scholarly journals Prediction of Factors Influencing the Timing and Prognosis of Early Tracheostomy in Patients with Multiple Rib Fractures using Propensity Score Matching Analysis

2021 ◽  
Author(s):  
Bing Zhang ◽  
GongKe Li ◽  
YuRong Wang ◽  
yong li
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Propensity Score ◽  
Tracheal Intubation ◽  
Propensity Score Matching ◽  
Rib Fractures ◽  
Early Tracheostomy ◽  
Multiple Rib Fractures ◽  
Propensity Score Matching Analysis ◽  
Independent Risk Factors

Abstract Objective To explore the factors affecting the timing and prognosis of early tracheostomy(within 7 days after tracheal intubation) in patients with multiple rib fractures. Methods A retrospective analysis of the medical history of 222 patients with multiple rib fractures who were admitted to the department of emergency intensive care unit(EICU) of the affiliated hospital of Yangzhou University from February 2015 to October 2019 underwent early tracheostomy. According to the time from tracheal intubation to tracheostomy after admission, the patients were divided into two groups: early tracheostomy group (within 7 days after tracheal intubation,ET) and late tracheostomy group (after the 7th day, LT). The propensity score matching analysis technique was used to compare the differences between the two groups in a 1:1 ratio. Results A total of 222 patients were enrolled, with 118 in the ET group and 104 in the LT group. After matching, 87 in the ET group and 87 in the LT group. The proportion of acute respiratory distress syndrome(ARDS)[59(67.8%)], the volume of pulmonary contusion (VPC)[33.8±11.4], and number of total rib fractures (NTRF)[10.8±2.7] in the ET were significantly higher than those in the LT group, P<0.05. Binary Logistic regression analysis showed that ARDS[OR=3.740, 95%CI(1.441, 9.711)], VPC[OR=1.087, 95%CI(1.052, 1.124)], and NTRF [OR=1.775, 95%CI(1.439, 2.188)] were independent risk factors for ET.The Pearson analysis showed that VPC and NTRF had significant correlation(R=0.369, P=0.01), ARDS and VPC had low degree correlation(R=0.179, P=0.018), while ARDS and NTRF had no significant correlation(R=0.132, P=0.110). Receiver operating characteristic(ROC)curve analysis showed that the area under VPC and NTRF curves [0.832(95%CI: 0.770~0.893),0.804(95%CI: 0.740~0.868)] were significantly more than the number of rib fractures(NFR), glasgow coma scale(GCS), and injury severity score(ISS), P<0.05. COX regression analysis showed that patients with underwent ET survived significantly better than the LT, P<0.05. Conclusions We found that ARDS, VPC, and NTFR were independent risk factors for ET; VPC ≥ 23.9% and (or) NTRF ≥ 8.5 could be used as predictors of ET in patients with multiple rib fractures. There was a linear relationship between NTRF and VPC. ET might benefit patients with multiple rib fractures.

scholarly journals The effect of prophylactic hemoclip placement and risk factors of delayed post-polypectomy bleeding in polyps sized 6 to 20 millimeters: a propensity score matching analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chun-Wei Chen ◽  
Chia-Jung Kuo ◽  
Cheng-Tang Chiu ◽  
Ming-Yao Su ◽  
Chun-Jung Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Major Complication ◽  
Potential Bias ◽  
Polyp Size ◽  
Propensity Score Matching Analysis ◽  
History Of ◽  
Snare Polypectomy

Abstract Background Delayed post-polypectomy bleeding (PPB) is a major complication of polypectomy. The effect of prophylactic hemoclipping on delayed PPB is uncertain. The aim of this study was to evaluate the effectiveness of prophylactic hemoclipping and identify the risk factors of delayed PPB. Methods Patients with polyps sized 6 to 20 mm underwent snare polypectomy from 2015 to 2017 were retrospectively reviewed. The patients with prophylactic hemoclipping for delayed PPB prevention were included in the clipping group, and those without prophylactic hemoclipping were included in the non-clipping group. The incidence of delayed PPB and time to bleeding were compared between the groups. Multivariate analysis was used to identify the risk factors of delayed PPB. Propensity score matching was used to minimize potential bias. Results After propensity score matching, 612 patients with 806 polyps were in the clipping group, and 576 patients with 806 polyps were in the non-clipping group. There were no significant differences in the incidence of delayed PPB and days to bleeding between two groups (0.8% vs 1.3%, p = 0.4; 3.4 ± 1.94 days vs 4.13 ± 3.39 days, p = 0.94). In the multivariate analysis, the polyp size [Odds ratio (OR):1.16, 95% confidence interval (CI):1.01–1.16, p = 0.03), multiple polypectomies (OR: 4.64, 95% CI:1.24–17.44, p = 0.02) and a history of anticoagulant use (OR:37.52, 95% CI:6.49–216.8, p < 0.001) were associated with delayed PPB. Conclusions In polyps sized 6 to 20 mm, prophylactic hemoclip placement did not decrease the risk of delayed PPB. Patients without risk factors including multiple polypectomies and anticoagulant use are no need to performing prophylactic hemoclipping.

scholarly journals The Outcome of Complex Hepato-Pancreato-Biliary Surgery for Elderly Patients: A Propensity Score Matching Analysis

2018 ◽  
Vol 36 (4) ◽  
pp. 323-330 ◽  
Author(s):  
Kosei Takagi ◽  
Yuzo Umeda ◽  
Ryuichi Yoshida ◽  
Daisuke Nobuoka ◽  
Takashi Kuise ◽  
...  
Keyword(s):  
Risk Factors ◽  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Postoperative Morbidity ◽  
Postoperative Mortality ◽  
Elderly Group ◽  
Postoperative Outcomes ◽  
Mortality And Morbidity ◽  
Propensity Score Matching Analysis

Background/Aims: Postoperative mortality and morbidity rates after hepato-pancreato-biliary (HPB) surgery remain high, and the number of elderly patients requiring such surgery has been increasing. This study aimed to investigate postoperative outcomes of complex HPB surgery for elderly patients. Methods: We retrospectively reviewed perioperative data of 721 patients who underwent complex HPB surgery between 2010 and 2015. The patients were divided into 2 groups: elderly (≥75 years) and non-elderly (< 75 years). Surgical outcomes of both groups were compared after propensity score-matching analysis. Subsequently, risk factors for serious postoperative morbidity were identified by multivariate analysis. Results: Before matching, the elderly group (n = 170) had more comorbidities, such as cardiovascular and renal disease, than the non-elderly group (n = 551). Matching yielded elderly (n = 170) and non-elderly groups (n = 170) with similar preoperative backgrounds. The mortality and morbidity rates did not differ significantly between the groups. In multivariate analyses, operative time (OR 1.79; p = 0.005) and blood loss (OR 1.66; p = 0.03) were identified as independent risk factors for serious postoperative morbidity, whereas older age did not have a predictive impact (OR 1.16; p = 0.52). Conclusions: Although elderly ­patients had more comorbidities and higher incidences of postoperative mortality and several complications before matching, their postoperative outcomes were equivalent to those of non-elderly patients after matching.

scholarly journals Association of Multiple Rib Fractures With Pneumonia After Successful Cardiopulmonary Resuscitation: A Retrospective Cohort Study Using Propensity Score Matching

2020 ◽  
Author(s):  
Yasuyuki Kawai ◽  
Keisuke Takano ◽  
Keita Miyazaki ◽  
Koji Yamamoto ◽  
Yusuke Tada ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Propensity Score ◽  
Cardiopulmonary Resuscitation ◽  
Propensity Score Matching ◽  
Retrospective Cohort ◽  
Rib Fractures ◽  
Confounding Factors ◽  
Fracture Group ◽  
Multiple Rib Fractures ◽  
Hospital Cardiac Arrest

Abstract Background: Few studies have examined the impact of chest wall injury on respiratory complications after cardiopulmonary resuscitation. This is due to many confounding factors for the development of complications after cardiopulmonary resuscitation. Accordingly, we investigated the association between multiple rib fractures and the incidence of pneumonia during the post-resuscitation period after adjusting for confounding factors using a propensity score.Methods: This single-centre, retrospective cohort study enrolled adult, non-traumatic, out-of-hospital, cardiac arrest patients who maintained circulation for >48 h between June 2015 and May 2019. Rib fractures were evaluated by computed tomography on the day of hospital admission, and the association with newly developed pneumonia within 7 days of hospitalisation was analysed using propensity score matching with adjustment for variables previously reported to be risk factors for the development of pneumonia.Results: Of the 683 out-of-hospital cardiac arrest patients treated during the study period, 87 eligible cases were enrolled for analysis. Thirty-two patients had multiple rib fractures identified by computed tomography and 35 patients developed pneumonia. The presence of multiple rib fractures was significantly associated with a higher incidence of pneumonia (propensity score-adjusted hazard ratio: 3.51; 95% confidence interval: 1.59–7.72; p=0.002). Consistently, after propensity score matching, the multiple rib fracture group showed significantly shorter pneumonia-free survival than the non-multiple rib fracture group (p<0.01).Conclusion: Multiple rib fractures are independently associated with the development of pneumonia after successful resuscitation.

scholarly journals Association of Multiple Rib Fractures With Pneumonia After Successful Cardiopulmonary Resuscitation: A Retrospective Cohort Study Using Propensity Score Matching

2020 ◽  
Author(s):  
Yasuyuki Kawai ◽  
Keisuke Takano ◽  
Keita Miyazaki ◽  
Koji Yamamoto ◽  
Yusuke Tada ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Propensity Score ◽  
Cardiopulmonary Resuscitation ◽  
Propensity Score Matching ◽  
Retrospective Cohort ◽  
Rib Fractures ◽  
Confounding Factors ◽  
Fracture Group ◽  
Multiple Rib Fractures ◽  
Hospital Cardiac Arrest

Abstract Background: Few studies have examined the impact of chest wall injury on respiratory complications after cardiopulmonary resuscitation. This is due to many confounding factors for the development of complications after cardiopulmonary resuscitation. Accordingly, we investigated the association between multiple rib fractures and the incidence of pneumonia during the post-resuscitation period after adjusting for confounding factors using a propensity score.Methods: This single-centre, retrospective cohort study enrolled adult, non-traumatic, out-of-hospital, cardiac arrest patients who maintained circulation for >48 h between June 2015 and May 2019. Rib fractures were evaluated by computed tomography on the day of hospital admission, and the association with newly developed pneumonia within 7 days of hospitalisation was analysed using propensity score matching with adjustment for variables previously reported to be risk factors for the development of pneumonia.Results: Of the 683 out-of-hospital cardiac arrest patients treated during the study period, 87 eligible cases were enrolled for analysis. Thirty-two patients had multiple rib fractures identified by computed tomography and 35 patients developed pneumonia. The presence of multiple rib fractures was significantly associated with a higher incidence of pneumonia (propensity score-adjusted hazard ratio: 3.51; 95% confidence interval: 1.59–7.72; p=0.002). Consistently, after propensity score matching, the multiple rib fracture group showed significantly shorter pneumonia-free survival than the non-multiple rib fracture group (p<0.01).Conclusion: Multiple rib fractures are independently associated with the development of pneumonia after successful resuscitation.

scholarly journals Relationship between tooth extraction and development of medication-related osteonecrosis of the jaw in cancer patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sakiko Soutome ◽  
Mitsunobu Otsuru ◽  
Saki Hayashida ◽  
Maho Murata ◽  
Souichi Yanamoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cancer Patients ◽  
Tooth Extraction ◽  
Patient Characteristics ◽  
Osteonecrosis Of The Jaw ◽  
Propensity Score Matching Analysis ◽  
Infection Source

AbstractTooth extraction has been avoided since it has been considered a major risk factor for medication-related osteonecrosis of the jaw (MRONJ). However, MRONJ may also develop from tooth that is an infection source. This study aimed to clarify whether tooth extraction is a risk factor for the development of MRONJ in cancer patients receiving bone-modifying agents (BMAs). This retrospective observational study included 189 patients (361 jaws) from two hospitals. The risk factors of MRONJ were identified by comparing patient characteristics between those who did and did not develop MRONJ. Furthermore, the effect of tooth extraction during BMA therapy was analyzed after adjusting for confounding factors using the propensity score matching method. MRONJ occurred in 33 patients jaws. A longer duration of BMA administration, fewer number of teeth, presence of symptoms of local infection, and infected teeth were independent risk factors of MRONJ. However, tooth extraction during BMA therapy did not increase the risk. Propensity score matching analysis showed that tooth extraction significantly lowered the risk of MRONJ development. Teeth that can be an infection source increases the risk of MRONJ, and thus, they need to be extracted even during BMA administration.

scholarly journals Feasibility and Safety of Drug-Coated Balloon-Only Angioplasty for De Novo Ostial Lesions of Left Anterior Descending Artery: Two Center’s Retrospective Study

2021 ◽  
Author(s):  
Chuang Li ◽  
Xuebo Ding ◽  
Lefeng Wang ◽  
Kuibao Li ◽  
Xinchun Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cox Regression ◽  
De Novo ◽  
Cox Regression Analysis ◽  
Left Circumflex Artery ◽  
Left Anterior Descending Artery ◽  
Drug Coated Balloon

Abstract Background:There is limited evidence of drug-coated balloon (DCB) only angioplasty in percutaneous treatment of complex de novo ostial coronary lesions. The major objective of our study is to explore the feasibility and test safety of this innovative approach in ostial lesions of left anterior descending artery (LAD). Methods:Patients treated with paclitaxel DCB or second-generation drug-eluting stent (DES) were retrospectively enrolled from two different large centers. The primary endpoints were defined as major adverse cardiovascular events (MACE) composed of cardiovascular death, target lesion revascularization (TLR), target vessel revascularization (TVR), and recurrent myocardial infarction related to target artery occlusion. Cox regression analysis were used to identify risk factors for MACE and propensity score matching is performed to minimize the selection bias.Results:A total of 53 patients were treated with paclitaxel DCB and 336 patients with DES in ostial lesions of LAD were recruited. In accordance with propensity score matching, 49 patients treated with DCB-only coordinated with 49 ones with the strategy of DES. After average follow-up time of 10 months, the rate of MACE trended to lower in DCB-only angioplasty treatment arm and triggered by post-procedure TLR (MACE: 6% vs. 4%, p=0.65; TLR: 2% vs. 4%, p=0.56). Cox regression analysis indicated that not DCB-only angioplasty was considered as an independent risk factor for adverse events after adjustment for cofound risk factors (HR: 1.748, p=0.48).Conclusions:Use of DCB-only approach in treatment of isolated ostial LAD disease could be an innovative and safe strategy without additional risk of aggressive progression of left circumflex artery.

P1513EDEMA SCORE OF CHRONIC KIDNEY DISEASE (CKD) 5D PATIENTS SHOW DIFFERENT CORRELATION WITH NON-CKD PATIENTS AND ARE STRONGLY INFLUENCED BY THE SERUM ALBUMIN VALUE ; PROPENSITY SCORE MATCHING ANALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Takuya Murakami ◽  
Osamu Saito ◽  
Takako Saito ◽  
Koushi Ueno ◽  
Tetsu Akimoto ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Propensity Score ◽  
Serum Albumin ◽  
Propensity Score Matching ◽  
Muscle Mass ◽  
Influential Factor ◽  
Propensity Score Matching Analysis ◽  
Number Of Patients ◽  
New Findings ◽  
Significant Difference

Abstract Background and Aims Previously studies reported bioelectrical impedance analysis (BIA) method is useful for body fluid evaluation, especially for evaluation of edema in CKD patients. However, it is still unelucidated what factor affects edema score in CKD patients. In this study, we investigated the factors that determine edema score of CKD 5D patients and reported new findings on the differences from non-CKD patients by using propensity score matching analysis. Method We measured the edema score of 117 CKD 5D patients and 303 non-CKD patients using the BIA method and analyzed the relationship with clinical laboratory factors. The edema score was expressed as the ratio of the total body weight (TBW) to the extracellular water (ECW) and was measured with InBody 20® (InBody Japan). All patients with CKD 5D were undergoing hemodialysis and the data were measured immediately after dialysis treatment. Results There were differences between CKD 5D patients and non-CKD patients in age, sex, and BMI. Since these factors were estimated to affect edema scores, we performed propensity score matching with age and sex, BMI in CKD 5D patients and non-CKD patients. After performing propensity score matching, the differences of age, sex, and BMI between the two groups disappeared. The number of patients became 70 in both groups. By analyzing the model, the edema score of CKD 5D patients indicated significantly higher than that of non-CKD patients (CKD 5D; 0.400±0.012 v. s. non-CKD; 0.389±0.008, P&lt;0.001). Edema score and factor which indicated significant difference by single regression analysis were examined using stepwise multiple regression analysis. As a result, we clarified that muscle mass is the most influential factor (p&lt;0.0001), and age is the next (p=0.025) on edema score in non-CKD patients, however, in CKD 5D patients, serum albumin level is the most influential factor, and no significant influence was found in muscle mass and age (p=0.0006). Conclusion For CKD 5D patients, the edema score is defined by serum albumin, and serum albumin value has much greater influence than age. It is known that low level of serum albumin is associated with poor prognosis in CKD 5D patients. From these results, it was suggested that edema score could be a better prognostic factor than ageing for CKD 5D patients.

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