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Sex differences in fracture outcomes within Taiwan population: A nationwide matched study.

台湾人群骨折结局的性别差异: 一项全国性匹配研究。

  • 影响因子:3.02
  • DOI:10.1371/journal.pone.0231374
  • 作者列表:"Chou FP","Chang HC","Yeh CC","Wu CH","Cherng YG","Chen TL","Liao CC
  • 发表时间:2020-04-09
Abstract

BACKGROUND AND AIMS:Because the sex difference in outcomes of fracture was incompletely understood, we evaluated the post-fracture complications and mortality of female and male patients. METHODS:We conducted a nationwide study of 498,586 fracture patients who received inpatient care using Taiwan's National Health Insurance Research Database 2008-2013 claims data. Female and male fracture patients were selected for comparison by using a propensity-score matching procedure. Age, low income, types of fracture, fracture with surgery, several medical conditions, number of hospitalization and emergency visits were considered as potential confounding factors. Multivariate logistic regressions were used to calculate the adjusted odds ratios (OR), the 95% CI of post-fracture complications and 30-day in-hospital mortality differences between women and men. RESULTS:Male patients had a higher risk of post-fracture pneumonia (OR 1.96, 95% CI 1.83-2.11), acute renal failure (OR 1.85, 95% CI 1.60-2.15), deep wound infection (OR 1.63, 95% CI 1.51-1.77), stroke (OR 1.58, 95% CI 1.49-1.67), septicemia (OR 1.51, 95% CI 1.42-1.61), acute myocardial infarction (OR 1.38, 95% CI 1.09-1.75) and 30-day in-hospital mortality (OR 1.69, 95% CI 1.48-1.93) compared with female patients. However, a lower risk of post-fracture urinary tract infection (OR 0.69, 95% CI 0.65-0.72) was found in men than in women. Male patients also had longer hospital stays and higher medical expenditures due to fracture admission than did the female patients. Higher rates of post-fracture adverse events in male patients were noted in all age groups and all types of fractures. CONCLUSION:We raised the possibility that male patients showed more complications and higher mortality rates after fracture admission compared with female patients, with the exception of urinary tract infections.

摘要

背景和目的: 由于对骨折结局的性别差异尚未完全了解,我们评估了女性和男性患者的骨折后并发症和死亡率。 方法: 我们使用台湾国家健康保险研究数据库 498,586-2008 索赔数据对 2013 名接受住院治疗的骨折患者进行了一项全国性研究。通过使用倾向评分匹配程序选择女性和男性骨折患者进行比较。年龄、低收入、骨折类型、骨折伴手术、多种疾病、住院次数和急诊次数被认为是潜在的混杂因素。使用多变量logistic回归计算女性和男性之间调整的比值比 (OR) 、骨折后并发症的 95% CI和 30 天住院死亡率差异。 结果: 男性患者发生骨折后肺炎 (OR 1.96,95% CI 1.83-2.11) 、急性肾功能衰竭 (OR 1.85,95% CI 1.60-2.15) 、深部伤口感染 (OR 1.63,95% CI 1.51-1.77),卒中 (OR 1.58,95% CI 1.49-1.67),败血症 (OR 1.51,95% CI 1.42-1.61),与女性患者相比,急性心肌梗死 (OR 1.38,95% CI 1.09-1.75) 和 30 天院内死亡率 (OR 1.69,95% CI 1.48-1.93)。然而,男性发生骨折后尿路感染的风险 (OR 0.69,95% CI 0.65-0.72) 低于女性。男性患者也有较长的住院时间和较高的医疗费用,由于骨折入院比女性患者。在所有年龄组和所有类型的骨折中,男性患者的骨折后不良事件发生率较高。 结论: 除泌尿系感染外,男性患者入院后并发症和死亡率均高于女性患者。

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影响因子:2.81
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作者列表:["Yang LC","Suen YJ","Wang YH","Lin TC","Yu HC","Chang YC"]

METHODS::Pneumonia is a common respiratory infectious disease that involves the inflammation of the pulmonary parenchyma. Periodontal disease is widespread and correlated with pneumonia. However, the relationship between periodontal treatment and clinical infectious outcomes in patients with pneumonia has remained undetermined. The aim of this study was to investigate the association between periodontal treatment and the risk of pneumonia events in the Taiwanese population. A nationwide population-based cohort study was conducted using data from the Taiwanese National Health Insurance Research Database (NHIRD). A total of 49,400 chronic periodontitis patients who received periodontal treatment from 2001 to 2012 were selected. In addition, 49,400 healthy individuals without periodontal diseases were picked randomly from the general population after propensity score matching according to age, gender, monthly income, urbanization, and comorbidities. The Cox proportional hazard regression analysis was adopted to assess the hazard ratio (HR) of pneumonia between the periodontal treatment cohort and the comparison cohort. The average ages of the periodontal treatment and comparison groups were 44.25 ± 14.82 years and 44.15 ± 14.5 years, respectively. The follow up durations were 7.66 and 7.41 years for the periodontal treatment and comparison groups, respectively. We found 2504 and 1922 patients with newly diagnosed pneumonia in the comparison cohort and the periodontal treatment cohort, respectively. The Kaplan-Meier plot revealed that the cumulative incidence of pneumonia was significantly lower over the 12 year follow-up period in the periodontal treatment group (using the log-rank test, p < 0.001). In conclusion, this nationwide population-based study indicated that the patients with periodontal treatment exhibited a significantly lower risk of pneumonia than the general population.

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影响因子:2.89
发表时间:2020-04-01
DOI:10.1016/j.ijid.2020.01.038
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肺炎方向

肺炎是指终末气道、肺泡和肺间质的炎症。可由细菌、病毒、真菌、寄生虫等致病微生物,以及放射线、吸入性异物等理化因素引起。临床主要症状为发热、咳嗽、咳痰、痰中带血,可伴胸痛或呼吸困难等。

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