scholarly journals Prevalence and factors associated with sepsis and septic shock in oncological patients in intensive therapy

2022 ◽  
Vol 75 (1) ◽  
Author(s):  
Miriam Maria Mota Silva ◽  
Danielle Samara Tavares de Oliveira-Figueiredo ◽  
Adilma da Cunha Cavalcanti

ABSTRACT Objectives: to analyze factors associated with sepsis and septic shock in cancer patients in the Intensive Care Unit. Methods: cross-sectional, retrospective study with a quantitative approach, with a sample of 239 patients in an oncology hospital. Secondary data from medical records were used. The outcome variable was “presence of sepsis and/or septic shock”; and exposures: sex, length of stay, origin, use of invasive procedures and primary tumor site. Descriptive, bivariate analyzes and multiple logistic regression models were performed. Results: the prevalence of sepsis was 95% CI: 14.7-24.7 and septic shock of 95% CI: 37.7-50.3. In the multiple analysis, sepsis and/or septic shock were associated with hospital stay longer than seven days, being from the Emergency Department, presence of invasive procedures and hematological site. Conclusions: sepsis and/or septic shock in cancer patients were associated with clinical characteristics and health care factors.

2021 ◽  
Author(s):  
Young-Taek Park ◽  
Kwang Gi Kim ◽  
Young Jae Kim

BACKGROUND Websites of hospitals and clinics play a critical role in delivering important clinical information between medical providers and patients. However, there have been few studies on its adoption. OBJECTIVE The objective of this study is to investigate the factors associated with the operation status of websites of medical facilities, defined by whether the facility has a website. METHODS A cross-sectional study design using secondary data was employed to investigate 1,519 hospitals (small hospitals with 30–100 beds), 33,043 medical clinics, and 18,240 dental clinics as of 2020. The study used the health insurance administrative data. The main outcome variable was the operation status of the website and independent variables were the location of study subjects, size of facilities, and advanced diagnostics medical equipment. The study used a logistic regression using SAS 9.4 version. RESULTS The percentage of small hospitals, clinics, and dental clinics with websites was 26.4%, 9.0%, and 6.6%, respectively. Several factors were significantly associated with running the websites: the years of operation (odds ratio [OR] 1.081,95% CI 1.064-1.098, P<.0001), number of physicians (OR 1.025; 95% CI 1.002-1.048, P=.030), and having a subway station near the hospital (OR 2.816; 95% CI 2.004-3.957, P<0.0001). The operation of the websites was related with the location of the facility, years of operation, number of physicians or dentists, having a subway station, and the number of clinics or dental clinics within the local areas in both clinics and dental clinics (P<.005). CONCLUSIONS This study showed that the proportion of small hospitals with websites was much higher than that of medical and dental clinics. However, the overall proportion was still low. Several facility-related and environmental factors were critically associated with website operations, but more factors affected small clinics and dental clinics.


2021 ◽  
pp. 105477382199968
Author(s):  
Anas Alsharawneh

Sepsis and neutropenia are considered the primary life-threatening complications of cancer treatment and are the leading cause of hospitalization and death. The objective was to study whether patients with neutropenia, sepsis, and septic shock were identified appropriately at triage and receive timely treatment within the emergency setting. Also, we investigated the effect of undertriage on key treatment outcomes. We conducted a retrospective analysis of all accessible records of admitted adult cancer patients with febrile neutropenia, sepsis, and septic shock. Our results identified that the majority of patients were inappropriately triaged to less urgent triage categories. Patients’ undertriage significantly prolonged multiple emergency timeliness indicators and extended length of stay within the emergency department and hospital. These effects suggest that triage implementation must be objective, consistent, and accurate because of the several influences of the assigned triage scoring on treatment and health outcomes.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elizabeth Katana ◽  
Bob Omoda Amodan ◽  
Lilian Bulage ◽  
Alex R. Ario ◽  
Joseph Nelson Siewe Fodjo ◽  
...  

Abstract Background In March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. Many countries in Sub-Saharan Africa, Uganda inclusive, implemented lockdowns, curfew, banning of both private and public transport systems, and mass gatherings to minimize spread. Social control measures for COVID-19 are reported to increase violence and discrimination globally, including in Uganda as some may be difficult to implement resulting in the heavy deployment of law enforcement. Media reports indicated that cases of violence and discrimination had increased in Uganda’s communities following the lockdown. We estimated the incidence and factors associated with experiencing violence and discrimination among Ugandans during the COVID-19 lockdown to inform control and prevention measures. Methods In April 2020, we conducted a secondary analysis of cross-sectional data under the International Citizen Project (ICP) to assess adherence to public health measures and their impact on the COVID-19 outbreak in Uganda. We analyzed data on violence and discrimination from the ICP study. We performed descriptive statistics for all the participants’ characteristics and created a binary outcome variable called experiencing violence and/or discrimination. We performed logistic regression analysis to identify the factors associated with experiencing violence and discrimination. Results Of the 1726 ICP study participants, 1051 (58.8%) were males, 841 (48.7%) were currently living with a spouse or partner, and 376 (21.8%) had physically attended work for more than 3 days in the past week. Overall, 145 (8.4%) experienced any form of violence and/or discrimination by any perpetrator, and 46 (31.7%) of the 145 reported that it was perpetrated by a law enforcement officer. Factors associated with experiencing violence or discrimination were: being male (AOR = 1.60 CI:1.10–2.33), having attended work physically for more than 3 days in the past week (AOR = 1.52 CI:1.03–2.23), and inability to access social or essential health services since the epidemic started (AOR = 3.10 CI:2.14–4.50). Conclusion A substantial proportion of Ugandan residents experienced violence and/or discrimination during the COVID-19 lockdown, mostly perpetrated by law enforcement officers. We recommend mitigation of the collateral impact of lockdowns with interventions that focus on improving policing quality, ensuring continuity of essential services, and strengthening support systems for vulnerable groups including males.


2021 ◽  
Author(s):  
Eyerusalem Worku ◽  
Hayat Aragaw ◽  
Damitie Kebede

Abstract Background Cancer is one of the leading causes of death in the world and it is considered that every fourth person dies of it. Under-nutrition is most commonly seen in cancer patients with some types of solid tumors, various chronic diseases, as well as in older persons and young children. This can result in longer hospital stay, reduced response to therapies, increased complications to therapy and surgery proceedings, poor survival and higher care costs. This study aimed to assess the prevalence and factors associated with under-nutrition on cancer patients attending Tikur Anbessa Specialized Hospital, Ethiopia.Methods Cross-sectional study was conducted from September to October 2018 among 347 cancer patients in Tikur Anbessa Specialized hospital Addis Ababa, Ethiopia. All cancer patients 18–65 years of age who were on the 2nd cycle and above treatment phase were included. Quantitative data was collected using questionnaires and the Patient Generated-Subjective Global Assessment (PG-SGA) score. Data was entered into Epi-Info version 7 and exported and analyzed by SPSS version 20. Both bivariate and multivariate logistic regression analyses were employed to identify the associated factors. Variables with 𝑃 value of less than 0.05 were considered as significant predictors.Results The prevalence of under-nutrition according to PG-SGA score result 202 (63.1%) and 88(27.5%) of the participants were moderately and severely undernourished, respectively. BMI of the participants also showed that 206 (64.4%) and 89 (27.8%) were normal and underweight, respectively. Two hundred seventy-six (86.3%) of the patients needed critical nutrition intervention. Performance status of ≥ 2 [AOR = 7.9, 95% CI (3.05, 20.48)] and cancer stage II, III & IV [AOR = 3.47, 95% CI (1.25, 9.58)], [AOR = 3.81, 95% CI (1.17, 12.31)] and [AOR = 6.11, 95% CI (1.48, 25.14)] were significantly associated with malnutrition on cancer patients at a P-value < 0.05.Conclusion The prevalence of under-nutrition is prevalent in the study area. Performance status of ≥ 2 and cancer stages were important factors associated with malnutrition in cancer patients. Screening and evaluation of nutritional status of the patients and planning nutritional therapy such as dietary supplements or enteral nutrition to counteract malnutrition on cancer patients should be implemented.


2019 ◽  
Vol 8 (12) ◽  
pp. 1003-1071
Author(s):  
Xinyan Zhang ◽  
Dongling Liu ◽  
Hongmei Dong ◽  
Yuxiang Li ◽  
Ye Zhang ◽  
...  

Aim: This study aimed to determine factors that influence delay in presentation among oral cancer patients. Materials & methods: A cross-sectional study with 128 Oral cancer patients receiving treatment from the Hospital of Stomatology, at Jilin University, in China, was conducted. Results: A total of 78 patients delayed seeking treatment for more than 3 weeks after noticing symptoms of oral anomaly. Patients who were male, farmers (Odds ratio [OR] = 2.617; 95% CI: 1.90–3.64), or currently smoking (OR = 4.651; 95% CI: 1.21–9.46), were more likely to delay. Patients alerted to the problem at a physical exam had much lower risk of delay than patients who discovered the disease independently (OR = 0.029; 95% CI: 0.01–0.30). Higher coping style scores (OR = 0.747; 95% CI: 0.47–1.18) and oral cancer knowledge scores (OR = 0.886; 95% CI: 0.60–2.01) were significantly correlated with shorter delays. Conclusion: Delay in presentation may be achieved through regular oral health screening and improved public education about factors influencing delay.


BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028646 ◽  
Author(s):  
Juan Li ◽  
Bei Wu ◽  
Kjerstin Tevik ◽  
Steinar Krokstad ◽  
AS Helvik

ObjectivesThe primary objective was to investigate the prevalence and factors associated with elevated alcohol consumption among older adults 65 years and above in China and Norway. The secondary objective was to compare the prevalence and factors in the two countries.DesignA secondary data analysis was conducted using two large cross-sectional studies (Chinese Longitudinal Healthy Longevity Survey data in 2008–2009 and Nord-Trøndelag Health Study data in 2006–2008).ParticipantsA total of 3223 (weighted) Chinese older adults and 6210 Norwegian older adults who responded drinking alcohol were included in the analysis.Outcome measuresThe dependent variable was elevated alcohol consumption, which was calculated as a ratio of those with elevated drinking among current drinkers. Multivariable logistic regression was used to test the dependent variable.ResultsThe prevalence of elevated alcohol consumption among current drinkers for the Chinese and Norwegian samples were 78.3% (weighted) and 5.1%, respectively. Being male was related to a higher likelihood of elevated alcohol consumption in both Chinese and Norwegian samples (OR=2.729, 95% CI 2.124 to 3.506, OR=2.638, 95% CI 1.942 to 3.585). Being older, with higher levels of education and a living spouse or partner were less likely to have elevated drinking in the Chinese sample (OR=0.497, 95% CI 0.312 to 0.794, OR=0.411, 95% CI 0.260 to 0.649, OR=0.533, 95% CI 0.417 to 0.682, respectively). Among Norwegian older adults, a higher level of education was related to higher likelihood of elevated drinking (OR=1.503, 95% CI 1.092 to 2.069, OR=3.020, 95% CI 2.185 to 4.175). Living in rural areas and higher life satisfaction were related to lower likelihood of elevated drinking in the Norwegian sample (OR=0.739, 95% CI 0.554 to 0.984, OR=0.844, 95% CI 0.729 to 0.977, respectively).ConclusionsThe elevated alcohol consumption patterns were strikingly different between China and Norway in regards to prevalence and socioeconomic distribution. To develop and implement culturally appropriate public health policies regarding alcohol in the future, public health policy makers and professionals need to be aware of the cultural differences and consider the demographic, social and economic characteristics of their intended population.


SAGE Open ◽  
2018 ◽  
Vol 8 (4) ◽  
pp. 215824401880458
Author(s):  
Robert Kaba Alhassan ◽  
Bismark Appiah Adu-Gyamfi ◽  
Agbolosu Oliver ◽  
Bright Ayensu ◽  
Gbekor Awoenam ◽  
...  

Abuse of injections, particularly in resource poor countries, remains a challenge evident in the increasing preference for therapeutic injections over oral medication. Objective of this study is to explore factors associated with patients’ preference for therapeutic injection over oral medication in the Volta Regional Hospital, Ho in Ghana. The study is a cross-sectional survey conducted among 200 patients accessing care in Volta Regional Hospital. Data were analyzed using STATA statistical software for data analysis. Univariate probit regression was used to ascertain factors associated with patients’ preference for therapeutic injections over oral medication (main outcome variable of interest). It was found that 74% of the 200 respondents preferred injection to oral medication. More outpatients preferred injectable medication over oral ( p = .041); 86% of the respondents said they never experienced complication related to injectable medication. Patients who perceived injection as more efficacious were more likely to opt for it over oral medication (coefficient = 2.22; SE = 0.33; p < .05). It is concluded that patients’ preference for injectable medication over oral remains high in Ghana, and this preference is significantly associated with patients’ perceptions on superiority of injections over oral medication. There is the need to intensify health education for clients and in-service trainings for health providers to control abuse of therapeutic injections and promote patient safety.


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