Association between age and incidence of deep vein thrombosis in patients with spinal cord injury: an observational cross-sectional study.

STUDY DESIGN: Cross-sectional study. OBJECTIVE: To elucidate the association between age and incidence of deep vein thrombosis (DVT) in patients with spinal cord injury (SCI). SETTING: Rehabilitation Medicine Department of the First Affiliated Hospital of China University of Science and Technology. METHODS: Patients from August 2018 to December 2020 with SCI (N = 260) were tertiles divided the age into three groups to analyze the association between age and incidence of DVT. RESULTS: American Spinal Cord Injury Association impairment scale (AIS), urinary tract infection (UTI), pulmonary infection (PI), and anticoagulation therapy (AT) were confounders for the association between age and incidence of DVT. The incidence of DVT increased by 1.07-fold (Non-adjusted model, OR = 1.07, P < 0.001), 1.05-fold (Minimally-adjusted model: adjusted for confounders, OR = 1.05, P = 0.010) and 1.06-fold [Fully-adjusted model: adjusted for confounders and unbalanced probable variables: AIS, UTI, PI, AT, Sex, D-dimer(new), Fibrinogen (new), Modes of injury and Level of injury, OR = 1.06, P = 0.012] when age increased by 1 year. The incidence of DVT had an increasing trend with age in different age tertile in the three models (P for trend <0.05). Age had a linearly association with incidence of DVT (OR = 1.07, P = 0.065) and stable in different subgroups, for lower age, the association was also linearly (OR = 4.40, P = 1.000), for middle (fold point = 46.46, P < 0.001) and higher age (fold point = 66, P = 0.017), the association was curvilinear. CONCLUSION: Age had a linearly association with incidence of DVT. Quitting smoking, preventing/treating UTI and AT should be adopted in advance for patients with SCI for all age, especially for older.

Association of age-adjusted D-dimer with deep vein thrombosis risk in patients with spinal cord injury: a cross-sectional study.

STUDY DESIGN: Article. OBJECTIVE: To elucidate the association of age-adjusted D-dimer (AAD) with deep vein thrombosis (DVT) risk to lower limbs in patients with spinal cord injury (SCI). SETTING: Rehabilitation Medicine Department of the First Affiliated Hospital of China University of Science and Technology. METHODS: Retrospective analysis of 250 patients with SCI in the rehabilitation department from August 2018 to December 2021. Quartiles divided the D-dimer level into four groups to analyze the association between AAD level and DVT risk. RESULTS: Age was identified as a covariate of D-dimer and DVT risk. For non-adjusted model, when D-dimer increased by 1 mg/L, DVT risk increased 0.23-fold (P < 0.05); for minimally-adjusted model (adjusted for age), the risk increased 0.22-fold (P < 0.05); and for fully-adjusted model (adjusted for age, sex, pulmonary infection, degree, grades, and career), it increased 0.19-fold (P < 0.05). AAD had a curvilinear association with DVT risk, and the fold point was 1.9 mg/L (P < 0.05). When serum AAD level was <1.9 mg/L (K < 1.9), the estimated change in DVT risk was 3.34 (P < 0.05), and when serum AAD level was >1.9 mg/L (K > 1.9), the estimated change was 1.14 (P < 0.05). Urinary tract infection (UTI) and fibrinogen(tertile) had a interaction association with D-dimer level and DVT risk (P interaction < 0.05). CONCLUSION: Patients with SCI who receive rehabilitation treatment with AAD level >1.9 mg/L need to be paid close attention to, especially those with UTI and high levels of fibrinogen.

A new scheduling method based on sequential time windows developed to distribute first-aid medicine for emergency logistics following an earthquake.

After an earthquake, affected areas have insufficient medicinal supplies, thereby necessitating substantial distribution of first-aid medicine from other supply centers. To make a proper distribution schedule, we considered the timing of supply and demand. In the present study, a "sequential time window" is used to describe the time to generate of supply and demand and the time of supply delivery. Then, considering the sequential time window, we proposed two multiobjective scheduling models with the consideration of demand uncertainty; two multiobjective stochastic programming models were also proposed to solve the scheduling models. Moreover, this paper describes a simulation that was performed based on a first-aid medicine distribution problem during a Wenchuan earthquake response. The simulation results show that the methodologies proposed in this paper provide effective schedules for the distribution of first-aid medicine. The developed distribution schedule enables some supplies in the former time windows to be used in latter time windows. This schedule increases the utility of limited stocks and avoids the risk that all the supplies are used in the short-term, leaving no supplies for long-term use.