The Relationship between Patient Age and Sensitivity to Known Risk Factors for Asthma Attacks

SummaryThe retrospective observational study surveys the relationship between development of inhibitors in the treatment of haemophilia patients and risk factors such as changing FVIII products. A total of 119 patients were included in this study, 198 changes of FVIII products were evaluated. Results: During the observation period of 12 months none of the patients developed an inhibitor, which was temporally associated with a change of FVIII products. A frequent change of FVIII products didn’t lead to an increase in inhibitor risk. The change between plasmatic and recombinant preparations could not be confirmed as a risk factor. Furthermore, no correlation between treatment regimens, severity, patient age and comorbidities of the patients could be found.

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Trastuzumab-mediated cardiotoxicity in the nontrial setting: Evaluation of patients receiving adjuvant trastuzumab at an academic centre

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e11550 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e11550-e11550

Author(s):

D. Withrow ◽

S. Verma ◽

R. Dent ◽

S. Ahmed ◽

J. Fralick ◽

...

Keyword(s):

Risk Factors ◽

Clinical Trials ◽

Ejection Fraction ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Adjuvant Trastuzumab ◽

Patient Age ◽

Ventricular Ejection Fraction ◽

Patient Âgé ◽

The Relationship

e11550 Background: Trastuzumab is effective in the treatment of HER-2 positive breast cancer. Although clinical trials have shown an increased risk of cardiotoxicity associated with trastuzumab, this risk has not been well studied in the non-trial setting. This study aims to examine (1) the incidence of cardiotoxicity associated with trastuzumab in the clinical setting (2) the relationship, if any, between risk factors and incidence of cardiotoxicity and (3) cardiac monitoring practices. Methods: A retrospective chart review was conducted of all patients receiving adjuvant trastuzumab therapy between August 2005 and May 2008, at a Canadian academic centre. The incidence of cardiotoxicity, defined as a significant reduction in left ventricular ejection fraction (drop of >10% leading to an ejection fraction of <50%) and/or New York Heart Association class III-IV CHF symptoms requiring trastuzumab delay or discontinuation was evaluated. Medical charts and patient surveys provided demographics, risk factors and cardiac toxicity for each patient. Results: 183 patients were included in the study. The average age of participating patients was 54.8 years and 51% of participants had node positive cancer. 72% were treated sequentially with Trastuzumab and 88% received anthracyclines. The incidence of cardiotoxicity was 6.0% (n=11). Upon univariate analysis, patient age was found to be the only variable significantly associated with the occurrence of cardiotoxicity (OR: 3.55, 95% CI 1.76–90.0). Left ventricular function was monitored by serial MUGA scan every 3.35 ±1.89 months as compared to the 3 month gold standard in clinical trials. Conclusions: In this study the incidence of cardiotoxicity was 6.0%. Patient age was the only significant variable associated with cardiotoxicity, as expected from previous studies. Clinically, this suggests that older patients may need more frequent monitoring for cardiac dysfunction via MUGA and/or ECHO scans. Future research needs to address the relationship between treatment regimens and the incidence of cardiotoxicity. Furthermore, we need to better define cardiotoxicity and the clinical significance of cardiac related symptoms. No significant financial relationships to disclose.

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Risk of hemorrhage from de novo cerebral aneurysms

Journal of Neurosurgery ◽

10.3171/2012.9.jns111512 ◽

2013 ◽

Vol 118 (1) ◽

pp. 58-62 ◽

Cited By ~ 22

Author(s):

William J. Kemp ◽

Daniel H. Fulkerson ◽

Troy D. Payner ◽

Thomas J. Leipzig ◽

Terry G. Horner ◽

...

Keyword(s):

Risk Factors ◽

De Novo ◽

Patient Age ◽

Patient Âgé ◽

Long Term Follow Up ◽

De Novo Aneurysm ◽

The Mean ◽

Risk Of Hemorrhage

Object A small percentage of patients will develop a completely new or de novo aneurysm after discovery of an initial aneurysm. The natural history of these lesions is unknown. The authors undertook this statistical evaluation a large cohort of patients with both ruptured and unruptured de novo aneurysms with the aim of analyzing risk factors for rupture and estimating a risk of subarachnoid hemorrhage (SAH). Methods A review of a prospectively maintained database of all aneurysm patients treated by the vascular neurosurgery service of Goodman Campbell Brain and Spine from 1976–2010 was performed. Of the 4718 patients, 611 (13%) had long-term follow-up imaging. The authors identified 27 patients (4.4%) with a total of 32 unruptured de novo aneurysms from routine surveillance imaging. They identified another 10 patients who presented with a new SAH from a de novo aneurysm after treatment of their original aneurysm. The total study group was thus 37 patients with a total of 42 de novo aneurysms. The authors then compared the 27 patients with incidentally discovered aneurysms with the 10 patients with SAH. A statistical analysis was performed, comparing the 2 groups with respect to patient and aneurysm characteristics and risk factors. Results Thirty-seven patients were identified as having true de novo aneurysms. This group had a female predominance and a high percentage of smokers. These 37 patients had a total of 42 de novo aneurysms. Ten of these 42 aneurysms hemorrhaged. De novo aneurysms in both the SAH and non-SAH group were anatomically small (< 10 mm). The estimated risk of hemorrhage over 5 years was 14.5%, higher than the expected SAH risk of small, unruptured aneurysms reported in the ISUIA (International Study of Unruptured Intracranial Aneurysms) trial. There was no statistically significant correlation between hemorrhage and any of the following risk factors: hypertension, diabetes, tobacco and alcohol use, polycystic kidney disease, or previous SAH. There was a statistically significant between-groups difference with respect to patient age, with the mean patient age being significantly older in the SAH aneurysm group than in the non-SAH group (p = 0.047). This is likely reflective of longer follow-up and discovery time, as the mean length of time between initial treatment and discovery of the de novo aneurysm was longer in the SAH group (p = 0.011). Conclusions While rare, de novo aneurysms may have a risk for SAH that is comparatively higher than the risk associated with similarly sized, small, initially discovered unruptured saccular aneurysms. The authors therefore recommend long-term follow-up for all patients with aneurysms, and they consider a more aggressive treatment strategy for de novo aneurysms than for incidentally discovered initial aneurysms.

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Epidemiology of jellyfish stings reported to poison centers in Texas

Human & Experimental Toxicology ◽

10.1191/0960327106ht604oa ◽

2006 ◽

Vol 25 (4) ◽

pp. 183-186 ◽

Cited By ~ 7

Author(s):

M B Forrester

Keyword(s):

Clinical Outcome ◽

Gulf Coast ◽

Clinical Parameters ◽

Patient Age ◽

Patient Âgé ◽

Prevention And Treatment ◽

Poison Centers ◽

The Relationship

This study examined the relationship between selected factors and all human exposures involving jellyfish stings reported to Texas poison centers. Cases were obtained retrospectively from calls to poison centers in Texas and included all reported human exposures during 1998-2004 involving jellyfish stings. The distribution of cases was determined for a variety of demographic and clinical parameters. There were 423 total cases. Among the cases with a known patient age, 19.8% were<6 years of age, 53.5% were age 6-19 years, and 26.7% were > 19 years of age. Males accounted for 52% of the cases. Of the 118 cases with a known clinical outcome, 0.8% had no effect, 80.5% had minor effects, and 18.6% had moderate effects. Counties along the Gulf Coast accounted for 72.3% of the calls. This information can be used to identify those portions of the population most at need of education regarding the prevention and treatment of jellyfish stings.

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IP127. Risk Factors for Major Adverse Clinical Events After Carotid Endarterectomy Based on Patient Age and Symptoms

Journal of Vascular Surgery ◽

10.1016/j.jvs.2018.03.150 ◽

2018 ◽

Vol 67 (6) ◽

pp. e120

Author(s):

Anjeza Zholanji ◽

David O'Connor ◽

Tracey Andrews ◽

Erica Amianda ◽

Themba Nyirenda ◽

...

Keyword(s):

Risk Factors ◽

Carotid Endarterectomy ◽

Patient Age ◽

Clinical Events ◽

Patient Âgé

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Understanding risk factors for perioperative ischemic events with carotid stenting: is patient age over 80 years or is unfavorable arch anatomy to blame?

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2013-010721 ◽

2013 ◽

Vol 6 (3) ◽

pp. 219-224 ◽

Cited By ~ 13

Author(s):

Travis M Dumont ◽

Maxim Mokin ◽

Michael M Wach ◽

Patrick S Drummond ◽

Adnan H Siddiqui ◽

...

Keyword(s):

Risk Factors ◽

Carotid Stenting ◽

Patient Age ◽

Patient Âgé ◽

Ischemic Events

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Predictors of Serious Complications Associated with Lower Gastrointestinal Endoscopy in a Major City-Wide Health Region

Canadian Journal of Gastroenterology ◽

10.1155/2010/714591 ◽

2010 ◽

Vol 24 (7) ◽

pp. 425-430 ◽

Cited By ~ 14

Author(s):

Harminder Singh ◽

Robert B Penfold ◽

Carolyn De Coster ◽

Wendy Au ◽

Charles N Bernstein ◽

...

Keyword(s):

Risk Factors ◽

Clinical Practice ◽

Hospital Admissions ◽

Patient Age ◽

Index Procedure ◽

Gi Endoscopy ◽

Patient Âgé ◽

Usual Clinical Practice ◽

Low Volume ◽

And Performance

BACKGROUND: There are limited data regarding complications associated with colonoscopy and flexible sigmoidoscopy in usual clinical practice in Canada.OBJECTIVE: To determine the risk factors for lower gastrointestinal (GI) endoscopy-associated complications in usual clinical practice.METHODS: All outpatient lower GI endoscopies performed in Winnipeg (Manitoba) between April 1, 2004 and March 31, 2006, were identified from the provincial physicians’ claims database. All subsequent hospital admissions within 30 days that documented potential complications associated with lower GI endoscopies were identified from the electronic hospital discharges database and reviewed. Multivariate generalized estimating equation regression analysis was performed to determine independent factors (patient, endoscopist and procedure) associated with the risk of developing complications.RESULTS: There were 29,990 outpatient lower GI endoscopies performed in Winnipeg during the years studied. Seventy-seven (0.26%) procedures were associated with complications requiring hospitalization within 30 days of the index procedure. Stricture dilation (rate ratio [RR] 23.14; 95% CI 6.70 to 76.51), polypectomy (RR 5.93; 95% CI 3.66 to 9.62), increasing patient age (for each year increase in age, RR 1.03; 95% CI 1.01 to 1.05) and performance of endoscopy by low-volume endoscopists (fewer than 200 procedures per year, RR 2.28; 95% CI 1.18 to 4.42) and family physicians (RR 2.23; 95% CI 1.39 to 3.58) were independently associated with complications.CONCLUSIONS: The results of the present study suggest that increasing patient age, complex procedures and performance of the index procedure by low-volume endoscopists are independent risk factors for lower GI endoscopy-associated complications in usual clinical practice. This suggests that it may be time to consider implementing minimum volume requirements for endoscopists performing non-screening lower GI endoscopies.

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The Relationship Between Patient Age and Pain Management of Long Bone Fracture in the Emergency Department

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2013.07.184 ◽

2013 ◽

Vol 62 (4) ◽

pp. S127-S128

Author(s):

E. Boccio ◽

S. Pasternak ◽

E. Kintzer ◽

J. D'Amore ◽

M.F. Ward ◽

...

Keyword(s):

Emergency Department ◽

Pain Management ◽

Bone Fracture ◽

Long Bone ◽

Patient Age ◽

Patient Âgé ◽

Long Bone Fracture ◽

The Relationship

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Food Insecurity in a Pediatric Emergency Department and the Feasibility of Universal Screening

Western Journal of Emergency Medicine ◽

10.5811/westjem.2021.7.52519 ◽

2021 ◽

Vol 22 (6) ◽

pp. 1295-1300

Author(s):

Jaqueline Valdez Gonzalez ◽

Emily Hartford ◽

Jennifer Moore ◽

Julie Brown

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Food Insecurity ◽

Private Insurance ◽

Care Quality ◽

Screening Methods ◽

Patient Age ◽

Cross Sectional ◽

Patient Âgé ◽

Medical Complexity

Introduction: Children with food insecurity (FI) experience adverse health outcomes due to inadequate quantity or quality of food. Food insecurity may be high among families seeking emergency care. The Hunger Vital Sign (HVS) is a two-question validated tool used to screen families for FI. Our goal in this study was to assess prevalence of FI among emergency department (ED) patients, patient-level risk factors for FI, and the feasibility of screening. Methods: This was a cross-sectional analysis of FI in the ED. Parents or guardians of ED patients and adult patients (18 years or older) were approached for screening using the HVS during screening periods spanning weekdays/weekends and days/evenings. All ED patients were eligible, excluding siblings, repeat visits, critically ill patients, minors without a guardian, and families that healthcare staff asked us not to disturb. Families answered the HVS questions verbally or in writing, based on preference. Families with positive screens received information about food resources. We summarized patient and visit characteristics and defined medical complexity using a published algorithm. Multivariable logistic regression was used to assess FI risk factors. Results: In July-August 2019, 527 patients presented during screening periods: 439 agreed to screening, 18 declined, 19 met exclusions, and 51 were missed. On average the screening tool required five minutes (range 3-10 minutes) to complete. Most families (328; 75%) preferred to answer in writing rather than verbally. Overall, 77 participants (17.5%) screened positive for FI. In regression analyses, FI was associated with self-reported race/ethnicity (combined variable) of African American or Black (odds ratio [OR] 5.21, 95% confidence interval [CI], 2.13-12.77), Hispanic (OR 3.47, 95% CI, 1.48-8.15), or mixed/other (OR 3.81, 95% CI, 1.54-9.39), compared to non-Hispanic white. FI was also associated with public insurance type (OR 5.74, 95% CI, 2.52-13.07, reference: private insurance), and each year of increasing patient age (OR 1.05, 95% CI, 1.01-1.09). There were no associations between FI and medical complexity or preferred language. Conclusion: Food insecurity was common among our ED patients. Race and ethnicity, insurance status, and increasing patient age were associated with increased odds of FI. Efforts to include universal FI screening for ED patients with immediate connection to resources will enhance overall care quality and address important health needs.

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