scholarly journals Trends in radiotherapy inpatient admissions in Germany: a population-based study over a 10-year period

Author(s):  
Daniel Medenwald ◽  
Rainer Fietkau ◽  
Gunther Klautke ◽  
Susan Langer ◽  
Florian Würschmidt ◽  
...  

Abstract Objective With the increasing complexity of oncological therapy, the number of inpatient admissions to radiotherapy and non-radiotherapy departments might have changed. In this study, we aim to quantify the number of inpatient cases and the number of radiotherapy fractions delivered under inpatient conditions in radiotherapy and non-radiotherapy departments. Methods The analysis is founded on data of all hospitalized cases in Germany based on Diagnosis-Related Group Statistics (G-DRG Statistics, delivered by the Research Data Centers of the Federal Statistical Office). The dataset includes information on the main diagnosis of cases (rather than patients) and the performed procedures during hospitalization based on claims of reimbursement. We used linear regression models to analyze temporal trends. The considered data encompass the period from 2008 to 2017. Results Overall, the number of patients treated with radiotherapy as inpatients remained constant between 2008 (N = 90,952) and 2017 (N = 88,998). Starting in January 2008, 48.9% of 4000 monthly cases received their treatment solely in a radiation oncology department. This figure decreased to 43.7% of 2971 monthly cases in October 2017. We found a stepwise decrease between December 2011 and January 2012 amounting to 4.3%. Fractions received in radiotherapy departments decreased slightly by 29.3 (95% CI: 14.0–44.5) fractions per month. The number of days hospitalized in radiotherapy departments decreased by 83.4 (95% CI: 59.7, 107.0) days per month, starting from a total of 64,842 days in January 2008 to 41,254 days in 2017. Days per case decreased from 16.2 in January 2008 to 13.9 days in October 2017. Conclusion Our data give evidence to the notion that radiotherapy remains a discipline with an important inpatient component. Respecting reimbursement measures and despite older patients with more comorbidities, radiotherapy institutions could sustain a constant number of cases with limited temporal shifts.

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1639
Author(s):  
Zhongyao Li ◽  
Dongqing Wang ◽  
Edward A. Ruiz-Narváez ◽  
Karen E. Peterson ◽  
Hannia Campos ◽  
...  

Only a few studies primarily examined the associations between starchy vegetables (other than potatoes) and metabolic syndrome (MetS). We aimed to evaluate the association between starchy vegetables consumption and MetS in a population-based sample of Costa Rican adults. We hypothesized that a higher overall intake of starchy vegetables would not be associated with higher MetS prevalence. In this cross-sectional study, log-binomial regression models were used to estimate prevalence ratios (PRs) of MetS across quintiles of total, unhealthy, healthy starchy vegetables, and individual starchy vegetables (potatoes, purple sweet potatoes, etc.), among 1881 Costa Rican adults. Least square means and 95% confidence intervals (CIs) from linear regression models were estimated for each MetS component by categories of starchy vegetable variables. Higher intakes of starchy vegetables were associated with a higher prevalence of MetS in crude models, but no significant trends were observed after adjusting for confounders. A significant inverse association was observed between total starchy and healthy starchy vegetables consumption and fasting blood glucose. In this population, starchy vegetables might be part of a healthy dietary pattern.


Pancreatology ◽  
2009 ◽  
Vol 9 (4) ◽  
pp. 420-426 ◽  
Author(s):  
Paul Georg Lankisch ◽  
Mirwais Karimi ◽  
Anja Bruns ◽  
Patrick Maisonneuve ◽  
Albert B. Lowenfels

2020 ◽  
Vol 18 (9) ◽  
pp. 1230-1237 ◽  
Author(s):  
Seyed M. Qaderi ◽  
Paul W. Dickman ◽  
Johannes H.W. de Wilt ◽  
Rob H.A. Verhoeven

Background: The increasing number of colorectal cancer (CRC) survivors need survival estimates that account for the time already survived. The aim of this population-based study was to determine conditional survival, cure proportions, and time-to-cure (TTC) of patients with colon or rectal cancer. Materials and Methods: All patients with pathologic stage I–III CRC treated with endoscopy or surgery, diagnosed and registered in the Netherlands Cancer Registry between 1995 and 2016, and aged 18 to 99 years were included. Conditional survival was calculated for those diagnosed before and after 2007. Cure proportions were calculated using flexible parametric models. Results: A total of 175,384 patients with pathologic stage I (25%), II (38%), or III disease (37%) were included. Conditional 5-year survival of patients with stage I, II, and III colon cancer having survived 5 years was 98%, 94%, and 92%, respectively. For patients with stage I–III rectal cancer, this was 96%, 89%, and 85%, respectively. Statistical cure in patients with colon cancer was reached directly after diagnosis (stage I) to 6 years (stage III) after diagnosis depending on age, sex, and disease stage. Patients with rectal cancer reached cure 0.5 years after diagnosis (stage I) to 9 years after diagnosis (stage III). In 1995, approximately 42% to 46% of patients with stage III colon or rectal cancer, respectively, were considered cured, whereas in 2016 this percentage increased to 73% to 78%, respectively. Conclusions: The number of patients with CRC reaching cure has increased substantially over the years. This study’s results provide valuable insights into trends of CRC patient survival and are important for patients, clinicians, and policymakers.


BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023004 ◽  
Author(s):  
Lindsay L Richter ◽  
Joseph Ting ◽  
Giulia M Muraca ◽  
Anne Synnes ◽  
Kenneth I Lim ◽  
...  

ObjectiveAfter a decade of increase, the preterm birth (PTB) rate has declined in the USA since 2006, with the largest decline at late preterm (34–36 weeks). We described concomitant changes in gestational age-specific rates of neonatal mortality and morbidity following spontaneous and clinician-initiated PTB among singleton infants.Design, setting and participantsThis retrospective population-based study included 754 763 singleton births in Washington State, USA, 2004–2013, using data from birth certificates and hospitalisation records. PTB subtypes included preterm premature rupture of membranes (PPROM), spontaneous onset of labour and clinician-initiated delivery.Outcome measuresThe primary outcomes were neonatal mortality and a composite outcome including death or severe neonatal morbidity. Temporal trends in the outcomes and individual morbidities were assessed by PTB subtype. Logistic regression yielded adjusted odds ratios (AOR) per 1 year change in outcome and 95% CI.ResultsThe rate of PTB following PPROM and spontaneous labour declined, while clinician-initiated PTB increased (all p<0.01). Overall neonatal mortality remained unchanged (1.3%; AOR 0.99, CI 0.95 to 1.02), though gestational age-specific mortality following clinician-initiated PTB declined at 32–33 weeks (AOR 0.85, CI 0.74 to 0.97) and increased at 34–36 weeks (AOR 1.10, CI 1.01 to 1.20). The overall rate of the composite outcome increased (from 7.9% to 11.9%; AOR 1.06, CI 1.05 to 1.08). Among late preterm infants, combined mortality or severe morbidity increased following PPROM (AOR 1.13, CI 1.08 to 1.18), spontaneous labour (AOR 1.09, CI 1.06 to 1.13) and clinician-initiated delivery (AOR 1.10, CI 1.07 to 1.13). Neonatal sepsis rates increased among all preterm infants (AOR 1.09, CI 1.08 to 1.11).ConclusionsTiming of obstetric interventions is associated with infant health outcomes at preterm. The temporal decline in late PTB among singleton infants was associated with increased mortality among late preterm infants born following clinician-initiated delivery and increased combined mortality or severe morbidity among all late preterm infants, mainly due to increased rate of sepsis.


2020 ◽  
Vol 145 (2) ◽  
pp. AB63
Author(s):  
Alyssa Kerber ◽  
Anna Kellund ◽  
Amy Weaver ◽  
Rachel Carlson ◽  
Seema Kumar ◽  
...  

2020 ◽  
Vol 44 (2) ◽  
pp. 204-210
Author(s):  
Mohamed M. Gad ◽  
Anas M. Saad ◽  
Muneer J. Al-Husseini ◽  
Youssef M. Abdel-Gawad ◽  
Obai M. Alsalhani ◽  
...  

Eye ◽  
2019 ◽  
Vol 34 (5) ◽  
pp. 892-900 ◽  
Author(s):  
Qing Zhang ◽  
Ye Zhang ◽  
Chen Xin ◽  
Yingyan Mao ◽  
Kai Cao ◽  
...  

Abstract Background/objectives To study the associations of intraocular pressure (IOP) and retinal vessel diameters: central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) with the maximum cup depth (MCD) in subjects with and without POAG. Subjects/methods Eligible subjects from the Handan Eye Study. All participants underwent physical and comprehensive eye examinations. Univariable and multivariable linear regression models assessed the association between MCD and other parameters. Results Four thousand one hundred and ninety-four eligible nonglaucoma and 40 POAG subjects were analyzed. On univariable analysis, deeper MCD was significantly associated with younger age, male gender, lower systolic blood pressure (BP), higher IOP, higher estimated cerebro-spinal fluid pressure (ECSFP), lower estimated trans-laminal cribrosa pressure difference (ETLCPD), longer axial length, narrower CRAE, narrower CRVE, larger disc area (DA) and a lower prevalence of hypertension and diabetes. On multivariable analysis, significant independent determinants of MCD were larger DA (P < 0.001; beta: 0.042; B: 0.20; 95% CI: 0.19, 0.22), younger age (P < 0.001; beta: −0.09; B: −0.002; 95% CI: −0.003, −0.001), higher IOP (P < 0.01; beta: 0.040; B: 0.003; 95% CI: 0.001, 0.005), and narrower CRAE (P < 0.001; beta: −0.06; B: −0.001; 95% CI: −0.001, −0.0003). On adding ECSFP and ETLCPD to the model, MCD was associated with IOP but not with estimated CSFP and TLCPD. A 1 μm decrease in CRAE or 1 mmHg increase of IOP was associated with a 1 μm increase of MCD (P < 0.001) and 3 μm increase of MCD respectively (P = 0.009). Conclusions Narrow CRVE and higher IOP are associated with an increase in MCD.


2017 ◽  
Vol 10 (2) ◽  
pp. 183-190 ◽  
Author(s):  
Falgun H Chokshi ◽  
David H Howard ◽  
Jeffrey G Jarvik ◽  
Richard Duszak

PurposeTo evaluate temporal trends and factors associated with vertebral augmentation use in myeloma patients with spinal fractures from 2002 to 2012.MethodsThis retrospective cohort study used the Surveillance, Epidemiology and End Results (SEER)-Medicare claims database for 2002 through 2012. We included patients age ≥66 years with myeloma and spinal fractures. First, we evaluated receipt of vertebral augmentation. Second, multivariate logistic regression was used to assess the impact of sociodemographic factors, treatment facility type, and underlying comorbidities on the odds of undergoing vertebral augmentation.ResultsOf 4725 myeloma patients with spinal fractures, 653 underwent vertebral augmentation. Procedures increased initially from <1.7% in 2002 to 21.0% (109/520) in 2007, 18.6% (81/435) in 2008, 21.4% (109/509) in 2009, and 17.5% (76/435) in 2011. Patients with a spinal fracture before myeloma diagnosis were twice as likely to undergo vertebral augmentation as patients with fracture after myeloma diagnosis (OR 2.06, 95% CI 1.55 to 2.75). Black patients were half as likely to undergo vertebral augmentation as white patients (OR 0.48, 95% CI 0.34 to 0.68). Patients with 3–5 comorbidities (OR 0.78, 95% CI 0.64 to 0.96) and ≥6 comorbidities (OR 0.69, 95% CI 0.54 to 0.87) were less likely than patients with 0–2 comorbidities to undergo vertebral augmentation.ConclusionsVertebral augmentation for myeloma patients with spinal fractures peaked between 2007 and 2009 and then declined. Providers may have adopted vertebral augmentation in myeloma patients since its introduction, and potentially modified practice patterns following the publication of trials of vertebral augmentation in patients with osteoporotic spinal fractures.


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