Estimation of the effect size of clinical intervention in otorhinolaryngology

Korneenkov, A. A.; Fanta, I. V.; Speech, Saint Petersburg

doi:10.18692/1810-4800-2020-2-42-50

Cited by 3 publications

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“…Для анализа динамики течения отдаленного послеоперационного периода при артропластике ТБС и КС выбран статистический метод анализа выживаемости [9,10]. В практике ортопеда-травматолога нередко через некоторое время после операции прекращается связь с пациентом, или времени наблюдения недостаточно, чтобы зарегистрировать интересующий исход.…”

Section: обоснованиеunclassified

Evaluation of the quality of life dynamics in comorbid patients with hip and knee joint arthroplasty

Aliev

Spichko²,

Sayganov

et al. 2023

HERALD of North-Western State Medical University named after I.

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BACKGROUND: In recent years, in traumatology and orthopedics, statistical methods of survival analysis have been used to assess long-term treatment results, which make it possible to take into account censored clinical observations. This method of statistical analysis allows to take into account both cases of attrition from care and cases of incomplete follow-ups. There is no concurrent point of view on the dependence of the long-term results of hip and knee arthroplasty on the comorbidity of a patient. This circumstance fosters a special study using survival analysis. AIM: To study the long-term results of total hip and knee arthroplasty in the patients with osteoarthritis. To determine the patients quality of life depending on the presence of pronounced concomitant pathology. MATERIALS AND METHODS: The groups of patients with comorbidity and without significant concomitant pathology have been compared. The first group included 806 patients aged 19 to 88 years who underwent primary total hip replacement in the Clinic of Traumatology and Orthopedics of the North-Western State Medical University named after I.I. Mechnikov from 2014 to 2018 in connection with osteoarthritis. The second group consisted of 376 patients aged 43 to 85 years who underwent primary total KR due to osteoarthritis in the V.A. Baranov Republican Hospital (Petrozavodsk) in 20162019. Statistical data processing and graph design have been carried out with R programming language with open access via https://cran.r-project.org. The probability of maintaining a satisfactory assessment of the quality of life by a certain observation point t (year of observation) has been assessed using the KaplanMayer method. The logrank test has been used in order to compare the probability of maintaining a satisfactory assessment of quality of life during the entire follow-up period in the groups of patients with and without polymorbidity. RESULTS: At the end of the 5th year of follow-up, the probability of maintaining excellent and good quality of life after hip replacement with a 95% confidence interval was 0.88 (0.81; 0.94) in the patients without comorbidity, 0.84 (0.79; 0.88) in the patients with severe concomitant pathology. Test statistics (Z = 0.93) and p = 0.31 indicate statistically insignificant differences in survival curves between the groups of patients with varying degrees of comorbidity. When analyzing the five-year results of the knee replacement, the quality of life among patients with high and low comorbidity did not differ significantly. The probability of excellent and good quality of life at the 5th year of follow-up in practically healthy patients and in cases of mild therapeutic disease was 0.78 (0.67; 0.88); with a high degree of comorbidity 0.74 (0.65; 0.81). CONCLUSIONS: By the end of the 5th year of follow-up of the patients who have undergone hip or knee replacement due to osteoarthritis, an excellent and good quality of life can be expected on average in 80% of the patients. Satisfactory and unsatisfactory in 20% of the patients. Excellent and good quality of life 5 years after hip or knee arthroplasty in the patients with severe comorbidity does not significantly differ from that in the practically healthy patients without comorbidity (р 0,05).

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Section: обоснованиеunclassified

Evaluation of the quality of life dynamics in comorbid patients with hip and knee joint arthroplasty

Aliev

Spichko²,

Sayganov

et al. 2023

HERALD of North-Western State Medical University named after I.

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Rhinological tactics in the complex treatment of patients with severe combined cranio-facial trauma who are on mechanical ventilation

et al. 2021

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Introduction. In recent years, injuries ranked fourth among the main causes of death of the population after diseases of the cardiovascular system, malignant neoplasms and infectious diseases. The clinical course of associated injuries, as a rule, is characterized by a high number of complications, much more than in isolated injuries.Objective. Explore approaches to improving otorynolaryngological tactics from the standpoint of normalizing the functional state of the nasal mucosa, as well as increasing the effectiveness of treatment of patients with severe concomitant trauma on prolonged mechanical ventilation.Materials and methods. In the process of studying the problem of impaired mucociliary clearance of the nasal mucosa, the functional state of the mucous membrane in patients with severe concomitant head trauma undergoing prolonged artificial lung ventilation was analyzed. We studied the state of one of the most important mechanisms of sanitation and local protection of the respiratory tract - mucociliary clearance, which provides the necessary potential for barrier, cleansing and immune functions. A study was made of the thermal effect of the nasal cavity, pH + of the mucous membrane, the study of the frequency of beating of the cilia of the ciliated epithelium and the rate of mucociliary transportResults and discussion. The results of the study showed that the problem of post-traumatic and nosocomial sinusitis in patients with severe concomitant head trauma must be resolved as soon as possible, with the involvement of modern diagnostic and treatment methods, including the proposed method of artificial ventilation of the nose. The severity of the patient's condition, the severity of the injuries received excludes the use of advanced methods of surgical, otorhinolaryngological treatment.Conclusion. 12:30 PMThe use of minimally invasive methods of treatment, precision technical execution, including under endovideo control, polysinusotomy made it possible not to burden the condition of the victims and exclude iatrogenic damage that could entail irreversible changes in the body and condition of the victim.

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Geography of patients in the federal ENT hospital before and after the COVID-19 pandemic: changing spatial patterns and characteristics

Korneenkov,

Ovchinnikov,

Vyazemskaya

et al. 2023

Medicinskij sovet

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Introduction. During the COVID-19 pandemic, access to elective specialized healthcare has decreased significantly. In addition to economic, social, cultural, organizational and language factors, access to healthcare also includes geographic factors. In our country, geographical barriers are an important negative factor hampering access to healthcare for patients living far from regional and federal centres.Aim. This analysis provides an indirect view of the change in the availability of specialized medical otorhinolaryngological care. Describe the procedure for conducting a spatial analysis of the geographic accessibility of medical care.Materials and methods. The study analyzed changes in the spatial characteristics of the place of residence of patients admitted for inpatient treatment at the St Petersburg Research Institute of Ear, Nose and Speech Throat before and after the onset of the COVID-19 pandemic. The study materials used anonymized data of 32,304 patients who were treated in a 24-hour hospital at the St Petersburg Research Institute of Ear, Nose and Throat and Speech from January 2016 to December 2022. Descriptive statistics, spatial statistics, non-parametric methods for testing hypotheses (Wilcoxon criterion for independent samples), odds ratio for binary factors and outcomes processed in the R software environment, built on the basis of OpenStreetMap cartography with QGIS geocoding, were used as research methods.Results and discussion. In the study, geographic patterns of places of residence (locations) of inpatients before and after COVID-19 were obtained, and a visual assessment of their changes was made. The distances between the place of residence of patients and the place of provision of ENT care were calculated, and hypotheses were tested on the equality of the average geographical distance to the places of residence of patients before and after the pandemic. A count of patients and areas of zones of nuclear assessment of the probability density of patient locations in the country before and after the pandemic was made. The design of the study was an observational analytical retrospective study of the spatial characteristics of inpatients, in which the event of the onset of the COVID-19 pandemic acted as a factor.Conclusion. In general, after the resumption of planned inpatient otorhinolaryngological care, its availability, which can indirectly be assessed using a spatial statistical analysis of the places of residence of patients of a federal budgetary institution, has not changed.

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Estimation of the effect size of clinical intervention in otorhinolaryngology

Cited by 3 publications

References 0 publications

Evaluation of the quality of life dynamics in comorbid patients with hip and knee joint arthroplasty

Evaluation of the quality of life dynamics in comorbid patients with hip and knee joint arthroplasty

Rhinological tactics in the complex treatment of patients with severe combined cranio-facial trauma who are on mechanical ventilation

Geography of patients in the federal ENT hospital before and after the COVID-19 pandemic: changing spatial patterns and characteristics

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