Motorcycle-related hospitalizations of the elderly

Hsieh, Ching-Hua; Liu, Hang-Tsung; Hsu, Shiun-Yuan; Hsieh, Hsiao-Yun; Chen, Yi‐Chun

doi:10.1016/j.bj.2016.10.006

Cited by 89 publications

(89 citation statements)

References 23 publications

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“…This study was approved by the institutional review board of the Kaohsiung Chang Gung Memorial Hospital, a 2,686‐bed medical center providing care to patients primarily from southern Taiwan (Hsieh, Hsu, Hsieh, & Chen, ; Hsieh, Liu, Hsu, Hsieh, & Chen, ), with the reference number of 201800440B0. We designed a retrospective study to review the data of all 2,004 patients with head and neck cancer who underwent tumor wide excision and primary free‐flap reconstruction or secondary free‐flap reconstruction between March 2008 and February 2017.…”

Section: Methodsmentioning

confidence: 99%

Association between operation‐ and operator‐related factors and surgical complications among patients undergoing free‐flap reconstruction for head and neck cancers: A propensity score‐matched study of 1,865 free‐flap reconstructions

Kuo

Yen

et al. 2019

Microsurgery

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Objective: Efforts have been devoted to clarify the possible factors related to postoperative complications in free-flap reconstruction. While patient-related factors have been widely discussed, studies regarding the operation/operatorrelated factors are rather limited in the literature. This study was designed to investigate the relationship between operation/operator-related factors and the surgical complications in free-flap reconstruction following head and neck cancer resection. Methods: Data of 1,841 patients with a total of 1,865 free-flap reconstructions (24 double free-flap reconstructions) between March 2008 and February 2017 were retrieved from the registered microsurgery database of the hospital. The association of operation/operator-related factors (including flap length and length-width ratio, flap types, use of vein graft, opposite side microanastomosis, number of microanastomoses, operators, operator experience, and operation time) with surgical complications was assessed by 1:1 propensity score-matched study groups.Results: After propensity score matching of the patient-related factors, the rate of vein grafting was significantly higher (0.6% vs. 2.2%, p = .038) and the operation time was longer (7.0 [5.8-8.5] vs. 7.4 [6.1-8.8] hr, p = .006) in the complication group. In addition, flap length and length-width ratio, flap types, opposite side microanastomosis, number of microanastomoses, operators, and operator experience were not associated with surgical complications. Conclusions:In a hospital that consisted of surgeons with high-volume or very-highvolume experience, the operators or operation experience were not significantly associated with the surgical complications. Only a longer operation time was associated with surgical complications in the patients who underwent free-flap reconstruction for head and neck cancer.

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Section: Methodsmentioning

confidence: 99%

Association between operation‐ and operator‐related factors and surgical complications among patients undergoing free‐flap reconstruction for head and neck cancers: A propensity score‐matched study of 1,865 free‐flap reconstructions

Kuo

Yen

et al. 2019

Microsurgery

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“…Data from an estimate in 2000 noted that approximately $8 billion is spent annually in the United States in the care of bicycle crash victims, which is a significant cost from a public health perspective [ 16 ]. Head injuries often occur in motorcycle and bicycle traffic accidents and have severe consequences [ 17 , 18 ], however, the current laws in Taiwan only enforce the use of helmets on motorcyclists, while helmet use remains optional for bicyclists. As a result, helmet use is more common among motorcycle riders than bicycle riders.…”

Section: Introductionmentioning

confidence: 99%

The protective effect of helmet use in motorcycle and bicycle accidents: a propensity score–matched study based on a trauma registry system

Kuo

Rau

et al. 2017

BMC Public Health

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BackgroundTransportation by motorcycle and bicycle has become popular in Taiwan, this study was designed to investigate the protective effect of helmet use during motorcycle and bicycle accidents by using a propensity score–matched study based on trauma registry system data.MethodsData of adult patients hospitalized for motorcycle or bicycle accidents between January 1, 2009 and December 31, 2015 were retrieved from the Trauma Registry System. These included 7735 motorcyclists with helmet use, 863 motorcyclists without helmet use, 76 bicyclists with helmet use, and 647 bicyclists without helmet use. The primary outcome measurement was in-hospital mortality. Secondary outcomes were the hospital length of stay (LOS), intensive care unit (ICU) admission rate, and ICU LOS. Normally distributed continuous data were analyzed by the unpaired Student t-test, and non-normally distributed data were compared using the Mann–Whitney U-test. Two-sided Fisher exact or Pearson chi-square tests were used to compare categorical data. Propensity score matching (1:1 ratio using optimal method with a 0.2 caliper width) was performed using NCSS software, adjusting for the following covariates: sex, age, and comorbidities. Further logistic regression was used to evaluate the effect of helmet use on mortality rates of motorcyclists and bicyclists, respectively.ResultsThe mortality rate for motorcyclists with helmet use (1.1%) was significantly lower than for motorcyclists without helmet use (4.2%; odds ratio [OR] 0.2; 95% confidence interval [CI]: 0.17–0.37; p < 0.001). Among bicyclists, there was no significant difference in mortality rates between the patients with helmet use (5.3%) and those without helmet use (3.7%; OR 1.4; 95% CI: 0.49–4.27; p = 0.524). After propensity-score matching for covariates, including sex, age, and comorbidities, 856 well-balanced pairs of motorcyclists and 76 pairs of bicyclists were identified for outcome comparison, showing that helmet use among motorcyclists was associated with lower mortality rates (OR 0.2; 95% CI: 0.09–0.44; p < 0.001). In contrast, helmet use among bicyclists was not associated with a decrease in mortality (OR 1.3; 95% CI: 0.30–5.96; p = 0.706). The hospital LOS was also significantly shorter for motorcyclists with helmet use than for those without (9.5 days vs. 12.0 days, respectively, p < 0.001) although for bicyclists, helmet use was not associated with hospital LOS. Fewer motorcyclists with helmet use were admitted to the ICU, regardless of the severity of injury; however, no significant difference of ICU admission rates was found between bicyclists with and without helmets.ConclusionsMotorcycle helmets provide protection to adult motorcyclists involved in traffic accidents and their use is associated with a decrease in mortality rates and the risk of head injuries. However, no such protective effect of helmet use was observed for bicyclists involved in collisions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4649-1) contains supplem...

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“…The present retrospective study retrieved the detailed information of patients from the registered free flap database and electric medical records of Kaohsiung Chang Gung Memorial Hospital (Hsieh, Chen, Hsu, Hsieh, & Chien, 2018; Hsieh, Hsu, Hsieh, & Chen, 2017; Hsieh, Liu, Hsu, Hsieh, & Chen, 2017). In this study, the patient cohort included 1,728 patients who underwent ALT or AMT free flap reconstruction after head and neck cancer surgery between March 1, 2008 and February 28, 2017.…”

Section: Methodsmentioning

confidence: 99%

Comparison of the outcomes between free anteromedial thigh flap and anterolateral thigh flap in head and neck cancer reconstruction: Analysis of propensity‐score‐matched patient cohorts

Moltedo

Lin

et al. 2020

Microsurgery

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Background The anterolateral thigh (ALT) flap is a workhorse flap in head and neck cancer reconstruction. The anteromedial thigh (AMT) flap was developed as a rescue or alternative flap whenever the ALT flap is not available; however, the harvest of AMT flap seems to be more challenging in the sense that perforators have multiple variations. This study was designed to compare the outcome of the AMT and ALT flaps in head and neck cancer reconstruction. Methods A total of 1,547 ALT and 57 AMT flaps were used for head and neck cancer reconstruction between March 1, 2008 and February 28, 2017. Differences in patient and operative characteristics were compared between the patients undergoing AMT and ALT flap reconstruction. The primary outcome of the free flap was its survival or failure, while the second outcome was the associated complications. Results Compared to those who had ALT flap reconstruction, the patients who underwent AMT flap reconstruction had a higher rate of conditions that required reconstruction after previous cancer ablation and recurrence but a lower rate of primary cancer and deeply located cancer. Analysis of the 40 well‐balanced pairs of propensity‐score‐matched patient cohorts revealed that the AMT flaps were associated with a significantly higher failure rate than the ALT flaps (15.0 vs. 0.0%, respectively; p = .026). Conclusion This study revealed that AMT flaps were associated with a significantly higher failure rate than ALT flaps in head and neck cancer reconstruction in the cohort of total patients and the propensity‐score‐matched cohorts.

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Motorcycle-related hospitalizations of the elderly

Cited by 89 publications

References 23 publications

Association between operation‐ and operator‐related factors and surgical complications among patients undergoing free‐flap reconstruction for head and neck cancers: A propensity score‐matched study of 1,865 free‐flap reconstructions

Association between operation‐ and operator‐related factors and surgical complications among patients undergoing free‐flap reconstruction for head and neck cancers: A propensity score‐matched study of 1,865 free‐flap reconstructions

The protective effect of helmet use in motorcycle and bicycle accidents: a propensity score–matched study based on a trauma registry system

Comparison of the outcomes between free anteromedial thigh flap and anterolateral thigh flap in head and neck cancer reconstruction: Analysis of propensity‐score‐matched patient cohorts

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