Risk factors for hydrocephalus and neurological deficit in children born with an encephalocele

OBJECT There is a known association of hydrocephalus with encephaloceles. Risk factors for hydrocephalus and neurological deficit were ascertained in a series of patients born with an encephalocele. METHODS A retrospective analysis was undertaken of patients treated for encephaloceles at Children's Hospital Los Angeles between 1994 and 2012. The following factors were evaluated for their prognostic value: age at presentation, sex, location of encephalocele, size, contents, microcephaly, presence of hydrocephalus, CSF leak, associated cranial anomalies, and neurological outcome. RESULTS Seventy children were identified, including 38 girls and 32 boys. The median age at presentation was 2 months. The mean follow-up duration was 3.7 years. Encephalocele location was classified as anterior (n = 14) or posterior (n = 56) to the coronal suture. The average maximum encephalocele diameter was 4 cm (range 0.5–23 cm). Forty-seven encephaloceles contained neural tissue. Eight infants presented at birth with CSF leaking from the encephalocele, with 1 being infected. Six patients presented with hydrocephalus, while 11 developed progressive hydrocephalus postoperatively. On univariate analysis, the presence of neural tissue, cranial anomalies, encephalocele size of at least 2 cm, seizure disorder, and microcephaly were each positively associated with hydrocephalus. On multivariate logistic regression modeling, the single prognostic factor for hydrocephalus of borderline statistical significance was the presence of neural tissue (odds ratio [OR] = 5.8, 95% confidence interval [CI] = 0.8–74.0). Fourteen patients had severe developmental delay, 28 had mild/moderate delay, and 28 were neurologically normal. On univariate analysis, the presence of cranial anomalies, larger size of encephalocele, hydrocephalus, and microcephaly were positively associated with neurological deficit. In the multivariable model, the only statistically significant prognostic factor for neurological deficit was presence of hydrocephalus (OR 17.2, 95% CI 1.7–infinity). CONCLUSIONS In multivariate models, the presence of neural tissue was borderline significantly associated with hydrocephalus and the presence of hydrocephalus was significantly associated with neurological deficit. The location of the encephalocele did not have a statistically significant association with incidence of hydrocephalus or neurological deficit. In contrast to modestly good/fair neurological outcome in children with an encephalocele without hydrocephalus, the presence of hydrocephalus resulted in a far worse neurological outcome.

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Association between preoperative serum albumin and prognosis in patients with adrenocortical carcinoma after primary resection: a retrospective study

BMC Cancer ◽

10.1186/s12885-021-08689-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fuxun Zhang ◽

Zhihong Liu ◽

Jiayu Liang ◽

Shengzhuo Liu ◽

Kan Wu ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factor ◽

Serum Albumin ◽

Adrenocortical Carcinoma ◽

Statistical Significance ◽

Univariate Analysis ◽

Primary Resection ◽

Rank Test ◽

Significant Prognostic Factor ◽

Preoperative Serum

Abstract Background Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with a poor prognosis. Given the limited treatment options, prognostic assessment of ACC is increasingly crucial. In this study, we aim to assess the correlation between preoperative serum albumin and prognosis in patients with ACC after primary resection. Methods We retrospectively collected and reviewed medical information about 71 ACC patients who underwent primary resection. Survival analysis was performed by Kaplan–Meier analysis with log-rank test or Breslow test. Receiver operating characteristic (ROC) curve and Jordan index was generated to explore optimal cut-off value of albumin. Univariate and multivariate analysis was conducted using Cox’s hazards model. Statistical significance was defined as P < 0.05. Results Among included patients, 33 patients (46.5%) relapsed at the end of follow-up, while 39 patients (54.9%) died. The median overall survival (OS) of included patients was 17 (range 1–104) months, and median recurrence-free survival (RFS) was 10 (range 0–104) months. In univariate analysis, the albumin was significantly associated with OS (HR:0.491, 95% CI: 0.260–0.930, P = 0.029) and RFS (HR: 0.383, 95% CI: 0.192–0.766, P = 0.007). In multivariate analysis, serum albumin as an independent prognostic factor of OS was confirmed (HR: 0.351, 95% CI: 0.126–0.982, P = 0.046). Conclusions Preoperative albumin might be a significant prognostic factor for ACC patients after primary resection. This result may be useful for risk stratification and management of this rare malignancy.

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Age-Adjusted Charlson Comorbidity Index in Recurrent Glioblastoma: A New Prognostic Factor?

10.21203/rs.3.rs-113876/v1 ◽

2020 ◽

Author(s):

Melanie Barz ◽

Stefanie Bette ◽

Insa Janssen ◽

A. Kaywan Aftahy ◽

Thomas Huber ◽

...

Keyword(s):

Prognostic Factor ◽

Charlson Comorbidity Index ◽

Karnofsky Performance Status ◽

Statistical Significance ◽

Performance Status ◽

Univariate Analysis ◽

Recurrent Glioblastoma ◽

Initial Diagnosis ◽

Significant Prognostic Factor ◽

Comorbidity Index

Abstract Backround: For recurrent glioblastoma (GB) patients, several therapy options have been established over the last years such as more aggressive surgery, re-irradiation or chemotherapy. Age and the Karnofsky Performance Status Scale (KPSS) are used to make decisions for these patients as these are established as prognostic factors in the initial diagnosis of GB. This study’s aim was to evaluate preoperative patient comorbidities by using the age-adjusted Charlson Comorbidity Index (ACCI) as a prognostic factor for recurrent GB patients.Methods: In this retrospective analysis we could include 133 patients with surgery for primary recurrence of GB from January 2007 until December 2016 (49 females, 84 males, mean age 58 years (range 21–80 years)). Preoperative age, sex, ACCI, KPSS and adjuvant treatment regimes were recorded for each patient. Extent of resection (EOR) was recorded as a complete/incomplete (including biopsy) resection of the contrast-enhancing tumor part.Results: Median overall survival (OS) after initial diagnosis was 20.0 months (95% confidence interval (CI) 17.2-22.9)) and 9.0 months (95% CI 7.1-10.9 months) after first re-resection. Preoperative KPSS > 80% (P<0.001) and ACCI <7 (P=0.020) were associated with significantly improved survival in univariate analysis. Including these preoperative factors in multivariate analysis, preoperative KPSS (≥80/<80) is the only significant prognostic factor (HR 1.934[1.3-3.0], P=0.003), whereas ACCI (<7/≥7) missed statistical significance (HR 1.608[0.8-3.1], P=0.154). Conclusion: ACCI might be an additional prognostic factor for patients with recurrent glioblastoma, especially in those with many comorbidities. However, besides the well-established KPSS, the ACCI does not add further information about patients’ prognosis.

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Which Factors Increase the Risk of Re-Operation after Meniscus Surgery in the Skeletally Immature?

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118s00064 ◽

2018 ◽

Vol 6 (7_suppl4) ◽

pp. 2325967118S0006

Author(s):

Neeraj M. Patel ◽

Surya Mundluru ◽

Nicholas Beck ◽

Theodore J. Ganley

Keyword(s):

Risk Factors ◽

Cruciate Ligament ◽

Statistical Significance ◽

Univariate Analysis ◽

Multivariate Model ◽

Skeletally Immature ◽

Initial Surgery ◽

Repeat Operation ◽

Operation Rate ◽

Meniscus Surgery

Objectives: The purpose of this study is to determine which factors heighten the risk for subsequent operations in skeletally immature patients undergoing meniscus surgery. Methods: A retrospective institutional database of 1,063 meniscus surgeries performed between 2000 and 2015 was reviewed. All procedures were performed in skeletally immature patients. Demographic and intra-operative information was recorded, as were concurrent injuries or operations and subsequent surgeries. Univariate analysis consisted of chi-square and independent-samples t-tests. Multivariate logistic regression was then performed to control for confounding factors. Results: The mean age at initial surgery was 13.4 years (standard deviation, SD, 2.2 years) and the average follow-up duration was 47 months (SD 54 months). Overall, 314 patients (29.5%) required repeat surgical intervention. 36% of all females required subsequent surgery compared to 26% of males (p<0.01). Discoid menisci underwent repeat operation more frequently than non-discoid menisci (35% vs. 27%, p=0.01). After accounting for confounders in a multivariate model, females had 2.2 times the odds of repeat surgery than males (95% CI 1.4-3.3, p<0.01) and each year of increasing age resulted in 1.3 times higher odds (95% CI 1.1 -1.4, p<0.01). The odds of subsequent surgeries were 4.2 times higher in those with flap tears (95% CI 1.8-9.7, p<0.01) and 2.9 times higher for discoid menisci (95% CI 1.4-6.0, p<0.01). Concomitant anterior cruciate ligament rupture or tibial spine fracture decreased the risk of needing additional surgeries in univariate analysis, but lost statistical significance in the multivariate model. Conclusion: Even when accounting for other factors in a multivariate model, female sex, increasing age, flap tears, and discoid meniscus were risk factors for subsequent procedures after meniscus surgery in skeletally immature patients. The re-operation rate in this population may be higher than previously reported. This study describes, for the first time, risk factors for repeat operations in skeletally immature patients undergoing meniscus surgery. These results can be used to counsel and monitor patients accordingly.

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Intestinal Microsporidiosis Among HIV/AIDS Patients Receiving Antiretroviral Therapy in Sana’a City, Yemen: First Report on Prevalence and Predictors

10.21203/rs.3.rs-684810/v1 ◽

2021 ◽

Author(s):

Kwkab A. R. Al-Barhami ◽

Rashad Abdul-Ghani ◽

Salah A. Al-Qobati

Keyword(s):

Risk Factors ◽

Antiretroviral Therapy ◽

Large Scale ◽

Statistical Significance ◽

Univariate Analysis ◽

Cell Counting ◽

Cd4 Cells ◽

Aids Patients ◽

Intestinal Microsporidiosis ◽

Hiv Aids

Abstract Background: Intestinal microsporidiosis is an opportunistic infection associated with persistent diarrhea among HIV/AIDS patients. In Yemen, however, its epidemiology is unknown. Therefore, this study determined its prevalence and predictors among HIV/AIDS patients receiving antiretroviral therapy (ART) in Sana'a city, Yemen.Methods: This cross-sectional study included 402 patients receiving ART at Al-Jomhori Educational Hospital in Sana'a from November 2019 to December 2020. Data about demographics, clinical characteristics and risk factors were collected using a pre-designed questionnaire. Stool samples were collected and examined for microsporidian spores using the Gram-chromotrope Kinyoun staining. Blood samples were also collected and used for CD4 cell counting by flow cytometry. Univariate analysis was used to test the association of patients’ characteristics and risk factors with intestinal microsporidiosis. Multivariable logistic regression was then used to identify the independent predictors of infection. Statistical significance was considered at P-values <0.05. Results: Intestinal microsporidiosis was prevalent among 14.2% (57/402) of HIV/AIDS patients but was not significantly associated with any of the studied demographics, source of drinking water, bathing and/or swimming outdoors, contact with soil, presence of domestic animals or indiscriminate defecation. However, it was significantly associated with diarrhea (OR=3.4, 95% CI: 1.7–6.6; P=0.001) and <200 CD4 cells/µl (OR=2.7, 95% CI: 1.5–5.0; P=0.001). The significant independent predictors of infection were <200 CD4 cells/µl (AOR=3.2, 95% CI: 1.5–6.9; P=0.003), not washing hands after contacting soil (AOR=2.5, 95% CI: 1.1–5.4; P=0.026) and before eating (AOR=3.1, 95% CI: 1.5–6.4; P=0.003), eating unwashed raw produce (AOR=2.5, 95% CI: 1.2–5.3; P=0.017) and absence of indoor latrines (AOR=6.2, 95% CI: 1.5–25.9; P=0.012).Conclusions: The prevalence of intestinal microsporidiosis among HIV/AIDS patients in Sana'a is high and comparable to that several other countries, being prevalent among approximately 14.0% of patients and significantly associated with diarrhea. It could be predicted among patients who have <200 CD4 cells/µl, poor hand hygiene after contacting soil and before eating, usually eat unwashed raw produce and do not possess indoor latrines. Large-scale studies on its epidemiology and predictors among HIV/AIDS patients across the country are warranted.

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Ten-year experience with standardized non-operating room anesthesia with Sevoflurane for MRI in children affected by neuropsychiatric disorders

BMC Anesthesiology ◽

10.1186/s12871-019-0897-1 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 5

Author(s):

Silvia Mongodi ◽

Gaia Ottonello ◽

Raffaelealdo Viggiano ◽

Paola Borrelli ◽

Simona Orcesi ◽

...

Keyword(s):

Risk Factors ◽

Clinical Judgment ◽

Statistical Significance ◽

Neuromuscular Disorders ◽

Univariate Analysis ◽

Neuromuscular Diseases ◽

Neuropsychiatric Disorders ◽

University Hospital ◽

Respiratory Complications ◽

Asa Score

Abstract Background Children require anesthesia for MRI to maintain immobility and reduce discomfort; clear indications about the best anesthesiologic management are lacking and each center developed its own protocol. Moreover, children with neuropsychiatric disorders more likely require sedation and are described in literature as more prone to general and respiratory complications. Aim of this study was to analyze the applicability of a sevoflurane-based approach, to describe general and respiratory complications and to identify risk factors in a pediatric neuropsychiatric population. Methods Retrospective cohort study, university Hospital (January 2007–December 2016). All the 1469 anesthesiologic records of children addressed from Neuropsychiatric Unit to undergo MRI under general anesthesia were analyzed; 12 patients equal or older than 18-year-old were excluded. We identified post-hoc nine macro-categories: static encephalopathies, metabolic/evolutive encephalopathies, epileptic encephalopathies, neuromuscular diseases, autistic spectrum disorders, migraine, psychiatric disorders, intellectual disabilities, others. A logistic regression model for events with low frequency (Firth’s penalized likelihood approach) was carried out to identify the mutually adjusted effect among endpoints (complications) and the independent variables chosen on the basis of statistical significance (univariate analysis, p ≤ 0.05) and clinical judgment. Results Of 1457 anesthesiologic records (age 4.0 (IQR 2.0 to 7.0) year-old, males 891 (61.2%), weight 17.0 (IQR 12.0 to 24.9) kg), 18 were cancelled for high anesthesiologic risk, 50 were cooperative, 1389 were anesthetized. A sevoflurane-based anesthesia was feasible in 92.3%; these patients required significantly less mechanical ventilation (8.6 vs. 16.2%; p = 0.012). Complications’ rate was low (6.2%; 3.1% respiratory). The risk for general complications increases with ASA score > 1 (OR 2.22, 95 CI% 1.30 to 3.77, p = 0.003), male sex (OR 1.73, 95% CI 1.07 to 2.81, p = 0.025), multi-drug anesthesia (OR 2.98, 95 CI% 1.26 to 7.06, p = 0.013). For respiratory complications, it increases with ASA score > 1 (OR 2.34, 95 CI% 1.19 to 4.73, p = 0.017), autumn-winter (OR 2.01, 95 CI% 1.06 to 3.78, p = 0.030), neuromuscular disorders (OR 3.18, 95 CI% 1.20 to 8.41, p = 0.020). We had no major complications compromising patients’ outcome or requiring admission to ICU. Conclusions Sevoflurane anesthesia is feasible and safe for children affected by neuropsychiatric disorders undergoing MRI. Specific risk factors for general and respiratory complications should be considered.

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Creatinine Clearance Is More Important Prognostic Factor Than ß2 Microglobulin in Multiple Myeloma.

Blood ◽

10.1182/blood.v104.11.4864.4864 ◽

2004 ◽

Vol 104 (11) ◽

pp. 4864-4864

Author(s):

Jae-Pil Yun ◽

Cheolwon Suh ◽

Eunkyoung Lee ◽

Jai Won Chang ◽

Won Seok Yang ◽

...

Keyword(s):

Multiple Myeloma ◽

Prognostic Factor ◽

Creatinine Clearance ◽

Survival Time ◽

Univariate Analysis ◽

Staging System ◽

Rank Test ◽

Significant Prognostic Factor ◽

Important Prognostic Factor ◽

Stage 1

Abstract In the new staging system of multiple myeloma (MM) by South West Oncology Group (SWOG), the concentration of serum β2 microglobulin (β2m) and serum albumin were focused as the most important prognostic factors for survival. However, serum concentration of β2m has been known as an indicator of glomerular filtration rate. The aim of this study was to compare the prognostic value of the level of β2m with that of creatinine clearance (Ccr) in patients with multiple myeloma. Retrospectively, from January 1, 1996 to November 30, 2003, we reviewed 176 MM patients (M: F 110:66 mean age: 58.5±11.0) whose 24-hour urinary creatinine clearance was available at the time of diagnosis. We collected clinical data such as hemoglobin, serum creatinine, calcium, albumin, β2m, creatinine clearance before chemotherapies, and patients’ survival time. Pretreatment β2m was inversely related to Ccr (Spearman’s correlation coefficient = −0.781, P <0.01). In univariate analysis, relative risk (RR) of death was 1.047 (p< 0.001) for β2m and 0.985 (p< 0.001) for Ccr. But multivariate analysis using Cox’s proportional hazard model showed β2m was not significant prognostic factor in patients’ survival after adjustment for Ccr (RR 1.025, p=0.054) but Ccr was an independent risk factor of death after adjustment for β2m (RR 0.990, p=0.013). And univariate analysis identified that RR for β2m is not significant in 88 MM patients (66 patients with β2m ≥ 2.5mg/l) with relatively normal renal function (Ccr ≥ 50 ml/min) (RR = 1.110, p=0.306) We could propose another new staging system with β2m replaced by Ccr in SWOG staging system. The stages were defined as: stage 1, Ccr ≥ 80ml/min; stage 2, 50< Ccr <80; stage 3, Ccr < 50 and albumin ≥ 3.0g/dl; and stage 4 Ccr < 50 ml/min and albumin< 3.0 g/dl. According to this proposed staging system, median survival time of each stage from 1 to 4 is 1475, 887, 513, and 196 days, respectively. (Log Rank test < 0.0001) In conclusion, Ccr could be more important prognostic factor than the level of β2m in patients of MM and we propose that Ccr should be reassessed as the component of staging system of MM.

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The prognostic significance of the number of extranodal sites in the patients with disseminated diffuse large B-cell lymphoma treated with R-CHOP

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.8570 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 8570-8570

Author(s):

C. Yoo ◽

B. Sohn ◽

J. Kim ◽

D. Yoon ◽

J. Huh ◽

...

Keyword(s):

Prognostic Factor ◽

B Cell ◽

Cell Lymphoma ◽

Univariate Analysis ◽

B Cell Lymphoma ◽

Risk Groups ◽

Stage Iii ◽

Significant Prognostic Factor ◽

Large B Cell Lymphoma ◽

Large B Cell

8570 Background: The combination of rituximab and CHOP chemotherapy (R-CHOP) has improved survival of patients with diffuse large B-cell lymphoma (DLBCL). Recently, several reports have shown that standard International Prognostic Index (IPI) became less powerful prognostic predictor in patients with DLBCL in the era of R-CHOP. We evaluated the prognostic factors of DLBCL patients treated with R-CHOP. Detailed analysis was planned regarding the number of extranodal sites because of its higher frequency in Korea. Methods: Between January 2002 and May 2008, 126 patients with stage III/IV DLBCL treated with R-CHOP were identified. We performed the retrospective analysis of the clinicopathologic factors and verified the predictive power of standard IPI and revised IPI (R-IPI) which was reported by the study group of British Columbia. Various numbers of extranodal sites were analyzed for further stratification and we set E-IPI as the IPI when the number of extranodal sites is stratified in ≤2 vs >2. Results: In the univariate analysis, the number of extranodal sites (≤2 vs >2) was a significant prognostic factor for complete response (CR) (p=0.04), event-free survival (EFS) (p=0.01) and overall survival (OS) (p<0.001). Age was also significant for EFS (p=0.03). When the number of extranodal site was stratified differently (0 vs >0, or ≤1 vs >1), these were not associated with CR, EFS and OS. On the multivariate analysis, the number of extranodal sites (≤2 vs >2) remained significant for EFS (p<0.01, HR 2.6) and OS (p<0.01, HR 3.5). The standard IPI identified 3 risk groups with 2-year EFS; 68%, 55%, 56% (p=0.17) and 2-year OS; 85%, 68%, 58%, respectively (p=0.04). The R-IPI classified 2 risk groups with 2-year EFS; 65%, 50% (p=0.02) and 2-year OS 76%, 62%, respectively (p=0.04). The E-IPI represented 3 risk groups with 2-year EFS; 79%, 56%, 42% (p=0.01) and 2-year OS; 86%, 70%, 39%, respectively (p=0.001). The patient group with survival of less than 50% was only recognized by E-IPI. Conclusions: The number of extranodal sites (≤2 vs >2) is the most significant prognostic factor of EFS and OS. Although all three indices remain predictive, E-IPI is the best model to identify the prognostic group in this cohort with stage III/IV DLBCL treated with R-CHOP. No significant financial relationships to disclose.

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Assessment of cerebrovascular insufficiency with MR-ASL perfusion in patients with moyamoya angiopathy

Medical Visualization ◽

10.24835/1607-0763-883 ◽

2021 ◽

Vol 25 (2) ◽

pp. 102-115

Author(s):

A. A. Shulgina ◽

V. A. Lukshin ◽

E. I. Shults ◽

A. I. Batalov ◽

I. N. Pronin ◽

...

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Neurological Deficit ◽

Univariate Analysis ◽

Statistical Processing ◽

Cerebrovascular Insufficiency ◽

Chi Square ◽

Moyamoya Angiopathy ◽

Average Maximum ◽

Chi Square Test

Purpose. To develop a methodology for assessing the degree of cerebrovascular insufficiency in patients with moyamoya angiopathy (AMM) based on measurement of cerebral blood flow (CBF) and determination the presence of arterial transit artifact (ATA) using MR method of arterial spin labeling (ASL).Materials and methods. The study included 47 patients with AMM who underwent 148 MR studies in PCASL mode (296 hemispheres), of which 47 (94 hemispheres) were done before surgical treatment. On received perfusion maps 7 areas of interest (ROI) were manually set in the gray and white matter of the brain using “Fusion” technique outside the ATA zones. The CBF values at the central point of the ATA were estimated. In the preoperative stage, 47 patients underwent direct angiography to assess the stage of the disease according to Suzuki, the presence and severity of leptomeningeal and transdural collaterals and MR angiography to assess the stage of the disease according to Houkin and the level of ICA stenosis. Statistical processing included univariate analysis of variance (ANOVA) and chi-square test (IBM SPSS Statistics 23).Results. ATA was detected in 77% of studies (69% of hemispheres). The average minimum CBF in ATA was 120.2 ± 21.1 ml/min/ 100 g at the lower bound of the confidence interval of 117.43 ml/min / 100 g. The average maximum CBF in ATA was 234.9. Depending on the CBF values in the MCA territory and the presence of ATA, 4 degrees of perfusion deficiency were identified: degree 0 (CBF = 64.5 ± 16.2 ml/min / 100 g, without ATA) corresponded to the stage of “compensation” of cerebral blood flow, degree 1 (CBF = 61.5 ± 16.6 ml/min/ 100 g, with ATA) – “subcompensation”, degree 2 (CBF = 26.5 ± 7.2 ml/min/100 g, with ATA) – “initial decompensation”, degree 3 (CBF = 16.0 ± 4.7 ml/min / 100 g, without ATA) – “decompensation”. The highlighted degrees statistically significantly differed among themselves in all ROIs (p < 0.0001). More severe perfusion deficiency corresponded to the more developed stages of AMM according to Suzuki and Houkin, proximal stenosis of the ICA (p < 0.0001), and more severe neurological deficit (p < 0.02). The occurrence of ATA reliably reflected the presence of leptomeningeal collaterals (p < 0.001).Conclusions. The proposed method for assessing patterns of ASL perfusion has a good agreement with the stage of the disease, the presence of sources of collateral circulation, the severity of neurological deficit and can be used to assess cerebrovascular insufficiency in patients with AMM.

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THE INCIDENCE AND RISK FACTORS OF CONTRAST INDUCED NEPHROPATHY IN PATIENTS UNDERGOING CORONARY ANGIOPLASTY.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i6.321 ◽

2019 ◽

Vol 3 (6) ◽

Author(s):

Mukesh Kumar Sharma ◽

Pradeep Kurmi ◽

Deepak Ameta ◽

Chandra Bhanu Chandan

Keyword(s):

Risk Factors ◽

Contrast Media ◽

Statistical Significance ◽

Univariate Analysis ◽

Kidney Injury ◽

Coronary Intervention ◽

Contrast Induced Nephropathy ◽

Absolute Increase ◽

Increased Risk ◽

Adequate Hydration

Background: Contrast induced nephropathy remains important cause of hospital-acquired acute kidney injury and affects between 2% of the general population to 50% of high-risk subgroups following coronary intervention. Objectives: To determine the incidence and to study the various risk factors associated with CIN. Patients and Methods: In our study, total of 212 patients (154 males and 58 females) who received non ionic iso osmolar contrast media during percutaneous transluminal coronary intervention (PCI) were included. We diagnosed CIN by a relative increase of >25% or an absolute increase of >0.5 mg/dl in serum creatinine levels two days after procedure. Results: The incidence of CIN in our study was 15.1%. In univariate analysis: age >75 years, hypertention diabetes mellitus (DM), heart failure, hypotension, CKD [creatinine >1.5mg/dl] and increased contrast volume were associated with increased risk of CIN whereas, gender, anemia and use of IABP failed to reach statistical significance. As the number of risk factor and/or volume of contrast increases, the incidence of CIN increases exponentially. Conclusion: Since there is no established treatment for CIN, all possible efforts should be taken to prevent it from occurring by identifying patients at risk. CIN is related with many risk factors, so whenever multiple risk factors are present in an individual patient, lowest dose of contrast should be used and adequate hydration should be given. Key Words: Contrast-induced nephropathy, Non ionic iso-osmolar contrast media, percutaneous coronary intervention.

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Incidence and Risk Factors for Bilateral Nephrolithiasis: A Large Case-retrospective Study

10.21203/rs.3.rs-414196/v1 ◽

2021 ◽

Author(s):

Xiong Yang ◽

Zhi Li ◽

Shiyong Qi ◽

Linguo Xie ◽

Qiduo Shi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Multivariate Analysis ◽

Kidney Stones ◽

Statistical Significance ◽

Univariate Analysis ◽

Renal Stones ◽

Urinary Stones ◽

Preoperative Imaging ◽

History Of

Abstract To determine the incidence and risk factors of bilateral kidney stones. Utilized the retrospective analysis method on demographic characteristics and clinical data of patients with renal stones in the Second Hospital of Tianjin Medical University. Grouped patients into unilateral and bilateral renal stones according to preoperative imaging and ultrasound examination. Univariate and multivariate analysis methods were used to evaluate the factors that may cause bilateral stones. The study included 7587 patients with kidney stones in total, of whom 4983 had unilateral kidney stones (including 2719 left stones and 2264 right stones), and 2604 had bilateral kidney stones (34.3%). By comparing the unilateral stones group with the bilateral stones group, the univariate analysis demonstrated that weight, body mass index (BMI), history of nephrolithiasis, diabetes mellitus (DM), hypertension, gout, and the maximal stone diameter had statistical significance. Binary logistic regression multivariate analysis demonstrated that BMI, history of nephrolithiasis, diabetes mellitus, hypertension, gout, and the maximal stone diameter were independent risk factors for bilateral urinary stones. This study shows that 34.3% of patients with kidney stones were diagnosed as having bilateral kidney stones; BMI and the maximal stone diameter are positively correlated with the incidence of bilateral kidney stones; Patients with a history of nephrolithiasis, diabetes, hypertension, and gout have a significantly higher risk of having bilateral kidney stones.

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