Risk factors for immersion pulmonary edema in recreational scuba divers: a case-control study

2019 ◽  
pp. 611-618
Author(s):  
Anne Henckes ◽  
◽  
Guy Cochard ◽  
Florence Gatineau ◽  
Pierre Louge ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Edema ◽  
Case Control Study ◽  
Univariate Analysis ◽  
Physical Exertion ◽  
Case Control ◽  
Individual Characteristics ◽  
Scuba Divers ◽  
Recreational Scuba ◽  
Control Study

Background: Immersion can cause immersion pulmonary edema (IPE) in previously healthy subjects. We performed a case-control study to better identify IPE risk factors. Methods: We prospectively included recreational scuba divers who had presented signs of IPE and control divers who were randomly chosen among diving members of the French Underwater Federation. We sent an anonymous questionnaire to each diver, with questions on individual characteristics, as well as the conditions of the most recent dive (controls) or the dive during which IPE occurred. Univariate logistic regressions were performed for each relevant factor. Then, multivariate logistic regression was performed. Results: Of the 882 questionnaires sent, 480 (54%) were returned from 88 cases (90%) and 392 control divers (50%). Multivariate analysis identified the following independent risk factors associated with IPE: • being aged over 50 years ((OR) 3.30, (95%CI) 1.76-6.19); • female sex (OR 2.20, 95%CI 1.19-4.08); • non-steroidal anti-inflammatory drug (NSAID) intake before diving (OR 24.32, 95%CI 2.86-206.91); • depth of dive over 20 m (OR 2.00, 95%CI 1.07-3.74); • physical exertion prior to or during the dive (OR 5.51, 95%CI 2.69-11.28); • training dive type (OR 5.34, 95%CI 2.62-10.86); and • daily medication intake (OR 2.79, 95%CI 1.50-5.21); this latter factor appeared to be associated with hypertension in the univariate analysis. Conclusions: To reduce the risk of experiencing IPE, divers over 50 years of age or with hypertension, especially women, should avoid extensive physical effort, psychological stress, deep dives and NSAID intake before diving.

scholarly journals Risk factors for suicidal tendency in people with epilepsy in China: a case–control study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mintao Lin ◽  
Jiani Chen ◽  
Sisi Li ◽  
Yingjie Qin ◽  
Xuruan Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Low Income ◽  
Case Control Study ◽  
Univariate Analysis ◽  
Case Control ◽  
Conditional Inference ◽  
Suicidal Tendency ◽  
Patients With Epilepsy ◽  
Nested Case Control ◽  
Control Study

AbstractPeople with epilepsy (PWE) have an increased suicide prevalence. This study aimed to identify the risk factors for suicidal tendency among PWE in West China. A nested case–control study was designed in a cohort of patients with epilepsy (n = 2087). In total, 28 variates were calculated. In the univariate analysis, unemployment, low income, seizure frequency, seizure-free time, infectious or structural etiology, levetiracetam or phenobarbital use, anxiety, depression, and stigma were associated with suicidal tendency. A multivariate analysis indicated that unemployment (odds ratio [OR] 5.74, 95% confidence interval [CI] 2.13–15.48), levetiracetam use (OR 2.80, 95%CI 1.11–7.05), depression (C-NDDI-E score ≥ 13; OR 3.21, 95%CI 1.26–8.21), and stigma (SSCI score ≥ 16; OR 6.67, 95%CI 1.80–24.69) were independently associated with suicidal tendency. Conditional inference tree analysis indicated that SSCI and C-NDDI-E scores could effectively identify patients with suicidal tendency. Thus, this study suggests that unemployment, levetiracetam use, depression, and stigma are independent risk factors for suicidal tendency in PWE in China.

scholarly journals 172. Risk Factors for 30-Day Mortality in Patients with Staphylococcus aureus Bacteremia at a Community Hospital: A Prospective Case–Control Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S109-S110
Author(s):  
Charles Hoffmann ◽  
Gordon Watkins ◽  
Patrick DeSimone ◽  
Peter Hallisey ◽  
David Hutchinson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Case Control Study ◽  
Community Hospital ◽  
Univariate Analysis ◽  
Case Control ◽  
Blood Cultures ◽  
Staphylococcus Aureus Bacteremia ◽  
Initial Blood ◽  
Control Study

Abstract Background Staphylococcus aureus bacteremia (SAB) is associated with 30-day all-cause mortality rates approaching 20–30%. The purpose of this case–control study was to evaluate risk factors for 30-day mortality in patients with SAB at a community hospital. Methods As part of an antimicrobial stewardship program (ASP) initiative mandating Infectious Diseases consultation for episodes of SAB, our ASP prospectively monitored all cases of SAB at a 341-bed community hospital in Jefferson Hills, PA from April 2017–February 2019. Cases included patients with 30-day mortality from the initial positive blood culture. Only the first episode of SAB was included; patients were excluded if a treatment plan was not established (e.g., left against medical advice). Patient demographics, comorbidities, laboratory results, and clinical management of SAB were evaluated. Inferential statistics were used to analyze risk factors associated with 30-day mortality. Results 100 patients with SAB were included; 18 (18%) experienced 30-day mortality. Cases were older (median age 76.5 vs. 64 years, P < 0.001), more likely to be located in the intensive care unit (ICU) at time of ASP review (55.6% vs. 30.5%, P = 0.043), and less likely to have initial blood cultures obtained in the emergency department (ED) (38.9% vs. 80.5%, P < 0.001). Variables associated with significantly higher odds for 30-day mortality in univariate analysis: older age, location in ICU at time of ASP review, initial blood cultures obtained at a location other than the ED, and total Charlson Comorbidity Index (CCI). Variables with P < 0.2 on univariate analysis were analyzed via multivariate logistic regression (Table 1). Conclusion Results show that bacteremia due to MRSA and total CCI were not significantly associated with 30-day mortality in SAB, whereas older age was identified as a risk factor. Patients with initial blood cultures obtained at a location other than the ED were at increased odds for 30-day mortality on univariate analysis, which may raise concern for delayed diagnosis. Disclosures All authors: No reported disclosures.

scholarly journals Risk factors associated with death in infants <120 days old with severe pertussis: a case-control study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Cong Liu ◽  
Lin Yang ◽  
Yuwei Cheng ◽  
Hongmei Xu ◽  
Feng Xu
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Case Control Study ◽  
Univariate Analysis ◽  
Laboratory Data ◽  
Case Control ◽  
Factors Associated ◽  
Young Infants ◽  
Protection Method ◽  
Control Study

Abstract Background and purpose Pertussis is a serious infectious disease in young infants, and severe cases frequently cause death. Our study explored risk factors for death from severe pertussis. Method A case-control study of infants with severe pertussis admitted to the paediatric intensive care unit (PICU) in the Children’s Hospital of Chongqing Medical University, China, from January 1, 2013, to June 30, 2019, was conducted. Pertussis was confirmed by clinical features and laboratory examinations. Severe pertussis was defined as patients with pertussis resulting in PICU admission or death. To understand the risk factors for death, we compared fatal and nonfatal cases of severe pertussis in infants aged < 120 days by collecting clinical and laboratory data. Results The participants included 63 infants < 120 days of age with severe pertussis. Fifteen fatal cases were confirmed and compared with 44 nonfatal severe pertussis cases, Four patients with termination of treatment were excluded. In the univariate analysis, the risk factors associated with death included apnoea (P = 0.001), leukocytosis (white blood cell (WBC) count≥30 × 109/L (P = 0.001) or ≥ 50 × 109/L (P = 0)), highest lymphocyte count (P = 0), pulmonary hypertension (P = 0.001), and length of PICU stay (P = 0.003). The multivariate analysis revealed that apnoea (OR 23.722, 95%CI 2.796–201.26, P = 0.004), leukocytosis (OR 63.708, 95%CI 3.574–1135.674, P = 0.005) and pulmonary hypertension (OR 26.109, 95%CI 1.800–378.809, P = 0.017) were significantly associated with death. Conclusion Leukocytosis and pulmonary hypertension exhibited the greatest associations with death in infants with severe pertussis admitted to the PICU. Vaccination is still the most effective protection method against pertussis.

scholarly journals RISK FACTORS FOR WOUND DEHISCENCE AFTER LAPAROTOMY: A CASE-CONTROL STUDY

2017 ◽  
Vol 27 (3) ◽  
pp. 84-88
Author(s):  
Tomas Poškus ◽  
Vilius Mačiūnas ◽  
Marius Kryžauskas ◽  
Saulius Mikalauskas ◽  
Donatas Danys ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Case Control Study ◽  
Univariate Analysis ◽  
Wound Dehiscence ◽  
Case Control ◽  
Control Group ◽  
P Value ◽  
Midline Laparotomy ◽  
Control Study

Background. Wound dehiscence is a life-threatening complication with the mortality rate up to 25 %. The objective of this study is to identify the risk factors for wound dehiscence after midline laparotomy in adult population. Methods. The case control study of patients, operated from January 2012 to May 2016, was performed. Patients, who underwent repeated laparotomy for wound dehiscence, were the cases group. Each case was matched by 3 control group patients undergoing similar primary operation. Following characteristics were observed: demographic, past medical and social history, concomitant diseases, intraoperative details, postoperative outcomes and were compared between the groups. Difference was significant, if p value was less than 0.05. Results. 100 patients were included in the study. There were 25 (25 %) patients of the cases group and 75 (75 %) patient of the control group. The majority of the patients were males (69 %). The mean age was 66.7 ± 10.8 years. Three risk factors were identified in the univariate analysis: male gender (88.0 %), wound infection (56 %) and cardiovascular diseases (88 %) for wound dehiscence with the mortality rate of 20 %. Conclusions. Wound dehiscence is a serious complication with a high mortality rate. The identification of preoperative and early postoperative risk factors may allow preventing and reduce the rate of wound dehiscence.

370. Risk factors of pulmonary edema among patients with pre-eclampsia : A case control study

2018 ◽  
Vol 13 ◽  
pp. S138
Author(s):  
Anish Keepanasseril ◽  
Joel Monarrez Espino ◽  
Dilip Kumar Maurya ◽  
V Priyadharshini ◽  
Ajith ananthakrishna Pillai
Keyword(s):  
Risk Factors ◽  
Pulmonary Edema ◽  
Case Control Study ◽  
Case Control ◽  
Control Study

scholarly journals Severe acquired subglottic stenosis in neonatal intensive care graduates: a case–control study

2017 ◽  
Vol 103 (4) ◽  
pp. F349-F354 ◽  
Author(s):  
Rebecca E Thomas ◽  
Shripada C Rao ◽  
Corrado Minutillo ◽  
Shyan Vijayasekaran ◽  
Elizabeth A Nathan
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Case Control Study ◽  
Surgical Intervention ◽  
Conditional Logistic Regression ◽  
Univariate Analysis ◽  
Case Control ◽  
Subglottic Stenosis ◽  
Control Study

ObjectiveTo analyse current incidence and risk factors associated with severe acquired subglottic stenosis (SASGS) requiring surgical intervention in neonates.DesignRetrospective case–control study.SettingSole tertiary children’s hospital.ParticipantsPatients who underwent surgical intervention for SASGS from January 2006 to December 2014. For each neonatal intensive care unit (NICU) graduate with acquired SASGS, two controls were selected (matched for gestation and year of birth).Main outcomes and measuresIncidences were calculated and cases and controls compared using conditional logistic regression analysis to identify risk factors for SASGS.ResultsThirty-seven NICU graduates required surgical intervention for SASGS of whom 35 were <30-week gestation at birth. The incidence of SASGS in surviving children who had required ventilation in the neonatal period was 27/2913 (0.93%). Incidence was higher in infants <28-week gestation (24/623=3.8%) compared with infants ≥28-week gestation (3/2290=0.13%; p=0.0001). On univariate analysis, risk factors for SASGS were: higher number of intubations (4 vs 2; p<0.001); longer duration ventilation (16 vs 9.5 days; p<0.001); unplanned extubation (45.7% vs 20.0%; p=0.007); traumatic intubation (34.3% vs 7.1%; p=0.003) and oversized endotracheal tubes (ETTs) (74.3% vs 42.9%; p=0.001). On multivariate analysis, risk factors for SASGS were: Sherman ratio >0.1 (adjusted OR (aOR) 6.40; 95% CI 1.65 to 24.77); more than five previous intubations (aOR 3.74; 95% CI 1.15 to 12.19); traumatic intubation (aOR 3.37; 95% CI 1.01 to 11.26).ConclusionsSASGS is a serious consequence of intubation for mechanical ventilation in NICU graduates, especially in preterm infants. Minimising trauma during intubations, avoiding recurrent extubation/reintubations and using appropriate sized ETTs may help prevent this serious complication.

Risk factors of pulmonary edema in women with preeclampsia from south India: a case-control study

2020 ◽  
Vol 34 (10) ◽  
pp. 727-734
Author(s):  
Anish Keepanasseril ◽  
Joel Monárrez-Espino ◽  
Priyadarshini Vadivelu ◽  
Dilip Kumar Maurya
Keyword(s):  
Risk Factors ◽  
Pulmonary Edema ◽  
South India ◽  
Case Control Study ◽  
Case Control ◽  
Control Study

Factors associated with adult poisoning in Northern Malaysia: a case-control study

2006 ◽  
Vol 25 (4) ◽  
pp. 167-173 ◽  
Author(s):  
A I Fathelrahman ◽  
A F Ab Rahman ◽  
Z Mohd Zain ◽  
M A Tengku
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Predictor Variable ◽  
Case Control ◽  
Factors Associated ◽  
And Gender ◽  
Medical Wards ◽  
Control Study

Data on adult risk factors associated with drug or chemical poisonings in Malaysia are scarce. The objective of the study was to identify possible risk factors associated with adult admissions to the Penang General Hospital (PGH) due to chemical poisoning and/or drug overdose. The present study was a case-control study, conducted over 18 weeks. One hundred acutely poisoned adult patients admitted to PGH during the period from September 2003 to February 2004 were considered as cases. Two hundred patients admitted to the same medical wards for other illnesses, during the same period, were matched for age and gender with the poisoned cases and thus selected as controls. McNemar test and binary logistic were used for univariate analysis and logistic regression analysis for multivariate analyses. The odds ratio (OR) and its 95% confidence interval (95% CI) were calculated for each predictor variable. Positive histories of psychiatric illness and previous poisoning, problems in boy/girl friend relationships, family problems, marital problems, Indian ethnicity, Chinese ethnicity, living in rented houses and living in a household with less than five people were significant risk factors associated with adult admissions due to poisoning.

scholarly journals Risk factors of carbapenem-resistant Enterobacteriaceae infection and colonisation: a Malaysian tertiary care hospital based case-control study

2021 ◽  
Vol 51 (1) ◽  
pp. 24-30
Author(s):  
Chuan Chuah ◽  
◽  
Yasmin Gani ◽  
Benedict Sim ◽  
Suresh Chidambaram
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Case Control ◽  
High Morbidity ◽  
Care Hospital ◽  
Carbapenem Resistant ◽  
Control Study ◽  
Carbapenem Resistant Enterobacteriaceae

Background Carbapenem-resistant Enterobacteriaceae (CRE) infection has become a major challenge to clinicians. The aim of this study is to identify the risk factors of acquiring CRE to guide more targeted screening for hospital admissions. Methods This is a retrospective case-control study (ratio 1:1) where a patient with CRE infection or colonisation was matched with a control. The control was an individual who tested negative for CRE but was a close contact of a patient testing positive and was admitted at the same time and place. Univariate and multivariate statistical analyses were done. Results The study included 154 patients. The majority of the CRE was Klebsiella species (83%). From univariate analysis, the significant risk factors were having a history of indwelling devices (OR: 2.791; 95% CI: 1.384–5.629), concomitant other MDRO (OR: 2.556; 95% CI: 1.144–5.707) and hospitalisation for more than three weeks (OR: 2.331; 95% CI: 1.163–4.673). Multivariate analysis showed that being unable to ambulate on admission (adjusted OR: 2.345; 95% CI: 1.170–4.699) and antibiotic exposure (adjusted OR: 3.515; 95% CI: 1.377–8.972) were independent predictors. The in-hospital mortality rate of CRE infection was high (64.5%). CRE acquisition resulted in prolonged hospitalisation (median=35 days; P<0.001). Conclusion CRE infection results in high morbidity and mortality. On top of the common risk factors, patients with mobility restriction, prior antibiotic exposures and hospitalisation for more than three weeks should be prioritised in the screening strategy to control the spread of CRE.

scholarly journals 2451. Hospital-acquired Legionella Pneumonia Outbreak at an Academic Medical Center. A Case–control Study of Risk Factors

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S847-S848
Author(s):  
Michael Kessler ◽  
Fay Osman ◽  
Aurora E Pop-Vicas ◽  
Nasia Safdar
Keyword(s):  
Risk Factors ◽  
Water Samples ◽  
Molecular Typing ◽  
Case Control Study ◽  
Univariate Analysis ◽  
Case Control ◽  
Solid Organ ◽  
Legionella Pneumonia ◽  
Hospital Acquired ◽  
Control Study

Abstract Background An outbreak of hospital-acquired Legionella pneumonia, associated with potable water contamination, occurred at our university hospital in November of 2018, despite a longstanding copper-silver ionization system. We conducted a case–control study to examine risk factors for Legionella pneumonia. Methods We matched controls to cases by dates of admission, hospital ward, and admitting service, in a 4:1 ratio. We reviewed patient charts for potential risk factors and exposures, and summarized demographic information using descriptive analyses. Univariate and multiple logistic regression analyses were also performed. We used pulsed-field gel electrophoresis for molecular typing of isolates from patient respiratory samples and hospital water samples. Results We identified 13 cases of nosocomial legionella pneumonia over a one-month period (Figure 1), with 8 males, 5 females, and a mean age of 63 years. The average time to diagnosis was 19 days following admission. Six patients were transplant recipients – two had solid organ, and six had bone marrow transplant. Urinary Legionella antigen was positive in all cases. Table 1 shows predictors for Legionella pneumonia in univariate analyses. Current smoking (OR = 7.5, 95% CI [1.11 – 50.84], p = 0.03], pre-admission steroid prescription (OR = 6.5, 95% CI [1.65 – 26.20], p = 0.008], documentation of shower (OR = 6.2, 95% CI [1.54 – 25.82], p = 0.01], and number of showers prior to hyper-chlorination (OR = 1.45, 95% CI [1.03 – 2.04], p = 0.03] were significant risk factors on univariate analysis. The multiple regression model was also significant (P < 0.001) with all of the above-identified predictors (Table 2). Molecular typing found Legionella strains from patient respiratory samples and water samples to be identical. Multiple interventions, including restriction of showering, hyper-chlorination, and optimization of water flow through the copper-silver ionization system were implemented, and were successful in mitigating the outbreak. Conclusion We found showering to be a modifiable risk factor for Legionella pneumonia in this outbreak. Interventions to reduce this risk might include point of use filters in showers in high-risk populations. Disclosures All authors: No reported disclosures.

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