Characteristics of pseudophakic retinal detachment and risk factors of recurrence.

BACKGROUND: The present study was designed to gain knowledge about the prognostic factors and evolution of pseudophakic retinal detachment (PRD) and to analyse the main characteristics of PRD, such as the mean time to retinal detachment following cataract surgery, as well as the clinical factors associated with the risk of recurrence and worse anatomical and functional outcomes. METHODS: This was a retrospective monocentric study of 330 patients with PRD who underwent surgery between 2012 and 2020. All patients were pseudophakic and were referred for retinal detachment surgery at Donostia University Hospital (Terciary Hospital, Spain). RESULTS: The mean age of the patients at the time of phacoemulsification was 63.06 ±â€¯10.8 years, and 49.09% of them had moderate myopia [axial length (AL) (23.5-26.5 mm)]. In our series, macular detachment was evident in 69.09% (n = 228) of the patients. The mean time that elapsed between phacoemulsification and PRD surgery was 4.04 ±â€¯4.17 years, which was reduced by half in the event of surgical complications (2.24 ±â€¯2.65). The rate of PRD was 28.79%. The anatomical results in terms of retinal reapplication were better with the combination of vitrectomy and scleral buckling (83.1% vs. 70.5%) (p = 0,127) compared with vitrectomy. The variables associated with a higher risk of recurrence were male sex (hazard ratio (HR) = 1.75), macular detachment (HR = 2.00) and the presence of proliferative vitreoretinopathy (PVR) (HR = 3.21). CONCLUSIONS: PRD usually occurs within 4 years of phacoemulsification, although it may occur significantly earlier in the event of surgical complications. Macular involvement, PVR, and male sex are all associated with a higher risk of PRD recurrence.

Impacto de la demencia en la supervivencia de los pacientes con fractura de cadera intervenidos mediante prótesis total y parcial / Impact of dementia on the survival of patients with hip fracture after undergoing total and partial prosthesis

Objetivo: Realizar un análisis de la supervivencia comparativa de los pacientes diagnosticados de fracturas de cadera (FC) en el Servicio Vasco de Salud de 2010 a 2016 en función de que estuviesen o no diagnosticados de demencia y del tipo de artroplastia. Material y métodos: Estudio de tipo observacional (real world data) de supervivencia. Los datos fueron obtenidos de las bases de datos administrativas y clínicas del Servicio Vasco de Salud mediante el gestor Oracle Business Intelligence (OBI). Se analizaron todos los casos de fracturas de cuello de fémur desde el año 2010 al 2016 en Servicio Vasco de Salud. Se realizó un análisis descriptivo para detectar diferencias entre grupos según diagnóstico previo de demencia y tipo de prótesis. Para obtener las curvas de supervivencia se utilizó el método de Kaplan?Meier y su comparación se realizó por parejas mediante el logrank test. Mediante la regresión de Cox se analizó el riesgo de fallecimiento ajustado de cada grupo. Resultados: Se identificaron 5.867 pacientes con FC, siendo 1.131 pacientes sin demencia y prótesis total, 3.073 sin demencia y prótesis parcial, 176 con demencia y prótesis total y 1.487 con demencia y prótesis parcial. La mediana de la supervivencia fue de 9,08 años, 3,79 años, 2,55 años y 2,54 años respectivamente. La comparación de las curvas de supervivencia resultó significativa para todos los casos excepto entre los dos últimos grupos. Utilizando el primer grupo como referencia, el odds ratio de fallecimiento del resto fue 1,56, 2,27 y 2,37 respectivamente. Al analizar el riesgo de fallecimiento únicamente para los pacientes con demencia, el tipo de prótesis no resultó ser estadísticamente significativo. Conclusiones: La demencia influye en la curva de supervivencia de los pacientes que son sometidos a una artroplastia tras una fractura de cuello femoral, teniendo una mortalidad similar los que reciben una artroplastia total que los que se intervienen con una parcial. (AU)

Objetive: To carry out a comparative survival analysis of patients diagnosed with hip fractures (HF) in the Basque Health Service from 2010 to 2016 depending on whether or not they were diagnosed with dementia and the type of arthroplasty. Material and methods: Observational study (real world data) of survival. The data were obtained from the administrative and clinical databases of the Basque Health Service using the Oracle Business Intelligence (OBI) manager. All cases of femur neck fractures from 2010 to 2016 were analyzed in the Basque Health Service. A descriptive analysis was carried out to detect differences between groups according to previous diagnosis of dementia and type of prosthesis. The Kaplan-Meier method was used to obtain the survival curves and their comparison was made in pairs using the Achievement test. The adjusted risk of death for each group was analyzed with the Cox regression model. Results: 5,867 patients with CF were identified, being 1,131 patients without dementia and total prosthesis, 3,073 without dementia and partial prosthesis, 176 with dementia and total prosthesis and 1,487 with dementia and partial prosthesis. The median survival was 9.08 years, 3.79 years, 2.55 years, and 2.54 years respectively. The comparison of the survival curves was significant for all cases except between the last two groups. Using the first group as a reference, the odds ratio of death for the rest was 1.56, 2.27 and 2.37 respectively. When analyzing the risk of death only for patients with dementia, the type of prosthesis was not statistically significant. Conclusions: Dementia influences the survival curve of patients who undergo arthroplasty after a femur neck fracture, with those who undergo a total arthroplasty have a similar mortality rate as those who undergo partial arthroplasty. (AU)