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  1. AU="Carlile, Catherine R"
  2. AU="Husain, Waleed"
  3. AU="Casanelia, S"
  4. AU="Ireland, D. G."
  5. AU=Sargon Peter J.

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  1. Article ; Online: Statistical Literacy in the Orthopaedic Trauma Population.

    Carlile, Catherine R / Rees, Andrew / Boyce, Robert H / Mitchell, Phillip M

    Journal of orthopaedic trauma

    2021  Volume 36, Issue 9, Page(s) 427

    Abstract: Objective: To evaluate the baseline level and demographic predictors of statistical literacy in orthopaedic patients who sustained traumatic injuries.: Design: Prospective observational.: Setting: Level 1 trauma center.: Patients: One hundred ... ...

    Abstract Objective: To evaluate the baseline level and demographic predictors of statistical literacy in orthopaedic patients who sustained traumatic injuries.
    Design: Prospective observational.
    Setting: Level 1 trauma center.
    Patients: One hundred ninety-eight patients presenting to the orthopaedic trauma clinic.
    Intervention: Berlin Numeracy Test (BNT) and General Health Numeracy Test-6 (GHNT-6).
    Results: When assessed using the BNT, 67% of patients had results that placed them into the lowest quartile of objective numeracy skills. Only 3.5% of patients had results that scored in the top quartile. Our multivariate ordinal regression model demonstrated lower education level ( P = 0.01), and older age ( P = 0.03) were significant predictors of poor performance on the BNT. The mean score on the GHNT-6 was 36% (SD 30%).
    Conclusions: In a cohort of traumatically injured patients, poor statistical literacy was common, occurring in more than two-thirds of patient surveyed. Older age and lower levels of education were predictive of poor BNT performance and should be considered when discussing surgical options, associated risks, and likelihood of potential complications.
    MeSH term(s) Cohort Studies ; Educational Status ; Health Literacy ; Humans ; Orthopedics ; Surveys and Questionnaires
    Language English
    Publishing date 2021-12-30
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 639099-7
    ISSN 1531-2291 ; 0890-5339
    ISSN (online) 1531-2291
    ISSN 0890-5339
    DOI 10.1097/BOT.0000000000002365
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2234: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  2. Article ; Online: Predicting Mortality in Elderly Spine Trauma Patients.

    Carlile, Catherine R / Rees, Andrew B / Schultz, Jacob D / Steinle, Anthony M / Nian, Hui / Smith, Melissa D / Guillamondegui, Oscar / Archer, Kristin R / Pennings, Jacquelyn S / Zuckerman, Scott L / Abtahi, Amir M / Stephens, Byron F

    Spine

    2022  Volume 47, Issue 14, Page(s) 977–985

    Abstract: Study design: Retrospective analysis on prospectively collected data.: Objective: The aim of this study was to construct a clinical prediction model for 90-day mortality in elderly patients with traumatic spine injuries.: Summary of background data! ...

    Abstract Study design: Retrospective analysis on prospectively collected data.
    Objective: The aim of this study was to construct a clinical prediction model for 90-day mortality in elderly patients with traumatic spine injuries.
    Summary of background data: Spine trauma in the elderly population is increasing. Comparing elderly spine trauma patients to younger patients with similar injuries proves challenging due to the extensive comorbidities and frailty found in the elderly. There is a paucity of evidence to predict survival of elderly patients following traumatic spinal injuries.
    Methods: All patients 65+ with spine trauma presenting to a level I trauma center from 2010 to 2019 were reviewed from a prospectively maintained trauma registry. Retrospective chart review was performed to record injury, frailty scores, comorbidities, presence of spinal cord injury, imaging evidence of sarcopenia and osteopenia, mortality, and complications. We preselected 13 variables for our multivariable logistic regression model: hypotension on admission, gender, marital status, age, max Abbreviated Injury Scale, Modified Frailty Index, surgical treatment, hematocrit, white blood count, spinal cord injury, closed head injury, injury level and presence of high energy mechanism. The performance of the prediction model was evaluated using a concordance index and calibration plot. The model was internally validated via bootstrap approach.
    Results: Over the 9-year period, 1746 patients met inclusion criteria; 359 (20.6%) patients died within 90 days after presenting with spine trauma. The most important predictors for 90-day mortality were age, hypotension, closed head injury, max Abbreviated Injury Scale and hematocrit. There was an optimism-corrected C-index of 0.77. A calculator was created to predict a personalized mortality risk.
    Conclusion: The incidence of spine trauma in elderly patients continues to increase. Previous publications described preexisting conditions that imply increased mortality, but ours is the first to develop a predictive calculator. Prospective research is planned to externally validate this model to better determine its predictive value and utility in the clinical setting.
    MeSH term(s) Aged ; Frailty/diagnosis ; Head Injuries, Closed ; Humans ; Hypotension ; Models, Statistical ; Prognosis ; Prospective Studies ; Retrospective Studies ; Spinal Cord Injuries/therapy ; Spinal Injuries/epidemiology ; Trauma Centers
    Language English
    Publishing date 2022-04-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 752024-4
    ISSN 1528-1159 ; 0362-2436
    ISSN (online) 1528-1159
    ISSN 0362-2436
    DOI 10.1097/BRS.0000000000004362
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 1305: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  3. Article ; Online: Duration and Dosage of Opioids After Spine Surgery: Implications on Outcomes at 1 Year.

    Hills, Jeffrey M / Carlile, Catherine R / Archer, Kristin R / Wick, Joseph B / Butler, Marjorie / Daryoush, Joshua / Khan, Inamullah / Call, Richard / Devin, Clinton J / Pennings, Jacquelyn S

    Spine

    2020  Volume 45, Issue 15, Page(s) 1081–1088

    Abstract: Study design: Longitudinal Cohort Study OBJECTIVE.: The aim of this study was to determine whether duration of postoperative opioids is associated with long-term outcomes, and if initial postoperative opioid dosage is associated with opioid cessation ... ...

    Abstract Study design: Longitudinal Cohort Study OBJECTIVE.: The aim of this study was to determine whether duration of postoperative opioids is associated with long-term outcomes, and if initial postoperative opioid dosage is associated with opioid cessation after spine surgery.
    Summary of background data: Preoperative opioid use is associated with poor outcomes, but little evidence exists regarding the implications of opioid dosage and duration after spine surgery.
    Methods: Data from our state's prescription drug database was linked to our prospective clinical spine registry to analyze opioid dispensing and outcomes in elective surgical spine patients between 2010 and 2017. Patients were stratified based on preoperative chronic opioid use and multivariable regression was used to assess associations between duration of postoperative opioids and outcomes at one year, including satisfaction, chronic opioid use, and meaningful improvements in pain, disability, and quality of life. In a secondary aim, a Cox proportional hazards model was used to determine whether initial postoperative opioid dosage was associated with time to opioid cessation.
    Results: Of 2172 patients included, 35% had preoperative chronic opioid use. In patients without preoperative chronic opioid use, a postoperative opioid duration of 31 to 60 days was associated with chronic opioid use at 1 year (adjusted odds ratio [aOR]: 4.1 [1.7-9.8]) and no meaningful improvement in extremity pain (aOR: 1.8 [1.3-2.6]) or axial pain (aOR: 1.6 [1.1-2.2]); cessation between 61 and 90 days was associated with no meaningful improvement in disability (aOR: 2 [1.3-3]) and dissatisfaction (aOR:1.8 [1-3.1]). In patients with preoperative chronic opioid use, postoperative opioids for ≥90 days was associated with dissatisfaction. Cox regression analyses showed lower initial postoperative opioid dosages were associated with faster opioid cessation in both groups.
    Conclusion: Our results suggest that a shorter duration of postoperative opioids may result in improved 1-year patient-reported outcomes, and that lower postoperative opioid dosages may lead to faster opioid cessation.
    Level of evidence: 2.
    MeSH term(s) Adult ; Aged ; Analgesics, Opioid/administration & dosage ; Analgesics, Opioid/adverse effects ; Cohort Studies ; Drug Administration Schedule ; Elective Surgical Procedures/adverse effects ; Elective Surgical Procedures/trends ; Female ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Opioid-Related Disorders/etiology ; Opioid-Related Disorders/prevention & control ; Pain, Postoperative/drug therapy ; Pain, Postoperative/etiology ; Patient Reported Outcome Measures ; Prospective Studies ; Retrospective Studies ; Spinal Diseases/drug therapy ; Spinal Diseases/surgery ; Time Factors
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2020-07-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 752024-4
    ISSN 1528-1159 ; 0362-2436
    ISSN (online) 1528-1159
    ISSN 0362-2436
    DOI 10.1097/BRS.0000000000003446
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 1305: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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