Outcomes after surgery in patients with previous stroke

Liao, Chien-Chang; Chang, Po-Cheng; Yeh, Chun Chieh; Hu, Chaur‐Jong; Wu, Chih-Hsiung; Chen, Ta-Liang

doi:10.1002/bjs.9639

Cited by 29 publications

(28 citation statements)

References 30 publications

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“…Information available for this study included gender, birth date, disease codes, health care rendered, medicines prescribed, diagnoses at admission and discharge, and medical institutions and physicians providing services. This study employed the All Stroke Database, which consisted of all prevalent and incident stroke patients across Taiwan between 2000 and 2008 [17–19]. …”

Section: Methodsmentioning

confidence: 99%

“…To protect personal privacy, the electronic database was decoded with patient identifications scrambled for further public access for research. Although the National Health Research Institute regulations do not require informed consent due to the use of decoded and scrambled patient identification, this study was approved by Taiwan’s National Health Research Institute (NHIRD-100-122) and the Institutional Review Board of E-DA Hospital, Kaohsiung, Taiwan (2014012) [17–19]. …”

Section: Methodsmentioning

confidence: 99%

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An investigation of the use of acupuncture in stroke patients in Taiwan: a national cohort study

Weng

Chen

Yeh

et al. 2016

BMC Complement Altern Med

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BackgroundAcupuncture is considered a complementary and alternative medicine in many countries. The purpose of this study was to report the pattern of acupuncture use and associated factors in patients with stroke.MethodsWe used claims data from Taiwan’s National Health Insurance Research Database and identified 285001 new-onset stroke patients in 2000–2008 from 23 million people allover Taiwan. The use of acupuncture treatment after stroke within one year was identified. We compared sociodemographics, coexisting medical conditions, and stroke characteristics between stroke patients who did and did not receive acupuncture treatment.ResultsThe use of acupuncture in stroke patients increased from 2000 to 2008. Female gender, younger age, white-collar employee status, higher income, and residence in areas with more traditional Chinese medicine (TCM) physicians were factors associated with acupuncture use in stroke patients. Ischemic stroke (odds ratio [OR] 1.21, 95 % confidence interval [CI] 1.15–1.28), having no renal dialysis (OR 2.76, 95 % CI 2.45–3.13), receiving rehabilitation (OR 3.20, 95 % CI 3.13–3.27) and longer hospitalization (OR 1.23, 95 % CI 1.19–1.27) were also associated with acupuncture use. Stroke patients using rehabilitation services were more likely to have more acupuncture visits and a higher expenditure on acupuncture compared with stroke patients who did not receive rehabilitation services.ConclusionsThe application of acupuncture in stroke patients is well accepted and increasing in Taiwan. The use of acupuncture in stroke patients is associated with sociodemographic factors and clinical characteristics.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

An investigation of the use of acupuncture in stroke patients in Taiwan: a national cohort study

Weng

Chen

Yeh

et al. 2016

BMC Complement Altern Med

View full text Add to dashboard Cite

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“…To avoid bias when investigating postoperative adverse outcomes in patients with PD, we used multivariate regression models to adjust these sociodemographic characteristics as potential confounding factors. Previous studies from our database have revealed that diabetes, 12 stroke, 13 heart failure, 22 atrial fibrillation, 23 liver cirrhosis, 14 renal dialysis, 24 chronic obstructive pulmonary disease, 25 and mental disorders 15 were noted as risk factors of perioperative complications and mortality. Some of these coexisting medical conditions were also considered as comorbidities for patients with PD.…”

Section: Discussionmentioning

confidence: 82%

“…Second, severity and disability levels of PD could not be obtained in the administrative data for stratification of perioperative risks. Third, even though the accuracy of major diagnosis codes from the NHIRD has been accepted by peer reviewers of scientific journals, 12,13,15–18 the validity of PD, comorbidity, and complication codes employed in this study might still be a concern. To reduce the possibility of misdiagnosis or miscoding, we used the inclusion criteria of at least 3 visits for medical care with physician's primary diagnosis of PD.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes After Non-neurological Surgery in Patients With Parkinson's Disease

et al. 2016

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Patients with Parkinson disease (PD) were known to have increased risk of complications during hospitalization. The purpose of this study is to validate the global features of postoperative adverse outcomes for patients with PD.Using reimbursement claims from Taiwan's National Health Insurance Research Database, we conducted a nationwide retrospective cohort study of 6455 patients with preoperative PD receiving major surgery during 2008 to 2012. With a propensity score matching procedure, 12,910 surgical patients without PD were selected for comparison. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for 9 major postoperative complications and 30-day postoperative mortality associated with preoperative PD were calculated in the multivariate logistic regressions.Patients with PD had increased risk of postoperative pulmonary embolism (OR 2.72, 95% CI 1.45–5.10), stroke (OR 1.77, 95% CI 1.53–2.05), pneumonia (OR 1.98, 95% CI 1.70–2.31), urinary tract infection (OR 1.52, 95% CI 1.35–1.70), septicemia (OR 1.54, 95% CI 1.37–1.73), acute renal failure (OR 1.36, 95% CI 1.07–1.73), and mortality (OR 1.45, 95% CI 1.06–1.98). The association between preoperative PD and postoperative adverse events was significant in both sexes and every age group. Low income, ≥65 years of age, surgery not in medical center, highest quartile of PD medication users, and more medical conditions worsen the risk of postoperative adverse events in patients with PD.This study showed increased postoperative complications and mortality in patients with PD. Our findings suggest that revision of postoperative care protocols for this population is urgently needed.

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