scholarly journals Incidence, Risk Factors, and Outcomes of Preterm and Early Term Births: A Population-Based Register Study

2021 ◽  
Vol 18 (11) ◽  
pp. 5865
Author(s):  
Salma Younes ◽  
Muthanna Samara ◽  
Rana Al-Jurf ◽  
Gheyath Nasrallah ◽  
Sawsan Al-Obaidly ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Population Based ◽  
Incidence Rates ◽  
Large For Gestational Age ◽  
Mortality And Morbidity ◽  
Early Term ◽  
Incidence Risk

Preterm birth (PTB) and early term birth (ETB) are associated with high risks of perinatal mortality and morbidity. While extreme to very PTBs have been extensively studied, studies on infants born at later stages of pregnancy, particularly late PTBs and ETBs, are lacking. In this study, we aimed to assess the incidence, risk factors, and feto-maternal outcomes of PTB and ETB births in Qatar. We examined 15,865 singleton live births using 12-month retrospective registry data from the PEARL-Peristat Study. PTB and ETB incidence rates were 8.8% and 33.7%, respectively. PTB and ETB in-hospital mortality rates were 16.9% and 0.2%, respectively. Advanced maternal age, pre-gestational diabetes mellitus (PGDM), assisted pregnancies, and preterm history independently predicted both PTB and ETB, whereas chromosomal and congenital abnormalities were found to be independent predictors of PTB but not ETB. All groups of PTB and ETB were significantly associated with low birth weight (LBW), large for gestational age (LGA) births, caesarean delivery, and neonatal intensive care unit (NICU)/or death of neonate in labor room (LR)/operation theatre (OT). On the other hand, all or some groups of PTB were significantly associated with small for gestational age (SGA) births, Apgar <7 at 1 and 5 minutes and in-hospital mortality. The findings of this study may serve as a basis for taking better clinical decisions with accurate assessment of risk factors, complications, and predictions of PTB and ETB.

scholarly journals How boys and testicles wander to surgery: a nationwide cohort study of surgical delay in Sweden

2020 ◽  
Vol 4 (1) ◽  
pp. e000741
Author(s):  
Erik Omling ◽  
Sanna Bergbrant ◽  
Andreas Persson ◽  
Jonas Björk ◽  
Lars Hagander
Keyword(s):  
Risk Factors ◽  
Travel Time ◽  
Gestational Age ◽  
Financial Support ◽  
Large For Gestational Age ◽  
Income Quintile ◽  
Paediatric Surgery ◽  
Delayed Treatment ◽  
Incidence Risk ◽  
Timely Treatment

BackgroundEarly orchidopexy is recommended for cryptorchidism and the surgery is increasingly centralised. The objectives were to determine the incidence, risk factors and if distance to treating hospital impacted on timely treatment of cryptorchidism.MethodsIn this observational study, all boys born in Sweden from 2001 to 2014 were followed in national registers to determine the incidence of cryptorchidism by levels of birth-related risk factors and social determinants. Travel time to hospital was used as the primary exposure in multivariable survival analysis, with age at surgery as main outcome.ResultsOf 748 678 boys at risk for cryptorchidism, 7351 were treated and evaluated for timing of surgery (cumulative childhood incidence 1.4%, 95% CI 1.3% to 1.5%). The incidence was clearly associated with prematurity and overdue pregnancy (HR for <32 weeks 2.77 (95% CI 2.39 to 3.21); 32–36 weeks HR 1.36 (95% CI 1.24 to 1.49); >41 weeks HR 1.19 (95% CI 1.10 to 1.29)), low birth weight (<1000 g HR 3.94 (95% CI 3.15 to 4.92); 1000–1499 g HR 3.70 (95% CI 3.07 to 4.46); 1500–2500 g HR 1.69 (95% CI 1.52 to 1.88)) and intrauterine growth restriction (small for gestational age HR 2.38 (95% CI 2.14 to 2.65); large for gestational age HR 1.26 (95% CI 1.13 to 1.42)), but not with smoking or maternal age. Each 30 min increase in travel time was associated with a reduced probability of timely treatment (HR for being treated by age 3 adjusted for risk factors and socioeconomic determinants: 0.91 (95% CI 0.88 to 0.95)). Lower income and financial support were also associated with treatment delays (adjusted HR for lowest income quintile 0.82 (95% CI 0.72 to 0.93) and for families with financial support 0.85 (95% CI 0.73 to 0.97)).ConclusionsTravel distance to treating hospital was associated with delayed treatment. ‘Not all those who wander are lost’, but these findings suggest a trade-off between centralisation benefits and barriers of geography also in elective paediatric surgery.

175 Risk Factors and Clinical Impact of Perioperative Neurological Deficits Following Thoracolumbar Arthrodesis: National Inpatient Sample Analysis

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 245-245
Author(s):  
Enyinna Levi Nwachuku ◽  
Amol Mehta ◽  
Nima Alan ◽  
James Zhou ◽  
David O Okonkwo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Female Gender ◽  
Patient Characteristics ◽  
The United States ◽  
Population Based ◽  
Neurological Deficits ◽  
Mortality And Morbidity ◽  
Cord Injury ◽  
Independent Risk Factors

Abstract INTRODUCTION The rates of arthrodesis performed in the United States and globally have increased tremendously in the last 10–15 years. Amongst the most devastating complications are neurological deficits including spinal cord injury, nerve root irritation, and cauda equine syndrome. The purpose of this study is to understand the risk factors for perioperative neurological deficits in patients undergoing thoracolumbar fusion and additionally, to investigate the contribution of perioperative neurological deficits to in-hospital mortality and morbidity. Lastly, we aimed to explore the early trends in outcomes and patient characteristics across our 13-year study period. METHODS This is a retrospective cohort study.Data from the Nationwide Inpatient Sample between the years of 1999–2011 was analyzed. We included patients between the ages of 18 and 65 who had undergone thoracolumbar fusion. We excluded patients who had undergone the procedure as a result of trauma or a malignancy. The primary outcome was perioperative neurological deficits.We compiled an extensive list of covariates, including demographic variables, pre-operative and post operative variables that are known to increase the risk of perioperative neurological deficits. We additionally used the van Walraven score, a weighted numerical surrogate for the Elixhauser comorbidity index as a covariate. RESULTS >Our analysis on 37,899 patients yielded an overall rate of perioperative neurological deficits, mortality, and morbidity of 1.20%, 0.27%, and 29.27% respectively. Risk factors for perioperative neurological deficits included increasing age (OR 1.023 95% CI 1.018-1.029), VWR 5–14 (OR 1.535 95% CI 1.054-2.235), and pre-operative paralysis (OR 2.551 95% CI 1.674-3.886. We found that perioperative neurological deficits were independent risk factors predictors of in-hospital mortality (OR 3.467 95% CI 1.473-8.158 P < 0.005) and morbidity (OR 4.084 95% CI 3.187-5.233 p<.0001). The rates of perioperative neurological deficits and morbidity trended upwards, as did the average age and van Walraven score. CONCLUSION In this large, longitudinal, and population based study, we found that age, higher comorbid burden, and pre-operative paralysis increased the risk of perioperative neurological deficits while female gender and hypertension were found to be protective. Additionally, we found that perioperative neurological deficits are in fact independent risk factors for in-hospital mortality and morbidity after thoracolumbar fusion.

scholarly journals Incidence, Risk Factors and Outcomes of New Onset Supraventricular Arrhythmias in African American Patients with Severe Sepsis

2016 ◽  
Vol 26 (2) ◽  
pp. 205 ◽  
Author(s):  
O'Dene Lewis ◽  
Julius Ngwa ◽  
Richard F. Gillum ◽  
Alicia Thomas ◽  
Wayne Davis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Hospital Mortality ◽  
Supraventricular Arrhythmias ◽  
Incidence Risk ◽  
New Onset

<p><strong>Purpose</strong>: New onset supraventricular arrhythmias (SVA) are commonly reported in mixed intensive care settings. We sought to determine the incidence, risk factors and outcomes of new onset SVA in African American (AA) patients with severe sepsis admitted to medical intensive care unit (MICU).</p><p><strong>Methods:</strong> Patients admitted to MICU between January 2012 through December 2012 were studied. Patients with a previous history of arrhythmia or with new onset of ventricular arrhythmia were excluded. Data on risk factors, critical care interventions and outcomes were obtained.</p><p><strong>Results:</strong> One hundred and thirty-one patients were identified. New onset SVA occurred in 34 (26%) patients. Of those 34, 20 (59%) had atrial fibrillation (AF), 6 (18%) had atrial flutter and 8 (24%) had other forms of SVA. Compared with patients without SVA, patients with new onset SVA were older (69 ± 12 yrs vs 59 ± 13 yrs, P=.003), had congestive heart failure (47% vs 24%, P=.015) and dyslipidemia (41% vs 15%, P=.002). Additionally, they had a higher mean mortality prediction model (MPM II) score (65 ± 25 vs 49 ± 26, P=.001) and an increased incidence of respiratory failure (85% vs 55%, P=.001). Hospital mortality in patients with new onset SVA was 18 (53%) vs 30 (31%); P=.024; however, in a multivariate analysis, new onset SVA was associated with nonsignificantly increased odds (OR 2.58, 95% CI 0.86-8.05) for in-hospital mortality.</p><p><strong>Conclusion:</strong> New onset SVA was prevalent in AA patients with severe sepsis and occurred more frequently with advanced age, increased severity of illness, congestive heart failure, and acute respiratory failure; it was associated with higher unadjusted in hospital mortality. However, after multiple adjustments, new onset SVA did not remain an independent predictor of mortality. <em>Ethn Dis.</em>2016;26(2):205-212; doi:10.18865/ ed.26.2.205</p>

Population-based assessment of intensive care unit-acquired bloodstream infections in adults: Incidence, risk factors, and associated mortality rate

2002 ◽  
Vol 30 (11) ◽  
pp. 2462-2467 ◽  
Author(s):  
Kevin B. Laupland ◽  
David A. Zygun ◽  
H. Dele Davies ◽  
Deirdre L. Church ◽  
Thomas J. Louie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Bloodstream Infections ◽  
Population Based ◽  
Incidence Risk
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