scholarly journals Single-Use vs. Reusable Digital Flexible Ureteroscope to Treat Upper Urinary Calculi: A Propensity-Score Matching Analysis

2022 ◽  
Vol 8 ◽  
Author(s):  
Fang Huang ◽  
Xiaoqiong Zhang ◽  
Yu Cui ◽  
Zewu Zhu ◽  
Yongchao Li ◽  
...  
Keyword(s):  
Propensity Score ◽  
Treatment Outcomes ◽  
Propensity Score Matching ◽  
Statistical Significance ◽  
Urinary Calculi ◽  
Propensity Score Matching Analysis ◽  
Flexible Ureteroscope ◽  
Significant Difference ◽  
Surgeon Experience ◽  
Single Use

Objective: The purpose of this research was to compare the treatment outcomes and costs of a single-use and reusable digital flexible ureteroscope for upper urinary calculi.Methods: Four hundred forty patients with reusable digital flexible ureteroscope and 151 patients with single-use flexible digital ureteroscope were included in this study. Through exclusion and inclusion criteria and 1:1 propensity-score matching analysis based on baseline characteristics, ultimately, 238 patients (119:119) were compared in terms of treatment outcomes. The cost analysis was based on the costs of purchase, repair, and reprocessing divided by the number of all procedures in each group (450 procedures with reusable digital flexible ureteroscope and 160 procedures with single-use digital flexible ureteroscope).Results: There was no statistical significance in mean operation time (P = 0.666). The single-use digital flexible ureteroscope group has a shorter mean length of hospital stay than the reusable digital flexible ureteroscope group (P = 0.026). And the two groups have a similar incidence of postoperative complications (P = 0.678). No significant difference was observed in the final stone-free rate (P = 0.599) and the probability of secondary lithotripsy (P = 0.811) between the two groups. After 275 procedures, the total costs of a single-use flexible ureteroscope would exceed the reusable flexible ureteroscope.Conclusion: Our data demonstrated that the single-use digital flexible ureteroscope is an alternative to reusable digital flexible ureteroscopy in terms of surgical efficacy and safety for upper urinary calculi. In terms of the economics of the two types of equipment, institutions should consider their financial situation, the number of FURS procedures, the volume of the patient's calculus, surgeon experience, and local dealerships' annual maintenance contract when making the choice.

scholarly journals Bicyclol for the treatment of drug-induced liver injury: a propensity score matching analysis using a nationwide inpatient database

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110059
Author(s):  
Yongfeng Wang ◽  
Rongtao Lai ◽  
Peilan Zong ◽  
Qingling Xu ◽  
Jia Shang ◽  
...  
Keyword(s):  
Liver Injury ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Statistical Significance ◽  
Control Group ◽  
Time Interval ◽  
Potential Candidate ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Propensity Score Matching Analysis

ObjectiveTo evaluate the efficacy and safety of bicyclol in patients with drug-induced liver injury (DILI) using a nationwide database.MethodsWe retrospectively analyzed the clinical data of DILI patients in the DILI-R database. Propensity score matching was performed to balance the bicyclol and control groups, and alanine aminotransferase (ALT) recovery was compared between the two groups. Factors associated with ALT recovery and safety were identified.ResultsThe analysis included the data of 25,927 patients. Eighty-seven cases were included in the bicyclol group, with 932 cases in the control group. One-to-one propensity score matching created 86 matched pairs. The ALT normalization rate in the bicyclol group was significantly higher than that in the control group (50.00% vs. 24.42%), and statistical significance was found in the superiority test. After adjustment of baseline ALT levels, baseline total bilirubin levels, sex, age, acute or chronic liver diseases, and suspected drugs in the multivariate logic regression analysis, the major influencing factors for ALT recovery included the time interval between ALT tests (days) and the group factor (bicyclol treatment). There were no differences in the proportion of renal function impairment or blood abnormalities between the two groups.ConclusionsBicyclol is a potential candidate for DILI.

scholarly journals Cold snare polypectomy reduced delayed postpolypectomy bleeding compared with conventional hot polypectomy: a propensity score-matching analysis

2017 ◽  
Vol 05 (07) ◽  
pp. E587-E594 ◽  
Author(s):  
Takeshi Yamashina ◽  
Manabu Fukuhara ◽  
Takanori Maruo ◽  
Gensho Tanke ◽  
Saiko Marui ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Secondary Analysis ◽  
Colorectal Polyps ◽  
Propensity Score Model ◽  
Propensity Score Matching Analysis ◽  
Significant Difference ◽  
Cold Snare Polypectomy ◽  
Few Data ◽  
Snare Polypectomy

Abstract Background and study aims Cold snare polypectomy (CSP) for small colorectal polyps has lower incidence of adverse events, especially delayed postpolypectomy bleeding (DPPB). However, few data are available on comparisons of the incidence of DPPB of CSP and hot polypectomy (HP). The aim of this study was to evaluate the incidence of DPPB after CSP and compare it with that of HP. A propensity score model was used as a secondary analysis. Patients and methods This was a retrospective cohort study conducted in a single municipal hospital. We identified 539 patients with colorectal polyps from 2 mm to 11 mm in size who underwent CSP (804 polyps in 330 patients) or HP (530 polyps in 209 patients) between July 2013 and June 2015. Results There were no cases of DPPB in the CSP group. Conversely, DPPB occurred in 4 patients (1.9 %) after HP, resulting in a significant difference between the CSP and HP groups (0.008 % vs 0 %, P = 0.02). Propensity score-matching analysis created 402 matched pairs, yielding a significantly higher DPPB rate in the HP group than CSP group (0.02 % vs 0 %, P = 0.04). However, significantly more patients in the CSP group had unclear horizontal margins that precluded assessment (83 vs 38 cases, P < 0.001). The retrieval failure rate was significantly higher in the CSP group than in the HP group (3 % vs 0.7 %, P = 0.01). Conclusions DPPB was less frequent with CSP than HP, as selected by the propensity score-matching model. Our findings indicate that CSP is recommended polypectomy in daily clinical setting. However, special care should be taken during polyp retrieval and horizontal margin assessment, and these issues could be taken into account in follow-up after CSP.

scholarly journals Association of Menopausal Status with COVID-19 Outcomes: A Propensity Score-Matching Analysis

2020 ◽  
Author(s):  
Xing-Wang Wang ◽  
Hao Hu ◽  
Zhi-Yong Xu ◽  
Gong-Kai Zhang ◽  
Qing-Hua Yu ◽  
...  
Keyword(s):  
Propensity Score ◽  
Postmenopausal Women ◽  
Propensity Score Matching ◽  
Severe Disease ◽  
Menopausal Status ◽  
Premenopausal Women ◽  
Disease Type ◽  
Propensity Score Matching Analysis ◽  
Significant Difference ◽  
Bilateral Lung

Abstract Background: Despite the growing number of studies on the Coronavirus Disease-19 (COVID-19), little is known about the association of menopausal status with COVID-19 outcomes.Materials and methods: In this retrospective study, we included 336 COVID-19 in-patients between February 15, 2020 and April 30, 2020 at the Taikang Tongji Hospital (Wuhan), China. Electronic medical records, including patient demographics, laboratory results, and chest computed tomography (CT) images were reviewed. Results: In total, 300 patients with complete clinical outcomes were included for analysis. The mean age was 65.3 years and most patients were women (n=167, 55.7%). Over 50% of patients presented with comorbidities, with hypertension (63.5%) being the most common comorbidity. After propensity-score matching, results showed that men had significantly higher odds than premenopausal women for developing severe disease type (23.7% vs. 0%, OR 17.12, 95% CI 1.00–293.60; p=0.003) and bilateral lung infiltration (86.1% vs. 64.7%, OR 3.39, 95% CI 1.08–10.64; p= 0.04), but not for mortality (2.0% vs. 0%, OR 0.88, 95% CI 0.04–19.12, p=1.00). However, non-significant difference was observed among men and post-menopause women in the percentage of severe disease type (32.7% vs. 41.7%, OR 0.68, 95% CI 0.37–1.24, p=0.21) and bilateral lung infiltration (86.1% vs. 91.7%, OR 0.56, 95% CI 0.22–1.47, p=0.24), mortality (2.0% vs. 6.0%, OR 0.32, 95% CI 0.06–1.69, p=0.25).Conclusions: Men had higher disease severity than premenopausal women, while the differences disappeared between postmenopausal women and men. These findings support aggressive treatment for the poor-prognosis of postmenopausal women in clinical practice.

scholarly journals Platelet transfusion and mortality in patients with sepsis-induced thrombocytopenia: a propensity score-matching analysis

2021 ◽  
Author(s):  
Aiming Zhou ◽  
Shanshan Wu ◽  
Qin Chen ◽  
Lili Chen ◽  
Jingye Pan
Keyword(s):  
Propensity Score ◽  
Hospital Mortality ◽  
Propensity Score Matching ◽  
Platelet Transfusion ◽  
Medical Information ◽  
Simplified Acute Physiology Score ◽  
Propensity Score Matching Analysis ◽  
Significant Difference ◽  
Failure Assessment ◽  
Mimic Iii

Abstract Thrombocytopenia is common among sepsis patients. Platelet transfusion is frequently administered to increase platelet counts but its clinical impacts remain unclear in sepsis-induced thrombocytopenia. The goal of this study was to explore the association between platelet transfusion and mortality in patients with sepsis-induced thrombocytopenia based on the Medical Information Mart for Intensive Care (MIMIC) III database. In this study, we included 1733 patients with sepsis-induced thrombocytopenia, and these patients were divided into two groups: platelet transfusion group (PT group) and no platelet transfusion group (NPT group). Propensity-score matching was used to reduce the imbalance. We found that patients in the PT group had a higher in-hospital mortality as compared with the NPT group. Furthermore, in the subgroup of age (>60 years), gender (female), sequential organ failure assessment score (≤8), simplified acute physiology score (≤47), platelet count (>27/nL), congestive heart failure, platelet transfusion was associated with increased in-hospital mortality. However, there was no significant difference in the 90-day mortality and the length of ICU stays (LOS-ICU) between these two groups. All these results remain stable after adjustment for confounders and in the comparisons after propensity score matching. In conclusion, platelet transfusion was associated with increased in-hospital mortality in patients with sepsis-induced thrombocytopenia.

Safety and effectiveness of mucosal traction using a snare combined with endoclips to assist the resection of esophageal intraepithelial neoplasia: a propensity score matching analysis

2021 ◽  
Author(s):  
Qiang Zhang ◽  
Zhou-yang Lian ◽  
Jian-Qun Cai ◽  
Yang Bai ◽  
Zhen Wang
Keyword(s):  
Postoperative Complications ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Operation Time ◽  
Intraepithelial Neoplasia ◽  
R0 Resection ◽  
En Bloc ◽  
Propensity Score Matching Analysis ◽  
Significant Difference ◽  
Traction Group

Summary Currently, the reports on esophageal endoscopic submucosal dissection (ESD) assisted by traction with a snare are rare. Because a snare is a commonly used endoscopic accessory and is easily available, its application in mucosal traction is worth exploring. The present study aims to evaluate the safety and effectiveness of snare-endoclip traction-assisted ESD for esophageal intraepithelial neoplasia. Cases of esophageal intraepithelial neoplasia resected using ESD in the Digestive Endoscopy Center of Guangzhou Nanfang Hospital, China from June 2013 to March 2019 were retrospectively analyzed. The procedure of snare-endoclip traction-assisted ESD was compared with nontraction-assisted ESD by using a propensity score matching analysis. Operation time, en bloc and R0 resection, intra- and postoperative complications, and surgery-related costs were mainly evaluated. Overall, 99 cases of esophageal intraepithelial neoplasia under tissue biopsy were included in the present study. Further, 22 exact matched pairs were obtained. There were no differences in en bloc and R0 resection rates, intra- and postoperative complications, and costs of disposable surgical accessories between the traction group and the nontraction group. However, median operation time showed a significant difference: traction group, 50.0 min (range, 20–100 min); nontraction group, 70.0 min (range, 35–133 min), P=0.012. In conclusion, snare-endoclip traction-assisted ESD for esophageal intraepithelial neoplasia was safe and shortened operation time in the study, thereby improving the efficiency of ESD. Despite the additional use of a snare and endoclips for traction, the total costs of endoscopic accessories seemed not to be increased.

scholarly journals Association of menopausal status with COVID-19 outcomes: a propensity score matching analysis

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Xing-Wang Wang ◽  
Hao Hu ◽  
Zhi-Yong Xu ◽  
Gong-Kai Zhang ◽  
Qing-Hua Yu ◽  
...  
Keyword(s):  
Propensity Score ◽  
Postmenopausal Women ◽  
Propensity Score Matching ◽  
Severe Disease ◽  
Menopausal Status ◽  
Premenopausal Women ◽  
Disease Type ◽  
Propensity Score Matching Analysis ◽  
Significant Difference ◽  
Bilateral Lung

Abstract Background Despite the growing number of studies on the coronavirus disease-19 (COVID-19), little is known about the association of menopausal status with COVID-19 outcomes. Materials and methods In this retrospective study, we included 336 COVID-19 inpatients between February 15, 2020 and April 30, 2020 at the Taikang Tongji Hospital (Wuhan), China. Electronic medical records including patient demographics, laboratory results, and chest computed tomography (CT) images were reviewed. Results In total, 300 patients with complete clinical outcomes were included for analysis. The mean age was 65.3 years, and most patients were women (n = 167, 55.7%). Over 50% of patients presented with comorbidities, with hypertension (63.5%) being the most common comorbidity. After propensity score matching, results showed that men had significantly higher odds than premenopausal women for developing severe disease type (23.7% vs. 0%, OR 17.12, 95% CI 1.00–293.60; p = 0.003) and bilateral lung infiltration (86.1% vs. 64.7%, OR 3.39, 95% CI 1.08–10.64; p = 0.04), but not for mortality (2.0% vs. 0%, OR 0.88, 95% CI 0.04–19.12, p = 1.00). However, non-significant difference was observed among men and postmenopausal women in the percentage of severe disease type (32.7% vs. 41.7%, OR 0.68, 95% CI 0.37–1.24, p = 0.21), bilateral lung infiltration (86.1% vs. 91.7%, OR 0.56, 95% CI 0.22–1.47, p = 0.24), and mortality (2.0% vs. 6.0%, OR 0.32, 95% CI 0.06–1.69, p = 0.25). Conclusions Men had higher disease severity than premenopausal women, while the differences disappeared between postmenopausal women and men. These findings support aggressive treatment for the poor prognosis of postmenopausal women in clinical practice.

scholarly journals Implications of anesthetic approach, spinal versus general, for the treatment of spinal disc herniation

2019 ◽  
Vol 30 (1) ◽  
pp. 78-82
Author(s):  
Nikhil Sharma ◽  
Matthew Piazza ◽  
Paul J. Marcotte ◽  
William Welch ◽  
Ali K. Ozturk ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Clinical Outcomes ◽  
Disc Herniation ◽  
Direct Costs ◽  
Perioperative Outcomes ◽  
Lumbar Spine Surgery ◽  
Propensity Score Matching Analysis ◽  
Significant Difference

OBJECTIVEHealthcare costs continue to escalate. Approaches to care that have comparable outcomes and complications are increasingly assessed for quality improvement and, when possible, cost containment. Efforts to identify components of care to reduce length of stay (LOS) have been ongoing. Spinal anesthesia (SA), for select lumbar spine procedures, has garnered interest as an alternative to general anesthesia (GA) that might reduce cost and in-hospital LOS and accelerate recovery. While clinical outcomes with SA or GA have been studied extensively, few authors have looked at the cost-analysis in relation to clinical outcomes. The authors’ objectives were to compare the clinical perioperative outcomes of patients who received SA and GA, as well as the direct costs associated with each modality of care, and to determine which, in a retrospective analysis, can serve as a dominant procedural approach.METHODSThe authors retrospectively analyzed a homogeneous surgical population of 550 patients who underwent hemilaminotomy for disc herniation and who received either SA (n = 91) or GA (n = 459). All clinical and billing data were obtained via each patient’s chart and the hospital’s billing database, respectively. Additionally, the authors prospectively assessed patient-reported outcome measures for a subgroup of consecutively treated patients (n = 75) and compared quality-adjusted life year (QALY) gains between the two cohorts. Furthermore, the authors performed a propensity score–matching analysis to compare the two cohorts (n = 180).RESULTSDirect hospital costs for patients receiving SA were 40% higher, in the hundreds of dollars, than for patients who received GA (p < 0.0001). Furthermore, there was a significant difference with regard to LOS (p < 0.0001), where patients receiving SA had a considerably longer hospital LOS (27.6% increase in hours). Patients undergoing SA had more comorbidities (p = 0.0053), specifically diabetes and hypertension. However, metrics of complications, including readmission (p = 0.3038) and emergency department (ED) visits at 30 days (p = 1.0), were no different. Furthermore, in a small pilot group, QALY gains were statistically no different (n = 75, p = 0.6708). Propensity score–matching analysis demonstrated similar results as the univariate analysis: there was no difference between the cohorts regarding 30-day readmission (p = 1.0000); ED within 30 days could not be analyzed as there were no patients in the SA group; and total direct costs and LOS were significantly different between the two cohorts (p < 0.0001 and p = 0.0126, respectively).CONCLUSIONSBoth SA and GA exhibit the qualities of a good anesthetic, and the utilization of these modalities for lumbar spine surgery is safe and effective. However, this work suggests that SA is associated with increased LOS and higher direct costs, although these differences may not be clinically or fiscally meaningful.

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.

scholarly journals Stereotactic Radiosurgery With vs. Without Prior Embolization for Brain Arteriovenous Malformations: A Propensity Score Matching Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Debin Yan ◽  
Yu Chen ◽  
Zhipeng Li ◽  
Haibin Zhang ◽  
Ruinan Li ◽  
...  
Keyword(s):  
Propensity Score ◽  
Stereotactic Radiosurgery ◽  
Propensity Score Matching ◽  
Arteriovenous Malformations ◽  
Research Database ◽  
Obliteration Rate ◽  
Propensity Score Matching Analysis ◽  
Brain Arteriovenous Malformations ◽  
Significant Difference ◽  
Secondary Outcomes

Objective: Whether partial embolization could facilitate the post-stereotactic radiosurgery (SRS) obliteration for brain arteriovenous malformations (bAVMs) remains controversial. We performed this study to compare the outcomes of SRS with and without prior embolization for bAVMs.Methods: We retrospectively reviewed the Beijing Tiantan AVMs prospective registration research database from September 2011 to October 2014. Patients were categorized into two groups, combined upfront embolization and SRS (Em+SRS group) and SRS alone (SRS group), and we performed a propensity score matching analysis based on pre-embolization baseline characteristics; the matched groups each comprised 76 patients.Results: The obliteration rate was similar between SRS and Em+SRS (44.7 vs. 31.6%; OR, 1.754; 95% CI, 0.905–3.401; p = 0.096). However, the SRS group was superior to the Em+SRS group in terms of cumulative obliteration rate at a follow-up of 5 years (HR,1.778; 95% CI, 1.017–3.110; p = 0.033). The secondary outcomes, including functional state, post-SRS hemorrhage, all-cause mortality, and edema or cyst formation were similar between the matched cohorts. In the ruptured subgroup, the SRS group could achieve higher obliteration rate than Em+SRS group (56.5 vs. 31.9%; OR, 2.773; 95% CI, 1.190–6.464; p = 0.018). The cumulative obliteration rate at 5 years was also higher in the SRS group (64.5 vs. 41.3%; HR, 2.012; 95% CI, 1.037–3.903; p = 0.038), and the secondary outcomes were also similar between the matched cohorts.Conclusion: Although there was no significant difference in the overall obliteration rate between the two strategies, this study suggested that pre-SRS embolization may have a negative effect on post-SRS obliteration. Furthermore, the obliteration rates of the SRS only strategy was significantly higher than that of the Em+SRS strategy in the ruptured cohort, while no such phenomenon was found in the unruptured cohort.

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