Complications after surgery for benign prostatic enlargement: a population-based cohort study in Ontario, Canada

ObjectivesTo examine the complication rates after benign prostatic enlargement (BPE) surgery and the effects of age, comorbidity and preoperative medical therapy.DesignA retrospective, population-based cohort study using linked administrative data.SettingOntario, Canada.Participants52 162 men≥66 years undergoing first BPE surgery between 1 January 2003 to 31 December 2014.InterventionMedical therapy preoperatively and surgery for BPE.Primary and secondary outcome measuresThe primary outcome was overall 30-day postoperative complication rates. Secondary outcomes included BPE-specific event rates (bleeding, infection, obstruction, trauma) and non-BPE specific event rates (cardiovascular, pulmonary, thromboembolic and renal). Multivariable analysis examined the association between preoperative medical therapy and postoperative complication rates.ResultsThe 30-day overall complication rate after BPE surgery was 2828 events/10 000 procedures and increased annually over the study period. Receipt of preoperative α-blocker monotherapy (relative rate (RR) 1.05; 95% CI 1.00 to 1.09; p=0.033) and antithrombotic medications (RR 1.27; 95% CI 1.22 to 1.31; p<0.0001) was associated with increased complication rates. Among the ≥80-year-old group, the rate of complications increased by 39% from 2003 to 2014 (RR 1.39; 95% CI 1.21 to 1.61; p<0.0001). The mean duration of medical and conservative management increased by a mean of 2.1 years between 2007 and 2014 (p<0.0001 for trend).ConclusionsThirty-day complication rates after BPE surgery have increased annually between 2003 and 2014. Preoperative medical therapy with alpha blockers or antithrombotics was independently associated with higher rates of complications. Over this time, the duration of conservative therapy also increased.

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Burden and outcome of neonatal surgical conditions in Nigeria: A countrywide multicenter cohort study

Journal of Neonatal Surgery ◽

10.47338/jns.v11.1029 ◽

2022 ◽

Vol 11 ◽

pp. 3

Author(s):

Hyginus Okechukwu Ekwunife ◽

Emmanuel Ameh ◽

Lukman Abdur-Rahman ◽

Adesoji Ademuyiwa ◽

Emem Akpanudo ◽

...

Keyword(s):

Cohort Study ◽

Surgical Site Infection ◽

Postoperative Complication ◽

Outcome Measure ◽

Postoperative Mortality ◽

Sub Saharan Africa ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Complication Rates ◽

Site Infection

Background: Despite a decreasing global neonatal mortality, the rate in sub-Saharan Africa is still high. The contribution and the burden of surgical illness to this high mortality rate have not been fully ascertained. This study is performed to determine the overall and disease-specific mortality and morbidity rates following neonatal surgeries; and the pre, intra, and post-operative factors affecting these outcomes. Methods: This was a prospective observational cohort study; a country-wide, multi-center observational study of neonatal surgeries in 17 tertiary hospitals in Nigeria. The participants were 304 neonates that had surgery within 28 days of life. The primary outcome measure was 30-day postoperative mortality and the secondary outcome measure was 30-day postoperative complication rates. Results: There were 200 (65.8%) boys and 104 (34.2%) girls, aged 1-28 days (mean of 12.1 ± 10.1 days) and 99(31.6%) were preterm. Sepsis was the most frequent major postoperative complication occurring in 97(32%) neonates. Others were surgical site infection (88, 29.2%) and malnutrition (76, 25.2%). Mortality occurred in 81 (26.6%) neonates. Case-specific mortalities were: gastroschisis (14, 58.3%), esophageal atresia (13, 56.5%) and intestinal atresia (25, 37.2%). Complications significantly correlated with 30-day mortality (p <0.05). The major risk predictors of mortality were apnea (OR=10.8), severe malnutrition (OR =6.9), sepsis (OR =7. I), deep surgical site infection (OR=3.5), and re-operation (OR=2.9). Conclusion: Neonatal surgical mortality is high at 26.2%. Significant mortality risk factors include prematurity, apnea, malnutrition, and sepsis.

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Complications after surgery for benign prostatic enlargement and medication use: A population-based cohort study in Ontario, Canada

European Urology Supplements ◽

10.1016/s1569-9056(19)30938-8 ◽

2019 ◽

Vol 18 (1) ◽

pp. e1299

Author(s):

R. Matta ◽

J.R.H. Labossiere ◽

C.J.D. Wallis ◽

A.E. Hird ◽

G.S. Kulkarni ◽

...

Keyword(s):

Cohort Study ◽

Medication Use ◽

Population Based ◽

Benign Prostatic Enlargement ◽

Prostatic Enlargement

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Excess burden of age-associated comorbidities among people living with HIV in British Columbia, Canada: a population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2020-041734 ◽

2021 ◽

Vol 11 (1) ◽

pp. e041734

Author(s):

Ni Gusti Ayu Nanditha ◽

Adrianna Paiero ◽

Hiwot M Tafessu ◽

Martin St-Jean ◽

Taylor McLinden ◽

...

Keyword(s):

British Columbia ◽

Cohort Study ◽

Population Based ◽

Age At Diagnosis ◽

Secondary Outcome ◽

People Living With Hiv ◽

Prevalence Trends ◽

Living With Hiv ◽

Negative Controls ◽

Hiv Negative

ObjectivesAs people living with HIV (PLWH) live longer, morbidity and mortality from non-AIDS comorbidities have emerged as major concerns. Our objective was to compare prevalence trends and age at diagnosis of nine chronic age-associated comorbidities between individuals living with and without HIV.Design and settingThis population-based cohort study used longitudinal cohort data from all diagnosed antiretroviral-treated PLWH and 1:4 age-sex-matched HIV-negative individuals in British Columbia, Canada.ParticipantsThe study included 8031 antiretroviral-treated PLWH and 32 124 HIV-negative controls (median age 40 years, 82% men). Eligible participants were ≥19 years old and followed for ≥1 year during 2000 to 2012.Primary and secondary outcome measuresThe presence of non-AIDS-defining cancers, diabetes, osteoarthritis, hypertension, Alzheimer’s and/or non-HIV-related dementia, cardiovascular, kidney, liver and lung diseases were identified from provincial administrative databases. Beta regression assessed annual age-sex-standardised prevalence trends and Kruskal-Wallis tests compared the age at diagnosis of comorbidities stratified by rate of healthcare encounters.ResultsAcross study period, the prevalence of all chronic age-associated comorbidities, except hypertension, were higher among PLWH compared with their community-based HIV-negative counterparts; as much as 10 times higher for liver diseases (25.3% vs 2.1%, p value<0.0001). On stratification by healthcare encounter rates, PLWH experienced most chronic age-associated significantly earlier than HIV-negative controls, as early as 21 years earlier for Alzheimer’s and/or dementia.ConclusionsPLWH experienced higher prevalence and earlier age at diagnosis of non-AIDS comorbidities than their HIV-negative controls. These results stress the need for optimised screening for comorbidities at earlier ages among PLWH, and a comprehensive HIV care model that integrates prevention and treatment of chronic age-associated conditions. Additionally, the robust methodology developed in this study, which addresses concerns on the use of administrative health data to measure prevalence and incidence, is reproducible to other settings.

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Benign prostatic enlargement is not associated with diabetes: a population-based study

Andrology ◽

10.1111/andr.12069 ◽

2015 ◽

Vol 3 (5) ◽

pp. 933-936 ◽

Cited By ~ 5

Author(s):

Y. L. Chiu ◽

S. Kao ◽

H. C. Lin ◽

S. P. Liu ◽

C. Y. Huang

Keyword(s):

Population Based ◽

Benign Prostatic Enlargement ◽

Population Based Study ◽

Prostatic Enlargement

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Association between the level of municipality healthcare services and outcome among acutely older patients in the emergency department: a Danish population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2018-026881 ◽

2019 ◽

Vol 9 (4) ◽

pp. e026881 ◽

Cited By ~ 1

Author(s):

Anette Tanderup ◽

Jesper Ryg ◽

Jens-Ulrik Rosholm ◽

Annmarie Touborg Lassen

Keyword(s):

Emergency Department ◽

Cohort Study ◽

Home Care ◽

Residential Care ◽

Strong Predictor ◽

Healthcare Services ◽

Population Based ◽

University Hospital ◽

Secondary Outcome ◽

Medical Patients

ObjectivesThis study aims to describe the association between use of municipality healthcare services before an emergency department (ED) contact and mortality, hospital reattendance and institutionalisation.DesignPopulation-based prospective cohort study.SettingED of a large university hospital.ParticipantsAll medical patients ≥65 years of age from a single municipality with a first attendance to the ED during a 1-year period (November 2013 to November 2014).Primary and secondary outcome measuresPatients were categorised as independent of home care, dependent of home care or in residential care depending on municipality healthcare before ED contact. Patients were followed 360 days after discharge. Outcomes were postdischarge mortality, hospital reattendance and institutionalisation.ResultsA total of 3775 patients were included (55% women), aged (median (IQR) 78 years (71–85)). At baseline, 48.9% were independent, 34.9% received home care and 16.2% were in residential care. Receiving home care or being in residential care was a strong predictor of mortality, hospital reattendance and institutionalisation. Among patients who were independent, 64.3% continued being independent up to 360 days after discharge. Even among patients ≥85 years, 35.4% lived independently in their own house 1 year after ED contact.ConclusionPrehospital information on municipality healthcare is closely related to patient outcome in older ED patients. It might have the potential to be used in risk stratification and planning of needs of older acute medical patients attending the ED.

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Increased Risk of Benign Prostatic Enlargement Among Patients With Liver Cirrhosis: A Nationwide Population-Based Study

Journal of Andrology ◽

10.2164/jandrol.110.011163 ◽

2010 ◽

Vol 32 (2) ◽

pp. 159-164 ◽

Cited By ~ 3

Author(s):

S.-D. Chung ◽

H.-C. Lin

Keyword(s):

Liver Cirrhosis ◽

Population Based ◽

Benign Prostatic Enlargement ◽

Population Based Study ◽

Increased Risk ◽

Prostatic Enlargement

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Healthcare resource utilisation and cost associated with elevated potassium levels: a Danish population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2018-026465 ◽

2019 ◽

Vol 9 (4) ◽

pp. e026465 ◽

Cited By ~ 4

Author(s):

Kun Kim ◽

Reimar Wernich Thomsen ◽

Sia Kromann Nicolaisen ◽

Lars Pål Hasvold ◽

Eirini Palaka ◽

...

Keyword(s):

Cohort Study ◽

Healthcare Costs ◽

Healthcare Providers ◽

Population Based ◽

Secondary Outcome ◽

Resource Utilisation ◽

Healthcare Resource Utilisation ◽

Before And After ◽

Patient Groups ◽

Diabetes Patients

ObjectivesTo investigate healthcare costs associated with hyperkalaemia (HK) among patients with chronic kidney disease (CKD), heart failure (HF) or diabetes.DesignBefore–after cohort study of patients with HK and matched patients without HK.SettingPopulation-based databases covering primary and secondary care for the entire of Northern Denmark.ParticipantsPatients with a first incident record of CKD (n=78 372), HF (n=14 233) or diabetes (n=37 479) during 2005–2011. Among all patients experiencing a first HK event (potassium level >5.0 mmol/L), healthcare costs were compared during 6 months before and 6 months after the HK event. The same cost assessment was conducted 6 months before and after a matched index date in a comparison cohort of patients without HK.Primary and secondary outcome measuresMean costs of hospital care, general practice and dispensed drugs converted to 2018 Euros.ResultsOverall, 17 747 (23%) CKD patients, 5141 (36%) HF patients and 4183 (11%) diabetes patients with a first HK event were identified. More than 40% of all HK patients across the patient groups had subsequent HK events with successively shorter times between the events. In CKD patients, overall mean costs were €5518 higher 6 months after versus before first HK, while €441 higher in matched CKD patients without HK, yielding HK-associated costs of €5077. Corresponding costs associated with a HK event were €6018 in HF patients, and €4862 in diabetes patients.ConclusionsAmong CKD, HF and diabetes patients, an incident HK event was common, and a large proportion of the patients experienced recurrent HK events. Substantial increase in healthcare costs associated with a HK event was observed in the HK patients compared with non-HK patients. These results are important to better understand the potential economic impact of HK among high-risk comorbid patients in a real-wold setting and help inform decision-making for clinicians and healthcare providers.

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S83. MORTALITY, REVASCULARIZATION AND CARDIOPROTECTIVE PHARMACOTHERAPY AFTER ACUTE CORONARY SYNDROME IN PATIENTS WITH PSYCHOTIC DISORDERS: A POPULATION-BASED COHORT STUDY

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa031.149 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S65-S66 ◽

Cited By ~ 1

Author(s):

Wing Chung Chang ◽

Joe Kwun Nam Chan ◽

Corine Sau Man Wong ◽

Philip Chi Fai Or ◽

JoJo Siu Han Hai

Keyword(s):

Acute Coronary Syndrome ◽

Cohort Study ◽

Psychotic Disorder ◽

Psychotic Disorders ◽

Cardiovascular Complications ◽

Population Based ◽

Public Healthcare ◽

Complication Rates ◽

Short Term ◽

Coronary Syndrome

Abstract Background Ischemic heart disease is the leading cause of premature mortality in psychotic disorders. The authors aimed to examine short-term mortality, cardiovascular complications, revascularization and cardioprotective medication receipt after incident acute coronary syndrome (ACS) among patients with psychotic disorders compared with patients without psychotic disorders. Methods This was a population-based cohort study with data retrieved from a territory-wide medical record database of public healthcare services to 7.5 million residents in Hong Kong. The study identified 67,692 patients aged ≥18 years admitted for first-recorded ACS between January 1, 2006 and December 31, 2016. The cohort was dichotomously divided by pre-ACS diagnosis of psychotic disorder. Multivariate regression (adjusted odds ratio [aOR] and 95%CI) was used to examine associations of psychotic disorders with all-cause 30-day and 1-year mortality, cardiovascular complications, 30-day and 1-year invasive cardiac procedures, and 90-day post-discharge cardioprotective medication prescription. Results Patients with psychotic disorders (N=703) had higher 30-day (aOR=1.99, 95%CI=1.65–2.39) and 1-year (aOR=2.13, 95%CI=1.79–2.54) mortality, and cardiovascular complication rates (aOR=1.20, 95%CI=1.02–1.41), lower receipt of cardiac catheterization (30-day: aOR=0.54, 95%CI=0.43–0.68; 1-year: aOR=0.46, 95%CI=0.38–0.56), percutaneous coronary intervention (30-day: aOR=0.55, 95%CI=0.44–0.70; 1-year: aOR=0.52, 95%CI=0.42–0.63) and reduced β-blockers (aOR=0.81, 95%CI=0.68–0.97), statins (aOR=0.54, 95%CI=0.44–0.66), and clopidogrel prescriptions (aOR=0.66, 95%CI=0.55–0.80). Effect of psychotic disorder on heightened mortality was more pronounced in younger-aged (<65 years) and male patients. Associations between psychotic disorder and increased mortality remained significant even after complications and treatment receipt were additionally adjusted. Discussion Psychotic disorders are associated with increased risks of short-term post-ACS mortality, cardiovascular complications and inferior treatment. Excess mortality is not substantially explained by treatment inequality. Further investigation is warranted to clarify factors for suboptimal cardiac-care and elevated mortality in psychotic disorders to enhance post-ACS outcome.

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