The Impact of Optimal Cerebral Perfusion Pressure on Postoperative Neurologic Outcome - A Propensity Score Analysis of 800 Patients with Selective Antegrade Cerebral Perfusion in Aortic Surgery

Background Percutaneous coronary intervention (PCI) is performed in patients with coronary artery disease who are undergoing major noncardiac procedures to reduce perioperative cardiac morbidity and mortality. However, the impact of this approach on postoperative outcome remains controversial. Methods The authors analyzed a cohort of 1,152 patients after abdominal aortic surgery in which 78 patients underwent PCI. A propensity score analysis was performed. Also, using a logistic regression model, the authors determined variables associated with a severe postoperative coronary event or a death in patients without PCI. Then, in patients with PCI, they compared the expected and observed outcome. Results Five variables (age > 75 yr, blood transfusion > 3 units, repeated surgery, preoperative hemodialysis, and previous cardiac failure) independently predicted (with 94% correctly classified) a severe postoperative coronary event, and five variables (age > 75 yr, repeated surgery, previously abnormal ST segment/T waves, previous hypertension, and previous cardiac failure) independently predicted (with 97% correctly classified) postoperative death. In the PCI group, the observed percentages of patients with a severe postoperative coronary event (9.0% [95% confidence interval, 4.4-17.4]) or death (5.1% [95% confidence interval, 2.0-12.5]) were not significantly different from the expected percentages (8.2 and 6.9%, respectively). When all patients were pooled together, the odds ratios of PCI were not significant. The propensity score analysis provided a similar conclusion. Conclusion PCI did not seem to limit significantly cardiac risk or death after aortic surgery.

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The Impact of Texas HIPPY on School Readiness and Academic Achievement: Optimal Full Propensity Score Analysis Approach

Early Childhood Education Journal ◽

10.1007/s10643-021-01226-w ◽

2021 ◽

Author(s):

Noor Amal Abdulaziz

Keyword(s):

Academic Achievement ◽

Propensity Score ◽

School Readiness ◽

Propensity Score Analysis ◽

Analysis Approach ◽

Score Analysis ◽

The Impact

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Burden of motorcyclists without helmets in a state without a universal helmet law: a propensity score analysis

Trauma Surgery & Acute Care Open ◽

10.1136/tsaco-2020-000583 ◽

2020 ◽

Vol 5 (1) ◽

pp. e000583

Author(s):

Michael D Jones ◽

Joel G Eastes ◽

Damjan Veljanoski ◽

Kristina M Chapple ◽

James N Bogert ◽

...

Keyword(s):

Propensity Score ◽

Propensity Score Analysis ◽

Alcohol Intoxication ◽

Civil Liberties ◽

Hospital Charges ◽

Trauma Patients ◽

Level Of Evidence ◽

Helmet Use ◽

Score Analysis ◽

The Impact

BackgroundAlthough helmets are associated with reduction in mortality from motorcycle collisions, many states have failed to adopt universal helmet laws for motorcyclists, in part on the grounds that prior research is limited by study design (historical controls) and confounding variables. The goal of this study was to evaluate the association of helmet use in motorcycle collisions with hospital charges and mortality in trauma patients with propensity score analysis in a state without a universal helmet law.MethodsMotorcycle collision data from the Arizona State Trauma Registry from 2014 to 2017 were propensity score matched by regressing helmet use on patient age, sex, race/ethnicity, alcohol intoxication, illicit drug use, and comorbidities. Linear and logistic regression models were used to evaluate the impact of helmet use.ResultsOur sample consisted of 6849 cases, of which 3699 (54.0%) were helmeted and 3150 (46.0%) without helmets. The cohort was 88.1% male with an average age of 40.9±16.0 years. Helmeted patients were less likely to be admitted to the intensive care unit (20.3% vs. 23.7%, OR 0.82 (0.72–0.93)) and ventilated (7.8% vs. 12.0%, OR 0.62 (0.52–0.75)). Propensity-matched analyses consisted of 2541 pairs and demonstrated helmet use to be associated with an 8% decrease in hospital charges (B −0.075 (0.034)) and a 56% decrease in mortality (OR 0.44 (0.31–0.58)).DiscussionIn a state without mandated helmet use for all motorcyclists, the burden of the unhelmeted rider is significant with respect to lives lost and healthcare charges incurred. Although the helmet law debate with respect to civil liberties is complex and unsettled, it appears clear that helmet use is strongly associated with both survival and less economic encumbrance on the state.Level of evidenceLevel III, prognostic and epidemiological.

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