Variation in referrals to secondary obstetrician-led care among primary midwifery care practices in the Netherlands: a nationwide cohort study

Abstract Objective: To study whether replacement of nosocomial ampicillin-resistant Enterococcus faecium (ARE) clones by vancomycin-resistant E. faecium (VRE), belonging to the same genetic lineages, increases mortality in patients with E. faecium bacteremia, and to evaluate whether any such increase is mediated by a delay in appropriate antibiotic therapy. Design: Retrospective, matched-cohort study. Setting: The study included 20 Dutch and Danish hospitals from 2009 to 2014. Patients: Within the study period, 63 patients with VRE bacteremia (36 Dutch and 27 Danish) were identified and subsequently matched to 234 patients with ARE bacteremia (130 Dutch and 104 Danish) for hospital, ward, length of hospital stay prior to bacteremia, and age. For all patients, 30-day mortality after bacteremia onset was assessed. Methods: The risk ratio (RR) reflecting the impact of vancomycin resistance on 30-day mortality was estimated using Cox regression with further analytic control for confounding factors. Results: The 30-day mortality rates were 27% and 38% for ARE in the Netherlands and Denmark, respectively, and the 30-day mortality rates were 33% and 48% for VRE in these respective countries. The adjusted RR for 30-day mortality for VRE was 1.54 (95% confidence interval, 1.06–2.25). Although appropriate antibiotic therapy was initiated later for VRE than for ARE bacteremia, further analysis did not reveal mediation of the increased mortality risk. Conclusions: Compared to ARE bacteremia, VRE bacteremia was associated with higher 30-day mortality. One explanation for this association would be increased virulence of VRE, although both phenotypes belong to the same well-characterized core genomic lineage. Alternatively, it may be the result of unmeasured confounding.

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Adverse intergenerational effects of ethnically-divisive social contexts on children's mental health: A prospective cohort study in the Netherlands

Social Science & Medicine ◽

10.1016/j.socscimed.2021.113932 ◽

2021 ◽

Vol 277 ◽

pp. 113932

Author(s):

Farah Qureshi ◽

Ivonne P.M. Derks ◽

Michelle A. Williams ◽

Karestan C. Koenen ◽

Henning Tiemeier ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

The Netherlands ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Children’S Mental Health ◽

Social Contexts ◽

Children's Mental Health ◽

Intergenerational Effects

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Platelet aggregation inhibitor prescription for newly diagnosed peripheral arterial disease in the Netherlands: a cohort study

BMJ Open ◽

10.1136/bmjopen-2020-041715 ◽

2021 ◽

Vol 11 (1) ◽

pp. e041715

Author(s):

Aarent RT Brand ◽

Eline Houben ◽

Irene D Bezemer ◽

Frank L J Visseren ◽

Michiel L Bots ◽

...

Keyword(s):

Primary Care ◽

Cohort Study ◽

The Netherlands ◽

Peripheral Arterial Disease ◽

Arterial Disease ◽

Free Text ◽

Newly Diagnosed ◽

Patient Journey ◽

P2y12 Inhibitors ◽

Peripheral Arterial

ObjectivesPharmacological treatment of peripheral arterial disease (PAD) comprises of antiplatelet therapy (APT), blood pressure control and cholesterol optimisation. Guidelines provide class-I recommendations on the prescription, but there are little data on the actual prescription practices. Our study provides insight into the prescription of medication among patients with PAD in the Netherlands and reports a ‘real-world’ patient journey through primary and secondary care.DesignWe conducted a cohort study among patients newly diagnosed with PAD between 2010 and 2014.SettingData were obtained from the PHARMO Database Network, a population-based network of electronic pharmacy, primary and secondary healthcare setting records in the Netherlands. The source population for this study comprised almost 1 million individuals.Participants‘Newly diagnosed’ was defined as a recorded International Classification of Primary Care code for PAD, a PAD-specific WCIA examination code or a diagnosis recorded as free text episode in the general practitioner records with no previous PAD diagnosis record and no prescription of P2Y12 inhibitors or aspirin the preceding year. The patient journey was defined by at least 1 year of database history and follow-up relative to the index date.ResultsBetween 2010 and 2014, we identified 3677 newly diagnosed patients with PAD. Most patients (91%) were diagnosed in primary care. Almost half of all patients (49%) had no APT dispensing record. Within this group, 33% received other anticoagulant therapy (vitamin K antagonist or direct oral anticoagulant). Mono-APT was dispensed as aspirin (40% of patients) or P2Y12 inhibitors (2.5% of patients). Dual APT combining aspirin with a P2Y12 inhibitor was dispensed to 8.5% of the study population.ConclusionHalf of all patients with newly diagnosed PAD are not treated conforming to (international) guideline recommendations on thromboembolism prevention through APT. At least 33% of all patients with newly diagnosed PAD do not receive any antithrombotic therapy. Evaluation and improvement of APT prescription and thereby improved prevention of (secondary) cardiovascular events is warranted.

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Outcomes after Prehospital Traumatic Cardiac Arrest in the Netherlands: a Retrospective Cohort Study

Injury ◽

10.1016/j.injury.2021.02.088 ◽

2021 ◽

Author(s):

Thymen Houwen ◽

Zar Popal ◽

Marcel A.N. de Bruijn ◽

Anna-Marie R. Leemeyer ◽

Joost H. Peters ◽

...

Keyword(s):

Cardiac Arrest ◽

Cohort Study ◽

The Netherlands ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Traumatic Cardiac Arrest

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Outcomes in Octogenarians and the Effect of Comorbidities After Intact Abdominal Aortic Aneurysm Repair in the Netherlands: A Nationwide Cohort Study

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2021.02.047 ◽

2021 ◽

Author(s):

Anna J. Alberga ◽

Eleonora G. Karthaus ◽

Erik W. van Zwet ◽

Jorg L. de Bruin ◽

Joost A. van Herwaarden ◽

...

Keyword(s):

Cohort Study ◽

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

The Netherlands ◽

Abdominal Aortic Aneurysm Repair ◽

Abdominal Aortic ◽

Aneurysm Repair ◽

Aortic Aneurysm Repair

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The accuracy of diagnostic Imaging techniques in patients with a suspected Fracture-related Infection (IFI) trial: study protocol for a prospective multicenter cohort study.

BMJ Open ◽

10.1136/bmjopen-2018-027772 ◽

2019 ◽

Vol 9 (9) ◽

pp. e027772 ◽

Cited By ~ 3

Author(s):

GAM Govaert ◽

MGG Hobbelink ◽

IHF Reininga ◽

P Bosch ◽

TC Kwee ◽

...

Keyword(s):

Cohort Study ◽

The Netherlands ◽

Diagnostic Imaging ◽

Fdg Pet ◽

Imaging Techniques ◽

Time Frame ◽

Imaging Modalities ◽

Multicenter Cohort Study ◽

Discriminative Ability ◽

Imaging Strategy

IntroductionThe optimal diagnostic imaging strategy for fracture-related infection (FRI) remains to be established. In this prospective study, the three commonly used advanced imaging techniques for diagnosing FRI will be compared. Primary endpoints are (1) determining the overall diagnostic performances of white blood cell (WBC) scintigraphy, fluorodeoxyglucose positron emission tomography (FDG-PET) and magnetic resonance imaging (MRI) in patients with suspected FRI and (2) establishing the most accurate imaging strategy for diagnosing FRI.Methods and analysisThis study is a non-randomised, partially blinded, prospective cohort study involving two level 1 trauma centres in The Netherlands. All adult patients who require advanced medical imaging for suspected FRI are eligible for inclusion. Patients will undergo all three investigational imaging procedures (WBC scintigraphy, FDG-PET and MRI) within a time frame of 14 days after inclusion. The reference standard will be the result of at least five intraoperative sampled microbiology cultures, or, in case of no surgery, the clinical presence or absence of infection at 1 year follow-up. Initially, the results of all three imaging modalities will be available to the treating team as per local protocol. At a later time point, all scans will be centrally reassessed by nuclear medicine physicians and radiologists who are blinded for the identity of the patients and their clinical outcome. The discriminative ability of the imaging modalities will be quantified by several measures of diagnostic accuracy.Ethics and disseminationApproval of the study by the Institutional Review Board has been obtained prior to the start of this study. The results of this trial will be disseminated by publication of peer-reviewed manuscripts, presentation in abstract form at scientific meetings and data sharing with other investigators through academically established means.Trial registration numberThe IFI trial is registered in the Netherlands Trial Register (NTR7490).

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