RESUMO
Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport-specific or setting-specific consensus statements on sports injury (and, eventually, illness) epidemiology to date. Our objective was to further strengthen consistency in data collection, injury definitions and research reporting through an updated set of recommendations for sports injury and illness studies, including a new Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist extension. The IOC invited a working group of international experts to review relevant literature and provide recommendations. The procedure included an open online survey, several stages of text drafting and consultation by working groups and a 3-day consensus meeting in October 2019. This statement includes recommendations for data collection and research reporting covering key components: defining and classifying health problems; severity of health problems; capturing and reporting athlete exposure; expressing risk; burden of health problems; study population characteristics and data collection methods. Based on these, we also developed a new reporting guideline as a STROBE Extension-the STROBE Sports Injury and Illness Surveillance (STROBE-SIIS). The IOC encourages ongoing in- and out-of-competition surveillance programmes and studies to describe injury and illness trends and patterns, understand their causes and develop measures to protect the health of the athlete. Implementation of the methods outlined in this statement will advance consistency in data collection and research reporting.
Assuntos
Traumatismos em Atletas/epidemiologia , Lista de Checagem , Projetos de Pesquisa Epidemiológica , Medicina Esportiva/estatística & dados numéricos , Traumatismos em Atletas/classificação , Doença/classificação , Humanos , Medicina Esportiva/classificaçãoRESUMO
PURPOSE: To determine whether the risk of adverse events and readmission after non-arthroplasty shoulder surgery is influenced by the outpatient setting of surgical care and to identify risk factors associated with these adverse events. METHODS: The Humana Claims Database was queried for all patients undergoing arthroscopic shoulder surgery and related open procedures in the hospital-based outpatient department (HOPD) or ambulatory surgical center (ASC) setting, using the PearlDiver supercomputer. Arthroplasty procedures were excluded because they carry a risk profile different from that of other outpatient surgical procedures. Outcome variables included unanticipated admission after surgery, readmission, deep vein thrombosis, pulmonary embolism, and wound infection within 90 days of surgery. The ASC and HOPD cohorts were propensity score matched, and outcomes were compared between them. Finally, logistic regression models were created to identify risk factors associated with unplanned admission after surgery. RESULTS: A total of 84,658 patients met the inclusion criteria for the study: 28,730 in the ASC cohort and 56,819 in the HOPD cohort. The rates of all queried outcomes were greater in the HOPD cohort and achieved statistical significance. Sex, region, race, insurance status, comorbidity burden, anesthesia type, and procedural type were included in the regression analysis of unplanned admission. Factors associated with unplanned admission included increasing Charlson Comorbidity Index (odds ratio [OR], 1.16; 95% confidence interval [CI], 1.12-1.17; P < .001); HOPD service location (OR, 2.37; 95% CI, 2.18-2.58; P < .001); general anesthesia (OR, 1.34; 95% CI, 1.08-1.59; P = .008); male sex (OR, 2.58; 95% CI, 2.17-3.15; P = .007); and open surgery (OR, 2.35; 95% CI, 1.90-2.61; P < .001). CONCLUSIONS: The lower rates of perioperative morbidity in the ASC cohort suggest that proper patient selection is taking place and lends reassurance to surgeons who are practicing or are considering practicing in an ASC. Patients to whom some or all the risk factors for unplanned admission apply (male sex, higher comorbidity burden, open surgery) may be more suitable for HOPDs because admission from an ASC can be difficult and potentially unsafe. LEVEL OF EVIDENCE: Level III, comparative study.
Assuntos
Procedimentos Cirúrgicos Ambulatórios/efeitos adversos , Procedimentos Ortopédicos/efeitos adversos , Articulação do Ombro/cirurgia , Adulto , Idoso , Procedimentos Cirúrgicos Ambulatórios/métodos , Artroscopia/efeitos adversos , Artroscopia/métodos , Estudos de Coortes , Comorbidade , Bases de Dados Factuais , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Procedimentos Ortopédicos/métodos , Readmissão do Paciente/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Embolia Pulmonar/epidemiologia , Embolia Pulmonar/etiologia , Estudos Retrospectivos , Fatores de Risco , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia , Resultado do Tratamento , Estados Unidos/epidemiologia , Trombose Venosa/epidemiologia , Trombose Venosa/etiologiaRESUMO
In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric ACL injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery & Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions.
Assuntos
Lesões do Ligamento Cruzado Anterior/diagnóstico , Lesões do Ligamento Cruzado Anterior/prevenção & controle , Lesões do Ligamento Cruzado Anterior/cirurgia , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/prevenção & controle , Traumatismos em Atletas/cirurgia , Lesões do Ligamento Cruzado Anterior/reabilitação , Traumatismos em Atletas/reabilitação , Criança , Consenso , Técnica Delphi , Humanos , Pediatria , Sociedades , EsportesRESUMO
In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric anterior cruciate ligament (ACL) injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery and Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America, and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis, and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions.
Assuntos
Lesões do Ligamento Cruzado Anterior/diagnóstico , Lesões do Ligamento Cruzado Anterior/terapia , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/terapia , Pediatria , Medicina Esportiva/normas , Comitês Consultivos , Reconstrução do Ligamento Cruzado Anterior/métodos , Pesquisa Biomédica , Tomada de Decisão Clínica , Técnica Delphi , Diagnóstico por Imagem , Epífises/crescimento & desenvolvimento , Humanos , Consentimento Livre e Esclarecido , Articulação do Joelho/crescimento & desenvolvimento , Medidas de Resultados Relatados pelo Paciente , Exame Físico , Modalidades de Fisioterapia , Volta ao Esporte , Prevenção SecundáriaRESUMO
ESSKA is constantly committed to promoting the improvement of scientific quality through the publication of books and the organization of dedicated conferences. In line with this commitment, this interview paper was crated with the aim of being useful for all the young scientists and orthopaedics keen in musculoskeletal and sport medicine research. Three Editors from the most important journals in our field were invited to participate: Jon Karlsson from Knee Surgery Sport Traumatology and Arthroscopy, Bruce Reider from The American Journal of Sport Medicine and Edward Wojtys from Sports Health.
RESUMO
BACKGROUND: Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport- or setting-specific consensus statements on sports injury (and, eventually, illnesses) epidemiology to date. OBJECTIVE: To further strengthen consistency in data collection, injury definitions, and research reporting through an updated set of recommendations for sports injury and illness studies, including a new Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist extension. STUDY DESIGN: Consensus statement of the International Olympic Committee (IOC). METHODS: The IOC invited a working group of international experts to review relevant literature and provide recommendations. The procedure included an open online survey, several stages of text drafting and consultation by working groups, and a 3-day consensus meeting in October 2019. RESULTS: This statement includes recommendations for data collection and research reporting covering key components: defining and classifying health problems, severity of health problems, capturing and reporting athlete exposure, expressing risk, burden of health problems, study population characteristics, and data collection methods. Based on these, we also developed a new reporting guideline as a STROBE extension-the STROBE Sports Injury and Illness Surveillance (STROBE-SIIS). CONCLUSION: The IOC encourages ongoing in- and out-of-competition surveillance programs and studies to describe injury and illness trends and patterns, understand their causes, and develop measures to protect the health of the athlete. The implementation of the methods outlined in this statement will advance consistency in data collection and research reporting.
RESUMO
A stringent outcome assessment is a key aspect of establishing evidence-based clinical guidelines for anterior cruciate ligament (ACL) injury treatment. To establish a standardized assessment of clinical outcome after ACL treatment, a consensus meeting including a multidisciplinary group of ACL experts was held at the ACL Consensus Meeting Panther Symposium, Pittsburgh, Pennsylvania, USA, in June 2019. The aim was to establish a consensus on what data should be reported when conducting an ACL outcome study, what specific outcome measurements should be used, and at what follow-up time those outcomes should be assessed. The group reached consensus on 9 statements by using a modified Delphi method. In general, outcomes after ACL treatment can be divided into 4 robust categories: early adverse events, patient-reported outcomes (PROs), ACL graft failure/recurrent ligament disruption, and clinical measures of knee function and structure. A comprehensive assessment after ACL treatment should aim to provide a complete overview of the treatment result, optimally including the various aspects of outcome categories. For most research questions, a minimum follow-up of 2 years with an optimal follow-up rate of 80% is necessary to achieve a comprehensive assessment. This should include clinical examination, any sustained reinjuries, validated knee-specific PROs, and health-related quality of life questionnaires. In the midterm to long-term follow-up, the presence of osteoarthritis should be evaluated. This consensus paper provides practical guidelines for how the aforementioned entities of outcomes should be reported and suggests the preferred tools for a reliable and valid assessment of outcome after ACL treatment.
Assuntos
Instabilidade Articular , Luxação do Ombro , Articulação do Ombro , Humanos , Artroscopia , Recidiva , Estudos RetrospectivosRESUMO
In October 2017, the International Olympic Committee hosted an international expert group of physical therapists and orthopaedic surgeons who specialize in treating and researching pediatric anterior cruciate ligament (ACL) injuries. The purpose of this meeting was to provide a comprehensive, evidence-informed summary to support the clinician and help children with ACL injury and their parents/guardians make the best possible decisions. Representatives from the following societies attended: American Orthopaedic Society for Sports Medicine; European Paediatric Orthopaedic Society; European Society for Sports Traumatology, Knee Surgery, and Arthroscopy; International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine; Pediatric Orthopaedic Society of North America; and Sociedad Latinoamericana de Artroscopia, Rodilla, y Deporte. Physical therapists and orthopaedic surgeons with clinical and research experience in the field and an ethics expert with substantial experience in the area of sports injuries also participated. This consensus statement addresses 6 fundamental clinical questions regarding the prevention, diagnosis, and management of pediatric ACL injuries. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision making with children and the potential long-term ramifications of the injury.