Risk Factors for CKD Progression

2020 ◽  
pp. CJN.07830520
Author(s):  
Mary Hannan ◽  
Sajid Ansari ◽  
Natalie Meza ◽  
Amanda H. Anderson ◽  
Anand Srivastava ◽  
...  
Keyword(s):  
Risk Factors ◽  
Genome Wide Association Study ◽  
Healthy Lifestyle ◽  
Interdisciplinary Collaboration ◽  
Fibroblast Growth Factor 23 ◽  
Kidney Injury ◽  
The United States ◽  
Future Research ◽  
Ckd Progression ◽  
Factors Associated

The Chronic Renal Insufficiency Cohort (CRIC) Study is an ongoing, multicenter, longitudinal study of nearly 5500 adults with CKD in the United States. Over the past 10 years, the CRIC Study has made significant contributions to the understanding of factors associated with CKD progression. This review summarizes findings from longitudinal studies evaluating risk factors associated with CKD progression in the CRIC Study, grouped into the following six thematic categories: (1) sociodemographic and economic (sex, race/ethnicity, and nephrology care); (2) behavioral (healthy lifestyle, diet, and sleep); (3) genetic (apoL1, genome-wide association study, and renin-angiotensin-aldosterone system pathway genes); (4) cardiovascular (atrial fibrillation, hypertension, and vascular stiffness); (5) metabolic (fibroblast growth factor 23 and urinary oxalate); and (6) novel factors (AKI and biomarkers of kidney injury). Additionally, we highlight areas where future research is needed, and opportunities for interdisciplinary collaboration.

Identifying Risk Factors for Acute Asthma Attacks: Application of Machine Learning in a Country-Wide Mobile Health Study (Preprint)

2021 ◽  
Author(s):  
Kevin Cheuk Him Tsang ◽  
Hilary Pinnock ◽  
Andrew M. Wilson ◽  
Syed Ahmar Shah
Keyword(s):  
Risk Factors ◽  
Mobile Health ◽  
The United States ◽  
Data Driven ◽  
Health Study ◽  
Future Research ◽  
Activity Levels ◽  
Factors Associated ◽  
Asthma Patients ◽  
Using Data

BACKGROUND Asthma is a variable long-term condition that affects 339 million people worldwide who are at risk of acute deteriorations or attacks. Because triggers, patterns, and risk of attacks vary from person to person, asthma can be difficult to study in small cohorts, but recent mobile-based studies like the Asthma Mobile Health Study (AMHS) provide an important opportunity to collect data from large populations. The AMHS is a publicly available dataset collected using a smartphone app from 10,010 asthma patients across the United States. OBJECTIVE Using data-driven methods, we aimed to identify different clusters of asthma patients based on patterns of clinical deterioration that may lead to loss of productivity, and determine key factors associated with each patient cluster. METHODS Based on existing asthma knowledge, 27 variables about the patient’s history, demographics, behaviour, and self-reported symptoms were extracted to generate 63 features. Of the 63 features, 10 were markers of attacks that were used to cluster patients with the k-means algorithm. We subsequently used a supervised learning approach, least absolute shrinkage and selection operator (LASSO), to rank the remaining 53 features and identify key risk factors associated with each patient cluster. The models were validated with 10-fold cross-validation. RESULTS Using data from 827 participants of AMHS with sufficient data, k-means clustering formed four patient clusters based on unscheduled healthcare usage and missed work. The most important factors contributing to the clustering were nocturnal symptoms, activity limitation, and sex. Being female, and having asthma that affects sleep and activity levels, were the key risk factors associated with having an asthma attack that necessitates the need for unscheduled medical care and time off work. Our internal validation resulted in an area under the curve (AUC) of up to 0.80. CONCLUSIONS The data-driven approach found risk factors associated with increased levels of asthma attacks that reflected those recognised in clinical practice. Future research about asthma risk factors should include these measures and also consider including work and school absence as markers of asthma attacks.

scholarly journals Early Outcomes After Surgical Management of Geriatric Patella Fractures

2021 ◽  
Vol 12 ◽  
pp. 215145932098769
Author(s):  
Jaclyn Kapilow ◽  
Junho Ahn ◽  
Kathryn Gallaway ◽  
Megan Sorich
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Length Of Stay ◽  
Geriatric Patients ◽  
The United States ◽  
Unplanned Readmission ◽  
Patella Fracture ◽  
Factors Associated ◽  
Prolonged Hospitalization ◽  
Patella Fractures

Objectives: To report the incidence and risk factors for prolonged hospitalization, discharge to a facility, and postoperative complications in geriatric patients who underwent surgery for patella fracture. Design: Retrospective database review. Setting: The American College of Surgeons—National Surgical Quality Improvement Program (NSQIP) collects data from 600 hospitals across the United States. Patients/Participants: NSQIP patients over 65 years of age with patella fractures. Intervention: Surgical fixation of patella fracture including extensor mechanism repair. Main Outcome Measurements: Prolonged hospitalization, discharge to a facility, and 30-day post-operative complications. Results: 1721 patients were included in the study. The average age was 74.9 years. 358 (20.8%) patients were male. 122 (7.1%) patients had a length of stay greater than 7 days. Factors associated with prolonged length of stay include pre-existing renal failure, need for emergent surgery, and time to surgery greater than 24 hours from admission. 640 patients (37.2%) of patients were discharged to a facility after surgery. Discharge to facility was associated with age >77 years, obesity, anemia, thrombocytopenia, pre-operative SIRS, and CCI > 0.5. Admission from home decreased the odds of discharge to a facility. The most common postoperative complications in this population were unplanned readmission (3.4%), unplanned reoperation (2.7%), surgical site infection (1.1%), mortality (1.0%), venous thromboembolism (0.8%), and wound dehiscence (0.2%). Complication rates increased with anemia and ASA class IV-V. Conclusions: Geriatric patients undergoing operative intervention for patella fractures are at high risk for prolonged hospitalization, discharge to facility, unplanned readmission or reoperation, and surgical site complications in the first 30 days following surgery. This study highlights modifiable and non-modifiable risk factors associated with adverse events. Early recognition of these factors can allow for close monitoring and multidisciplinary intervention in the perioperative period to improve outcomes. Level of Evidence: Prognostic level III.

Cervical insufficiency: a noteworthy disease with controversies

2020 ◽  
Vol 48 (7) ◽  
pp. 648-655
Author(s):  
Yu Han ◽  
Mengnan Li ◽  
Huijing Ma ◽  
Hailan Yang
Keyword(s):  
Risk Factors ◽  
Diagnosis And Treatment ◽  
Practical Significance ◽  
Future Research ◽  
Cervical Insufficiency ◽  
Factors Associated ◽  
The World ◽  
Potential Risk Factors ◽  
Recurrent Pregnancy Losses ◽  
Recurrent Abortions

AbstractCervical insufficiency (CI) is a mainly disease leading to recurrent abortions and preterm birth which may present in about 1% of obstetric populations. Recurrent pregnancy losses caused by CI incur serious economic burdens on society as well as huge psychological burdens to family members. However, many patients even clinicians in some areas of the world still remain confused about this disease. At the same time, the etiology of CI is still uncertain and it is still a controversial disease in diagnosis and treatment. This article summarizes the potential risk factors associated with CI, which could be worthy of attention and helpful for future research. It also reviews the methods for diagnosis and treatment of CI to better understand this noteworthy disease, as well as presents the related consensus and controversies according to the newly updated guidelines, which has practical significance for conducting more in-depth investigations in the future.

Trail running injury risk factors: a living systematic review

2022 ◽  
pp. bjsports-2021-104858
Author(s):  
Carel Viljoen ◽  
Dina C (Christa) Janse van Rensburg ◽  
Willem van Mechelen ◽  
Evert Verhagen ◽  
Bruno Silva ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Injury Risk ◽  
Previous History ◽  
Future Research ◽  
Injury Incidence ◽  
Extrinsic Factors ◽  
Factors Associated ◽  
Injury Risk Factors ◽  
Trail Running

ObjectiveTo review and frequently update the available evidence on injury risk factors and epidemiology of injury in trail running.DesignLiving systematic review. Updated searches will be done every 6 months for a minimum period of 5 years.Data sourcesEight electronic databases were searched from inception to 18 March 2021.Eligibility criteriaStudies that investigated injury risk factors and/or reported the epidemiology of injury in trail running.ResultsNineteen eligible studies were included, of which 10 studies investigated injury risk factors among 2 785 participants. Significant intrinsic factors associated with injury are: more running experience, level A runner and higher total propensity to sports accident questionnaire (PAD-22) score. Previous history of cramping and postrace biomarkers of muscle damage is associated with cramping. Younger age and low skin phototypes are associated with sunburn. Significant extrinsic factors associated with injury are neglecting warm-up, no specialised running plan, training on asphalt, double training sessions per day and physical labour occupations. A slower race finishing time is associated with cramping, while more than 3 hours of training per day, shade as the primary mode of sun protection and being single are associated with sunburn. An injury incidence range 0.7–61.2 injuries/1000 hours of running and prevalence range 1.3% to 90% were reported. The lower limb was the most reported region of injury, specifically involving blisters of the foot/toe.ConclusionLimited studies investigated injury risk factors in trail running. Our review found eight intrinsic and nine extrinsic injury risk factors. This review highlighted areas for future research that may aid in designing injury risk management strategies for safer trail running participation.PROSPERO registration numberCRD42021240832.

Abstract 78: Factors Associated with Thrombotic Events During Pregnancy in the United States: NIS 2000-2010

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Ali Razmara ◽  
Steven Cen ◽  
Diana L Jin ◽  
Nerses Sanossian ◽  
Amytis Towfighi
Keyword(s):  
Risk Factors ◽  
The United States ◽  
The South ◽  
Targeted Interventions ◽  
Factors Associated ◽  
Thrombosis Risk ◽  
Significant Difference ◽  
Acute Mi ◽  
Hospital Factors ◽  
Peripartum Period

Intro: Thrombosis risk is increased during pregnancy and puerperium. There are no recent data on nationwide trends in thrombotic events during the delivery period. Objective: To determine risk factors for thrombotic events in women hospitalized for deliveries. Methods: Data from the Nationwide Inpatient Sample (2000-2010) were used to identify deliveries. Weighted proportion of pregnancy hospitalizations with comorbid thrombotic events, including TIA, ischemic stroke, hemorrhagic stroke, acute MI, and venous thromboembolism, was determined. Poisson regression was used to identify risk factors for thrombotic events. The first multivariable model adjusted for sociodemographic and hospital factors. The second model in addition adjusted for comorbid conditions. Results: There were 4,305,561 women hospitalized for delivery (21.5 million US deliveries), of which 7,242 (0.17%) had thrombotic events in the peripartum period. From 2000-2010, there was an increase in deliveries with associated thrombotic events observed from 7.46/10K to 34.8/10K. Compared to 2000, deliveries with thromboses was 8-fold more likely in 2010 (RR 7.94, 95% CI 1.98-31.93). There was no significant difference in rates from 2000 to 2010 after adjustment for sociodemographic and hospital factors. From 2000-2010, pregnant women with thrombotic events were older, more likely to be White, to smoke, to lack insurance, to be admitted to rural hospitals, and to be admitted in the South or Midwest. After multivariable adjustment for sociodemographics, hospital factors, and comorbidities, admissions in the South (RR 1.26, 95% CI 1.02-1.55) or Midwest (1.33, 95% CI 1.05-1.68), atrial fibrillation (1.28, 95% CI 1.01-1.62), pre-/eclampsia (5.78, 95% CI 4.37-7.66), dyslipidemia (1.72, 95% CI 1.42-2.09), atrial septal defect (14.38, 95% CI 6.76-30.58), and valvular heart disease (1.67, 95% CI 1.25-2.24) were independently associated with higher risk of thrombotic events. Conclusions: From 2000-2010, there was a sizeable increase in deliveries with associated thrombosis. Identification of factors associated with thrombotic events for women hospitalized for normal pregnancies will aid in targeted interventions to screen for, prevent and treat thrombosis related to pregnancy.

scholarly journals Acute kidney injury and other factors associated with mortality in hiv-infected patients

2018 ◽  
Vol 64 (6) ◽  
pp. 509-517
Author(s):  
Geraldo Bezerra da Silva Junior ◽  
Sérgio Luiz Arruda Parente Filho ◽  
Douglas de Sousa Soares ◽  
Rodrigo da Nóbrega de Alencar ◽  
Tiago Tomaz Teles Peixoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Laboratory Data ◽  
Kidney Injury ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Respiratory Impairment ◽  
Factors Associated ◽  
Disseminated Histoplasmosis ◽  
Related Mortality

SUMMARY OBJECTIVE: HIV-related mortality is still high, especially in developed countries. The aim of this study is to investigate factors associated to death in HIV-infected patients. METHODS: This is a cross-sectional study with all HIV adult patients admitted to a tertiary infectious diseases hospital in Fortaleza, Northeast Brazil, from January 2013 to December 2014. Patients were divided into two groups: survivors and non-survivors. Demo-graphical, clinical and laboratory data were compared and a logistic regression was performed in order to investigate risk factors for death. P values ≤0.05 were considered statistically significant. RESULTS: A total of 200 patients with mean age of 39 years were including in the study, 69.5% males. Fifteen patients (7.5%) died. Non-survivors presented a higher percentage of males (93.3 vs. 67.3%, p = 0.037). Non-survivors presented AKI (73.3 vs. 10.3%, p < 0.001), liver dysfunction (33.3 vs. 11.5, p = 0.031), dyspnea (73.3 vs. 33.0%, p = 0.002) and disorientation (33.3 vs. 12.4%, p = 0.025) more frequently. Non-survivors also had higher levels of urea (73.8 ± 52.7vs. 36.1 ± 29.1 mg/dL, p < 0.001), creatinine (1.98 ± 1.65 vs. 1.05 ± 1.07 mg/dL, p < 0.001), aspartate aminotransferase (130.8 vs. 84.8 U/L, p = 0.03), alanine aminotransferase (115.6 vs. 85.4 U/L, p = 0.045) and lactate dehydrogenase (LDH) (1208 vs. 608 U/L, p = 0.012), as well as lower levels of bicarbonate (18.0 ± 4.7 vs. 21.6 ± 4.6 mEq/L, p = 0.016) and PCO2 (27.8 ± 7.7 vs. 33.0 ± 9.3 mmHg, p = 0.05). In multivariate analysis, disorientation (p = 0.035, OR = 5.523, 95%CI = 1.130 – 26.998), dyspnoea (p = 0.046, OR = 4.064, 95%CI = 1.028 – 16.073), AKI (p < 0.001, OR = 18.045, 95%CI = 4.308 – 75.596) and disseminated histoplasmosis (p = 0.016, OR = 12.696, 95%CI = 1.618 – 99.646) and LDH > 1000 U/L (p = 0.038, OR = 4.854, 95%CI = 1.093 – 21.739) were risk factors for death.]CONCLUSION: AKI and disseminated histoplasmosis (DH) were the main risk factors for death in the studied population. Neurologic and respiratory impairment as well as higher levels of LDH also increased mortality in HIV-infected patients.

Environmental risk factors associated with Helicobacter pylori seroprevalence in the United States: a cross-sectional analysis of NHANES data

2015 ◽  
Vol 143 (12) ◽  
pp. 2520-2531 ◽  
Author(s):  
W. S. KRUEGER ◽  
E. D. HILBORN ◽  
R. R. CONVERSE ◽  
T. J. WADE
Keyword(s):  
United States ◽  
Risk Factors ◽  
Helicobacter Pylori ◽  
Environmental Risk ◽  
The United States ◽  
Environmental Risk Factors ◽  
Living Conditions ◽  
Well Water ◽  
Factors Associated ◽  
H Pylori

SUMMARYHelicobacter pylori imparts a considerable burden to public health. Infections are mainly acquired in childhood and can lead to chronic diseases, including gastric ulcers and cancer. The bacterium subsists in water, but the environment's role in transmission remains poorly understood. The nationally representative National Health and Nutrition Examination Survey (NHANES) was examined for environmental risk factors associated with H. pylori seroprevalence. Data from 1999–2000 were examined and weighted to represent the US population. Multivariable logistic regression estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI) for associations with seropositivity. Self-reported general health condition was inversely associated with seropositivity. Of participants aged <20 years, seropositivity was significantly associated with having a well as the source of home tap water (aOR 1·7, 95% CI 1·1–2·6) and living in a more crowded home (aOR 2·3, 95% CI 1·5–3·7). Of adults aged ⩾20 years, seropositivity was not associated with well water or crowded living conditions, but adults in soil-related occupations had significantly higher odds of seropositivity compared to those in non-soil-related occupations (aOR 1·9, 95% CI 1·2–2·9). Exposures to both well water and occupationally related soil increased the effect size of adults' odds of seropositivity compared to non-exposed adults (aOR 2·7, 95% CI 1·3-5·6). Environmental exposures (well-water usage and occupational contact with soil) play a role in H. pylori transmission. A disproportionate burden of infection is associated with poor health and crowded living conditions, but risks vary by age and race/ethnicity. These findings could help inform interventions to reduce the burden of infections in the United States.

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