Category: Statistics

J Prim Care Community Health. 2024 Jan-Dec;15:21501319231222364. doi: 10.1177/21501319231222364.

ABSTRACT

BACKGROUND: Despite all the progress in the management of acute COVID-19, it is still not clear why some people continue to experience symptoms after recovery. Using data from a self-administered online survey, we assessed the prevalence and predictors of post-acute COVID-19 in an unselected population followed by GPs.

METHODS: Patients ≥18 years with a confirmed COVID-19 diagnosis were included. The survey collected information on demographics, risk factors, COVID-19 course and symptomatology. Fatigue and Quality of Life questionnaires were also administered. Descriptive statistics were used to describe patients’ characteristics, stratified as acute and post-acute COVID-19. Logistic regression models were used to assess the association between clinical characteristics and post-acute COVID-19.

RESULTS: A total of 1108 surveys were analyzed. Nearly 29% of patients reported post-acute COVID-19. The more persistent symptoms were fatigue, memory and concentration impairment. Adjusted Odds Ratio (OR) showed a significantly higher probability of post-acute COVID-19 for women compared to men (OR 1.9, 95% CI 1.4-2.5), for age >50 years than ≤50 years (OR 1.6, 95% CI 1.2-2.2), for BMI > 25 compared to BMI ≤ 25 (OR 1.6, 95% CI 1.1-2.1) and those with autoimmune diseases, compared to those without (OR 1.8 95% CI 1.1-2.9). In addition, a significant association was found with COVID-19 hospitalization, anxiety and allergies. We found that post-acute COVID-19 patients showed a higher fatigue and a worst quality of life.

CONCLUSIONS: These findings suggest the need for tailored personalized strategies to improve the management of patients with post-acute COVID-19.

PMID:38166461 | DOI:10.1177/21501319231222364

JDR Clin Trans Res. 2024 Jan 3:23800844231216356. doi: 10.1177/23800844231216356. Online ahead of print.

ABSTRACT

INTRODUCTION: The number of surgical extractions performed in hospitals in England remains unclear. This study reports the volume of surgical extractions conducted in hospitals and change in activity during the COVID-19 pandemic.

METHODS: We conducted a nationwide observational cohort study using Hospital Episode Statistics (HES) in England for patients undergoing surgical removal of a tooth (defined using OPSC-4 code F09) between April 1, 2015, and December 31, 2020. Procedures were stratified by age, gender, and urgency (elective or nonelective), reported using descriptive statistics, number, and percentage. We conducted post hoc modeling to predict surgical activity to December 2023. In addition, we contrasted this with aggregate national data on simple dental extraction procedures and drainage of dental abscesses in hospital as well as dental activity in general practice.

RESULTS: We identified a total of 569,938 episodes for the surgical removal of a tooth (females 57%). Of these, 493,056/569,938 (87%) were for adults and 76,882/569,938 (13%) children ≤18 years. Surgical extractions were most frequent in adult females. Elective cases accounted for 96% (n = 548,805/569,938) of procedures. The median number of procedures carried out per quarter was 27,256, dropping to 12,003 during the COVID-19 pandemic, representing a 56% reduction in activity. This amounted to around 61,058 cancelled procedures. Modeling predicts that this activity has not returned to prepandemic levels.

CONCLUSIONS: The number of surgical extractions taking place in hospitals during the pandemic fell by 56%. The true impact of this reduction is unknown, but delayed treatment increases the risk of complications, including life-threatening infections.

KNOWLEDGE TRANSFER STATEMENT: The result of this study provides an evidence-based overview of the trends relating to surgical extractions of teeth in England taking place in hospitals. This information can be used to inform service and workforce planning to meet the needs of patients requiring surgical extractions. The data also provide an insight into the oral health needs of the population in England.

PMID:38166457 | DOI:10.1177/23800844231216356

Am J Sports Med. 2024 Jan 3:3635465231214192. doi: 10.1177/03635465231214192. Online ahead of print.

ABSTRACT

BACKGROUND: Femoroacetabular impingement syndrome (FAIS) is common among ice hockey and soccer players. To evaluate the prevalence of return to sports after hip arthroscopy or level of sports before surgery, self-reported questionnaires such as the Hip Sports Activity Scale (HSAS) are frequently used. There is a risk of self-reporting bias when using these tools.

PURPOSE: To evaluate how self-reported levels of sports using HSAS correspond to objective data.

STUDY DESIGN: Cohort study, Level of evidence: 3.

METHOD: Ice hockey and soccer players undergoing hip arthroscopy for FAIS between 2011 and 2019 and included in the local hip arthroscopy registry in Gothenburg, Sweden, aged ≥18 years at the time of surgery, with a self-reported HSAS level of 7 or 8 before onset of symptoms, were included. Objective data on level of sports were collected through sports-specific sources (https://football.instatscout.com, https://hockey.instatscout.com, https://www.eliteprospects.com, and Swedish Football Association). Objective data were collected for the corresponding season when the athletes reported their symptom onset. Agreement between subjective and objective data was described using descriptive statistics, and comparison between subgroups was made.

RESULTS: A total of 483 athletes met the inclusion criteria: 80 ice hockey and 403 soccer players. The majority were men (90%). The mean age was 26.5 years (SD, 8.3 years). When comparing HSAS level with objective data, 112 athletes (23%) had a correct self-reported HSAS level. Of 251 athletes with a self-reported HSAS level of 8, 76 (30%) had a matching objective HSAS level, and 36 of 232 (16%) athletes with a self-reported HSAS level of 7 had a matching objective HSAS level. Of the erroneous subjective ratings, 98% were higher than the objective data. Athletes reporting a correct HSAS level were younger (24.6 vs 26.4 years; P = .04) and had a shorter symptom duration (18 vs 24 months; P < .001). Ice hockey players scored themselves correctly more often than soccer players (P < .001).

CONCLUSION: Only 23% of athletes undergoing hip arthroscopy for FAIS self-reported an HSAS level before onset of symptoms that was accurate according to the objectively recorded data. The majority self-reported an HSAS level above their correct level of sports. Ice hockey players, younger age, and shorter symptom duration were associated with correct self-assessment.

PMID:38166446 | DOI:10.1177/03635465231214192

Environ Sci Technol. 2024 Jan 2. doi: 10.1021/acs.est.3c07882. Online ahead of print.

ABSTRACT

Coastal wetlands are hotspots for methane (CH₄) production, reducing their potential for global warming mitigation. Nitrite/nitrate-dependent anaerobic methane oxidation (n-DAMO) plays a crucial role in bridging carbon and nitrogen cycles, contributing significantly to CH₄ consumption. However, the role of n-DAMO in reducing CH₄ emissions in coastal wetlands is poorly understood. Here, the ecological functions of the n-DAMO process in different saltmarsh vegetation habitats as well as bare mudflats were quantified, and the underlying microbial mechanisms were explored. Results showed that n-DAMO rates were significantly higher in vegetated habitats (Scirpus mariqueter and Spartina alterniflora) than those in bare mudflats (P < 0.05), leading to an enhanced contribution to CH₄ consumption. Compared with other habitats, the contribution of n-DAMO to the total anaerobic CH₄ oxidation was significantly lower in the Phragmites australis wetland (15.0%), where the anaerobic CH₄ oxidation was primarily driven by ferric iron (Fe³⁺). Genetic and statistical analyses suggested that the different roles of n-DAMO in various saltmarsh wetlands may be related to divergent n-DAMO microbial communities as well as environmental parameters such as sediment pH and total organic carbon. This study provides an important scientific basis for a more accurate estimation of the role of coastal wetlands in mitigating climate change.

PMID:38166438 | DOI:10.1021/acs.est.3c07882

J Vasc Access. 2024 Jan 2:11297298231218468. doi: 10.1177/11297298231218468. Online ahead of print.

ABSTRACT

BACKGROUND: Short peripheral catheters (SPCs) are used to provide intravenous therapies in hospitalized patients. Recently, the category of SPC has become more complex, with the introduction in clinical practice of “integrated” SPCs (ISPCs), renewed regarding the material (polyurethane rather than polytetrafluoroethylene) and design (large wing; pre-assembled extension; preassembled needle-free connector (NFC)).

METHODS: This systematic review and meta-analysis aimed to analyze randomized controlled trials (RCTs) and quasi-randomized studies in hospitalized patients, analyzing the risk of overall catheter failure as well as the risk of each type of complication (occlusion, infiltration, thrombophlebitis, and dislodgement) for ISPCs compared to non-integrated SPCs. These systematic review and meta-analysis were registered on PROSPERO (CRD42022322970).

DATA SOURCES: We searched PUBMED^®, EMBASE^®, and the Cochrane Controlled Clinical Trials register from April to November 2022.

RESULTS: INCLUDED STUDIES: The research identified 1260 articles. After the abstract review, 13 studies were included for full manuscript review and, after that, six papers (4727 patients) were included in the meta-analysis.

DESCRIPTION OF THE EFFECT: We found a significantly reduced risk of catheter failure (pooling all complications) for ISPCs compared to SPCs (p = 0.002 RR 0.65; 95% CI 0.63-0.9). A significant reduction in the risks of occlusion (p = 0.007 RR 0.72; 95% CI 0.56-0.92) was observed. As regards the risk of infiltration, thrombophlebitis, and dislodgement, the analysis showed a trend in favor of ISPCs, though not statistically significant (respectively p = 0.2 RR 0.84; 95% CI 0.64-1.1; p = 0.25 RR 0.91; 95% CI 0.78-1.07; p = 0.06 RR 0.72; 95% CI 0.52-1.01).

CONCLUSIONS: ISPCs significantly reduce the risks of catheter failure (overall complications) and occlusion. More RCTs are needed to understand if the preassembled ISPC is better than the composted closed system (non-integrated SPC + extension line + NFC).

PMID:38166435 | DOI:10.1177/11297298231218468

Int J Soc Psychiatry. 2024 Jan 3:207640231221094. doi: 10.1177/00207640231221094. Online ahead of print.

ABSTRACT

BACKGROUND: Severe Mental Disorders (SMDs) cause mental health worldwide challenges because of several relapses and extensive recovery periods of hospitalization, which put a lot of economic and social burden on families and governments. Therefore, interventions are necessary to decrease the relapse of these disorders.

AIM: This study was conducted to investigate the effect of Information Technology Assisted Relapse Prevention Program (ITAREP) on relapse among people who live with SMDs.

METHOD: This study was a randomized clinical trial with intervention and control groups. ITAREP is a remote intervention based on monitoring the Early Warning Signs (EWS) to decrease the number of potential relapses. Using convenience sampling, people with SMDs admitted to Sina Juneqan Psychiatric Hospital and their caregivers were recruited in this study and randomly allocated to the control and intervention groups. Two checklists of the EWS for the patient and the patient’s caregiver were used for monitoring the relapse signs. Data were collected at baseline and 90 days after discharge and were analyzed using t-test and Chi-square statistical tests and linear regression in SPSS software.

RESULTS: Fifty-two patients who lived with SMDs participated in this study (26 in the intervention group and 26 in the control group). The two groups were homogeneous regarding age, gender, type of mental disorder, and duration of the disorder. Forty-two males and ten females participated in this research. Most of the participants were diagnosed with schizophrenia. The results showed that the number of relapses in the intervention group was significantly lower than in the control group in the post-test.

CONCLUSION: Social workers, as the case managers and a member of the interdisciplinary psychiatric team, can actively perform follow-up measures after discharge using ITAREP, and it can be expected that these interventions will reduce the number of relapses among patients who live with SMDs.

PMID:38166425 | DOI:10.1177/00207640231221094

Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296231221772. doi: 10.1177/10760296231221772.

ABSTRACT

This study investigated the efficacy and safety of pharmaco-invasive strategy with half-dose recombinant human prourokinase (PHDP) during hospitalization for patients with ST-segment elevation myocardial infarction (STEMI) to provide references for the treatment of STEMI. Patients with STEMI who fulfilled the inclusion and exclusion criteria and attended Chengde Central Hospital, Hebei Province, China, between September 3, 2019, and December 28, 2021, were included in this study. The experimental group received PHDP and the control group underwent primary percutaneous coronary intervention (PPCI). This study enrolled 150 patients with STEMI, 75 in the experimental group and 75 in the control group. Coronary angiography revealed successful thrombolysis in 64 (85.33%) patients. Compared with the control group, the experimental group had shorter first medical contact-reperfusion time (P < 0.001), less slow flow/no-reflow (P < 0.001), and a lower utilization rate of Tirofiban (P < 0.001). Validity endpoints: no statistically significant differences between the two groups. Safety endpoints: no statistically significant differences between bleeding and major adverse cardiovascular and cerebrovascular events (MACCEs), but the experimental group was more prone to arrhythmias (P = 0.040), particularly premature ventricular beats (PVB) (P = 0.008). In conclusion, the efficacy and safety of PHDP in the treatment of patients with STEMI were positive. Complete epicardial and myocardial reperfusion rates, risk for bleeding during hospitalization, and incidence of MACCEs were similar to those of the PPCI strategy. Although the PHDP group has a higher incidence of PVB, it does not increase the incidence of malignant arrhythmia. This study aimed to provide a new therapeutic strategy for the treatment of STEMI in hospitals without adequate PPCI resources condition.

PMID:38166398 | DOI:10.1177/10760296231221772

Int J Gen Med. 2023 Dec 28;16:6163-6176. doi: 10.2147/IJGM.S447354. eCollection 2023.

ABSTRACT

OBJECTIVE: Escherichia coli and Klebsiella pneumoniae are prevalent Gram-negative microorganisms responsible for pneumonia, as well as the primary Enterobacteriaceae pathogens causing bacteremic pneumonia. The objective of this research is to analyze the risk factors associated with bacteremic pneumonia caused by these pathogens and develop a predictive model.

PATIENTS AND METHODS: This retrospective investigation encompassed a cohort of 252 patients diagnosed with Escherichia coli or Klebsiella pneumoniae-induced bacteremic pneumonia between 2018 and 2022. The primary endpoint was 30-day mortality, which was analyzed using multifactorial logistic regression, nomogram construction, and Bootstrap validation.

RESULTS: Among the 252 patients diagnosed with Escherichia coli and Klebsiella pneumoniae, 65 succumbed to the disease while 187 survived. The overall 30-day mortality was found to be 25.8%. A multifactorial logistic regression analysis revealed that diastolic blood pressure, cerebrovascular diseases/transient ischemic attacks (TIA), immunosuppression, blood urea nitrogen, Pitt score, and CURB-65 score were statistically significant factors. The Nomogram model demonstrated an AUC of 0.954, which closely aligns with the Bootstrap-derived mean AUC of 0.953 (95% CI: 0.952-0.954).

CONCLUSION: In patients with bacteremic pneumonia caused by Escherichia coli and Klebsiella pneumoniae, Low diastolic blood pressure (≤61 mmHg), pre-existing cerebrovascular disease/ transient ischemic attacks (TIA), immunosuppression status, elevated blood urea nitrogen levels (≥8.39 mmol/L), high Pitt score (≥3), and a high CURB-65 score (≥2) are all independent risk factors for Escherichia coli and Klebsiella pneumoniae bacteremic pneumonia, among which the first three warrant particular attention.

PMID:38164517 | PMC:PMC10758180 | DOI:10.2147/IJGM.S447354

China CDC Wkly. 2023 Dec 29;5(52):1161-1166. doi: 10.46234/ccdcw2023.218.

ABSTRACT

INTRODUCTION: Varicella outbreaks significantly disrupt schools and other child-centered institutions. This study aimed to identify patterns and epidemiological features of varicella outbreaks in China from 2006 to 2022.

METHODS: Data were extracted from outbreak reports submitted to the Public Health Emergency Reporting Management Information System within the specified timeframe. Analytical methods included Spearman correlation tests and the Mann-Kendall trend tests, conducted using R software to analyze and summarize reported data. Additionally, statistical analyses of trends and epidemiological characteristics were performed using SPSS software.

RESULTS: Between 2006 and 2022, a total of 11,990 varicella outbreaks were reported in China, resulting in 354,082 cases. The attack rates showed a decreasing trend over the years (Z=-4.49, P<0.05). These outbreaks occurred in two peaks annually. The eastern region accounted for the highest number of outbreaks (31.53%), followed by the southwestern (24.22%) and southern (17.93%) regions. Varicella outbreaks were most common in elementary schools. Most of the outbreaks (60.43%) were classified as Grade IV (general) severity, with 86.41% of the outbreaks having 10-49 cases. The median and inter-quartile ranges (IQR) of the duration of outbreaks, response time, and case counts were 21 (10, 39) days, 4 (0, 12) days, and 23 (16, 35) cases, respectively. These variables showed a positive correlation (P<0.001).

CONCLUSIONS: Varicella outbreaks exhibited fluctuating trends, initially decreasing until 2012, followed by an increase, reaching the highest peak in 2018-2019. Continual monitoring of varicella epidemiology is necessary to assess the burden of the disease and formulate evidence-based strategies and policies for its prevention and control.

PMID:38164468 | PMC:PMC10757729 | DOI:10.46234/ccdcw2023.218

J Multidiscip Healthc. 2023 Dec 27;16:4255-4264. doi: 10.2147/JMDH.S435570. eCollection 2023.

ABSTRACT

OBJECTIVE: In this study, the clinical application and efficacy of three different methods for placing and repositioning patients in the lithotomy position over the bed using stirrups were evaluated.

METHODS: A total of 240 surgical patients who underwent surgery in Chongqing Traditional Chinese Medicine Hospital between July and November 2022 were selected as study participants. Using envelopes, they were randomly divided into three groups of 80 cases each using a randomization method. The groups included the traditional over-bed method, the postural trolley-assisted over-bed method, and the direct over-bed method. Using the Kruskal-Wallis rank-sum test, analysis of variance, and multiple linear regression equations, the placement time, over-bed repositioning time, and total time of the three methods for placing and repositioning in the lithotomy position supported by stirrups were analyzed statistically. In addition, we investigated and examined the satisfaction of nurses and doctors with the aforementioned techniques.

RESULTS: The placement time, repositioning time, and total time were significantly higher for the traditional over-bed method than for the postural trolley-assisted over-bed method and the direct over-bed method (both P < 0.01). However, there was no statistically significant difference between the postural trolley-assisted over-bed method and the direct over-bed method (P > 0.05). Nurses and doctors reported significantly higher satisfaction with the postural trolley-assisted over-bed method and the direct over-bed method compared to the traditional over-bed method (both P < 0.01). In addition, nurses were more satisfied with the direct over-bed method than the postural trolley-assisted over-bed method (P < 0.05).

CONCLUSION: The results of this study demonstrate that the direct over-bed method is preferred for positioning and repositioning patients in the lithotomy position with the support of stirrups.

PMID:38164462 | PMC:PMC10758315 | DOI:10.2147/JMDH.S435570