High relative risk of all-cause mortality attributed to smoking in China: Guangzhou Biobank Cohort Study

Background: Nonunion rates in hind or midfoot arthrodesis have been reported as high as 41%. The most notable and readily modifiable risk factor that has been identified is smoking. In 2018, 14.4% of the UK population were active smokers. We examined the effect of smoking status on union rates for a large cohort of patients undergoing hind- or midfoot arthrodesis. Methods: In total, 381 consecutive primary joint arthrodeses were identified from a single surgeon’s logbook (analysis performed on a per joint basis, with a triple fusion reported as 3 separate joints). Patients were divided based on self-reported smoking status. Primary outcome was clinical union. Delayed union, infection, and the need for ultrasound bone stimulation were secondary outcomes. Results: Smoking prevalence was 14.0%, and 32.2% were ex-smokers. Groups were comparable for sex, diabetes, and body mass index. Smokers were younger and had fewer comorbidities. Nonunion rates were higher in smokers (relative risk, 5.81; 95% CI, 2.54-13.29; P < .001) with no statistically significant difference between ex-smokers and nonsmokers. Smokers had higher rates of infection ( P = .05) and bone stimulator use ( P < .001). Among smokers, there was a trend toward slower union with heavier smoking ( P = .004). Conclusion: This large retrospective cohort study confirmed previous evidence that smoking has a considerable negative effect on union in arthrodesis. The 5.81 relative risk in a modifiable risk factor is extremely high. Arthrodesis surgery should be undertaken with extreme caution in smokers. Our study shows that after cessation of smoking, the risk returns to normal, but we were unable to quantify the time frame. Level of Evidence: Level III, retrospective cohort study.

Download Full-text

Blood pressure categories defined by the 2017 ACC/AHA guideline and all-cause mortality: a national cohort study in China and meta-analysis

Journal of Human Hypertension ◽

10.1038/s41371-021-00495-7 ◽

2021 ◽

Author(s):

Jiaxiang Wang ◽

Jieyu Liu ◽

Haoyue Teng ◽

Yushan Zhang ◽

Xingxuan Dong ◽

...

Keyword(s):

Blood Pressure ◽

Cohort Study ◽

Meta Analysis ◽

All Cause Mortality ◽

National Cohort

Download Full-text

Body mass index and risk of all-cause mortality in normotensive and hypertensive adults: The Rural Chinese Cohort Study

Public Health Nutrition ◽

10.1017/s1368980021001592 ◽

2021 ◽

pp. 1-25

Author(s):

Qionggui Zhou ◽

Xuejiao Liu ◽

Yang Zhao ◽

Pei Qin ◽

Yongcheng Ren ◽

...

Keyword(s):

Cohort Study ◽

Population Based ◽

Normal Weight ◽

Sensitivity Analyses ◽

Hypertension Status ◽

Moderation Effect ◽

Increased Risk ◽

All Cause Mortality ◽

Chinese Cohort ◽

The Impact

Abstract Objective: The impact of baseline hypertension status on the BMI–mortality association is still unclear. We aimed to examine the moderation effect of hypertension on the BMI–mortality association using a rural Chinese cohort. Design: In this cohort study, we investigated the incident of mortality according to different BMI categories by hypertension status. Setting: Longitudinal population-based cohort Participants: 17,262 adults ≥18 years were recruited from July to August of 2013 and July to August of 2014 from a rural area in China. Results: During a median 6-year follow-up, we recorded 1109 deaths (610 with and 499 without hypertension). In adjusted models, as compared with BMI 22-24 kg/m2, with BMI ≤18, 18-20, 20-22, 24-26, 26-28, 28-30 and >30 kg/m2, the HRs (95% CI) for mortality in normotensive participants were 1.92 (1.23-3.00), 1.44 (1.01-2.05), 1.14 (0.82-1.58), 0.96 (0.70-1.31), 0.96 (0.65-1.43), 1.32 (0.81-2.14), and 1.32 (0.74-2.35) respectively, and in hypertensive participants were 1.85 (1.08-3.17), 1.67 (1.17-2.39), 1.29 (0.95-1.75), 1.20 (0.91-1.58), 1.10 (0.83-1.46), 1.10 (0.80-1.52), and 0.61 (0.40-0.94) respectively. The risk of mortality was lower in individuals with hypertension with overweight or obesity versus normal weight, especially in older hypertensives (≥60 years old). Sensitivity analyses gave consistent results for both normotensive and hypertensive participants. Conclusions: Low BMI was significantly associated with increased risk of all-cause mortality regardless of hypertension status in rural Chinese adults, but high BMI decreased the mortality risk among individuals with hypertension, especially in older hypertensives.

Download Full-text

Association between bariatric surgery with long-term analgesic prescription and all-cause mortality among patients with osteoarthritis: a general population-based cohort study

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2021.05.063 ◽

2021 ◽

Author(s):

Chao Zeng ◽

Nancy E. Lane ◽

Xiaoxiao Li ◽

Jie Wei ◽

Houchen Lyu ◽

...

Keyword(s):

Bariatric Surgery ◽

Cohort Study ◽

General Population ◽

Population Based ◽

All Cause Mortality

Download Full-text

Systemic inflammation and the relationship between periodontitis, edentulism and all‐cause mortality: a 17‐year prospective cohort study

Journal Of Clinical Periodontology ◽

10.1111/jcpe.13510 ◽

2021 ◽

Author(s):

Lewis Winning ◽

Christopher C. Patterson ◽

Katie Linden ◽

Kathy M. Cullen ◽

Frank Kee ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Systemic Inflammation ◽

Prospective Cohort ◽

All Cause Mortality ◽

The Relationship

Download Full-text

Analysis of the relationship between surgeon procedure volume and complications after total knee arthroplasty using a propensity-matched cohort study

BMJ Surgery, Interventions, & Health Technologies ◽

10.1136/bmjsit-2020-000072 ◽

2021 ◽

Vol 3 (1) ◽

pp. e000072

Author(s):

Tosan Okoro ◽

Sebastian Tomescu ◽

J Michael Paterson ◽

Bheeshma Ravi

Keyword(s):

Total Knee Arthroplasty ◽

Cohort Study ◽

Relative Risk ◽

Knee Arthroplasty ◽

Deep Infection ◽

Matched Cohort ◽

Surgical Infection ◽

Matched Cohort Study ◽

Total Knee

ObjectivesThis study aimed to identify a threshold in annual surgeon volume associated with increased risk of revision (for any cause) and deep infection requiring surgery following primary elective total knee arthroplasty (TKA).DesignA propensity score matched cohort study.SettingOntario, Canada.Participants169 713 persons who received a primary TKA between 2002 and 2016, with 3-year postoperative follow-up.Main outcome measuresRevision arthroplasty (for any cause), and the occurrence of deep surgical infection requiring surgery.ResultsBased on restricted cubic spline analysis, the threshold for increased probability of revision and deep infection requiring surgery was <70 cases/year. After matching of 51 658 TKA recipients from surgeons performing <70 cases/year to TKA recipients from surgeons with greater than 70 cases/year, patients in the former group had a higher rate of revision (for any cause, 2.23% (95% Confidence Interval (CI) 1.39 to 3.07) vs 1.70% (95% CI 0.85 to 2.55); Hazard Ratio (HR) 1.33, 95% CI 1.21 to 1.47, p<0.0001) and deep infection requiring surgery (1.29% (95% CI 0.44 to 2.14) vs 1.09% (95% CI 0.24 to 1.94); HR 1.33, 95% CI 1.17 to 1.51, p<0.0001).ConclusionsFor primary TKA recipients, cases performed by surgeons who had performed fewer than 70 TKAs in the year prior to the index TKA were at 31% increased relative risk of revision (for any cause), and 18% increased relative risk for deep surgical infection requiring surgery, at 3-year follow-up.

Download Full-text