Faculty Opinions recommendation of Effectiveness of bisphosphonates on nonvertebral and hip fractures in the first year of therapy: the risedronate and alendronate (REAL) cohort study.

BACKGROUND The Copperbelt University is the second public University in Zambia. The School of Medicine has four major programs namely; Bachelor of Medicine and Surgery, Bachelor of Dental Surgery, Bachelor of Clinical Medicine and Bachelor of Biomedical sciences. The Copperbelt University School of Medicine runs a five-year training program for both the BDS and the MBCHB programs. Students are admitted into the Medical school after successfully completing their first year at the Main campus in the School of Natural Sciences with an average of 4 B grades or higher (B grade is a mark of 65 to 74%). OBJECTIVE The study was done to determine the association between admission criteria and academic performance among preclinical students. Hence, the study compares the academic performance among preclinical students admitted into the Bachelor of Dental Surgery and Bachelor of Medicine and Surgery at the Copperbelt University School of Medicine. METHODS This is a retrospective cohort study conducted at Michael Chilufya Sata School of medicine Campus. A pilot study was conducted with 30 BDS and 30 MBCHB students and the obtained information helped determine the sample size. SPSS was used to analyze the data. The study period lasted approximately 7 weeks at a cost of K1621. RESULTS In 2014, there was an improvement in average performance between 2nd and 3rd year for each program. An average score of 15.4 (SD 4.2) was obtained in 3rd year compared to 12.8 (SD 4.9) in 2nd year (p<0.001). Meanwhile, 3rd MB ChB mean score was 12.6 (SD 3.7) compared to 10.7 (SD 3.6) in 2nd years (p<0.05). However, in 2016, both programs, 3rd year mean scores were lower than 2nd year (MB ChB 2nd year mean score was 12.0 (SD 4.3) compared to 3rd year with a mean score of 9.5 (SD 4.5), p<0.001; BDS 2nd year mean score was 10.6 (SD 4.0) compared to 3rd year mean score of 8.2 (SD 3.4), p<0.01. On average MB ChB students performed better than BDS students in all the years (p<0.05), except in 2016 when the results were comparable. CONCLUSIONS Results from the study shows that entry criteria has a correlation to academic performance as students admitted with higher grades perform much better than those with lower grades.

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Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459320986299 ◽

2021 ◽

Vol 12 ◽

pp. 215145932098629 ◽

Cited By ~ 1

Author(s):

Yulia Bugaevsky ◽

Yochai Levy ◽

Avital Hershkovitz ◽

Irena Ocheretny ◽

Adaya Nissenholtz ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Hip Fracture ◽

Hip Fractures ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Functional Independence ◽

Functional Improvement ◽

Orthopedic Department ◽

Successful Recovery

Introduction: Hip fractures are a significant health risk in older adults and a major cause of morbidity, functional decline and mortality. Our aim was to compare clinical outcomes of older patients hospitalized in an ortho-geriatric (OG) unit to those hospitalized in an orthopedic department (OD) for surgical treatment of a hip fracture. Methods: A retrospective cohort study of hip fractured patients hospitalized between 2015-2016 in a single tertiary university-affiliated medical center. Included were patients aged 65 and older who had undergone hip fracture surgery and were admitted to either a geriatric or orthopedic ward. Results: 441 patients met the inclusion criteria (195 in the OG unit, 246 in the OD); 257 were transferred to an affiliated geriatric center hospital (107 from the OG unit and 127 from the OD) for rehabilitation. Patients in the OG unit were older, more cognitively and functionally impaired and with more comorbidities. The 1-year mortality rate was significantly lower in the OD group (OR 0.32, CI 95% 0.19-0.53, p < 0.001), however, after propensity matching, the 30-day and 1 year mortality rates were similar in both groups. No difference was found in the rehabilitation length of stay between the groups. The functional independence measure improvement was similar in both groups, with a non-significant trend toward better functional improvement among OG unit patients. Conclusions: Despite the higher complexity of patients, worse baseline functional capacity in the OG unit, improvement after rehabilitation was similar in both groups. These results demonstrate the advantages of the OG unit in treating and stabilizing frail older adults, thus maximizing their chances for a successful recovery after hip fractures. Level of Evidence: Level IV

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Mortality in older adults following a fragility fracture: real-world retrospective matched-cohort study in Ontario

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-03960-z ◽

2021 ◽

Vol 22 (1) ◽

Cited By ~ 2

Author(s):

Jacques P. Brown ◽

Jonathan D. Adachi ◽

Emil Schemitsch ◽

Jean-Eric Tarride ◽

Vivien Brown ◽

...

Keyword(s):

Cohort Study ◽

Hip Fracture ◽

Fragility Fracture ◽

Mortality Risk ◽

Real World ◽

First Year ◽

Matched Cohort ◽

Matched Cohort Study ◽

Fracture Cohort ◽

One Year

Abstract Background Recent studies are lacking reports on mortality after non-hip fractures in adults aged > 65. Methods This retrospective, matched-cohort study used de-identified health services data from the publicly funded healthcare system in Ontario, Canada, contained in the ICES Data Repository. Patients aged 66 years and older with an index fragility fracture occurring at any osteoporotic site between 2011 and 2015 were identified from acute hospital admissions, emergency and ambulatory care using International Classification of Diseases (ICD)-10 codes and data were analyzed until 2017. Thus, follow-up ranged from 2 years to 6 years. Patients were excluded if they presented with an index fracture occurring at a non-osteoporotic fracture site, their index fracture was associated with a trauma code, or they experienced a previous fracture within 5 years prior to their index fracture. This fracture cohort was matched 1:1 to controls within a non-fracture cohort by date, sex, age, geography and comorbidities. All-cause mortality risk was assessed. Results The survival probability for up to 6 years post-fracture was significantly reduced for the fracture cohort vs matched non-fracture controls (p < 0.0001; n = 101,773 per cohort), with the sharpest decline occurring within the first-year post-fracture. Crude relative risk of mortality (95% confidence interval) within 1-year post-fracture was 2.47 (2.38–2.56) in women and 3.22 (3.06–3.40) in men. In the fracture vs non-fracture cohort, the absolute mortality risk within one year after a fragility fracture occurring at any site was 12.5% vs 5.1% in women and 19.5% vs 6.0% in men. The absolute mortality risk within one year after a fragility fracture occurring at a non-hip vs hip site was 9.4% vs 21.5% in women and 14.4% vs 32.3% in men. Conclusions In this real-world cohort aged > 65 years, a fragility fracture occurring at any site was associated with reduced survival for up to 6 years post-fracture. The greatest reduction in survival occurred within the first-year post-fracture, where mortality risk more than doubled and deaths were observed in 1 in 11 women and 1 in 7 men following a non-hip fracture and in 1 in 5 women and 1 in 3 men following a hip fracture.

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Nasal colonization with Staphylococcus aureus is a risk factor for ventricular assist device infection in the first year after implantation: A prospective, single-centre, cohort study

Journal of Infection ◽

10.1016/j.jinf.2020.02.015 ◽

2020 ◽

Vol 80 (5) ◽

pp. 511-518

Author(s):

Dennis Nurjadi ◽

Katharina Last ◽

Sabrina Klein ◽

Sébastien Boutin ◽

Bastian Schmack ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Risk Factor ◽

Cohort Study ◽

Ventricular Assist Device ◽

First Year ◽

Nasal Colonization ◽

Single Centre ◽

Assist Device ◽

Ventricular Assist ◽

Device Infection

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One‐year clinically important deterioration and long‐term clinical course in Japanese patients with COPD: a multicenter observational cohort study

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01510-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yuki Abe ◽

Masaru Suzuki ◽

Hironi Makita ◽

Hirokazu Kimura ◽

Kaoruko Shimizu ◽

...

Keyword(s):

Cohort Study ◽

Disease Progression ◽

Clinical Outcomes ◽

Japanese Patients ◽

Drop Out ◽

Chronic Obstructive ◽

First Year ◽

Severe Exacerbation ◽

Clinically Important Deterioration

Abstract Background Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with a complex progression of many clinical presentations, and clinically important deterioration (CID) has been proposed in the Western studies as a composite endpoint of disease progression. The aim of this study was to investigate the relationships between 1-year CID and the following long-term clinical outcomes in Japanese patients with COPD who have been reported to have different characteristics compared to the Westerners. Methods Among Japanese patients with COPD enrolled in the Hokkaido COPD cohort study, 259 patients who did not drop out within the first year were analyzed in this study. Two definitions of CID were used. Definition 1 comprised ≥ 100 mL decrease in forced expiratory volume in 1 s (FEV1), ≥ 4-unit increase in St George’s Respiratory Questionnaire (SGRQ) score from baseline, or moderate or severe exacerbation. For Definition 2, the thresholds for the FEV1 and SGRQ score components were doubled. The presence of CID was evaluated within the first year from enrollment, and analyzed the association of the presence of CID with following 4-year risk of exacerbations and 9-year mortality. Results Patients with CID using Definition 1, but not any single CID component, during the first year had a significantly worse mortality compared with those without CID. Patients with CID using Definition 2 showed a similar trend on mortality, and had a shorter exacerbation-free survival compared with those without CID. Conclusions Adoption of CID is a beneficial and useful way for the assessment of long-term disease progression and clinical outcomes even in Japanese population with COPD. The definition of CID might be optimized according to the characteristics of COPD population and the observation period for CID.

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Mortality among older Spanish people with hip fractures: a population-based matched cohort study

Aging Clinical and Experimental Research ◽

10.1007/s40520-021-01836-9 ◽

2021 ◽

Author(s):

Alicia Gutiérrez-Misis ◽

Rocío Queipo ◽

María Victoria Castell ◽

Teresa Alarcón ◽

Rocío Menéndez-Colino ◽

...

Keyword(s):

Cohort Study ◽

Hip Fractures ◽

Population Based ◽

Matched Cohort ◽

Matched Cohort Study

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Hepatic encephalopathy increases the risk of hip fracture: a nationwide cohort study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03811-3 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Kuang-Ting Yeh ◽

Tzai-Chiu Yu ◽

Ru-Ping Lee ◽

Jen-Hung Wang ◽

Kuan-Lin Liu ◽

...

Keyword(s):

Cohort Study ◽

Hepatic Encephalopathy ◽

Hip Fracture ◽

Hip Fractures ◽

Human Life ◽

National Database ◽

Research Database ◽

Older Individuals ◽

Osteoporotic Hip Fracture ◽

Increased Risk

Abstract Background Osteoporotic hip fracture is a common general health problem with a significant impact on human life because it debilitates the patients and largely decreases their quality of life. Early prevention of fractures has become essential in recent decades. This can be achieved by evaluating the related risk factors, as a reference for further intervention. This is especially useful for the vulnerable patient group with comorbidities. Hepatic encephalopathy (HE), a major complication of liver cirrhosis, may increase the rate of falls and weaken the bone. This study evaluated the correlation between hepatic encephalopathy and osteoporotic hip fracture in the aged population using a national database. Methods This retrospective cohort study used data from Taiwan’s National Health Insurance Research Database between 2000 and 2012. We included people who were older than 50 years with hepatic encephalopathy or other common chronic illnesses. Patients with and without hepatic encephalopathy were matched at a ratio of 1:4 for age, sex, and index year. The incidence and hazard ratios of osteoporotic hip fracture between the both cohorts were calculated using Cox proportional hazard regression models. Results The mean age of the enrolled patients was 66.5 years. The incidence ratio of osteoporotic hip fracture in the HE group was significantly higher than that in the non-HE group (68/2496 [2.7%] vs 98/9984 [0.98%]). Patients with HE were 2.15-times more likely to develop osteoporotic hip fractures than patients without HE in the whole group. The risk ratio was also significantly higher in female and older individuals. The results were also similar in the comorbidity subgroups of hypertension, diabetes mellitus, hyperlipidemia, senile cataract, gastric ulcer, and depression. Alcohol-related illnesses seemed to not confound the results of this study. Conclusions HE is significantly associated with an increased risk of osteoporotic hip fractures, and the significance is not affected by the comorbidities in people aged more than 50 years. The cumulative risk of fracture increases with age.

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