scholarly journals Outcomes and Risk Factors for Failed Trial of Labor After Cesarean Delivery (TOLAC) in Women with One Previous Cesarean Section: A Chinese Population-Based Study

2021 ◽  
Author(s):  
Xiaobo He ◽  
Qiaona Dai ◽  
Xiaoli Wu ◽  
Junjun Zhou ◽  
Jie Li
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cesarean Delivery ◽  
Chinese Population ◽  
Pregnancy Termination ◽  
Multiple Logistic Regression Analysis ◽  
Induction Of Labor ◽  
Multiple Logistic Regression ◽  
Trial Of Labor ◽  
Previous Cesarean

Abstract Background To evaluate the outcomes and risk factors for trial of labor after cesarean delivery (TOLAC) failure in patients in China. Methods Consecutive patients who had a previous cesarean delivery (CD) and were scheduled for TOLAC were included from 2014 to 2020. Patients who successfully delivered were classified into the TOLAC success group. Patients who were scheduled for TOLAC and had a repeat CD due to medical issues were classified into the TOLAC failure group. Multiple logistic regression analyses were performed to examine the risk factors for TOLAC failure. Results In total, 720 women who had a previous CD and were scheduled for TOLAC were identified and included. The success rate of TOLAC was 84.17% (606/720). Seven patients were diagnosed with uterine rupture, none of whom underwent hysterectomy. Multiple logistic regression analysis showed that the gestational weeks at pregnancy termination (odds ratio [OR] = 3.046, 95% confidence interval [CI]: 0.962-9.642, P = 0.005) and induction of labor (OR = 2.843, 95% CI: 1.571-5.145, P = 0.001) were positively associated with TOLAC failure. In contrast, the thickness of the lower uterine segment (LUS) (OR = 0.215, 95% CI: 0.103-0.448, P = 0.001) was negatively related to TOLAC failure. Conclusions This study suggests that TOLAC is effective in decreasing CD rates in the Chinese population. The gestational weeks at pregnancy termination and induction of labor were positively associated with TOLAC failure. Our findings need to be confirmed in larger samples with patients of different ethnicities.

Case control study of gastrointestinal complications after cardiopulmonary bypass heart surgery

Perfusion ◽  
2009 ◽  
Vol 24 (3) ◽  
pp. 173-178 ◽  
Author(s):  
Guowei Zhang ◽  
Naishi Wu ◽  
Hongyu Liu ◽  
Hang Lv ◽  
Zhifa Yao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cardiopulmonary Bypass ◽  
Heart Surgery ◽  
Perfusion Pressure ◽  
Multiple Logistic Regression Analysis ◽  
Univariate Analysis ◽  
Multiple Logistic Regression ◽  
Gastrointestinal Complications ◽  
Preoperative Serum

Background: Gastrointestinal complications (GIC) after cardiopulmonary bypass (CPB) surgery are rare, but, nevertheless, extremely dangerous.The identification of risks for GIC may be helpful in planning appropriate perioperative management strategies. The aim of the present study was to analyze perioperative factors of GIC in patients undergoing CPB surgery. Methods: We retrospectively analysed 206 patients who underwent GIC after cardiopulmonary bypass surgery from 2000 to 2007 and compared them with 206 matched control patients (matched for surgery, temperature, hemodilution and date). Univariate analysis and multiple logistic regression analysis were performed on 12 risk factors. Result: Sex and types of cardioplegia perfusate did not significantly influence the GIC after CPB surgery. Multiple logistic regression revealed that CPB time, preoperative serum creatinine (PSC) ≥ 179 mg/dL, emergency surgery, perfusion pressure ≤40mmHg, low cardiac output syndrome (LCOS), age ≥ 61, mechanical ventilation ≥96 h, New York Heart Association (NYHA) class III and IV were predictors of the occurrence of GIC after CPB surgery. Perfusion pressure and aprotinin administration were protective factors. Conclusion: Gastrointestinal complications after CPB surgery could be predictive in the presence of the above risk factors. This study suggests that GIC can be reduced by maintenance of higher perfusion pressure and shortening the time on CPB and ventilation.

scholarly journals Association of the location and initial degree of malignant central airway stenosis with the risk of severe restenosis after interventional bronchoscopy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saibin Wang ◽  
Renzhi Zhou ◽  
Siyao Zhu ◽  
Dan Yan
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Main Bronchus ◽  
Multiple Logistic Regression Analysis ◽  
Left Main Bronchus ◽  
Multiple Logistic Regression ◽  
Left Main ◽  
Initial Degree ◽  
Central Airway

Abstract Background Therapeutic bronchoscopy is one of the effective methods in the treatment and management of malignant central airway stenosis (MCAS). However, restenosis after therapeutic bronchoscopy frequently occurs and severe restenosis (SR) can be life-threatening. Therefore, this study aimed at investigating the risk factors for SR after therapeutic bronchoscopy. Methods The data of 233 consecutive cases with MCAS who were subjected to therapeutic bronchoscopy between 2015 and 2020 at a tertiary hospital were collected. Patients were divided into SR group and non-SR during 6 months after therapeutic bronchoscopy. Multiple logistic regression analysis was performed to determine the risk factors for SR. Results SR during 6 months after therapeutic bronchoscopy occurred in 39.5% (92/233) of patients. The location and the initial degree of MCAS were associated with SR, as assessed by multiple logistic regression analysis (P < 0.05). The risk of SR after therapeutic bronchoscopy in the left main bronchus, right main bronchus, and right intermediate bronchus increased, compared to the risk when of MCAS was located in the trachea (OR (95% CI) of 8.821 (1.850-25.148), 6.583 (1.791–24.189), and 3.350 (0.831–13.511), respectively). In addition, the initial degree of MCAS was positively associated with an increased risk of SR (OR 1.020; 95% CI 1.006–1.035). Conclusions MCAS located in the left main bronchus, right main bronchus and right intermediate bronchus, as well as the higher initial degree of MCAS were independent risk factors for SR during 6 months after therapeutic bronchoscopy.

scholarly journals Cardiovascular Risk Factors in Pre-dialysis Chronic Kidney Disease patients of Nepal

2020 ◽  
Vol 9 (2) ◽  
pp. 47-53
Author(s):  
Kashyap Dahal ◽  
A. Baral ◽  
K.K. Sah ◽  
J.R. Shrestha ◽  
A. Niraula ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Kidney Disease ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Traditional Risk Factors

Background and Aims: Cardiovascular disease (CVD) is the commonest cause of morbidity and mortality in patients with chronic kidney disease (CKD) due to increased prevalence of traditional and nontraditional CVD risk factors. Our study aimed to evaluate these risk factors in pre-dialysis Nepalese CKD patients. Methods: This was a cross-sectional study conducted in Department of Nephrology, Bir hospital. Total 100 consecutive pre-dialysis CKD patients were enrolled. Ten traditional and six nontraditional CVD risk factors were analyzed and compared between CKD stages. Descriptive statistics was used to illustrate the socio-demographic and clinical characteristics, chi square test for categorical variables and multiple logistic regression analysis was done to determine the risk factors of CVD in CKD patients. p-value<0.05 was considered to be statistically significant. Results: Mean patient age was 52.03}13.64 years with majority (60%) of the patients being male. Comparison of traditional risk factors in different stages depicted similar trend except for old age in Stage 3 CKD (p=0.002). Anemia (p<0.001), hyperphosphatemia (p=0.01), hyperparathyroidism (p<0.01) and cumulative nontraditional risk factors were significantly higher (p=0.01) in stage 5 CKD. The predicted CVD events by Framingham risk score showed high risk in 37% with no significant difference among the stages. Multiple logistic regression analysis showed increased body mass index, low serum albumin and increased serum phosphate as the three significant predictors for left ventricular hypertrophy. Conclusion: Our study shows that the CVD risk factors were prevailing along the various stages of CKD. The occurrence of non-traditional risk factors increased with increasing stage of CKD.

scholarly journals Prevalence of Depression and its Associated Factors among Medical Students in International Islamic University Malaysia (IIUM)

2021 ◽  
Vol 20 (4) ◽  
Author(s):  
Abdul Hadi Said ◽  
Muhammad Addin Nur Hakim Azmi ◽  
Haziqah Mohd Hanapiah ◽  
Anis Wardati Abdullah ◽  
Mohd Shaiful Ehsan Shalihin
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Logistic Regression ◽  
Medical Students ◽  
Associated Factors ◽  
Multiple Logistic Regression Analysis ◽  
Regular Physical Activity ◽  
Multiple Logistic Regression ◽  
Cross Sectional ◽  
Prevalence Of Depression

Introduction: Globally, depression is one of the serious problems reported among medical students. Various studies reported that the prevalence of depression among medical students was high due to multiple risk factors. Therefore, this study aimed to measure the prevalence of depression and its associated factors among medical students in International Islamic University Malaysia (IIUM). Materials and Methods: A cross-sectional study was conducted among 500 medical students in IIUM Kuantan. A validated self-reported questionnaire using Depression Anxiety Stress Score 21 was distributed during the second semester of the 2018/2019 session. Descriptive statistics were used to measure the prevalence of depression. Chi-square test, Fisher’s exact test, independent sample T-test, and multiple logistic regression were used to determine the association between risk factors and depression. Result: The prevalence of depression was 39% with 10.5% of them were having severe and extremely severe level of depression. Multiple logistic regression analysis showed regular physical activity (AOR=0.64, 95% CI: 0.42-0.98) and Tahajjud prayer practice (AOR: 0.76, 95% CI 0.66-0.88) are two protective factors against depression among medical students. Conclusion: About two out of every five IIUM medical students had depression. Regular physical activity and Tahajjud prayer practised may reduce the risk of depression and should be encouraged.

scholarly journals Outcomes of induction in trial of labor after cesarean delivery

2019 ◽  
Vol 8 (3) ◽  
pp. 1076
Author(s):  
Anubha Varshney ◽  
Zehra Mohsin
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Induction Of Labor ◽  
Control Group ◽  
Study Group ◽  
Previous Cesarean Section ◽  
Trial Of Labor ◽  
Previous Cesarean

Background: The objective of this study is to evaluate the outcomes of induction of labor in women attempting trial of labor after cesarean delivery and to compare maternal and neonatal morbidity and mortality in women who were induced to those delivering spontaneously.Methods: The prospective study was carried out in the Department of Obstetrics and Gynecology in collaboration with the Neonatal Section, Department of Pediatrics at J.N. Medical College and Hospital, AMU Aligarh. The sample included 280 women with one previous cesarean section, of whom 130 women underwent induction of labor (study group) and 150 were admitted with spontaneous onset of labor. Prostaglandin gel and intracervical Foley’s were used for cervical ripening in the study group. Indication of cesarean section, mode of delivery, maternal and neonatal outcome were studied in between groups.Results: Overall rate of vaginal delivery after cesarean section was 45.3% and 56% in both study and control group respectively. The rate of cesarean section were higher in women who were induced and having unfavorable cervix. Maternal and neonatal morbidity were not significantly higher as compared in both groups, however one case of scar rupture was found in study group.Conclusions: Induction of labor in women with previous cesarean section had higher rates of cesarean section however it does not adversely affect neonatal and maternal morbidity. Overall vaginal birth is safe and effective in women with previous cesarean section by prostaglandin gel or intracervical Foley’s. Authors cautiously suggest, induction of labor should be considered in preselected patient with strict monitoring.

scholarly journals 447 - Risk factors associated with sleep disturbance in a general elderly Japanese population: The Arao Cohort Study

2020 ◽  
Vol 32 (S1) ◽  
pp. 167-167
Author(s):  
Kazuki Honda ◽  
Tomohisa Ishikawa ◽  
Ryuji Fukuhara ◽  
Seiji Yuki ◽  
Yusuke Miyagawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Sleep Disturbance ◽  
Logistic Regression Analysis ◽  
Barthel Index ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Factors Associated

[Background]Sleep disturbance is a common symptom in elderly people. However, the associated risk factors have not been completely clarified. We examined possible risk factors associated with sleep disturbance in a community-based Japanese cohort study.[Methods]1521 community-dwelling individuals aged 65 years or older were selected from a consecutive series at a cohort study from 2016 to 2018 in Arao city, where located at south part of Japan. In this survey, the clinical valuables were collected as follows: age, sex, occupational status, education, lifestyle information, medical history, EuroQoL(EQ)-5D (a score of health-related quality of life [QOL]), Barthel index (a score of performance in activities of daily living), a score of Geriatric Depression Scale (GDS) and a score of Mini-Mental State Examination (MMSE). Sleep disturbance was assessed by the Pittsburgh Sleep Quality Index (when the global score was 6 or over, sleep disturbance was determined to be present). Multiple logistic regression analysis was used to examine the association between clinical valuables and sleep disturbance. This research was supported by AMED (Japan Agency for Medical Research and Development) under Grant Number JP18dk0207025h0003 and has been approved by the research ethics committee of Kumamoto University. Informed consent was obtained from all participants and their family members.[Results]Multiple logistic regression analysis revealed that Parkinson disease (Odds ratio[OR]=5.59), living alone (OR=1.93), liver disease (OR=1.89), hyperlipidemia (OR=1.36), higher score of GDS (OR=1.14), lower scores of both EQ-5D index (OR=1.11) and Barthel index (OR=1.03) were significantly associated as risk factors with sleep disturbance. Unexpectedly, lower score of MMSE was not a significant risk factor.[Conclusion]These results suggest that several physical illnesses, solitude, depressive symptoms and lower QOL, but not cognitive impairment, might be crucial risk factors associated with sleep disturbance in elderly population.

scholarly journals Early detection of postpartum depression (PPD) for women suffering high-risk pregnancy: An explorative study on self-perceived burden and other prenatal risk factors of immediate PPD among women hospitalized with threatened preterm labour1

2020 ◽  
Author(s):  
Qianqian Ni ◽  
GuiZhi Cheng ◽  
An Chen ◽  
Seppo Heinonen
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Logistic Regression ◽  
High Risk ◽  
Postpartum Depression ◽  
Pregnant Women ◽  
Multiple Logistic Regression Analysis ◽  
Delivery Mode ◽  
Multiple Logistic Regression ◽  
Perceived Burden

Abstract Background: The mental health of pregnant women, particularly those with elevated risks, has been an issue of global concern. Thus far, few studies have addressed mental health of pregnant women with threatened preterm labour (TPL). In the present study, we investigated self-perceived burden (SPB) and postpartum depression (PPD) among hospitalized pregnant women with TPL, exploring the association of SPB with PPD, and identifying other potential risk factors of early PPD. Methods: A self- reported survey conducted in the Obstetrics Department of Anhui Provincial Hospital, People’s Republic of China. Women hospitalized with TPL were approached one week after delivery. One hundred fifty women were recruited from January 2017 to December 2017. Self-Perceived Burden Scale (SPBS), Edinburgh Postnatal Depression Scale (EPDS), and Multidimensional Scale of Perceived Social Support (MSPSS) were the main measures. Descriptive statistics, Spearman's correlation, and multiple logistic regression were employed for data analysis.Results: SPB and PPD were commonly experienced by women hospitalized with TPL, and SPB was positively and significantly correlated with PPD. A multiple logistic regression analysis revealed that, for the women hospitalized with TPL during pregnancy, the emotional aspect of SPB (OR = 1.473, 95% CI = 1.141–1.903, p = 0.003), age (OR = 1.178, 95%CI = 1.056–1.314, p = 0.003), occupation (OR = 0.282, 95%CI = 0.095–0.023, p = 0.023), history of scarred uterus (OR = 0.163, 95%CI = 0.034–0.769, p = 0.022), delivery mode (OR = 5.974, 95%CI = 1.750–20.396, p = 0.004), and family support to women hospitalized with TPL during pregnancy (OR = 0.665, 95% CI = 0.498–0.887, p = 0.006) were the significant factors predicting early signs of PPD. Conclusion: This study indicated that SPB and PPD were prevalent mental issues among hospitalized women with TPL, and SPB, especially perceived emotional burden, is a strong predictor of PPD. Our study suggests the necessity of paying attention to mental health issues—especially SPB and PPD—among hospitalized women with TPL, as well as providing appropriate interventions at the prenatal stage to prevent adverse consequences. Perceiving support from family during pregnancy with high risk can help women in reducing the risk of PPD.

scholarly journals The feasibility of colorectal endoscopic submucosal dissection for the treatment of residual or recurrent tumor localized in therapeutic scar tissue

2017 ◽  
Vol 05 (12) ◽  
pp. E1242-E1250 ◽  
Author(s):  
Ryosuke Kobayashi ◽  
Kingo Hirasawa ◽  
Ryosuke Ikeda ◽  
Takeh de Fukuchi ◽  
Yasuaki Ishii ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Treatment Time ◽  
Multiple Logistic Regression Analysis ◽  
Scar Tissue ◽  
Prolonged Treatment ◽  
Multiple Logistic Regression ◽  
Colorectal Tumors ◽  
High Risk Factors

Abstract Background and study aims Endoscopic submucosal dissection (ESD) is used to treat superficial colorectal tumors. Previous studies have reported the efficacy of ESD for treating residual or local recurrent colorectal tumors. This study sought to evaluate the efficacy of ESD in treating these lesions and to assess factors that prevent successful ESD. Methods This retrospective study assessed 25 cases of residual or local recurrent lesions that were previously treated using EMR (18 lesions), TEM (5 lesions), ESD (1 lesion) or surgery (1 lesion), and 459 primary lesions treated using ESD between April 2008 and September 2015. Clinicopathological characteristics, treatment outcome and adverse events were compared between groups with or without scar tissue. Factors related to perforation and a prolonged treatment time, which indicate the likelihood of technical difficulties, were identified using multiple logistic regression analysis. Results In residual or local recurrent lesions groups, patients experienced more perforations (32 % vs 4 %, P < 0.001) and required a longer treatment time (117 min vs 61 min, P < 0.001) compared with the primary lesions group. Both groups showed a similar curative resection rate. Emergency surgery was not needed in any case. Multiple logistic regression analysis indicated that tumor location and therapeutic scar tissue were high risk factors for perforation, and that large tumor size and therapeutic scar tissue were high risk factors for prolonged treatment time. Conclusions ESD for residual or local recurrent colorectal tumors is a technically challenging, but effective and minimally invasive treatment. When performed carefully with sufficient proficiency, it is a useful treatment option.

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