Analysis Of Risk Factors Research Articles

Trends and risk factors analysis of NEC in preterm infants over 9 years

BackgroundInvestigating the trend of changes in the occurrence of necrotizing enterocolitis (NEC) in preterm infants during 9 years and analyzing the risk factors of NEC with the purpose of providing reference for clinical diagnosis and treatment of NEC.MethodsClinical data of NEC in preterm infants with Bell’s stage ≥ II from January 2013 to December 2021 in the Neonatology Department of the Third Affiliated Hospital of Zunyi Medical University was retrospectively analyzed. Trends in the occurrence of NEC in preterm infants were analyzed by the trend chi-square test. Subsequently, the general data (sex, gestational age, singleton or multiple births, birth weight, serum albumin, alkaline phosphatase, sepsis, blood transfusion, mechanical ventilation, RDS, arterial catheterization) and perinatal data (intrauterine distress, turbid amniotic fluid, premature rupture of membranes, mode of delivery, fetal heart abnormalities, diabetes mellitus) were collected; then, the risk factors for NEC were analyzed by univariate and multivariate logistic-regression analysis.ResultsIn the past 9 years, 77 cases of NEC occurred, with the incidence rate of 1.95%, and the incidence of NEC in preterm infants has been increasing year by year (P < 0.05). The results of univariate analysis showed that the morbidity of NEC in preterm infants was associated with premature rupture of membranes, blood transfusion, sepsis, and the of serum albumin (P < 0.05). Multivariate logistic regression analysis revealed that blood transfusion (OR = 2.232, 95% CI: 1.012–4.923) and sepsis (OR = 0.899, 95% CI: 0.809–3.915) were independent risk factors of NEC in preterm infants, while high serum albumin (OR = 0.899, 95% CI: 0.809–3.915) was an independent protective factor of NEC in preterm infants.ConclusionThe morbidity of NEC is gradually increasing. Inhibition of infection and limitation of blood transfusion are effective measures to reduce the occurrence of NEC. Meanwhile, high serum albumin is a protective factor for NEC.

Analysis of postoperative urinary incontinence and influencing factors of transurethral holmium laser enucleation of the prostate.

To investigate the related factors of urinary incontinence after transurethral holmium laser enucleation of the prostate (HoLEP), and to provide guidance for clinical urinary control of HoLEP. The clinical data of 548 patients who underwent HoLEP were retrospectively analyzed. The patients were followed up for the occurrence of urinary incontinence in the short term (2 weeks), medium term (3 months) and long term (6 months) after HoLEP. Among the 548 benign prostatic hyperplasia (BPH) patients, 79 cases (14.42%) had urinary incontinence at 2 weeks, 19 cases (3.47%) at 3 months and 2 cases (0.36%) at 6 months after surgery. Logistic regression analysis showed that age, prostate volume, diabetes mellitus, operation time, prostate tissue weight and histological prostatitis were risk factors for recent urinary incontinence (P&lt;0.05). Age, diabetes and operation time were risk factors for mid-term urinary incontinence (P&lt;0.05). The incidence of long-term urinary incontinence was low and no risk factor analysis was performed. For good urinary control after HoLEP, in addition to surgery-related factors such as surgical skills, proficiency and precise anatomy, patients' risk factors should also be paid attention to in order to improve postoperative urinary control more effectively and reduce the incidence of urinary incontinence.

A regressive analysis of the main environmental risk factors of human echinococcosis in 370 counties in China.

Echinococcosis is a natural focal, highly prevalent disease in China. Factors influencing the spread of echinococcosis are not only related to personal exposure but also closely related to the environment itself. The purpose of this study was to explore the influence of environmental factors on the prevalence of human echinococcosis and to provide a reference for prevention and control of echinococcosis in the future. Data were collected from 370 endemic counties in China in 2018. By downloading Modis, DEM and other remote-sensing images in 2018. Data on environmental factors, i.e., elevation, land surface temperature (LST) and normalized difference vegetation index (NDVI) were collected. Rank correlation analysis was conducted between each environmental factor and the prevalence of echinococcosis at the county level. Negative binomial regression was used to analyze the impact of environmental factors on the prevalence of human echinococcosis at the county level. According to rank correlation analysis, the prevalence of human echinococcosis in each county was positively correlated with elevation, negatively correlated with LST, and negatively correlated with NDVI in May, June and July. Negative binomial regression showed that the prevalence of human echinococcosis was negatively correlated with annual LST and summer NDVI, and positively correlated with average elevation and dog infection rate. The prevalence of human cystic echinococcosis was inversely correlated with the annual average LST, and positively correlated with both the average elevation and the prevalence rate of domestic animals. The prevalence of human alveolar echinococcosis was positively correlated with both NDVI in autumn and average elevation, and negatively correlated with NDVI in winter. The prevalence of echinococcosis in the population is affected by environmental factors. Environmental risk assessment and prediction can be conducted in order to rationally allocate health resources and improve both prevention and control efficiency of echinococcosis.

Corrigendum: Analysis of risk factors for changes of left ventricular function indexes in Chinese patients with gout by echocardiography

Corrigendum: Analysis of risk factors for changes of left ventricular function indexes in Chinese patients with gout by echocardiography

Analysis of Risk Factors for Psychological Stress in Breast Cancer Patients: Observational Study in West Java, Indonesia

Analysis of Risk Factors for Psychological Stress in Breast Cancer Patients: Observational Study in West Java, Indonesia

Analysis of risk factors for the recurrence of osteomyelitis of the limb after treatment with antibiotic-loaded calcium sulfate and autologous bone graft

Analysis of risk factors for the recurrence of osteomyelitis of the limb after treatment with antibiotic-loaded calcium sulfate and autologous bone graft

Risk factors for delayed colorectal postpolypectomy bleeding: a meta-analysis

BackgroundTo systematically analyze risk factors for delayed postpolypectomy bleeding (DPPB) in colorectum.MethodsWe searched seven large databases from inception to July 2022 to identify studies that investigated risk factors for DPPB. The effect sizes were expressed by relative risk (RR) and 95% confidence interval (95% CI). The heterogeneity was analyzed by calculating I2 values and performing sensitivity analyses.ResultsA total of 15 articles involving 24,074 subjects were included in the study. The incidence of DPPB was found to be 0.02% (95% CI, 0.01–0.03), with an I2 value of 98%. Our analysis revealed that male sex (RR = 1.64), history of hypertension (RR = 1.54), anticoagulation (RR = 4.04), polyp size (RR = 1.19), polyp size ≥ 10 mm (RR = 2.43), polyp size > 10 mm (RR = 3.83), polyps located in the right semicolon (RR = 2.48) and endoscopic mucosal resection (RR = 2.99) were risk factors for DPPB.ConclusionsMale sex, hypertension, anticoagulation, polyp size, polyp size ≥ 10 mm, polyps located in the right semicolon, and endoscopic mucosal resection were the risk factors for DPPB. Based on our findings, we recommend that endoscopists should fully consider and implement effective intervention measures to minimize the risk of DPPB.

Characteristics and Outcome of Vascular Graft Infections - A Risk Factor and Survival Analysis

Abstract Background Vascular graft infection (VGI) is a serious complication after implantation of arterial vascular grafts. Optimal surgical and pathogen-specific antimicrobial treatment regimens for VGI are largely unknown. We evaluated patients with arterial VGI according to onset, location, microbiological and imaging characteristics, surgical and antimicrobial treatment and performed an outcome evaluation. Methods Consecutive patients with VGI treated in two hospitals from 2010 through 2020 were retrospectively analyzed. Uniform definition criteria and standardized outcome evaluation were applied. Logistic regression was used for multiple analysis, survival analysis was performed with Kaplan-Meier analysis and log-rank test. Results Seventy-eight patients with VGI were included, consisting of 30 early-onset (&amp;lt;8 weeks after graft implantation) and 48 late-onset cases, involving 49 aortic and 29 peripheral grafts. The median time from initial implantation to diagnosis of VGI was significantly longer in aortic than peripheral VGIs (363 days vs. 56 days, p = 0.018). Late-onset VGI (OR 7.3, p = 0.005) and the presence of surgical site infection/complication (OR 8.21, p = 0.006) were independent risk factors for treatment failure. Surgical site infection/complication was associated with higher risk for early-onset VGI (OR 3.13, p = 0.040). Longer infection-free survival was observed in cases where the infected graft was surgically removed (p = 0.037). Conclusion This study underlines the importance of timely diagnosis of VGI and preventing surgical site infections/complications at graft implantation. It highlights the complexity of infection eradication, especially of late-onset infections, and the importance of adequate antimicrobial and surgical treatment.

Epidemiology of cutaneous leishmaniasis in children of Khyber Pakhtunkhwa, Pakistan.

In Pakistan, cutaneous leishmaniasis is an emerging tropical disease and a very high number (>70%) of children are afflicted by this marring infection. This study aimed to scrutinise the prevalence, spatial distribution and socio-demographic and behavioural risk factors associated with cutaneous leishmaniasis in children aged <5-15 years in Khyber Pakhtunkhwa. A total of 1, 559 clinically confirmed records of children diagnosed with cutaneous leishmaniasis (January-December) from 2020 and 2022 were obtained from selected district hospitals. In addition, a risk factors-related questionnaire was administered to 1, 011 households (400 in 2020 and 611 in 2022) in nine districts during a household survey. The maximum number of cutaneous leishmaniasis cases was recorded in 2022 (n = 877, 56.25%) as compared to 2020 (n = 682, 43.75%). The hospital records showed a greater number of male patients in the 2022 cohort (n = 603, 68.76%). The highest number of cases were observed in children aged 5-9 years in 2022 (n = 282, 32.16%) and 2020 (n = 255, 37.39%). In 2020 and 2022, cutaneous leishmaniasis cases showed peak aggregation in March (n = 118, 17.3%) and January (n = 322, 36.72%). From a spatial analysis, the maximum number of cutaneous leishmaniasis cases was recorded at 59-1700 m elevation in various land-use/land-cover and climatic regions with quaternary alluvium rock formations. A multivariate logistic regression model analysis of risk factors from the households survey suggested that age group, socio-economic status, construction materials of the house, use of insect repellents, Afghan refugee camps in the village/district, knowledge and biting times of sand flies, frequent use of mosquito bed nets, presence of domestic animals in the house, knowledge of the transmission period and peak month of leishmaniasis infection increased the risk of acquiring cutaneous leishmaniasis (p value < 0.05). Our analysis demonstrated that cutaneous leishmaniasis in children is influenced by a variety of environmental, socio-demographic and behavioural risk factors in Khyber Pakhtunkhwa. The increase in recorded cases of cutaneous leishmaniasis in children in 2022 compared to 2020 suggests that the infection likely extended to new foci in the province.

Predictive Factors for Major Complications and Urological Cancer Diagnosis in Older Adults (≥80 Years) Admitted to the Emergency Department for Hematuria

Background: Gross Hematuria is a relevant cause of admission to the emergency department in the general population and particularly in older adults (≥80 years). This specific urological symptom is often underestimated and usually associated with benign conditions such as urinary infections or poor hydration. Nevertheless, hematuria could lead to severe acute complications or be the first symptom of urological cancers. Methods: We retrospectively analyzed clinical data from 1169 patients aged ≥80 years consecutively admitted to the emergency department for hematuria. The primary endpoint of the study was to identify risk factors for major complications, and the secondary endpoint was to analyze risk factors for urological cancer diagnosis. The median age was 85 years (IQR 82–88 years), and 908 (77%) were males. Among them, 449 (38.4%) had a past medical history of urological neoplasm (kidney, ureter, bladder, prostate, or urethral cancer). Results: Overall, 87 patients (7.4%) had major complications (patient death, septic shock, and admission to the intensive care unit). Worse vital signs at admission, fever, and confusion (p &lt; 0.001, OR 18.0 IC 95% [5.5–58.7]; p = 0.015, OR 2.0 IC 95% [1.1–3.5]; p = &lt;0.001, OR 4.2 IC 95% [1.9–3.5], respectively), as well as lower hemoglobin values and higher Charlson comorbidity index (p &lt; 0.001, OR 0.8 IC 95% [0.7–0.9]), p = 0.002, OR = 1.2 [1.1–1.3]) were independent predictive factors for major complications. The multivariate analysis identified as risk factors for diagnosis of urological cancer older age, male sex and higher comorbidity (OR 1.05 IC95% [1–1.09]; OR 2.19 IC95% [1.42–3.39] and OR 1.11 IC95% [1.2–1.2], respectively); interestingly the presence of indwelling vesical catheter (IVC) (OR 0.44 IC95% [0.24–0.82]) resulted as an independent factor for absence of urological cancers. Conclusions: Hematuria is a frequent symptom in older adults admitted to the emergency department. While this is often associated with benign conditions, there are some risk factors for major complications and for urological cancer that must be taken into account to identify the patients who need further evaluation or prompt hospital admission.

Profile and Outcomes of COVID-19 Infection in Pediatric Patients with and without Cancer: A Case–Control Study

Abstract Objectives Pediatric patients with cancer are considered a vulnerable population to the ill effects of coronavirus disease 2019 (COVID-19). We hereby studied the difference between clinical characteristics, lab parameters, and outcomes of COVID-19 among children suffering from cancer and those without cancer. We also analyzed risk factors for the occurrence of moderate-to-severe COVID-19 disease in pediatric cancer patients. Materials and Methods This retrospective case–control study was carried out using the medical record review method over 6 months in a tertiary-care center in India. All patients below 18 years of age, with reverse-transcriptase polymerase chain reaction (RTPCR) confirmed COVID-19, were screened for enrolment. Patients were split into two groups: Group A comprised of patients with cancer, while group B consisted of patients without any underlying comorbidity. Patients with other comorbidity except cancer and inadequately recorded case sheets were excluded. Details regarding demography, clinical features, investigations, treatment, and outcomes were recorded. Statistical Analysis Microsoft Excel and Statistical Package for the Social Sciences (SPSS) software, version 25 was used for data analysis. A p-value less than 0.05 was considered significant. Results Two-hundred-five pediatric inpatients with RTPCR-established COVID-19 infection were screened and final analyses were performed on 97 patients, of which 31 children were classified into group A and 66 into group B. Median age of enrolled children was 5 years with 58.8% males. The prevalence of cancer as a comorbidity in pediatric inpatients with COVID-19 was 15%. Fifty-five percent of cancer patients had hematological malignancies, while 45% had solid tumors. Fever (p = 0.001) and gastrointestinal manifestations (p = 0.0001) were significantly less common among pediatric cancer patients. Children with cancer had significantly more leukopenia (p = 0.003), neutropenia (p = 0.003), and lymphopenia (p = 0.005). The case fatality rate was higher in children with cancer (3.2%) as compared to noncancer patients (1.5%, p = 1.0). Few risk factors for moderate-to-severe COVID-19 among children with cancer included age less than 2 years (p = 0.06), undernutrition (p = 0.33), advanced stage of cancer (p = 0.49), and presence of coinfection (p = 0.35) Conclusion Cancer is a significant comorbidity among pediatric COVID-19 patients. While children with cancer have less severe COVID-19, their case fatality rate is higher than those without cancer. Younger age, undernutrition, advanced stage of cancer, and presence of coinfections may predispose to the development of moderate-to-severe COVID-19 among pediatric cancer patients.

OBESITY AND IN-HOSPITAL OUTCOMES AMONG PATIENTS WITH SEVERE COVID-19 IN VIET NAM

Introduction: COVID-19 (Coronavirus disease 2019) is a global pandemic. Overweight and obesity are risk factors related to mortality as well as disease severity. Overweight and obesity are also increasing in Vietnam. Data related to the characteristics of COVID-19 in this vulnerable population was limited in Vietnam. The study was conducted (1) to describe the outcomes of overweight and obese COVID-19 patients, and (2) to investigate factors associated with the outcomes of overweight and obese COVID-19 patients. Methods: A cross-sectional description was conducted at the Hospital for Tropical Diseases from July 2021 to December 2021. Patients who were (1) ≥ 18 years old (2) diagnosed with COVID-19 with a positive RT-PCR SARS-CoV-2 result and (3) had BMI ≥ 23 kg/m2. Female pregnant women or ascites were excluded from this study. To determine factors associated with mortality and ICU admission, chi-square and Fisher's Exact were used. Variables with p &lt; 0.05 were included in the logistic regression model to investigate independent risk factors. Cases directly admitted to the ICU were excluded when analyzing risk factors for ICU admission. Results: 173 patients were recruited (70 patients (40.46%) were overweight, 74 patients (42.77%) were obesity class I and 29 patients (16.76%) were obesity class II). The overall mortality rate was 28.9%. The ICU admission rate was 46.2% with a median ICU stay of 9 (6 – 15.25) days. The rate of respiratory support was 83.8%, of which 31.8% of patients required invasive mechanical ventilation and the median duration of respiratory support was 12 (6.5 – 16.5) days. Independently factors associated with ICU admission were diabetes (OR = 2.92 (1.27 – 6.67)) and a severe or critical condition at admission (OR = 8.82 (2.51 – 31.08). Independently factors associated with death were vaccination (OR = 0.23 (0.08 – 0.63)), a severe or critical at admission (OR = 15.74 (3.46 – 71.55)) and remdesivir usage (OR = 0.78 (0.16 – 0.87)). Recommendation: Vaccination against COVID-19 has been shown to be effective in the obese and overweight population.

Analysis of Risk Factors for Death in the Coronavirus Disease 2019 (COVID-19) Population: Data Analysis from a Large General Hospital in Anhui, China.

During the coronavirus disease 2019 (COVID-19) pandemic, clinical prevention, early diagnosis, and hematological monitoring were challenging areas.This study aims to comparerisk factors and hematological and biochemical data in non-survivor group patientswith COVID-19 versus survivor group patients.A total of 204 patients with COVID-19 were selected as research subjects from December 2022 to January 2023. We analyzed the age, sex, time from onset to admission, and laboratory test indicators upon admission. The differences between surviving and deceased patients and mortality-related risk factors were examined. Among the 204 patients, 168 survived, whereas 36 died during hospitalization. Significant differences were observed between the two groups with COVID-19 across various factors, including age (p < 0.0001), WBC count (p < 0.0001), RBC count (p < 0.05), neutrophils (p < 0.0001), lymphocytes (p < 0.05), mean corpuscular hemoglobin concentration (MCHC) (p < 0.0001), RBC distribution width-standard deviation (RDW-SD) (p < 0.0001), RBC distribution width coefficient of variation (RDW-CV) (p < 0.0001), aspartate aminotransferase (AST) (p < 0.05), albumin (ALB) (p < 0.0001), creatinine (CR) (p < 0.0001), uric acid (UA) (p < 0.0001), blood urea nitrogen (BUN) (p < 0.0001), plasma thrombin time (TT) (p < 0.05), prothrombin time (PT) (p < 0.0001), and D-dimer (p < 0.0001). Multivariate logistic analysis revealed that older age, CR, UA, and ALB were independent factors associated with death (p < 0.05).Elderly patients with underlying diseases, abnormal routine blood test indices, and abnormal renal function and coagulation indices are at an increased worse prognosisand should be identified early. Age, UA, CR, and ALB can be used as predictors to assess the worse prognosisin the hospital.

Seromolecular survey and risk factor analysis of Crimean-Congo haemorrhagic fever orthonairovirus in occupationally exposed herdsmen and unexposed febrile patients in Kwara State, Nigeria.

Crimean-Congo haemorrhagic fever virus (CCHFV) is a globally significant tick-borne zoonotic pathogen that causes fatal haemorrhagic disease in humans. Despite constituting an ongoing public health threat, limited research exists on the presence of CCHFV among herdsmen, an occupationally exposed population that has prolonged contact with ruminants and ticks. This cross-sectional study, conducted between October 2018 and February 2020 in Kwara State, Nigeria, was aimed at assessing CCHFV seroprevalence among herdsmen and non-herdsmen febrile patients, and identifying the associated risk factors. Blood samples from herdsmen (n = 91) and febrile patients in hospitals (n = 646) were analyzed for anti-CCHFV IgG antibodies and CCHFV S-segment RNA using ELISA and RT-PCR, respectively. Results revealed a remarkably high CCHFV seroprevalence of 92.3% (84/91) among herdsmen compared to 7.1% (46/646) in febrile patients. Occupational risk factors like animal and tick contact, tick bites, and hand crushing of ticks significantly contributed to higher seroprevalence in the herdsmen (p<0.0001). Herdsmen were 156.5 times more likely (p<0.0001) to be exposed to CCHFV than febrile patients. Notably, the odds of exposure were significantly higher (OR = 191.3; p<0.0001) in herdsmen with a history of tick bites. Although CCHFV genome was not detectable in the tested sera, our findings reveal that the virus is endemic among herdsmen in Kwara State, Nigeria. CCHFV should be considered as a probable cause of febrile illness among humans in the study area. Given the nomadic lifestyle of herdsmen, further investigations into CCHF epidemiology in this neglected population are crucial. This study enhances our understanding of CCHFV dynamics and emphasizes the need for targeted interventions in at-risk communities.

Pigs in southern Italy are exposed to three ruminant pathogens: an analysis of seroprevalence and risk factors analysis study

BackgroundPigs are susceptible to several ruminant pathogens, including Coxiella burnetti, Schmallenberg virus (SBV) and bovine viral diarrhea virus (BVDV). These pathogens have already been described in the pig population, although the dynamics of the infection and the impact on pig farms are currently unclear. The aim of this work was to evaluate the presence of these infections in the pig population of the Campania region, southern Italy, and to evaluate the risk factors associated with a greater risk of exposure.ResultsA total of 414 serum samples belonging to 32 herds were tested for the presence of antibodies against SBV, Coxiella, and BVD using commercial multispecies ELISA kits. SBV (5.3%) was the most prevalent pathogen, followed by Coxiella (4.1%) and BVD (3%). The risk factors included in the study (age, sex, province, farming system, ruminant density and major ruminant species) had no influence on the probability of being exposed to BVD and Coxiella, except for the location, in fact more pigs seropositive to Coxiella were found in the province of Caserta. However, the univariate analysis highlighted the influence of age, location, and sex on exposure to SBV. The subsequent multivariate analysis statistically confirmed the importance of these factors. The presence of neutralizing antibodies for SBV and BVDV, or antibodies directed towards a specific phase of infection for Coxiella was further confirmed with virus-neutralization assays and phase-specific ELISAs in a large proportion of positive samples. The presence of high neutralizing antibody titers (especially for SBV) could indicate recent exposures. Twelve of the 17 positive samples tested positive for antibodies against Coxiella phase I or II antigens, indicating the presence of both acute and chronic infections (one animal tested positive for both phases antibodies).ConclusionsOur study indicates a non-negligible exposure of pigs from southern Italy to the above pathogens. Further studies are necessary to fully understand the dynamics of these infections in pigs, the impact on productivity, and the public health consequences in the case of Coxiella.

Gallbladder Wall Thickening for Early Detection of Plasma Leakage Among Children with Dengue Fever Admitted in a Tertiary Care Hospital

Background: Plasma leakage is defined as e”20% elevation of hematocrit from baseline or evidence of plasma leakages such as pleural effusion, ascites, or hypoalbuminemia. In the early phase, these signs of plasma leakage are usually difficult to ascertain by physical examination and laboratory tests. Objective: This study aimed to investigate whether gallbladder wall thickening (GBWT) in the febrile phase of the disease can be used to detect the occurrence of plasma leakage in dengue patients. Methods: A cross-sectional analytical study was conducted during a 4-month period in Dr. M R Khan Shishu Hospital and ICH from September 2021 to December 2021. Children from 6 months to 14 years who were admitted with acute onset of fever less than 3 days with NS1 positivity were included consecutively. Laboratory tests and abdominal Ultrasonography were also performed to confirm the occurrence of plasma leakage. Result: Out of 114 patients, the majority were male (64%), in the 5-&lt;10-year age group(48.25%). Common presentations include fever (100%), flushed appearance (66.7%), abdominal pain (66.7%), vomiting (44.7%), bodyache (39.5%), During the febrile phase, 56patients were presented with GBWT, 49 of which showed plasma leakage during treatment. The sensitivity and specificity of GBWT during fever were 89% and 88%. PPV and NPV were 87% and 90% respectively. In risk factor analysis, Gallbladder wall thickening was found statistically significant (&lt;.009) predictor of plasma leakage in dengue. Conclusion: Gallbladder wall thickening during the febrile phaseis a predictor of plasma leakage in Dengue. BANGLADESH J CHILD HEALTH 2022; VOL 46 (3) : 138-143

Descriptive analysis of incidence and risk factors for short intramedullary nail breakage in femoral intertrochanteric fractures: a multicenter (TRON group) retrospective study.

The incidence of hip fractures is increasing. Femoral intertrochanteric fractures make up 50% of hip fractures and are treated by intramedullary nails. Implant breakage is a recognized complication that can have rare and serious implications. This study aimed to investigate implant breakage rates after surgical treatment for femoral intertrochanteric fractures. This was a retrospective multicenter analysis. All 1854 patients who underwent surgical treatment for femoral intertrochanteric fractures were selected from 12 hospitals (TRON group) between 2016 and 2020. Exclusion criteria included implants other than those specified and follow-up periods less than threemonths. Demographic data, surgical details, and radiographic assessments were collected from medical records and X-ray evaluations. Among the 983 study patients, consisting of 245 males (24.9%) and 738 females (75.1%), the implant breakage rate was 0.31%, with three confirmed cases. The average age was 83.9years. The mean follow-up period was 640.9days. Two cases were linked to ASULOCK implants, and one to an OLSII implant. Statistical analysis showed a significantly higher incidence of ASULOCK implant breakage (p < 0.001). In the two cases of ASULOCK implant breakage and one case of OLSII implant breakage, breakage in all three implants occurred at the anti-rotation screws. There were no implant breakages of the main body of the implants; all breakages occurred in the additional anti-rotation screw. The necessity of the anti-rotation screw will require further discussion. These results can potentially inform clinical decisions and guide further research in preventing implant breakage.

Predictors for temporary stomas non-closure among non-metastatic rectal cancer patients undergoing curative resection: a retrospective analysis

BackgroundThe primary treatment for non-metastatic rectal cancer is curative resection. However, sphincter-preserving surgery may lead to complications. This study aims to develop a predictive model for stoma non-closure in rectal cancer patients who underwent curative-intent low anterior resection.MethodsConsecutive patients diagnosed with non-metastatic rectal cancer between January 2005 and December 2017, who underwent low anterior resection, were retrospectively included in the Chang Gung Memorial Foundation Institutional Review Board. A comprehensive evaluation and analysis of potential risk factors linked to stoma non-closure were performed.ResultsOut of 956 patients with temporary stomas, 10.3% (n = 103) experienced non-closure primarily due to cancer recurrence and anastomosis-related issues. Through multivariate analysis, several preoperative risk factors significantly associated with stoma non-closure were identified, including advanced age, anastomotic leakage, positive nodal status, high preoperative CEA levels, lower rectal cancer presence, margin involvement, and an eGFR below 30 mL/min/1.73m2. A risk assessment model achieved an AUC of 0.724, with a cutoff of 2.5, 84.5% sensitivity, and 51.4% specificity. Importantly, the non-closure rate could rise to 16.6% when more than two risk factors were present, starkly contrasting the 3.7% non-closure rate observed in cases with a risk score of 2 or below (p < 0.001).ConclusionPrognostic risk factors associated with the non-closure of a temporary stoma include advanced age, symptomatic anastomotic leakage, nodal status, high CEA levels, margin involvement, and an eGFR below 30 mL/min/1.73m2. Hence, it is crucial for surgeons to evaluate these factors and provide patients with a comprehensive prognosis before undergoing surgical intervention.

A comprehensive analysis of patients with cerebral arteriovenous malformation with headache: assessment of risk factors and treatment effectiveness

BackgroundDue to the high mortality and disability rate of intracranial hemorrhage, headache is not the main focus of research on cerebral arteriovenous malformation (AVM), so research on headaches in AVM is still scarce, and the clinical understanding is shallow. This study aims to delineate the risk factors associated with headaches in AVM and to compare the effectiveness of various intervention treatments versus conservative treatment in alleviating headache symptoms.MethodsThis study conducted a retrospective analysis of AVMs who were treated in our institution from August 2011 to December 2021. Multivariable logistic regression analysis was employed to assess the risk factors for headaches in AVMs with unruptured, non-epileptic. Additionally, the effectiveness of different intervention treatments compared to conservative management in alleviating headaches was evaluated through propensity score matching (PSM).ResultsA total of 946 patients were included in the analysis of risk factors for headaches. Multivariate logistic regression analysis identified that female (OR 1.532, 95% CI 1.173–2.001, p = 0.002), supply artery dilatation (OR 1.423, 95% CI 1.082–1.872, p = 0.012), and occipital lobe (OR 1.785, 95% CI 1.307–2.439, p < 0.001) as independent risk factors for the occurrence of headaches. There were 443 AVMs with headache symptoms. After propensity score matching, the microsurgery group (OR 7.27, 95% CI 2.82–18.7 p < 0.001), stereotactic radiosurgery group(OR 9.46, 95% CI 2.26–39.6, p = 0.002), and multimodality treatment group (OR 8.34 95% CI 2.87–24.3, p < 0.001) demonstrate significant headache relief compared to the conservative group. However, there was no significant difference between the embolization group (OR 2.24 95% CI 0.88–5.69, p = 0.091) and the conservative group.ConclusionsThis study identified potential risk factors for headaches in AVMs and found that microsurgery, stereotactic radiosurgery, and multimodal therapy had significant benefits in headache relief compared to conservative treatment. These findings provide important guidance for clinicians when developing treatment options that can help improve overall treatment outcomes and quality of life for patients.

Chronic Pulmonary Aspergillosis after Surgical Treatment for Non-Small Cell Lung Cancer—An Analysis of Risk Factors and Clinical Outcomes

Chronic pulmonary aspergillosis (CPA) is a rare but significant complication of lung cancer surgery. Its effect on survival remains unclear. Our aim was to describe the outcomes of the patients who developed CPA following the surgery for non-small cell lung cancer (NSCLC), identify the risk factors associated with its development following lung resection, and evaluate its impact on survival. All the patients with a diagnosis of CPA and operated NSCLC were identified in the National Aspergillosis Centre (NAC) database (2009–2020). Additional patients were identified in the Northwest Clinical Outcomes Research Registry (2012–2019) database. A regression analysis was performed to examine potential links between CPA and long-term outcomes and also to identify the factors associated with the development of CPA. The primary outcomes were the development of CPA, 1-year and 5-year mortality, and overall survival. Thirty-two patients diagnosed with CPA after lung resection were identified in the NAC database, of which 11 were also contained within the NCORR database, with a prevalence of 0.2% (n = 11/4425). Post-operative CPA was associated with significantly lower survival on log-rank analysis (p = 0.020). Mortality at one year was 25.0% (n = 8) and 59.4% (n = 19) at five years after the CPA diagnosis. On univariable analysis, a lower mean percentage-predicted forced expiratory volume in 1 s, ischaemic heart disease, and chronic obstructive pulmonary disease were all significantly associated with CPA development. CPA is a rare complication following lung cancer surgery which has a significant impact on long-term survival. Its development may be associated with pre-existing cardiopulmonary comorbidities. Further research in larger cohorts is required to substantiate these findings.