Characteristics of Hospital Acquired Pressure Injury and Factors Affecting Its Development: A Retrospective Study (Preprint)

2020 ◽  
Author(s):  
Hatan Mortada ◽  
Nader Malatani ◽  
Basim Awan ◽  
Hattan Aljaaly
Keyword(s):  
Retrospective Study ◽  
Pressure Ulcer ◽  
Neurological Deficit ◽  
Multinomial Logistic Regression ◽  
Influential Factors ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Major Surgery ◽  
P Value ◽  
Pressure Injury

BACKGROUND Across the globe, Pressure Injury (PI) has been implicated billion costs annually and mortality were 60,000 deaths out of 2.5 million hospitalized patients from complication related to PI. Through avoiding PI will avoid the incidence of other illnesses, decrease the financial costs and improve the quality of life for our patients. OBJECTIVE Therefore, this retrospective study aimed to identify most influential factors which increase the risk of developing pressure injuries among hospitalized patients at a university hospital according to the Waterlow scale. METHODS Data were collected retrospectivity including patients who developed pressure injury during January 2016 to December 2018 were evaluated using Waterlow pressure injury risk assessment tool at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. The analysis was performed in 95% confidence interval using the Statistical Package for Social Science (SPSS), version 23.0 (IBM, Armonk, NY, USA). Ethical approval was obtained from the Institutional Review Board and the Research Ethics Committee. RESULTS Total 272 cases were included in this study. Highest number of cases belong to age group 50 to 64 years, 83 (30.5%). The majority had stage 2 pressure ulcer, 165 (60.7%). The most frequent location of pressure ulcer was ‘back’, 97 (35.7%). History of undergoing major surgery was statistically significantly associated with higher stage of pressure ulcer (p-value .040). The mean Waterlow pressure injury score for all cases was 27.19 ± 13.143. There is a moderate uphill correlation between neurological deficit score and Waterlow PI score was observed, (Correlation coefficient: .447, p. <.001). Multinomial logistic regression analysis revealed increasing age is a significant predictive factor for developing higher stages of pressure ulcer (p .046). CONCLUSIONS This study indicated that major surgery, neurological deficit, low hemoglobin, and increasing age are strong predictors for developing higher stages of pressure injury. Therefore, health care contributors should consider these risks when applying a comprehensive pressure injury management plan.

Utility of Anakinra in Acute Crystalline Diseases: A Retrospective Study Comparing a University Hospital with a Veterans Affairs Medical Center

2018 ◽  
Vol 46 (7) ◽  
pp. 748-750 ◽  
Author(s):  
Julianna Desmarais ◽  
Cong-Qiu Chu
Keyword(s):  
Retrospective Study ◽  
Adverse Effects ◽  
Medical Center ◽  
Veterans Affairs ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Acute Gout ◽  
Efficacy And Safety ◽  
Inpatient Management ◽  
Gout Flares

Objective.To evaluate the efficacy and safety of anakinra in inpatient management of acute gout and pseudogout.Methods.Hospitalized patients with acute gout (n = 77) or pseudogout (n = 11) or both (n = 3) were analyzed for response to anakinra and adverse effects.Results.Half of all patients had comorbidities limiting the treatment choice. Anakinra was well tolerated, and 92% of gout flares and 79% of pseudogout flares responded to treatment.Conclusion.Anakinra is an effective and safe treatment for acute gout and pseudogout in hospitalized patients, particularly in those with comorbidities.

scholarly journals Predictors of Cerebral Arteriovenous Malformation Mortality: A Single-center, Five-year Retrospective Study

2021 ◽  
Vol 9 (3) ◽  
pp. 213-218
Author(s):  
Patricio Garcia-Espinosa ◽  
Edgar Botello-Hernández ◽  
Gabriela Torres-Hernández ◽  
Clarissa Guerrero-Cavazos ◽  
Estefania Villareal-Garza ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Univariate Analysis ◽  
International Classification Of Diseases ◽  
University Hospital ◽  
P Value ◽  
Predictors Of Mortality ◽  
The Hours ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
History Of

Background: Arteriovenous Malformations (AVMs) are abnormalities in intracranial vessels between the arterial and venous systems. This study aimed to identify the predictors of mortality in patients that presented to our hospital with AVMs, ruptured or unruptured, and correlate them to those available in the literature. Methods: An analytical, observational, retrospective study was performed to review data of patients with cerebral AVMs in the University Hospital “Dr José Eleuterio González” from January 2016 to December 2020. Clinical files were reviewed based on AVMs diagnosis according to the  International Classification of Diseases 10th Revision, ICD-10. Variables were subjected to a univariate analysis and those found significant (p-value < 0.05) were subjected to a logistic regression. Results: A total of 80 patients were included in our study. Most of the participants were females (56.3%) and three were pregnant. The most common presenting symptom was holocranial headache (34 cases) occurring between the hours of 22:00 to 7:00. The most significant predictors of mortality were a total bleeding volume greater than 9.18 cm3 (p = 0.010), the presence of more than one symptom (p = 0.041), and a history of previous cerebral intraparenchymal hemorrhage (p = 0.014). Conclusion: Results demonstrated an important association between intracranial bleeding and mortality. Ultimately, more prospective studies are needed to determine predictor factors for mortality in AVMs patients.

scholarly journals The Utility of Hereditary Thrombophilia Testing Among Hospitalized Patients: A Single Center Experience

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 2231-2231
Author(s):  
Omar Abughanimeh ◽  
Mohammad Tahboub ◽  
Anahat Kaur ◽  
Mouhanna Abu Ghanimeh ◽  
Zhang Zhiheng ◽  
...  
Keyword(s):  
Health Care ◽  
Retrospective Study ◽  
Venous Thromboembolism ◽  
Health Care System ◽  
Protein C ◽  
Thromboembolic Disease ◽  
Hospitalized Patients ◽  
Positive Test ◽  
P Value ◽  
Total Cost

Abstract Background: Hereditarythrombophilias (HT) are a group of inherited diseases that predispose to venous thromboembolism (VTE). It can increase the risk of VTE by 3 to 20-fold compared to general population. HT are common and present in 7% of the population. Testing for HT is routine but knowing when to order the tests and how to interpret the results can be challenging. In the United Kingdom, it is estimated that 30,000 tests are done each year to screen for HT with an annual cost of 15,000,000 Euros. This led the British Committee For Standards in Haematology (BCSH) to release guidelines in 2010 that recommends against testing patients at the time of acute venous thrombosis as it will not influence the initial treatment. In the United States there are no clear guidelines regarding testing for HT. We performed a retrospective study to look at the utilization of HT tests among hospitalized patients. This study attempts to address the clinical utility of these tests and concurrent costs to the health care system. Methods: This is a retrospective study. We reviewed 2402 patient charts with at least one HT test ordered between 2/2016-1/2018 in St Luke's Health Care System records in Kansas City, MO. The following HT tests were included: Activated protein C resistance, antiphospholipid panel, antithrombin III level, factor V Leiden mutation, factor VIII level, homocysteine level, protein C level, protein S level, and prothrombin 20210 mutation. Only patients who had testing done during hospitalization were included. Positive actionable tests were analyzed to determine the clinical benefit of ordering the tests. A positive actionable test was defined as a positive test that changed the anticoagulation intensity, type or duration. Patients with history of previous thromboembolic disease, ongoing medical condition requiring life-long anticoagulation (such as atrial fibrillation), or unprovoked thromboembolic disease were considered non actionable. We also documented the total number of positive tests, ordering providers, and total cost related to ordering these tests (total cost of tests+ cost of hematology consult after an abnormal test). Results: A total of 2402 patients were reviewed. 954 patients were included with a mean age of 54 years. 397 (41.6%) were ordered for venous thromboembolism (VTE) (Deep vein thrombosis, pulmonary embolism or both). Among the included patients, 634 had at least one positive test (Table-1). Only 89 positive tests were actionable (14% of the positive tests and 9.3% of the total ordered tests). There was a statistically significant association between increasing age and having both a positive test result (P-value 0.006), and an actionable test (P-value 0.046). The chance of having actionable tests was more if the test was done in an inpatient setting rather that in the emergency room (OR 0.361, CI 95% (0.177-0.737)). The total cost of ordering these tests was estimated to be $551,218.1 and the cost of subsequent hematology consults was $15,367 leading to total cost of $566,585 during our study period. Conclusion: Inpatient testing for thrombophilia is associated with increased health care cost and did not change management in many situations. The decision of ordering these tests should be based on a clinical risk assessment. Disclosures No relevant conflicts of interest to declare.

scholarly journals Incidence of pressure injury and nursing care time in intensive care

2020 ◽  
Author(s):  
Yasmin Cardoso Metwaly Mohamed Ali ◽  
Taís Milena Milena Pantaleão Souza ◽  
Paulo Carlos Garcia ◽  
Paula Cristina Nogueira
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Data Analysis ◽  
Nursing Care ◽  
University Hospital ◽  
Central Tendency ◽  
Hospital Data ◽  
Nursing Team ◽  
Pressure Injury

Objectives: To correlate the incidence of pressure injury (PI) with the average time of nursing care in an intensive care unit (ICU). Method: Epidemiological, observational, retrospective study, carried out in the ICU of a university hospital. Data were collected by consulting the PI incidence and the average nursing care time from ICU databases between 2010 and 2014. Measures of central tendency and variability, and Pearson’s correlation coefficient were used for data analysis. Results: The average incidence of PI between 2010 and 2014 was 10.83% (SD = 2.87) and the average time spent in nursing care for patients admitted to the ICU was 15 hours (SD = 0.94). There was no statistically significant correlation between the incidence of PI and the nursing care time (r = -0.17; p = 0.199), however, the results suggested an overload on the nursing team. Conclusion: This study confirms the importance of implementing and reassessing the effectiveness of preventive care protocols for PI, in addition to warning about the work overload of nursing in assisting critically ill patients.

Comparison of risk factors and outcomes of Candida auris candidemia with non-Candida auris candidemia: A retrospective study from Pakistan

2019 ◽  
Vol 58 (6) ◽  
pp. 721-729 ◽  
Author(s):  
Muneeba Ahsan Sayeed ◽  
Joveria Farooqi ◽  
Kauser Jabeen ◽  
Syed Faisal Mahmood
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Hospital Stay ◽  
Candida Species ◽  
Antifungal Susceptibility ◽  
Positive Culture ◽  
University Hospital ◽  
Prior History ◽  
P Value ◽  
Candida Auris

Abstract Candida auris has emerged as a nosocomial multi-drug resistant pathogen. This study aimed to compare the risk factors and outcomes of C. auris candidemia patients with non-C. auris candidemia, at a single center in Pakistan. A retrospective study compared 38 C. auris with 101 non-C. auris (36 C. albicans, 38 C. tropicalis, and 27 C. parapsilosis) candidemia patients between September 2014 and March 2017 at the Aga Khan University Hospital, Pakistan. Demographics, clinical history, management and outcomes were studied. Prior history of surgery (adjusted odds ratio [aOR] 4.9, 95% confidence interval [CI]: 1.4–17.5), antifungals exposure (aOR 38.3, 95% CI: 4.1–356) and prior MDR bacteria isolation (aOR 5.09, 95% CI: 1.6–15.9) were associated with C. auris candidemia. On survival analysis both groups of patients had similar outcome in terms of mortality (62.6% vs. 52.54%, hazard ratio [HR] 1.45, 95% CI: 0.84–2.4, P-value = .17) and microbiological failure rates (42.3% vs. 32.2%, HR 0.65, 95% CI: 0.35–1.2, P-value = .17) however, C. auris patients had a higher mean hospital stay (36.32 days vs. 14.8 days, P-value = &lt;.001) and higher &gt;15-day in-hospital stay from positive culture (HR 2.68, 95% CI: 1.1–6.3, P-value = .025). Antifungal susceptibility was different, with C. auris more often resistant to voriconazole (29.6% vs. 0%) and amphotericin (3.7 vs. 0%); though no echinocandin resistance was detected in either group. As opposed to other Candida species, C. auris candidemia occurred after nosocomial exposure, and its source was most commonly an indwelling line. Although these patients had a higher in-hospital stay, but there was no excess mortality when compared to other Candida species.

Delirium in hospitalized patients: A descriptive and retrospective study in the Clinical University Hospital of Valladolid

2011 ◽  
Vol 26 (S2) ◽  
pp. 397-397
Author(s):  
I. Sánchez Lorenzo ◽  
I. López Saracho ◽  
A. Ledo Rubio ◽  
D. Gómez Pizarro
Keyword(s):  
Retrospective Study ◽  
Negative Impact ◽  
Symptomatic Treatment ◽  
Acute Onset ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Altered Level ◽  
Risk Patients ◽  
Impaired Attention ◽  
Serious Disease

IntroductionThe syndrome confusional acute (SCA) is one of the most frequent mental disorders in patients hospitalized by medical diseases. It is characterized by acute onset symptoms fluctuating course, impaired attention, unorganized thinking, and altered level of conciousness. Though it is considered to be a reversible disease, often it is a sign of future deterioration of the cognitive functions.ObjectiveTo determine delirium prevalence and risk factors in a cohort of hospitalized patients. To know the characteristics of this population and the psychopharmaceuticals used.MethodologyA descritptive and retrospective study was conducted, based on the review of 2642 medical records of hospitalized patients in the Clinical University Hospital of Valladolid between July, 2007 and February, 2010.Results893 (33,8%) presented delirium. 63,3% were men and 36,7% were women. The mean of age was 77 years. Turned out as significant predictive factors with highest percentages: cardiovascular disease (18,3%), traumophaty (15,1%). The principal motive of consultation was surgical pathology (48,1%). 30% presented cognitive deterioration also. They were medicated with tiaprizal (75%), olanzapina (24%), quetiapina (22,5%) and other medications.ConclusionsThe SCA is a frequent syndrome and has a negative impact on morbidity, as well as in resource use. It is possible to identify risk patients. The SCA can be the form of presentation of a physical serious disease or appear as a serious complication of a disease or of treatment. The treatment must divide in three principal aspects: prevention, treatment of the causal disease and symptomatic treatment of the delirium.

scholarly journals The Prevalence of Cesarean Scar Niche and Its Relation to Certain Gynecological and Obstetrical Issues

2021 ◽  
pp. 152-158
Author(s):  
Mazen Mohammed AlRassad ◽  
Mohammed Mohsen ElNamoury ◽  
Mona Khaled Omar ◽  
Manal Mostafa Abdallah
Keyword(s):  
Cesarean Section ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Abnormal Uterine Bleeding ◽  
University Hospital ◽  
Major Surgery ◽  
P Value ◽  
Long Term Effects ◽  
Cross Sectional ◽  
Cesarean Scar

Background: A cesarean section (CS) is a life-saving surgical procedure when certain complications arise during pregnancy and labor. However, it is a major surgery and is associated with immediate maternal and perinatal risks and may have implications for future pregnancies as well as long-term effects that are still being investigated. This study aims at determining the prevalence of isthmocele (niche) among those who gave birth through Cesarean section, and figure out how many of the women diagnosed with scar niche are symptomatic. Methods: This observational cross-sectional study involved 300 women who gave birth by CS at the latest 6 months and they were recruited from the outpatient clinics of obstetrics and gynecology department, Tanta university hospital. Results: The prevalence of the niche was 21.7%. And the most common shapes of niche documented were the semicircular defects followed by the triangular defects. The majority of cases were symptomatic while only 7.7% were asymptomatic and discovered accidentally by routine ultrasound examination. The most common symptoms documented were abnormal uterine bleeding (AUB), chronic pelvic pain, dysmenorrhea, and secondary infertility. There was a positive significant relationship between the number of CS, the size of the niche, and the severity or frequency of the presenting symptom (P value < 0.01). Conclusion: Cesarean scar niche has a strong statistically significant association with symptoms such as AUB (especially inter-menstrual bleeding), chronic pelvic pain, and dysmenorrhea. In our study, the prevalence of cesarean niche was 21.7% and the common niche shapes documented were the semicircular and triangular niches.

Post-operative endophthalmitis after immediate sequential bilateral cataract Surgery: a retrospective study from Pakistan.

2021 ◽  
Author(s):  
Muhammad Abdul Rehman Siddiqui ◽  
Syed Zohaib Maroof Hussain ◽  
Irfan Jeeva
Keyword(s):  
Retrospective Study ◽  
Cataract Surgery ◽  
Middle Income Country ◽  
Income Country ◽  
University Hospital ◽  
P Value ◽  
Safe Procedure ◽  
Coding System ◽  
Middle Income ◽  
Bilateral Cataract

Objective: The aim of this study was to assess the frequency of post-operative complications after immediate sequential bilateral cataract surgery (ISBSC) in Pakistan, a low-middle income country. Methods: This is a 10-year retrospective study including all consecutive patients who underwent ISBCS between 1st January 2009 and 31st December 2018 at Aga Khan University Hospital (AKUH), Karachi, Pakistan. We identified potential patients through the procedure coding system of the hospital. A structured proforma was used to collect information. The inclusion criterion was bilateral cataract extraction without any additional secondary procedures. Patients who underwent a planned additional procedure on the operated eye on the same day, such as phaco combined with vitrectomy, corneal graft, or glaucoma surgery, were excluded. The primary outcome measure was the incidence of endophthalmitis. The data were analyzed with Statistical Package for the Social Sciences (SPSS) version 23.0, IBM Corporation, Armonk, New York, United States. A p-value of < 0.05 was considered significant. Results: We identified 352 patients through the coding system of our hospital who underwent ISBCS from January 2009 to December 2018. A total of 298 patients (596 eyes) met the inclusion criteria. The mean age was 33.14±25.83 years. Participants were divided into two  age groups:  <16 (39.26 %) years and  >16 (60.73)  years of age. Best-corrected visual acuity improved from -0.5650±8.2027 to -0.0043+4.05. Among 596 eyes, we found no case of post-operative endophthalmitis after ISBCS. Conclusions: ISBCS is a safe procedure in selected patients undergoing cataract surgery in a low-middle income country. Continuous...

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