Family Functioning Affected by Adolescent Idiopathic Scoliosis in China: a Cross-sectional Survey

2020 ◽  
Author(s):  
Yue Huang ◽  
Tao Li ◽  
Wangshu Yuan ◽  
Hai Wang ◽  
Jianxiong Shen
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Family Functioning ◽  
Independent Risk Factor ◽  
Behavior Control ◽  
Coronal Imbalance ◽  
The Family ◽  
The Mean ◽  
And Behavior ◽  
Affective Involvement

Abstract Backgrounds: Adolescent idiopathic scoliosis(AIS) is a common chronic disease in youths, presenting with spinal deformity. Previous studies reported that family functioning of family members will be affected after a child is diagnosed with a chronic health condition. Family functioning would be evaluated in AIS patients and their parents in this study.Methods: 54 AIS patients (age=14.9±1.9 years old; F:M=51:3) who underwent conservative or surgical treatments in our hospital from April 2017 to March 2018, and their parents (age=43.0±4.1 years old; F:M=40:14) were enrolled in this study. Family functioning of both the patients and their parents was evaluated using McMaster family assessment device (FAD). The relationship of family functioning between the patients and their parents was first accessed using paired-samples t-test. Family functioning was defined to be “Unhealthy” if the family FAD scores (the mean scores of the patients and their parents) were above the cut-off. The potential risk factors of the unhealthiest subscales were analyzed using the chi-squared test or the independent t-test. Then, the effects of independent risk factors were analyzed using the logistic regression model if more than two risk factors were identified.Results: There is no significant difference between the AIS patients (1.90±0.42~2.23±0.32) and their parents (1.92±0.35~2.21±0.29) in all seven subscales (p≥0.05). The scores of the parents were moderately/strongly correlated with those of the AIS patients in all seven subscales (𝛄=0.456~0.696, p<0.05). 20.4% to 87.0% of the families experienced unhealthy family functioning, and affective involvement (57.4%), and behavior control (87.0%) were the unhealthiest subscales with the mean scores above the cut-off. Coronal imbalance (p=0.041, Odds ratio [OR]=3.685) was the independent risk factor of unhealthy affective involvement.Conclusions: 20.4%~ 87.0% families reported unhealthy family functioning, especially for affective involvement and behavior control. Coronal imbalance (body image) was an independent risk factor of unhealthy affective involvement. These facts suggest a potential need of the family for assistance with establishing and maintaining near-normal daily routines after a child is diagnosed with AIS. Medical workers should provide some practical suggestions for AIS families to improve their family functioning.

FAMILY FUNCTION LEVELS OF TURKISH FATHERS WITH CHILDREN AGED BETWEEN 0 – 6

2007 ◽  
Vol 35 (4) ◽  
pp. 429-442 ◽  
Author(s):  
Seher Balci Çelik
Keyword(s):  
Problem Solving ◽  
Behavior Control ◽  
Family Structures ◽  
Family Function ◽  
Family Assessment Device ◽  
Level Of Education ◽  
Significant Difference ◽  
The Family ◽  
And Behavior ◽  
Affective Involvement

Family function levels of fathers with children aged 0–6 in Samsun, Turkey were compared on the basis of length of marriage, level of education, family structure, and type of marriage. The sample consisted of 171 fathers aged between 24–36 (average age 29.2). The Family Assessment Device (Epstein, Baldwin, & Bishop, 1983) was used to measure family function levels of fathers and t-test and one way ANOVA were used to analyze the data. There was a significant difference in family function levels of the fathers, according to length of their marriage, in the subdimensions of problem solving, communication, affective involvement, behavior control and general functionings, according to their level of education. In all the subdimensions of affective involvement and behavior control, according to the family structures of fathers, significant differences were found between groups and total general points; according to fathers' types of marriage, a significant difference was found between the groups regarding problem solving, communication, affective involvement, behavior control and general total points.

scholarly journals Hyperhomocysteinemia as an Independent Risk Factor for Coronary Heart Disease. Comparison with Conventional Risk Factors

2023 ◽  
Vol 83 ◽  
Author(s):  
R. Muzaffar ◽  
M. A. Khan ◽  
M. H. Mushtaq ◽  
M. Nasir ◽  
A. Khan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Logistic Regression ◽  
Risk Factor ◽  
Heart Disease ◽  
Independent Risk Factor ◽  
Plasma Homocysteine ◽  
History Of ◽  
The Mean ◽  
Conventional Risk Factors

Abstract The present study was designed to evaluate the strength of association of raised plasma homocysteine concentration as a risk factor for coronary heart disease independent of conventional risk factor. It was a case control study conducted at Punjab Institute of Cardiology Lahore. A total of 210 subjects aged 25 to 60 years comprising of 105 newly admitted patients of CHD as cases and 105 age and sex matched healthy individuals with no history of CHD as control were recruited for the study. Fasting blood samples were obtained from cases and controls. Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) method on automated immunoassay analyzer (Abbott IMX). Total cholesterol, triglyceride and HDL cholesterol were analyzed using calorimetric kit methods. The concentration of LDL cholesterol was calculated using Friedewald formula. The patients were also assessed for traditional risk factors such as age, sex, family history of CVD, hypertension, smoking and physical activity, and were compared with control subjects. The collected data was entered in SPSS version 24 for analysis and interpretation.The mean age in controls and experimental groups were 43.00± 8.42 years and 44.72± 8.59 years with statistically same distribution (p- value= 0.144). The mean plasma homocysteine for cases was 22.33± 9.22 µmol/L where as it was 12.59±3.73 µmol/L in control group. Highly significant difference was seen between the mean plasma level of homocysteine in cases and controls (p˂0.001).Simple logistic regression indicates a strong association of coronary heart disease with hyperhomocysteinemia (OR 7.45), which remained significantly associated with coronary heart disease by multivariate logistic regression (OR 7.10, 95%C1 3.12-12.83, p=0.000). The present study concludes that elevated levels of Plasma homocysteine is an independent risk factor for coronary heart disease independent of conventional risk factors and can be used as an indicator for predicting the future possibility for the onset of CVD.

scholarly journals Risk Factors for Neonatal Bronchopulmonary Dysplasia in Extremely Preterm Premature Rupture of Membranes: A Retrospective Study

2020 ◽  
Author(s):  
Eishin Nakamura ◽  
Shigetaka Matsunaga ◽  
Yoshihisa Ono ◽  
Yasushi Takai ◽  
Hiroyuki Seki
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Optimal Timing ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Extremely Preterm ◽  
Gestational Week ◽  
The Mean

Abstract Background:Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD and the optimal timing for termination of pregnancy in pPROM cases.Methods:Subjects were 73 cases of single pregnancy who were diagnosed with pPROM during the period from 22 weeks and 0 days to 27 weeks and 6 days of gestation. The following factors were retrospectively examined: the gestational week at which a diagnosis of pPROM was made; the gestational week at which delivery occurred; the period for which the volume of amniotic fluid was maintained; and neonatal BPD as a complication. A receiver operating characteristic (ROC) curve was drawn in order to analyse the relationship between the duration of oligohydramnios and the onset of BPD.ResultsThe mean gestational week at which a diagnosis of amniorrhexis was made was 24.5 ± 1.9 weeks (mean ± SD), and that at which delivery occurred was 27.0 ± 3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4 ± 20.5 days. The mean birth weight of neonates was 1000 ± 455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. Multivariate analysis of various risk factors for the onset of BPD indicated that oligohydramnios is an independent risk factor for BPD. The ROC curve indicated that the cut-off value was 4 days. In this case, the levels of sensitivity and specificity for predicting the onset of neonatal BPD were 0.941 and 0.917 respectively.ConclusionOur findings suggest that oligohydramnios is an independent risk factor for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.

scholarly journals Risk Factors for Neonatal Bronchopulmonary Dysplasia in Extremely Preterm Premature Rupture of Membranes: A Retrospective Study

2020 ◽  
Author(s):  
Eishin Nakamura ◽  
Shigetaka Matsunaga ◽  
Yoshihisa Ono ◽  
Yasushi Takai ◽  
Hiroyuki Seki
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Optimal Timing ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Extremely Preterm ◽  
Gestational Week ◽  
The Mean

Abstract Background: Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD and the optimal timing for termination of pregnancy in pPROM cases.Methods:Subjects were 73 cases of singleton pregnancy who were diagnosed with pPROM during the period from 22 weeks and 0 days to 27 weeks and 6 days of gestation. The following factors were retrospectively examined: the gestational week at which a diagnosis of pPROM was made; the gestational week at which delivery occurred; the period for which the volume of amniotic fluid was maintained; and neonatal BPD as a complication. A receiver operating characteristic (ROC) curve was drawn in order to analyse the relationship between the duration of oligohydramnios and the onset of BPD.Results: The mean gestational week at which a diagnosis of amniorrhexis was made was 24.5±1.9 weeks (mean±SD), and that at which delivery occurred was 27.0±3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4±20.5 days. The mean birth weight of neonates was 1000±455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. Multivariate analysis of various risk factors for the onset of BPD indicated that oligohydramnios is an independent risk factor for BPD. The ROC curve indicated that the cut-off value was 4 days. In this case, the levels of sensitivity and specificity for predicting the onset of neonatal BPD were 0.941 and 0.917 respectively.Conclusion: Our findings suggest that oligohydramnios is an independent risk factor for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.

Clinical characteristics and prognosis in patients with premature coronary artery disease of different genders after intervention

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
X.F Tang ◽  
Y Yao ◽  
S.D Jia ◽  
Y Liu ◽  
B Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Coronary Intervention ◽  
Premature Coronary Artery Disease ◽  
Minor Bleeding ◽  
Bleeding Events ◽  
Cerebrovascular Events ◽  
Independent Risk Factors ◽  
Artery Disease

Abstract Objective To investigate the clinical characteristics and long-term prognosis of coronary intervention in patients with premature coronary artery disease (PCAD) between different genders. Methods From January 2013 to December 2013, 4 744 patients diagnosed as PCAD with percutaneous coronary intervention (PCI) in our hospital were enrolled. The general clinical data, laboratory results and interventional treatment data of all patients were collected, and the occurrence of major adverse cardio-cerebrovascular events (MACCE) within 2 years after PCI was followed up. Results Of the 4 744 patients undergoing PCI, 3 390 (71.5%) were males and 1 354 (28.5%) were females. The 2-year follow-up results showed that the incidence of BARC grade 1 hemorrhage in female patients was significantly higher than that in male patients (6.9% vs. 3.7%; P&lt;0.001); however, there was no significant difference in the incidence of major adverse cardiovascular and cerebrovascular events (MACCE), all-cause death, cardiac death, recurrent myocardial infarction, revascularization (target vessel revascularization and target lesion revascularization), stent thrombosis, stroke and BARC grade 2–5 hemorrhage between the two groups (P&gt;0.05). Multivariate COX regression analysis showed that gender was an independent risk factor for BARC grade 1 bleeding events in PCAD patients (HR=2.180, 95% CI: 1.392–3.416, P&lt;0.001), but it was not an independent risk factor for MACCE and BARC grade 2–5 bleeding. Hyperlipidemia, preoperative SYNTAX score, multivessel lesions and NSTE-ACS were the independent risk factors for MACCE in PCAD patients with PCI (HR=1.289, 95% CI: 1.052–1.580, P=0.014; HR=1.030, 95% CI: 1.019–1.042, P&lt;0.001; HR=1.758, 95% CI: 1.365–2.264, P&lt;0.001; HR=1.264, 95% CI: 1.040–1.537, P=0.019); gender, hyperlipidemia, anticoagulant drugs like low molecular weight heparin or sulfonate were the independent risk factors for bleeding events (HR=1.579,95% CI 1.085–2. 297, P=0.017; HR=1.305, 95% CI 1.005–1.695, P=0.046; HR=1.321, 95% CI 1.002–1.741, P=0.048; HR=1.659, 95% CI 1.198–2.298, P=0.002). Conclusion The incidence of minor bleeding in women with PCAD is significantly higher than that in men; After adjusting for various risk factors, gender is an independent risk factor for minor bleeding events, but not an independent risk factor for MACCE in patients with PCAD. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Science and Technology Support Program of China

scholarly journals Temporary hemiepiphysiodesis using an eight‐plate implant for coronal angular deformity around the knee in children aged less than 10 years: efficacy, complications, occurrence of rebound and risk factors

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhen-Zhen Dai ◽  
Zhen-Peng Liang ◽  
Hao Li ◽  
Jing Ding ◽  
Zhen-Kai Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Deformity Correction ◽  
Genu Valgum ◽  
Angular Deformity ◽  
Screw Loosening ◽  
Logistic Regression Models ◽  
The Mean ◽  
Low Incidence ◽  
Angular Deformities

Abstract Background Temporary hemiepiphysiodesis (TH) using an eight-Plate implant is one of the most common surgeries used for the correction of coronal angular deformities around the knee in adolescents. However, few studies have focused on children aged less than 10 years treated with TH using an eight-Plate implant. The purpose of this study was to investigate the efficacy, correction velocity, and complications of TH with an eight-Plate implant as well as the occurrence of rebound and risk factors in this population. Methods This retrospective study included a total of 135 physes (101 knees) from 66 children (mean age of 4.69 years old, range from 1 to 10 years old) who underwent TH with an eight-Plate implant to correct coronal genu angular deformities in our hospital. Related clinical factors were recorded and analysed by multivariable linear and logistic regression models. Results The mean deformity correction period was 13.26 months, and the mean follow-up after eight-Plate removal was 12.71 months. In all, 94.06% (95/101 knees) of the genu angular deformities were completely corrected. Non-idiopathic genu angular deformity was found to be an independent risk factor for deformity correction failure (odds ratio (OR) = 2.47). The femoral correction velocity was significantly higher than the tibial correction velocity (1.28° vs. 0.83° per month, p < 0.001). After adjustment for other factors, younger children had higher correction velocities in the distal femur; however, genu valgum and idiopathic deformities were associated with higher correction velocities in the proximal tibia. In addition, we found three (3/101, 2.97%) knees with genu valgum that experienced rebound after removal of the eight-Plate, while five (5/101, 4.95%) knees with non-idiopathic genu angular deformity experienced screw loosening. No other complications were found, and non-idiopathic deformity was the only risk factor for complications (OR = 3.96). No risk factor was found for rebound in our study. Conclusions TH using an eight-Plate implant is an effective procedure for coronal genu angular deformities with a low incidence of complications and rebound in patients younger than 10 years old. For this population, TH using an eight-Plate should be considered as soon as the deformity stops responding to conservative treatments. The parents of children younger than 10 years of age with non-idiopathic deformities should be informed preoperatively that the deformity may be prone to correction failure or screw loosening after eight-Plate implantation.

scholarly journals The Association of Familial Hypertension and Risk of Gestational Hypertension and Preeclampsia

2021 ◽  
Vol 18 (13) ◽  
pp. 7045
Author(s):  
Małgorzata Lewandowska
Keyword(s):  
Risk Factor ◽  
Pregnant Women ◽  
Odds Ratio ◽  
Independent Risk Factor ◽  
Gestational Hypertension ◽  
First Trimester ◽  
Chronic Hypertension ◽  
Modifiable Factors ◽  
The Family ◽  
Maternal Hypertension

It has not been established how history of hypertension in the father or mother of pregnant women, combined with obesity or smoking, affects the risk of main forms of pregnancy-induced hypertension. A cohort of 912 pregnant women, recruited in the first trimester, was assessed; 113 (12.4%) women developed gestational hypertension (GH), 24 (2.6%) developed preeclampsia (PE) and 775 women remained normotensive (a control group). Multiple logistic regression was used to calculate adjusted odds ratios (AOR) (and 95% confidence intervals) of GH and PE for chronic hypertension in the father or mother of pregnant women. Some differences were discovered. (1) Paternal hypertension (vs. absence of hypertension in the family) was an independent risk factor for GH (AOR-a = 1.98 (1.2–3.28), p = 0.008). This odds ratio increased in pregnant women who smoked in the first trimester (AOR-a = 4.71 (1.01–21.96); p = 0.048) or smoked before pregnancy (AOR-a = 3.15 (1.16–8.54); p = 0.024), or had pre-pregnancy overweight (AOR-a = 2.67 (1.02–7.02); p = 0.046). (2) Maternal hypertension (vs. absence of hypertension in the family) was an independent risk factor for preeclampsia (PE) (AOR-a = 3.26 (1.3–8.16); p = 0.012). This odds ratio increased in the obese women (AOR-a = 6.51 (1.05–40.25); p = 0.044) and (paradoxically) in women who had never smoked (AOR-a = 5.31 (1.91–14.8); p = 0.001). Conclusions: Chronic hypertension in the father or mother affected the risk of preeclampsia and gestational hypertension in different ways. Modifiable factors (overweight/obesity and smoking) may exacerbate the relationships in question, however, paradoxically, beneficial effects of smoking for preeclampsia risk are also possible. Importantly, paternal and maternal hypertension were not independent risk factors for GH/PE in a subgroup of women with normal body mass index (BMI).

Risk Factors for Aortic Valve Calcification in Patients on Regular Hemodialysis

2009 ◽  
Vol 32 (3) ◽  
pp. 173-179 ◽  
Author(s):  
Dejan Petrović ◽  
Radmila Obrenović ◽  
Biljana Stojimirović
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Risk Factor ◽  
Aortic Valve ◽  
Independent Risk Factor ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Aortic Valve Calcification ◽  
Valve Calcification ◽  
Regular Hemodialysis

Introduction Aortic valve calcification (AVC) accelerates development of aortic valve stenosis and cardiovascular complications. Hyperphosphatemia is one of the key risk factors for aortic valve calcification. Aim The aim of this study was to evaluate the prevalence of AVC in patients on regular hemodialysis and to assess the impact of different factors on its appearance. Method: The study investigated a total of 115 patients treated in the Hemodialysis Department of the Urology and Nephrology Clinic at the Kragujevac Clinical Center in Serbia. The variables investigated were: serum albumin, C-reactive protein (CRP), homocysteine, total cholesterol, LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), triglycerides (TG), Apolipoprotein A-I (Apo A-I), Apolipoprotein B (Apo B) and lipoprotein (a), calcium, phosphate and parathormone, and calcium-phosphorus product (Ca × P). Patients were evaluated by echocardiography for AVC. Statistical analysis included univariate and multivariate logistic regression analysis. Results Univariate regression analysis showed that serum phosphate levels and Ca × P are the most important risk factors for AVC (p<0.001). Multivariate logistic regression analysis revealed that hyperphosphatemia is an independent risk factor for AVC (p<0.001). Conclusion Hyperphosphatemia is an independent risk factor for aortic valve calcification.

Abstract P146: Uric Acid is an Independent Risk Factor for Developing Hypertension From Prehypertension: A 5-year Japanese Cohort Study

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Masanari Kuwabara ◽  
Shigeko Hara ◽  
Koichiro Niwa ◽  
Minoru Ohno ◽  
Ichiro Hisatome
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Pressure ◽  
Body Mass Index ◽  
Uric Acid ◽  
Risk Factor ◽  
Cohort Study ◽  
Serum Uric Acid ◽  
Independent Risk Factor ◽  
Drinking Habits

Objectives: Prehypertension frequently progresses to hypertension and is associated with cardiovascular diseases, stroke, excess morbidity and mortality. However, the identical risk factors for developing hypertension from prehypertension are not clarified. This study is conducted to clarify the risks. Methods: We conducted a retrospective 5-year cohort study using the data from 3,584 prehypertensive Japanese adults (52.1±11.0 years, 2,081 men) in 2004 and reevaluated it 5 years later. We calculated the cumulative incidences of hypertension over 5 years, then, we detected the risk factors and calculated odds ratios (ORs) for developing hypertension by crude analysis and after adjustments for age, sex, body mass index, smoking and drinking habits, baseline systolic and diastolic blood pressure, pulse rate, diabetes mellitus, dyslipidemia, chronic kidney disease, and serum uric acid. We also evaluated whether serum uric acid (hyperuricemia) provided an independent risk for developing hypertension. Results: The cumulative incidence of hypertension from prehypertension over 5 years was 25.3%, but there were no significant differences between women and men (24.4% vs 26.0%, p=0.28). The cumulative incidence of hypertension in subjects with hyperuricemia (n=726) was significantly higher than those without hyperuricemia (n=2,858) (30.7% vs 24.0%, p<0.001). After multivariable adjustments, the risk factors for developing hypertension from prehypertension were age (OR per 1 year increased: 1.023; 95% CI, 1.015-1.032), women (OR versus men: 1.595; 95% CI, 1.269-2.005), higher body mass index (OR per 1 kg/m 2 increased: 1.051; 95% CI 1.021-1.081), higher baseline systolic blood pressure (OR per 1 mmHg increased: 1.072; 95% CI, 1.055-1.089) and diastolic blood pressure (OR per 1 mmHg increased: 1.085; 95% CI, 1.065-1.106), and higher serum uric acid (OR pre 1 mg/dL increased: 1.149; 95% CI, 1.066-1.238), but not smoking and drinking habits, diabetes mellitus, dyslipidemia, and chronic kidney diseases. Conclusions: Increased serum uric acid is an independent risk factor for developing hypertension from prehypertension. Intervention studies are needed to clarify whether the treatments for hyperuricemia in prehypertensive subjects are useful.

Outcomes for and Risk Factors Associated With Vancomycin-ResistantEnterococcus faecalisand Vancomycin-ResistantEnterococcus faeciumBacteremia in Cancer Patients

2007 ◽  
Vol 28 (9) ◽  
pp. 1054-1059 ◽  
Author(s):  
G. Ghanem ◽  
R. Hachem ◽  
Y. Jiang ◽  
R. F. Chemaly ◽  
I. Raad
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Mortality Rate ◽  
Cancer Patients ◽  
Independent Risk Factor ◽  
Response To Therapy ◽  
Aminoglycoside Therapy ◽  
Significant Difference ◽  
Vancomycin Resistant ◽  
And Control

Objective.Vancomycin-resistant enterococci (VRE) are a major cause of nosocomial infection. We sought to compare vancomycin-resistant (VR)Enterococcus faecalisbacteremia and VREnterococcus faeciumbacteremia in cancer patients with respect to risk factors, clinical presentation, microbiological characteristics, antimicrobial therapy, and outcomes.Methods.We identified 210 cancer patients with VRE bacteremia who had been treated between January 1996 and December 2004; 16 of these 210 had VRE. faecalisbacteremia and were matched with 32 patients with VRE. faeciumbacteremia and 32 control patients. A retrospective review of medical records was conducted.Results.Logistic regression analysis showed that, compared with VRE. faecalisbacteremia, VRE. faeciumbacteremia was associated with a worse clinical response to therapy (odds ratio [OR], 0.3 [95% confidence interval (CI), 0.07-0.98];P= .046) and a higher overall mortality rate (OR, 8.3 [95% CI, 1.9-35.3];P= .004), but the VRE-related mortality rate did not show a statistically significant difference (OR, 6.8 [95% CI, 0.7-61.8];P= .09). Compared with control patients, patients with VRE. faecalisbacteremia were more likely to have received an aminoglycoside in the 30 days before the onset of bacteremia (OR, 5.8 [95% CI, 1.2-27.6];P= .03), whereas patients with VRE. faeciumbacteremia were more likely to have received a carbapenem in the 30 days before the onset of bacteremia (OR, 11.7 [95% CI, 3.6-38.6];P<.001). In a multivariate model that compared patients with VRE. faeciumbacteremia and control patients, predictors of mortality included acute renal failure on presentation (OR, 15.1 [95% CI, 2.3-99.2];P= .004) and VRE. faeciumbacteremia (OR, 11 [95% CI, 2.7-45.1];P<.001). No difference in outcomes was found between patients with VRE. faecalisbacteremia and control patients.Conclusions.VRE. faeciumbacteremia in cancer patients was associated with a poorer outcome than was VRE. faecalisbacteremia. Recent receipt of carbapenem therapy was an independent risk factor for VRE. faeciumbacteremia, and recent receipt of aminoglycoside therapy was independent risk factor forE. faecalisbacteremia.

Sign in / Sign up

Export Citation Format

Share Document