Risk factors for post-polypectomy bleeding; a retrospective case-control study of a high-volume colonoscopy center

2021 ◽  
Author(s):  
Dimitrios Eleftheriadis ◽  
Christina Imalis ◽  
Guido Gerken ◽  
Heiner Wedemeyer ◽  
Jan Duerig
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Ileocecal Valve ◽  
Binary Logistic Regression ◽  
High Volume ◽  
Binary Logistic Regression Analysis ◽  
Care Hospital ◽  
Retrospective Case ◽  
Polyp Size ◽  
Epinephrine Injection

Abstract Background and aim Post-polypectomy bleeding (PPB) remains an uncommon although serious complication of colonoscopy. The aim of this study is to determine the PPB-prevalence in a secondary care hospital and its associated risk factors. Patients and methods We collected data from 581 patients, with the removal of 1593 polyps between August 2017 and August 2019. A univariate binary logistic regression analysis was conducted retrospectively. Results PPB occurred in only 10 cases, representing 1.7% of patients: immediate in 1.2% and delayed in 0.5%. The number of removed polyps per patient [4.5 (SD 2.59) for hemorrhagic vs. 2.74 (SD 1.98) for non-hemorrhagic group] and the propofol dose [232 mg (SD 93.07) for hemorrhagic vs. 133 mg (SD 57.28) for non-hemorrhagic group] were relevant patient-related risk factors. The polyp-based analysis showed the polyp size [18.4 mm (SD 10.44) for hemorrhagic vs. 4.42 mm (SD 4.29) for non-hemorrhagic group], the morphology [wide-based: OR 24.83 (95 % CI 2.76 – 223.44), pedunculated: OR 56.67 (95 % CI 5.03 – 638.29)], the location at ileocecal valve [OR 20.48, 95 % CI 1.81 – 231.97)], and the polypectomy method [hot snare piecemeal with epinephrine injection: OR 75.38 (95 % CI 7.67 – 741.21)] as significant risk factors for PPB, too. Conclusions The low rate of PPB confirms the safety of the procedure in non-tertiary, high-volume colonoscopy centers. The number of polyps removed per patient, the polyp size, morphology and location, as well as the sedation dose and the method of polypectomy were shown as relevant risk factors.

scholarly journals Mycoplasma pneumoniae and Recurrent Respiratory Tract Infection Within One Year After Treatment in Infants: Risk Factors and Prevalence

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Cheng-Yi Wang ◽  
Chao-Min Song ◽  
Guang-Hua Liu
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Respiratory Tract ◽  
Mycoplasma Pneumoniae ◽  
Significant Risk ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
History Of ◽  
One Year ◽  
Tract Infections

Background: Mycoplasma pneumoniae pneumonia (MPP) is common in pediatric patients. Many studies showed that recurrent respiratory tract infections (RRTIs) are common in the year following treatment of MPP in infants, but the factors associated with the occurrence of RRTIs are rarely reported. Therefore, the present study aimed to identify these factors. Methods: This retrospective observational study included infants (< one year) who were clinically treated for MPP from January 2015 to December 2018. Clinical features and relevant data were collected on admission. The cases of the occurrence of RRTIs and the presence of related factors after one year of follow-up were investigated by questionnaires. The questionnaires contained the number of upper respiratory infections, tracheobronchitis, and pneumonia, the titers and course of MP-IgG and positive IgM antibody, eczema, pet ownership, interior decoration, inhaled or ingested allergens, exposure to environmental tobacco smoke, and gastrointestinal function. Independent significant risk factors for RRTIs were identified using binary logistic regression. Results: A total of 300 MPP cases were included, among which RRTIs occurred in 134 (44.7%) cases in the year following MPP treatment. Binary logistic regression analysis showed that a history of prematurity (OR = 6.336, 95% CI: 2.337 - 17.116, P ≤ 0.001), a history of exposure to inhaled or ingested allergens (OR = 2.527, 95% CI: 1.289 - 4.956, P = 0.007), and co-infection involving Chlamydia pneumoniae (OR = 2.787, 95% CI: 1.145 - 6.784, P = 0.024) were significantly and positively associated with RRTIs after MPP, while age (OR = 0.894, 95% CI: 0.825 - 0.970, P = 0.007) showed a negative correlation with RRTIs. Conclusions: RRTIs in the year following clinical treatment of MPP in infants are relatively common and significantly associated with the patient’s age, history of prematurity, history of exposure to inhaled or ingested allergens, and C. pneumoniae co-infection. Thus, these factors should be carefully assessed in pediatric MPP cases to predict the risk of RRTIs and appropriately manage the patient.

scholarly journals Risk Factors of Extubation Failure in Intubated Preterm Infants at a Tertiary Care Hospital in Oman

2021 ◽  
Author(s):  
Hilal KT Al Mandhari ◽  
Buthina Al Riyami ◽  
Ashfaq Khan ◽  
Mika Nonoyama ◽  
Syed GA Rizvi
Keyword(s):  
Risk Factors ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
Binary Logistic Regression ◽  
Extubation Failure ◽  
Binary Logistic Regression Analysis ◽  
Care Hospital ◽  
Airway Extubation

Objectives: To determine extubation failure (EF) rate among intubated preterm infants (<37 weeks gestational age [GA]) admitted to a tertiary care neonatal intensive care unit (NICU) in Oman and identify the risk factors associated with EF. Methods: Charts of all intubated preterm infants (<37 weeks GA) from January 2013 to December 2017 were retrospectively reviewed. EF was defined as reintubation within 7 days of planned extubation. Demographics, ventilation parameters, blood gas values and other possible risk factors of EF were collected. Statistical analysis included comparisons between EF and extubation success (ES) groups, and binary logistic regression analysis. Results: A total of 190 preterm infants were intubated during the study period, with 140 eligible for analysis. N=106 were successfully extubated; 34 (24.3%) failed extubation. GA <28 weeks (p=0.029), lower 1-minute APGAR score (p=0.023) and patent ductus arteriosus diagnosis (PDA) (p=0.018) were significantly associated with EF. After the multivariate analysis, only GA <28 weeks predicted EF with adjusted odds ratio (95% confidence interval) of 2.62 (1.17 – 6.15). Conclusions: EF rate in preterm infants admitted at our NICU in Oman, was within international rates. GA <28 weeks was the only predictor of extubation failure identified. Neonatal practitioners need to seriously consider extreme prematurity in extubation process and consider implementing strategies to decrease extubation failure in this group of fragile infants. Keywords: Premature Infants; Neonate; Airway Extubation; Extubation Failure, Risk Factors.

scholarly journals Utility of a routine ultrasound for detection of ectopic pregnancies among women requesting abortion: a retrospective review

2020 ◽  
pp. bmjsrh-2020-200888
Author(s):  
Clara I Duncan ◽  
John J Reynolds-Wright ◽  
Sharon T Cameron
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Care ◽  
Significant Risk ◽  
Intrauterine Pregnancy ◽  
Retrospective Case ◽  
Case Record ◽  
Ultrasound Findings ◽  
Ectopic Pregnancies ◽  
Record Review

IntroductionRoutine ultrasound may be used in abortion services to determine gestational age and confirm an intrauterine pregnancy. However, ultrasound adds complexity to care and results may be inconclusive, delaying abortion. We sought to determine the rate of ectopic pregnancy and the utility of routine ultrasound in its detection, in a community abortion service.MethodsRetrospective case record review of women requesting abortion over a 5-year period (2015–2019) with an outcome of ectopic pregnancy or pregnancy of unknown location (PUL) at a service (Edinburgh, UK) conducting routine ultrasound on all women. Records were searched for symptoms at presentation, development of symptoms during clinical care, significant risk factors and routine ultrasound findings.ResultsOnly 29/11 381 women (0.25%, 95% CI 0.18%, 0.33%) had an ectopic pregnancy or PUL (tubal=18, caesarean scar=1, heterotopic=1, PUL=9). Eleven (38%) cases had either symptoms at presentation (n=8) and/or significant risk factors for ectopic pregnancy (n=4). A further 12 women developed symptoms during their clinical care. Of the remaining six, three were PUL treated with methotrexate and three were ectopic (salpingectomy=2, methotrexate=1). In three cases, the baseline ultrasound indicated a probable early intrauterine pregnancy.ConclusionsEctopic pregnancies are uncommon among women presenting for abortion. The value of routine ultrasound in excluding ectopic pregnancy in symptom-free women without significant risk factors is questionable as it may aid detection of some cases but may provide false reassurance that a pregnancy is intrauterine.

Use of neutrophil/lymphocyte ratio as a marker in patients with suspicious diaphragmatic attenuation artifact

2021 ◽  
Vol 8 (12) ◽  
pp. 706-710
Author(s):  
Kemal Göçer ◽  
Ahmet Çağrı Aykan ◽  
Bayram Öztürk ◽  
Alihan Erdoğan
Keyword(s):  
Risk Factors ◽  
Binary Logistic Regression ◽  
Myocardial Perfusion Spect ◽  
Binary Logistic Regression Analysis ◽  
Inferior Wall ◽  
Roc Curve Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Significant Difference ◽  
Attenuation Artifact ◽  
Artery Disease

Objective: This study aimed to evaluate whether neutrophil/lymphocyte (N/L) ratio assists in the diagnosis of coronary artery disease (CAD) in patients with suspected diaphragmatic attenuation artifact (DAA) on myocardial perfusion SPECT (MP-SPECT). Material and Methods: A total of 255 patients undergoing coronary angiography between 2015-2020 due to unclear DAA of the inferior wall on MP-SPECT were included in this retrospective study. Patients were divided into two groups (CAD and non-CAD) according to angiographic images. Significant CAD was defined as ≥50% stenosis of coronary arteries feeding the inferior wall. White blood cell count, biochemical parameters, and risk factors for CAD were compared between the two groups. Results: There was no statistically significant difference between the two groups in terms of age (p = 0.055), gender (p = 0.482), and body mass index (p = 0.305). N/L ratio (OR = 1.397 p = 0.002 95% Cl = 1.128-1.732) and left ventricle ejection fraction (OR = 0.896 p = 0.023 95% Cl = 0.815-0.985) were independent risk factors for CAD in multivariate binary logistic regression analysis. Receiver Operating Characteristic (ROC) curve analysis showed that a cut-off value of ≥2 for N/L ratio predicted the presence of CAD (sensitivity=63.5%, specificity=60.7%, AUC=0.668, 95% CI=0.596 – 0.740, p<0.001). Conclusion: N/L ratio is a simple and accessible test and may increase the diagnostic accuracy of MP-SPECT for CAD in patients with suspicious diaphragmatic attenuation on MP-SPECT.

Risk of Retinal Toxicity in Longterm Users of Hydroxychloroquine

2017 ◽  
Vol 44 (11) ◽  
pp. 1674-1679 ◽  
Author(s):  
Ji-Won Kim ◽  
Yoon Young Kim ◽  
Hwajeong Lee ◽  
Sung-Hoon Park ◽  
Seong-Kyu Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Disease ◽  
Fundus Autofluorescence ◽  
Binary Logistic Regression ◽  
Field Testing ◽  
Retinal Toxicity ◽  
Binary Logistic Regression Analysis ◽  
Visual Field Testing ◽  
Daily Dose ◽  
Study Participants

Objective.Several studies have reported risk factors for hydroxychloroquine (HCQ) retinal toxicity, but data are limited for patients of Asian ancestry. The aim of this study was to investigate the rate of and factors for HCQ retinal toxicity in the Korean population.Methods.There were 123 patients enrolled in this study who were using or had used HCQ. Retinal toxicity was detected using spectral domain optical coherence tomography, fundus autofluorescence, multifocal electroretinography, and automated visual field testing. Binary logistic regression analysis was performed to identify factors associated with HCQ retinal toxicity.Results.Mean duration of HCQ use and mean HCQ dose in study participants was 10.1 years and 6.4 mg/kg, respectively. We found 17 patients (13.8%) with HCQ retinal toxicity among 123 patients. Patients with retinal toxicity took HCQ ranging from 6.7–21.9 years and daily dosage ranging from 4.9–9.1 mg/kg. Only 1 patient had retinal toxicity among patients with daily dose < 5.0 mg/kg. These factors increased the risk of HCQ retinal toxicity: longer duration of HCQ use [adjusted OR (aOR) = 4.71, 95% CI 2.18–10.15 for duration of HCQ use in 5-yr increments], higher daily HCQ dose (aOR = 3.34, 95% CI 1.03–10.80 for daily HCQ dose in 100-mg increments), and the presence of kidney disease (aOR = 8.56, 95% CI 1.15–64.00).Conclusion.HCQ retinal toxicity is associated with duration of HCQ use, daily HCQ dose, and presence of kidney disease. Proper dosing of maximum 5 mg/kg and regular screening according to risk factors are important in HCQ use.

scholarly journals Vancomycin-resistance Enterococcal Colonization in Hospitalized Patients in Relation to Antibiotic Usage in a Tertiary Care Hospital of North India

2015 ◽  
Vol 7 (02) ◽  
pp. 108-111 ◽  
Author(s):  
Tuhina Banerjee ◽  
Shampa Anupurba ◽  
Joel Filgona ◽  
Dinesh K Singh
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Tertiary Care ◽  
Significant Risk ◽  
Antibiotic Use ◽  
Antibiotic Usage ◽  
Hospitalized Patients ◽  
University Hospital ◽  
North India ◽  
Care Hospital

ABSTRACT Background: Alarming rise of vancomycin-resistant enterococci (VRE) is a global cause of concern. Several factors have been held responsible for such rise, of which antibiotic usage is a prominent one. Objectives: This study was undertaken to determine the intestinal VRE colonization rate amongst hospitalized patients in relation to use of various antibiotics in the Intensive Care Unit (ICU) of a tertiary care university hospital, India. Materials and Methods: Stool samples were collected weekly from all the patients in the adult ICU for a period of 6 months and processed for isolation and phenotypic and genotypic characterization of VRE isolates. Patient and treatment details were noted and cases (those with VRE in stool) and controls (those without VRE in stool) were compared statistically. Further, a multivariate analysis was done to identify those antibiotics as independent risk factors for VRE colonization. Results: VRE colonization was found in 34.56% (28/81) of the patients studied, with the majority 75% (21/28) carrying the vanA gene. The cases had significantly more (P < 0.05) duration of hospital stay and antibiotic exposure. Intake of metronidazole, vancomycin, and piperacillin-tazobactam were identified as significant risk factors both in univariate and multivariate analysis. Conclusion: A potential reservoir of VRE was thus revealed even in low VRE prevalence setting. Based on this high colonization status, restriction of empirical antibiotic use, reviewing of the ongoing antibiotic policy, and active VRE surveillance as an integral part of infection control strategy were suggested.

scholarly journals HEPATITIS B AND C: FREQUENCY, MODES OF TRANSMISSION AND RISK FACTORS ALONG WITH SOME UNORTHODOX ROUTES OF SPREAD

2020 ◽  
Vol 9 (3) ◽  
pp. 161-165
Author(s):  
Iftikhar Haider Naqvi ◽  
Abu Talib ◽  
Gohar Baloch ◽  
Khalid Mahmood ◽  
Zahid Qadari
Keyword(s):  
Risk Factors ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Dental Treatment ◽  
Significant Risk ◽  
Transmission Risk ◽  
Retrospective Case ◽  
Leech Therapy ◽  
Ear Piercing

Background: Pakistan's being a country placed in intermediate endemicity zone of HBV and HCV, with rising population, there is lack scarcity of knowledge about transmission of risk factors specially unorthodox and frequency of this health challenge. Methods: A retrospective case control study where case records of all patients aged from 18 - 70 years from 2012 to 2017 with either gender diagnosed as chronic hepatitis B and C were included. Information about shave from barber-shop, sharing of toothbrush at home, tattooing, cautery, and ear piercing were collected. Information about unorthodox risks for transmission of HBV and HCV, like skin branding, cupping of blood, circumcision by the barber, sharing of tooth brushes and leech therapy was collected. Results: Among 1134 patients of chronic hepatitis B (HBV) and chronic hepatitis C (HCV), Age > 35 years, shave from barber and dental treatment were found to be risk factor for both HCV and HBV transmission. Amongst unorthodox risk factors like skin branding, cupping of blood, circumcision by the barber, sharing of tooth brushes and leech therapy, only cupping of blood (Hijama) was a significant risk for transmission of both HBV and HCV. Conclusion: Viral related chronic hepatitis is frequently reported problem in this part of the world where HCV supersedes HBV. Socieodemographic factor like age > 35 year, shave from barbers and dental treatment were risk factors for transmission of both HCV and HBV. Among orthodox routes of transmission blood cupping (hijama) has shown as a significant transmission risk for both HCV and HBV.

scholarly journals Risk factors for extended length of stay following hip fracture surgery: A retrospective cohort study of patients aged 90 years and over in China

2019 ◽  
Author(s):  
Ling Lan ◽  
Li-jian Pei ◽  
Feifei Zhai ◽  
Yuelun Zhang ◽  
Jun Jing ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Retrospective Cohort ◽  
Binary Logistic Regression ◽  
Postoperative Pneumonia ◽  
Binary Logistic Regression Analysis ◽  
Hip Fracture Surgery ◽  
Extended Length ◽  
Potential Risk Factors ◽  
Fracture Surgery

Abstract Background Hip fractures are typical fractures in geriatric patients and are associated with a high risk of postoperative complications and extended length of stay (LOS) compared with other osteoporotic fractures, particularly among patients over age 90. We aimed to identify the risk factors for extended LOS (more than 14 days) in patients older than 90 years. Methods A single-centre retrospective cohort study was performed in 50 patients (over age 90) who experienced hip fracture between June 1, 2013, and August 31, 2017. Their medical records were retrospectively reviewed from the hospital’s electronic database. The baseline characteristics of the patients, intraoperative data and postoperative complications were collected for the assessment of potential risk factors. Univariate analysis and multivariate binary logistic regression analysis were performed to determine potential risk factors for extended LOS. Results The age of the patients in the cohort ranged from 90 to 101 years, and the analysis demonstrated that 70% (n = 35) of the patients experienced a complicated course of treatment with an in-hospital mortality rate of 4% (n = 2). The most common complication was the occurrence of postoperative pneumonia (38%). The median duration of hospital stay was 18 (IQR 11, 21) days. Multivariate binary logistic regression analysis showed that a LOS of more than 14 days was significantly associated with a lower mean diastolic blood pressure during surgery [odds ratio (OR) =0.86, 95% confidence interval (CI)=0.76-0.98, P = 0.018] and the occurrence of postoperative pneumonia (OR=8.95, 95% CI=1.45-55.3, P = 0.018). The occurrence of postoperative pneumonia was significantly associated with the neutrophil-to-lymphocyte ratio (NLR) at admission (D0) [odds ratio (OR) =1.20, 95% confidence interval (CI)=1.02-1.41, P = 0.029]. Neither the LOS nor postoperative pneumonia was found to be associated with the anaesthesia technique. Conclusions A lower mean diastolic blood pressure during surgery and the occurrence of postoperative pneumonia may extend the LOS in patients aged 90 years and over who undergo hip fracture surgery. The use of regional anaesthesia was not associated with a shorter LOS.

Risk Factors for Nephrolithiasis in Adults with Short Bowel Syndrome

2019 ◽  
Vol 75 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Jianbo Yang ◽  
Haifeng Sun ◽  
Songlin Wan ◽  
Gulsudum Mamtawla ◽  
Xuejin Gao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Short Bowel Syndrome ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Creatinine Concentration ◽  
Short Bowel ◽  
Tertiary Referral Center ◽  
Prolonged Duration ◽  
Clinical Consequences ◽  
The Mean

Introduction: Patients with short bowel syndrome (SBS) commonly develop nephrolithiasis. However, the risk factors for nephrolithiasis in patients with SBS remain unclarified. The present study aimed to identify the risk factors for nephrolithiasis in adults with SBS. Methods: All eligible adults diagnosed with SBS and admitted to a tertiary referral center from December 2008 to 2018 were retrospectively identified from a prospectively maintained database. Patients’ demographic and clinical characteristics were analyzed using univariate and multivariate analyses to identify the risk factors for nephrolithiasis. Results: Of 231 adults with SBS, 42 (18.2%) developed nephrolithiasis. The mean age was 46.4 ± 17.8 years, the mean body mass index was 18.2 ± 3.8 kg/m2, and median duration of SBS was 11 months (range 2–324 months). Multivariate binary logistic regression analysis revealed that the independent risk factors for nephrolithiasis in adults with SBS were jejuno-ileal anastomosis and colon-in-continuity (OR 4.335; 95% CI 1.175–16.002; p = 0.028), prolonged duration of SBS (OR 1.008; 95% CI 1.002–1.014; p = 0.010), and increased serum creatinine concentration (OR 1.005; 95% CI 1.001–1.009; p = 0.012). Conclusions: Nephrolithiasis is common in adults with SBS. As nephrolithiasis can have adverse clinical consequences, patients with SBS should be closely monitored, and prophylactic interventions should be considered.

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