scholarly journals Risk Evaluation of General Anesthesia in Pediatric Skin Surgeries: A Retrospective Cohort Study in Saudi Arabia

2019 ◽  
Vol 2 (3) ◽  
pp. 106-114
Author(s):  
Alhabeeb BM ◽  
Alharthi AA ◽  
Nasser Alhazmi AM ◽  
Alobaid OA ◽  
Mostafa Al‑Habib NI ◽  
...  
Keyword(s):  
Cohort Study ◽  
Adverse Events ◽  
General Anaesthesia ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Pediatric Population ◽  
Modern Technology ◽  
P Value ◽  
Complication Rates ◽  
Invasive Procedures

Background: Use of general anaesthesia in outpatient invasive procedures has increased, especially in the field of dermatology. Being uncooperative, children often require general anaesthesia. Especially since surgical skin operations are painful and lengthy, dictating the use of general anaesthesia. Aim: The purpose of this study was to evaluate the safety, significant adverse events, and the complication rates related to general anaesthesia, when used among pediatric population underwent skin surgeries. Methods: We conducted a retrospective cohort study in the form of randomly selected patient chart review, with a surgical code in the array of 8,539–16,782 for 2 years. We reviewed registers to document any unexpected admissions, adverse events or complications. Surgical outcomes and anaesthesia complications were reviewed by three anaesthesia consultants. We conducted Inter-rater reliability test analysis and per cent agreement to determine the level of agreement between raters. Results: A total of 211 procedures were reported for 211 patients with 19 diagnoses. No adverse events related to anesthesia were recognized in any of those selected patients, apart from minor complications noticed in twelve patients (P value<0.03). Kappa value range between 0.78-1.00 (95% CI, 0.46809 to 1.00). Conclusion: In case of proper deploying of staff experience, appropriateness of choice of surgical procedure, patient selection, and modern technology as non-dependent confounding variables. Pediatric-trained anesthesiologists can safely use general anaesthesia in dermatological invasive procedures without significant complications.

scholarly journals Risk of General Anesthesia in Pediatric Skin Procedures with Projection on Tumescent Anesthesia

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Abdulmajeed Alajlan ◽  
Bader M. Alhabeeb ◽  
Ali M. Alhazmi ◽  
Osama A. Alobaid ◽  
Ahmed A. Alharthi ◽  
...  
Keyword(s):  
Adverse Events ◽  
General Anaesthesia ◽  
Chart Review ◽  
Pediatric Population ◽  
Complication Rates ◽  
Invasive Procedures ◽  
Tumescent Anesthesia ◽  
Pediatric Age Group ◽  
Kappa Value ◽  
Value Range

Background. Uses of general anaesthesia in outpatient invasive procedures have increased, especially in dermatology. Being uncooperative, children often require general anaesthesia, since surgical skin operations are mostly painful. Aim. The purpose of this study is to evaluate the safety, significant adverse events, and the complication rates related to general anaesthesia, when used among pediatric population undergoing skin procedures. Methods. We conducted a first retrospective cohort study of patient chart review during the period from September 1, 2017 through September 2019. All patients admitted for pediatric skin procedures during this period have participated in our study. We reviewed selected charts to document any unexpected admissions, adverse events, or complications. Surgical outcomes and anaesthesia complications were reviewed by three anesthesiologists. We assessed inter-rater reliability. Results. A total of 211 procedures were reported for 211 patients with 19 diagnoses. No adverse events related to anaesthesia were recognized, apart from minor complications noticed in twelve patients. The kappa value range is between 0.78 and 1.00 (95% C.I., 0.46809 to 1.00). Conclusion. Dermatologist and pediatricians can safely do necessary procedures under general anaesthesia with the supervision of pediatric-trained anesthesiologists while considering other safety and risk precautions and the pediatric age group.

scholarly journals Adverse events in a Tunisian hospital: results of a retrospective cohort study

2010 ◽  
Vol 22 (5) ◽  
pp. 380-385 ◽  
Author(s):  
Mondher Letaief ◽  
Sana El Mhamdi ◽  
Riham El-Asady ◽  
Sameen Siddiqi ◽  
Ahmed Abdullatif
Keyword(s):  
Cohort Study ◽  
Adverse Events ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort

Thoracoscopic esophagomyotomy for achalasia in the pediatric population: A retrospective cohort study

2019 ◽  
Vol 54 (3) ◽  
pp. 572-576 ◽  
Author(s):  
Eileen M. Duggan ◽  
Samuel Nurko ◽  
Charles J. Smithers ◽  
Leonel Rodriguez ◽  
Victor L. Fox ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Pediatric Population

scholarly journals Comparison of two methods to estimate adverse events in the IBEAS Study (Ibero-American study of adverse events): cross-sectional versus retrospective cohort design

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016546 ◽  
Author(s):  
Jesus Maria Aranaz Andrés ◽  
Ramon Limón Ramírez ◽  
Carlos Aibar Remón ◽  
Maria Teresa Gea-Velázquez de Castro ◽  
Francisco Bolúmar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Adverse Events ◽  
Retrospective Cohort Study ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hospital Size ◽  
Cohort Design ◽  
Cohort Study Design

BackgroundAdverse events (AEs) epidemiology is the first step to improve practice in the healthcare system. Usually, the preferred method used to estimate the magnitude of the problem is the retrospective cohort study design, with retrospective reviews of the medical records. However this data collection involves a sophisticated sampling plan, and a process of intensive review of sometimes very heavy and complex medical records. Cross-sectional survey is also a valid and feasible methodology to study AEs.ObjectivesThe aim of this study is to compare AEs detection using two different methodologies: cross-sectional versus retrospective cohort design.SettingSecondary and tertiary hospitals in five countries: Argentina, Colombia, Costa Rica, Mexico and Peru.ParticipantsThe IBEAS Study is a cross-sectional survey with a sample size of 11 379 patients. The retrospective cohort study was obtained from a 10% random sample proportional to hospital size from the entire IBEAS Study population.MethodsThis study compares the 1-day prevalence of the AEs obtained in the IBEAS Study with the incidence obtained through the retrospective cohort study.ResultsThe prevalence of patients with AEs was 10.47% (95% CI 9.90 to 11.03) (1191/11 379), while the cumulative incidence of the retrospective cohort study was 19.76% (95% CI 17.35% to 22.17%) (215/1088). In both studies the highest risk of suffering AEs was seen in Intensive Care Unit (ICU) patients. Comorbid patients and patients with medical devices showed higher risk.ConclusionThe retrospective cohort design, although requires more resources, allows to detect more AEs than the cross-sectional design.

scholarly journals Diabetes Mellitus as a Risk Factor for Drug Resistance Tuberculosis: A Retrospective Cohort Study at King Abdul Aziz University, Jeddah

2021 ◽  
pp. 136-145
Author(s):  
Sumyia Mehrin M. D. Abulkalam ◽  
Mai Kadi ◽  
Mahmoud A. Gaddoury ◽  
Wallaa Khalid Albishi
Keyword(s):  
Diabetes Mellitus ◽  
Drug Resistance ◽  
Risk Factor ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
University Hospital ◽  
P Value ◽  
Baseline Characteristic ◽  
Drug Resistant

Background: The association between tuberculosis (TB) and diabetes mellitus (DM) is re-emerging with the epidemic of type II diabetes. Both TB and DM were of the top 10 causes of death.[1] This study explores diabetes mellitus as a risk factor for developing the different antitubercular drug-resistant (DR) patterns among TB patients.  Methods: A retrospective cohort study has been conducted on all TB cases reported to the King Abdul Aziz University Hospital, Jeddah, between January 2012 to January 2021. All culture-confirmed and PCR-positive TB cases were included in this study. Categorical baseline characteristic of TB patient has been compared with DM status by using Fisher's exact and Pearson chi-square test. The univariable and multivariable logistic regression model was used to estimate the association between DM and different drug resistance patterns.  Results: Of the total 695 diagnosed TB patients, 92 (13.24%) are resistant to 1st line anti TB drugs. Among 92 DR-TB patients, 36 (39.13%) are diabetic. The percentage of different patterns of DR-TB with DM, in the case of mono DR (12.09%), poly DR (4.19%) MDR (0.547%). As a risk factor, DM has a significant association with DR-TB, mono drug-resistant, and pyrazinamide-resistant TB (P-value <0.05). The MDR and PDR separately do not show any significant association with DM, but for further analysis, it shows a significant association with DM when we combined.  Conclusion: Our study identified diabetes mellitus as a risk factor for developing DR-TB. Better management of DM and TB infection caring programs among DM patients might improve TB control and prevent DR-TB development in KSA.

scholarly journals Morbidity and mortality outcomes of COVID-19 patients with and without hypertension in Lagos, Nigeria: A retrospective cohort study

2020 ◽  
Author(s):  
Akin Osibogun ◽  
Akin Abayomi ◽  
Oluchi Kanma-Okafor ◽  
Jide Idris ◽  
Abimbola Bowale ◽  
...  
Keyword(s):  
Cohort Study ◽  
Critical Illness ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Outcome Data ◽  
Morbidity And Mortality ◽  
P Value ◽  
Hypertensive Patients ◽  
Increased Risk

Abstract Background: The current pandemic of coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown epidemiological and clinical characteristics that appear worsened in hypertensive patients. The morbidity and mortality of the disease among hypertensive patients in Africa have yet to be well described.Methods: In this retrospective cohort study all confirmed COVID-19 adult patients (≥18 years of age) in Lagos between February 27 to July 6 2020 were included. Demographic, clinical and outcome data were extracted from electronic medical records of patients admitted at the COVID-19 isolation centers in Lagos. Outcomes included dying, being discharged after recovery or being evacuated/transferred. Descriptive statistics considered proportions, means and medians. The Chi-square and Fisher’s exact tests were used in determining associations between variables. Kaplan–Meier survival analysis and Cox regression were performed to quantify the risk of worse outcomes among hypertensives with COVID-19 and adjust for confounders. P-value ≤0.05 was considered statistically significant.Results: A total of 2075 adults with COVID-19 were included in this study. The prevalence of hypertension, the most common comorbidity, was 17.8% followed by diabetes (7.2%) and asthma (2.0%). Overall mortality was 4.2% while mortality among the hypertensives was 13.7%. Severe symptoms and mortality were significantly higher among the hypertensives and survival rates were significantly lowered by the presence of an additional comorbidity to 50% from 91% for those with hypertension alone and from 98% for all other patients (P<0.001). After adjustment for confounders (age and sex), severe COVID-19and death were higher for hypertensives {severe/critical illness: HR=2.41, P=0.001, 95%CI=1.4–4.0, death: HR=2.30, P=0.001, 95%CI=1.2–4.6, for those with hypertension only} {severe/critical illness: HR=3.76, P=0.001, 95%CI=2.1–6.4, death: crude HR=6.63, P=0.001, 95%CI=3.4–1.6, for those with additional comorbidities}. Hypertension posed an increased risk of severe morbidity (approx. 4-fold) and death (approx. 7-fold) from COVID-19 in the presence of multiple comorbidities. Conclusion: The potential morbidity and mortality risks of hypertension especially with other comorbidities in COVID-19 could help direct efforts towards prevention and prognostication. This provides the rationale for improving preventive caution for people with hypertension and other comorbidities and prioritizing them for future antiviral interventions.

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