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Journal articles on the topic 'Compression of morbidity'

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Published: 4 June 2021

Last updated: 19 February 2022

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1

Seaman, Rosie, Andreas Höhn, Rune Lindahl-Jacobsen, Pekka Martikainen, Alyson van Raalte, and Kaare Christensen. "Rethinking morbidity compression." European Journal of Epidemiology 35, no. 5 (May 2020): 381–88. http://dx.doi.org/10.1007/s10654-020-00642-3.

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2

FRIES, JAMES F. "The Compression of Morbidity." Milbank Quarterly 83, no. 4 (November 9, 2005): 801–23. http://dx.doi.org/10.1111/j.1468-0009.2005.00401.x.

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3

Crimmins, E. M., and H. Beltran-Sanchez. "Mortality and Morbidity Trends: Is There Compression of Morbidity?" Journals of Gerontology Series B: Psychological Sciences and Social Sciences 66B, no. 1 (December 6, 2010): 75–86. http://dx.doi.org/10.1093/geronb/gbq088.

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4

Fries, James F. "Compression of morbidity in the elderly." Vaccine 18, no. 16 (February 2000): 1584–89. http://dx.doi.org/10.1016/s0264-410x(99)00490-9.

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5

Nusselder, W. J. "Smoking and the compression of morbidity." Journal of Epidemiology & Community Health 54, no. 8 (August 1, 2000): 566–74. http://dx.doi.org/10.1136/jech.54.8.566.

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6

Guralnik, Jack M. "Prospects for the Compression of Morbidity." Journal of Aging and Health 3, no. 2 (May 1991): 138–54. http://dx.doi.org/10.1177/089826439100300202.

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7

Hubert, H. B., D. A. Bloch, J. W. Oehlert, and J. F. Fries. "Lifestyle Habits and Compression of Morbidity." Journals of Gerontology Series A: Biological Sciences and Medical Sciences 57, no. 6 (June 1, 2002): M347—M351. http://dx.doi.org/10.1093/gerona/57.6.m347.

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8

Cheng, Sheung-Tak. "Double Compression: A Vision for Compressing Morbidity and Caregiving in Dementia." Gerontologist 54, no. 6 (March 11, 2014): 901–8. http://dx.doi.org/10.1093/geront/gnu015.

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9

Leigh, J. Paul, and James F. Fries. "Education, Gender, and the Compression of Morbidity." International Journal of Aging and Human Development 39, no. 3 (October 1994): 233–46. http://dx.doi.org/10.2190/xqxr-utgp-wa8x-9fqj.

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According to the Compression of Morbidity (CM) hypothesis, people who exercise, eat nutritiously, do not smoke, and maintain good weight, i.e., people who practice healthy habits, will be more likely to live free of disabling diseases and injuries up until the last few months or years of life. The Increasing Misery (IM) hypothesis, on the other hand, holds that preventive health measures will extend life expectancy but will also increase the number of infirm years. The CM theory implies that curves of morbidity or disability with age should become increasingly “rectangular” for groups who practice healthy habits in the broadest sense. The IM theory does not. This Rectangularization hypothesis is examined with cross-sectional data measuring disability from the Epidemiological Follow-up to the National Health and Nutrition Examination Survey, I (NHEFS), using years of schooling as the independent variable proxy representing favored health status, and examining interactions with age. A modified version of the Disability Index (DI) from the Stanford Health Assessment Questionnaire (HAQ) is used to measure disability. In some analyses, deceased subjects were assigned the worst disability score. Four subsamples of women and men, fifty years old and over, alive and deceased in 1982–84, were analyzed. Female, and especially male, subsamples which included the deceased provided evidence for the CM hypothesis. Results for the subsamples of those remaining alive in 1982–84 were ambiguous. However, lifetime (over age 50) cumulative disability was 21 to 60 percent less for the more educated than the less educated, depending upon whether deceased were included or excluded. If higher education level is an appropriate surrogate for the effect of good health practices, then extending such practices will result in less, rather than more, lifetime disability.

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10

Fries, James F. "The Compression of Morbidity: Near or Far?" Milbank Quarterly 67, no. 2 (1989): 208. http://dx.doi.org/10.2307/3350138.

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11

Fries, JamesF, LawrenceW Green, and Sol Levine. "HEALTH PROMOTION AND THE COMPRESSION OF MORBIDITY." Lancet 333, no. 8636 (March 1989): 481–83. http://dx.doi.org/10.1016/s0140-6736(89)91376-7.

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12

Crombie, Hugo. "Physical Activity and the Compression of Morbidity." Journal of the Royal Society of Medicine 89, no. 5 (May 1996): 299. http://dx.doi.org/10.1177/014107689608900533.

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13

Stallard, Eric. "Compression of Morbidity and Mortality: New Perspectives." North American Actuarial Journal 20, no. 4 (October 2016): 341–54. http://dx.doi.org/10.1080/10920277.2016.1227269.

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14

Kaplan, George A. "Epidemiologic Observations on the Compression of Morbidity." Journal of Aging and Health 3, no. 2 (May 1991): 155–71. http://dx.doi.org/10.1177/089826439100300203.

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15

Beltrán-Sánchez, Hiram, Fahad Razak, and S. V. Subramanian. "Going beyond the disability-based morbidity definition in the compression of morbidity framework." Global Health Action 7, no. 1 (September 24, 2014): 24766. http://dx.doi.org/10.3402/gha.v7.24766.

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16

Fries, J. F. "Reducing cumulative lifetime disability: the compression of morbidity." British Journal of Sports Medicine 32, no. 3 (September 1, 1998): 193. http://dx.doi.org/10.1136/bjsm.32.3.193.

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17

Gorin, S. H., and B. Lewis. "The Compression of Morbidity: Implications for Social Work." Health & Social Work 29, no. 3 (August 1, 2004): 249–54. http://dx.doi.org/10.1093/hsw/29.3.249.

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18

Fries, James F. "Aging, cumulative disability, and the compression of morbidity." Comprehensive Therapy 27, no. 4 (December 2001): 322–29. http://dx.doi.org/10.1007/s12019-001-0030-4.

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19

Geyer, Siegfried. "Morbidity compression: a promising and well-established concept?" International Journal of Public Health 61, no. 7 (July 21, 2016): 727–28. http://dx.doi.org/10.1007/s00038-016-0853-5.

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20

Allen, Norrina B., Lihui Zhao, Lei Liu, Martha Daviglus, Kiang Liu, James Fries, Ya-Chen Tina Shih, et al. "Favorable Cardiovascular Health, Compression of Morbidity, and Healthcare Costs." Circulation 135, no. 18 (May 2, 2017): 1693–701. http://dx.doi.org/10.1161/circulationaha.116.026252.

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21

Campolina, Alessandro Gonçalves, Fernando Adami, Jair Licio Ferreira Santos, and Maria Lucia Lebrão. "Effect of eliminating chronic diseases among elderly individuals." Revista de Saúde Pública 47, no. 3 (June 2013): 514–22. http://dx.doi.org/10.1590/s0034-8910.2013047004570.

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OBJECTIVE: To determine whether the elimination of certain chronic diseases is capable of leading to the compression of morbidity among elderly individuals.METHODS: A population-based, cross-sectional study was carried out with official data for the city of Sao Paulo, Southeastern Brazil in 2000 and data from the SABE (Health, Wellbeing and Ageing) study. Sullivan's method was used to calculate disability-free life expectancy. Cause-deleted life tables were used to calculate the probabilities of death and disabilities with the elimination of health conditions.RESULTS: The largest gains in disability-free life expectancy, with the elimination of chronic illness, occurred in the female gender. Among individuals of a more advanced age, gains in disability-free life expectancy occurred as result of a relative compression of morbidity. Among men aged 75 years, all conditions studied, except heart disease and systemic arterial pressure, led to an absolute expansion of morbidity and, at the same time, to a relative compression of morbidity upon being eliminated.CONCLUSIONS: The elimination of chronic diseases in the elderly could lead to the compression of morbidity in elderly men and women.

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22

Fries, James F. "Physical Activity, the Compression of Morbidity, and the Health of the Elderly." Journal of the Royal Society of Medicine 89, no. 2 (February 1996): 64–68. http://dx.doi.org/10.1177/014107689608900202.

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The Compression of Morbidity hypothesis envisions a potential reduction of overall morbidity, and of health care costs, now heavily concentrated in the senior years, by compression of morbidity between an increasing age of onset of disability and the age of death, increasing perhaps more slowly1,2. For this scenario to be able to be widely achieved, largely through prevention of disease and disability, we need to identify variables which predict future ill health, modify these variables, and document the improvements in health that result3. Physical activity is perhaps the most obvious of the variables which might reduce overall lifetime morbidity.

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23

Ismail, Khadija, Lisa Nussbaum, Paola Sebastiani, Stacy Andersen, Thomas Perls, Nir Barzilai, and Sofiya Milman. "Compression of Morbidity Is Observed Across Cohorts with Exceptional Longevity." Journal of the American Geriatrics Society 64, no. 8 (July 5, 2016): 1583–91. http://dx.doi.org/10.1111/jgs.14222.

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24

Powell, Jane. "Compression of morbidity outcomes key to investment in public health." Journal of Public Health 34, no. 3 (May 21, 2012): 329. http://dx.doi.org/10.1093/pubmed/fds043.

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25

Romeu Gordo, Laura. "Compression of morbidity and the labour supply of older people." Applied Economics 43, no. 4 (June 25, 2009): 503–13. http://dx.doi.org/10.1080/00036840802599941.

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26

Grey, Aubrey D. N. J. de. "Compression of Morbidity: The Hype and the Reality, Part 1." Rejuvenation Research 9, no. 1 (March 2006): 1–2. http://dx.doi.org/10.1089/rej.2006.9.1.

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27

de Grey, Aubrey D. N. J. "Compression of Morbidity: The Hype and the Reality, Part 2." Rejuvenation Research 9, no. 2 (June 2006): 167–68. http://dx.doi.org/10.1089/rej.2006.9.167.

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28

Then, Francisca S., Tobias Luck, Arno Villringer, Matthias C. Angermeyer, and Steffi G. Riedel-Heller. "O2-11-05: Compression of dementia morbidity by higher education." Alzheimer's & Dementia 11, no. 7S_Part_4 (July 2015): P201. http://dx.doi.org/10.1016/j.jalz.2015.07.193.

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29

O'Donnell, Michael P. "Compression of Morbidity: A Personal, Research, and National Fiscal Solvency Perspective." American Journal of Health Promotion 27, no. 2 (November 2012): iv—vi. http://dx.doi.org/10.4278/ajhp.27.2.iv.

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30

LANTZ, PAULA M. "Revisiting Compression of Morbidity and Health Disparities in the 21st Century." Milbank Quarterly 98, no. 3 (August 18, 2020): 664–67. http://dx.doi.org/10.1111/1468-0009.12472.

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31

Fries, James F. "Aging, Illness, and Health Policy: Implications of the Compression of Morbidity." Perspectives in Biology and Medicine 31, no. 3 (1988): 407–28. http://dx.doi.org/10.1353/pbm.1988.0024.

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32

Laditka, James N., and Sarah B. Laditka. "The Morbidity Compression Debate: Risks, Opportunities, and Policy Options for Women." Journal of Women & Aging 12, no. 1-2 (January 1, 2000): 23–38. http://dx.doi.org/10.1300/j074v12n01_03.

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33

Baskett, T. F. "Uterine Compression Sutures for Postpartum Hemorrhage: Efficacy, Morbidity, and Subsequent Pregnancy." Obstetric Anesthesia Digest 28, no. 1 (March 2008): 11–12. http://dx.doi.org/10.1097/01.aoa.0000308291.76037.2d.

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34

Mitnitski, Arnold B., and Gordon J. Gubitz. "Trends in Survival and Recovery From Stroke and Compression of Morbidity." Stroke 41, no. 3 (March 2010): 415–16. http://dx.doi.org/10.1161/strokeaha.109.574459.

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35

Jagger, C. "Editorial. Compression or expansion of morbidity - what does the future hold?" Age and Ageing 29, no. 2 (March 1, 2000): 93–94. http://dx.doi.org/10.1093/ageing/29.2.93.

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36

Fries, James F., Bonnie Bruce, and Eliza Chakravarty. "Compression of Morbidity 1980–2011: A Focused Review of Paradigms and Progress." Journal of Aging Research 2011 (2011): 1–10. http://dx.doi.org/10.4061/2011/261702.

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The Compression of Morbidity hypothesis—positing that the age of onset of chronic illness may be postponed more than the age at death and squeezing most of the morbidity in life into a shorter period with less lifetime disability—was introduced by our group in 1980. This paper is focused upon the evolution of the concept, the controversies and responses, the supportive multidisciplinary science, and the evolving lines of evidence that establish proof of concept. We summarize data from 20-year prospective longitudinal studies of lifestyle progression of disability, national population studies of trends in disability, and randomized controlled trials of risk factor reduction with life-style-based “healthy aging” interventions. From the perspective of this influential and broadly cited paradigm, we review its current history, the development of a theoretical structure for healthy aging, and the challenges to develop coherent health policies directed at reduction in morbidity.

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37

Beltrán-Sánchez, Hiram, Marcia P. Jiménez, and S. V. Subramanian. "Assessing morbidity compression in two cohorts from the Health and Retirement Study." Journal of Epidemiology and Community Health 70, no. 10 (April 21, 2016): 1011–16. http://dx.doi.org/10.1136/jech-2015-206722.

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38

Becker, James T., Luis Tarraga Mestre, Scott Ziolko, and Oscar L. Lopez. "Gene-Environment Interactions With Cognition in Late Life and Compression of Morbidity." American Journal of Psychiatry 164, no. 6 (June 2007): 849–52. http://dx.doi.org/10.1176/ajp.2007.164.6.849.

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39

Varga, Péter Pál, István Béla Bors, and Áron Lazáry. "Orthopedic treatment of vertebral compression fractures in osteoporosis." Orvosi Hetilap 152, no. 33 (August 2011): 1328–36. http://dx.doi.org/10.1556/oh.2011.29178.

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Vertebral compression fracture is the most common type of fractures in osteoporosis increasing the mortality and morbidity of the systemic disease. Adequate treatment of the vertebral compression fractures is always in the focus of the national and international spine meetings and one of the most innovative fields in the spine care is the surgical therapy of the osteoporotic spine. Here, the authors summarize the orthopedic treatment options for vertebral compression fractures based on a literature review

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40

Steensma, Colin, Lidia Loukine, and Bernard Choi. "Evaluating compression or expansion of morbidity in Canada: trends in life expectancy and health-adjusted life expectancy from 1994 to 2010." Health Promotion and Chronic Disease Prevention in Canada 37, no. 3 (March 2017): 68–76. http://dx.doi.org/10.24095/hpcdp.37.3.02.

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Introduction The objective of this study was to investigate whether morbidity in Canada, at the national and provincial levels, is compressing or expanding by tracking trends in life expectancy (LE) and health-adjusted life expectancy (HALE) from 1994 to 2010. “Compression” refers to a decrease in the proportion of life spent in an unhealthy state over time. It happens when HALE increases faster than LE. “Expansion” refers to an increase in the proportion of life spent in an unhealthy state that happens when HALE is stable or increases more slowly than LE. Methods We estimated LE using mortality and population data from Statistics Canada. We took health-related quality of life (i.e. morbidity) data used to calculate HALE from the National Population Health Survey (1994–1999) and the Canadian Community Health Survey (2000–2010). We built abridged life tables for seven time intervals, covering the period 1994 to 2010 and corresponding to the year of each available survey cycle, for females and males, and for each of the 10 Canadian provinces. National and provincial trends were assessed at birth, and at ages 20 years and 65 years. Results We observed an overall average annual increase in HALE that was statistically significant in both Canadian females and males at each of the three ages assessed, with the exception of females at birth. At birth, HALE increased an average of 0.2% (p = .08) and 0.3% (p $lt; .001) annually for females and males respectively over the 1994 to 2010 period. At the national level for all three age groups, we observed a statistically nonsignificant average annual increase in the proportion of life spent in an unhealthy state, with the exception of men at age 65, who experienced a non-significant decrease. At the provincial level at birth, we observed a significant increase in proportion of life spent in an unhealthy state for Newfoundland and Labrador (NL) and Prince Edward Island (PEI). Conclusion Our study did not detect a clear overall trend in compression or expansion of morbidity from 1994 to 2010 at the national level in Canada. However, our results suggested an expansion of morbidity in NL and PEI. Our study indicates the importance of continued tracking of the secular trends of life expectancy and HALE in Canada in order to verify the presence of compression or expansion of morbidity. Further study should be undertaken to understand what is driving the observed expansion of morbidity in NL and in PEI.

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41

Fries, James F. "The Theory and Practice of Active Aging." Current Gerontology and Geriatrics Research 2012 (2012): 1–7. http://dx.doi.org/10.1155/2012/420637.

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“Active aging” connotes a radically nontraditional paradigm of aging which posits possible improvement in health despite increasing longevity. The new paradigm is based upon postponing functional declines more than mortality declines and compressing morbidity into a shorter period later in life. This paradigm (Compression of Morbidity) contrasts with the old, where increasing longevity inevitably leads to increasing morbidity. We have focused our research on controlled longitudinal studies of aging. The Runners and Community Controls study began at age 58 in 1984 and the Health Risk Cohorts study at age 70 in 1986. We noted that disability was postponed by 14 to 16 years in vigorous exercisers compared with controls and postponed by 10 years in low-risk cohorts compared with higher risk. Mortality was also postponed, but too few persons had died for valid comparison of mortality and morbidity. With the new data presented here, age at death at 30% mortality is postponed by 7 years in Runners and age at death at 50% (median) mortality by 3.3 years compared to controls. Postponement of disability is more than double that of mortality in both studies. These differences increase over time, occur in all subgroups, and persist after statistical adjustment.

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42

Garcia-Hidalgo, Catalina, and Georg M. Schmölzer. "Chest Compressions in the Delivery Room." Children 6, no. 1 (January 3, 2019): 4. http://dx.doi.org/10.3390/children6010004.

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Annually, an estimated 13–26 million newborns need respiratory support and 2–3 million newborns need extensive resuscitation, defined as chest compression and 100% oxygen with or without epinephrine in the delivery room. Despite such care, there is a high incidence of mortality and neurologic morbidity. The poor prognosis associated with receiving chest compression alone or with medications in the delivery room raises questions as to whether improved cardiopulmonary resuscitation methods specifically tailored to the newborn could improve outcomes. This review discusses the current recommendations, mode of action, different compression to ventilation ratios, continuous chest compression with asynchronous ventilations, chest compression and sustained inflation optimal depth, and oxygen concentration during cardiopulmonary resuscitation.

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43

Campolina, Alessandro Gonçalves, Fernando Adami, Jair Licio Ferreira Santos, and Maria Lucia Lebrão. "Effect of the elimination of chronic diseases on disability-free life expectancy among elderly individuals in Sao Paulo, Brazil, 2010." Ciência & Saúde Coletiva 19, no. 8 (August 2014): 3327–34. http://dx.doi.org/10.1590/1413-81232014198.06952013.

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The scope of this study was to establish whether the elimination of certain chronic diseases is capable of leading to the compression of morbidity among elderly individuals in Sao Paulo (Brazil), 2010. A population-based, cross-sectional study was carried out with official data for the city of Sao Paulo (Brazil) in 2010 and data from the SABE (Health, Wellbeing and Ageing) study. A total of 907 elderly individuals were evaluated, 640 of whom were women (64.6%). Sullivan's method was used for the calculation of disability-free life expectancy (DFLE). Life tables for cause elimination were used to calculate the probabilities of death with the elimination of health conditions. In absolute terms, the gains in LE and DFLE were greater in the younger age group (60 to 74 years) in both genders. In relative terms (%DFLE in LE), the gains were higher among women aged 75 years or older and among men aged 60 years. If eliminated, heart disease was the condition that would most lead to the compression of morbidity in both genders. The elimination of chronic diseases from the elderly population could lead to a compression of morbidity in men and women at both 60 years of age and 75 years of age or older.

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44

Todd, Marie. "Compression therapy for chronic oedema and venous leg ulcers: AndoFlex TLC Calamine." British Journal of Nursing 28, no. 12 (June 27, 2019): S32—S37. http://dx.doi.org/10.12968/bjon.2019.28.12.s32.

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The prevalence of venous leg ulcers and chronic oedema is increasing because of the rise in the older population who have comorbidities. Managing and living with these conditions is extremely costly in resource and human terms and there is often a cyclical process of ulceration, healing and recurrence, resulting in significant physical and psychosocial morbidity. Identifying those at risk and advising on lifestyle changes to prevent progression of these conditions will help in avoiding high wound management and compression costs, nursing input and associated patient morbidity. Compression bandaging is the linchpin in managing these conditions and it must be started as early as possible. However, many patients find it difficult to tolerate bandaging because of issues such as pain, the inability to wear shoes and itch. Therefore, if compliance is to be achieved, it is important to select a compression bandaging system that addresses the issues that patients have difficulty with. AndoFlex TLC Calamine is a compression bandaging system that deals with many of these problems, and is easy to apply and remove. Testimonials by practitioners treating patients with chronic oedema, ulceration and/or skin problems will demonstrate the benefits and effectiveness of AndoFlex TLC Calamine.

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45

Silberman, Jordan, Chun Wang, Shawn T. Mason, Steven M. Schwartz, Matthew Hall, Jason L. Morrissette, Xin M. Tu, and Janet Greenhut. "The Avalanche Hypothesis and Compression of Morbidity: Testing Assumptions through Cohort-Sequential Analysis." PLOS ONE 10, no. 5 (May 11, 2015): e0123910. http://dx.doi.org/10.1371/journal.pone.0123910.

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46

Brown, Jeffrey A., and Mark C. Preul. "Percutaneous trigeminal ganglion compression for trigeminal neuralgia." Journal of Neurosurgery 70, no. 6 (June 1989): 900–904. http://dx.doi.org/10.3171/jns.1989.70.6.0900.

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✓ Between 1983 and 1988, a percutaneous trigeminal ganglion compression (PTGC) procedure for trigeminal neuralgia was performed on 22 patients. All patients were initially relieved of their pain. There were three recurrences (14%); two of these patients underwent a second PTGC procedure and one a partial trigeminal nerve root section. Follow-up examination 3 to 53 months after the procedure showed that all patients were free of pain. Morbidity included persistent minor hypesthesia in five patients, persistent minor dysesthesias in three, persistent minor weakness in three, aseptic meningitis in one, transient sixth nerve palsy in one, and transient otalgia in three. None of the patients had either anesthesia dolorosa or an absent corneal reflex.

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47

Kraus, Arthur S. "Is a Compression of Morbidity in Late Life Occurring?: Examination of Death Certificate Evidence." Canadian Journal on Aging / La Revue canadienne du vieillissement 7, no. 1 (1988): 58–70. http://dx.doi.org/10.1017/s071498080000711x.

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ABSTRACTFries predicted in 1980 a continuing rectangularization of the survival curve, and trends toward delayed age of onset of chronic disease and toward compression of morbidity in late life. Others have presented evidence that challenges the first two predictions. However, direct evidence regarding the last one has been lacking.The study reported here analyzed death certificate data on the longest interval between the onset of any condition listed as causing or contributing to the death and the occurrence of the death, from a representative sample of 500 Ontario death certificates in 1975 versus 1985, to deceased individuals aged 65 +. There was a statistically significant decrease between 1975 and 1985 in the frequency of the shortest intervals (under a month) and a not statistically significant increase in the frequency of the longest intervals (5+ years or “years”). Adjustments regarding not-stated intervals and attempts to control for a confounding factor did not change the picture. This study did not yield any statistically significant evidence of a compression of morbidity in late life, and did yield statistically significant findings that were inconsistent with that hypothesis.

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48

Scott, Andrew J., Martin Ellison, and David A. Sinclair. "The economic value of targeting aging." Nature Aging 1, no. 7 (July 2021): 616–23. http://dx.doi.org/10.1038/s43587-021-00080-0.

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AbstractDevelopments in life expectancy and the growing emphasis on biological and ‘healthy’ aging raise a number of important questions for health scientists and economists alike. Is it preferable to make lives healthier by compressing morbidity, or longer by extending life? What are the gains from targeting aging itself compared to efforts to eradicate specific diseases? Here we analyze existing data to evaluate the economic value of increases in life expectancy, improvements in health and treatments that target aging. We show that a compression of morbidity that improves health is more valuable than further increases in life expectancy, and that targeting aging offers potentially larger economic gains than eradicating individual diseases. We show that a slowdown in aging that increases life expectancy by 1 year is worth US$38 trillion, and by 10 years, US$367 trillion. Ultimately, the more progress that is made in improving how we age, the greater the value of further improvements.

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49

de Almeida Bastos, Dhiego Chaves, Richard George Everson, Bruno Fernandes de Oliveira Santos, Ahmed Habib, Rafael A. Vega, Marilou Oro, Ganesh Rao, et al. "A comparison of spinal laser interstitial thermotherapy with open surgery for metastatic thoracic epidural spinal cord compression." Journal of Neurosurgery: Spine 32, no. 5 (May 2020): 667–75. http://dx.doi.org/10.3171/2019.10.spine19998.

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OBJECTIVEThe proximity of the spinal cord to compressive metastatic lesions limits radiosurgical dosing. Open surgery is used to create safe margins around the spinal cord prior to spinal stereotactic radiosurgery (SSRS) but carries the risk of potential surgical morbidity and interruption of systemic oncological treatment. Spinal laser interstitial thermotherapy (SLITT) in conjunction with SSRS provides local control with less morbidity and a shorter interval to resume systemic treatment. The authors present a comparison between SLITT and open surgery in patients with metastatic thoracic epidural spinal cord compression to determine the advantages and disadvantages of each method.METHODSThis is a matched-group design study comprising patients from a single institution with metastatic thoracic epidural spinal cord compression that was treated either with SLITT or open surgery. The two cohorts defined by the surgical treatment comprised patients with epidural spinal cord compression (ESCC) scores of 1c or higher and were deemed suitable for either treatment. Demographics, pre- and postoperative ESCC scores, histology, morbidity, hospital length of stay (LOS), complications, time to radiotherapy, time to resume systemic therapy, progression-free survival (PFS), and overall survival (OS) were compared between groups.RESULTSEighty patients were included in this analysis, 40 in each group. Patients were treated between January 2010 and December 2016. There was no significant difference in demographics or clinical characteristics between the cohorts. The SLITT cohort had a smaller postoperative decrease in the extent of ESCC but a lower estimated blood loss (117 vs 1331 ml, p < 0.001), shorter LOS (3.4 vs 9 days, p < 0.001), lower overall complication rate (5% vs 35%, p = 0.003), fewer days until radiotherapy or SSRS (7.8 vs 35.9, p < 0.001), and systemic treatment (24.7 vs 59 days, p = 0.015). PFS and OS were similar between groups (p = 0.510 and p = 0.868, respectively).CONCLUSIONSThe authors’ results have shown that SLITT plus XRT is not inferior to open decompression surgery plus XRT in regard to local control, with a lower rate of complications and faster resumption of oncological treatment. A prospective randomized controlled study is needed to compare SLITT with open decompressive surgery for ESCC.

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Rodriguez, Francisca S., Herbert Matschinger, Matthias C. Angermeyer, Tobias Luck, and Steffi G. Riedel-Heller. "Compression of cognitive morbidity by higher education in individuals aged 75+ living in Germany." International Journal of Geriatric Psychiatry 33, no. 10 (July 19, 2018): 1389–96. http://dx.doi.org/10.1002/gps.4950.

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