scholarly journals Quality of prescribing predicts hospitalisation in octogenarians: life and living in advanced age: a cohort study in New Zealand (LiLACS NZ)

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cristín Ryan ◽  
Ruth Teh ◽  
Simon Moyes ◽  
Tim Wilkinson ◽  
Martin Connolly ◽  
...  
Keyword(s):  
Cohort Study ◽  
New Zealand ◽  
Inappropriate Prescribing ◽  
Advanced Age ◽  
Medical Conditions ◽  
Potentially Inappropriate Medicines ◽  
Prescribing Omissions ◽  
Potential Prescribing Omissions

Abstract Background Prescribing for older people is complex, and many studies have highlighted that appropriate prescribing in this cohort is not always achieved. However, the long-term effect of inappropriate prescribing on outcomes such as hospitalisation and mortality has not been demonstrated. The aim of this study was to determine the level of potentially inappropriate prescribing (PIP) for participants of the Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ) study at baseline and examine the association between PIP and hospitalisation and mortality at 12-months follow-up. Methods PIP was determined using STOPP/START. STOPP identified potentially inappropriate medicines (PIMs) prescribed, START identified potential prescribing omissions (PPOs). STOPP/START were applied to all LiLACS NZ study participants, a longitudinal study of ageing, which includes 421 Māori aged 80–90 years and 516 non-Māori aged 85 years. Participants’ details (e.g. age, sex, living arrangements, socioeconomic status, physical functioning, medical conditions) were gathered by trained interviewers. Some participants completed a core questionnaire only, which did not include medications details. Medical conditions were established from a combination of self-report, review of hospital discharge and general practitioner records. Binary logistic regression, controlled for multiple potential confounders, was conducted to determine if either PIMs or PPOs were associated with hospital admissions and mortality (p < 0.05 was considered significant). Results Full data were obtained for 267 Māori and 404 non-Māori. The mean age for Māori was 82.3(±2.6) years, and 84.6(±0.53) years for non-Māori. 247 potentially inappropriate medicines were identified, affecting 24.3% Māori and 28.0% non-Māori. PIMs were not associated with 12-month mortality or hospitalisation for either cohort (p > 0.05; adjusted models). 590 potential prescribing omissions were identified, affecting 58.1% Māori and 49.0% non-Māori. PPOs were associated with hospitalisation (p = 0.001 for Māori), but were not associated with risk of mortality (p > 0.05) for either cohort within the 12-month follow-up (adjusted models). Conclusion PPOs were more common than PIMs and were associated with an increased risk of hospitalisation for Māori. This study highlights the importance of carefully considering all indicated medicines when deciding what to prescribe. Further follow-up is necessary to determine the long-term effects of PIP on mortality and hospitalisation.

scholarly journals Tremor measurements in a 22-year cohort study of workers exposed to hand-held vibrating tools

2021 ◽  
Author(s):  
Rita Bast-Pettersen ◽  
Karl-Christian Nordby ◽  
Gunilla Wastensson ◽  
Lisa Aarhus
Keyword(s):  
Cohort Study ◽  
Current Medical ◽  
Manual Dexterity ◽  
Medical Conditions ◽  
Long Term Effects ◽  
Rest Tremor ◽  
Tremor Frequency ◽  
Activation Conditions

Abstract Objectives The objectives of this cohort study were to evaluate possible long-term effects of occupational exposure to hand-arm vibration (HAV) in terms of increased tremor. The aims were to evaluate whether exposure during follow-up, baseline hand-arm vibration syndrome (HAVS), baseline manual dexterity or current medical conditions or life-style habits might be associated with increased tremor. A further aim was to compare two different activation conditions: postural vs rest tremor. Methods Forty men (current age: 60.4 years) who had previously worked as manual workers in a specialized engineering and construction company enrolled in the study. Their hand functions had been examined in 1994. At the baseline examination, 27 had been diagnosed with HAVS, while 13 were not exposed. The follow-up examination in 2016–2017 comprised the CATSYS Tremor Pen® for measuring postural and rest tremor and the Grooved Pegboard Test for assessing manual dexterity. Blood samples were taken for assessing biomarkers that might have impact on tremor. Results Neither cumulative exposure to HAV during follow-up nor HAVS at baseline were associated with increased tremor. A test for manual dexterity at baseline was significantly associated with increased tremor (Tremor Intensity) at follow-up. Blood markers of current medical conditions and tobacco consumption were associated with increased tremor. Rest tremor frequency was higher than postural tremor frequency (p < 0.001). Conclusions The main findings of this 22-year cohort study were no indications of long-term effects on tremor related to HAV exposure and previous HAVS status. However, baseline manual dexterity was significantly associated with increased tremor at follow-up. Activation conditions (e.g., hand position) are important when testing tremor.

scholarly journals Long‐term follow‐up of the DeKAF cross‐sectional cohort study

2019 ◽  
Vol 19 (5) ◽  
pp. 1432-1443 ◽  
Author(s):  
Arthur J. Matas ◽  
Ann Fieberg ◽  
Roslyn B. Mannon ◽  
Robert Leduc ◽  
Joe Grande ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cross Sectional ◽  
Long Term Follow Up

scholarly journals Withdrawal notice: Long-term follow-up after abdominal cerclage: A population-based cohort study

2017 ◽  
Vol 210 ◽  
pp. R1
Author(s):  
Kirstine Sneider ◽  
Ole Bjarne Christiansen ◽  
Iben Blaabjerg Sundtoft ◽  
Jens Langhoff-Roos
Keyword(s):  
Cohort Study ◽  
Population Based ◽  
Long Term Follow Up

scholarly journals Risk of suicide after suicide attempt according to coexisting psychiatric disorder: Swedish cohort study with long term follow-up

BMJ ◽  
2008 ◽  
Vol 337 (nov18 3) ◽  
pp. a2205-a2205 ◽  
Author(s):  
D. Tidemalm ◽  
N. Langstrom ◽  
P. Lichtenstein ◽  
B. Runeson
Keyword(s):  
Cohort Study ◽  
Suicide Attempt ◽  
Psychiatric Disorder ◽  
Long Term Follow Up ◽  
Swedish Cohort

Beneficial effect of statins on total mortality in abdominal aortic aneurysm (AAA) repair

2017 ◽  
Vol 22 (5) ◽  
pp. 406-410 ◽  
Author(s):  
Sven Ross Mathisen ◽  
Michael Abdelnoor
Keyword(s):  
Cohort Study ◽  
Beneficial Effect ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Open Surgery ◽  
Total Mortality ◽  
Abdominal Aortic ◽  
Statin Use

In this single center, retrospective cohort study we wished to compare early and total mortality for all patients treated for abdominal aortic aneurysms (AAA) with open surgery who were taking statins compared to those who were not. A cohort of 640 patients with AAA was treated with open surgery between 1999 and 2012. Patients were consecutively recruited from a source population of 390,000; 21.3% were female, and the median age was 73 years. The median follow-up was 3.93 years, with an interquartile range of 1.79–6.58 years. The total follow-up was 2855 patient-years. An explanatory strategy was used. The propensity score (PS) was implemented to control for selection bias and confounders. The crude effect of statin use showed a 78% reduction of the 30-day mortality. A stratified analysis using the Mantel–Haenszel method on quintiles of the PS gave an adjusted effect of the odds ratio equal to 0.43 (95% CI: 0.18–0.96), indicating a 57% reduction of the 30-day mortality for statin users. The adjusted rate ratio was 0.62 (95% CI: 0.45–0.83), indicating a reduction of long-term mortality of 38% for statin users compared to non-users for a median follow-up of 3.93 years. This retrospective cohort study showed a significant beneficial effect of statin use on early and long-term survival for patients treated with open surgery. To be conclusive, our results need to be replicated by a randomized clinical trial.

Sign in / Sign up

Export Citation Format

Share Document