scholarly journals Clinical characteristics and factors influencing the outcome of hospitalised COVID-19 patients in a semi-urban primary healthcare center

2021 ◽  
Vol 14 (2) ◽  
pp. 42-54
Author(s):  
Wasim Md Mohosin Ul Haque ◽  
Chinmay Saha Podder ◽  
Nandini Chowdhury ◽  
Md Mohim Ibne Sina ◽  
SKM Shameem Kawser ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Outcome ◽  
Severe Disease ◽  
Tertiary Care ◽  
Chronic Obstructive ◽  
Care Hospital ◽  
Rt Pcr ◽  
District Health ◽  
Factors Associated ◽  
Negative Outcome

Background and objectives: Various new manifestations and risk factors for COVID-19 have been unveiled in the course of the current pandemic. Understanding the clinical spectrums as well as the risk factors associated with the adverse outcome of the disease is critical to combat this pandemic. This study was conducted to identify the clinical features, overall outcome and the factors associated with adverse outcome of the hospitalised COVID-19 patients in a semi-urban healthcare setting. Methods: This study was conducted at Debidwar Upazila (sub-district) Health Complex under the Cumilla district from April 2020 to October 2020. Reverse transcriptase-polymerase chain reaction (RT-PCR) positive COVID-19 patients, aged 18 years and above, admitted at the Health Complex were enrolled in the study. All patients were followed till their recovery, referral or death. The data were collected in a pre-designed semi-structured questionnaire that included demographic, epidemiological, clinical and laboratory parameters. Result: Out of 50 RT-PCR positiveCOVID-19 adult participants, 30 (60%) were males and 20 (40%) were females. Twenty-four percent, 36%, and 40% of the patients had mild, moderate and severe disease respectively. The most common clinical symptom was fever (96%), followed by cough (86%) and shortness of breath (60%). Hypertension (54%), diabetes mellitus (40%), bronchial asthma (20%) and chronic obstructive pulmonary disease (COPD, 14%) were the major co-morbid conditions. Of the total cases, 2 (4%) died and 8 (16%) required referral to tertiary care hospital while 40 (80%) recovered. COPD was associated with poor outcome (OR 19; 95% CI: 2.88, 125.31; p < 0.05). Smokers were 7 times more likely to exhibit the negative outcome than non-smokers (95% CI: 1.52, 32.33; p < 0.05). Conclusion: In this study, COPD was associated with a negative outcome. Further study with larger sample should be carried out to determine the spectrum of risk factors. Ibrahim Med. Coll. J. 2020; 14(2): 42-54

scholarly journals Role of BAP 65 (Blood Urea Nitrogen, Altered Mental Status, Pulse, Age 65 Years) Scoring System in Risk Stratification of Patients with Acute Exacerbation of Chronic Obstructive Lung Disease in Tertiary Care Hospital

2019 ◽  
Vol 2 (2) ◽  
pp. 5-10
Author(s):  
Ashish Thapa
Keyword(s):  
Mechanical Ventilation ◽  
Acute Exacerbation ◽  
Severe Disease ◽  
Tertiary Care ◽  
Chronic Obstructive Lung Disease ◽  
Institutional Review Boards ◽  
Mortality Data ◽  
Chronic Obstructive ◽  
P Value ◽  
Care Hospital

Introduction: Exacerbations are important events in the management of COPD because they negatively impact health status, rates of hospitalization and readmission, and disease progression. COPD AE is one of the commonest case presenting to the TUTH Emergency, average being 5 patients a day. The aim of the study was to co-relate the BAP 65 score, mortality and mechanical ventilation in patients with acute exacerbation of COPD. Methods: It was an observational study, 648 patients from emergency of TUTH were screened for the study from Magh 2073 to Asar 2074 after getting approval from the institutional review boards, among them 114 were included after applying inclusion and exclusion criteria and BAP 65 score was calculated. The patients were followed till discharge, mechanical ventilation or mortality. Data entry was done in MS EXCEL and statistical analysis was done using SPSS version 24. Results: Total of 114 patients enrolled for the study from the emergency of TUTH. There were total 16 mortality and 12 patients were mechanically ventilated. Most of the mortality and mechanical ventilation were from severe group ie BAP class IV and V. We used Pearson Chi-squared test to compare between BAP 65 class and Mortality, and found that mortality rate increased with increasing BAP 65 class with a p value of < 0.0001. The need of Mechanical Ventilation increased as well, as the BAP 65 Class increased, less than 1% of the patients with BAP class I needed MV, the cause being Type II Respiratory Failure, while around 50% of the patients with BAP class V needed MV. Conclusions: BAP 65 score is an effective and simple tool to classify the patients presenting with AECOPD, it correlated well with both the need of mechanical ventilation and mortality. Higher the score higher the chances of severe disease.

scholarly journals Incidence, Etiology and Risk Factors Associated with Mortality of Nosocomial Candidemia in a Tertiary Care Hospital in Istanbul, Turkey

2010 ◽  
Vol 19 (6) ◽  
pp. 463-467 ◽  
Author(s):  
Ilknur Erdem ◽  
Naz Oguzoglu ◽  
Derya Ozturk Engin ◽  
Asu Ozgultekin ◽  
Asuma Sengoz Inan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Factors Associated ◽  
Nosocomial Candidemia

scholarly journals Recurrent Emergency Department Users: Two Categories with Different Risk Profiles

2019 ◽  
Vol 8 (3) ◽  
pp. 333 ◽  
Author(s):  
Ksenija Slankamenac ◽  
Meret Zehnder ◽  
Tim Langner ◽  
Kathrin Krähenmann ◽  
Dagmar Keller
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Emergency Services ◽  
Hospital Admissions ◽  
Tertiary Care ◽  
Chronic Obstructive ◽  
Care Hospital ◽  
Co Morbidity ◽  
Ed Visits ◽  
Morbidity Index

Recurrent emergency department (ED) visits are responsible for an increasing proportion of overcrowding. Therefore, our aim was to investigate the characteristics and prevalence of recurrent ED visitors as well as to determine risk factors associated with multiple ED visits. ED patients visiting the ED of a tertiary care hospital at least four times consecutively in 2015 were enrolled. Of 33,335 primary ED visits, 1921 ED visits (5.8%) were performed by 372 ED patients who presented in the ED at least four times within the one-year period. Two different categories of recurrent ED patients were identified: repeated ED users presenting always with the same symptoms and frequent ED visitors who were suffering from different symptoms on each ED visit. Repeated ED users had more ED visits (p < 0.001) and needed more hospital admissions (p < 0.010) compared to frequent ED users. Repeated ED users visited the ED more likely due to symptoms from chronic obstructive pulmonary diseases (p < 0.001) and mental disorders (p < 0.001). In contrast, frequent ED patients showed to be at risk for multiple ED visits when being disabled (p = 0.001), had an increased Charlson co-morbidity index (p = 0.004) or suffering from rheumatic diseases (p < 0.001). A small number of recurrent ED visitors determines a relevant number of ED visits with a relevance for and impact on patient centred care and emergency services. There are two categories of recurrent ED users with different risk factors for multiple ED visits: repeated and frequent. Therefore, multi-professional follow-up care models for recurrent ED patients are needed to improve patients’ needs, quality of life as well as emergency services.

scholarly journals Acute Febrile Encephalopathy in Children: A Prospective Study of Clinical Features, Etiology, Mortality, and Risk Factors from Western India

2018 ◽  
Vol 09 (01) ◽  
pp. 019-025 ◽  
Author(s):  
Kirti Gupta ◽  
Charul S. Purani ◽  
Anirban Mandal ◽  
Amitabh Singh
Keyword(s):  
Risk Factors ◽  
Respiratory Failure ◽  
Clinical Features ◽  
High Mortality ◽  
Tertiary Care ◽  
Primary Objective ◽  
Medical Emergency ◽  
Western India ◽  
Care Hospital ◽  
Factors Associated

ABSTRACT Introduction: Acute febrile encephalopathy (AFE) in children is a medical emergency and could be a manifestation of many systemic and central nervous system pathologies. The clinical features of AFE are nonspecific and etiological spectrum variable depending on the studied population. Materials and Methods: A prospective, observational study was carried out including children aged between 1 month and 12 years with AFE admitted to the Pediatric Intensive Care Unit of a tertiary care hospital in Western India. The primary objective was to assess the clinical presentation and etiology of AFE while the secondary objectives were to correlate the clinical and etiological findings and to determine the risk factors associated with mortality. Results: Out of the ninety children with AFE included in this study, male:female ratio was 1.2:1; most of them were aged between 1 and 5 years and came with a history of <7 days (82.2%). All of them had altered sensorium, about 2/3rd had seizures and 47.8% having a Glasgow Coma Score (GCS) <8. Etiology remained elusive in about 40% of the cases, and viral infections were the most common among the ones with an identifiable cause. A variety of morbidity (shock, disseminated intravascular coagulopathy, respiratory failure, etc.) and high mortality (40%) was observed with risk factors associated with mortality being GCS <8, the presence of raised intracranial pressure, shock, and respiratory failure. Conclusion: AFE, though a rare diagnosis in children, is associated with significant morbidity and high mortality in a developing country like India.

scholarly journals A Hospital based cross sectional study to find out factors associated with disease severity and length of hospital stay in COVID-19 patients in Tertiary Care Hospital of Ahmedabad city

2021 ◽  
Vol 33 (2) ◽  
pp. 256-259
Author(s):  
Arpit Chelabhai Prajapati ◽  
Mansi Maulik Patel ◽  
Hardika Jamanadas Khanpara ◽  
Rujul Pankajbhai Shukla ◽  
Donald Shailendra Christian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Disease Severity ◽  
Tertiary Care Hospital ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Care Hospital ◽  
Factors Associated ◽  
High Dependency

Background: Tertiary hospital care may vary from isolation bed ward care to high dependency units (HDUs) with oxygen support to intensive care unit (ICU) where patients may be intubated for mechanical ventilation The major risk factors for severe disease are age more than 60 years and underlying diseases like diabetes, hypertension. COVID-19 patients present at varying levels of severity. Understanding how long patients hospitalized with COVID-19 remain in hospital is critical for planning. Objectives: 1. To determine risk factors associated with disease severity 2. To determine risk factors associated with length of hospital stay in COVID-19 patients 3. To study the disease outcome Material & Methods: This was retrospective record-based study of inpatients with COVID-19 at Tertiary Care Hospital of Ahmedabad City. All patients admitted at tertiary care hospital diagnosed with COVID-19 between April 2020 to June, 2020, were included in present study. Inclusion criteria were all COVID-19 patients admitted at tertiary care hospital during the duration of April 2020 to June 2020. Results: A total of 916 COVID-19 patients were included in the study. Out of 916 total admitted patients 526 (57.4%) were male. 174 (19%) patients having one or more comorbidities like diabetes, hypertension, tuberculosis, heart diseases etc. Total 769 discharged (83.9%), 115 deaths (12.6%) and 32 transferred to other COVID-19 hospital (3.5%) out of total 916 patients admitted during study period. Conclusion: Severity of disease and deaths were associated with age and comorbidities. COVID-19 patients with comorbidities have more deteriorating outcomes compared with patients without.

scholarly journals An Assessment of Risk Factors Associated with Osteoarthritis: A Study in a Tertiary Care Hospital of Bangladesh

2021 ◽  
Vol 9 (3) ◽  
pp. 98
Author(s):  
Shamsul Alam ◽  
Erfanul Huq Siddiqui ◽  
Sheikh Forhad ◽  
Anjumun Ara ◽  
Jannat Sultana
Keyword(s):  
Risk Factors ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Factors Associated

scholarly journals Risk Factors Associated With Sino-Nasal Polyposis And Its Relationship With The Occupational Inhalants

2019 ◽  
Vol 09 (04) ◽  
pp. 290-293
Author(s):  
Qaisar Sajad ◽  
Ayub Musani ◽  
Faheem Ahmed Khan
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Nasal Polyposis ◽  
Local Population ◽  
Tertiary Care ◽  
Nasal Allergy ◽  
Care Hospital ◽  
Common Risk Factor ◽  
Factors Associated ◽  
Number Of Patients

Objective: To determine the risk factors associated with sino-nasal polyposis and its relationship with the exposure of occupational inhalants in patients presenting in a tertiary care hospital of Karachi. Study design and Settings: Cross-sectional study conducted at department of otorhino-laryngology Karachi Medical & Dental College and Abbasi Shaheed Hospital Karachi for a period of two and a half years from October 2015 to April 2018. Methodology: Total number of patients included for this study were 221 patients with diagnosis of bilateral and multiple nasal polyposis with age greater than 10 years. Specifically, designed proforma was used for data collection specially in relation with occupation and exposure to different occupational inhalants and entered in SPSS version 23 for analysis. Results: There were 133 male and 88 female patient with a mean age was 36.16 ± 12.33 years. Mostly patients belonged to poor socio-economic status i.e. 133 (60.70%). Allergic rhinitis or nasal allergy was the most common risk factor present in 114 patients (51.6%) while aspirin hypersensitivity was the least common risk factor present in only 19 patients (8.5%). Most of the patients (76 or 34.4%) were related with one or the other form of agriculture and were exposed to different occupational inhalants like mud, pollens, animals and plants. Conclusions: Nasal allergy is the most common risk factor and occupational inhalant specially related with agriculture, poultry and pets are the common agents responsible for nasal polyposis in our local population.

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