Risk Factors for Adverse Drug Events: A 10-Year Analysis

2005 ◽  
Vol 39 (7-8) ◽  
pp. 1161-1168 ◽  
Author(s):  
R Scott Evans ◽  
James F Lloyd ◽  
Gregory J Stoddard ◽  
Jonathan R Nebeker ◽  
Matthew H Samore
Keyword(s):  
Risk Factors ◽  
Creatinine Clearance ◽  
Drug Administration ◽  
Adverse Drug Events ◽  
Conditional Logistic Regression ◽  
Patient Characteristics ◽  
Patient Specific ◽  
Administration Route ◽  
Odds Ratios ◽  
Tertiary Teaching

BACKGROUND Many adverse drug events (ADEs) are the result of known pharmacologic properties, and some result from medication errors. However, some are the result of patient-specific risk factors. OBJECTIVE To identify inpatient risk factors for ADEs. METHODS Conditional logistic regression was used to analyze all pharmacist-verified ADEs by therapeutic class of drugs and severity during a 10-year study period. All inpatients ≥18 years of age from a 520-bed tertiary teaching hospital were included. Each case patient was matched with up to 16 control patients. Odds ratios for patient factors associated with ADEs were calculated from different therapeutic classes of drugs. RESULTS Odds ratios for numerous risk factors were identified for 4376 ADEs and were found to vary depending on therapeutic classification. The risk factors for the different classifications were grouped by (1) patient characteristics—female (OR 1.5–1.7), age (0.7–0.9), weight (1.2–1.4), creatinine clearance (0.8–4.7), and number of comorbidities (1.1–12.6); (2) drug administration—dosage (1.2–3.7), administration route (1.4–149.9), and number of concomitant drugs (1.2–2.4); and (3) patient type—service (1.2–4.9), nursing division (1.5–3.8), and diagnosis-related group (1.5–5.7). CONCLUSIONS Some risk factors are consistent for all ADEs and across multiple therapeutic classes of drugs, while others are class specific. High-risk agents should be closely monitored based on patient characteristics (gender, age, weight, creatinine clearance, number of comorbidities) and drug administration (dosage, administration route, number of concomitant drugs).

scholarly journals An outbreak of haemorrhagic fever with renal syndrome linked with mountain recreational activities in Zagreb, Croatia, 2017

2018 ◽  
Vol 146 (10) ◽  
pp. 1236-1239
Author(s):  
Z. Lovrić ◽  
B. Kolarić ◽  
M. L. Kosanović Ličina ◽  
M. Tomljenović ◽  
O. Đaković Rode ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Conditional Logistic Regression ◽  
Hantavirus Infection ◽  
Haemorrhagic Fever ◽  
Recreational Activity ◽  
Odds Ratios ◽  
Recreational Activities

AbstractIn 2017 Zagreb faced the largest outbreak of haemorrhagic fever with renal syndrome (HFRS) to date. We investigated to describe the extent of the outbreak and identify risk factors for infection. We compared laboratory-confirmed cases of Hantavirus infection in Zagreb residents with the onset of illness after 1 January 2017, with individually matched controls from the same household or neighbourhood. We calculated adjusted matched odds ratios (amOR) using conditional logistic regression. During 2017, 104 cases were reported: 11–81 years old (median 37) and 71% (73) male. Compared with 104 controls, cases were more likely to report visiting Mount Medvednica (amOR 60, 95% CI 6–597), visiting a forest (amOR 46, 95% CI 4.7–450) and observing rodents (amOR 20, 95% CI 2.6–159). Seventy per cent of cases (73/104) had visited Mount Medvednica prior to infection. Among participants who had visited Mount Medvednica, cases were more likely to have drunk water from a spring (amOR 22, 95% CI 1.9–265), observed rodents (amOR 17, 95% CI 2–144), picked flowers (amOR 15, 95% CI 1.2–182) or cycled (amOR 14, 95% CI 1.6–135). Our study indicated that recreational activity around Mount Medvednica was associated with HFRS. We recommend enhanced surveillance of the recreational areas during an outbreak.

Patient-specific risk factors of adverse drug events in adult inpatients - evidence detected using the Global Trigger Tool method

2014 ◽  
Vol 24 (3-4) ◽  
pp. 582-591 ◽  
Author(s):  
Marja Härkänen ◽  
Marjo Kervinen ◽  
Jouni Ahonen ◽  
Ari Voutilainen ◽  
Hannele Turunen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Drug Events ◽  
Patient Specific ◽  
Trigger Tool ◽  
Specific Risk ◽  
Global Trigger Tool

scholarly journals Patient Characteristics Associated with Adverse Drug Events in Hospital: An Overview of Reviews

2016 ◽  
Vol 69 (4) ◽  
Author(s):  
Silvija Mihajlovic ◽  
Jeremie Gauthier ◽  
Erika MacDonald
Keyword(s):  
Risk Factors ◽  
Systematic Reviews ◽  
Adverse Drug Events ◽  
Facteurs De Risque ◽  
Patient Characteristics ◽  
Overview Of Reviews ◽  
Factors Associated ◽  
Cochrane Database ◽  
Hospital Inpatients ◽  
Preventable Ades

<p><strong>ABSTRACT</strong></p><p><strong>Background:</strong> Adverse drug events (ADEs) occurring in hospital inpatients can have serious implications. The ability to identify and prioritize patients at higher risk of ADEs could help pharmacists to optimize their impact as members of the patient care team.</p><p><strong>Objective:</strong> To identify risk factors, patient characteristics, and medications associated with a higher likelihood of ADEs in adult inpatients through an overview of reviews on this topic.</p><p><strong>Data Sources:</strong> Systematic reviews and narrative reviews or guidelines identified through a search of MEDLINE and the Cochrane Database of Systematic Reviews (limited to articles published from 1995 to June 4, 2015), as well as a grey literature search.</p><p><strong>Study Selection and Data Extraction:</strong> For inclusion in this overview, a review had to discuss patient characteristics or risk factors associated with ADEs, medications associated with ADEs, or drug–drug interactions associated with ADEs, in adult inpatients. Articles retrieved by the literature search were screened for eligibility by a single reviewer.</p><p><strong>Data Synthesis:</strong> Eleven articles were deemed eligible for inclusion in this overview: 4 systematic reviews and 7 narrative reviews or guidelines. Their results were described narratively. Older age and polypharmacy were the most frequently cited risk factors associated with ADEs in hospital inpatients. Renal impairment, female sex, and decline in cognition were also frequently reported as being associated with ADEs. Medication classes reported to be associated with ADEs during the hospital stay included anticoagulants, anti-infectives/antibiotics, antidiabetic agents, analgesics (including opioids and nonsteroidal anti-inflammatory drugs), and cardiovascular drugs (including antihypertensive agents, diuretics, and digoxin). Two publications reported on preventable ADEs in hospital inpatients; the medications associated with preventable ADEs were consistent with those reported above.</p><p><strong>Conclusions:</strong> The risk factors, patient characteristics, and medication classes highlighted in this overview may help clinicians to prioritize patient populations who may be at higher risk of ADEs.</p><p><strong>RÉSUMÉ</strong></p><p><strong>Contexte :</strong> Les événements indésirables liés aux médicaments (EIM) touchant les patients hospitalisés peuvent avoir de graves conséquences. La capacité d’identifier les patients qui présentent un haut risque d’EIM et de les prioriser pourrait aider les pharmaciens à optimiser l’influence qu’ils exercent comme membres de l’équipe de soins aux patients.</p><p><strong>Objectif :</strong> Identifier les facteurs de risque, les caractéristiques des patients ou les médicaments associés à un potentiel plus élevé d’EIM chez les patients adultes hospitalisés à l’aide d’une synthèse des comptes rendus sur le sujet.</p><p><strong>Sources des données :</strong> Des analyses systématiques et des revues narratives ou des lignes directrices trouvées à l’aide d’une recherche dans MEDLINE et la Cochrane Database of Systematic Reviews (se limitant aux articles publiés entre 1995 et le 4 juin 2015) et d’une recherche dans la littérature grise.</p><p><strong>Sélection des études et extraction des données :</strong> Afin d’être admissible à la présente synthèse, un compte rendu devait aborder les caractéristiques des patients ou les facteurs de risque associés aux EIM, les médicaments associés aux EIM ou les interactions médicament médicament associées aux EIM chez le patient adulte hospitalisé. L’admissibilité des articles trouvés grâce à la recherche documentaire n’a été évaluée que par une seule personne.</p><p><strong>Synthèse des données :</strong> Les résultats des comptes rendus retenus ont été décrits de manière narrative. Onze articles ont été admis dans la présente synthèse : quatre analyses systématiques et sept revues narratives ou lignes directrices. L’âge avancé et la polypharmacie représentaient les facteurs de risque associés aux EIM les plus souvent mentionnés chez le patient adulte hospitalisé. L’insuffisance rénale, le sexe féminin et le déclin cognitif étaient eux aussi fréquemment indiqués comme étant des facteurs liés aux EIM. Parmi les classes de médicaments signalées comme étant associées aux EIM pendant le séjour à l’hôpital, on comptait : les anticoagulants, les anti-infectieux et les antibiotiques, les antidiabétiques, les analgésiques (notamment les opioïdes et les anti-inflammatoires non stéroïdiens) et les agents cardiovasculaires (notamment les antihypertenseurs, les diurétiques et la digoxine). Deux publications abordaient les EIM évitables chez le patient hospitalisé; les médicaments associés aux EIM faisaient partie de ceux mentionnés ci-dessus.</p><p><strong>Conclusion :</strong> Connaître les facteurs de risque, les caractéristiques des patients et les classes de médicaments mis en évidence dans la présente synthèse peut aider les cliniciens à accorder la priorité aux populations de patients qui pourraient présenter un plus grand risque d’EIM.</p>

scholarly journals Differential Impact of Risk Factors on Stroke Occurrence Among Men Versus Women in West Africa

Stroke ◽  
2019 ◽  
Vol 50 (4) ◽  
pp. 820-827 ◽  
Author(s):  
Albert Akpalu ◽  
Mulugeta Gebregziabher ◽  
Bruce Ovbiagele ◽  
Fred Sarfo ◽  
Henry Iheonye ◽  
...  
Keyword(s):  
Risk Factors ◽  
West Africa ◽  
Salt Intake ◽  
Comprehensive Evaluation ◽  
Conditional Logistic Regression ◽  
Population Attributable Risk ◽  
Leafy Vegetables ◽  
Sub Saharan Africa ◽  
Odds Ratios ◽  
Modifiable Factors

Background and Purpose— The interplay between sex and the dominant risk factors for stroke occurrence in sub-Saharan Africa has not been clearly delineated. We compared the effect sizes of risk factors of stroke by sex among West Africans. Methods— SIREN study (Stroke Investigative Research and Educational Networks) is a case-control study conducted at 15 sites in Ghana and Nigeria. Cases were adults aged >18 years with computerized tomography/magnetic resonance imaging confirmed stroke, and controls were age- and sex-matched stroke-free adults. Comprehensive evaluation for vascular, lifestyle, and psychosocial factors was performed using validated tools. We used conditional logistic regression to estimate odds ratios and reported risk factor specific and composite population attributable risks with 95% CIs. Results— Of the 2118 stroke cases, 1193 (56.3%) were males. The mean±SD age of males was 58.1±13.2 versus 60.15±14.53 years among females. Shared modifiable risk factors for stroke with adjusted odds ratios (95% CI) among females versus males, respectively, were hypertension [29.95 (12.49–71.77) versus 16.1 0(9.19–28.19)], dyslipidemia [2.08 (1.42–3.06) versus 1.83 (1.29–2.59)], diabetes mellitus [3.18 (2.11–4.78) versus 2.19 (1.53–3.15)], stress [2.34 (1.48–3.67) versus 1.61 (1.07–2.43)], and low consumption of green leafy vegetables [2.92 (1.89–4.50) versus 2.00 (1.33–3.00)]. However, salt intake and income were significantly different between males and females. Six modifiable factors had a combined population attributable risk of 99.1% (98.3%–99.6%) among females with 9 factors accounting for 97.2% (94.9%–98.7%) among males. Hemorrhagic stroke was more common among males (36.0%) than among females (27.6%), but stroke was less severe among males than females. Conclusions— Overall, risk factors for stroke occurrence are commonly shared by both sexes in West Africa favoring concerted interventions for stroke prevention in the region.

scholarly journals Risk factors for hospital-acquired influenza A and patient characteristics: A matched case-control study

2020 ◽  
Author(s):  
Kui Yang ◽  
Ni Zhang ◽  
Chunchen Gao ◽  
Hongyan Qin ◽  
Anhui Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pleural Effusion ◽  
Influenza A ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Patient Characteristics ◽  
Case Control ◽  
Hospitalized Patients ◽  
Hospital Acquired ◽  
Control Study

Abstract Background: While hospital-acquired influenza A results in an additional cost burden and considerable mortality in patients, its risk factors are unknown. We aimed to describe the characteristics of patients vulnerable to hospital-acquired influenza A and to identify its risk factors to assist clinicians control hospital-acquired infections and reduce the burden of treatment.Methods: A case-control study was conducted among hospitalized patients aged ≥18 years at a tertiary level teaching hospital during the 2018–2019 influenza A season. Patient data were retrieved from hospital-based electronic medical records. Hospital-acquired influenza A was defined as a case of influenza A diagnosed 7 days or more after admission, in a patient with no evidence of influenza A infection on admission. The controls without influenza A were selected among patients exposed to the same setting and time period. We identified risk factors using conditional logistic regression and described the characteristics of hospital-acquired influenza A by comparing the clinical data of infected patients and the controls.Results: Of the 412 hospitalized patients with influenza A from all the departments in the study hospital, 93 (22.6%) cases were classified as hospital-acquired. The most common comorbidities of the 93 cases were hypertension (41.9%), coronary heart disease (21.5%), and cerebrovascular disease (20.4%). Before the onset of hospital-acquired influenza A, patients presented more lymphocytopenia (51.6% vs 35.5%, P=0.027), hypoalbuminemia (78.5% vs 57.0%, P=0.002), and pleural effusion (26.9% vs 9.7%, P=0.002) than the matched controls. Infected patients also had longer hospital stays (18 days vs 14 days, P=0.002), and higher mortality rates (10.8% vs 2.2%, P=0.017) than the matched controls. Lymphocytopenia (odds ratio [OR]: 3.11; 95% confidence interval [CI]: 1.24–7.80; P=0.016), hypoalbuminemia (OR: 2.24; 95% CI: 1.10–4.57; P=0.027), and pleural effusion (OR: 3.09; 95% CI: 1.26–7.58; P=0.014) were independently associated with hospital-acquired influenza A.Conclusions: Lymphocytopenia, hypoalbuminemia and pleural effusion are independent risk factors that can help identify patients at high risk of hospital-acquired influenza A, which can extend hospital stay and is associated with a high mortality.

scholarly journals Risk factors for hospital-acquired influenza A and patient characteristics: A matched case-control study

2020 ◽  
Author(s):  
Kui Yang ◽  
Ni Zhang ◽  
Chunchen Gao ◽  
Hongyan Qin ◽  
Anhui Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pleural Effusion ◽  
Influenza A ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Patient Characteristics ◽  
Case Control ◽  
Hospitalized Patients ◽  
Hospital Acquired ◽  
Control Study

Abstract Background: While hospital-acquired influenza A results in an additional cost burden and considerable mortality in patients, its risk factors are unknown. We aimed to describe the characteristics of patients vulnerable to hospital-acquired influenza A and to identify its risk factors to assist clinicians control hospital-acquired infections and reduce the burden of treatment.Methods: A case-control study was conducted among hospitalized patients aged ≥18 years at a tertiary level teaching hospital during the 2018–2019 influenza A season. Patient data were retrieved from hospital-based electronic medical records. Hospital-acquired influenza A was defined as a case of influenza A diagnosed 7 days or more after admission, in a patient with no evidence of influenza A infection on admission. The controls without influenza A were selected among patients exposed to the same setting and time period. We identified risk factors using conditional logistic regression and described the characteristics of hospital-acquired influenza A by comparing the clinical data of infected patients and the controls.Results: Of the 412 hospitalized patients with influenza A from all the departments in the study hospital, 93 (22.6%) cases were classified as hospital-acquired. The most common comorbidities of the 93 cases were hypertension (41.9%), coronary heart disease (21.5%), and cerebrovascular disease (20.4%). Before the onset of hospital-acquired influenza A, patients presented more lymphocytopenia (51.6% vs 35.5%, P=0.027), hypoalbuminemia (78.5% vs 57.0%, P=0.002), and pleural effusion (26.9% vs 9.7%, P=0.002) than the matched controls. Infected patients also had longer hospital stays (18 days vs 14 days, P=0.002), and higher mortality rates (10.8% vs 2.2%, P=0.017) than the matched controls. Lymphocytopenia (odds ratio [OR]: 3.11; 95% confidence interval [CI]: 1.24–7.80; P=0.016), hypoalbuminemia (OR: 2.24; 95% CI: 1.10–4.57; P=0.027), and pleural effusion (OR: 3.09; 95% CI: 1.26–7.58; P=0.014) were independently associated with hospital-acquired influenza A.Conclusions: Lymphocytopenia, hypoalbuminemia and pleural effusion are independent risk factors that can help identify patients at high risk of hospital-acquired influenza A, which can extend hospital stay and is associated with a high mortality.

scholarly journals Risk factors for hospital-acquired influenza A and patient characteristics: a matched case-control study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kui Yang ◽  
Ni Zhang ◽  
Chunchen Gao ◽  
Hongyan Qin ◽  
Anhui Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pleural Effusion ◽  
Influenza A ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Patient Characteristics ◽  
Case Control ◽  
Hospitalized Patients ◽  
Hospital Acquired ◽  
Control Study

Abstract Background While hospital-acquired influenza A results in an additional cost burden and considerable mortality in patients, its risk factors are unknown. We aimed to describe the characteristics of patients vulnerable to hospital-acquired influenza A and to identify its risk factors to assist clinicians control hospital-acquired infections and reduce the burden of treatment. Methods A case-control study was conducted among hospitalized patients aged ≥18 years at a tertiary level teaching hospital during the 2018–2019 influenza A season. Patient data were retrieved from hospital-based electronic medical records. Hospital-acquired influenza A was defined as a case of influenza A diagnosed 7 days or more after admission, in a patient with no evidence of influenza A infection on admission. The controls without influenza A were selected among patients exposed to the same setting and time period. We identified risk factors using conditional logistic regression and described the characteristics of hospital-acquired influenza A by comparing the clinical data of infected patients and the controls. Results Of the 412 hospitalized patients with influenza A from all the departments in the study hospital, 93 (22.6%) cases were classified as hospital-acquired. The most common comorbidities of the 93 cases were hypertension (41.9%), coronary heart disease (21.5%), and cerebrovascular disease (20.4%). Before the onset of hospital-acquired influenza A, patients presented more lymphocytopenia (51.6% vs 35.5%, P = 0.027), hypoalbuminemia (78.5% vs 57.0%, P = 0.002), and pleural effusion (26.9% vs 9.7%, P = 0.002) than the matched controls. Infected patients also had longer hospital stays (18 days vs 14 days, P = 0.002), and higher mortality rates (10.8% vs 2.2%, P = 0.017) than the matched controls. Lymphocytopenia (odds ratio [OR]: 3.11; 95% confidence interval [CI]: 1.24–7.80; P = 0.016), hypoalbuminemia (OR: 2.24; 95% CI: 1.10–4.57; P = 0.027), and pleural effusion (OR: 3.09; 95% CI: 1.26–7.58; P = 0.014) were independently associated with hospital-acquired influenza A. Conclusions Lymphocytopenia, hypoalbuminemia and pleural effusion are independent risk factors that can help identify patients at high risk of hospital-acquired influenza A, which can extend hospital stay and is associated with a high mortality.

scholarly journals Risk Factors for Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae (CP-CRE) Acquisition Among Contacts of Newly Diagnosed CP-CRE Patients

2016 ◽  
Vol 37 (10) ◽  
pp. 1219-1225 ◽  
Author(s):  
Anat Schwartz-Neiderman ◽  
Tali Braun ◽  
Noga Fallach ◽  
David Schwartz ◽  
Yehuda Carmeli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Close Contact ◽  
Conditional Logistic Regression ◽  
Tertiary Care ◽  
Patient Characteristics ◽  
Index Patient ◽  
Multidrug Resistant ◽  
Resistant Organism ◽  
Care Hospital ◽  
Carbapenem Resistant

OBJECTIVECarbapenemase-producing carbapenem-resistantEnterobacteriaceae(CP-CRE) are extremely drug-resistant pathogens. Screening of contacts of newly identified CP-CRE patients is an important step to limit further transmission. We aimed to determine the risk factors for CP-CRE acquisition among patients exposed to a CP-CRE index patient.METHODSA matched case-control study was performed in a tertiary care hospital in Israel. The study population was comprised of patients who underwent rectal screening for CP-CRE following close contact with a newly identified CP-CRE index patient. Cases were defined as positive tests for CP-CRE. For each case patient, 2 matched controls were randomly selected from the pool of contacts who tested negative for CP-CRE following exposure to the same index case. Bivariate and multivariate analyses were conducted using conditional logistic regression.RESULTSIn total, 53 positive contacts were identified in 40 unique investigations (896 tests performed on 735 contacts) between October 6, 2008, and June 7, 2012.blaKPCwas the only carbapenemase identified. In multivariate analysis, risk factors for CP-CRE acquisition among contacts were (1) contact with an index patient for ≥3 days (odds ratio [OR], 9.8; 95% confidence interval [CI], 2.0–48.9), (2) mechanical ventilation (OR, 4.1; 95% CI, 1.4–11.9), and (3) carriage or infection with another multidrug-resistant organism (MDRO; OR, 2.6; 95% CI, 1.0–7.1). Among patients who received antibiotics, cephalosporins were associated with a lower risk of acquisition.CONCLUSIONSPatient characteristics (ventilation and carriage of another MDRO) as well as duration of contact are risk factors for CP-CRE acquisition among contacts. The role of cephalosporins requires further study.Infect Control Hosp Epidemiol2016;1–7

scholarly journals Data-driven identification of health conditions associated with incident Alzheimer's disease dementia risk: a 15 years follow-up cohort from electronic health records in France and the United Kingdom

2021 ◽  
Author(s):  
Thomas Nedelec ◽  
Baptiste Couvy-Duchesne ◽  
Fleur Monnet ◽  
Manon Ansart ◽  
Timothy Daly ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Weight Loss ◽  
United Kingdom ◽  
Conditional Logistic Regression ◽  
Health Conditions ◽  
Health Improvement ◽  
Odds Ratios ◽  
Health Records ◽  
The United Kingdom

Importance. The identification of modifiable risk factors for Alzheimer s disease (AD) is paramount for early prevention and the targeting of new interventions. Objective. To assess the associations between health conditions diagnosed in primary care and the risk of incident AD over time. Design, Setting, and Participants. Data for 20,214 AD patients from the United Kingdom and 19,458 AD patients from France were extracted from The Health Improvement Network (THIN) database. For each AD case, a control was randomly assigned after matching for sex and age at dementia diagnosis. We agnostically tested the associations between 123 different ICD10 diagnoses extracted from health records and AD dementia, by conditional logistic regression. We focused on two time periods: 2 to 10 years vs. 0 to 2 years before the diagnosis of AD, to separate risk factors from early symptoms/comorbidities. Exposures. We considered all health conditions that had been recorded in more than 0.1% of visits per 1000 person-years in both cohorts, corresponding to 123 potential types of exposure. Main Outcomes and Measures. Odds ratios (ORs) for the association of AD with the various health conditions were calculated after Bonferroni correction for multiple comparisons. Results. Ten health conditions were significantly associated with high odds ratios for AD when diagnosed 2 to 10 years before AD, in the British and French samples: major depressive disorder (OR 95% confidence interval (UK):1.23-1.46)), anxiety (1.25-1.47), reaction to severe stress (1.24-1.59), hearing loss (1.11-1.28), constipation (1.22-1.41), spondylosis (1.14-1.39), abnormal weight loss (1.33-1.63), malaise and fatigue (1.14-1.32), memory loss (6.65-8.76) and syncope and collapse (1.1-1.37). Depression was the first comorbid condition associated with AD, appearing at least nine years before the first clinical diagnosis of AD, followed by, anxiety, constipation and abnormal weight loss. Conclusions and Relevance. These results from two independent primary care databases provide new evidence on the temporality of risk factors and early signs of Alzheimer s disease. These results could guide new dementia prevention strategies.

scholarly journals Risk Factors for Failure in Conservatively Treated Osteoporotic Vertebral Fractures: A Systematic Review

2021 ◽  
pp. 219256822098227
Author(s):  
Max J. Scheyerer ◽  
Ulrich J. A. Spiegl ◽  
Sebastian Grueninger ◽  
Frank Hartmann ◽  
Sebastian Katscher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Treatment Failure ◽  
Patient Specific ◽  
Mineral Density ◽  
Radiographic Findings ◽  
Specific Risk ◽  
Fracture Development ◽  
Predict Treatment Failure

Study Design: Systematic review. Objectives: Osteoporosis is one of the most common diseases of the elderly, whereby vertebral body fractures are in many cases the first manifestation. Even today, the consequences for patients are underestimated. Therefore, early identification of therapy failures is essential. In this context, the aim of the present systematic review was to evaluate the current literature with respect to clinical and radiographic findings that might predict treatment failure. Methods: We conducted a comprehensive, systematic review of the literature according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) checklist and algorithm. Results: After the literature search, 724 potentially eligible investigations were identified. In total, 24 studies with 3044 participants and a mean follow-up of 11 months (range 6-27.5 months) were included. Patient-specific risk factors were age >73 years, bone mineral density with a t-score <−2.95, BMI >23 and a modified frailty index >2.5. The following radiological and fracture-specific risk factors could be identified: involvement of the posterior wall, initial height loss, midportion type fracture, development of an intravertebral cleft, fracture at the thoracolumbar junction, fracture involvement of both endplates, different morphological types of fractures, and specific MRI findings. Further, a correlation between sagittal spinal imbalance and treatment failure could be demonstrated. Conclusion: In conclusion, this systematic review identified various factors that predict treatment failure in conservatively treated osteoporotic fractures. In these cases, additional treatment options and surgical treatment strategies should be considered in addition to follow-up examinations.

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