Analysis of Risk Factors for Non-union After Surgery for Limb Fractures: A Case-Control Study of 669 Subjects

Objective: The purpose of this study was to analyze the risk factors for limb fracture non-union in order to improve non-union prevention and early detection.Methods: A total of 223 patients with non-union after surgery for limb fractures performed at our institution from January 2005 to June 2017 were included as the case group, while a computer-generated random list was created to select 446 patients with successful bone healing after surgery for limb fractures who were treated during the same period as the control group, thus achieving a ratio of 1:2. The medical records of these patients were reviewed retrospectively. Age, sex, body mass index, obesity, smoking, alcohol, diabetes, hypertension, osteoporosis, fracture type, multiple fractures, non-steroidal anti-inflammatory drugs (NSAIDs) use, delayed weight bearing, internal fixation failure, and infection data were analyzed and compared between the two groups. A multivariate logistic regression model was constructed to determine relevant factors associated with non-union.Results: After comparison between two groups by univariate analysis and multivariate logistic regression, we found some risk factors associated that osteoporosis (odds ratio [OR] = 3.16, 95% confidence interval [CI]: 2.05–4.89, p < 0.001), open fracture (OR = 2.71, 95%CI: 1.72–4.27, p < 0.001), NSAIDs use (OR = 2.04, 95%CI: 1.24–3.37, p = 0.005), delayed weight bearing (OR = 1.72, 95%CI: 1.08–2.74, p = 0.023), failed internal fixation (OR = 5.93, 95%CI: 2.85–12.36, p < 0.001), and infection (OR = 6.77, 95%CI: 2.92–15.69, p < 0.001) were independent risk factors for non-union after surgery for limb fractures.Conclusions: Osteoporosis, open fracture type, NSAIDs use, delayed weight bearing, failed internal fixation, and infection were found to be the main causes of bone non-union; clinicians should, therefore, take targeted measures to intervene in high-risk groups early.

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Analysis of Risk Factors for Non-Union After Surgery for Limb Fractures: A Case-Control Study of 669 Subjects

10.21203/rs.3.rs-74785/v1 ◽

2020 ◽

Author(s):

Qiang Xu ◽

Bin Zhang ◽

Min Dai ◽

Xuqiang Liu

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Internal Fixation ◽

Weight Bearing ◽

Multivariate Logistic Regression Analysis ◽

Control Group ◽

Fracture Type ◽

Multivariate Logistic Regression ◽

Non Union ◽

Limb Fractures

Abstract Objective: Although a large number of clinical and animal experimental studies have explored factors affecting fracture healing, there are only a few examples of systematic research on these factors for limb fractures. The purpose of this study was to analyse the risk factors for limb fracture non-union in order to improve non-union prevention and early detection.Methods: A total of 223 patients with non-union after surgery for limb fractures performed at our institution from January 2005 to June 2017 were included as the case group, while a computer-generated random list was created to select 446 patients with successful bone healing who were treated during the same period as the control group, thus achieving a ratio of 1:2. The medical records of these patients were reviewed retrospectively. Age, sex, body mass index, obesity, smoking, alcohol, diabetes, hypertension, osteoporosis, fracture type, multiple fractures, non-steroidal anti-inflammatory drugs (NSAIDs) use, delayed weight bearing, internal fixation failure, and infection data were analysed and compared between the two groups. A multivariate logistic regression model was constructed to determine relevant factors associated with non-union.Results: The multivariate logistic regression analysis revealed that osteoporosis, open fractures, NSAIDs use, delayed weight bearing, failed internal fixation, and infection were independent risk factors for non-union after surgery for limb fractures.Conclusions: Osteoporosis, open fracture type, NSAIDs use, delayed weight bearing, failed internal fixation, and infection were found to be the main causes of bone non-union; clinicians should, therefore, take targeted measures to intervene in high-risk groups early.

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Nomogram for predicting reoperation following internal fixation of nondisplaced femoral neck fractures in elderly patients

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02697-8 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Jian Zhu ◽

Hongzhi Hu ◽

Xiangtian Deng ◽

Yiran Zhang ◽

Xiaodong Cheng ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Femoral Neck ◽

Elderly Patients ◽

Internal Fixation ◽

Calibration Curve ◽

Weight Bearing ◽

Femoral Neck Fractures ◽

Multivariate Logistic Regression ◽

Independent Risk Factors

Abstract Objective We aimed to evaluate risk factors and develop a nomogram for reoperation after internal fixation of nondisplaced femoral neck fractures (FNFs) in elderly patients. Methods We conducted a retrospective study involving a total of 255 elderly patients who underwent closed reduction and internal fixation with cannulated screw system for nondisplaced FNFs between January 2016 and January 2019. We collected data on demographics, preoperative radiological parameters, surgery, serum biochemical markers, and postoperative rehabilitation. In addition, we performed univariate and multivariate logistic regression analyses to determine independent risk factors for reoperation, and then developed a nomogram to assess the risks of reoperation. Besides, discriminative ability, calibration, and clinical usefulness of the nomogram were evaluated using the concordance index (C-index), the receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA), respectively. We employed bootstrap method to validate the performance of the developed nomogram. Results Our analysis showed that among the 255 patients, 28 (11.0%) underwent reoperation due to osteonecrosis of the femoral head (14 cases), mechanical failure (8 cases) or nonunion (6 cases). All of the 28 patients underwent conversion surgery to arthroplasty. The multivariate logistic regression analysis demonstrated that preoperative posterior tilt angle ≥ 20°, Pauwel’s III type, younger patients, preoperative elevated levels of alkaline phosphatase (ALP), preoperative hypoalbuminemia, and early postoperative weight-bearing were independent risk factors for reoperation. In addition, the C-index and the bootstrap value of the developed nomogram was 0.850 (95% CI = 0.803–0.913) and 0.811, respectively. Besides, the calibration curve showed good consistency between the actual diagnosed reoperation and the predicted probability, while the DCA indicated that the nomogram was clinically valuable. Conclusions Our analysis showed we successfully developed and validated a nomogram for personalized prediction of reoperation after internal fixation of nondisplaced FNFs in elderly patients. This model would help in individualized evaluation of the need for reoperation and inform strategies aimed at eliminating the need for the reoperation.

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Factors associated with depression in the patients with diabetes mellitus type 2

Vojnosanitetski pregled ◽

10.2298/vsp170328029s ◽

2019 ◽

Vol 76 (11) ◽

pp. 1178-1183 ◽

Cited By ~ 1

Author(s):

Admir Sabanovic ◽

Natasa Maksimovic ◽

Mirjana Stojanovic-Tasic ◽

Marijan Bakic ◽

Anita Grgurevic

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Diabetes Mellitus Type 2 ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Factors Associated

Background/Aim. The assessment of association of depression and diabetes mellitus type 2 using the Patient Health Questionaire (PHQ-9) has not been done in Montenegro. The aim of this study was to assess the prevalence of depression in the patients with type 2 diabetes mellitus, and to identify the risk factors associated with the presence of depression. Methods. A cross-sectional study was conducted at the General Hospital in Bijelo Polje, from July to September, 2015. It included 70 patients over 35 years of age with the diagnosis of diabetes for at least six months. For the assessment of depression presence and intensity PHQ?9 was used. All variables associated with the presence of depression at a significance level of p < 0.05 were included into the final method of the multivariate logistic regression analysis. Results. Comorbidities were statistically significant more frequent among patients with depression (?2 = 5.40; p = 0.020). Duration of diabetes over five years was significantly associated with depression (?2 = 12.48; p < 0.001). Depression occurred more frequently among physically inactive subjects (?2 = 10.74; p = 0.005). The presence of diabetic polyneuropathy (?2 = 6.04; p = 0.014) and cataract (?2 = 5.351; p = 0.021) were also significantly associated with depression. A multivariate logistic regression analysis showed that the duration of diabetes over five years and presence of cataract were independently associated with depression. Conclusion. The risk factors for depression among the subjects with diabetes were disease duration more than five years and the presence of cataract. Since depression is a serious disease and can be a risk factor for many chronic diseases, the best way of prevention is its early detection and treatment.

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Forced Sexual Victimization Among Youth in Custody: Do Risk Factors Vary by Gender and Perpetrator?

The Prison Journal ◽

10.1177/0032885519894561 ◽

2019 ◽

Vol 100 (2) ◽

pp. 151-172

Author(s):

Eileen M. Ahlin

Keyword(s):

Risk Factors ◽

Gender Differences ◽

Logistic Regression ◽

National Survey ◽

Regression Models ◽

Sexual Victimization ◽

Multivariate Logistic Regression ◽

Logistic Regression Models ◽

Factors Associated ◽

Using Data

There is relatively little literature examining risk factors associated with sexual victimization among youth in custody. The current study explored whether risk of forced sexual victimization among youth in custody differs by gender or perpetrator. Using data from a sample of 8,659 youth who participated in the National Survey of Youth in Custody, multivariate logistic regression models were employed to investigate gender differences in risk factors associated with overall forced sexual victimization and staff-on-inmate and inmate-on-inmate forced sexual victimization. Findings suggest that gender differences are more pronounced when perpetrator type is considered.

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Incidence and risk factors for hypoglycemia in patients with hepatocellular carcinoma

10.21203/rs.3.rs-905429/v1 ◽

2021 ◽

Author(s):

XiaoJing Zheng ◽

Hong-Hong Yan ◽

Bin Gan ◽

Xiao-Ting Qiu ◽

Jie Qiu ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Logistic Regression ◽

Hba1c Level ◽

Glycated Hemoglobin ◽

Multivariate Logistic Regression Analysis ◽

Cancer Center ◽

Regression Analyses ◽

Multivariate Logistic Regression ◽

Factors Associated

Abstract AimTo evaluate the incidence and risk factors for hypoglycemia in patients with hepatocellular carcinoma (HCC).MethodsWe collected and analyzed the clinical data of patients with HCC in our cancer center between April 2020 and June 2021. Univariate and multivariate logistic regression analyses were performed to identify the risk factors associated with hypoglycemia.ResultsThe incidence rate of hypoglycemia in patients with HCC was 28.9% (67/232). Multivariate logistic regression analysis showed a significant association between hypoglycemia and Child-Pugh grade C (odds ratio [OR]=7.3, 95% confidence interval [CI] 2.28–23.31, p=0.001), alpha-fetoprotein (AFP) level (OR=1.000035, 95% CI 1.000007–1.000063, p=0.015), and glycated hemoglobin (HbA1c) level (OR=0.46, 95% CI 0.29–0.73, p=0.001).ConclusionChild-Pugh stage and HbA1c and AFP levels were associated with hypoglycemia in patients with HCC. Our study suggests that these three factors should be comprehensively considered when estimating the risk of hypoglycemia in these patients, and the diagnosis, treatment, and nursing plan should be adjusted in time to reduce the incidence of hypoglycemia.

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Prevalence, Awareness and Risk Factors of Hypertension among Public Sector Workers Aged 40 Years and above in the Tamale Metropolis of Ghana

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i1731045 ◽

2021 ◽

pp. 202-213

Author(s):

Mishio Bawa Elijah ◽

Mensah-Onumah Deborah ◽

Julius Tieroyaare Dongdem ◽

Cletus Adiyaga Wezena

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Scale Up ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Hypertension Status ◽

Factors Associated ◽

Awareness Campaigns ◽

Physical Measurements ◽

Tamale Metropolis

Aim: To determine the prevalence, awareness and risk factors associated with hypertension among adults. Study Design: Cross-sectional study. Place and Duration of Study: Tamale Metropolis from January to March 2020. Methodology: 200 adults (101 men and 99 females) aged 40 years and above were recruited. Socio-demographic characteristics, anthropometric and blood pressure data of participants collected through face-to-face administered questionnaire and physical measurements were analyzed for prevalence, knowledge and awareness of hypertension. Binary and multivariate logistic regression was used to estimate the odds of association of risk factors with hypertension. Results: Overall age-standardized prevalence of hypertension was 46.00% (49.50% in males, 42.42% in females). The prevalence of both systolic and diastolic hypertension was higher in males than in females. 49.10% of hypertensive participants were unaware of their status at the time of this study and 83.3% of the hypertensive participants who were aware of their status were diagnosed incidentally. Multivariate logistic regression analysis revealed a significant positive association of being male [AOR = 2.39, (95% CI: 1.08–5.30)], aged between 50 – 65 years [AOR = 2.03, (95% CI: 1.03–4.01)], and being obese [AOR = 3.64, (95% CI: 1.43–9.29)] with hypertension. Being widowed [AOR = 0.06, (95% CI: 0.01–0.66)] was negatively associated with hypertension. Only obesity [AOR = 2.81, (95% CI: 1.29–6.14)] was independently associated with hypertension. Conclusion: Hypertension affects one in every two adults aged 40 years and above in the Tamale Metropolis of Ghana. Awareness of adult hypertension status in the Metropolis is very low with the most diagnoses of the disease occurring accidentally. Obesity, advancing age, being male and being widowed are risk factors associated with hypertension. The study suggests workplace BP screening and a scale-up of awareness campaigns in the Metropolis to curb the incidence of the disease and control associated risk factors.

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Risk factors associated with stillbirth of piglets born from oxytocin-assisted parturitions

Veterinary World ◽

10.14202/vetworld.2020.2172-2177 ◽

2020 ◽

Vol 13 (10) ◽

pp. 2172-2177

Author(s):

Nguyen Hoai Nam ◽

Peerapol Sukon

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Models ◽

Significant Risk ◽

Gestation Length ◽

Stillbirth Rate ◽

Multivariate Logistic Regression ◽

Crown Rump Length ◽

Logistic Regression Models ◽

Factors Associated

Aim: The present study aimed to investigate the effects of different risk factors on stillbirth of piglets born from oxytocin-assisted parturitions. Materials and Methods: Data were collected from a total of 1121 piglets born from 74 Landrace x Yorkshire crossbred sows from a herd. Logistic regression models were used to determine the associations between stillbirth and different risk factors including parity (1, 2, 3-5, and 6-10), gestation length (GL) (112-113, 114-116, and 117-119 days), litter size, birth order (BO), sex, birth interval (BI), cumulative farrowing duration, birth weight (BW), crown rump length, BW deviation, body mass index, ponderal index (PI), and the use of oxytocin during expulsive stage of farrowing. Results: The incidence of stillbirth at litter level and stillbirth rate was 59.5% (44/74) and 8.1% (89/1094), respectively. The final multivariate logistic regression selected BO, BI, PI, GL, and parity as the five most significant risk factors for stillbirth. Increased BO and BI, GL <114 and >116 days, parity 6-10, and low PI increased the stillbirth rate in piglets. Conclusion: Several factors previously determined as risks for stillbirth in exogenous oxytocin-free parturitions also existed in exogenous oxytocin-assisted parturitions. One dose of oxytocin at fairly high BO did not increase stillbirth, whereas two doses of oxytocin were potentially associated with increased values.

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Seroprevalence of bovine coronavirus and factors associated with the serological status in dairy cattle in the western region of Thailand

Veterinary World ◽

10.14202/vetworld.2021.2041-2047 ◽

2021 ◽

pp. 2041-2047

Author(s):

Samnang Ven ◽

Pipat Arunvipas ◽

Preeda Lertwatcharasarakul ◽

Niorn Ratanapob

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Dairy Cattle ◽

Western Region ◽

Multivariate Logistic Regression ◽

Bovine Coronavirus ◽

Exact Test ◽

Factors Associated ◽

Serological Status ◽

The Western Region

Background and Aim: Bovine coronavirus (BCoV) is a pathogen affecting the productivities of dairy cattle worldwide. The present study aimed to determine the seroprevalence and factors associated with BCoV serological status using a commercial indirect enzyme-linked immunosorbent assay (ELISA). Materials and Methods: A cross-sectional study was conducted in the western region of Thailand. Blood samples were collected from 30 dairy herds. In total, 617 blood serum samples were tested using a commercial indirect ELISA for BCoV-specific immunoglobulin G antibodies. A questionnaire was used to collect data on the factors which have been identified as risk factors for BCoV antibody detection. The age and history of diarrhea of each animal were recorded. Fisher's exact test was performed to univariately assess the association between BCoV serological status and possible risk factors. Variables with Fisher's exact test p<0.10 were then evaluated using multivariate logistic regression to identify factors associated with BCoV serological status. The Bonferroni adjustment was used for multiple comparisons of significant variables in the final multivariate logistic regression model. Results: No herd was free from antibodies to BCoV. The individual seroprevalence of BCoV was 97.89% (604/617). The prevalence within herds was in the range of 45.45-100%. Cattle >3 years of age were more likely to be seropositive to BCoV compared to cattle <1 year of age (p=0.003), with the odds ratio being 81.96. Disinfecting diarrhea stools were a protective factor for being BCoV seropositive, with odds ratios of 0.08 and 0.06 compared to doing nothing (p=0.008) and to clean with water (p=0.002), respectively. Conclusion: BCoV seropositive dairy cattle were distributed throughout the western region of Thailand. The probability of being seropositive for BCoV increased with increasing animal age. Cleaning the contaminated stool with appropriate disinfectants should be recommended to farmers to minimize the spread of the virus.

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Adults Aging With Spinal Cord Injury: Prevalence and Associated Risk Factors for Diagnosis of Diabetes Mellitus

Innovation in Aging ◽

10.1093/geroni/igab046.3170 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 877-877

Author(s):

Junha Park ◽

Lisa Bratzke

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Logistic Regression ◽

Model Systems ◽

Multivariate Logistic Regression ◽

Factors Associated ◽

Cord Injury ◽

Associated Risk Factors

Abstract With the increased life expectancy, people aging with spinal cord injury (SCI) are more likely to experience chronic conditions, including diabetes mellitus (DM). The results of previous literature related to the prevalence of DM are mixed and risk factors associated with diagnosis of DM after SCI are not well defined. This study aims to investigate the prevalence of DM and explore associated risk factors for diagnosis of DM among adults aging with long-standing spinal cord injury in the United States. This is a secondary data analysis using the National Spinal Cord Injury Model Systems Database. Participants included 516 people age 45 and older who have been living with SCI for more than 10 years. The prevalence of DM in this sample was 13.2%. Multivariate logistic regression, controlling for confounding variables, was conducted to identify risk factors associated with DM diagnosis in this sample. The multivariate logistic regression model found that the participants who responded with less severe SCI measured by the ASIA impairment scale were less likely to be diagnosed with DM (OR=0.332, p=.017). Also, DM was found to be significantly associated with BMI (OR=1.043, p=.010) and age (OR=1.038, p= .010) respectively. Duration of disability was not significantly associated with DM. Future research is needed to validate these findings and identify other common risk factors for DM such as diet/nutrition. Further, exploration of the effect size of risk factors is also warranted. Such findings will inform interventions to aid prevention and early detection of DM.

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Anatomical and technical factors associated with superior facet joint violation in lumbar fusion

Journal of Neurosurgery Spine ◽

10.3171/2017.6.spine17130 ◽

2018 ◽

Vol 28 (2) ◽

pp. 173-180 ◽

Cited By ~ 8

Author(s):

Alisson R. Teles ◽

Michael Paci ◽

Gabriel Gutman ◽

Fahad H. Abduljabbar ◽

Jean A. Ouellet ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Surgical Technique ◽

Facet Joint ◽

Lumbar Fusion ◽

Screw Placement ◽

Multivariate Logistic Regression ◽

Factors Associated ◽

Facet Joint Violation ◽

Superior Level

OBJECTIVEThe aim of this study was to evaluate the anatomical and surgical risk factors for screw-related facet joint violation at the superior level in lumbar fusion.METHODSThe authors conducted a retrospective review of a consecutive series of posterior lumbar instrumented fusions performed by a single surgeon. Inclusion criteria were primary lumbar fusion of 1 or 2 levels for degenerative disorders. The following variables were analyzed as possible risk factors: surgical technique (percutaneous vs open screw placement), depth of surgical field, degree of anterior slippage of the superior level, pedicle and facet angle, and facet degeneration of the superior level. Postoperative CT scans were evaluated by 2 independent reviewers. Axial, sagittal, and coronal views were reviewed. Pedicle screws were graded as intra-articular if they clearly interposed between the superior and inferior facet joints of the superior level. Multivariate logistic regression analyses were conducted to assess the factors associated with this complication.RESULTSOne hundred thirty-one patients were included. Interobserver reliability for facet joint violation assessment was high (κ = 0.789). The incidence of superior facet joint violation was 12.59% per top-level screw (33 of 262 proximal screws). The rate of facet violation was 28.0% in the percutaneous technique group (14 of 50 patients) and 12.3% in the open surgery group (10 of 81 patients) (OR 2.26, 95% CI 1.09–4.21; p = 0.024). In multivariate logistic regression analysis, independent predictors of facet violation were percutaneous screw placement (adjusted OR 3.31, 95% CI 1.42–7.73; p = 0.006), right-side pedicle screw (adjusted OR 3.14, 95% CI 1.29–7.63; p = 0.011), and facet angle > 45° (adjusted OR 10.95, 95% CI 4.64–25.84; p < 0.0001).CONCLUSIONSThe incidence of facet joint violation was higher in percutaneous minimally invasive than in open technique for posterior lumbar spine surgery. Also, coronal orientation of the facet joint is a significant risk factor independent of the surgical technique.

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