Aspirin versus anticoagulation for stroke prophylaxis in blunt cerebrovascular injury: a propensity-matched retrospective cohort study

OBJECTIVE The goal of this study was to compare the odds of stroke 24 hours or more after hospital arrival among patients with blunt cerebrovascular injury (BCVI) who were treated with therapeutic anticoagulation versus aspirin. METHODS The authors conducted a retrospective cohort study at a regional level I trauma center including all patients with BCVI who were treated over a span of 10 years. Individuals with stroke on arrival or within the first 24 hours were excluded, as were those receiving alternative antithrombotic drugs or procedural treatment. Exact logistic regression was used to examine the association between treatment and stroke, adjusting for injury grade. To account for the possibility of residual confounding, propensity scores for the likelihood of receiving anticoagulation were determined and used to match patients from each treatment group; the difference in the probability of stroke between the two groups was then calculated. RESULTS A total of 677 patients with BCVI receiving aspirin or anticoagulation were identified. A total of 3.8% (n = 23) of 600 patients treated with aspirin sustained a stroke, compared to 11.7% (n = 9) of 77 receiving anticoagulation. After adjusting for injury grade with exact regression, anticoagulation was associated with higher likelihood of stroke (OR 3.01, 95% CI 1.00–8.21). In the propensity-matched analysis, patients who received anticoagulation had a 15.0% (95% CI 3.7%–26.3%) higher probability of sustaining a stroke compared to those receiving aspirin. CONCLUSIONS Therapeutic anticoagulation may be inferior to aspirin for stroke prevention in BCVI. Prospective research is warranted to definitively compare these treatment strategies.

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Comparison of anticoagulation and antiplatelet therapy for treatment of blunt cerebrovascular injury in children <10 years of age: a multicenter retrospective cohort study

Child s Nervous System ◽

10.1007/s00381-020-04672-w ◽

2020 ◽

Vol 37 (1) ◽

pp. 47-54

Author(s):

Vijay M. Ravindra ◽

Robert J. Bollo ◽

Michael C. Dewan ◽

Jay K. Riva-Cambrin ◽

Daniel Tonetti ◽

...

Keyword(s):

Cohort Study ◽

Antiplatelet Therapy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Blunt Cerebrovascular Injury ◽

Cerebrovascular Injury

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Separation and not residency permit restores function in resignation syndrome: a retrospective cohort study

European Child & Adolescent Psychiatry ◽

10.1007/s00787-021-01833-3 ◽

2021 ◽

Author(s):

Karl Sallin ◽

Kathinka Evers ◽

Håkan Jarbin ◽

Lars Joelsson ◽

Predrag Petrovic

Keyword(s):

Cohort Study ◽

Social Services ◽

Residential Care ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Care Home ◽

Essential Components ◽

Residential Care Home ◽

The Difference ◽

Oriented Approach

AbstractDespite poor treatment results, a family-oriented approach and the securing of residency have been deemed essential to recovery from resignation syndrome (RS). In a retrospective cohort study, we evaluated an alternative method involving environmental therapy, with patients separated from their parents, while actively abstaining from involving the asylum process in treatment. We examined medical records, social services acts, and residential care home acts from 13 individuals treated at Solsidan residential care home between 2005 and 2020. Severity and outcome were assessed with Clinical Global Impression, Severity and Improvement subscales. Thirteen participants were included and out of these nine (69%) recovered, i.e. they very much or much improved. Out of the eight that were separated, all recovered, also, one non-separated recovered. The difference in outcome between subjects separated and not was significant (p = 0.007). Moreover, out of the five which received a residency permit during treatment, one recovered whereas four did not. The difference in outcome between subjects granted residency and not was significant (p = 0.007). The data revealed three (23%) cases of simulation where parents were suspected to have instigated symptoms. Our evaluation suggests that separation from parents and abstaining from invoking residency permit could be essential components when treating RS. Relying on a family-oriented approach, and residency could even be detrimental to recovery. The examined intervention was successful also in cases of probable malingering by proxy.

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Empiric Therapeutic Anticoagulation and Mortality in Critically Ill Patients With Respiratory Failure From SARS‐CoV‐2: A Retrospective Cohort Study

The Journal of Clinical Pharmacology ◽

10.1002/jcph.1749 ◽

2020 ◽

Vol 60 (11) ◽

pp. 1411-1415

Author(s):

John Ferguson ◽

Stacy Volk ◽

Thomas Vondracek ◽

John Flanigan ◽

Andrew Chernaik

Keyword(s):

Cohort Study ◽

Respiratory Failure ◽

Critically Ill ◽

Retrospective Cohort Study ◽

Critically Ill Patients ◽

Retrospective Cohort ◽

Therapeutic Anticoagulation

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Increased risk of rheumatoid arthritis among patients with endometriosis: a nationwide population-based cohort study

Rheumatology ◽

10.1093/rheumatology/keaa784 ◽

2020 ◽

Author(s):

Yu-Hao Xue ◽

Liang-Tian You ◽

Hsin-Fu Ting ◽

Yu-Wen Chen ◽

Zi-Yun Sheng ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Propensity Scores ◽

Population Based ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Increased Risk ◽

Potential Risks ◽

Using Data

Abstract Objectives Autoimmunity may play a role in endometriosis. The association between endometriosis and RA remains unknown. This study was conducted to identify any evidence for this relationship. Methods This 13-year, nationwide, population-based, retrospective cohort study analysed the risk of RA in a cohort of individuals with endometriosis. We investigated the incidence of RA among patients with endometriosis using data from the Longitudinal Health Insurance Database 2000, which is maintained by the Taiwan National Health Research Institutes. We used propensity scores to match comorbidities in the two cohorts. Kaplan–Meier analysis and Cox proportional hazard model were employed to analyse the association between endometriosis and RA among patients with different potential risks. Results Patients with endometriosis [adjusted hazard ratio (HR) 1.75, 95% CI 1.27, 2.41], aged ≥45 years (adjusted HR 1.50, 95% CI 1.06–2.13) and with autoimmune disease (adjusted HR 6.99, 95% CI 2.84–17.21) had a significantly higher risk of RA. The analyses also showed that when stratified by age, comorbidities and medication use, the risk of RA in patients with endometriosis was also higher than in those without endometriosis. Conclusions This 14-year, nationwide, population-based retrospective cohort study revealed that patients with endometriosis have a higher risk of RA. In the clinical management of patients with RA, rheumatologists should be especially mindful of the possibility of underlying endometriosis.

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Clinical analysis of treatment strategies to cholecystocholedocholithiasis patients with previous subtotal or total gastrectomy: a retrospective cohort study

BMC Surgery ◽

10.1186/s12893-018-0388-1 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 5

Author(s):

Mingjie Zhang ◽

Jianxin Zhang ◽

Xu Sun ◽

Jie Xu ◽

Jing Zhu ◽

...

Keyword(s):

Cohort Study ◽

Total Gastrectomy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Treatment Strategies ◽

Clinical Analysis

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Does tonsillectomy reduce medical care visits for pharyngitis/tonsillitis in children and adults? Retrospective cohort study from Sweden

BMJ Open ◽

10.1136/bmjopen-2019-033817 ◽

2019 ◽

Vol 9 (11) ◽

pp. e033817 ◽

Cited By ~ 3

Author(s):

Eirik Østvoll ◽

Ola Sunnergren ◽

Joacim Stalfors

Keyword(s):

Cohort Study ◽

Surgical Treatment ◽

Medical Care ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Control Group ◽

Clinical Value ◽

Recurrent Tonsillitis ◽

Visit Rate ◽

The Difference

ObjectiveTo assess the effectiveness of tonsillectomy/adenotonsillectomy in reducing medical care visits for pharyngitis or tonsillitis in children and adults with chronic/recurrent tonsillitis.DesignRetrospective cohort study.SettingData were retrieved from the VEGA register, a comprehensive regional cohort in Sweden.Participants1044 children (<15 years) and 2244 adults.InterventionTonsillectomy/adenotonsillectomy compared with no surgical treatment.Main outcome measuresChanges in yearly mean rates of medical care visits due to pharyngitis/tonsillitis.ResultsIn children, there was a significant decrease in the yearly mean medical care visits rate from 1.93 (1.82 to 2.04) before surgery to 0.129 (0.099 to 0.165) after surgery, with a mean change of −1.80 (−1.90 to −1.69), p<0.0001. In patients who did not undergo surgery, the corresponding mean change was −1.51 (−1.61 to −1.41), resulting in a mean difference in the change in visit rates between the intervention and control groups of −0.283 (−0.436 to −0.135), p=0.0002. In adults, a significant decrease in the yearly mean medical care visit rate was observed from 1.45 (1.39 to 1.51) before surgery to 0.152 (0.132 to 0.173) after surgery, with a mean change of −1.30 (−1.36 to −1.24), p<0.0001, compared with −1.18 (−1.24 to −1.13) in the control group. The difference in the change in yearly mean visit rate between the surgical and non-surgical groups was −0.111 (−0.195 to −0.028), p=0.0097. The subgroup analysis showed a greater effect of surgery in children, in patients with a higher number of medical care visits before surgery and in the first year of follow-up.ConclusionIn this cohort of patients moderately or less affected with chronic/recurrent tonsillitis, the effectiveness of tonsillectomy/adenotonsillectomy in reducing medical care visits for pharyngitis and tonsillitis compared with no surgical treatment was low and of questionable clinical value.

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A Comparison of the Efficacy and Cost of Different Venous Leg Ulcer Dressings: A Retrospective Cohort Study

International Journal of Vascular Medicine ◽

10.1155/2015/187531 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Syed M. Asim Hussain

Keyword(s):

Cohort Study ◽

Standard Deviation ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Healing Rate ◽

Leg Ulcer ◽

University Hospital ◽

Venous Leg Ulcer ◽

Number Of Patients ◽

The Difference

Objective. To compare the efficacy and cost-effectiveness of simple nonadherent dressings with other more expensive dressing types in the treatment of venous leg ulcers.Study Design. Retrospective cohort study.Location. The leg ulcer clinic at the University Hospital of South Manchester.Subjects and Methods. The healing rates of twelve leg ulcer patients treated with simple nonadherent dressings (e.g., NA Ultra) were compared with an equal number of patients treated with modern dressings to determine differences in healing rates and cost.Main Outcome Measures. Rate of healing as determined by reduction in ulcer area over a specified period of time and total cost of dressing per patient.Results. Simple nonadherent dressings had a mean healing rate of 0.353 cm2/week (standard deviation ± 0.319) compared with a mean of 0.415 cm2/week (standard deviation ± 0.383) for more expensive dressings. This resulted in a one-tailedpvalue of 0.251 and a two-tailedpvalue of 0.508. Multiple regression analysis gave a significanceFof 0.8134.Conclusion. The results indicate that the difference in healing rate between simple and modern dressings is not statistically significant. Therefore, the cost of dressing type should be an important factor influencing dressing selection.

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