Faculty Opinions recommendation of Introduction of national guidelines for restrictive blood transfusion threshold for hip fracture patients--a consecutive cohort study based on complete follow-up in national databases.

2018 ◽  
Author(s):  
Davide Cattano
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Blood Transfusion ◽  
National Guidelines ◽  
Transfusion Threshold ◽  
National Databases

scholarly journals Retrospective Cohort Study of Neonatal Blood Transfusion in China

2021 ◽  
Author(s):  
Ting Ma ◽  
Yang Sun ◽  
Qiushi Wang ◽  
Fenghua Liu ◽  
Kai Hua ◽  
...  
Keyword(s):  
Cohort Study ◽  
Blood Transfusion ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Secondary Outcome ◽  
Multicenter Cohort Study ◽  
Transfusion Threshold ◽  
Neonatal Blood ◽  
Outcome Index

Abstract Background: Blood transfusion treatment is extremely important for newborns，but the threshold of neonatal blood transfusion is not same in different countries, which may be due to differences in regions, races and nationalities, as well as medical conditions and treatment methods. Up to now, there are not enough clinical studies and prospective follow-up to determine the suitable threshold for Chinese newborns. Therefore, it is important to establish a retrospective and prospective multicenter cohort study to evaluate whether the blood transfusion scheme is suitable for newborns in China.Methods: This is a retrospective cohort study of neonatal blood transfusion and prospective follow-up from January 1, 2017 to June 30, 2021, aim to evaluate the effect of restricted and unrestricted blood transfusion on neonatal health. Diagnosis and blood transfusion data of 5,669 newborns between January 1, 2017 and June 30, 2018 from 46 hospitals in China were analyzed through retrospective study and followed up for 1w,1m and 3y after discharge. The variable data of newborns and their mothers was collected in this cohort study with 280 variables and 2.98 million data volumes including in the database. The primary outcome index of the study was death, and the secondary outcome index was complications during hospitalization, hospitalization time, NICU hospitalization days and hospitalization expenses.Discussion: The groups were grouped by birth weight, and each group was defined as a restricted and unrestricted cohort according to the Recommended Program for Neonatal Blood Transfusion (5th Edition), and evaluate applicability of this scheme for Chinese newborns based on outcome indicators. According to the neonatal treatment data, a appropriate neonatal blood transfusion threshold and neonatal blood transfusion program for China would be determined.

Hip Fracture in Men-Survival and Subsequent Fractures: A Cohort Study with 22-Year Follow-Up

2011 ◽  
Vol 59 (5) ◽  
pp. 806-813 ◽  
Author(s):  
My von Friesendorff ◽  
Fiona E. McGuigan ◽  
Jack Besjakov ◽  
Kristina Åkesson
Keyword(s):  
Cohort Study ◽  
Hip Fracture

scholarly journals Transition of care in stroke patients discharged home: a single-center prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. J. de Mooij ◽  
I. Ahayoun ◽  
J. Leferink ◽  
M. J. Kooij ◽  
F. Karapinar-Çarkit ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ischemic Stroke ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Descriptive Analysis ◽  
Clinical Information ◽  
National Guidelines ◽  
Stroke Patients ◽  
Discharge Letter

Abstract Introduction Approximately two-thirds of the patients admitted to the hospital with an ischemic stroke are discharged directly home. Discontinuity of care may result in avoidable patient harm, re-admissions and even death. We hypothesized that the transfer of information is most essential in this patient group since any future care for these patients relies solely on the information that is available to the care provider responsible at that time. Aim The objective of this study was to evaluate the continuity of transmural care in ischemic stroke patients by assessing 1) the transfer of clinical information through discharge letters to general practitioners (GPs), 2) subsequent documentation of this information and early follow-up by GPs and 3) the documentation of medication-related information in discharge letters, at GPs and community pharmacies (CPs). Methods This prospective cohort study was conducted from September 2019 through March 2020 in OLVG, Amsterdam, the Netherlands, in patients with a first stroke discharged directly home. Outcome measures were derived from national guidelines and regional agreements. Results were analyzed using descriptive analysis. Results A total of 33 patients were included. Discharge letters (n = 33) and outpatient clinic letters (n = 24) to GPs contained most of the essential items, but 16% (n = 9) of the letters were sent in time. GPs (n = 31) infrequently adhered to guidelines since 10% (n = 3) of the diagnoses were registered using the correct code and 55% (n = 17) of the patients received follow-up shortly after discharge. Medication overviews were inaccurately communicated to GPs since 62% (n = 150) of all prescriptions (n = 243) were correctly noted in the discharge letter. Further loss of information was seen as only 39% (n = 95) of all prescriptions were documented correctly in GP overviews. We found that 59% (n = 144) of the prescriptions were documented correctly in CP overviews. Conclusion In this study, we found that discontinuity of care occurred to a varying extent throughout transmural care in patients with a first stroke who were discharged home.

In-Hospital Delirium as a Prognostic Factor for New Cognitive Disorder in a 1-Year Post-Hip Fracture Follow-Up

2021 ◽  
pp. 1-7
Author(s):  
Roope Jaatinen ◽  
Tiina Luukkaala ◽  
Markus T. Hongisto ◽  
Heli Helminen ◽  
Maria S. Nuotio
Keyword(s):  
Hip Fracture ◽  
Nutritional Status ◽  
Living Arrangements ◽  
Prognostic Significance ◽  
Cognitive Disorders ◽  
Assessment Method ◽  
Cognitive Disorder ◽  
National Guidelines ◽  
Poor Nutritional Status

<b><i>Background:</i></b> Older hip fracture patients are at high risk of delirium during acute hospital care. Pre-fracture dementia is known to increase the risk of in-hospital delirium. Data on the development of new cognitive disorders in patients with delirium are scarce. <b><i>Objective:</i></b> The objective of this study is to evaluate the prognostic significance of in-hospital delirium on the development of new cognitive disorders in a 1-year follow-up in older hip fracture patients. <b><i>Material and Methods:</i></b> Data consisted of 476 hip fracture patients aged 65 years or more with no known cognitive disorder on admission. Delirium was assessed using the Confusion Assessment Method (CAM). Cognitive disorders were diagnosed following the national guidelines. Information on the new diagnoses of cognitive disorders (NDCD) at 1-year follow-up was elicited in a telephone interview and confirmed from the electronic patient files. Logistic regression analyses were conducted to examine the association of delirium with NDCDs. <b><i>Results:</i></b> Of the 476 patients, 87 (18%) had delirium during hospital stay. Patients with delirium were older, they had poorer nutritional status, lower mobility level, and more supported living arrangements than did patients without delirium. At the 1-year time point, 205 (43%) had NDCDs or were strongly suspected of this. CAM result was statistically significantly associated with development of NDCD in multivariable-adjusted analysis (odds ratio [OR] 2.29; 95% confidence interval [CI]: 1.39–3.79). Also, poor nutritional status continued to be associated with NDCDs (multivariable-adjusted OR 1.58; 95% CI: 1.03–2.43). <b><i>Conclusion:</i></b> Delirium during hospitalization and poor nutritional status on admission are independent prognostic factors for development of subsequent cognitive disorders in older hip fracture patients.

Screening and treatment of osteoporosis in breast cancer survivors treated with aromatase inhibitors: Gap between the national guidelines and real-world practice.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 113-113 ◽  
Author(s):  
Sukriti Kamboj ◽  
Sandhya Sharma ◽  
Anuradha Sethi ◽  
Aref Agheli
Keyword(s):  
Breast Cancer ◽  
Hip Fracture ◽  
Adjuvant Therapy ◽  
Cancer Survivors ◽  
Aromatase Inhibitors ◽  
Breast Cancer Survivors ◽  
National Guidelines ◽  
Treatment Of Osteoporosis ◽  
Osteoporosis Related Fracture

113 Background: Breast cancer survivors who are on adjuvant therapy with Aromatase Inhibitors (AIs) are known to have an increased risk of osteoporosis. AIs reduce estrogen levels and cause accelerated loss of bone density. Being at high risk for osteoporosis, these patients should be screened and followed up for bone mineral density (BMD) with dual energy X-ray absorptiometry (DEXA) scan as directed by national guidelines. The purpose of this study was to evaluate if this patient population is adequately screened and intervened appropriately. Methods: We conducted a two center, retrospective, clinical observational study at Guthrie cancer center at Sayre and Corning using Guthrie tumor registry. Patients with diagnosis of invasive breast cancer and on adjuvant therapy with AIs were included in this study. Patients with metastatic bone disease and those who were receiving palliative care were excluded. Results: During the study period, a total of 703 breast cancer patients were identified and 292 patients were on AIs. Baseline DXA scan for BMD was done in 54 % (158 out of 292) patients. Of these, 22% (n=35) had osteoporosis and 43% (n=68) had osteopenia. FRAX (Fracture risk assessment tool) score using WHO algorithm was calculated in patients with osteopenia. After calculating FRAX score, 28 of 68 patients were found to have ≥3% ten year probability (TYP) of a hip fracture or ≥20% TYP of a major osteoporosis-related fracture. These 28 patients with osteopenia and 35 patients (total n=64) with osteoporosis were required to be on treatment as per guideline recommendations. Only 23% (15 of 64) patients recieved treatment. Two year follow up on patients taking AI was done (n=292) and 46% (n= 137) patients had repeat BMD. Of the patients who had known osteoporosis and TYP of hip fracture ≥ 3% or a TYP of a major osteoporosis-related fracture ≥ 20%, only 54% (35 of 64) had follow up BMD. Conclusions: This study highlights the fact that osteoporosis is an under-detected and inadequately treated condition in breast cancer survivors who are on AIs. There is still a huge gap between guidelines and real world practice on prevention and treatment of osteoporosis this patient population.

Fracture of the distal forearm as a forecaster of subsequent hip fracture: A population-based cohort study with 24 years of follow-up

1993 ◽  
Vol 52 (4) ◽  
pp. 269-272 ◽  
Author(s):  
Hans Mallmin ◽  
Sverker Ljunghall ◽  
Ingemar Persson ◽  
Tord Naessén ◽  
Ulla-Brith Krusemo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Population Based ◽  
Distal Forearm

scholarly journals Blood Transfusion for Elderly Patients with Hip Fracture: a Nationwide Cohort Study

2020 ◽  
Vol 35 (37) ◽  
Author(s):  
Suk-Yong Jang ◽  
Yong-Han Cha ◽  
Jun-IL Yoo ◽  
Taeho Oh ◽  
Jung-Taek Kim ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Blood Transfusion ◽  
Elderly Patients

scholarly journals Fall-risk increasing drugs and recurrent injurious falls association in older patients after hip fracture: a cohort study protocol

2019 ◽  
Vol 10 ◽  
pp. 204209861986864 ◽  
Author(s):  
Andrea Correa-Pérez ◽  
Eva Delgado-Silveira ◽  
Sagrario Martín-Aragón ◽  
Alfonso J. Cruz-Jentoft
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Hospital Discharge ◽  
Fall Risk ◽  
Hospital Admissions ◽  
Emergency Department Visits ◽  
High Risk Population ◽  
Very Old ◽  
Injurious Falls

Polypharmacy and fall-risk increasing drugs (FRIDS) have been associated with injurious falls. However, no information is available about the association between FRIDS and injurious falls after hospital discharge due to hip fracture in a very old population. We aim to assess the association between the use of FRIDS at discharge and injurious falls in patients older than 80 years hospitalized due to a hip fracture. A retrospective cohort study using routinely collected health data will be conducted at the Orthogeriatric Unit of a teaching hospital. Patients will be included at hospital discharge (2014), with a 2-year follow-up. Fall-risk increasing drugs will be recorded at hospital discharge, and exposure to drugs will be estimated from usage records during the 2-year follow-up. Injurious falls are defined as falls that lead to any kind of health care (primary or specialized care, including emergency department visits and hospital admissions). A sample size of 193 participants was calculated, assuming that 40% of patients who receive any FRID at discharge, and 20% who do not, will experience an injurious fall during follow up. This protocol explains the study methods and the planned analysis. We expect to find a relevant association between FRIDS at hospital discharge and the incidence of injurious falls in this very old, high risk population. If confirmed, this would support the need for a careful pharmacotherapeutic review in patients discharged after a hip fracture. However, results should be carefully interpreted due to the risk of bias inherent to the study design.

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