scholarly journals Impact of Multiple Factors on the Incidence of Developmental Dysplasia of the Hip

2021 ◽  
Author(s):  
Łukasz Pulik ◽  
Krzysztof Romaniuk ◽  
Aleksandra Sibilska ◽  
Andrzej Jedynak ◽  
Ignacy Tołowiński ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Positive Family History ◽  
Developmental Dysplasia ◽  
Risk Calculator ◽  
The Impact ◽  
Dysplasia Of The Hip

Abstract Introduction: Developmental dysplasia of the hip (DDH) is one of the most common musculoskeletal conditions in children. Not treated DDH leads to disability, gait abnormalities, limb shortening and chronic pain. Our study aims to determine the impact of multiple risk factors on the occurrence of DDH and develop an interactive risk assessment tool.Methods: We conducted a retrospective cohort study in the Outpatient Clinic for Children of University Hospital. The Graf classification system was used for ultrasonographic universal screening. In total, 4881 infants met the eligibility criteria (n = 9762 hip joints). Hypothesis testing was performed with χ² test and logistic regression.Results: The incidence of DDH was 4.57%. We have proven risk factors of DDH: female gender (OR=7.11), breech position (OR=3.65), Caesarean section (OR=1.43), positive family history in parent (OR=1.92) or sibling (OR=3.84). Preterm delivery decreased the risk (OR=0.17). Logistic regression was used to construct the interactive risk calculator.Conclusion: The DDH risk calculator was built but needs external validation in prospective study before being used in a clinical setting. We confirmed well-known DDH risk factors in the studied population. Our results support the recent hypothesis that preterm infants (37 < week) have lower rate of DDH.Level of Evidence:Retrospective cohort study: Level III

scholarly journals Impact of multiple factors on the incidence of developmental dysplasia of the hip: risk assessment tool

2022 ◽  
Author(s):  
Łukasz Pulik ◽  
Katarzyna Poszka ◽  
Krzysztof Romaniuk ◽  
Aleksandra Sibilska ◽  
Andrzej Jedynak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Assessment Tool ◽  
Developmental Dysplasia ◽  
Risk Assessment Tool ◽  
Risk Calculator ◽  
Dysplasia Of The Hip

Abstract Introduction: Developmental dysplasia of the hip (DDH) is one of the most common musculoskeletal conditions in children. Not treated DDH leads to disability, gait abnormalities, limb shortening and chronic pain. Our study aims to determine the impact of multiple risk factors on the occurrence of DDH and develop an interactive risk assessment tool.Materials and Methods: We conducted a retrospective cohort study in the Outpatient Clinic for Children of University Hospital. The Graf classification system was used for ultrasonographic universal screening. In total, 3102 infants met the eligibility criteria (n =6204 hip joints). Results: The incidence of DDH was 4.45%. In multivariate analysis, risk factors for DDH were weight (OR = 2.17 (1.41-3.32)), week of delivery (OR = 1.18 (1.00-1.37)), gender (OR = 8.16 (4.86-13.71)), breech delivery presentation (OR = 5.92 (3.37-10.40)), symptoms of DDH (25.28 (8.77-72.83)) and positive family history in siblings (5.74 (2.68-12.31)). Multivariate logistic regression predictive model was used to construct the interactive risk calculator.Conclusion: We confirmed well-known DDH risk factors in the studied population. Our results support the recent hypothesis that preterm infants (37 < week) have lower rate of DDH. The DDH risk calculator was built but needs external validation in prospective study before being used in a clinical setting.Level of Evidence: Retrospective cohort study: Level III

scholarly journals Pre-Existing Lymphopenia Increases the Risk of Hospitalization and Death after SARS-CoV-2 Infection

2022 ◽  
Vol 14 (1) ◽  
pp. 20-25
Author(s):  
Riccardo Garbo ◽  
Francesca Valent ◽  
Gian Luigi Gigli ◽  
Mariarosaria Valente
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cohort Study ◽  
General Population ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Logistic Regression Model ◽  
Protective Factor ◽  
Absolute Lymphocyte Count ◽  
Limited Information

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.

scholarly journals Cryptococcal meningitis in a tertiary hospital in Pretoria, mortality and risk factors – A retrospective cohort study

2016 ◽  
Vol 28 (5) ◽  
pp. 480-485 ◽  
Author(s):  
J Hiesgen ◽  
C Schutte ◽  
S Olorunju ◽  
J Retief
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Mortality Risk ◽  
Retrospective Cohort Study ◽  
Cryptococcal Meningitis ◽  
Retrospective Cohort ◽  
Nausea And Vomiting ◽  
People Living With Hiv

Aim This retrospective cohort study analyzes the impact of possible risk factors on the survival chance of patients with cryptococcal meningitis. These factors include the patient’s socio-economic background, age, gender, presenting symptoms, comorbidities, laboratory findings and, in particular, non-adherence versus adherence to therapy. Methods Data were collected from all adult patients admitted to Kalafong Hospital with laboratory confirmed cryptococcal meningitis over a period of 24 months. We analyzed the data by the presentation of descriptive summary statistics, logistic regression was used to assess factors which showed association between outcome of measure and factor. Furthermore, multivariable logistic regression analysis using all the factors that showed significant association in the cross tabulation was applied to determine which factors had an impact on the patients’ mortality risk. Results A total of 87 patients were identified. All except one were HIV-positive, of which 55.2% were antiretroviral therapy naïve. A history of previous tuberculosis was given by 25 patients (28.7%) and 49 (56.3%) were on tuberculosis treatment at admission or started during their hospital stay. In-hospital mortality was 31%. Statistical analysis showed that antiretroviral therapy naïve patients had 9.9 (CI 95% 1.2–81.2, p < 0.0032) times greater odds of dying compared to those on antiretroviral therapy, with 17 from 48 patients (35.4%) dying compared with 1 out of 21 patients (4.8%) on treatment. Defaulters had 14.7 (CI 95% 1.6–131.6, p < 0.016) times greater odds of dying, with 9 from 18 patients dying (50%), compared to the non-defaulters. In addition, patients who presented with nausea and vomiting had a 6.3 (95% CI 1.7–23.1, p < 0.005) times greater odds of dying (18/47, 38.3%); this remained significant when adjusted for antiretroviral therapy naïve patients and defaulters. Conclusion Cryptococcal meningitis is still a common opportunistic infection in people living with HIV/AIDS resulting in hospitalization and a high mortality. Defaulting antiretroviral therapy and presentation with nausea and vomiting were associated with a significantly increased mortality risk.

scholarly journals Fatality and risk features for prognosis in COVID-19 according to the care approach – a retrospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248869
Author(s):  
Mariano Andrés ◽  
Jose-Manuel Leon-Ramirez ◽  
Oscar Moreno-Perez ◽  
José Sánchez-Payá ◽  
Ignacio Gayá ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Troponin T ◽  
Invasive Mechanical Ventilation ◽  
Academic Center ◽  
Care Approach ◽  
Independent Risk Factors ◽  
The Impact

Introduction This study analyzed the impact of a categorized approach, based on patients’ prognosis, on major outcomes and explanators in patients hospitalized for COVID-19 pneumonia in an academic center in Spain. Methods Retrospective cohort study (March 3 to May 2, 2020). Patients were categorized according to the followed clinical management, as maximum care or limited therapeutic effort (LTE). Main outcomes were all-cause mortality and need for invasive mechanical ventilation (IMV). Baseline factors associated with outcomes were analyzed by multiple logistic regression, estimating odds ratios (OR; 95%CI). Results Thirty-hundred and six patients were hospitalized, median age 65.0 years, 57.8% males, 53.3% Charlson index ≥3. The overall all-cause fatality rate was 15.0% (n = 46). Maximum care was provided in 238 (77.8%), IMV was used in 38 patients (16.0%), and 5.5% died. LTE was decided in 68 patients (22.2%), none received IMV and fatality was 48.5%. Independent risk factors of mortality under maximum care were lymphocytes <790/mm3, troponin T >15ng/L and hypotension. Advanced age, lymphocytes <790/mm3 and BNP >240pg/mL independently associated with IMV requirement. Conclusion Overall fatality in the cohort was 15% but markedly varied regarding the decided approach (maximum care versus LTE), translating into nine-fold higher mortality and different risk factors.

Traditional Chinese Medicine Decoctions Significantly Reduce the Mortality in Severe and Critically Ill Patients with COVID-19: A Retrospective Cohort Study

2021 ◽  
pp. 1-30
Author(s):  
Qin-Guo Sun ◽  
Xue-Dong An ◽  
Ping Xie ◽  
Bo Jiang ◽  
Jia-Xing Tian ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cohort Study ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Propensity Score ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Hospital Death ◽  
The Impact

Coronavirus disease (COVID-19) is a new infectious disease associated with high mortality, and traditional Chinese medicine decoctions (TCMDs) have been widely used for the treatment of patients with COVID-19 in China; however, the impact of these decoctions on severe and critical COVID-19-related mortality has not been evaluated. Therefore, we aimed to address this gap. In this retrospective cohort study, we included inpatients diagnosed with severe/critical COVID-19 at the Tongren Hospital of Wuhan University and grouped them depending on the recipience of TCMDs (TCMD and non-TCMD groups). We conducted a propensity score-matched analysis to adjust the imbalanced variables and treatments and used logistic regression methods to explore the risk factors associated with in-hospital death. Among 282 patients with COVID-19 who were discharged or died, 186 patients (66.0%) received TCMD treatment (TCMD cohort) and 96 (34.0%) did not (non-TCMD cohort). After propensity score matching at a 1:1 ratio, 94 TCMD users were matched to 94 non-users, and there were no significant differences in baseline clinical variables between the two groups of patients. The all-cause mortality was significantly lower in the TCMD group than in the non-TCMD group, and this trend remained valid even after matching (21.3% [20/94] vs. 39.4% [37/94]). Multivariable logistic regression model showed that disease severity (odds ratio: 0.010; 95% CI: 0.003, 0.037; [Formula: see text] < 0.001) was associated with increased odds of death and that TCMD treatment significantly decreased the odds of in-hospital death (odds ratio: 0.115; 95% CI: 0.035, 0.383; [Formula: see text] < 0.001), which was related to the duration of TCMD treatment. Our findings show that TCMD treatment may reduce the mortality in patients with severe/critical COVID-19.

scholarly journals Long-term outcome following medial open reduction in developmental dysplasia of the hip: a retrospective cohort study

2016 ◽  
Vol 10 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Richard O. E. Gardner ◽  
Catharine S. Bradley ◽  
Om P. Sharma ◽  
Lin Feng ◽  
Michelle EyunJung Shin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Open Reduction ◽  
Retrospective Cohort ◽  
Developmental Dysplasia ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Medial Open Reduction ◽  
Dysplasia Of The Hip

Risk factors for amendment in type, duration and setting of prescribed outpatient parenteral antimicrobial therapy (OPAT) for adult patients with cellulitis: a retrospective cohort study and CART analysis

2017 ◽  
Vol 94 (1107) ◽  
pp. 25-31 ◽  
Author(s):  
Michael Quirke ◽  
Emma May Curran ◽  
Patrick O’Kelly ◽  
Ruth Moran ◽  
Eimear Daly ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cohort Study ◽  
Antimicrobial Therapy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Adult Patients ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Cart Analysis ◽  
Cart Algorithm

Purpose of the studyTo measure the percentage rate and risk factors for amendment in the type, duration and setting of outpatient parenteral antimicrobial therapy (OPAT) for the treatment of cellulitis.Study designA retrospective cohort study of adult patients receiving OPAT for cellulitis was performed. Treatment amendment (TA) was defined as hospital admission or change in antibiotic therapy in order to achieve clinical response. Multivariable logistic regression (MVLR) and classification and regression tree (CART) analysis were performed.ResultsThere were 307 patients enrolled. TA occurred in 36 patients (11.7%). Significant risk factors for TA on MVLR were increased age, increased Numerical Pain Scale Score (NPSS) and immunocompromise. The median OPAT duration was 7 days. Increased age, heart rate and C reactive protein were associated with treatment prolongation. CART analysis selected age <64.5 years, female gender and NPSS <2.5 in the final model, generating a low-sensitivity (27.8%), high-specificity (97.1%) decision tree.ConclusionsIncreased age, NPSS and immunocompromise were associated with OPAT amendment. These identified risk factors can be used to support an evidence-based approach to patient selection for OPAT in cellulitis. The CART algorithm has good specificity but lacks sensitivity and is shown to be inferior in this study to logistic regression modelling.

scholarly journals Risk Factors for Mortality in Melioidosis: A Single-Centre, 10-Year Retrospective Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Raviraj Menon ◽  
Poornima Baby ◽  
Anil Kumar V. ◽  
Sandeep Surendran ◽  
Manu Pradeep ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Logistic Regression Analysis ◽  
Mortality Risk ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Therapeutic Benefits ◽  
Chi Square Analysis

Melioidosis is a tropical infectious disease with diverse clinical presentations. We aimed to investigate the characteristics and mortality risk factors of patients diagnosed with melioidosis in the past 10 years. This was a retrospective cohort study conducted at a quaternary care centre in South India. Clinical, demographic, and biochemical data in patients diagnosed with melioidosis with cultures were collected between January 2011 and December 2020 from medical records. Logistic regression analysis was performed to screen mortality risk factors of melioidosis in addition to descriptive statistics and chi-square analysis. Seventy-three melioidosis patients’ records were analysed, and the most common comorbidity was type 2 diabetes mellitus (n = 53, 72.6%). The patients showed diverse presentations: pulmonary involvement, 30 (41.1%); splenomegaly, 29 (39.7%); abscesses and cutaneous involvement, 18 (24.7%); lymph node, 10 (13.7%); arthritis and osteomyelitis, 9 (12.3%); and genitourinary infection, 4 (5.4%). The mortality was noted to be 15 (20.5%). Logistic regression analysis indicated that chronic kidney disease (OR = 14.0), CRP >100 IU/L (OR = 6.964), and S. albumin <3 gm/dl (OR = 8.0) were risk factors associated with mortality and can guide in risk stratification. Hypoalbuminemia is a novel mortality risk factor, detected in this study, and requires further investigation to validate its utility as a prognostic marker and reveal possible therapeutic benefits in clinical correction.

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