scholarly journals Culture-negative versus Culture-positive in pyogenic spondylitis and Analysis of risk factors for relapse

2020 ◽  
Author(s):  
guohua dai ◽  
shu zhong li ◽  
chuqiang yin ◽  
yuanliang sun ◽  
qizun wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Temperature ◽  
Treatment Time ◽  
Reactive Protein ◽  
Pyogenic Spondylitis ◽  
Decline Rate ◽  
Independent Risk Factors ◽  
Culture Positive ◽  
Culture Negative ◽  
Infection Recurrence

Abstract Objectives This study aims to compare and analyze the clinical features, diagnosis, treatment and prognosis of culture-negative and culture-positive primary pyogenic spondylitis. Methods A retrospective analysis of 202 cases of adult primary pyogenic spondylitis with complete clinical data in our hospital from January 2013 to January 2020 were divided into 2 groups according to the bacterial culture results: culture negative group (n = 126), culture Positive group (n = 76). Compare the clinical characteristics, diagnosis, treatment and prognosis of patients with different culture results. Results The culture positive rate was 37.62% (76/202). There were no significant differences in age, gender, affected segment, spinal abscess, diabetes mellitus, course of disease, surgery, recurrence, and follow-up time between the two groups (P > 0.05). Two groups of hospital admission erythrocyte sedimentation rate (erythrocyte sedimentation rate, ESR), admission C-reactive protein (C-reactive protein, CRP), admission white blood cell count (white blood cell, WBC), discharge ESR, discharge CRP, ESR decline rate, CRP There were statistically significant differences in the rate of decline, hospitalization days, and body temperature ≥ 38 °C (P < 0.05). Higher CRP levels on admission, antibiotic treatment time < 6 weeks, and body temperature ≥ 38 ℃ are independent risk factors for infection recurrence. Conclusion The culture-negative group's admission WBC, admission ESR, admission CRP, discharge ESR, discharge CRP, ESR decline rate, CRP decline rate, and hospital stay were lower than the culture positive group, the difference was statistically significant (P < 0.05). The independent risk factors for infection recurrence are higher CRP levels in hospital admission, antibiotic treatment time < 6 weeks, and body temperature ≥ 38 °C.

scholarly journals Culture-negative versus culture-positive in pyogenic spondylitis and analysis of risk factors for relapse

2021 ◽  
pp. 1-5
Author(s):  
Guohua Dai ◽  
Shuzhong Li ◽  
Chuqiang Yin ◽  
Yuanliang Sun ◽  
Jianwen Hou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pyogenic Spondylitis ◽  
Culture Positive ◽  
Culture Negative

scholarly journals Hyperglycemia, hyperadiposity and leukocytosis are independent risk factors for higher serum C‐reactive protein in free‐living adults

2012 ◽  
Vol 26 (S1) ◽  
Author(s):  
Fernando Moreto ◽  
Rodrigo Minoru Manda ◽  
Gabriel Augusto Torezan ◽  
Okesley Teixeira ◽  
Roberto Carlos Burini
Keyword(s):  
Risk Factors ◽  
C Reactive Protein ◽  
Free Living ◽  
Reactive Protein ◽  
Independent Risk Factors

scholarly journals Helicobacter pylori Recurrence after Eradication Therapy in Jiangjin District, Chongqing, China

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Gang Zhou
Keyword(s):  
Risk Factors ◽  
Helicobacter Pylori ◽  
Recurrence Rate ◽  
Standard Therapy ◽  
Family Members ◽  
Significant Difference ◽  
Independent Risk Factors ◽  
Eating Out ◽  
H Pylori ◽  
Infection Recurrence

Purpose. To investigate the recurrence rate of Helicobacter pylori infection after eradication in Jiangjin District, Chongqing, China, and to analyze the related causes. Methods. Outpatients who were eradicated of H. pylori infection with standard therapy between August 2014 and August 2017 were included in this study. The recurrence rate was investigated 1 year later. Data regarding gender, smoking, alcohol intake, frequency of eating out, and treatment strategy were recorded, and their relationships with the recurrence rate were analyzed. Multivariate logistic regression analysis was performed to determine the independent risk factors for H. pylori infection recurrence. Results. In total, 400 patients (225 males and 175 females) were included in this study. Of them, the recurrence rate of H. pylori infection was 4.75% (19/400), with 5.33% (12/225) in males and 4.57% (7/175) in females, showing no gender difference. The recurrence rate was 7.03% (9/128) in smokers and 3.68% (10/272) in nonsmokers, while it was 6.45% (12/186) in those who drink alcohol and 3.27% (7/214) in those who do not drink alcohol, showing no significant differences. The higher the frequency of eating out, the higher the recurrence rate of H. pylori infection (P=0.001). There was a statistically significant difference in the recurrence rate between patients receiving treatment alone and patients whose family members also received treatment (6.08% vs. 0.96%, P=0.035). Drinking and dining out were independent risk factors for H. pylori infection recurrence (P=0.014 for drinkers and P=0.015 and P=0.003 for those who sometimes and often dine out, respectively). Conclusions. The overall recurrence rate after H. pylori eradication by standard therapy in Jiangjin District is 4.75%. Reducing the frequency of eating out and family members receiving treatment may reduce the recurrence of H. pylori infection.

scholarly journals Associations Between Procalcitonin and Markers of Bacterial Sepsis

Medicina ◽  
2012 ◽  
Vol 48 (8) ◽  
pp. 57 ◽  
Author(s):  
Veeresh Patil ◽  
Jaymin Morjaria ◽  
Francois De Villers ◽  
Suresh Babu
Keyword(s):  
Bacterial Culture ◽  
White Cell Count ◽  
Bacterial Sepsis ◽  
Reactive Protein ◽  
Paired Samples ◽  
Positive Bacterial Culture ◽  
Specificity And Sensitivity ◽  
Significant Difference ◽  
Culture Positive ◽  
Culture Negative

Background. Bacterial sepsis with no bacterial isolates can be a difficult clinical conundrum, where other markers like C-reactive protein (CRP), white cell count (WCC), and neutrophilia are helpful to arrive at a diagnosis. Procalcitonin (PCT) has been shown to be a useful biomarker in bacterial sepsis. The aim of the study was to look at the association of PCT with bacterial cultures and compare this to currently used markers of bacterial sepsis. Material and Methods. WCC, neutrophil count, and CRP with PCT were compared in patients with a positive bacterial culture from blood/body fluid. The specificity and sensitivity of PCT were compared with those of CRP. Results. Of the 99 paired samples obtained, 25 cultures were positive for bacteria. There was a significant difference in CRP (P=0.04) and PCT (P<0.001) levels between culture-positive and culture-negative samples. PCT had a better sensitivity and specificity than CRP (84% and 64.9% vs. 69.6% and 52.9%, respectively), with a combined specificity (CRP and PCT) of 83.5%. Conclusions. PCT has a better association with bacterial sepsis and is superior to currently available biomarkers in the clinical setting. The rapid pharmacodynamics of PCT can serve as an early predictor of the diagnosis of bacterial sepsis while awaiting the bacterial culture results avoiding undue delay in the institution of antibiotics, hence, potentially improving the prognosis of patients with bacterial sepsis.

scholarly journals Analysis of Perioperative Risk Factors for Deep Vein Thrombosis in Patients With Femoral and Pelvic Fractures

2020 ◽  
Author(s):  
Linqin Wu ◽  
Bo Cheng
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Blood Transfusion ◽  
Perioperative Period ◽  
Pelvic Fractures ◽  
C Reactive Protein ◽  
Vein Thrombosis ◽  
Reactive Protein ◽  
Independent Risk Factors ◽  
Deep Vein

Abstract Objective: Clinical characteristics, anticoagulant protocols and risk factors of deep Vein thrombosis (DVT) in patients with femoral and pelvic fractures were analyzed throughout the perioperative period to provide references for early identification and optimization of risk factors.Methods: This was a retrospective study. A total of 569 patients undergoing surgery of femoral and pelvic fractures from May 2018 to December 2019 were included. The Clinical data including general conditions,trauma, surgery,anticoagulant protocols and laboratory indexes were collected.According to the results of deep vein Doppler ultrasonography of the lower extremities, the patients were divided into non-DVT group and DVT group.Univariate analysis and multivariate logistic regression analysis were used to identify the independent risk factors of preoperative and postoperative DVT.Results: The incidence of DVT was 40.25%, PE was 1.93%, and preoperative DVT was 26.71%,which was higher than the incidence of postoperative DVT of 17.22%. Most of them were thrombus on the affected side (60.26%) and distal thrombus (81.66%).The average time of DVT formation was 6.55±0.47 days after trauma and 6.67±0.48 days after surgery. Chronic obstructive pulmonary disease(COPD), anemia, hypoproteinemia, non-anticoagulation before surgery, delayed anticoagulation after trauma and admission, high energy trauma, multiple injuries, drinking history, and advanced age were independent risk factors for perioperative DVT.The increased level of fibrinogen degradation products was an independent risk factor for preoperative DVT. These risk factors were identified to be independently associated with postoperative DVT, including intraoperative blood transfusion, postoperative blood transfusion, pulmonary infection, preoperative non-anticoagulation, postoperative delayed anticoagulation, preoperative waiting time > 7d, operative time > 2h, c-reactive protein, fibrinogen level, platelet count 1 day after surgery, c-reactive protein, fibrinogen, and hemoglobin levels 3 days after surgery, comminuted fracture.Conclusions: At present, anticoagulation and other DVT prevention and treatment programs have not changed the current situation that the incidence of DVT is still high. Through the analysis of the risk factors of DVT throughout the perioperative period, optimizing the perioperative blood transfusion, preoperative lung disease, hypoproteinemia, anemia, inflammation, etc., and surgery as soon as possible after trauma may further reduce its incidence.

scholarly journals Risk factors for clinical progression in patients with COVID-19: a retrospective study of electronic health record data in the United Kingdom

2020 ◽  
Author(s):  
Robert A Fletcher ◽  
Thomas Matcham ◽  
Marta Tibúrcio ◽  
Arseni Anisimovich ◽  
Stojan Jovanović ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Logistic Regression ◽  
Body Temperature ◽  
Blood Cell ◽  
Severe Disease ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Multivariable Logistic Regression ◽  
D Dimer

Background: The novel coronavirus disease 2019 (COVID-19) outbreak presents a significant threat to global health. A better understanding of patient clinical profiles is essential to drive efficient and timely health service strategies. In this study, we aimed to identify risk factors for a higher susceptibility to symptomatic presentation with COVID-19 and a transition to severe disease. Methods: We analysed data on 2756 patients admitted to Chelsea & Westminster Hospital NHS Foundation Trust between 1st January and 23rd April 2020. We compared differences in characteristics between patients designated positive for COVID-19 and patients designated negative on hospitalisation and derived a multivariable logistic regression model to identify risk factors for predicting risk of symptomatic COVID-19. For patients with COVID-19, we used univariable and multivariable logistic regression to identify risk factors associated with progression to severe disease defined by: 1) admission to the hospital AICU, 2) the need for mechanical ventilation, 3) in-hospital mortality, and 4) at least one measurement of elevated D-dimer (equal or superior to 1,000 ug/L) indicative of increased risk of venous thromboembolism. Results: The patient population consisted of 1148 COVID-19 positive and 1608 COVID-19 negative patients. Age, sex, self-reported ethnicity, C-reactive protein, white blood cell count, respiratory rate, body temperature, and systolic blood pressure formed the most parsimonious model for predicting risk of symptomatic COVID-19 at hospital admission. Among 1148 patients with COVID-19, 116 (10.1%) were admitted to the AICU, 71 (6.2%) required mechanical ventilation, 368 (32.1%) had at least one record of D-dimer levels ≥1,000 μg/L, and 118 patients died. In the multivariable logistic regression, age (OR = 0.953 per 1 year, 95% CI: 0.937-0.968) C-reactive protein (OR = 1.004 per 1 mg/L, 95% CI: 1.002-1.007), and white blood cell counts (OR = 1.059 per 109/L, 95% CI: 1.010-1.111) were found to be associated with admission to the AICU. Age (OR = 0.973 per 1 year, 95% CI: 0.955-0.990), C-reactive protein (OR = 1.003 per 1 mg/L, 95% CI: 1.000-1.006) and sodium (OR = 0.915 per 1 mmol/L, 0.868-0.962) were associated with mechanical ventilation. Age (OR = 1.023 per 1 year, 95% CI: 1.004-1.043), CRP (OR = 1.004 per 1 mg/L, 95% CI: 1.002-1.006), and body temperature (OR = 0.723 per 1oC, 95% CI: 0.541-0.958) were associated with elevated D-dimer. For mortality, we observed associations with age (OR = 1.060 per 1 year, 95% CI: 1.040-1.082), female sex (OR = 0.442, 95% CI: 0.442, 95% CI: 0.245-0.777), Asian ethnic background (OR = 2.237 vs White ethnic background, 95% CI: 1.111-4.510), C-reactive protein (OR = 1.004 per 1 mg/L, 95% CI: 1.001-1.006), sodium (OR = 1.038 per 1 mmol/L, 95% CI: 1.001-1.006), and respiratory rate (OR = 1.054 per 1 breath/min, 95% CI: 1.024-1.087). Conclusion: Our analysis suggests there are several demographic, clinical and laboratory findings associated with a symptomatic presentation of COVID-19. Moreover, significant associations between patient deterioration were found with age, sex and specific blood markers, chiefly C-reactive protein, and could help early identification of patients at risk of poorer prognosis. Further work is required to clarify the extent to which our observations are relevant beyond current settings.

Increased pretreatment C-reactive protein-to-albumin ratio predicts severe coronavirus disease 2019

2020 ◽  
Author(s):  
Xiaoyue Wang ◽  
Yan Xu ◽  
Huang Huang ◽  
Desheng Jiang ◽  
Chunlei Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Early Warning ◽  
Warning Signs ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Independent Risk Factors

Abstract Objective The aim of this study was to identify early warning signs for severe coronavirus disease 2019 (COVID-19). Methods We retrospectively analysed the clinical data of 90 patients with COVID-19 from Guanggu District of Hubei Women and Children Medical and Healthcare Center, comprising 60 mild cases and 30 severe cases. The demographic data, underlying diseases, clinical manifestations and laboratory blood test results were compared between the two groups. The cutoff values were determined by receiver operating characteristic curve analysis. Logistic regression analysis was performed to identify the independent risk factors for severe COVID-19. Results The patients with mild and severe COVID-19 had significant differences in terms of cancer incidence, age, pretreatment neutrophil-to-lymphocyte ratio (NLR), and pretreatment C-reactive protein-to-albumin ratio (CAR) ( P =0.000; P =0.008; P=0.000; P =0.000). The severity of COVID-19 was positively correlated with comorbid cancer, age, NLR, and CAR ( P <0.005). Multivariate logistic regression analysis showed that age, the NLR and the CAR were independent risk factors for severe COVID-19 (OR=1.086, P =0.008; OR=1.512, P =0.007; OR=17.652, P =0.001). Conclusion An increased CAR can serve as an early warning sign of severe COVID-19 in conjunction with the NLR and age.

Prospective, Multicenter Evaluation of Risk Factors Associated With Invasive Bacterial Infection in Children With Cancer, Neutropenia, and Fever

2001 ◽  
Vol 19 (14) ◽  
pp. 3415-3421 ◽  
Author(s):  
M. E. Santolaya ◽  
A. M. Alvarez ◽  
A. Becker ◽  
J. Cofré ◽  
N. Enríquez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bacterial Infection ◽  
Large Population ◽  
Cancer Type ◽  
Monocyte Count ◽  
Children With Cancer ◽  
Protein Levels ◽  
Reactive Protein ◽  
Invasive Bacterial Infection ◽  
Independent Risk Factors

PURPOSE: To identify clinical and laboratory parameters present at the time of a first evaluation that could help predict which children with cancer, fever, and neutropenia were at high risk or low risk for an invasive bacterial infection. PATIENTS AND METHODS: Over a 17-month period, all children with cancer, fever, and neutropenia admitted to five hospitals in Santiago, Chile, were enrolled onto a prospective protocol. Associations between admission parameters and risk for invasive bacterial infection were assessed by univariate and logistic regression analyses. RESULTS: A total of 447 febrile neutropenic episodes occurred in 257 children. Five parameters were statistically independent risk factors for an invasive bacterial infection. Ranked by order of significance, they were as follows: C-reactive protein levels of 90 mg/L or higher (relative risk [RR], 4.2; 95% confidence interval [CI], 3.6 to 4.8); presence of hypotension (RR, 2.7; 95% CI, 2.3 to 3.2); relapse of leukemia as cancer type (RR, 1.8, 95% CI, 1.7 to 2.3); platelet count less than or equal to 50,000/mm3 (RR, 1.7; 95% CI, 1.4 to 2.2); and recent (≤ 7 days) chemotherapy (RR, 1.3; 95% CI, 1.1 to 1.6). Other previously postulated risk factors (magnitude of fever, monocyte count) were not independent risk factors in this study population. CONCLUSION: In a large population of children, common clinical and laboratory admission parameters were identified that can help predict the risk for an invasive bacterial infection. These results encourage the possibility of a more selective management strategy for these children.

scholarly journals Clinical Features and Risk Factors of ICU Admission for COVID-19 Patients with Diabetes

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Ming Lei ◽  
Kashuai Lin ◽  
Yaoqiu Pi ◽  
Xiaomei Huang ◽  
Lixin Fan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Rate ◽  
Early Stage ◽  
Binary Logistic Regression ◽  
C Reactive Protein ◽  
Radiographic Findings ◽  
Icu Admission ◽  
Reactive Protein ◽  
Patients With Diabetes ◽  
Independent Risk Factors

Introduction. Previous studies of coronavirus disease 2019 (COVID-19) have focused on the general population. However, diabetes (DM) as one of the most common comorbidities is rarely studied in detail. This study is aimed at describing clinical characteristics and determining risk factors of ICU admission for COVID-19 patients with DM. Methods. Data were extracted from 288 adult patients with laboratory-confirmed COVID-19 from Guangzhou Eighth People’s Hospital. Demographic characteristics, laboratory results, radiographic findings, complications, and treatments were collected and compared between DM and non-DM groups. Binary logistic regression was used to identify the risk factors associated with ICU admission for COVID-19 patients with DM or non-DM. Results. COVID-19 patients with DM showed as older ages, higher levels of C-reactive protein (CRP), myoglobin, alanine transaminase (ALT), and aspartate transaminase (AST). They were also more prone to transfer to the intensive care unit (ICU) for treatment. Multiple regression analysis showed that the following were the independent risk factors for COVID-19 patients with DM that received ICU admission: each 1-year increase in age (odds ratio (OR), 1.07; 95% CI, 1.02-1.13; P = 0.007 ), respiratory rate over 24 times per minute (OR, 5.22; 95% CI, 2.26-16.58; P = 0.016 ), HbA1c greater than 7% (OR, 4.58; 95% CI, 1.82-10.55; P = 0.012 ), and AST higher than 40 U/L (OR, 2.96; 95% CI, 1.58-8.85; P = 0.022 ). In addition, each 1-year increase in age (OR, 1.05; 95% CI, 1.01-1.10; P = 0.006 ), diarrhea (OR, 4.62; 95% CI, 2.01-9.36; P = 0.022 ), respiratory rate over 24 times per minute (OR, 5.13; 95% CI, 1.18-16.82; P = 0.035 ), CRP greater than 10 mg/L (OR, 5.19; 95% CI, 1.37-13.25, P = 0.009 ), and TnI higher than 0.03 μg/L (OR, 6.48; 95% CI, 1.17-21.38; P = 0.036 ) were risk factors for ICU admission of COVID-19 patients with non-DM. Conclusions. The older age, respiratory rate over 24 times per minute, HbA1c greater than 7%, and AST higher than 40 U/L were risk factors of ICU admission for COVID-19 patients with diabetes. Investigating and monitoring these factors could assist in the risk stratification of COVID-19 patients with DM at an early stage.

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