Improvement of locomotive syndrome with surgical treatment in patients with degenerative diseases in the lumbar spine and lower extremities: a prospective cohort study

Abstract BackgroundWe assessed predictive factors of patients with fractures of the lower extremities caused by trauma. We examined which factors might increase failure rates. Furthermore, the predictive factors were set into context with other long-term outcomes, concrete pain and physical functioning.MethodsWe performed a prospective cohort study at a single level I trauma center. We enrolled patients with traumatic fractures of the lower extremities treated with internal fixation from April 2017 to July 2018. We evaluated the following predictive factors: age, gender, diabetes, smoking status, obesity, open fractures and peripheral arterial diseases. The primary outcome was time to failure (nonunion, implant failure or reposition), secondary outcomes were pain and physical functioning measured at follow up 6 months after initial surgery. For the analysis of the primary outcome we used a multivariate stratified (according fracture location) Cox proportional hazard regression model.Results We included 204 patients. Overall, we observed a failure in 33 patients (16.2%). Most of the failures occurred within the first 3 months. Obesity and open fractures increased the risk of failure and decreased physical functioning. None of the predictors had an impact on pain. Age, female gender and smoking of more than ≥ 10 package years increased failure risk numerically but statistical uncertainty was high.Conclusion We found that obesity and open fractures strongly increased the risk of failure. These seem promising candidates to be included in a risk prediction model and can be considered as a good start for clinical decision making across different types of fractures in the lower limb. However, large heterogeneity in the other analyzed factors suggest that for a precise personalized risk estimation, computer-based models incorporating a variety of detailed information (e.g. pattern of injury, x-ray and clinical data) and their interrelation might be needed to increase precision of prediction significantly.Trial registrationNCT03091114

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ARE RADIOLOGIC CHANGES IN THE THORACIC AND LUMBAR SPINE OF ADOLESCENTS RISK FACTORS FOR LOW BACK PAIN IN ADULTS? A 25-YEAR PROSPECTIVE COHORT STUDY OF 640 SCHOOL CHILDREN

Journal of Pediatric Orthopaedics ◽

10.1097/00004694-199605000-00035 ◽

1996 ◽

pp. 414,415

Author(s):

&NA;

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Low Back Pain ◽

Back Pain ◽

Lumbar Spine ◽

Prospective Cohort Study ◽

School Children ◽

Prospective Cohort ◽

Low Back ◽

Thoracic And Lumbar Spine

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Effect of total hip arthroplasty on improving locomotive syndrome in hip disease patients: A prospective cohort study focused on total clinical decision limits stage 3

Journal of Orthopaedic Science ◽

10.1016/j.jos.2020.12.028 ◽

2021 ◽

Author(s):

Shigeaki Miyazaki ◽

Kurumi Tsuruta ◽

Saori Yoshinaga ◽

Yoichiro Yamaguchi ◽

Yoshinori Fujii ◽

...

Keyword(s):

Cohort Study ◽

Total Hip Arthroplasty ◽

Prospective Cohort Study ◽

Hip Arthroplasty ◽

Prospective Cohort ◽

Clinical Decision ◽

Locomotive Syndrome ◽

Total Hip ◽

Hip Disease ◽

Clinical Decision Limits

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Surgical treatment for antiplatelet intracerebral hemorrhage (SAP-ICH): protocol for a prospective cohort study of emergency surgery for severe spontaneous intracerebral hemorrhage patients on long-term oral antiplatelet treatment

Chinese Neurosurgical Journal ◽

10.1186/s41016-020-00225-x ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Jun Wu ◽

Xinguo Sun ◽

Qingyuan Liu ◽

Maogui Li ◽

Shanwen Chen ◽

...

Keyword(s):

Cohort Study ◽

Surgical Treatment ◽

Intracerebral Hemorrhage ◽

Prospective Cohort Study ◽

Emergency Surgery ◽

Prospective Cohort ◽

Spontaneous Intracerebral Hemorrhage ◽

Antiplatelet Treatment ◽

Spontaneous Intracranial Hemorrhage

Abstract Background Despite the capability of emergency surgery to reduce the mortality of severe spontaneous intracranial hemorrhage (SSICH) patients, the effect and safety of surgical treatment for severe spontaneous intracranial hemorrhage (SSICH) patients receiving long-term oral antiplatelet treatment (LOAPT) remains unclear. In consideration of this, the cohort study is aimed at figuring out the effect and safety of emergency surgery for SSICH patients on LOAPT. Methods As a multicenter and prospective cohort study, it will be conducted across 7 representative clinical centers. Starting in September 2019, the observation is scheduled to be completed by December 2022, with a total of 450 SSICH patients recruited. The information on clinical, radiological, and laboratory practices will be recorded objectively. All of the patients will be monitored until death or 6 months after the occurrence of primary hemorrhage. Results In this study, two comparative cohorts and an observational cohort will be set up. The primary outcome is the effect of emergency surgery, which is subject to assessment using the total mortality and comparison in the survival rate of SSICH patients on LOAPT between surgical treatment and conservative treatment. The second outcome is the safety of surgery, with the postoperative hemorrhagic complication which is compared between the operated SSICH patients on and not on LOAPT. Based on the observation of the characteristics and outcome of SSICH patients on LOAPT, the ischemic events after discontinuing LOAPT will be further addressed, and the coagulation function assessment system for operated SSICH patients on LOAPT will be established. Conclusions In this study, we will investigate the effect and safety of emergency surgery for SSICH patients on LOAPT, which will provide an evidence for management in the future. Ethics and dissemination The research protocol and informed consent in this study were approved by the Institutional Review Board of Beijing Tiantan Hospital (KY2019-096-02). The results of this study are expected to be disseminated in peer-reviewed journals in 2023. Trial registration Name: Effect and safety of surgical intervention for severe spontaneous intracerebral hemorrhage patients on long-term oral antiplatelet treatment. ChiCTR1900024406. Date of registration is July 10, 2019.

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