scholarly journals The Costs of Operative Complications for Ankle Fractures: A Case Control Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Frank R. Avilucea ◽  
Sarah E. Greenberg ◽  
W. Jeffrey Grantham ◽  
Vasanth Sathiyakumar ◽  
Rachel V. Thakore ◽  
...  
Keyword(s):  
Ankle Fracture ◽  
Case Control Study ◽  
Case Control ◽  
Ankle Fractures ◽  
Control Analysis ◽  
Operative Complications ◽  
Minimal Data ◽  
Level I ◽  
Case Control Analysis ◽  
Control Study

As our healthcare system moves towards bundling payments, it is vital to understand the potential financial implications associated with treatment of surgical complications. Considering that surgical treatment of ankle fractures is common, there remains minimal data relating costs to postsurgical intervention. We aimed to identify costs associated with ankle fracture complications through case-control analysis. Using retrospective analysis at a level I trauma center, 28 patients with isolated ankle fractures who developed complications (cases) were matched with 28 isolated ankle fracture patients without complications (controls) based on ASA score, age, surgery type, and fracture type. Patient charts were reviewed for demographics and complications leading to readmission/reoperation and costs were obtained from the financial department. Wilcoxon tests measured differences in the costs between the cases and controls. 28 out of 439 patients (6.4%) developed complications. Length of stay and median costs were significantly higher for cases than controls. Specifically, differences in total costs existed for infection and hardware-related pain. This is the first study to highlight the considerable costs associated with the treatment of complications due to isolated ankle fractures. Physicians must therefore emphasize methods to control surgical and nonsurgical factors that may impact postoperative complications, especially under a global payment system.

Abstract TP216: Subtle Cardiovascular Measures in Young-onset Cryptogenic Ischemic Stroke: A Prospective Case-control Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Nicolas Martinez-Majander ◽  
Daniel Gordin ◽  
Jani Pirinen ◽  
Juha Sinisalo ◽  
Mika Lehto ◽  
...  
Keyword(s):  
Heart Rate ◽  
Case Control Study ◽  
Augmentation Index ◽  
Supply And Demand ◽  
Case Control ◽  
Applanation Tonometry ◽  
Control Analysis ◽  
Independent Association ◽  
Case Control Analysis ◽  
Control Study

Background: Worldwide, ≈1.3 million annual ischemic strokes (IS) occur in young adults (<50 years of age), of which up to 50% remain cryptogenic after a complete diagnostic work-up. In a pilot case-control study, we studied the value of arterial stiffness and related subendocardial viability in the search of underlying pathophysiology in these patients. Methods: We prospectively enrolled 51 patients aged 18-49 with recent imaging-positive cryptogenic IS and 51 age- and sex-matched stroke-free controls (NCT01934725). Measurements were done with an applanation tonometry (SphygmoCor). Augmentation Index (AIx) served as a measure of stiffness in small arteries. Aortic and brachial pulse wave velocities (aPWV; bPWV) reflected stiffness in large and intermediate-sized arteries, respectively. Subendocardial viability ratio (SEVR) was derived from radial artery waveform measures, reflecting myocardial oxygen supply and demand. Related-samples statistics were applied for univariate case-control analyses and linear regression to explore the relationship between parameters with significant association in case-control analysis. Results: AIx, aPWV, bPWV, heart rate, and systolic or diastolic blood pressures did not differ statistically between patients and controls. Mean SEVR was significantly lower in patients compared with controls (148±35 vs. 161±29, P=0.003). In patients, higher heart rate was inversely associated with SEVR (P<0.001). Age, sex, migraine with and without aura, smoking, and systolic and diastolic blood pressure showed no independent association with SEVR. Conclusions: To our knowledge, this is the first report to show an association between SEVR and stroke. Yet unrecognized subtle cardiovascular pathology may play a role in early-onset cryptogenic IS.

scholarly journals Association of bone mineral density with reoperation rate following instrumented lumbar spinal fusion: a retrospective cohort and case-control study

2019 ◽  
Author(s):  
Maximilian Thomas Löffler ◽  
Niklas Loreck ◽  
Nico Sollmann ◽  
Johannes Kaesmacher ◽  
Felix Zibold ◽  
...  
Keyword(s):  
Case Control Study ◽  
Cohort Analysis ◽  
Case Control ◽  
Control Analysis ◽  
Lumbar Spinal Fusion ◽  
Mineral Density ◽  
Lumbar Spinal ◽  
Case Control Analysis ◽  
Prevalence Of Osteoporosis ◽  
Control Study

Abstract Background Low bone mineral density (BMD) is believed to influence the outcome of instrumented spinal surgery and can lead to reoperation. Purpose of this retrospective cohort and case-control study was to investigate the association of BMD with the risk of reoperation following instrumented lumbar spinal fusion (LSF). Methods For the cohort analysis, 81 patients were included who received LSF with and without polymethyl methacrylate (PMMA)-augmentation. For the case-control analysis, 18 patients who had reoperation following LSF were matched to 26 patients who did not have reoperation (matching criteria: sex, age ± 5 years, fused levels, and augmentation). Opportunistic BMD screening was performed in perioperative CT scans using asynchronous calibration. Mean BMD was compared between patients with and without reoperation in augmented and non-augmented surgeries. Results In the cohort analysis, prevalence of osteoporosis (BMD < 80 mg/cm³) was 29% in non-augmented and 85% in augmented LSF. Seven of 48 patients with non-augmented (15%) and 4 of 33 patients with augmented LSF (12%) had reoperation. In non-augmented LSF, patients with reoperation had significantly lower BMD than patients without reoperation (p = 0.005). In the case-control analysis, patients with reoperation presented numerically lower BMD of 78.8 ± 33.1 mg/cm³ than patients without reoperation with BMD of 89.4 ± 39.7 mg/cm³ (p = 0.357).Conclusions Prevalence of osteoporosis in patients undergoing LSF is relatively high. Patients with reoperation following LSF showed slightly lower BMD compared to matched patients without reoperation, but the difference was not statistically significant. Opportunistic BMD screening in preoperative CT is feasible and can provide valuable information about osteoporotic bone status.

scholarly journals A case-control study of autoimmune AEFIs following COVID-19 vaccination reported to VAERS

2021 ◽  
Author(s):  
Chris von Csefalvay
Keyword(s):  
Myasthenia Gravis ◽  
Case Control Study ◽  
Case Reports ◽  
Transverse Myelitis ◽  
Case Control ◽  
Vaccine Hesitancy ◽  
Control Analysis ◽  
Safety Signal ◽  
Case Control Analysis ◽  
Control Study

Autoimmune adverse effects following immunisation (AEFIs) are widely regarded as a chief concern driving vaccine hesitancy. This case-control study seeks to shed light on the true risk of autoimmune AEFIs associated with the COVID-19 vaccine through a case-control analysis of VAERS reports. Reports of autoimmune aetiology were matched with reports of non-autoimmune controls. Statistical analysis reveals that the safety profile of COVID-19 vaccines with regard to autoimmune AEFIs is highly favourable. In particular, neuroautoimmune AEFIs have statistically significant reporting odds ratios below unity (Guillain-Barre syndrome: 0.35, multiple sclerosis: 0.70, transverse myelitis: 0.79), indicating a reduced association of reports of these conditions with the COVID-19 vaccine versus other vaccines. Only three autoimmune aetiologies exceed a ROR of 2.0 and thus present a potential signal. Of these, myasthenia gravis (ROR = 3.90, p < 0.001, 95% CI: 2.63-5.80) may be the result of epidemiological confounding factors not sufficiently controlled by matching, as the population most likely to develop myasthenia gravis was strongly prioritised in the COVID-19 vaccine's initial rollout. Immune thrombocytopaenia (ROR = 26.83, p < 0.001, 95% CI: 16.93-42.54) is a clear safety signal, confirming a large number of case reports and studies that indicate a risk of immune thrombocytopaenic events following the COVID- 19 vaccine. The lone strong safety signal of immune thrombocytopaenia notwithstanding, this study attests to the safety of the COVID-19 vaccine where autoimmune conditions are concerned. Through quantifying the risk of autoimmune disorders associated with COVID-19 vaccination, this study contributes to a growing body of evidence supporting the safety of such vaccines.

scholarly journals Dose-specific effectiveness of 7- and 13-valent pneumococcal conjugate vaccines against vaccine-serotype Streptococcus pneumoniae colonization: a matched, case-control study

2019 ◽  
Author(s):  
Joseph A. Lewnard ◽  
Noga Givon-Lavi ◽  
Ron Dagan
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
Control Analysis ◽  
Reduced Dose ◽  
Pneumococcal Carriage ◽  
Matched Case ◽  
Case Control Analysis ◽  
To Receive ◽  
Matched Case Control Study ◽  
Control Study

ABSTRACTBackgroundReduced-dose pneumococcal conjugate vaccine (PCV) schedules are under consideration in countries where children are currently recommended to receive three PCV doses. However, dose-specific PCV effectiveness against vaccine-serotype colonization is uncertain.MethodsFrom 2009-2016, we conducted surveillance of pneumococcal carriage in southern Israel, where PCV is administered at ages 2, 4, and 12 months (2+1 schedule). We obtained nasopharyngeal swabs and vaccination histories from 4245 children ages 0-59 months without symptoms of diseases that could be caused by pneumococci. In a case-control analysis, we measured protection against vaccine-serotype colonization as one minus the matched odds ratio for PCV doses received.ResultsAt ages 5-12 months, a second PCV7/13 dose increased protection against PCV7-serotype carriage from –23.6% (95%CI: –209.7-39.1%) to 27.1% (–69.2-64.5%), and a second PCV13 dose increased protection against carriage of all PCV13 serotypes from –54.8% (–404.3-39.1%) to 23.4% (– 128.5-67.1%). At ages 13-24 months, a third PCV7/13 dose increased protection against PCV7-serotype carriage from 32.4% (–8.4-58.0%) to 74.1% (58.4-84.6%), and a third PCV13 dose increased protection against carriage of all PCV13 serotypes from –50.0% (–194.0-42.7%) to 49.7% (15.8-83.3%). On average, each PCV13 dose conferred 37.7% (7.0-61.8%) greater protection against carriage of serotypes 1, 5, 6A, 7F, and 19A than carriage of serotype 3. PCV13-derived protection against carriage of serotypes 1, 5, 6A, 7F, and 19A was equivalent to PCV7/13-derived protection against carriage of PCV7 serotypes.ConclusionsIn a setting implementing a 2+1 PCV schedule, protection against vaccine-serotype colonization is sustained primarily by the third dose.

scholarly journals Inhaled Corticosteroids and COVID-19 Risk and Mortality: A Nationwide Cohort Study

2020 ◽  
Vol 9 (11) ◽  
pp. 3406 ◽  
Author(s):  
Jae Chol Choi ◽  
Sun-Young Jung ◽  
Una A. Yoon ◽  
Seung-Hun You ◽  
Myo-Song Kim ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Case Control Study ◽  
Inhaled Corticosteroids ◽  
Case Control ◽  
Control Analysis ◽  
Hospital Type ◽  
Poor Outcomes ◽  
Case Control Analysis ◽  
Nested Case Control ◽  
Control Study

Inhaled corticosteroids (ICS) could increase both the risk of coronavirus disease 2019 (COVID-19) and experiencing poor outcomes. To compare the clinical outcomes between ICS users and nonusers, COVID-19-related claims in the Korean Health Insurance Review and Assessment database were evaluated. To evaluate susceptibility to COVID-19 among patients with COPD or asthma, a nested case-control study was performed using the same database. In total, 7341 patients were confirmed to have COVID-19, including 114 ICS users and 7227 nonusers. Among 5910 patients who were hospitalized, death was observed for 9% of ICS users and 4% of nonusers. However, this association was not significant when adjusted for age, sex, region, comorbidities, and hospital type (aOR, 0.94; 95% CI, 0.43–2.07). The case-control analysis of COPD compared 640 cases with COVID-19 to 2560 matched controls without COVID-19, and the analysis of asthma compared 90 cases with COVID-19 to 360 matched controls without COVID-19. Use of ICS was not significantly associated with COVID-19 among patients with COPD (aOR, 1.02; 95% CI, 0.46–2.25) or asthma (aOR, 0.38; 95% CI, 0.13–1.17). Prior ICS use was not significantly associated with COVID-19 in patients with COPD or asthma, nor with clinical outcomes among patients with COVID-19.

scholarly journals Management of Esophageal Carcinoma Associated with Cirrhosis: A Retrospective Case-Control Analysis

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Florence Trivin ◽  
Eveline Boucher ◽  
Elodie Vauléon ◽  
Isabelle Cumin ◽  
Elisabeth Le Prisé ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Esophageal Carcinoma ◽  
Case Control ◽  
Control Analysis ◽  
Retrospective Case ◽  
Compensated Cirrhosis ◽  
Dismal Prognosis ◽  
Chemotherapy Dose ◽  
Case Control Analysis ◽  
Control Study

Objectives. Esophageal carcinoma and cirrhosis have the overlapping etiologic factors.Methods. In a retrospective analysis conducted in 2 Breton institutions we wanted to asses the frequency of this association and the outcome of these patients in a case-control study where each case (cirrhosis and esophageal cancer) was paired with two controls (esophageal cancer).Results. In a 10-year period, we have treated 958 esophageal cancer patients; 26 (2.7%) had a cirrhosis. The same treatments were proposed to the 2 groups; cases received nonsignificantly different radiation and chemotherapy dose than controls. Severe toxicities and deaths were more frequent among the cases. At the end of the treatment 58% of the cases and 67% of the controls were in complete remission; median and 2-year survival were not different between the 2 groups. All 4 Child-Pugh B class patients experienced severe side effects and 2 died during the treatment.Conclusions. This association is surprisingly infrequent in our population! Child-Pugh B patients had a dismal prognosis and a bad tolerance to radiochemotherapy; Child-Pugh A patients have the same tolerance and the same prognosis as controls and the evidence of a well-compensated cirrhosis has not modified our medical options.

scholarly journals Sarcoidosis and silica dust exposure among men in Sweden: a case–control study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038926
Author(s):  
Pål Graff ◽  
Johanna Larsson ◽  
Ing-Liss Bryngelsson ◽  
Pernilla Wiebert ◽  
Per Vihlborg
Keyword(s):  
Occupational Exposure ◽  
Case Control Study ◽  
Older Men ◽  
Case Control ◽  
Dust Exposure ◽  
Control Analysis ◽  
Silica Exposure ◽  
Silica Dust ◽  
Increased Risk ◽  
Control Study

ObjectiveTo determine whether occupational exposure to silica dust is associated with an increased risk of developing sarcoidosis.DesignCase–control study of all individuals between 20 and 65 years of age diagnosed with sarcoidosis (D86) in Sweden between 2007 and 2016. Controls were matched to cases (2:1) based on age, sex and county at the time of diagnosis. A Job Exposure Matrix was used to estimate the occupational silica exposure of all cases and controls.SettingMedical and occupational data from the National Outpatient Register were used to implement a case–control analysis, while the two controls used for each case were selected from the National Register of the Total Population. Information about occupation and time of employment were collected from the Swedish Occupational Register.ParticipantsAll men and women aged 20–65 years old who were diagnosed sarcoidosis (D86) from 2007 to 2016 were included and assigned two controls.Main outcomesSilica dust exposure correlates with an increased risk of developing sarcoidosis in men.ResultsThe prevalence of silica exposure at work was statistically significantly higher among male cases than controls (OR 1.27, 95% CI 1.13 to 1.43). For men of an age of 35 years or younger the correlation seems to be stronger (OR 1.48, 95% CI 1.1 to 1.87) than in older men (OR 1.21, 95% CI 1.05 to 1.39). For men older than 35 with exposure to silica the prevalence of sarcoidosis increased with the exposure time, with an OR of 1.44 (95% CI 1.04 to 2.00) for exposure of more than 10 years.ConclusionsOccupational exposure to silica dust seems to increase the risk of sarcoidosis among men between 20 and 65 years of age. The risk is higher among exposed men 35 years or younger and older men with longer exposure (>6 years).

Matched case control analysis of breast cancer specific factors impacting risk of developing SARS-Cov-2 infection.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18579-e18579
Author(s):  
Joanna Zurko ◽  
Aniko Szabo ◽  
Yee Chung Cheng ◽  
Sailaja Kamaraju ◽  
John Burfeind ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Triple Negative ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Control Analysis ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

e18579 Background: Patients with cancer have increased risk of developing SARS-Cov-2 (COVID-19) infection. It is unknown if characteristics related to breast cancer increase the risk of COVID-19 infection. In this retrospective matched case control study, we aim to identify breast cancer related risk factors associated with developing COVID-19 and describe outcomes of patients with breast cancer diagnosed with COVID-19. Methods: Women with breast cancer treated at the Medical College of Wisconsin and diagnosed with COVID-19 between March and December 2020 served as cases. Women with breast cancer without COVID-19 diagnosis within the same time frame were identified as potential controls. Controls were chosen by matching for age (≥60 vs <60), obesity (BMI <30 vs ≥30), county (Milwaukee vs suburban), race (white vs non-white) and diabetes mellitus (DM) with 3:1 matching planned. Univariate comparisons between cases and controls were done via Rao-Scott stratified chi-square test for categorical outcomes and stratified t-test for continuous variables. Conditional logistic regression was done to evaluate the joint effect of multiple characteristics on the odds of being a COVID-19 case. Results: Twenty-five cases and 77 controls were identified. All cases were fully matched by age, obesity, county, and race with 3 cases not able to be matched for DM. Mean age was 54.6 vs 54.9 (p=0.88), BMI 31.0 vs 31.6 (p=0.69), 48% lived in Milwaukee county and 68% were white (cases 24% black & 8% American Indian; controls 32% black). Regarding COVID outcomes, 24.0% (n=6) of cases were hospitalized, median length of stay was 2 days, 8% (n=2) needed oxygen, 4% (n=1) were intubated and 4% (n=1) died due to COVID-19. COVID-19 led to treatment delays in 40% of cases. On univariate analysis of cases vs controls, 64 vs 75% were ER/PR+ (p=0.31), 6.5 vs 5.2% HER2+ (p=0.34), and 9.0 vs 4.2% triple negative (p=0.10). There were no significant differences in breast cancer stage. At time of COVID diagnosis (or last clinic contact if control), 16 vs 14% had active disease (p=0.81), 72 vs 74% were on active treatment (p=0.85), with 21 vs 4% being on chemotherapy (p=0.007), and 44 vs 52% on endocrine therapy (p=0.49). On conditional logistic regression, being on active chemotherapy (OR 5.8, p=0.043) significantly increased the likelihood of developing COVID with a trend seen for triple negative disease (OR 2.8, p=0.12). Conclusions: In this matched case control study of patients with breast cancer, active chemotherapy was significantly associated with an increased likelihood of developing COVID-19 with a trend seen for triple negative disease. Rates of death due to COVID-19 were overall low. Our analysis was limited by small numbers and an inability to fully match patients for DM. These findings support continued strict precautions for those on active chemotherapy and warrants further analysis in those with triple negative disease.

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