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Wongtangman K, Azimaraghi O, Freda J, Ganz-Lord F, Shamamian P, Bastien A, Mirhaji P, Himes CP, Rupp S, Green-Lorenzen S, Smith RV, Medrano EM, Anand P, Rego S, Velji S, Eikermann M. Incidence and predictors of case cancellation within 24 h in patients scheduled for elective surgical procedures. J Clin Anesth 2022; 83:110987. [PMID: 36308990 DOI: 10.1016/j.jclinane.2022.110987] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/22/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Avoidable case cancellations within 24 h reduce operating room (OR) efficiency, add unnecessary costs, and may have physical and emotional consequences for patients and their families. We developed and validated a prediction tool that can be used to guide same day case cancellation reduction initiatives. DESIGN Retrospective hospital registry study. SETTING University-affiliated hospitals network (NY, USA). PATIENTS 246,612 (1/2016-6/2021) and 58,662 (7/2021-6/2022) scheduled elective procedures were included in the development and validation cohort. MEASUREMENTS Case cancellation within 24 h was defined as cancelling a surgical procedure within 24 h of the scheduled date and time. Our candidate predictors were defined a priori and included patient-, procedural-, and appointment-related factors. We created a prediction tool using backward stepwise logistic regression to predict case cancellation within 24 h. The model was subsequently recalibrated and validated in a cohort of patients who were recently scheduled for surgery. MAIN RESULTS 8.6% and 8.7% scheduled procedures were cancelled within 24 h of the intended procedure in the development and validation cohort, respectively. The final weighted score contains 29 predictors. A cutoff value of 15 score points predicted a 10.3% case cancellation rate with a negative predictive value of 0.96, and a positive predictive value of 0.21. The prediction model showed good discrimination in the development and validation cohort with an area under the receiver operating characteristic curve (AUC) of 0.79 (95% confidence interval 0.79-0. 80) and an AUC of 0.73 (95% confidence interval 0.72-0.73), respectively. CONCLUSIONS We present a validated preoperative prediction tool for case cancellation within 24 h of surgery. We utilize the instrument in our institution to identify patients with high risk of case cancellation. We describe a process for recalibration such that other institutions can also use the score to guide same day case cancellation reduction initiatives.
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Affiliation(s)
- Karuna Wongtangman
- Department of Anesthesiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA; Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Omid Azimaraghi
- Department of Anesthesiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Jeffrey Freda
- Vice President, Surgical Services, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Fran Ganz-Lord
- Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Peter Shamamian
- Department of Surgery, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Alexandra Bastien
- Department of Anesthesiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Parsa Mirhaji
- Center for Health Data Innovations, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Carina P Himes
- Department of Anesthesiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Samuel Rupp
- Department of Anesthesiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
| | | | - Richard V Smith
- Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Elilary Montilla Medrano
- Department of Anesthesiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Preeti Anand
- Department of Anesthesiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Simon Rego
- Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Salimah Velji
- Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Matthias Eikermann
- Department of Anesthesiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA; Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen, Essen, Germany.
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Ebrahimi H, Shayestefar M, Talebi SS, Christie J, Ebrahimi MH. Prevalence of hypertension and its associated factors among professional drivers: a population-based study. Acta Cardiol 2022:1-9. [PMID: 35969164 DOI: 10.1080/00015385.2022.2045753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Hypertension is one of the most important causes of cardiovascular disease. It has been found that professional drivers are at high risk of hypertension. This study has been performed to determine the prevalence of hypertension and its associated factors among professional drivers in Shahroud. METHODS AND RESULTS In this study, the prevalence of hypertension was determined according to the definition by the American Heart Association among 1461 professional drivers participating in the first cross-sectional phase of Shahroud drivers' prospective cohort study. The prevalence of elevated blood pressure and hypertension was examined based on the initial age, and gender presented, along with the factors affecting this disease based on multinomial logistic regression. The prevalence of elevated blood pressure, stage 1 and 2 hypertension was 46.9%, 6%, and 1.3%, respectively. In the multivariate multinomial logistic regression model, having diabetes, Body Mass Index ≥25, and driving years was associated with an increased chance of developing elevated blood pressure and hypertension. CONCLUSIONS Attention should be paid to high prevalence of elevated blood pressure and hypertension among professional drivers in Iran as a health priority for drivers. Plans should be made to reduce it as well as to prevent its complications.
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Affiliation(s)
- Hossein Ebrahimi
- Center for Health-Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mina Shayestefar
- School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran
| | - Seyedeh Solmaz Talebi
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Janice Christie
- Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Mohammad Hossein Ebrahimi
- Environmental and Occupational Health Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
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Application of Artificial Intelligence in the Establishment of an Association Model between Metabolic Syndrome, TCM Constitution, and the Guidance of Medicated Diet Care. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5530717. [PMID: 34007288 PMCID: PMC8110390 DOI: 10.1155/2021/5530717] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/23/2021] [Indexed: 12/17/2022]
Abstract
Background This study conducted exploratory research using artificial intelligence methods. The main purpose of this study is to establish an association model between metabolic syndrome and the TCM (traditional Chinese medicine) constitution using the characteristics of individual physical examination data and to provide guidance for medicated diet care. Methods Basic demographic and laboratory data were collected from a regional hospital health examination database in northern Taiwan, and artificial intelligence algorithms, such as logistic regression, Bayesian network, and decision tree, were used to analyze and construct the association model between metabolic syndrome and the TCM constitution. Findings. It was found that the phlegm-dampness constitution (90.6%) accounts for the majority of TCM constitution classifications with a high risk of metabolic syndrome, and high cholesterol, blood glucose, and waist circumference were statistically significantly correlated with the phlegm-dampness constitution. This study also found that the age of patients with metabolic syndrome has been advanced, and shift work is one of the risk indicators. Therefore, based on the association model between metabolic syndrome and TCM constitution, in the future, metabolic syndrome can be predicted through the syndrome differentiation of the TCM constitution, and relevant medicated diet care schemes can be recommended for improvement. Conclusion In order to increase the public's knowledge and methods for mitigating metabolic syndrome, in the future, nursing staff can provide nonprescription medicated diet-related nursing guidance information via the prediction and assessment of the TCM constitution.
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Mandal SK, Mitra A, Alok Y, Gupta S, Majumdar A. Awareness and perceptions regarding taxation and health warnings related to sugar-sweetened beverages and the factors associated with these among visitors of a general out-patient clinic in Bhopal, India. J Family Med Prim Care 2020; 9:2350-2358. [PMID: 32754500 PMCID: PMC7380747 DOI: 10.4103/jfmpc.jfmpc_226_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/13/2020] [Accepted: 03/23/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Although increased taxation on sugar-sweetened beverages (SSBs) and warning labels on their packaging have been successful in other countries, India has not implemented these. It is imperative to understand the user perspectives before implementation, regarding which almost no information exists. OBJECTIVES To assess the awareness and perceptions of people regarding taxation and health warnings on SSB packaging, and to determine the factors associated with these. METHODOLOGY This cross-sectional study was conducted in the general out-patient clinic of a public tertiary care hospital in Bhopal, India, between April and November 2018. Patients and accompanying persons ≥15 years of age and attending the clinic were included. Severely ill patients were excluded. Exit interviews were conducted after the clinical consultation using a pre-tested semi-structured interview schedule. Data were analyzed using IBM SPSS version 21. RESULTS Out of the 503 participants interviewed, three-fourths had never heard of taxes on SSBs and had never seen any health warning on SSB packaging. Most participants (96.6%) wanted some health warning to be present on the packaging. Majority of them (69.3%) wanted both textual and pictorial warnings. Close to half of those who wanted a pictorial warning to be present opined that it should occupy <25% of the surface area of the packaging. Multivariable analysis showed that participants aged <25 years and females were not in favor of tax increment. CONCLUSION Government policies should also focus on user perspectives and preferences before deciding to increase tax on SSBs or introducing mandatory health warnings on SSBs.
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Affiliation(s)
- Soumya K Mandal
- All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Arun Mitra
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Yash Alok
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Shubhanshu Gupta
- Department of Community Medicine, Datia Medical College, Datia, Madhya Pradesh, India
| | - Anindo Majumdar
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
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