PubMed | Ottawa Hospital Research Institute, The Ottawa Hospital Ottawa and NYU Langone Medical Center
Type: | Journal: The Journal of urology | Year: 2016
Midurethral sling surgery is common. Post-operative urinary tract infection rates vary in the literature and independent risk factors for urinary tract infection are not well defined. We sought to determine the incidence of and risk factors for urinary tract infection following midurethral sling surgery.A retrospective cohort of females who underwent sling surgery was captured from the National Surgical Quality Improvement Program (NSQIP) database 2006-2014. Exclusion criteria included male sex, non-elective surgery, totally dependent functional status, preoperative infection, prior surgery within 30 days, ASA 4, concomitant procedure and operative time >60 minutes. The primary outcome was incidence of urinary tract infection within 30 days of midurethral sling surgery. Risk factors for urinary tract infection were assessed by examining patient demographic, comorbidity and surgical variables. Logistic regression analyses were performed to estimate odds ratios for individual risk factors. Multivariable logistic regression was then performed to adjust for confounding.9,022 midurethral sling surgeries were identified. Urinary tract infection incidence was 2.6%. Factors independently associated with an increased infection risk include age >65 (OR 1.54 95 % CI 1.07-2.22), BMI>40 (OR 1.89 95% CI 1.23-2.92) and admission to hospital (OR 2.06 95% CI 1.37-3.11). Midurethral sling surgery performed by urologists had a reduced risk of infection (OR 0.52 95 % CI 0.40-0.69) compared to gynecologists.Urinary tract infection risk following midurethral sling surgery in NSQIP associated hospitals is low. Novel patient and surgical factors for post-operative urinary tract infection have been identified and merit further study.
PubMed | The Ottawa Hospital Ottawa
Type: Journal Article | Journal: Clinical case reports | Year: 2015
Hemophagocytic lymphohistiocytosis (HLH) is a potentially life-threatening clinical syndrome caused by uncontrolled activation of lymphocytes and histiocytes resulting in high levels of cytokines. Acquired HLH occurs in autoimmune, inflammatory, infectious, and immunosuppressive disorders. Prompt identification and treatment of an underlying triggering cause improves clinical outcome.