scholarly journals Factors associated with urosepsis following percutaneous nephrolithotomy

2021 ◽  
Vol 42 (1) ◽  
pp. 56-62
Author(s):  
Krit Santanapipatkul ◽  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Urine Culture ◽  
Multivariable Analysis ◽  
Urinary Calculi ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Model ◽  
Factors Associated ◽  
Increased Risk ◽  
Pelvic Urine ◽  
Staghorn Stone

Objective: To evaluate factors associated with urosepsis after percutaneous nephrolithotomy (PCNL). Materials and Methods: Seventy-six upper tract urinary calculi patients underwent PCNL at Loei Hospital between July 2014 to January 2019, all were enrolled onto the study. The following data were collected: demographics, type and size of stone, intraoperative data, pelvic urine culture and urosepsis complications after the procedure. Association of factors with urosepsis after PNCL were identified using a binary logistic regression model with a bootstrap estimation. Results: Urosepsis complications occurred in 7 patients (9.2%). Mean (SD) of age was 54.4 (10.3) years. Of all patients, 2% with staghorn stone and 22% positive urine culture. Multivariable analysis indicated that staghorn stone (a OR =6.75; 95%CI: 1.59-28.63, p=0.01) and positive pelvic urine culture (a OR =7.51; 95%CI: 1.35-41.77, p=0.02) were associated with urosepsis after PCNL. Conclusion: There was no mortality after PCNL in this study. Staghorn stone and positive pelvic urine culture may be associated with an increased risk of urosepsis complication.

scholarly journals Predictors of Suicide Behavior Relapse in Pediatric Population

2018 ◽  
Vol 21 ◽  
Author(s):  
Francisco Villar ◽  
Carmina Castellano-Tejedor ◽  
Mireia Verge ◽  
Bernardo Sánchez ◽  
Tomás Blasco-Blasco
Keyword(s):  
Family History ◽  
Personality Disorder ◽  
Suicide Attempt ◽  
Suicidal Behavior ◽  
Longitudinal Design ◽  
Pediatric Population ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Model ◽  
Increased Risk ◽  
History Of

AbstractIdentifying patients at increased risk of suicide remains a challenge today. It has been reported that 10% of patients committing a suicide attempt end up dying and that both the risk and the severity of clinical symptomatology increase with the number of attempts. Within the framework of selective and indicated prevention, it is essential to identify the group of patients with an increased risk of recurrence. The objective of this study is to identify factors predicting suicide attempt relapse to improve the decision making process in the therapeutic approach to suicidal behavior. The methodology employed was a longitudinal design aimed at identifying factors, in a binary logistic regression model (stepwise), predicting the repetition of suicidal behavior among a sample of 417 participants aged between 8 and 17 years old, at the six months follow-up. A statistically significant model χ2(3, N = 417) = 18.610; p < .001; Nagelkerke R2 = .096 including the following factors was obtained: current diagnosis of personality disorder/maladaptive personality OR = .806, p = .028, 95% CI [1.091, 4.595], personal history of self-injury OR = .728, p = .043, 95% CI [1.023, 4.192], and family history of psychopathological diagnosis OR = .925, p = .021, 95% CI [1.151, 5.530]. Considering these results, having a diagnosis of personality disorder or maladaptive personality traits, presence or history of self-harm and family history of psychopathology draws a predictive profile of autolytic attempt recurrence during the six months after the initial intervention at the emergency room.

Identifying consumers’ profile and factors associated with the valorization of pulque: A traditional fermented beverage in Central Mexico

2020 ◽  
Vol 26 (7) ◽  
pp. 593-602 ◽  
Author(s):  
Edgar Rojas-Rivas ◽  
Facundo Cuffia
Keyword(s):  
Low Income ◽  
Educational Level ◽  
Binary Logistic Regression ◽  
High Educational Level ◽  
Central Mexico ◽  
Binary Logistic Regression Model ◽  
Factors Associated ◽  
Consumption Frequency ◽  
Fermented Beverage ◽  
High Educational

The aims of this work were to (i) identify the consumers’ profile of pulque through their consumption frequency and their sensory perception of this beverage and (ii) identify the factors that contribute to the valorization of pulque among Mexican consumers. A survey was designed and conducted with 221 consumers in pulque-selling locations (pulquerías) in a place of Central Mexico. Consumers were characterized according to their consumption frequency. Factors associated with the valorization of pulque were identified through Binary Logistic Regression model. Two types of consumers were identified: Frequent Consumers and Not Frequent Consumers. Both groups were comprised mostly of men, including students with medium to high levels of education. However, the first group showed more traditional and conservative behavior patterns since there was a higher proportion of consumers with a low educational level ( p < 0.05) and they had more years of consumption, spend more time in the selling locations, and preferred “natural pulque.” The second group of consumers was comprised mostly ( p < 0.05) of women, including students with a high educational level who prefer “cured pulque.” In this sense, our results showed that gender and time spent in the pulquerías together with sensory, cultural, and functional characteristics associated with the beverage influence its valorization among consumers. These results can help both producers and marketers to classify segments of consumers according to their preferences and consumption patterns in order to revalorize the pulque market. Finally, it is necessary to highlight that young consumers with high educational level show interest in this beverage, since for years its consumption has been associated with low-income populations.

scholarly journals Acquired infection during neonatal and pediatric extracorporeal membrane oxygenation

Perfusion ◽  
2018 ◽  
Vol 33 (6) ◽  
pp. 472-482 ◽  
Author(s):  
Katherine Cashen ◽  
Ron Reeder ◽  
Heidi J. Dalton ◽  
Robert A. Berg ◽  
Thomas P. Shanley ◽  
...  
Keyword(s):  
Viral Infections ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Secondary Analysis ◽  
Hazard Ratio ◽  
Research Network ◽  
Factors Associated ◽  
Increased Risk ◽  
Neonatal Icu ◽  
Pediatric Icu

Introduction: Our objectives are to (1) describe the pathogens, site, timing and risk factors for acquired infection during neonatal and pediatric ECMO and (2) explore the association between acquired infection and mortality. Methods: Secondary analysis of prospective data collected by the Collaborative Pediatric Critical Care Research Network between December 2012 and September 2014. Clinical factors associated with acquired infection were assessed with multivariable Cox regression. Factors associated with mortality were assessed with logistic regression. Results: Of 481 patients, 247 (51.3%) were neonates and 400 (83.2%) received venoarterial ECMO. Eighty (16.6%) patients acquired one or more infections during ECMO; 60 (12.5%) patients had bacterial, 21 (4.4%) had fungal and 11 (2.3%) had viral infections. The site of infection included respiratory for 53 (11.0%) patients, bloodstream for 21 (4.4%), urine for 20 (4.2%) and other for 7 (1.5%). Candida species were most common. Median time to infection was 5.2 days (IQR 2.3, 9.6). On multivariable analysis, a greater number of procedures for ECMO cannula placement was independently associated with increased risk of acquired infection during ECMO (Hazard Ratio 2.13 (95% CI 1.22, 3.72), p<0.01) and receiving ECMO in a neonatal ICU compared to a pediatric or cardiac ICU was associated with decreased risk (Hazard Ratio pediatric ICU 4.25 (95% CI 2.20, 8.20), cardiac ICU 2.91 (95% CI 1.48, 5.71), neonatal ICU as reference, p<0.001). Acquired infection was not independently associated with mortality. Conclusion: ECMO procedures and location may contribute to acquired infection risk; however, acquired infection did not predict mortality in this study.

scholarly journals Likely Uptake of a Future a Lung Cancer Screening Programme in Hodgkin Lymphoma Survivors: a Questionnaire Study

2021 ◽  
Author(s):  
Rachel Broadbent ◽  
Christopher J. Armitage ◽  
Philip Crosbie ◽  
John Radford ◽  
Kim Linton
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Hodgkin Lymphoma ◽  
Multivariable Analysis ◽  
Lung Cancer Screening ◽  
Smoking History ◽  
Malignant Neoplasms ◽  
Heavy Smoking ◽  
Factors Associated ◽  
Increased Risk

Abstract Background Many Hodgkin lymphoma (HL) survivors are at increased risk of subsequent malignant neoplasms (SMN), including lung cancer, due to previous treatment for HL. Lung cancer screening (LCS) detects early-stage lung cancers in ever smokers but HL survivors without a heavy smoking history are ineligible for screening. There is a rationale to develop a targeted LCS. The aim of this study was to investigate levels of willingness to undergo LCS in HL survivors, and to identify the psycho-social factors associated with screening hesitancy. Methods A postal questionnaire was sent to 281 HL survivors registered in a long-term follow-up database and at increased risk of SMNs. Demographic, lung cancer risk factors, psycho-social and LCS belief variables were measured. Multivariable logistic regression analysis was performed to determine the factors associated with lung cancer screening hesitancy, defined as those who would ‘probably’ or ‘probably not’ participate. Results The response rate to the questionnaire was 58% (n=165). Participants were more likely to be female, older and living in a less deprived area than non-participants. Uptake (at any time) of breast and bowel cancer screening among those previously invited was 99% and 77% respectively. 159 participants were at excess risk of lung cancer. The following results refer to these 159. Around half perceived themselves to be at greater risk of lung cancer than their peers. Only 6% were eligible for lung cancer screening pilots aimed at ever smokers in the UK. 98% indicated they would probably or definitely participate in LCS were it available. Psycho-social variables associated with LCS hesitancy on multivariable analysis were male gender (OR 5.94 CI 1.64-21.44, p<0.01), living in an area with a high index of multiple deprivation (IMD) decile (deciles 6-10) (OR 8.22 CI 1.59-42.58, p<0.05) and lower levels of self-efficacy (OR 1.64 CI 1.30-2.08 p<0.01). Conclusion HL survivors responding to this survey were willing to participate in a future LCS programme but there was some hesitancy. A future LCS trial for HL survivors should consider the factors associated with screening hesitancy in in order to minimise barriers to participation.

scholarly journals O-P06 Early postoperative differentiation between biochemical leak and clinically-relevant pancreatic fistula after pancreaticoduodenectomy: development of a predictive risk score

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Syed Soulat Raza ◽  
Anisa Nutu ◽  
Sarah Powell-Brett ◽  
Amanda Carvalheiro Boteon ◽  
James Hodson ◽  
...  
Keyword(s):  
Pancreatic Fistula ◽  
Risk Score ◽  
Multivariable Analysis ◽  
Length Of Hospital Stay ◽  
Binary Logistic Regression ◽  
Early Postoperative Period ◽  
Risk Scores ◽  
Binary Logistic Regression Model ◽  
Reactive Protein ◽  
Predictive Risk

Abstract Background Several risk scores are available which predict pancreatic fistula after pancreaticoduodenectomy (PD), but do not differentiate between biochemical leak (BL) and clinically relevant pancreatic fistula (CR-POPF). The aim of this study was to identify factors that differentiate between BL and CR-POPF in the early postoperative period. Methods Consecutive patients diagnosed with BL and CR-POPF after PD were identified from a prospectively maintained database (2009-2019). Data were collected for demographics, intraoperative and laboratory parameters on the first five postoperative days (PODs), including drain fluid amylase (DFA), C-reactive protein (CRP) and albumin. Independent predictors of CR-POPF were identified using a multivariable binary logistic regression model, which was subsequently converted to a risk score Results 187 patients consisted of 99 BL and 88 CR-POPF. In those with CR-POPF, the leak became clinically relevant a median of 9 days after surgery; these patients had a significantly higher length of hospital stay than those with BL (median: 24 vs. 10 days, p &lt; 0.001). On multivariable analysis, male gender (p = 0.002), higher DFA (p &lt; 0.001) or CRP (p &lt; 0.001) on POD3, lower albumin (p = 0.028) on POD3 were all found to be independent predictors of CR-POPF. A risk score based on these factors returned an area under the ROC curve of 0.78. Conclusions In patients with a confirmed pancreatic fistula it may be possible to differentiate between BL and CR-POPF using early postoperative variables, particularly DFA, serum albumin and CRP. Early identification of CR-POPF may allow earlier intervention to improve clinical outcomes.

Factors associated with acute toxicity during chemoradiation therapy for rectal cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 734-734
Author(s):  
Pooja Monpara ◽  
Scott Rice ◽  
Talha Shaikh ◽  
Jeffrey M. Farma ◽  
Elin R. Sigurdson ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Weight Loss ◽  
Acute Toxicity ◽  
Performance Status ◽  
Multivariable Analysis ◽  
Rectal Adenocarcinoma ◽  
Factors Associated ◽  
Increased Risk ◽  
Grade 3 ◽  
Experienced Grade

734 Background: Acute toxicity may be a factor interfering with receipt of chemoradiation (CRT) therapy for rectal cancer. The purpose of this study was to identify clinical and treatment factors associated with increased acute toxicity in patients receiving CRT therapy for rectal cancer. Methods: We identified patients with rectal adenocarcinoma treated with CRT between 2006-2014 at an NCI-designated cancer center. Patients with metastatic disease or missing treatment information were excluded. Acute toxicity information including weight loss, pain, fatigue, constipation, diarrhea, anorexia, and performance status was extracted from weekly on treatment visit notes. Multivariable logistic regression was used to assess predictors of grade 3+ toxicity using covariates significant on univariable analysis. Results: A total of 148 patients were included with a median age of 59 (range 29-99). The majority of patients were male (55%) and received 5-FU based chemotherapy (82%). During CRT, 35 (24%) patients experienced at least one grade 3+ toxicity: 13 (9%) patients experienced grade 3+ fatigue, 1 (1%) experienced grade 3+ constipation, 11 (7%) experienced grade 3+ diarrhea, 14 (10%) experienced grade 3+ pain, and 11 (7%) experienced grade 3+ anorexia. Eight (5.4%) patients had an ECOG performance status > 3 and 28 (19%) patients had weight loss > 5 lbs during CRT. On multivariable analysis, increased distance from the anal verge (OR 0.78 95% CI 0.636-0.998) was associated with a decreased risk for grade 3+ pain and age > 75 was associated with an increased risk of grade 3+ anorexia (OR 6.07 95% CI 1.067-34.56). Clinical T4 disease was associated with an increased risk of weight loss > 5 lbs (OR 0.17 95% CI 0.100-0.446). On multivariable analysis, there were no factors associated with grade 3+ fatigue, diarrhea, or constipation. There were no factors associated with a decline in performance status to > 3 while on treatment. Conclusions: Our results suggest that rectal cancer patients who are older, have more advanced disease, or with low lying tumors may be at an increased risk for treatment-related toxicity. Identifying predictors of toxicity may allow for tailored interventions to minimize toxicity for these patients.

scholarly journals Factors associated with complex surgical wounds in breast and abdomen: a case-control observational study

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Josimare Aparecida Otoni Spira ◽  
Eline Lima Borges ◽  
Patrícia Aparecida Barbosa Silva ◽  
Mery Natali Silva Abreu ◽  
Antônio Carlos Martins Guedes ◽  
...  
Keyword(s):  
Protective Factor ◽  
Binary Logistic Regression ◽  
Case Control ◽  
Wound Complications ◽  
Unexpected Result ◽  
Surgical Wound ◽  
Binary Logistic Regression Model ◽  
Significance Level ◽  
Factors Associated ◽  
Surgical Wounds

ABSTRACT Objective: to identify factors associated with complex surgical wounds in the breasts and abdomen in outpatients. Method: observational case-control study involving 327 patients, distributed into 160 cases (complex surgical wound) and 167 controls (simple surgical wound). Data were extracted from the medical records and a binary logistic regression model was used for analysis, considering a significance level of 5%. Results: the factors associated with greater chance of occurrence of complex surgical wound were 18 to 59 years of age (p = 0.003), schooling < 8 years (p = 0.049), radiotherapy (p < 0.001), hysterectomy (p = 0.003), glycemia (≤ 99 mg/dL) and arterial hypertension (p = 0.033), while quadrantectomy (p = 0.025) served as a protective factor. Conclusion: radiotherapy was the most significant factor for surgical wound complications. Glycemic alteration was an unexpected result and shows the need for further studies related to this topic.

scholarly journals Hip Stability May Influence the Development of Greater Trochanteric Pain Syndrome: A Case-Control Study of Consecutive Patients

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712095869
Author(s):  
LCDR Ashton H. Goldman ◽  
ENS Vaughn Land ◽  
Matthew H. Adsit ◽  
CDR George C. Balazs
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Binary Logistic Regression ◽  
Pain Syndrome ◽  
Posterior Wall ◽  
Binary Logistic Regression Model ◽  
Greater Trochanteric Pain Syndrome ◽  
Increased Risk ◽  
Posterior Wall Sign

Background: Greater trochanteric pain syndrome (GTPS) is thought to relate primarily to tendinosis/tendinopathy of the hip abductors. Previous studies have suggested that certain anatomic factors may predispose one to development of the condition. Hypothesis: It was hypothesized that intrinsic acetabular bony stability of the hip is related to the development of GTPS. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 198 consecutive patients diagnosed with GTPS were compared with 198 consecutive patients without clinical evidence of GTPS. Electronic health records of the included patients were examined; data recorded included patient age, sex, race, and body mass index (BMI). Standing anteroposterior radiographs were evaluated by 2 blinded examiners who measured the Tönnis angle, lateral center-edge angle (LCEA), and acetabular depth/width ratio (ADW) and assessed for the presence of a posterior wall sign. The number of dysplastic measures was recorded for each patient based on published norms. Associations between radiographic and patient variables versus the presence or absence of GTPS were determined. Factors with univariate associations where P < .20 were included in a binary logistic regression model to identify independent predictors of the presence of GTPS. Results: There was no difference between groups in terms of age, BMI, or race. There were significantly more women than men in the GTPS group (71% vs 30%; P < .001). Intraclass correlation coefficients were good for the LCEA (0.82) and Tönnis angle (0.82) and poor (0.08) for the ADW. Kappa was moderate for the presence of a posterior wall sign (0.51). An increased Tönnis angle, decreased ADW, and ADW <0.25 were significantly associated with the presence of GTPS. The binary logistic regression model identified an increased Tönnis angle ( P < .010) and female sex ( P < .001) as independent risk factors for GTPS. Conclusion: Based on this preliminary retrospective study, decreased intrinsic acetabular bony stability of the hip may be associated with an increased risk of GTPS.

scholarly journals AB0281 MORTALITY PREDICTORS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A SINGLE TERTIARY CENTER REFERRAL EXPERIENCE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1166.2-1167
Author(s):  
C. M. Gamboa-Alonso ◽  
G. Figueroa-Parra ◽  
A. L. De-Leon-Ibarra ◽  
M. Á. Villarreal-Alarcón ◽  
J. Díaz-Angulo ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Renal Involvement ◽  
Binary Logistic Regression ◽  
University Hospital ◽  
Binary Logistic Regression Analysis ◽  
Systemic Lupus ◽  
Factors Associated ◽  
Increased Risk ◽  
Tertiary Center

Background:Systemic Lupus Erythematosus (SLE) is a heterogeneous chronic multisystemic disease that has an increased risk of requiring inpatient management with higher morbidity and mortality rates.The most frequent causes of mortality are a high disease activity, infections, and cardiovascular diseases.Objectives:To determine the predictors of mortality in patients diagnosed with SLE.Methods:A longitudinal, descriptive, observational study was performed from March 2017-March 2020 at the University Hospital of the Autonomous University of Nuevo León, México, including patients with a diagnosis of SLE according to the ACR-EULAR 2012/2019 criteria.Descriptive statistics were used for demographic variables. Associations between mortality and clinical variables were determined using binary logistic regression analysis; a p <0.05 was considered statistically significant. The SPSS program version 20 was used.Results:One-hundred and eighty-six patients with SLE diagnosis who fulfilled ACR-EULAR 2012/2019 criteria were included, 161 (86.6%) were women; the mean age was 35.8 (SD 15.41) years. The main chief complaints were dyspnea 31 (16.7%), fever in 28 (15.1%), renal involvement in 21 (11.29%), and arthritis in 19 (10.22%) patients.Of the 186 patients, 34 (18.3%) had a readmission, 13 (7%) required intensive care unit management, 68 (36.6%) had some type of infection and 22 (11.8%) died. Factors associated with mortality are shown in table 1.Patients receiving steroids and immunosuppression previous to hospitalization were 73 (39.2%) and 92 (49.5%) respectively.Conclusion:Infections remain the leading cause of death in SLE patients. Factors that predispose to infections are a chronic use of steroids and immunosuppression as well as high activity of disease.References:[1]Wu X-Y, Yang M, Xie Y-S, Xiao W-G, Lin J, Zhou B, et al. Causes of death in hospitalized patients with systemic lupus erythematosus: a 10-year multicenter nationwide Chinese cohort. Clin Rheumatol. enero de 2019;38(1):107-15.Table 1.Association between clinical and therapeutic factors with mortality in SLE patients.Factors associated with mortalityUnivariadoMultivariadoβ (95 % IC)β (95 % IC)□Age0.93 (0.96-1.02)0.98 (0.96-1.02)Use of mechanical ventilation3.83 (1.07-13.4)*3.07 (0.59-16.04)Previous use of steroids3.92 (1.51-10.15)*2.04 (0.58-7.35)Previous use of immunosupression4.04 (1.42-11.45)*2.85 (0.71-11.48)Infection3.57 (1.41-9.01)*3.25 (1.19-8.86)*p <0.05 *Disclosure of Interests:None declared

scholarly journals Factors associated with COVID-19 severity and mortality among Hispanic patients living on the USA–Mexico border

2021 ◽  
pp. jim-2020-001667
Author(s):  
Jorge Cervantes ◽  
Amit Sureen ◽  
Gian Galura ◽  
Christopher Dodoo ◽  
Alok Kumar Dwivedi ◽  
...  
Keyword(s):  
Multivariable Analysis ◽  
Ethnic Disparities ◽  
Factors Associated ◽  
Icu Admission ◽  
Risk Of Death ◽  
Imaging Characteristics ◽  
Increased Risk ◽  
Hispanic Patients ◽  
The Usa ◽  
Mexico Border

COVID-19 has ravaged the medical, social, and financial landscape across the world, and the USA–Mexico border is no exception. Although some risk factors for COVID-19 severity and mortality have already been identified in various ethnic cohorts, there remains a paucity of data among Hispanics, particularly those living on borders. Ethnic disparities in COVID-19 outcomes in Hispanic and black populations have been reported. We sought to identify the clinical presentation, treatment, laboratory, and imaging characteristics of 82 Hispanic patients in a county hospital and describe the factors associated with rates of hospitalization, intensive care unit (ICU) admission, and mortality. The most common comorbidities were hypertension (48.8%) and diabetes mellitus (DM) (39%), both found to be associated with hospitalization and mortality, while only DM was associated with increased rate of ICU admission. Multivariable analysis showed that individuals with fever, low oxygen saturation (SpO2), nasal congestion, shortness of breath, and DM had an increased risk of hospitalization. Individuals with fever, decreased levels of SpO2, and advanced age were found to be associated with an increased risk of death. The most common cause of death was respiratory failure (28.9%), followed by shock (17.8%) and acute kidney injury (15.6%). Our findings are critical to developing strategies and identifying at-risk individuals in a Hispanic population living on borders. Research aiming to identify key evidence‐based prognostic factors in our patient population will help inform our healthcare providers so that best interventions can be implemented to improve the outcomes of patients with COVID-19.

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