Preoperative bacterial culture can predict severe pneumonia in patients receiving esophagectomy

Abstract Background Postoperative pneumonia is one of the major complications after esophagectomy. The aim of this study was to determine whether bacterial cultures before esophagectomy could predict occurrence of postoperative pneumonia and help treatment strategies for postoperative pneumonia. Methods Sixty-nine patients who underwent subtotal esophagectomy at Fukushima Medical University hospital between January 2017 and May 2021 were included in this study. We collected sputum, oral and/or nasopharyngeal swabs for bacterial culture preoperatively from all patients and from those who were suspected of postoperative pulmonary infections. We compared cultured pathogenic bacteria obtained preoperatively and postoperatively from patients who developed postoperative pneumonia, and investigated their association with incidence of postoperative pneumonia. Fisher’s exact test was used to compare categorical variables between groups, and Wilcoxon test was used to compare continuous variables. Risk factors for postoperative pneumonia and severe pneumonia were analyzed using multivariate logistic regression models. Results Postoperative pneumonia occurred in 22 (31%) of the 69 patients, and 13 of the 22 patients were classified as with severe pneumonia. Multivariate analysis revealed that longer operative duration (for 30 minutes increase; odds ratio 1.27, 95% confidence interval 1.01–1.51, p=0.039) and positivity for preoperative bacterial culture (odds ratio 5.03, 95% confidence interval 1.31–19.2, p=0.018) were independent risk factors for severe postoperative pneumonia, but not for all incidence of postoperative pneumonia. Of note, in only 5 out of the 22 patients with pneumonia, the same pathogen species were detected preoperatively and after the onset of pneumonia. Conclusions In conclusion, our results implied that preoperative bacterial culture may be useful to predict severe postoperative pneumonia. However, it may not be useful in determining pathogenic bacteria responsible for postoperative pneumonia.

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Excessive intravenous crystalloid infusion after video-assisted thoracoscopic surgery lobectomy is associated with postoperative pneumonia

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-019-1024-6 ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Rong Yang ◽

Chengli Du ◽

Jinming Xu ◽

Linpeng Yao ◽

Siying Zhang ◽

...

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Confidence Interval ◽

Odds Ratio ◽

Thoracoscopic Surgery ◽

Postoperative Pneumonia ◽

Lung Lobe ◽

Video Assisted ◽

Crystalloid Infusion ◽

Video Assisted Thoracoscopic Surgery

Abstract Background Video-assisted thoracoscopic surgery has been widely used in thoracic surgery worldwide. Our goal was to identify the risk factors for postoperative pneumonia in patients undergoing video-assisted thoracoscopic surgery lobectomy. Methods A retrospective analysis of adult patients undergoing video-assisted thoracoscopic surgery lobectomy between 2016 and 05 and 2017–04 was performed. We used univariate analyses and multivariate analyses to examine risk factors for postoperative pneumonia after lobectomy. Results The incidence of postoperative pneumonia was 19.7% (n = 143/727). Patients with postoperative pneumonia had a higher postoperative length of stay and total hospital care costs when compared to those without postoperative pneumonia. Multivariate analysis showed that body mass index grading ≥24.0 kg/m2 (vs. <24.0 kg/m2: odds ratio 1.904, 95% confidence interval 1.294–2.802, P = 0.001) and right lung lobe surgery (vs. left lung lobe surgery: odds ratio 1.836, 95% confidence interval 1.216–2.771, P = 0.004) were independent risk factors of postoperative pneumonia. Total intravenous crystalloid infusion grading in the postoperative 24 h ≥ 1500 mL was also identified as the risk factors (vs. 1000 to < 1500 mL: odds ratio 2.060, 95% confidence interval 1.302–3.260, P = 0.002). Conclusions Major risk factors for postoperative pneumonia following video-assisted thoracoscopic surgery lobectomy are body mass index grading ≥24.0 kg/m2, right lung lobe surgery and total intravenous crystalloid infusion grading in the postoperative 24 h ≥ 1500 mL.

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Risk Factors for Exposure of Baerveldt Glaucoma Drainage Implants: A Case-Control Study

10.21203/rs.3.rs-41812/v2 ◽

2020 ◽

Author(s):

Ayaka Edo ◽

Koji Jian ◽

Yoshiaki Kiuchi

Keyword(s):

Risk Factors ◽

Confidence Interval ◽

Medical Records ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Significant Risk ◽

University Hospital ◽

Implant Surgery ◽

Implant Exposure ◽

Patients With Diabetes

Abstract Background: Glaucoma drainage implant exposure is one of the serious complications after glaucoma drainage implant surgery. The purpose of this study is to evaluate the risk factors for exposure of the device after implantation of a Baerveldt glaucoma drainage implant.Methods: This is a retrospective review of the medical records of all patients who underwent Baerveldt glaucoma drainage implant surgery at the Hiroshima University Hospital between April 1, 2012 and October 31, 2016, and who were followed for at least 6 months after surgery. We examined the risk factors for implant exposure based on data obtained from the medical records, with particular focus on the differences in implant models.Results: A total of 80 eyes from 80 patients were identified; all patients were Japanese. In this study, the rate of Baerveldt glaucoma drainage implant exposure was 15.0% (12 of 80). The exposure rate of the BG 102-350 was tended to be higher than that for the BG 101-350 and BG 103-250 (p=0.092; adjusted odds ratio=3.34; 95% confidence interval, 0.82–13.58). In the patients who had diabetic mellitus, the BG 102-350 showed a significant risk of implant exposure (p=0.038; adjusted odds ratio =15.36; 95% confidence interval, 1.17–202.59).Conclusions: In Baerveldt glaucoma drainage implant surgery in patients with diabetes, using the BG 102-350 was associated with greater risk of implant exposure compared with using BG 101-350 or BG 103-250.

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Abstract WP220: The Effect of Self-Reported Optimism on the Incidence of Stroke

Stroke ◽

10.1161/str.48.suppl_1.wp220 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Ahmed Malik ◽

Haseeb Rahman ◽

Adnan Qureshi ◽

Martha A Wojtowycz

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Standard Deviation ◽

Confidence Interval ◽

Stroke Prevention ◽

Odds Ratio ◽

Categorical Variables ◽

The Mean ◽

Baseline Characteristics

Purpose: The purpose of this study is to determine whether having an optimistic outlook on life decreases the risk of developing incident stroke. Methods: Participants who developed incident stroke in Americans’ Changing Lives study, and participants who did not develop incident stroke (dependent variable) in were compared for demographics, baseline characteristics, comorbidities, and optimistic outlook on life. Numbers and proportions of respondents in both groups were reported for all categorical variables, while mean and standard deviation were reported for age. All statistically significant variables from the above analyses were entered into a logistic regression analysis to ascertain the association between optimistic outlook on life and stroke. Results: Of the 98,577,928 participants, 73,040,055 did not have stroke at baseline. There were 599,190 who developed incident stroke and 1,104,751 who did not develop incident stroke. The mean age (standard deviation) was lower in those who developed incident stroke compared to those who did not [45.9 (13.8) vs. 46.4 (9.9) p<.0001], and participants with an optimistic outlook on life, were 0.20 times less likely to develop stroke as those who did not have an optimistic outlook on life [OR (Odds ratio) 0.20 95% CI (95% confidence interval) 0.20,0.21], after adjusting for confounders. Conclusions: People who have an optimistic outlook on life are less likely to develop incident stroke. The protective value of optimism lends credence to the value of targeting unconventional risk factors in stroke prevention.

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Risk factors for exposure of Baerveldt glaucoma drainage implants: a case-control study

BMC Ophthalmology ◽

10.1186/s12886-020-01632-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Ayaka Edo ◽

Koji Jian ◽

Yoshiaki Kiuchi

Keyword(s):

Risk Factors ◽

Confidence Interval ◽

Medical Records ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Significant Risk ◽

University Hospital ◽

Implant Surgery ◽

Implant Exposure ◽

Patients With Diabetes

Abstract Background Glaucoma drainage implant exposure is one of the serious complications after glaucoma drainage implant surgery. The purpose of this study is to evaluate the risk factors for exposure of the device after implantation of a Baerveldt glaucoma drainage implant. Methods This is a retrospective review of the medical records of all patients who underwent Baerveldt glaucoma drainage implant surgery at the Hiroshima University Hospital between April 1, 2012 and October 31, 2016, and who were followed for at least 6 months after surgery. We examined the risk factors for implant exposure based on data obtained from the medical records, with a particular focus on the differences in implant models. Results A total of 80 eyes from 80 patients were identified; all patients were Japanese. In this study, the rate of Baerveldt glaucoma drainage implant exposure was 15.0% (12 of 80 eyes). The exposure rate for the BG 102-350 tended to be higher than that for the BG 101-350 and BG 103-250 (p = 0.092; adjusted odds ratio = 3.34; 95% confidence interval, 0.82–13.58). In the patients who had diabetic mellitus, the BG 102-350 showed a significant risk of implant exposure (p = 0.038; adjusted odds ratio = 15.36; 95% confidence interval, 1.17–202.59). Conclusions In Baerveldt glaucoma drainage implant surgery in patients with diabetes, using the BG 102-350 was associated with greater risk of implant exposure compared with using the BG 101-350 or BG 103-250.

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Risk Factors for Exposure of Baerveldt Glaucoma Drainage Implants: A Case-Control Study

10.21203/rs.3.rs-41812/v1 ◽

2020 ◽

Author(s):

Ayaka Edo ◽

Koji Jian ◽

Yoshiaki Kiuchi

Keyword(s):

Risk Factors ◽

Confidence Interval ◽

Medical Records ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Significant Risk ◽

University Hospital ◽

Implant Surgery ◽

Implant Exposure ◽

Patients With Diabetes

Abstract Background Glaucoma drainage implant exposure is one of the serious complications after glaucoma drainage implant surgery. The purpose of this study is to evaluate the risk factors for exposure of the device after implantation of a Baerveldt glaucoma drainage implant. Methods This is a retrospective review of the medical records of all patients who underwent Baerveldt glaucoma drainage implant surgery at the Hiroshima University Hospital between April 1, 2012 and October 31, 2016, and who were followed for at least 6 months after surgery. We examined the risk factors for implant exposure based on data obtained from the medical records, with particular focus on the differences in implant models. Results A total of 80 eyes from 80 patients were identified; all patients were Japanese. In this study, the rate of Baerveldt glaucoma drainage implant exposure was 15.0% (12 of 80). The exposure rate of the BG 102–350 was tended to be higher than that for the BG 101–350 and BG 103–250 (p = 0.092; adjusted odds ratio = 3.34; 95% confidence interval, 0.82–13.58). In the patients who had diabetic mellitus, the BG 102–350 showed a significant risk of implant exposure (p = 0.038; adjusted odds ratio = 15.36; 95% confidence interval, 1.17–202.59). Conclusions In Baerveldt glaucoma drainage implant surgery in patients with diabetes, using the BG 102–350 was associated with greater risk of implant exposure compared with using BG 101–350 or BG 103–250.

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Parental risk factors for congenital diaphragmatic hernia – a large German case-control study

BMC Pediatrics ◽

10.1186/s12887-021-02748-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Felicitas Schulz ◽

Ekkehart Jenetzky ◽

Nadine Zwink ◽

Charlotte Bendixen ◽

Florian Kipfmueller ◽

...

Keyword(s):

Risk Factors ◽

Confidence Interval ◽

Environmental Risk ◽

Odds Ratio ◽

Alcohol Intake ◽

Case Control Study ◽

Case Control ◽

Parental Risk Factors ◽

Healthy Control ◽

Control Study

Abstract Background Evidence for periconceptional or prenatal environmental risk factors for the development of congenital diaphragmatic hernia (CDH) is still scarce. Here, in a case-control study we investigated potential environmental risk factors in 199 CDH patients compared to 597 healthy control newborns. Methods The following data was collected: time of conception and birth, maternal BMI, parental risk factors such as smoking, alcohol or drug intake, use of hairspray, contact to animals and parental chronic diseases. CDH patients were born between 2001 and 2019, all healthy control newborns were born in 2011. Patients and control newborns were matched in the ratio of three to one. Results Presence of CDH was significantly associated with maternal periconceptional alcohol intake (odds ratio = 1.639, 95% confidence interval 1.101–2.440, p = 0.015) and maternal periconceptional use of hairspray (odds ratio = 2.072, 95% confidence interval 1.330–3.229, p = 0.001). Conclusion Our study suggests an association between CDH and periconceptional maternal alcohol intake and periconceptional maternal use of hairspray. Besides the identification of novel and confirmation of previously described parental risk factors, our study underlines the multifactorial background of isolated CDH.

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Age and multimorbidities as poor prognostic factors for COVID-19 in hemodialysis: a Lebanese national study

BMC Nephrology ◽

10.1186/s12882-021-02270-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Mabel Aoun ◽

Rabab Khalil ◽

Walid Mahfoud ◽

Haytham Fatfat ◽

Line Bou Khalil ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Coronary Artery Disease ◽

Confidence Interval ◽

Odds Ratio ◽

Death Rate ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

National Study ◽

Artery Disease

Abstract Background Hemodialysis patients with COVID-19 have been reported to be at higher risk for death than the general population. Several prognostic factors have been identified in the studies from Asian, European or American countries. This is the first national Lebanese study assessing the factors associated with SARS-CoV-2 mortality in hemodialysis patients. Methods This is an observational study that included all chronic hemodialysis patients in Lebanon who were tested positive for SARS-CoV-2 from 31st March to 1st November 2020. Data on demographics, comorbidities, admission to hospital and outcome were collected retrospectively from the patients’ medical records. A binary logistic regression analysis was performed to assess risk factors for mortality. Results A total of 231 patients were included. Mean age was 61.46 ± 13.99 years with a sex ratio of 128 males to 103 females. Around half of the patients were diabetics, 79.2% presented with fever. A total of 115 patients were admitted to the hospital, 59% of them within the first day of diagnosis. Hypoxia was the major reason for hospitalization. Death rate was 23.8% after a median duration of 6 (IQR, 2 to 10) days. Adjusted regression analysis showed a higher risk for death among older patients (odds ratio = 1.038; 95% confidence interval: 1.013, 1.065), patients with heart failure (odds ratio = 4.42; 95% confidence interval: 2.06, 9.49), coronary artery disease (odds ratio = 3.27; 95% confidence interval: 1.69, 6.30), multimorbidities (odds ratio = 1.593; 95% confidence interval: 1.247, 2.036), fever (odds ratio = 6.66; 95% confidence interval: 1.94, 27.81), CRP above 100 mg/L (odds ratio = 4.76; 95% confidence interval: 1.48, 15.30), and pneumonia (odds ratio = 19.18; 95% confidence interval: 6.47, 56.83). Conclusions This national study identified older age, coronary artery disease, heart failure, multimorbidities, fever and pneumonia as risk factors for death in patients with COVID-19 on chronic hemodialysis. The death rate was comparable to other countries and estimated at 23.8%.

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Subclinical atherosclerosis in children and adolescents with congenital heart disease

Cardiology in the Young ◽

10.1017/s1047951120004448 ◽

2020 ◽

pp. 1-8

Author(s):

Silvia M. Cardoso ◽

Michele Honicky ◽

Yara M. F. Moreno ◽

Luiz R. A. de Lima ◽

Matheus A. Pacheco ◽

...

Keyword(s):

Risk Factors ◽

Congenital Heart Disease ◽

Confidence Interval ◽

Odds Ratio ◽

Clinical Characteristics ◽

Congenital Heart ◽

Subclinical Atherosclerosis ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Media Thickness

Abstract Background: Subclinical atherosclerosis in childhood can be evaluated by carotid intima-media thickness, which is considered a surrogate marker for atherosclerotic disease in adulthood. The aims of this study were to evaluate carotid intima-media thickness and, to investigate associated factors. Methods: Cross-sectional study with children and adolescents with congenital heart disease (CHD). Socio-demographic and clinical characteristics were assessed. Subclinical atherosclerosis was evaluated by carotid intima-media thickness. Cardiovascular risk factors, such as physical activity, screen time, passive smoke, systolic and diastolic blood pressure, waist circumference, dietary intake, lipid parameters, glycaemia, and C-reactive protein, were also assessed. Factors associated with carotid intima-media thickness were analysed using multiple logistic regression. Results: The mean carotid intima-media thickness was 0.518 mm and 46.7% had subclinical atherosclerosis (carotid intima-media thickness ≥ 97th percentile). After adjusting for confounding factors, cyanotic CHD (odds ratio: 0.40; 95% confidence interval: 0.20; 0.78), cardiac surgery (odds ratio: 3.17; 95% confidence interval: 1.35; 7.48), and be hospitalised to treat infections (odds ratio: 1.92; 95% confidence interval: 1.04; 3.54) were associated with subclinical atherosclerosis. Conclusion: Clinical characteristics related to CHD were associated with subclinical atherosclerosis. This finding suggests that the presence of CHD itself is a risk factor for subclinical atherosclerosis. Therefore, the screen and control of modifiable cardiovascular risk factors should be made early and intensively to prevent atherosclerosis.

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Clinical and imaging variables associated to Microvascular Angina, a 13N-AMMONIA MPI Approach

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeab111.064 ◽

2021 ◽

Vol 22 (Supplement_3) ◽

Author(s):

JK Rojas-Senarque ◽

H Gurrola-Luna ◽

I Carvajal-Juarez ◽

ME Soto-Lopez ◽

B Belen-Rivera ◽

...

Keyword(s):

Risk Factors ◽

Microvascular Dysfunction ◽

Wilcoxon Test ◽

Systemic Hypertension ◽

Categorical Variables ◽

Microvascular Angina ◽

Cardiac Computed Tomography Angiography ◽

Pet Ct ◽

Group B ◽

Severe Ischemia

Abstract Funding Acknowledgements Type of funding sources: None. On Behalf of MiniFellows Research Group CLINICAL AND IMAGING VARIABLES IN MICROVASCULAR ANGINA. A 13N-AMMONIA MPI APPROACH Background Patients with typical angina may have no obstructive artery disease1 and 2/3 may present microvascular dysfunction(MVD)2 which is associated with poor prognosis3,4,5. In 2017 the Coronary Vasomotion Disorders International Study Group (COVADIS) included it as a criteria of MVA6; later, included in MINOCA ESC 2020 guidelines.7 For diagnosis6,7: symptoms of ischemia; absence of relevant epicardial CAD (<50% diameter reduction or FFR >0.80); myocardial ischemia; impaired coronary microvascular function (CFR < 2 or <2.5 depending on methodology). Our aim was to identify clinical and imaging variables in patients with MVA due to 13N-ammonia Positron Emission Tomography/Cardiac Tomography(PET/CT) and Cardiac Computed Tomography Angiography(CCTA) in a cardiovascular imaging referral center. Methods.Retrospective, cross-sectional study of patients with suspected CAD. For inclusion: ischemia quantitation (summed stress score,SDS < 3) and obstruction <50% in all vessels. Exclusion criteria: previous infarction, intervention, or incomplete study. Clinical data was assessed. Both studies performed on the same day. Frequencies and percentages to report categorical variables; x2 and Fisher´s exact tests to compare them. Mean (+/-DE) or median (interquartile range) to report continuous variables according to their distribution, and T student or Wilcoxon test to compare them. Results 274 patients included: Group A (CFR <2) and group B (CFR 2)(108vs166). Difference for systemic hypertension(p <0.001), type 2 diabetes mellitus(p <0.001), dyslipidemia(p = 0.019), smoking(p <0.001). Group B presented higher incidence for mild ischemia(p = 0.004) while MVA for severe ischemia(p = 0.002). Difference between groups for EDV and ESV at rest (p = 0.002), EDV at stress(p = 0.03) and at rest(p < 0.001), LVEF at rest and stress(p < 0.001) and for a negative change of LVEF(p < 0.001). Also, reduced Calcium Score(SC)(p < 0.001) Discussion With a higher prevalence reported in women8,9, no difference for women in both groups. Presentation been reported as atypical 3,6,10, as in our study. Traditional risk factors may affect the microvascular circulation earlier in the disease. Regarding mild and severe ischemia, CFR´s may be lower in defect perfusion zones and presence of both ischemia and MVD has worse prognosis11 suggesting ischemia could had already developed in this group. LVEF drop supports the relation between CFR and ventricular function12. Finally, MVA group had a reduced CS, associated with CAD and worse prognosis, suggesting it also affects the microvasculature function. Conclusions 13N-ammonia PET/CT MPI with CCTA is a great combination to diagnose MVA, whose main component is microvascular dysfunction. Recognizing the risk factors associated with this pathology allows making opportune detections, implementing early treatment strategies, controlling symptoms and avoiding the disease"s evolution

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Venous Thromboembolism in Patients With Thrombocytopenia: Risk Factors, Treatment, and Outcome

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029615613158 ◽

2015 ◽

Vol 23 (4) ◽

pp. 345-350 ◽

Cited By ~ 4

Author(s):

Jens Kristian Baelum ◽

Espen Ellingsen Moe ◽

Mads Nybo ◽

Pernille Just Vinholt

Keyword(s):

Risk Factors ◽

Platelet Count ◽

Venous Thromboembolism ◽

Blood Cells ◽

Medical Records ◽

Odds Ratio ◽

Conditional Logistic Regression ◽

University Hospital ◽

Hospital Department ◽

Bleeding Episodes

Background: Venous thromboembolism (VTE) is a frequent and potentially lethal condition. Venous thrombi are mainly constituted of fibrin and red blood cells, but platelets also play an important role in VTE formation. Information about VTE in patients with thrombocytopenia is, however, missing. Objectives: To identify VTE risk factors and describe treatment and outcome (bleeding episodes and mortality) in patients with thrombocytopenia. Patients/Methods: Patients with thrombocytopenia (platelet count <100 × 109/L) admitted to Odense University Hospital, Denmark, between April 2000 and April 2012 were included. Fifty cases had experienced VTE. Controls without VTE were matched 3:1 with cases on sex and hospital department. Medical records were examined, and data were analyzed using conditional logistic regression. Results: In multivariate analysis, platelet count <50 × 109/L (odds ratio [OR] 0.22, P < .05) and chronic liver disease (OR 0.05, 95% confidence interval [CI] 0.01-0.58) reduced the risk of VTE. Surgery (OR 6.44, 95% CI 1.37-30.20) and previous thromboembolism (OR 6.16, 95% CI 1.21-31.41) were associated with an increased VTE risk. Ninety-two percent of cases were treated with anticoagulants. There was no difference in bleeding incidence between cases and controls. Conclusions: Several known VTE risk factors also seems to apply in patients with thrombocytopenia. Also, patients with thrombocytopenia may be VTE risk stratified based on platelet count and comorbidities. Finally, patients having thrombocytopenia with VTE seem to be safely treated with anticoagulants without increased occurrence of bleeding.

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