Risk Factors for the Development of an Incisional Hernia after Sigmoid Resection for Diverticulitis: An Analysis of 33 Patient, Operative and Disease-associated Factors

2015 ◽  
Vol 81 (5) ◽  
pp. 492-497 ◽  
Author(s):  
Tara M. Connelly ◽  
Rafel Tappouni ◽  
Paul Mathew ◽  
Javier Salgado ◽  
Evangelos Messaris
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Incisional Hernia ◽  
Multivariate Regression Analysis ◽  
Sigmoid Resection ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
History Of

Incisional hernia (IH) is a relatively common sequelae of sigmoidectomy for diverticulitis. The aim of this study was to investigate factors that may predict IH in diverticulitis patients. Two hundred and one diverticulitis patients undergoing sigmoidectomy between January 2002 and December 2012 were identified (mean follow-up 5.15 ± 2.33 years). Patients with wound infections were excluded. Thirteen patient-associated, three diverticular disease-related, and 17 operative variables were evaluated in patients with and without IH. Volumetric fat was measured on pre-operative CTs. Fischer's exact, χ2, and Mann–Whitney tests and multivariate regression analysis were used for statistics. Thirty-four (17%) patients had an IH. On multivariate analysis, wound packing (OR 3.4, P = 0.017), postoperative nonwound infection (OR 7.4, P = 0.014), and previous hernia (OR 3.6, P = 0.005) were as independent predictors of IH. Fifteen of 34 (44%) patients who developed a hernia had a history of prior hernia. Of 33 potential risk factors analyzed, including smoking, chronic obstructive pulmonary disease, and obesity, the only patient factor present preoperatively associated with increased risk of a postsigmoidectomy hernia after multivariate analysis was a history of a previous hernia. Preoperative identification of patients with a history of hernia offers the opportunity to employ measures to decrease the likelihood of IH.

scholarly journals Clinical Characteristics and Risk Factors for Myocardial Injury and Arrhythmia in COVID-19 patients

2020 ◽  
Author(s):  
Hong Gang Ren ◽  
Xingyi Guo ◽  
Lei Tu ◽  
Qinyong Hu ◽  
Kevin Blighe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Myocardial Injury ◽  
Heart Diseases ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk ◽  
History Of ◽  
Cross Sectional Design

ABSTRACTBackgroundPatients with COVID-19 can develop myocardial injury and arrhythmia during the course of their illness. However, the underlying risk factors for the development of cardiovascular related manifestations are unclear.MethodsUsing a register-based multi-center cross-sectional design, we analyzed 80 patients with myocardial injury and 401 controls, as well as 71 patients with arrhythmia and 409 controls, all admitted with COVID-19. Putative risk factors for myocardial injury and arrhythmia were evaluated with logistic regression with adjustment for potential confounders.ResultsCOVID-19 patients with myocardial injury had fatigue (66.2%) and dyspnea (63.7%), while those with arrhythmia had dyspnea (71.8%). Patients with myocardial injury and arrhythmia had a significant mortality of 92.5% and 94.4%, respectively. A history of chronic obstructive pulmonary disease (COPD) or heart diseases was associated with an increased risk of myocardial injury (odds ratio [OR] = 1.94, 95% confidence interval [CI]: 1.01-3.71; OR = 7.43, 95% CI: 3.99-13.83) and arrhythmia (OR = 1.94, 95% CI: 1.00-3.75; OR = 13.16, 95% CI: 6.75-25.68). In addition, we found that gamma glutamyltranspeptidase (GGT) >50U/L (OR = 2.14, 95% CI: 1.37-3.32; OR = 1.85, 95% CI: 1.19-2.85), serum creatinine >111μmol/L (OR = 8.96, 95% CI: 4.4-18.23; OR = 3.71, 95% CI: 2.01-6.85), serum sodium <136 mmol/L (OR = 4.68, 95% CI: 2.46-8.91; OR = 2.06; 95% CI: 1.06-4.00) were all associated with increased risk of myocardial injury and arrhythmia, respectively.ConclusionOur reported clinical characteristics and identified risk factors are important for clinical study of COVID-19 patients developing myocardial injury and arrhythmia.

Risk Factors for Developing Postprocedural Microemboli following Carotid Interventions

2007 ◽  
Vol 14 (4) ◽  
pp. 561-567 ◽  
Author(s):  
Maureen M. Tedesco ◽  
Sheila M. Coogan ◽  
Ronald L. Dalman ◽  
Jason S. Haukoos ◽  
Barton Lane ◽  
...  
Keyword(s):  
Risk Factors ◽  
Patient Characteristics ◽  
Time Frame ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk ◽  
Mri Scans ◽  
History Of ◽  
Distal Protection

Purpose: To determine risk factors predictive of microemboli found on diffusion-weighted magnetic resonance imaging (DW-MRI) following carotid angioplasty and stenting (CAS) with distal protection and carotid endarterectomy (CEA). Methods: A retrospective review was conducted of all carotid interventions at a single institution between 2004 and 2006. In that time frame, 64 carotid interventions (34 CAS, 30 CEA) were performed in 63 male patients (mean age 69.5 years, range 52 to 91) with DW-MRI scans available for review. Patient characteristics, including age, gender, smoking history, diabetes mellitus, hypertension, hyperlipidemia, obesity (body mass index >30), coronary artery disease (CAD), chronic obstructive pulmonary disease, peripheral vascular disease, and atrial fibrillation, were documented. For the CAS patients, anatomical and procedural characteristics, including fluoroscopy time, contrast volume, performance of an arch angiogram, and lesion anatomy, were recorded. Bivariate analyses were performed to determine which parameters were associated with the occurrence of acute postprocedural microemboli found on DW-MRI by 2 blinded neuroradiologists. Results: Twenty-four (71%) of the 34 CAS patients and 1 (3%) of the 30 CEA patients demonstrated new cerebral microemboli postoperatively. In the bivariate analyses of all patient, anatomical, and procedural characteristics, only a history of CAD was associated with an increased risk of microemboli; 20 (80%) of the 25 patients who had postprocedure microemboli had CAD compared to 18 (46%) of 39 patients without microemboli (p=0.007). Twenty (53%) of the 38 (59%) patients with CAD developed microemboli compared to 5 (19%) of the 26 patients without CAD (p=0.007). All other patient, procedural, and anatomical characteristics were not found to be independent risk factors predictive of postprocedure microemboli. Conclusion: CAS with distal protection carries a significantly greater risk for developing new microemboli compared to CEA. Of all the risk factors analyzed, only a history of CAD emerged as an independent risk factor for the development of microemboli following carotid intervention. This finding may influence the decision to perform CAS in patients deemed high risk solely due to the presence of CAD.

scholarly journals COVID-19 Prevalence and Mortality Among Schizophrenia Patients: A Large-Scale Retrospective Cohort Study

2021 ◽  
Author(s):  
Dana Tzur Bitan ◽  
Israel Krieger ◽  
Khalaf Kridin ◽  
Doron Komantscher ◽  
Yochai Scheinman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Large Scale ◽  
Morbidity And Mortality ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Total N ◽  
Logistic Regression Models ◽  
Disease Characteristics ◽  
Increased Risk ◽  
Potential Risk Factors

Abstract Objective Individuals with schizophrenia may be at an increased risk for COVID-19 morbidity due to the disease characteristics. In this study, we aimed to explore the odds of significant COVID-19 morbidity and mortality among schizophrenia patients while controlling for potential sociodemographic and medical confounders. Methods Schizophrenia patients and age-and-sex matched controls (total n = 51 078) were assessed for frequency of COVID-19 positivity, hospitalizations, and mortality. The odds for COVID-19-associated hospitalization and mortality were calculated using logistic regression models, while controlling for age, sex, marital status, sector, socioeconomic status, diabetes, ischemic heart disease, hypertension, hyperlipidemia, obesity, smoking, and chronic obstructive pulmonary disease. Results Individuals with schizophrenia were less likely to test positive for COVID-19; however, they were twice as likely to be hospitalized for COVID-19 (OR 2.15 95% CI 1.63–2.82, P &lt; .0001), even after controlling for sociodemographic and clinical risk factors (OR 1.88 95% CI 1.39–2.55, P &lt; .0001). Furthermore, they were 3 times more likely to experience COVID-19 mortality (OR 3.27 95% CI 1.39–7.68, P &lt; .0001), compared to controls. Conclusions We found evidence of associations between schizophrenia and increased COVID-19 morbidity and mortality compared to controls regardless of sociodemographic and medical factors. As these patients present with a combination of potential risk factors for mortality, efforts should be made to minimize the effects of the pandemic on this vulnerable population.

scholarly journals Risk for Cardiovascular Disease and One-Year Mortality in Patients With Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea Syndrome Overlap Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Manyun Tang ◽  
Yidan Wang ◽  
Mengjie Wang ◽  
Rui Tong ◽  
Tao Shi
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cardiovascular Diseases ◽  
Overlap Syndrome ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Independent Risk Factors

Background: Patients with chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSAS) overlap syndrome (OS) are thought to be at increased risk for cardiovascular diseases.Objective: To evaluate the burden of cardiovascular diseases and long-term outcomes in patients with OS.Methods: This was a retrospective cohort study. The prevalence of cardiovascular diseases and 1-year mortality were compared among patients diagnosed with OS (OS group), COPD alone (COPD group) and OSAS alone (OSAS group), and Cox proportional hazards models were used to assess independent risk factors for all-cause mortality.Results: Overall, patients with OS were at higher risk for pulmonary hypertension (PH), heart failure and all-cause mortality than patients with COPD or OSAS (all p &lt; 0.05). In multivariate Cox regression analysis, the Charlson comorbidity index (CCI) score [adjusted hazard ratio (aHR): 1.273 (1.050–1.543); p = 0.014], hypertension [aHR: 2.006 (1.005–4.004); p = 0.048], pulmonary thromboembolism (PTE) [aHR: 4.774 (1.335–17.079); p = 0.016] and heart failure [aHR: 3.067 (1.521–6.185); p = 0.002] were found to be independent risk factors for 1-year all-cause mortality.Conclusion: Patients with OS had an increased risk for cardiovascular diseases and 1-year mortality. More efforts are needed to identify the causal relationship between OS and cardiovascular diseases, promoting risk stratification and the management of these patients.

scholarly journals Risk Factors for Postural and Functional Balance Impairment in Patients with Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 9 (2) ◽  
pp. 609
Author(s):  
Jaekwan K. Park ◽  
Nicolaas E. P. Deutz ◽  
Clayton L. Cruthirds ◽  
Sarah K. Kirschner ◽  
Hangue Park ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Postural Balance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Balance Impairment ◽  
Functional Balance ◽  
Control Subjects ◽  
Increased Risk

Reduced balance function has been observed during balance challenging conditions in the chronic obstructive pulmonary disease (COPD) population and is associated with an increased risk of falls. This study aimed to examine postural balance during quiet standing with eyes open and functional balance in a heterogeneous group of COPD and non-COPD (control) subjects, and to identify risk factors underlying balance impairment using a large panel of methods. In COPD and control subjects, who were mostly overweight and sedentary, postural and functional balance were assessed using center-of-pressure displacement in anterior-posterior (AP) and medio-lateral (ML) directions, and the Berg Balance Scale (BBS), respectively. COPD showed 23% greater AP sway velocity (p = 0.049). The presence of oxygen therapy, fat mass, reduced neurocognitive function, and the presence of (pre)diabetes explained 71% of the variation in postural balance in COPD. Transcutaneous oxygen saturation, a history of exacerbation, and gait speed explained 83% of the variation in functional balance in COPD. Neurocognitive dysfunction was the main risk factor for postural balance impairment in the control group. This suggests that specific phenotypes of COPD patients can be identified based on their type of balance impairment.

scholarly journals Investigation of the Prevalence and Diagnosis of Chronic Obstructive Pulmonary Disease in a Group of Elderly Individuals Residing in an Island Area of Ningbo

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Wei Sheng ◽  
Youchang Huang ◽  
Zaichun Deng ◽  
Hongying Ma
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Diagnosis And Treatment ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Elderly Individuals ◽  
Island Area ◽  
History Of ◽  
Missed Diagnosis

Objective. This epidemiological investigation aimed at determining the current situation regarding the diagnosis and treatment of chronic obstructive pulmonary disease (COPD), especially missed diagnosis and missed treatment, in a group of individuals residing in an island area of Ningbo. Methods. Adults ≥60 years of age were selected from an island area of Ningbo. All participants completed a COPD-Screening Questionnaire and underwent a post-bronchodilator pulmonary function test. COPD-positive individuals then completed a questionnaire surveying the status of diagnosis and treatment of COPD and the reasons for missed diagnosis and treatment. The data were collated and analyzed using SPSS version 22.0 (IBM Corporation, Armonk, NY, USA). Findings. (1) A total of 1526 individuals were screened, of whom 1371 (89.8%) were eventually included in data analysis. From these, 254 were diagnosed with spirometry-defined COPD, corresponding to an overall prevalence of 18.5%. Prevalence was higher in men (28.9%) than in women (8.3%) among the sample. (2) According to chi-squared test results, risk factors for COPD included sex, age, smoking history (pack-years), cough, and dyspnea. Body mass index, family history of respiratory diseases, and exposure to biomass smoke from cooking were not risk factors for COPD. (3) Multivariate logistic regression analysis revealed that age and smoking were independent risk factors for COPD. (4) Receiver operating curve analysis revealed that, at a cutoff of 19.5, the highest sum of sensitivity and specificity was 69.7% and 75.5%, respectively. The COPD-Screening Questionnaire could be used as a preselection method to screen for COPD in primary care settings. (5) Of 254 individuals diagnosed with COPD, only 10 had a history of COPD and only 35 had a previous diagnosis of pneumonia or bronchitis. These data revealed that the rate of missed diagnosis of COPD in the Ningbo island area was 96.1%. Conclusion. The prevalence of COPD among elderly individuals in the Ningbo island area was significantly higher than in other parts of China. Moreover, the rate of missed diagnosis of COPD in the Ningbo island area was extremely high. Smoking and age were independent factors for the occurrence of COPD.

scholarly journals Serological prevalence of toxoplasmosis in pregnant women in Luanda (Angola): Geospatial distribution and its association with socio-demographic and clinical-obstetric determinants

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241908
Author(s):  
Amélia Nkutxi Vueba ◽  
Clarissa Perez Faria ◽  
Ricardo Almendra ◽  
Paula Santana ◽  
Maria do Céu Sousa
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Hepatitis B ◽  
Pregnant Women ◽  
Dietary Habits ◽  
Congenital Toxoplasmosis ◽  
Maternity Hospital ◽  
Serum Samples ◽  
Increased Risk ◽  
Potential Risk Factors

We report a study on toxoplasmosis in pregnant women in Luanda, Angola, determining the seroprevalence, geospatial distribution and its association with socio-economic features, dietary habits and hygiene and health conditions. Anti-Toxoplasma gondii IgG and IgM were quantified in serum samples of women attended at the Lucrecia Paim Maternity Hospital between May 2016 and August 2017. The IgG avidity test and qPCR assay were used for dating the primary infection. Data were collected by questionnaire after written consent, and spatial distribution was assessed through a Kernel Density Function. The potential risk factors associated with Toxoplasma infection were evaluated using bivariate and multivariate binomial logistic regression analysis. Anti-T. gondii antibodies were quantified in 878 pregnant women, and 346 (39.4%) samples were IgG positive, 2 (0.2%) positive for IgM and IgG, and 530 (60.4%) negative for both immunoglobulins. The longitudinal study showed that none of the seronegative women seroconverted during the survey. Regarding other infections, 226 (25.7%) were positive for hepatitis B, while 118 (13.4%) were HIV-positive. The seroprevalence of toxoplasmosis was similar in most municipalities: 43.8% in Cazenga (28 of 64); 42.5% in Viana (88 of 207); 42.3% in Cacuaco (22 of 52); and 41.1% in Luanda ((179 of 435). In contrast, the seroprevalence in municipality of Belas was lower (25.8%; 31 of 120) and bivariate and multivariate analysis has shown a lower risk for toxoplasmosis in this area (OR 0.479, CI: 0.305–0.737; OR 0.471, CI: 0.299–0.728). The multivariate analysis has shown a significant increased risk for toxoplasmosis in women in the last trimester of pregnancy (OR 1.457, CI: 1.011–2.102), suffering spontaneous abortion (OR 1.863, CI: 1.014–3.465) and having pets at home (OR 1.658, CI: 1.212–2.269). Also, women who tested positive for hepatitis B (OR 1.375, CI: 1.008–1.874) and HIV (OR 1.833, CI: 1.233–2.730) had a significant increased risk for T. gondii infection. In conclusion, our study showed that a large number of pregnant women are not immunized for toxoplasmosis and identified the risk factors for this infection in Luanda. It is crucial to establish the diagnosis of primary maternal infection as well as the diagnosis of congenital toxoplasmosis. Our results underlined the need for diagnostic and clinical follow-up of toxoplasmosis, HIV and hepatitis B during pregnancy.

scholarly journals Incidence of wound dehiscence after colorectal cancer surgery: results from a national population-based register for colorectal cancer

2019 ◽  
Vol 34 (10) ◽  
pp. 1757-1762 ◽  
Author(s):  
Harald Söderbäck ◽  
Ulf Gunnarsson ◽  
Anna Martling ◽  
Per Hellman ◽  
Gabriel Sandblom
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inflammatory Disease ◽  
Wound Dehiscence ◽  
Male Gender ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
History Of

Abstract Background Patient-related risk factors for wound dehiscence after colorectal surgery remain obscure. Methods All open abdominal procedures for colorectal cancer registered in the Swedish Colorectal Cancer Registry (SCRCR, 5) 2007–2013 were identified. Potential risk factors for wound dehiscence were identified by cross-matching between the SCRCR and the National Patient Register (NPR). The endpoint in this study was reoperation for wound dehiscence registered in either the SCRCR or NPR and patients not reoperated were considered controls. Results A total of 30,050 patients were included in the study. In a multivariable regression analysis, age > 70 years, male gender, BMI > 30, history of chronic obstructive pulmonary disease, history of generalised inflammatory disease, and duration of surgery less than 180 min were independently and significantly associated with increased risk for wound dehiscence. A history of diabetes, chronic renal disease, liver cirrhosis, and distant metastases was not associated with wound dehiscence. The hazard ratio for postoperative death was 1.24 for patients who underwent reoperation for wound dehiscence compared with that for controls. Discussion Patients reoperated for wound dehiscence face a significantly higher postoperative mortality than those without. Risk factors include male gender, age > 70 years, obesity, history of chronic obstructive pulmonary disease, and history of generalised inflammatory disease. Patients at high risk for developing wound dehiscence may, if identified preoperatively, benefit from active prevention measures implemented in routine surgical practice.

Abstract 11046: Chronic Obstructive Pulmonary Disease and Sudden Cardiac Death in Hypertensive Patients: The LIFE Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Peter M Okin ◽  
Sverre E Kjeldsen ◽  
Richard B Devereux
Keyword(s):  
Blood Pressure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Heart Rate ◽  
Cardiac Death ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Hypertensive Patients ◽  
Copd Patients ◽  
Increased Risk ◽  
History Of

Background: Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of cardiovascular (CV) disease and CV mortality. A recent large, population-based study suggested that COPD is associated with an increased risk of sudden cardiac death (SCD). However, whether COPD predicts SCD in hypertensive patients during aggressive blood pressure (BP) lowering has not been examined. Methods: Risk of SCD was examined in relation to a history of COPD in 9193 hypertensive patients with ECG left ventricular hypertrophy (LVH) who were randomly assigned to losartan- or atenolol-based treatment. A history of COPD was present in 385 patients (4.2%). SCD, a prespecified secondary endpoint in LIFE, was defined as death that was sudden and unexpected, including observed arrhythmic deaths and those not attributable to myocardial infarction (MI), intractable heart failure (HF) or other identifiable cause, occurring within 24 hours of symptom onset or when the subject was last seen alive if unwitnessed SCD. Results: During mean follow-up of 4.8±0.9 years, 178 patients (2.4%) had SCD, with a higher incidence rate per 1000 person-years in those with COPD: 9.0; 95% CI, 6.1-11.9 vs 3.8; 95% CI, 3.4-4.2; p=0.001. In a univariate Cox model, COPD was associated with a > 2-fold increased risk of SCD (HR 2.36, 95% CI 1.42-3.95, p=0.001). In a multivariable Cox regression model that adjusted for other predictors of SCD in this population (randomized treatment, age, gender, race, history of atrial fibrillation, stroke or transient ischemic attack, baseline serum creatinine and glucose entered as standard covariates and incident MI, incident HF and in-treatment diastolic pressure, heart rate, QRS duration, HDL cholesterol, and use of hydrochlorothiazide or a statin entered as time-varying covariates), COPD remained associated with a nearly 2-fold increased risk of SCD (HR, 1.82; 95% CI, 1.04-3.18, p=0.035). Conclusions: COPD is associated with an increased risk of SCD in hypertensive patients. The higher SCD risk in COPD patients persists after adjusting for the higher prevalence of risk factors in COPD patients, in-treatment blood pressure, incident MI and HF, and the established predictive value of in-treatment ECG LVH and heart rate for SCD in this population.

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