scholarly journals A Multi-Centre Survey on Hospital Malnutrition: Result of PNSI Study

2020 ◽  
Author(s):  
Somayeh Poudineh ◽  
Forough Shayesteh ◽  
Jamshid Kermanchi ◽  
Ali-Akbar Haghdoost ◽  
Parisa Torabi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Malignant Disease ◽  
Heart Surgery ◽  
Length Of Hospital Stay ◽  
Male Gender ◽  
Adverse Outcomes ◽  
University Hospitals ◽  
Cross Sectional ◽  
Independent Risk Factors

Abstract Background: Disease-related malnutrition is associated with adverse outcomes such as increased rates of morbidity and mortality, prolonged hospital stay, and extra costs of health care. This study was conducted to assess nutritional status among patients and to determine the risk factors for malnutrition in Iran university hospitals. Methods: Persian Nutritional Survey In Hospitals (PNSI) was a cross-sectional study that conducted in 20 university hospitals across Iran. All the patients with age range of 18 to 65 years, who were admitted or discharged, were assessed by subjective global assessment (SGA). Results: In total, 2306 patients were evaluated for malnutrition. Mean values of age and body mass index were 44.7±14 years and 25.2±6 kg/m2, respectively. Malnutrition (SGA-B & C) was identified in 23.9% of the patients, 26.2% and 21% of whom were among the admitted and discharged patients, respectively. The prevalence of malnutrition was higher in burns (78%) and heart surgery (58%) patients. Malnutrition was not associated with age (P=0.1). Multivariate analysis presented male gender (OR=1.023, P<0.001), malignant disease (OR=1.409, P<0.001), length of hospital stay (OR=1.206, P<0.001), and polypharmacy (OR=1.066, P<0.001) as independent risk factors for malnutrition.Conclusion: One out of four patients in the studied university hospitals was suffering from malnutrition; thus, appropriate measures should be taken to ameliorate this condition. Male gender, malignant disease, length of hospital stay, and polypharmacy were identified as independent risk factors for malnutrition.

scholarly journals A multi-centre survey on hospital malnutrition: result of PNSI study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Somayeh Poudineh ◽  
Forough Shayesteh ◽  
Jamshid Kermanchi ◽  
Ali-Akbar Haghdoost ◽  
Parisa Torabi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Heart Surgery ◽  
Length Of Hospital Stay ◽  
Cross Sectional Study ◽  
Adverse Outcomes ◽  
University Hospitals ◽  
Cross Sectional ◽  
Mean Values ◽  
Hospital Malnutrition

Abstract Background Disease-related malnutrition is associated with adverse outcomes such as increased rates of morbidity and mortality, prolonged hospital stay, and extra costs of health care. This study was conducted to assess nutritional status among patients and to determine the risk factors for malnutrition in Iran university f. Methods Persian Nutritional Survey In Hospitals (PNSI) was a cross-sectional study that conducted in 20 university hospitals across Iran. All the patients with age range of 18 to 65 years, who were admitted or discharged, were assessed by subjective global assessment (SGA). Results In total, 2109 patients were evaluated for malnutrition. Mean values of age and body mass index were 44.68 ± 14.65 years and 25.44 ± 6.25 kg/m2, respectively. Malnutrition (SGA-B & C) was identified in 23.92% of the patients, 26.23 and 21% of whom were among the admitted and discharged patients, respectively. The highest prevalence of malnutrition was in burns (77.70%) and heart surgery (57.84%) patients. Multivariate analysis presented male gender (OR = 1.02, P < 0.00), malignant disease (OR = 1.40, P < 0.00), length of hospital stay (OR = 1.20, P < 0.00), and polypharmacy (OR = 1.06, P < 0.00) as independent risk factors for malnutrition. Malnutrition was not associated with age (P = 0.10). Conclusion This study provides an overall and comprehensive illustration of hospital malnutrition in Iran university hospitals, finding that one out of four patients were malnourished; thus, appropriate consideration and measures should be taken to this issue.

Analysis of the influence of risk factors on the development of complications after heart surgery

2021 ◽  
Vol 22 (2) ◽  
pp. 111-114
Author(s):  
V. V. Sokolova ◽  
◽  
V. E. Shneider ◽  
T. E. Burova ◽  
A. V. Dorovikova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Comparative Analysis ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Heart Surgery ◽  
Length Of Hospital Stay ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Surgery Department

Aim. To study the influence of risk factors on the development of complications in patients after heart surgery. Materials and methods. The study was carried out on the basis of the cardiac surgery department of the «OKB № 1», Tyumen. In the course of the work, a retrospective analysis of the results of cardiac surgery with sternotomy access was carried out on the basis of 469 case histories of patients in the period 2014-2020. Results. During the study, all patients were divided into 2 groups: patients with complications associated with access and without complications. As a result, a database of patients was created, on the basis of which a comparative analysis of 45 risk factors was carried out. Based on a comparative analysis, it was proved that in the development of postoperative complications, the leading risk factors among preoperative ones are diabetes mellitus, chronic obstructive pulmonary disease, obesity; among intraoperative risk factors, hemorrhage during surgery of more than 1000 ml is statistically significant. The number of resternotomies in history and the presence of risk factors affect the length of hospital stay and mortality after cardiac surgery. Conclusion. Timely diagnosis of concomitant diseases, their compensation and correction in the postoperative period affects and prevents the development of early postoperative complications. Careful hemostasis, a differentiated approach to osteosynthesis of the sternum after sternotomy reduce the risk of postoperative complications and the number of hospital stay days, which significantly reduces the economic costs of the hospital.

scholarly journals Alternative diagnoses based on CT angiography of the chest in patients with suspected pulmonary thromboembolism

2016 ◽  
Vol 42 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Eleci Vaz Ferreira ◽  
Marcelo Basso Gazzana ◽  
Muriel Bossle Sarmento ◽  
Pedro Arends Guazzelli ◽  
Mariana Costa Hoffmeister ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Ct Angiography ◽  
Pulmonary Thromboembolism ◽  
Length Of Hospital Stay ◽  
X Rays ◽  
Cross Sectional ◽  
Median Hospital Stay ◽  
Alternative Diagnosis ◽  
Number Of Patients

Objective : To determine the prevalence of alternative diagnoses based on chest CT angiography (CTA) in patients with suspected pulmonary thromboembolism (PTE) who tested negative for PTE, as well as whether those alternative diagnoses had been considered prior to the CTA. Methods : This was a cross-sectional, retrospective study involving 191 adult patients undergoing CTA for suspected PTE between September of 2009 and May of 2012. Chest X-rays and CTAs were reviewed to determine whether the findings suggested an alternative diagnosis in the cases not diagnosed as PTE. Data on symptoms, risk factors, comorbidities, length of hospital stay, and mortality were collected. Results : On the basis of the CTA findings, PTE was diagnosed in 47 cases (24.6%). Among the 144 patients not diagnosed with PTE via CTA, the findings were abnormal in 120 (83.3%). Such findings were consistent with an alternative diagnosis that explained the symptoms in 75 patients (39.3%). Among those 75 cases, there were only 39 (20.4%) in which the same alterations had not been previously detected on chest X-rays. The most common alternative diagnosis, made solely on the basis of the CTA findings, was pneumonia (identified in 20 cases). Symptoms, risk factors, comorbidities, and the in-hospital mortality rate did not differ significantly between the patients with and without PTE. However, the median hospital stay was significantly longer in the patients with PTE than in those without (18.0 and 9.5 days, respectively; p = 0.001). Conclusions : Our results indicate that chest CTA is useful in cases of suspected PTE, because it can confirm the diagnosis and reveal findings consistent with an alternative diagnosis in a significant number of patients.

scholarly journals Risk factors for composite adverse outcomes of postpartum haemorrhage in a low-resource setting: a single-centre cross-sectional study in Mpilo Central Hospital, Bulawayo, Zimbabwe

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 211
Author(s):  
Solwayo Ngwenya
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Caesarean Section ◽  
Postpartum Haemorrhage ◽  
Cross Sectional Study ◽  
Adverse Outcomes ◽  
Prior History ◽  
Cross Sectional ◽  
History Of ◽  
Independent Risk Factors

Background: Primary postpartum haemorrhage continues to cause considerable global maternal morbidity and mortality. The aim of this study was to determine the risk factors for composite adverse outcomes in postpartum haemorrhage using multivariable logistic regression. The findings could potentially be used to anticipate and prevent composite adverse outcomes in postpartum haemorrhage. Methods: This was a retrospective cross-sectional study carried out at Mpilo Central Hospital, a government tertiary referral centre, covering the period 1 July 2016 to 30 November 2019. Participants were included in the study if they had a diagnosis of postpartum haemorrhage. Those variables that had a p<0.2 from the univariate logistic regression analyses were considered for multivariable logistic regression. The association between independent variables and the dependent variable was assessed using odds ratio with 95% confidence intervals, to identify independent risk factors for composite adverse outcomes in PPH. Results: The independent risk factors for composite adverse outcomes in postpartum haemorrhage were place of dwelling (AOR 4.57, 95% CI 1.87-11.12, p=0.01), prior history of a Caesarean section (AOR 2.57, 95% CI 1.10-6.00, p=0.03), APH (AOR 5.45, 95% CI 2.23-13.27, p<0.0001), antenatal haemoglobin level (AOR 19.64, 95% CI 1.44-268.50, p=0.03), and delivery by Caesarean section (AOR 10.21, 95% CI 4.39-23.74, p<0.0001). Blood loss was also an independent risk factor for composite adverse outcomes in postpartum haemorrhage with the following blood loss; 1001-1500 ml (AOR 9.94, 95% CI 3.68-26.88, p<0.0001), 500-1000 ml (AOR 41.27, 95% CI 11.32-150.54, p<0.0001), and 2001 ml (AOR 164.77, 95% CI 31.06-874.25, p<0.0001). Conclusions: This study found that the independent predictors for composite adverse outcomes in PPH were rural dwelling, prior history of a Caesarean section, antenatal haemoglobin level, delivery by Caesarean section, and blood. In low- and middle-income countries, such information should help in increasing clinical vigilance and preventing maternal deaths.

scholarly journals Assessment of Gingival Health Status among 5- and 12-Year-Old Children in Yemen: A Cross-Sectional Study

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Khaled A. Al-Haddad ◽  
Yahia T. Ibrahim ◽  
Ahmed M. Al-Haddad ◽  
Nezar N. Al-Hebshi
Keyword(s):  
Risk Factors ◽  
Health Status ◽  
School Children ◽  
Oral Hygiene ◽  
Rural Areas ◽  
Primary Schools ◽  
Male Gender ◽  
Cross Sectional ◽  
Gingival Health ◽  
Independent Risk Factors

Purpose. There are limited data about the gingival health status in Yemeni children. The aim, therefore, was to assess oral hygiene status and prevalence and severity of gingivitis among Yemeni preschool and school children. Materials and Methods. A total of 5396 children were included from 5 representative Yemeni governorates: Sana'a, Hajjah, Hodeida, Hadramaut, and Taiz. Five-year olds (1292) were recruited from private kindergartens while 12-year olds (4104) were selected from public primary schools. Gingival health status was assessed using the plaque index (PI), calculus index (CAI), and gingival index (GI) on the 6 Ramfjord teeth. The latter index was used to categorize gingivitis severity at the subject level. Data were analyzed using simple hypothesis testing, as well as ordinal regression. Results. The 12-year old children had significantly much higher mean PI, CAI, and GI (P<0.001) with 78.6% presenting with gingivitis and 47.8% with moderate gingivitis. In contrast, the figures were 27.2% and 3.1% in the younger group (P<0.001). There were significant variations according to gender, area of residence, and governorate. Regression analysis revealed that mean PI (OR=35), mean CAI (OR=7.7), male gender (OR=1.6), living in rural areas (OR=1.4), and being from Hajjah or Sana’a were independent risk factors of gingivitis severity in the older group. For the 5-year olds, the determinants were mean PI (OR=122), male gender (OR=1.4), and living in Sana'a or Taiz. Conclusions. Bad oral hygiene and moderate gingivitis are highly prevalent among Yemeni preschool and school children. Geographical location appeared as important independent risk factors of gingival inflammation.

Predictors and Risk Factors of Surgical Site Infection (SSI) Following Adult Spine Surgery: A Cross-sectional Study

2021 ◽  
pp. 6
Author(s):  
Waleed Awwad ◽  
Abdullah Alnasser ◽  
Abdulrahman Almalki ◽  
Rohail Mumtaz ◽  
Bander Alsubaie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Spine Surgery ◽  
Length Of Hospital Stay ◽  
Cross Sectional Study ◽  
Site Infection ◽  
Sectional Study ◽  
Cross Sectional ◽  
Duration Of Surgery

Introduction: Surgical site infection (SSI) is a major cause of morbidity and mortality as it is known to increase the length of hospital stay, revision surgery, and re-operation. Identifying patients at risk of developing SSI before surgery is the key to prevent SSI. Methodology: This cross-sectional study was performed at the orthopedic department in King Khalid University Hospital, Riyadh, Saudi Arabia. SSIs were defined according to the Centers for Disease Control (CDC) case definition for SSI. Potential risk factors for postoperative wound infection were collected. Data were analyzed using the SPSS, version 23.0, and p-value < 0.05 was considered to be statistically significant. Result: A total of 214 patients were included in the study and the incidence of SSI following spine surgery was 9.81% (N = 21). Obesity, diabetes, location of surgery, ASA score, duration of surgery, length of hospital stay, and location/level of operated vertebrae were all found to have a significant correlation with the SSI (p < 0.05). Conclusion: Having a strong background of SSI risk factors and predictors is core to preventing the incidence of SSI and further enhance and optimize operative outcomes, as well as increasing the cost-effectiveness of the surgical intervention.

scholarly journals Hypertension and chronic cor pulmonale were the independent risk factors for a prolonged length of hospital stay in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients: a multicenter cross-sectional study

2021 ◽  
Author(s):  
Hong Wang ◽  
TAO YANG ◽  
Zhihong Chen ◽  
Yajuan Ran ◽  
Jiajia Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Hospital Stay ◽  
Cross Sectional Study ◽  
Cor Pulmonale ◽  
Sectional Study ◽  
Cross Sectional ◽  
Prolonged Length ◽  
Logistics Regression ◽  
Independent Risk Factors ◽  
Chronic Cor Pulmonale

Background: AECOPD is a severe status of COPD. The prolonged length of hospital stay (LHS) was associated with poor prognosis and higher medical costs in AECOPD patients. Identification of the risk factors for prolonged LHS will help physicians provide targeted and personalized interventions, reduce LHS, and avoid unnecessary health services in COPD patients. This study aimed to explore the risk factors for prolonged LHS in hospitalized AECOPD patients. Methods: In this multicenter cross-sectional study, 598 AECOPD patients were screened. In the end, the LHS of 111 were <7 days (Normal LHS, N-LHS), 218 were 7-10 days (Mild Prolonged LHS, MP-LHS), and 100 were≥11 days (Severe Prolonged LHS, SP-LHS). Demographic data, underlying diseases, symptoms, and laboratory findings were collected. Multiple logistics regression was performed to investigate the independent risk factors for prolonged LHS in AECOPD patients. Results: The significant differences in 11 variables were found by univariate analysis. Since significant collinearities among white blood cells (WBC), neutrophils (NS), and NS% were observed, WBC and NS% were excluded. Therefore, 9 factors were included in multiple logistics regression. Subsequently, our results identified that the rates of hypertension and chronic cor pulmonale (CCP) were independently associated with prolonged LHS in AECOPD patients. Conclusions: Collectively, our results suggested that complications of hypertension and CCP were at a higher risk of prolonged LHS in AECOPD patients. It also indicated that AECOPD combined with hypertension and/or CCP probably more severe. Then, more extensive management should be initially administrated.

scholarly journals The Clinical Characteristics of ARDS in Children With Hematological Neoplasms

2021 ◽  
Vol 9 ◽  
Author(s):  
Qiao Zhang ◽  
Wen-ting Hu ◽  
Fan Yin ◽  
Han Qian ◽  
Ying Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Clinical Characteristics ◽  
Length Of Hospital Stay ◽  
Fluid Volume ◽  
Survival Group ◽  
Total Length ◽  
Hematological Neoplasms ◽  
Independent Risk Factors ◽  
Overall Mortality

In order to explore the clinical characteristics of pediatric patients admitted to the pediatric intensive care unit (PICU) who suffered from hematological neoplasms complicated with acute respiratory distress syndrome (ARDS), we retrospectively analyzed 45 ARDS children with hematological neoplasms who were admitted to the PICU of Shanghai Children's Medical Center from January 1, 2014, to December 31, 2020. The 45 children were divided into a survival group and a non-survival group, a pulmonary ARDS group and an exogenous pulmonary ARDS group, and an agranulocytosis group and a non-agranulocytosis group, for statistical analysis. The main clinical manifestations were fever, cough, progressive dyspnea, and hypoxemia; 55.6% (25/45) of the children had multiple organ dysfunction syndrome (MODS). The overall mortality rate was 55.6% (25/45). The vasoactive inotropic score (VIS), pediatric critical illness scoring (PCIS), average fluid volume in the first 3 days and the first 7 days, and the incidence of MODS in the non-survival group were all significantly higher than those in the survival group (P &lt; 0.05). However, total length of mechanical ventilation and length of hospital stay and PICU days in the non-survival group were significantly lower than those in the survival group (P &lt; 0.05). The PCIS (OR = 0.832, P = 0.004) and the average fluid volume in the first 3 days (OR = 1.092, P = 0.025) were independent risk factors for predicting death. Children with exogenous pulmonary ARDS were more likely to have MODS than pulmonary ARDS (P &lt; 0.05). The mean values of VIS, C-reactive protein (CRP), and procalcitonin (PCT) in children with exogenous pulmonary ARDS were also higher (P &lt; 0.05). After multivariate analysis, PCT was independently related to exogenous pulmonary ARDS. The total length of hospital stay, peak inspiratory pressure (PIP), VIS, CRP, and PCT in the agranulocytosis group were significantly higher than those in the non-agranulocytosis group (P &lt; 0.05). Last, CRP and PIP were independently related to agranulocytosis. In conclusion, children with hematological neoplasms complicated with ARDS had a high overall mortality and poor prognosis. Children complicated with MODS, positive fluid balance, and high VIS and PCIS scores were positively correlated with mortality. In particular, PCIS score and average fluid volume in the first 3 days were independent risk factors for predicting death. Children with exogenous pulmonary ARDS and children with agranulocytosis were in a severely infected status and more critically ill.

Indications and practice of enteral nutrition

2014 ◽  
Vol 155 (51) ◽  
pp. 2028-2033 ◽  
Author(s):  
Judit Hallay ◽  
Dániel Nagy ◽  
Béla Fülesdi
Keyword(s):  
Risk Factors ◽  
Treatment Outcome ◽  
Enteral Nutrition ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Nutrition Therapy ◽  
Present Review ◽  
Hospitalised Patients ◽  
Impact On Treatment ◽  
Efficacy Of Treatment

Malnutrition in hospitalised patients has a significant and disadvantageous impact on treatment outcome. If possible, enteral nutrition with an energy/protein-balanced nutrient should be preferred depending on the patient’s condition, type of illness and risk factors. The aim of the nutrition therapy is to increase the efficacy of treatment and shorten the length of hospital stay in order to ensure rapid rehabilitation. In the present review the authors summarize the most important clinical and practical aspects of enteral nutrition therapy. Orv. Hetil., 2014, 155(51), 2028–2033.

scholarly journals O6: EARLY ANASTOMOTIC BILIARY COMPLICATIONS AFTER LIVER TRANSPLANTATION

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
SJ Tingle ◽  
ER Thompson ◽  
SS Ali ◽  
IK Ibrahim ◽  
E Irwin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Hospital Stay ◽  
Graft Survival ◽  
Cox Regression ◽  
Risk Groups ◽  
Biliary Complications ◽  
Anastomotic Strictures ◽  
Selection Of Variables ◽  
Independent Risk Factors

Abstract Introduction Biliary leaks and anastomotic strictures are common early biliary complications (EBC) following liver transplantation. However, their impact on outcomes remains controversial and poorly described. Method The NHS registry on adult liver transplantation between 2006 and 2017 was retrospectively reviewed (n=8304). Multiple imputations were performed to account for missing data. Adjusted regression models were used to assess predictors of EBC, and their impact on outcomes. 35 potential variables were included, and backwards stepwise selection enabled unbiased selection of variables for inclusion in final models. Result EBC occurred in 9.6% of patients. Adjusted cox regression revealed that EBCs have a significant and independent impact on graft survival (Leak HR=1.325; P=0.021, Stricture HR=1.514; P=0.002, Leak plus stricture HR=1.533; P=0.034) and patient survival (Leak HR=1.218; P=0.131, Stricture HR=1.578; P&lt;0.001, Leak plus stricture HR=1.507; P=0.044). Patients with EBC had longer median hospital stay (23 versus 15 days; P&lt;0.001) and increased chance for readmission within the first year (56% versus 32%; P&lt;0.001). On adjusted logistic regression the following were identified as independent risk factors for development of EBC: donation following circulatory death (OR=1.280; P=0.009), accessory hepatic artery (OR=1.324; P=0.005), vascular anastomosis time in minutes (OR=1.005; P=0.032) and ethnicity ‘other’ (OR=1.838; P=0.011). Conclusion EBCs prolong hospital stay, increase readmission rates and are independent risk factors for diminished graft survival and increased mortality in liver transplantation. We have identified factors that increase the likelihood of EBC occurrence; further research into interventions to prevent EBCs in these at-risk groups is vital to improve liver transplantation outcomes. Take-home message Using a large registry database we have shown that early anastomotic biliary complications are independent risk factors for decreased graft survival and increased mortality after liver transplantation. Research into interventions to prevent biliary complications in high risk groups are essential to improve liver transplant outcomes.

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