scholarly journals Are Routine Postoperative Laboratory Tests Really Necessary After High Tibial Osteotomy Surgery?

2020 ◽  
Author(s):  
Min Lan ◽  
Si Nie
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
High Tibial Osteotomy ◽  
Laboratory Tests ◽  
Clinical Treatment ◽  
Tibial Osteotomy ◽  
Binary Logistic Regression Model ◽  
Postoperative Blood Transfusion ◽  
Estimated Blood Loss ◽  
Independent Risk Factors

Abstract Background: The purpose of this study was to assess the necessity and cost-effectiveness of routine postoperative laboratory tests for patients undergoing high tibial osteotomy (HTO) surgery.Methods: A prospective study was conducted and 513 patients with symptomatic isolated medial compartment osteoarthritis received HTO surgery from January 2015 to May 2020 were included in this study. The associations between different clinical factors and postoperative clinical treatment were analyzed. Finally, A logistic regression analysis was performed to detect independent risk factors for patients requiring postoperative clinical treatment. Results: In this study, 482 patients had completed the full set of postoperative laboratory studies within 3 days after surgery were included in the present study. However, only a small proportion of the patients with anemia (3.9%), hypoalbuminemia (4.1%), and abnormal serum potassium levels (3.5%) required clinical intervention after surgery. Binary logistic regression model analysis showed that body mass index (BMI), preoperative hemoglobin level, estimated blood loss and operative time were the independent risk factors correlated with postoperative blood transfusion in patients with HTO surgery. Female gender and preoperative albumin level were independent risk factors for patients who had requiring albumin supplementation after HTO surgery. Finally, preoperative potassium was the independent risk factors for patients required potassium supplementation postoperatively.Conclusions: based on the analysis, we conclude that routinely ordering postoperative laboratory texts after HTO surgery are both unnecessary and cost inefficient for most of the patients. However, for patients with identified risk factors, routine postoperative laboratory tests are still needed.

scholarly journals Are Routine Postoperative Laboratory Tests Really Necessary after High Tibial Osteotomy surgery?

2021 ◽  
Author(s):  
Nie Si ◽  
Li Hong-bo ◽  
Lan Min ◽  
Liao Xin-gen ◽  
Tang Zhi-ming
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
High Tibial Osteotomy ◽  
Laboratory Tests ◽  
Clinical Treatment ◽  
Tibial Osteotomy ◽  
Laboratory Studies ◽  
Postoperative Blood Transfusion ◽  
Estimated Blood Loss ◽  
Independent Risk Factors

Abstract Background: The purpose of this study was to assess the necessity and cost-effectiveness of routine postoperative laboratory tests for patients undergoing high tibial osteotomy (HTO) surgery.Methods: A prospective study was conducted and 513 patients with symptomatic isolated medial compartment osteoarthritis received HTO surgery from January 2015 to May 2020 were included in this study. The associations between different clinical factors and postoperative clinical treatment were analyzed. Finally, A logistic regression analysis was performed to detect independent risk factors for patients requiring postoperative clinical treatment. Results: In this study, 482 patients had completed the full set of postoperative laboratory studies within 3 days after surgery were included in the present study. However, only a small proportion of the patients with anemia (3.9%), hypoalbuminemia (4.1%), and abnormal serum potassium levels (3.5%) required clinical intervention after surgery. Binary logistic regression model analysis showed that body mass index (BMI), preoperative hemoglobin level, estimated blood loss and operative time were the independent risk factors correlated with postoperative blood transfusion in patients with HTO surgery. Female gender and preoperative albumin level were independent risk factors for patients who had requiring albumin supplementation after HTO surgery. Finally, preoperative potassium was the independent risk factors for patients required potassium supplementation postoperatively.Conclusions: based on the analysis, we conclude that routinely ordering postoperative laboratory studies after HTO surgery are both unnecessary and cost inefficient. However, for patients with identified risk factors, routine postoperative laboratory tests are still needed.

scholarly journals Re-evaluating the necessity of routine laboratory tests after high tibial osteotomy surgery

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hong-bo Li ◽  
Si Nie ◽  
Min Lan ◽  
Xin-gen Liao ◽  
Zhi-ming Tang
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
High Tibial Osteotomy ◽  
Logistic Regression Analysis ◽  
Laboratory Tests ◽  
Clinical Treatment ◽  
The Body ◽  
Tibial Osteotomy ◽  
Independent Risk Factors

Abstract Background To assess the utility of routine postoperative laboratory tests for patients undergoing high tibial osteotomy (HTO) surgery. Methods The associations between clinical risk factors and postoperative clinical treatment were analyzed. Additionally, a logistic regression analysis was performed to detect independent risk factors for patients requiring postoperative clinical treatment. Results A total of 482 patients with symptomatic isolated medial compartment osteoarthritis from January 2015 to May 2020 were included in the present study and underwent examination by the full set of postoperative laboratory tests within 3 days after HTO surgery. However, only a small proportion of the patients with anemia (3.9 %), hypoalbuminemia (4.1 %), and abnormal serum potassium levels (3.5 %) required clinical intervention after surgery. Binary logistic regression analysis showed that the body mass index (BMI), preoperative hemoglobin level, estimated blood loss and operative duration were independent risk factors for postoperative blood transfusion in patients who underwent HTO surgery, and factors associated with albumin supplementation were female sex and preoperative albumin level. In addition, these results indicated that preoperative potassium was potential risk factor for patients who required potassium supplementation postoperatively. Conclusions Based on the analysis, we conclude that routinely ordering postoperative laboratory tests after HTO surgery is unnecessary. However, for patients with identified risk factors, routine postoperative laboratory tests are still needed.

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

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

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

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

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

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

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

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

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

scholarly journals Risk factors on admission associated with hospital length of stay in patients with COVID-19: a retrospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anping Guo ◽  
Jin Lu ◽  
Haizhu Tan ◽  
Zejian Kuang ◽  
Ying Luo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Liver Disease ◽  
Length Of Stay ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Hospital Length ◽  
Clinical Treatment ◽  
Hospital Length Of Stay ◽  
Female Sex

AbstractTreating patients with COVID-19 is expensive, thus it is essential to identify factors on admission associated with hospital length of stay (LOS) and provide a risk assessment for clinical treatment. To address this, we conduct a retrospective study, which involved patients with laboratory-confirmed COVID-19 infection in Hefei, China and being discharged between January 20 2020 and March 16 2020. Demographic information, clinical treatment, and laboratory data for the participants were extracted from medical records. A prolonged LOS was defined as equal to or greater than the median length of hospitable stay. The median LOS for the 75 patients was 17 days (IQR 13–22). We used univariable and multivariable logistic regressions to explore the risk factors associated with a prolonged hospital LOS. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated. The median age of the 75 patients was 47 years. Approximately 75% of the patients had mild or general disease. The univariate logistic regression model showed that female sex and having a fever on admission were significantly associated with longer duration of hospitalization. The multivariate logistic regression model enhances these associations. Odds of a prolonged LOS were associated with male sex (aOR 0.19, 95% CI 0.05–0.63, p = 0.01), having fever on admission (aOR 8.27, 95% CI 1.47–72.16, p = 0.028) and pre-existing chronic kidney or liver disease (aOR 13.73 95% CI 1.95–145.4, p = 0.015) as well as each 1-unit increase in creatinine level (aOR 0.94, 95% CI 0.9–0.98, p = 0.007). We also found that a prolonged LOS was associated with increased creatinine levels in patients with chronic kidney or liver disease (p < 0.001). In conclusion, female sex, fever, chronic kidney or liver disease before admission and increasing creatinine levels were associated with prolonged LOS in patients with COVID-19.

scholarly journals Risk Factor Analysis for Infection after Medial Open Wedge High Tibial Osteotomy

2021 ◽  
Vol 10 (8) ◽  
pp. 1727
Author(s):  
Ta-Wei Liu ◽  
Chih-Hao Chiu ◽  
Alvin Chao-Yu Chen ◽  
Shih-Sheng Chang ◽  
Yi-Sheng Chan
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Multivariate Analysis ◽  
High Tibial Osteotomy ◽  
Univariate Analysis ◽  
Arthroscopic Surgery ◽  
Underlying Disease ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Wedge High Tibial Osteotomy

Background: Medial open wedge high tibial osteotomy (MOWHTO) is a well-established treatment for osteoarthritis of the medial tibiofemoral compartment. Surgical site infection (SSI) after MOWHTO is a devastating complication that may require further surgery. In this study, we aimed to identify the risk factors for infection after MOWHTO over 1 to 4 years of follow-up. Methods: Fifty-nine patients who underwent MOWHTO combined with knee arthroscopic surgery were included in this prospective study. Artificial bone grafts were used in all cases. Possible risk factors, including sex, age, body mass index (BMI), underlying disease, hospitalization length, correction angle, and surgery time, were recorded. Both univariate and multivariate analysis were used. Results: A total of 59 patients who underwent 61 operations were included. Eleven patients (18.0%) were reported to have SSI. Univariate analysis showed that smoking and diabetes mellitus were positively associated with SSI. Multivariate analysis showed that smoking and age were positively associated with SSI. Three patients (4.9%) were reported to suffer from deep SSI, requiring surgical debridement, all of whom were male smokers. Conclusion: Smoking, diabetes mellitus, and old age were identified to be possible risk factors of SSI after MOWHTO. These findings are common risk factors of SSI after orthopedic surgery according to the literature. Patient selection should be performed cautiously, and postoperative prognosis for MOWHTO should be carefully explained to patients who smoke.

scholarly journals Risk factors for peripheral venous catheter failure: A prospective cohort study of 5345 patients

2021 ◽  
pp. 112972982110150
Author(s):  
Ya-mei Chen ◽  
Xiao-wen Fan ◽  
Ming-hong Liu ◽  
Jie Wang ◽  
Yi-qun Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cohort Study ◽  
Goodness Of Fit ◽  
Insertion Site ◽  
Healthcare Providers ◽  
Venous Catheter ◽  
Goodness Of Fit Test ◽  
Peripheral Venous Catheter ◽  
Independent Risk Factors

Purpose: The objective of this study was to determine the independent risk factors associated with peripheral venous catheter (PVC) failure and develop a model that can predict PVC failure. Methods: This prospective, multicenter cohort study was carried out in nine tertiary hospitals in Suzhou, China between December 2017 and February 2018. Adult patients undergoing first-time insertion of a PVC were observed from catheter insertion to removal. Logistic regression was used to identify the independent risk factors predicting PVC failure. Results: This study included 5345 patients. The PVC failure rate was 54.05% ( n = 2889/5345), and the most common causes of PVC failure were phlebitis (16.3%) and infiltration/extravasation (13.8%). On multivariate analysis, age (45–59 years: OR, 1.295; 95% CI, 1.074–1.561; 60–74 years: OR, 1.375; 95% CI, 1.143–1.654; ⩾75 years: OR, 1.676; 95% CI, 1.355–2.073); department (surgery OR, 1.229; 95% CI, 1.062–1.423; emergency internal/surgical ward OR, 1.451; 95% CI, 1.082–1.945); history of venous puncture in the last week (OR, 1.298, 95% CI 1.130–1.491); insertion site, number of puncture attempts, irritant fluid infusion, daily infusion time, daily infusion volume, and type of sealing liquid were independent predictors of PVC failure. Receiver operating characteristic curve analysis indicated that a logistic regression model constructed using these variables had moderate accuracy for the prediction of PVC failure (area under the curve, 0.781). The Hosmer-Lemeshow goodness of fit test demonstrated that the model was correctly specified (χ2 = 2.514, p = 0.961). Conclusion: This study should raise awareness among healthcare providers of the risk factors for PVC failure. We recommend that healthcare providers use vascular access device selection tools to select a clinically appropriate device and for the timely detection of complications, and have a list of drugs classified as irritants or vesicants so they can monitor patients receiving fluid infusions containing these drugs more frequently.

scholarly journals Higher D-dimer level in the early third trimester predicts the occurrence of postpartum hemorrhage

2016 ◽  
Vol 44 (5) ◽  
Author(s):  
Naho Endo-Kawamura ◽  
Mana Obata-Yasuoka ◽  
Hiroya Yagi ◽  
Rena Ohara ◽  
Yuko Nagai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postpartum Hemorrhage ◽  
Blood Parameters ◽  
Demographic Characteristics ◽  
Activity Level ◽  
Late Gestation ◽  
Antithrombin Activity ◽  
Estimated Blood Loss ◽  
Independent Risk Factors ◽  
D Dimer

AbstractThis study aimed to determine effective predictive factors for primary postpartum hemorrhage (PPH) among clinical blood parameters associated with coagulation and fibrinolysis and demographic characteristics.We retrospectively studied 1032 women who underwent determinations of clinical blood parameters at gestational week (GW) 29–32 and GW 35–37 and gave birth to singleton infants at our hospital between January 2011 and December 2013. PPH was defined as estimated blood loss ≥700 mL. Multivariate logistic regression analyses were used to determine independent risk factors and odds ratios (OR) for PPH.PPH occurred in 104 of 1032 women (10%). Three blood variables, fibrinogen level <4.0 g/L (OR [95% CI], 1.96 [1.18–3.27]), antithrombin activity <85% of normal activity level (1.84 [1.05–3.21]), and D-dimer level >2.7 μg/mL (2.03 [1.29–3.19]) at GW 35–37, and three demographic characteristics, maternal age ≥35 years (1.75 [1.15–2.68]), BMI >28.2 kg/mAmong blood parameters, higher D-dimer levels and lower levels of antithrombin activity and fibrinogen in late gestation were independent risk factors for PPH.

scholarly journals Monocytes as an Early Predictor for Patients with Acute Paraquat Poisoning: A Retrospective Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yong Zhao ◽  
Ya Qi Song ◽  
Jie Gao ◽  
Shun Yi Feng ◽  
Yong Li
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Receiver Operator Characteristic ◽  
Monocyte Count ◽  
Central Hospital ◽  
Predictive Values ◽  
Kaplan Meier ◽  
Independent Risk Factors ◽  
Early Predictor

Background. The predictive values of monocytes in the prognosis of patients with acute paraquat (PQ) poisoning are unclear. This retrospective study investigated the predictive values of monocytes in the prognosis of patients with acute PQ poisoning. Methods. Adult patients who suffered from acute PQ poisoning in the emergency care unit of Cangzhou Central Hospital from May 2012 to December 2018 were enrolled. The patients were divided into groups, namely, survival and nonsurvival, according to a 90-day prognosis. Moreover, correlation, logistic regression, receiver-operator characteristic (ROC), and Kaplan–Meier curve analyses were applied to evaluate the monocyte values used to predict the prognosis of patients with acute PQ poisoning. Result. Among the 109 patients, 45 survived within 90 days after the poisoning, resulting in a 41.28% survival rate. The monocyte count of the nonsurvivors was significantly higher than that of the survivors (P< 0.001). Correlation analysis showed that monocyte count positively correlated with plasma PQ concentration (r= 0.413; P< 0.001) and negatively correlated with survival time (r= 0.512; P< 0.001) and 90-day survival (r= 0.503; P< 0.001). Logistic regression analysis showed that elevated monocytes were the independent risk factors for the 90-day survival. The area under the ROC curve of the monocyte count used to predict the 90-day survival was 0.826 (95% CI: 0.751–0.904), the optimal cut-off was 0.51×109/L, sensitivity was 73.4%, and specificity was 86.7%. Conclusion. This study demonstrated that elevated monocyte count is a useful early predictor of 90-day survival in patients with acute PQ poisoning. However, further studies are warranted to draw firm conclusions.

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