The association the patient-reported outcomes after periacetabular osteotomy with radiographic features: a short-term retrospective study

Abstract Background Bernese periacetabular osteotomy (PAO) is an effective treatment for patients with developmental dysplasia of the hip (DDH). PAO has been widely used in China, but few follow-up outcomes have been reported in the international community. Moreover, the risk factors affecting patient-reported outcomes have not been discussed in recent studies. In this study, patient-reported outcomes after PAO were reported, and risk factors affecting patient-reported outcomes were analyzed. Methods Patients who underwent PAO for DDH from January 2014 to January 2020 were selected as the study subjects, and 66 hips were included in the analysis after screening (59 patients, with an average follow-up time of 3.01 years). The Harris Hip Score (HHS) and International Hip Outcome Instrument-12 (iHOT-12) were used to assess hip function and patient quality of life. The changes of preoperative and latest follow-up HHSs less than 9 were defined as symptomatic hips, that is, an adverse outcome; otherwise, the score indicates preserved hips. Also, the changes of preoperative and latest follow-up iHOT-12 were defined as symptomatic hips and preserved hips. Multivariate logistic regression analysis was used to predict the risk factors influencing the patient-reported outcomes, and receiver operating characteristic (ROC) curve analysis was performed on the risk factors to determine their sensitivity, specificity and cutoff value. Results Clinical outcome analysis demonstrates marked improvements in patient-reported outcomes. The multivariate logistic regression analysis showed that when the postoperative LCEA was > 38°, adverse outcomes were much more likely. However, a Tönnis angle of − 10° to 0° was a protective factor. In addition, hips with fair or poor joint congruency were more likely to develop negative outcomes. The ROC curve analysis showed that the optimal thresholds for the LCEA and Tönnis angles used to predict outcomes after PAO were 38.2° and − 9°, respectively. Based on the results of the ROC curve analysis, among hips with poor or fair joint congruency preoperatively treated by surgeons who obtained the improper postoperative LCEAs and Tönnis angles, bad patient-reported outcomes will most likely be obtained. Conclusions Our results demonstrate marked improvements in patient-reported outcomes. Among hips with preoperative excellent or good joint congruency treated by experienced surgeons who obtain the proper postoperative LCEA and Tönnis angles, good patient-reported outcomes can be expected.

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How Can Patient-Reported Outcomes of Periacetabular Osteotomy be Improved? A Short-Term Follow-up of 79 Hips.

10.21203/rs.3.rs-428249/v1 ◽

2021 ◽

Author(s):

YiNuo Fan ◽

Weifeng Li ◽

Yunlong Wu ◽

Guoju Hong ◽

Zhongfeng Li ◽

...

Keyword(s):

Risk Factors ◽

Success Rate ◽

Patient Reported Outcomes ◽

Periacetabular Osteotomy ◽

Multivariate Logistic Regression Analysis ◽

Roc Curve Analysis ◽

Factors Affecting ◽

Joint Congruency ◽

Patient Reported

Abstract Background Bernese periacetabular osteotomy (PAO) is an effective treatment for patients with developmental dysplasia of the hip (DDH). PAO has been widely used in China, but few follow-up outcomes have been reported in the international community. Moreover, the risk factors affecting patient-reported outcomes have not been discussed in recent studies. In this study, patient-reported outcomes after PAO were reported, and risk factors affecting patient-reported outcomes were analyzed. Methods Patients who underwent PAO for DDH from January 2014 to January 2020 were selected as the study subjects, and 79 hips were included in the analysis after screening (71 patients, with an average follow-up time of 2.98 years). The Harris Hip Score (HHS) and International Hip Outcome Instrument-12 (iHOT-12) were used to assess hip function and patient quality of life. A HHS < 80 was defined as symptomatic hips, that is, an adverse outcome; otherwise, it indicated preserved hips. Multivariate logistic regression analysis was used to predict the risk factors influencing the patient-reported outcomes, and receiver operating characteristic (ROC) curve analysis was performed on the risk factors to determine their sensitivity, specificity and cutoff value. Results Clinical outcome analysis demonstrates marked improvements in patient-reported outcomes. The multivariate logistic regression analysis showed that when the postoperative LCEA was > 38°, adverse outcomes were much more likely. However, a Tönnis angle of -10°-0 was a protective factor. In addition, hips with fair or poor joint congruency were 7.794-fold more likely to develop negative outcomes. The ROC curve analysis showed that the optimal thresholds for the LCEA and Tönnis angles used to predict outcomes after PAO were 38.1° and − 9°, respectively. The patients with a postoperative LCEA < 38.1° had a success rate of 83%. In contrast, the success rate was 32% for patients with a postoperative LCEA > 38.1°. In addition, while the patients with a postoperative Tönnis angle of -9°-0 had a success rate of 70%, and those with a Tönnis angle of 0–10° had a success rate of 65%; the success rate of a Tönnis angle <-9° was only 10%. Conclusions Our results demonstrate marked improvements in patient-reported outcomes. Among hips with preoperative excellent or good joint congruency treated by experienced surgeons who obtain the proper postoperative LCEA and Tönnis angles, good patient-reported outcomes can be expected.

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Factors predictive of cystoid macular oedema following endothelial keratoplasty: a single-centre review of 2233 cases

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-318076 ◽

2021 ◽

pp. bjophthalmol-2020-318076

Author(s):

James Myerscough ◽

Harry William Roberts ◽

Angeli Christy Yu ◽

Michael Mimouni ◽

Luca Furiosi ◽

...

Keyword(s):

Risk Factors ◽

Roc Curve ◽

Macular Oedema ◽

Curve Analysis ◽

Cystoid Macular Oedema ◽

Continuous Variables ◽

Endothelial Keratoplasty ◽

Roc Curve Analysis ◽

Close Observation ◽

Independent Risk Factors

AimsTo describe the incidence of postoperative cystoid macular oedema (CMO) after endothelial keratoplasty (EK) and to identify its contributory risk factors.Methods2233 patients undergoing EK at Ospedali Privati Forlì ‘Villa Igea’, between January 2005 to October 2018 for Descemet stripping automated endothelial keratoplasty (DSAEK) and June 2014 to August 2018 for Descemet membrane endothelial keratoplasty (DMEK) with a minimum follow-up of 18 months were evaluated. Univariate and multivariate analyses were conducted to identify and quantify contributory risk factors. Receiver operating characteristic (ROC) curve analysis were performed to determine ideal cut-off points of continuous variables.ResultsCMO was identified in 2.82% (n=63) of the cases. CMO occurred in 2.36% of DSAEK eyes and in 5.56% of DMEK eyes (p=0.001). Average onset of CMO was 4.27±6.63 months (range: 1–34 months) postoperatively. Compared with those who did not develop CMO, a higher proportion of patients in the CMO group had diabetes (24.2% vs 9.8%, p<0.001) (OR=3.16, 95% CI: 1.72 to 5.81, p<0.001), a higher proportion of patients who underwent DMEK rather than DSAEK (28.6% vs 14.1%, p=0.001) (OR=2.42, 95% CI: 1.35 to 4.33, p=0.003) and were older (70.5±10.0 vs 67.1±14.3 years, p=0.01). Using the cut-off of 67 years as identified by ROC curve analysis, subjects aged >67 years (OR=2.35, 95% CI: 1.30 to 4.26, p=0.005) were more likely to develop CMO. There were no other significant differences between the groups.ConclusionsOlder age (>67 years), diabetes mellitus and DMEK have been identified as independent risk factors for postoperative CMO following EK. Close observation is necessary during the first postoperative year after EK, particularly in patients with risk factors.

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What are the Risk Factors for Worse Outcomes of Meniscus Surgery in 23-39-Year-Old Patients Ligamentously Stable Knees?

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00468 ◽

2020 ◽

Vol 8 (7_suppl6) ◽

pp. 2325967120S0046

Author(s):

◽

Megan Flynn ◽

Anthony Egger ◽

Yuxuan Jin ◽

Elizabeth Sosic ◽

...

Keyword(s):

Risk Factors ◽

Young Adult ◽

Patient Reported Outcomes ◽

Meniscal Repair ◽

Patient Specific ◽

Lower Baseline ◽

Patient Reported ◽

Grade 3 ◽

One Year

Objectives: Meniscus tears are a common and significant source of knee dysfunction in active young adult patients, and no high-quality prospective cohort or RCTs studies exist evaluating patient-reported outcomes in patients in this age group with ligamentously stable knees. Our objective was to identify patient-reported outcomes and patient-specific risk factors from a prospective cohort with a minimum of one-year follow-up following meniscal repair or excision in patients with ligamentously stable knees. We hypothesized that both groups would have significant improvement in outcomes; patients undergoing meniscal repair would have a higher reoperation rate; and articular cartilage injuries, subsequent knee surgery, and certain demographic characteristics would be significant risk factors to inferior outcomes at one year. Methods: Between February 2015 and December 2017, ligamentously stable meniscal procedures were enrolled and prospectively followed using the outcomes management evaluation system (OME) at Cleveland Clinic. Patients aged 23-39 preoperatively completed a series of validated outcome measurements including the Knee Injury and Osteoarthritis Outcome Score for both Pain (KOOS Pain) and Quality of Life (KOOS QoL). At the time of surgery, physicians documented all intra-articular findings, treatment, and surgical techniques utilized. Patients were followed at minimum of 1-year postoperatively through the OME platform and asked to complete the same outcome instruments done at baseline as well as a question designed to evaluate the Patient Acceptable Symptom State (PASS). The incidence and details of any subsequent knee surgeries were also obtained. Multivariable regression analysis was used to identify significant predictors of outcomes. Results: A total of 371 patients aged 23-39 underwent meniscus excision or repair during the study period. One hundred ninety-four met inclusion criteria, and one-year follow-up was obtained on 72% (n = 139) of the cohort (67% male; median age 32). Both KOOS Pain and KOOS QoL improved significantly at one-year for the entire cohort. Fourteen percent of the cohort (9% on the ipsilateral knee, 5% on the contralateral knee) underwent subsequent surgery at a minimum of one-year postoperatively. The patient-specific risk factors for worse one-year outcomes included preoperative baseline mental capacity score (VR-12 MCS), lower baseline KOOS QoL score, and the intraoperative finding of any grade 3 or 4 chondral changes. Conclusion: Young adult patients with ligamentously stable knees undergoing meniscal surgery have significantly improved patient-reported outcomes regardless of excision or repair; however, 14% of patients underwent additional knee surgery at a minimum of one-year postoperatively. The risk factors for worse outcomes include lower baseline mental health score, lower baseline KOOS QoL score, and any grade 3 or 4 chondromalacia scene.

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Analysis of fungal bloodstream infection in intensive care units in the Meizhou region of China: species distribution and resistance and the risk factors for patient mortality

10.21203/rs.2.12729/v1 ◽

2019 ◽

Author(s):

Guang-Wen Xiao ◽

Wan-qing Liao ◽

Yuenong Zhang ◽

Xiaodong Luo ◽

Cailing Zhang ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care ◽

Serum Albumin ◽

Roc Curve ◽

Bloodstream Infections ◽

Mortality Rates ◽

Curve Analysis ◽

Roc Curve Analysis ◽

Candida Spp ◽

Icu Patients

Abstract Background : Fungal bloodstream infections (FBI) among intensive care unit (ICU) patients are increasing. Our objective was to characterize the fungal pathogens that cause bloodstream infections and determine the epidemiology and risk factors for patient mortality among ICU patients in Meizhou, China. Methods Eighty-one ICU patients with FBI during their stays were included in the study conducted from January 2008 to December 2017. Blood cultures were performed and the antimicrobial susceptibility profiles of the resulting isolates were determined. Logistic multiple regression and receiver operating characteristics (ROC) curve analysis were used to assess the risk factors for mortality among the cases. Results The prevalence of FBI in ICU patients was 0.38% (81/21,098) with a mortality rate of 35.8% (29/81). Ninety-eight strains of bloodstream-infecting fungi, mainly Candida spp., were identified from these patients. Candida albicans was most common (42.9%). Two strains of C. parapsilosis were no-sensitive to caspofungin, C. glabrata were less than 80% sensitive to azole drugs.. Logistic multiple regression showed that age, serum albumin, Acute Physiology and Chronic Health Evaluation (APACHE) II score, three or more underlying diseases, and length of stay in ICU were independent risk factors for mortality in FBI. ROC curve analysis showed that APACHE II scores > 19 and serum albumin ≤ 25g/L were the best predictors of mortality. Conclusion Candida spp. predominated with high mortality rates among cases of FBI in ICU. Thus, clinical staff should enhance overall patient monitoring and especially monitor fungal susceptibility to reduce mortality rates.

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Title: Preoperative albumin-to-fibrinogen ratio predicts postoperative pulmonary complications in patients after minimally invasive esophagectomy

10.21203/rs.3.rs-604731/v1 ◽

2021 ◽

Author(s):

Zhang Peng ◽

Zhao Song

Keyword(s):

Risk Factors ◽

Esophageal Cancer ◽

Logistic Regression ◽

Roc Curve ◽

Training Group ◽

Pulmonary Complications ◽

Curve Analysis ◽

Postoperative Pulmonary Complications ◽

Multivariate Logistic Regression ◽

Roc Curve Analysis

Abstract Background Postoperative pulmonary complications (PPCs) are the most common postoperative complications in patients with esophageal cancer. Prediction of PPCs by establishing a preoperative physiological function parameter model can help patients make adequate preoperative preparation, reduce treatment costs, and improve prognosis and quality of life. The purpose of this study was to investigate the relationship between albumin-to-fibrinogen ratio (AFR), prognostic nutritional index (PNI), albumin-to-globulin ratio (AGR), neutrophils-to-lymphocyte ratio (NLR), platelet-to-lymphocyte (PLR), and monocyte-to -lymphocyte ratio (MLR) and other preoperative laboratory tests and PPCs in patients after esophagectomy. Methods Retrospective analysis was performed on total 712 consecutive patients who underwent esophagectomy in the Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University from July 2018 to December 2020. Patients were divided into training (535 patients) and validation (177) groups for comparison of baseline data, perioperative indicators, and laboratory examination data. Receiver operating characteristic (ROC) curve analysis was used to evaluate the efficacy, sensitivity and specificity of AFR, and Youden’s index was used to calculate the cut-off values of AFR. Univariate and multivariate logistic regression analyses were used to assess the risk factors for PPCs in training group. Results 112 (20.9%) in training group and 36 (20.3%) in validation group developed PPCs. The AUC value predicted by AFR using ROC curve analysis was 0.817, sensitivity 76.2% and specificity 78.7% in training group while AUC 0.803, sensitivity 69.4% and specificity 85.8%. Multivariate logistic regression analysis showed that smoking index, American Society of Anesthesiologists (ASA), AFR, and recurrent laryngeal nerve palsy were independent risk factors for PPCs. Conclusion Preoperative AFR can effectively predict the occurrence of PPCs in patients with esophageal cancer

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A randomised trial of the effect and cost-effectiveness of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with screen-detected type 2 diabetes: the Anglo–Danish–Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION-Europe) study

Health Technology Assessment ◽

10.3310/hta20640 ◽

2016 ◽

Vol 20 (64) ◽

pp. 1-86 ◽

Cited By ~ 5

Author(s):

Rebecca K Simmons ◽

Knut Borch-Johnsen ◽

Torsten Lauritzen ◽

Guy EHM Rutten ◽

Annelli Sandbæk ◽

...

Keyword(s):

Risk Factors ◽

Patient Reported Outcomes ◽

Cost Effective ◽

Well Being ◽

Health Technology ◽

Patient Reported ◽

All Cause Mortality

BackgroundIntensive treatment (IT) of cardiovascular risk factors can halve mortality among people with established type 2 diabetes but the effects of treatment earlier in the disease trajectory are uncertain.ObjectiveTo quantify the cost-effectiveness of intensive multifactorial treatment of screen-detected diabetes.DesignPragmatic, multicentre, cluster-randomised, parallel-group trial.SettingThree hundred and forty-three general practices in Denmark, the Netherlands, and Cambridge and Leicester, UK.ParticipantsIndividuals aged 40–69 years with screen-detected diabetes.InterventionsScreening plus routine care (RC) according to national guidelines or IT comprising screening and promotion of target-driven intensive management (medication and promotion of healthy lifestyles) of hyperglycaemia, blood pressure and cholesterol.Main outcome measuresThe primary end point was a composite of first cardiovascular event (cardiovascular mortality/morbidity, revascularisation and non-traumatic amputation) during a mean [standard deviation (SD)] follow-up of 5.3 (1.6) years. Secondary end points were (1) all-cause mortality; (2) microvascular outcomes (kidney function, retinopathy and peripheral neuropathy); and (3) patient-reported outcomes (health status, well-being, quality of life, treatment satisfaction). Economic analyses estimated mean costs (UK 2009/10 prices) and quality-adjusted life-years from an NHS perspective. We extrapolated data to 30 years using the UK Prospective Diabetes Study outcomes model [version 1.3;©Isis Innovation Ltd 2010; seewww.dtu.ox.ac.uk/outcomesmodel(accessed 27 January 2016)].ResultsWe included 3055 (RC,n = 1377; IT,n = 1678) of the 3057 recruited patients [mean (SD) age 60.3 (6.9) years] in intention-to-treat analyses. Prescription of glucose-lowering, antihypertensive and lipid-lowering medication increased in both groups, more so in the IT group than in the RC group. There were clinically important improvements in cardiovascular risk factors in both study groups. Modest but statistically significant differences between groups in reduction in glycated haemoglobin (HbA1c) levels, blood pressure and cholesterol favoured the IT group. The incidence of first cardiovascular event [IT 7.2%, 13.5 per 1000 person-years; RC 8.5%, 15.9 per 1000 person-years; hazard ratio 0.83, 95% confidence interval (CI) 0.65 to 1.05] and all-cause mortality (IT 6.2%, 11.6 per 1000 person-years; RC 6.7%, 12.5 per 1000 person-years; hazard ratio 0.91, 95% CI 0.69 to 1.21) did not differ between groups. At 5 years, albuminuria was present in 22.7% and 24.4% of participants in the IT and RC groups, respectively [odds ratio (OR) 0.87, 95% CI 0.72 to 1.07), retinopathy in 10.2% and 12.1%, respectively (OR 0.84, 95% CI 0.64 to 1.10), and neuropathy in 4.9% and 5.9% (OR 0.95, 95% CI 0.68 to 1.34), respectively. The estimated glomerular filtration rate increased between baseline and follow-up in both groups (IT 4.31 ml/minute; RC 6.44 ml/minute). Health status, well-being, diabetes-specific quality of life and treatment satisfaction did not differ between the groups. The intervention cost £981 per patient and was not cost-effective at costs ≥ £631 per patient.ConclusionsCompared with RC, IT was associated with modest increases in prescribed treatment, reduced levels of risk factors and non-significant reductions in cardiovascular events, microvascular complications and death over 5 years. IT did not adversely affect patient-reported outcomes. IT was not cost-effective but might be if delivered at a reduced cost. The lower than expected event rate, heterogeneity of intervention delivery between centres and improvements in general practice diabetes care limited the achievable differences in treatment between groups. Further follow-up to assess the legacy effects of early IT is warranted.Trial registrationClinicalTrials.gov NCT00237549.Funding detailsThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 64. See the NIHR Journals Library website for further project information.

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The Prediction Model of Risk Factors for COVID-19 Developing into Severe Illness Based on 1046 Patients with COVID-19

Emergency Medicine International ◽

10.1155/2021/7711056 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Zhichuang Lian ◽

Yafang Li ◽

Wenyi Wang ◽

Wei Ding ◽

Zongxin Niu ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Prediction Model ◽

Logistic Regression Analysis ◽

Roc Curve ◽

Curve Analysis ◽

Severe Illness ◽

Roc Curve Analysis ◽

Underlying Diseases

This study analyzed the risk factors for patients with COVID-19 developing severe illnesses and explored the value of applying the logistic model combined with ROC curve analysis to predict the risk of severe illnesses at COVID-19 patients’ admissions. The clinical data of 1046 COVID-19 patients admitted to a designated hospital in a certain city from July to September 2020 were retrospectively analyzed, the clinical characteristics of the patients were collected, and a multivariate unconditional logistic regression analysis was used to determine the risk factors for severe illnesses in COVID-19 patients during hospitalization. Based on the analysis results, a prediction model for severe conditions and the ROC curve were constructed, and the predictive value of the model was assessed. Logistic regression analysis showed that age (OR = 3.257, 95% CI 10.466–18.584), complications with chronic obstructive pulmonary disease (OR = 7.337, 95% CI 0.227–87.021), cough (OR = 5517, 95% CI 0.258–65.024), and venous thrombosis (OR = 7322, 95% CI 0.278–95.020) were risk factors for COVID-19 patients developing severe conditions during hospitalization. When complications were not taken into consideration, COVID-19 patients’ ages, number of diseases, and underlying diseases were risk factors influencing the development of severe illnesses. The ROC curve analysis results showed that the AUC that predicted the severity of COVID-19 patients at admission was 0.943, the optimal threshold was −3.24, and the specificity was 0.824, while the sensitivity was 0.827. The changes in the condition of severe COVID-19 patients are related to many factors such as age, clinical symptoms, and underlying diseases. This study has a certain value in predicting COVID-19 patients that develop from mild to severe conditions, and this prediction model is a useful tool in the quick prediction of the changes in patients’ conditions and providing early intervention for those with risk factors.

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Risk factors to predict ocular metastasis in older adult patients with gastric cancer:LDL, ApoA1, and CA724

10.21203/rs.3.rs-245016/v1 ◽

2021 ◽

Author(s):

Wenqing Shi ◽

Shinan Wu ◽

Tie Sun ◽

Huiye Shu ◽

Qichen Yang ◽

...

Keyword(s):

Risk Factors ◽

Older Adult ◽

Roc Curve ◽

Demographic Characteristics ◽

Curve Analysis ◽

Adult Patients ◽

Apolipoprotein A1 ◽

Roc Curve Analysis ◽

Significant Difference ◽

Ocular Metastasis

Abstract Background: Gastric cancer (GC) is one of the most common malignancies in the population. Although the incidence of GC has reduced, patient prognosis remains poor. Ocular metastases (OM) from GC are rare, and the occurrence of OM is often indicative of severe disease. The purpose of this study was to explore the risk factors for OM of GC.Methods: A total of 1165 older adult patients with GC were enrolled in this study from June 2003 to May 2019 and divided into OM and non-ocular metastasis (NOM) groups. Chi-square and independent samples t tests were used to determine whether differences in demographic characteristics and serological indicators (SI) between the two groups were significant. In addition, binary logistic regression was used to analyze the value of various SI as risk factors for OM in patients with GC. The statistical threshold was set as P < 0.05. Finally, receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic value of various SI in differentiating the occurrence of OM in patients with GC. Results: The incidence of OM in older adults with GC was 1.1%. Adenocarcinoma was the most common type of GC in both groups, and there was no significant difference in demographic characteristics, including sex and age between the groups. Low-density lipoprotein (LDL), carbohydrate antigen-724 (CA724), and carcinoembryonic antigen levels were significantly higher in the OM group than the NOM group, while those of apolipoprotein A1 (ApoA1) were significantly lower in the OM than the NOM group. Binary logistic analysis showed that LDL, ApoA1, and CA724 were independent risk factors for OM in patients with GC (P < 0.001,P = 0.033, and P = 0.008, respectively). ROC curve analysis generated area under the curve (AUC) values of 0.881, 0.576, and 0.906 for LDL, ApoA1, and CA724, respectively. In addition, combined analysis of LDL, ApoA1, and CA724 generated the highest AUC value of 0.924 (P < 0.001).Conclusion: Among SI, LDL, ApoA1, and CA724 have predictive value for the occurrence of OM in GC, with the three factors combined having the highest value.

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Patient-Reported Outcomes After Multiligament Knee Injury

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967117694818 ◽

2017 ◽

Vol 5 (3) ◽

pp. 232596711769481 ◽

Cited By ~ 9

Author(s):

Jessica M. Hanley ◽

Christopher A. Anthony ◽

David DeMik ◽

Natalie Glass ◽

Annunziato Amendola ◽

...

Keyword(s):

Risk Factors ◽

Patient Reported Outcomes ◽

Knee Injury ◽

Lysholm Score ◽

Level Of Evidence ◽

Time To Surgery ◽

Patient Reported ◽

Ikdc Score ◽

Univariate Analyses

Background: Management of the medial collateral ligament (MCL) in the setting of a multiligamentous knee injury (MLKI) represents an area of great controversy. Purpose: Our study was designed to compare long-term patient-reported outcomes (PROs) after MCL repair versus reconstruction in the setting of a multiligamentous injury of the knee. Study Design: Cohort study; Level of evidence, 3. Methods: At a single institution, 68 patients were identified over a 10-year period as having MCL intervention in the setting of MLKI. Of these patients, 34 (50%) were successfully contacted via telephone to collect Lysholm and International Knee Documentation Committee (IKDC) scores. A retrospective chart review of these subjects was also conducted to identify patient and surgical factors affecting PROs. Results: At a mean 6-year follow-up (range, 2-11 years), the mean Lysholm score was 77.4 ± 23.1 and mean IKDC score was 72.6 ± 23.6. Univariate analyses identified time to surgery ( P = .005) and MCL reconstruction ( P = .001) as risk factors for Lysholm score ≤75. Univariate analyses identified patient age ( P = .049), time to surgery ( P = .018), and MCL reconstruction ( P = .004) as risk factors for IKDC score ≤75. On subsequent multivariate analysis, MCL reconstruction was found to be a predictor of Lysholm or IKDC score of ≤75. Conclusion: Patients undergoing MCL repair in the setting of MLKI generally had higher PROs than those undergoing reconstructions at a mean 6 years of follow-up. Further work is needed to elucidate patient and surgical factors that may influence subjective outcomes after multiligament knee injuries.

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Impact of comorbidity burden on mortality in patients with COVID-19 using the Korean health insurance database

Scientific Reports ◽

10.1038/s41598-021-85813-2 ◽

2021 ◽

Vol 11 (1) ◽

Cited By ~ 2

Author(s):

Soo Ick Cho ◽

Susie Yoon ◽

Ho-Jin Lee

Keyword(s):

Risk Factors ◽

Health Insurance ◽

Roc Curve ◽

Significant Risk ◽

Curve Analysis ◽

Roc Curve Analysis ◽

Comorbidity Burden ◽

Comorbidity Index ◽

The Impact ◽

Age And Sex

AbstractWe aimed to investigate the impact of comorbidity burden on mortality in patients with coronavirus disease (COVID-19). We analyzed the COVID-19 data from the nationwide health insurance claims of South Korea. Data on demographic characteristics, comorbidities, and mortality records of patients with COVID-19 were extracted from the database. The odds ratios of mortality according to comorbidities in these patients with and without adjustment for age and sex were calculated. The predictive value of the original Charlson comorbidity index (CCI) and the age-adjusted CCI (ACCI) for mortality in these patients were investigated using the receiver operating characteristic (ROC) curve analysis. Among 7590 patients, 227 (3.0%) had died. After age and sex adjustment, hypertension, diabetes mellitus, congestive heart failure, dementia, chronic pulmonary disease, liver disease, renal disease, and cancer were significant risk factors for mortality. The ROC curve analysis showed that an ACCI threshold > 3.5 yielded the best cut-off point for predicting mortality (area under the ROC 0.92; 95% confidence interval 0.91–0.94). Our study revealed multiple risk factors for mortality in patients with COVID-19. The high predictive power of the ACCI for mortality in our results can support the importance of old age and comorbidities in the severity of COVID-19.

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