Types Of Complications In Patients Research Articles

Frequency and Distribution of Complications in Cholesteatoma Patients: A Tertiary Care Hospital Study

Background: Cholesteatoma, a benign epithelial lesion, progresses with time, necessitating surgical intervention. The most common surgical treatments are canal wall up (CWU) and canal wall down (CWD). CWU, though preserving ear canal anatomy, has a higher risk of recurrence, prompting a need to evaluate the frequency and nature of complications arising from cholesteatoma to improve treatment outcomes. Objective: This study aims to identify the frequency and types of complications in patients diagnosed with cholesteatoma at a tertiary care hospital. Methods: Conducted as a cross-sectional analysis at the Department of ENT, Jinnah Postgraduate Medical Centre, Karachi, from August 10, 2019, to February 9, 2020, this study included 210 diagnosed patients. Through otoscopy, audiologic evaluations, and microscope examinations for selected cases, patients with signs of persistent disease underwent mastoid exploration. Surgical interventions were tailored based on disease extent and type. Statistical analysis employed descriptive statistics, stratification, and Chi-square tests for significance (P-value ≤0.05). Results: Of the participants, 57.6% were male, and 42.4% were female, with an average age of 31.30±8.75 years and a mean disease duration of 8.73±3.63 months. Extracranial complications were identified in 29% of patients, with 12.4% experiencing ossicular damage. Intracranial complications were found in 18.1% of patients, with meningitis constituting 8.6% of these cases. A total of 5.7% presented with multiple complications. No significant associations were found between the complications and variables such as gender, age, BMI, and disease duration. Conclusion: Extracranial complications, notably ossicular damage, were most common, followed by intracranial complications and multiple complications, underlining the necessity for early diagnosis and targeted treatment strategies.

Frequency and Types of Complications Encountered in Patients With Nonconvulsive Status Epilepticus in the Neurological ICU: Impact on Outcome.

Objectives. The frequency and types of complications in patients with nonconvulsive status epilepticus (NCSE) who are followed up in the intensive care unit (ICU), and the impact of these complications on outcome are not well-known. We investigated the complications and their effects on prognosis in NCSE patients. Methods. After reviewing the video-EEG monitoring (VEEGM) reports of all the consecutive patients who were followed up in our ICU between 2009 and 2019, we identified two groups of patients: 1-patients with NCSE (study group) and 2-patients who underwent VEEGM for possible NCSE but did not have ictal recordings (no-NCSE group). Electronic health records were reviewed to identify demographic and clinical data, duration of ICU care, medical and surgical complications, pharmacologic treatment, and outcome. These parameters were compared statistically between the groups. We also investigated the parameters affecting prognosis at discharge. Results. Thirty-two patients with NCSE comprised the study group. Infection developed in 84%. More than half were intubated, had tracheostomy or percutaneous endoscopic gastrostomy application. Refractory NCSE was associated with significantly more frequent complications and worse outcome. There was a higher tendency of infections in the study group (P = .059). Higher organ failure scores and prolonged stay in ICU predicted worse outcome (P < .05). Conclusion. The frequency of complications in patients with NCSE who are cared for in the ICU is considerable. Most of the complications are similar to the other patients in ICU, except for the higher frequency of infections. Increased physician awareness about modifiable parameters and timely interventions might help improve prognosis.

Medical complications during inpatient rehabilitation in patients with ischemic stroke in a tertiary care hospital in Nepal

Background: Complications are common in patients with ischemic stroke and hinder successful rehabilitation. Timely identification and management of complications are key factors in the management of patients with ischemic stroke.&#x0D; Objectives: The aim of this study is to find the occurrence of different types of complications in patients admitted with the diagnosis of ischemic stroke and to find the risk factors associated with the occurrence of complications.&#x0D; Methodology: The study is a cross sectional descriptive study. A total of 96 patients with ischemic stroke admitted to the Department of Neurology of Kathmandu Medical College Teaching Hospital over a period of six months (July 2018 to December 2018) were recruited. Data was recorded according to a designed proforma and analysed using Statistical Package for the Social Sciences version 20.&#x0D; Results: The age group ranged from 25 to 91 years with the mean age of 64.36 years and 50 (52.1%)patients were male. A total of 62 (64.6%) patients developed at least one complication during hospital stay. Pneumonia and urinary tract infection were the most common complications occurring in 22(22.9%) patients. The occurrence of complications was positively correlated with National Institutes of Health Stroke Scale and Glasgow Coma Scale.&#x0D; Conclusion: Pneumonia and urinary tract infection were the most common complications in our study and were similar to those quoted in the western literature. Severity of stroke had positive correlations with occurrence of complications.

2990 Evaluation of the Incidence and Types of Complications in Patients Undergoing for Robot – Assisted Hysterectomy in a Third Level Care Hospital in Mexico

Study Objective To evaluate the incidence and types of complications in patients undergoing Robot-assisted hysterectomy. Design Retrospective study. Setting 3rd level care hospital in Zumpango, State of Mexico. Patients or Participants Women undergoing robotic-assisted laparoscopic hysterectomy. Interventions Robotic-assisted laparoscopic hysterectomy. Interventions A total of 49 patients were included; the main indication for the procedure was uterine myomatosis in 75.5%, abnormal uterine bleeding refractory to treatment in 12.24% and in the rest, endometrial intraepithelial neoplasia, cervical cancer in situ among others. The incidence of complications was 20.40% (10 patients in total), some of them presenting up to two different complications. Complications were classified according to the scale of Claiven and Dindo, finding type I in 58% (most frequent seromas, lesion in the serosa of the sigmoid rectum and a perforation in the posterior cul-de-sac with uterine mobilizer). Type II in 8.3% (one patient with erosive gastritis requiring transfusion) and type III b in 33.3% with two conversions to open surgery (one for hemorrhage and one for non-recoverable equipment failure) and two re interventions (laparotomy due to hemoperitoneum and a laparoscopy for residual abscess drainage) no type IV or V lesions were found. Measurements and Main Results The files of the patients undergoing robotic assisted laparoscopic hysterectomy from May 1, 2014 to April 30, 2019 were analyzed. Conclusion The incidence of complications is similar to that reported in open surgery and discretely larger than laparoscopic, however type I complications were the most frequent. The high incidence of probably due to what we are is a school hospital and surgeons are training period. To evaluate the incidence and types of complications in patients undergoing Robot-assisted hysterectomy. Retrospective study. 3rd level care hospital in Zumpango, State of Mexico. Women undergoing robotic-assisted laparoscopic hysterectomy. Robotic-assisted laparoscopic hysterectomy. A total of 49 patients were included; the main indication for the procedure was uterine myomatosis in 75.5%, abnormal uterine bleeding refractory to treatment in 12.24% and in the rest, endometrial intraepithelial neoplasia, cervical cancer in situ among others. The incidence of complications was 20.40% (10 patients in total), some of them presenting up to two different complications. Complications were classified according to the scale of Claiven and Dindo, finding type I in 58% (most frequent seromas, lesion in the serosa of the sigmoid rectum and a perforation in the posterior cul-de-sac with uterine mobilizer). Type II in 8.3% (one patient with erosive gastritis requiring transfusion) and type III b in 33.3% with two conversions to open surgery (one for hemorrhage and one for non-recoverable equipment failure) and two re interventions (laparotomy due to hemoperitoneum and a laparoscopy for residual abscess drainage) no type IV or V lesions were found. The files of the patients undergoing robotic assisted laparoscopic hysterectomy from May 1, 2014 to April 30, 2019 were analyzed. The incidence of complications is similar to that reported in open surgery and discretely larger than laparoscopic, however type I complications were the most frequent.

Predictive factors for persistent and late radiation complications in breast cancer survivors.

With improved diagnostic techniques and treatments of breast cancer, overall survival times are longer, giving more opportunity for normal tissue complications of treatment to manifest. Radiation late effects (RLEs) could have profound long-term impacts on the quality of life of the survivors. The aim of this study was to identify predictive factors influencing timing and types of complications in patients referred to the Adult Radiation Late Effects Clinic (ARLEC). In a period of 16years, 296 breast cancer patients were referred to the ARLEC. The clinical records were retrospectively studied to collect epidemiologic, medical and treatment data. Associations were sought between candidate predictive factors and time to the first complication after radiation treatment (RT) completion (primary outcome), and pain or swelling (secondary outcomes) using univariable and multivariable linear and logistic regression analyses. All analyses were performed in SAS, version 9.4. All patients were female with a mean age of 56.3years. The first treatment-related complication occurred after a median of 3 months. Patients were followed at ARLEC for a median of 18months. Older age and delay from surgery to RT (S-RT delay) were associated with earlier onset of complications (both p < 0.001). The most common complications were breast pain (62.1%) and swelling (45.9%). Histology and RT boost were associated with pain (p = 0.035 and 0.013). RT boost and S-RT delay on the other hand were associated with swelling (p = 0.013 and 0.005). Clinical factors identified could help recognize the patients at high risk for developing RLEs and alert physicians to initiate earlier diagnostic and therapeutic measures.

Different Types of Complications in Patients Suffering from B-Thalassemia (Thalassemia Major)

INTRODUCTIONThalassemia is a heterogeneous group of gene disorders caused byan inherited mutation or deletion of genes at chromosome 16 &amp; 11 resulting in decreased synthesis of adult hemoglobin. Its incidence is higher in people/children having a positive family history of Thalassemia Among its various types Beta Thalassemia major is the one which requires regular blood transfusions.OBJECTIVESThe main objective of the study was to determine the frequency of different types of complications in patients suffering from B-Thalassemia.METHODOLOGYThe study was conducted in two private originations in Peshawar i.e. Fatimid Foundation and Hamza Foundation.150 patients) were studied, the study was Cross-Sectional, descriptive type and sampling type was Non-Probability, convenience type sampling. All necessary data were obtained by using semi structured questionnaire, having both closed and open ended questions. Pilot Study was conducted on 15 patients (10%of target questionnaires). After completing the pilot study necessary changes were made in questionnaire and a well-informed, well-designed and organized questionnaire was finalized. An informed consent was taken from respondents and the responses were obtained each from the parents &amp; from children themselves (in case of older children). Data was collected and results were presented in the form of tables and charts. Manual analysis of the data was carried out.RESULTSAccording to the study, among 150 patients, Splenectomy was done in about 86% patients. Consanguinity among the parents of these patients was about 76%, while awareness only 72% of patients. About 64% patients were having psychological problem. Among neurological problems 57% of patients had headache. Among complications, majority of patients had palpitations about 54% joint pains about 32% &amp; history of bones fractures about 21%. Socioeconomic condition of majority of them was poor about 52%. All of them were taking primary treatment i.e. Blood transfusion &amp;Chelating Therapy to prevent iron overload.CONCLUSSIONSThalassemia major is a life threatening disease causing morbidity and mortality among those who are not treated properly. The incidence of the disease is high among those with a family history of Thalassemia.

Are complications of stress urinary incontinence surgery procedures associated with the position of the sling?

To evaluate whether the sling position is associated with particular types of complications in patients undergoing suburethral sling placement for stress urinary incontinence. Data from 100 women diagnosed at the Evangelical Hospital Hagen-Haspe with complications after suburethral sling insertion were analyzed. All patients underwent pelvic floor ultrasound to assess: urethral length, sling location in relation to the urethral length (%) and the sling distance to the longitudinal smooth muscle complex of the urethra (the sling-longitudinal smooth muscle distance). The shortest median sling-longitudinal smooth muscle distance was observed in patients with recurrent urinary tract infections, urinary retention and overactive bladder: 0.9, 1.1 and 1.75 mm, respectively (P < 0.05). In women with persistent stress urinary incontinence and sling erosion, the sling-longitudinal smooth muscle distance was 3.6 and 4.6 mm, respectively (P < 0.05). Persistent stress urinary incontinence was connected with the position of the sling in relation to the bladder neck - in these patients, the sling was closer to the bladder neck. Sling location plays a pivotal role in the occurrence of certain complications. The sling position in the proximal part of the urethra or between the middle and proximal urethra appears to be connected with a high rate of unsuccessful stress urinary incontinence treatment. A sling-longitudinal smooth muscle distance below 2 mm is often connected with sling complications, such as overactive bladder, urinary retention and recurrent urinary tract infections.

Reverse arthroplasty for patients with chronic locked dislocation of the shoulder (type 2 fracture sequela)

The aim of this multicenter study was to analyze the clinical and radiographic outcome and to report on the types of complications in patients with chronic locked shoulder dislocation treated with reverse shoulder arthroplasty. Twenty-two patients with a mean age of 71 years were included. The mean duration of follow-up was 3.5 years. Preoperatively, computed tomography or magnetic resonance imaging scans were performed and analyzed for bone defects and the status of the rotator cuff. Radiographs in 2 planes were obtained before arthroplasty and at final follow-up (mean, 3.5 years; range, 2-9 years). The Constant-Murley score was documented, together with active shoulder flexion, external rotation, and internal rotation. There was a significant increase in mean Constant-Murley score from 13.6 points preoperatively to 47.4 points postoperatively (P < .001). Mean shoulder flexion was 37.7° before arthroplasty and 103° thereafter (P < .001). External rotation increased from -0.5° to 14.7° (P < .003). There were 7 complications (32%), leading to revision surgery in 6 cases (27%). The most common reason for revision surgery was failure of the glenoid component due to bone defects on the glenoid side. Eight patients rated their subjective result as very good, 5 as good, 5 as satisfactory, and 4 as unsatisfactory. Reverse shoulder arthroplasty may be a viable treatment option for chronic locked shoulder dislocations with concomitant rotator cuff lesions and an intact glenoid. However, improvement in function is only fair and in this series, there was a high percentage of complications requiring re-operation.

Costs of bleeds relating to acute coronary syndrome therapies

Objective: To estimate the costs to manage selected types of bleeding complications in patients with acute coronary syndrome (ACS) treated with antithrombotics, including antiplatelet, and fibrinolytic therapies: decrease in haemoglobin >3 g/dL, puncture site, and bleeding requiring transfusion of blood products.Methods: Retrospective chart reviews of ACS patients experiencing decrease in Hb, puncture site, or bleeding requiring transfusion were conducted in hospitals in France, Germany, Italy, Spain and Sweden to determine the total length of stay (LOS), stay post-bleeding, procedures to identify the extent of bleeding, number and types of transfusion products, patient demographics, reason for hospital admission and disposition upon discharge. Country-specific costs were applied to estimate the average cost per patient by type of bleeding event.Results: Records of 158 ACS patients with the bleeding complications were examined (26.9% decrease in Hb, 35.5% puncture site, and 37.8% transfusion). The average LOS was 10.6 days for decreasing Hb, 7.7 days for puncture site bleeding, and 11.3 days for patients receiving transfusions due to these bleeding events. The average costs per patient ranged between €3,986 and €10,252. The LOS ranged widely both within and across countries.Limitations: The study has a small sample size and costs are confounded by co-morbidities.Conclusions: The estimated costs for decreasing Hb, puncture site bleeding and bleeding resulting in transfusions provide a tool for researchers to conduct economic analyses of bleeding events associated with therapies for ACS.

Complications During the Rehabilitation Period in Thai Patients with Stroke

To examine the frequency and types of complications in patients with stroke. A multicenter, prospective cohort study was performed in 327 patients with stroke (134 women, 193 men), who attended inpatient rehabilitation in nine centers. The frequency and severity of consequences and complications related to strokes were monitored weekly. In addition, correlations with stroke-related complications were analyzed. At least one complication after a stroke was found in 232 (71.0%) patients. The mean age was 62 (+/-12) yrs, and 59% were men. Shoulder subluxation was found in 37.3% with mild to moderate degree. Limb spasticity was presented in 41.6%, and almost all were a severity grade of less than 3 on the Modified Ashworth Scale. The common complications were musculoskeletal pain (32.4%), bowel/bladder dysfunction (31.5%), infection (16.5%), depression (13.8%), and anxiety (5.8%). Symptomatic urinary tract infection was found in 35 (10.7%) patients. Urinary incontinence was the most common among bowel/bladder problems (24.5%). Time since onset of stroke > or = 1 mo (adjusted odds ratio [OR] = 2.12; 95% confidence interval [CI] = 1.07-4.17), length of stay > 21 days (adjusted OR = 2.36; 95% CI = 1.26-4.43), and anxiety score at admission > or = 11 (adjusted OR = 6.87; 95% CI = 2.45-19.29) were statistically associated with stroke-related complications. Medical complications were common among patients with stroke who had been hospitalized longer, during inpatient rehabilitation and among those who had high anxiety scores.

Evaluation of the incidence and types of complications in patients undergoing radical retropubic prostatectomy based on own material

Introduction. Radical retropubic prostatectomy constitutes one of the major methods of treatment for clinically organ-confined prostate cancer. Numerous studies have reported different morbidities associated with this procedure. We assessed postoperative complications connected with radical retropubic prostatectomy in our series and compared them to the data obtained from the literature. Material and methods. We analyzed a consecutive series of 108 patients undergoing radical retropubic prostatectomy between 01.01.2000 and 30.12.2005 in the Urology Department of the Regional Railway Hospital in Lublin. We evaluated intraoperative complications, early complications (within 1 month postoperatively) and late complications (after 1 month postoperatively.) results. There were no deaths in the studied group. Overall, there were 62 intraoperative and early complications observed in 51 (47.2%) patients undergoing the procedure. The main complication was intraoperative hemorrhage requiring blood transfusion observed in 44 (40.7%) patients. As for late complications urinary incontinence and anastomotic stricture was found in 12.1% and 13.7% of patients, respectively. All patients reported erectile dysfunction. Conclusions. Radical retropubic prostatectomy is a relatively safe procedure. Most patients were not affected by any postoperative complications and urinary continence 12 months after the procedure is consistent with the major referral centers.