scholarly journals Analysis of clinico-demographic risk factors for postoperative pulmonary complications following gastrointestinal surgery

2019 ◽  
Vol 7 (1) ◽  
pp. 93
Author(s):  
Vijay Sinouvassan ◽  
Hemalatha Dayalane ◽  
Subalakshmi Balagurunathan ◽  
Ashok Kumar Sahoo ◽  
Vishnu Kanth ◽  
...  
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Gastrointestinal Surgery ◽  
Pulmonary Complications ◽  
Lung Pathology ◽  
Postoperative Pulmonary Complications ◽  
Increased Risk ◽  
Education Status ◽  
Demographic Risk ◽  
Demographic Risk Factors

Background: Postoperative pulmonary complications (PPC) are one of the commonest complications following gastrointestinal surgery. They lead to increased mortality, increased length of intensive care unit (ICU) stay, and higher cost of treatment. Identifying the risk factors of PPC helps in predicting its occurrence and to develop preventive measures. The objectives of the present study were to study the clinical and demographic risk factors for PPC following gastrointestinal surgery.Methods: The study was designed as an observational descriptive analytic study. All the patients ≥18 years of age undergoing gastrointestinal surgery were included. The patients with preoperative lung pathology requiring ICU care or ventilatory support and patients with lung metastasis were excluded. The demographic and clinical parameters at admission were recorded. The details of pulmonary complications like the time of occurrence after surgery and the mode of treatment for pulmonary complications were noted. The risk association was assessed for statistical significance.Results: A total of 100 patients were underwent various gastrointestinal surgeries during the study period. The incidence of PPC was 34% in our study. Age, education status, smoking, and presence of comorbidities were found to be positively associated with an increased incidence of PPCs. The serum albumin of less than 3.5gm and the haemoglobin of less than 8 gm were also associated with an increased incidence of PPC. Pleural effusion was the commonest PPC seen in 15 (44.1%) patients followed by pneumonia in 9 (26.5%).Conclusions: Age, smoking, education status, serum albumin, haemoglobin, emergency surgery, elective postoperative ventilation, nasogastric intubation and blood loss in the intraoperative period were found to associated with increased risk of PPCs. 

scholarly journals Metastatic Bladder Cancer Presenting with Persistent Hematuria in Young Man with Cystic Fibrosis

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Premal Patel ◽  
Harvey R. Rabin ◽  
Michael M. Vickers ◽  
Michael D. Parkins
Keyword(s):  
Risk Factors ◽  
Cystic Fibrosis ◽  
Bladder Cancer ◽  
Renal Colic ◽  
Atypical Symptoms ◽  
Metastatic Bladder Cancer ◽  
Increased Risk ◽  
Demographic Risk ◽  
Demographic Risk Factors ◽  
Rule Out

We report a case of metastatic bladder cancer developing in a young man with cystic fibrosis (CF) that was initially diagnosed as ureterolithiasis and managed as renal colic. With the improved survival of patients with CF, an increasing burden of extrapulmonary disease manifestations is apparent. Renal colic is observed at an increased frequency in patients with CF relative to the general population and is a commonly recognized cause of hematuria. However, CF patients harboring a malignancy are recognized to be at increased risk of delayed identification owing to atypical symptoms and lack of demographic risk factors. This case illustrates how investigations to rule out malignancy are warranted in those CF patients not responding to therapies directed towards presumptive diagnoses.

Emotional and Behavioral Problems in Early Adolescents and Association with Socio-demographic Risk Factors

2017 ◽  
Vol 41 (S1) ◽  
pp. S128-S128
Author(s):  
L. Dostovic Hamidovic
Keyword(s):  
Risk Factors ◽  
Behavioral Problems ◽  
Parental Education ◽  
Early Adolescents ◽  
Emotional And Behavioral Problems ◽  
Behavioural Problems ◽  
Emotional And Behavioural Problems ◽  
Increased Risk ◽  
Demographic Risk ◽  
Demographic Risk Factors

AimThe aim is to analyse the frequency emotional and behavioural problems early adolescents and association with socio-demographic risk factors.Subject and methodsWe analysed a group of 240 early adolescents (11–15 years) from the area of Tuzla Canton, Bosnia and Herzegovina, in the general population. For the assessment of children's emotional and behavioural problems, the Strength and Difficulties Questionnaire – SDQ is used. Data were processed by descriptive statistics. For the assessment association between socio-demographic risk factors and emotional and behavioural problems in early adolescents we used Pearson correlation test.ResultsThe result show that the frequency of emotional and behavioural problems are present in 3% of cases, The results of correlation sociodemographic risk factors and emotional and behavioral problems, showed that unemployed mothers have a significant increased risk of developing behavioral disorders in early adolescents (P < 0.05). Low family economic status leads to a significantly higher frequency of emotional symptoms in early adolescents, poor attitude towards society and significantly higher overall difficulties (P < 0.05). Higher levels of parental education was significantly associated with a higher frequency of behavioral problems and illness in the family leads to a much more emotional problems (P < 0.05).ConclusionThe obtained results of this study indicate that early adolescents showed low levels of emotional and behavioral problems. There is a significant correlation between socio-demographic risk factors and emotional and behavioral problems early adolescents.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

scholarly journals Risk Factors for Postoperative Pulmonary Complications after Abdominal Surgery

2016 ◽  
Vol 4 (2) ◽  
pp. 259-263 ◽  
Author(s):  
Nertila Kodra ◽  
Vjollca Shpata ◽  
Ilir Ohri
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Clinical Laboratory ◽  
Multivariate Regression Analysis ◽  
Hospital Length ◽  
Pulmonary Complications ◽  
Hospital Length Of Stay ◽  
Postoperative Pulmonary Complications ◽  
Increased Risk ◽  
Surgical Ward

BACKGROUND: Incidence of postoperative pulmonary complications (PPC) in patients undergoing non-cardiothoracic surgery remains high and the occurrence of these complications has enormous implications for the patient and the health care system.AIM: The aim of the study was to identify risk factors for PPC in patients undergoing abdominal surgical procedures.MATERIALS AND METHODS: A prospective cohort study in abdominal surgical patients, admitted to the emergency and surgical ward of the UHC of Tirana, Albania, was conducted during the period: March 2014-March 2015. We collected data on the occurrence of a symptomatic and clinically significant PPC using clinical, laboratory, and radiology data. We evaluated the relations between PPCs and various pre-operative or intra-operative factors to identify risk factors.RESULTS: A total of 450 postoperative patients admitted to the surgical emergency and surgical ward were studied. The mean age were 59.85 ±13.64 years with 59.3% being male. Incidence of PPC was 27.3% (123 patients) and hospital length of stay was 4.93 ± 4.65 days. Length of stay was substantially prolonged for those patients who developed PPC (7.48 ± 2.89 days versus 3.97± 4.83 days, p < 0.0001. PPC were identified as risk factors for mortality, OR: 21.84; 95%CI: 11.66-40.89; P < 0.0001. The multivariate regression analysis identified as being independently associated with an increased risk of PPC: age ≥ 65 years (OR 11.41; 95% CI: 4.84-26.91, p < 0.0001), duration of operation ≥ 2.5 hours (OR 8.38; 95%CI: 1.52-46.03, p = 0.01, history of previous pulmonary diseases (OR 11.12; 95% CI: 3.28-37.65, P = 0.0001) and ASA > 2 (OR 6.37; 95% CI: 1.54-26.36, P = 0.01). CONCLUSION: We must do some efforts in reducing postoperative pulmonary complications, firstly to identify which patients are at increased risk, and then following more closely high-risk patients because those patients are most likely to benefit.

scholarly journals Depression, Anxiety and Stress in Women with Breech Pregnancy - "Be not Afraid": A Prospective Study

2021 ◽  
Author(s):  
Madeleine Schauer ◽  
Elisabetta Latartara ◽  
Maria Alonso-Espias ◽  
Emma Rossetti ◽  
Pimrapat Gebert ◽  
...  
Keyword(s):  
Risk Factors ◽  
Psychological Distress ◽  
Cesarean Section ◽  
Mental Disorder ◽  
Pregnant Women ◽  
Clinical Care ◽  
Breech Presentation ◽  
Increased Risk ◽  
Demographic Risk ◽  
Demographic Risk Factors

Abstract Background: Breech presentation at term is associated with higher perinatal complications through the increased incidence of cesarean section and complications by vaginal breech birth. The decision-making process between breech delivery, trial of external cephalic version or cesarean section may lead to maternal depression, stress and anxiety. Mental disorder in itself is associated with poorer maternal and fetal outcomes, such as preterm birth, small for gestational age infants, lower birth weight and increased risk for postnatal depression. This study aims to evaluate the level of psychological distress for women with breech presentation compared to cephalic presentation. We hypothesized, that women with breech presentation have higher levels of depression, stress and anxiety than other pregnant women. Secondary objectives were to analyze potential demographic risk factors and comorbidity of psychological distress in breech pregnancy. Methods: The breech study group was formed by 379 women with breech presentation. A sample of 128 women with cephalic presentation was recruited during routine clinical care. Depression, anxiety and stress symptoms were ascertained by means of the Depression-Anxiety-Stress-Score (DASS)-21 questionnaire. Categorial data was analyzed with Chi-square or exact test, continuous data with unpaired t-test or Mann-Whitney-U-test. Demographic risk factors were identified using a binary logistic regression model.Results: Prevalence of psychological distress among women with breech was not higher compared to those of other pregnant women. Symptomatic depression, anxiety and stress affected 5.8%, 14.5% and 11.9% of women with breech, respectively. Decreasing age was identified as a risk factor for anxiety (p = 0.006). Multiparity increased risk for depression (p = 0.001), for anxiety (p = 0.026) and for perinatal stress (p = 0.010). More than 80% of women with depressive symptoms had comorbidities of psychological distress.Conclusions: Breech presentation compared to cephalic presentation was not associated with higher levels of psychological distress. However, breech pregnancies are affected by symptoms of potential mental disorder. Multiparous women and younger women may need additional support and would benefit from a standardized screening tool for the assessment of perinatal psychological distress.Clinical Trial Registration: Ethical approval (EA2/241/18) was granted by the Ethics Commission of the Charité University Hospital on the 23.01.2019 (ClinicalTrials.gov Identifier: NCT03827226)

Obesity Increases the Odds of Acquiring and Incarcerating Noninguinal Abdominal Wall Hernias

2012 ◽  
Vol 78 (10) ◽  
pp. 1118-1121 ◽  
Author(s):  
Briana Lau ◽  
Hanjoo Kim ◽  
Philip I. Haigh ◽  
Talar Tejirian
Keyword(s):  
Risk Factors ◽  
Abdominal Wall ◽  
Significant Risk ◽  
Female Gender ◽  
Current Data ◽  
Current Prevalence ◽  
Increased Risk ◽  
Demographic Risk ◽  
Demographic Risk Factors ◽  
Relationship Of

The current data available describing the relationship of obesity and abdominal wall hernias is sparse. The objective of this study was to investigate the current prevalence of noninguinal abdominal wall hernias and their correlation with body mass index (BMI) and other demographic risk factors. Patients with umbilical, incisional, ventral, epigastric, or Spigelian hernias with or without incarceration were identified using the regional database for 14 hospitals over a 3-year period. Patients were stratified based on their BMI. Univariate and multivariate analyses were performed to distinguish other significant risk factors associated with the hernias. Of 2,807,414 patients, 26,268 (0.9%) had one of the specified diagnoses. Average age of the patients was 52 years and 61 per cent were male. The majority of patients had nonincarcerated umbilical hernias (74%). Average BMI was 32 kg/m2. Compared with patients with a normal BMI, the odds of having a hernia increased with BMI: BMI of 25 to 29.9 kg/m2 odds ratio (OR) 1.63, BMI of 30 to 39.9 kg/m2 OR 2.62, BMI 40 to 49.9 kg/m2 OR 3.91, BMI 50 to 59.9 kg/m2 OR 4.85, and BMI greater than 60 kg/m2 OR 5.17 ( P < 0.0001). Age older than 50 years was associated with a higher risk for having a hernia (OR, 2.12; 95% [CI], 2.07 to 2.17), whereas female gender was associated with a lower risk (OR, 0.53; 95% CI, 0.52 to 0.55). Those with incarcerated hernias had a higher average BMI (32 kg/m2 vs 35 kg/m2; P < 0.0001). Overall, BMI greater than 40 kg/m2 showed an increased chance of incarceration, and a BMI greater than 60 kg/m2 had the highest chance of incarceration, OR 12.7 ( P < 0.0001). Age older than 50 years and female gender were also associated with a higher risk of incarceration (OR, 1.28; 95% CI, 1.02 to 1.59 and OR, 1.80; CI, 1.45 to 2.24). Increasing BMI and increasing age are associated with a higher prevalence and an increased risk of incarceration of noninguinal abdominal wall hernias.

Clinical and Demographic Risk Factors for COVID-19 during Delivery Hospitalizations in New York City

2021 ◽  
Author(s):  
Desmond Sutton ◽  
Timothy Wen ◽  
Anna P. Staniczenko ◽  
Yongmei Huang ◽  
Maria Andrikopoulou ◽  
...  
Keyword(s):  
Risk Factors ◽  
New York ◽  
New York City ◽  
Logistic Regression ◽  
York City ◽  
Demographic Data ◽  
Outcome Data ◽  
Demographic Risk ◽  
Demographic Risk Factors ◽  
Zip Code

Objective This study was aimed to review 4 weeks of universal novel coronavirus disease 2019 (COVID-19) screening among delivery hospitalizations, at two hospitals in March and April 2020 in New York City, to compare outcomes between patients based on COVID-19 status and to determine whether demographic risk factors and symptoms predicted screening positive for COVID-19. Study Design This retrospective cohort study evaluated all patients admitted for delivery from March 22 to April 18, 2020, at two New York City hospitals. Obstetrical and neonatal outcomes were collected. The relationship between COVID-19 and demographic, clinical, and maternal and neonatal outcome data was evaluated. Demographic data included the number of COVID-19 cases ascertained by ZIP code of residence. Adjusted logistic regression models were performed to determine predictability of demographic risk factors for COVID-19. Results Of 454 women delivered, 79 (17%) had COVID-19. Of those, 27.9% (n = 22) had symptoms such as cough (13.9%), fever (10.1%), chest pain (5.1%), and myalgia (5.1%). While women with COVID-19 were more likely to live in the ZIP codes quartile with the most cases (47 vs. 41%) and less likely to live in the ZIP code quartile with the fewest cases (6 vs. 14%), these comparisons were not statistically significant (p = 0.18). Women with COVID-19 were less likely to have a vaginal delivery (55.2 vs. 51.9%, p = 0.04) and had a significantly longer postpartum length of stay with cesarean (2.00 vs. 2.67days, p < 0.01). COVID-19 was associated with higher risk for diagnoses of chorioamnionitis and pneumonia and fevers without a focal diagnosis. In adjusted analyses, including demographic factors, logistic regression demonstrated a c-statistic of 0.71 (95% confidence interval [CI]: 0.69, 0.80). Conclusion COVID-19 symptoms were present in a minority of COVID-19-positive women admitted for delivery. Significant differences in obstetrical outcomes were found. While demographic risk factors demonstrated acceptable discrimination, risk prediction does not capture a significant portion of COVID-19-positive patients. Key Points

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