Irish Journal of Medical Science最新文献

{"title":"Correlation between clinical and MRI findings in disc herniation in the lumbosacral region.","authors":"Mustafa Saad Ghanim, Mohammed Shihab Al-Edanni, Laith Thamer Al-Ameri","doi":"10.1007/s11845-024-03788-1","DOIUrl":"10.1007/s11845-024-03788-1","url":null,"abstract":"<p><strong>Aim of the study: </strong>To compare clinical findings with MRI findings and evaluate the role of physical examination in the diagnosis, localization of the level, site, size, and type of lumbosacral disc herniation.</p><p><strong>Materials and methods: </strong>A prospective study of 104 patients with low back pain and/or sciatica was conducted et al.-Kindy Teaching Hospital between January to December 2022. All Participants were evaluated via history, clinical examination, and MRI. One hundred patients had a disc herniation in the lumbosacral region, which was confirmed by MRI assessment after clinical presentation and physical examination. The data were collected and analyzed by the chi-square test.</p><p><strong>Results: </strong>Most of the patients (84%) experienced pain in the lower back that radiated to the lower limb or limbs, and nearly half of the patients experienced paresthesia (48%). Sixty-six percent of the patients had a scoliotic list; limitation of lumbar spine movements was common in 96%, and a decrease in the straight leg raising test (SLR) was detected in 98%. Cross SLR \"Well test\" was positive in 64% of patients. The femoral nerve stretch test was positive in 40% of patients. Sixty-four percent were presented with neurological deficits, 42% with affected L5 nerve roots, 22% with affected S1 nerve roots, and no patients with L4 affected. Twenty-two percent showed a positive SLR test with an angle between 41 and 70°.</p><p><strong>Conclusion: </strong>Proper correlation between clinical and MRI will help determine the lesion's level, horizontal location, herniation type, and herniated disc size in the lumbosacral region and achieve a more accurate diagnosis.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2995-3000"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"D-dimer/high sensitive troponin I ratio is useful in predicting in-hospital mortality in pulmonary embolism patients.","authors":"Ahmet Burak Urfalioglu, Ertugrul Altug, Hayri Cinar, Erdem Aksay, Onder Yesiloglu, Adem Cakir, Mustafa Avsar, Ozlem Ercen Diken, Ramazan Guven, Akkan Avci","doi":"10.1007/s11845-024-03766-7","DOIUrl":"10.1007/s11845-024-03766-7","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary embolism requires careful differential diagnosis as it is associated with a wide range of symptoms that may suggest different diseases such as chest pain, shortness of breath and syncope. Since the disease can be fatal, especially in cases where right ventricular failure and hemodynamic instability develop, prognostic markers are great importance in terms of monitoring the patient during the treatment process.</p><p><strong>Aim: </strong>We aimed in our study to compare the relationship between the ratio of D-dimer and High Sensitive Troponin T (HsTnT) values ​​with short-term mortality and to compare this relationship with Pulmonary Embolism Severity Index (PESI) scoring.</p><p><strong>Method: </strong>Our study was conducted with patients who applied to the emergency department of our hospital between 01/01/2022 and 01/01/2023 and were definitively diagnosed with Pulmonary thromboembolism after their evaluation.</p><p><strong>Findings: </strong>The success of D-dimer/HsTroponin, D-dimer/CK-MB and troponin/D-dimer indices calculated from the laboratory test results of the cases in predicting mortality was examined, and a comparison was made with the success of the PESI score in predicting mortality. Among these indices, D-dimer/CK-MB was found to be the most successful index in predicting 7-day mortality (AUC: 0.734; 95% CI: 0.653-0.815; p < 0.001). Additionally, the D-dimer/HsTroponin ratio was found to be statistically significant as a successful index in predicting 7-day mortality (AUC: 0.697; 95% CI: 0.621-0.774; p < 0.001).</p><p><strong>Conclusion: </strong>FD-dimer/HsTroponin ratio, which is a powerful, fast, low-cost, easy and simple test, can be used especially in emergency services instead of the PESI score as a mortality marker in pulmonary embolism, which has a high mortality rate.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2695-2703"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucometrics utilisation in an urban teaching hospital in ireland: current practice and future aims.","authors":"Joseph McGauran, Arianna Dart, Phyllis Reilly, Matthew Widdowson, Gerard Boran","doi":"10.1007/s11845-024-03768-5","DOIUrl":"10.1007/s11845-024-03768-5","url":null,"abstract":"<p><strong>Background: </strong>Dysglycaemia in hospitalised patients is associated with poorer clinical outcomes, including cardiovascular events, longer hospital stays, and increased risk of mortality. Therefore, glucose monitoring is necessary to achieve best outcomes.</p><p><strong>Aims: </strong>This audit assesses use of point-of-care (POC) blood glucose (BG) testing in Tallaght University Hospital (TUH) over an 8-day period. It evaluates compliance with international and TUH glucose monitoring protocols and determines frequency of diabetes team consultations for inpatient adults.</p><p><strong>Methods: </strong>Data from an 8-day period (12/03/2023-19/03/2023) were extracted from the TUH COBAS-IT system and analysed. Invalid tests were excluded. Hyperglycaemia was defined as ≥ 10 mmol/L and hypoglycaemia as ≤ 3.9 mmol/L. Persistent hyperglycaemia was defined as two BG results of ≥ 10 mmol/L. A chart review was conducted on adult patients with persistent hyperglycaemia to assess for HbA1C results, diabetes diagnosis, and diabetes consult.</p><p><strong>Results: </strong>3,530 valid tests were included and analysed. 674 individual patients had tests done. 1,165 tests (33.00%) were hyperglycaemic and 75 (2.12%) were hypoglycaemic. 68.25% of adults with persistent hyperglycaemia had an HbA1C test performed or documented within three months. 42.71% of inpatient adults with persistent hyperglycaemia and a known diabetes diagnosis received a consult from the diabetes team.</p><p><strong>Conclusion: </strong>Increased adherence to hospital protocols for testing HbA1C in adults with persistent hyperglycaemia could improve treatment and clinical outcomes. Increased diabetes team consultation could facilitate appropriate treatment and improve patient outcomes in persistently hyperglycaemic adult patient populations.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2773-2779"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guided growth surgery for angular deformity of the knee: one centres experience.","authors":"Dave M Moore, Henry Turner, Oliver Boughton, Maria Noonan, Jacques Noel, Pat Kiely, Pat O'Toole, Paula M Kelly, David P Moore","doi":"10.1007/s11845-024-03794-3","DOIUrl":"10.1007/s11845-024-03794-3","url":null,"abstract":"<p><strong>Background: </strong>Angular deformity in the lower extremity can result in pain, gait disturbance, cosmetic deformity and joint degeneration. Up until the introduction of guided growth, which has since become the widely accepted treatment for frontal plane angular angular deformity around the knee in skeletally immature patients, treatment consisted of staples, corrective osteotomy or an angular epiphysiodesis. Guided growth modulation uses the tension band principle with the goal of treatment being to normalise the lower limb mechanical axis resulting in lower morbidity than previous treatments. In order to assess the success of this procedure we reviewed our results in an attempt to identify patients who may not benefit from this elegant procedure.</p><p><strong>Methods: </strong>We performed a retrospective review of prospectively collected surgical records and diagnostic imaging in our paediatric tertiary national referral centre to identify all patients who had guided growth surgery for coronal plane angular deformity of the knee from 2007 to 2023. We noted the patient demographics, diagnosis, peri-operative experience and outcome. All patients were followed until skeletal maturity, until their hardware was removed or at least 2 years.</p><p><strong>Results: </strong>Two hundred thirty-six patients were assessed for eligibility. Of the 282 treated knees which met the criteria for final assessment 55 (19.5%) were unsuccessful. Complications were few but included infection and metal-work prominence. Procedures that were less likely to be successfully included growth disturbances following trauma (18.8% failure) or infection (40%), tumour (66.6%), mucopolysaccharidoses type I (15.7%), spondyloepiphyseal dysplasia (25%) or Blount's disease (60%). Idiopathic angular deformity showed an 89.5% success rate with guided growth.</p><p><strong>Conclusion: </strong>In our hands, guided growth had an 80.5% success rate when all diagnoses were considered. We continue to advocate the use of guided growth as a successful treatment option for skeletally immature patients with limb deformity however caution should be employed when considering its use in certain patient groups.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2825-2833"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Craic, Ceoil agus COVID-19: the impact of 'Fleadh Cheoil na hÉireann' on presentations to the local emergency department.","authors":"Freya Guinness, Aoife Corcoran, Michael J O'Grady, Jennifer Finnegan","doi":"10.1007/s11845-024-03786-3","DOIUrl":"10.1007/s11845-024-03786-3","url":null,"abstract":"<p><strong>Aims: </strong>Fleadh Cheoil Na hÉireann, the world's largest Irish music festival, was held in Mullingar in August 2023, gathering a crowd of nearly 600,000 people. Our aim was to assess the impact on presentations to the local emergency department (ED).</p><p><strong>Methods: </strong>We performed a retrospective case analysis on all presentations to the ED at Regional Hospital Mullingar (RHM) from 23/7/2023 to 02/09/2023. We also collected data on COVID-19 swab results processed in our laboratory.</p><p><strong>Results: </strong>There was a 10% increase in ED attendances during the 2 weeks of the Fleadh. There was a statistically significant increase in COVID-19 presentations when compared to national positivity rates.</p><p><strong>Discussion/conclusion: </strong>Our study shows that the Fleadh led to an increase in all-cause ED visits as well as an increase in COVID-19 cases. Our study plays an important role in informing health service preparation for future host towns of the Fleadh.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"3025-3027"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chaperone in breast examination: a comprehensive systematic review of patient and clinician perspectives, and documentation.","authors":"Kai Qi Ou, Zhen Ning Wong, Zhen Yu Wong","doi":"10.1007/s11845-024-03803-5","DOIUrl":"10.1007/s11845-024-03803-5","url":null,"abstract":"<p><strong>Background: </strong>The General Medical Council (GMC) has made it mandatory to have a chaperone present during intimate examinations, including breast exams, highlighting the importance of medicolegal protection for both patients and clinicians.</p><p><strong>Aims: </strong>The use of chaperones during breast examinations is logical, especially in an increasingly litigious society. This review aims to summarize current information regarding patients' and clinicians' perspectives on chaperone use in breast examination.</p><p><strong>Methods: </strong>A PRISMA-compliant search was conducted in electronic databases from inception until April 2023 for qualitative literature on patients' and clinicians' perspectives on chaperone use in breast examination. The inclusion criteria focused on studies related to breast examinations, excluding other intimate examinations. An inductive thematic analysis was performed in three domains: physician-associated factors, patient-associated factors, and chaperone documentation.</p><p><strong>Results: </strong>Ten studies were included after screening 939 articles. For breast examination, the presence of male and older surgeons, nurse availability, rural settings, and patients' psychiatric comorbidities increased the likelihood of chaperone use during consultations. Medico-legal concerns were prominent for male physicians, while female physicians highlighted the need for technical support. Logistical issues were a common hindrance. The gender of physicians was important for patients, but there was conflicting evidence regarding patient preferences for chaperones and their purpose. Poor documentation was generally observed despite quality improvement projects.</p><p><strong>Conclusion: </strong>This study emphasizes the vital role of chaperones in clinical practice, urging a precise definition and targeted resolution for implementation challenges. Patient preferences highlight the need for a personalized approach, and increased awareness among healthcare professionals is essential.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2955-2963"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical diagnostic value of CRISPR-Cas13a-based molecular technology for tuberculosis.","authors":"Kai Wu, Zhenyao Wu, Xiongjie Li","doi":"10.1007/s11845-024-03799-y","DOIUrl":"10.1007/s11845-024-03799-y","url":null,"abstract":"<p><strong>Objective: </strong>To address the clinical diagnostic value of CRISPR-Cas13a-based molecular technology for tuberculosis (TB).</p><p><strong>Methods: </strong>The 189 suspected TB patients were simultaneously sent for acid-fast staining smear of bronchoalveolar lavage fluid, MGIT 960 cultures, Xpert MTB/RIF assay, and CRISPR-Cas13a assay. Using the final clinical diagnosis as the gold standard, the TB and non-TB groups were determined, and the diagnostic values of the four assays and the combined test in TB were compared. Using MGIT 960 culture as the gold standard, the diagnostic value of CRISPR-Cas13a assay was explored in TB, and the concordance between the CRISPR-Cas13a assay and MGIT 960 culture was compared.</p><p><strong>Results: </strong>The 189 preliminary diagnosed patients with suspected TB were diagnosed, with 147 in the TB group and 42 in the non-TB group. Taking the final clinical diagnosis as the gold standard, the sensitivity, negative predictive value, and accuracy of CRISPR-Cas13a assay, MGIT 960 culture, and XpertMTB/RIF assay were higher than those of acid-fast staining smear; by comparing the area under the ROC curve, the diagnostic value of the CRISPR-Cas13a assay, MGIT 960 culture, and XpertMTB/RIF assay was superior to that of acid-fast staining smear (all P < 0.05). Using the MGIT 960 culture results as the gold standard, there was a moderate concordance between the CRISPR-Cas13a assay and the MGIT 960 culture (kappa = 0.666).</p><p><strong>Conclusion: </strong>Bronchoalveolar lavage fluid CRISPR-Cas13a assay has high application value in the clinical diagnosis of TB and can be recommended for the initial screening of patients with suspected TB.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2889-2895"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing recurrence rates in hiatal hernia repair: Results of a quality improvement study.","authors":"Laura M Staunton, Jarlath C Bolger, Rakesh Ahmed, Waqas T Butt, John V Reynolds, Narayanasamy Ravi, Claire L Donohoe","doi":"10.1007/s11845-024-03743-0","DOIUrl":"10.1007/s11845-024-03743-0","url":null,"abstract":"<p><strong>Background: </strong>Patient and procedure factors are considered in the decision-making process for surgical repair of hiatal hernias. Recurrence is multi-factorial and has been shown to be related to size, type, BMI and age.</p><p><strong>Aims: </strong>This study examined recurrence rates in a single institution, identified areas for improved surgical technique, and re-assessed recurrence following implantation of a quality improvement initiative.</p><p><strong>Methods: </strong>A retrospective review of patients undergoing hiatal hernia repair surgery between 2018 and 2022 was conducted. Demographics, pre-operative characteristics, intra-operative procedures and recurrence rates were reviewed.</p><p><strong>Results: </strong>Seventy-five patients from 2018 to 2020 and 34 patients from 2021 to 2022 were identified. The recurrence rate was 21% in 2018-2020, with 14% requiring a revisional procedure. Recurrence and re-operation were subsequently reduced to 6% in 2021 and 2022, which was statistically significant (p = 0.043). There was an increase in gastropexy from 21% to 41% following the review (p = 0.032), which was mainly reserved for large and giant hernias. Procedural and literature review, alongside gastropexy, can be attributed to recurrence rate reduction.</p><p><strong>Conclusions: </strong>It is important to educate patients on the likelihood and risk factors of recurrence. A comprehensive review of procedures and a quality improvement program in our facility for hiatal hernia repair is shown to reduce recurrence.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2929-2934"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of educators and students on the efficacy of online teaching and learning strategies employed during COVID-19 in a health sciences institution.","authors":"Keith Geraghty, Nicole Heng, Juliette Duff, Jacinta Burke, A D K Hill, John Jenkins, Gozie Offiah","doi":"10.1007/s11845-024-03773-8","DOIUrl":"10.1007/s11845-024-03773-8","url":null,"abstract":"<p><strong>Background: </strong>Healthcare education encountered unprecedented challenges during the COVID-19 pandemic, but the necessary responses have also provided learning opportunities for the future.</p><p><strong>Aims: </strong>We aimed to evaluate the impact of COVID-19 on teaching and learning strategies and the perceptions of clinical educators and health sciences students on novel methods to improve online student engagement in Ireland's largest medical school.</p><p><strong>Methods: </strong>Two separate online surveys designed to gain insights into the perceived efficacy of online teaching strategies were distributed to clinical educators and health sciences students (medical and pharmacy) over 7 months via email.</p><p><strong>Results: </strong>A total of 86.4% of educators responded that rapport was more difficult to build online, and 90.5% reported less engagement from students online. The most popular methods that improved student engagement included using polls, a chat box function for questions, small group discussions and having student cameras turned on. Amongst educators surveyed, 81.8% felt a training course focused on teaching strategies at the start of every academic year would be beneficial. From the students' perspective, no difference was noted between the medicine and the pharmacy students. Seventy-five percent reported using quizzes/polls, and 63% reported using game-based platforms as techniques to improve online learning. Sixty-two percent of students described it as a positive outcome of learning during the pandemic.</p><p><strong>Conclusion: </strong>Any pandemic poses unique challenges to the delivery of healthcare education. These surveys report educators' and students' views on online teaching and learning strategies, highlighting novel mechanisms to improve student engagement and ultimately impact on graduate outcomes.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"3045-3051"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Cancer Network Ireland (BCNI) and National Cancer Registry Ireland (NCRI) collaboration: challenges and utility of an Enhanced Blood Cancer Outcomes Registry (EBCOR) pilot.","authors":"Seán R Millar, Mohamed Bakri Mohamed, Vitaliy Mykytiv, Rose McMorrow, Conan Donnelly, Eamonn O'Leary, Nina Orfali, Philip Murphy, Paul V Browne, John Quinn, Peter O'Gorman, Mary F Ryan, Ruth Clifford, Ezzat El Hassadi, Derville O'Shea, Oonagh Gilligan, Janusz Krawczyk, Michael E O'Dwyer, Eva Szegezdi, Mary R Cahill","doi":"10.1007/s11845-024-03756-9","DOIUrl":"10.1007/s11845-024-03756-9","url":null,"abstract":"<p><strong>Background: </strong>The Blood Cancer Network Ireland and National Cancer Registry Ireland worked to create an Enhanced Blood Cancer Outcomes Registry (EBCOR). Enhanced data in acute myeloid leukaemia (AML) included an extensive data dictionary, bespoke software and longitudinal follow-up.</p><p><strong>Aims: </strong>To demonstrate the utility of the database, we applied the data to examine a clinically relevant question: Charlson comorbidity index (CCI) usefulness in predicting AML patients' survival.</p><p><strong>Methods: </strong>A software designer and consultant haematologists in Cork University Hospital worked together to standardise a data dictionary, train registrars and populate a database. One hundred and forty-one AML patients underwent enhanced data registration. Comorbidities identified by chart review were used to examine the capability of the CCI and age at diagnosis to predict mortality using Kaplan-Meier curves, Cox regression and receiver operating characteristic curves.</p><p><strong>Results: </strong>In regression analysis, a dose-response relationship was observed; patients in the highest CCI tertile displayed a greater risk (HR = 4.90; 95% CI 2.79-8.63) of mortality compared to subjects in tertile 2 (HR = 2.74; 95% CI 1.64-4.57) and tertile 1 (reference). This relationship was attenuated in an analysis which adjusted for age at diagnosis. The area under the curve (AUC) for the CCI was 0.76 (95% CI 0.68-0.84) while the AUC for age at diagnosis was 0.84 (95% CI 0.78-0.90).</p><p><strong>Conclusions: </strong>Results suggest that the CCI provides no additional prognostic information beyond that obtained from age alone at AML diagnosis and that an EBCOR can provide a rich database for cancer outcomes research, including predictive models and resource allocation.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2615-2623"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}