Risk Factors for Post-Intensive Care Syndrome in Family Members (PICS-F) of Adult Patients: A Systematic Review.

Abstract Background: Relatives of critically ill patients who either die or survive the intensive care unit (ICU) may develop substantial mental health problems that are collectively defined as Post-Intensive Care Syndrome in Family (PICS-F). It is important to document in a systematic manner all of the possible risk factors associated with the development of the latter.Methods: By using a systematized search strategy we included studies that focused on PICS-F in relatives of adult ICU patients and reported the risk factors associated with its development. The search was conducted within PubMed, Embase, SCOPUS, clinicaltrials.gov and Cochrane Library on the 2nd of May, 2021. PRISMA guidelines were implemented for appropriate reporting. Results: We included 52 papers covering 8293 relatives. The prevalence of PICS-F varied between 2.5-69%. We identified over 70 different risk factors of PICS-F, among which we distinguished patient-related (n=28), relative-related (n=33) and medical staff-related (n=9) risk factors. Among 17 studies with the highest quality we identified the 7 following factors associated with the development of PICS-F: younger age of a patient, death of a patient, depression in relatives during the ICU stay, history of mental disorders in relatives, being a spouse and low satisfaction with communication & care in the ICU.Conclusions: PICS-F is a highly prevalent phenomenon that may be exacerbated by a number of risk factors. Special attention should be paid to proper identification of susceptible relatives in order to prevent PICS.

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Ventilator-Associated Pneumonia: Incidence and risk factors six intensive care units in Tunisia

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.712 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Ben Cheikh ◽

S Bhiri ◽

N ketaka ◽

A Gara ◽

S Khefacha ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Intensive Care ◽

University Hospital ◽

Ventilator Associated Pneumonia ◽

Factors Associated ◽

History Of ◽

Independent Risk Factors ◽

The University ◽

Very High

Abstract Background Ventilator-Associated Pneumonia (VAP) continues to cause significant morbidity, mortality, and hospital costs, especially in the intensive care unit (ICU). This study aimed to determine incidence and factors associated with VAP in six ICUs of the University Hospital-Sahloul (Sousse, Tunisia) in 2018. Methods We conducted a prospective observational cohort study over a three months period in six ICUs of the University Hospital-Sahloul (Sousse, Tunisia) in 2018. All patients hospitalized with mechanical ventilation (MV) for more than 48 hours in the ICUs were included. Logistic regression with the stepwise method of Hosmer and Lemeshow was used to identify factors associated with VAP. Results Overall, 110 patients were enrolled. The mean age of patients was 44 ± 25 years. Of them, 66.4% were male. The median duration of MV was 5 days [2-16]. The incidence of VAP was 32% and the density incidence was 33/1000 ventilator days. The most common organism were Pseudomonas aeruginosa (n = 14). Of them, 12 were ceftazidime-resistant and thee were resistant to imipenem. Independent risk factors associated with VAP in ICU were history of antibiotic therapy during last 6 months (p = 0.007), tracheotomy (p < 0.001) and reintubation (p < 0.001). Conclusions VAP rates in our ICUs were very high. Antimicrobial stewardship programs involving pharmacists and physicians must be elaborated to optimize the antibiotic prescribing. Mechanical ventilation require more-effective interventions control in our hospital. Key messages Ventilator-Associated Pneumonia rates were very high. Independent risk factors associated with Ventilator-Associated Pneumonia were history of antibiotic therapy during last 6 months, tracheotomy and reintubation.

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Socio-demographic risk factors associated with febrile seizures at Puducherry: a retrospective study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20201653 ◽

2020 ◽

Vol 7 (5) ◽

pp. 1130

Author(s):

Gobinaath . ◽

Arun Daniel J.

Keyword(s):

Risk Factors ◽

Family History ◽

Age At Onset ◽

Febrile Seizures ◽

Factors Associated ◽

Younger Age ◽

History Of ◽

Demographic Risk ◽

Tract Infections ◽

Demographic Risk Factors

Background: Febrile seizures occur commonly in the under 5 age group and is associated with few risk factors causing its recurrence like very high fever, family history of seizures, low sodium levels and younger age of onset which are subject to seasonal and wide geographical variations. This study aimed at detecting the major risk factors associated with recurrent febrile seizures in an Indian population.Methods: A retrospective hospital-based study was conducted among a total of 300 cases aged 6 months to 5 years attending to the paediatric OPD with history of fever followed by febrile seizures. Information regarding socio-demographic and clinical variables associated with febrile seizure was collected and analyzed.Results: The mean age of the study participants was 25.6±2.2 months and majority (60%) were males. Family history of seizures was present in 25.3% (n=76) of the children with febrile seizures. Respiratory infections (73.3%) and gastroenteritis (17%) were the major infective reasons associated with the occurrence of febrile seizures followed by pneumonia (6.3%) and urinary tract infections (5%). Recurrence of FS was significantly higher among the children with family history of FS (p=0.009), age at onset lesser (p<0.001) and simple FS seizures.Conclusions: Younger age at onset and positive family history of seizures were important socio-demographic risk factors associated with recurrent febrile seizures.

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Risk Factors for Colonization and Infection With Resistant Pseudomonas Aeruginosa in Intensive Care Unit: Protocol for a Systematic Review and Meta-analysis

10.21203/rs.3.rs-287779/v1 ◽

2021 ◽

Author(s):

Serge Eyebe ◽

Hugues Nana-Djeunga ◽

Magellan Guewo-Fokeng ◽

Guy Sadeu Wafeu ◽

Marius Wouking ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Intensive Care Unit ◽

Pseudomonas Aeruginosa ◽

Intensive Care ◽

Environmental Factors ◽

Meta Analysis ◽

Cochrane Library ◽

Prevalence Odds Ratio ◽

Factors Associated

Abstract Background: Infection with resistant Pseudomonas aeruginosa (RPA) in Intensive Care Unit (ICU) is known to be either endogenous or exogenous or both, but the roles of each of these contamination routes is yet to be clarified. Data regarding prevalence, risk factors and environmental factors associated with RPA in ICU are very scanty and even when they exist, they seem to be contradictory. So, there is a strong interest in understanding both individual and environmental factors associated with RPA infection. This systematic review aims to investigate individual and environmental factors associated with the colonization and infection with RPA in ICU.Methodology: MEDLINE (Pubmed), EMBASE (OVID), the Cochrane Library (Wiley), Web of Science, CINAHL (EBSCOHost) and LILACS (BIREME) will be searched from inception onwards. Grey literature will be identified through Google Scholar and open Grey. Two reviewers will independently screen all citations, abstracts and full-text articles. Potential conflicts will be resolved through discussion. Methodological quality including bias will be appraised using appropriate approaches. A narrative synthesis will describe quality and content of the epidemiological evidence. Prevalence, Odds ratio, Relative Risk, Hazard radio with their respective 95% confidence intervals will be calculated. A meta-analysis of data extracted from eligible studies with similar population and RPA testing will be performed. The analysis will evaluate factors influencing the estimates. A random effect model will be used to summarize effect sizes.Discussion: Two contrasting hypotheses on risk factors of acquisition, colonisation, and infection of RPA are being debated, especially in a context where available data are scanty or exhibit high discrepancy. Indeed, most of the reviews have been focalized on hospitalised patients, and not in ICU, and few of them really address the environmental factors issue. To fill that gap, this review will combine both analysis of individual and environmental risk factors using prevalence study in ICU and evaluation of different methodologies. These two hypotheses will be tested and challenged, and could serve as a basis for a more in-depth studies to fill the methodological gaps that will be identified as part of this current review.Systematic review registration: This protocol has been submitted registered with Prospective Register of Systematic Reviews (PROSPERO) on 07 march 2021 under number CRD42021233832

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Activities and risk factors associated with fall-related injuries among US Army soldiers

BMJ Military Health ◽

10.1136/bmjmilitary-2020-001564 ◽

2020 ◽

pp. bmjmilitary-2020-001564

Author(s):

Raina D Brooks ◽

T Grier ◽

B H Jones ◽

M C Chervak

Keyword(s):

Risk Factors ◽

Cross Sectional Study ◽

Cross Sectional ◽

Physically Active ◽

Us Army ◽

Factors Associated ◽

Younger Age ◽

Near Falls ◽

Independent Risk Factors ◽

Army Soldiers

IntroductionFalls/near falls are the second leading cause of hospitalisation and outpatient visits among US Army soldiers. While numerous studies have evaluated fall-related or near fall-related injuries among elderly adults, few have evaluated this association among young adults. The objective of this study is to describe the characteristics and risk factors associated with fall-related or near fall-related injuries among male US Army soldiers.MethodsThis is a cross-sectional study of male US Army Airborne Division soldiers (n=5187). Electronic surveys captured demographic, lifestyle, physical training (PT), fitness and injury data during spring/summer of 2016. Multiple logistic regression was used to identify independent risk factors of fall-related or near fall-related injuries, adjusting for potential confounders.ResultsPrimary findings indicated that activities and risk factors associated with fall-related or near fall-related injuries among soldiers included younger age (≤35 years), holding a job that required minimal lifting activities, slower 2-mile run times and not running during personal PT.ConclusionsThe findings from this study suggest that male US Army soldiers and other physically active men may benefit from (1) obtaining and/or maintaining higher aerobic endurance and muscular strength, and (2) training focused on preventing fall-related injuries during PT, road marching and sports/recreational activities. Moreover, prevention strategies and education should further target younger soldiers (≤35 years old), as younger age is not modifiable.

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Incidence of postural headache after lumbar puncture requiring epidural blood patch: Effects of needle caliber; 2-year experience

The Neuroradiology Journal ◽

10.1177/19714009211000630 ◽

2021 ◽

pp. 197140092110006

Author(s):

Warren Chang ◽

Ajla Kadribegic ◽

Kate Denham ◽

Matthew Kulzer ◽

Tyson Tragon ◽

...

Keyword(s):

Risk Factors ◽

Lumbar Puncture ◽

Conservative Management ◽

Epidural Blood Patch ◽

Female Gender ◽

Regional Hospital ◽

Younger Age ◽

Blood Patch ◽

History Of ◽

The Difference

Purpose A common complication of lumbar puncture (LP) is postural headaches. Epidural blood patches are recommended if patients fail conservative management. Owing to a perceived increase in the number of post-lumbar puncture headaches (PLPHs) requiring epidural blood patches at a regional hospital in our network, the decision was made to switch from 20 to 22 gauge needles for routine diagnostic LPs. Materials and methods Patients presenting for LP and myelography at one network regional hospital were included in the study. The patients were contacted by nursing staff 3 days post-procedure; those patients who still had postural headaches after conservative management and received epidural blood patches were considered positive cases. In total, 292 patients were included; 134 underwent LP with 20-gauge needles (53 male, 81 female, average age 57.7) and 158 underwent LP with 22-gauge needles (79 male, 79 female, average age 54.6). Results Of 134 patients undergoing LP with 20-gauge needles, 15 (11%) had PLPH requiring epidural blood patch (11 female, 3 male, average age 38). Of 158 patients undergoing LP with 22-gauge needles, only 5 (3%) required epidural blood patches (all female, average age 43). The difference was statistically significant ( p < 0.01). Risk factors for PLPH included female gender, younger age, lower body mass index, history of prior PLPH and history of headaches. Conclusion Switching from 20-gauge to 22-gauge needles significantly decreased the incidence of PLPH requiring epidural blood patch. Narrower gauge or non-cutting needles should be considered in patients with risk factors for PLPH, allowing for CSF requirements.

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Pattern of Congenital Heart Diseases and Associated Risk Factors among Children at a Tertiary Care Hospital

10.53350/pjmhs211592451 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2451-2453

Author(s):

Shahid Iqbal ◽

Muhammad Fareed Khan ◽

Raja Imtiaz Ahmed ◽

Shahab Saidullah ◽

Nisar Ahmed ◽

...

Keyword(s):

Risk Factors ◽

Folic Acid ◽

Congenital Heart ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Febrile Illness ◽

Care Hospital ◽

Younger Age ◽

History Of ◽

Associated Risk Factors

Objective: To find out the pattern of CHD and associated risk factors among children presenting at a tertiary care hospital. Study Design: A case-control study. Place and Duration of the Study: The Department of Pediatrics and Department of Cardiology, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawlakot from July 2020 to June 2021. Material and Methods: A total of 207 children of both genders, screened by ECG along with chest x-ray and further confirmed with the diagnosis of CHD through echocardiography were enrolled as cases. Same number of healthy controls (n=207) were recruited from immunization center of the study institution. Among cases, types of CHD were noted. For cases and controls, demographic, antenatal and maternal risk factors including maternal age, gender of the child, history of consanguinity, history of febrile illness in pregnancy, use or multi-vitamin or folic acid in pregnancy, bad obstetrical history and maternal diabetes mellitus were noted. Results: In a total of 414 children (207 cases and 207 controls), there were 219 (53.8%) male. In terms of CHD types among cases, VSD was the most noted in 62 (30.0%), ASD 35 (16.9%), TOF 33 (15.9%) and PDA in 30 (14.5%). Cases were found to have significant association with younger age (78.3% cases below 1 year of age vs. 64.7% in controls, p=0.0085), bad obstetrical history (p=0.0002), history of febrile illness in 1st trimester of pregnancy (p=0.0229) and lack of multivitamins and folic acid in the 1st trimester of pregnancy (p=0.0147). Conclusion: Majority of the children with CHDs were male and aged below 1 year. VSD, ASD, TOF and PDA were the most frequent types of CHD. Younger age, bad obstetrical history, history of febrile illness in 1st trimester of pregnancy and lack of multivitamins and folic acid in the 1st trimester of pregnancy were found to have significant association with CHDs among children. Keywords: Congenital heart disease, echocardiography, ventricular septal defect.

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Predictors of progression in untreated keratoconus: a Save Sight Keratoconus Registry study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-317547 ◽

2021 ◽

pp. bjophthalmol-2020-317547

Author(s):

Alex Ferdi ◽

Vuong Nguyen ◽

Himal Kandel ◽

Jeremy C K Tan ◽

Francisco Arnalich-Montiel ◽

...

Keyword(s):

Risk Factors ◽

Visual Acuity ◽

New Zealand ◽

Corneal Thickness ◽

Clinical Parameter ◽

Clinical Parameters ◽

Registry Study ◽

Factors Associated ◽

Younger Age ◽

Secondary Outcomes

AimsWe set out to identify risk factors for progression in untreated keratoconus patients from 34 centres across Australia, New Zealand, Spain and Italy.MethodsPatients were divided into ‘progressors’ and ‘stable’ patients for each clinical parameter: visual acuity (VA), steepest keratometry (maximum keratometry (Max-K)) and thinnest corneal thickness (TCT). Primary outcomes were the proportion of eyes with sustained progression in VA, Max-K or TCT within 3 years. Secondary outcomes included predictors of progression.ResultsThere were 3994 untreated eyes from 2283 patients. The proportion of eyes with VA, Max-K and TCT progression at 1 year were 3.2%, 6.6% and 3.1% respectively. Factors associated with VA loss were higher baseline VA (HR 1.15 per logMAR line increase in VA; p<0.001) and steeper baseline Max-K (HR 1.07 per 1D increase; p<0.001). Younger baseline age was associated with Max-K steepening (HR 0.96 per year older; p=0.001). Thicker baseline TCT, steeper baseline Max-K and younger baseline age were associated with TCT thinning: (HR 1.08 per 10 µm increase in TCT; p<0.001), (HR 1.03 per 1D increase; p=0.02) and (HR 0.98 per year younger; p=0.01), respectively.ConclusionsSteeper Max-K and younger age were the most clinically useful baseline predictors of progression as they were associated with worsening of two clinical parameters. Every 1D steeper Max-K was associated with a 7% and 3% greater risk of worsening VA and thinning TCT, respectively. Each 1 year younger was associated with a 4% and 2% greater risk of steepening Max-K and thinning TCT, respectively.

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Risk Factors for Community Acquired Extended-Spectrum Β-lactamase (ESBL) Producing Enterobacteriaceae Urinary Tract Infections (UTIs)

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.827 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S345-S345

Author(s):

Dheeraj Goyal ◽

Kristin Dascomb ◽

Peter S Jones ◽

Bert K Lopansri

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Urinary Catheter ◽

Univariate Analysis ◽

Prior History ◽

Factors Associated ◽

Extended Spectrum ◽

History Of ◽

Enterobacteriaceae Infections ◽

Tract Infections

Abstract Background Community-acquired extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae infections pose unique treatment challenges. Identifying risk factors associated with ESBL Enterobacteriaceae infections outside of prior colonization is important for empiric management in an era of antimicrobial stewardship. Methods We randomly selected 251 adult inpatients admitted to an Intermountain healthcare facility in Utah with an ESBL Enterobacteriaceae urinary tract infection (UTI) between January 1, 2001 and January 1, 2016. 1:1 matched controls had UTI at admission with Enterobacteriaceae but did not produce ESBL. UTI at admission was defined as urine culture positive for > 100,000 colony forming units per milliliter (cfu/mL) of Enterobacteriaceae and positive symptoms within 7 days prior or 2 days after admission. Repeated UTI was defined as more than 3 episodes of UTI within 12 months preceding index hospitalization. Cases with prior history of ESBL Enterobacteriaceae UTIs or another hospitalization three months preceding the index admission were excluded. Univariate and multiple logistic regression techniques were used to identify the risk factors associated with first episode of ESBL Enterobacteriaceae UTI at the time of hospitalization. Results In univariate analysis, history of repeated UTIs, neurogenic bladder, presence of a urinary catheter at time of admission, and prior exposure to outpatient antibiotics within past one month were found to be significantly associated with ESBL Enterobacteriaceae UTIs. When controlling for age differences, severity of illness and co-morbid conditions, history of repeated UTIs (adjusted odds ratio (AOR) 6.76, 95% confidence interval (CI) 3.60–13.41), presence of a urinary catheter at admission (AOR 2.75, 95% CI 1.25 – 6.24) and prior antibiotic exposure (AOR: 8.50, 95% CI: 3.09 – 30.13) remained significantly associated with development of new ESBL Enterobacteriaceae UTIs. Conclusion Patients in the community with urinary catheters, history of recurrent UTIs, or recent antimicrobial use can develop de novo ESBL Enterobacteriaceae UTIs. Disclosures All authors: No reported disclosures.

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Risk factors associated with early childhood caries – a case control study

Revista Odonto Ciência ◽

10.15448/198-6523.2016.2.21496 ◽

2016 ◽

Vol 31 (2) ◽

pp. 83

Author(s):

Marina De Deus Moura Lima ◽

Zacarias Soares Brito-Neto ◽

Heylane Oliveira Amaral ◽

Cacilda Castelo Branco Lima ◽

Marcoeli Silva de Moura ◽

...

Keyword(s):

Risk Factors ◽

Early Childhood ◽

Early Childhood Caries ◽

Case Control Study ◽

Case Control ◽

Control Group ◽

Factors Associated ◽

History Of ◽

Control Study ◽

Childhood Caries

Objective: The aim of this study was to determine the risk factors associated with early childhood caries (ECC).Methods: It was an observational retrospective case-control study. The case group consisted of all patients diagnosed with ECC in the records of an active program of maternal and child care. The control group was composed of an equal number of children, matched for gender and age, who attended the program and did not have ECC. The process of data collection consisted of completing a pre-established schedule to analyse variables related to the mother/caregiver and child.Statisticalanalysis was performed using the chi-squared and odds ratio (OR), with alpha (α) = 0.05.Results: History of caries in the mother (OR=2.61; CI 95%=1.45-4.67) and father (OR=1.72; CI 95%=1.02-2.89) were key determinants in the child being diagnosed with ECC.Conclusions: The risk factors associated with ECC were the following: no oral hygiene acceptance, nocturnal feeding duration of more than 16 months, a daily intake of sugar greater than 4 times a day, a Baume type II maxillary arch, fewer than 3 consultations with the program, and a history of decay in the parents.

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945. Prevalence of HIV Associated Non-AIDS Conditions and Associated Risk Factors among Hospitalized HIV-infected Patients in India

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1131 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S504-S505

Author(s):

Amyeo A Jereen ◽

Celia Kucera ◽

Saniya Pervin ◽

Muralidhar Varma ◽

Radhakrishnan Rajesh ◽

...

Keyword(s):

Risk Factors ◽

Transmitted Disease ◽

Multivariate Logistic Regression Analysis ◽

Patient Risk ◽

Sexually Transmitted ◽

Factors Associated ◽

Immunodeficiency Virus ◽

History Of ◽

Artery Disease ◽

Associated Risk Factors

Abstract Background HIV-associated non-AIDS (HANA) conditions are becoming common as People Living with Human Immunodeficiency Virus (PLWHIV) age. However, data estimating the prevalence of HANA conditions and associated risk factors is lacking in developing countries. This study evaluates reasons for hospitalizations among PLWHIV in Udupi, India in the antiretroviral era, and describes associated risk factors. Methods Demographic and clinical data were extracted from medical charts of 1280 HIV-infected patients 18 years and older who were admitted to Kasturba Hospital, Manipal, India between January 1, 2013 and December 31, 2017, for a total of 2157 hospitalizations. Primary reasons for hospitalization were categorized into AIDS-defining vs Non-AIDS-defining and HANA vs Non-HANA conditions (Fig 1). Multivariate logistic regression analysis was performed to estimate demographic and clinical factors associated with hospitalizations due to AIDS-defining illness and HANA conditions. Categorization of Reasons for Hospitalization Results Patients’ median age was 45 (18-80) years; 70% male. Median age of patients with AIDS-defining illness (45% of hospitalizations) was lower at 44 (18-75) years compared with HANA (15% of hospitalizations) at 48 (21-80) years. Age (OR, 95% CI) (0.985, 0.974-0.995), admission CD4 (0.998, 0.997 - 0.998), history of hypertension (HTN) (0.59, 0.42-0.82), stroke (0.49, 0.24 - 0.93), diabetes (1.56, 1.10 - 2.19), and AIDS-defining cancers (1.74, 1.05 - 2.89) were associated with AIDS-defining hospitalizations (Fig 2). Additionally, age (1.016, 1.001 - 1.031), history of HTN (1.70, 1.16 - 2.46), coronary artery disease (CAD) (4.02, 1.87- 9.02), chronic kidney disease (CKD) (2.30, 1.15 - 4.61), stroke (2.93, 1.46 - 5.96), Hepatitis B (3.32, 1.66- 6.72), Hepatitis C (16.1, 2.84 - 314), sexually transmitted disease (STD) (3.76, 1.38- 10.8), and HANA-associated cancer (2.44, 1.28- 6.42) were associated with HANA hospitalizations (Fig 3). Patient Risk Factors for AIDS-related Hospitalization Patient Risk Factors for HANA-related Hospitalization Conclusion Prevalence of HANA conditions was lower than AIDS-defining illnesses possibly because of a younger population. Patients with AIDS-defining illnesses were also likely to have HANA conditions. Early detection and effective treatment of both HIV and HANA conditions is essential to decrease hospitalizations in low-resource settings. Disclosures All Authors: No reported disclosures

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