Risk factors medical patients

Schwappach DLB Risk factors for patient-reported medical errors in eleven countries. Health Expect 2014 17 321-331. 

Branca et al. found that risk factors indicating preoperative medical instabdity, particularly cardiac or pulmonary insufficiency, predicted the highest risk of PMV (>4 days) after cardiac surgery (44). In a study of 139 cardiac surgery patients, chronic obstructive airways disease was identified as a risk factor for patients requiting seven or more days of MV postoperatively (45). In thoracic trauma patients, the presence of bilateral chest injuries, older age, and severity of concomitant head injury predicted the need for more than seven days of MV (46). 

In principal, data on the epidemiology of anaphylaxis will help to identify causes, risk factors and circumstances of the reaction. It will support the medical commimity to develop measures for the protection of affected patients. A true incidence of anaphylaxis has not been established, reasons are diverse study designs and the fact that there has been no universal consensus as to the definition of anaphylaxis [ 1 ]. 

Patients should be classified as low-, moderate-, or at high-risk depending on their medical condition and presence of risk factors... 

Given that VTE can be debilitating or fatal, it is important to treat it quickly and aggressively.8 On the other hand, because major bleeding induced by antithrombotic drugs can be equally harmful, it is important to avoid treatment when the diagnosis is not reasonably certain. Assessment of the patient s status should focus on the search for risk factors in the patient s medical history... 

Acute stroke is considered to be an acute medical emergency. Identification of the time and manner of stroke onset is an important determinant in treatment. The time the patient was last without symptoms is used as the time of stroke onset. Since patients typically do not experience pain, determining the onset time can be difficult. It is also important to document risk factors and previous functional status of the patient to assess current disability due to the stroke. 

Assess the patient s symptoms and history of exposure to risk factors. For new patients obtain a detailed medical history including ... 

Assess for the safety of others and potential for violence. If accompanied by friends or family with whom the patient is living, ask them to remove from the home all guns, caustic chemicals, medications, and objects the person might use to harm self or others. Risk factors for suicide include severity of depression, feelings of hopelessness, comorbid personality disorder, and a history of a previous suicide attempt.19... 

Obtain a thorough medical and family history and carefully evaluate each patient s risk factors prior to prescribing contraceptives. 

As the number of medications that a patient takes increases, so does the potential for DDIs. Disease severity, patient age, and organ dysfunction are all risk factors for increased DDIs. In general, DDIs can be broken down into two categories (1) pharmacokinetic interactions and (2) pharmacodynamic interactions. 

A high index of suspicion should be maintained for patients at risk for CNS infections. Prompt recognition and diagnosis are essential so that antimicrobial therapy can be initiated as quickly as possible. A medical history (including risk factors for infection and history of possible recent exposures) and... 

In addition to medical and surgical management, non-pharmacologic interventions that reduce risk factors for developing osteomyelitis should be communicated to the patient. Examples include smoking cessation, weight-control, exercise, and good nutrition.2 Additionally, a diabetic patient... 

Review the patient s medical and social history. Was the patient exposed to clinical risk factors for lung cancer ... 

Prophylaxis should be continued throughout the period of risk. For general surgical procedures and medical conditions, prophylaxis can be discontinued once the patient is able to ambulate regularly and other risk factors are no longer present. Most clinical trials support the use of antithrombotic therapy for 21 to 35 days after total hip replacement and hip fracture repair surgeries. 

Korevaar JC, van Munster BC, de Rooij SE (2005) Risk factors for delirium in acutely admitted elderly patients a prospective cohort study. BMC Geriatr 5 6 Kudoh A, Takase H, Takahira Y et al. (2004) Postoperative confusion increases in elderly longterm benzodiazepine users. Anesth Analg 99 (6) 1674-1678 McCusker J, Cole M, Dendukuri N et al. (2001) Delirium in older medical inpatients and subsequent cognitive and functional status a prospective study. Cmaj 165 (5) 575-583 McCusker J, Cole M, Dendukuri N et al. (2003) The course of delirium in older medical inpatients a prospective study. J Gen Intern Med 18 (9) 696-704 McShane R, Areosa Sastre A, Minakaran N (2006) Memantine for dementia. Cochrane Database Syst Rev 19 (2) CD003154... 

Polypharmacy is often a consequence of the cascade of problems. A literature review found that polypharmacy continues to increase and is a known risk factor for important morbidity and mortality (Hajjar et al. 2007). The reviewers states that many studies have found that various numbers of medications are associated with negative health outcomes, but more research is needed to further delineate the consequences associated with unnecessary drug use in elderly patients. Health care professionals should be aware of the risks and fully evaluate all medications at each patient visit to prevent polypharmacy from occurring . 

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