scholarly journals Predictors of Extubation Failure In Thymomatous Myasthenia Gravis Patient After Thymectomy: Ten Years of Data From A Tertiary Teaching Hospital In Mainland China

2021 ◽  
Author(s):  
Anqi Du ◽  
Xiao Li ◽  
Youzhong An
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Myasthenia Gravis ◽  
Mainland China ◽  
Extubation Failure ◽  
Surgical Trauma ◽  
First Line Therapy ◽  
Tertiary Teaching ◽  
Lower Spo2 ◽  
Tertiary Teaching Hospital

Abstract Background: Thymectomy was consider to be the first line therapy for Patients with thymoma-associated myasthenia gravis(T-MG). But weaning is still a big challenge for MG patents, especially after surgery. The ideal time for extubation and the risk factors of extubation failure is uncertain. This study was to investigate the risk factors of extubation failure in T-MG patients after thymectomy.Methods: Retrospective review of consecutive T-MG patients admitted in intensive care unit after thymectomy and need mechanical ventilation at least 6h between January 2010 and December 2019. Weaning was according to a unified process. Extubation failure was defined as need for reintubation within 48h after extubation or death during ventilation. Univariate logistic regression was used to identify predictors of extubation failure.Results: 38 patients were included. 13 patients (34.2%) were extubation failure and with longer ventilation duration (153 vs. 29 h, p < 0.05) and hospital stay (26 vs. 13 days, p < 0.05). Univariate regression shows the ratio of transsternal thymectomy, the incident of never or diaphragm injury during the surgery or the PTMC, atelectasis, pneumonia during ventilation (p<0.05). Furthermore, even passed SBT, a higher HR, RR and lower SpO2 also indicate high risk of exutbation failure(p<0.05).Conclusions: Extubation failure is relatively common in T-MG patients after thymectomy. Minimizing surgical trauma may contributes to successful extubation. But the incidence of PTMC or pulmonary compliances during ventilation was associate with high risk of extubation failure. A higher HR, RR and lower SpO2 after SBT and also can be a reliable indicator.

scholarly journals Prediction of prolonged mechanical ventilation in critically ill obstetric patients: Ten years of data from a tertiary teaching hospital in mainland China

2020 ◽  
Author(s):  
Huiying Zhao ◽  
Guangjie Wang ◽  
Jie Lyu ◽  
Xiaohong Zhang ◽  
Youzhong An
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Critically Ill ◽  
Myocardial Injury ◽  
Prolonged Mechanical Ventilation ◽  
Mainland China ◽  
Estimated Blood Loss ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Independent Risk Factors

Abstract Background: Maternal admission to the intensive care unit (ICU) during pregnancy or in the postpartum period is a marker of severe acute maternal morbidity. Mechanical ventilation is an important and basic method of maintaining life support in the ICU, but prolonged mechanical ventilation (PMV) is associated with a prolonged length of hospital stay and other adverse outcomes. Therefore, we conducted this retrospective study to describe morbidity and further try to identify the risk factors for PMV in critically ill obstetric women.Methods: The clinical data were obtained from a single-centre retrospective comparative study of 143 critically ill obstetric patients at a tertiary teaching hospital in mainland China between January 1, 2009, and December 31, 2019. Clinical and obstetric parameters were collected to analyse the risk factors for PMV. Patients were separated into groups with and without PMV. Potential risk factors were identified by univariate testing. Multivariate logistic regression was used to evaluate independent predictors of PMV.Results: Out of 29,236 hospital deliveries, 265 critically ill obstetric patients entered the ICU. One hundred forty-five (54.7%) of them were treated with mechanical ventilation. Two were excluded because of death within 24 hours. Sixty-five critically ill obstetric patients (45.5%) underwent PMV. The independent risk factors for PMV included estimated blood loss (odds ratio (OR) =1.296, P=0.029), acute kidney injury (AKI) (OR=4.305, P=0.013), myocardial injury (OR=4.586, P=0.012), and PaO2/FiO2 (OR=0.989, P<0.001). The area under the receiver operating characteristic (ROC) curve based on the predicted probability of the logistic regression was 0.934.Conclusions: Estimated blood loss, AKI, myocardial injury, and PaO2/FiO2 were independent risk factors for PMV in critically ill obstetric patients.

scholarly journals Prediction of mechanical ventilation greater than 24 hours in critically ill obstetric patients: Ten years of data from a tertiary teaching hospital in mainland China

2021 ◽  
Author(s):  
Huiying Zhao ◽  
Guangjie Wang ◽  
Jie Lyu ◽  
Xiaohong Zhang ◽  
Youzhong An
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Logistic Regression ◽  
Critically Ill ◽  
Myocardial Injury ◽  
Mainland China ◽  
Estimated Blood Loss ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Independent Risk Factors

Abstract Background: Maternal admission to the intensive care unit (ICU) during pregnancy or in the postpartum period is a marker of severe acute maternal morbidity. Mechanical ventilation is an important and basic method of maintaining life support in the ICU, but prolonged mechanical ventilation (PMV) is associated with a prolonged length of hospital stay and other adverse outcomes. Therefore, we conducted this retrospective study to describe morbidity and further try to identify the risk factors for PMV in critically ill obstetric women.Methods: The clinical data were obtained from a single-centre retrospective comparative study of 143 critically ill obstetric patients at a tertiary teaching hospital in mainland China between January 1, 2009, and December 31, 2019. PMV was defined as a mechanical ventilation length of more than 24 hours. Clinical and obstetric parameters were collected to analyse the risk factors for PMV. Patients were separated into groups with and without PMV. Potential risk factors were identified by univariate testing. Multivariate logistic regression was used to evaluate independent predictors of PMV.Results: Out of 29,236 hospital deliveries, 265 critically ill obstetric patients entered the ICU. One hundred forty-five (54.7%) of them were treated with mechanical ventilation. Two were excluded because of death within 24 hours. Sixty-five critically ill obstetric patients (45.5%) underwent PMV. The independent risk factors for PMV included estimated blood loss (odds ratio (OR) =1.296, P=0.029), acute kidney injury (AKI) (OR=4.305, P=0.013), myocardial injury (OR=4.586, P=0.012), and PaO2/FiO2 (OR=0.989, P<0.001). The area under the receiver operating characteristic (ROC) curve based on the predicted probability of the logistic regression was 0.934.Conclusions: Estimated blood loss, AKI, myocardial injury, and PaO2/FiO2 were independent risk factors for PMV in critically ill obstetric patients.

scholarly journals Prediction of prolonged mechanical ventilation in critically ill obstetric patients: Ten years of data from a tertiary teaching hospital in mainland China

2020 ◽  
Author(s):  
Huiying Zhao ◽  
Guangjie Wang ◽  
Jie Lyu ◽  
Xiaohong Zhang ◽  
Youzhong An
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Logistic Regression ◽  
Critically Ill ◽  
Myocardial Injury ◽  
Prolonged Mechanical Ventilation ◽  
Mainland China ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Independent Risk Factors

Abstract BackgroundMaternal admission to the intensive care unit (ICU) during pregnancy or in the postpartum period is a marker of severe acute maternal morbidity. Mechanical ventilation is an important and basic method of maintaining life support in the ICU, but prolonged mechanical ventilation (PMV) is associated with a prolonged length of hospital stay and other adverse outcomes. Therefore, we conducted this retrospective study to describe morbidity and further try to identify the risk factors for PMV in critically ill obstetric women.MethodsThe clinical data were obtained from a single-centre retrospective comparative study of 143 critically ill obstetric patients at a tertiary teaching hospital in mainland China between January 1, 2009, and December 31, 2019. Clinical and obstetric parameters were collected to analyse the risk factors for PMV. Patients were separated into groups with and without PMV. Potential risk factors were identified by univariate testing. Multivariate logistic regression was used to evaluate independent predictors of PMV.ResultsOut of 29,236 hospital deliveries, 265 critically ill obstetric patients entered the ICU. One hundred forty-five (54.7%) of them were treated with mechanical ventilation. Two were excluded because of death within 24 hours. Sixty-five critically ill obstetric patients (45.5%) underwent PMV. The independent risk factors for PMV included estimated blood loss (odds ratio (OR) = 1.296, P = 0.029), acute kidney injury (AKI) (OR = 4.305, P = 0.013), myocardial injury (OR = 4.586, P = 0.012), and PaO2/FiO2 (OR = 0.989, P < 0.001). The area under the receiver operating characteristic (ROC) curve based on the predicted probability of the logistic regression was 0.934.ConclusionsEstimated blood loss, AKI, myocardial injury, and PaO2/FiO2 were independent risk factors for PMV in critically ill obstetric patients.

scholarly journals Prediction of mechanical ventilation greater than 24 hours in critically ill obstetric patients: ten years of data from a tertiary teaching hospital in mainland China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huiying Zhao ◽  
Guangjie Wang ◽  
Jie Lyu ◽  
Xiaohong Zhang ◽  
Youzhong An
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Logistic Regression ◽  
Critically Ill ◽  
Myocardial Injury ◽  
Mainland China ◽  
Estimated Blood Loss ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Independent Risk Factors

Abstract Background Maternal admission to the intensive care unit (ICU) during pregnancy or in the postpartum period is a marker of severe acute maternal morbidity. Mechanical ventilation is an important and basic method of maintaining life support in the ICU, but prolonged mechanical ventilation (PMV) is associated with a prolonged length of hospital stay and other adverse outcomes. Therefore, we conducted this retrospective study to describe morbidity and further try to identify the risk factors for PMV in critically ill obstetric women. Methods The clinical data were obtained from a single-centre retrospective comparative study of 143 critically ill obstetric patients at a tertiary teaching hospital in mainland China between January 1, 2009, and December 31, 2019. PMV was defined as a mechanical ventilation length of more than 24 h. Clinical and obstetric parameters were collected to analyse the risk factors for PMV. Patients were separated into groups with and without PMV. Potential risk factors were identified by univariate testing. Multivariate logistic regression was used to evaluate independent predictors of PMV. Results Out of 29,236 hospital deliveries, 265 critically ill obstetric patients entered the ICU. One hundred forty-five (54.7%) of them were treated with mechanical ventilation. Two were excluded because of death within 24 h. Sixty-five critically ill obstetric patients (45.5%) underwent PMV. The independent risk factors for PMV included estimated blood loss (odds ratio (OR) =1.296, P=0.029), acute kidney injury (AKI) (OR=4.305, P=0.013), myocardial injury (OR=4.586, P=0.012), and PaO2/FiO2 (OR=0.989, P< 0.001). The area under the receiver operating characteristic (ROC) curve based on the predicted probability of the logistic regression was 0.934. Conclusions Estimated blood loss, AKI, myocardial injury, and PaO2/FiO2 were independent risk factors for PMV in critically ill obstetric patients.

scholarly journals Prediction of mechanical ventilation greater than 24 hours in critically ill obstetric patients: Ten years of data from a tertiary teaching hospital in mainland China

2020 ◽  
Author(s):  
Huiying Zhao ◽  
Guangjie Wang ◽  
Jie Lyu ◽  
Xiaohong Zhang ◽  
Youzhong An
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Logistic Regression ◽  
Critically Ill ◽  
Myocardial Injury ◽  
Mainland China ◽  
Estimated Blood Loss ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Independent Risk Factors

Abstract Background: Maternal admission to the intensive care unit (ICU) during pregnancy or in the postpartum period is a marker of severe acute maternal morbidity. Mechanical ventilation is an important and basic method of maintaining life support in the ICU, but prolonged mechanical ventilation (PMV) is associated with a prolonged length of hospital stay and other adverse outcomes. Therefore, we conducted this retrospective study to describe morbidity and further try to identify the risk factors for PMV in critically ill obstetric women.Methods: The clinical data were obtained from a single-centre retrospective comparative study of 143 critically ill obstetric patients at a tertiary teaching hospital in mainland China between January 1, 2009, and December 31, 2019. PMV was defined as a mechanical ventilation length of more than 24 hours. Clinical and obstetric parameters were collected to analyse the risk factors for PMV. Patients were separated into groups with and without PMV. Potential risk factors were identified by univariate testing. Multivariate logistic regression was used to evaluate independent predictors of PMV.Results: Out of 29,236 hospital deliveries, 265 critically ill obstetric patients entered the ICU. One hundred forty-five (54.7%) of them were treated with mechanical ventilation. Two were excluded because of death within 24 hours. Sixty-five critically ill obstetric patients (45.5%) underwent PMV. The independent risk factors for PMV included estimated blood loss (odds ratio (OR) =1.296, P=0.029), acute kidney injury (AKI) (OR=4.305, P=0.013), myocardial injury (OR=4.586, P=0.012), and PaO2/FiO2 (OR=0.989, P<0.001). The area under the receiver operating characteristic (ROC) curve based on the predicted probability of the logistic regression was 0.934.Conclusions: Estimated blood loss, AKI, myocardial injury, and PaO2/FiO2 were independent risk factors for PMV in critically ill obstetric patients.

scholarly journals Prospective surveillance of hospital associated infections epidemiology in a haematology-oncology department

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Nabiha Bouafia ◽  
Asma Ammar ◽  
Olfa Ezzi ◽  
Asma Ben Chiekh ◽  
Mohamed Mahjoub ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analyses ◽  
University Hospital ◽  
Prospective Surveillance ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Oncology Unit ◽  
A Prospective Study ◽  
Healthcare Associated ◽  
Hospital Associated Infections

In haematology-oncology, intensified procedures have been associated with higher risk of healthcare associated infections (HAIs).This study aimed to estimate the incidence and to identify risk factors of HAIs in a haematology-oncology unit in a Tunisian university hospital. We conducted a prospective study, during 06 months from Mars through September 2016 in the department of hematology- oncology in a tertiary teaching hospital in Tunisia. Patients, admitted for ≥48 h, were followed until hospital discharge. The (CDC) criteria for site-specific infections were used to define HAIs. Bivariate and multivariate analyses were performed to identify risk factors of HAIs. P

scholarly journals Classification of stillbirth by relative condition at death (Re Co De) at various trimesters of pregnancy: a rural tertiary teaching hospital based study

2017 ◽  
Vol 6 (8) ◽  
pp. 3550 ◽  
Author(s):  
V. Meera Rajagopal ◽  
Kalpana Betha ◽  
Satya Priya G.
Keyword(s):  
Risk Factors ◽  
Teaching Hospital ◽  
Rural Areas ◽  
Gestational Hypertension ◽  
Economic Status ◽  
Mode Of Delivery ◽  
Middle Income ◽  
Low Middle Income Countries ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital

Background: New global health figures show India to have the highest rates of stillbirth in the world. While maternal and under 5 child mortality rates have halved, stillbirth remains a neglected global endemic. To reduce stillbirths, the prevalence, risk factors and causes must be known. The aim of the present study is to know the prevalence and classify stillbirths by ReCoDe classification system at different trimesters of pregnancy.Methods: This was a retrospective study done between January 2013 to March 2017 at MediCiti Institute of Medical Sciences, a rural tertiary teaching hospital, Telangana, India. A total of 112 cases of stillbirths were included. Data was obtained on demographic variables, risk factors such as preeclampsia, etc. Data regarding mode of delivery, fetal asphyxia, were recorded.Results: Stillbirth rate was 12.1/1000 births. Fifty four percent of the women were unbooked. Preterm stillbirths were a majority (67%). The intra-partum still birth rate was low (15.1%) contrary to what is seen in low middle-income countries. Gestational hypertension/Pre-eclampsia, abruptio placenta, fetal growth restriction and oligohydramnios were the leading causes of stillbirths.Conclusions: Pregnant women from rural background with low socio-economic status are prone for stillbirths. As stillbirths were more among unbooked cases, the study highlights the importance of counselling, creating awareness in the rural areas regarding the importance of regular antenatal checkups. Identifying risk factors like pre-eclampsia, anemia etc., at early weeks will enable us to initiate appropriate strategies to improve pregnancy outcome.

scholarly journals Prevalence of gestational diabetes mellitus and perinatal outcome: a rural tertiary teaching hospital based study

2017 ◽  
Vol 6 (8) ◽  
pp. 3594 ◽  
Author(s):  
Ke Manga Reddy ◽  
Lakshmi Sailaja P. ◽  
Sahithi Balmuri ◽  
Avinash Jagarlamudi ◽  
Kalpana Betha
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Teaching Hospital ◽  
Perinatal Outcome ◽  
Oral Glucose ◽  
Increased Risk ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital

Background: Gestational diabetes mellitus is the commonest medical disorder in pregnancy. Women with GDM are at increased risk for adverse obstetric and perinatal outcome. Prevalence of GDM is known to vary widely depending on region of the country, dietary habits and socio-economic status. This study was undertaken to evaluate the prevalence of GDM and risk factors associated with it among women delivered in a rural tertiary teaching hospital in Telangana and further assess its impact on feto-maternal outcome.Methods: A retrospective study was conducted at Mediciti Institute of Medical Sciences on GDM cases delivered from May 2015 to April 2017. GDM was diagnosed using 2 step procedure of screening with glucose challenge test followed by confirmation with oral glucose tolerance test using Carpenter and Couston criteria. Demographic data and details about perinatal outcome were obtained from medical records and analyzed.Results: The prevalence was low (1.83%) compared to other studies. Majority of the women did not have risk factors. Preeclampsia is the commonest maternal complication seen (18%). Hypothyroidism is more often associated with GDM (15%). Caesarean section rate was high (62%). Though the NICU admission rate was high (76%), neonatal outcome was found to be satisfactory.Conclusions: The low prevalence of GDM seen highlights the importance of carrying out studies in different population groups of India to know the exact prevalence of GDM in the country. Pregnancies in women with GDM continue to be at increased risk of maternal and perinatal complications.

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