Deaths Associated with Ankylosing Spondylitis in France from 1969 to 2009.

Objective.To describe deaths for which ankylosing spondylitis (AS) was on death certificates in France.Methods.Death certificates in which AS was indicated were evaluated. Standard mortality ratio (SMR) was assessed.Results.AS appeared in 2940 death certificates. The mortality rate of AS seemed stable. The most frequent initial causes were diseases of the circulatory system [28.3% in the International Classification of Diseases, 10th ed (ICD-10)]. SMR adjusted for age and sex were 2.1 (95% CI 1.45–2.91) for infections and 0.43 (0.36–0.5) for cancers (ICD-10 period).Conclusion.This study found an increase in mortality from infectious and external causes of death; conversely, patients with AS…

La question de l'accessibilité dans les décisions des médecins régulateurs des centres 15

National audience

Les incidences du sentiment de culpabilité sur la demande d’aide de l’aidant familial

Resume Cet article presente les principaux resultats d’une recherche, menee a partir d’une approche quantitative et qualitative, sur le sentiment de culpabilite de l’aidant familial. Cette recherche postule que le sentiment de culpabilite tend a freiner la demande d’aide de l’aidant familial qui prend en charge un proche atteint d’une pathologie dementielle, lorsque ce dernier vit a domicile. Elle vise a differencier les ressorts et les manifestations de la culpabilite, selon la place de l’aidant familial dans la relation d’aide. Mais elle interroge aussi les liens existants, entre la culpabilite et l’angoisse de perte, dans l’espace psychique et intersubjectif, a la lumiere du travail du p…

L'aide à la décision dans la régulation médicale téléphonique : l'apport du géographe

International audience

Proceedings of Réanimation 2017, the French Intensive Care Society International Congress

To assess hemodynamic disturbances to the ostia of the renal arteries generated by the implantation of EVAR with a suprarenal fixation

Abstract Introduction: The treatment of abdominal aortic aneurysm (AAA) is increasingly performed via endovascular aneurysm repair (EVAR). Different types of fixation are possible with EVAR, i.e., below (infrarenal fixation) or above (suprarenal fixation) the renal arteries. Hemodynamic alterations in renal arterial flow with suprarenal (SR) fixation remain to be demonstrated. The IFIXEAR (Impact of Supra-renal Fixation of EVAR on Hemodynamics of Renal Arteries) study is designed to assess the hemodynamic effects at the ostia of at least 1 renal artery, generated immediately post-surgery by the implantation of an aortic stent with SR fixation. Methods: IFIXEAR is a prospective, 2 center stu…

Validation and update of the thoracic surgery scoring system (Thoracoscore) risk model.

Abstract OBJECTIVES The performance of prediction models tends to deteriorate over time. The purpose of this study was to update the Thoracoscore risk prediction model with recent data from the Epithor nationwide thoracic surgery database. METHODS From January 2016 to December 2017, a total of 56 279 patients were operated on for mediastinal, pleural, chest wall or lung disease. We used 3 recommended methods to update the Thoracoscore prediction model and then proceeded to develop a new risk model. Thirty-day hospital mortality included patients who died within the first 30 days of the operation and those who died later during the same hospital stay. RESULTS We compared the baseline patient…

Comparison of Epithor clinical national database and medico-administrative database to identify the influence of case-mix on the estimation of hospital outliers

BackgroundThe national Epithor database was initiated in 2003 in France. Fifteen years on, a quality assessment of the recorded data seemed necessary. This study examines the completeness of the data recorded in Epithor through a comparison with the French PMSI database, which is the national medico-administrative reference database. The aim of this study was to demonstrate the influence of data quality with respect to identifying 30-day mortality hospital outliers.MethodsWe used each hospital's individual FINESS code to compare the number of pulmonary resections and deaths recorded in Epithor to the figures found in the PMSI. Centers were classified into either the good-quality data (GQD) …

L’aide à la décision dans la régulation médicale téléphonique: l'apport du géographe

International audience