scholarly journals Risk factor scenario in an industrial set-up: Need for an effective screening tool to assess the high-risk group

2010 ◽  
Vol 35 (2) ◽  
pp. 262 ◽  
Author(s):  
Uma Iyer ◽  
Garima Mathur ◽  
Nandini Panchanmiya ◽  
Swati Dhruv
Keyword(s):  
Risk Factor ◽  
High Risk ◽  
Screening Tool ◽  
Risk Group ◽  
High Risk Group ◽  
Effective Screening ◽  
Set Up

scholarly journals The Impact of Preoperative Risk on the Association between Hypotension and Mortality after Cardiac Surgery: An Observational Study

2020 ◽  
Vol 9 (7) ◽  
pp. 2057
Author(s):  
Vanja Ristovic ◽  
Sophie de Roock ◽  
Thierry G. Mesana ◽  
Sean van Diepen ◽  
Louise Y. Sun
Keyword(s):  
Cardiac Surgery ◽  
Risk Factor ◽  
High Risk ◽  
Hospital Mortality ◽  
Risk Group ◽  
High Risk Group ◽  
Group Care ◽  
Intermediate Risk ◽  
Intraoperative Hypotension ◽  
The Impact

Background: Despite steady improvements in cardiac surgery-related outcomes, our understanding of the physiologic mechanisms leading to perioperative mortality remains incomplete. Intraoperative hypotension is an important risk factor for mortality after noncardiac surgery but remains relatively unexplored in the context of cardiac surgery. We examined whether the association between intraoperative hypotension and in-hospital mortality varied by patient and procedure characteristics, as defined by the validated Cardiac Anesthesia Risk Evaluation (CARE) mortality risk score. Methods: We conducted a retrospective cohort study of consecutive adult patients who underwent cardiac surgery requiring cardiopulmonary bypass (CPB) from November 2009–March 2015. Those who underwent off-pump, thoracic aorta, transplant and ventricular assist device procedures were excluded. The primary outcome was in-hospital mortality. Hypotension was categorized by mean arterial pressure (MAP) of <55 and between 55–64 mmHg before, during and after CPB. The relationship between hypotension and death was modeled using multivariable logistic regression in the intermediate and high-risk groups. Results: Among 6627 included patients, 131 (2%) died in-hospital. In-hospital mortality in patients with CARE scores of 1, 2, 3, 4 and 5 was 0 (0%), 7 (0.3%), 35 (1.3%), 41 (4.6%) and 48 (13.6%), respectively. In the intermediate-risk group (CARE = 3–4), MAP < 65 mmHg post-CPB was associated with increased odds of death in a dose-dependent fashion (adjusted OR 1.30, 95% CI 1.13–1.49, per 10 min exposure to MAP < 55 mmHg, p = 0.002; adjusted OR 1.18 [1.07–1.30] per 10 min exposure to MAP 55–64 mmHg, p = 0.001). We did not observe an association between hypotension and mortality in the high-risk group (CARE = 5). Conclusions: Post-CPB hypotension is a potentially modifiable risk factor for mortality in intermediate-risk patients. Our findings provide impetus for clinical trials to determine if hemodynamic goal-directed therapies could improve survival in these patients.

A risk-factor analysis of medical litigation judgments related to fall injuries in Korea

2017 ◽  
Vol 58 (1) ◽  
pp. 16-24
Author(s):  
Insook Kim ◽  
Seonae Won ◽  
Mijin Lee ◽  
Won Lee
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Environmental Factors ◽  
Fall Prevention ◽  
Systems Approach ◽  
Risk Group ◽  
Past History ◽  
High Risk Group ◽  
Fall Injuries

The aim of this study was to find out the risk factors through analysis of seven medical malpractice judgments related to fall injuries. The risk factors were analysed by using the framework that approaches falls from a systems perspective and comprised people, organisational or environmental factors, with each factor being comprised of subfactors. The risk factors found in each of the seven judgments were aggregated into one framework. The risk factors related to patients (i.e. the people factor) were age, pain, related disease, activities and functional status, urination state, cognitive function impairment, past history of fall, blood transfusion, sleep endoscopy state and uncooperative attitude. The risk factors related to the medical staff and caregivers (i.e. people factor) were observation negligence, no fall prevention activities and negligence in managing high-risk group for fall. Organisational risk factors were a lack of workforce, a lack of training, neglecting the management of the high-risk group, neglecting the management of caregivers and the absence of a fall prevention procedure. Regarding the environment, the risk factors were found to be the emergency room, chairs without a backrest and the examination table. Identifying risk factors is essential for preventing fall accidents, since falls are preventable patient-safety incidents. Falls do not happen as a result of a single risk factor. Therefore, a systems approach is effective to identify risk factors, especially organisational and environmental factors.

scholarly journals Fatty liver index as a predictive marker for the development of diabetes: A retrospective cohort study using Japanese health check-up data

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257352
Author(s):  
Atsushi Kitazawa ◽  
Shotaro Maeda ◽  
Yoshiharu Fukuda
Keyword(s):  
Risk Factor ◽  
High Risk ◽  
Fatty Liver ◽  
Risk Group ◽  
High Risk Group ◽  
Health Check ◽  
Incident Diabetes ◽  
Standard Group ◽  
Fatty Liver Index

Background & aims Fatty liver is associated with incident diabetes, and the fatty liver index (FLI) is a surrogate marker for non-alcoholic fatty liver disease (NAFLD). We aimed to determine whether or not FLI was associated with incident diabetes in relation to obesity and prediabetic levels in the general Japanese population. Methods This was a retrospective study using the Japanese health check-up database of one health insurance from FY2015 to FY2018. This study included 28,991 individuals with prediabetes. First, we stratified all participants into two groups: “high-risk,” comprising patients with HbA1c >6.0%, and “standard,” comprising the rest. Subsequently, we divided them into four groups according to FLI (<30 or not) and obesity (BMI <25 kg/m2 or not). Subsequently, the incidence rate of diabetes was compared among the groups after 3 years of follow-up using multiple logistic regression models after adjusting for potential confounders. Results After 3 years of follow-up, 1,547 new cases of diabetes were found, and the cumulative incidence was 2.96% for the standard group and 26.1% for the high-risk group. In non-obese individuals, odds ratios (95% confidence interval) for FLI ≥30 versus FLI <30 were: 1.44 (1.09–1.92) for the standard group and 1.42 (0.99–2.03) for the high-risk group. In the high-risk group, obesity (BMI ≥25 kg/m2) but FLI <30 was not a risk factor for developing diabetes. Conclusion Although high FLI is generally considered to be a risk factor for developing diabetes, obesity might have been a confounding factor. However, the present study showed that high FLI is a risk factor for the development of diabetes, even in non-obese individuals. Our results include suggestion to develop a screening tool to effectively identify people at high risk of developing diabetes from the population (especially non-obese prediabetes) who are apparently at low health risk and are unlikely to be targeted for health guidance.

scholarly journals Depression in Age-Related Macular Degeneration

2008 ◽  
Vol 102 (10) ◽  
pp. 591-599 ◽  
Author(s):  
Robin Casten ◽  
Barry Rovner
Keyword(s):  
Risk Factor ◽  
High Risk ◽  
General Population ◽  
Macular Degeneration ◽  
Risk Group ◽  
The Elderly ◽  
High Risk Group ◽  
Age Related Macular Degeneration ◽  
Age Related

Age-related macular degeneration (AMD) is a major cause of disability in the elderly, substantially degrades the quality of their lives, and is a risk factor for depression. Rates of depression in AMD are substantially greater than those found in the general population of older people, and are on par with those of other chronic and disabling diseases. This article discusses the effect of depression on vision-related disability in patients with AMD, suggests methods for screening for depression, and summarizes interventions for preventing depression in this high-risk group.

Mouth self-examination as a screening tool for oral cancer in a high-risk group of patients with Fanconi anemia

2014 ◽  
Vol 118 (4) ◽  
pp. 440-446 ◽  
Author(s):  
Camila Pinheiro Furquim ◽  
Allana Pivovar ◽  
Laura Grein Cavalcanti ◽  
Renata Fuentes Araújo ◽  
Carmem Maria Sales Bonfim ◽  
...  
Keyword(s):  
High Risk ◽  
Oral Cancer ◽  
Fanconi Anemia ◽  
Screening Tool ◽  
Risk Group ◽  
High Risk Group ◽  
Self Examination

Cannabis Use is Not Associated With the Development of Psychosis in an ‘Ultra’ High-Risk Group

2002 ◽  
Vol 36 (6) ◽  
pp. 800-806 ◽  
Author(s):  
Lisa J Phillips ◽  
Christina Curry ◽  
Alison R Yung ◽  
Hok Pan Yuen ◽  
Steven Adlard ◽  
...  
Keyword(s):  
Risk Factor ◽  
High Risk ◽  
Psychotic Disorder ◽  
Risk Group ◽  
High Risk Group ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Psychotic Episode ◽  
Ultra High Risk

Background: The association between cannabis use and the development of a first psychotic episode was studied in a group of 100 young people identified as being at very high risk for the onset of psychosis. Method: The ‘ultra’ high risk cohort was identified by the presence of subthreshold psychotic symptoms, or a combination of first-degree relative with a psychotic disorder and recent functional decline. Thirty-two per cent of the cohort developed an acute psychotic episode over the 12-month period after recruitment. As a component of a larger research study, the level of cannabis use by participants in the year prior to enrolment in the study was assessed at intake. Results: Cannabis use or dependence in the year prior to recruitment to this study was not associated with a heightened risk of developing psychosis over the following 12-month period and therefore did not appear to contribute to the onset of a psychotic disorder. Conclusion: The results of this study suggest that cannabis use may not play an integral role in the development of psychosis in a high-risk group. While this study does not support a role for cannabis in the development of first-episode psychosis, we cannot conclude that cannabis use should be completely ignored as a candidate risk factor for onset of psychosis. A number of weaknesses of the study (the low level of cannabis use in the current sample, the lack of monitoring of cannabis use after intake) suggest that it may be premature to dismiss cannabis use as a risk factor for the development of psychosis and further research is urged in this area.

Evaluation of a medication intensity screening tool used in malignant hematology and bone marrow transplant services to identify patients at risk for medication-related problems

2017 ◽  
Vol 24 (4) ◽  
pp. 243-252 ◽  
Author(s):  
Mariana Lucena ◽  
Carolyn Bondarenka ◽  
Genevieve Luehrs-Hayes ◽  
Andy Perez
Keyword(s):  
At Risk ◽  
Bone Marrow ◽  
High Risk ◽  
Hospital Stay ◽  
Bone Marrow Transplant ◽  
Screening Tool ◽  
Risk Group ◽  
Anticoagulation Therapy ◽  
Marrow Transplant ◽  
High Risk Group

Background In 2014, a screening tool was implemented at Medical University of South Carolina (MUSC) Health to identify patients who are at risk for medication-related events. Patients are classified as high-risk if they meet one of the following criteria: receiving anticoagulation therapy, taking more than 10 scheduled medications upon admission, or readmission within the past 30 days. The goal of this study was to determine risk criteria specific to the malignant hematology (MH) and bone marrow transplant (BMT) patients. Methods A retrospective chart review of 114 patients admitted and discharged from the MH/BMT services between 1 September 2015 and 31 October 2015 was performed. A pharmacist-conducted medication history was completed and documented, and all interventions at admission and throughout hospitalization were categorized by severity and by value of service. The primary objective was to evaluate if patients in the MH/BMT services have more medication-related interventions documented upon admission compared with patients who are not screened as high risk. The secondary objectives were to evaluate the different types and severities of interventions made by pharmacists during the entire hospital stay, and to determine if there are certain characteristics that can help identify hematology/oncology high-risk patients. Results More interventions documented upon admission in the high-risk group as a whole when compared with the not high-risk group (73 vs. 31), but when normalized per patients in each group, there was an equal number of interventions (1.0). The most common interventions were to modify regimen (36%) and discontinue therapy (16%). The patient characteristics associated with high-risk included neutropenia, lower average platelet counts on admission, and longer length of stay. Conclusion The screening tool does not further differentiate an already complex MH/BMT patient population. Pharmacists may be more useful at capturing errors or changes during a patient’s hospital stay instead of upon admission. Thrombocytopenia, neutropenia, and active infections may correlate with higher-risk status.

scholarly journals TINGKAT KECEMASAN IBU HAMIL TRIMESTER III BERDASARKAN KELOMPOK FAKTOR RESIKO KEHAMILAN

2020 ◽  
Vol 2 (1) ◽  
pp. 16
Author(s):  
Ika Septiana Saputri ◽  
Ika Yudianti
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
P Value ◽  
Pregnancy Risk ◽  
Cross Sectional ◽  
Work Area ◽  
Anxiety Levels

Kecemasan pada ibu bahkan yang mempunyai resiko kehamilan yang tinggi dapat memicu terjadinya rangsangan kontraksi rahim sehingga mampu mengakibatkan preeklampsi dan keguguran, kelahiran Bayi Berat Lahir Rendah dan bayi prematur. Perlunya melakukan pengkajian tingkat kecemasan sehingga tidak mengakibatkan komplikasi dalam kehamilan. Tujuan dari penelitian ini yaitu untuk mengetahui perbedaan tingkat kecemasan ibu hamil trimester III berdasarkan kelompok faktor resiko kehamilan Desain penelitian menggunakan analitik komparasi dengan pendekatan cross-sectional. Penelitian ini menggunakan teknik Purposive sampling. Sampel berjumlah 51 orang yang memenuhi kriteria inklusi yaitu tercatat didalam kohort dengan usia kehamilan 28-37 minggu di Wilayah Kerja Puskesmas Gribig, mengetahui faktor resiko kehamilannya, dapat membaca dan menulis, serta bersedia menjadi responden. Analisis data menggunakan uji Kruskall Wallis. Pengumpulan data menggunakan kuesioner ZSAS yang telah dimodifikasi. Hasil uji statistik p value (0,000) < α = (0,05) maka Ho ditolak yang berarti terdapat perbedaan antara Tingkat Kecemasan Ibu Hamil Trimester III berdasarkan Kelompok Faktor Resiko Kehamilan di Wilayah Kerja Puskesmas Gribig Kecamatan Kedungkandang Kota Malang. Mayoritas responden yang termasuk kelompok resiko rendah (88,9%) mengalami tingkat kecemasan ringan, kelompok resiko tinggi (86,7%) mengalami tingkat kecemasan sedang, dan kelompok resiko sangat tinggi (66,7%) mengalami tingkat kecemasan berat. Dari hasil penelitian tersebut, menunjukkan bahwa semakin tinggi faktor resiko yang dialami akan semakin tinggi pula tingkat kecemasan. Sehingga diharapkan bidan dapat memberikan KIE tentang hasil skrinning kelompok faktor resiko kehamilan, serta meningkatkan perhatian dan empati pada ibu hamil yang sangat membutuhkan infomasi lebih mengenai kehamilan guna dapat mengatasi kecemasan yang terjadi. Anxiety in mothers even who have a high risk of pregnancy can trigger stimulation of uterine contractions so that it can lead to preeclampsia and miscarriage, low birth weight birth (LBW) and premature babies. The need to assess anxiety levels so that they do not cause complications in pregnancy. The purpose of this study is to determine differences in anxiety levels of third trimester pregnant women based on pregnancy risk factor groups. The study design uses comparative analytics with cross-sectional approaches. This research uses purposive sampling technique. A sample of 51 people who met the inclusion criteria was recorded in a cohort with 28-37 weeks' gestation in the Gribig Community Health Center Work Area, knew the risk factors for pregnancy, could read and write, and was willing to be respondents. Data analysis using the Kruskall Wallis test. Data collection uses a modified ZSAS questionnaire. Statistical test results p value (0,000) <α = (0.05) then Ho is rejected, which means there is a difference between the Anxiety Levels of Trimester III Pregnancy based on Pregnancy Risk Factors in Gribig Puskesmas Work Area in Kedungkandang District, Malang. The majority of respondents who belong to the low risk group (88.9%) experienced mild anxiety levels, the high risk group (86.7%) experienced moderate anxiety levels, and the very high risk group (66.7%) experienced severe anxiety levels. From the results of the study, showed that the higher the risk factors experienced the higher the level of anxiety. It is hoped that midwives can provide IEC about the screening results of pregnancy risk factor groups, and increase the attention and empathy of pregnant women who really need more information about pregnancy in order to overcome the anxiety that occurs.

scholarly journals RISK FACTORS FOR PREMATURE BIRTH. IS EVERYTHING UNAMBIGU-OUS?

2021 ◽  
Vol 9 (1) ◽  
pp. 77-90
Author(s):  
I.V. Galinova ◽  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Premature Birth ◽  
Risk Group ◽  
Polycystic Ovary ◽  
Asymptomatic Bacteriuria ◽  
High Risk Group ◽  
Ovary Syndrome ◽  
History Of

Aim. Despite the fact that ischemic-cervical insufficiency (ICI) is considered to be a risk factor for preterm birth (PB), a comparative analysis of the risk factors for each complication of gestation (ICI and PB) showed considerable differences. This was the reason for conducting a study to identify the most significant risk factors for PB and ICI. Materials and Methods. A questionnaire survey of 267 pregnant women was carried out to study the anamnestic risk factors for PR and for assessment of the course and outcomes of the current pregnancy. The existence of statistically significant differences was determined using Fishers exact test, and the ranking of risk factors was performed by the value of x2 criterion, adjusted for likelihood. Results. Pregnancy ended prematurely in 14 women (5.2%). Extremely early PB made 14.3% among all PB, premature births – 21.4%, late births – 64.3%, early PB were absent. Spontaneous and induced PB occurred with the same frequency – 50% each in the PB structure. Based on the x2 calculation, a rating of the PB risk factors was made. The 1st place – history of induced PB, 2 – history of polycystic ovary syndrome; 3 – in vitro fertilization; 4 – arterial hypertension; 5 – asymptomatic bacteriuria; 6 – ICI; 7 – hypothyroidism; 8 – the premature birth of the father. Also, an assessment of the risk factors for ICI was carried out and their rating was compiled: 1 – intra-uterine interventions before the first birth; 2 – repeated intrauterine interventions; 3 – history of ICI. Conclusion. Women with endocrine disorders (thyroid disease, polycystic ovary syndrome), arterial hypertension before and during pregnancy, physical inactivity before pregnancy should be considered a high risk group for PB. Asymptomatic bacteriuria is a risk factor not only for PB, but also for ICI, in which connection its early detection and rehabilitation is advisable. In the course of our study, the necessity for cervicometry during the 1st ultrasound screening was confirmed, and dynamic cervicometry can be recommended not only for women with PB, late spontaneous miscarriages, history of ICI and ICI in the current pregnancy, but also for pregnant women with repeated intrauterine interventions and with intrauterine interventions before the first forthcoming birth, for the earlier detection of ICI and formation of a high-risk group for PR for arrangement of preventive measures.

scholarly journals Prognostic Significance of NLR About NETosis and Lymphocytes Perturbations in Localized Renal Cell Carcinoma With Tumor Thrombus

2021 ◽  
Vol 11 ◽  
Author(s):  
Bingqing Shang ◽  
Liping Guo ◽  
Rongfang Shen ◽  
Chuanzhen Cao ◽  
Ruiyang Xie ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Risk Factor ◽  
High Risk ◽  
Tumor Thrombus ◽  
Independent Risk Factor ◽  
Immune Status ◽  
Risk Group ◽  
Basic Research ◽  
High Risk Group ◽  
Clinical Cohort

BackgroundNon-metastatic renal cell carcinoma (RCC) with tumor thrombus showed a greater tendency for developing metastases after surgery. Early identification of patients with high risk of poor prognosis is especially important to explore adjuvant treatment of improving outcomes. Neutrophil-to-lymphocyte ratio (NLR) was a systemic inflammation marker and outcome predictor in RCC, reflecting the chaos in systemic immune status in cancer as myeloid cell expansion and lymphatic cell suppression. Neutrophil extracellular traps (NET) formation (NETosis) is the process of neutrophils generating an extracellular DNA net-like structure. NETosis in tumor was demonstrated to conduce to the subsequent metastases of tumor. However, the role of NLR for systemic immune status and tumor local immune infiltration, especially for neutrophil-associated NETs, in non-metastatic RCC with thrombus remains unclear.Patients and MethodsIn our clinical cohort, we enrolled the clinical, pathologic, and preoperative laboratory parameters of 214 RCC patients with tumor thrombus who were treated surgically. The clinical endpoint was defined as cancer-specific survival (CSS). In our basic research cohort, RNA-seq, TCR-seq, and scRNA-seq data were analyzed. Patients who reached the endpoint as recurrence-free survival (RFS) were defined as the “High-risk” group. Otherwise, they were separated into the “Low-risk” group.ResultsIn the clinical cohort, NLR≥4 was an independent risk factor for 203 localized RCC with tumor thrombus. In the basic research cohort, tumor thrombi were separated into NETosis-thrombi belonging to the “High-risk” group and non-NETosis-thrombi to the “Low-risk” group. NETs induced by tumor-derived G-CSF in tumor thrombus has a mechanistic role in unfavorable prognosis. Besides, NETs-score from single sample GSEA (ssGSEA) algorithm was an independent prognostic factor validated in the TCGA data. Apart from the neutrophils-associated NETosis, systemic immune perturbations of lymphocytes occurred in the “High-risk” group, represented with decreased TCR diversity and increasingly high proportion of CD4-positive effector memory T (Tem) cells, which indirectly represented the state of lymphopenia.ConclusionsOur findings firstly demonstrated that neutrophils-associated NETosis and systemic lymphocytes perturbations were considered as tumor progression in patients of localized RCC with tumor thrombus, which reflected NLR≥4 as an independent risk factor for patients.

Sign in / Sign up

Export Citation Format

Share Document