Background: Massive hemoptysis is a common and fatal complication of bronchiectasis. However, the risk factors for massive hemoptysis in patients with bronchiectasis have not yet been reported. This study investigated the potential risk factors for massive hemoptysis in patients with bronchiectasis.Methods: This retrospective study included patients with bronchiectasis and their data were obtained from medical records. The risk factors for massive hemoptysis were evaluated by multivariate analysis of patient characteristics, medical history, and computed tomography imaging data, including the number of lesions, lesion location, and laboratory findings.Results: Among 379 patients, 61 (16.09%) experienced severe hemoptysis. Multivariate analysis revealed that diabetes (odds ratio (OR), 2.885; 95% confidence interval (CI), 1.009–8.247), lesions involving two lobes (OR, 4.347; 95% CI, 1.960–9.638) and three lobes (OR, 2.787; 95% CI, 1.055–7.363) were significant predictors of severe hemoptysis. However, a disease course between 1 and 5 years (OR, 0.300; 95% CI, 0.112–0.801) and involvement of the left lower lobe (OR, 0.394; 95% CI, 0.196–0.793) were protective factors for the prevention of massive hemoptysis. Lesions in the right upper lobe were more likely to cause massive hemoptysis (OR, 1.458) than involvement of other lobes.Conclusions: Diabetes and lesions involving two and three lobes, were risk factors for massive hemoptysis in patients with bronchiectasis. Disease duration between 1 and 5 years and involvement of the left lower lobe were protective factors, while lesions in the right upper lobe had a stronger relationship with massive hemoptysis in patients with bronchiectasis.
Background Community health centers (CHCs) have now served as the primary healthcare facilities especially for older adults in China. There is a paucity in current literature about public satisfaction with CHC services from the perspective of subjective perception. We aimed to identify the perception factors influencing satisfaction with CHC services among older adults or their families, and explore the influence paths, in Banan district of Chongqing, China. Methods A sample survey was conducted among 879 households in 32 communities in Banan district in March 2019 to obtain the basic data. The hypothetical service satisfaction model, the degree of the influence of each perception factor on final satisfaction, and influence paths were analyzed using the Smart PLS 3.0 software. Results A total of 800 households with older adult(s) aged 60 years and over were included in the study. Service expectation (-0.191), perceived quality (0.508) and perceived value (0.441) were the three direct factors influencing the satisfaction with CHC services. Both perceived quality and service expectation could indirectly affect public satisfaction by way of influencing perceived value (0.224 and -0.087, respectively). Conclusions Service expectation, service quality and value recognition are the main factors affecting satisfaction with CHC services. Service quality and accessibility should be improved along with the incremental construction of rational service expectation towards CHCs. Policy and financial inputs and the introduction of well-trained health providers are of great importance. Furthermore, equal access to CHC services should be gradually promoted especially for older adults.
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