Swiss medical weekly最新文献

{"title":"Non-invasive prenatal testing is not a substitute for first trimester ultrasound screening.","authors":"Boris Tutschek, Luigi Raio, David Baud","doi":"10.57187/s.4610","DOIUrl":"10.57187/s.4610","url":null,"abstract":"<p><p>The ultrasound examination in the first trimester is a crucial tool in prenatal diagnostics. Its primary aim is the early detection of fetal structural anomalies with the option to assess the risk for the common fetal trisomies (in Switzerland: \"Ersttrimestertest\"). The latter is achieved by combining ultrasound data with biochemical blood tests. In addition to chromosomal diagnostics, the first-trimester ultrasound plays an essential role in evaluating pregnancy risks as well as the overall health of the fetus. This method is non-invasive, safe and effective, offering invaluable information to both healthcare professionals and expectant parents that is critical for further pregnancy care. The introduction and wide-spread use of another, molecular test, NIPT (\"non-invasive prenatal testing\") should be seen as a useful additional option to, not a substitute for first trimester ultrasound. NIPT has high detection rates for \"the common trisomies\", but, in isolation, is insufficient for comprehensive early fetal assessment.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4610"},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508406","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":"Update on prevention and antimicrobial prophylaxis of infective endocarditis.","authors":"Maryam Pavlicek-Bahlo, Barbara Hasse, Michelle Frank, Anna Conen, Matthaios Papadimitriou-Olivgeris, Benoit Guery, Alain M Bernheim, Philipp K A Agyeman, Walter Knirsch, Michael M Bornstein, Matthias Greutmann, Parham Sendi","doi":"10.57187/s.4169","DOIUrl":"10.57187/s.4169","url":null,"abstract":"<p><p>The Swiss expert group published revised guidelines on the prevention and antibiotic prophylaxis against infective endocarditis in 2021. In this viewpoint article, the group reports on their experiences two years after implementing the new prevention concept, which included information flyers and antimicrobial prophylaxis cards. Challenges included communicating the concept and indications for antimicrobial prophylaxis to both high-risk patients and providers.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4169"},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508413","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":"An approach to implementing patient and public involvement in investigator-initiated clinical trials.","authors":"Kristin Marie Bivens, Amélie J A A Guyon, Valerie Behan, Eva Segelov","doi":"10.57187/s.4563","DOIUrl":"10.57187/s.4563","url":null,"abstract":"<p><p>As patient and public involvement (PPI) in academic clinical research, especially clinical trials, is gaining recognition, including acceptance and implementation, questions arise about how to establish an effective \"basic framework for PPI in academic clinical research\" for all stakeholders in Switzerland. In this Viewpoint, the authors focus on one aspect of the survey and interview results reported by Eberle and colleagues from PPI contributors, researchers, academic research infrastructure staff, and representatives of regulatory and funding bodies to identify a possible direction for a basic PPI framework in Switzerland. Specifically, they describe how they prepare two groups of stakeholders - clinical researchers and PPI contributors - for collaboration. They present clear definitional distinctions to help clinical researchers prepare for the 2025 call for proposals from the Swiss National Science Foundation (SNSF) for Investigator-Initiated Clinical Trials (IICT) and provide important background information that is essential for understanding the fundamentals of PPI.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4563"},"PeriodicalIF":2.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508380","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":"The Swiss Endometriosis Database: a retrospective multicentre cohort study on pain levels and multimodal treatment needs of endometriosis patients.","authors":"Sara Imboden, Selina Lang, Antonalla Martino, Peter Martin Fehr, Lea Duempelmann, Cloé Vaineau, Heike Willi, Nicolas Samartzis, Simone Kamm, Dimitri Sarlos, Stephanie Verta, Tina Rohrbach, Christian Polli, Alexandra Kochanowski, Michael Mueller","doi":"10.57187/s.3854","DOIUrl":"10.57187/s.3854","url":null,"abstract":"<p><strong>Study aims: </strong>This study aimed to deepen the understanding of endometriosis symptoms, types, and therapy recommendations for Swiss endometriosis patients in Swiss-certified endometriosis centres in 2022.</p><p><strong>Methods: </strong>In this exploratory retrospective multicentre cohort study, data from 3538 women who had their first consultation at a certified endometriosis centre in Switzerland in 2022 were analysed retrospectively. Data were collected by using questionnaires that were filled out by the patient and the physician at the first consultation, to evaluate parameters that included the main reason for consultation, visual analogue scale (VAS) scores for pain, clinical findings and therapy recommendations.</p><p><strong>Results: </strong>This study analysed all patients who had provided consent and were diagnosed with endometriosis (n = 3403, 96.2%) during their first consultation at a Swiss-certified endometriosis centre in 2022. The median age was 33.0 years (11-66 years). Of 812 documented VAS scores, 71.6% of the patients felt general pain, resulting in a median VAS score for dysmenorrhoea of 8 (0-10). After the first examination, peritoneal endometriosis (n = 1453, 54.8%) was diagnosed most often, followed by adenomyosis (n = 1366, 51.5%), deep infiltrating endometriosis (n = 857, 32.3%) and cystic/ovarian endometriosis (n = 643, 24.2%). In 46.2% of the patients, more than one working hypothesis, with regard to their condition, was identified - in most cases, a combination of peritoneal endometriosis and adenomyosis (15.6%). Endocrine therapy was the most frequent treatment recommended (60.6%), followed by recommendations for medical pain therapy (57%), surgery (34.4%), complementary procedures (23.5%), reproductive therapy (5.7%) and multimodal pain therapy (5.6%). Analysis of correlations between symptoms, diagnosis and treatment recommendations showed only a few notable findings such as correlations between peritoneal endometriosis and hormonal-/medical treatment as well as correlations between deep infiltrating endometriosis and treatment recommendation for surgery.</p><p><strong>Conclusion: </strong>The high VAS scores in dysmenorrhoea underline the degree of suffering of patients with endometriosis seeking consultation at a certified endometriosis centre. Most patients presented multiple phenotypes with uncorrelated symptoms and diverse as well as multimodal treatment options were indicated, underlining the complexity and individuality of the disease.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"3854"},"PeriodicalIF":2.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508412","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":"The sociopolitical discourse on health data sharing in Switzerland: lessons learned from 1992 to 2023 for present public trust building - a multi-method study.","authors":"Federica Zavattaro, Paola Daniore, Viktor Von Wyl, Felix Gille","doi":"10.57187/s.4277","DOIUrl":"10.57187/s.4277","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Public trust is central for the successful implementation of health data sharing initiatives, and it is partly shaped by the public's past experiences with the system. Understanding how these experiences have framed current public trust is essential to adequately inform trust-building measures in current and future health data sharing initiatives. The aim of the present study was to trace the evolution of the sociopolitical discourse surrounding health data sharing in Switzerland from 1992 to the present by identifying (1) key policy documents; (2) opinion-shaping and (3) negative events influencing public experience and trust in health data sharing over the last 31 years; (4) implementation obstacles and (5) lessons learned throughout this period. The analysis offers the opportunity to reflect on challenges in implementing data sharing initiatives and their impact on public trust, aiming to provide insights for guiding Swiss and European policymakers in designing future health data sharing initiatives while fostering public trust.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We designed a multi-method study comprising (A.I) a thematic analysis of online interviews with key stakeholders and (A.II) a scoping review of expert opinion papers to capture expert perspectives; (B) a policy analysis of government policies to comprehend the political trajectory of the health data sharing discourse; and (C) an analysis of news articles across eight major Swiss newspapers to trace the evolution of the media narrative around data sharing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;While the digitisation of private life in the early 2000s and the COVID-19 pandemic positively influenced Switzerland's sociopolitical discourse on health data sharing, triggering policy waves on the primary and secondary use of health data, recent setbacks with the Electronic Patient Dossier (EPD) initiative negatively impacted public trust. Key obstacles to EPD implementation were identified across policy, public, professional and technical levels, providing valuable lessons and actionable recommendations for improving the implementation of current and future health data sharing initiatives.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The sociopolitical discourse on health data sharing in Switzerland is mainly framed by past and present negative narratives on the EPD, compounded by national and international scandals. It is recommended to centralise coordination at the federal level and to foster stakeholder collaboration. To build and maintain public trust, comprehensive public engagement strategies and user-friendly solutions that offer citizens autonomy are needed. Also, careful narrative management is essential. Healthcare professionals should be actively involved in the development and policymaking process from the outset and provided with financial support to facilitate their digital transition. Considering the promising health data sharing initiatives under the DigiSanté p","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4277"},"PeriodicalIF":2.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508411","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":"A comparative cost analysis of 25-fraction vs 5-fraction postoperative radiotherapy regimens for breast cancer.","authors":"Dem Aliaj, Guido Schüpfer, Gabriela Studer","doi":"10.57187/s.3464","DOIUrl":"10.57187/s.3464","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the costs of 25-fraction vs 5-fraction postoperative radiotherapy regimens in breast cancer patients. Several clinical trials have confirmed at least comparable safety and efficacy of short hypofractionated partial and whole breast radiation regimens. This study was focused on providing detailed cost data and analysing the advantages or disadvantages of either treatment strategy for patients.</p><p><strong>Materials and methods: </strong>Calculations were performed based on patient and infra-structure data collected from the department of radiation oncology at Lucerne Cantonal Hospital (LUKS) in Switzerland from 1 July to 31 December 2020. The process maps were created to identify resources used for each radiation therapy option, from initial consultation to treatment completion. Cost comparisons represent the viewpoints of the hospital, insurance coverages and societal costs. To estimate hospital costs, time-driven activity-based costing was used, including equipment purchase and personnel costs. For insurers, estimates were based on the TARMED tariff system in Switzerland, which is used for billing ambulatory services and reflecting insurance coverage. The social cost was defined as productivity loss (e.g. absence from work) due to treatment appointments.</p><p><strong>Results: </strong>The 5-fraction regimens resulted in a total of 53% (972 CHF) lower hospital costs, including personnel and equipment resources, a 42% (3153 CHF) reduction of charges to insurers and a 62% (372 CHF) lower social burden in terms of productivity losses due to the patient's absence from work. The major findings from studies using 5-fraction regimens have shown a comparable result in terms of local control and treatment tolerance.</p><p><strong>Conclusion: </strong>A5-fraction radiotherapy regimen in breast cancer patients results in a lower cost than a conventional 25-fraction regimen.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"3464"},"PeriodicalIF":2.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508378","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":"Long-term impacts of Legionnaires' disease on health and wellbeing: rationale, study design and baseline findings of a matched cohort study (LongLEGIO).","authors":"Melina Bigler, Malina Vaucher, Manuel Wiederkehr, Sophia Brülisauer, Werner C Albrich, Sarah Dräger, Valentin Gisler, Isabel Akers, Daniel Mäusezahl","doi":"10.57187/s.4333","DOIUrl":"10.57187/s.4333","url":null,"abstract":"<p><strong>Background and study aims: </strong>Is there a post-acute infection syndrome for Legionnaires' disease? Legionnaires' disease is a form of primarily community-acquired pneumonia caused by Legionella spp. bacteria. Legionnaires' disease and other forms of bacterial community-acquired pneumonia may lead to persistent health and wellbeing impairments. It remains unclear whether these are caused by the community-acquired pneumonia-causing pathogen or the pneumonia itself. We present the rationale and design of a matched cohort study to investigate the persistent health impacts of Legionnaires' disease and compare them with persistent manifestations of other bacterial (Legionella test-negative) community-acquired pneumonia. We also present baseline characteristics of the study cohorts.</p><p><strong>Methods: </strong>Legionnaires' disease patients and Legionella test-negative community-acquired pneumonia patients with confirmed or clinically suspected bacterial aetiology were recruited from university and cantonal/regional hospitals and matched for sex, age, hospital type and date of diagnosis. Questionnaire-based interviews are conducted at baseline and 2, 6 and 12 months after the start of appropriate antibiotics. The questionnaires focus on patient-reported outcome measures and cover long-term symptoms, use of health services and health-related quality of life.</p><p><strong>Results: </strong>Between June 2023 and June 2024, 59 patients with Legionnaires' disease (59.3% male, median age 69 years [interquartile range [IQR]: 57-80]) and 60 patients with other bacterial (Legionella test-negative) community-acquired pneumonia (63.3% male, median age 69 years [IQR: 60-79]) were enrolled. Admission to the intensive care unit was required for 13.6 % of Legionnaires' disease patients and 8.3 % of other bacterial community-acquired pneumonia patients. Chronic kidney failure was more prevalent among Legionnaires' disease patients (15.3% vs 10.0%), while chronic obstructive pulmonary disease (20.0% vs 11.9%), malignancies (33.3% vs 13.6%) and an immunocompromised status (25.0% vs 13.6%) were more common in Legionella test-negative community-acquired pneumonia patients. Furthermore, Legionella test-negative community-acquired pneumonia patients reported lower baseline quality of life scores than Legionnaires' disease patients. Differences in pneumonia severity, comorbidities and self-reported quality of life scores will be accounted for in future analyses.</p><p><strong>Conclusions: </strong>The LongLEGIO study will contribute to research on post-acute infection syndromes and provide the data for a more holistic assessment of the disease burden of Legionnaires' disease.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4333"},"PeriodicalIF":2.1,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508405","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":"Determinants and health-related consequences of screen time in children and adolescents: post-COVID-19 insights from a prospective cohort study.","authors":"Viviane Richard, Elsa Lorthe, Roxane Dumont, Andrea Loizeau, Hélène Baysson, María-Eugenia Zaballa, Julien Lamour, Mayssam Nehme, Rémy P Barbe, Klara M Posfay-Barbe, Idris Guessous, Silvia Stringhini","doi":"10.57187/s.4247","DOIUrl":"10.57187/s.4247","url":null,"abstract":"<p><strong>Aims: </strong>This study aims to provide age-specific prevalence of time spent on-screen among children and adolescents, to identify its sociodemographic and family-related determinants and to assess its impact on physical and psychosocial health outcomes.</p><p><strong>Methods: </strong>Data was drawn from the SEROCoV-KIDS prospective cohort study, which includes randomly selected children living in Geneva, Switzerland. Daily screen time, sociodemographic and family characteristics were collected at baseline (December 2021 to June 2022). Physical and psychosocial health outcomes were measured at one-year follow-up.</p><p><strong>Results: </strong>Among 674 children (2-8 years old), 752 preadolescents (9-13 years old) and 434 adolescents (14-17 years old), median daily screen time was 0h29, 1h14 and 3h18, respectively. Lower parental education and poorer parenting practices were associated with higher screen time in all age groups. In children only, poor parental mental health (+14 minutes/day; 95% CI: 2-27) and work-family conflicts (+6 minutes/day; 95% CI: 2-10) were related to increased screen time. After adjustment, elevated screen time was associated with an increased likelihood of poor physical-, emotional- and school-related quality of life in preadolescents and adolescents and of social difficulties in adolescents one year later.</p><p><strong>Conclusion: </strong>Almost all children engage with screens, but those from socially disadvantaged backgrounds and with strained families face a heightened risk of prolonged screen time. The health consequences we identified call for close monitoring.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4247"},"PeriodicalIF":2.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508402","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":"Registry-based surveillance of paediatric home respiratory support in Switzerland: methodology and initial findings.","authors":"Sophie Guerin, Christian Bieli, Regula Corbelli, Thomas Ferry, Miriam Giaranna, Matthias Horn, Silvia Miano, Nicolas Regamey, Daniel Trachsel, Sylvain Blanchon","doi":"10.57187/s.4193","DOIUrl":"10.57187/s.4193","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The use of long-term home respiratory support in children has increased dramatically worldwide in recent decades. However, no national data are available in Switzerland since the last survey in 2001. In 2022, the national prospective Swiss Paediatric Home Respiratory Support (SwissPedHRS) registry was created on behalf of the Swiss Society of Paediatric Pulmonology, involving all centres caring for children with home respiratory support. Its main goal is to prospectively describe and study the population of children requiring home respiratory support in Switzerland. This first publication aims to present the SwissPedHRS methodology and describe the current paediatric population with home respiratory support in Switzerland and its evolution from 2001 to 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Inclusion criteria in the registry are age &lt;18 years, use of home respiratory support for ≥3 months and follow-up in Switzerland. The seven paediatric centres caring for patients with long-term home respiratory support in Switzerland participated, asking all their patients who met the criteria to participate. Each centre designated a local person to enter data collected from medical files into a dedicated database. Inclusions began in April 2022. Data from all patients included during the first year of the registry (i.e. until March 2023) were extracted, and the following data were analysed: sex; age at inclusion; underlying pathology; age, place, and context of home respiratory support initiation; decisive test leading to home respiratory support initiation; breathing disorder mechanism; and type of home respiratory support.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The registry included 146 patients, and the prevalence of children with home respiratory support in Switzerland was estimated at 11.9/100,000 children (59% boys, 41% girls). The most common underlying medical conditions were related to neuro-muscular (38%) and central nervous system (25%) diseases. The home respiratory support type was bilevel positive airway pressure (BPAP) for 67% of patients, continuous positive airway pressure (CPAP) for 32%, and high flow nasal cannula for 1%. Respiratory support was delivered invasively (via tracheostomy) for 14%. The median age at home respiratory support initiation was 6.6 years. Home respiratory support was initiated electively in 68% of patients and in acute situations (weaning failure after an acute respiratory exacerbation, neonatal hospitalisation, or surgery) in 32%. The place of initiation was either an outpatient clinic (19%), standard care unit (15%) or intensive/intermediate care unit (66%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;SwissPedHRS is the first national prospective registry dedicated to children with home respiratory support. It is a valuable resource for improving knowledge and, therefore, the management of children with home respiratory support. Analysis of the first year's data in the SwissPedHRS registry showed a ","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4193"},"PeriodicalIF":2.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508407","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":"Risk prediction for major postoperative complications in people with chronic spinal cord injury/disorder and stage III and IV pressure injury.","authors":"Carina Fähndrich, Armin Gemperli, Michael Baumberger, Michael Harder, Dirk J Schaefer, Reto Wettstein, Anke Scheel-Sailer","doi":"10.57187/s.3977","DOIUrl":"10.57187/s.3977","url":null,"abstract":"<p><strong>Background: </strong>Approximately 20% of flap surgeries in people with spinal cord injury/disorder and stage III and IV pressure injury result in a major complication requiring re-surgery. Although several factors are associated with postoperative complications according to the literature, there is no risk prediction model for major postoperative complications in the treatment of stage III and IV pressure injuries in people with spinal cord injury/disorder.</p><p><strong>Study aim: </strong>The study aims to predict the risk of major postoperative complications in people with spinal cord injury/disorder and stage III and IV pressure injury at hospital admission.</p><p><strong>Setting: </strong>The study was conducted in a Swiss acute and rehabilitation hospital for people with spinal cord injury/disorder that specialises in the treatment of people with spinal cord injury/disorder using the Basel Decubitus Approach.</p><p><strong>Methods: </strong>We performed a retrospective cohort study based on routinely collected clinical data in a Swiss hospital. Risk predictors for major postoperative complications during hospitalisation in pressure injuries over the sacrum/coccyx, ischium or trochanter between 01/2016 and 12/2022 were identified using a mixed effects logistic Bayesian LASSO analysis.</p><p><strong>Results: </strong>We included 252 treatment procedures in 167 individuals. Major complications occurred in 48 (19%) treatment procedures. Estimated glomerular filtration rate (eGFR) according to the cystatin formula (odds ratio [OR] 0.91, confidence interval [CI] 0.62-1.02), vitamin D (25-hydroxy vitamin D; OR 1.05, CI 0.98-1.23), vitamin B12 (OR 0.91, CI 0.74-1.05), sodium (OR 0.75, CI 0.16-1.05) and C-reactive protein (CRP; OR 0.98, CI 0.79-1.07) were found to be predictive of major complications at hospital admission.</p><p><strong>Conclusion: </strong>For the Basel Decubitus Approach, high levels of eGFR, vitamin B12 and sodium negatively affected major postoperative complications and should, therefore, be assessed during hospital stay. Further investigation is needed to determine the positive effect of high vitamin D and low CRP levels on major postoperative complications.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"3977"},"PeriodicalIF":2.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508408","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}