1.Health-related quality of life in Singapore: Population norms for the EQ-5D-5L and EORTC QLQ-C30.
Jaclyn TAN ; Mervyn Jr LIM ; Ravindran KANESVARAN ; Richard NORMAN ; Wen Yee CHAY ; Mohamad Farid Bin HARUNAL RASHID ; Mihir GANDHI ; Madeleine KING ; Nan LUO
Annals of the Academy of Medicine, Singapore 2025;54(3):147-159
INTRODUCTION:
Comparison of patient health-related quality of life (HRQOL) scores to a reference group is needed to quantify the HRQOL impact of disease or treatment. This study aimed to establish population norms for 2 HRQOL questionnaires-EuroQol 5-dimension 5-level questionnaire (EQ-5D-5L) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core Question-naire 30 (EORTC QLQ-C30) according to age, sex and ethnicity-and to explore relationships between the EQ-5D-5L, EORTC QLQ-C30 and sociodemographic characteristics. We used a representative sample of adult Singapore residents aged 21 years and above.
METHOD:
This study used data collected from a cross-sectional household survey in which 600 adult Singaporeans completed questions on sociodemo-graphic characteristics-the EQ-5D-5L and the EORTC QLQ-C30. Multiple linear regression analyses were conducted to explore associations between sociodemographic characteristics, the EQ-5D-5L scores and the EORTC QLQ-C30 scores. Regression-based population norms were computed for each subgroup using a post-stratification method.
RESULTS:
In multiple linear regression analysis, age was significantly associated with EQ-5D-5L index and visual analogue scale (VAS) scores, while no sociodemographic characteristics were significantly associated with EORTC QLQ-C30 summary scores. The normative EQ-5D-5L index and VAS scores decreased in adults aged 65 years and above, and EQ-5D-5L index scores were slightly lower in females than males and in non-Chinese than Chinese. The normative EORTC QLQ-C30 summary scores were slightly higher in Chinese than in the non-Chinese group and in the 45-64 age group than other age groups.
CONCLUSION
This study provides population norms for the EQ-5D-5L and EORTC QLQ-C30 for the general adult population in Singapore. Future studies of patient populations in Singapore using EQ-5D-5L or QLQ-C30 can use these normative data to interpret the HRQOL data collected.
Humans
;
Quality of Life
;
Singapore
;
Male
;
Female
;
Middle Aged
;
Adult
;
Cross-Sectional Studies
;
Aged
;
Surveys and Questionnaires
;
Young Adult
;
Health Status
;
Age Factors
;
Linear Models
;
Aged, 80 and over
2.Preterm birth trends and risk factors in a multi-ethnic Asian population: A retrospective study from 2017 to 2023, can we screen and predict this?
Rachel Phoy Cheng CHUN ; Hiu Gwan CHAN ; Gilbert Yong San LIM ; Devendra KANAGALINGAM ; Pamela PARTANA ; Kok Hian TAN ; Tiong Ghee TEOH ; Ilka TAN
Annals of the Academy of Medicine, Singapore 2025;54(5):296-304
INTRODUCTION:
Preterm birth (PTB) remains a leading cause of perinatal morbidity and mortality worldwide. Understanding Singapore's PTB trends and associated risk factors can inform effective strategies for screening and intervention. This study analyses PTB trends in Singapore from 2017 to 2023, identifies risk factors in this multi-ethnic population and evaluates a predictive model for PTB.
METHOD:
A retrospective analysis of all PTBs between 22+0 and 36+6 weeks of gestation, from 1 January 2017 to 31 December 2023, was performed by extracting maternal and neonatal data from electronic medical records. These PTBs were taken from the registry of births for Singapore and SingHealth cluster data. Cochran- Armitage trend test and multinomial logistic regression were used. An extreme gradient boosting (XGBoost) model was developed to test and predict the risk of PTB.
RESULTS:
The PTB rate in Singapore did not show a significant change. However, there was modest downward trend in the SingHealth population from 11.3% to 10.2%, mainly in late spontaneous PTBs (sPTBs). sPTBs accounted for ∼60% of PTBs. Risk factors for very/extreme sPTB included Chinese ethnicity, age ≥35 years, body mass index (BMI) ≥23 kg/m2, being unmarried, primiparity, twin pregnancy and maternal blood group AB. The XGBoost model achieved an area under the receiver operating characteristic curve of 0.75, indicating moderate ability to predict PTB.
CONCLUSION
The overall PTB rate in Singapore has not improved. This study underscores the importance of local factors, particularly advanced maternal age, BMI, primiparity, unmarried, Chinese ethnicity and maternal blood group AB influencing PTB risk. Artificial intelligence methods show promise in improving PTB risk stratification, ultimately supporting personalised care and intervention.
Humans
;
Singapore/epidemiology*
;
Retrospective Studies
;
Female
;
Risk Factors
;
Premature Birth/ethnology*
;
Pregnancy
;
Adult
;
Infant, Newborn
;
Asian People/statistics & numerical data*
;
Gestational Age
;
Body Mass Index
;
Maternal Age
;
Logistic Models
;
Ethnicity
3.Analysis of demographic and clinical characteristics of 744 inpatients with osteoporotic vertebral compression fractures.
Bo ZHANG ; Wenlong MA ; Weihua FENG ; Yanjin WANG ; Hanjie ZHUO ; Yihang QIAO ; Haobo LIANG ; Zhenjie ZHAO
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(3):354-361
OBJECTIVE:
To analyze the demographic and clinical characteristics of inpatients with osteoporotic vertebral compression fractures (OVCF) and provide a basis for clinical prevention and treatment.
METHODS:
A retrospective analysis was performed on the clinical data of 744 inpatients diagnosed with OVCF between January 2017 and December 2021 who met the inclusion criteria. Among them, 146 were male and 598 were female, with age ranging from 50 to 95 years (mean, 69.37 years). The demographic characteristics (gender, age, ethnicity, occupation, regional distribution, urban-rural distribution, and seasonal incidence) and clinical features [causes of injury, history of vertebral fractures, smoking and drinking history in males, comorbidities (hypertension, diabetes, coronary atherosclerotic heart disease, cerebral infarction), body mass index (BMI), blood lipid levels, menopausal age in females, vertebral bone mineral density T-value, number of vertebral fractures, and fracture segment distribution] of OVCF patients were analyzed. Multiple linear regression was used to analyze the independent risk factors of vertebral osteoporosis.
RESULTS:
The demographic analysis indicated that female patients with OVCF were significantly younger than male patients ( P<0.05). Significant differences were observed in the age distribution of OVCF between males and females ( P<0.05), with the highest proportion of male patients in the 70-79 years group (37.0%) and the highest proportion of female patients in the 60-69 years group (40.0%). From 2017 to 2021, the age of onset for OVCF gradually increased, with a similar trend observed for both genders. The distribution of occupations between genders also showed significant differences ( P<0.05); with the top three occupations for males being farmers (48.6%), retirees (24.7%), and workers (13.7%), while for females, the leading occupations were farmers (51.5%), retirees (19.4%), and service workers (10.0%). Female OVCF patients had higher BMI, vertebral bone mineral density T-value, history of vertebral fractures, hypertension prevalence, and blood lipid levels compared to male patients ( P<0.05). No significant difference between the males and the females was found in ethnicity, seasonal distribution, regional distribution, urban-rural distribution, causes of injury, number of vertebral fractures, or prevalence of comorbidities (except hypertension) ( P>0.05). Among the 744 OVCF patients, a total of 1 309 vertebrae were involved, with 628 thoracic vertebrae (48.0%) and 681 lumbar vertebrae (52.0%). The most common fracture segments were L 1 (22.5%), T 12 (21.2%), followed by L 2 (12.2%) and T 11 (10.2%). No significant gender difference was observed in the distribution of fracture segments ( P>0.05). Multiple linear regression analysis indicated that older age, female, and lower BMI were independent risk factors for vertebral osteoporosis ( P<0.05).
CONCLUSION
The age of onset of OVCF patients is increasing year by year. The number of fractured vertebral bodies, age distribution of morbidity, occupational distribution, BMI, history of vertebral fracture, hypertension, and blood lipid levels are related to gender. The occurrence of OVCF is mainly in the thoracolumbar segment. The female, older age, and lower BMI are independent risk factors of osteoporosis.
Humans
;
Male
;
Female
;
Aged
;
Middle Aged
;
Retrospective Studies
;
Spinal Fractures/etiology*
;
Aged, 80 and over
;
Osteoporotic Fractures/etiology*
;
Fractures, Compression/etiology*
;
Risk Factors
;
Bone Density
;
China/epidemiology*
;
Osteoporosis/epidemiology*
;
Comorbidity
;
Inpatients
;
Sex Factors
;
Age Factors
4.Analysis of current status and trends of disease burden of knee osteoarthritis in China, 1990-2023.
Jie LIAO ; Qiongyao WU ; Gonghua WU ; Bing GUO ; Juying ZHANG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(11):1381-1387
OBJECTIVE:
To analyze the current status and trends of the disease burden of knee osteoarthritis (KOA) in China from 1990 to 2023, and to examine the epidemiological characteristics of age, gender differences, and attribution to high body mass index (BMI), in order to provide a basis for formulating prevention and treatment strategies to reduce the disease burden of KOA in China.
METHODS:
Based on the 2023 Global Burden of Disease Study (GBD) database, data on the number, rate, and age-standardized rate of incidence, prevalence, disability-adjusted life years (DALYs) for KOA, and DALYs for KOA attributable to high BMI in the Chinese population from 1990 to 2023 were integrated. The Joinpoint 5.4.0.0 software was used to analyze the age and gender differences in KOA and the epidemiological characteristics attributable to high BMI.
RESULTS:
The standardized incidence, prevalence, and DALYs rates of KOA in China in 2023 increased by 6.46%, 6.43%, and 6.93%, respectively, compared with 1990. In terms of age, the disease burden of KOA in China was lowest in the age group of 30-34 years, with the highest incidence rate in the age group of 50-54 years, whereas the prevalence rate and DALYs rate continued to increase with age, and both were highest in the age group of ≥70 years. In terms of gender, all disease burden standardized rate indicators were higher in females than in males, and the difference widened with age. The rate of BMI-attributable DALYs increased at an annual average rate of 1.57% (95% CI: 1.55, 1.59) from 1990 to 2023, again with significant age and gender differences.
CONCLUSION
The continued growth of the KOA disease burden and significant population differences characterizing China call for focused attention on the female middle-aged and elderly population, enhanced weight management, and implementation of targeted preventive and control measures.
Humans
;
Osteoarthritis, Knee/epidemiology*
;
China/epidemiology*
;
Male
;
Female
;
Middle Aged
;
Incidence
;
Aged
;
Adult
;
Prevalence
;
Body Mass Index
;
Disability-Adjusted Life Years
;
Cost of Illness
;
Aged, 80 and over
;
Sex Factors
;
Global Burden of Disease
;
Age Factors
;
Young Adult
;
Quality-Adjusted Life Years
5.The surveillance and assessment of acute injuries in different age categories in national wrestling championships.
Sema CAN ; Erkan DEMIRKAN ; Mustafa ARICI ; Mehmet İsmail TOSUN ; Halil İbrahim CICIOĞLU
Chinese Journal of Traumatology 2025;28(6):485-490
PURPOSE:
The purpose of this study is to surveil the injuries in wrestling according to the different age categories and wrestling styles throughout the competition season.
METHODS:
The study was designed as a descriptive study. The study was conducted during the wrestling competition season in 2023 (from January 2023 to July 2023), which includes 5 different age categories: U-15, U-17, U-20, U-23, and seniors, along with the Turkey National Wrestling Championships. The data of injuries was recorded immediately after the acute injury was treated by the medical expert during the competitions and evaluated according to the parameters that were obtained. In the statistical analysis, the frequency and percentage values were presented as descriptive statistics and the Chi-square test was used.
RESULTS:
The study incorporated a total of 6214 wrestlers and a total of 7151 wrestling bouts were performed during these competitions. The analyses indicated that the rate of injury incidence was 42.65‰ in all wrestling styles. When taking account of the injured body parts in all wrestlers' exposures, the occurrence of injuries to the head-face, neck, trunk, upper extremity, and lower extremity, rates of 17.6‰, 1.3‰, 3.6‰, 13.5‰, and 6.6‰, respectively, were observed. According to the pre-diagnosis based on freestyle, Greco-Roman, and female wrestling styles, injuries with bleeding (39.6%, 46.3%, and 14.6%, respectively) and muscle strain (37.9%, 28.7 %, and 52.6%, respectively) most often occurred.
CONCLUSION
The study findings indicate that most cases of injury appeared to occur in bleeding and muscle strain in all wrestling styles. We suggest that medical experts should set up their health equipment with consideration to the injuries that occur most frequently.
Humans
;
Male
;
Wrestling/injuries*
;
Young Adult
;
Adolescent
;
Female
;
Athletic Injuries/epidemiology*
;
Turkey/epidemiology*
;
Adult
;
Age Factors
;
Incidence
;
Child
6.The age, sex, and provoked factors of acute symptomatic deep vein thrombosis on the left and right lower extremities.
Chong-Li REN ; Jian-Ming SUN ; Hai-Yang WANG ; Jian FU ; Ye-Liang XU ; Jin WANG ; Meng-Lin NIE
Chinese Journal of Traumatology 2025;28(2):96-100
PURPOSE:
Deep vein thrombosis (DVT) of the left and right lower extremities was treated in the same way, but the left and right extremities received different levels of attention. This study aimed to investigate the differences between the right and left lower extremity deep vein thrombosis (LEDVT).
METHODS:
Clinical characteristics of LEDVT patients from July 2020 to June 2022 were retrospectively analyzed to compare the incidence of LEDVT on different limbs, demographics, predisposing factors, and anatomical characteristics. The exclusion criteria were bilateral LEDVT and recurrent thrombosis. Measured data was analyzed using independent samples t-test or Mann-Whitney test. Count data were analyzed by Chi-square test. A p < 0.05 was considered a statistically significant difference.
RESULTS:
There were 478 patients included in this study and the ratio of left to right LEDVT on the left and right limbs was 3.16:1 (363:115). Left LEDVT predominantly affected female, with the major aged > 50 years (50 - 60 years: 16.80%; > 60 years: 57.30%). The primary predisposing factor was iliac vein compression syndrome, with iliofemoral thrombosis being the main type. Male patients with LEDVT on the right limb were predominant and the age of onset was usually ≤ 60 years (52.17%). The main predisposing factor was recent surgery or trauma (< 30 days) and femoropopliteal thrombosis was the main type. In more detail, the left iliac vein was compressed mainly in the proximal segment, and the right iliac vein was compressed mainly in the intermediate and distal segments. Recent surgery or trauma to the locomotor system and genitourinary system often induced LEDVT.
CONCLUSION
The incidence of LEDVT on the left is significantly higher than that on the right. LEDVT on different sides has different characteristics, which is crucial for prevention and diagnosis in the relevant population so there are also differences in treatment of the affected limbs.
Humans
;
Venous Thrombosis/etiology*
;
Male
;
Female
;
Middle Aged
;
Lower Extremity/blood supply*
;
Retrospective Studies
;
Adult
;
Aged
;
Age Factors
;
Sex Factors
;
Risk Factors
;
Acute Disease
;
Incidence
;
Aged, 80 and over
;
Young Adult
;
Adolescent
7.Age-related changes in the impact of metabolic syndrome on prostate volume: a cross-sectional study.
Guo-Rong YANG ; Chao LV ; Kai-Kai LV ; Yang-Yang WU ; Xiao-Wei HAO ; Qing YUAN ; Tao SONG
Asian Journal of Andrology 2025;27(4):475-481
This study investigated the impact of metabolic syndrome (MetS) and its components on prostate volume (PV) in the general Chinese population. In total, 43 455 participants in The First Medical Center of the Chinese PLA General Hospital (Beijing, China) from January 1, 2012, to December 31, 2022, undergoing health examinations were included in the study. Participants were categorized into four groups according to PV quartiles: Q1 (PV ≤24.94 ml), Q2 (PV >24.94 ml and ≤28.78 ml), Q3 (PV >28.78 ml and ≤34.07 ml), and Q4 (PV >34.07 ml), with Q1 serving as the reference group. Logistic regression analyses were used to examine the association between MetS and PV, with subgroup analyses conducted by age. Among the participants, 18 787 (43.2%) were diagnosed with MetS. In the multivariate analysis model, a significant correlation between MetS and PV was observed, with odds ratios (ORs) increasing as PV increased (Q2, OR = 1.203, 95% confidence interval [CI]: 1.139-1.271; Q3, OR = 1.300, 95% CI: 1.230-1.373; and Q4, OR = 1.556, 95% CI: 1.469-1.648). Analysis of MetS components revealed that all components were positively associated with PV, with abdominal obesity showing the most significant effect. The number of MetS components was identified as a dose-dependent risk factor for elevated PV. The impact of MetS, its components, and component count on PV exhibited a decreasing trend with advancing age. Overall, the influence of MetS, its components, and component count on PV was predominantly observed in the age groups of 40-49 years and 50-59 years. Early intervention targeting MetS can significantly alleviate the increase in PV, particularly benefiting individuals aged 40-59 years who have abdominal obesity.
Humans
;
Male
;
Metabolic Syndrome/complications*
;
Middle Aged
;
Cross-Sectional Studies
;
Aged
;
Prostate/diagnostic imaging*
;
Adult
;
Age Factors
;
Organ Size
;
China/epidemiology*
;
Obesity, Abdominal
;
Risk Factors
8.Risk factors for erectile dysfunction after penile fracture and surgical repair: 12 years of clinical experience.
Mehmet OZTURK ; Muharrem BATURU ; Ozlem BASGUT ; Omer TURGUT ; Yasin KURT ; Omer BAYRAK
Asian Journal of Andrology 2025;27(6):738-742
Penile fracture is a rare urological emergency that may cause erectile dysfunction (ED). We analyzed the factors affecting erectile function in patients who underwent surgical repair for the management of penile fractures. Eighty-two patients who underwent penile fracture surgery in the Department of Urology, University of Gaziantep (Gaziantep, Türkiye) between January 2012 and January 2023 were evaluated. Age, body mass index, time elapsed from the incident of penile fracture to surgery, size, laterality, level of the defect, causes of fracture, presenting signs and symptoms, and relevant complications were recorded. Erectile function of the patients was evaluated preoperatively and at postoperative 3 rd and 6 th months according to the International Index of Erectile Function-5 (IIEF-5) scoring system. The factors decreasing the erection quality of the patients after surgical repair of penile fractures were investigated using IIEF-5 scoring system. Only age, defect size, and time elapsed from fracture onset to surgery were found to be effective on the occurrence of ED ( P = 0.005, P < 0.001, and P < 0.001, respectively). In the receiver operating characteristic (ROC) analysis, the cut-off values were 12.5 mm for defect size ( P < 0.001), 8.5 h for the time elapsed from fracture onset to surgery ( P = 0.036), and 40.5 years for the age of the patients ( P = 0.005). Delayed surgery, defect size, and advanced age had significant and negative effects on erectile function in cases of penile fracture. Before repair of the defect, patients should be given appropriate counseling about the possibility of ED, and early penile rehabilitation should be initiated.
Humans
;
Male
;
Erectile Dysfunction/epidemiology*
;
Penis/surgery*
;
Adult
;
Middle Aged
;
Risk Factors
;
Postoperative Complications/etiology*
;
Young Adult
;
Rupture/surgery*
;
Age Factors
;
Aged
;
Penile Erection
;
Retrospective Studies
9.Risk factors for plastic bronchitis in children with macrolide-unresponsive Mycoplasma pneumoniae pneumonia and establishment of a nomogram model.
Xiao-Song SHI ; Xiao-Hua HE ; Jie CHEN
Chinese Journal of Contemporary Pediatrics 2025;27(1):62-67
OBJECTIVES:
To investigate the risk factors for plastic bronchitis (PB) in children with macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) and to establish a nomogram prediction model.
METHODS:
A retrospective analysis was conducted on 178 children with MUMPP who underwent bronchoscopy from January to December 2023. According to the presence or absence of PB, the children were divided into a PB group (49 children) and a non-PB group (129 children). The predictive factors for the development of PB in children with MUMPP were analyzed, and a nomogram prediction model was established. The model was assessed in terms of discriminatory ability, accuracy, and clinical effectiveness.
RESULTS:
The multivariate logistic regression analysis showed that older age and higher levels of lactate dehydrogenase and fibrinogen were closely associated with the development of PB in children with MUMPP (P<0.05). A nomogram model established based on these factors had an area under the receiver operating characteristic curve of 0.733 (95%CI: 0.651-0.816, P<0.001) and showed a good discriminatory ability. The Hosmer-Lemeshow goodness-of-fit test indicated that the predictive model had a good degree of fit (P>0.05), and the decision curve analysis showed that the model had a good clinical application value.
CONCLUSIONS
The risk nomogram model established based on age and lactate dehydrogenase and fibrinogen levels has good discriminatory ability, accuracy, and predictive efficacy for predicting the development of PB in children with MUMPP.
Retrospective Studies
;
Risk Factors
;
Nomograms
;
Mycoplasma pneumoniae/isolation & purification*
;
Pneumonia, Mycoplasma/microbiology*
;
Bronchitis/microbiology*
;
Macrolides/therapeutic use*
;
Drug Resistance, Bacterial
;
Bronchoscopy
;
Area Under Curve
;
ROC Curve
;
Fibrinogen/analysis*
;
Age Factors
;
Humans
;
Male
;
Female
;
Infant
;
Child, Preschool
;
Child
;
Adolescent
;
L-Lactate Dehydrogenase/blood*
10.Impact of different treatment attitudes on survival and risk factors for poor clinical outcomes in extremely preterm infants: a retrospective real-world study.
Meng-Meng LI ; Shu-Shu LI ; Miao QIAN ; Min ZHANG ; Shu-Ping HAN
Chinese Journal of Contemporary Pediatrics 2025;27(3):269-278
OBJECTIVES:
To explore the impact of different treatment attitudes on the survival status of extremely preterm infants (EPIs) and evaluate the mortality and occurrence of severe complications in actively treated infants, as well as their risk factors.
METHODS:
A retrospective analysis was conducted on perinatal data of EPIs born between January 1, 2016, and December 31, 2023, who were admitted to the neonatal intensive care unit of Nanjing Women and Children's Healthcare Hospital within 24 hours after birth. The analysis focused on the attributable risk of mortality associated with different treatment attitudes in EPIs of varying gestational ages and birth weights. A multivariate logistic regression model was used to analyze the risk factors for mortality and severe complications in the actively treated group.
RESULTS:
A total of 485 EPIs were included. As gestational age or birth weight increased, the attributable risk of mortality with care withdrawal increased. Active treatment significantly improved the survival status of EPIs born at a gestational age of ≥24 weeks. Multivariate logistic regression analysis indicated that lower gestational age and the need for mechanical ventilation within 72 hours after birth were independent risk factors for mortality or severe complications in EPIs (P<0.05).
CONCLUSIONS
Active treatment can significantly extend the survival time of EPIs born at a gestational age of ≥24 weeks. Lower gestational age and the need for mechanical ventilation within 72 hours after birth are closely associated with poor survival outcomes in EPIs.
Humans
;
Retrospective Studies
;
Infant, Extremely Premature
;
Risk Factors
;
Infant, Newborn
;
Female
;
Male
;
Gestational Age
;
Logistic Models
;
Birth Weight

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