scholarly journals Prognostic Factors for Recovery in Chronic Nonspecific Low Back Pain: A Systematic Review

2012 ◽  
Vol 92 (9) ◽  
pp. 1093-1108 ◽  
Author(s):  
Karin Verkerk ◽  
Pim A.J. Luijsterburg ◽  
Harard S. Miedema ◽  
Annelies Pool-Goudzwaard ◽  
Bart W. Koes
Keyword(s):  
Prognostic Factors ◽  
Return To Work ◽  
Pain Intensity ◽  
Short Term ◽  
Conflicting Evidence ◽  
Long Term Follow Up ◽  
Physical Job Demands

Background Few data are available on predictors for a favorable outcome in patients with chronic nonspecific low back pain (CNLBP). Purpose The aim of this study was to assess prognostic factors for pain intensity, disability, return to work, quality of life, and global perceived effect in patients with CNLBP at short-term (≤6 months) and long-term (>6 months) follow-up. Data Sources Relevant studies evaluating the prognosis of CNLBP were searched in PubMed, CINAHL, and EMBASE (through March 2010). Study Selection Articles with all types of study designs were included. Inclusion criteria were: participants were patients with CNLBP (≥12 weeks' duration), participants were older than 18 years of age, and the study was related to prognostic factors for recovery. Fourteen studies met the inclusion criteria. Data Extraction Two reviewers extracted the data and details of each study. Data Synthesis A qualitative analysis using “level of evidence” was performed for all included studies. Data were summarized in tables and critically appraised. Limitations The results of the studies reviewed were limited by their methodological weaknesses. Conclusions At short-term follow-up, no association was found for the factors of age and sex with the outcomes of pain intensity and disability. At long-term follow-up, smoking had the same result. At long-term follow-up, pain intensity and fear of movement had no association with disability. At short-term follow-up, conflicting evidence was found for the association between the outcomes pain intensity and disability and the factor of fear of movement. At long-term follow-up, conflicting evidence was found for the factors of age, sex, and physical job demands. At long-term follow-up, conflicting evidence also was found for the association between return to work and age, sex, and activities of daily living. At baseline, there was limited evidence of a positive influence of lower pain intensity and physical job demands on return to work. No high-quality studies were found for the outcomes of quality of life and global perceived effect.

scholarly journals Long-term Outcomes and Quality of Life Following Parotidectomy for Benign Disease: A Cohort Study

2020 ◽  
Author(s):  
Michaela Plath ◽  
Matthias Sand Sand ◽  
Peter K. Plinkert ◽  
Ingo Baumann ◽  
Karim Zaoui
Keyword(s):  
Quality Of Life ◽  
Long Term Outcomes ◽  
Short Term ◽  
Minor Problem ◽  
Long Term Follow Up ◽  
Short And Long Term ◽  
Term Data

Abstract Backround:Parotidectomy may be burdened by numerous complications that may worsen subjects' quality of life (QoL). So far, the literature still lacks of long-term data (> 10 years) answering to the question what impacted the patients the most on QOL after parotidectomy compared to well-published short-term data.Methods:A prospective long-term follow-up study was carried out. Participants were divided into three groups concerning the follow-up: short-term (ST; 6 postoperative weeks), long-term (LT; 13 years postoperative) and short- and long-term (SLT) on same patient collective. QOL was assessed by the Parotidectomy Outcome Inventory (POI-8). Demographic and clinical data were collected from all patients. Operative reports were used to classify all parotidectomies as great nerve auricular (GAN) “preserving” or GAN “sacrificing” surgical preparations.Results:74 LT, 57 ST and 33 SLT patients were enrolled in this study. Hypoesthesia posed the major short- and long-term problem whereas facial palsy posed the minor problem. Pain (p < 0.01) and hypoesthesia (p < 0.001) significantly improved from six weeks to 13 years after parotidectomy as well as the overall POI-8 score (p = 0.04). The disease-specific impairment rate decreased from short (≈ 70%) to long-term (≈ 30%) follow-up. Sacrifice of the auricular nerve was associated with hypoesthesia in the ST-cohort (p = 0.028).Conclusion:To our knowledge, this study represents the longest follow-up of patients undergoing parotidectomy. Hypoesthesia significantly improved but still remains on long-follow-up without impacting QOL. As part of the preoperative informed consent, prolonged or permanent hypoesthesia should be explicitly emphasized.Trial registration:This study was prospectively approved and registered by the local Ethics Committee (Project Trial No: S-300/2007 and S-443/2018).

scholarly journals Long-term Outcomes and quality of life following parotidectomy for benign disease: A cohort study

2020 ◽  
Author(s):  
Michaela Plath ◽  
Matthias Sand ◽  
Peter K. Plinkert ◽  
Ingo Baumann ◽  
Karim Zaoui
Keyword(s):  
Quality Of Life ◽  
Long Term Outcomes ◽  
Short Term ◽  
Great Auricular Nerve ◽  
Long Term Follow Up ◽  
Short And Long Term ◽  
Term Data

Abstract Background: Parotidectomy may be burdened by numerous complications that may worsen subjects' quality of life (QoL). So far, the literature still lacks of long-term data (>10 years) answering to the question what impacted the patients the most on QOL after parotidectomy compared to well-published short-term data.Methods: A prospective long-term follow-up study was carried out. Participants were divided into three groups concerning the follow-up: short-term (ST; 6 postoperative weeks), long-term (LT; 13 years postoperative) and short- and long-term (SLT) on same patient collective. QOL was assessed by the Parotidectomy Outcome Inventory (POI-8). Demographic and clinical data were collected from all patients. Operative reports were used to classify all parotidectomies as great auricular nerve (GAN) “preserving” or GAN “sacrificing” surgical preparations.Results: 74 LT, 57 ST and 33 SLT patients were enrolled in this study. Hypoesthesia posed the major short- and long-term problem whereas facial palsy posed the minor problem. Pain (p < 0.01) and hypoesthesia (p < 0.001) significantly improved from six weeks to 13 years after parotidectomy as well as the overall POI-8 score (p = 0.04). The disease-specific impairment rate decreased from short (» 70%) to long-term (» 30%) follow-up. Sacrifice of the auricular nerve was associated with hypoesthesia in the ST-cohort (p = 0.028).Conclusion: To our knowledge, this study represents the longest follow-up of patients undergoing parotidectomy. Hypoesthesia significantly improved but still remains on long-follow-up without impacting QOL. As part of the preoperative informed consent, prolonged or permanent hypoesthesia should be explicitly emphasized.Trial registration: This study was prospectively approved and registered by the local Ethics Committee (Project Trial No: S-300/2007 and S-443/2018).

scholarly journals An Analysis of Real Life Data Obtained from 30 Years Follow-up of Primary Myelodysplastic Syndromes (MDS) Patients Confirms a Leading Role of Stem Cell Transplantation (SCT) for Achievement of Prolonged Survival

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4372-4372
Author(s):  
Jaroslav Cermak ◽  
Antonin Vitek ◽  
Dana Mikulenkova ◽  
Jacqueline Soukupova ◽  
Jana Brezinova ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Supportive Care ◽  
Disease Progression ◽  
Median Survival ◽  
Prolonged Survival ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Follow Up

Abstract AIM OF THE STUDY, PATIENTS AND METHODS : The data obtained from a long-term follow-up for a period of 30 years (1988-2017) were analyzed in a group of 529 patients with primary MDS and factors affecting prolonged survival were detected using different statistical methods including Kaplan Maier test and multivariate analysis. RESULTS : The results confirmed usefulness of both IPSS and IPSS-R (median survival in months for risk groups : very low - 73.7, low - 40.0, intermediate - 27.0, high - 9.0, very high - 3.5). In a subgroup of 249 patients with less advanced disease without excess of blasts, allogeneic SCT represented the most favouring treatment approach leading to estimated 10 years survival in 49.1% of patients. However, when compared to patients treated by supportive care only, a benefit in overall survival for SCT did not become significant before 5 years of follow-up (estimated 5 years survival /e5yS/: 43.3% for supportive care vs. 54.7 % for SCT). Only 2 (3.8%) out of 53 transplanted patients died later than after 5 years follow-up in comparison to 31 (20.8%) out of 149 patients on supportive care; 22 of them died on complications not directly related to MDS and a late disease progression (between 6 and 26 years after diagnosis of MDS) was observed in 9 patients. Transplantation related mortality was 30.2%, SCT at the time of disease progression (>5% of bone marrow /BM/ blasts) and prolonged (>3 months) administration of corticosteroids prior to SCT were independent adverse prognostic factors for SCT outcome (P<0.001). Special treatment approaches were effective in selected subgroups of patients : rHuEPO in patients with sEPO < 100 IU/l and ≤ 2 TU of RBC/month, lenalidomide in patients with isolated del(5q) and ATG in hypoplastic MDS with e5yS of 63.6%,75.0% and 83.3%, respectively. In 169 patients with advanced MDS ( ≥ 10% BM blasts), allogeneic SCT was the only treatment option leading to prolonged survival ( e5yS: 48,9%). The difference between efficiency of SCT and treatment with hypomethylating agents (HMA) became significant after 2 years of follow-up, estimated 3years survival was 53,2% for SCT and 26.9% for HMA, e5yS for HMA was only 3.8%. The differences were similar in a subset of patients older than 50 years of age (e5yS for SCT: 31.3%, for HMA: 3.2%). Reduction of BM blasts below 10% prior to SCT was an important factor affecting outcome of patients (median survival 62.3 months for those transplanted with < 10% BM blasts vs. 17.0 months for those with ≥ 10% BM blasts /P<0.001/). The type and intensity of conditioning did not affect outcome of SCT. Seven (14.9%) out of 47 transplanted patients relapsed, all of them within 3 years after SCT, 6 of them entered SCT with ≥ 10% BM blasts. Only 3 (6.4%) SCT patients died later than 5 years after SCT. Introduction of HMA improved short term outcome of patients not indicated for SCT ( estimated 1 year survival for HMA was 80.8% vs. 41.3% for combination chemotherapy and 52.9% for low dose ARA-C) but only minimum (4.1%) of non-transplanted patients survived 5 years. CONCLUSIONS : The analysis of long-term follow-up showed that younger patients with less advanced MDS without excess of blasts and adverse prognostic factors should be transplanted as soon as possible after diagnosis before disease progression. An advantage of more conservative approach to patients with early disease who are not indicated for SCT was confirmed by presence of a relatively high number of patients surviving 5 years with supportive care only. SCT represented the treatment of choice for advanced MDS and reduction of BM blasts prior to SCT siginficantly affected outcome of SCT. Administration of HMA significantly improved short term survival but did not affect long term outcome of patients. Disclosures No relevant conflicts of interest to declare.

Abstract P350: Completion of Cardiac Rehabilitation Reduces Hospital Admission Rates in Long Term Follow-up

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Maria Sobolev ◽  
David Z Prince ◽  
Ju Gao ◽  
Cynthia Taub
Keyword(s):  
Cardiac Rehabilitation ◽  
Short Term ◽  
Admission Rates ◽  
Hospitalization Rates ◽  
Gender And Age ◽  
Long Term Follow Up ◽  
Cardiac Diagnosis

Introduction: Cardiac rehabilitation (CR) improves exercise tolerance, quality of life, and mortality among patients with heart disease in short term follow-up. Less is known regarding the sustained benefits attributable to CR after 1 year. Hypothesis: CR attendees have decreased morbidity, represented by lower admission rates. Methods: A database of patients referred to CR between May 2001 and January 2011 was constructed. Data on gender, race, age, and attendance was collected. Completion of CR was designated as 36 sessions. Participants attending 1 to 35 sessions were excluded. All cause hospitalization was recorded from the date of primary cardiac diagnosis. Data was analyzed using a t-test to compare hospitalization rates between participants and non-participants. Baseline admission rates were compared. Results: 162 participants competed CR, 84 (52%) of minority race, 98 (60%) males, 95 (59%) were 65 or older. There were 229 non-participants, 147 (64%) of minority race, 147 (64%) males, 77 (34%) were 65 or older. Mean follow up time was 6 years. Completion of CR resulted in lower mean hospitalization rates (1.19 vs. 2.93, p = 0.001) in all groups: Caucasians 0.92 vs. 2.99 (p = 0.005), minorities 1.44 vs. 2.89 (p = 0.035), males 1.32 vs. 2.89 (p = 0.011), females 1.00 vs. 3.02 (p = 0.003), age 65 or older 0.96 vs. 3.96 (p = <0.001). There was no difference in baseline mean hospitalization rates between participants and non-participants when comparing race or gender: non-participant Caucasians 2.99 vs. minorities 2.89 (p = 0.895), participant Caucasians 0.92 vs. minorities 1.44 (p = 0.246), non-participant males 2.87 vs. females 3.02 (p = 0.834), participant males 1.32 vs. females 1.00 (p=0.489). There was no difference in baseline mean hospitalization rates when comparing participants younger than 65 with 65 or older (1.52 vs. 0.96, p = 0.212). Non-participants 65 or older had significantly higher hospitalization rates than younger non-participants (3.96 vs. 2.33, p = 0.027). Conclusions: Long term follow-up of CR participants demonstrated a sustained morbidity benefit. Previous studies were limited to 1 year follow-up. Race, gender, and age did not influence morbidity, although participants older than 65 may have an additional morbidity reduction.

scholarly journals Individualised exercise in chronic non-specific low back pain: a systematic review with meta-analysis on the effects of exercise alone or in combination with psychological interventions on pain and disability

2021 ◽  
Author(s):  
Johannes Fleckenstein ◽  
Philipp Floessel ◽  
Tilman Engel ◽  
Laura Klewinghaus ◽  
Josefine Stoll ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Meta Analysis ◽  
Group Analysis ◽  
Low Back ◽  
Short Term ◽  
Long Term Follow Up

Objective To investigate the effects of individualised exercise interventions consisting with or without combined psychological intervention on pain intensity and disability in patients with chronic non-specific low back pain. Design Systematic review with meta-analysis and meta-regression. Data sources Five databases (PubMed, Cochrane Central, EMBASE, Clarivate Web of Science, and Google Scholar) were searched up to 31 March 2021. Selection criteria Randomised controlled trials were eligible if they included participants with chronic non-specific low back pain, compared at least one individualised/personalised/stratified exercise intervention with or without psychological treatment to any control / comparator group, and if they assessed at least pain intensity or disability as outcome measure. Results Fifty-eight studies (n = 9099 patients, 44.3 years, 56% female) compared individualised to other types of exercise (n = 44; 62%), usual care (n = 16; 23%), advice to stay active, or true controls. The remaining studies had passive controls. At short-term follow-up, low-certainty evidence for pain intensity (SMD -0.33 [95%CI -0.47 to -0.18]) and very low-certainty evidence for disability (-0.16 [-0.30 to -0.02]) indicates effects of individualised exercise compared to other exercises. Very low-certainty evidence for pain intensity (-0.35; [-0.53 to -0.17])) and low-certainty evidence for disability (-0.12; [-0.22 to -0.02]) indicates effects compared to passive controls. At long-term follow-up, moderate-certainty evidence for pain intensity (-0.14 [-0.23 to -0.06]) and disability (-0.23 [-0.33 to -0.12]) indicates effects compared to passive controls exercises. All findings stayed below the threshold for minimal clinically important difference (MCID). Certainty of evidence was downgraded mainly due to evidence of risk of bias, publication bias and inconsistency that could not be explained. Sensitivity analyses indicated that the effects on pain, but not on disability (always short-term and versus active treatments) were robust. Sub-group analysis of pain outcomes suggested that individualised exercise treatment is probably more effective in combination with psychological interventions (-0.32 [-0.51 to -0.14]), a clinically important difference Conclusion We found very low to moderate-certainty evidence that individualised exercise is effective for treatment of chronic non-specific low back pain. Individualised exercise seems superior to other active treatments and sub-group analysis suggests that some forms of individualised exercise (especially motor-control based treatments) combined with behavioural therapy interventions enhances the treatment effect. Certainty of evidence was higher for long-term follow-up. In summary, individualised exercise can be recommended from a clinical point of view.

Anticoagulation in addition to dual antiplatelet therapy has no impact on long-term follow-up after endovascular treatment of (sub)acute lower limb ischemia

VASA ◽  
2019 ◽  
Vol 48 (4) ◽  
pp. 321-329
Author(s):  
Mariya Kronlage ◽  
Erwin Blessing ◽  
Oliver J. Müller ◽  
Britta Heilmeier ◽  
Hugo A. Katus ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Limb Ischemia ◽  
Bleeding Complications ◽  
Severe Bleeding ◽  
Short Term ◽  
Long Term Follow Up

Summary. Background: To assess the impact of short- vs. long-term anticoagulation in addition to standard dual antiplatelet therapy (DAPT) upon endovascular treatment of (sub)acute thrombembolic occlusions of the lower extremity. Patient and methods: Retrospective analysis was conducted on 202 patients with a thrombembolic occlusion of lower extremities, followed by crirical limb ischemia that received endovascular treatment including thrombolysis, mechanical thrombectomy, or a combination of both between 2006 and 2015 at a single center. Following antithrombotic regimes were compared: 1) dual antiplatelet therapy, DAPT for 4 weeks (aspirin 100 mg/d and clopidogrel 75 mg/d) upon intervention, followed by a lifelong single antiplatelet therapy; 2) DAPT plus short term anticoagulation for 4 weeks, followed by a lifelong single antiplatelet therapy; 3) DAPT plus long term anticoagulation for > 4 weeks, followed by a lifelong anticoagulation. Results: Endovascular treatment was associated with high immediate revascularization (> 98 %), as well as overall and amputation-free survival rates (> 85 %), independent from the chosen anticoagulation regime in a two-year follow up, p > 0.05. Anticoagulation in addition to standard antiplatelet therapy had no significant effect on patency or freedom from target lesion revascularization (TLR) 24 months upon index procedure for both thrombotic and embolic occlusions. Severe bleeding complications occurred more often in the long-term anticoagulation group (9.3 % vs. 5.6 % (short-term group) and 6.5 % (DAPT group), p > 0.05). Conclusions: Our observational study demonstrates that the choice of an antithrombotic regime had no impact on the long-term follow-up after endovascular treatment of acute thrombembolic limb ischemia whereas prolonged anticoagulation was associated with a nominal increase in severe bleeding complications.

Long term follow-up in quality of life after mitral valve surgery

2012 ◽  
Vol 60 (S 01) ◽  
Author(s):  
I Kammerer ◽  
M Höhn ◽  
AH Kiessling ◽  
S Becker ◽  
FU Sack
Keyword(s):  
Quality Of Life ◽  
Mitral Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Long Term Follow Up

Prognostic factors that mandate long term follow up following surgery for appendix neuroendocrine tumours (aNETs)

2016 ◽  
Author(s):  
Edward Alabraba ◽  
Heman Joshi ◽  
Andrea Tufo ◽  
Hassan Malik ◽  
Melissa Banks ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Neuroendocrine Tumours ◽  
Long Term Follow Up
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