Objective To explore the impact of hospital staff’s risk perception on their emergency responses, and provide reference for future responses to public health emergencies. Methods Based on participatory observation and in-depth interviews, the staff of the First Affiliated Hospital of Guangzhou Medical University who participated in the prevention and control of the coronavirus disease 2019 from April to September 2020 were selected. The information on risk perception and emergency responses of hospital staff was collected. Results A total of 61 hospital staff were included. The positions of hospital staff were involved including hospital leading group, hospital office, medical department, logistics support department and outpatient isolation area. The interview results showed that both individual and organizational factors of hospital staff would affect the risk perception of hospital staff, thus affecting the emergency responses of hospital staff, mainly reflected in the psychological and behavioral aspects. Among them, their psychological reactions were manifested as more confidence, sensitivity, and sense of responsibility and mission; The behavior aspects was mainly reflected in the initiation time, execution ability, and standardization level of emergency responses actions. Conclusion Therefore, relevant departments should pay attention to the risk perception of hospital staff, improve the risk perception and emergency responses of hospital staff by influencing the individual and organizational factors of hospital staff, so as to respond more effectively to future public health emergencies and reduce the adverse impact of public health emergencies on the work of hospital staff.
Objective To analyze and explore the risk factors of secondary tricuspid regurgitation (TR) after left-sided valve surgery (left cardiac valve replacement or valvuloplasty) using meta-analysis, so as to provide evidence for clinical diagnosis and treatment of secondary TR. Methods We electronically searched databases including PubMed, MEDLINE, CBM, CNKI, VIP, for literature on the risk factors of secondary TR after left-sided valve surgery from 1995 to 2012. According to the inclusion and exclusion criteria, we screened literature, extracted data, and assessed methodological quality. Then, meta-analysis was performed using RevMan 5.0 software. Results A total of 6 case-control studies were included, involving 437 patients and 2 102 controls. The results of meta-analysis showed that, the risk factors of progressive exacerbation of secondary TR after left-sided valve surgery included preoperative atrial fibrillation (OR=3.90, 95%CI 3.00 to 5.07; adjusted OR=3.04, 95%CI 2.21 to 4.16), age (MD=5.36, 95%CI 3.49 to 7.23), huge left atrium (OR=5.17, 95%CI 3.12 to 8.57; adjusted OR=1.91, 95%CI 1.49 to 2.44) or left atrium diameter (MD=4.85, 95%CI 3.18 to 6.53), degradation of left heart function (OR=2.97, 95%CI 1.73 to 5.08), rheumatic pathological change (OR=3.06, 95%CI 1.66 to 4.68), preoperative TR no less than 2+ (OR=3.52, 95%CI 1.26 to 9.89), and mitral valve replacement (MVR) (OR=2.35, 95%CI 1.68 to 3.30). Sex (OR=1.54, 95%CI 0.94 to 2.52) and preoperative pulmonary arterial hypertension (OR=1.28, 95%CI 0.77 to 2.12) were not associated with secondary TR after left-sided valve surgery. Conclusion The risk factors of progressive exacerbation of secondary TR after left-sided valve surgery include preoperative atrial fibrillation, age, huge left atrium or left atrium diameter, degradation of left heart function, rheumatic pathological change, preoperative TR no less than 2+, and MVR. Understanding these risk factors helps us to improve the long-time effectiveness of preventing and treating TR after left-sided valve surgery.
Objective To investigate the prevalence of anxiety and depression in patients with epilepsy (PWE) in West China, and to explore the related risk factors. Methods The Chinese version of Generalized Anxiety Disorder (GAD)-7 and Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) scales were used to evaluate the anxiety and depression in 176 PWE patients between December 2016 and February 2017. Univariate analysis was used to screen the factors that may cause anxiety and depression in PWE, and then logistic regression analysis was performed on the possible risk factors. Results In the 176 PWE, about 27.3% had anxiety, and about 28.4% had depression. Multivariate logistic regression analysis showed that seizure occurrence in the recent six months [odds ratio (OR)=3.481, 95% confidence interval (CI) (1.292, 9.380),P=0.014], seizure occurring more than once in a month [OR=3.231, 95%CI (1.468, 7.111),P=0.004], and focal seizures with conscious disorders [OR=2.416, 95%CI (1.082, 5.397),P=0.031] were risk factors for anxiety in PWE. Unmarried status [OR=0.428, 95%CI (0.195, 0.940),P=0.035], seizure occurring more than once in a month [OR=2.685, 95%CI (1.206, 5.979),P=0.016], focal seizures with conscious disorders [OR=2.541, 95%CI (1.112, 5.808),P=0.027] and seizure occurrence in the last six months [OR=7.582, 95%CI (2.416, 23.794),P=0.001] were risk factors for depression in PWE. Conclusions Anxiety and depression are common comorbidities in PWE. For patients with risk factors, early identification and intervention should be performed.
【Abstract】ObjectiveTo determine the risk factors associated with development of pancreatic fistula after pancreatoduodenectomy (PD). Methods The clinical data of 123 consecutive patients who underwent PD from Dec. 1994 to Dec. 2003 were analysed retrospectively. Results The incidence of pancreatic fistula was 11.4% (14/123). Univariate analysis showed history of upper abdominal operation, texture of pancreas, postoperative serum hemoglobin level, type of pancreatojejunostomy and diameter of pancreatic duct were significantly associated with pancreatic fistula after PD. Multivariate analysis using Logistic regression identified four variables as independent factors associated with the occurrence of pancreatic fistula: history of upper abdominal operation, texture of pancreas, postoperative serum hemoglobin level and type of pancreatojejunostomy. Conclusion History of upper abdominal operation, soft texture of pancreas, postoperative serum hemoglobin level less than 90 g/L and routine invaginated pancreaticojejunostomy are main risk factors associated with development of pancreatic fistula after PD.
Objectives To analyze the risk factors for cardiovascular disease (CVD) in patients with chronic obstructive pulmonary disease (COPD) of different severities. Methods The study included 50 patients with mild-to-moderate COPD and 50 with severe-to-very severe COPD admitted between January 2014 and January 2016. Comorbidities were recorded on the basis of data obtained from medical charts and clinical evaluations. The Charlson comorbidity index was calculated, and the Hospital Anxiety and Depression Scale (HADS) score was determined in each subject. Results There were more prevalences of smoking, depression and dyslipidemia in the patients with mild-to-moderate COPD than those with severe-to-very severe COPD (all P<0.001). The prevalences of high blood pressure, diabetes mellitus, alcoholism, and chronic heart failure were not different significantly between the two groups. The Charlson comorbidity index and HADS scores were not different between the two groups. Conclusions Comorbidities are fairly common in COPD regardless of its severity. Certain risk factors for CVD, as smoking, dyslipidemia, and depression, appear to be more prevalent in patients with mild-to-moderate COPD.
Objective To investigate the clinical features and risk factors of diabetic foot. Methods A total of 100 patients with diabetic foot and 158 diabetic patients without diabetic foot were selected from April 2012 to May 2015 in Meishan Hospital of Traditional Chinese Medicine. Clinical data of the patients in the two groups was comparatively analyzed. Multiple logistic regression analysis was used to explore the risk factors. Results The age, duration of diabetes, incidences of complications, count of white blood cells, level of fibrinogen, level of high-sensitivity C-reactive protein (hs-CRP) and level of glycated hemoglobin (HbA1c) in diabetic foot group were significantly higher than those in non-diabetic foot group (P<0.05), while the ankle-brachial index, level of hemoglobin and level of albumin in diabetic foot group were significantly lower than those in non-diabetic foot group (P<0.05). The independent risk factors of diabetic foot were Wanger grade, age, ankle-brachial index, hs-CRP, albumin and HbA1c (P<0.05). HbA1c and hs-CRP level were independent risk factors of disease severity in patients with diabetic foot; the difference of prognosis in patients with different Wanger grading was statistically significant (Z=–4.394, P<0.001). Conclusions The risk of diabetic foot in diabetic patients increases with older age, the more serious Wanger grade, the higher hs-CRP and HbA1c level, and the lower ankle-brachial index and albumin level. Taking precautions based on the patient’s situation is conducive to early prevention of amputation in diabetic patients with diabetic foot.
Objective To Analyze the high risk factors correlated to the perioperative complications of patients with lung cancer, aiming to study their predictive value on surgical safety and guide the perioperative treatment. Methods The clinical experience of 452 lung cancer patients undergone operation from June 2000 to May 2006 were retrospectively study. The risk factors which closely related to the occurrence of postoperative complications were analyze by multivariate statistical analysis with logistic regression. Results The operative mortality was 0.66%（3/452）, and the incidence rate of postoperative complications was 8.85%(40/452), including pulmonary infection, pulmonary atelectasis, arrhythmia, respiratory function failure, empyema, bronchopleural fistula, thoracic bleeding, etc. Multivariate statistical analysis with logistic regression demonstrated that the risk factors which closely related to the occurrence of postoperative complications were age over 70 year (OR=17.823), smoking index over 400 piece year(OR=5.666), concomitance with diseases of vital organs(OR=8.290), modus operandi of pneumonectomy(OR=7.991), forced expiratory volume in one second (FEV1.0%)≤60% (OR=0.922). Conclusion To evaluate above factors of lung cancer patients before operation, the probability of postoperative complications occurrence can be roughly forecasted. This can provide actively clinical guide to help the patients overcome the perioperation successfully and to increase the safety of surgery.
ObjectiveTo analyze the risk factors of cognitive dysfunction in patients with epilepsy, and provide evidence for clinical prevention and treatment.MethodsDuring the period from January 1, 2018 to January 31, 2019, 101 patients with epilepsy who were admitted to the epilepsy specialist clinic of the General Hospital of Ningxia Medical University were included in this study. The cognitive function of the patients was evaluated by the Mini-mental State Examination (MMSE) scale and patients were divided into cognitive impairment group and normal cognitive function group according to the MMSE. Single factor and logistic regression analysis were used to find the differences of influencing factors between the two groups.Results① There were 27 cases of cognitive dysfunction in 101 patients with epilepsy, the incidence of cognitive impairment was 26.7%; ② Univariate analysis showed that the course of disease, frequency of seizures, seizure forms, anti-epileptic drugs (AEDs) and abnormal rate of electroencephalogram (EEG) existed significant differences between the two groups (P<0.05). ③ Logistic regression showed that course of disease, frequency of seizures and AEDs multidrug therapy were independent risk factors for cognitive dysfunction in patients with epilepsy (P<0.05).ConclusionCourse of disease, frequency of seizures and AEDs multidrug therapy are independent risk factors for cognitive dysfunction in patients with epilepsy.
Objective To establish a scoring system for patients withnon-small cell lung cancer (NSCLC), complicated by chemotherapy and myelosuppression based on Logistic regression analysis. Methods The clinical data of patients with lung cancer who received chemotherapy in our hospital from January 2018 to April 2024 were collected. The influencing factors of chemotherapy complicated with myelosuppression were analyzed by univariate and Logistic regression, and a nematographic model was established. Results Compared with non-myelosuppressive group, there were statistically significant differences in pre-chemotherapy leukocyte, pre-chemotherapy hemoglobin, ECOG score, use of platinum drugs, use of anti-metabolic drugs, use of anti-microtubule drugs in myelosuppressive group (P<0.05). WBC<4.0×109/L (OR:4.166, 95%CI: 1.521~11.410), hemoglobin<110g/L (OR: 6.926, 95%CI: 1.817~26.392), ECOG score ≥2 points (OR: 2.235, 95%CI: 1.032~4.840), platinum drugs (OR: 5.738, 95%CI: 2.514~13.097), anti-microtubule drugs (OR: 4.284, 95%CI: 1.853~9.905) and anti-metabolic drugs (OR: 7.180, 95%CI: 2.608~19.769) was an independent risk factor for chemotherapy complicated with myelopathic depression in lung cancer patients (P<0.05). Model verification results showed that the C-index was 0.817 (95%CI: 0.783~0.851), the calibration curve of the model was close to the ideal curve, and the AUC of the ROC curve was 0.811 (95%CI: 0.780~0.842), which showed a net benefit of the model within the range of 10% to 87.5%. Conclusion The constructed nomogram model can effectively predict the risk of chemotherapy complicated with myelosuppression in non-small cell lung cancer patients.
Objective To investigate the risk factors，clinical features and outcome of invasive aspergillosis（IA） in nonneutropenic patients.Methods Fifty-four patients with IA at the First Affiliated Hospital of Zhengzhou University from Jan 2001 to Dec 2006 were analyzed retrospectively.According to the definitions of EORTC/MSG，proven diagnosis was made in 9 cases，probable diagnosis in 30 cases and possible diagnosis in 15 cases.Results In the neutropenic group（n=24），hematological malignancies were the major underlying conditions（n=20）.In nonneutropenic group（n=30），the main underlying condition was steroid-treated COPD（n=11）.Fever，dyspnea，cough，chest pain and haemoptysis were commonly symptoms.Thoracic computed tomography showed that segmental consolidation occurred more frequently in neutropenic patients，whereas diffuse nodules more frequently in nonneutropenic patients.Nodules or consolidation with evidence of cavity lesion had a higher sensitivity than the halo sign or air crescent sign in both groups.The total mortality of IA was 72.2%.The mortality of nonneutropenic group was higher than that of neutropenic group（83.3% vs 58.3%，P=0.042）.Multivariate analysis showed that secondary central nerves system IA and delayed diagnosis were associated with poor outcome of IA.Conclusion There were high incidence and mortality of IA among nonneutropenic patients，especially those with COPD treated with long-term corticosteroids.