ABSTRACT
Pericardiocentesis (PC) in patients with pulmonary hypertension (PH) and pericardial effusions has unclear benefits because it has been associated with acute hemodynamic collapse and increased mortality. Data on in-hospital outcomes in this population are limited. The National Inpatient Sample database was used to identify adult patients who underwent PC during hospitalizations between 2016 and 2020. Data were stratified by the presence or absence of PH. A multivariate regression model and case-control matching was used to estimate the association of PH with PC in-hospital outcomes. A total of 95,665 adults with a procedure diagnosis of PC were included, of whom 7,770 had PH. Patients with PH tended to be older (aged 67 ± 15.7 years) and female (56%) and less frequently presented with tamponade (44.9% vs 52.4%). Patients with PH had significantly higher rates of chronic kidney disease, coronary artery disease, heart failure, and chronic lung disease, among other co-morbidities. In the multivariate analysis, PC in PH was associated with higher all-cause mortality (adjusted odds ratio [aOR] 1.40, confidence interval [CI] 1.30 to 1.51) and higher rates of postprocedure shock (aOR 1.53, CI 1.30 to 1.81) than patients without PH. Mortality was higher in those with pulmonary arterial hypertension than other nonpulmonary arterial hypertension PH groups (aOR 2.35, 95% CI 1.46 to 3.80, p <0.001). The rates of cardiogenic shock (aOR 1.49, 95% CI 1.38 to 1.61), acute respiratory failure (aOR 1.56, 95% CI 1.48 to 1.64), and mechanical circulatory support use (aOR 1.86, 95% CI 1.63 to 2.12) were also higher in patients with PH. There was no significant volume-outcome relation between hospitals with a high per-annum pericardiocentesis volume compared with low-volume hospitals in these patients. In conclusion, PC is associated with increased in-hospital mortality and higher rates of cardiovascular complications in patients with PH, regardless of the World Health Organization PH group.
Subject(s)
Coronary Artery Disease , Heart Failure , Hypertension, Pulmonary , Pericardial Effusion , Adult , Humans , Female , United States/epidemiology , Pericardiocentesis , Hypertension, Pulmonary/etiology , Heart Failure/complications , Pericardial Effusion/etiology , Coronary Artery Disease/complications , Hospital Mortality , Retrospective StudiesABSTRACT
Fundamento: el bruxismo es de las alteraciones parafuncionales el más prevalente, complejo y destructivo de los desordenes orofaciales. Objetivo: determinar los factores de riesgo de bruxismo en pacientes adultos atendidos en la consulta de Oclusión dentaria. Métodos: se realizó un estudio analítico de casos-controles desde enero de 2014 hasta julio de 2016, de un universo de 2000 pacientes, a través de un muestreo aleatorio simple. La selección de la muestra quedó conformada por 678 individuos, dividida en dos grupos: uno de estudio y el otro de control, integrado cada uno por 339 pacientes. Se evaluaron por método de regresión logística univariado y multivariado las asociaciones entre los presuntos factores de riesgo y la ocurrencia del bruxismo. Resultados: existió relación de riesgo entre el bruxismo y el estrés, el recurso de afrontamiento al estrés con focalización negativa, el hábito tóxico de tabaquismo, interferencias oclusales y maloclusión. Conclusiones: se determinó la probabilidad de ser bruxópata en función de las variables incluidas y estimó la influencia independiente de cada variable sobre el bruxismo al controlar las restantes.
Background: bruxism is among the parafunctional alterations the most prevalent, complex and destructive of the orofacial disorders. Objective: to determine the risk factors of bruxism adult patients assisted in the dental Occlussion. Methods: an analytical study of control-cases was carried out from January 2014 to 2016, from a universe of 2000 patients, by means of a simple random sampling, the selection of the sample was composed of 678 individuals, divided in two groups: a study group and a control group, integrated by 339 patients each one, the associations between the alleged risk factors and the occurrence of bruxism were evaluated by unvaried and multivaried logistic regression. Results: there was a risk relationship between bruxism and stress, the resource of facing stress with a negative focalization, the smoking toxic habit, occlusive interference and malocclusion. Conclusions: the likelihood of being a bruxist patient was determined in relation to the included variables and to estimate the independent influence of each variable over bruxism when controlling the rest of them.
ABSTRACT
Fundamento: el bruxismo es de las alteraciones parafuncionales el más prevalente, complejo y destructivo de los desordenes orofaciales.Objetivo: determinar los factores de riesgo de bruxismo en pacientes adultos atendidos en la consulta de Oclusión dentaria.Métodos: se realizó un estudio analítico de casos-controles desde enero de 2014 hasta julio de 2016, de un universo de 2000 pacientes, a través de un muestreo aleatorio simple. La selección de la muestra quedó conformada por 678 individuos, dividida en dos grupos: uno de estudio y el otro de control, integrado cada uno por 339 pacientes. Se evaluaron por método de regresión logística univariado y multivariado las asociaciones entre los presuntos factores de riesgo y la ocurrencia del bruxismo.Resultados: existió relación de riesgo entre el bruxismo y el estrés, el recurso de afrontamiento al estrés con focalización negativa, el hábito tóxico de tabaquismo, interferencias oclusales y maloclusión.Conclusiones: se determinó la probabilidad de ser bruxópata en función de las variables incluidas y estimó la influencia independiente de cada variable sobre el bruxismo al controlar las restantes(AU)
Background: bruxism is among the parafunctional alterations the most prevalent, complex and destructive of the orofacial disorders.Objective: to determine the risk factors of bruxism adult patients assisted in the dental Occlussion.Methods: an analytical study of control-cases was carried out from January 2014 to 2016, from a universe of 2000 patients, by means of a simple random sampling, the selection of the sample was composed of 678 individuals, divided in two groups: a study group and a control group, integrated by 339 patients each one, the associations between the alleged risk factors and the occurrence of bruxism were evaluated by unvaried and multivaried logistic regression.Results: there was a risk relationship between bruxism and stress, the resource of facing stress with a negative focalization, the smoking toxic habit, occlusive interference and malocclusion.Conclusions: the likelihood of being a bruxist patient was determined in relation to the included variables and to estimate the independent influence of each variable over bruxism when controlling the rest of them(AU)
