ObjectiveTo investigate the incidence of perioperative anemia and the influencing factors of preoperative anemia in patients with colorectal cancer.MethodsThe clinicopathological data of 1 250 patients with colorectal cancer who underwent surgery in our hospital from January 1, 2019 to December 31, 2019 were analyzed retrospectively. According to the preoperative hemoglobin level, patients were divided into anemia group and non-anemia group. Univariate analysis and multivariate logistic regression analysis were used to explore the influencing factors of preoperative anemia in patients with colorectal cancer, and the effects of preoperative anemia on intraoperative blood transfusion, postoperative complications, and postoperative hospital stay were analyzed.ResultsThe incidence of preoperative anemia in patients with colorectal cancer was 40.6% (508/1 250), and the incidence of preoperative anemia in patients with right colon cancer, left colon cancer, and rectal cancer was 66.0% (192/291), 41.1% (139/338), and 28.5% (177/621), respectively. The incidence of postoperative anemia in patients with colorectal cancer was 69.4% (867/1 250), and the incidence of postoperative anemia in patients with right colon cancer, left colon cancer, and rectal cancer was 81.8% (238/291), 68.9% (233/338), and 63.8% (396/621), respectively. Multivariate logistic regression analysis showed that age >60 years old, nutritional risk screening 2002 ≥3, right colon cancer, T3–4 stage, and M1 stage were risk factors for preoperative anemia in patients with colorectal cancer (P<0.05). The rate of intraoperative blood transfusion and the incidence of postoperative complications in the preoperative anemia group of patients with colorectal cancer were higher than those in the non-anemia group (P<0.05). The postoperative hospital stay in the preoperative anemia group of patients with colon cancer was longer than that in the non-anemia group (P<0.05).ConclusionsThe incidence of perioperative anemia in patients with colorectal cancer is high. Advanced age, high nutritional risk, right colon cancer, T3–4 stage, and distant metastasis were the risk factors of preoperative anemia in patients with colorectal cancer. Preoperative anemia can increase the demand for intraoperative blood transfusion and the incidence of postoperative complications in patients with colorectal cancer, and prolong postoperative hospital stay of colon cancer patients.
ObjectiveTo systematically review the incidence and influencing factors of early enteral nutritional feeding interruptions in critically ill patients. MethodsThe PubMed, Web of Science, Embase, Cochrane Library, CNKI, WanFang Data and CBM databases were electronically searched to collect observational studies on the early enteral nutritional feeding interruptions in critically ill patients from inception to January 2, 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 17.0 software. ResultsA total of 12 studies including 1 121 patients were included. Meta-analysis showed that the incidence of early enteral nutritional feeding interruptions in critically ill patients was 75.0% (95%CI 64.0% to 84.0%). Influenced by feeding intolerance, airway management, tube problems, radiological examination, and endoscopy, surgery and so on, interruptions of early enteral nutritional feeding frequently occur in critically ill patients. ConclusionCurrent evidence shows that early enteral feeding interruptions in critically ill patients are affected by many factors, and the incidence is high. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the characteristics of adverse transfusion reaction in Grade Three Class-A hospitals in China, and to provide scientific evidence for related control and prevention work. MethodsSuch databases as the PubMed, EMbase, The Cochrane Library (Issue 11, 2014), CNKI, VIP, WanFang Data and CBM were searched for studies investigating the characteristics of adverse transfusion reaction with ≥6 months observation time in Grade Three Class-A hospitals in China up to November 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed by using the R 3.1.1 software. ResultsSeventy-two studies involving 1 660 472 cases of blood transfusion were included. The results of pooled analysis showed that the total number of adverse transfusion reaction rate was 0.58% (95%CI 0.48 to 0.69). Sub-group analysis shows that the blood transfusion adverse reaction rates in the eastern, central and western regions were 0.42% (95%CI 0.31 to 0.55), 0.55% (95%CI 0.41 to 0.70), 0.56% (95%CI 0.43 to 0.70), respectively; and there were statistical differences between regions (P<0.05). Different types of adverse transfusion reaction rates were 38.85% (95%CI 34.27 to 43.53) for non hemolytic febrile reaction and 55.67% (95%CI 50.79 to 60.50) for allergic. The adverse reactions incidence of different kinds of blood products transfusion occurred were 0.41% (95%CI 0.32 to 0.50) in red blood cell, 0.57% (95%CI 0.43 to 0.72) in plasma, 1.00% (95%CI 0.73 to 1.30) in platelet. The incidence of adverse reaction of platelet transfusion was significantly higher than that of red blood cell and plasma (P<0.05). ConclusionThere is a big gap between domestic and foreign blood transfusion adverse reaction reports, therefore comprehensive measures should be taken for further prevention and control.
ObjectiveTo explore the influence of nursing interruption event intervention on the incidence of nursing risk events. MethodsIn January 2012, we carried out intervention on nursing interruption events. And general situation questionnaire was used on December 30th, 2011 (control group) and December 30th, 2012 (intervention group) respectively to investigate 190 clinical nurses. ResultsThe occurrence of the interruption events was positively correlated with the incidence of nursing risk events. Effective intervention significantly reduced the incidence of risk events (P<0.05). ConclusionEffective prevention of adverse outcomes caused by interruption events reduces the risk of nursing, improves the quality of care, and ensures the safety of the patient.
Objective To investigate the suicide related factors of the teenagers after trauma and further discuss the prevalence and related factors of suicide idea plan and behavior. Methods Using the general information questionnaire and the Youth Risk Behavior Survey (YRBS) to investigate the primary and secondary students in the nine worst-hit areas in Wenchuan earthquake of 2008, with cluster random sampling and the class as a sampling unit, to extract random 110 primary and middle schools and gather their general information, disaster-related cases and scores of suicide in YRBS. According to the different types of data, we used descriptive statistics,t test,Chi square test and Logistic regression analysis and respectively use single factor analysis and multivariate logistic regression analysis for suicide idea, plan and behavior. Results A total of 7 833 questionnaires were sent out and a total of 7 521 questionnaires were collected and the recovery rate was 96. 02%. Among them, there were 6 875 valid questionnaires (91.41%) and 636 invalid questionnaires. According to the investigation, the prevalence of the primary and secondary students which had seriously considered suicide was 6. 90%, which had a plan to commit suicide was 4.00% and which tried to take over the action of suicide was 2.70%. With general information for the independent variable, logistic regression analysis showed that whether there had seriously considered suicide as the dependent variable: age (OR=1.178, 95%CI 1.098 to 1.178) and changed in family structure after the earthquake (OR=1.360, 95%CI 1.360 to 1.085) were risk factors for post disaster the teenagers with suicide idea; whether there had been plan to commit suicide as the dependent variable: age (OR=1.099, 95%CI 1.050 to 1.150), the history of being buried in ruin (OR=2.155, 95%CI to 1.104 to 4.205) and changed in family structure after the earthquake (OR=1.495, 95%CI 1.128 to 1.981) were risk factors for post disaster the teenagers with suicide plan; whether took over the action of suicide as the dependent variable: male (OR=1.513, 95%CI 1.122 to 2.039) and changed in family structure after the earthquake (OR=1.555, 95%CI 1.112 to 2.175) were risk factors for post disaster the teenagers with suicide behavior. Conclusion Age and changed in family structure after the earthquake were the risk factors for suicide idea and age was positively correlated with suicidal idea. Age, had the history of being buried in ruin and changed in family structure after the earthquake were the risk factors for suicide plan and age was positively associated with suicide plan. Male and changed in family structure after the earthquake were the risk factors for suicide behavior. Among them, changed in family structure after the earthquake was the common risk factor. So there should be targeted psychological assessment and psychological rehabilitation intervention to avoid the risk of suicide among the teenagers after the disaster.
Objective To investigate the prevalence of depression in patients with chronic obstructive pulmonary disease ( COPD) and risk factors. Methods 215 patients with stable COPD were recruited in the study. The Patient Health Questionnaire-9 ( PHQ-9) standardized scale were performed for the depression survey. Meanwhile CAT, pulmonary function test and the history taking ( sex, age, height, weigh, smoking status, education level) were applied to evaluate all the COPD patients. The COPD patients were classified into A, B, C, and D groups according to 2011 GOLD new COPD classification system. Pearson chi-square test and multivariate logistic modeling were used to estimate the prevalence of depression and the risk factors. Results The prevalence of depression in COPD patients whose PHQ-9 scores ≥7 was 37.7% with 18.5% , 35.8% , 46.5% , and 62.5% respectively in A, B, C, and D groups. There was significant difference in prevalence between each groups ( Plt;0.05) . Compared with the COPD patients without depression, the COPD patients with depression had younger age, more female, higher education level, higher CAT scores and smaller means of body mass index ( BMI) . Logistic analysis revealed that depression in COPD was associated with age, sex, education level, BMI, FEV1% pred and CAT scores. The patients who with younger age, female sex, higher education level, lower FEV1% pred, lower BMI and higher CAT scores were had higher rsik to be complicated with depression. However no significant difference was observed between different FEV1 /FVC or smoking status. Conclusions This study confirms the high prevalence of depression in patients with stable COPD, and the prevalence in A, B, C, and D groups of COPD are different. Sex, age, education level, FEV1% pred, BMI, and CAT scores are the risk factors of depression in COPD.
ObjectiveTo comprehensively evaluate the incidence of venous thromboembolism (VTE) after colorectal surgery.MethodsWe searched PubMed/Medline, Web of science, and Embase databases by computer, collected studies by using the combination of corresponding English keywords. Then, we screened literatures according to inclusion and exclusion criteria, and evaluated the quality of literatures by using Downs and Black tools. Finally, we used Stata 15.1 and R Project 3.4.1 for meta-analysis.ResultsA total of 15 studies (n=721 730) were included in the meta-analysis. The combined incidence of VTE after colorectal surgery was 2.26% [95% CI was (1.93%, 2.61%), P<0.000 1], and the incidence of VTE after adjusting for publication bias was 1.82% [95% CI was (1.53%, 2.13%), P<0.000 1]. Meta regression analysis revealed that patients’ age (P<0.000 1), smoking (P=0.000 4), open surgery (P=0.020 0), preoperative albumin level (P=0.023 6), and malignant tumor (P=0.036 4) were correlated with the incidence of VTE after colorectal surgery, which may be potential factors for heterogeneity.ConclusionsThe incidence of VTE after colorectal surgery is not insignificant. It is necessary for clinicians to be vigilant about the occurrence of VTE after colorectal surgery and provide appropriate preventive interventions in combination with patients’ own risk factors, disease-related factors, and surgical factors.
ObjectiveTo investigate the associations of preoperative red cell distribution width (RDW) with mortality and morbidity in patients underwent liver transplantation. MethodsThis investigation was a retrospective study, the patients underwent liver transplantation met the inclusion criteria from June 2017 to May 2020 in the West China Hospital of Sichuan University were enrolled. The patients were divided into RDW≤14.5% group and RDW>14.5% group according to the normal RDW critical value (14.5%). The propensity score matching (PSM) was used to adjust the baseline characteristics. The primary outcome was 1-year mortality. The secondary outcomes included 1-year survival, 30-day mortality, incidence of early allograft dysfunction, acute kidney injury, renal replacement therapy, and pulmonary complications, as well as ICU stay and postoperative hospital stay. ResultsA total of 303 patients who met the analysis conditions were included. After PSM, 57 patients in each group were matched. There were no significant differences between the two groups in the baseline data such as the gender, age, body mass index (BMI), initial diagnosis, MELD score, Child-Pugh grade of the recipients, and the gender, age, and BMI of the donors (P>0.05). The 1-year [22.8% (13/57) versus 5.3% (3/57), χ2=7.27, P=0.007] and 30-day [15.8% (9/57) versus 3.5% (2/57), χ2=4.93, P=0.026] mortality of the patients with RDW >14.5% were higher than that of the patients with RDW ≤14.5% . The Kaplan-Meier survival curve showed that the 1-year survival of the patients with RDW ≤14.5% after liver transplantation was better than that of the patients with RDW >14.5% [hazard ratio=4.75, 95%CI (1.78, 12.67), P=0.007], but there were no significant differences between the two groups in the incidence of early graft dysfunction, acute renal injury, renal replacement therapy, and pulmonary complications, as well as postoperative hospital stay and ICU stay (P>0.05). ConclusionPreliminary results of this study indicate that preoperative RDW of patients underwent allogeneic liver transplantation is associated with1-year mortality, 30-day mortality, and 1-year survival.
ObjectiveTo systematically review the incidence of adverse skin reactions in lung cancer patients treated by immunotherapy. MethodsPubMed, Web of Science, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect the studies on the incidence of skin adverse reactions in lung cancer patients treated with immunotherapy from June 2011 to June 2021. Two reviewers independently screened literature, extracted data and assessed the risk bias of the included studies. Meta-analysis was then performed by using Stata 15.0 software. ResultsA total of 63 studies were included, with a total sample size of 13 386 cases. The results of meta-analysis showed that the overall incidence of adverse skin reactions in lung cancer patients was 14.0% (95%CI 11.6% to 16.5%). ConclusionCurrent evidence shows that the incidence of adverse skin reactions in lung cancer patients with immunotherapy is high. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.