{"id":24540,"date":"2023-09-18T04:09:00","date_gmt":"2023-09-17T20:09:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24540"},"modified":"2023-09-18T05:26:05","modified_gmt":"2023-09-17T21:26:05","slug":"jama-surg%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%90%8c%e6%80%a7%e5%88%ab%e5%ad%aa%e7%94%9f%e5%ad%90%e5%8f%91%e7%94%9f%e5%88%9b%e4%bc%a4%e4%b8%8e%e6%ad%bb%e4%ba%a1%e5%8f%8a%e5%85%8d%e7%96%ab","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24540","title":{"rendered":"[JAMA Surg\u53d1\u8868\u8bba\u6587]\uff1a\u540c\u6027\u522b\u5b6a\u751f\u5b50\u53d1\u751f\u521b\u4f24\u4e0e\u6b7b\u4ea1\u53ca\u514d\u75ab\u4ecb\u5bfc\u6216\u80bf\u7624\u6027\u75be\u75c5\u7684\u8fdc\u671f\u98ce\u9669\u7684\u76f8\u5173\u6027"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

May 17, 2023<\/p>\n\n\n\n

Association of Trauma With Long-Term Risk of Death and Immune-Mediated or Cancer Disease in Same-Sex Twins<\/h1>\n\n\n\n

Trine O.\u00a0Eskesen,\u00a0Martin\u00a0Sillesen,\u00a0Jacob Krabbe\u00a0Pedersen,\u00a0et al<\/h3>\n\n\n\n

JAMA Surg.\u00a0<\/em>2023;158(7):738-745. doi:10.1001\/jamasurg.2023.1560<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  Is moderate to severe trauma associated with long-term increased risk of death or immune-mediated or cancer disease?<\/p>\n\n\n\n

Findings<\/strong>  In this nationwide co-twin cohort study of same-sex twins discordant on trauma, twins exposed to moderate to severe trauma had a significantly increased risk of death or immune-mediated or cancer disease for more than 20 years after the trauma when compared with their co-twin who had not been exposed to trauma.<\/p>\n\n\n\n

Meaning<\/strong>  Moderate to severe trauma may increase the risk of death and immune-mediated or cancer disease not only close to the trauma but continues to be a risk factor several years after the injury.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Immediate consequences of trauma include a rapid and immense activation of the immune system, whereas long-term outcomes include premature death, physical disability, and reduced workability.<\/p>\n\n\n\n

Objective<\/strong>  To investigate if moderate to severe trauma is associated with long-term increased risk of death or immune-mediated or cancer disease.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This registry-based, matched, co-twin control cohort study linked the Danish Twin Registry and the Danish National Patient Registry to identify twin pairs in which 1 twin had been exposed to severe trauma and the other twin had not from 1994 to 2018. The co-twin control design allowed for matching on genetic and environmental factors shared within twin pairs.<\/p>\n\n\n\n

Exposure<\/strong>  Twin pairs were included if 1 twin had been exposed to moderate to severe trauma and the other twin had not (ie, co-twin). Only twin pairs where both twins were alive 6 months after the trauma event were included.<\/p>\n\n\n\n

Main Outcome and Measure<\/strong>  Twin pairs were followed up from 6 months after trauma until 1 twin experienced the primary composite outcome of death or 1 of 24 predefined immune-mediated or cancer diseases or end of follow-up. Cox proportional hazards regression was used for intrapair analyses of the association between trauma and the primary outcome.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0A total of 3776 twin pairs were included, and 2290 (61%) were disease free prior to outcome analysis and were eligible for the analysis of the primary outcome. The median (IQR) age was 36.4 (25.7-50.2) years. The median (IQR) follow-up time was 8.6 (3.8-14.5) years. Overall, 1268 twin pairs (55%) reached the primary outcome; the twin exposed to trauma was first to experience the outcome in 724 pairs (32%), whereas the co-twin was first in 544 pairs (24%). The hazard ratio for reaching the composite outcome was 1.33 (95% CI, 1.19-1.49) for twins exposed to trauma. Analyses of death or immune-mediated or cancer disease as separate outcomes provided hazard ratios of 1.91 (95% CI, 1.68-2.18) and 1.28 (95% CI, 1.14-1.44), respectively.<\/p>\n\n\n\n

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Conclusion and Relevance<\/strong>  In this study, twins exposed to moderate to severe trauma had significantly increased risk of death or immune-mediated or cancer disease several years after trauma compared with their co-twins.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  May 17, 2023 Association o […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24540"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24540"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24540\/revisions"}],"predecessor-version":[{"id":24541,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24540\/revisions\/24541"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24540"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24540"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24540"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}