OPS Data Research Articles

The development, incidence and treatment trends of trochanteric fractures in Germany: a cohort study

BackgroundHip fractures are a major public health problem worldwide and can lead to disability, increased mortality, and reduced quality of life. We aim to provide a nationwide epidemiological analysis of trochanteric and subtrochanteric fractures and their respective surgical treatments.MethodsData were retrieved from the national database of the German Department of the Interior. ICD-10-GM and OPS data from the period of 2006 to 2020 were analysed and all patients with trochanteric and subtrochanteric fractures as their main diagnosis, who were treated in a German hospital, were included. Patients were grouped by age and gender and linear regression was performed where suitable to calculate statistically significant correlations between variables and incidences.Results985,104 pertrochanteric fractures and 178,810 subtrochanteric fractures were reported during the analysed period. We calculated a mean incidence of 80.08 ± 6.34 for pertrochanteric and 14.53 ± 1.50 for subtrochanteric fractures per million inhabitants. In both fracture types, a distinct dependence of incidence on age can be determined. Incidence rates equally rise in both sexes through the age groups with an increase of about 288-fold from those under the age of 60 to those over the age of 90 in pertrochanteric fractures, and about 123-fold in subtrochanteric fractures. Intramedullary nailing was the most common kind of treatment for both fracture types with augmentative cerclages on the rise throughout the whole period. Plate and dynamic compression screws were decreasing in frequency over the analysed period in both fractures.ConclusionsWe provided incidence data on per- and subtrochanteric fractures and their treatment. We calculated an economic impact of approximately 1.563 billion € per year in Germany. With regards to recent literature on costs of treatment and our findings regarding the implementation and utilization of different treatment methods, we conclude that the reinforcement of nationwide prevention programs is a relevant step in lessening the economic burden. We welcome the increased utilisation of intramedullary nailing as many studies show beneficiary outcomes and cost effectiveness in most of the included fracture types.

High comorbidity burden is not associated with increased risk of periprocedural pericardial effusionduring left atrial ablation procedures: data from a large tertiary-care ablation center

Abstract Funding Acknowledgements Type of funding sources: None. Background Catheter ablation is the most effective rhythm control treatment for atrial fibrillation (AF) and benefits of early rhythm control (ERC) were recently demonstrated to be enhanced in patients with a high comorbidity burden (CHA2DS2-VASc ≥ 4). Incidence of pericardial effusion, a dreaded, potentially life-threatening complication that is associated with catheter ablation,has not been analyzed in larger patient cohorts stratified by CHA2DS2-VASc. Purpose To determine incidence of pericardial effusion and drained pericardial effusion related to left-atrial (LA) procedures in billing data between 2010 and 2021 of a large tertiary-care ablation center in Germany. Method Eligible cases of LA procedures were identified through analysis of coded OPS data between 2010 and 2021. This analysis included patients with atrial fibrillation undergoing an ablation procedure including a transseptal puncture and mapping in the left atrium, not for other supraventricular tachycardias. Analysis accounted for different versions of the ICD-10-GM and OPS-ICHI catalogues. Comorbidities and occurrences of complications were defined as derived variables on a case-wise analysis from documented ICD-10 and OPS codes. CHA2DS2-VASc-score was calculated from these derived variables and demographic parameters (age and sex). Results 8396 left atrial procedures in 6184 patients (35% female, 63.6±11.0 years old at index procedure) were analysed. Derived CHA2DS2-VASc was < 4 in 6529 (78%) and ≥ 4 in 1867 (22%) cases, median CHA2DS2-VASc was 2 (IQR 1;3) in the overall cohort. Non-paroxysmal AF was more prevalent in the CHA2DS2-VASc ≥ 4 group (62.5%) than in the overall cohort (56%) and in the CHA2DS2-VASc < 4 group (54%). Hypertension was the most common comorbidity in 5285 (63%) patients. Coronary artery disease was present in 1433 (17%), heart failure in 3757 (45%), chronic kidney disease in 899 (11%) patients, thereof 591 (7%) at a stage ≥ KDIGO III. Pericardial effusion was documented in 78/6529 (1.2%) in the CHA2DS2-VASc < 4 group. Thereof 35/78 (45%) required interventional or surgial drainage. In the CHA2DS2-VASc ≥ 4 group, pericardial effusion occurred in 21/1867 (1.1%) cases. Here, 10/21 (48%) required drainage. Occurrence of pericardial effusion did not differ between CHA2DS2-VASc-score stratified groups (χ2 p=0.805). Pericardial effusion requiring drainage was not different petween groups (χ2 p=0.822). Conclusion Patients with a higher comorbidity burden undergoing catheter ablation for atrial fibrillation in the past 10 years were not subject to an increased risk for pericardial effusion or drainage. This observation allows to perform highly efficient ablation procedures equally in patients with low and high comorbidity burden safely. Further analysis of the dataset regarding further left atrial ablation associated complications and their predictors will be provided.

Increasing comorbidity burden of patients undergoing catheter ablation for atrial fibrillation in the past 10 years: An analysis of more than 8000 left-atrial ablation procedures

Abstract Funding Acknowledgements Type of funding sources: None. Background Catheter ablation is the most effective rhythm control treatment for atrial fibrillation (AF). While it was indicated as a symptomatic treatment in the past years, prognostic benefits of early rhythm control (ERC) were recently demonstrated and catheter ablation advances more and more into this indication. Restrictions in patient selection for catheter ablation seem to melt. Only few data on comorbidity burden in patients undergoing AF ablation is available. Purpose To determine prevalence of common cardiovascular and related comorbidities in patients undergoing left-atrial (LA) procedures between 2010 and 2021 at a large tertiary-care ablation center.. Method Eligible cases with LA procedures were identified through analysis of coded OPS data between 2010 and 2021. Analysis included patients with atrial fibrillation undergoing an ablation procedure including a transseptal puncture and mapping in the left atrium, not for other supraventricular tachycardias. Analysis accounted for different versions of the ICD-10-GM and OPS-ICHI catalogues. Comorbidities were defined as derived variables on a case-wise analysis from documented ICD-10 and OPS codes. CHA2DS2-VASc-score was calculated from these derived variables and demographic parameters. Procedures were clustered by intervention year in one of following ranges 2010-2012, 2013-2015, 2016-2018 and 2019-2021. Results 8396 left atrial procedures in 6184 individual patients (35% female, 63.6±11.0 years old at index procedure) were identified. Median CHA2DS2-VASc was 2 (IQR 1;3) in the overall cohort. Mean age increased constantly from 60.3±11.4 years in 2011 to 64.5±11.1 years in 2021. Median CHA2DS2-VASc-score remained constant at 2 points. While the share of non-paroxysmal AF patients was 52% between 2010 and 2012, it increased to 59% in 2016-2018 and decreased again to 55% in 2019-2021. The relative number of cases in which patients suffered from diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease (COPD), obstructive sleep apnea (OSA), pulmonary hypertension, coronary artery disease and prior myocardial infarction increased constantly between 2010-2012. While the share of patients with heart failure was highest between 2013 and 2015 (1368/2117 cases, 65%), it decreased to 833/2318 cases (36%) in 2019-2021. the absolute number of procedures nearly doubled from 2010-2012 to 2013-2015, it increased by only 36% from range 2013-2015 to 2016-2018. The number of procedures decreased again from 2016-2018 to 2019-2021 by 19%, likely due to COVID19-pandemic restrictions. Conclusion Over the last decade, the age and number of comorbidities increased in patients undergoing AF ablation procedures. These results put emphasis on offering safe procedures and perform adequate pre-procedural assessment of comorbidity burden.

Fast Healthcare Interoperability Resources (FHIR®) Representation of Medication Data Derived from German Procedure Classification Codes (OPS) Using Identification of Medicinal Products (IDMP) Compliant Terminology.

Electronic documentation of medication data is one of the biggest challenges associated with digital clinical documentation. Despite its importance, it has not been consistently implemented in German university hospitals. In this paper we describe the approach of the German Medical Informatics Initiative (MII) towards the modelling of a medication core dataset using FHIR® profiles and standard-compliant terminologies. The FHIR profiles for Medication and MedicationStatement were adapted to the core dataset of the MIl. The terminologies to be used were selected based on the criteria of the ISO-standard for the Identification of Medicinal Products (IDMP). For a first use case with a minimal medication dataset, the entries in the medication chapter of the German Procedure Classification (OPS codes) were analyzed and mapped to IDMP-compliant medication terminology. OPS data are available at all German hospitals as they are mandatory for reimbursement purposes. Reimbursement-relevant encounter data containing OPS medication procedures were used to create a FHIR representation based on the FHIR profiles MedicationStatement and Medication. This minimal solution includes - besides the details on patient and start-/end-dates - the active ingredients identified by the IDMP-compliant codes and - if specified in the OPS code - the route of administration and the range of the amount of substance administered to the patient, using the appropriate unit of measurement code. With FHIR, the medication data can be represented in the data integration centers of the MII to provide a standardized format for data analysis across the MII sites.

A novel robust prediction algorithm based on REMD-MWNN for AIOps

AIOps(Artificial Intelligence Operations) is emerging as one of the most important technology in industrial automation, and accurate time series prediction plays a crucial role in it. However, due to the non-linear and non-stationary characteristics of Ops(operations) data, traditional time series forecasting models can not effectively extract good enough sequence data features and result in poor forecasting accuracy. To fully extract the Ops data information and construct a robust prediction model, this paper proposes a hybrid model based on recursive empirical mode decomposition (REMD) and memory wavelet neural network (MWNN) to improve the forecasting accuracy of Ops data. In REMD-MWNN, we first use REMD to decompose the Ops data into multiple intrinsic modal functions (IMF) at different time scales. Then, to make full use of the historical information of the Ops data and reduce the running time, we designed a new memory recurrent neural network, namely MWNN. Next, use MWNN to predict multiple inherent IMFs respectively to obtain the predicted value of the corresponding subsequence. Finally, the final prediction result is obtained by reconstructing the prediction value of each subsequence. In the comprehensive experiment, we selected the Ops data of an open education platform. The experimental results show that, compared with other algorithms, the model proposed in this paper is highly competitive in predicting future changes and capturing the evolution mode of hidden factors. The experimental data involved in this paper can be downloaded from this website: https://github.com/1600383075/REMD-MWNN/tree/master/data.

Increasing Stocking Density Reduces Emissions of Fugitive Dust from Cattle Feedyards

<abstract><title><italic>Abstract. </italic></title> The moisture and compaction dynamics of an open-lot corral surface in a cattle feedyard depend strongly on the spatial density at which the animals are stocked. Because the moisture content and bulk density of the corral surface directly influence its intrinsic dust susceptibility, emission of fugitive dust from a feedyard surface should be sensitive to changes in stocking density. In the summer of 2012 we measured airborne dust concentrations upwind and downwind of feedyard pens stocked at two different densities, 718 (control) and 1,435 hd ha^-1, over a 160-d feeding period. Doubled stocking density was achieved in two different ways, by (A) confining cattle to half the pen area using electric cross-fencing and (B) doubling the number of cattle in the pens. Path-averaged dust concentrations were measured upwind and downwind of feedyard pens using an optical particle sizer (OPS model 3330, TSI Inc., Shoreview, Minn.) and an earlier-model optical sensor (model DUSTTRAK II 8530, TSI Inc., Shoreview, Minn.) mounted on mobile monitoring platforms. Because the monitoring platforms used different instruments, during the data analysis phase DUSTTRAK data were compared only to DUSTTRAK data, and OPS data were compared only to OPS data. Downwind 1-min concentrations of dust varied from 1 to 4,478 μg m^-3 for the control pens, 1 to 2,431 μg m^-3 for the pens with cross-fencing (treatment A), and 1 to 2,872 μg m^-3 for the pens with twice as many cattle as the control pens (treatment B). Dispersion modeling using AERMOD revealed that the apparent dust-emission fluxes from treatments A and B were 79.4% and 80.6% lower, respectively, than the apparent emission flux from the control pens (23.45 μg m^-2 s^-1). We conclude that stocking-density manipulation is likely to be a viable Beneficial Management Practice (BMP) for controlling fugitive dust from open-lot cattle feedyards but that improved, path-averaged monitoring techniques appropriate to the feedyard source geometry are needed.

Sublinguale Mikrozirkulationsstörungen bei Patienten im septischen Schock: Untersuchungen mittels OPS-Imaging-System und PiCCO®-Monitoring

Haemodynamic monitoring of septic patients is impeded by the discrepancy between the macrohaemodynamics and the microcirculation of internal organs. Pulse contour analysis (PiCCO) provides new parameters for an improved assessment of the volume status of critically ill patients. However, changes in regional circulation, in particular those affecting the splanchnic perfusion, have proven to be especially important. The aim of our study was to compare macrohaemodynamic parameters (PiCCO) with microcirculation (OPS imaging) in severely septic patients with multiple organ failure. In seven patients suffering from septic shock and multiple organ failure (APACHE II score > 25) repeated examinations at a twenty-four hour interval were carried out by PiCCO monitoring and OPS imaging. OPS data were recorded for twenty seconds at 6 different buccal and sublingual localisations, adequately reflecting microvascular perfusion of the liver and the small intestine. Data were videotaped for off-line analysis, calculating current velocity in small and large venules (< 25 and > 25 microm), as well as functional capillary density. Significant correlations were found for current velocity in small venules with systemic vascular resistance (r(2) = 0.252, p < 0.05), mean arterial blood pressure (r(2) = 0.259, p < 0.05), and pH value (r(2) = 0.265, p < 0.05). In addition, a significant correlation was found between the oxygen transport index and the density of small vessels (r(2) = 0.355; p < 0.05). According to our findings, data acquired through PiCCO monitoring may be used for a rough estimation of the microcirculation during severe sepsis and multiple organ failure. For an assessment of the local conditions of perfusion, however, there are limits in the use of the parameters that were the object of our research. For the measurement at localisations which are accessible non-invasively and representative of the splanchnic perfusion, OPS is the more accurate method for characterisation of the microcirculation, although a more extensive and time-consuming analysis is needed.

Sublingual microcirculatory response to fluid challenge in septic shock patients

During microcirculatory failure in septic shock, the relationship between modifications in macro-circulation and micro-circulation may depend on the resuscitation. How is the microcirculation modified during cardiac output (CO) increase by fluid? Four septic shock patients (73 ± 12 years old) were investigated with orthogonal polarization spectral imaging (OPS) and with a Swan–Ganz catheter. The SAPS score was 60 ± 8, and norepinephrine was 0.6 ± 0.3 μg/kg/min. In three sublingual areas per patient, the number of vessels (small, medium, large) were quoted as no flow = 0, sludge = 1, moderate = 2, normal = 3, allowing one to compute a microcirculatory ratio for each vessel category. Systemic hemodynamic and OPS data were taken before and within 30 min after fluid bolus (5–7 ml/kg). OPS data presented as median (interquartile range), demographic and hemodynamic data presented as median ± SE. Only the number of small vessels/field tended to increase after fluid from 34 (15) to 55 (21) (P = 0.09). In Fig. ​Fig.1,1, all vessel categories increased the ratio (P < 0.01). The blood pressure did not increase after fluid challenge, whereas the CO increased by 39 ± 18% (P < 0.05; Fig. ​Fig.22). Figure 1 Figure 2 SAP, systolic arterial pressure; DAP, diastolic arterial pressure; CVP, central venous pressure. All sizes of microvessels changed with fluid loading, with different patterns between small and larger vessels, going from recruitment to increased blood velocity.

Digital Terrain Model from JERS-1/OPS stereo-pairs and its verification using GSI numerical elevation map

A DTM(Digital Terrain Model) generation process was studied using the stereoscopic function of JERS-1/OPS. For the test data, a horizontal orientation error of about 0.27 pixels remained. This value corresponds to the elevation estimation error of about 20m. For the image correlation process, relationship between the correlation noise and the correlation window size trade-off was found. The size of the window for automatic stereoscopy was presumed to be suitable at a size of 7×7 pixels. The DTM accuracy from OPS data was found to be about 30m in standard deviation, when compared with the DTM of GSI(Geographical Survey Institute).

Application of forest cover classification using OPS data

Application of forest cover classification using OPS data

Early Evaluation of JERS-1 OPS Data and their Distribution

Early Evaluation of JERS-1 OPS Data and their Distribution