scholarly journals Risk Factors and Outcomes of Hospital Acquired Pneumonia in Young Bangladeshi Children

Life ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1030
Author(s):  
Abu Sadat Mohammad Sayeem Bin Shahid ◽  
Tahmina Alam ◽  
Lubaba Shahrin ◽  
K. M. Shahunja ◽  
Md. Tanveer Faruk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Severe Acute Malnutrition ◽  
Multivariate Logistic Regression Analysis ◽  
Acute Malnutrition ◽  
Persistent Diarrhea ◽  
Multivariate Logistic Regression ◽  
Resource Limited ◽  
Hospital Acquired Pneumonia ◽  
Independent Risk Factors ◽  
Hospital Acquired

Hospital acquired pneumonia (HAP) is common and often associated with high mortality in children aged five or less. We sought to evaluate the risk factors and outcome of HAP in such children. We compared demographic, clinical, and laboratory characteristics in children <5 years using a case control design during the period of August 2013 and December 2017, where children with HAP were constituted as cases (n = 281) and twice as many randomly selected children without HAP were constituted as controls (n = 562). HAP was defined as a child developing a new episode of pneumonia both clinically and radiologically after at least 48 h of hospitalization. A total of 4101 children were treated during the study period. The mortality was significantly higher among the cases than the controls (8% vs. 4%, p = 0.014). In multivariate logistic regression analysis, after adjusting for potential confounders, it was found that persistent diarrhea (95% CI = 1.32–5.79; p = 0.007), severe acute malnutrition (95% CI = 1.46–3.27; p < 0.001), bacteremia (95% CI = 1.16–3.49; p = 0.013), and prolonged hospitalization of >5 days (95% CI = 3.01–8.02; p < 0.001) were identified as independent risk factors for HAP. Early identification of these risk factors and their prompt management may help to reduce HAP-related fatal consequences, especially in resource limited settings.

scholarly journals Risk factors affecting the 1-year outcomes of minor ischemic stroke: results from Xi’an stroke registry study of China[1]

2020 ◽  
Author(s):  
Zhongzhong Liu ◽  
Wenjuan Lin ◽  
Qingli Lu ◽  
Jing Wang ◽  
Pei Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Multivariate Logistic Regression Analysis ◽  
Stroke Recurrence ◽  
Multivariate Logistic Regression ◽  
Factors Affecting ◽  
Nihss Score ◽  
Minor Ischemic Stroke ◽  
Independent Risk Factors

Abstract Background: The incidences of stroke recurrence, disability, and all-cause death of patients with minor ischemic stroke (MIS) remain problematic. The aim of the present was to identify risk factors associated with adverse outcomes at 1-year after MIS in the Xi’an region of China. Methods: The cohort of this prospective cohort study included MIS patients aged 18–97 years with a National Institutes of Health Stroke Scale (NIHSS) score of ≤ 3 who were treated in any of four hospitals in Xi’an region of China between January and December 2015. The 1-year percentage of stroke recurrence, disability, and all-cause death were evaluated. Multivariate logistic regression analysis was performed to assess the association between the identified risk factors and clinical outcomes. Results: Among the 1,121 patients included for analysis, the percentage of stroke recurrence, disability, and all-cause death at 1 year after MIS were 3.4% (38/1121), 9.3% (104/1121), and 3.3% (37/1121), respectively. Multivariate logistic regression analysis identified age, current smoking, and pneumonia as independent risk factors for stroke recurrence. Age, pneumonia, and alkaline phosphatase were independent risk factors for all-cause death. Independent risk factors for disability were age, pneumonia, NIHSS score on admission, and leukocyte count. Conclusions: The 1-year outcomes of MIS is not optimistic in the Xi’an region of China, especially high percentage of disability. In this study, we found the risk factors affecting 1-year stroke recurrence, disability and, all-cause death which need further verification in the subsequent studies.

Prevalence of antibodies to prothrombin in solid phase (aPT) and to phosphatidylserine-prothrombin complex (aPS/PT) in patients with and without lupus anticoagulant

2013 ◽  
Vol 109 (02) ◽  
pp. 207-213 ◽  
Author(s):  
Savino Sciascia ◽  
Veronica Murru ◽  
Cesar Garcia-Fernandez ◽  
Giovanni Sanna ◽  
Munther Khamashta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Lupus Anticoagulant ◽  
Pregnancy Loss ◽  
Solid Phase ◽  
Multivariate Logistic Regression Analysis ◽  
Diagnostic Value ◽  
Multivariate Logistic Regression ◽  
Independent Risk Factors ◽  
True Relationship

SummaryAntibodies to prothrombin in solid phase (aPT) and those to phosphatidiyserine- prothrombin complex (aPS/PT) have been suggested to strongly correlate with the presence of lupus anticoagulant (LA). As their clinical diagnostic value and true relationship with the LA remains elusive, we designed this study to evaluate the prevalence and significance of aPT and aPS/PT in a large cohort of patients with and without LA. Samples from 257 patients were included. aPT and aPS/PT were tested by ELISA. LA was tested as per the current criteria from the ISTH Subcommittee on LA-Phospholipid-dependent antibodies. aPS/PT and aPT were found in 51% and 32% of LA-positive (LA+ve) patients and in 22% and 28% of LA-negative (LA-ve) patients, respectively. Thrombosis, particularly venous thrombosis was associated with IgG aPT in the LA+ve group (p=0.0006) and in the LA-ve group (p=0.017). Antibodies to phosphatidylserine-prothrombin, either IgG and IgM were associated with thrombosis in general (p=0.0003) in particularly with venous thrombosis in the LA+ve group (p<0.0001 for IgG and p=0.025 for IgM; respectively) and the LA-ve group (p=0.028, 0.02 and 0.001, respectively). Further multivariate logistic regression analysis showed that LA and of IgG and/or IgM aPS/PT were independent risk factors for thrombosis and pregnancy loss. In conclusion, aPS/PT, but not aPT, are more frequently found in patients with LA. Their association with thrombosis seems to be independent of the presence of LA.

scholarly journals Nomogram for Predicting Persistent Organ Failure with Acute Pancreatitis in Pregnancy

2022 ◽  
Author(s):  
Chengcheng Sheng ◽  
Zongxu Xu ◽  
Jun Wang
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Organ Failure ◽  
Multivariate Logistic Regression Analysis ◽  
Concordance Index ◽  
Multivariate Logistic Regression ◽  
Independent Risk Factors ◽  
In Pregnancy

Abstract Background: Acute pancreatitis in pregnancy (APIP) with persistent organ failure (POF) poses a high risk of death for mother and fetus. This study sought to create a nomogram model for early prediction of POF with APIP patients.Methods: We conducted a cross-sectional study on APIP patients with organ failure (OF) between January 2012 and March 2021 in a university hospital. 131 patients were collected. Their clinical courses and pregnancy outcomes were obtained. Risk factors for POF were identified by univariate and multivariate logistic regression analysis. Prediction models with POF were built and nomogram was plotted. The performance of the nomogram was evaluated by using a bootstrapped-concordance index and calibration plots.Results: Hypertriglyceridemia was the most common etiology in this group of APIP patients, which accounted for 50% of transient organ failure (TOF) and 72.3% of POF. All in-hospital maternal death was in the POF group (P<0.05), which also had a significantly higher perinatal mortality rate than the TOF group (P<0.05). Univariate and multivariate logistic regression analysis determined that lactate dehydrogenase, triglycerides, serum creatinine, and procalcitonin were independent risk factors for predicting POF in APIP. A nomogram for POF was created by using the four indicators. The area under the curve was 0.875 (95% confidence interval 0.80–0.95). The nomogram had a bootstrapped-concordance index of 0.85 and was well-calibrated.Conclusions: Hypertriglyceridemia was the leading cause of organ failure-related APIP. Lactate dehydrogenase, triglycerides, serum creatinine, and procalcitonin were the independent risk factors of POF in APIP. Our nomogram model showed an effective prediction of POF with the four indicators in APIP patients.

Risk Factors for Postoperative Unplanned Intubation: Analysis of a National Database

2015 ◽  
Vol 81 (8) ◽  
pp. 820-825 ◽  
Author(s):  
Martin P. Alvarez ◽  
Andres X. Samayoa-Mendez ◽  
Mary C. Naglak ◽  
James V. Yuschak ◽  
Kenric M. Murayama
Keyword(s):  
Risk Factors ◽  
Multivariate Logistic Regression Analysis ◽  
National Database ◽  
Chronic Obstructive ◽  
Multivariate Logistic Regression ◽  
Improvement Program ◽  
Surgical Quality ◽  
Obstructive Pulmonary Disease ◽  
National Rate ◽  
Independent Risk Factors

Postoperative unplanned intubation (PUI) is a significant complication and is associated with severe adverse events and mortality. By participating in the National Surgical Quality Improvement Program (NSQIP), we learned that PUI occurred more frequently than expected at our institution. The aim of this study was to identify risk factors that are predictors of PUI at our institution. We reviewed the NSQIP data from our institution and the NSQIP national database for surgery patients from 2010 through 2013. The rate of PUI at our institution was 1.54 per cent compared with the national rate of 1.03 per cent. Perioperative risk factors were analyzed by multivariate logistic regression. Analysis of the national NSQIP database identified 14 independent risk factors for PUI. Analysis of the NSQIP data at our institution demonstrated that emergent cases, preoperative ventilator status, smoking, chronic obstructive pulmonary disease, and older age were independent risk factors. In conclusion, patients at our institution with these five risk factors were at higher risk of requiring PUI. These risk factors could be used to help identify patients at high risk and possibly help prevent postoperative respiratory failure and unplanned intubation.

scholarly journals Sociodemographic, Epidemiological, and Clinical Risk Factors for Childhood Pulmonary Tuberculosis in Severely Malnourished Children Presenting With Pneumonia

2015 ◽  
Vol 2 ◽  
pp. 2333794X1559418 ◽  
Author(s):  
Mohammod Jobayer Chisti ◽  
Tahmeed Ahmed ◽  
Abu S. M. S. B. Shahid ◽  
K. M. Shahunja ◽  
Pradip Kumar Bardhan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Tuberculosis ◽  
Severe Acute Malnutrition ◽  
Positive Tuberculin Skin Test ◽  
Clinical Risk Factors ◽  
Acute Malnutrition ◽  
Working Mother ◽  
Clinical Risk ◽  
Resource Limited ◽  
History Of

We aimed to evaluate sociodemographic, epidemiological, and clinical risk factors for pulmonary tuberculosis (PTB) in children presenting with severe acute malnutrition (SAM) and pneumonia. Children aged 0 to 59 months with SAM and radiologic pneumonia from April 2011 to July 2012 were studied in Bangladesh. Children with confirmed PTB (by culture and/or X-pert MTB/RIF) (cases = 27) and without PTB (controls = 81; randomly selected from 378 children) were compared. The cases more often had the history of contact with active PTB patient ( P < .01) and exposure to cigarette smoke ( P = .04) compared with the controls. In logistic regression analysis, after adjusting for potential confounders, the cases were independently associated with working mother ( P = .05) and positive tuberculin skin test (TST; P = .02). Thus, pneumonia in SAM children is a common presentation of PTB and further highlights the importance of the use of simple TST and/or history of contact with active TB patients in diagnosing PTB in such children, especially in resource-limited settings.

G6PD deficiency, absence of α-thalassemia, and hemolytic rate at baseline are significant independent risk factors for abnormally high cerebral velocities in patients with sickle cell anemia

Blood ◽  
2008 ◽  
Vol 112 (10) ◽  
pp. 4314-4317 ◽  
Author(s):  
Françoise Bernaudin ◽  
Suzanne Verlhac ◽  
Sylvie Chevret ◽  
Martine Torres ◽  
Lena Coic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
G6pd Deficiency ◽  
Odds Ratio ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Alpha Thalassemia ◽  
Independent Risk Factors ◽  
First Time

AbstractStroke is predicted by abnormally high cerebral velocities by transcranial doppler (TCD). This study aimed at defining predictive factors for abnormally high velocities (≥ 2 m/sec) based on the Créteil pediatric sickle cell anemia (SCA) cohort composed of 373 stroke-free SCA children. α genes and β-globin haplotypes were determined. Biologic parameters were obtained at baseline. α-thalassemia was present in 155 of 325 and G6PD deficiency in 36 of 325 evaluated patients. TCD was abnormal in 62 of 373 patients. Multivariate logistic regression analysis showed that G6PD deficiency (odds ratio [OR] = 3.36, 95% confidence interval [CI] 1.10-10.33; P = .034), absence of alpha-thalassemia (OR = 6.45, 95% CI 2.21-18.87; P = .001), hemoglobin (OR per g/dL = 0.63, 95% CI 0.41-0.97; P = .038), and lactate dehydrogenase (LDH) levels (OR per IU/L = 1.001, 95% CI 1.000-1.002; P = .047) were independent risk factors for abnormally high velocities. This study confirms the protective effect of alpha-thalassemia and shows for the first time that G6PD deficiency and hemolysis independently increase the risk of cerebral vasculopathy.

scholarly journals Risk Factors for Maternal and Fetal Mortality in Acute Fatty Liver of Pregnancy and New Predictive Models

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhaoli Meng ◽  
Wei Fang ◽  
Mei Meng ◽  
Jicheng Zhang ◽  
Qizhi Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Maternal Mortality ◽  
Predictive Models ◽  
Multivariate Logistic Regression Analysis ◽  
Fetal Mortality ◽  
Multivariate Logistic Regression ◽  
Acute Fatty Liver ◽  
Independent Risk Factors

Acute fatty liver of pregnancy (AFLP) is a rare but potentially life-threatening hepatic disorder that leads to considerable maternal and fetal mortality. To explore the risk factors for maternal and fetal mortality in AFLP and develop new predictive models, through this retrospective study, we analyzed the demographic characteristics, clinical symptoms, and laboratory findings of 106 patients with AFLP who were admitted to Shandong Provincial Hospital. Risk factors for maternal and fetal mortality were analyzed by univariate and multivariate logistic regression analysis. The new models based on the multivariate logistic regression analysis and the model for end-stage liver disease (MELD) were tested in AFLP. The receiver operating characteristic curve (ROC) was applied to compare the predictive efficiency, sensitivity, and specificity of the two models. Prenatal nausea (p = 0.037), prolonged prothrombin time (p = 0.003), and elevated serum creatinine (p = 0.003) were independent risk factors for maternal mortality. The ROC curve showed that the area under the curve (AUC) of the MELD was 0.948, with a sensitivity of 100% and a specificity of 83.3%. The AUC of the new model for maternal mortality was 0.926, with a sensitivity of 90% and a specificity of 94.8%. Hepatic encephalopathy (p = 0.016) and thrombocytopenia (p = 0.001) were independent risk factors for fetal mortality. Using the ROC curve, the AUC of the MELD was 0.694, yielding a sensitivity of 68.8% and a specificity of 64.4%. The AUC of the new model for fetal mortality was 0.893, yielding a sensitivity of 100% and a specificity of 73.3%. Both the new predictive model for maternal mortality and the MELD showed good predictive efficacy for maternal mortality in patients with AFLP (AUC = 0.926 and 0.948, respectively), and the new predictive model for fetal mortality was superior to the MELD in predicting fetal mortality (AUC = 0.893 and 0.694, respectively). The two new predictive models were more readily available, less expensive, and easier to implement clinically, especially in low-income countries.

scholarly journals Hemodynamic and Morphological Parameters of Ruptured Mirror Posterior Communicating Artery Aneurysms

2021 ◽  
Vol 12 ◽  
Author(s):  
Jinlong Yuan ◽  
Chenlei Huang ◽  
Zhenbao Li ◽  
Xiaochun Jiang ◽  
Xintong Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Roc Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Posterior Communicating Artery ◽  
Morphological Parameters ◽  
Hemodynamic Parameters ◽  
Multivariate Logistic Regression ◽  
Independent Risk Factors ◽  
Wall Shear

Objective: Morphological and hemodynamic parameters might predict rupture of intracranial aneurysms (IAs). A practical model for the study is patients with ruptured mirror IAs in which one is ruptured and the other is unruptured. Although there have been analyses of the morphology and hemodynamics of ruptured mirror posterior communicating artery aneurysms (PComAAs), the sample sizes in these studies were small and only considered hemodynamics or morphological characters. Therefore, this study aimed to investigate the morphological and hemodynamic parameters associated with ruptured mirror PComAAs.Methods: We considered 72 patients with ruptured mirror PComAAs using computational fluid dynamics (CFDs). Ruptured mirror PComAAs were divided into ruptured and unruptured groups. Fourteen morphological and eight hemodynamic parameters were calculated and compared. Significant parameters were analyzed by the multivariate logistic regression to identify independent risk factors. Receiver operating characteristic (ROC) analysis was performed, and the area under the ROC curve (AUC) was calculated for all independent risk factors to determine the predictability and identify the optimal threshold.Results: Four hemodynamic and three morphological parameters were significantly different between ruptured and unruptured groups: normalized wall shear stress (NWSS), mean WSS, low wall shear WSS area (LSA%), size, aspect ratio (AR), size ratio (SR), and inflow angle (IA). Multivariate logistic regression analysis showed that AR, SR, NWSS, mean WSS, and LSA% were all independent factors significantly associated with PComAAs rupture. The ROC analysis for independent risk factors indicated that AR (0.751), NWSS (0.755), mean WSS (0.69), and LSA (0.778) had merely acceptable AUC values. Only SR (0.803) had a high acceptable AUC value. The threshold value of SR was 1.96.Conclusions: SR (&gt;1.96) was the most significant parameter associated with IA rupture, whereas AR, NWSS, mean WSS, and LSA independently characterized the status of IA rupture.

scholarly journals Risk Factors for Multiple Implant-Related Complications (MIRC) with Growing-Rod for Early-Onset Scoliosis

2021 ◽  
Author(s):  
Haijun Jiang ◽  
Junrui Jonathan Hai ◽  
Yong Hai ◽  
Peng Yin ◽  
Qingjun Su ◽  
...  
Keyword(s):  
Risk Factors ◽  
Early Onset ◽  
Lumbar Lordosis ◽  
Thoracic Kyphosis ◽  
Multivariate Logistic Regression Analysis ◽  
Early Onset Scoliosis ◽  
Multivariate Logistic Regression ◽  
Growing Rod ◽  
Independent Risk Factors

Abstract Study design: A retrospective single center study.Objective：To identify risk factors for multiple implant-related complications with growing-rod for early-onset scoliosis.Background: High incidence of implant-related complications in the treatment of early-onset scoliosis with traditional growing rod. The risk factors for multiple implant-related complications (MIRC) have not been adequately studied.Methods: Data of 59 early-onset scoliosis patients who had been underwent growing rod surgery at Beijing Chao-yang Hospital from September 2007 to December 2017 were reviewed. All patients had complete clinical and radiographic data. Patients were divided into groups with or without MIRC. The univariate and multivariate logistic regression analysis were performed to identify the risk factors associated MIRC.Results: The average age of insertion was 8.9 years and mean follow-up was 51.91 months. 234 implantation or expansion surgeries were performed and the average operation interval was 11.4 months. A total of 60 implant-related complications occurred. Ultimately, MIRC developed in 20 (33.9%) of 59 patients. Number of surgery procedure > 3 times , follow-up time ³50 months , preoperative thoracic kyphosis > 50°, postoperative thoracic kyphosis >50°, postoperative lumbar lordosis >50°, postoperative sagittal vertical axial >40mm are potential risk factors for MIRC (P<0.1). Multivariate logistic regression analysis showed that Number of surgery procedure > 3 times, postoperative thoracic kyphosis >50°, postoperative lumbar lordosis >50°are independent risk factors for MIFRC (P<0.05), Among them, patients with postoperative thoracic kyphosis >50°had an 18.647 times higher risk of MIFRC than postoperative thoracic kyphosis angle <50°.Conclusions: Traditional growing rod in the setting of EOS has excellent clinical and radiographic outcomes but a high multiple implant-related complications. Number of surgery procedure > 3 times, postoperative thoracic kyphosis >50°, postoperative lumbar lordosis >50° are independent risk factors for MIRC.

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