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Chan V, Mollayeva T, Ottenbacher KJ, Colantonio A. Clinical profile and comorbidity of traumatic brain injury among younger and older men and women: a brief research notes. BMC Res Notes 2017; 10:371. [PMID: 28789695 PMCID: PMC5549298 DOI: 10.1186/s13104-017-2682-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 07/22/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Comorbid disorders influence the course and outcomes of rehabilitation following traumatic brain injury (TBI), yet sex- and age-related disparities in the frequency distribution of these disorders remain poorly understood. We aimed to describe comorbid disorders by the International Classification of Diseases in patients with TBI undergoing inpatient rehabilitation in Ontario, Canada over a 3-year period, by sex and age, and discuss their potential impact on rehabilitation outcomes. RESULTS The percentage of TBI patients with one or more comorbid disorder is higher among older (≥65 years) men and women than among those who are younger or middle-aged (<65 years). Among younger and middle-aged patients, multiple injuries and trauma, mental health conditions, and nervous system disorders were the most prevalent comorbidities. In older patients, circulatory, endocrine, nutritional, metabolic, and immune disorders were the most prevalent comorbidities. Our results suggest that a multisystem view of rehabilitation of men and women with TBI across age categories is needed to reflect the complex clinical profile of TBI patients undergoing rehabilitation.
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Affiliation(s)
- Vincy Chan
- Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario Canada
| | - Tatyana Mollayeva
- Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario Canada
| | - Kenneth J. Ottenbacher
- Division of Rehabilitation Science, Center for Recovery, Physical Activity and Nutrition, School of Health Professions, University of Texas Medical Branch, Galveston, Texas USA
| | - Angela Colantonio
- Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario Canada
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van der Velde RY, Wyers CE, Teesselink E, Geusens PPMM, van den Bergh JPW, de Vries F, Cooper C, Harvey NC, van Staa TP. Trends in oral anti-osteoporosis drug prescription in the United Kingdom between 1990 and 2012: Variation by age, sex, geographic location and ethnicity. Bone 2017; 94:50-55. [PMID: 27742502 PMCID: PMC5124498 DOI: 10.1016/j.bone.2016.10.013] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 09/28/2016] [Accepted: 10/10/2016] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Given the expected increase in the number of patients with osteoporosis and fragility fractures it is important to have concise information on trends in prescription rates of anti-osteoporosis drugs (AOD). METHODS We undertook a retrospective observational study using the UK Clinical Practice Research Datalink (CPRD) in the UK between 1990 and 2012 in subjects 50years or older, stratified by age, sex, geographic region and ethnicity. Yearly prescription incidence rates of any AOD and of each specific AOD were calculated as the number of patients first prescribed these AODs per 10,000person-years (py). RESULTS In women, yearly rates of first prescription of any AOD increased from 1990 to 2006 (from 2.3 to 169.7 per 10,000py), followed by a plateau and a 12% decrease in the last three years. In men, a less steep increase from 1990 to 2007 (from 1.4 to 45.3 per 10,000py) was followed by a plateau from 2008 onwards. Yearly rates of first prescription of any AOD increased up to the age of 85-89years (248.9 per 10,000py in women and 119.3 in men). There were marked differences between ethnic groups and regions. Bisphosphonates were the most frequently prescribed AODs: etidronate till 2000, and then subsequently alendronate. CONCLUSION We have demonstrated marked secular changes in rates of anti-osteoporosis drug prescription over the last two decades. The plateau (and decrease amongst women) in rates in recent years, set against an ever ageing population, is worrying, suggesting that the well-documented care gap in osteoporosis treatment persists. The differences in prescription rates by geographic location and ethnicity raise intriguing questions in relation to underlying fracture rates, provision of care and health behaviour. SUMMARY We studied the prescription incidence of anti-osteoporosis drugs (AOD) from 1990 to 2012 in the UK CPRD. Overall AOD prescription incidence showed a strong increase from 1990 to 2006, followed by a plateau in both sexes and a decrease amongst women in the last three years.
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Affiliation(s)
- R Y van der Velde
- Department of Internal Medicine, VieCuri Medical Centre, PO Box 1926, 5900 BX Venlo, The Netherlands; Department of Internal Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre (MUMC), PO Box 616, 6200 MD Maastricht, The Netherlands
| | - C E Wyers
- Department of Internal Medicine, VieCuri Medical Centre, PO Box 1926, 5900 BX Venlo, The Netherlands; Department of Internal Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre (MUMC), PO Box 616, 6200 MD Maastricht, The Netherlands
| | - E Teesselink
- Department of Clinical Pharmacology and Toxicology, University Medical Centre Maastricht, Maastricht, The Netherlands
| | - P P M M Geusens
- Department of Internal Medicine, Subdivision Rheumatology, CAPHRI, Maastricht University Medical Centre (MUMC), PO Box 616, 6200 MD Maastricht, The Netherlands; Biomedical Research Centre, Hasselt University, Agoralaan - gebouw D, 3590 Diepenbeek, Belgium
| | - J P W van den Bergh
- Department of Internal Medicine, VieCuri Medical Centre, PO Box 1926, 5900 BX Venlo, The Netherlands; Department of Internal Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre (MUMC), PO Box 616, 6200 MD Maastricht, The Netherlands; Biomedical Research Centre, Hasselt University, Agoralaan - gebouw D, 3590 Diepenbeek, Belgium
| | - F de Vries
- Department of Clinical Pharmacology and Toxicology, University Medical Centre Maastricht, Maastricht, The Netherlands
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK; NIHR Musculoskeletal Biomedical Research Unit, Institute of Musculoskeletal Sciences, University of Oxford, Oxford, UK.
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - T P van Staa
- Health eResearch Centre, University of Manchester, Manchester, UK; Department of Pharmacoepidemiology & Clinical Pharmacology, University of Utrecht, Utrecht 3508 TB, The Netherlands
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