Social Environmental Factors Related to Resuming Driving after Brain Injury: A Multicenter Retrospective Cohort Study

Many patients resume driving after brain injury regardless of their ability to drive safely. Predictors for resuming driving in terms of actual resumption status and environmental factors are unclear. We evaluated the reasons for resuming driving after brain injury and examined whether social environmental factors are useful predictors of resuming driving. This retrospective cohort study was based on a multicenter questionnaire survey at least 18 months after discharge of brain injury patients with rehabilitation. A total of 206 brain injury patients (cerebrovascular disease and traumatic brain injury) were included in the study, which was conducted according to the International Classification of Functioning (ICF) items using log-binominal regression analysis, evaluating social environmental factors as associated factors of resuming driving after brain injury. Social environmental factors, inadequate public transport (risk ratio (RR), 1.38), and no alternative driver (RR, 1.53) were included as significant independent associated factors. We found that models using ICF categories were effective for investigating factors associated with resuming driving in patients after brain injury and significant association between resuming driving and social environmental factors. Therefore, social environmental factors should be considered when predicting driving resumption in patients after brain injury, which may lead to better counseling and environmental adjustment.

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Mortality and associated factors among adult patients on tuberculosis treatment in Tanzania: A retrospective cohort study

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases ◽

10.1016/j.jctube.2021.100263 ◽

2021 ◽

pp. 100263

Author(s):

Elias M. Bukundi ◽

Francis Mhimbira ◽

Rogath Kishimba ◽

Zuweina Kondo ◽

Candida Moshiro

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Associated Factors ◽

Adult Patients ◽

Tuberculosis Treatment

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The trend of direct medical costs and associated factors in patients with chronic hepatitis B in Guangzhou, China: an eight-year retrospective cohort study

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-021-01429-6 ◽

2021 ◽

Vol 21 (S2) ◽

Author(s):

Shuo Yang ◽

Ge Chen ◽

Yueping Li ◽

Guanhai Li ◽

Yingfang Liang ◽

...

Keyword(s):

Cohort Study ◽

Hepatitis B ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Associated Factors ◽

Medical Insurance ◽

Medical Costs ◽

Direct Medical Costs ◽

B Virus ◽

The Cost

Abstract Background Although the expenses of liver cirrhosis are covered by a critical illness fund under the current health insurance program in China, the medical costs associated with hepatitis B virus (HBV) related diseases is not well addressed. In order to provide evidence to address the problem, we investigated the trend of direct medical costs and associated factors in patients with chronic HBV infection. Methods A retrospective cohort study of 65,175 outpatients and 12,649 inpatients was conducted using a hospital information system database for the period from 2008 to 2015. Generalized estimating equations (GEE) were applied to explore associations between annual direct medical costs and corresponding factors, meanwhile quantile regression models were used to evaluate the effect of treatment modes on different quantiles of annual direct medical costs stratified by medical insurances. Results The direct medical costs increased with time, but the proportion of antiviral costs decreased with CHB progression. Antiviral costs accounted 54.61% of total direct medical costs for outpatients, but only 6.17% for inpatients. Non-antiviral medicine costs (46.06%) and lab tests costs (23.63%) accounted for the majority of the cost for inpatients. The direct medical costs were positively associated with CHB progression and hospitalization days in inpatients. The direct medical costs were the highest in outpatients with medical insurance and in inpatients with free medical service, and treatment modes had different effects on the direct medical costs in patients with and without medical insurance. Conclusions CHB patients had a heavy economic burden in Guangzhou, China, which increased over time, which were influenced by payment mode and treatment mode.

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Prevalence of antiretroviral treatment failure and associated factors in HIV infected children on antiretroviral therapy at Gondar University Hospital, retrospective cohort study

International Journal of Medicine and Medical Sciences ◽

10.5897/ijmms2015.1164 ◽

2016 ◽

Vol 8 (11) ◽

pp. 125-132 ◽

Cited By ~ 9

Author(s):

Zeleke Abiyie

Keyword(s):

Cohort Study ◽

Antiretroviral Therapy ◽

Treatment Failure ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Associated Factors ◽

Antiretroviral Treatment ◽

University Hospital ◽

Gondar University Hospital ◽

Antiretroviral Treatment Failure

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Use of Vasopressors Increases the Risk of Mortality in Severe Traumatic Brain Injury: A Nationwide Retrospective Cohort Study in Japan

10.21203/rs.3.rs-149055/v1 ◽

2021 ◽

Author(s):

Sanae Hosomi ◽

Tomotaka Sobue ◽

Tetsuhisa Kitamura ◽

Atsushi Hirayama ◽

Hiroshi Ogura ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Emergency Department ◽

Cohort Study ◽

Brain Injury ◽

Propensity Score ◽

Hospital Discharge ◽

Severe Traumatic Brain Injury ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Clinical Practices

Abstract BackgroundPharmacological elevation of blood pressure is frequently incorporated in severe traumatic brain injury management algorithms. However, there is limited evidence on prevalent clinical practices regarding resuscitation for severe traumatic brain injury using vasopressors. We conducted a nationwide retrospective cohort study to determine the association between the use of vasopressors and mortality following hospital discharge in patients with severe traumatic brain injury, and to determine whether the use of vasopressors affects emergency department mortality or the occurrence of cognitive dysfunction.MethodsData were collected between January 2004 and December 2018 from the Japanese Trauma Data Bank, which includes data from 272 emergency hospitals in Japan. Adults aged ≥16 years with severe traumatic brain injury, without other major injuries, were examined. A severe traumatic brain injury was defined based on the Abbreviated Injury Scale code and a Glasgow Coma Scale score of 3–8 on admission. Multivariable analysis and propensity score matching were performed. Statistical significance was assessed using 95% confidence intervals (CIs).ResultsIn total, 10 284 patients were eligible for analysis, with 650 patients (6.32%) included in the vasopressor group and 9634 patients (93.68%) included in the non-vasopressor group. The proportion of deaths on hospital discharge was higher in the vasopressor group than in the non-vasopressor group (81.69% [531/650] vs. 40.21% [3,874/9,634]). This finding was confirmed by multivariable logistic regression analysis (adjusted odds ratio [OR], 5.71; 95% CI: 4.56–7.16). Regarding propensity score-matched patients, the proportion of deaths on hospital discharge remained higher in the vasopressor group than in the non-vasopressor group (81.66% [530/649] vs. 50.69% [329/649]) (OR, 4.33; 95% CI: 3.37–5.57). The vasopressor group had a higher emergency department mortality rate than the non-vasopressor group (8.01% [52/649] vs. 2.77% [18/649]) (OR, 3.05; 95% CI: 1.77–5.28). There was no reduction in complications of cognitive disorders in the vasopressor group (5.39% [35/649] vs. 5.55% [36/649]) (OR, 0.97; 95% CI: 0.60–1.57).ConclusionsIn this population, the use of vasopressors for severe traumatic brain injury was associated with higher mortality on hospital discharge. Our results suggest that vasopressors should be avoided in most cases of severe traumatic brain injury.

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