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 investigate the incidence of full-term prelabor rupture of membranes (FPROM) and risk factors for FPROM. Methods A prospective nested case-control study was performed on pregnant women in early pregnancy and their spouses, who underwent prenatal examination for the first time in Zhuhai Center for Maternal and Child Health Care from May 2021 to December 2022. Pregnant women with a clear diagnosis of FPROM were included in the case group, and pregnant women without FPROM were randomly selected at a 1∶3 ratio for inclusion in the control group. A questionnaire survey was performed to collect exposure information possibly related to FPROM. The hospital's medical record system was used for information verification and to record the pregnancy outcomes. A multivariate logistic regression analysis was used to investigate the risk factors for FPROM. Results The incidence of FPROM in this study was 24.27%. The multivariate logistic regression analysis showed that obesity pregnant women, smoking, drinking, unbalanced diet, high-intensity physical activity during pregnancy, eating areca nut before pregnancy, using glucocorticoids during pregnancy, older at the time of first pregnancy, a history of adverse pregnancy outcomes, a history of pregnancy complications, a history of diabetes, a history of scar uterus, no folate supplementation during pregnancy, repeated intrauterine operations, polyembryony, polyhydramnios, transverse fetus and fetal cephalopelvic disproportion as the way of conception were risk factors for FPROM (P<0.05). Additionally, the pregnant women whose spouses were obese or smoked or drinking had an increased risk of FPROM (P<0.05). Lower gravidity and lower parity were protective factors against FPROM (P<0.05). Conclusion There are many risk factors for FPROM. Special attention should be given to the life behaviors of pregnant women during pregnancy, and health education should be strengthened for pregnant women and their spouses to help them develop good living habits and reduce the incidence of FPROM.
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 analyze the risk factors for duration of mechanical ventilation in critically ill patients. Methods Ninety-six patients who received mechanical ventilation from January 2011 to December 2011 in intensive care unit were recruited in the study. The clinical data were collected retrospectively including the general condition, underlying diseases, vital signs before ventilation, laboratory examination, and APACHEⅡ score of the patients, etc. According to ventilation time, the patients were divided into a long-term group ( n = 41) and a short-term group ( n = 55) . Risk factors were screened by univariate analysis, then analyzed by logistic regression method.Results Univariate analysis revealed that the differences of temperature, respiratory index, PaCO2 , white blood cell count ( WBC) , plasma albumin ( ALB) , blood urea nitrogen ( BUN) , pulmonary artery wedge pressure ( PAWP) , APACHEⅡ, sex, lung infection in X-ray, abdominal distention, and complications between two groups were significant.With logistic multiple regression analysis, the lower level of ALB, higher level of PAWP, lung infection in X-ray, APACHE Ⅱ score, abdominal distention, and complications were independent predictors of long-term mechanical ventilation ( P lt;0. 05) . Conclusion Early improving the nutritional status and cardiac function, control infection effectively, keep stool patency, and avoid complications may shorten the duration of mechanical ventilation in critically ill patients.
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 study the risk factors of lung cancer and provide scientific evidence for preventing and managing such disease. Methods?The database of MEDLINE, CNKI, and CBM were searched and literature domestically and internationally from January 1997 to January 2007 was collected. The RevMan 4.2 software was used for meta-analysis. Results A total of 40 studies involving 16 559 cases and 25 119 controls were included. The pooled OR values and population attributable risk percentage (PARP) for smoking, female passive smoking from husband, female passive smoking from colleague, chronic bronchitis, emphysema, pulmonary tuberculosis, family history of cancer, and family history of lung cancer were 5.75 (69.16%), 1.32 (14.52%), 1.21 (5.87%), 1.68 (7.45%), 2.70 (10.18%), 1.58 (1.91%), 1.24 (8.92%), and 1.59 (5.33%), respectively. Conclusion Risk factors related to the incidence of lung cancer are smoking, female passive smoking from husband and colleague, chronic bronchitis, emphysema, pulmonary tuberculosis, family history of cancer, family history of lung cancer and so on. Besides, the results of PARP indicate that smoking is the most important factor, followed by female passive smoking from husband, emphysema, family history of cancer sequentially, which suggest that environmental and genetic factors play important roles in the development of lung cancer.
Objective To analyze the risk factors of postoperative vitreous hemorrhage (PVH) after pars plana vitrectomy (PPV) for vitreous hemorrhage (VH) secondary to retinal vein occlusion (RVO). Methods A retrospective case-control study. A total of 195 RVO patients (195 eyes) with VH were first treated with PPV from November 2015 to December 2021 were included in this study. There were 102 males (102 eyes) and 93 females (93 eyes), with an age of (62.93±9.78) years. The patients were divided into PVH group (17 patients, 8.72%) and non-PVH group (178 patients, 91.28%) according to the occurrence of PVH. The time of occurrence of PVH was (140.33±130.85) days after PPV. All eyes were performed 23G or 25G systematic PPV by the same doctor. During the operation, different types of intraocular tamponade and intravitreal injection of anti-vascular endothelial growth factor or triamcinolone acetonide after operation were selected according to the severity of retinopathy. The follow-up time was (9.45±6.68) months. The baseline systemic parameters, ocular parameters and intraoperative parameters affecting the occurrence of PVH were analyzed. Baseline systemic parameters included sex, age, diabetes mellitus and hypertension; ocular parameters included RVO type, lens status, VH course, preoperative best corrected visual acuity and intraocular pressure; intraoperative parameters included cataract phacoemulsification, removal of internal limiting membrane, type of intraocular tamponade, type of intravitreal injection drug at the end of operation, etc. Kaplan-Meier survival analysis, and Cox univariate and multivariate regression analysis were performed to analyze the risk factors of PVH after PPV in RVO with VH patients. Results In PVH group, the number of patients with diabetes was more than that in the non-PVH group, and the course of diabetes was longer, and differences were statistically significant. There were significant differences in RVO type, lens status and type of intraocular tamponade. Univariate Cox regression analysis showed that the combination with diabetes [odds ratio (OR)=2.724, 95% confidence interval (CI) 1.006-7.374, P=0.049], duration of diabetes (OR=1.071, 95%CI 1.013-1.134, P=0.016), central retinal vein occlusion (OR=4.387, 95%CI 1.421-13.546, P=0.010), intraocular lens (OR=3.493, 95%CI 1.229-9.925, P=0.019), and intraocular gas tamponade (OR=3.640, 95%CI 1.365-9.702, P=0.010) were associated with PVH. Multivariate Cox regression analysis showed that intraocular gas tamponade was independent risk factor for PVH. Conclusion Intraocular gas tamponade can increase the risk of PVH after PPV in patients with VH secondary to RVO.
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.