Abstract: Objective To explore the inhospital mortalityrelated risk factors in the patients undergoing offpump coronary artery bypass grafting (OPCAB). Methods We retrospectively analyzed the clinical data of 215 patients undergoing OPCAB in our hospital from November 2007 to November 2008. There were 171 males and 44 females aged between 40 and 85 years old. Among them, there were 47 patients older than 70 years old. All of them were coronary artery disease (CAD) patients with triple vessel disease. We adopted univarialble analysis and logistic multivariable regression analysis to screen the risk factors for the mortality of OPCAB. Results Six patients died in hospital after OPCAB with a mortality rate of 2.79% (6/215). No renal dysfunction or respiratory failure occurred. The rate of reoperation for bleeding was 4.65% (10/215) and all the 10 patients having undergone reoperation were alive. A total of 209 patients were all alive after 1year follow-up. The results of logistic multivariable regression analysis showed that New York Heart Association (NYHA) Ⅲ and Ⅳ heart function (OR=42.116，95% CI 3.319 to 534.465，P=0.004) and mechanical ventilation duration (OR=1.007，95%CI 1.001 to 1.013，P=0.028) were independent risk factors for inhospital mortality of OPCAB. Conclusion OPCAB is an effective and safe treatment for CAD with triple vessel disease. NYHA Ⅲ and Ⅳ heart function and mechanical ventilation time after OPCAB are the risk factors for OPCAB inhospital mortality, yet, needs further study with large sample.
Objective To analyze the risk factors of hospitalized children with acute asthma exacerbation in Chongqing region. Methods A total of 193 cases were randomly selected from the hospitalized children with acute asthma exacerbation in Chongqing Children’s hospital and Jiangjin District People’s Hospital from January 2009 to December 2009. A self-designed questionnaire was used to collect data. A control group of children were randomly selected from the out-patients who received regular maintain therapy without asthma attacks for more than 3 months. Results The first independent risk factor of asthma hospitalization was respiratory infection ( 85. 5%, 165 /193) . Irregular use of control medications was the second important factor for the acute exacerbation. There were 75% ( 138 /193) patients didn’t take controlmedications regularly, includes 102 undiagnosed and 36 pre-diagnosed cases which was more common than that in regular maintain therapy group ( 21/110, 19. 1% ) . A variety of allergen-induced acute exacerbation of asthma was also common, which accountted for 9. 3 % ( 18/193) . There were more boys than girls ( M/F:124 /69) and no significant difference in the family history of allergic diseases ( P gt; 0. 05) . Conclusion Respiratory infection, under-diagnosis of asthma, and irregular use of the control medications are risk factors of acute exacerbation in children with asthma in Chongqing region. Meanwhile allergen exposure warrantsmore attention.
Objective To study the prevalence of snoring in adults aged over 35 yrs in Kelamayi city of Xinjiang province, and screen the snoring associated factors.Methods 2600 subjects( age≥35 yrs) were enrolled from a random sample of the population living in 5 streets, two districts in Kelamayi city. All subjects were required to answer questions about their snoring by himself or bed partner at home. The questionnaire included items concerning snoring, daytime sleepness ( Epworth sleep scale, ESS) , smoking and drinking habits, while height, weight, neck circumference, abdominal circumference, waistline, and hip circumference were meatured. The subjects were assigned to a high risk group and a low risk group according to the questionaire of scoring. Results 2590 subjects had completed the questionnaire and 2513 ( 97. 0% )were eligble for evaluation. The cases of ever snoring was 1312 ( 52. 2% ) , among which moderate to severe snoring accounted for 38. 9% . Before the age of 60 yrs, the risk of snoring increased with age, and higher in males than females( 61. 7% vs. 45. 1% ) . The prevalence of snoring increased with neck circumference( P lt;0. 05) . The body mass index ( BMI) [ ( 28. 2 ±3. 6) kg/m2 vs. ( 25. 1 ±3. 9) kg/m2 ] , neck circumference [ ( 37. 7 ±3. 6) cmvs. ( 35. 6 ±3. 6) cm] , abdominal circumference [ ( 96. 9 ±13. 6) cm vs. ( 88. 7 ±11. 1) cm] , waistline [ ( 92. 2 ±9. 8) cm vs. ( 84. 7 ±10. 2) cm] , hip circumference [ ( 102. 9 ±9. 6) cm vs.( 96. 4 ±9. 3) cm] , proportionlity of waistline to hip circumference ( 0. 90 ±0. 07 vs. 0. 88 ±0. 08) , systolic blood pressure [ ( 132. 0 ±17. 5) mm Hg vs. ( 125. 6 ±16. 8) mm Hg] , and diastolic blood pressure [ ( 83. 3 ±12. 8) mm Hg vs. ( 78. 3 ±12. 6) mm Hg] were significantly different bettween the high and the low risk groups ( P lt; 0. 01) . Logistic regression analysis revealed that age ( OR = 1. 519) , BMI ( OR =2. 549) , neck circumference (OR = 2. 473) , smoking (OR = 2. 765) , ESS(OR = 2. 575) , and postmenopause( OR=1. 806) were main risk factors for snoring( P lt; 0. 05) . Conclusions The prevalence of snoring in adults over 35 yrs is high in Kelamayi city. The high risk factors for snoring are age, BMI, neck circumference, smoking, ESS, and post-menopause.
Objective To systematically evaluate the risk factors for secondary respiratory failure (RF) on chronic obstructive pulmonary disease (COPD), so as to provide evidence for formulating prevention and control strategies. Methods PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, Chongqing VIP databases and SinoMed were searched for articles published from the dates of establishment of databases to August 2021. To collect the relevant case-control studies or cohort studies on the risk factors of secondary RF in patients with COPD. The patients were divided into two groups, RF group and non RF group. Meta-analysis was carried out with RevMan 5.3 software after selecting literature, extracting data and evaluating quality according to inclusion and exclusion criteria. Results A total of 16 case-control studies involving 2 417 patients were included. There were 856 cases in RF group and 1 561 cases in non RF group. The results of meta-analysis showed that age [mean difference (MD)=0.58 years, 95% confidence interval (CI) (0.18, 0.97) years, P=0.004], number of acute attacks per year [MD=2.68 times, 95%CI (2.58, 2.78) times, P<0.001], number of acute attacks per year over 3 [odds ratio (OR)=3.37, 95%CI (2.40, 4.73), P<0.001], serum albumin level [MD=−2.93 g/L, 95%CI (−3.92, −1.94), P<0.001], serum uric acid [MD= −59.91 mmol/L, 95%CI (−66.57, −53.25) mmol/L, P<0.001], nosocomial infection [OR=4.53, 95%CI (3.44, 5.98), P<0.001], no-inhaled glucocorticoid [OR=3.63, 95%CI (2.95, 4.48), P<0.001], acid-base imbalance [OR=13.22, 95%CI (10.14, 17.23), P<0.001], COPD very serious [OR=1.82, 95%CI (1.50, 2.21), P<0.001], cardiovascular disease [OR=2.73, 95%CI (1.99, 3.74), P<0.001], kidney disease [OR=3.62, 95%CI (2.67, 4.90), P<0.001] were risk factors for RF in COPD. Sensitivity analysis showed that the results of meta-analysis were stable. Conclusion According to the results of meta-analysis, the risk factors of secondary RF in COPD can be identified in time and preventive measures can be taken to effectively reduce the incidence of aspiration failure and improve the prognosis and outcome of patients.
ObjectiveIn order to improve the prevention and treatment of bronchial asthma, the prevalence and risk factors of asthma in Chengdu among residents over 14 years old were investigated.MethodsA cross-sectional survey was conducted in Chengdu. The inhabitants (age > 14 years) recruited in this household questionnaire survey were through multi-stage cluster random sampling. Univariate and multivariate logistic regression were used to analyze the risk factors of asthma.ResultsA total of 3 477 subjects were finally recruited in this study. Of them, 131 were asthmatic patients; and the prevalence rate was 3.8%. There were significant differences observed in the prevalence of asthma among people of different ages, residences, occupations and educational levels (χ2=191.084, P<0.05; χ2=9.114, P<0.05; χ2=114.268, P<0.05; χ2=62.123, P<0.05). Univariate regression analysis showed that the risk factors of asthma included five factors (measles, chickenpox, pneumonia, tracheobronchitis and intestinal parasitic diseases) related to childhood illness, and two factors (asthma and chronic bronchitis) related to the first-degree relatives (P<0.05). In addition, active smoking history was a risk factor for asthma in men (P<0.05). Multivariate logistic regression indicated that measles, pneumonia, tracheobronchitis, intestinal parasitic diseases in childhood and first-degree relatives suffering from asthma were independent risk factors for asthma.ConclusionsThis study describes the epidemiological characteristics of asthma in Chengdu among adolescents (age>14 years) and adults. The history of measles, pneumonia, tracheobronchitis, and intestinal parasitic diseases in childhood, and first-degree relatives suffering from asthma are the independent risk factors for asthma. In addition, active smoking history is a risk factor for asthma in men.
Objective To explore the risk factors of catheter-associated bloodstream infections ( CRBSI) in intensive care unit ( ICU) of primary hospital. Methods A total of 623 patients with central venous catheters were recruited in the study. 60 of themsuffered fromCRBSI served as an observation group and other 563 cases without CRBSI served as control. Univariate analysis was used to scan possible risk factors. Then logistic regression analysis was used to exclude the confounding factors. Results The overall incidence rate of CRBSI was 9. 63% ( 60 /623) . There were significant differences in APACHE score, type of catheter, location of catheter, duration of central venous catheter, intravenous nutrition, use of steroid, times of intubation, urgent intubations, nutritional status, diabetes, and MODS between the two groups. Logistic regression analysis revealed that higher APACHE score, double-lumen catheter, femoral vein catheter, catheter indwelling more than two weeks, intravenous nutrition, intubation more than 2 times, and emergency intubation were risk factors of CRBSI. Conclusions Higher APACHE score, double-lumen catheter, femoral vein catheter, catheter indwelling more than two weeks, intravenous nutrition, intubation more than 2 times, and emergency intubation were major risk factors of CRBSI in ICU of primary hospital.
Objective To observe the incidence of hypotony and its risk factors in the early stage after 23-gauge sutureless microincisional vitrectomy. Methods A retrospective case series. Seventy patients (70 eyes) who had undergone 23-gauge sutureless microincisional vitrectomy were enrolled. There were 41 phakic eyes, 29 eyes with intraocular lens; 68 eyes with a single surgical procedure and 2 eyes with a second surgical procedure; 34 eyes with BSS tamponade and 36 with gas tamponade. Intraocular pressure (IOP) was measured by non-contact tonometry. Hypotony was defined as an IOP of 5 mm Hg (1 mm Hg=0.133 kPa ) or less. The incidence of hypotony and other complications at postoperative day 1, 3 and 7 were observed. The influence of age, sex, side of operation, type of tamponade, status of lens, surgical time on postoperative hypotony was analyzed. Results Hypotony was found in 8 eyes (11.4%) on postoperative day 1 and recovered spontaneously on postoperative day 3. There were no significant differences comparing age (t=1.12), sex (chi;2=2.23) and side of operation (chi;2=2.01) between patients with hypotony and those without it. The patients with hypotony suffered longer surgical time than that of those without hypotony (chi;2=5.48,P＜0.05). The incidence of hypotony in eyes with gas tamponade was significantly lower than that in eyes with BSS tamponade (chi;2=5.48,P＜0.05). The incidence of hypotony in eyes with phakic eyes was lower than that in eyes with intraocular lens (chi;2=4.20,P＜0.05). Hypotony was encountered in the 2 re-operated eyes. Choriodal folds were encountered in 2 eyes, but there was no other complication in other eyes. Conclusions A transient hypotony occurs commonly in first 3 days after 23-gauge sutureless microincisional vitrectomy. Hypotony was significantly influenced by type of tamponade, reoperation and intraoperative lens status.
ObjectiveTo analyze the related factors of cognitive impairment in patients with post-traumatic epilepsy. MethodsFrom January 2016 to January 2019, 45 patients with post-traumatic epilepsy (epilepsy group) and 48 patients with physical examination (control group) at the Department of Neurosurgery, the 904th Hospital of PLA were analyzed retrospectively. Cognitive assessment were evaluated by the following scales: Montreal cognitive assessment (MoCA), Mini-mental state examination (MMSE), Audio verbal memory test (AVMT), Rey-osterrieth complex figure test (CFT) and Trail making test (TMT). Then we analyzed the influences of gender, age, course of disease, cause, type, degree and location of injury, seizure frequency and Anti-seizure medications (ASMs) on cognitive impairment. ResultsThe results showed that there were significant differences between the epilepsy group and the control group in all scales (P<0.01). Analysis of influencing factors in epilepsy group showed: MoCA and MMSE scores: there were statistical significance in the comparison of seizure frequency and injury degree (P<0.05); AVMT, CFT and TMT scores: there were statistical significance in the comparison of seizure frequency, injury degree and location, ASMs within the group (P<0.05). ConclusionPost-traumatic epilepsy can cause cognitive impairment. The more frequent epileptic seizures and the more severe the degree of trauma, the more serious the cognitive impairment. Different injury sites affect the scope of cognitive impairment, temporal lobe injury is easy to cause memory function decline, frontal lobe injury is easy to cause spatial structure and executive ability decline, at the same time, the combined use of ASMs has an impact on cognitive function.
Objective To investigate the risk factors and treatment of silicone oil glaucoma (SOG). Methods Ninety-five eyes of 93 patients who underwent pars plana vitrectomy and silicone oil tamponade were evaluated in this study. The lens was removed in 58 eyes in which intraocular lens (IOL) was implanted in 10 eyes, so 48 eyes were aphakic. Silicone oil tamponade time was le;6 months in 32 eyes, and ＞6 months in 63 eyes. The follow-up time ranged from 2 to 25 months, with a mean of (9.5plusmn;5.1) months. The fundus and intraocular pressure (IOP) were evaluated at 1 week, 2 weeks and 1 month after surgery. The diagnosis of SOG was established if the onemonth postoperative IOP＞21 mm Hg （1 mm Hg=0.133 kPa）, and primary and neovascular glaucoma were excluded. After the diagnosis of SOG, carteolol hydrochloride and brinzolamide solution were immediately applied to the eye, and intravenous mannitol infusion was performed. If the IOP still can not be controlled after 1 week of such treatment, silicone oil removal surgery will be performed. If removal of silicone oil can not control the IOP, trabeculectomy surgery will be performed. Results SOG occurred in 21 eyes (22.1%), including 5 phakic eyes (10.6% of 47 phakic eyes) and 16 aphakic eyes (33.3% of 48 aphakic eyes), 3 eyes (9.4% of 32 eyes) with short tamponade time (le;6 months) and 18 eyes (28.6% of 63 eyes) with long tamponade time (＞6 months). The average silicone oil tamponade time was (10.8plusmn;5.1) months. Emulsification of the silicone oil occurred in 17 eyes (81.0%). After silicone oil removed, IOP was controlled in 17 eyes (81.0%) within one week. Conclusions Aphakic eye and the duration of silicone oil tamponade are the risk factors of SOG. Emulsification of silicone oil is the main cause. Silicone oil removal is an effective way to treat SOG.
ObjectiveTo explore the risk factors of nosocomial infection in children with acute lymphoblastic leukemia during induction remission chemotherapy.MethodsThe children with acute lymphoblastic leukemia who were admitted to the Department of Pediatrics, Huai’an First Hospital Affiliated to Nanjing Medical University between December 2012 and December 2018 were divided into the infection group (including the severe infection subgroup and the non-severe infection subgroup) and the non-infection group according to whether nosocomial infection occurred during induction and remission chemotherapy. The clinical data of patients were collected. Univariate analysis and multivariate logistic regression were used to analyze the risk factors of nosocomial infection during induction remission chemotherapy in children with acute lymphoblastic leukemia.ResultsA total of 96 patients were included. There were 67 cases in the infection group (26 in the severe infection subgroup and 41 in the non-severe infection subgroup) and 29 cases in the non-infection group. Univariate analysis showed that the granulocyte deficiency time and the prevalence of skin and mucosal damage in the infection group were significantly higher than those in the non-infection group, and the infection group had significantly lower laminar bed use and serum albumin level than the non-infection group did (P< 0.05). Multivariate logistic regression analysis showed that prolonged agranulocytosis [odds ratio (OR)=23.075, 95% confidence interval (CI) (3.682, 144.617), P=0.001], skin and mucosal lesions [OR=12.376, 95%CI (1.211, 126.507), P=0.034], hypoalbuminemia [OR=5.249, 95%CI (1.246, 22.113), P=0.024] were independent risk factors for nosocomial infection during induction and remission of childhood acute lymphoblastic leukemia, while laminar bed [OR=0.268, 95%CI (0.084, 0.854), P=0.026] was the protective factor.ConclusionsLong-term agranulocytosis, skin and mucosal lesions, and hypoalbuminemia are independent risk factors for nosocomial infection in children with acute lymphoblastic leukemia during induction remission chemotherapy. Laminar flow bed is its protective factor.