Postoperative Morbidity Risk Factors After Conservative Surgery of Hydatic Cyst of the Liver: A Retrospective Study of 151 Hydatic Cysts of the Liver

Abstract Background: Hepatic hydatid cyst is an endemic parasitosis in Tunisia. Although most of these cysts are benign; their treatment may lead to several complications which can cause an important post-operative morbidity and mortality.The purpose of the present paper is to assess the morbidity and mortality specifics risk factors of hepatic hydatid cysts after conservative surgery.Methods: We conducted a retrospective study of 102 patients over a period of 13 years, from 2006 to 2019. We included all patients operated on for hydatid cyst of the liver, complicated and uncomplicated, in the Department of General Surgery of Mahdia, Tunisia.We excluded patients who received an exclusive medical treatment and those who have other hydatic cyst localizations.Descriptive statistics,bivariate analysis using chi-squared test and Fisher’s exact test for categorical variables;t-test,ANOVA , and Kruskal–Wallis for continuous variables; odds ratio calculations, ordinal and multivariate logistic regression models were appliedResults: The cohort was composed of 102 patients with a total of 151 cysts operated on using conservative surgery, among them there was 75 women (73, 5%) and 27 men (26.5%). The median age was 43, with extremes ranging from 12 to 88 years. The majority of patients (94. 1%) were from rural areas. The cysts were uncomplicated in about half of the cases (48%), elsewhere complications such as compression of neighboring organs (25,5%), opening in the bile ducts (16,7%), infection (9,8%), and rupture in the peritoneum (2%) were found. Conservative surgery was the mainstay of treatment with an overall mortality rate of 1. 9%. The overall morbidity rate was 22%: 14% specific morbidity and 8% non-specific morbidity. External biliary fistula was the most common postoperative complication (9%). The predictive factors of morbidity in univariate analysis were Preoperative hydatid cyst infection (P = 0.01), Compressive cysts (P=0.05), preoperative fever and jaundice, (respectively P=0. 03 and P=0. 02), no one achieved statistical significance in the multivariate modelConclusions:Preoperative hydatid cyst infection, compressive cysts and preoperative fever and jaundice are significant predictor factors of morbidity after conservative surgery for liver hydatid cyst. They must be considered in the treatment and the surgical decision for patients with hydatid cyst.

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Risk factors for drug-resistant tuberculosis, the association between comorbidity status and drug-resistant patterns: a retrospective study of previously treated pulmonary tuberculosis in Shandong, China, during 2004–2019

BMJ Open ◽

10.1136/bmjopen-2020-044349 ◽

2021 ◽

Vol 11 (6) ◽

pp. e044349

Author(s):

Ning-ning Tao ◽

Yi-fan Li ◽

Wan-mei Song ◽

Jin-yue Liu ◽

Qian-yun Zhang ◽

...

Keyword(s):

Risk Factors ◽

Drug Resistance ◽

Retrospective Study ◽

Pulmonary Tuberculosis ◽

Logistic Models ◽

Smoking History ◽

Categorical Variables ◽

Drug Resistant ◽

Drug Resistant Tuberculosis ◽

Resistant Tuberculosis

ObjectiveThis study was designed to identify the risk factors for drug-resistant tuberculosis (DR-TB) and the association between comorbidity and drug resistance among retreated pulmonary tuberculosis (PTB).DesignA retrospective study was conducted among all the 36 monitoring sites in Shandong, China, over a 16-year period. Baseline characteristics were collected from the TB Surveillance System. Categorical variables were compared by Fisher’s exact or Pearson’s χ2 test. The risk factors for drug resistance were identified using univariable analysis and multivariable logistic models. The influence of comorbidity on different types of drug resistance was evaluated by performing multivariable logistic models with the covariates adjusted by age, sex, body mass index, drinking/smoking history and cavity.ResultsA total of 10 975 patients with PTB were recorded during 2004–2019, and of these 1924 retreated PTB were finally included. Among retreated PTB, 26.2% were DR-TB and 12.5% had comorbidity. Smoking (adjusted OR (aOR): 1.69, 95% CI 1.19 to 2.39), cavity (aOR: 1.55, 95% CI 1.22 to 1.97) and comorbidity (aOR: 1.44, 95% CI 1.02 to 2.02) were risk factors for DR-TB. Of 504 DR-TB, 9.5% had diabetes mellitus, followed by hypertension (2.0%) and chronic obstructive pulmonary disease (1.8%). Patients with retreated PTB with comorbidity were more likely to be older, have more bad habits (smoking, alcohol abuse) and have clinical symptoms (expectoration, haemoptysis, weight loss). Comorbidity was significantly associated with DR-TB (aOR: 1.44, 95% CI 1.02 to 2.02), overall rifampin resistance (aOR: 2.17, 95% CI 1.41 to 3.36), overall streptomycin resistance (aOR: 1.51, 95% CI 1.00 to 2.27) and multidrug resistance (aOR: 1.96, 95% CI 1.17 to 3.27) compared with pan-susceptible patients (p<0.05).ConclusionSmoking, cavity and comorbidity lead to an increased risk of drug resistance among retreated PTB. Strategies to improve the host’s health, including smoking cessation, screening and treatment of comorbidity, might contribute to the control of tuberculosis, especially DR-TB, in China.

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MO775CONTROL OF BONE DISEASE ASSOCIATED WITH CHRONIC KIDNEY DISEASE AS A PREDICTOR OF PRIMARY PERMEABILITY AFTER THE CREATION OF THE VASCULAR ACCESS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab103.0013 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Luis Guillermo Piccone Saponara ◽

Maria Paz Castro Fernández ◽

Nancy Giovanna Uribe Heredia ◽

Agustin Carreno ◽

Sara Anaya Fernandez ◽

...

Keyword(s):

Antiplatelet Therapy ◽

Vascular Access ◽

Statistical Significance ◽

Univariate Analysis ◽

Primary Patency ◽

Categorical Variables ◽

Cross Sectional ◽

High Phosphorus ◽

The Creation ◽

Phosphorus Levels

Abstract Background and Aims Clinical practice guidelines recommend an arteriovenous fistula (AVF) as the preferred vascular access for hemodialysis. Patency of the arteriovenous access is important for effective hemodialysis. However, maintaining the patency of the AVF remains a challenge. We determined those independent prognostic factors for the patency of the AVF at the time of its creation. Method Cross-sectional study; We include all AVFs performed at the HGUCR in the last 2 decades. Demographic variables (age, sex), etiology of CKD and associated comorbidity were collected. We determine the factors involved in the primary patency of AVFs. Statistical analysis with SPSS 25.0. Categorical variables are expressed as percentages and are compared using the Chi2 test. Quantitative variables are expressed as mean ± standard deviation and the Mann Whitney Student-T/U was used to compare them. Statistical significance for a value of p <0.05. Results 622 AVFs performed in 482 patients were reviewed. 86.8% were autologous. The mean age was 65.4±14 years; 66.6% were male. The most frequent etiologies of CKD were diabetic nephropathy (30.2%), unknown (18%), and glomerulonephritis (16.6%). 91.2% had arterial hypertension (HBP) and diabetes mellitus (DM) 47.9%. 48.7% received antiplatelet therapy and 15.6% anticoagulation prior to the creation of the AVF. 27% presented primary failure. The univariate analysis showed statistical significance for the qualitative variables HTA (p=0.002), treatment with statins (p<0.01) and antiplatelet (p<0.01), and for the quantitative variables fibrinogen (p=0.048), serum phosphorus (p=0.001), CRP (p=0.004), triglycerides (p=0.05), ferritin (p=0.006) and age (p=0.05). When performing a multivariate analysis using logistic regression, HTA (OR: 0.46 95% CI 0.22-0.95 p = 0.036), high phosphorus levels (OR: 1.22 95% CI 1.08-1, 49 p = 0.004) and statin treatment (OR: 0.58 95% CI 0.36-0.96 p = 0.004) are predictors of primary VA failure. Conclusion In our study, HTA and antiplatelet therapy prior to the creation of the VA behave as protective factors for primary failure, with high phosphorus levels being an independent factor for primary failure of AVFs.

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Which Factors Increase the Risk of Re-Operation after Meniscus Surgery in the Skeletally Immature?

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118s00064 ◽

2018 ◽

Vol 6 (7_suppl4) ◽

pp. 2325967118S0006

Author(s):

Neeraj M. Patel ◽

Surya Mundluru ◽

Nicholas Beck ◽

Theodore J. Ganley

Keyword(s):

Risk Factors ◽

Cruciate Ligament ◽

Statistical Significance ◽

Univariate Analysis ◽

Multivariate Model ◽

Skeletally Immature ◽

Initial Surgery ◽

Repeat Operation ◽

Operation Rate ◽

Meniscus Surgery

Objectives: The purpose of this study is to determine which factors heighten the risk for subsequent operations in skeletally immature patients undergoing meniscus surgery. Methods: A retrospective institutional database of 1,063 meniscus surgeries performed between 2000 and 2015 was reviewed. All procedures were performed in skeletally immature patients. Demographic and intra-operative information was recorded, as were concurrent injuries or operations and subsequent surgeries. Univariate analysis consisted of chi-square and independent-samples t-tests. Multivariate logistic regression was then performed to control for confounding factors. Results: The mean age at initial surgery was 13.4 years (standard deviation, SD, 2.2 years) and the average follow-up duration was 47 months (SD 54 months). Overall, 314 patients (29.5%) required repeat surgical intervention. 36% of all females required subsequent surgery compared to 26% of males (p<0.01). Discoid menisci underwent repeat operation more frequently than non-discoid menisci (35% vs. 27%, p=0.01). After accounting for confounders in a multivariate model, females had 2.2 times the odds of repeat surgery than males (95% CI 1.4-3.3, p<0.01) and each year of increasing age resulted in 1.3 times higher odds (95% CI 1.1 -1.4, p<0.01). The odds of subsequent surgeries were 4.2 times higher in those with flap tears (95% CI 1.8-9.7, p<0.01) and 2.9 times higher for discoid menisci (95% CI 1.4-6.0, p<0.01). Concomitant anterior cruciate ligament rupture or tibial spine fracture decreased the risk of needing additional surgeries in univariate analysis, but lost statistical significance in the multivariate model. Conclusion: Even when accounting for other factors in a multivariate model, female sex, increasing age, flap tears, and discoid meniscus were risk factors for subsequent procedures after meniscus surgery in skeletally immature patients. The re-operation rate in this population may be higher than previously reported. This study describes, for the first time, risk factors for repeat operations in skeletally immature patients undergoing meniscus surgery. These results can be used to counsel and monitor patients accordingly.

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Intestinal Microsporidiosis Among HIV/AIDS Patients Receiving Antiretroviral Therapy in Sana’a City, Yemen: First Report on Prevalence and Predictors

10.21203/rs.3.rs-684810/v1 ◽

2021 ◽

Author(s):

Kwkab A. R. Al-Barhami ◽

Rashad Abdul-Ghani ◽

Salah A. Al-Qobati

Keyword(s):

Risk Factors ◽

Antiretroviral Therapy ◽

Large Scale ◽

Statistical Significance ◽

Univariate Analysis ◽

Cell Counting ◽

Cd4 Cells ◽

Aids Patients ◽

Intestinal Microsporidiosis ◽

Hiv Aids

Abstract Background: Intestinal microsporidiosis is an opportunistic infection associated with persistent diarrhea among HIV/AIDS patients. In Yemen, however, its epidemiology is unknown. Therefore, this study determined its prevalence and predictors among HIV/AIDS patients receiving antiretroviral therapy (ART) in Sana'a city, Yemen.Methods: This cross-sectional study included 402 patients receiving ART at Al-Jomhori Educational Hospital in Sana'a from November 2019 to December 2020. Data about demographics, clinical characteristics and risk factors were collected using a pre-designed questionnaire. Stool samples were collected and examined for microsporidian spores using the Gram-chromotrope Kinyoun staining. Blood samples were also collected and used for CD4 cell counting by flow cytometry. Univariate analysis was used to test the association of patients’ characteristics and risk factors with intestinal microsporidiosis. Multivariable logistic regression was then used to identify the independent predictors of infection. Statistical significance was considered at P-values <0.05. Results: Intestinal microsporidiosis was prevalent among 14.2% (57/402) of HIV/AIDS patients but was not significantly associated with any of the studied demographics, source of drinking water, bathing and/or swimming outdoors, contact with soil, presence of domestic animals or indiscriminate defecation. However, it was significantly associated with diarrhea (OR=3.4, 95% CI: 1.7–6.6; P=0.001) and <200 CD4 cells/µl (OR=2.7, 95% CI: 1.5–5.0; P=0.001). The significant independent predictors of infection were <200 CD4 cells/µl (AOR=3.2, 95% CI: 1.5–6.9; P=0.003), not washing hands after contacting soil (AOR=2.5, 95% CI: 1.1–5.4; P=0.026) and before eating (AOR=3.1, 95% CI: 1.5–6.4; P=0.003), eating unwashed raw produce (AOR=2.5, 95% CI: 1.2–5.3; P=0.017) and absence of indoor latrines (AOR=6.2, 95% CI: 1.5–25.9; P=0.012).Conclusions: The prevalence of intestinal microsporidiosis among HIV/AIDS patients in Sana'a is high and comparable to that several other countries, being prevalent among approximately 14.0% of patients and significantly associated with diarrhea. It could be predicted among patients who have <200 CD4 cells/µl, poor hand hygiene after contacting soil and before eating, usually eat unwashed raw produce and do not possess indoor latrines. Large-scale studies on its epidemiology and predictors among HIV/AIDS patients across the country are warranted.

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Ten-year experience with standardized non-operating room anesthesia with Sevoflurane for MRI in children affected by neuropsychiatric disorders

BMC Anesthesiology ◽

10.1186/s12871-019-0897-1 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 5

Author(s):

Silvia Mongodi ◽

Gaia Ottonello ◽

Raffaelealdo Viggiano ◽

Paola Borrelli ◽

Simona Orcesi ◽

...

Keyword(s):

Risk Factors ◽

Clinical Judgment ◽

Statistical Significance ◽

Neuromuscular Disorders ◽

Univariate Analysis ◽

Neuromuscular Diseases ◽

Neuropsychiatric Disorders ◽

University Hospital ◽

Respiratory Complications ◽

Asa Score

Abstract Background Children require anesthesia for MRI to maintain immobility and reduce discomfort; clear indications about the best anesthesiologic management are lacking and each center developed its own protocol. Moreover, children with neuropsychiatric disorders more likely require sedation and are described in literature as more prone to general and respiratory complications. Aim of this study was to analyze the applicability of a sevoflurane-based approach, to describe general and respiratory complications and to identify risk factors in a pediatric neuropsychiatric population. Methods Retrospective cohort study, university Hospital (January 2007–December 2016). All the 1469 anesthesiologic records of children addressed from Neuropsychiatric Unit to undergo MRI under general anesthesia were analyzed; 12 patients equal or older than 18-year-old were excluded. We identified post-hoc nine macro-categories: static encephalopathies, metabolic/evolutive encephalopathies, epileptic encephalopathies, neuromuscular diseases, autistic spectrum disorders, migraine, psychiatric disorders, intellectual disabilities, others. A logistic regression model for events with low frequency (Firth’s penalized likelihood approach) was carried out to identify the mutually adjusted effect among endpoints (complications) and the independent variables chosen on the basis of statistical significance (univariate analysis, p ≤ 0.05) and clinical judgment. Results Of 1457 anesthesiologic records (age 4.0 (IQR 2.0 to 7.0) year-old, males 891 (61.2%), weight 17.0 (IQR 12.0 to 24.9) kg), 18 were cancelled for high anesthesiologic risk, 50 were cooperative, 1389 were anesthetized. A sevoflurane-based anesthesia was feasible in 92.3%; these patients required significantly less mechanical ventilation (8.6 vs. 16.2%; p = 0.012). Complications’ rate was low (6.2%; 3.1% respiratory). The risk for general complications increases with ASA score > 1 (OR 2.22, 95 CI% 1.30 to 3.77, p = 0.003), male sex (OR 1.73, 95% CI 1.07 to 2.81, p = 0.025), multi-drug anesthesia (OR 2.98, 95 CI% 1.26 to 7.06, p = 0.013). For respiratory complications, it increases with ASA score > 1 (OR 2.34, 95 CI% 1.19 to 4.73, p = 0.017), autumn-winter (OR 2.01, 95 CI% 1.06 to 3.78, p = 0.030), neuromuscular disorders (OR 3.18, 95 CI% 1.20 to 8.41, p = 0.020). We had no major complications compromising patients’ outcome or requiring admission to ICU. Conclusions Sevoflurane anesthesia is feasible and safe for children affected by neuropsychiatric disorders undergoing MRI. Specific risk factors for general and respiratory complications should be considered.

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Risk Factors for Development of Biliary Complications after Surgery for Solitary Liver Hydatid Cyst

The American Surgeon ◽

10.1177/000313481708300119 ◽

2017 ◽

Vol 83 (1) ◽

pp. 30-35 ◽

Cited By ~ 6

Author(s):

Ali Surmelioglu ◽

Ilter Ozer ◽

Enver Reyhan ◽

Tahsin Dalgic ◽

Yilmaz Ozdemir ◽

...

Keyword(s):

Risk Factors ◽

Hydatid Cyst ◽

Significant Risk ◽

Conservative Surgery ◽

World Health ◽

Biliary Leakage ◽

Liver Hydatid Cyst ◽

Related Risk ◽

Solitary Liver ◽

Health Organization

Biliary leakage (BL) is the most common cause of postoperative morbidity after conservative liver hydatid cyst surgery. The objective of this study was to determine incidence of BL and related risk factors in patients with solitary liver hydatid cyst who underwent conservative surgery. A total of 186 patients were included in this study. Age, gender, cyst recurrence, diameter, and localization, World Health Organization Informal Working Group on Echinococcosis (WHO-IWGE) classification, cavity management techniques, cyst content, and alkaline phosphatase (ALP) levels were evaluated with univariate and multivariate analyses. Of these patients 104 were female and 82 were male. The mean age was 43.5 ± 14.7 years. Postoperative BL was detected in 36 (19.4%) patients. Cyst diameter (P = 0.019), cyst localization (P = 0.007), WHO-IWGE classification (P = 0.017), and ALP level (P = 0.001) were the most significant risk factors for BL. Independent risk factors for BL were perihilar localization, large cyst diameter, high ALP level, and advanced age according to WHO-IWGE classification.

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Risk factors for infection with multidrug-resistant bacteria in non-ventilated patients with hospital-acquired pneumonia

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132013000300011 ◽

2013 ◽

Vol 39 (3) ◽

pp. 339-348 ◽

Cited By ~ 18

Author(s):

Renato Seligman ◽

Luis Francisco Ramos-Lima ◽

Vivian do Amaral Oliveira ◽

Carina Sanvicente ◽

Juliana Sartori ◽

...

Keyword(s):

Risk Factors ◽

Independent Predictor ◽

Univariate Analysis ◽

Tertiary Care ◽

Multidrug Resistant ◽

Categorical Variables ◽

Resistant Bacteria ◽

Hospital Acquired Pneumonia ◽

Hospital Acquired ◽

Ventilated Patients

OBJECTIVE: To identify risk factors for the development of hospital-acquired pneumonia (HAP) caused by multidrug-resistant (MDR) bacteria in non-ventilated patients. METHODS: This was a retrospective observational cohort study conducted over a three-year period at a tertiary-care teaching hospital. We included only non-ventilated patients diagnosed with HAP and presenting with positive bacterial cultures. Categorical variables were compared with chi-square test. Logistic regression analysis was used to determine risk factors for HAP caused by MDR bacteria. RESULTS: Of the 140 patients diagnosed with HAP, 59 (42.1%) were infected with MDR strains. Among the patients infected with methicillin-resistant Staphylococcus aureus and those infected with methicillin-susceptible S. aureus, mortality was 45.9% and 50.0%, respectively (p = 0.763). Among the patients infected with MDR and those infected with non-MDR gram-negative bacilli, mortality was 45.8% and 38.3%, respectively (p = 0.527). Univariate analysis identified the following risk factors for infection with MDR bacteria: COPD; congestive heart failure; chronic renal failure; dialysis; urinary catheterization; extrapulmonary infection; and use of antimicrobial therapy within the last 10 days before the diagnosis of HAP. Multivariate analysis showed that the use of antibiotics within the last 10 days before the diagnosis of HAP was the only independent predictor of infection with MDR bacteria (OR = 3.45; 95% CI: 1.56-7.61; p = 0.002). CONCLUSIONS: In this single-center study, the use of broad-spectrum antibiotics within the last 10 days before the diagnosis of HAP was the only independent predictor of infection with MDR bacteria in non-ventilated patients with HAP.

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Racial differences in the pattern of hematologic toxicity in the treatment of colorectal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.4_suppl.679 ◽

2012 ◽

Vol 30 (4_suppl) ◽

pp. 679-679

Author(s):

Olalekan O. Oluwole ◽

William Wu ◽

Steven N. Wolff ◽

Kenneth R. Hande

Keyword(s):

Colorectal Cancer ◽

Racial Differences ◽

Statistical Significance ◽

Dihydropyrimidine Dehydrogenase ◽

Univariate Analysis ◽

Small Sample ◽

Categorical Variables ◽

Hematological Toxicity ◽

Hematologic Toxicity ◽

Grade 3

679 Background: 5-fluorouracil (5-FU), a synthetic fluoropyrimidine, is a critical component of chemotherapy in many cancers. Its metabolites inhibit Thymidylate Synthetase (TS) causing cessation of DNA synthesis and are misincorporated into DNA and RNA causing ineffective DNA repair and faulty mRNA splicing. The rate limiting step in the catabolism of 5-FU is by the Dihydropyrimidine Dehydrogenase enzyme (DPD) which catabolizes over 80% of 5-FU. Patients with near total DPD enzymatic deficiency develop life threatening toxicity after a single administration and those with less severe deficiency will have delayed elimination of 5-FU and slowly accumulate active metabolites leading to toxicities. Methods: We conducted a pilot retrospective cohort study of African American (AA) and Caucasian patients treated for colorectal cancer over a 9 year period, 2000 – 2008, in this IRB approved study. The primary outcome of interest was the rate of development of grade 3 or 4 neutropenia (Absolute Neutrophil Count <1000/uL = grade 3 and <500/uL = grade 4). Descriptive and univariate analysis were done. To test for differences between AA and Caucasians, we computed independent t-test for continuous and Fisher’s exact test for categorical variables. Relative Risk (RR) and p-values were computed. All statistics were done with SPSS v19 software. Results: There were 66 evaluable patients (40 men, 26 women), 40 AA, 24 Caucasians and 2 of other races. Thirty-eight patients (15 Caucasians and 23 AA) received 5-FU containing chemotherapy. The two groups were comparable in baseline characteristics. AA were more likely to develop grade 3-4 hematological toxicity. Nine of 23 AA (39.1%) and one of 15 Caucasians (6.7%) developed grade 3-4 hematological toxicity. RR 8.56, 95% confidence interval 0.95 – 421.06 (p-value of 0.0561) Conclusions: These results suggest that AA were more likely than Caucasians to have severe hematologic toxicity with the use of 5-FU containing chemotherapy. This difference did not meet statistical significance due to small sample size and few numbers of events in the Caucasian arm. A larger prospective study is needed to further evaluate the observed difference.

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THE INCIDENCE AND RISK FACTORS OF CONTRAST INDUCED NEPHROPATHY IN PATIENTS UNDERGOING CORONARY ANGIOPLASTY.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i6.321 ◽

2019 ◽

Vol 3 (6) ◽

Author(s):

Mukesh Kumar Sharma ◽

Pradeep Kurmi ◽

Deepak Ameta ◽

Chandra Bhanu Chandan

Keyword(s):

Risk Factors ◽

Contrast Media ◽

Statistical Significance ◽

Univariate Analysis ◽

Kidney Injury ◽

Coronary Intervention ◽

Contrast Induced Nephropathy ◽

Absolute Increase ◽

Increased Risk ◽

Adequate Hydration

Background: Contrast induced nephropathy remains important cause of hospital-acquired acute kidney injury and affects between 2% of the general population to 50% of high-risk subgroups following coronary intervention. Objectives: To determine the incidence and to study the various risk factors associated with CIN. Patients and Methods: In our study, total of 212 patients (154 males and 58 females) who received non ionic iso osmolar contrast media during percutaneous transluminal coronary intervention (PCI) were included. We diagnosed CIN by a relative increase of >25% or an absolute increase of >0.5 mg/dl in serum creatinine levels two days after procedure. Results: The incidence of CIN in our study was 15.1%. In univariate analysis: age >75 years, hypertention diabetes mellitus (DM), heart failure, hypotension, CKD [creatinine >1.5mg/dl] and increased contrast volume were associated with increased risk of CIN whereas, gender, anemia and use of IABP failed to reach statistical significance. As the number of risk factor and/or volume of contrast increases, the incidence of CIN increases exponentially. Conclusion: Since there is no established treatment for CIN, all possible efforts should be taken to prevent it from occurring by identifying patients at risk. CIN is related with many risk factors, so whenever multiple risk factors are present in an individual patient, lowest dose of contrast should be used and adequate hydration should be given. Key Words: Contrast-induced nephropathy, Non ionic iso-osmolar contrast media, percutaneous coronary intervention.

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Incidence and Risk Factors for Bilateral Nephrolithiasis: A Large Case-retrospective Study

10.21203/rs.3.rs-414196/v1 ◽

2021 ◽

Author(s):

Xiong Yang ◽

Zhi Li ◽

Shiyong Qi ◽

Linguo Xie ◽

Qiduo Shi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Multivariate Analysis ◽

Kidney Stones ◽

Statistical Significance ◽

Univariate Analysis ◽

Renal Stones ◽

Urinary Stones ◽

Preoperative Imaging ◽

History Of

Abstract To determine the incidence and risk factors of bilateral kidney stones. Utilized the retrospective analysis method on demographic characteristics and clinical data of patients with renal stones in the Second Hospital of Tianjin Medical University. Grouped patients into unilateral and bilateral renal stones according to preoperative imaging and ultrasound examination. Univariate and multivariate analysis methods were used to evaluate the factors that may cause bilateral stones. The study included 7587 patients with kidney stones in total, of whom 4983 had unilateral kidney stones (including 2719 left stones and 2264 right stones), and 2604 had bilateral kidney stones (34.3%). By comparing the unilateral stones group with the bilateral stones group, the univariate analysis demonstrated that weight, body mass index (BMI), history of nephrolithiasis, diabetes mellitus (DM), hypertension, gout, and the maximal stone diameter had statistical significance. Binary logistic regression multivariate analysis demonstrated that BMI, history of nephrolithiasis, diabetes mellitus, hypertension, gout, and the maximal stone diameter were independent risk factors for bilateral urinary stones. This study shows that 34.3% of patients with kidney stones were diagnosed as having bilateral kidney stones; BMI and the maximal stone diameter are positively correlated with the incidence of bilateral kidney stones; Patients with a history of nephrolithiasis, diabetes, hypertension, and gout have a significantly higher risk of having bilateral kidney stones.

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