Prolonged length of stay (LOS) in osteoporotic femoral neck fracture patients increased the hospital care cost and demonstrated in-hospital complications. This study aimed to develop an ease-of use predictive model of prolonged LOS in osteoporotic femoral neck fracture patients. In this 5-year retrospective study, the medical charts of 255 patients admitted to hospital with an osteoporotic femoral neck fracture resulting from a simple fall from January 2014 to December 2018 were reviewed. Multivariable fractional polynomials (MFP) algorithms was applied to develop the predictive model from candidate predictors of prolonged LOS. The discrimination performance of predictive model was evaluated using the receiver operating characteristic curve (ROC). Internal validity was assessed using bootstrapping. From 289 patients who were hospitalized with an osteoporotic fracture of femoral neck throughout this study, 255 (88%) fulfilled the inclusion criteria. There was 54.90% (140 of 255 patients) of patients who had prolonged LOS. The predictors of the predictive model were age, BMI, ASA score class 3 or 4, arthroplasty and time from injury to surgery. The area under ROC curve of the model was 0.83 (95% confidence interval 0.77–0.88). Internal validation with bootstrap re-sampling revealed an optimism of −0.002 (range −0.300–0.296) with an estimated shrinkage factor of 0.907 for the predictive model. The current predictive model developed from preoperative predictors which had a good discriminative ability to differentiate between length of hospitalization less than 14 days and prolonged LOS in osteoporotic femoral neck patients. This model can be applied as ease-of use calculator application to help patients, their families and clinicians make appropriate decisions in terms of treatment planning, postoperative care program, and cost-effectiveness before patients receiving the definitive treatments.

Background Carpal tunnel syndrome (CTS) is the most common entrapment mononeuropathy. Menopausal status and/or estrogen level may play a role in CTS. The evidence regarding the association between hormone replacement therapy (HRT) in postmenopausal women and CTS is still conflicting. This meta-analysis aimed to investigate the association between carpal tunnel syndrome (CTS) and women using hormone replacement therapy (HRT). Methods A search was conducted in the PubMed/Medline, Scopus, Embase, and Cochrane databases, from their inception through July 2022. Studies which reported on the association between any type of HRT use and the risk of developing CTS in postmenopausal women compared to a control group were included. Studies which did not include a control group were excluded. Of the 1573 articles extracted from database searches, seven studies involving 270,764 women were included of which 10,746 had CTS. The association between CTS and HRT use was evaluated using the pooled odds ratio (OR) with a 95% confidence interval (CI) under random-effects modelling. Risk of bias in each study was assessed using the Newcastle–Ottawa Scale (NOS) and version 2 of the Cochrane tool for assessing risk of bias in randomized trials (RoB 2). Results HRT use showed no statistically significant association with a higher risk of CTS with pooled odds ratio (OR) 1.49, 95% confidence interval (CI) 0.99–2.23, and p = 0.06, although high heterogeneity among the studies was observed (I2 97.0%, Q-test p-value < 0.001). Subgroup analysis of groups in non-randomized controlled studies showed a significantly increased risk of CTS, while groups in randomized controlled studies showed a decreased risk of CTS (pooled OR 1.87, 95% CI 1.24–2.83 versus pooled OR 0.79, 95% CI 0.69–0.92, respectively) with the p-value of group difference < 0.001. The risk of bias in most of the included studies was estimated to be low. Conclusions This meta-analysis supports the safety of using HRT in postmenopausal women with potential risk factors for CTS. Level of evidence I, Prognosis. Registration: INPLASY (202280018).

The effect of sodium-glucose cotransporter-2 inhibitors (SGLT2i) on plasma aldosterone concentration (PAC) and plasma renin activity (PRA) levels are still inconclusive. This meta-analysis aimed to demonstrate the changes in PAC and PRA levels after the use of SGLT2i in type 2 diabetes patients. A search for relevant publications was performed using PubMed/Medline, Scopus, Cochrane, and Embase databases from their inception through May 2022. Inclusion criteria were studies that contained data on crude PAC and PRA levels before and after the use of SGLT2i in adult type 2 diabetes patients. Standardized mean difference (SMD) with a 95% confidence interval (95% CI) was calculated. Data was separately analyzed by study design: randomized controlled study (RCT) and non-randomized controlled study (non-RCT). Ten studies involving 380 patients were included with two RCT and eight non-RCT. Serum PAC levels showed no significant change after the use of SGLT2i in both RCT and non-RCT. Significantly higher PRA levels were observed after the use of SGLT2i in both RCT and non-RCT with SMD of 0.40 ng/mL/hr; 95% CI (0.06, 0.74) and SMD of 0.36 ng/mL/hr; 95%CI (0.17, 0.55), respectively. Subgroup analysis found significantly higher PRA levels after the use of SGLT2i (SMD 0.45 ng/mL/hr; 95% CI (0.18, 0.71)) only in subgroups that used for three months or less. The use of SGLT2i in diabetes mellitus type 2 patients can affect PRA levels, especially during short-term use. PRA levels should be interpreted with caution in this population.