scholarly journals Impact of intensive care unit admission during handover on mortality: a propensity matched cohort study

2019 ◽  
Author(s):  
Thais Dias Midega ◽  
Newton Carlos Viana Leite Filho ◽  
Antônio Paulo Nassar ◽  
Roger Monteiro Alencar ◽  
Antônio Capone Neto ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Hospital Mortality ◽  
Propensity Score Matching ◽  
Clinical Outcomes ◽  
Control Group ◽  
Matched Cohort ◽  
Single Center ◽  
Icu Admission ◽  
Matched Cohort Study

AbstractIntroductionHandover is a process of transferring information, responsibility and authority for providing care of critically ill patients from a departing intensivist to an oncoming intensivist. The effect of i admission during a medical handover on clinical outcomes is unknown.ObjectivesOur purpose was to evaluate the impact of ICU admission during a medical handover on clinical outcomes.MethodsPost hoc analysis of a cohort study addressing the effect of ICU admissions during the handover on outcomes. This retrospective, single center, propensity matched cohort study was conducted in a 41-bed open general ICU located in a private tertiary care hospital in São Paulo, Brazil. Based on time of ICU admission, patients were categorized into two cohorts: handover group (ICU admission between 6:30 am to 7:30 or 6:30 pm to 7:30 pm) or control group (admission between 7:31 am to 6:29 pm or 7:31 pm to 6:29 am). Patients in the handover group were propensity matched to patients in the control group at 1:2 ratio. Our primary outcome was hospital mortality.ResultsBetween June 1, 2013 and May 31, 2015, 6,650 adult patients were admitted to the ICU. Following exclusion of ineligible participants, 5,779 patients [389 (6.7%) in handover group and 5390 (93.3%) in control group] were eligible for propensity score matching, of whom 1,166 were successfully matched [389 (33.4%) handover group and 777 (66.6%) in control group]. Before matching, hospital mortality was 14.1% (55/389 patients) in handover group compared to 11.7% (628/5,390) in control group (p=0.142). After propensity-score matching, ICU admission during handover was not associated with increased risk of ICU (OR, 1.40; 95% CI, 0.92 to 2.11; p=0.11) and hospital (OR, 1.23; 95%CI, 0.85 to 1.75; p=0.26) mortality. ICU and hospital length of stay did not differ between the groups.ConclusionIn this propensity-matched single center cohort study, ICU admission during medical handover did not affect clinical outcomes.

Excess Mortality Among Hospitalized Patients With Hypopituitarism—A Population-Based, Matched-Cohort Study

2020 ◽  
Vol 105 (11) ◽  
Author(s):  
Fahim Ebrahimi ◽  
Alexander Kutz ◽  
Ulrich Wagner ◽  
Ben Illigens ◽  
Timo Siepmann ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Excess Mortality ◽  
Population Based ◽  
Hospitalized Patients ◽  
Matched Cohort ◽  
Prolonged Length ◽  
Matched Cohort Study ◽  
Increased Risk

Abstract Context Patients with hypopituitarism face excess mortality in the long-term outpatient setting. However, associations of pituitary dysfunction with outcomes in acutely hospitalized patients are lacking. Objective The objective of this work is to assess clinical outcomes of hospitalized patients with hypopituitarism with or without diabetes insipidus (DI). Design, Setting, and Patients In this population-based, matched-cohort study from 2012 to 2017, hospitalized adult patients with a history of hypopituitarism were 1:1 propensity score–matched with a general medical inpatient cohort. Main Outcome Measures The primary outcome was in-hospital mortality. Secondary outcomes included all-cause readmission rates within 30 days and 1 year, intensive care unit (ICU) admission rates, and length of hospital stay. Results After matching, 6764 cases were included in the study. In total, 3382 patients had hypopituitarism and of those 807 (24%) suffered from DI. All-cause in-hospital mortality occurred in 198 (5.9%) of patients with hypopituitarism and in 164 (4.9%) of matched controls (odds ratio [OR] 1.32, [95% CI, 1.06-1.65], P = .013). Increased mortality was primarily observed in patients with DI (OR 3.69 [95% CI, 2.44-5.58], P < .001). Patients with hypopituitarism had higher ICU admissions (OR 1.50 [95% CI, 1.30-1.74], P < .001), and faced a 2.4-day prolonged length of hospitalization (95% CI, 1.94–2.95, P < .001) compared to matched controls. Risk of 30-day (OR 1.31 [95% CI, 1.13-1.51], P < .001) and 1-year readmission (OR 1.29 [95% CI, 1.17-1.42], P < .001) was higher among patients with hypopituitarism as compared with medical controls. Conclusions Patients with hypopituitarism are highly vulnerable once hospitalized for acute medical conditions with increased risk of mortality and adverse clinical outcomes. This was most pronounced among those with DI.

scholarly journals In-Hospital Mortality After Blood Purification With and Without Acrylonitrile-Co-Methallyl Sulfonate Surface-Treated Membrane for Pneumonia-Associated Sepsis: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Kentaro Hayashi ◽  
Yusuke Sasabuchi ◽  
Hiroki Matsui ◽  
Mikio Nakajima ◽  
Hiroyuki Ohbe ◽  
...  
Keyword(s):  
Cohort Study ◽  
Mortality Rate ◽  
Propensity Score ◽  
Hospital Mortality ◽  
Propensity Score Matching ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Control Group ◽  
Diagnosis Procedure Combination ◽  
Inpatient Database

Abstract Background: Cytokine removal therapy is one of the available therapies for sepsis. Acrylonitrile-co-methallyl sulfonate surface-treated (AN69ST, sepXiris®) membrane has cytokine adsorption capacity and has been widely used for treating sepsis in Japan. The aim of this study was to compare the effects of continuous renal replacement therapy (CRRT) with AN69ST membrane and conventional CRRT for patients with pneumonia-associated sepsis.Methods: We conducted a retrospective cohort study using the Diagnosis Procedure Combination database, a nationwide inpatient database in Japan. We identified adult patients who were hospitalized due to pneumonia and received CRRT within 2 days of admission from September 2014 to March 2017. We included patients who received CRRT with AN69ST membrane within 2 days of admission in the treatment group (AN69ST group); those who received CRRT with other membranes within 2 days of admission were included in the control group (non-AN69ST group). Propensity score matching was used to compare in-hospital mortality between the two groups.Results: Eligible patients (n=2,393) were categorized into the AN69ST group (n=631) or the non-AN69ST group (n=1,762). The overall in-hospital mortality rate in pneumonia patients treated with CRRT was 38.9%. Propensity score matching created a matched cohort of 545 pairs of patients. The in-hospital mortality rate was significantly lower in the AN69ST group than in the non-AN69ST group (35.8 vs. 41.8%, p=0.046).Conclusion: Our data suggest that CRRT with the AN69ST membrane was associated with a significantly lower in-hospital mortality than CRRT with standard membranes among patients with pneumonia-associated sepsis.

Comparison of PED and FRED flow diverters for posterior circulation aneurysms: a propensity score matched cohort study

2020 ◽  
pp. neurintsurg-2020-016055
Author(s):  
Christoph J Griessenauer ◽  
Alejandro Enriquez-Marulanda ◽  
Sissi Xiang ◽  
Tao Hong ◽  
Hongqi Zhang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Functional Outcome ◽  
Propensity Score Matching ◽  
Posterior Circulation ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Posterior Circulation Aneurysms ◽  
Aneurysm Occlusion ◽  
Flow Diverters

AbstractBackgroundFlow diversion is a common endovascular treatment for cerebral aneurysms, but studies comparing different types of flow diverters are scarce.ObjectiveTo perform a propensity score matched cohort study comparing the Pipeline Embolization Device (PED) and Flow Redirection Intraluminal Device (FRED) for posterior circulation aneurysms.MethodsConsecutive aneurysms of the posterior circulation treated at 25 neurovascular centers with either PED or FRED were collected. Propensity score matching was used to control for age, duration of follow-up imaging, adjunctive coiling, and aneurysm location, size, and morphology; previously ruptured aneurysms were excluded. The two devices were compared for the following outcomes: procedural complications, aneurysm occlusion, and functional outcome.ResultsA total of 375 aneurysms of the posterior circulation were treated in 369 patients. The PED was used in 285 (77.2%) and FRED in 84 (22.8%) procedures. Aneurysms treated with the PED were more commonly fusiform and larger than those treated with FRED. To account for these important differences, propensity score matching was performed resulting in 33 PED and FRED unruptured aneurysm pairs. No differences were found in occlusion status and neurologic thromboembolic or hemorrhagic complications between the two devices. The proportion of patients with favorable functional outcome was higher with FRED (100% vs 87.9%, p=0.04).ConclusionComparative analysis of PED and FRED for the treatment of unruptured posterior circulation aneurysms did not identify significant differences in aneurysm occlusion or neurologic complications. Variations in functional outcomes warrant additional investigations.

Acromioplasty rates in patients with shoulder disorders with and without acupuncture treatment: a retrospective propensity score–matched cohort study

2020 ◽  
Vol 38 (4) ◽  
pp. 255-263
Author(s):  
Gujin Yang ◽  
Boyoung Jung ◽  
Me-riong Kim ◽  
Wonil Koh ◽  
Namkwen Kim ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Acupuncture Treatment ◽  
Acupuncture Group ◽  
Control Group ◽  
Matched Cohort ◽  
Control Groups ◽  
Matched Cohort Study ◽  
Shoulder Disorders ◽  
And Control

Objective: This retrospective propensity score–matched cohort study aimed to examine the frequency of acromioplasty among patients with shoulder disorders receiving and not receiving acupuncture, based on Korea National Health Insurance Service-National Sample Cohort (NHIS-NSC) data. Methods: We included cases of high-frequency shoulder disorders—adhesive capsulitis, rotator cuff syndrome, shoulder impingement syndrome, and sprain and strain of the shoulder joint—stratified from the Korea NHIS-NSC database between 2002 and 2013; cases were classified into two groups based on a history of acupuncture treatment performed at least twice within 6 weeks (acupuncture group: n = 111,561; control group: n = 71,340). We examined propensity scores and hazard ratios (HRs) for the frequency of acromioplasty, within 2 years of the first treatment or first examination in the acupuncture and control groups, respectively; cumulative survival rates were estimated using Kaplan–Meier survival analysis. Results: Following propensity score matching, no differences were observed between the acupuncture and control groups for variables including sex, age, income and the Charlson comorbidity index. In addition, the incidence rates of acromioplasty within 2 years were lower in the acupuncture group than in the control group (HR 0.264; 95% confidence interval 0.224–0.311). Based on differences in sensitivity analyses for the numbers of acupuncture sessions and treatment duration, the frequency of acromioplasty within 2 years was lower in the acupuncture group than in the control group. Conclusion: This study found that the frequency of acromioplasty was reduced in patients with shoulder disorders who had been treated with acupuncture. Although the findings need to be verified by prospective randomized clinical trials, these results imply that acupuncture may be effective at reducing the incidence rate of shoulder surgery.

scholarly journals Care Needs and Clinical Outcomes of Older People with Dementia: A Population-Based Propensity Score-Matched Cohort Study

PLoS ONE ◽  
2015 ◽  
Vol 10 (5) ◽  
pp. e0124973 ◽  
Author(s):  
Fei-Yuan Hsiao ◽  
Li-Ning Peng ◽  
Yu-Wen Wen ◽  
Chih-Kuang Liang ◽  
Pei-Ning Wang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Older People ◽  
Clinical Outcomes ◽  
Population Based ◽  
Matched Cohort ◽  
Care Needs ◽  
Matched Cohort Study ◽  
People With Dementia

scholarly journals The association between bowel resection and the risk of nontyphoidal salmonella infection: a nationwide propensity score-matched cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kuang-Tsu Yang ◽  
Sin-Ei Juang ◽  
Yao-Min Hung ◽  
James Cheng-Chung Wei ◽  
Hei-Tung Yip ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Bowel Resection ◽  
Significant Risk ◽  
University Hospital ◽  
Control Group ◽  
Matched Cohort ◽  
Human Beings ◽  
Matched Cohort Study ◽  
Increased Risk

AbstractNontyphoidal salmonella (NTS) infection has a high mortality rate. Bowel resections affect gut microbiota and immune function, and the association between bowel resection and NTS infection in human beings has not been addressed. We conducted a nationwide propensity score (PS)-matched cohort study to clarify this association. Data from the Longitudinal Health Insurance Database of Taiwan were used to establish a case-cohort with bowel resections from 2000 to 2013. Informed consent was waived by the Institutional Review Board of China Medical University Hospital (CMUH104-REC2-115) because all personal identifying information used had been de-identified. Each case was matched with one control without any bowel resection according to age, gender, index date, and propensity score (PS). Cumulative incidences of and hazard ratios (HRs) for NTS infection development were analyzed. The incidence of NTS infection was greater in patients with a bowel resection than in the control group (2.97 vs. 1.92 per 10,000 person-years), with an adjusted hazard ratio (aHR) of 1.64 (95% CI = 1.08–2.48). The incidence of NTS infection increased significantly for cases with small bowel resections and right hemicolectomies. Age (31–40 and > 50 years), hypertension, chronic kidney disease, chronic obstructive pulmonary disease, and autoimmune diseases were significant risk factors of NTS infection. Stratification analysis revealed that patients without comorbidities were prone to NTS infection after bowel resections. The increased risk of developing NTS infection could be related to the bowel resection. Specific age groups and comorbidities also contribute to increased risk of NTS infection.

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