Risk factors associated with irreversible airway obstruction in nonsmoking adult patients with severe asthma

2014 ◽  
Vol 35 (5) ◽  
pp. 72-79 ◽  
Author(s):  
Maciej Ciebiada ◽  
Mateusz Domagała ◽  
Małgorzata Gorska-Ciebiada ◽  
Paweł Gorski
Keyword(s):  
Risk Factors ◽  
Airway Obstruction ◽  
Severe Asthma ◽  
Adult Patients ◽  
Factors Associated ◽  
Irreversible Airway Obstruction

scholarly journals Risk Factors Associated with Irreversible Airway Obstruction in Asthma: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Lanlan Zhang ◽  
Lixiu He ◽  
Jin Gong ◽  
Chuntao Liu
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Atopic Dermatitis ◽  
Airway Obstruction ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Case Control Studies ◽  
Smoking Exposure ◽  
Asthma Patients ◽  
Irreversible Airway Obstruction

Irreversible airway obstruction (IAO) is a subtype of asthma and relates to poorer prognosis in some asthma patients. However, the prevalence and risk factors for IAO are unknown. A systematic review regarding controlled clinical studies (cohort, case-control studies) on IAO asthma in adult and/or children affected by asthma/early wheeze was performed. Eighteen papers were identified in this study. It was reported that the incidence of IAO at random effects or fixed effects in severe asthma and nonsevere asthma was 0.54 (95% CI: 0.45–0.62) and 0.16 (95% CI: 0.12–0.20), respectively. In IAO asthma, the pooled odds ratio (OR) related to smoking exposure was 2.22 (95% CI: 1.82–2.73), the OR for male, smoking, and fractional exhaled nitric oxide (FENO) was 2.22 (95% CI: 1.82–2.7), 1.79 (95% CI: 1.46–2.19), and 2.16 (95% CI: 1.05–4.43), respectively, suggesting these factors increase the risk of IAO. However, a decreased OR in IAO asthma was observed due to rhinitis (OR = 0.31, 95% CI: 0.24–0.40), atopy (OR = 0.584, 95% CI: 0.466–0.732), and atopic dermatitis (OR = 0.60, 95% CI: 0.42–0.85), indicating these factors are associated with reduced risk of IAO. IAO in asthma is associated with gender, smoking, FENO, rhinitis, atopy, and atopic dermatitis.

Risk Factors Associated With Falls in Adult Patients After Stroke Living in the Community: Baseline Data From a Stroke Cohort in Brazil

2014 ◽  
Vol 21 (3) ◽  
pp. 220-227 ◽  
Author(s):  
Elen Beatriz Pinto ◽  
Carla Nascimento ◽  
Camila Marinho ◽  
Ilana Oliveira ◽  
Maiana Monteiro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Baseline Data ◽  
Adult Patients ◽  
Factors Associated

Risk Factors for the Development of Nosocomial Pneumonia and Its Clinical Impact in Cardiac Surgery

2021 ◽  
Author(s):  
Ferdinand Jr Rivera Gerod ◽  
Edgar Ongjoco ◽  
Rod Castro ◽  
Armin Masbang ◽  
Elmer Casley Repotente ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Hospital Mortality ◽  
Nosocomial Pneumonia ◽  
Clinical Impact ◽  
Adult Patients ◽  
Mortality And Morbidity ◽  
Factors Associated ◽  
Prolonged Icu Stay

Abstract BackgroundThe development of nosocomial pneumonia after cardiac surgery is a significant post-operative complication that may lead to increased morbidity, mortality, and hospital cost. We aimed to identify risk factors associated with it and to determine its clinical impact in terms of in-hospital mortality and morbidity.MethodsThis is a retrospective cohort study conducted among all adult patients who underwent cardiac surgery from 2014-2019 in St. Luke’s Medical Center, Quezon City, Philippines. Baseline characteristics and possible risk factors for pneumonia were retrieved from medical records. Nosocomial pneumonia was based on the Centers for Disease Control and Prevention criteria. Clinical outcomes include in-hospital mortality and morbidity. Odds ratios from logistic regression was computed to determine risk factors associated with pneumonia using STATA 15.0.ResultsOut of 373 patients included in this study, 104 (28%) patients acquired pneumonia. Most surgeries were coronary artery bypass graft (CABG) (71.58%), followed by valve repair/replacement (29.76%). Neither age, sex, BMI, diabetes, LV dysfunction, renal dysfunction, COPD/asthma, urgency of surgery, surgical time, nor smoking showed association in the development of pneumonia. However, preoperative stay of >2 days was associated with 92.3% (95%CI 18–213%) increased odds of having pneumonia (p=.009). Also, every additional hour on mechanical ventilation conferred 0.8% (95%CI, 0.3–1%) greater odds of acquiring pneumonia (p=.003).Patients who developed pneumonia had 3.9 times odds of mortality (95%CI 1.51–9.89, p=.005), 3.8 times odds of prolonged hospitalization (95%CI 1.81–7.90,p<.001), 6.4 times odds of prolonged ICU stay (95%CI 3.59–11.35,p<.001), and 9.5 times odds of postoperative reintubation (95%CI 3.01–29.76,p<.001). ConclusionAmong adult patients undergoing cardiac surgeries, prolonged preoperative hospital stay and prolonged mechanical ventilation were both associated with an increased risk for nosocomial pneumonia. Those who developed pneumonia had worse outcomes with significantly increased in-hospital mortality, prolonged hospitalization, prolonged ICU stay, and increased postoperative re-intubation. Clinicians should therefore minimize delays in surgery to avoid unnecessary exposure to pathogenic organisms. Also, timely liberation from mechanical ventilation after surgery should be encouraged.

scholarly journals Risk factors Associated to Extubation Failure in Adult Patients in an Intensive Care Unit of the City of Cali

2017 ◽  
Vol 15 (2) ◽  
pp. 237
Author(s):  
Deiby Alomía ◽  
Mirdza Coral ◽  
Sindy Ortegón ◽  
Rodolfo Soto ◽  
Vilma Muñoz
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Extubation Failure ◽  
Adult Patients ◽  
Apache Ii ◽  
Factors Associated ◽  
Factores De Riesgo ◽  
The City ◽  
Los Grupos

Objetivo: identificar los factores de riesgo asociados a la extubación fallida en pacientes adultos hospitalizados en una Unidad de Cuidados Intensivo de una clínica de III nivel de la ciudad de Cali, durante el período transcurrido entre junio de 2012 y junio de 2014. Materiales y métodos: estudio de casos y controles, de pacientes adultos que requirieron ventilación mecánica mayor a 48 horas. Los pacientes que fallaron en la extubación (casos) se compararon con los pacientes que fueron extubados exitosamente (control), se analizaron la edad, el índice de oxigenación PaO2/FIO2, el balance de líquidos, la hemoglobina, los días de ventilación mecánica, el tipo de destete y la mortalidad. Resultados: la población estuvo conformada por 130 pacientes, de los cuales 26 (20%) tuvieron una extubación fallida (casos). No hubo diferencias significativas entre los grupos en relación a la edad, género, diagnóstico y comorbilidades. El destete prolongado fue el único factor asociado a la extubación fallida 3,17 (ic 95% 1,01-9,90). No se observó una rela- ción estadísticamente signi cativa entre PaO2/FIO2, Hb, balance hídrico o escala Apache II con la ocurrencia de extubación fallida. La mortalidad fue más alta en el grupo de casos (23,1% vs 2,9%) con un or 10,1 (ic 95% 1,9-65,8). Conclusiones: el destete prolongado fue el único factor asociado al fracaso en la extubación. El riesgo de morir de un paciente con una extubación fallida fue 10 veces el riesgo de un paciente con una extubación exitosa.

Risk factors for irreversible airway obstruction after infant bronchiolitis

2021 ◽  
pp. 106545
Author(s):  
Riikka Riikonen ◽  
Matti Korppi ◽  
Sari Törmänen ◽  
Petri Koponen ◽  
Kirsi Nuolivirta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Airway Obstruction ◽  
Irreversible Airway Obstruction

scholarly journals Predicting Inpatient Mortality Among Encephalitis Patients: A Novel Admission Risk Score

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Michael A Hansen ◽  
Mohammed S Samannodi ◽  
Rodrigo Hasbun
Keyword(s):  
Risk Factors ◽  
Clinical Features ◽  
Risk Score ◽  
Risk Groups ◽  
Adult Patients ◽  
Charlson Score ◽  
Care Providers ◽  
Inpatient Mortality ◽  
Factors Associated ◽  
System 1

Abstract Background Identifying underlying commonalities among all-cause encephalitis cases can be extraordinarily useful in predicting meaningful risk factors associated with inpatient mortality. Methods A retrospective cohort of patients with encephalitis was derived from a clinical chart review of adult patients (age ≥18 years) across 16 different hospitals in Houston, Texas, between January 2005 and July 2015. Clinical features at admission were assessed for their correlation with inpatient mortality and used to derive a final risk score prediction tool. Results The study included a total of 273 adult patients with all-cause encephalitis, 27 (9.9%) of whom died during hospitalization. A limited number of clinical features were substantially different between patients who survived and those who died (Charlson score, Glasgow coma scale [GCS], immunosuppression, fever on admission, multiple serologic studies, and abnormal imaging). A final multivariable logistic model was derived with the following risk factors, which were transformed into a scoring system: 1 point was assigned to the presence of a Charlson score &gt;2, thrombocytopenia, or cerebral edema, and 2 points for a GCS value &lt;8. Patients were then classified into different risk groups for inpatient mortality: 0 points (0%), 1 point (7%), 2 points (10.9%), 3 points (36.8%), and ≥4 points (81.8%). Conclusions The risk score developed from this study shows a high predictive value. This can be highly beneficial in alerting care providers to key clinical risk factors associated with in-hospital mortality in adults with encephalitis.

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