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What Is Breech?

When a fetus is delivered buttocks or feet first

• Types of Presentation

Risk Factors

Complications.

Breech concerns the position of the fetus before labor . Typically, the fetus comes out headfirst, but in a breech delivery, the buttocks or feet come out first. This type of delivery is risky for both the pregnant person and the fetus.

This article discusses the different types of breech presentations, risk factors that might make a breech presentation more likely, treatment options, and complications associated with a breech delivery.

Verywell / Jessica Olah

Types of Breech Presentation

During the last few weeks of pregnancy, a fetus usually rotates so that the head is positioned downward to come out of the vagina first. This is called the vertex position.

In a breech presentation, the fetus does not turn to lie in the correct position. Instead, the fetus’s buttocks or feet are positioned to come out of the vagina first.

At 28 weeks of gestation, approximately 20% of fetuses are in a breech position. However, the majority of these rotate to the proper vertex position. At full term, around 3%–4% of births are breech.

The different types of breech presentations include:

• Complete : The fetus’s knees are bent, and the buttocks are presenting first.
• Frank : The fetus’s legs are stretched upward toward the head, and the buttocks are presenting first.
• Footling : The fetus’s foot is showing first.

Signs of Breech

There are no specific symptoms associated with a breech presentation.

Diagnosing breech before the last few weeks of pregnancy is not helpful, since the fetus is likely to turn to the proper vertex position before 35 weeks gestation.

A healthcare provider may be able to tell which direction the fetus is facing by touching a pregnant person’s abdomen. However, an ultrasound examination is the best way to determine how the fetus is lying in the uterus.

Most breech presentations are not related to any specific risk factor. However, certain circumstances can increase the risk for breech presentation.

These can include:

• Previous pregnancies
• Multiple fetuses in the uterus
• An abnormally shaped uterus
• Uterine fibroids , which are noncancerous growths of the uterus that usually appear during the childbearing years
• Placenta previa, a condition in which the placenta covers the opening to the uterus
• Preterm labor or prematurity of the fetus
• Too much or too little amniotic fluid (the liquid that surrounds the fetus during pregnancy)
• Fetal congenital abnormalities

Most fetuses that are breech are born by cesarean delivery (cesarean section or C-section), a surgical procedure in which the baby is born through an incision in the pregnant person’s abdomen.

In rare instances, a healthcare provider may plan a vaginal birth of a breech fetus. However, there are more risks associated with this type of delivery than there are with cesarean delivery. 

Before cesarean delivery, a healthcare provider might utilize the external cephalic version (ECV) procedure to turn the fetus so that the head is down and in the vertex position. This procedure involves pushing on the pregnant person’s belly to turn the fetus while viewing the maneuvers on an ultrasound. This can be an uncomfortable procedure, and it is usually done around 37 weeks gestation.

ECV reduces the risks associated with having a cesarean delivery. It is successful approximately 40%–60% of the time. The procedure cannot be done once a pregnant person is in active labor.

Complications related to ECV are low and include the placenta tearing away from the uterine lining, changes in the fetus’s heart rate, and preterm labor.

ECV is usually not recommended if the:

• Pregnant person is carrying more than one fetus
• Placenta is in the wrong place
• Healthcare provider has concerns about the health of the fetus
• Pregnant person has specific abnormalities of the reproductive system

Recommendations for Previous C-Sections

The American College of Obstetricians and Gynecologists (ACOG) says that ECV can be considered if a person has had a previous cesarean delivery.

During a breech delivery, the umbilical cord might come out first and be pinched by the exiting fetus. This is called cord prolapse and puts the fetus at risk for decreased oxygen and blood flow. There’s also a risk that the fetus’s head or shoulders will get stuck inside the mother’s pelvis, leading to suffocation.

Complications associated with cesarean delivery include infection, bleeding, injury to other internal organs, and problems with future pregnancies.

A healthcare provider needs to weigh the risks and benefits of ECV, delivering a breech fetus vaginally, and cesarean delivery.

In a breech delivery, the fetus comes out buttocks or feet first rather than headfirst (vertex), the preferred and usual method. This type of delivery can be more dangerous than a vertex delivery and lead to complications. If your baby is in breech, your healthcare provider will likely recommend a C-section.

A Word From Verywell

Knowing that your baby is in the wrong position and that you may be facing a breech delivery can be extremely stressful. However, most fetuses turn to have their head down before a person goes into labor. It is not a cause for concern if your fetus is breech before 36 weeks. It is common for the fetus to move around in many different positions before that time.

At the end of your pregnancy, if your fetus is in a breech position, your healthcare provider can perform maneuvers to turn the fetus around. If these maneuvers are unsuccessful or not appropriate for your situation, cesarean delivery is most often recommended. Discussing all of these options in advance can help you feel prepared should you be faced with a breech delivery.

American College of Obstetricians and Gynecologists. If your baby is breech .

TeachMeObGyn. Breech presentation .

MedlinePlus. Breech birth .

Hofmeyr GJ, Kulier R, West HM. External cephalic version for breech presentation at term . Cochrane Database Syst Rev . 2015 Apr 1;2015(4):CD000083. doi:10.1002/14651858.CD000083.pub3

By Christine Zink, MD Dr. Zink is a board-certified emergency medicine physician with expertise in the wilderness and global medicine.

2019 Novel Coronavirus Research Compendium (NCRC)

Clinical presentation & prognostic risk factors.

This section prioritizes studies with original data on the clinical manifestations of SARS-CoV-2 infection, morbidity and mortality estimates among those infected, factors associated with disease severity and mortality, and risk assessment tools that aid clinical decision-making. Panel or practice statements and studies focused principally on radiologic modalities are generally outside the scope of our review.

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Risk factors for adverse outcomes among pregnant and postpartum women with acute respiratory distress syndrome due to COVID-19 in Brazil

Among 2,475 pregnant women in Brazil with indications of severe COVID-19, a large proportion (24%) either died, was admitted to the ICU, or required mechanical ventilation. In addition to comorbidities known to be associated with adverse COVID-19 outcomes, Black ethnicity…

Trends in COVID-19 Risk-Adjusted Mortality Rates

Mortality risks among 5,121 hospitalized patients with COVID-19 declined each month in New York City from March through August 2020. This study, which adjusted for patient demographic and clinical characteristics, provides support that improved survival was not only because of…

First 100 Persons with COVID-19 — Zambia, March 18–April 28, 2020

This case series provides a characterization of the first 100 cases of confirmed COVID-19 in Zambia, a lower-middle income country in sub-Saharan Africa, and includes a description of the national response in the early days of the pandemic. While this…

Outcomes of COVID-19 related hospitalization among people with HIV in the ISARIC WHO Clinical Characterization Protocol (UK): a prospective observational study

This was a prospective cohort study that included 47592 participants who were hospitalized between Jan 18 and June 4,2020 with COVID-19 in 207 hospitals in London, Wales and Scotland. 122 of the total participants were HIV positive (PWH). PWH had…

Body Mass Index as a Risk Factor for Clinical Outcomes in Patients Hospitalized with COVID-19 in New York

This large retrospective cohort study from the early phase of the pandemic (March 1 to May 12, 2020) found that among 10,861 inpatients in New York who tested positive for SARS-CoV-2 infection, underweight and obese patients were at greater risk…

Immunity and Coagulation/Fibrinolytic Processes May Reduce the Risk of Severe Illness in Pregnant Women with COVID-19

This descriptive study from China presents a rich characterization of immune, coagulation, and fibrinolysis laboratory markers at admission and COVID-19 severity in a small sample of pregnant women with COVID-19, finding less similarity to age-matched non-pregnant women with COVID-19, and…

Clinical and Epidemiologic Analysis of COVID-19 Children Cases in Colombia PEDIACOVID

This study compared the age distribution among individuals

Multi-organ impairment in low-risk individuals with long COVID

This cross-sectional study, available as a preprint and thus not yet peer reviewed, described symptoms and evidence of organ impairment up to four and a half months from acute SARS-CoV-2 infection or a clinical diagnosis of COVID-19 among relatively low-risk…

Case Series of Multisystem Inflammatory Syndrome in Adults Associated with SARS-CoV-2 Infection – United Kingdom and United States, March-August 2020

Several CDC case reports and published case series suggest that multisystem inflammatory syndrome due to SARS-CoV-2 infection may not be limited to children. This MMWR describes 27 cases of MIS-A (adults) who had confirmed SARS-CoV-2 infection (either previously or currently)…

The Direct and Indirect Impact of SARS-CoV-2 Infections on Neonates: A Series of 26 Cases in Bangladesh

This study reported a high positivity rate of SARS-CoV-2 testing among neonates (aged 0-28 days) in serious condition at a referral center in Bangladesh. Six of the 8 babies who died had serious comorbidities that are commonly seen in neonates…

Frequent neurologic manifestations and encephalopathy-associated morbidity in Covid-19 patients

In this case series of 509 patients hospitalized in Chicago with COVID-19, neurologic manifestations were common (e.g. myalgias, headache, dysgeusia, anosmia, encephalopathy): 42% of patients had at least one at symptom onset, and 82% experienced one at any time during…

Follow-up of adults with non-critical COVID-19 two months after symptoms’ onset

This small, prospective study from a single center in France suggests that persistent COVID-19 symptoms are common up to 60 days from SARS-CoV-2 diagnosis in patients with symptomatic, but non-critical COVID-19 disease. If larger studies confirm these findings, it could…

Seroprevalence of SARS-CoV-2 antibodies in people with an acute loss in their sense of smell and/or taste in a community-based population in London, UK: An observational cohort study

This cross-sectional study screened for SARS-CoV-2 antibodies among a sample of adults who reported recent loss of taste and/or smell before they were a widely-recognized COVID-19 symptom. SARS-CoV-2 antibodies were detected in three-quarters of respondents with either/both symptoms, suggestive of…

Clinical Characteristics, Hospitalization and Mortality Rates of COVID-19 Among Liver Transplant Patients in the United States: A Multi-Center Research Network Study

This retrospective cohort study compared the risk of hospitalization, mortality, thrombosis, and intensive care admission in US patients with and without liver transplantation who were infected with SARS-CoV-2, after adjusting for differences in age, race, and comorbidities. Patients with a…

Biomarkers of Cytokine Release Syndrome Predict Disease Severity and Mortality From COVID-19 in Kidney Transplant Recipients

This case series followed 49 patients with a history of kidney transplant who contracted COVID-19 in Alsace, France at the beginning of the pandemic. No patients lost their grafted kidneys, but 9 patients died. High levels of all measured inflammatory…

Clinical Characteristics and Mortality of Healthcare Workers with SARS-CoV-2 infection in Mexico City

This large study using publicly-available data from Mexico City revealed a lower risk of death among HCW compared to non-HCW, with nurses experiencing the lowest risk. These findings were independent of confounding factors and matching on important covariates. These results…

SARS-CoV-2 Infection Among Hospitalized Pregnant Women: Reasons for Admission and Pregnancy Characteristics — Eight U.S. Health Care Centers, March 1–May 30, 2020

This descriptive study of 105 pregnant women hospitalized with COVID-19 at eight U.S. surveillance sites demonstrated a significantly higher risk profile among pregnant cases admitted for non-obstetric reasons compared to those hospitalized for obstetric reasons, underscoring the need to consider…

Systematic evaluation and external validation of 22 prognostic models among hospitalised adults with COVID-19: An observational cohort study

Twenty-two COVID-19 prognostic models for clinical deterioration or mortality were systematically and externally validated with an independent dataset of 411 COVID-19 patients in London. Although the NEWS2 and final Carr model performed relatively well in this population, single-variable models with…

Characteristics and Maternal and Birth Outcomes of Hospitalized Pregnant Women with Laboratory-Confirmed COVID-19 – COVID-NET, 13 States, March 1-August 22, 2020

This descriptive study compared characteristics and outcomes among hospitalized pregnant women with COVID-19 with and without symptoms. The high proportion of asymptomatic cases suggests that, in many areas of the US, asymptomatic pregnant women are screened for COVID-19 prior to…

Auto-antibodies against type I IFNs in patients with life threatening COVID-19

Variations in immune response are suspected to underlie some COVID-19 disease outcomes. In this important study, about 10% of patients with severe COVID-19 pneumonia had neutralizing IgG auto-antibodies to type I interferons, which were not present in any patients with…

Inborn errors of type I IFN immunity in patients with life-threatening COVID-19

A subset (3.5%) of 659 patients with severe COVID-19 pneumonia had uncommon genetic variants that suppress the type I interferon response to SARS-CoV-2 infection; none had previous severe viral illness. Some of these mutations are known to increase susceptibility to…

Infant Outcomes Following Maternal Infection with SARS-CoV-2: First Report from the PRIORITY Study

This prospective cohort study provides reassuring preliminary data on adverse birth outcomes among infants whose mothers are infected with SARS-CoV-2 during pregnancy. There were no major differences in preterm birth, neonatal intensive care admission, or infant respiratory distress by maternal…

Cardiovascular Magnetic Resonance Findings in Competitive Athletes Recovering From COVID-19 Infection

This small, cross-sectional study used cardiac magnetic resonance imaging to determine whether or not competitive athletes had findings consistent with myocarditis (heart muscle inflammation) after a mild or asymptomatic SARS-CoV-2 infection. While the study found evidence of heart muscle inflammation…

Risk stratification of patients admitted to hospital with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol: development and validation of the 4C Mortality Score

This paper details a promising tool for risk stratification of patients hospitalized with COVID-19. The risk score includes 8 variables (age, sex, number of comorbidities, respiratory rate, peripheral oxygen saturation, Glasgow coma scale, urea, and C-reactive protein) that are often…

Characteristics, Comorbidities, and Outcomes in a Multicenter Registry of Patients with HIV and Coronavirus Disease-19

The findings from this study suggest that, along with the well-established predictors of older age and comorbidities, persons with HIV who have low CD4 cell counts (CD4

Comparison of Clinical Features of COVID-19 vs Seasonal Influenza A and B in US Children

This retrospective study found that hospitalization rates, ICU admission rates, and use of mechanical ventilation were similar between individuals (mostly children) diagnosed with COVID-19 and seasonal influenza at a single children’s hospital in Washington DC. However, patients presenting for these…

Adverse outcomes and mortality in users of non-steroidal anti-inflammatory drugs who tested positive for SARS-CoV-2: A Danish nationwide cohort study

Despite early concern that ibuprofen may influence COVID-19 outcomes, population-based epidemiologic studies have not confirmed those results. Results from this study suggest that use of NSAIDs does not contribute to increased mortality among individuals with COVID-19. However, NSAID users appeared…

Sex differences in immune responses that underlie COVID-19 disease outcomes

Men tend to have a more severe COVID-19 disease course than women, and it is thought that differences in the immune response to SARS-CoV-2 infection might contribute to this disparity. This study considered 39 patients (who were not in intensive…

COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study

This cohort study in the UK compared active cancer patients with confirmed COVID-19 (n=1044) between March 18 and May 8, 2020 to a national cancer registry (ONS), and examined the association between cancer subtypes and all-cause mortality following COVID-19 infection.…

COVID-19 and dementia: Analysis of risk, disparity, and outcomes from electronic health records in the US

This retrospective case-control study used electronic health records from 61.9 million adults in the United States from January to August 21, 2020. Patients with dementia had twice the odds of COVID-19 compared to patients without dementia, after adjusting for several…

Effects of a major deletion in the SARS-CoV-2 genome on the severity of infection and the inflammatory response: an observational cohort study

This study provides evidence from Singapore that a SARS-CoV-2 variant (involving a 382-nucleotide deletion in the ORF8 protein) was associated with a less severe clinical presentation, and found that differences in concentrations of immunological markers may mediate this relationship. Although…

Evaluating the Association of Clinical Characteristics With Neutralizing Antibody Levels in Patients Who Have Recovered From Mild COVID-19 in Shanghai, China

In this cohort study of 175 patients hospitalized with mild COVID-19 in Shanghai, China, there was wide variation in the level of SARS-CoV-2 specific neutralizing antibodies at discharge, with levels generally reaching their peak 10 to 15 days post symptom…

Inference from longitudinal laboratory tests characterizes temporal evolution of COVID-19-associated coagulopathy (CAC)

This was a retrospective study considering serial laboratory measurements from patients who had received PCR testing for SARS-CoV-2 infection at Mayo Clinic hospitals in Minnesota, Arizona, and Florida between February 15 to May 28, 2020. At the time of PCR…

Hospitalization Rates and Characteristics of Children Aged <18 Years Hospitalized with Laboratory-Confirmed COVID-19 – COVID-NET, 14 States, March 1-July 25, 2020

In this study of children hospitalized with COVID-19 from 14 US states, Hispanic and Black children were far more likely to be hospitalized than white children, and they were more likely to have underlying conditions that are associated with disease…

Risk factors for COVID-19-related mortality in people with type 1 and type 2 diabetes in England: a population-based cohort study

In this population-based cohort study of individuals with Type 1 and Type 2 diabetes in England, several clinical and demographic factors were associated with COVID-19 mortality. In addition to established risk factors such as age, sex, race/ethnicity, and socioecnomic status,…

Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study

This population-based cohort study of more than 61 million people in England demonstrated that one third of in-hospital COVID-19 deaths between March 1 and May 11, 2020 were among people with diabetes, and that the odds of in-hospital death from…

Obesity and Mortality Among Patients Diagnosed With COVID-19: Results From an Integrated Health Care Organization

In a large cohort of patients from a single health care network in California, obesity had strong associations with mortality, but only among men, and only among those younger than 60 years. These associations were large, and the differences by…

SARS-CoV-2 viral load in the upper respiratory tract of children and adults with early acute COVID-19

This single-center study with a fairly small sample size showed similar quantities of detectable SARS-CoV-2 RNA from nasopharyngeal swabs across age groups, including children. However, some cautions apply: 1) all patients were symptomatic, and results are not representative of all…

Immune complement and coagulation dysfunction in adverse outcomes of SARS-CoV-2 infection

With data from a retrospective cohort study, transcriptional profiling of nasopharyngeal swabs, and candidate-driven genetic association study, these results add to the growing body of research that suggests the complement system and coagulation function influence severity of COVID-19. Given these…

The effect of frailty on survival in patients with COVID-19 (COPE): a multicentre, European, observational cohort study

In this multisite study in the UK and Italy, almost half of the 1,564 participants were considered frail (clinical frailty score >4). Frailty was associated with COVID-19 mortality after adjusting for other factors associated with death. The findings provide preliminary…

Risk of severe COVID-19 disease with ACE inhibitors and angiotensin receptor blockers: cohort study including 8.3 million people

There were early concerns that taking ACE inhibitors and ARBs, which are drugs used to treat cardiovascular disease, might increase risks of COVID-19 by increasing expression of the ACE2 receptor, which is used by SARS-CoV-2 for cell entry. This study…

Children and COVID-19: State Data Report

This report summarizes all publicly available data from state and local health departments on the burden of COVID-19 disease and mortality among children in the US as of July 30, 2020. Despite incomplete reporting, missing data, and divergent methods of…

Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching

Preliminary results from this study suggest that recent and short-term proton pump inhibitor (PPI) use may be associated with more severe outcomes of COVID-19, however, causality may not be inferred as a number of biases could explain the observed association…

Longitudinal analyses reveal immunological misfiring in severe COVID-19

This study tracked immune responses among 113 COVID-19 patients over time (up to 51 days after symptom onset), identifying distinct disease courses that were associated with inflammatory “signatures.” The magnitude of early inflammatory cytokine response correlated with disease outcomes, and…

Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)

Findings from this prospective study suggest that many patients who recently recovered from COVID-19 infection have ongoing cardiac involvement, mostly characterized by myocardial inflammation. Most of these patients were not hospitalized during their initial infection, and the results appear to…

Neonatal management and outcomes during the COVID-19 pandemic: an observation cohort study

This observational study of neonates whose mothers had COVID-19 at delivery found no cases of transmission within the first two weeks of life. Though it is possible that some infections were missed due to lower participation in follow-up testing and…

Continued in-hospital ACE inhibitor and ARB Use in hypertensive COVID-19 patients is associated with positive clinical outcomes

There had been early concern that patients with hypertension might be at risk for more severe COVID-19 if they continued taking ACE inhibitors or ARBs. However, several studies have failed to show any increased risk associated with the use of…

Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single-blind, randomised controlled trial

This Phase 1, comparator-vaccine controlled study provides encouraging preliminary evidence that the ChAdOx1 nCoV-19 vaccine candidate is well tolerated and elicits an immune response at least comparable to antibody levels observed in a panel of convalescent plasma. This study suggests…

Characteristics of Persons Who Died with COVID-19 – United States, February 12-May 18, 2020

This CDC report provides a detailed description of confirmed 10,647 COVID-19 deaths, though the generalizability of results is questionable because most of these deaths occurred early in the epidemic in specific geographic areas. The median age of death of those…

Deep immune profiling of COVID-19 patients reveals distinct immunotypes with therapeutic implications

Immune responses to COVID-19 are not well understood, but evidence suggests that they may be crucial to patient outcomes. This analysis considered a very large number of immune responses to COVID-19 among hospitalized patients, noting considerable heterogeneity in responses, but…

Blood type and outcomes in patients with COVID-19

Contrary to previous studies, blood type A was not associated with testing positive for COVID-19. Blood types AB and B were associated with increased odds of testing positive for COVID-19, while blood type O appeared slightly protective. None of the…

Impaired type I interferon activity and inflammatory responses in severe COVID-19 patients

Among a group of COVID-19 patients with a spectrum of disease severity, severe-to-critical disease was associated with an exacerbated inflammatory response (specifically, elevated IL-6 and TNF-alpha), high blood viral load, and a disturbance of the antiviral IFN expression and activation…

Persistent Symptoms in Patients after Acute COVID-19

Anecdotal evidence has long suggested that many people suffer persistent symptoms following COVID-19 recovery. In this account of follow-up among 143 patients previously hospitalized with COVID-19, most (77%) were still experiencing at least one symptom and 44% self-reported worsened quality…

The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings

Emerging evidence indicates that COVID-19 is associated with challenging neurological dysfunction; however, data have been limited and optimal treatment strategies are unknown. Considerable uncertainty remains about the specific neuropathologic mechanisms involved, which may involve direct viral injury, hyperinflammation, and/or coagulopathy.…

OpenSAFELY: factors associated with COVID-19 death in 17 million patients

This study, covering over 17 million adults in England, confirms previously observed associations with mortality: higher risks were seen with older age, male sex, chronic comorbidities, socioeconomic deprivation, and nonwhite ethnicity. Although causality cannot be inferred for any given risk…

Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza

Growing evidence suggests that COVID-19 leads to a hypercoagulable and prothrombotic state that may result in a greater risk of neurologic complications such as ischemic stroke. This study is one of the first to indicate that the risk of ischemic…

Multisystem Inflammatory Syndrome in Children in New York State

Consistent with previous reports from Europe and the US, this study shows evidence of a severe, novel immune-mediated disease in children (MIS-C) occurring in response to infection with SARS-CoV-2. This syndrome appears to occur about three weeks after SARS-CoV-2 infection…

Multisystem Inflammatory Syndrome in U.S. Children and Adolescents

This study was the largest to date to characterize multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 infection, which still appears to be relatively uncommon. The authors report on severe clinical illness affecting multiple organ systems. Most children were…

Incidence and Severity of COVID-19 in HIV-Positive Persons Receiving Antiretroviral Therapy: A Cohort Study

In this large, multi-site cohort study of 60 HIV clinics throughout Spain, age- and sex-adjusted risk estimates of COVID-19 diagnosis, hospitalization, ICU admission, and death were similar for persons with and without HIV. Of most interest, HIV-positive patients receiving TDF/FTC…

Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status — United States, January 22-June 7, 2020

Although pregnant women in this study were more likely than non-pregnant women to require ICU care and mechanical ventilation, these associations could be artifacts of biases introduced by the substantially incomplete data from the US COVID-19 surveillance system, and by…

Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study

This study provides a snapshot of the scope of neurological and neuropsychiatric complications associated with COVID-19 early in the pandemic in the UK. It contributes to a growing body of literature suggesting that COVID-19 may result in acute cerebrovascular events…

Impaired glucose metabolism in patients with diabetes, prediabetes, and obesity is associated with severe COVID-19

This single-center prospective cohort study showed that diabetes mellitus, pre-diabetes mellitus, and high body mass index (BMI) were individually associated with poorer COVID-19 prognosis. New onset hyperglycemia was associated with severe COVID-19 illness in patients without diabetes mellitus, which may…

The Epidemiology of SARS-CoV-2 in a Pediatric Healthcare Network in the United States

In a large US pediatric care network, the overall prevalence of SARS-CoV-2 was relatively low, but differed by testing site and indication for testing. Results reveal some concerning racial and ethnic disparities with Black patients and those with public insurance…

Characteristics and Outcomes of 241 Births to Women With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection at Five New York City Medical Centers

This case-series followed 241 pregnant women with COVID-19 who delivered in 5 New York City hospitals. It demonstrated that 31% developed severe or critical disease, 7% required ICU admission, and 14.6% (34) of births were preterm. Obesity was a strong…

Clinical characteristics of COVID-19 in 104 people with SARS-CoV-2 infection on the Diamond Princess cruise ship: a retrospective analysis

Outbreak investigations that examine factors associated with asymptomatic or pre-symptomatic COVID-19 are important to understand the clinical features and disease pathogenesis of the virus. Findings from this study highlight serum lactate dehydrogenase, lymphopenia, age, and consolidation on CT scan as…

Natural History of Asymptomatic SARS-CoV-2 Infection

This article describes viral shedding among “asymptomatic” cases on the Diamond Princess cruise ship, where asymptomatic was defined as developing neither fever nor respiratory symptoms rather than no symptoms at all. The median number of days between the first positive…

Clinical Characteristics of 58 Children With a Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2

Previous studies from Europe and North America have reported a multisystem inflammatory syndrome among children that appears to be associated with SARS-CoV-2 infection. This case series from the UK reported strikingly similar findings, and identified a wide range of clinical…

Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study

This study presented national data on the incidence and outcomes of COVID-19 hospitalizations during pregnancy in the UK. There was significantly higher incidence of hospitalization among pregnant Black women relative to pregnant white women. These results are consistent with findings…

SARS-CoV-2 infection, clinical features and outcome of COVID-19 in United Kingdom nursing homes

In this outbreak investigation, over 60% of nursing home residents who tested positive for SARS-CoV-2 were either asymptomatic or only had atypical symptoms (confusion, anorexia, diarrhea/vomiting), which can pose a challenge to identifying and controlling COVID-19 outbreaks in nursing homes.…

Obesity is associated with worse outcomes in COVID-19: Analysis of Early Data From New York City

In this group of patients admitted to two New York City hospitals with COVID-19, obesity, defined as a body mass index greater than 30, was a risk factor for ICU admission or death after controlling for age and race/ethnicity. It…

Clinical characteristics and risk factors associated with COVID-19 disease severity in patients with cancer in Wuhan, China: a multicentre, retrospective, cohort study

The results of this study suggest that patients with cancer were more likely to have severe COVID-19 than patients without cancer. In addition to providing more support for the hypothesis that pro-inflammatory cytokines and coagulation-related indicators are associated with severe…

COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study

This study showed high mortality among 800 cancer patients with COVID-19 in the UK. Mortality was associated with known risk factors for COVID-19 mortality, including older age and comorbidities. Results from adjusted analyses did not support an association between chemotherapy…

Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study

In a large study from the US, Canada, and Spain, patients with cancer and COVID-19 had a high likelihood of severe disease and death. A history of smoking, increased age, and the presence of active cancer were risk factors for…

Hospitalization and Mortality among Black Patients and White Patients with COVID-19

Existing research on racial and ethnic differences in COVID-19 outcomes is lacking. Though Black patients make up only 31% of established patients at Ochsner Health, they comprised 70.4% of COVID-19 diagnoses, and 76.9% of all hospital admissions. However, Black patients…

Features of 20,133 UK patients in hospital with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study

In this large, prospective cohort study that began during the early stages of the COVID-19 outbreak, the clinical presentation and outcomes of 20,133 patients hospitalized in the UK with COVID-19 were described. Possibly due to the high median age (80…

Pathophysiology of SARS-CoV-2: targeting of endothelial cells renders a complex disease with thrombotic microangiopathy and aberrant immune response. The Mount Sinai COVID-19 autopsy experience

This paper was a preprint and thus was not yet peer reviewed. Findings from this interdisciplinary autopsy series of 67 SARS-CoV-2 positive patients suggest endothelial dysfunction and hypercoagulability in several major organs, as well as immune dysfunction. These results provide…

Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in COVID-19

In a small autopsy study, lungs from COVID-19 patients demonstrated similar diffuse alveolar damage with immune cell infiltration as is typically seen with influenza. However, COVID-19 lungs also had evidence of notable blockage of the vessels with rampant new vascular…

Viral and host factors related to the clinical outcome of COVID-19

In this study of 326 patients with laboratory-confirmed SAR-CoV-2 infection in Shanghai, severe disease was more likely to be associated with host factors than with viral characteristics. Older age, reduced levels of CD4+ and CD8+ T cells, and elevated levels…

SARS2-CoV-2 and Stroke in a New York Healthcare System

Coagulopathy has been identified as an important manifestation of COVID-19. This fairly small study of ischemic stroke patients showed greater stroke severity and higher mortality among those who were infected with SARS-CoV-2 relative to those who were not. More than…

Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study

The results of this study add to a growing body of literature suggesting that elevated levels of proinflammatory cytokines, such as IL-6, and markers of thrombosis, such as D-dimer, influence severe clinical presentation and mortality due to COVID-19, although there…

Acute heart failure in multisystem inflammatory syndrome in children (MIS-C) in the context of global SARS-CoV-2 pandemic

Emerging evidence suggests a multisystem inflammatory syndrome in children infected with SARS-CoV-2 that can cause critical illness. However, overall risks of severe illness and mortality in pediatric cases of COVID-19 remain low compared to those in adults. This case series…

Analysis of the infection status of the health care workers in Wuhan during the COVID-19 outbreak: A cross-sectional study

In this descriptive study, health care workers (HCW) had higher rates of infection but a lower case fatality rate than the general population. HCW in general hospitals had a higher infection rate than those at specialty or community hospitals. Results…

Acute pulmonary embolism and COVID-19

In this case series from Michigan, the authors report a high prevalence of pulmonary embolism among COVID-19 patients who received CT angiography, particularly among obese patients. This adds to the growing body of evidence of hypercoagulability and thrombotic complications in…

An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study

This study documented a significantly elevated incidence of Kawasaki-like disease among children in a northern Italian hospital during the COVID-19 epidemic, and detected SARS-CoV-2 antibodies in 80% of these cases. Compared to the prior 5-year period, children presenting with Kawasaki-like…

Variation in False-Negative Rate of Reverse Transcriptase Polymerase Chain Reaction–Based SARS-CoV-2 Tests by Time Since Exposure

Because RT-PCR tests for COVID-19 are often used to rule out infection, it is important to understand how good these tests are. The high false negative rate within the first few days post-infection means caution must be exercised when telling…

Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19

The authors present COVID-GRAM, a web-based application that aims to predict incident critical illness among patients hospitalized for COVID-19. Considering several limitations, including bias due to overfitting, and the need for validation in settings outside of China, the risk score…

Clinical Characteristics and Outcomes of Hospitalized and Critically Ill Children and Adolescents with Coronavirus Disease 2019 (COVID-19) at a Tertiary Care Medical Center in New York City

In a small case series from New York, a sizable proportion of children presenting to hospital for SARS-CoV-2 testing required admission and ICU care. Further study is needed to understand what proportion of all infected children develop clinical disease.

Characteristics and Outcomes of Children With Coronavirus Disease 2019 (COVID-19) Infection Admitted to US and Canadian Pediatric Intensive Care Units

Most children admitted to intensive care for COVID-19 had significant underlying health conditions, and many had complex developmental and/or congenital disorders. 2 of 18 children requiring mechanical ventilation died by the end of follow-up, though 7 remained hospitalized. This proportion…

Characteristics and Clinical Outcomes of Adult Patients Hospitalized with COVID-19 – Georgia, March 2020

In this study from mostly metropolitan Atlanta, Black patients represented a higher-than-expected proportion of COVID-19 hospitalizations, but were not more likely to die or receive invasive mechanical ventilation than a combined group of non-Black patients. These patterns should continue to…

Clinical course of severe and critical COVID-19 in hospitalized pregnancies: a US cohort study

This study of 64 pregnant women with severe and critical COVID-19 in the US from May 2020, provides evidence that their disease course was similar to that reported among nonpregnant populations. Half of women with severe disease were discharged by…

Hyperinflammatory shock in children during COVID-19 pandemic

This small case series from the UK identified an unusual cluster of cases of acute inflammatory shock, resembling atypical Kawasaki disease, in children, most of whom were of Afro-Caribbean descent. Many of these children had exposure to known cases of…

Acute Liver Injury in COVID-19: Prevalence and Association with Clinical Outcomes in a Large US Cohort

This retrospective cohort study documented increased prevalence of acute liver injury (ALI) among patients who tested positive for SARS-CoV-2 infection versus those testing negative in New York from March 8 to April 14, 2020. Among patients testing positive, elevated alanine…

Autopsy findings and venous thromboembolism in patients with COVID-19

In a small autopsy series of patients dying with COVID-19, pulmonary emboli and deep vein thromboses were frequently found, even in patients without suspected clot burden. This adds important data to recent evidence of hypercoagulability in COVID-19, and adds support…

Clinical Characteristics and Outcomes of Coronavirus Disease 2019 Among Patients with Preexisting Liver Disease in the United States: A Multicenter Research Network Study

This retrospective cohort study from the early phase of the pandemic (January-April 2020) showed that signs of new onset liver injury were common across US patients with COVID-19 disease, and patients with preexisting liver disease, especially cirrhosis, were at greater…

Prevalence and Clinical Presentation of Health Care Workers With Symptoms of Coronavirus Disease 2019 in 2 Dutch Hospitals During an Early Phase of the Pandemic

Within 2 weeks of the first Dutch case of COVID-19, 14% of health care workers at 2 hospitals reported symptoms of COVID-19 and were tested. Eighty-six people (6% of those tested) tested positive for SARS-CoV-2. The health care workers presented…

Renin-Angiotensin-Aldosterone System Blockers and the Risk of COVID-19

This study adds valuable evidence that ACE inhibitors and angiostatin receptor blockers, two antihypertensive medications, are not associated with a heightened risk of COVID-19 or severe clinical illness.

Renin-Angiotensin-Aldosterone System Inhibitors and Risk of COVID-19

In a large study from New York, patients with hypertension taking ACE inhibitors and ARBs were neither more susceptible to SARS-CoV-2 infection nor more likely to experience a severe disease once infected. In conjunction with Mancia et al. (2020), this…

Cardiovascular Disease, Drug Therapy, and Mortality in COVID-19

This article has been retracted due to concerns over data veracity

Clinical and Epidemiological Characteristics of 1,420 European Patients with mild-to-moderate Coronavirus Disease 2019

This study highlights the prevalence and duration of several key symptoms in a moderately sized sample of patients with mild-to-moderate COVID-19 (not requiring admission to ICU). Symptom presentation differed by age and sex. Similar to recent studies, loss of smell…

Gender-Based Disparities in COVID-19: Clinical Characteristics and Propensity-Matched Analysis of Outcomes

This study was available in preprint and thus was not yet peer-reviewed. Among a large cohort of individuals diagnosed with COVID-19 in a multi-site, international, electronic medical record database (TriNetX), men had a higher risk for mortality, hospitalization, and mechanical…

Large-Vessel Stroke as a Presenting Feature of COVID-19 in the Young

Emerging evidence suggests that coagulopathy and vascular dysfunction are a significant complications of COVID-19. This small study provides clinical and laboratory characterizations of 5 COVID-19 patients less than 50 years old who presented with large-vessel ischemic stroke. This exploratory evidence…

Renal Involvement and Early Prognosis in Patients with COVID-19 Pneumonia

This study showed that renal injury was common among patients hospitalized for COVID-19 in hospital in Wuhan, China, particularly for those with severe or critical pneumonia, and was associated with mortality. The fact that the majority of patients developed AKI…

Pulmonary Embolism in COVID-19 Patients: Awareness of an Increased Prevalence

COVID-19 patients in the ICU may be at increased risk for pulmonary embolism, which has the potential to worsen individual prognosis if not identified and managed appropriately. Despite the study’s small sample and potential for selection bias due to differences…

Chilblain-like lesions on feet and hands during the COVID-19 Pandemic

Physicians should keep an eye out for chilblain-like lesions on toes and fingers, as these may be a late presentation of COVID-19, or may help with diagnosis of COVID-19 in otherwise asymptomatic persons. Persons presenting with these skin-like lesions should…

Coronavirus disease 2019 (COVID-19) in pregnant women: A report based on 116 cases

COVID-19 outcomes among pregnant women in China did not appear to be more severe in this study than among the wider population. Risks of spontaneous abortion and preterm birth did not appear to be elevated with SARS-CoV-2 infection, but background…

Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

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1.4: Risk Factors and Levels of Disease Prevention

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• Kelly Falcone
• Palomar College

What is a Risk Factor?

Part of learning how to take charge of your health requires understanding your risk factors for different diseases. Risk fac­tors are things in your life that increase your chances of getting a certain disease. Some risk factors are beyond your control. You may be born with them or exposed to them through no fault of your own.

Some risk factors that you have little or no control over include your:

• Family history of a disease
• Sex/gender — male or female

Some risk factors you can control include:

• What you eat
• How much physical activity you get
• Whether you use tobacco
• How much alcohol you drink
• Whether you misuse drugs

In fact, it has been estimated that almost 35 percent of all U.S. early deaths in 2000 could have been avoided by changing just three behaviors:

• Stopping smoking
• Eating a healthy diet (for example, eating more fruits and vegetables and less red meat)
• Getting more physical activity

You can have one risk factor for a disease or you can have many. The more risk factors you have, the more likely you are to get the disease. For example, if you eat healthy, exercise on a regular basis, and control your blood pressure, your chances of getting heart disease are less than if you are diabetic, a smoker, and inactive. To lower your risks, take small steps toward engaging in a healthy lifestyle, and you’ll see big rewards.

People with a family health history of chronic disease may have the most to gain from making lifestyle changes. You can’t change your genes, but you can change behaviors that affect your health, such as smoking, inactivity, and poor eating habits. In many cases, making these changes can reduce your risk of disease even if the disease runs in your family. Another change you can make is to have screening tests, such as mammograms and colorectal cancer screening. These screening tests help detect disease early. People who have a family health history of a chronic disease may benefit the most from screening tests that look for risk factors or early signs of disease. Finding disease early, before symptoms appear, can mean better health in the long run.

Levels of Disease Prevention

Prevention includes a wide range of activities — known as “interventions” — aimed at reducing risks or threats to health. You may have heard researchers and health experts talk about three categories of prevention: primary, secondary and tertiary. What do they mean by these terms?

Primary prevention aims to prevent disease or injury before it ever occurs. This is done by preventing exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviors that can lead to disease or injury, and increasing resistance to disease or injury should exposure occur. Examples include:

• legislation and enforcement to ban or control the use of hazardous products (e.g. asbestos) or to mandate safe and healthy practices (e.g. use of seatbelts and bike helmets)
• education about healthy and safe habits (e.g. eating well, exercising regularly, not smoking)
• immunization against infectious diseases.

Secondary prevention aims to reduce the impact of a disease or injury that has already occurred. This is done by detecting and treating disease or injury as soon as possible to halt or slow its progress, encouraging personal strategies to prevent reinjury or recurrence, and implementing programs to return people to their original health and function to prevent long-term problems. Examples include:

• regular exams and screening tests to detect disease in its earliest stages (e.g. mammograms to detect breast cancer)
• daily, low-dose aspirins and/or diet and exercise programs to prevent further heart attacks or strokes
• suitably modified work so injured or ill workers can return safely to their jobs.

Tertiary prevention aims to soften the impact of an ongoing illness or injury that has lasting effects. This is done by helping people manage long-term, often-complex health problems and injuries (e.g. chronic diseases, permanent impairments) in order to improve as much as possible their ability to function, their quality of life and their life expectancy. Examples include:

• cardiac or stroke rehabilitation programs, chronic disease management programs (e.g. for diabetes, arthritis, depression, etc.)
• support groups that allow members to share strategies for living well
• vocational rehabilitation programs to retrain workers for new jobs when they have recovered as much as possible.

Contributors and Attributions

CC licensed content, Shared previously

• Disease Prevention. Authored by : Institute for Work & Health. Located at : https://www.iwh.on.ca/wrmb/primary-secondary-and-tertiary-prevention . License : CC BY-NC-ND: Attribution-NonCommercial-NoDerivatives

Public domain content

• Risk Factors. Authored by : womenshealth.gov. Provided by : U.S. Department of Health and Human Services, Office on Women's Health. Located at : www.womenshealth.gov/files/a...th-english.pdf. License : Public Domain: No Known Copyright

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Slides | 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease

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Description: Slides | 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease

Date: March 17, 2019    

Keywords: Antihypertensive Agents, Platelet Aggregation Inhibitors, Atherosclerosis, Atrial Fibrillation, Blood Pressure, Cholesterol, Cardiac Imaging Techniques, Multidetector Computed Tomography, Vascular Calcification, Diabetes Mellitus, Diet, Exercise, Heart Failure, Hypertension, Hypertension, Pulmonary, Life Style, Risk Reduction Behavior, Lipids, Obesity, Overweight, Motor Activity, Primary Prevention, Risk Assessment, Risk Factors, Decision Making, Smoking, Smoking Cessation, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Patient Care Team, Body Weight Changes, Tobacco, Secondary Prevention

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How to Make Risk Management Presentations Engaging and Actionable Across Your Organization

Life is full of risk. We face risks from the moment we wake up in the morning until we fall asleep at night. Will the alarm fail to sound? Will I get into a car accident on my way to work? Will I catch a virus when I go to dinner? Heck, there’s a risk— no matter how small— that we will die in our sleep during each night.

Risk is simply an inherent element of everything we do, and business is no exception. Will a vital employee quit, or will there be a labor shortage? What will happen in the stock market, and how will it impact the economy? What if there is an accident or a lawsuit involving the company? What happens if a new product fails? What actions will be taken in the event of a security breach or equipment failure?

We might not be able to prevent risk, but we can manage it. Managing business risk requires identifying and understanding risks while seeking ways to reduce risk in a way that also supports other business goals.

Companies heavily invest every year in ways to mitigate and respond to risk. But how do they make sure everyone is on board? 

There might be a variety of ways to communicate a risk management plan to all the relevant players, but a visual presentation can be effective in not only presenting the risk management plan, but also ensuring that it is engaging and actionable across your organization.

What to include when you prepare a risk management plan:

A written risk management plan for business should not only include a listing of possible risks, but it also should feature plans to manage risk and respond to incidents.

• Identify risks

Risk management refers to a variety of business aspects, both internal weaknesses, and external threats. Like much in life, knowing is half the battle, and therefore identifying risks is key in addressing them. 

Risk management should be considered before embarking on any new task or project, and everyone connected to a business should be encouraged to identify additional risks. Not only should the risk itself be considered, but companies also should identify possible consequences to better prepare to address each one.

• Minimize risks

A variety of strategies are available to manage and minimize risks once they are identified. One popular method of mitigating risk involves the 4Ts:

• Transfer risk by assigning a responsible team or party to each identified risk.
• Tolerate risk by monitoring it before taking further action.
• Treat risk by taking actions that reduce the likelihood that it will occur.
• Terminate risk by adopting or amending processes that eliminate it.
• Assign roles

Staff members should be assigned to each potential risk or risk category. These individuals will be responsible for mitigating their assigned risks, as well as reporting and responding to applicable incidents. A list of these roles should be included in the risk management plan.

• Plan recovery

Each risk included in the management plan must be followed by a strategy for preventing and addressing issues. An effective risk management plan will include a compilation of business projects, the risk applicable to each and an operational plan to respond and recover from incidents. Part of that plan also should include updating mitigation efforts following an incident to prevent it from repeating.

• Communicate plan

A risk management plan can’t be effective unless everyone within a company is on board. In addition to presenting the plan to principle players, be sure that it is also published somewhere that the full risk management plan can be accessed and understood by anyone within the company at any time.

• Rinse and repeat

The most effective risk management plans are living documents, continually updated with new or changed risks and new strategies to address them. Each risk outlined in the plan should be periodically reevaluated and new risks identified. The plan also should be monitored along with staff turnover to ensure no tasks fall through the cracks.

Tips to make risk management presentations engaging and actionable across your organization:

Audience engagement is vital to a successful risk management training presentation. After all, if staff and executives are asleep they will hardly become familiar with the plan and their assigned roles.

• Include visual assets

About 90 percent of human thought is visually-based. Therefore, it’s no shocker that including visual assets within a presentation is one of the most effective strategies for engaging all types of audiences . 

Releasing the risk management plan through a visual presentation is a great start, but the content within the slide deck is just as important. After all, the average PowerPoint slide includes 40 words , which is entirely too many. Instead, include more images, videos and animations within a financial risk management presentation or any other risk management training presentations.

• Illustrate data

Data is one of the most convincing sorts of content that can be presented to an audience. As anyone can attest— at least in most cases— numbers don’t lie. In fact, they can tell their own stories. A crowded slide full of stats and figures is a quick way to send your audience off to Dreamland. 

Instead, illustrate your data through infographics. Beautiful.ai offers a host of various infographics through our smart slide templates. Just input your data and watch our artificial intelligence-powered presentation software design the infographic accordingly. Choose from infographics like scattergraphs , process diagrams , pie charts and bar graphs to tell the story of different risks and strategies to address them.

• Tell a story

According to the 2018 State of Attention survey, almost 90 percent of respondents said a strong narrative or story backing a presentation is critical in maintaining audience engagement. Sure, facts and data can persuade audiences and get them on board, but only if people are paying attention. 

Stories have kept audiences engaged since before recorded history. Tell the story of your risk management plan by including real-life examples or by creating a character for hypothetical scenarios. Those unsure how to incorporate a story into the structure of their presentation can look to Beautiful.ai’s various presentation templates for inspiration.

• Include your audience

If you really want to keep your audience engaged with your risk management presentation slides, be sure you talk with people, not at them. Include your audience in your presentation by asking questions, taking surveys or presenting group activities. Of course, the first step is identifying who makes up that audience. You won’t necessarily present the same content to an executive board as to a room full of new hires.

One effective way to engage an audience with a risk management plan presentation from the very start is through a pre-presentation quiz or survey that gauges how much participants already know about risk management, like this example from the U.S. Small Business Association. Not only will the activity engage the audience, but it will alert participants to what they don’t know from the very start. Other engagement tools include Q&A sessions, humor and gamification.

As mentioned, the average PowerPoint slide consists of 40 words… way too many to keep audiences engaged. Remember, your presentation should be based on an outline of your plan, not a verbatim recitation of it. 

Not only are uncluttered slides more effective, but shorter presentations also are more effective than longer ones, based on both audience attention and respect for time. Especially when delivering a risk management board presentation, it’s vital to respect your audience’s time. Beautiful.ai’s library of presentation templates can serve as a guideline to effective presentation lengths for a variety of topics.

Samantha Pratt Lile

Samantha is an independent journalist, editor, blogger and content manager. Examples of her published work can be found at sites including the Huffington Post, Thrive Global, and Buzzfeed.

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Home PowerPoint Templates Business PowerPoint Templates Business Risk Factors PowerPoint Template

Business Risk Factors PowerPoint Template

Showcase and discuss your business risk factors using our Business Risk Factors PowerPoint Template . Considering risks is crucial to guarantee the sustenance of any business organization. And these risk factors have a long list ranging from in-house raw material spillage to government policies. Business executives design practical strategies to mitigate such risks ensuring minimum or no loss. This PPT template provides an editable layout to present those risks. Professionals can use this layout for strategic planning and team presentations to discuss internal and external risk factors. Risk management consultants can also employ this template to suggest strategic steps corresponding to impending risks.

The Business Risk Factors PowerPoint Template has two slide layouts. A rocket launch illustration is used, which represents rapid growth and development. On the first slide, two three-segment columns are created on either side of the central rocket diagram. The left-hand side section represents the internal factors (the organization’s human capital, technology, and physical assets of the business). Similarly, the right side shows the external risk factors (economic risks, natural risks, and political risks). Presenters can conveniently edit the risk factor titles according to their business structure. The second slide design has an engaging design of a rocket launch. It shows the rocket launch attached to the internal & external factor segments. This infographic scene depicts how business growth is associated with these risk factors. 

Users can adjust the color scheme of the rocket diagram and the editable segments. Likewise, the font styles and titles can be personalized to match the presentation topic. This business risk factors template helps communicate the risk factors before different departments. It can also be re-purposed to showcase key strategy points in marketing or business presentations. Both slides are fully compatible with all PowerPoint versions, Google Slides, and Keynote. Download and try this template now!

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5 Examples of Risk Matrix PowerPoint Visualization

Last Updated on February 21, 2024 by Anastasia

One way to perform and document a risk analysis and assessment is using the risk matrix diagram. This simple visualization matrix is a management method that helps you present possible risks, and define the risk levels. As a result, you can support management decision-making and plan activities to mitigate those risks.

Explore our Business Performance PPT Reports category on the website for more resources to boost your presentation impact.

If you don’t invest in risk management, it doesn’t matter what business you’re in, it’s a risky business. Gary Cohn

Risk Matrix analysis can be easily visualized in a PowerPoint presentation. Your presentation will look more creative if you use a consistent and clear risk matrix diagram for visualization of the new company’s competitors or changes in government policy.

Remark: You can get all presented icons and slide examples in the Risk Matrix Diagram PPT set .

This visual framework is part of other management strategy tools such as SWOT, Porter Forces, and PEST. You may check this article “ 7 Visual Frameworks for Strategy Analysis Presentation ” for more examples.

Why use a Risk Matrix?

The purpose of risk management is to anticipate and control risks so as to minimize their threats and maximize their potential. The risk matrix diagram will help you to create a memorable presentation of those risks. Using a diagram illustration you can visualize with colors all risk categories and focus attention on the main subject. Risk Matrix graphics can be handy presenters who need to show risk assessment or different states of consequence process.

In this blog, we propose examples of creating and presenting risk matrix diagrams , which will help you to make the possible risks visible.

You’ll find a few variations of showing the Risk Matrix Diagram on the slide:

• showing risk types in the form of a list
• illustrating levels of probability and impact
• presenting probability and severity risk levels
• creating a risk matrix with a place for notes

Let’s start our journey over the Risk Matrix Diagram illustrations examples. See how you can show it creatively so that your audience will be focused on your presentation.

#1: Presenting Types of Risk with Creative Bullet Points

In the beginning, you may want to introduce types of risk:

• Economic risk
• Social risk
• Risk related to the use of various technological advancements
• Risk related to natural forces, so unpredictable sometimes
• Political risks covering country leaders’ actions, various lobbying on a government level, federal agencies regulations, etc.

But instead of putting those risks as a standard bullet point list, consider the example below: The first and easiest way to show various types of risk – use a simple list. This diagram includes all kinds of risks, illustrated with icons and colors. The icons for each stage will help your listeners to focus their attention on one or another point.

 #2: Illustrating Risk Probability and Impact

The next example is a typical risk matrix diagram, consisting of 4 parts. Each of them includes an eye-catching icon, therefore it can be employed for any audience: starting from students to your business partners.

#3: Adding Description to Risk Matrix

This type of risk matrix slide includes a place for the description of each point of risk. The advantage of this diagram is various symbols that illustrate emotions, so you can easily show risk analysis results.

#4: Showing Risk Probability and Severity Levels

This full-slide risk matrix diagram will help you to conduct a detailed analysis. You can identify your severity and probability risks. A colorful matrix will help you show all levels of risk:  low, medium, and high. With such a diagram template, you can easily illustrate the most dangerous risks and keep listeners attention on it.

#5: Creating Risk Matrix in Minimalist Style

If you like minimalism in your slides, then you can choose such type of risk matrix: white rectangles with colored outlines and simple icons.

Recap of four presented Risk Matrix visualizations

We presented here a bunch of ideas on how you can talk about risk without boring your audience with text-only slides. Get inspired by the examples we mentioned:

• agenda for showing all types of risk
• diagram with a minimalist style with the icons of emotions
• showing risk severity and probability in a big matrix with hand-drawn symbols
• templates for illustrating risk probability and impact

Why use diagrams for the risk matrix concept?

A risk matrix diagram is a simple mechanism to increase the visibility of risks. It is a basic management tool that is useful for strategic planning. Risk provides the objective metric to help the decision-making process. That’s why the risk matrix has been widely adopted by many businesses. The risk matrix diagram focuses on the highest-priority risks and presents complex risk data in a visual chart. 

What’s inside the Risk Matrix Template collection?

We created a collection of risk matrix diagrams in various versions and added iconic symbols for 5 types of risk. All icons are fully editable, so you can change their color and resize them without losing the image quality.

The slide set contains:

13 Matrix PPT Slide Layouts for Two-Dimensional Risk Assessment:

• Explanation of the risk matrix concept.
• Diagrams for 2×2, 3×3, and 5×5 matrices with description areas.
• 30 icons for various 5 types of risk, risk severity, and risk probability levels, in flat and handwritten styles.

All examples above are part of the infoDiagram PowerPoint Diagrams collection. It contains vector graphics that can be easily edited and added to other presentations:

Risk Matrix Diagram

Explore our YouTube channel for more creative ideas:

2 thoughts on “5 Examples of Risk Matrix PowerPoint Visualization”

Brilliantly executed read about the Risk Matrix. The slide show is a great visual aid.

thanks Jennifer! We’re glad our blog is useful for you.

Comments are closed.

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Deliver this complete deck to your team members and other collaborators. Encompassed with stylized slides presenting various concepts, this Cobot Safety And Risk Factors Powerpoint Presentation Slides is the best tool you can utilize. Personalize its content and graphics to make it unique and thought-provoking. All the fifty five slides are editable and modifiable, so feel free to adjust them to your business setting. The font, color, and other components also come in an editable format making this PPT design the best choice for your next presentation. So, download now.

Presenting potential risk factors in a marketing plan example ppt presentation. This is a potential risk factors in a marketing plan example ppt presentation. This is a four stage process. The stages in this process are risk, opportunism, strategy alliances, strategy.

This slide depicts the major factors that influences the sales performance of a company. It includes pie chart with weightage showing initial risks like shortage of raw material, increase in price. Introducing our Analysis Of Risk Factor Influencing Sales Performance set of slides. The topics discussed in these slides are Analysis, Risk Factor, Influencing Sales Performance. This is an immediately available PowerPoint presentation that can be conveniently customized. Download it and convince your audience.

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The information presented in this slide has been researched by our team of professional business analysts. This is part of our Company Profiles products selection, and you will need a Paid account to download the actual report with accurate data and sources. Downloaded report will be in Powerpoint and will contain the actual editable slides with the actual data and sources for each data. This slide provides key risk factors competition, business model, regulations etc. of Papa Johns International, Inc in the year 2018. Download it immediately and use it for your business.

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The following slide showcases the factors indicating towards firms insolvency. The factors covered are continued losses, inability to get funds from bank, unable to pay taxes, creditors demanding COD and legal problems. Presenting our set of slides with name Potential Risk Factors Indicating Company Insolvency. This exhibits information on five stages of the process. This is an easy-to-edit and innovatively designed PowerPoint template. So download immediately and highlight information on Legal Problems, Continued Losses, Unable To Pay Taxes.

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• v.2(6); 2013 Dec

Pulmonary Embolism in Ischemic Stroke: Clinical Presentation, Risk Factors, and Outcome

Jitphapa pongmoragot.

1 Stroke Outcomes Research Center, Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, , Ontario, Canada (J.P., G.S.)

Alejandro A. Rabinstein

2 Department of Neurology, Mayo Clinic, , Rochester, MN (A.A.R.)

Yongchai Nilanont

3 Siriraj Hospital, Division of Neurology, Department of Medicine, Mahidol University, , Bangkok, Thailand (Y.N.)

Richard H. Swartz

4 Sunnybrook Hospital, Division of Neurology, Department of Medicine, University of Toronto, , Ontario, Canada (R.H.S.)

5 Institute for Clinical Evaluative Sciences (ICES), , Toronto, Ontario, Canada (L.Z.)

Gustavo Saposnik

6 Li Ka Shing Knowledge Institute, St. Michael's Hospital, , Toronto, Ontario, Canada (G.S.)

7 Institute of Health Policy, Management and Evaluation (iHPME), University of Toronto, , Ontario, Canada (G.S.)

Limited information is available on the frequency of pulmonary embolism (PE) in patients with an acute ischemic stroke (AIS). We evaluated clinical characteristics, predisposing factors, and outcomes in AIS patients with PE.

Methods and Results

We included all AIS patients admitted to participating institutions in the Registry of the Canadian Stroke Network. Clinically PE was documented by a physician and confirmed by computed tomography pulmonary angiography within 30 days of the stroke case index. The primary outcome was death or disability at discharge. Secondary outcomes included disposition, length of hospital stay, mortality at 3 months and 1 year. Among 11 287 patients with AIS, PE was found in 89 (0.78%) patients. History of cancer, deep vein thrombosis (DVT)/PE, and DVT during the hospitalization were associated with PE. PE was associated with higher risk of death at 30 days (25.8% versus 13.6%; P <0.001), at 1 year (47.2% versus 24.6%; P <0.001), and disability at discharge (85.4% versus 63.6%; P <0.001). Mean length of stay was longer in stroke patients with PE (36 versus 16 days; P =0.001). After adjusting for age, sex, and stroke severity, PE remained associated with lower survival at 30 days and 1 year, and death or disability at discharge (OR 3.02; 95% CI 1.56 to 5.83).

Conclusions

In this large cohort study, PE occurred in nearly 1% of AIS patients. PE was more common in patients with severe stroke, history of cancer, previous DVT/PE or acute DVT and associated with lower short‐ and long‐term survival, greater disability, and longer length of stay.

Introduction

Stroke is a leading cause of death and disability. Medical complications after ischemic stroke contribute substantially to poor stroke outcomes. 1 – 6 Pulmonary embolism (PE) is a serious medical condition with an annual incidence rate of 0.50 to 0.69 per 1000 persons in the general population. 7 – 8 PE carries a high mortality with case fatality at 3 months ranging between 8.6% and 17%. 9 – 10 Longer‐term mortality can be as high as 24%. 11 The risk of PE, including fatal cases, in patients with acute ischemic stroke (AIS) is well known but insufficiently examined. 3 , 12 Studies of in‐hospital complications after stroke have often used the combined category of venous thromboembolism (VTE), thus grouping PE with deep venous thrombosis (DVT). 13 In the general medical population, immobility, older age, smoking, hypertension, thrombophilia, and cancer are commonly reported risk factors of PE. 14 All these factors are frequent in AIS patients; yet, no studies have analyzed how they influence the risk of PE specifically in the AIS population. Limited information is available on the impact of PE on stroke outcomes.

The aim of our study was to assess clinical characteristics, risk factors, and relevant clinical outcomes in patients who developed a PE within 30 days after an AIS.

We collected data from the Registry of the Canadian Stroke Network (RCSN). The RCSN is a clinical database of consecutive acute stroke patients admitted to 12 stroke centers in Ontario, Canada from July 1, 2003 to June 30, 2008 that has been collected for the purposes of monitoring quality of stroke care.

Study Design and Data Collection

Patients aged 18 years and older with an AIS were included in this analysis. For the purpose of this study, we excluded patients missing a unique health identifier (n=1518) and those with a transient ischemic attack (TIA) (n=268) or hemorrhagic stroke (n=290) as these represent distinct populations. Details of the RCSN can be obtained from http://www.rcsn.org . The cause of poststroke mortality was obtained through linkages of the Ontario Registered Persons Database (RPDB) at the Institute for Clinical Evaluative Sciences. The RPDB is a population‐based administrative database that includes basic demographic data and date of death, and provides complete follow‐up for all residents in the province. Stroke was diagnosed by a physician, and each patient had CT or MRI to confirm diagnosis and rule out other causes of stroke. We recorded demographic data as well as clinical variables including vascular risk factors, past medical history of chronic obstructive pulmonary disease (COPD), cancer, pulmonary embolism, DVT, prothrombotic state, stroke types, Canadian neurological scale (CNS), iScore, 15 – 16 and laboratory on arrival. Prothrombotic states, including antiphopholipid antibody syndrome (APA)/lupus anticoagulant, hyperhomocysteinemia, Protein C or S deficiency, Factor V Leiden, and prothrombin gene mutation were identified from laboratory reports or hematology consult. Patients with history of VTE, cryptogenic stroke, or stroke at young age received these investigations. Clinically suspected PE was defined by documented physician diagnosis and confirmed by CT pulmonary angiography within 30 days of admission at hospital.

Outcome Measures

The primary outcome was death or disability at discharge defined as the modified Rankin scale ≥3. Secondary outcomes included disposition status, length of hospital stay (LOS), and death at 3 months and at 1 year.

Statistical Analysis

Chi squared tests were used to compare categorical variables, and analysis of variance (ANOVA) or Kruskal–Wallis tests were used to compare mean and median differences for continuous variables. As differences may be significant but not clinically meaningful, we used standardized differences to compare baseline characteristics between those with and without PE. Standardized differences reflect the mean difference as a percentage of the standard deviation. Effect sizes greater than 0.1 are typically felt to be clinically meaningful. 17 Multivariate logistic regression analysis using backward selection was used to identify variables associated with the occurrence of PE and poor outcomes in ischemic stroke patients. Survival function is represented using Kaplan Meyer curves with differences between groups using the log‐rank test. Statistical analysis was performed using SAS statistical software version 9.2.2 (SAS Institute Inc). All tests were 2‐tailed, and P values <0.05 were considered significant. Approvals from the St. Michael's Hospital review board and the RCSN Publications Committee were obtained.

Overall, there were 11 287 patients with AIS included in the study. PE within 30 days after admission at hospital was found in 89 (0.78%) patients. AIS patients with PE were most common (53.9%) in the age group ranging 60 to 79 years. Differences in baseline characteristics between stroke patients with and without PE are represented in Table 1 . AIS patients with PE were more likely to have history of cancer (29.2% versus 9.9%, P <0.001), previous DVT/PE (10.1% versus 2.7%, P <0.001), and documented prothrombotic state (4.5% versus 0.6%, P <0.001) as compared to patients without PE. Patients with PE were also likely to have a more severe stroke (CNS≤4.5: 30.3% versus 17.6%, P <0.001) and coma 5.6% versus 3.1%, P <0.001). No difference was found in stroke subtypes, iScore, or rates of intravenous recombinant tissue plasminogen activator (rtPA) administration between PE and non‐PE groups. DVT during hospitalization was diagnosed in 0.9% of AIS patients without PE and in 36% of stroke patients with PE ( P <0.001). DVT, cancer, and prothrombotic state were the only 3 variables with P values <0.05 and standardized differences > 0.1, suggestimg that they were clinically meaningful. In the multivariable analysis, age, sex, stroke severity, past history of cancer (OR 3.25, 95% CI 1.94 to 5.45, P <0.0001), past history of DVT/PE (OR 2.41, 95% CI 1.07 to 5.42, P =0.03), and the development of in‐hospital DVT (OR 71.3, 95% CI 42.5 to 119.5, P <0.0001) were significant factors associated with PE.

Clinical Characteristics of Patients With and Without PE

Number between brackets indicate percentages, unless otherwise indicated. To preserve patients' identity, cell with number (%) of patients <5 are not reported. P value <0.05 significant. COPD indicates chronic obstructive pulmonary disease; DVT, deep venous thrombosis; PE, pulmonary embolism; rtPA, recombinant tissue plasminogen activator; SD, standardized difference.

Overall, 1446 (12.8%) ischemic stroke patients died during the hospitalization. Higher in‐hospital mortality was found in stroke patients with PE (31.5% versus 12.7%, P <0.001). Total death and disability at discharge (mRS≥3) was significantly higher among AIS with PE compared to those without PE (85.4% versus 63.6%, P <0.001) ( Table 2 , Figure 1 ). While the mean LOS was 16 days, patients with PE group had longer LOS (36 versus 16 days, P <0.001). AIS patients with PE were also more often discharged to long‐term care facilities (21.3% versus 10%, P <0.001) and rehabilitation institutions (37.7% versus 35.1%, P <0.001). Approximately, only 20% of AIS patients with PE were discharged home compared to 43.9% of those without PE ( P <0.001). In‐hospital complications and recurrent stroke within 30 days of admission, including ischemic and hemorrhagic stroke, were significantly more frequent in the PE group ( Table 2 ). Survival curves at 30 days and 1 year after the stroke case index are shown in Figures ​ Figures2 2 and ​ and3. 3 . In the multivariable analysis, PE (OR 3.02, 95% CI 1.56 to 5.83) was a significant predictor of poor outcome (mRS 3 to 6) ( Table 3 ) and lower survival at 30 days and 1 year (Figures ​ (Figures2 2 and ​ and3 3 ).

To preserve patients' identity, cell with number (%) of patients <5 are not reported. P value <0.05 significant. mRS indicates modified‐Rankin scale; SD, standard deviation.

Multivariate Analysis: Variables Associated With Poor Outcome (mRS 3 to 6) Among Ischemic Stroke Patients

Adjusted for age, sex, stroke severity, history of VTE, and cancer. Only significant variables are presented. P value <0.05 significant. CI indicates confidence interval; mRS, modified‐Rankin scale; OR, odds ratio.

Functional outcomes based on mRS at discharge in IS with and without PE. Note: Functional status was not known in 5 (1.1%) patients with PE and 45 (0.4%) patients without PE. IS indicates ischemic stroke; mRS, modified Rankin Scale; PE, pulmonary embolism.

Kaplan–Meier curves for 30‐day survival in patients with and without PE. Log‐rank test <0.0012. PE indicates pulmonary embolism.

Kaplan–Meier curves for 1‐year survival in patients with and without PE. Log‐rank test <0.0001. PE indicates pulmonary embolism.

In this large cohort study including 11 287 patients with AIS, we found PE in nearly 1% of cases. Patients with PE had higher rates of in‐hospital death (almost one‐third of patients with PE after AIS died in the hospital) and disability, higher case fatality at 30 days and 1 year, higher prevalence of in‐hospital complications, and longer LOS. One‐third of stroke patients with PE died during the hospitalization and only 1 in 5 patients were discharged home. PE was a predictor of poor outcomes after adjusting for age, stroke severity, and other comorbid conditions. Risk factors for PE in stroke patients included age, stroke severity, history of cancer, previous DVT/PE, or development of in‐hospital DVT.

The frequency of PE in AIS in our cohort is consistent with previous studies (0.2% to 0.8%). 2 – 3 , 2 – 19 Kelly et al 20 studied venous thromboembolism in AIS patients receiving aspirin and graded compression stockings for thromboprophylaxis and PE in 11.8% of patients. In other studies including cryptogenic stroke and patent foramen ovale, PE was found in up 20% to 37% of patients, though the great majority of these cases were asymptomatic and only recognized by dedicated testing required by the research design. 21 – 22

Risk factors of PE in the general population are well known, including age, obesity, immobility, cigarette smoking, hormonal replacement, pregnancy, previous medical illness (particularly PE or DVT, cancer, COPD, hypertension, amd congestive heart failure), stroke with limb paresis, thrombophilia, and recent surgery. 14 In our AIS cohort we found higher risk of PE among patients with history of cancer or DVT/PE. In addition, DVT during the acute hospitalization had the highest risk of PE. This is not surprising as stroke patients with an acute DVT during hospitalization are the ones at the highest risk. We found no difference in the distribution of stroke subtypes between patients with and without PE. Similar to other reports, we found AIS patients with PE had more severe strokes. 20

In the International Cooperative Pulmonary Embolism Registry (ICOPER) 9 study of clinical outcomes in 2110 patients with acute PE in a general population, the poor prognostic factors included > 70 years, cancer, congestive heart failure, COPD, systolic arterial hypotension, tachypnea, and right‐ventricular hypokinesis on echocardiography. Laporte et al 10 reported that the risk of death in patients with acute PE was associated with age >75 years, immobilization because of a neurologic disease, cardiac or respiratory disease, and cancer. Our study found that in patients with AIS complicated by PE, age of > 60 years and moderate‐to‐severe stroke severity (CNS<7.5) were associated with poor outcomes. In addition, PE was a predictor of poor outcomes after adjusting from relevant covariates.

The in‐hospital mortality rate in AIS patients with PE was 31.5% in our study, comparable with previous findings from Taiwan (35.7%) 23 and Germany (46.8%) 2 ; both including a substantially lower absolute number of stroke patients with PE. The 30‐day mortality rate of PE in AIS in our cohort was 25.8%, thus higher than the rates reported in association with PE in the general population (8.6% and 17%). 9 – 10 Long‐term mortality of PE in AIS patients (47.2%) was also higher than previous rates reported in cohorts of PE patients from the general population (24%). 11 It is noteworthy that barely 1 in 2 stroke patients with PE were alive at 1 year in our cohort.

PE is a potentially preventable complication after stroke. A review article suggests the coexistence of PE and pneumonia or PE misdiagnosed as pneumonia due to common risk factors and clinical presentations. PE accounts for the largest proportion of early death, highlighting the importance of thromboprophylaxis. 24 More recently, thromboprophylaxis has become one of the quality measures in acute stroke care. 25 Unfractionated heparin (UFH) and low‐molecular‐weight heparin (LMWH) reduce VTE after AIS. 26 – 27 The Clots in Legs Or sTockings after Storke (CLOT) 3 study reported the intermittent pneumatic compression reducing the risk of DVT in AIS with immobility. 28 The American Heart Association/American Stroke Association, 29 Canadian best practice recommendations for stroke care, 30 and the American College of Chest Physicians 31 clinical guideline for ischemic stroke management recommend prophylactic LMWH or UFH be administered to all immobilized patients with an absence of contraindications. In patients who cannot receive anticoagulants for DVT prophylaxis, the use of aspirin and intermittent external compression devices are reasonable. 29

Our study has some strengths and limitations that deserve comment. First, we had no information on factors that may have affected the risk of PE (eg, time to first mobilization, time of antithrombotics use). Second, we had limited information about the performance status of patients with cancer. Third, it is possible that the lack of association between some variables (eg, stroke subtype) could be due to the limited statistical power. Finally, information on the treatment during hospitalization for stroke patients with PE was not available. Despite these limitations, our study provides relevant information about specific risk factors for PE and the impact of PE on stroke outcomes. Other strengths include a large sample size, the adjustment for relevant covariates including stroke severity, and the near complete follow‐up of the patients.

In summary, PE is an uncommon but serious medical complication after an AIS. PE after stroke is associated with higher risk of death, worse disability, higher in‐hospital complications, and longer LOS. Our findings highlight the importance of ensuring compliance with thromboprophylaxis measures and guideline recommendations for patients with AIS. 29 – 31 The risk of PE is higher in older patients with more severe strokes, history of cancer or DVT/PE, or DVT during admission. Early recognition of predisposing conditions may help implement strategies for its early detection and the appropriate preventative measures aimed at improving the quality of stroke care.

Sources of Funding

This study was supported by the Institute for Clinical Evaluative Sciences, which is funded by an annual grant from the Ontario Ministry of Health and Long‐Term Care. The opinions, results and conclusions reported in this article are those of the authors and are independent from the funding sources. No endorsement by Institute for Clinical Evaluative Sciences or the Ontario Ministry of Health and Long‐Term Care is intended or should be inferred.

Disclosures

Dr Saposnik is supported in part by the Distinguished Clinician‐Scientist Award from the Heart and Stroke Foundation of Canada (HSFC).

Acknowledgments

These data sets were held securely in a linked, de‐identified form and analyzed at the Institute for Clinical Evaluative Sciences.