scholarly journals The impact of systematic assessment for adverse events on unscheduled hospital utilization in patients receiving neoadjuvant or adjuvant chemotherapy: A retrospective multicenter study

2021 ◽  
Author(s):  
Jwa Hoon Kim ◽  
Seyoung Seo ◽  
Jee Hyun Kim ◽  
Su‐Jin Koh ◽  
Yongchel Ahn ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Adverse Events ◽  
Multicenter Study ◽  
Hospital Utilization ◽  
Systematic Assessment ◽  
The Impact ◽  
Retrospective Multicenter Study

Tocilizumab in Giant Cell Arteritis: A Multicenter Retrospective Study of 34 Patients

2016 ◽  
Vol 43 (8) ◽  
pp. 1547-1552 ◽  
Author(s):  
Alexis Régent ◽  
Serge Redeker ◽  
Alban Deroux ◽  
Pierre Kieffer ◽  
Kim Heang Ly ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Side Effects ◽  
Adverse Events ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Multicenter Study ◽  
Efficacy And Safety ◽  
Severe Adverse Events ◽  
Retrospective Multicenter Study

Objective.To report the efficacy and safety of tocilizumab (TCZ) for giant cell arteritis (GCA).Methods.A retrospective multicenter study that included 34 patients receiving TCZ for GCA.Results.TCZ was effective in all but 6 patients, who still had mild symptoms. Mean glucocorticoid dose was tapered. One patient died and 3 patients had to stop TCZ therapy because of severe adverse events. Twenty-three patients stopped treatment; 8 of these experienced relapses after a mean of 3.5 ± 1.3 months.Conclusion.TCZ is effective in GCA. However, side effects occur. Whether this treatment has only a suspensive effect remains to be determined.

scholarly journals Effects of Relaxed Lockdown on Pediatric ER Visits during SARS-CoV-2 Pandemic in Italy

2021 ◽  
Vol 18 (18) ◽  
pp. 9547
Author(s):  
Luigi Matera ◽  
Raffaella Nenna ◽  
Francesca Ardenti Morini ◽  
Giuseppe Banderali ◽  
Mauro Calvani ◽  
...  
Keyword(s):  
Emergency Room ◽  
Multicenter Study ◽  
Preventive Measures ◽  
Pediatric Emergency ◽  
Communicable Diseases ◽  
Social Activities ◽  
Triage Category ◽  
The Impact ◽  
Retrospective Multicenter Study

Previously, we demonstrated an 81% reduction in pediatric Emergency Room (ER) visits in Italy during the strict lockdown due to the SARS-CoV-2 pandemic. Since May 2020, lockdown measures were relaxed until 6 November 2020, when a strict lockdown was patchily reintroduced. Our aim was to evaluate the impact of the relaxed lockdown on pediatric ER visits in Italy. We performed a retrospective multicenter study involving 14 Italian pediatric ERs. We compared total ER visits from 24 September 2020 to 6 November 2020 with those during the corresponding timeframe in 2019. We evaluated 17 ER specific diagnoses grouped in air communicable and non-air communicable diseases. We recognized four different triage categories: white, green, yellow and red. In 2020 total ER visits were reduced by 51% compared to 2019 (16,088 vs. 32,568, respectively). The decrease in air communicable diseases was significantly higher if compared to non-air communicable diseases (−64% vs. −42%, respectively). ER visits in each triage category decreased in 2020 compared to 2019, but in percentage, white and red codes remained stable, while yellow codes slightly increased and green codes slightly decreased. Our results suggest that preventive measures drastically reduced the circulation of air communicable diseases even during the reopening of social activities but to a lesser extent with regard to the strict lockdown period (March–May 2020).

scholarly journals Impact of surgical site infection on patients’ outcome after fixation of tibial plateau fractures: a retrospective multicenter study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ralf Henkelmann ◽  
Richard Glaab ◽  
Meinhard Mende ◽  
Christopher Ull ◽  
Philipp-Johannes Braun ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Tibial Plateau ◽  
Patient Reported Outcome ◽  
Tibial Plateau Fractures ◽  
Site Infection ◽  
Patient Reported ◽  
Outcome Scores ◽  
The Impact ◽  
Retrospective Multicenter Study

Abstract Background Surgical site infection (SSI) occurs in 3–10 % of patients with surgically treated tibial plateau fractures. This study aimed to evaluate the impact of SSI on patients’ outcome after fixation of tibial plateau fractures. Methods We conducted a retrospective multicenter study in seven participating level I trauma centers between January 2005 and December 2014. All participating centers followed up with patients with SSI. In addition, three centers followed up with patients without SSI as a reference group. Descriptive data and follow-up data with patient-reported outcome scores (Knee Injury and Osteoarthritis Outcome Score [KOOS] and Lysholm knee scoring scale score) were evaluated. Results In summary, 287 patients (41 with SSI and 246 without SSI; average 50.7 years) with an average follow-up of 75.9 ± 35.9 months were included in this study. Patients with SSI had a significantly poorer overall KOOS (KOOS5) (48.7 ± 23.2 versus [vs.] 71.5 ± 23.5; p < 0.001) and Lysholm knee scoring scale score (51.4 ± 24.0 vs. 71.4 ± 23.5; p < 0.001) than patients without SSI. This significant difference was also evident in the KOOS subscores for pain, symptoms, activities of daily living (ADL), and quality of life (QoL). SSI remained an important factor in multivariable models after adjusting for potential confounders. Clinically relevant differences in the KOOS5 and KOOS subscores for symptoms, pain, and ADL were found between those with SSI and without SSI even after adjustment. Furthermore, the number of previous diseases, Arbeitsgemeinschaft für Osteosynthesefragen Foundation (AO) C fractures, and compartment syndrome were found to be additional factors related to poor outcome. Conclusions Compared to previous studies, validated patient-reported outcome scores demonstrated that the impact of SSI in patients with surgically treated tibial plateau fractures is dramatic, in terms of not only pain and symptoms but also in ADL and QoL, compared to that in patients without SSI.

scholarly journals Clinical spectrum and risk factors for mortality among seawater and freshwater critically ill drowning patients: a French multicenter study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Florian Reizine ◽  
Agathe Delbove ◽  
Alexandre Dos Santos ◽  
Laetitia Bodenes ◽  
Pierre Bouju ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Multicenter Study ◽  
Psychiatric Comorbidity ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
Multicenter Cohort ◽  
Global Threat ◽  
The Impact ◽  
Retrospective Multicenter Study

Abstract Background Drowning is a global threat and one of the leading causes of injury around the world. The impact of drowning conditions including water salinity on patients’ prognosis remains poorly explored in Intensive Care Units (ICUs) patients. Methods We conducted a retrospective multicenter study on patients admitted to 14 ICUs in the west of France from January 2013 to January 2020. We first compared demographic and clinical characteristics at admission as well as clinical courses of these patients according to the salinity of drowning water. Then, we aimed to identify variables associated with 28-day survival using a Cox proportional hazard model. Results Of the 270 consecutive included patients, drowning occurred in seawater in 199 patients (73.7%) and in freshwater in 71 patients (26.3%). Day-28 mortality was observed in 55 patients (20.4%). Freshwater was independently associated with 28-day mortality (Adjusted Hazard Ratio (aHR) 1.84 [95% Confidence Interval (CI) 1.03–3.29], p = 0.04). A higher proportion of freshwater patients presented psychiatric comorbidities (47.9 vs. 19.1%; p < 0.0001) and the etiology of drowning appeared more frequently to be a suicide attempt in this population (25.7 vs. 4.2%; p < 0.0001). The other factors independently associated with 28-day mortality were the occurrence of a drowning-related cardiac arrest (aHR 11.5 [95% CI 2.51–52.43], p = 0.0017), duration of cardiopulmonary resuscitation (aHR 1.05 [95% CI 1.03–1.07], p < 0.0001) and SOFA score at day 1 (aHR 1.2 [95% CI 1.11–1.3], p < 0.0001). Conclusions In this large multicenter cohort, freshwater drowning patients had a poorer prognosis than saltwater drowning patients. Reasons for such discrepancies include differences in underlying psychiatric comorbidity, drowning circumstances and severities. Patients with initial cardiac arrest secondary to drowning remain with a very poor prognosis.

Surgical Minimally Invasive Pulmonary Vein Isolation for Lone Atrial Fibrillation

2013 ◽  
Vol 8 (6) ◽  
pp. 410-415 ◽  
Author(s):  
Gijs E. De Maat ◽  
Alberto Pozzoli ◽  
Marcoen F. Scholten ◽  
Hans L. Hillege ◽  
Isabelle C. Van Gelder ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Adverse Events ◽  
Minimally Invasive ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Multicenter Study ◽  
Long Term Results ◽  
Lone Atrial Fibrillation ◽  
Retrospective Multicenter Study

Objective Minimally invasive surgical pulmonary vein isolation (SMI-PVI) is an emerging therapy for the treatment of symptomatic drug-refractory atrial fibrillation (AF). Nevertheless, the midterm and long-term results of SMI-PVI remain unknown. The aim of this retrospective multicenter study was to report on midterm efficacy and safety of SMI-PVI. Methods The study design was retrospective, multicentric, and observational. From July 2005 to November 2011, a total of 86 patients with drug-refractory paroxysmal or persistent AF underwent SMI-PVI in three centers. Patients were eligible for SMI-PVI if they had symptomatic, drug-refractory AF or after failed transcatheter pulmonary vein isolation. Success was defined as absence of AF on 24- or 96-hour Holter monitoring during follow-up, in the absence of antiarrhythmic drugs (AADs). Results The mean ± SD age was 54 ± 11 years, and 78% were men. The median AF duration was 30 months (range, 2–203); paroxysmal AF was present in 86% of the patients, persistent in 14%. Fifteen patients (17%) underwent previous transcatheter ablations. After a median follow-up of 24 months (range, 6–78), 72% of all patients were free from atrial arrhythmias without the use of AADs. With AADs, this was 83%. Major perioperative adverse events occurred in 7 patients (8%). Conclusions This retrospective multicenter study shows that SMI-PVI is effective at a median follow-up of 24 months for the treatment of mostly paroxysmal drug-refractory AF. Perioperative adverse events do remain a point of caution.

scholarly journals Corticosteroid Treatment in Severe Patients With SARS-CoV-2 and Chronic HBV Co-infection: a Retrospective Multicenter Study

2021 ◽  
Author(s):  
Mei Meng ◽  
Yufeng Chu ◽  
Sheng Zhang ◽  
Jing Sha ◽  
Peng Wang ◽  
...  
Keyword(s):  
Treatment Group ◽  
Corticosteroid Therapy ◽  
Multicenter Study ◽  
Multivariable Analysis ◽  
Corticosteroid Treatment ◽  
Confounding Variables ◽  
Chronic Hepatitis B Virus ◽  
The Impact ◽  
Retrospective Multicenter Study ◽  
D Dimer

Abstract Background. The impact of corticosteroids on severe patients with coronavirus disease 2019 (COVID-19)/ chronic hepatitis B virus (HBV) co-infection is currently unknown. We aimed to investigate effect of corticosteroid on these subgroup patients.Methods. In this retrospective multicenter study including 5447 confirmed COVID-19 patients from Jan 1, 2020 to Apr 18, 2020, severe patients with COVID-19/HBV co-infection were identified. To minimize the bias of confounding variables on effect of corticosteroid treatment, inverse probability of treatment weighting (IPTW) based on propensity score was employed.Results. The prevalence of HBV co-infection in hospitalization COVID-19 patients was 4.1%. 105 severe patients with COVID-19/HBV co-infection were enrolled (median age 62 years, 57.1% male). Fifty-five patients received corticosteroid treatment and 50 patients did not. Corticosteroid treatment was associated with high D-dimer level, neutrophil count (all P<0.05). With IPTW analysis, corticosteroid treatment worsen acute liver injury (OR, 1.767, 95%CI, 1.018-3.065, P=0.043). Corticosteroids might delay SARS-CoV-2 viral RNA clearance (OR, 4.963, 95%CI, 2.717-9.065, P <0.001). The 28-day and in-hospital mortality were both significantly higher in corticosteroid treatment group than non-corticosteroid treatment group (OR, 8.738, 95%CI, 2.826-27.022, P <0.001; OR, 10.122, 95%CI, 3.291-31.129, P <0.001, respectively). In multivariable analysis, higher D-dimer level (>1µg/ml) (OR, 10.686, 95%CI, 2.421-47.159, P=0.002) and corticosteroid therapy (OR, 11.236, 95%CI, 1.273-99.154, P=0.029) were independently associated with 28-day mortality. Methylprednisolone dose per day and cumulative dose in non-survivors was significantly higher than in survivors.Conclusions. In severe patients with COVID-19/HBV co-infection, corticosteroid treatment may increase mortality. Therefore, corticosteroid therapy should be prescribed with caution in the subset of patients.

scholarly journals Impact of Surgical Site Infection To Outcome In Patients With Operatively Treated Tibial Plateau Fractures– A Retrospective Multicenter Study

2021 ◽  
Author(s):  
Ralf Henkelmann ◽  
Karl-Heinz Frosch ◽  
Richard Glaab ◽  
Meinhard Mende ◽  
Christopher Ull ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Multicenter Study ◽  
Tibial Plateau ◽  
Tibial Plateau Fractures ◽  
Site Infection ◽  
Significant Difference ◽  
Patient Reported ◽  
The Impact ◽  
Retrospective Multicenter Study

Abstract Background: Tibial plateau fractures (TPF) can be a life changing injury. Surgical site infection (SSI) occur in 3-10% and is a feared complication. Aim of this study was to evalute the impact of SSI to outcome in patients with operatively treated TPF.Methods: We conducted a retrospective multicenter study in seven participating countries. Between January 2005 and December 2014 all participating centers have followed up patients with SSI. In addition, three centers followed up patients without SSI as a reference group. Descriptive data and follow up data with patient reported outcome scores (KOOS, Lysholm) were evaluated. Statistic analyses were performed with IBM SPSS and two-sided tests to the significance level of α = 0.05. Results: In summary, 287 patients (41 with SSI and 246 without SSI) with an average follow-up of 75.9 ± 35.9 months were included in this study. Patients with a SSI had a significant poorer Outcome in KOOS5 (48.7 ± 23.2 vs. 71.5 ± 23.5; p < 0.001) and Lysholm (51.4 ± 24.0 vs. 71.4 ± 23.5; p < 0.001) compared to patients without SSI. This significant difference was also evident in the KOOS subscores pain (57.9 ± 22,9 vs. 75.0 ± 22.3; p < 0.001), symptoms (54.5 ± 28.8 vs. 75.4 ± 23.4; p < 0.001), ADL (48.8 ± 27.5 vs. 80.5 ± 22.6; p < 0.001) and QOL (37.8 ± 31.5 vs. 56.4 ± 30.2; p = 0.001).Conclusion: Patients with SSI differed significantly from patients without SSI in terms of gender, smoking and drug addiction. The trauma-associated data showed a significant difference in the severity of fracture morphology, concomitant injuries (especially open fracture and compartment syndrome), and the incidence of polytraumata. In terms of PRO, a significantly poorer outcome was recorded in patients with SSI.

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