The Risk Factor of Worsening Low Back Pain in Older Adults Living in a Local Area of Japan: The GAINA Study

Factors associated with mortality in patients with extremity necrotizing soft-tissue infections: a single academic center experience

PURPOSE

Necrotizing soft-tissue infection (NSTI) is a surgical emergency associated with high mortality. This study primarily aimed to identify the factors associated with in-hospital mortality due to NSTI in the extremities at a single institution. Secondarily, we aimed to clarify the effectiveness of the optimal combination of hyperbaric oxygen therapy (HBOT) and surgery for NSTI treatment.

STUDY DESIGN

Retrospective observational study.

METHODS

This study included all patients newly diagnosed with NSTI in the extremity from 2003 to 2021 in our hospital. Factors associated with mortality, including patient's characteristics, duration from onset to hospitalization, NSTI type, and clinical data at the initial visit; acute disseminated intravascular coagulation (DIC), laboratory risk indicator for necrotizing fasciitis score, and sequential organ failure assessment score; treatment, initial surgery, surgery times, amputation, HBOT, combined surgery with HBOT, and clinical outcomes; amputation rate, mortality rate, and hospitalization duration were examined.

RESULTS

A total of 37 cases were treated for NSTIs. The median age was 64 years (range: 22-86). Five cases (13.5%) died during hospitalization. Ten patients were diagnosed with DIC at the initial visit, of whom four died. HBOT combined with surgery was performed in 23 cases, and 16 cases underwent multiple surgeries. Factors associated with mortality included DIC (p = 0.015, 95% confidence interval [CI]: 0.015-0.633) and multiple surgeries combined with HBOT (p = 0.028, 95% CI: 1.302-95.418).

CONCLUSION

This study demonstrates that DIC at the initial visit is associated with mortality in extremity NSTI. Additionally, HBOT might improve prognosis when combined with multiple surgeries.

Sensitivity and Specificity of Anthropometric Indices in Identifying Obesity in Women over 40 Years of Age and Their Variability in Subsequent Decades of Life

Anthropometric measurements and indices are a simple and inexpensive method to assess normal physical development and quickly identify the risk of diseases. The aim of the study was to verify the sensitivity (Se) and specificity (Sp) of selected anthropometric indices in a group of women over 40 years. The study included 87 women (group I-40 to 49 years, group II-50 to 59 years, group III-60 to 69 years, and group IV-70 to 79 years). Anthropometric characteristics were measured: body mass (BM), body height (BH), waist circumference (WC), and hip circumference (HC). Body mass index (BMI), body adiposity index (BAI), waist-hip ratio (WHR), and waist-to-height ratio (WHTR) were calculated. The percentage of fat tissue (FT) and visceral fat volume (FV) were evaluated using DEXA. A decrease in mean BH with an increase in the mean WC, WHR, and WHTR in subsequent decades. There were strong statistically significant correlations between FT and most indicators (except for WHR). FV was correlated at a strong or moderate level with most parameters. In the group of women aged 40 to 80 years, the most favorable AUC was obtained for WC, followed by BMI. BAI can be recommended as a complementary indicator to BMI.

Profile of individuals with low back pain and factors defining chronicity of pain: a population-based study in Ethiopia

Purpose

Low back pain (LBP) is the most prevalent public health problem globally, second only to headaches in the ranking of painful disorders that affect human beings. However, evidence about the profile of LBP patients is lacking in low-income countries for appropriate management approaches. This study examined the profile of individuals with LBP and factors defining chronicity of pain in Ethiopia.

Methods

A population-based cross-sectional study design was used to collect data from 1812 adults (≥ 18 years) with LBP at present. Data were collected by interviewing the study participants using an instrument developed and validated in the same study population. The instrument includes socio-demographic information, health behaviours/lifestyle habits, beliefs about pain, and pain and general health-related characteristics of the participants. Data analysis was performed using R version 3.5.1. Both unconditional and conditional logistic regression models were fitted and Odds Ratio (OR) with 95% confidence intervals (95% CIs) were computed to identify factors significantly associated with chronicity of pain at p ≤ 0.05 significance level.

Results

Negative beliefs about pain, a varying degree of pain interference with daily and social activities, complaining of pain in other anatomical sites other than the low back region, general health status rated as not excellent, depressive symptomology, and sleeping problems/insomnia were common within the profile of individuals with LBP. Age, educational level, residential setting, beliefs about pain, and depressive symptomology were found to have a statistically significant association with chronicity of pain.

Conclusions

This study provides an overview of the profile of individuals with LBP and factors defining chronicity of pain, assisting clinicians to design appropriate management strategies to improve patients' outcomes.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11136-022-03148-5.