- 著者
- Akiko Hasebe Ichiro Nakahara Shoji Matsumoto Jun Morioka Jun Tanabe Sadayoshi Watanabe Kenichiro Suyama Takuma Ishihara Yuichi Hirose
- 出版者
- Fujita Medical Society
- 雑誌
- Fujita Medical Journal (ISSN:21897247)
- 巻号頁・発行日
- pp.2022-033, (Released:2023-05-09)
- 参考文献数
- 16
Objective: This retrospective study aimed to investigate factors associated with inhibition of early aneurysm obliteration after flow diverter (FD) treatment. We also created the early obliteration inhibition (EOI) score for pre-operative evaluation.Methods: We examined 110 cerebral aneurysms in 104 patients who underwent FD treatment. The following parameters were investigated: age, sex, symptoms, aneurysm location and type, maximum aneurysm diameter, parent vessel diameter, neck diameter, and dome–neck ratio. We also noted aneurysm location relative to the curvature of the parent artery and any branches arising from the aneurysm dome. Procedural factors such as FD diameter and length, number of FDs placed, type of FD, and use of adjunctive coiling were also investigated. Aneurysm obliteration was evaluated using digital subtraction angiography 3 months after the procedure. Adequate obliteration was defined as grade C or D on the O’Kelly–Marotta scale.Results: The following factors inhibited early obliteration: 1) extradural location, 2) saccular aneurysm, 3) aneurysm neck located at the outer convexity of the parent artery, and 4) arterial branch arising from the aneurysm dome. Odds ratios were used to create an EOI score. Receiver operating characteristic curve analysis showed that the optimal cut-off EOI score for adequate obliteration was 1.5 (area under the curve, 0.81; 95% confidence interval, 0.73–0.9; sensitivity, 0.9; specificity, 0.57).Conclusion: The EOI score, which is based on factors that inhibit early obliteration, may predict early treatment outcomes of FD placement.
- 著者
- Ayumi KONO Naomi FUKUSHIMA Takuma ISHIHARA Noriko YOSHIYUKI Kouji YAMAMOTO
- 出版者
- Japanese Society of Public Health
- 雑誌
- 日本公衆衛生雑誌 (ISSN:05461766)
- 巻号頁・発行日
- vol.68, no.4, pp.267-275, 2021-04-15 (Released:2021-04-23)
- 参考文献数
- 34
Objectives We investigated the 5-year disease-related mortality risk, including that associated with neoplasms, mental/behavioral/neurodevelopmental disorders, and diseases of the circulatory system and respiratory system,in ambulatory frail Japanese older adults.Methods We retrospectively analyzed long-term care and health insurance claims data in this cohort study performed between April 2012 and March 2017. The primary outcome was mortality, and the secondary outcome was care-need level decline. Risk factors were determined based on the International Statistical Classification of Disease and Related Health Problems, 10th Revision codes, hospitalization, and institutionalization. The study included 1,239 ambulatory frail older adults newly certified as needing Support-Level care at baseline (April 2012-March 2013) across three Japanese municipalities.Results Of the 1,239 participants, 454 (36.6%) died. Neoplasms (hazard ratio [HR] 2.69, 95% confidence interval [CI] 1.97-3.68) or respiratory system diseases (HR 1.62, 95%CI 1.26-2.08) were independently associated with mortality. Mental/behavioral/neurodevelopmental disorders (HR 1.39, 95%CI 1.17-1.66) or diseases of the respiratory system(HR 86, 95%CI 75-99) were independently associated with care-need level decline.Conclusions This study suggests that neoplasms or respiratory system diseases were associated with a high mortality risk and that mental/behavioral/neurodevelopmental disorders were associated with care-need level decline among ambulatory frail older adults. Optimal disease management and effective long-term care are important to delay the onset of these events in older adults certified as needing Support-Level care.