scholarly journals National record-linkage study of hospital admissions for schizophrenia in childhood and adolescence in England

2021 ◽  
Author(s):  
Olena Seminog ◽  
Uy Hoang ◽  
Michael Goldacre ◽  
Anthony James
Keyword(s):  
Hospital Admissions ◽  
Population Based ◽  
Linkage Study ◽  
Incidence Rates ◽  
Childhood And Adolescence ◽  
Childhood Onset ◽  
Affective Psychosis ◽  
Health Service Provision ◽  
Childhood Onset Schizophrenia ◽  
Icd 10

Abstract Background There is a lack of information on changes in hospital admission rates for childhood-onset schizophrenia (COS), or on patient characteristics, to inform clinical research and health service provision. Aims To report age- and sex-specific incidence rates of hospital admissions and day patient care for schizophrenia (ICD-10 F20) and non-affective psychosis (ICD-10 F20-29), by year of occurrence and age, in childhood and adolescence. Methods Population-based study using person-linked data for England (available 2001–2016); time-periods in single years and 4-year groups. Results Hospitalised incidence for schizophrenia increased with increasing age, from 0.03 (95% confidence interval (CI) 0.02–0.05) and 0.01 (0–0.01) per 100,000 in, respectively, males and females aged 5–12 years, to 3.67 (3.44–3.91) in males and 1.58 (1.43–1.75) in females aged 13–17 years. There was no gender difference in hospitalised incidence rates in children aged 5–12, but in 13–17 years old, there was a male excess. Rates for schizophrenia were stable over time in 5–12 years old. In ages 13–17, rates for schizophrenia decreased between 2001–2004 and 2013–2016 in males, from 6.65 (6.04–7.31) down to 1.40 (1.13–1.73), and in females from 2.42 (2.05–2.83) to 1.18 (0.92–1.48). The hospitalisation rates for schizophrenia and non-affective psychosis, combined, in 13–17 years old decreased in males from 14.20 (13.30–15.14) in 2001–2004 to 10.77 (9.97–11.60) in 2013–2016, but increased in females from 7.49 (6.83–8.20) to 10.16 (9.38–11.00). Conclusions The study confirms that childhood-onset schizophrenia is extremely rare, with only 32 cases identified over a 15-year period in the whole of England. The incidence of schizophrenia and non-affective psychosis increased substantially in adolescence; however, the marked reduction in the proportion of those diagnosed with schizophrenia in this age group suggests a possible change in diagnostic practice.

Abstract P625: Rate of Hemorrhagic Transformation After Ischemic Stroke and Associated Risk Factors: The Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS)

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Robert J Stanton ◽  
Eleni Antzoulatos ◽  
Elisheva R Coleman ◽  
Felipe De Los Rios La Rosa ◽  
Stacie L Demel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Case Fatality ◽  
Population Based ◽  
Hemorrhagic Transformation ◽  
Incidence Rates ◽  
Icd 10 ◽  
Potential Risk Factors ◽  
Adjusted Rate ◽  
Associated Risk Factors

Background: Hemorrhagic transformation (HT) of ischemic stroke can have devastating consequences, leading to longer hospitalizations, increased morbidity and mortality. We sought to identify the rate of HT in stroke patients not treated with tPA within a large, biracial population. Methods: The GCNKSS is a population-based stroke epidemiology study from five counties in the Greater Cincinnati region. During 2015, we captured all hospitalized strokes by screening ICD-9 codes 430-436 and ICD-10 codes I60-I68, and G45-46. Study nurses abstracted all potential cases and physicians adjudicated cases, including classifying the degree of HT. Patients treated with thrombolytics were excluded. Incidence rates per 100,000 and associated 95% confidence intervals (CI) were estimated for HT cases, age and sex adjusted to the 2000 US population. Multiple logistic regression was used to examine risk factors associated with HT. Results: In 2015, there were 2301 ischemic strokes included in the analysis. Of these 104 (4.5%) had HT; 23 (22.1%) symptomatic, 55 (52.9%) asymptomatic and 26 (25%) unknown. Documented reasons for not receiving tPA in these patients were: time (71, 68.3%), anticoagulant use (1, 1.0%), other (18,17.3%) and unknown (14, 13.5%), which were not significantly different compared to those without HT. Only 29/104 (18.3%) had HT classified as PH-1 or PH-2. The age, sex and race-adjusted rate of HT was 9.8 (7.9, 11.6) per 100,000. The table shows rates of potential risk factors and the adjusted odds of developing HT. 90 day all-cause case fatality for patients with HT was significantly higher, 27.9% vs. 15.7%, p<0.0001. Conclusion: We found that 4.5% of non-tPA treated IS patients had HT. These patients had more severe strokes, were more likely to have abnormal coagulation tests or anticoagulant use, and were more likely to die within 90 days. We also report the first population-based incidence rate of HT in non-tPA treated of 9.8/100,000, a rate similar to the incidence of SAH.

scholarly journals Causes of death among homeless people: a population-based cross-sectional study of linked hospitalisation and mortality data in England.

2019 ◽  
Vol 4 ◽  
pp. 49 ◽  
Author(s):  
Robert W Aldridge ◽  
Dee Menezes ◽  
Dan Lewer ◽  
Michelle Cornes ◽  
Hannah Evans ◽  
...  
Keyword(s):  
Causes Of Death ◽  
Hospital Admissions ◽  
Social Deprivation ◽  
Homeless People ◽  
Population Based ◽  
Cross Sectional Study ◽  
Mortality Data ◽  
Cross Sectional ◽  
Icd 10 ◽  
External Causes

Background: Homelessness has increased by 165% since 2010 in England, with evidence from many settings that those affected experience high levels of mortality. In this paper we examine the contribution of different causes of death to overall mortality in homeless people recently admitted to hospitals in England with specialist integrated homeless health and care (SIHHC) schemes. Methods: We undertook an analysis of linked hospital admission records and mortality data for people attending any one of 17 SIHHC schemes between 1st November 2013 and 30th November 2016. Our primary outcome was death, which we analysed in subgroups of 10th version international classification of disease (ICD-10) specific deaths; and deaths from amenable causes. We compared our results to a sample of people living in areas of high social deprivation (IMD5 group).Results: We collected data on 3,882 individual homeless hospital admissions that were linked to 600 deaths. The median age of death was 51.6 years (interquartile range 42.7-60.2) for SIHHC and 71.5 for the IMD5 (60.67-79.0).  The top three underlying causes of death by ICD-10 chapter in the SIHHC group were external causes of death (21.7%; 130/600), cancer (19.0%; 114/600) and digestive disease (19.0%; 114/600).  The percentage of deaths due to an amenable cause after age and sex weighting was 30.2% in the homeless SIHHC group (181/600) compared to 23.0% in the IMD5 group (578/2,512).Conclusion: Nearly one in three homeless deaths were due to causes amenable to timely and effective health care. The high burden of amenable deaths highlights the extreme health harms of homelessness and the need for greater emphasis on prevention of homelessness and early healthcare interventions.

RCVS: Symptoms, Incidence, and Resource Utilization in a Population-Based US Cohort

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012223
Author(s):  
Jessica Magid-Bernstein ◽  
Setareh Salehi Omran ◽  
Neal S. Parikh ◽  
Alexander E. Merkler ◽  
Babak Navi ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Administrative Data ◽  
Census Data ◽  
Hospital Admissions ◽  
Population Based ◽  
Cerebrovascular Diseases ◽  
Cerebral Vasoconstriction ◽  
Icd 10 ◽  
Incidence Of Hospitalization ◽  
Age And Sex

Objective:To estimate the incidence of hospitalization for reversible cerebral vasoconstriction syndrome (RCVS), we identified RCVS-related hospital admissions across 11 U.S. states in 2016.Methods:We tested the validity of ICD-10 code I67.841 in 79 patients with hospital admissions for RCVS or other cerebrovascular diseases at one academic and one community hospital. After determining that this code had a sensitivity of 100% (95% CI, 82-100%) and a specificity of 90% (95% CI, 79-96%), we applied it to administrative data from the Healthcare Cost and Utilization Project on all ED visits and hospital admissions. Age- and sex-standardized RCVS incidence was calculated using census data. Descriptive statistics were used to analyze associated diagnoses.Results:Across 5,067,250 hospital admissions in our administrative data, we identified 222 patients with a discharge diagnosis of RCVS in 2016. The estimated annual age- and sex-standardized incidence of RCVS hospitalization was 2.7 (95% CI, 2.4-3.1) cases per million adults. Many patients had concomitant neurologic diagnoses, including subarachnoid hemorrhage (37%), ischemic stroke (16%), and intracerebral hemorrhage (10%). In the 90 days before the index admission, 97 patients had an ED visit and 34 patients a hospital admission, most commonly for neurologic, psychiatric, and pregnancy-related diagnoses. Following discharge from the RCVS hospital admission, 58 patients had an ED visit and 31 had a hospital admission, most commonly for neurologic diagnoses.Conclusions:Using population-wide data, we estimated the age- and sex-standardized incidence of hospitalization for RCVS in U.S. adults as approximately 3 per million per year.

The Risk and Consequences of Vertebral Fracture in Patients with Ankylosing Spondylitis: A Population-based Data Linkage Study

2020 ◽  
Vol 47 (11) ◽  
pp. 1629-1636 ◽  
Author(s):  
Milica Ognjenovic ◽  
Warren D. Raymond ◽  
Charles A. Inderjeeth ◽  
Helen I. Keen ◽  
David B. Preen ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Vertebral Fracture ◽  
Proportional Hazards ◽  
Tumor Necrosis Factor Inhibitor ◽  
Population Based ◽  
Linkage Study ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Risk Of Death ◽  
Increased Risk

Objective.To compare the long-term prevalence, incidence, and outcomes of vertebral fracture (VF) between ankylosing spondylitis (AS) patients and matched controls, including the role of extraarticular manifestations (EAM) and osteoporosis.Methods.This was a statewide observational study using linked health data for 2321 patients with AS and 22,976 controls presenting to hospital from 1980 to 2015. Data were analyzed using incidence rates (per 1000 person-yrs) and ratios (IRR), multivariable Cox proportional hazards regression, and Kaplan-Meier survival curves.Results.Over a median 13.92 (interquartile range 7.58–21.67) years of follow-up, patients with AS had a greater VF prevalence and greater incidence of developing a new VF compared to controls (9.3% vs 2.5%, 6.8% vs 1.9%, respectively, all P < 0.001). Patients with AS had an increased risk of developing a VF after adjustments for age, sex, and osteoporosis (HR 2.55, 95% CI 2.11–3.09) compared to controls; this risk remained throughout the study period. Patients with AS were 5 years younger at time of first VF (P = 0.008) and had a greater likelihood of a recurrent VF (IRR 4.64; 95% CI 4.54–4.75) compared to respective controls. Mortality overall was comparable between patients with AS and controls after adjustment for age, sex, osteoporosis, and VF status (HR 0.90; 95% CI 0.80–1.01).Conclusion.The significantly increased risk of VF in patients with AS has not altered following the introduction of tumor necrosis factor inhibitor treatment. Although patients with AS experience a first VF at a younger age than controls, this does not lead to an increased risk of death.

scholarly journals Epidemiology of Endometriosis in Spain and Its Autonomous Communities: A Large, Nationwide Study

2021 ◽  
Vol 18 (15) ◽  
pp. 7861
Author(s):  
Almudena Ávalos Marfil ◽  
Enriqueta Barranco Castillo ◽  
Raúl Martos García ◽  
Nicolás Mendoza Ladrón de Guevara ◽  
Maryna Mazheika
Keyword(s):  
National Level ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Incidence Rates ◽  
Reproductive Age ◽  
Hospital Data ◽  
Autonomous Communities ◽  
Spanish Study ◽  
Classification Of Diseases ◽  
Icd 10

A retrospective population-based study aimed to assess the incidence of endometriosis in the general population in Spain and in each of its autonomous communities. The authors used the incidence of diagnosed endometriosis in the minimum basic dataset at discharge in the national hospital discharge registry of Spain. This analysis was carried out with hospital data with a diagnosis of endometriosis (International Classification of Diseases (ICD)-9 code 617.xx and ICD-10 code N80.xx) and covered the period from 1 January 2014 to 31 December 2017 and a population of 12,775,911 women of reproductive age (15–54 years). The data were then analyzed at the national level and separately for each autonomous community. This nationwide Spanish study estimated the overall incidence of endometriosis among autonomous communities in Spain to be 16.1 per 10,000 women (range, 6.8 to 24). The mean age of the 20,547 women diagnosed with endometriosis during the study period was 36.8 ± 5.4 years. The types (proportions) of endometriosis were uterine (28.4%), tubo-ovarian (35.2%), peritoneal (8.1%), vesical (6.8%) and intestinal (3.2%) endometriosis. Further studies are needed to assess the reasons for the decrease in the observed incidence and for the significant differences in the regional incidence rates of this disease.

High Altitude Is Associated With Lower Stroke-Related Mortality: A 17-Year Nationwide Population-Based Analysis From Ecuador

2021 ◽  
Author(s):  
Esteban Ortiz-Prado ◽  
Patricio. S Espinosa ◽  
Alfredo Borrero ◽  
Simone P. Cordovez ◽  
Jorge E. Vasconez ◽  
...  
Keyword(s):  
High Altitude ◽  
Protective Factor ◽  
Hospital Admissions ◽  
Population Based ◽  
Incidence Rates ◽  
Stroke Incidence ◽  
Hypoxia Exposure ◽  
Admission Rates ◽  
Disability Adjusted Life ◽  
Life Years

Abstract Background: Globally, more than 5.7% of the population reside above 1,500 m of elevation. It has been hypothesized that acute short-term hypoxia exposure could increase the risk of developing a stroke. Studies assessing the effect of altitude on stroke have provided conflicting results, some analysis suggest that long-term chronic exposure could be associated with reduced mortality and lower stroke incidence rates. Methods:An ecological analysis of all stroke hospital admissions, mortality rates and disability adjusted life years in Ecuador was performed from 2001-2017. The cases and population at risk were categorized in low (<1,500 m), moderate (1,500-2,500 m), high (2,500-3,500 m) and very high altitude (3,500-5,500 m) according to place of residence. The derived crude and direct standardized age-sex adjusted mortality and hospital admission rates were calculated. Results: A total of 38,201 deaths and 75,893 stroke-related hospital admissions were reported. High-altitude populations (HAP) had lower stroke mortality in men (RR: 0.91 [0.88 - 0.95]) and women (RR: 0.83 [0.79 - 0.86]). In addition, HAP had a significant lower risk of getting admitted to the hospital when compared with the low altitude group in men (RR: 0.55 [CI95% 0.54 - 0.56]) and women (RR: 0.65 [CI95% [0.64 - 0.66]). Conclusions: This is the first epidemiological study that aims to elucidate the association between stroke and altitude using four different elevation ranges. Our findings suggest that living at higher elevations offers a reduction or the risk of dying due to stroke as well as a reduction in the probability of being admitted to the hospital. Nevertheless, this protective factor has the stronger effect between 2,000 m to 3,500 m.

scholarly journals Quantifying the incidence and cost of acute gastrointestinal illness in Sweden, 2013–2014

2016 ◽  
Vol 144 (13) ◽  
pp. 2831-2839 ◽  
Author(s):  
M. EDELSTEIN ◽  
H. MERK ◽  
C. DEOGAN ◽  
A. CARNAHAN ◽  
A. WALLENSTEN
Keyword(s):  
Primary Care ◽  
Hospital Admissions ◽  
Productivity Loss ◽  
Gastrointestinal Symptoms ◽  
Population Based ◽  
Incidence Rates ◽  
Gastrointestinal Illness ◽  
Age Group ◽  
Acute Gastrointestinal Illness ◽  
Direct Healthcare Costs

SUMMARYIn Sweden, acute gastrointestinal illness (AGI) incidence, severity, impact on productivity, related healthcare usage and associated costs are not ascertained. We measured these in 2013–2014 using a population-based cohort reporting weekly. We defined AGI as ⩾3 episodes of loose stools or vomiting/24 h; or loose stools or vomiting with ⩾2 other gastrointestinal symptoms. After each AGI episode, we collected information about perceived severity, healthcare use and absenteeism. We calculated incidence rates, AGI absenteeism and costs comprising direct healthcare costs and productivity loss due to work/school absenteeism. A total of 3241 participants reported 1696 AGI episodes [incidence 360/1000 person-years, 95% confidence interval (CI) 326–395; highest in the <5 years age group]. In the <5 years age group, 31% of episodes were perceived as mild, 61% as moderate and 8% as severe; 9·4% led to primary-care consultations, and 1·4% to hospital admissions. In the ⩾5 years age group, 18% of episodes were perceived as mild, 64% as moderate and 18% as severe; 6·4% led to primary-care consultations, and 1·9% to hospital admissions. AGI caused 8 891 000 days of absenteeism (95% CI 6 009 000–12 780 000). AGI cost €1 005 885 000 (95% CI 754 309 000–1 257 195 000) nationally for the year. In Sweden, a minority of cases perceive AGI as a mild illness. AGI is a burden on the healthcare system and causes productivity loss, with high costs. Countries may consider these estimates when prioritizing health interventions.

scholarly journals Linking the Australian Childhood Immunisation Register to population-based perinatal datasets to assess coverage in at-risk groups

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Hannah Moore ◽  
Lisa McCallum ◽  
Parveen Fathima ◽  
Nicholas De Klerk ◽  
Bette Liu ◽  
...  
Keyword(s):  
At Risk ◽  
Birth Cohort ◽  
Hospital Admissions ◽  
Risk Groups ◽  
Population Based ◽  
Linkage Study ◽  
Childhood Immunisation ◽  
Preterm Children ◽  
National Immunisation ◽  
Extremely Preterm

ABSTRACT ObjectiveImmunisation remains one of the most important public health interventions. However, linkage of population-based immunisation registers to perinatal and health outcome datasets to evaluate immunisation programs is limited. We have conducted the first-ever linkages of immunisation records from Australia’s Childhood Immunisation Register (ACIR) for the purposes of evaluating Australia’s unique national immunisation program. As an initial outcome of our linkage study we present estimates of pneumococcal conjugate vaccine (PCV) coverage for the 3rd dose assessed at 12 months of age in extremely preterm children (gestational age <28 weeks), in whom a funded vaccination program was established in 2001 prior to a universal funded program for all children in 2005. ApproachIndividual immunisation records from ACIR, hospital admissions, deaths and infectious diseases notifications were linked to perinatal records for a cohort of births from 1996 to 2012 in two Australian states. Three separate data linkage units were involved in the process with varying procedures for linkage. The perinatal datasets were used to identify extremely preterm children. ResultsThe birth cohort for the study included 1,958,537 live births in New South Wales (1,492,399) and Western Australia (461,620). Linkage weights based on sensitivity and positive predictive value of >99% were used to identify immunisation records from ACIR to link to the birth cohort. A unique scrambled pin on ACIR was used to link immunisation records to birth cohort datasets. The final cohort consisted of 1,954,019 children with 95.5% linking to at least 1 ACIR record from a total of >26.6 million ACIR records. In 2001, coverage of the 3rd dose of PCV in extremely preterm children was 0.9% and increased to 69.1% in 2004 (overall coverage 2001-2004: 25.3%). From 2005 to 2012, coverage increased to an average of 89.7%. ConclusionThese are the first results of cross-jurisdictional linkages of immunisation records to state-based administrative datasets in Australia. This process has identified some improvements that are needed to streamline future linkage projects of this scale. Linkage of perinatal datasets to ACIR has enabled us to assess the first-ever coverage estimates in specific medically at-risk population subgroups. Future analyses will focus on the predictors and timeliness of vaccination coverage and population based estimates of vaccine effectiveness.

scholarly journals Urban–rural differences in incidence rates of psychiatric disorders in Denmark

2016 ◽  
Vol 208 (5) ◽  
pp. 435-440 ◽  
Author(s):  
Evangelos Vassos ◽  
Esben Agerbo ◽  
Ole Mors ◽  
Carsten Bøcker Pedersen
Keyword(s):  
Psychiatric Disorders ◽  
Emotional Disorders ◽  
Rural Areas ◽  
Psychotic Disorders ◽  
Population Based ◽  
Incidence Rates ◽  
Increased Risk ◽  
Icd 10 ◽  
Urban Rural ◽  
Rate Ratios

BackgroundPeople born in densely populated areas have a higher risk of developing schizophrenia, bipolar disorder and autism.AimsThe purpose of this study was to investigate whether urban–rural differences in place of birth influence a broad range of mental disorders.MethodPopulation-based cohort study of everyone born in Denmark between 1955 and 2006 (n = 2 894 640). Main outcome measures were incidence rate ratios for five levels of urbanisation and summary estimates contrasting birth in the capital with birth in rural areas.ResultsFor all psychiatric disorders, except intellectual disability (ICD-10 ‘mental retardation’) and behavioural and emotional disorders with onset in childhood, people born in the capital had a higher incidence than people born in rural areas.ConclusionsBirth in an urban environment is associated with an increased risk for mental illness in general and for a broad range of specific psychiatric disorders. Given this new evidence that urban–rural differences in incidence are not confined to the well-studied psychotic disorders, further work is needed to identify the underlying aetiopathogenic mechanisms.

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