scholarly journals Risk factors for mortality of patients with ceftriaxone resistant e. Coli bacteremia receiving carbapenem versus beta lactam/beta lactamase inhibitor therapy

2019 ◽  
Author(s):  
Nosheen Nasir ◽  
Sara Ahmed ◽  
Samrah Razi ◽  
Safia Awan ◽  
Faisal Mahmood
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Combination Therapy ◽  
Hospital Mortality ◽  
Logistic Regression Analysis ◽  
P Value ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
E Coli

Abstract Objective: Extended spectrum β-lactamases (ESBL) producing Enterobacteriaceae predominantly E. coli and K. pneumoniae bacteremia have limited treatment options and high mortality. The objective was to determine the risk factors for in-hospital mortality particularly treatment with Carbapenem versus Beta lactam/beta lactamase combination (BL/BLI) in patients with Ceftriaxone resistant E. coli bacteremia. A retrospective cohort study was conducted at the Aga Khan University, Karachi, Pakistan. Adult patients with sepsis and monomicrobial Ceftriaxone resistant E. coli bacteremia were enrolled. Factors associated with mortality in patients were determined using logistic regression analysis. Results: Mortality rate was 37% in those empirically treated with carbapenem compared to 20% treated with BL/BLI combination therapy (p-value: 0.012) and was 21% in those treated with a carbapenem compared to 13% in patients definitively treated with BL/BLI combination therapy (p-value: 0.152). In multivariable logistic regression analysis, only Pitt bacteremia score of ≥ four was significantly associated with mortality (OR: 7.7 CI: 2.6-22.8) while a urinary source of bacteremia was protective (OR: 0.26 CI: 0.11-0.58). In-hospital mortality in patients with Ceftriaxone resistant E. coli bacteremia did not differ in patients treated with either a carbapenem or BL/BLI combination. However, Pitt bacteremia score of ≥ 4 was strongly associated with mortality.

scholarly journals RISK FACTORS FOR MORTALITY OF PATIENTS WITH CEFTRIAXONE RESISTANT E. COLI BACTEREMIA RECEIVING CARBAPENEM VERSUS BETA LACTAM/BETA LACTAMASE INHIBITOR THERAPY

2019 ◽  
Author(s):  
Nosheen Nasir ◽  
Sara Ahmed ◽  
Samrah Razi ◽  
Safia Awan ◽  
Faisal Mahmood
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Combination Therapy ◽  
Hospital Mortality ◽  
Logistic Regression Analysis ◽  
P Value ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
E Coli

Abstract Objective: Extended spectrum β-lactamases (ESBL) producing Enterobacteriaceae predominantly E. coli and K. pneumoniae bacteremia have limited treatment options and high mortality. The objective was to determine the risk factors for in-hospital mortality particularly treatment with Carbapenem versus Beta lactam/beta lactamase combination (BL/BLI) in patients with Ceftriaxone resistant E. coli bacteremia. A retrospective cohort study was conducted at the Aga Khan University, Karachi, Pakistan. Adult patients with sepsis and monomicrobial Ceftriaxone resistant E. coli bacteremia were enrolled. Factors associated with mortality in patients were determined using logistic regression analysis. Results: Mortality rate was 37% in those empirically treated with carbapenem compared to 20% treated with BL/BLI combination therapy (p-value: 0.012) and was 21% in those treated with a carbapenem compared to 13% in patients definitively treated with BL/BLI combination therapy (p-value: 0.152). In multivariable logistic regression analysis, only Pitt bacteremia score of ≥ four was significantly associated with mortality (OR: 7.7 CI: 2.6-22.8) while a urinary source of bacteremia was protective (OR: 0.26 CI: 0.11-0.58). In-hospital mortality in patients with Ceftriaxone resistant E. coli bacteremia did not differ in patients treated with either a carbapenem or BL/BLI combination. However, Pitt bacteremia score of ≥ 4 was strongly associated with mortality.

scholarly journals Risk factors for mortality of patients with ceftriaxone resistant E. coli bacteremia receiving carbapenem versus beta lactam/beta lactamase inhibitor therapy

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Nosheen Nasir ◽  
Sara Ahmed ◽  
Samrah Razi ◽  
Safia Awan ◽  
Syed Faisal Mahmood
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Combination Therapy ◽  
Hospital Mortality ◽  
Logistic Regression Analysis ◽  
P Value ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
E Coli

Abstract Objective Extended spectrum β-lactamases (ESBL) producing Enterobacteriaceae predominantly E. coli and K. pneumoniae bacteremia have limited treatment options and high mortality. The objective was to determine the risk factors for in-hospital mortality particularly treatment with carbapenem versus beta lactam/beta lactamase combination (BL/BLI) in patients with ceftriaxone resistant E. coli bacteremia. A retrospective cohort study was conducted at the Aga Khan University, Karachi, Pakistan. Adult patients with sepsis and monomicrobial ceftriaxone resistant E. coli bacteremia were enrolled. Factors associated with mortality in patients were determined using logistic regression analysis. Results Mortality rate was 37% in those empirically treated with carbapenem compared to 20% treated with BL/BLI combination therapy (p-value: 0.012) and was 21% in those treated with a carbapenem compared to 13% in patients definitively treated with BL/BLI combination therapy (p-value: 0.152). In multivariable logistic regression analysis, only Pitt bacteremia score of ≥ four was significantly associated with mortality (OR: 7.7 CI 2.6–22.8) while a urinary source of bacteremia was protective (OR: 0.26 CI 0.11–0.58). In-hospital mortality in patients with Ceftriaxone resistant E. coli bacteremia did not differ in patients treated with either a carbapenem or BL/BLI combination. However, Pitt bacteremia score of ≥ 4 was strongly associated with mortality.

scholarly journals RISK FACTORS FOR MORTALITY AND TREATMENT OUTCOMES OF PATIENTS WITH CEFTRIAXONE RESISTANT E. COLI BACTEREMIA RECEIVING CARBAPENEM VERSUS BETA LACTAM/BETA LACTAMASE INHIBITOR THERAPY

2019 ◽  
Author(s):  
Nosheen Nasir ◽  
Sara Ahmed ◽  
Samrah Razi ◽  
Safia Awan ◽  
Faisal Mahmood
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Combination Therapy ◽  
Hospital Mortality ◽  
Logistic Regression Analysis ◽  
P Value ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
E Coli

Abstract Background: Extended spectrum β-lactamases (ESBL) producing Enterobacteriaceae predominantly E. coli and K. pneumonia bacteremia have limited treatment options and high mortality. Objective: To determine the risk factors for in-hospital mortality particularly treatment with Carbapenem versus Beta lactam/beta lactamase combination (BL/BLI) in patients with Ceftriaxone resistant E. coli bacteremia. Methods: A retrospective descriptive study was conducted at the Aga Khan University, Karachi, Pakistan. Adult patients with monomicrobial Ceftriaxone resistant E. coli bacteremia were enrolled. Factors associated with mortality in patients were determined using logistic regression analysis. Results: Mortality rate was 37% in those empirically treated with carbapenem compared to 20% treated with BL/BLI combination therapy (p-value: 0.012) and was 21% in those treated with a carbapenem compared to 13% in patients definitively treated with BL/BLI combination therapy (p-value: 0.152). In multivariable logistic regression analysis, only Pitt bacteremia score of ≥ four was significantly associated with mortality (OR: 7.7 CI: 2.6-22.8) while a urinary source of bacteremia was protective (OR: 0.26 CI: 0.11-0.58). Conclusions: In-hospital mortality in patients with Ceftriaxone resistant E. coli bacteremia did not differ in patients treated with either a carbapenem or BL/BLI combination. However, Pitt bacteremia score of ≥ 4 was strongly associated with mortality.

scholarly journals Clinical profile and factors determining outcome of intramural very low birth weight babies in a tertiary care centre: a retrospective study

2017 ◽  
Vol 5 (2) ◽  
pp. 520
Author(s):  
Devi Meenakshi K. ◽  
Arasar Seeralar A. T. ◽  
Srinivasan Padmanaban
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Logistic Regression Analysis ◽  
Very Low Birth Weight ◽  
Tertiary Care ◽  
P Value ◽  
Increased Risk

Background: Very low birth weight (VLBW) babies are at increased risk of a number of complications both immediate and late. Worldwide it has been observed that these babies contribute to a significant extent to neonatal mortality and morbidity. Aim of the study was to study the risk factors contributing to mortality in VLBW babies and to evaluate the morbidity pattern in these infants.Methods: A retrospective analysis of data retrieved from the case records of VLBW babies admitted in the NICU of Kilpauk Medical College between January 2015 to December 2015. Out of the 2360 intramural babies admitted during the study period, 99 babies were less than 1500 gms. The risk factors for these babies were analyzed for their association with the outcome. Data were statistically analyzed.Results: In present study, we found that sex of the baby, gestational age, obstetric score, birth asphyxia, pulmonary haemorrhage, ROP and presence of shock were found to be associated with increased mortality. By logistic regression analysis it was observed that birth weight of the baby (p value 0.002), duration of stay (p value 0.0006), presence of shock (p<0.0001), were the risk factors significantly associated with poor outcome.Conclusions: Among the maternal and neonatal factors analyzed in the study using logistic regression analysis, birth weight, duration of hospital stay and presence of shock were significantly related to poor outcome. Of these presence of shock was the single most important factor that predicted increased mortality.

scholarly journals 146. Infective Endocarditis in South Korea: a 12-year Single-Center Experience of 419 Patients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S100-S101
Author(s):  
Jung Ho Kim ◽  
Hi Jae Lee ◽  
Woon Ji Lee ◽  
Hye Seong ◽  
Jin young Ahn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
South Korea ◽  
Hospital Mortality ◽  
Incidence Rate ◽  
Logistic Regression Analysis

Abstract Background Infective endocarditis (IE) is a potentially lethal disease that has undergone constant changes in epidemiology and pathogen. Treatment of IE has become more complex with today’s myriad healthcare-associated factors as well as regional differences in causative organisms. Therefore, it is necessary to investigate the overall trends, microbiological features, clinical characteristics and outcomes of IE in South Korea. Methods We performed a retrospective cohort study of patients with the diagnosis of probable or definite IE according to the modified Duke Criteria admitted to a tertiary care center in South Korea between November 2005 and August 2017. Poisson log-linear regression was used to estimate time trends of IE incidence rate and mortality rate. Risk factors for in-hospital mortality were evaluated by multivariate logistic regression analysis including an interaction term. Results There were 419 IE patients (275 male vs. 144 female) during the study period. The median age of the patients was 56 years. The annual incidence rate of IE of our institution was significantly increased. (RR 1.05; 95% CI, 1.02–1.08; P = 0.006) The mortality rate showed trends toward down, but not statistically significant (P = 0.875). IE was related to a prosthetic valve in 15.0% and 21.7% patients developed IE during hospitalization. The mitral valve was the most commonly affected valve (61.3%). Causative microorganisms were identified in 309 patients (73.7%) and included streptococci (34.6%), followed by Staphylococcus aureus (15.8%) and enterococci (7.9%). The in-hospital mortality rate was 14.6%. Logistic regression analysis found aortic valve endocarditis (OR 3.18; P = 0.001), IE caused by staphylococcus aureus (OR 2.32; P = 0.026), a presence of central nervous system embolic complication (OR 1.98; P = 0.031), a high SOFA score (OR 1.22; P = 0.023) and a high Charlson’s comorbidity index (OR 1.11; P = 0.019) as predictors of in-hospital mortality. On the other hand, surgical intervention for IE was found to be a protective factor against mortality. (OR 0.25, P < 0.001) Conclusion Although IE has been increasing, the mortality rate has not yet reduced significantly. Studies on causative organisms of IE and risk factors for mortality are warranted in improving prognosis. Disclosures All authors: No reported disclosures.

scholarly journals Prevalence and Risk Factors for Mortality among COVID-19 Patients Hospitalized in Karachi City Pakistan

2021 ◽  
Vol 2 (3) ◽  
pp. 66-71
Author(s):  
Salman Imtiaz ◽  
Ashar Alam ◽  
Faiza Saeed ◽  
Beena Salman ◽  
Shoukat Memon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Virus Disease ◽  
Multivariate Logistic Regression Analysis ◽  
Ethical Review ◽  
P Value ◽  
Age Group ◽  
Continuous Variables

Background: Corona virus disease (Covid -19) is the most contagious form of the disease of present time. Therefore, the risk factors which proliferate the spread and hinders the better outcome should be identified. There is gross difference in the spread and outcome of covid 19 in different region of the world. There is need to identify these factors in different communities of the globe. Material and method: This is a retrospective observational cohort study of Covid -19 patients admitted during the study period. Institutional and ethical review board permission was taken prior to the study. Univariate and multivariate binary logistic regression was run and odds ratio with 95% confidence intervals were obtained. P value of ≤ 0.05 was considered significant. Outcome variables were recovery and death. Results: There were 840 patients admitted between the study duration, while 704 (83.8%) were included in our study. There were 491(69.7%) males and 213(30.3%) females. The mean age of the population was 54.6±15.5 years. All continuous variables were categorized according to binary outcome (recovered and death) of patients. In Logistic regression analysis we found that patients in age group of 51-65 years died 2.5 time more than patients of age ≤ 50 years. Similarly, the patients within age group of > 65 died 4.5 times higher than ≤ 50 years of age (p<0.001). Male patients died 1.5 times more than females. Among all comorbid conditions HTN had significant effect on death, they died 1.5 times more than normotensive patients. In multivariate logistic regression analysis, the age groups had same significant effect on death when adjusted with other parameters, while effect of gender vanished. Similarly, the effect of HTN was also abolished when other factors were included in analysis. Conclusion: We concluded that there is an urgent need of reevaluation of the traditional risk factors associated with viral epidemic and understanding the changing paradigm of epidemiology emerging out from this epidemic in both developed and developing counties. There is need of more data from developing world to elucidate the risk factors.

scholarly journals Cancer Patients at Risk for Medication-Related Osteonecrosis of the Jaw. A Case and Control Study Analyzing Predictors of MRONJ Onset

2021 ◽  
Vol 10 (20) ◽  
pp. 4762
Author(s):  
Antonia Marcianò ◽  
Ylenia Ingrasciotta ◽  
Valentina Isgrò ◽  
Luca L’Abbate ◽  
Saveria Serena Foti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Zoledronic Acid ◽  
Cancer Patients ◽  
Logistic Regression Analysis ◽  
Osteonecrosis Of The Jaw ◽  
P Value ◽  
Multiple Variables

The goal of this investigation was to identify potential risk factors to predict the onset of medication-related osteonecrosis of the jaw (MRONJ). Through the identification of the multiple variables positively associated to MRONJ, we aim to write a paradigm for integrated MRONJ risk assessment built on the combined analysis of systemic and local risk factors. The characteristics of a cohort of cancer patients treated with zoledronic acid and/or denosumab were investigated; beyond the set of proven risk factors a new potential one, the intake of new molecules for cancer therapy, was addressed. Registered data were included in univariate and multivariate logistic regression analysis in order to individuate significant independent predictors of MRONJ; a propensity score-matching method was performed adjusting by age and sex. Univariate logistic regression analysis showed a significant effect of the parameters number of doses of zoledronic acid and/or denosumab (OR = 1.03; 95% CI = 1.01–1.05; p = 0.008) and chemotherapy (OR = 0.35; 95% CI = 0.17–0.71; p = 0.008). The multiple logistic regression model showed that breast, multiple myeloma, and prostate cancer involved a significantly higher risk compared to lung cancer; a significant effect of the combined variables number of doses of zoledronic acid and/or denosumab (OR = 1.03; 95% CI = 1.01–1.06); p-value = 0.03) and exposure to novel molecule treatment (OR = 34.74; 95% CI = 1.39–868.11; p-value = 0.03) was observed. The results suggest that a risk assessment paradigm is needed for personalized prevention strategies in the light of patient-centered care.

scholarly journals RISK FACTORS OF PREECLAMPSIA WITH SEVERE FEATURES AND ITS COMPLICATIONS

2021 ◽  
Vol 5 (1) ◽  
pp. 29
Author(s):  
Eka Suci Wulandari ◽  
Ernawati Ernawati ◽  
Djohar Nuswantoro
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Gestational Age ◽  
Multiple Logistic Regression Analysis ◽  
Severe Preeclampsia ◽  
Control Group ◽  
P Value ◽  
Multiple Logistic Regression

 Abstract.Background : The maternal mortality rate in Indonesia is dominated by preeclampsia as the second highest cause after bleeding. Several predictors can be categorized as risk factors that can be used to increase alertness in the care of pregnant women with severe preeclampsia to avoid complications. The purpose of this study was to study the relationship between risk factors for severe preeclampsia and its complications. Methods: This study used an observational analytic method with a case control design. The sampling technique is simple random sampling. The number of samples in this study were 80 samples, with 40 samples in each group. The case group was severe preeclampsia with one complication and the control group was severe preeclampsia without complications. Statistical analysis used was chi square and multiple logistic regression analysis. Results: The results showed that there was a significant relationship between age variables (p value = 0.001 < 0.05; OR = 5.318; CI = 2.118 – 13,356), BMI (p value = 0.002 < 0.05; OR = 6.000; CI = 1.958 – 18.384 ) and gestational age (p value = 0.039 < 0.05; OR = 2.636; CI = 1.040 – 6.685). Multiple logistic regression analysis showed that BMI (p = 0.003), age (p = 0.001) and gestational age (p = 0.048) were variables included in the final modeling of the regression analysis with the incidence of severe preeclampsia complications. Conclusion: BMI is the variable that has the strongest relationship with the incidence of severe preeclampsia complications.  

scholarly journals Association of biomarkers related to preoperative inflammatory and coagulation with postoperative in-hospital deaths in patients with type A acute aortic dissection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ming Li ◽  
Suochun Xu ◽  
Yang Yan ◽  
Haichen Wang ◽  
Jianjie Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Hospital Mortality ◽  
Logistic Regression Analysis ◽  
Type A ◽  
Multivariable Logistic Regression Analysis ◽  
Hospital Deaths ◽  
Independent Risk Factors ◽  
D Dimer

AbstractThe aim of this study was to analyze the role of blood biomarkers regarding preoperative inflammation and coagulation in predicting the postoperative in-hospital mortality of patients with type A acute aortic dissection (AAD). A total of 206 patients with type A AAD who had received surgical treatment were enrolled in this study. Patients were divided into two groups: the death group (28 patients who died during hospitalization) and the survival group (178 patients). Peripheral blood samples were collected before anesthesia induction. Preoperative levels of D-dimer, fibrinogen (FIB), platelet (PLT), white blood cells (WBC) and neutrophil (NEU) were compared between the two groups. Univariable and multivariable logistic regression analysis were utilized to identify the independent risk factors for postoperative in-hospital deaths of patients with type A AAD. Receiver operating characteristic (ROC) curve were used to analyze the predictive value of these indices in the postoperative in-hospital mortality of the patients. Univariable logistic regression analysis showed that the P values of the five parameters including D-dimer, FIB, PLT, WBC and NEU were all less than 0.1, which may be risk factors for postoperative in-hospital deaths of patients with type A AAD. Further multivariable logistic regression analysis indicated that higher preoperative D-dimer and WBC levels were independent risk factors for postoperative in-hospital mortality of patients with type A AAD. ROC curve analysis indicated that application of combining FIB and PLT could improve accuracy in prediction of postoperative in-hospital mortality in patients with type A AAD. Both preoperative D-dimer and WBC in patients with type A AAD may be used as independent risk factors for the postoperative in-hospital mortality of such patients. The combination of FIB and PLT may improve the accuracy of clinical prognostic assessment.

scholarly journals Risk factors for tissue expander infection in scar reconstruction: a retrospective cohort study of 2374 consecutive cases

2020 ◽  
Vol 8 ◽  
Author(s):  
Chen Dong ◽  
Minhui Zhu ◽  
Luguang Huang ◽  
Wei Liu ◽  
Hengxin Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Treatment Failure ◽  
Logistic Regression Analysis ◽  
Disease Duration ◽  
Multivariate Logistic Regression Analysis ◽  
Tissue Expansion ◽  
Multivariate Logistic Regression ◽  
Hematoma Evacuation

Abstract Background Tissue expansion is used for scar reconstruction owing to its excellent clinical outcomes; however, the complications that emerge from tissue expansion hinder repair. Infection is considered a major complication of tissue expansion. This study aimed to analyze the perioperative risk factors for expander infection. Methods A large, retrospective, single-institution observational study was carried out over a 10-year period. The study enrolled consecutive patients who had undergone tissue expansion for scar reconstruction. Demographics, etiological data, expander-related characteristics and postoperative infection were assessed. Univariate and multivariate logistic regression analysis were performed to identify risk factors for expander infection. In addition, we conducted a sensitivity analysis for treatment failure caused by infection as an outcome. Results A total of 2374 expanders and 148 cases of expander infection were assessed. Treatment failure caused by infection occurred in 14 expanders. Multivariate logistic regression analysis identified that disease duration of ≤1 year (odds ratio (OR), 2.07; p &lt; 0.001), larger volume of expander (200–400 ml vs &lt;200 ml; OR, 1.74; p = 0.032; &gt;400 ml vs &lt;200 ml; OR, 1.76; p = 0.049), limb location (OR, 2.22; p = 0.023) and hematoma evacuation (OR, 2.17; p = 0.049) were associated with a high likelihood of expander infection. Disease duration of ≤1 year (OR, 3.88; p = 0.015) and hematoma evacuation (OR, 10.35; p = 0.001) were so related to high risk of treatment failure. Conclusions The rate of expander infection in patients undergoing scar reconstruction was 6.2%. Disease duration of &lt;1 year, expander volume of &gt;200 ml, limb location and postoperative hematoma evacuation were independent risk factors for expander infection.

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