scholarly journals The long-term effects of out-of-home placement in late adolescence: A propensity score matching analysis among Swiss youths

2018 ◽  
Vol 9 (1) ◽  
Author(s):  
Margit Averdijk ◽  
Denis Ribeaud ◽  
Manuel Eisner
Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Nathan Belkin ◽  
Alexander S Fairman ◽  
Benjamin M Jackson ◽  
Paul J Foley ◽  
Scott M Damrauer ◽  
...  

Introduction: Current evidence suggests that dual antiplatelet therapy (DAPT) reduces perioperative stroke, but increases bleeding after carotid endarterectomy (CEA). The long term effects of antiplatelet therapy after CEA have yet to be studied. Methods: A retrospective review of patients undergoing CEA in the national Vascular Quality Initiative database (2003-2018) was performed. Based on antiplatelet regimen at discharge, patients were propensity score matched on aspirin monotherapy vs. DAPT. Multivariable logistic regression and Kaplan-Meier analyses were used to investigate the long term effects of antiplatelet regimen on mortality and stroke/TIA. Results: Of the 72,122 patients undergoing CEA, 64.6% were discharged on aspirin, and 35.4% on DAPT. The DAPT group had higher frequencies of comorbidities (COPD, HTN, CHF, smoking, diabetes) as well as atherosclerotic diseases (PAD, CAD, prior PCI, prior CABG). After propensity score matching, two groups of 8,722 patients with comparable comorbidities were formed. While unmatched Kaplan-Meier analysis showed the DAPT cohort to have higher mortality (p=0.001), this difference dissipated after matching. The resultant matched DAPT cohort did not differ from the aspirin group in one year stroke/TIA (1.7% vs. 1.6%, p=0.70), or mortality (3.1% vs. 3.3%, p=0.55). At 5 years, however, patients treated with DAPT did exhibit a mortality benefit (6.4% vs. 7.3%, p=0.02) with multivariable logistic regression identifying DAPT as an independent predictor of reduced mortality (OR 0.94, 95% CI 0.88-0.99, p=0.04). Conclusions: Patients discharged on DAPT after CEA represent a significantly different cohort than those discharged on aspirin monotherapy. After propensity score matching, there was no difference at one year stroke/TIA or mortality outcomes, but DAPT was found to be protective against long-term mortality. Further study is warranted to investigate this finding.


2019 ◽  
Vol 43 (9) ◽  
pp. 2281-2289 ◽  
Author(s):  
Ricardo Robles-Campos ◽  
Roberto Brusadin ◽  
Asunción López-Conesa ◽  
Víctor López-López ◽  
Álvaro Navarro-Barrios ◽  
...  

2018 ◽  
Vol 33 (3) ◽  
pp. 46-56
Author(s):  
A. V. Evtushenko ◽  
V. V. Evtushenko ◽  
E. N. Pavlyukova ◽  
I. O. Kurlov ◽  
V. Kh. Vaizov ◽  
...  

The article is devoted to the evaluation of the results of clinical application of penetrating radiofrequency ablation techniques on atrial myocardium.Material and Methods. A total of 298 patients with valvular heart disease complicated with atrial fibrillation were operated. All operations were performed under cardiopulmonary bypass and cardioplegia. The main group consisted of 198 patients who were operated using penetrating technique radiofrequency exposure. The control group consisted of 100 patients who underwent surgery with the use of «classical» monopolar radiofrequency-ablation technique. Both groups did not significantly differ in any parameter before surgery, but to increase confidence in the results, pseudo-randomization was performed using the Propensity score matching technique.Results. Patients with previous heart surgery were excluded during the selection of candidates for the procedure because of the presence of adhesions in the pericardium that did not allow good visualization of the left atrium, sufficient to perform the procedure. Penetrating technique had significantly higher efficiency compared to the «classic» technique in the early and long-term postoperative periods. The efficiency was 93% in the early postoperative period and 88% in the long term. The efficacy of «classical» monopolar procedure was lower: 86 and 68%, respectively.


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