scholarly journals Trending Towards Safer Breast Cancer Surgeries? Examining Acute Complication Rates from A 13-Year NSQIP Analysis

Cancers ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 253 ◽  
Author(s):  
Michael Jonczyk ◽  
Jolie Jean ◽  
Roger Graham ◽  
Abhishek Chatterjee
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Breast Cancer Surgery ◽  
Partial Mastectomy ◽  
Complication Rates ◽  
Acute Complication ◽  
Younger Age ◽  
History Of ◽  
Muscular Flap ◽  
Predictive Risk

As breast cancer surgery continues to evolve, this study highlights the acute complication rates and predisposing risks following partial mastectomy (PM), mastectomy(M), mastectomy with muscular flap reconstruction (M + MF), mastectomy with implant reconstruction (M + I), and oncoplastic surgery (OPS). Data was collected from the American College of Surgeons NSQIP database (2005–2017). Complication rate and trend analyses were performed along with an assessment of odds ratios for predisposing risk factors using adjusted linear regression. 226,899 patients met the inclusion criteria. Complication rates have steadily increased in all mastectomy groups (p < 0.05). Cumulative complication rates between surgical categories were significantly different in each complication cluster (all p < 0.0001). Overall complication rates were: PM: 2.25%, OPS: 3.2%, M: 6.56%, M + MF: 13.04% and M + I: 5.68%. The most common predictive risk factors were mastectomy, increasing operative time, ASA class, BMI, smoking, recent weight loss, history of CHF, COPD and bleeding disorders (all p < 0.001). Patients who were non-diabetic, younger (age < 60) and treated as an outpatient all had protective OR for an acute complication (p < 0.0001). This study provides data comparing nationwide acute complication rates following different breast cancer surgeries. These can be used to inform patients during surgical decision making.

Incidence of postural headache after lumbar puncture requiring epidural blood patch: Effects of needle caliber; 2-year experience

2021 ◽  
pp. 197140092110006
Author(s):  
Warren Chang ◽  
Ajla Kadribegic ◽  
Kate Denham ◽  
Matthew Kulzer ◽  
Tyson Tragon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lumbar Puncture ◽  
Conservative Management ◽  
Epidural Blood Patch ◽  
Female Gender ◽  
Regional Hospital ◽  
Younger Age ◽  
Blood Patch ◽  
History Of ◽  
The Difference

Purpose A common complication of lumbar puncture (LP) is postural headaches. Epidural blood patches are recommended if patients fail conservative management. Owing to a perceived increase in the number of post-lumbar puncture headaches (PLPHs) requiring epidural blood patches at a regional hospital in our network, the decision was made to switch from 20 to 22 gauge needles for routine diagnostic LPs. Materials and methods Patients presenting for LP and myelography at one network regional hospital were included in the study. The patients were contacted by nursing staff 3 days post-procedure; those patients who still had postural headaches after conservative management and received epidural blood patches were considered positive cases. In total, 292 patients were included; 134 underwent LP with 20-gauge needles (53 male, 81 female, average age 57.7) and 158 underwent LP with 22-gauge needles (79 male, 79 female, average age 54.6). Results Of 134 patients undergoing LP with 20-gauge needles, 15 (11%) had PLPH requiring epidural blood patch (11 female, 3 male, average age 38). Of 158 patients undergoing LP with 22-gauge needles, only 5 (3%) required epidural blood patches (all female, average age 43). The difference was statistically significant ( p < 0.01). Risk factors for PLPH included female gender, younger age, lower body mass index, history of prior PLPH and history of headaches. Conclusion Switching from 20-gauge to 22-gauge needles significantly decreased the incidence of PLPH requiring epidural blood patch. Narrower gauge or non-cutting needles should be considered in patients with risk factors for PLPH, allowing for CSF requirements.

scholarly journals Incidence and Risk Factors of Symptomatic Venous Thromboembolism Following Foot and Ankle Surgery

2018 ◽  
Vol 40 (1) ◽  
pp. 98-104 ◽  
Author(s):  
Johanna Marie Richey ◽  
Miranda Lucia Ritterman Weintraub ◽  
John M. Schuberth
Keyword(s):  
Risk Factors ◽  
Hormone Replacement ◽  
Case Series ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Ankle Surgery ◽  
History Of ◽  
Low Incidence ◽  
Predictive Risk

Background: The incidence rate of venous thrombotic events (VTEs) following foot and ankle surgery is low. Currently, there is no consensus regarding postoperative prophylaxis or evidence to support risk stratification. Methods: A 2-part study assessing the incidence and factors for the development of VTE was conducted: (1) a retrospective observational cohort study of 22 486 adults to calculate the overall incidence following foot and/or ankle surgery from January 2008 to May 2011 and (2) a retrospective matched case-control study to identify risk factors for development of VTE postsurgery. One control per VTE case matched on age and sex was randomly selected from the remaining patients. Results: The overall incidence of VTE was 0.9%. Predictive risk factors in bivariate analyses included obesity, history of VTE, history of trauma, use of hormonal replacement or oral contraception therapy, anatomic location of surgery, procedure duration 60 minutes or more, general anesthesia, postoperative nonweightbearing immobilization greater than 2 weeks, and use of anticoagulation. When significant variables from bivariate analyses were placed into the multivariable regression model, 4 remained statistically significant: adjusted odds ratio (aOR) for obesity, 6.1; history of VTE, 15.7; use of hormone replacement therapy, 8.9; and postoperative nonweightbearing immobilization greater than 2 weeks, 9.0. The risk of VTE increased significantly with 3 or more risk factors ( P = .001). Conclusion: The overall low incidence of VTE following foot and ankle surgery does not support routine prophylaxis for all patients. Among patients with 3 or more risk factors, the use of chemoprophylaxis may be warranted. Level of Evidence: Level III, retrospective case series.

scholarly journals Risk Factors for Chronic Pain Following Breast Cancer Surgery: A Prospective Study

2006 ◽  
Vol 7 (9) ◽  
pp. 626-634 ◽  
Author(s):  
Ellen L. Poleshuck ◽  
Jennifer Katz ◽  
Carl H. Andrus ◽  
Laura A. Hogan ◽  
Beth F. Jung ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Chronic Pain ◽  
Prospective Study ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
A Prospective Study

Pattern of Congenital Heart Diseases and Associated Risk Factors among Children at a Tertiary Care Hospital

2021 ◽  
Vol 15 (9) ◽  
pp. 2451-2453
Author(s):  
Shahid Iqbal ◽  
Muhammad Fareed Khan ◽  
Raja Imtiaz Ahmed ◽  
Shahab Saidullah ◽  
Nisar Ahmed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Folic Acid ◽  
Congenital Heart ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Care Hospital ◽  
Younger Age ◽  
History Of ◽  
Associated Risk Factors

Objective: To find out the pattern of CHD and associated risk factors among children presenting at a tertiary care hospital. Study Design: A case-control study. Place and Duration of the Study: The Department of Pediatrics and Department of Cardiology, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawlakot from July 2020 to June 2021. Material and Methods: A total of 207 children of both genders, screened by ECG along with chest x-ray and further confirmed with the diagnosis of CHD through echocardiography were enrolled as cases. Same number of healthy controls (n=207) were recruited from immunization center of the study institution. Among cases, types of CHD were noted. For cases and controls, demographic, antenatal and maternal risk factors including maternal age, gender of the child, history of consanguinity, history of febrile illness in pregnancy, use or multi-vitamin or folic acid in pregnancy, bad obstetrical history and maternal diabetes mellitus were noted. Results: In a total of 414 children (207 cases and 207 controls), there were 219 (53.8%) male. In terms of CHD types among cases, VSD was the most noted in 62 (30.0%), ASD 35 (16.9%), TOF 33 (15.9%) and PDA in 30 (14.5%). Cases were found to have significant association with younger age (78.3% cases below 1 year of age vs. 64.7% in controls, p=0.0085), bad obstetrical history (p=0.0002), history of febrile illness in 1st trimester of pregnancy (p=0.0229) and lack of multivitamins and folic acid in the 1st trimester of pregnancy (p=0.0147). Conclusion: Majority of the children with CHDs were male and aged below 1 year. VSD, ASD, TOF and PDA were the most frequent types of CHD. Younger age, bad obstetrical history, history of febrile illness in 1st trimester of pregnancy and lack of multivitamins and folic acid in the 1st trimester of pregnancy were found to have significant association with CHDs among children. Keywords: Congenital heart disease, echocardiography, ventricular septal defect.

scholarly journals Reproductive risk factors and breast cancer: a case control study from rural India

2015 ◽  
Vol 14 (3) ◽  
pp. 258-264 ◽  
Author(s):  
Vaishali R Mohite ◽  
Asha K Pratinidhi ◽  
Rajsinh Vishwasrao Mohite
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Breast Feeding ◽  
Menopausal Status ◽  
Hormonal Contraceptives ◽  
Reproductive Risk ◽  
History Of ◽  
Reproductive Risk Factors ◽  
Post Menopausal ◽  
Strength Of Association

Background: Breast cancer is the most common type of cancer in women and is influenced by reproductive factors perceived by women worldwide.Aims: To identify the reproductive risk factors of breast cancer in newly diagnosed cases and to find out the strength of association of the risk factors with the breast cancer. Material and Methods: A hospital based case-control study was conducted in Satara district, India during year 2009 to 2011 among newly diagnosed cases of breast cancer and matched controls. A total of 434 participants including 217 cases and 217 controls were enrolled by purposive sampling technique from selected hospitals of study area. The information was collected by employing pre-tested questionnaire by utilizing interview method. Statistical Analysis used: Descriptive statistics, Odds ratio and Chi-square test was used to find out strength of association and statistical significant difference. Results: Highest proportion [31.80%] breast cancer cases was in age group 40-49 years with lowest age of 25 years at diagnosis of the disease. A very high proportion of both cases [88.02%] and controls [67.28%] were Hindu by religion and were from rural residence. Maximum proportion of breast cancer cases were housewives [63.59%], literate [71.42%] and from upper economic class [56.68%]. The proportions of cases were higher as compared to the controls with respect to risk factors like unmarried status, nulliparity, history of abortion, post menopausal status, absence of breast feeding and the history of exposure to hormonal contraceptives. The risk of getting breast cancer as indicated by Odds ratio was 8 times higher in unmarried women, 2.8 times in nulliparous women, 2.4 times with post menopausal status, 10.4 times with absence of breast feeding, 1.5 times with exposure to hormonal contraceptives and 4.5 times with history of ovarian disease respectively. Conclusion: The reproductive risk factors such as unmarried status of women, nulliparity, menopause, absence of breast feeding, history of ovarian disease and use of contraceptives were strongly associated with breast cancer.Bangladesh Journal of Medical Science Vol.14(3) 2015 p.258-264

scholarly journals The incidence and risk factors of frozen shoulder in patients with breast cancer surgery

2019 ◽  
Vol 26 (4) ◽  
pp. 825-828 ◽  
Author(s):  
Chul‐Hyun Cho ◽  
Kyoung‐Lak Lee ◽  
Jihyoung Cho ◽  
Duhan Kim
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Frozen Shoulder ◽  
Cancer Surgery ◽  
Breast Cancer Surgery

scholarly journals Re: Risk Factors for Breast Cancer According to Family History of Breast Cancer

1996 ◽  
Vol 88 (14) ◽  
pp. 1003-1004 ◽  
Author(s):  
F. PARAZZINI ◽  
C. L. VECCHIA ◽  
L. CHATENOUD ◽  
E. NEGRI ◽  
S. FRANCESCHI
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Family History ◽  
History Of

A retrospective study on breast cancer presentation, risk factors, and protective factors in patients with a positive family history of breast cancer

2020 ◽  
Vol 26 (3) ◽  
pp. 469-473
Author(s):  
Ying Yi Liaw ◽  
Foong Shiang Loong ◽  
Suzanne Tan ◽  
Sze Yun On ◽  
Evelyn Khaw ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Retrospective Study ◽  
Family History ◽  
Protective Factors ◽  
Positive Family History ◽  
History Of

scholarly journals Relapse predictors and serologically unstable condition of IgG4-related disease: a large Chinese cohort

Rheumatology ◽  
2020 ◽  
Vol 59 (8) ◽  
pp. 2115-2123 ◽  
Author(s):  
Yanying Liu ◽  
Qiaozhu Zeng ◽  
Lijuan Zhu ◽  
Jingyuan Gao ◽  
Ziqiao Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Relapse Rate ◽  
Unstable Condition ◽  
Serum Igg4 Level ◽  
Related Disease ◽  
Igg4 Related Disease ◽  
Younger Age ◽  
Serum Igg4 ◽  
History Of ◽  
Igg4 Level

Abstract Objectives Patients with IgG4-related disease (IgG4-RD) typically respond well to initial glucocorticoid therapy, but always relapse with tapered or maintenance dosage of steroid. We aimed to identify the risk factors for relapse of IgG4-RD and explore the impact of active intervention on the serologically unstable condition. Methods We performed a retrospective study of 277 IgG4-RD patients at Peking University People’s Hospital from February 2012 through February 2019. They were all followed for &gt;4 months. The primary outcome was patient relapse. Data on recurrence of IgG4-RD symptoms, laboratory and image findings were recorded, along with information on treatment in the serologically unstable condition. Results The cumulative relapse rate was 12.86%, 27.84% and 36.1% at 12, 24 and 36 months, respectively. Younger age at onset, younger age at diagnosis, longer time from diagnosis to treatment and history of allergy were associated with relapse. Identified independent risk factors were longer time from diagnosis to treatment and history of allergy. When serum IgG4 level was 20%, 50% or 100% higher than that of the remission period, similar percentages of patients finally relapsed, regardless of whether they were in the immunosuppression intensified or non-intensified group. Median duration from serum IgG4 level instability to relapse in the intensified and non-intensified group was not statistically different. Conclusion The risk factors of relapse were longer time from diagnosis to treatment and history of allergy. Intervention in the serologically unstable condition was not helpful for reducing relapse rate.

scholarly journals Predictors of mammographic density among women with a strong family history of breast cancer

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Olivia Moran ◽  
Andrea Eisen ◽  
Rochelle Demsky ◽  
Kristina Blackmore ◽  
Julia A. Knight ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Body Weight ◽  
Family History ◽  
Mammographic Density ◽  
Premenopausal Women ◽  
Percent Density ◽  
Strong Family History ◽  
Dense Area ◽  
History Of

Abstract Background Mammographic density is one of the strongest risk factors for breast cancer. In the general population, mammographic density can be modified by various exposures; whether this is true for women a strong family history is not known. Thus, we evaluated the association between reproductive, hormonal, and lifestyle risk factors and mammographic density among women with a strong family history of breast cancer but no BRCA1 or BRCA2 mutation. Methods We included 97 premenopausal and 59 postmenopausal women (age range: 27-68 years). Risk factor data was extracted from the research questionnaire closest in time to the mammogram performed nearest to enrollment. The Cumulus software was used to measure percent density, dense area, and non-dense area for each mammogram. Multivariate generalized linear models were used to evaluate the relationships between breast cancer risk factors and measures of mammographic density, adjusting for relevant covariates. Results Among premenopausal women, those who had two live births had a mean percent density of 28.8% vs. 41.6% among women who had one live birth (P=0.04). Women with a high body weight had a lower mean percent density compared to women with a low body weight among premenopausal (17.6% vs. 33.2%; P=0.0006) and postmenopausal women (8.7% vs. 14.7%; P=0.04). Among premenopausal women, those who smoked for 14 years or longer had a lower mean dense area compared to women who smoked for a shorter duration (25.3cm2 vs. 53.1cm2; P=0.002). Among postmenopausal women, former smokers had a higher mean percent density (19.5% vs. 10.8%; P=0.003) and dense area (26.9% vs. 16.4%; P=0.01) compared to never smokers. After applying the Bonferroni correction, the association between body weight and percent density among premenopausal women remained statistically significant. Conclusions In this cohort of women with a strong family history of breast cancer, body weight was associated with mammographic density. These findings suggest that mammographic density may explain the underlying relationship between some of these risk factors and breast cancer risk, and lend support for the inclusion of mammographic density into risk prediction models.

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