scholarly journals RISK FACTORS FOR WOUND DEHISCENCE AFTER LAPAROTOMY: A CASE-CONTROL STUDY

2017 ◽  
Vol 27 (3) ◽  
pp. 84-88
Author(s):  
Tomas Poškus ◽  
Vilius Mačiūnas ◽  
Marius Kryžauskas ◽  
Saulius Mikalauskas ◽  
Donatas Danys ◽  
...  

Background. Wound dehiscence is a life-threatening complication with the mortality rate up to 25 %. The objective of this study is to identify the risk factors for wound dehiscence after midline laparotomy in adult population. Methods. The case control study of patients, operated from January 2012 to May 2016, was performed. Patients, who underwent repeated laparotomy for wound dehiscence, were the cases group. Each case was matched by 3 control group patients undergoing similar primary operation. Following characteristics were observed: demographic, past medical and social history, concomitant diseases, intraoperative details, postoperative outcomes and were compared between the groups. Difference was significant, if p value was less than 0.05. Results. 100 patients were included in the study. There were 25 (25 %) patients of the cases group and 75 (75 %) patient of the control group. The majority of the patients were males (69 %). The mean age was 66.7 ± 10.8 years. Three risk factors were identified in the univariate analysis: male gender (88.0 %), wound infection (56 %) and cardiovascular diseases (88 %) for wound dehiscence with the mortality rate of 20 %. Conclusions. Wound dehiscence is a serious complication with a high mortality rate. The identification of preoperative and early postoperative risk factors may allow preventing and reduce the rate of wound dehiscence.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yusuke Watanabe ◽  
Itaru Nakamura ◽  
Yuri Miura ◽  
Hidehiro Watanabe

Abstract Background Despite having a high mortality rate, Asian studies about the characteristics of adult listeriosis are limited. We investigated the incidence of listeriosis per admissions, associated factors, and rate of mortality in listeriosis, compared with non-listeriosis. Methods We recorded the incidence of listeriosis per 10,000 admissions and conducted a case–control study from January 1, 2010, to December 31, 2019, at Tokyo Medical University Hospital (TMUH) in Japan. Cases were defined as adult with listeriosis that was bacteremia due to L. monocytogenes. Controls, defined as adult with non-listeriosis bacteremia due to other pathogens, were matched by age and clinical department to cases. We analyzed differences in seasonality, including warm season (defined as the period from May to October), medication including steroids, laboratory findings, and mortality. The odds ratio and p value between the cases group and control group were calculated using a chi-square test and Fisher’s exact test. Results The incidence of listeriosis per 10,000 admissions to TMUH was 0.51. Eleven patients, excluding one neonate, were included in the case group. Twenty-six patients, excluding one patient because of contamination and one patient because of insufficient medical record, were included in the control group. Listeriosis onset was associated with the warm season (90.9% vs. 53.8%; p = 0.033), steroid use (54.5% vs. 19.2%; p = 0.042), and a lower ratio of neutrophils to lymphocytes (9.46 vs. 18.44; p = 0.015). The 30-day mortality rate of listeriosis was similar to non-listeriosis (18.3% vs. 19.2%; p = 0.619). Conclusion The incidence of listeriosis per admissions in this study was similar to that in other Asian countries. Factors associated with listeriosis were the warm season, steroid use, and a lower ratio of neutrophils to lymphocytes. Additionally, the 30-day mortality rate was similarly high in both the listeriosis and non-listeriosis groups.


2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Patorn Piromchai ◽  
Sanguansak Thanaviratananich

Background. Invasive fungal rhinosinusitis with orbital complications (IFSwOC) is a life-threatening condition. The incidence of mortality has been reported to be up to 80 percent. This study was conducted to determine the risk factors, presentations, clinical, and imaging findings that could help to manage this condition promptly.Methods. We conducted a case-control study of 100 patients suffering from rhinosinusitis with orbital complications. The risk factors, clinical presentations, radiological findings, medical and surgical managements, durations of hospital stay, and mortality rate data were collected.Results. Sixty-five patients were diagnosed with IFSwOC, while the other thirty-five patients composed the control group. The most important risk factor for IFSwOC was diabetes mellitus. Visual loss and diplopia were the significant symptom predictors. The significant clinical predictors were nasal crust, oculomotor nerve, and optic nerve involvement. The CT findings of IFSwOC were sinus wall erosion and hyperdensity lesions. The mortality rate was 25.71 percent in the IFSwOC group and 3.17 percent in the control group.Conclusions. Invasive fungal rhinosinusitis with orbital complications is symptomatic of a high mortality rate. The awareness of a patient’s risk factors, the presenting symptoms, signs of fungal invasion, and aggressive management will determine the success of any treatment procedures.


Author(s):  
Ari W. Nanda ◽  
Alit Semarawisma

Background: Preeclampsia is one of the most common health problems in pregnancy that relates to several risk factors leading to an increase in maternal and perinatal mortality. The risk factors for preeclampsia include maternal age ≥35 years old, primigravida, chronic hypertension, obesity, and history of preeclampsia. However, studies investigating anemia as a risk factor for preeclampsia were still limited and showed conflicting results. This study aims to investigate the association between anemia and preeclampsia.Methods: A case-control study was conducted in the department of obstetrics and gynecology Dr. M. M. Dunda public hospital, Indonesia, from December 2020 to May 2021. Secondary data was collected in singleton pregnancy patients aged <35 years, admitted from 2016 to 2020. The number of patients used in this study was 264 consisting of 132 preeclampsia and 132 healthy women. Patient basic characteristics, obstetrics status, urinalysis, and complete blood count were collected and analysed using SPSS 25 for Mac. Kolmogorov-Smirnov test was done to examine data distribution. Chi-square was used to analyse the association between anemia and preeclampsia, p<0.05 is considered to be statistically significant.Results: BMI was found significantly higher in preeclampsia group (p<0.000), and infants born to mothers with preeclampsia had lower birth weight and height compared to the control group with p-value respectively p<0.032 and p<0.001. There was no significant association between anemia and pre-eclampsia (p=0.712; p>0.05).Conclusions: Preeclampsia is significantly associated with higher maternal BMI and lower birth weight/height. However, no association was identified between anemia and preeclampsia.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mintao Lin ◽  
Jiani Chen ◽  
Sisi Li ◽  
Yingjie Qin ◽  
Xuruan Wang ◽  
...  

AbstractPeople with epilepsy (PWE) have an increased suicide prevalence. This study aimed to identify the risk factors for suicidal tendency among PWE in West China. A nested case–control study was designed in a cohort of patients with epilepsy (n = 2087). In total, 28 variates were calculated. In the univariate analysis, unemployment, low income, seizure frequency, seizure-free time, infectious or structural etiology, levetiracetam or phenobarbital use, anxiety, depression, and stigma were associated with suicidal tendency. A multivariate analysis indicated that unemployment (odds ratio [OR] 5.74, 95% confidence interval [CI] 2.13–15.48), levetiracetam use (OR 2.80, 95%CI 1.11–7.05), depression (C-NDDI-E score ≥ 13; OR 3.21, 95%CI 1.26–8.21), and stigma (SSCI score ≥ 16; OR 6.67, 95%CI 1.80–24.69) were independently associated with suicidal tendency. Conditional inference tree analysis indicated that SSCI and C-NDDI-E scores could effectively identify patients with suicidal tendency. Thus, this study suggests that unemployment, levetiracetam use, depression, and stigma are independent risk factors for suicidal tendency in PWE in China.


2021 ◽  
Author(s):  
Abdulkareem Ali Hussein Nassar ◽  
Amr Abdulaziz Torbosh ◽  
Yassin Abdulmalik Mahyoub ◽  
Mohammed Abdullah Al Amad

Abstract Background: Dengue Fever (DF) is a significant health problem in Yemen especially in the coastal areas. On November 6, 2018, Taiz governorates surveillance officer notified the Ministry of Public Health and Population on an increase in the number of suspected DF in Al Qahirah and Al Mudhaffar districts, Taiz governorate. On November 7, 2018, Field Epidemiology Training Program sent a team to perform an investigation. The aims were to confirm and describe the outbreak by person, place and time in Taiz governorate, and identify its risk factors.Methodology: Descriptive and case-control study (1:2 ratio) were conducted. WHO case definition was used to identify cases in Al Qahirah or Al Mudhaffar districts during August-November 2018. Control was selected from the same districts who did not suffer from DF. Predesigned questionnaire was used to collect data related to sociodemographic, behavioral and environmental characteristics. Bivariate and multivariate backward stepwise analyses were used. The adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were calculated. A P value < 0.05 was considered as the cut point for statistically significant. Epi info version 7.2 was used.Results: A total of 50 DF cases were found. Almost 52% were males and 76% were <30 years of age. The overall attack rate was 1/10,000 of the population. Case fatality rate was 4%. In multivariate analysis, not working (aOR = 26.6, 95% CI: 6.8–104.7), not using mosquito repellent (aOR = 13.9, 95% CI:1.4–136.8), wearing short sleeves/pants (aOR = 27.3, 95% CI: 4.8–156.8), poor sanitation (aOR = 5.4, 95% CI: 1.4–20.3), presence of outdoor trees (aOR = 13.2, 95% CI: 2.8–63.0) and houses without window nets (aOR = 15.7, 95% CI: 3.9–63.4) were statistically significant risk factors associated with DF outbreak. Eleven 11 (58%) of blood samples were positive for DF IgM.Conclusions: DF outbreak in Al Qahirah and Al Mudhaffar districts, Taiz governorate was confirmed. This study provides evidence-based information regarding the identified risk factors that contributed to the occurrence of this outbreak. Raising community awareness on the importance of personal protection measures and improving the sanitation services are strongly recommended.


Author(s):  
Mayadevi Brahmanandan ◽  
Lekshmi Murukesan ◽  
Bindu Nambisan ◽  
Shaila Salmabeevi

Background: The greatest risks to life are in its very beginning. Although a good start in life begins well before birth, it is just before, during, and in the very first hours and days after birth that life is most at risk. This prospective case control study was designed on maternal risk factors for perinatal mortality.Methods: This was a case control study conducted in the Department of Obstetrics and Gynecology and Department of Paediatrics, Medical College Trivandrum for one year period in 2004-2005. The cases were all the fresh and macerated still births and early neonatal death cases during the study period. The controls were chosen as the next delivery entry in the OR register.Results: During this period, the total number of deliveries was 14,796 and there were 431 perinatal deaths. The perinatal mortality rate was 29.12. This was much higher compared to Kerala’s perinatal mortality rate of 10, the reason being that the study is conducted in a tertiary referral hospital with one of the best new born care nurseries and a large number of referrals. The most significant risk factors for perinatal mortality were low socio-economic status, referrals, late registration, prematurity, low birth weight, intra-uterine growth restriction, maternal diseases like gestational hypertension and gestational diabetes and intrapartum complications like abruption.Conclusions: Perinatal mortality rate serves as the most sensitive index of maternal and neonatal care. Good antenatal care and prevention of preterm birth may play a key role in further reduction of PMR.


2016 ◽  
Vol 31 (2) ◽  
pp. 83
Author(s):  
Marina De Deus Moura Lima ◽  
Zacarias Soares Brito-Neto ◽  
Heylane Oliveira Amaral ◽  
Cacilda Castelo Branco Lima ◽  
Marcoeli Silva de Moura ◽  
...  

Objective: The aim of this study was to determine the risk factors associated with early childhood caries (ECC).Methods: It was an observational retrospective case-control study. The case group consisted of all patients diagnosed with ECC in the records of an active program of maternal and child care. The control group was composed of an equal number of children, matched for gender and age, who attended the program and did not have ECC. The process of data collection consisted of completing a pre-established schedule to analyse variables related to the mother/caregiver and child.Statisticalanalysis was performed using the chi-squared and odds ratio (OR), with alpha (α) = 0.05.Results: History of caries in the mother (OR=2.61; CI 95%=1.45-4.67) and father (OR=1.72; CI 95%=1.02-2.89) were key determinants in the child being diagnosed with ECC.Conclusions: The risk factors associated with ECC were the following: no oral hygiene acceptance, nocturnal feeding duration of more than 16 months, a daily intake of sugar greater than 4 times a day, a Baume type II maxillary arch, fewer than 3 consultations with the program, and a history of decay in the parents.


2015 ◽  
Vol 40 (3) ◽  
pp. 113-117 ◽  
Author(s):  
A Jahan ◽  
SZR Rezina Parvin ◽  
D Bugum

This case-control study was done to identify the correlation between the familial, social and environmental risk factors and autism. This hospital and specialized centre based study done from January 2002 to November, 2004. Thirty two children from the autism group and 14 children from the control group were enrolled. Mean age were 3.75 yrs. and 2.83 yrs. respectively. Significant proportion of children were in the highest birth orders, 68.8% in autism and 78.6% in the control group. Full term children were 96.9% and 92.9% respectively. 53.1% children in the autism and 57.1% in the normal speech delay group were born by cesarean sections. Higher education of parents in autism group was statistically significant (p<0.05). Too much watching TV, inadequate opportunity to mix with peers and inadequate interactive relationship with the family members in the early childhood were significantly (p= 0.001) related to the development of autism.Bangladesh Med Res Counc Bull 2014; 40 (3): 113-117


2020 ◽  
Vol 3 (1) ◽  
pp. 16
Author(s):  
Siti Lestari ◽  
Dyah Dwi Astuti ◽  
Fachriza Malika Ramadhani

Asfiksia perinatal merujuk pada kekurangan oksigen selama persalinan, sehingga berpotensi menyebabkan kematian dan kecacatan. WHO memperkirakan  4 juta anak terlahir dengan asfiksia setiap tahun, dimana 1 juta di antaranya meninggal dan 1 juta anak bertahan hidup dengan gejala sisa neurologis yang parah. Penelitian ini bertujuan untuk menganalisis faktor risiko fetal dan tali pusat pada asfiksia neonatal.Penelitian dilakukan di lakukan di RS Dr Moewardi Surakarta dengan pendekatan  quantitative retrospective case control study. Data diambil dari rekam medis antara  tahun 2013-2018. Penelitan ini melibatkan  264 neonatal yang terdiri dari 88 kelompok kasus dan 176  kelompok control. Kelompok kasus adalah bayi dengan diagnosa  asfiksia yang  dilakukan analisis terhadap faktor risiko fetal, sedangkan bayi yang tidak mengalami asfiksia dijadikan  kelompok kontrol. Hasil analisis statistik uji Chi-Square dan Fisher Exact ditemukan bahwa  kelahiran prematur (OR 2,07 CI 95% P 0,02), persalinan dengan tindakan (OR 3,61 CI 95% P 0,00), berat bayi (OR 2,85 CI 95% P 0,00), posisi janin (OR 2,37 CI 95% P 0,05), tali pusat ( QR 3,071 CI 95%  P 0,01)  berisiko terhadap insiden asfiksia perinatal. Air ketuban yang bercampur meconium (OR 1,51 CI 95% P 0,16) tidak memiliki risiko  dengan Asfiksia perinatal. Kesimpulan: Risiko terhadap insiden asfiksia perinatal  meliputi kelahiran prematur, persalinan dengan tindakan, berat bayi, posisi janin,  dan tali pusat.Perinatal asphyxia refers to a lack of oxygen during labor, which has the potential to cause death and disability. WHO estimates  4 million children born with asphyxia each year, in  which 1 million dies and 1 million survive with severe neurological sequelae. This study aims to analyze fetal and umbilical risk factors in neonatal asphyxia.This research is a quantitative retrospective case-control study, which was conducted at The Dr. Moewardi  hospital,  Surakarta. Data was taken from  medical records from 2013-2018. The case group was patients diagnosed  asphyxia, while those who did not experience asphyxia were treated as a control group.  A total of 264  samples, consisting of 88 case group respondents and 176 control group respondents. Statistical analysis Chi- Square and Fisher Exact found that preterm birth (OR 2.07 CI 95% P 0.02), labor with instrument or complication (OR 3.61 CI 95% P 0.00), infant weight (OR 2.85 CI 95% P 0, 00), fetal position (OR 2.37 CI 95% P 0.05), umbilical cord (QR 3.071 CI 95% P 0.01) are at risk for the incidence of perinatal Asphyxia. The amniotic fluid mixed with meconium (OR 1.51 CI 95% P 0.16) has no risk with perinatal asphyxia.The risk factors of incidences of perinatal asphyxia were  preterm birth, labor with instrument or complication, baby weight, fetal position and umbilical cord. 


Author(s):  
Niaz Mustafa Kamal ◽  
Nasih Othman

Congenital anomalies comprise a wide range of abnormalities in body structure or function that are present at birth and are of prenatal origin. These are defined as structural changes that have significant medical, social or cosmetic consequences for the affected individual, and typically require medical intervention. According to our Knowledge, research is scarce on these conditions in Sulaimaniyah city. Therefore, the current study was conducted to investigate potential risk factors for congenital anomalies. A case-control study was carried out from March to August 2017 involving 400 children (200 cases and 200 controls) aged 0-5 years. Required data were obtained on the risk factors through face to face interviews with mothers of cases and controls. The data were using descriptive statistical methods, Chi-square and Logistic Regression using STATA 11, calculating odds ratios and condensing P value less than 0.05 as statistically significant. The mean age of the children was 1.9 years and age of their mothers at the time of pregnancy was 28 years. Congenital heart anomalies were the commonest type accounting for 27.5%. Significant risk factors for congenital anomalies were family history (OR=2.24, P= 0.007), maternal obesity (OR= 2.26, P= 0.001), mothers age over 30 (OR=2.78, P= 0.002) and mothers not using folic acid during pregnancy (OR=2.12, P= 0.0007). In general, in order to control and prevent the cases of CM, it is important to provide health education and policies to reduce environmental and maternal risk factors. Further, studies with larger sample size are needed to investigate incidence and risk factors of congenital anomalies.


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