scholarly journals Clinical and Laboratory Predictors of Mortality in Patients With SARS-CoV-2 Infection in A Tertiary Care Center of Central Kerala, India - A Case control Study

2021 ◽  
Vol 6 (4) ◽  
pp. 111-120
Author(s):  
Priyanka Rajmohan ◽  
◽  
Anil Kumar Chellappan pillai Chellappan pillai Rajamma ◽  
Mimtha Ayiravelil Mohanan ◽  
Ponnu Jose ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Serum Creatinine ◽  
Case Control Study ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Case Control ◽  
Hospital Death ◽  
Predictors Of Mortality ◽  
Multivariable Logistic Regression ◽  
Control Study

Background: Since various studies indicate differences in the case fatality rate of SARS-CoV-2 in different settings, it is vital to elucidate the clinical and laboratory parameters. This would be helpful in identifying individuals who are susceptible to adverse outcomes, thereby targeting essential health interventions to resource poor settings. This study aimed to determine the clinical and laboratory predictors of mortality due to COVID-19. Materials & Methods: In this case control study, we included 162 adult inpatients who died due to COVID-19 from May 2020 to February 2021, as cases (n=81) and those discharged as controls (n=81). Demographic, clinical, treatment, and laboratory data was extracted from medical records and electronic database and compared between survivors and non-survivors. Univariate analysis and multivariable logistic regression methods were used to identify the risk factors associated with in-hospital death. Results: Comorbidities were present among 82 (50.6%) participants. Hypertension was the most common comorbidity 99(61.1%) followed by diabetes mellitus 92 (56.8%) and coronary artery disease 55(34%). Multivariable logistic regression model showed that cardiovascular disease (OR=5.80, 95%CI: 1.09–47.55, P=0.011), decreased oxygen saturation (OR=33.68, 95%CI: 2.81–403.80, P=0.006), elevated CRP (OR=1.16, 95%CI: 1.01–1.32, P=0.026), and serum creatinine (OR=3.26, 95%CI: 1.02–11.55, P=0.047) were the significant predictors of mortality. Conclusion: This study found that comorbidities such as CAD, elevated serum creatinine, elevated inflammatory markers, and decreased O2 saturation were independent predictors of mortality among COVID-19 patients.

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 Risk factors of non-typhoidal Salmonella gastroenteritis in hospitalised young children: a case–control study

2021 ◽  
Vol 5 (1) ◽  
pp. e000898
Author(s):  
Pei Yee Woh ◽  
May Pui Shan Yeung ◽  
E Anthony S Nelson ◽  
William Bernard III Goggins
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Hong Kong ◽  
Young Children ◽  
Case Control Study ◽  
Case Control ◽  
Public Hospitals ◽  
Potential Implication ◽  
Multivariable Logistic Regression ◽  
Control Study

ObjectiveTo explore risk factors associated with non-typhoidal Salmonella gastroenteritis in young children in Hong Kong.DesignA case–control study.SettingPaediatrics wards at three public hospitals in Hong Kong.ParticipantsCases were children aged above 30 days to below 5 years hospitalised for gastroenteritis at three public hospitals in Hong Kong with culture confirmed non-typhoidal Salmonella infection. Controls were age-matched (±2 months) children admitted for a reason other than gastroenteritis.Main outcomes measuresA face-to-face interview by using standardised questionnaire on exposures 3 days prior to illness. Adjusted OR (aORs) and 95% CIs were calculated using multivariable logistic regression.ResultsA total of 102 cases and 204 age-matched controls were included in the analysis. Multivariable logistic regression revealed that having food purchased from places other than a supermarket, that is, from wet market/restaurant/farm (aOR, 2.64; 95% CI, 1.03 to 6.77; p=0.044) was a significant risk factor for non-typhoidal Salmonella infection. Having a household member with gastroenteritis symptoms (aOR, 2.03; 95% CI, 0.94 to 4.39; p=0.072) was of borderline significance and playing at a children’s indoor playroom was a protective factor (aOR, 0.28; 95% CI, 0.09 to 0.85; p=0.024).ConclusionsConsumption of food purchased from places other than a supermarket was the identified determinant factor for non-typhoidal Salmonella gastroenteritis in Hong Kong. Parents/caregivers should be alerted to this risk when choosing foods for their young children. The protective effect of playing in an indoor playroom could be confounded by socioeconomic factors and further investigation is required to better understand its potential implication. There was some support for person-to-person transmission and good family hygiene needs to be emphasised.

scholarly journals Risk factors and etiology of neonatal sepsis after hospital delivery: A case-control study in a tertiary care hospital of Rajshahi, Bangladesh

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242275
Author(s):  
Md. Abdur Rafi ◽  
M. Morsed Zaman Miah ◽  
Md. Abdul Wadood ◽  
Md. Golam Hossain
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Neonatal Sepsis ◽  
Case Control Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Control ◽  
Care Hospital ◽  
Multiple Logistic Regression ◽  
Control Study

Background Sepsis is one of the major causes of neonatal death worldwide as well as in Bangladesh. The objective of the present study was to identify the risk factors and causative organisms of neonatal sepsis after delivery in a tertiary care hospital, Bangladesh. Methods This was a case-control study conducted in the neonatal ward of Rajshahi Medical College Hospital (RMCH), a 1000-bed tertiary hospital situated in Rajshahi, Bangladesh. Neonates diagnosed as neonatal sepsis by clinical and laboratory parameters were included as cases in this study. Admitted neonates unsuspected or undiagnosed for sepsis were considered as controls. Maternal and neonatal information and their laboratory reports were collected and analyzed. Both bivariate and multiple logistic regression models were used to identify the risk factors of neonatal sepsis. Results A total of 91 cases and 193 controls were included in the study. Maternal history of urinary tract infection (UTI) during the third trimester of pregnancy (aOR 2.75, 95% CI: 1.04–7.23, p <0.05), premature birth (aOR 2.77, 95% CI: 1.08–7.13, p <0.05) and APGAR score <7 at five minutes (aOR 2.58, 95% CI: 1.04–6.39, p <0.05) were associated with onset of neonatal sepsis in multiple logistic regression model. All these factors were also associated with developing early-onset neonatal sepsis, while maternal UTI and male sex of neonates were associated with developing late-onset neonatal sepsis. Escherichia coli (40.7%), Staphylococcus aureus (27.5%), and Klebsiella pneumoniae (18.7%) were the commonly isolated organisms causing neonatal sepsis. All these organisms were highly resistant to common antibiotics like amoxicillin, cephalosporins, aminoglycosides and quinolones. Carbapenemase group of drugs along with amikacin, nitrofurantoin and linezolid were the most sensitive drugs. Conclusions Strengthening the existing facility for antenatal screening for early diagnosis and treatment of maternal infection during pregnancy as well as identifying high-risk pregnancy for adequate perinatal management is necessary to prevent neonatal sepsis-related morbidity and mortality. Rational use of antibiotics according to local epidemiology and culture and sensitivity reports may minimize the increasing hazards of antibiotic resistance.

Predictors of mortality among neonates hospitalized with neonatal sepsis: a case control study from southern Ethiopia

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Tadele Bekele ◽  
Hailu Merga ◽  
Tamiru Tesfaye ◽  
Henok Asefa
Keyword(s):  
Logistic Regression ◽  
Respiratory Distress ◽  
General Hospital ◽  
Neonatal Mortality ◽  
Neonatal Sepsis ◽  
Case Control Study ◽  
Case Control ◽  
Southern Ethiopia ◽  
Predictors Of Mortality ◽  
Control Study

Abstract Background Neonatal sepsis, which resulted from bacterial, viral, and fungal invasions of the bloodstream, is the major cause of neonatal mortality and neurodevelopmental impairment among neonates. It is responsible for more than one-third of neonatal deaths in Ethiopia. Frequently neonates referred to health facilities are at high risk of death. Hence, assessing and preventing the predictors of mortality in neonatal sepsis helps to reduce the burden of neonatal mortality. Objectives To determine predictors of mortality among neonates admitted with sepsis at Durame general hospital, southern Ethiopia, 2020. Methods Institution-based unmatched case-control study was carried out from March 8 to 30, 2020, among 219 neonates in Durame general hospital in southern Ethiopia. Neonates admitted with sepsis and died were considered as cases and neonates admitted with sepsis and survived (discharged alive) as controls. Cases were selected by taking the deaths of neonates consecutively among those neonates admitted with the diagnosis of neonatal sepsis. The next immediate three corresponding controls were selected by lottery method from the Neonatal Intensive Care Unit (NICU) case registration book. Data was collected by using structured pretested checklists from neonates’ records and then entered into Epi data version 3.1 and exported to SPSS version 20. Logistic regression was used to identify the predictors of mortality. Statistical significance was declared at P < 0.05. Results A total of 55 cases and 164 controls were included in this study. More than three quarters (81.8%) of cases had early onset sepsis. The multivariable logistic regression analysis showed that predictors of mortality in this study were; poor feeding [AOR = 4.15; 95% CI (1.64, 10.49)], respiratory distress [AOR = 2.72; 95% CI (1.31, 5.61)], estimated gestational age less than 37 weeks [AOR = 4.64; 95% CI (2.17, 9.91)], and convulsion [AOR = 3.13; 95% CI (1.12, 8.76)]. Conclusion This study showed that prematurity, convulsion, poor feeding, and respiratory distress were the predictors of sepsis-related neonatal mortality. It is important to pay attention to septicemic babies with any of the identified predictors to reduce sepsis-related mortality.

scholarly journals A Case-Control Study on Maternal caffeine intake during Pregnancy and Risk of Low Birth Weight in Wolaita zone, Southern Ethiopia

2020 ◽  
Author(s):  
Leila Hussen ◽  
Blen Desu
Keyword(s):  
Logistic Regression ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Case Control Study ◽  
Case Control ◽  
World Health ◽  
Caffeine Intake ◽  
Caffeine Consumption ◽  
Multivariable Logistic Regression ◽  
Control Study

Abstract Background: World Health Organization (WHO) recommends caffeine intake during pregnancy should be lower than 300 mg/day. Maternal caffeine intake is associated with adverse birth outcomes. However, little information is available on maternal caffeine consumption during pregnancy and its effect on birth weight. Objective: This study aimed to evaluate the level of maternal caffeine intake during pregnancy and its effect on birth weight in Wolaita zone hospitals in South Ethiopia. .Method: The case-control study design was applied from March 1 to July 30, 2019. A total of 395 mothers (99cases and 296 controls) were interviewed by trained data collectors using a structured and pretested questionnaire. Anthropometric measurements were taken both from mothers and newborns. The association between maternal caffeine intake and birth weight was computed through bivariable and multivariable logistic regression analyses and statistical significance was declared at p-value < 0.05. Results: Mean (±SD) caffeine intake among pregnant women was 342±172 mg/day. A vast majority of the respondents 374(94.7%) consumed caffeine during the current pregnancy, out of this 269(68%) ingested 300mg or more of caffeine per day (high consumers).Relatively more mothers of low birth weight infants were consumed high caffeine 87(87.9%) compared with controls (51.5%). multivariable logistic regression model indicated that those mothers who consumed high caffeine during pregnancy were four times more likely to have a newborn with low birth weight (AOR= 4.1( 95% CI 1.2, 10.1)Conclusion: This research result gives insight for health professional should be aware of the impact of heavy caffeine consumption on birth outcome and try to screen and consulate pregnant mothers who are at risk of having infants with LBW and provide skilled nutritional counseling during ANC visits, including the intake of caffeine.

Risk factors associated with subacromial pain in young athletes: A case control study

2021 ◽  
pp. 1-9
Author(s):  
Zoran Z. Sarcevic ◽  
Andreja P. Tepavcevic
Keyword(s):  
Logistic Regression ◽  
Case Control Study ◽  
Case Control ◽  
Sternoclavicular Joint ◽  
Pectoralis Major ◽  
Young Athletes ◽  
Serratus Anterior ◽  
Significant Difference ◽  
Lower Trapezius ◽  
Control Study

BACKGROUND: Subacromial pain (SAP) is a common complaint of young athletes, independently of the sport engaged. The prevalence of SAP in some sports is up to 50%. OBJECTIVE: The study was aimed to investigate some new factors possibly associated to subacromial pain in young athletes. The factors considered were the grade of tightness of the clavicular portion of the pectoralis major, dysfunction of the sternoclavicular joint, and serratus anterior and lower trapezius strength. METHODS: This case-control study included 82 young athletes 9–15 years, 41 with the symptoms of SAP and 41 controls. All participants self-reported whether they had subacromial pain. In addition, Hawkins–Kennedy Test was performed to all the participants to evaluate the subacromial pressure. Main outcome measures were the grade of tightness of the clavicular portion of the pectoralis major, dysfunction of the sternoclavicular joint, and serratus anterior and lower trapezius strength. The grade of tightness of the clavicular portion of the pectoralis major and the dysfunction of the sternoclavicular joint were measured with an inclinometer. Serratus anterior and lower trapezius strength were measured by a handheld dynamometer with external belt-fixation. The data were analyzed using t-test for independent samples, Mann-Whitney U test, contingency coefficients and a stepwise binary logistic regression. RESULTS: Significant statistical difference was observed in the grade of tightness of the clavicular portion of the pectoralis major and in the variable representing the physiological functioning of the sternoclavicular joint, between the cases and the controls. There was no significant difference in serratus anterior and lower trapezius strength between the cases and the controls. Logistic regression analysis showed that the variable representing the physiological functioning of the sternoclavicular joint and the grade of shortening of the clavicular portion of the pectoralis major were good predictors for presence of SAP. CONCLUSIONS: A strong association was determined between subacromial pain in young athletes, clavicular portion of pectoralis major tightness and the dysfunction of the sternoclavicular joint.

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 Association between insulin resistance and left ventricular hypertrophy in asymptomatic, Black, sub-Saharan African, hypertensive patients: a case–control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bernard Kianu Phanzu ◽  
Aliocha Nkodila Natuhoyila ◽  
Eleuthère Kintoki Vita ◽  
Jean-René M’Buyamba Kabangu ◽  
Benjamin Longo-Mbenza
Keyword(s):  
Insulin Resistance ◽  
Logistic Regression ◽  
Ventricular Hypertrophy ◽  
Case Control Study ◽  
Case Control ◽  
Left Ventricular ◽  
Hypertensive Patients ◽  
Independent Variables ◽  
Sub Saharan ◽  
Control Study

Abstract Background Conflicting information exists regarding the association between insulin resistance (IR) and left ventricular hypertrophy (LVH). We described the associations between obesity, fasting insulinemia, homeostasis model assessment of insulin resistance (HOMA-IR), and LVH in Black patients with essential hypertension. Methods A case–control study was conducted at the Centre Médical de Kinshasa (CMK), the Democratic Republic of the Congo, between January and December 2019. Cases and controls were hypertensive patients with and without LVH, respectively. The relationships between obesity indices, physical inactivity, glucose metabolism and lipid disorder parameters, and LVH were assessed using linear and logistic regression analyses in simple and univariate exploratory analyses, respectively. When differences were observed between LVH and independent variables, the effects of potential confounders were studied through the use of multiple linear regression and in conditional logistic regression in multivariate analyses. The coefficients of determination (R2), adjusted odds ratios (aORs), and their 95% confidence intervals (95% CIs) were calculated to determine associations between LVH and the independent variables. Results Eighty-eight LVH cases (52 men) were compared against 132 controls (81 men). Variation in left ventricular mass (LVM) could be predicted by the following variables: age (19%), duration of hypertension (31.3%), body mass index (BMI, 44.4%), waist circumference (WC, 42.5%), glycemia (20%), insulinemia (44.8%), and HOMA-IR (43.7%). Hypertension duration, BMI, insulinemia, and HOMA-IR explained 68.3% of LVM variability in the multiple linear regression analysis. In the logistic regression model, obesity increased the risk of LVH by threefold [aOR 2.8; 95% CI (1.06–7.4); p = 0.038], and IR increased the risk of LVH by eightfold [aOR 8.4; 95 (3.7–15.7); p < 0.001]. Conclusion Obesity and IR appear to be the primary predictors of LVH in Black sub-Saharan African hypertensive patients. The comprehensive management of cardiovascular risk factors should be emphasized, with particular attention paid to obesity and IR. A prospective population-based study of Black sub-Saharan individuals that includes the use of serial imaging remains essential to better understand subclinical LV deterioration over time and to confirm the role played by IR in Black sub-Saharan individuals with hypertension.

An Outbreak of Pyodermas Among Neonates Caused by Ultrasound Gel Contaminated With Methicillin-SusceptibleStaphylococcus Aureus

2000 ◽  
Vol 21 (12) ◽  
pp. 761-764 ◽  
Author(s):  
Klaus Weist ◽  
Constanze Wendt ◽  
Lyle R. Petersen ◽  
Hans Versmold ◽  
Henning Rüden
Keyword(s):  
Hip Joint ◽  
Case Control Study ◽  
Tertiary Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Case Control ◽  
University Hospital ◽  
Good Physical Condition ◽  
Rapd Pcr ◽  
Control Study

Objective:To investigate an outbreak of methicillin-susceptibleStaphylococcus aureus(MSSA); infections in a neonatal clinic.Design:Prospective chart review, environmental sampling, and genotyping by two independent methods: pulsed-field gel electrophoresis (PFGE) and randomly amplified polymorphic DNA polymerase chain reaction (RAPD-PCR). A case-control study was performed with 31 controls from the same clinic.Setting:A German 1,350-bed tertiary-care teaching university hospital.Results:There was a significant increase in the incidence of pyodermas with MSSA 10 neonates in good physical condition with no infection immediately after birth developed pyodermas. A shared spatula and ultrasound gel were the only identified infection sources. The gel contained MSSA and was used for hip-joint sonographies in all neonates. PFGE and RAPD-PCR patterns from 6 neonates and from the gel were indistinguishable and thus genetically related clones. The case-control study revealed no significant risk factor with the exception of cesarean section (P=.006). The attack rate by days of hip-joint sonography between April 15 and April 27, 1994, was 11.8% to 40%.Conclusions:Inappropriate hygienic measures in connection with lubricants during routine ultrasound scanning may lead to nosocomialS aureusinfections of the skin. To our knowledge this source ofS aureusinfections has not previously been described.

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