scholarly journals Risk Factors of Postoperative Vomiting in the Eye of “Real-World Evidence”—Modifiable and Clinical Setting-Dependent Risk Factors in Surgical Trauma Patients

2021 ◽  
Vol 11 (5) ◽  
pp. 386
Author(s):  
Yan-Yuen Poon ◽  
Ting-Yu Ke ◽  
Kuo-Chuan Hung ◽  
Hsiao-Feng Lu ◽  
Min-Hsien Chiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Potential Risk ◽  
Clinical Setting ◽  
Female Gender ◽  
Opioid Consumption ◽  
Surgical Trauma ◽  
Trauma Patients ◽  
Postoperative Vomiting ◽  
Potential Risk Factors ◽  
Predicting Factor

Numerous studies on postoperative nausea and vomiting (PONV) have been carried out since the early days of contemporary surgery. The incidence of PONV has been greatly reduced in recent years and new drugs for PONV keep evolving in the market; however, a substantial number of patients are still under the threat of PONV. Female gender, non-smokers, a history of PONV/motion sickness, and postoperative opioid use are four well-recognized risk factors of PONV. Many potential risk factors reported in previous studies were not consistently presented as predictors for PONV. Two questions then arise; are risk factors clinical setting dependent and are risk factors modifiable? We attempted to answer the questions through a comprehensive review of perioperative records of surgical patients from the Trauma Department of our hospital. As nausea is subjective and no standard is applicable for its measurement, postoperative vomiting (POV) was used as an endpoint in this study. To the best of our knowledge, this is the first study to address the POV issue in surgical trauma patients. A total of 855 patients were enrolled in this study after excluding age below 20 years old, total intravenous anesthesia, desflurane anesthesia, or records with missing data. Our results showed that female gender (OR 4.89) is the strongest predicting factor, followed by a less potent predicting factor—more intraoperative opioid consumption (OR 1.07)—which favor more POV. More intraoperative crystalloid supply (OR 0.71) and a higher body weight (OR 0.9) favor less POV. Other potential risk factors did not reach statistical significance in this study as independent risk factors. Our results also showed that when the intraoperative crystalloid infusion rate is greater than 4 mL/kg/h (OR 0.20), it favors a lower rate of POV; when intraoperative opioid consumption is greater than 12 mg morphine equivalents, MME (OR 1.87), it favors a higher rate of POV. We concluded that dominance of any independent risk factor over other risk factors depends on how individual factors interact with the clinical setting. Some risk factors could be modified, and a cut-off value could be derived to facilitate a better plan for POV prevention.

Critical Care: Incidence and Risk Factors of Thrombocytopenia in Critically Ill Trauma Patients

1997 ◽  
Vol 31 (3) ◽  
pp. 285-289 ◽  
Author(s):  
Scott D Hanes ◽  
Deborah A Quarles ◽  
Bradley A Boucher
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Potential Risk ◽  
University Hospital ◽  
Minor Role ◽  
Trauma Patients ◽  
Icu Stay ◽  
Potential Risk Factors ◽  
Trauma Score ◽  
Type Of Injury

Objective To determine the incidence of thrombocytopenia (<100 platelets × 103/mm3) and potential risk factors, including medications, associated with the development of thrombocytopenia in critically ill trauma patients. Design Prospective, observational study. Setting A 20-bed trauma intensive care unit (ICU) at a university hospital. Patients Sixty-three critically ill trauma patients without baseline thrombocytopenia admitted to the trauma ICU for at least 48 hours. Interventions Patients were followed for up to 14 days. Platelet counts were determined daily. The following data were collected and analyzed as potential risk factors for the development of thrombocytopenia: medications, age, sex, race, trauma score, mode and type of injury, alcohol history, units of packed red blood cells (PRBC) and platelets transfused, surgical procedures, duration of ICU stay, and the development of systemic inflammatory response syndrome or disseminated intravascular coagulation. Results Thrombocytopenia occurred in 26 (41%) of the patients. Among risk factors studied, nonhead injury, age, trauma score, duration of ICU stay, and the number of PRBC transfusions were significanüy associated with the development of thrombocytopenia (P < 0.05). However, nonhead injury, age, and trauma score were useful variables in predicting the development of thrombocytopenia by using multivariate analysis. Medications were not associated with the development of thrombocytopenia. Conclusions The type of injury sustained, the quantity of platelet-deficient transfusions, and age are the greatest risk factors associated with the development of thrombocytopenia in critically ill trauma patients. Drug-induced thrombocytopenia appears to play a minor role in the development of thrombocytopenia; therefore, medications should not be automatically discontinued or substituted when thrombocytopenia occurs.

Premature Arterial Disease Associated with Familial Antithrombin III Deficiency

1990 ◽  
Vol 63 (01) ◽  
pp. 013-015 ◽  
Author(s):  
E J Johnson ◽  
C R M Prentice ◽  
L A Parapia
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Potential Risk ◽  
Antithrombin Iii ◽  
Arterial Disease ◽  
Coagulation System ◽  
Early Age ◽  
Arterial Thromboembolism ◽  
Potential Risk Factors ◽  
Antithrombin Iii Deficiency

SummaryAntithrombin III (ATIII) deficiency is one of the few known abnormalities of the coagulation system known to predispose to venous thromboembolism but its relation to arterial disease is not established. We describe two related patients with this disorder, both of whom suffered arterial thrombotic events, at an early age. Both patients had other potential risk factors, though these would normally be considered unlikely to lead to such catastrophic events at such an age. Thrombosis due to ATIII deficiency is potentially preventable, and this diagnosis should be sought more frequently in patients with arterial thromboembolism, particularly if occurring at a young age. In addition, in patients with known ATIII deficiency, other risk factors for arterial disease should be eliminated, if possible. In particular, these patients should be counselled against smoking.

Classification of Potential Risk Factors through HIRARC Method in Assessing Indoor Environment of Museums

2018 ◽  
Vol 10 (8) ◽  
Author(s):  
Syahrun Neizam Mohd Dzulkifli ◽  
◽  
Abd Halid Abdullah ◽  
Yee Yong Lee ◽  
Mohd Mahathir Suhaimi Shamsuri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Potential Risk ◽  
Indoor Environment ◽  
Potential Risk Factors

Lack of Social Support and Social Trust as Potential Risk Factors for Dry Eye Disease: JPHC-NEXT Eye Study

2018 ◽  
Author(s):  
Chi Hoang Viet Vu ◽  
Miki Uchino ◽  
Motoko Kawashima ◽  
Akihiro Nishi ◽  
Christopher A. German ◽  
...  
Keyword(s):  
Risk Factors ◽  
Social Support ◽  
Dry Eye ◽  
Potential Risk ◽  
Social Trust ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Potential Risk Factors

scholarly journals Low frequency of local findings in periprosthetic hip infection caused by low-virulent bacteria compared to periprosthetic knee infection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takashi Imagama ◽  
Kazushige Seki ◽  
Toshihiro Seki ◽  
Yuta Matsuki ◽  
Kazuhiro Yamazaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Potential Risk ◽  
Bacterial Species ◽  
Joint Infection ◽  
Sinus Tract ◽  
Musculoskeletal Infection ◽  
Knee Infection ◽  
Hip Infection ◽  
Potential Risk Factors ◽  
Periprosthetic Knee Infection

AbstractPeriprosthetic joint infection (PJI) is suspected when local findings such as pain, swelling, hyperthermia, and sinus tract are present. However, the frequency of these findings and the difference between hip and knee are unclear. This study compared the positive rates of local findings in periprosthetic hip infection (PHI) with periprosthetic knee infection (PKI), and aimed to identify potential risk factors associated with the frequency. One hundred one PJI (46 hips and 55 knees) fulfilled the 2018 Musculoskeletal infection society criteria were analysed retrospectively to assess the positive rates of each local finding. Patients were categorized into two groups based on the presence or absence of each local finding, and the influence of two potential risk factors [body mass index (BMI) and C-reactive protein (CRP)] was investigated. Causative bacterial species were divided into high and low-virulent groups, and then culture negative cases were included in low-virulent group. PHI had significantly lower rates of pain, swelling and hyperthermia compared to PKI. Overall, up to one-third of PHI had pain as only symptom. High BMI and low-virulent bacteria were associated with lower frequency of swelling and hyperthermia in PHI. CRP had no impact on positive rates of local findings. PHI was oligosymptomatic in a significant percentage of cases. This is particularly important in obese patients and infection by low-virulent bacteria.

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