cohort design
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Author(s):  
Ziba Taherian ◽  
Mostafa Rezaei ◽  
Asefeh Haddadpour ◽  
Zahra Amini

Background: We aimed to evaluate the effect of COVID-19 vaccines in preventing infection, hospitalization, and mortality due to COVID-19 in Isfahan Province, Iran. Methods: Following a retrospective cohort design, data of all vaccinated individuals since the rollout of vaccination of the general population are analyzed, Mar 2020 to Aug 13, 2021. Moreover, the data of all non-vaccinated people were collected by the census method for this period. The two groups were compared concerning hospitalization and mortality using the Chi-square test. Kaplan-Meyer was also used to calculate the median interval between receiving a vaccine and outcome (hospitalization and death). Results: Overall, 583434 people have received a second dose of a vaccine from Mar 2020 to Aug 2021, which 74% (n=433403) was Sinopharm, 18.2% (n=106027) AstraZeneca, 3.6% (n=21216) Sputnik, and 3.9% (n=22,788) Barekat. In contrast, 2,551,140 people living in the Isfahan Province did not receive a vaccine. The median interval between injection of the first dose and the hospitalization for those who received Sinopharm, AstraZeneca, Sputnik, and Barekat was 22, 61, 19, and 19 days, respectively. For unvaccinated cases, the rates of infection, hospitalization, and mortality (per 1000 population) were 69.7, 12.1, and 1.04, respectively. In contrast, for vaccinated individuals, these rates were 3.9, 1.08, and 0.09, two weeks after the second dose, respectively. Conclusion: The highest and lowest reduction in relative risk was for those who received AstraZeneca and Sputnik, respectively.  


2022 ◽  
Vol 29 (1) ◽  
Author(s):  
Septiani Hidianingsih ◽  
Yonas Immanuel Hutasoit

Objective: This study compared several factors that are thought to contribute to the incidence of complications of urethroplasty fistula after urethroplasty, including meatus location, degree of chordee, surgical technique, and postoperative stent type. Material & Methods: This study is an analytical study with retrospective cohort design. After adjusting to the inclusion and exclusion criteria, 89 subjects with proximal hypospadias were subjected to urethroplasty at Fatmawati General Hospital, Jakarta from 2016 to 2019. An analysis of the relationship between several variables and the incidence of uretrocutaneous fistula was analyzed. Results: There was no significant difference between the one-stage and two-stage urethroplasty technique on the incidence of urethrocutaneous fistula (p = 0.063). There was no significant difference between the degree of chordee and complications of urethrocutaneous fistula after urethroplasty (p = 0.677). The relationship between the use of silastic stent, catheter, or cystostomy type was also not significant in complications of urethrocutaneous fistula (p = 0.576). The location of the urethral meatus also did not have a significant role in predicting the incidence of post-urethroplasty urethrocutaneous fistula (p = 0.169). Conclusion: Surgical technique (one stage and two stages), type of stent, degree of chordee, and location of the urethral meatus, did not have a significant correlation with the incidence of urethrocutaneous fistula in hypospadias patients after urethroplasty.


2021 ◽  
Vol 17 (2) ◽  
pp. 127-136
Author(s):  
Rina Oktaviani ◽  
Zullies Ikawati ◽  
Nanang Munif Yasin

Background: Diabetic ketoacidosis (DKA) is a life-threatening complication of acute diabetes mellitus (DM). Insulin is one of the therapies for DKA, which can reduce potassium levels by shifting potassium from extracellular to intracellular. Consequently, early administration of potassium is important in the resolution of DKA. Objective: To determine the correlation between potassium administration and resolution in patients with DKA and the factors affecting such resolution. Methods: An observational study was employed with a retrospective cohort design for inpatients with a diagnosis of DKA during the period of January 2015-August 2020 at Dr. Sardjito Hospital Yogyakarta. Appraisal of the resolution of DKA variable was based on the achievement of blood glucose targets, followed by 2 criteria of serum bicarbonate, pH, and anion gap during 24 hours of therapy. This study involved 55 patients divided into groups with potassium administration and without potassium administration. Data were analyzed using the chi-square test and multivariate logistic regression. Results: The resolution of DKA achieved in less than equal to 24 hours in the group with potassium was 48.5% (16 patients) while it was 18.2% (4 patients) without potassium. Based on the chi-square analysis, there was a relationship between potassium administration and the resolution of DKA (p=0.045; RR=2.667; 95%CI=1.028-6.920). The multivariate analysis showed that the severity and history of DM were positively related to the resolution of DKA (p=0.025; OR: 8.901; 95%CI=1.318-60.123 and p=0.017; OR: 0.090; 95%CI=0.012-0.652). Conclusion: Potassium administration resulted in 48.5% of the DKA patients achieving a resolution in less than equal to 24 hours from the commencement of DKA therapy. The severity and history of DM became the factors that affected the resolution of DKA. Keywords: diabetic ketoacidosis, potassium, resolution


2021 ◽  
Vol 2 (1) ◽  
pp. 170-183
Author(s):  
Nugroho H.S. ◽  
Mafiana R ◽  
Irwanto FH ◽  
Husin Syarif

Introduction: The mortality rate from sepsis is much greater than that from acute coronary syndrome or stroke. Uncontrolled release of cytokines (abnormalities in the inflammatory response) such as TNF-α and IL-1, IL-6 can reduce serum albumin level, so that the presence of hypoalbuminemia conditions can indicate how the inflammatory reaction occurs in septic patients. Albumin can be a predictor of mortality in septic patients. This study aims to determine the correlation between serum albumin level and the 28-day mortality of patients with sepsis. Methods: This study is an analytical observational study with a retrospective cohort design. The research was conducted in September 2020 until the completion of data collection at dr. Mohammad Hoesin Hospital Palembang. The sample in this study were all sepsis patients in the intensive care unit who were registered in the Medical Record Installation of dr. Mohammad Hoesin Hospital Palembang from 1 January 2019 to 31 December 2019 met the inclusion and exclusion criteria. After the data was collected, analysis was carried out using the STATA program. Results: The serum albumin value ≤ of 2.6 mg / dL on the fourth day was significant with the mortality of septic patients. Patients with a serum albumin value ≤ 2.6 mg / dL had a risk of 1.288 times experiencing death compared to an albumin value> 2.6 mg / dL. Albumin in the fourth day had moderate correlation with sepsis patient mortality (r = 0.497; p = 0.001) Conclusion: Albumin serum on the fourth day had a moderate correlation with 28 days sepsis patient mortality


BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053758
Author(s):  
Marla K Beauchamp ◽  
Brenda Vrkljan ◽  
Renata Kirkwood ◽  
Elisabeth Vesnaver ◽  
Luciana G Macedo ◽  
...  

IntroductionThe novel COVID-19 required many countries to impose public health measures that likely impacted the participation and mobility of community-dwelling older adults. This protocol details a multimethod cohort design undertaken to describe short-term and medium-term changes to the mobility and participation of older Canadians living in the community rather than retirement facilities during the COVID-19 pandemic.Methods and analysisA longitudinal telephone (or online)-administered survey is being conducted with a random sample of older adults living within 20 km of McMaster University, Hamilton, Ontario, Canada, identified from census dissemination areas. Baseline data collection of community-dwelling older adults aged 65 years and over began in May 2020 with follow-ups at 3, 6, 9 and 12 months. The Late-Life Function and Disability Instrument and global rating of change anchors are the primary outcomes of interest. A subsample of respondents will participate in open-ended, semistructured interviews conducted over the telephone or through video-conference, to explore participants’ lived experiences with respect to their mobility and participation during the pandemic. Descriptive statistics and quantitative approaches will be used to determine changes in mobility and social and personal participation, and associated personal and environmental factors. For the interviews, qualitative data will be analysed using descriptive phenomenology.Ethics and disseminationApproval was obtained from the Hamilton Integrated Research Ethics Board of McMaster University (2020-10814-GRA). This study may inform the design of programmes that can support community-dwelling older adults during and after the COVID-19 pandemic. Findings will be disseminated through peer-reviewed publications and conferences focused on ageing.


2021 ◽  
Author(s):  
Shunsuke Oyamada ◽  
Shih-Wei Chiu ◽  
Takuhiro Yamaguchi

Abstract Background: There are currently no methodological studies on the performance of the statistical models for estimating intervention effects based on the time-to-recurrent-event (TTRE) in stepped wedge cluster randomised trial (SWCRT) using an open cohort design. This study aims to address this by evaluating the performance of these statistical models using an open cohort design with the Monte Carlo simulation in various settings and their application using an actual example.Methods: Using Monte Carlo simulations, we evaluated the performance of the existing extended Cox proportional hazard models, i.e., the Andersen-Gill (AG), Prentice-Williams-Peterson Total-Time (PWP-TT), and Prentice-Williams-Peterson Gap-time (PWP-GT) models, using the settings of several event generation models and true intervention effects, with and without stratification by clusters. Unidirectional switching in SWCRT was represented using time-dependent covariates.Results: Using Monte Carlo simulations with the various described settings, the PWP-GT model with stratification by clusters showed the best performance in most settings and reasonable performance in the others. The only situation in which the performance of the PWP-TT model with stratification by clusters was not inferior to that of the PWP-GT model with stratification by clusters was when there was a certain amount of follow-up period, and the timing of the trial entry was random within the trial period, including the follow-up period. The AG model performed well only in a specific setting. By analysing actual examples, it was found that almost all the statistical models suggested that the risk of events during the intervention condition may be somewhat higher than in the control, although the difference was not statistically significant.Conclusions: The PWP-GT model with stratification by clusters had the most reasonable performance when estimating intervention effects based on the TTRE in SWCRT in various settings using an open cohort design.


2021 ◽  
pp. 85-100
Author(s):  
Alvaro Muñoz ◽  
F. Javier Nieto

The simplest cohort design is to obtain exposure data at baseline and follow-up individuals to obtain data up to the point when the event of interest occurs. A richer design includes regularly scheduled visits at which data on exposures are updated. The exposures can be either fixed over time (e.g. race), change directly with time (e.g. age and calendar), or change at their own pace (e.g. biological markers). According to the scientific aims of a cohort study, disease occurrence can be measured as an event in person-time, time-to-endpoint of interest, or change in a biomarker repeatedly measured at follow-up visits. Analytical methods include survival analyses to handle censored observations and late entries due to incomplete observation of the development of events and origin, and longitudinal data analyses for the trajectories of markers of disease progression. Stratification, multivariate regression, and causal inference methods are key tools to accomplish comparability among exposed and unexposed groups. Identification of exposures and risk factors for disease provides a basis for prevention strategies. Data from cohort studies can be used to assess the effects of interventions by using data at the individual level to determine individual effectiveness or by comparing occurrence of disease in the population when typically none or only a few are intervened to determine population effectiveness.


Author(s):  
d’Errico Angelo ◽  
Strippoli Elena ◽  
Vasta Rosario ◽  
Ferrante Gianluigi ◽  
Spila Alegiani Stefania ◽  
...  

Abstract Introduction Few epidemiological studies have assessed the risk of parkinsonisms after prolonged use of neuroleptics. We aimed to examine the long-term risk of degenerative parkinsonisms (DP) associated with previous use of neuroleptics. Methods All residents in Piedmont, Northern-west Italy, older than 39 years (2,526,319 subjects), were retrospectively followed up from 2013 to 2017. Exposure to neuroleptics was assessed through the regional archive of drug prescriptions. The development of DP was assessed using the regional archives of both drug prescriptions and hospital admissions. We excluded prevalent DP cases at baseline as well as those occurred in the first 18 months (short-term risk). The risk of DP associated with previous use of neuroleptics was examined through Cox regression, using a matched cohort design. Results The risk of DP was compared between 63,356 exposed and 316,779 unexposed subjects. A more than threefold higher risk of DP was observed among subjects exposed to antipsychotics, compared to those unexposed (HR = 3.27, 95% CI 3.00–3.57), and was higher for exposure to atypical than typical antipsychotics. The risk decreased after 2 years from therapy cessation but remained significantly elevated (HR = 2.38, 95% CI 1.76–3.21). Conclusions These results indicate a high risk of developing DP long time from the start of use and from the cessation for both typical and atypical neuroleptics, suggesting the need of monitoring treated patients even after long-term use and cessation.


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