Chirurgie combinée de la cataracte et endophtalmie postopératoire aiguë en France de 2005 à 2014

Introduction : L’objectif de cette étude était d’analyser l’association entre chirurgie de la cataracte combinée avec des interventions chirurgicales de traitement du glaucome, vitréorétiniennes ou cornéennes et la survenue d’une (EPOA), de 2005 à 2014 en France. Méthodes : Les procédures de chirurgie de la cataracte par phacoémulsification et/ou de traitement du glaucome, vitréorétiniennes ou cornéennes ont été repérées par les codes correspondant de la classification commune des actes médicaux (CCAM) dans le programme de médicalisation des systèmes d’information (PMSI) du 1er janvier 2005 au 31 décembre 2014. L’EPOA était définie par la présence d’un diagnostic d’endophtalmie lors d’une h…

Mesure de la qualité des soins à partir de la base de données nationale du PMSI. Étude de la mortalité hospitalière après résections pulmonaires pour cancer

Introduction En 2009, les centres prenant en charge des cancers ont ete soumis a autorisation suite au premier plan cancer. Cinq annees plus tard, il nous paraissait interessant de connaitre l’impact de cette nouvelle organisation. L’objectif est d’estimer l’effet periode et d’evaluer l’influence du volume d’activite sur la mortalite. Methodes De la base de donnees PMSI ont ete extraits pour tous les patients ayant eu une resection pulmonaire pour cancer bronchique. Les caracteristiques des centres comprennent le volume d’activite annuel et le type d’etablissement : publiques non universitaires, prives et CHU. L’indicateur de qualite utilise est la mortalite hospitaliere definie comme tout …

Does age over 80 years have to be a contraindication for lung cancer surgery—a nationwide database study

IF 1.804 (2017); International audience; Background: Nowadays surgery remains the best treatment for localized lung cancer (LC). However, patients over 80 years old are often denied surgery because of the postoperative risk of death. This study aimed to estimate in-hospital mortality (IHM) and determine whether age over 80 is the most important predictor of IHM after LC surgery.Methods: From January 2005 to December 2015, 97,440 patients, including 4,438 patients over 80 years old, were operated on for LC and recorded in the French Administrative Database. Characteristics of patients, hospitals and surgery were analysed.Results: Crude IHM was 3.73% (n=3,639) and 7.77% (n=345) for the over 8…

Air pollution and stroke. A new modifiable risk factor is in the air

Abstract Evidence from epidemiological studies has demonstrated that outdoor air pollution is now a well-known major problem of public health, mainly in low and middle income countries. Contrasting with myocardial infarction , there are few data on the association of air pollution and stroke. Methods We propose a narrative literature review of the effects and the underlying biological mechanisms of short- and long-term exposure to air pollutants on stroke risk and mortality, using the following key-words: stroke, cerebrovascular events, ischemic and haemorrhage stroke, transient ischaemic attack , mortality, air pollution and air pollutants. Results Twenty-one papers were selected. Air poll…

Multiple pregnancies and environmental exposure: An impact of air pollution on fetal growth?

Introduction Multiple pregnancies display all the complications of singletons, but in highest frequencies, especially for fetal growth abnormalities. In singletons, air pollution seems to be negatively associated with fetal growth. A similar relationship in multiple pregnancies can be expected. However, multiple pregnancies are systematically excluded from the studies of the impact of air pollution on pregnancy outcomes. This study aims to analyze in a population of multiple pregnancies the relationship between fetal growth restriction (FGR), small for gestational age (SGA) and environmental chronic exposure to air pollution in moderately polluted cities. Methods All the multiple pregnancie…

Multiple pregnancies and air pollution in moderately polluted cities: Is there an association between air pollution and fetal growth?

Background: Multiple pregnancies (where more than one fetus develops simultaneously in the womb) are systematically excluded from studies of the impact of air pollution on pregnancy outcomes. This study aims to analyze, in a population of multiple pregnancies, the relationship between fetal growth restriction (FGR), small for gestational age (SGA) and exposure to air pollution in moderately polluted cities. Methods: All women with multiple pregnancies living in the city of Besançon or in the urban area of Dijon and who delivered at a university hospital between 2005 and 2009 were included. FGR and SGA were obtained from medical records. Outdoor residential nitrogen dioxide (NO2) exposure wa…

T080 - The incidence of rhegmatogenous retinal detachment in France from 2010 to 2016: seasonal and geographical variations

Hospital Readmission after Major Pulmonary Resection for Lung Cancer in France: A Nationwide Medico-Administrative Database

Objectives: After major pulmonary resection for lung cancer, hospital readmission is considered an indicator of the quality of care. Our main objective was to define the readmission rate at 30 days after pulmonary resection. Secondary objectives were to determine the causes and predictive factors. Methods: Data for all patients operated for lung cancer were extracted from the national medico-administrative database of the Programme de Medicalisation des Systemes d'Information (PMSI). Thirty-days hospital readmission was defined as any new hospitalization within 30 days after discharge from the surgical department following major lung resection, regardless of the reason for readmission. Resu…

Early cardiovascular events in women with a history of gestational diabetes mellitus

International audience; Background: The effect of gestational diabetes mellitus (GDM) on cardiovascular diseases (CVD) is not assessed within the first 10 years postpartum, regardless of subsequent diabetes. The aim of this study was to determine the risk of CVD events related to GDM within 7 years of postpartum.Methods: This nationwide population-based study of deliveries in 2007 and 2008 with a follow-up of 7 years was based on data from the French medico-administrative database. Two groups were formed: women with a history of GDM and women without GDM or previous diabetes. CVD included angina pectoris, myocardial infarction, stroke, heart bypass surgery, coronary angioplasty, carotid end…

Précocité des pathologies cardiovasculaires chez les femmes ayant un antécédent de diabète gestationnel

Introduction La precocite de dysfonctions cardiaques et du syndrome metabolique apres une grossesse marquee par un diabete gestationnel (DG) est un sujet d’actualite. L’objectif de l’etude etait de determiner, a partir des donnees hospitalieres, l’association entre antecedent de DG et maladies cardiovasculaires (MCV) dans les six annees du post-partum. Methodes Cette etude concerne l’ensemble des accouchements reperes dans la base nationale du PMSI en 2007 et 2008. Parmi ces femmes, ont ete distinguees celles ayant presente un DG au cours de leur grossesse (en 2007 ou 2008), et celles sans DG. Ces femmes ont ete suivies via le chainage des resumes PMSI, jusqu’en 2013. Une analyse par regres…

Does low to moderate environmental exposure to noise and air pollution influence preterm delivery in medium-sized cities?

International audience; Background: Preterm birth (PB) is an important predictor of childhood morbidity and educational performance. Beyond the known risk factors, environmental factors, such as air pollution and noise, have been implicated in PB. In urban areas, these pollutants coexist. Very few studies have examined the effects of multi-exposure on the pregnancy duration. The objective of this study was to analyse the relationship between PB and environmental chronic multi-exposure to noise and air pollution in medium-sized cities.Methods: A case-control study was conducted among women living in the city of Besançon (121 671 inhabitants) or in the urban unit of Dijon (243 936 inhabitants…

Epidemiology of acute endophthalmitis after ophthalmological procedures, a national database description

International audience; Purpose : Although rare, endophthalmitis is a severe complication of ophthalmological procedures. The incidence of endophthalmitis following cataract, glaucoma, vitreoretinal surgeries, and intravitreal injections has previously been described in large-scale studies, but no data is available on the proportion of causative procedures. We aimed to describe longitudinally the causes of endophthalmitis at a national scale using the French medico-administrative database.Methods : The SNIIRAM (French national inter-scheme insurance database) collects all data of medical expenditures and procedures performed in France. We extracted acute endophthalmitis occurring 42 days af…

Antibiotic prophylaxis and intravitreal injections: impact on the incidence of acute endophthalmitis

International audience

Low risk of intracranial emergency in patients with minor head injury treated with antiplatelet therapy.

Is an activity volume threshold really realistic for lung cancer resection?

IF 1.804 (2017); International audience; Background:We analyzed volume as a continuous variable to estimate threshold, which is a methodology rarely seen in the literature. The objective of this work was to assess hospital volume for lung cancer (LC) surgery and to establish the associated threshold for acceptable in-hospital mortality (IHM). Data was obtained from the French national medico-administrative database.Methods:From January 2005 to December 2016, data from 108,571 patients operated for LC in France were collected from the national administrative database. To estimate the volume threshold, hierarchical logistic regression models were developed.Results:The crude IHM rate was 5.2% …

Cancer du sein chez l’homme en France

Introduction En France, il n’existe pas de donnees decrivant les caracteristiques cliniques ainsi que les traitements des hommes atteints de cancer du sein. L’objectif de cette etude etait de decrire les caracteristiques cliniques et les traitements des hommes atteints de cancer du sein en France entre 2007 et 2013 et identifies grâce aux donnees du PMSI national. Methodes Les cas de cancer du sein infiltrant chez l’homme entre 2007 et 2013 ont ete identifies grâce aux donnees du PMSI national. La prevalence par annee a ete calculee en faisant le rapport entre le nombre de cas prevalents par annee et la population francaise pour l’annee correspondante. Les donnees cliniques : âge, la presen…

Evolution of Corneal Graft Survival Over a 30-Year Period and Comparison of Surgical Techniques: A Cohort Study.

Purpose To compare graft survival between 3 10-year periods and according to surgical techniques performed in the last years. Design Cohort study. Methods setting: Regional center (Besancon University Hospital, France). patients: All 1132 patients operated on between 1983 and 2014. Graft and patient baseline characteristics, risk factors for failure, surgical procedures, and postoperative corneal status were collected. main outcome measures: Five-year survival rate in the whole cohort; 1-year and 3-year survival rates, respectively, among 88 patients with endothelial dystrophy (ED) or postoperative bullous keratopathy (PBK) operated on using endothelial lamellar keratoplasty (ELK) or penetr…

Incidence de l’endophtalmie aiguë postopératoire après chirurgie de la cataracte par phacoémulsification et injection intracamérulaire d’antibiotiques, en France de 2005 à 2014

National audience; Introduction La chirurgie de la cataracte est l’intervention la plus fréquente dans le monde. Parmi ses complications, l’endophtalmie aiguë postopératoire (EAPO) est une infection intraoculaire sévère, qui peut conduire à la cécité. Les objectifs étaient de déterminer l’incidence de l’EAPO après chirurgie de la cataracte par phacoémulsification en France de 2005 à 2014 et d’analyser l’association entre injection intracamérulaire d’antibiotique (IICA) et EAPO. Méthodes Tous les patients hospitalisés pour une chirurgie de la cataracte en France entre le 1er janvier 2005 et le 31 décembre 2014 ont été identifiés dans le programme de médicalisation des systèmes d’information …

Impact of video-assisted thoracic surgery approach on postoperative mortality after lobectomy in octogenarians.

The number of octogenarians who present with localized lung cancer eligible for surgical resection is increasing. Video-assisted thoracic surgery lobectomy has been widely accepted, but the potential benefit in octogenarians is not well established, especially for postoperative mortality. This study aimed to assess the impact of a video-assisted thoracic surgery approach on postoperative mortality after lobectomy for lung cancer in octogenarians.From January 2005 to December 2016, all patients aged more than 80 years who received lobectomy treatment for lung cancer were retrieved from the French Administrative Database. The end point was 30-day postoperative death. A propensity score was ge…

Dépistage précoce du diabète après une grossesse marquée par un diabète gestationnel

Introduction Les femmes ayant presente un diabete gestationnel (DG) ont ulterieurement un risque eleve de diabete de type 2 (DT2). Le taux de depistage du DT2 apres un antecedent de DG est estime entre 3,4 et 92,6 % selon les etudes. L’objectif de notre etude etait de decrire le depistage precoce du DT2 apres une grossesse marquee par un DG entre 2007 et 2013. Methodes L’etude s’est interessee aux femmes ayant presente un DG a partir de l’echantillon generaliste des beneficiaires des donnees de l’assurance maladie obligatoire. Dans les donnees hospitalieres, les accouchements ont ete reperes a partir des codes Z37 de la CIM-10 et le diabete gestationnel a partir du code O24.4. Les examens d…

Incidence de l’endophtalmie postopératoire aiguë après chirurgie maculaire en France entre 2006 et 2016

Etat de la question L’objectif de cette etude nationale etait de rapporter l’incidence de l’endophtalmie postoperatoire aigue (EPOA) apres chirurgie maculaire en France entre 2006 et 2016 et d’identifier si le passage a la vitrectomie transconjonctivale en 2010–2011 etait associe a une modification du risque d’EPOA en France. Materiel et methodes Toutes les interventions chirurgicales pour membrane epiretinienne ou trou maculaire realisees en France entre janvier 2006 et octobre 2016 ont ete incluses a partir du PMSI. L’EPOA etait identifiee dans les 42 jours apres la chirurgie maculaire. Les effets du changement de technique (periode), des facteurs demographiques et cliniques sur la surven…

Vulnerability during pregnancy in an urban environment : do environmental and individual risk factors cumulate?

International audience; Apart from demographic, socio-economic, behavioral, nutritional and medico-obstetrical factors, environmental factors have been suggested to be associated with adverse pregnancy outcomes, such as preterm birth, low birth weight or hypertensive disorders. According to a recent review of the literature, there is some suggestive evidence of adverse associations with environmental noise especially for low birth weight. However, the way these individual and environmental vulnerabilities combine has been scarcely studied. The objective of this study was to describe the accumulation of individual, socio-economics, medical and environmental vulnerability markers and to asses…

Exposition environnementale au bruit et à la pollution de l'air au cours de la grossesse avec comorbidités associées

L’objectif était d’analyser le lien entre l’exposition environnementale au bruit et à la pollution de l’air en milieu urbain et la prématurité chez les femmes dont le risque d’accouchement prématuré était augmenté par la présence d’une ou plusieurs comorbidités. Méthode. Une étude cas-témoins a été conduite sur les grossesses uniques accompagnées d’au moins une comorbidité. Les accouchements ont eu au CHU de Besançon ou de Dijon entre 2005 et 2009. Le niveau sonore de nuit (Lnight en façade du bâtiment d’habitation) et la concentration en dioxyde d’azote (NO2) dans les 50 m autour de l’habitation ont été modélisés à l’adresse déclarée au moment de l’accouchement. Une régression logistique c…

Prevalence of patients hospitalised for male breast cancer in France using the French nationwide hospital administrative database

BACKGROUND Breast cancer (BC) in men is a rare and neglected disease representing <1% of all cancers in men and only 1% of all incident BC in western countries. OBJECTIVE This study aimed to describe trends in the prevalence of patients hospitalised for male BC in France from 2009 to 2013, using the national administrative database (PMSI). METHODS We included all men aged ≥18 admitted to hospital for BC during this period and estimated the prevalence of male breast cancer hospitalised in France over 5 years. We also describe clinical characteristics and treatments in men with surgery for BC over the 5-year period of the study. RESULTS The prevalence of patients hospitalised for BC significa…

In-hospital mortality following lung cancer resection: nationwide administrative database.

Our aim was to determine the effect of a national strategy for quality improvement in cancer management (the “Plan Cancer”) according to time period and to assess the influence of type and volume of hospital activity on in-hospital mortality (IHM) within a large national cohort of patients operated on for lung cancer.From January 2005 to December 2013, 76 235 patients were included in the French Administrative Database. Patient characteristics, hospital volume of activity and hospital type were analysed over three periods: 2005–2007, 2008–2010 and 2011–2013.Global crude IHM was 3.9%: 4.3% during 2005–2007, 4% during 2008–2010 and 3.5% during 2011–2013 (p&lt;0.01). 296, 259 and 209 centres p…

Noise annoyance in urban children: a cross-sectional population-based study

International audience; Acoustical and non-acoustical factors influencing noise annoyance in adults have been well-documented in recent years; however, similar knowledge is lacking in children. The aim of this study was to quantify the annoyance caused by chronic ambient noise at home in children and to assess the relationship between these children0s noise annoyance level and individual and contextual factors in the surrounding urban area. A cross sectional population-based study was conducted including 517 children attending primary school in a European city. Noise annoyance was measured using a self-report questionnaire adapted for children. Six noise exposure level indicators were built…