 ◽  
Author(s):  
Chengda Zhang ◽  
Lingli Ge ◽  
Tingbao Zhang ◽  
Zhengwei Li ◽  
Jincao Chen
Keyword(s):  
Risk Factors ◽  
Ventriculoperitoneal Shunt ◽  
Malignant Tumors ◽  
Obstructive Hydrocephalus ◽  
Tumor Resection ◽  
External Ventricular Drainage ◽  
Postoperative Hemorrhage ◽  
Ventricular Tumors ◽  
Independent Risk Factors ◽  
Postoperative Hydrocephalus

Abstract The aim of this study was to identify the predictors of postoperative hydrocephalus in patients with lateral ventricular tumors (LVTs) and to guide the management of perioperative hydrocephalus. We performed a retrospective analysis of patients who received LVT resection at the Department of Neurosurgery, Zhongnan Hospital of Wuhan University between January 2011 and March 2021. Patients were divided between a prophylactic external ventricular drainage (EVD) group and a non-prophylactic EVD group. We analyzed the non-prophylactic EVD group to identify predictors of acute postoperative hydrocephalus. We analyzed all enrolled patients to determine predictors of postoperative ventriculoperitoneal shunt placement. A total of 97 patients were included in this study. EVD was performed in 23 patients with postoperative acute obstructive hydrocephalus, nine patients with communicative hydrocephalus, and two patients with isolated hydrocephalus. Logistic regression analysis showed that tumor anterior invasion of the ventricle (P = 0.020) and postoperative hemorrhage (P = 0.004) were independent risk factors for postoperative acute obstructive hydrocephalus, while a malignant tumor (P = 0.004) was an independent risk factor for a postoperative ventriculoperitoneal shunt. In conclusion, anterior invasion of the lateral ventricle and postoperative hemorrhage are independent risk factors for acute obstructive hydrocephalus after LVT resection. Patients with malignant tumors have a greater risk of shunt dependence after LVT resection.

scholarly journals Hallux Rigidus: Prevalence and Risk Factors

2021 ◽  
Author(s):  
Yoshiyuki Senga ◽  
Akinobu Nishimura ◽  
Naoya Ito ◽  
Yukie Kitaura ◽  
Akihiro Sudo
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Univariate Analysis ◽  
Metatarsophalangeal Joint ◽  
The Elderly ◽  
Hallux Rigidus ◽  
Degenerative Arthritis ◽  
First Metatarsophalangeal Joint ◽  
Independent Risk Factors ◽  
Overall Ratio

Abstract Background: Hallux rigidus (HR) is a common degenerative arthritis of the first metatarsophalangeal joint. However, the epidemiology and risk factors of this pathology have yet to be clarified.Methods: This cohort study estimated the prevalence of and clarified risk factors for radiographic HR in individuals over 50 years old.Results: The prevalence of HR was 26.7% (161/604). Rates of grade 0, 1, 2, and 3 HR according to the Hattrup and Johnson classification were 73.3% (443/604), 16.4% (99/604), 8.0% (48/604), and 2.3% (14/604), respectively. Overall ratio of symptomatic HR was 8.1%. Univariate analysis revealed knee osteoarthritis (KOA), gout attack (GA), and hallux valgus (HV) as significantly associated with HR. The same factors were confirmed as independent risk factors for HR in multivariate analysis. All parameters were significantly associated with HR. Odds ratios of KOA, HV, and GA for HR were 1.73, 3.98, and 3.86, respectively. The presence or absence of KOA was significantly associated with severity of HR.Conclusion: Our study revealed the prevalence of HR in the elderly (≥50 years) was 26.7%, and KOA, HV, and GA were independent risk factors for HR. KOA was associated with severity of HR.

scholarly journals Risk factors for baclofen pump infection in children: a multivariate analysis

2016 ◽  
Vol 17 (6) ◽  
pp. 756-762 ◽  
Author(s):  
Heather S. Spader ◽  
Robert J. Bollo ◽  
Christian A. Bowers ◽  
Jay Riva-Cambrin
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Potential Risk ◽  
Univariate Analysis ◽  
Wound Dehiscence ◽  
Young Age ◽  
Csf Leak ◽  
Pump Placement ◽  
Potential Risk Factors ◽  
Independent Risk Factors

OBJECTIVE Intrathecal baclofen infusion systems to manage severe spasticity and dystonia are associated with higher infection rates in children than in adults. Factors unique to this population, such as poor nutrition and physical limitations for pump placement, have been hypothesized as the reasons for this disparity. The authors assessed potential risk factors for infection in a multivariate analysis. METHODS Patients who underwent implantation of a programmable pump and intrathecal catheter for baclofen infusion at a single center between January 1, 2000, and March 1, 2012, were identified in this retrospective cohort study. The primary end point was infection. Potential risk factors investigated included preoperative (i.e., demographics, body mass index [BMI], gastrostomy tube, tracheostomy, previous spinal fusion), intraoperative (i.e., surgeon, antibiotics, pump size, catheter location), and postoperative (i.e., wound dehiscence, CSF leak, and number of revisions) factors. Univariate analysis was performed, and a multivariate logistic regression model was created to identify independent risk factors for infection. RESULTS A total of 254 patients were evaluated. The overall infection rate was 9.8%. Univariate analysis identified young age, shorter height, lower weight, dehiscence, CSF leak, and number of revisions within 6 months of pump placement as significantly associated with infection. Multivariate analysis identified young age, dehiscence, and number of revisions as independent risk factors for infection. CONCLUSIONS Young age, wound dehiscence, and number of revisions were independent risk factors for infection in this pediatric cohort. A low BMI and the presence of either a gastrostomy or tracheostomy were not associated with infection and may not be contraindications for this procedure.

scholarly journals Incidence and risk factors of preoperative venous thromboembolism in patients with malignant musculoskeletal tumors: an analysis based on D-dimer screening and imaging

2021 ◽  
Author(s):  
Kenta Hayashida ◽  
Yusuke Kawabata ◽  
Keiju Saito ◽  
Shintaro Fujita ◽  
Hyonmin Choe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Roc Analysis ◽  
Tumor Location ◽  
Lower Limbs ◽  
Cutoff Value ◽  
Increased Risk ◽  
Orthopedic Oncology ◽  
Independent Risk Factors ◽  
D Dimer

Abstract Background: Venous thromboembolism (VTE) is a major complication in patients with malignant tumors and orthopedic disorders. Although it is known that patients undergoing surgery for orthopedic oncology are at an increased risk of thromboembolic events, only few studies have investigated this risk in detail. Therefore, the aim of this study was to determine the incidence and risk factors for preoperative VTE in orthopedic oncology patients.Methods: We retrospectively reviewed the medical records of 270 patients who underwent surgical procedures, including biopsy for orthopedic oncology, have undergone measurements of preoperative D-dimer levels, and were subsequently screened for VTE by lower extremity venous ultrasonography and/or contrast-enhanced computed tomography scans. Statistical analyses were performed to examine the incidence and risk factors for VTE. Receiver operating characteristic (ROC) analysis was performed to verify the D-dimer cutoff value for the diagnosis of VTE.Results: Overall, 199 patients (103 with primary soft tissue sarcomas, 38 with primary bone sarcomas, 46 with metastatic tumors, and 12 with hematologic malignancies) were included. D-dimer levels were high in 79 patients; VTE was detected in 19 patients (9.5%). Multivariate analysis indicated that age ≥60 years (P = 0.021) and tumor location in the lower limbs (P = 0.048) were independent risk factors for VTE. ROC analysis showed that the D-dimer cutoff value for the diagnosis of VTE was 1.53 µg/mL; the sensitivity and specificity were 89.5% and 79.4%, respectively.Conclusions: Our study indicated that age and tumor location in the lower limbs were independent risk factors for preoperative VTE in orthopedic oncology patients. D-dimer levels were not associated with VTE in the multivariate analysis, likely because they are affected by a wide variety of conditions, such as malignancy and aging. Patients with high D-dimer levels and the identified risk factors are at an increased risk of preoperative VTE, and additional ultrasonography should be considered.Trial registration: Our study was approved by the institutional review board. The registration number is B200600056. The registration date was July 13, 2020.

Identifying patients with CKD risk at the time of nephrectomy: When to initiate nephrology consult

2021 ◽  
pp. 239936932110319
Author(s):  
Yihe Yang ◽  
Zachary Kozel ◽  
Purva Sharma ◽  
Oksana Yaskiv ◽  
Jose Torres ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Radical Nephrectomy ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Interstitial Fibrosis ◽  
Kidney Neoplasm ◽  
Tubular Atrophy ◽  
Independent Risk Factors

Introduction: The prevalence of chronic kidney disease (CKD) is high among kidney neoplasm patients because of the overlapping risk factors. Our purpose is to identify kidney cancer survivors with higher CKD risk. Methods: We studied a retrospective cohort of 361 kidney tumor patients with partial or radical nephrectomy. Linear mixed model was performed. Results: Of patients with follow-up >3 months, 84% were identified retrospectively to fulfill criteria for CKD diagnosis, although CKD was documented in only 15%. Urinalysis was performed in 205 (57%) patients at the time of nephrectomy. Multivariate analysis showed interstitial fibrosis and tubular atrophy (IFTA) >25% ( p = 0.005), severe arteriolar sclerosis ( p = 0.013), female gender ( p = 0.024), older age ( p = 0.012), BMI ⩾ 25 kg/m2 ( p < 0.001), documented CKD ( p < 0.001), baseline eGFR ⩽ 60 ml/min/1.73 m2 ( p < 0.001), and radical nephrectomy ( p < 0.001) were independent risk factors of lower eGFR at baseline and during follow-up. Average eGFR decreased within 3 months post nephrectomy. However, patients with different risk levels showed different eGFR time trend pattern at longer follow-ups. Multivariate analysis of time × risk factor interaction showed BMI, radical nephrectomy and baseline eGFR had time-dependent impact. BMI ⩾ 25 kg/m2 and radical nephrectomy were associated with steeper eGFR decrease slope. In baseline eGFR > 90 ml/min/1.73 m2 group, eGFR rebounded to pre-nephrectomy levels during extended follow-up. In partial nephrectomy patients with baseline eGFR ⩾ 90 ml/min/1.73 m2 ( n = 61), proteinuria ( p < 0.001) and BMI ( p < 0.001) were independent risk factors of decreased eGFR during follow up. Conclusions: As have been suggested by others and confirmed by our study, proteinuria and CKD are greatly under-recognized. Although self-evident as a minimum workup for nephrectomy patients to include SCr, eGFR, urinalysis, and proteinuria, the need for uniform applications of this practice should be reinforced. Non-neoplastic histology evaluation is valuable and should include an estimate of global sclerosis% (GS) and IFTA%. Patients with any proteinuria and/or eGFR ⩽ 60 at the time of nephrectomy or in follow-up with urologists, and/or >25% GS or IFTA, should be referred for early nephrology consultation.

scholarly journals Risk factors for cholesterol polyp formation in the gallbladder are closely related to lipid metabolism

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhihao Yu ◽  
Changlin Yang ◽  
Xuesong Bai ◽  
Guibin Yao ◽  
Xia Qian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Low Density Lipoprotein ◽  
Univariate Analysis ◽  
Density Lipoprotein ◽  
High Volume ◽  
Population Characteristics ◽  
Polyp Formation ◽  
Logistic Analysis ◽  
Cholesterol Polyp ◽  
Independent Risk Factors

Abstract Background The purpose of this study was to assess the risk factors for cholesterol polyp formation in the gallbladder. Methods This was a multicenter retrospective study based on pathology. From January 2016 to December 2019, patients who underwent cholecystectomy and non-polyp participants confirmed by continuous ultrasound follow-ups were reviewed. Patients in the cholesterol polyp group were recruited from three high-volume centers with a diagnosis of pathologically confirmed cholesterol polyps larger than 10 mm. Population characteristics and medical data were collected within 24 h of admission before surgery. The non-polyp group included participants from the hospital physical examination center database. They had at least two ultrasound examinations with an interval longer than 180 days. Data from the final follow-up of the non-polyp group were analyzed. The risk factors for cholesterol polyp formation were analyzed by comparing the two groups. Results A total of 4714 participants were recruited, including 376 cholesterol polyp patients and 4338 non-polyp participants. In univariate analysis, clinical risk factors for cholesterol polyps were age, male sex, higher body mass index (BMI), higher low-density lipoprotein (LDL), lower high-density lipoprotein (HDL), and higher aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. In multivariate logistic analysis, independent risk factors were age > 50 years (odds ratio [OR] = 3.02, 95% confidence interval [CI] 2.33–3.91, P < 0.001], LDL > 2.89 mmol/L (OR = 1.38, 95% CI 1.08–1.78, P = 0.011), lower HDL (OR = 1.78 95% CI 1.32–2.44, P < 0.001), AST > 40 IU/L (OR = 3.55, 95% CI 2.07–6.07, P < 0.001), and BMI > 25 kg/m 2 (OR = 1.32, 95% CI 1.01–1.72, P = 0.037). Conclusions Age, LDL, HDL, AST, and BMI are strong risk factors for cholesterol polyp formation. Older overweight patients with polyps, accompanied by abnormal lipid levels, are at high risk for cholesterol polyps.

scholarly journals Stroke prediction in patients presenting with isolated dizziness in the emergency department

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
June-sung Kim ◽  
Hong Jun Bae ◽  
Muyeol Kim ◽  
Shin Ahn ◽  
Chang Hwan Sohn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Multivariate Analysis ◽  
Acute Stroke ◽  
Neurological Deficits ◽  
Cerebrovascular Injury ◽  
Risk Patients ◽  
History Of ◽  
Independent Risk Factors ◽  
Record Review

AbstractDiagnosing stroke in patients experiencing dizziness without neurological deficits is challenging for physicians. The aim of this study was to evaluate the prevalence of acute stroke in patients who presented with isolated dizziness without neurological deficits at the emergency department (ED), and determine the relevant stroke predictors in this population. This was an observational, retrospective record review of consecutive 2215 adult patients presenting with dizziness at the ED between August 2019 and February 2020. Multivariate analysis was performed to identify risk factors for acute stroke. 1239 patients were enrolled and analyzed. Acute stroke was identified in 55 of 1239 patients (4.5%); most cases (96.3%) presented as ischemic stroke with frequent involvement (29.1%) of the cerebellum. In the multivariate analysis, the history of cerebrovascular injury (odds ratio [OR] 3.08 [95% confidence interval {CI} 1.24 to 7.67]) and an age of > 65 years (OR 3.01 [95% CI 1.33 to 6.83]) were the independent risk factors for predicting acute stroke. The combination of these two risks showed a higher specificity (94.26%) than that of each factor alone. High-risk patients, such as those aged over 65 years or with a history of cerebrovascular injury, may require further neuroimaging workup in the ED to rule out stroke.

Sign in / Sign up

Export Citation Format

Share Document