scholarly journals Risk factors for malnutrition in refractory convulsive status epilepticus

2020 ◽  
Author(s):  
Yu Zhang ◽  
Deng Chen ◽  
Li-na Zhu ◽  
ling liu

Abstract Purpose: To study the risk factors and prognosis of malnutrition in patients with refractory convulsive status epilepticus. Methods: A total of 73 patients with refractory convulsive epileptic status in West China Hospital from January 2017 to May 2019 were collected. All patients met the 2016 International Anti-epileptic Alliance diagnostic criteria for refractory convulsive status epilepticus. A logistic regression model was used to evaluate the risk factors of malnutrition in refractory convulsive status epilepticus. Results: Of the 73 patients with refractory convulsive status epilepticus, 33 (45.21%) suffered from malnutrition during hospitalization, and hospitalization days (OR =1.251; 95% CI: 1.067-1.384; P =0.007), nasal feeding (OR =22.623; 95% CI: 1.091-286.899; P =0.013), and malnutrition on admission (OR =30.760; 95% CI: 1.064-89.797; P =0.046) were risk factors for malnutrition in patients with refractory convulsive status epilepticus. Conclusion: Malnutrition is a common complication during hospitalization in patients with refractory convulsive status epilepticus. Hospitalization days, nasal feeding, and malnutrition at admission are risk factors for malnutrition in patients with refractory convulsive status epilepticus. Further longitudinal studies are needed to identify the relationship between refractory convulsive status epilepticus and adverse outcomes.

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhang Yu ◽  
Liu Ling

Abstract Background This study aimed to investigate the association between nutritional characteristics in patients with refractory convulsive status epilepticus. Methods We retrospectively enrolled 73 patients with refractory convulsive status epilepticus over 18 years of age at the West China Hospital between January 2017 and May 2019. All patients met the 2016 International League Against Epilepsy diagnostic criteria for refractory convulsive status epilepticus. A logistic regression model was used to evaluate the association between malnutrition and refractory convulsive status epilepticus. Results Of the 73 patients with refractory convulsive status epilepticus, 33 (45.21 %) suffered from malnutrition during hospitalization, and duration of hospitalization in days (OR = 1.251; 95 % CI,–1.067–1.384; P = 0.007), nasal feeding (OR = 22.623; 95 % CI: 1.091-286.899; P = 0.013), and malnutrition on admission (OR = 30.760; 95 % CI: 1.064–89.797; P = 0.046) were significantly associated with malnutrition in patients with refractory convulsive status epilepticus. Conclusions Malnutrition is a common complication during hospitalization in patients with refractory convulsive status epilepticus. The duration of hospitalization (days), nasal feeding, and malnutrition at admission are associated with malnutrition in patients with refractory convulsive status epilepticus. Further longitudinal studies are needed to identify the relationship between refractory convulsive status epilepticus and adverse outcomes.


2019 ◽  
Vol 85 (11) ◽  
pp. 1253-1260
Author(s):  
Jeremy D. Kauffman ◽  
Paul D. Danielson ◽  
Nicole M. Chandler

The purpose of this study was to determine risk factors for 30-day complications, reoperation, and readmission after ostomy reversal in infants less than six months old. Infants aged two weeks to six months who underwent ostomy reversal were identified in the 2012 to 2016 ACS NSQIP Pediatric database. Demographics, comorbidities, and 30-day outcomes were assessed. Multivariable logistic regression was used to estimate the independent effects of clinical variables on risk of 30-day complications, reoperation, and readmission. Among 1021 infants, 163 (16%) suffered a 30-day complication. SSIs were the most common complication (5.7%), followed by unplanned reintubation (5.2%) and bleeding (3%). Mortality was 0.4 per cent. Dependence on nutritional support and hematologic disorders were independently associated with postoperative complications. Forty-five children (4.4%) required reoperation and 22 (2.2%) were readmitted for conditions related to the procedure. Younger age and preoperative dependence on oxygen or nutritional support were associated with increased length of stay. SSI, unplanned reintubation, and bleeding are the most frequent complications after ostomy takedown in infants less than six months old. Attention to risk factors predisposing to these complications, including dependence on nutritional support and hematologic disorders, may contribute to improved surgical outcomes.


2021 ◽  
Vol 8 (6) ◽  
pp. 881-887
Author(s):  
Amaal Sadeq Hamoodi

Many studies have found that age, race, gender, past family history, and intraocular pressure (IOP) of the eyes are key risk factors for glaucoma disease. The current study aims to evaluate the relationship between glaucoma and various glaucoma risk factors in the Arabian ethnicity using a cohort cross-sectional observational design. Therefore, the current study is targeted at building a regression model to estimate the probability of injury to glaucoma disease, which is one of the serious diseases that affect the eyes. It uses the logistic regression model, which is one of the modern non parametric methods, and a cohort cross-sectional observational design. The study included a total of 136 glaucoma patients. The findings show that there is no link between gender and glaucoma (p = 0.202), while there is a link between age and glaucoma (p = 0.004). Furthermore, the findings demonstrate that there is no association between diabetic mellitus (DM) and glaucoma (p = 0.273), although there is a relationship between hypertension and healing degree (p = 0.035) and diabetes and healing degree (p = 0.001). The findings also show that the factors affecting injury are: age, gender, pressure, and geographical location, and that diabetes and climatic factors are not influential. Current findings may aid in the development of intervention strategies that will raise glaucoma awareness in the future.


2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
T Heseltine ◽  
SW Murray ◽  
RL Jones ◽  
M Fisher ◽  
B Ruzsics

Abstract Funding Acknowledgements Type of funding sources: None. onbehalf Liverpool Multiparametric Imaging Collaboration Background Coronary artery calcium (CAC) score is a well-established technique for stratifying an individual’s cardiovascular disease (CVD) risk. Several well-established registries have incorporated CAC scoring into CVD risk prediction models to enhance accuracy. Hepatosteatosis (HS) has been shown to be an independent predictor of CVD events and can be measured on non-contrast computed tomography (CT). We sought to undertake a contemporary, comprehensive assessment of the influence of HS on CAC score alongside traditional CVD risk factors. In patients with HS it may be beneficial to offer routine CAC screening to evaluate CVD risk to enhance opportunities for earlier primary prevention strategies. Methods We performed a retrospective, observational analysis at a high-volume cardiac CT centre analysing consecutive CT coronary angiography (CTCA) studies. All patients referred for investigation of chest pain over a 28-month period (June 2014 to November 2016) were included. Patients with established CVD were excluded. The cardiac findings were reported by a cardiologist and retrospectively analysed by two independent radiologists for the presence of HS. Those with CAC of zero and those with CAC greater than zero were compared for demographic and cardiac risks. A multivariate analysis comparing the risk factors was performed to adjust for the presence of established risk factors. A binomial logistic regression model was developed to assess the association between the presence of HS and increasing strata of CAC. Results In total there were 1499 patients referred for CTCA without prior evidence of CVD. The assessment of HS was completed in 1195 (79.7%) and CAC score was performed in 1103 (92.3%). There were 466 with CVD and 637 without CVD. The prevalence of HS was significantly higher in those with CVD versus those without CVD on CTCA (51.3% versus 39.9%, p = 0.007). Male sex (50.7% versus 36.1% p= <0.001), age (59.4 ± 13.7 versus 48.1 ± 13.6, p= <0.001) and diabetes (12.4% versus 6.9%, p = 0.04) were also significantly higher in the CAC group compared to the CAC score of zero. HS was associated with increasing strata of CAC score compared with CAC of zero (CAC score 1-100 OR1.47, p = 0.01, CAC score 101-400 OR:1.68, p = 0.02, CAC score >400 OR 1.42, p = 0.14). This association became non-significant in the highest strata of CAC score. Conclusion We found a significant association between the increasing age, male sex, diabetes and HS with the presence of CAC. HS was also associated with a more severe phenotype of CVD based on the multinomial logistic regression model. Although the association reduced for the highest strata of CAC (CAC score >400) this likely reflects the overall low numbers of patients within this group and is likely a type II error. Based on these findings it may be appropriate to offer routine CVD risk stratification techniques in all those diagnosed with HS.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anping Guo ◽  
Jin Lu ◽  
Haizhu Tan ◽  
Zejian Kuang ◽  
Ying Luo ◽  
...  

AbstractTreating patients with COVID-19 is expensive, thus it is essential to identify factors on admission associated with hospital length of stay (LOS) and provide a risk assessment for clinical treatment. To address this, we conduct a retrospective study, which involved patients with laboratory-confirmed COVID-19 infection in Hefei, China and being discharged between January 20 2020 and March 16 2020. Demographic information, clinical treatment, and laboratory data for the participants were extracted from medical records. A prolonged LOS was defined as equal to or greater than the median length of hospitable stay. The median LOS for the 75 patients was 17 days (IQR 13–22). We used univariable and multivariable logistic regressions to explore the risk factors associated with a prolonged hospital LOS. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated. The median age of the 75 patients was 47 years. Approximately 75% of the patients had mild or general disease. The univariate logistic regression model showed that female sex and having a fever on admission were significantly associated with longer duration of hospitalization. The multivariate logistic regression model enhances these associations. Odds of a prolonged LOS were associated with male sex (aOR 0.19, 95% CI 0.05–0.63, p = 0.01), having fever on admission (aOR 8.27, 95% CI 1.47–72.16, p = 0.028) and pre-existing chronic kidney or liver disease (aOR 13.73 95% CI 1.95–145.4, p = 0.015) as well as each 1-unit increase in creatinine level (aOR 0.94, 95% CI 0.9–0.98, p = 0.007). We also found that a prolonged LOS was associated with increased creatinine levels in patients with chronic kidney or liver disease (p < 0.001). In conclusion, female sex, fever, chronic kidney or liver disease before admission and increasing creatinine levels were associated with prolonged LOS in patients with COVID-19.


2018 ◽  
Vol 41 (4) ◽  
pp. 707-713 ◽  
Author(s):  
Allison Milner ◽  
Anne-Marie Bollier ◽  
Eric Emerson ◽  
Anne Kavanagh

Abstract Background People with disabilities often face a range of social and economic adversities. Evidence suggests that these disadvantages result in poorer mental health. Some research also indicates that people with disabilities are more likely experience thoughts about suicide than people without disability, although most of this research is based on small cross-sectional samples. Methods We explored the relationship between self-reported disability (measured at baseline) and likelihood of reporting thoughts of suicide (measured at follow up) using a large longitudinal cohort of Australian males. A logistic regression model was conducted with thoughts of suicide within the past 12 months (yes or no) as the outcome and disability as the exposure. The models adjusted for relevant confounders, including mental health using the SF-12 MCS, and excluded males who reported thoughts of suicide at baseline. Results After adjustment, there was a 1.48 (95% CI: 0.98–2.23, P = 0.063) increase in the odds of thoughts of suicide among men who also reported a disability. The size of association was similar to that of being unemployed. Conclusions Males reporting disability may also suffer from thoughts of suicide. We speculate that discrimination may be one explanation for the observed association. More research on this topic is needed.


2022 ◽  
Vol 14 (1) ◽  
pp. 20-25
Author(s):  
Riccardo Garbo ◽  
Francesca Valent ◽  
Gian Luigi Gigli ◽  
Mariarosaria Valente

There is limited information regarding the severity of COVID-19 in immunocompromized patients. We conducted a retrospective cohort study considering the period from 1 March 2020 to 31 December 2020 to determine whether previously existing lymphopenia increases the risk of hospitalization and death after SARS-CoV-2 infection in the general population. The laboratory and hospital discharge databases of the Azienda Sanitaria Universitaria Friuli Centrale were used, and 5415 subjects infected with SARS-CoV-2 and with at least one recent absolute lymphocyte count determination before SARS-CoV-2 positivity were included. In total, 817 (15.1%) patients had severe COVID-19. Patients developing severe COVID-19 were more frequently males (44.9% of the severe COVID-19 group vs. 41.5% in the non-severe COVID-19 group; p < 0.0001) and were older (73.2 ± 13.8 vs. 58.4 ± 20.3 years; p < 0.0001). Furthermore, 29.9% of the lymphopenic patients developed severe COVID-19 vs. 14.5% of the non-lymphopenic patients (p < 0.0001). In a logistic regression model, female sex remained a protective factor (OR = 0.514, 95%CI 0.438–0.602, p < 0.0001), while age and lymphopenia remained risk factors for severe COVID-19 (OR = 1.047, 95%CI 1.042–1.053, p < 0.0001 for each additional year of age; OR = 1.715, 95%CI 1.239–2.347, p = 0.0011 for lymphopenia). This provides further information to stratify the risk of COVID-19 severity, which may be an important element in the management of immunosuppressive therapies.


2021 ◽  
Author(s):  
Li Lu Wei ◽  
Yu jian

Abstract Background Hypertension is a common chronic disease in the world, and it is also a common basic disease of cardiovascular and brain complications. Overweight and obesity are the high risk factors of hypertension. In this study, three statistical methods, classification tree model, logistic regression model and BP neural network, were used to screen the risk factors of hypertension in overweight and obese population, and the interaction of risk factors was conducted Analysis, for the early detection of hypertension, early diagnosis and treatment, reduce the risk of hypertension complications, have a certain clinical significance.Methods The classification tree model, logistic regression model and BP neural network model were used to screen the risk factors of hypertension in overweight and obese people.The specificity, sensitivity and accuracy of the three models were evaluated by receiver operating characteristic curve (ROC). Finally, the classification tree CRT model was used to screen the related risk factors of overweight and obesity hypertension, and the non conditional logistic regression multiplication model was used to quantitatively analyze the interaction.Results The Youden index of ROC curve of classification tree model, logistic regression model and BP neural network model were 39.20%,37.02% ,34.85%, the sensitivity was 61.63%, 76.59%, 82.85%, the specificity was 77.58%, 60.44%, 52.00%, and the area under curve (AUC) was 0.721, 0.734,0.733, respectively. There was no significant difference in AUC between the three models (P>0.05). Classification tree CRT model and logistic regression multiplication model suggested that the interaction between NAFLD and FPG was closely related to the prevalence of overweight and obese hypertension.Conclusion NAFLD,FPG,age,TG,UA, LDL-C were the risk factors of hypertension in overweight and obese people. The interaction between NAFLD and FPG increased the risk of hypertension.


2020 ◽  
Author(s):  
Ying Tang ◽  
Huiquan Hu ◽  
Yalan Tang ◽  
Fangxiang Tang ◽  
Dan Lin ◽  
...  

Abstract Background: Detailed descriptions of the relationship between lymphocyte-to-monocyte ratio alone and combined with CA125 (COLC) and advanced stage of ovarian cancer (OC) have been lacking to date. This study is to analyze the relationship between LMR, CA125 and COLC and advanced stage of OC.Methods: A retrospective clinicopathologic review was performed. The receiver-operating characteristic (ROC) curves of LMR, CA125, and COLC staging OC were constructed. Furthermore, a binary logistic regression model was used to assay the independent risk factors.Results: A total of 225 patients with OC were identified in this cohort. Eighty-five patients with OC were diagnosed at an early stage, and 140 OC patients were diagnosed at an advanced stage. The median of LMR at the early stage was higher than the advanced stage (4.39 vs. 2.78), and the median of CA125 was lower than the advanced stage (80 U/mL vs. 251.25 U/mL). Multivariate logistic regression indicated that LMR (OR=0.314, 95% confidence interval [CI]: 0.143–0.687, P=0.004) and CA125 (OR=4.045, 95%CI: 1.883–8.692, P<0.001) were associated with OC staging. Furthermore, the area under the curve of COLC was higher than that of LMR (0.779 vs. 0.732) or CA125 (0.779 vs. 0.708) in staging OC. The specificity of COLC was higher than that of LMR (87.11% vs. 70.61%) or CA125 (87.11% vs. 61.21%) in staging OC.Conclusions: LMR alone or in combination with CA125 might be associated with OC staging. Besides, as a predictive factor, COLC may have high specificity in staging OC.


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