Risk factors for pregnancy-associated venous thromboembolism in Singapore

AbstractObjectivesPregnancy-associated venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), is associated with increased risk of maternal mortality and morbidity. This study aimed to assess potential risk factors for pregnancy-associated VTE.MethodsIn this case-control study, women with pregnancy-associated VTE were identified via International Classification of Diseases codes and included if they had been objectively diagnosed with VTE during pregnancy or within six weeks postpartum, from 2004 to 2016, at KK Women’s and Children’s Hospital or Singapore General Hospital in Singapore. Controls, i.e. pregnant women without VTE, were selected from a prospective longitudinal study. The odds ratio (OR) for VTE was computed for a range of maternal and obstetric factors.Results and conclusionsFrom 2004 to 2016, 89 cases of pregnancy-associated VTE and 926 controls were identifed and analysed using logistic regression. The most significant risk factors for pregnancy-associated VTE were smoking (OR 5.44, p=0.0002) and preterm delivery (OR 5.06, p=0.023). Malay race, multiparity, non-O blood group and caesarean section, were also identified to be of higher risk. These risk factors should be useful in the development of thromboprophylaxis strategies for pregnancy and the postpartum period, especially in Singapore.

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Post-Bariatric Abdominoplasty: Analysis of 406 Cases With Focus on Risk Factors and Complications

Aesthetic Surgery Journal ◽

10.1093/asj/sjaa067 ◽

2020 ◽

Vol 41 (1) ◽

pp. 59-71 ◽

Cited By ~ 3

Author(s):

Torsten Schlosshauer ◽

Marcus Kiehlmann ◽

Diana Jung ◽

Robert Sader ◽

Ulrich M Rieger

Keyword(s):

Risk Factors ◽

Wound Healing ◽

Surgical Technique ◽

Significant Risk ◽

Level Of Evidence ◽

Increased Risk ◽

Potential Risk Factors ◽

Wound Healing Problems ◽

Bariatric Patients

Abstract Background Post-bariatric patients present a surgical challenge within abdominoplasty because of residual obesity and major comorbidities. In this study, we analyzed complications following abdominoplasty in post-bariatric patients and evaluated potential risk factors associated with these complications. Objectives The authors sought to determine the complications and risk factors following abdominoplasty in post-bariatric patients. Methods A retrospective study of patients who underwent abdominoplasty was performed from January 2009 to December 2018 at our institution. Variables analyzed were sex, age, body mass index (BMI), smoking, surgical technique, operative time, resection weight, drain output, and complications. Results A total of 406 patients were included in this study (320 female and 86 male) with a mean age of 44.4 years and a BMI of 30.6 kg/m2. Abdominoplasty techniques consisted of traditional (64.3%), fleur-de-lis technique (27.3%), and panniculectomy without umbilical displacement (8.4%). Overall complications recorded were 41.9%, the majority of these being wound-healing problems (32%). Minor and major complications were found in 29.1% and 12.8% of patients, respectively. A BMI value of ≥30 kg/m2 was associated with an increased risk for wound-healing problems (P = 0.001). The frequency of total complications was significantly related to age (P = 0.007), BMI (P = 0.004), and resection weight (P = 0.001). Abdominoplasty technique tended to influence total complications. Conclusions This study demonstrates in a fairly large sample of post-bariatric patients (n = 406) that abdominoplasty alone can be performed safely, with an acceptable complication rate. Age, BMI, and resection weight are shown to be significant risk factors for total complications. The role of surgical technique needs to be evaluated further. Level of Evidence: 4

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Influence of Tumor Thrombus on Occurrence of Distant Venous Thromboembolism and Survival in Patients With Renal Cell Carcinoma After Surgery

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029618823288 ◽

2019 ◽

Vol 25 ◽

pp. 107602961882328 ◽

Cited By ~ 1

Author(s):

Hyunkyung Park ◽

Chang Wook Jeong ◽

Hyeongdong Yuk ◽

Ja Hyeon Ku ◽

Hyeon Hoe Kim ◽

...

Keyword(s):

Risk Factors ◽

Renal Cell Carcinoma ◽

Venous Thromboembolism ◽

Cell Carcinoma ◽

Renal Cell ◽

Tumor Thrombus ◽

Multivariable Analysis ◽

Significant Risk ◽

Increased Risk ◽

The Impact

Tumor thrombus is a unique characteristic of renal cell carcinoma (RCC). However, only a few studies have reported its clinical influence on the occurrence of venous thromboembolism (VTE). This study aimed to clarify the influence of tumor thrombus and other risk factors for VTE and to elucidate the impact of tumor thrombus on survival outcomes. We retrospectively reviewed data from patients with RCC who underwent radical or partial nephrectomy from September 1999 to August 2015 at Seoul National University Hospital. A total of 2762 patients were enrolled. The 1- and 5-year cumulative incidences of VTE were 0.5% ± 0.1% and 1.5% ± 0.3%, respectively. During a median follow-up of 39.0 months (95% confidence interval [CI], 37.1-41.0 months), deep vein thrombosis occurred in 13 patients and pulmonary embolism in 15 patients. Patients with tumor thrombus (diagnosed by surgical pathology findings) had a significantly higher incidence of VTE than those without thrombus (odds radio 8.160, 95% CI, 1.480-45.004). Older age (≥60 years) and higher preoperative C-reactive protein (>0.5 mg/dL) were also significant risk factors for VTE. Additionally, tumor thrombus was independently associated with worse progression-free survival (PFS) but not with overall survival (OS) in multivariable analysis (hazard ratio [HR] 1.916, 95% CI, 1.295-2.834 for PFS; HR 1.164, 95% CI, 0.755-1.793 for OS). In conclusion, the incidence of VTE was relatively low in patients who underwent surgery for RCC. Nevertheless, patients with tumor thrombus had an increased risk of VTE and should be closely monitored for VTE.

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Large overjet as a risk factor of traumatic dental injuries: a prospective longitudinal study

Progress in Orthodontics ◽

10.1186/s40510-020-00341-5 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Jean-Paul Schatz ◽

Enrico Ostini ◽

Magnus Hakeberg ◽

Stavros Kiliaridis

Keyword(s):

Risk Factor ◽

Prospective Study ◽

Significant Risk ◽

Dental Trauma ◽

Significant Risk Factor ◽

Prospective Longitudinal Study ◽

Increased Risk ◽

Traumatic Dental Injuries ◽

Dental Injuries ◽

Prospective Longitudinal

Abstract Purpose The aim of this longitudinal prospective study was to evaluate if schoolchildren with large overjet experience a greater risk of traumatic dental injuries (TDI) compared to children with normal or small overjet. Methods A sample of children aged 6‑13 years was prospectively evaluated after 1 year: from the initial sample, data concerning trauma cases of 1413 children were collected to determine the number and types of injuries, the influence of overjet on the risk of TDI, and the relationships between trauma, age, and gender. Results The observed prevalence of trauma was higher for boys, with the largest frequency between the ages of 8 to 12 years: 67.9% of all injuries were hard tissue injuries and 32.1% subluxation and luxation injuries. Children with an overjet of 6 mm or more showed a statistically increased risk of getting trauma [RR = 3.37 with CI (1.81; 6.27)]. Conclusion In this prospective study, overjet stood out among variables as the most significant risk factor of TDI: an increased overjet of 6 mm or more had a major impact on the risk of trauma, which would speak in favor of early orthodontic correction of an increased overjet to reduce the prevalence of dental trauma

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Risk factors for surgical site infections in neurosurgery

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2019.0001 ◽

2019 ◽

Vol 101 (3) ◽

pp. 220-225 ◽

Cited By ~ 2

Author(s):

S Patel ◽

D Thompson ◽

S Innocent ◽

V Narbad ◽

R Selway ◽

...

Keyword(s):

Risk Factors ◽

Significant Risk ◽

Surgical Site Infections ◽

Reoperation Rate ◽

High Morbidity ◽

Clinical Notes ◽

Increased Risk ◽

Public Data ◽

Potential Risk Factors ◽

Risk Patients

Introduction Surgical site infections (SSIs) are of profound significance in neurosurgical departments, resulting in high morbidity and mortality. There are limited public data regarding the incidence of SSIs in neurosurgery. The aim of this study was to determine the rate of SSIs (particularly those requiring reoperation) over a seven-year period and identify factors leading to an increased risk. Methods An age matched retrospective analysis was undertaken of a series of 16,513 patients at a single centre. All patients who required reoperation for suspected SSIs within a 7-year period were identified. Exclusion criteria comprised absence of infective material intraoperatively and patients presenting with primary infections. Clinical notes were reviewed to confirm presence or absence of suspected risk factors. Results Of the 16,513 patients in the study, 1.20% required at least one further operation to treat a SSI. Wound leak (odds ratio [OR]: 27.41), dexamethasone use (OR: 3.55), instrumentation (OR: 2.74) and operative duration >180 minutes (OR: 1.85) were statistically significant risk factors for reoperation. Conclusions This is the first UK study of such a duration that has documented a SSI reoperation rate in a cohort of this size. Various risk factors are associated with the development of SSIs, making it essential to have robust auditing and monitoring of high risk patients to ensure excellent standards of healthcare. Departmental and public registers to record all SSIs may be beneficial, particularly for those treated solely by general practitioners, allowing units to address potential risk factors prior to surgical intervention.

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The Golden Retriever Lifetime Study: establishing an observational cohort study with translational relevance for human health

Philosophical Transactions of the Royal Society B Biological Sciences ◽

10.1098/rstb.2014.0230 ◽

2015 ◽

Vol 370 (1673) ◽

pp. 20140230 ◽

Cited By ~ 22

Author(s):

Michael K. Guy ◽

Rodney L. Page ◽

Wayne A. Jensen ◽

Patricia N. Olson ◽

J. David Haworth ◽

...

Keyword(s):

Risk Factors ◽

Biological Sample ◽

Disease Incidence ◽

Historical Context ◽

Quality Data ◽

Golden Retriever ◽

Prospective Longitudinal Study ◽

Incidence Data ◽

Potential Risk Factors ◽

Prospective Longitudinal

The Golden Retriever Lifetime Study (GRLS) is the first prospective longitudinal study attempted in veterinary medicine to identify the major dietary, genetic and environmental risk factors for cancer and other important diseases in dogs. The GRLS is an observational study that will follow a cohort of 3000 purebred Golden Retrievers throughout their lives via annual online questionnaires from the dog owner and annual physical examinations and collection of biological samples by the primary care veterinarian. The field of comparative medicine investigating naturally occurring disorders in pets is specifically relevant to the many diseases that have a genetic basis for disease in both animals and humans, including cancer, blindness, metabolic and behavioural disorders and some neurodegenerative disorders. The opportunity for the GRLS to provide high-quality data for translational comparative medical initiatives in several disease categories is great. In particular, the opportunity to develop a lifetime dataset of lifestyle and activity, environmental exposure and diet history combined with simultaneous annual biological sample sets and detailed health outcomes will provide disease incidence data for this cohort of geographically dispersed dogs and associations with a wide variety of potential risk factors. The GRLS will provide a lifetime historical context, repeated biological sample sets and outcomes necessary to interrogate complex associations between genes and environmental influences and cancer.

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Risk factors and protective factors of depression in older people 65+. A systematic review

PLoS ONE ◽

10.1371/journal.pone.0251326 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0251326

Author(s):

Alexander Maier ◽

Steffi G. Riedel-Heller ◽

Alexander Pabst ◽

Melanie Luppa

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Older People ◽

Smoking Behavior ◽

Significant Risk ◽

Female Gender ◽

Assessment Tools ◽

Mobility Impairment ◽

Increased Risk ◽

Potential Risk Factors

Objectives Identifying risk factors of depression can provide a better understanding of the disorder in older people. However, to minimize bias due to the influence of confounders and to detect reverse influence, a focus on longitudinal studies using multivariate analysis is required. Design A systematic literature search was conducted by searching the databases MEDLINE, Cochrane, PsycINFO and Web of Science for all relevant articles published from January 2000 to the end of March 2020. The following inclusion criteria were used: prospective design, nationally or regionally representative sample, published in English or German, analyzed risk factors for depression of individuals 65+ identified by multivariate analysis, and provided validity of diagnostic instrument. All results of multivariate analysis were reported and summarized. Results Thirty articles were identified. Heterogeneous results were found for education, female gender, self-rated health, cognitive impairment and older age, although significant in several studies. Findings hinted at a protective quality of physical activity. In terms of physical health, chronic disease and difficulty initiating sleep homogeneously increased risk of depression. Mobility impairment resulted as a risk factor in three studies. IADL impairment and vision impairment were mostly identified as significant risk factors. Alcohol consumption and smoking behavior yielded heterogenous results. Psychosocial factors were assessed similarly in multiple studies and yielded heterogenous results. Limitations Research was limited to articles published in English or German. Length of follow up was not considered for the presentation of results. Adjustments for and inclusion of different variables in the studies may distort results. Conclusion Our findings demonstrate the necessity of refined, more comparable assessment tools for evaluating potential risk factors.

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PSV-1 A prospective longitudinal study of the incidence and risk factors associated with footrot in feedlot lambs in Southern Alberta

Journal of Animal Science ◽

10.1093/jas/skaa278.417 ◽

2020 ◽

Vol 98 (Supplement_4) ◽

pp. 227-227

Author(s):

Karen S Schwartzkopf-Genswein ◽

Wiolene M Nordi ◽

Désirée Gellatly ◽

Daniela M Meléndez ◽

Timothy D Schwinghamer ◽

...

Keyword(s):

Risk Factors ◽

Significant Risk ◽

Prospective Longitudinal Study ◽

Factors Associated ◽

Southern Alberta ◽

Unit Increase ◽

Feedlot Lambs ◽

Potential Strategy ◽

Associated Risk Factors ◽

Prospective Longitudinal

Abstract Lameness in sheep caused by footrot (FR) is a significant health, welfare, and economic concern worldwide. To date, no studies have documented the incidence of FR or associated risk factors in feedlot lambs in Alberta. The objectives of this study were to determine 1) FR incidence and 2) animal, managerial and environmental risk factors associated with FR in one Southern Alberta, lamb feedlot. Assessments were conducted biweekly (average of 10 pens per visit) by 2 experienced observers. A total of 73,150 lambs were assessed between October 2017 and March 2019. All lame lambs were scored according to a 3-point mobility scale (1 = mild, 2 = moderate, and 3 = severe lameness) and physically examined to diagnose the cause of lameness. Risk factors associated with FR were documented and included gender, days on feed (DOF), diet composition, and season. Multivariable regression models (SAS PROC GLIMMIX) were used to determine significant risk factors. A total of 473 lambs were identified as lame, 107 of which were diagnosed with FR (incidence of 22.6%). Footrot affected lambs had greater mobility scores (≥ 2; P < 0.0001) than all other lame diagnoses. Footrot was 4.40 and 0.10 times more likely (P < 0.0001) in female and wether than ram lambs, and 0.60 and 0.23 times more likely (P < 0.0001) in fall and summer than winter and spring seasons. The odds of being diagnosed with FR increased for each additional DOF and each unit increase of barley in the diet (P = 0.0268), while the odds decreased (P = 0.0016) for each additional unit of supplement in the diet. Based on our findings, footrot is an issue to lambs in Alberta, and further studies are still necessary to understand the risk factors associated with potential strategy for mitigating FR in feedlot lambs.

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Chronic hypersensitivity pneumonitis is associated with an increased risk of venous thromboembolism: a retrospective cohort study

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01794-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Małgorzata Sobiecka ◽

Monika Szturmowicz ◽

Katarzyna Lewandowska ◽

Agata Kowalik ◽

Ewa Łyżwa ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Venous Thromboembolism ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Hypersensitivity Pneumonitis ◽

Significant Risk ◽

Increased Risk ◽

Chronic Hypersensitivity Pneumonitis ◽

Incident Cases

Abstract Background Idiopathic pulmonary fibrosis (IPF) and chronic hypersensitivity pneumonitis share commonalities in pathogenesis shifting haemostasis balance towards the procoagulant and antifibrinolytic activity. Several studies have suggested an increased risk of venous thromboembolism in IPF. The association between venous thromboembolism and chronic hypersensitivity pneumonitis has not been studied yet. Methods A retrospective cohort study of IPF and chronic hypersensitivity pneumonitis patients diagnosed in single tertiary referral center between 2005 and 2018 was conducted. The incidence of symptomatic venous thromboembolism was evaluated. Risk factors for venous thromboembolism and survival among those with and without venous thromboembolism were assessed. Results A total of 411 (259 IPF and 152 chronic hypersensitivity) patients were included (mean age 66.7 ± 8.4 vs 51.0 ± 13.3 years, respectively). There were 12 (4.6%) incident cases of venous thromboembolism in IPF and 5 (3.3%) in chronic hypersensitivity pneumonitis cohort. The relative risk (RR) of venous thromboembolism in chronic hypersensitivity pneumonitis was not significantly different to that found in patients with IPF (7.1 vs 11.8/1000 person-years, RR 1.661 95% CI 0.545–6.019, respectively). The treatment with systemic steroids (OR 5.38; 95% CI 1.65–18.8, p = 0.006) and GAP stage 3 (OR 7.85; 95% CI 1.49–34.9; p = 0.037) were significant risk factors for venous thromboembolism in IPF. Arterial hypertension and pulmonary hypertension significantly increased risk of venous thromboembolism in chronic hypersensitivity pneumonitis. There were no significant differences in survival between patients with and without venous thromboembolism. Conclusions The patients with chronic hypersensitivity pneumonitis have a marked increase in the risk of venous thromboembolism, similar to the patients with IPF. Venous thromboembolism does not affect the survival of patients with IPF and chronic hypersensitivity pneumonitis.

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Incidence and risk factors for H5 highly pathogenic avian influenza infection in flocks of apparently clinically healthy ducks

Epidemiology and Infection ◽

10.1017/s0950268812001100 ◽

2012 ◽

Vol 141 (2) ◽

pp. 390-401 ◽

Cited By ~ 5

Author(s):

J. HENNING ◽

J. M. MORTON ◽

H. WIBAWA ◽

D. YULIANTO ◽

T. B. USMAN ◽

...

Keyword(s):

Risk Factors ◽

Avian Influenza ◽

Highly Pathogenic Avian Influenza ◽

Influenza Infection ◽

Incidence Rates ◽

Highly Pathogenic ◽

Prospective Longitudinal Study ◽

Pathogenic Avian Influenza ◽

Increased Risk ◽

Prospective Longitudinal

SUMMARYA prospective longitudinal study was conducted on 96 smallholder duck farms in Indonesia over a period of 14 months in 2007 and 2008 to monitor bird- and flock-level incidence rates of H5 highly pathogenic avian influenza (HPAI) infection in duck flocks, and to identify risk factors associated with these flocks becoming H5 seropositive. Flocks that scavenged around neighbouring houses within the village were at increased risk of developing H5 antibodies, as were flocks from which carcases of birds that died during the 2 months between visits were consumed by the family. Duck flock confinement overnight on the farm and sudden deaths of birds between visits were associated with lower risk of the flock developing H5 antibodies. Scavenging around neighbouring houses and non-confinement overnight are likely to be causal risk factors for infection. With this study we have provided insights into farm-level risk factors of HPAI virus introduction into duck flocks. Preventive messages based on these risk factors should be included in HPAI awareness programmes.

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Can We Identify Risk Factors for Postoperative Delirium in Cardiac Coronary Patients? Our Experience

The Heart Surgery Forum ◽

10.1532/hsf98.20111166 ◽

2012 ◽

Vol 15 (4) ◽

pp. 195 ◽

Cited By ~ 7

Author(s):

Bojan D. Nikolić ◽

Svetozar M. Putnik ◽

Dejan M. Lazovic ◽

Mile D. Vranes

Keyword(s):

Risk Factors ◽

Predictive Factors ◽

Postoperative Delirium ◽

Confusion Assessment Method ◽

Assessment Method ◽

Negative Consequences ◽

Mortality And Morbidity ◽

Prolonged Intubation ◽

Increased Risk ◽

Potential Risk Factors

Introduction: Delirium is a temporary mental disorder that frequently occurs among elderly hospitalized patients. Patients who undergo cardiac operations have an increased risk of postoperative delirium, which is associated with higher mortality and morbidity rates, a prolonged hospital stay, and reduced cognitive and functional recovery.Patients and Methods: In our prospective study, we included 370 consecutive adult patients who underwent on-pump coronary artery surgery between January 1, 2011, and July 1, 2011. We selected 21 potential risk factors and divided them into preoperative, intraoperative, and postoperative groups. Delirium was diagnosed with the Confusion Assessment Method.Results: Postoperative delirium was diagnosed in 74 patients (20%). Four predictive factors were associated with postoperative delirium: diabetes mellitus, cerebrovascular disease, peripheral vascular disease, and prolonged intubation (P < .05).Conclusion: Three of the four predictive factors significantly associated with delirium are preoperative. They are relatively easy to measure and can be used to identify patients at higher risk. Fast extubation of these patients and preventive interventions can be taken to prevent negative consequences of this postoperative complication.

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