scholarly journals 1409. Pulmonary Non-tuberculous Mycobacterium Infection (PNTMI) and COVID-19: Characterization of the National COVID Collaborative Cohort (N3C)

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S788-S789
Author(s):  
Carlos E Figueroa Castro ◽  
William Hersh
Keyword(s):  
Statistical Significance ◽  
Demographic Data ◽  
Adverse Outcomes ◽  
Descriptive Statistics ◽  
Statistical Significance Testing ◽  
Data Resource ◽  
Mycobacterium Infection ◽  
Number Of Patients ◽  
Low Prevalence ◽  
The Impact

Abstract Background Establishing whether a low-prevalence clinical condition is a risk factor for COVID-19 infection, or serious adverse outcomes, is difficult due to a limited number of patients, and lack of access to patient’s data by researchers. The National COVID Collaborative Cohort (N3C), a centralized national data resource to study COVID-19, provides access to structured clinical data derived from electronic health records. As of June 2021, N3C contains data on 6,193,738 patients (2,090,138 with COVID-19, 33.7%) from 55 participating sites (Figure 1). We describe the characteristics of patients with PNTMI based on COVID-19 infection status. Figure 1 N3C Basic Demographic Data Methods COVID-19 is defined by positive lab result (PCR, antigen, or antibody) or COVID-19 coding diagnosis, as defined by N3C. PNTMI phenotype was built with N3C Data Enclave concept set tool, and ATLAS (https://atlas.ohdsi.org/). We limited analysis to adults (18 years-old or older). We used de-identified data sets stripped of protected health information (PHI). We used N3C Data Enclave analytical tools for exploratory data analysis, and descriptive statistics. Results We identified five hundred and eighty six individuals from 19 sites fulfilling the PNTMI phenotype (9.46 cases per 100,000 people). After our age limit, 555 individuals were included for analysis (Figure 2). 340 were females (61.3%), 447 of white race (80.5%), and 30 were Hispanic (5.4%). Additional descriptive statistics and statistical significance testing are provided (Table 1). The most common concept were "Non-tuberculous mycobacterial pneumonia", and "Pulmonary Mycobacterium avium complex infection". Four sites accounted for more than 50% of identified patients (Figure 2). We identified 24 individuals with COVID-19 (4.32%), and 44 deaths in this cohort (7.9%). Deaths were unrelated to COVID-19 event. Figure 2. Basic demographic data of pulmonary non-tuberculous Mycobacterium infection phenotype in N3C Figure 3. Concepts and data sources of pulmonary non-tuberculous Mycobacterium infection phenotype in N3C Conclusion In N3C, the PNTMI cohort has a lower proportion of COVID-19 infection than the general population, and it was not a cause of mortality. Further analysis to study impact of comorbidities, and differences in race and geographical location are warranted. N3C is a powerful research platform to study the impact of COVID-19 in special populations with low prevalence, and it can be used to study other populations of interest. Disclosures All Authors: No reported disclosures

scholarly journals Clinicopathological features of Egyptian colorectal cancer patients regarding somatic genetic mutations especially in KRAS gene and microsatellite instability status: a pilot study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Neemat M. Kassem ◽  
Gamal Emera ◽  
Hebatallah A. Kassem ◽  
Nashwa Medhat ◽  
Basant Nagdy ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Microsatellite Instability ◽  
Cpg Island ◽  
Human Cancer ◽  
Statistical Significance ◽  
Public Health Problem ◽  
World Health ◽  
Cpg Island Methylator Phenotype ◽  
Number Of Patients ◽  
The Impact

Abstract Background Colorectal cancer (CRC) is the third most common cause of cancer-related deaths which contributes to a significant public health problem worldwide with 1.8 million new cases and almost 861,000 deaths in 2018 according to the World Health Organization. It exhibits 7.4% of all diagnosed cancer cases in the region of the Middle East and North Africa. Molecular changes that happen in CRCs are chromosomal instability, microsatellite instability (MSI), and CpG island methylator phenotype. The human RAS family (KRAS, NRAS, and HRAS) is the most frequently mutated oncogenes in human cancer appearing in 45% of colon cancers. Determining MSI status across CRCs offers the opportunity to identify patients who are likely to respond to targeted therapies such as anti-PD-1. Therefore, a method to efficiently determine MSI status for every cancer patient is needed. Results KRAS mutations were detected in 31.6% of CRC patients, namely in older patients (p = 0.003). Codons 12 and 13 constituted 5/6 (83.3%) and 1/6 (16.7%) of all KRAS mutations, respectively. We found three mutations G12D, G12C, and G13D which occur as a result of substitution at c.35G>A, c.34G>T, and c.38G>A and have been detected in 4/6 (66.6%), 1/6 (16.7%), and 1/6 (16.7%) patients, respectively. Eleven (57.9%) patients had microsatellite instability-high (MSI-H) CRC. A higher percentage of MSI-H CRC was detected in female patients (p = 0.048). Eight patients had both MSI-H CRC and wild KRAS mutation with no statistical significance was found between MSI status and KRAS mutation in these studied patients. Conclusion In conclusion, considering that KRAS mutations confer resistance to EGFR inhibitors, patients who have CRC with KRAS mutation could receive more tailored management by defining MSI status. MSI-high patients have enhanced responsiveness to anti-PD-1 therapies. Thus, the question arises as to whether it is worth investigating this association in the routine clinical setting or not. Further studies with a larger number of patients are needed to assess the impact of MSI status on Egyptian CRC care.

Primary care physician services and the frequency of comorbidities in patients with acute myocardial infarction

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
R King ◽  
D Giedrimiene
Keyword(s):  
Myocardial Infarction ◽  
Primary Care ◽  
Acute Myocardial Infarction ◽  
Primary Care Physician ◽  
Care Physician ◽  
Adverse Outcomes ◽  
Coronary Syndrome ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background The management of patients with multiple comorbidities represents a significant burden on healthcare each year. Despite requiring regular medical care to treat chronic conditions, a large number of these patients may not receive proper care. Significant disparities have been identified in patients with multiple comorbidities and those who experience acute coronary syndrome or acute myocardial infarction (AMI). Only limited data exists to identify the impact of comorbidities and utilization of primary care physician (PCP) services on the development of adverse outcomes, such as AMI. Purpose The primary objective was to analyze how PCP services utilization can be associated with comorbidities in patients who experienced an AMI. Methods This study was based on retrospective data analysis which included 250 patients admitted to the Hartford Hospital Emergency Department (ED) for an AMI. Out of these, 27 patients were excluded due to missing documentation. Collected data included age, gender, medications and recorded comorbidities, such as hypertension, hyperlipidemia, diabetes mellitus (DM), chronic kidney disease (CKD) and previous arrhythmia. Each patient was assessed regarding utilization of PCP services. Statistical analysis was performed in order to identify differences between patients with documented PCP services and those without by using the Chi-square test. Results The records allowed for identification of documented PCP services for 172 out of 223 (77.1%) patients. The most common comorbidities were hypertension and hyperlipidemia: in 165 (74.0%) and 157 (70.4%) cases respectively. The most frequent comorbidity was hypertension: 137 out of 172 (79.7%) in pts with PCP vs 28 out of 51 (54.9%) without PCP, and significantly more often in patients with PCP, p< 0.001. Hyperlipidemia was the second most frequent comorbidity: in 130 out of 172 (75.6%) vs 27 out of 51 (52.9%) accordingly, and also significantly more often (p< 0.002) in patients with PCP services. The number of comorbidities ranged from 0-5, including 32 (14.3%) patients without comorbidities: 16 (9.3%) with a PCP and 16 (31.4%) without PCP services. The majority of patients - 108 (48.5% of 223), had 2-3 documented comorbidities: 89 (51.8%) had two and 19 (34.6%) had three. The remaining 40 (17.9%) patients had 4-5 comorbidities: 37 (21.5%) of them with a PCP and 3 (10.3%) without, with a significant difference (p < 0.001) found for patients with a higher number of comorbidities who utilized PCP services. Conclusions Our study shows that the majority of patients who presented with an AMI had one or more comorbidities. Furthermore, patients who did not utilize PCP services had fewer identified comorbidities. This suggests that there may be a significant number of patients who experienced AMI with undiagnosed comorbidities due to not having access to PCP services.

scholarly journals Impact of health disparities on treatment for single-suture craniosynostosis in an era of multimodal care

2021 ◽  
Vol 50 (4) ◽  
pp. E13
Author(s):  
Caitlin Hoffman ◽  
Alyssa B. Valenti ◽  
Eseosa Odigie ◽  
Kwanza Warren ◽  
Ishani D. Premaratne ◽  
...  
Keyword(s):  
Open Surgery ◽  
Statistical Significance ◽  
Demographic Data ◽  
Tertiary Care ◽  
Insurance Status ◽  
Significant Difference ◽  
Race Ethnicity ◽  
The Impact ◽  
Type Of Surgery ◽  
Surgical Group

Craniosynostosis is the premature fusion of the skull. There are two forms of treatment: open surgery and minimally invasive endoscope-assisted suturectomy. Candidates for endoscopic treatment are less than 6 months of age. The techniques are equally effective; however, endoscopic surgery is associated with less blood loss, minimal tissue disruption, shorter operative time, and shorter hospitalization. In this study, the authors aimed to evaluate the impact of race/ethnicity and insurance status on age of presentation/surgery in children with craniosynostosis to highlight potential disparities in healthcare access. Charts were reviewed for children with craniosynostosis at two tertiary care hospitals in New York City from January 1, 2014, to August 31, 2020. Clinical and demographic data were collected, including variables pertaining to family socioeconomic status, home address/zip code, insurance status (no insurance, Medicaid, or private), race/ethnicity, age and date of presentation for initial consultation, type of surgery performed, and details of hospitalization. Children with unknown race/ethnicity and those with syndromic craniosynostosis were excluded. The data were analyzed via t-tests and chi-square tests for statistical significance (p < 0.05). A total of 121 children were identified; 62 surgeries were performed open and 59 endoscopically. The mean age at initial presentation of the cohort was 6.68 months, and on the day of surgery it was 8.45 months. Age at presentation for the open surgery cohort compared with the endoscopic cohort achieved statistical significance at 11.33 months (SD 12.41) for the open cohort and 1.86 months (SD 1.1473) for the endoscopic cohort (p < 0.0001). Age on the day of surgery for the open cohort versus the endoscopic cohort demonstrated statistical significance at 14.19 months (SD 15.05) and 2.58 months (SD 1.030), respectively. A statistically significant difference between the two groups was noted with regard to insurance status (p = 0.0044); the open surgical group comprised more patients without insurance and with Medicaid compared with the endoscopic group. The racial composition of the two groups reached statistical significance when comparing proportions of White, Black, Hispanic, Asian, and other (p = 0.000815), with significantly more Black and Hispanic patients treated in the open surgical group. The results demonstrate a relationship between race and lack of insurance or Medicaid status, and type of surgery received; Black and Hispanic children and children with Medicaid were more likely to present later and undergo open surgery.

scholarly journals 257 The Effect of the COVID-19 Pandemic on Mental Health Associated Trauma, Admissions and Fractures at a London Major Trauma Centre

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M S Jamal ◽  
D Hay ◽  
K Al-Tawil ◽  
A Petohazi ◽  
V Gulli ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychiatric Diagnosis ◽  
Major Trauma ◽  
Mental Health Problems ◽  
Demographic Data ◽  
Trauma Centre ◽  
Related Factors ◽  
Number Of Patients ◽  
Major Trauma Centre ◽  
The Impact

Abstract Aim Non-injury related factors have been extensively studied in major trauma and shown to have a significant impact on patient outcomes, with mental illness and associated medication use proven to have a negative effect on bone health and fracture healing. We report the epidemiological effect of COVID-19 pandemic on mental health associated Orthopaedic trauma, fractures, and admissions to our centre. Method We collated data retrospectively from the electronic records of Orthopaedic inpatients in an 8-week non-COVID and COVID period analysing demographic data, referral and admission numbers, orthopaedic injuries, surgery performed and patient co-morbidities including psychiatric history. Results here were 824 Orthopaedic referrals and 358 admissions (6/day) in the non-COVID period with 38/358 (10.6%) admissions having a psychiatric diagnosis and 30/358 (8.4%) also having a fracture. This was compared to 473 referrals and 195 admissions (3/day) in the COVID period with 73/195 (37.4%) admissions having a documented psychiatric diagnosis and 47/195 (24.1%) a fracture. 22/38 (57.9%) and 52/73 (71.2%) patients were known to mental health services, respectively. Conclusions Whilst total numbers utilising the Orthopaedic service decreased, the impact of the pandemic and lockdown disproportionately affected those with mental health problems, a group already at higher risk of poorer functional outcomes and non-union. The proportion of patients with both a fracture and a psychiatric diagnosis more than doubled and the number of patients presenting due to a traumatic suicide attempt almost tripled. It is imperative that adequate support is in place for vulnerable mental health patients, particularly as we are currently experiencing the “second wave” of COVID-19.

scholarly journals Impact of Demonetization Process on the Performance of Nifty

2021 ◽  
Vol 2 (1) ◽  
pp. 16-30
Author(s):  
Mohd. Shamim
Keyword(s):  
Statistical Significance ◽  
T Test ◽  
Descriptive Statistics ◽  
Periodic Review ◽  
Paired Sample ◽  
Long Run ◽  
Negative Impacts ◽  
Future Policy ◽  
The Impact ◽  
Statistical Results

This paper investigates the impact of demonetization process on the performance of Nifty 50 and its Sectorial Indices. The study uses data of closing prices from 28 June 2016 up to 20 March 2017. The study employs descriptive statistics, paired sample T test and ANOVA to evaluate the impact of demonetization process on the performance of Nifty 50 and its Sectorial Indices. It has found that there is statistical significance at the level of 5% that Nifty 50 dropped after the demonetization event as compared to the pre demonetization event. Further, the results reveal that most of Sectorial Indices of Nifty 50 sloped downward post demonetization event and the significance of the statistical results are varied from one sector to another. It is recommended that periodic review of the policy should be made to iron out the negative impacts of demonetization. Also, it is imperative to evaluate the impact of demonetization on the short, medium, and long run to avoid any grey areas for any future policy regarding cashless economy or demonetization.

scholarly journals Access to Breast Cancer Care in Jos, North Central

2020 ◽  
pp. 1-7
Author(s):  
Alexander Femi Ale ◽  
Mercy Wakili Isichei ◽  
Michael Ayedima Misauno
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Cancer Care ◽  
Demographic Data ◽  
Descriptive Statistics ◽  
University Teaching ◽  
Treatment Modalities ◽  
Breast Cancer Care ◽  
Number Of Patients ◽  
Health Care Centers

Aims: This paper seeks to evaluate the extent to which breast cancer patients from two tertiary health care centers in Jos were able to access the different components of breast cancer care. Background: Breast cancer in low- and middle-income countries is associated with poor outcomes when compared with high-income countries. Numerous studies have identified factors responsible for this, one of them being a lack of access to the various components of breast cancer care. Breast cancer care requires a multimodal approach involving prevention, early detection, diagnosis and treatment, rehabilitation and palliative care. Access to the various modalities of care is key to a good outcome. Study Design: This study is a retrospective study. Place and Duration of the Study: The study was carried out at Jos University Teaching Hospital, and FOMAS Hospital which are both tertiary health care centers located in the city of Jos, Plateau State, Nigeria. The study spanned January 2016 to June 2019.We applied descriptive statistics for data analysis. Methodology: We included all patients who were diagnosed with breast cancer between January 2016 and December 2017. Patients were followed up for a minimum of one and a half years (from January 2018 to June 2019). The project team performed a review of medical records and charts for data elements which included; sex, age, site of tumor, stage of tumor at presentation, and access to the different treatment modalities. Data was entered into a pre-designed proforma and analyzed on the SPSS 20 Chicago, Illinois. We applied descriptive statistics to the demographic data and clinical information of patients. Results: The total number of patients was 110. Forty-four (40%) patients had access to immunohistochemistry (IHC). Eighty-nine (81%) patients were eligible for chemotherapy. Twenty-one (19%) patients were not fit for chemotherapy. Ten (9%) patients received radiotherapy.  A total of 73 (66%) patients had different forms of breast surgeries. Three (3%) patients declined surgery, while 34 (31%) were not fit for surgery. Thirty-four (31%) patients were treated with hormonal therapy. Conclusion: This study examined access to the various components of breast cancer care within two tertiary health centers. It shows that in our environment, there is limited access to immunohistochemistry, chemotherapy, radiotherapy and targeted therapy.

scholarly journals E-Learning perception and satisfaction among health sciences students amid the COVID-19 pandemic

Work ◽  
2020 ◽  
Vol 67 (3) ◽  
pp. 549-556
Author(s):  
Maria S. Abbasi ◽  
Naseer Ahmed ◽  
Batool Sajjad ◽  
Abdullah Alshahrani ◽  
Sumera Saeed ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Demographic Data ◽  
Developed Countries ◽  
Health Sciences ◽  
T Test ◽  
P Value ◽  
Exit Exams ◽  
Health Sciences Students ◽  
E Learning ◽  
The Impact

BACKGROUND: E-learning is increasingly used during the COVID-19 pandemic, however the impact of this change on students is not known. This study aimed to evaluate perception and satisfaction of health sciences students towards E-learning during the COVID-19 lockdown. METHODS: A structured questionnaire was distributed to 2000 health care students either through email or social media platforms. The questionnaire was divided into two sections: the first section addressed demographic information such as age, education level, course of study, number of lectures attended and country. The second section gathered information on perception and satisfaction of students using 13 close-ended questions. Frequencies and percentages were assessed for demographic data, perception and satisfaction level of students. The paired sample t-test, independent t test and Spearman correlation were applied to evaluate statistical significance between different variables of the study. A p-value of <0.05 was considered significant. RESULTS: Data from 1255 participants were included at a response rate of 66.4%. More than one third (37%) of the students took 25 or more online E-learning sessions and 47% preferred Zoom as an online platform. Participants belonged to 11 countries from developed and developing nations. 41% reported interference of E-learning due to network problems. 60% considered that clinical and practical skills are best learned in clinics and laboratories. More than one third of the students preferred classroom teaching and 34% of the students did not feel confident enough to take exit exams after E-learning sessions. CONCLUSION: E-learning satisfaction levels were better among developed countries (7.34) compared to developing countries (5.82). The majority of participants agreed that E-learning was satisfactory in acquiring knowledge, however not effective in acquiring clinical and technical skills. As the COVID-19 lockdown eases, there is a need for improvement in the methods employed in E-learning and more blended learning among healthcare students is recommended.

scholarly journals Patients’ perceptions and experiences about the root canal treatment: An exploratory study among Saudi population

2021 ◽  
Vol 11 ◽  
pp. 5
Author(s):  
Abdulaziz Abdulrahman Aleid
Keyword(s):  
Root Canal ◽  
Statistical Significance ◽  
Demographic Data ◽  
Post Treatment ◽  
Root Canal Treatment ◽  
Saudi Population ◽  
Dental Patients ◽  
Number Of Patients ◽  
Significant Difference ◽  
Pre Treatment

Objectives: Root canal treatment (RCT) is one of the most popular treatments at dental setting and pain and anxiety is a great source of concern for dental patients and dentist. However, in Saudi Arabia the current literature containing data on endodontic pain with clear comparisons of pre-treatment and post-treatment is extremely rare. The aim of this study was to investigate the perception of Saudi population about RCT and its relation with pain and anxiety. Material and Methods: A sample of 76 patients were selected for this questionnaire based survey. Participants were asked to provide their response toward the endodontic treatment before and after the treatment. Pre-validated questionnaires consisted of demographic data, questions on anxiety, pain, and concerned about RCT. Descriptive statistics, independent, and paired t-tests were used to compare between pre-test and post-test score. The level of statistical significance was set at 5%. Results: In the present study, patient’s anxiety score was assessed which was found to be significantly decreased from pre-treatment 31.47 ± 28.90 to post-treatment 23.28 ± 25.95. Likewise, mean anticipated and experience of pain score were also significantly reduced pre-treatment 41.07 ± 29.35 to post-treatment 21.90 ± 24.50. Conclusion: Current study reported a significant difference in reduction of mean anxiety for RCT post-treatment. Moreover, there was significant difference found between anticipated pain and experienced pain for the treatment. Before the treatment significant number of patients was not concerned for RCT and majority of the patients were concerned for pain associated to RCT.

scholarly journals Toxicogenetic analysis of Δ9-THC-metabolizing enzymes

2020 ◽  
Vol 134 (6) ◽  
pp. 2095-2103
Author(s):  
Angela Gasse ◽  
Marielle Vennemann ◽  
Helga Köhler ◽  
Jennifer Schürenkamp
Keyword(s):  
Phase I ◽  
Statistical Significance ◽  
Demographic Data ◽  
Plasma Concentrations ◽  
Driving Under The Influence ◽  
Metabolizing Enzymes ◽  
Cytochrome P450 2C19 ◽  
Cyp2c9 Gene ◽  
The Impact ◽  
Specific Influence

Abstract While the impact of genetic polymorphisms on the metabolism of various pharmaceuticals is well known, more data are needed to better understand the specific influence of pharmacogenetics on the metabolism of delta 9-tetrahydocannabinol (Δ9-THC). Therefore, the aim of the study was to analyze the potential impact of variations in genes coding for phase I enzymes of the Δ9-THC metabolism. First, a multiplex assay for genotyping different variants of genes coding for phase I enzymes was developed and applied to 66 Δ9-THC-positive blood samples obtained in cases of driving under the influence of drugs (DUID). Genetic and demographic data as well as plasma concentrations of Δ9-THC, 11-hydroxy-Δ9-tetrahydrocannabinol (11-OH-Δ9-THC), and 11-nor-9-carboxy-Δ9-THC (Δ9-THC-COOH) were combined and statistically investigated. For cytochrome P450 2C19 (CYP2C19) variants, no differences in analyzed cannabinoid concentrations were found. There were also no differences in the concentrations of Δ9-THC and 11-OH-Δ9-THC for the different allelic CPY2C9 status. We recognized significantly lower Δ9-THC-COOH concentrations for CYP2C9*3 (p = 0.001) and a trend of lower Δ9-THC-COOH concentrations for CYP2C9*2 which did not reach statistical significance (p = 0.068). In addition, this study showed significantly higher values in the ratio of Δ9-THC/Δ9-THC-COOH for the carriers of the CYP2C9 variants CYP2C9*2 and CYP2C9*3 compared with the carriers of the corresponding wild-type alleles. Therefore, an impact of variations of the CYP2C9 gene on the interpretation of cannabinoid plasma concentrations in DUID cases should be considered.

scholarly journals Daily Medical Liaison Is Associated with Reduced Length of Stay and Complications in Selected Patients Admitted to a Regional Vascular Surgery Service

Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 78
Author(s):  
Emma Mitchell ◽  
Roisin Coary ◽  
Paul White ◽  
Emily Farrow ◽  
Amy Crees ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Vascular Surgery ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Primary Outcome Measure ◽  
Adverse Outcomes ◽  
Mean Difference ◽  
Post Intervention ◽  
Randomised Controlled ◽  
The Impact

Older adults undergoing vascular surgery are particularly vulnerable to adverse outcomes by virtue of their vascular risk factors and medical comorbidities. This study aimed to determine the impact of daily medical liaison for patients aged 65 years and older admitted to a regional vascular surgery centre. This was a descriptive before-and-after study concerning 375 patients. The primary outcome measure was length of stay (LOS). Following intervention, we identified a reduction in mean LOS in the sample from 10.75 to 7.95 days (p = 0.635, 95% Confidence Interval [CI] 0–5 days) with a statistically significant reduction in mean LOS for “stranded” patients admitted for more than seven days (mean 7.84 days reduction, p = 0.025, 95% CI for mean difference, 1.5 to 14 days). These patients did not display elevated 30-day readmission rates (12/60 to 8/72, p = 0.156, 95% CI −3% to 21%). A non-significant reduction in postoperative complications was seen in all patients in the post-intervention cohort (1.09 to 0.86 per person, p = 0.181, 95% CI −0.11 to 0.56), reaching statistical significance in emergency vascular admissions (1.81 to 0.97 complications per person, p = 0.01, mean difference = 0.84, 95% CI 0.21–1.46). This study demonstrated reduced LOS and complications in selected older patients admitted under vascular surgery after the introduction of a daily medical liaison model. These data are amongst the first to reproduce randomised controlled trial findings in a non-trial setting. Subgroup analysis indicates that patients admitted with acute pathology and those with long LOS may benefit most from medical liaison where resources are finite.

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