scholarly journals Adverse Health Outcomes After Discharge from the Emergency Department—Incidence and Risk Factors in a Veteran Population

2007 ◽  
Vol 22 (11) ◽  
pp. 1527-1531 ◽  
Author(s):  
S. Nicole Hastings ◽  
Kenneth E. Schmader ◽  
Richard J. Sloane ◽  
Morris Weinberger ◽  
Kenneth C. Goldberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Health Outcomes ◽  
Adverse Health ◽  
Adverse Health Outcomes

scholarly journals Using logic regression to characterize extreme heat exposures and their health associations: a time-series study of emergency department visits in Atlanta

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shan Jiang ◽  
Joshua L. Warren ◽  
Noah Scovronick ◽  
Shannon E. Moss ◽  
Lyndsey A. Darrow ◽  
...  
Keyword(s):  
Emergency Department ◽  
Time Series ◽  
Health Outcomes ◽  
Simulation Study ◽  
Heat Exposure ◽  
Emergency Department Visits ◽  
Extreme Heat ◽  
Logic Regression ◽  
Adverse Health ◽  
Adverse Health Outcomes

Abstract Background Short-term associations between extreme heat events and adverse health outcomes are well-established in epidemiologic studies. However, the use of different exposure definitions across studies has limited our understanding of extreme heat characteristics that are most important for specific health outcomes or subpopulations. Methods Logic regression is a statistical learning method for constructing decision trees based on Boolean combinations of binary predictors. We describe how logic regression can be utilized as a data-driven approach to identify extreme heat exposure definitions using health outcome data. We evaluated the performance of the proposed algorithm in a simulation study, as well as in a 20-year time-series analysis of extreme heat and emergency department visits for 12 outcomes in the Atlanta metropolitan area. Results For the Atlanta case study, our novel application of logic regression identified extreme heat exposure definitions that were associated with several heat-sensitive disease outcomes (e.g., fluid and electrolyte imbalance, renal diseases, ischemic stroke, and hypertension). Exposures were often characterized by extreme apparent minimum temperature or maximum temperature over multiple days. The simulation study also demonstrated that logic regression can successfully identify exposures of different lags and duration structures when statistical power is sufficient. Conclusion Logic regression is a useful tool for identifying important characteristics of extreme heat exposures for adverse health outcomes, which may help improve future heat warning systems and response plans.

scholarly journals Emergency Department Discharge Diagnosis and Adverse Health Outcomes in Older Adults

2009 ◽  
Vol 57 (10) ◽  
pp. 1856-1861 ◽  
Author(s):  
S. Nicole Hastings ◽  
Heather E. Whitson ◽  
Jama L. Purser ◽  
Richard J. Sloane ◽  
Kimberly S. Johnson
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Health Outcomes ◽  
Discharge Diagnosis ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Emergency Department Discharge

scholarly journals Risk factors associated with loneliness, social isolation, and neuroticism in the UK Biobank cohort

2020 ◽  
Author(s):  
Ann-Marie G de Lange ◽  
Tobias Kaufmann ◽  
Daniel S Quintana ◽  
Adriano Winterton ◽  
Lars T. Westlye ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Outcomes ◽  
Social Isolation ◽  
Social Deprivation ◽  
Lifestyle Behaviors ◽  
Unhealthy Lifestyle ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Health Initiatives ◽  
The Uk

Amidst the global COVID-19 pandemic, there is an urgent need for establishing knowledge about risk factors for adverse health outcomes associated with loneliness and social isolation. In this study, we show that self-perceived loneliness coincides with objective measures of social isolation as well as the personality trait neuroticism, and that these comorbidities contribute to differential associations with risk factors including depression, social deprivation, unhealthy lifestyle behaviors, cardiovascular risk, and aging of the brain. The findings contribute to identifying groups of individuals who may be vulnerable to loneliness and associated health problems, and emphasize the need for public-health initiatives addressing socioeconomic conditions as well as social, mental, and physical health to reduce the risk of loneliness and adverse health outcomes in the population.

Frequency and Predictors of Adverse Health Outcomes in Older Medicare Beneficiaries Discharged From the Emergency Department

Medical Care ◽  
2008 ◽  
Vol 46 (8) ◽  
pp. 771-777 ◽  
Author(s):  
S Nicole Hastings ◽  
Eugene Z. Oddone ◽  
Gerda Fillenbaum ◽  
Richard J. Sloane ◽  
Kenneth E. Schmader
Keyword(s):  
Emergency Department ◽  
Health Outcomes ◽  
Medicare Beneficiaries ◽  
Adverse Health ◽  
Adverse Health Outcomes

scholarly journals Predicting Adverse Health Outcomes in Older Patients Presenting to the Emergency Department: The Acutely Presenting Older Patient Study

2017 ◽  
Vol 24 (4) ◽  
pp. 505-505 ◽  
Author(s):  
Jelle de Gelder ◽  
Jacinta A. Lucke ◽  
Bas de Groot ◽  
Anne J. Fogteloo ◽  
Sander Anten ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Outcomes ◽  
Older Patients ◽  
Older Patient ◽  
Patient Study ◽  
Adverse Health ◽  
Adverse Health Outcomes

scholarly journals Hypothalamic-Pituitary Disorders in Childhood Cancer Survivors: Prevalence, Risk Factors and Long-Term Health Outcomes

2019 ◽  
Vol 104 (12) ◽  
pp. 6101-6115 ◽  
Author(s):  
Laura van Iersel ◽  
Zhenghong Li ◽  
Deo Kumar Srivastava ◽  
Tara M Brinkman ◽  
Kari L Bjornard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Outcomes ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Alkylating Agents ◽  
Tertiary Care ◽  
Childhood Cancer Survivors ◽  
Mineral Density ◽  
Adverse Health ◽  
Adverse Health Outcomes

Abstract Context Data on hypothalamic-pituitary (HP) disorders in systematically evaluated childhood cancer survivors are limited. Objective To describe prevalence, risk factors, and associated adverse health outcomes of deficiencies in GH deficiency (GHD), TSH deficiency (TSHD), LH/FSH deficiency (LH/FSHD), and ACTH deficiency (ACTHD), and central precocious puberty (CPP). Design Retrospective with cross-sectional health outcomes analysis. Setting Established cohort; tertiary care center. Patients Participants (N = 3141; median age, 31.7 years) were followed for a median 24.1 years. Main Outcome Measure Multivariable logistic regression was used to calculate ORs and 95% CIs for associations among HP disorders, tumor- and treatment-related risk factors, and health outcomes. Results The estimated prevalence was 40.2% for GHD, 11.1% for TSHD, 10.6% for LH/FSHD, 3.2% for ACTHD, and 0.9% for CPP among participants treated with HP radiotherapy (n = 1089), and 6.2% for GHD, and <1% for other HP disorders without HP radiotherapy. Clinical factors independently associated with HP disorders included HP radiotherapy (at any dose for GHD, TSHD, LH/FSHD, >30 Gy for ACTHD), alkylating agents (GHD, LH/FSHD), intrathecal chemotherapy (GHD), hydrocephalus with shunt placement (GHD, LH/FSHD), seizures (TSHD, ACTHD), and stroke (GHD, TSHD, LH/FSHD, ACTHD). Adverse health outcomes independently associated with HP disorders included short stature (GHD, TSHD), severe bone mineral density deficit (GHD, LH/FSHD), obesity (LH/FSHD), frailty (GHD), impaired physical health-related quality of life (TSHD), sexual dysfunction (LH/FSHD), impaired memory, and processing speed (GHD, TSHD). Conclusion HP radiotherapy, central nervous system injury, and, to a lesser extent, chemotherapy are associated with HP disorders, which are associated with adverse health outcomes.

scholarly journals Adverse Health Outcomes in Relationship to Hypogonadism After Chemotherapy: A Multicenter Study of Testicular Cancer Survivors

2019 ◽  
Vol 17 (5) ◽  
pp. 459-468 ◽  
Author(s):  
Mohammad Abu Zaid ◽  
Paul C. Dinh ◽  
Patrick O. Monahan ◽  
Chunkit Fung ◽  
Omar El-Charif ◽  
...  
Keyword(s):  
Risk Factors ◽  
Erectile Dysfunction ◽  
Testicular Cancer ◽  
Health Outcomes ◽  
Cancer Survivors ◽  
Testosterone Replacement Therapy ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Platinum Based Chemotherapy ◽  
Testicular Cancer Survivors

Background: This study examined the prevalence of hypogonadism, its clinical and genetic risk factors, and its relationship to adverse health outcomes (AHOs) in North American testicular cancer survivors (TCS) after modern platinum-based chemotherapy. Patients and Methods: Eligible TCS were <55 years of age at diagnosis and treated with first-line platinum-based chemotherapy. Participants underwent physical examinations and completed questionnaires regarding 15 AHOs and health behaviors. Hypogonadism was defined as serum testosterone levels ≤3.0 ng/mL or use of testosterone replacement therapy. We investigated the role of 2 single nucleotide polymorphisms (rs6258 and rs12150660) in the sex hormone–binding globulin (SHBG) locus implicated in increased hypogonadism risk in the general population. Results: Of 491 TCS (median age at assessment, 38.2 years; range, 18.7–68.4 years), 38.5% had hypogonadism. Multivariable binary logistic regression analysis identified hypogonadism risk factors, including age at clinical evaluation (odds ratio [OR], 1.42 per 10-year increase; P= .006) and body mass index of 25 to <30 kg/m2 (OR, 2.08; P= .011) or ≥30 kg/m2 (OR, 2.36; P= .005) compared with <25 kg/m2. TCS with ≥2 risk alleles for the SHBG SNPs had a marginally significant increased hypogonadism risk (OR, 1.45; P= .09). Vigorous-intensity physical activity appeared protective (OR, 0.66; P= .07). Type of cisplatin-based chemotherapy regimen and socioeconomic factors did not correlate with hypogonadism. Compared with TCS without hypogonadism, those with hypogonadism were more likely to report ≥2 AHOs (65% vs 51%; P= .003), to take medications for hypercholesterolemia (20.1% vs 6.0%; P<.001) or hypertension (18.5% vs 10.6%; P= .013), and to report erectile dysfunction (19.6% vs 11.9%; P= .018) or peripheral neuropathy (30.7% vs 22.5%; P= .041). A marginally significant trend for increased use of prescription medications for either diabetes (5.8% vs 2.6%; P= .07) or anxiety/depression (14.8% vs 9.3%; P= .06) was observed. Conclusions: At a relatively young median age, more than one-third of TCS have hypogonadism, which is significantly associated with increased cardiovascular disease risk factors, and erectile dysfunction. Providers should screen TCS for hypogonadism and treat symptomatic patients.

Adverse health outcomes in relationship to hypogonadism (HG) after platinum-based chemotherapy: A multicenter study of North American testicular cancer survivors (TCS).

2017 ◽  
Vol 35 (18_suppl) ◽  
pp. LBA10012-LBA10012 ◽  
Author(s):  
Mohammad Issam Abu Zaid ◽  
Alvaro G. Menendez ◽  
Omar El Charif ◽  
Chunkit Fung ◽  
Patrick O. Monahan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Outcomes ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Testosterone Replacement Therapy ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Risk Alleles ◽  
Platinum Based Chemotherapy ◽  
Increased Risk

LBA10012 Background: HG affects a substantial percentage of TCS and can contribute to significant morbidity, but few studies have examined the relationship between HG and adverse health outcomes (AHO), taking into account genetic variation. Methods: Eligible TCS were < 55 y at diagnosis and treated with only first line chemotherapy after 1990. TCS underwent physical exams and genotyping, and completed questionnaires regarding 16 AHO and health behaviors. HG was defined as serum testosterone ≤ 3.0 ng/mL or the use of testosterone replacement therapy. Results: We evaluated 491 TCS. Median age at evaluation was 38 y (range 19-68). 38.5% had HG. Two SNPs in the sex-hormone-binding globulin ( SHBG) locus previously implicated in increased HG risk in the general population (Ohlsson et al, PLOS Genetics 2011) displayed effect sizes consistent with prior reports (rs6258, OR = 1.3; rs12150660, OR = 0.79), but were not statistically significant. However, TCS with ≥ 2 risk alleles for the two SNPs in the SHBG locus vs no risk alleles had 2-fold increased risk for HG (OR = 2.2, P = .12). Multivariate analysis identified risk factors for HG including: age (OR = 1.4 per 10 year increase, P = .007), and BMI ≥ 25 kg/m2 (OR = 2.2, P = .003). Vigorous-intensity physical activity appeared protective (OR = 0.6, P = .06). Type of chemotherapy regimen and socioeconomic factors did not correlate with HG. Only 35% of TCS with HG vs 49% of those without HG reported none or 1 AHO ( P = .003). TCS with HG were more likely to take medications for dyslipidemia (20% vs 6%, P < .001), hypertension (19% vs 11%, P = .01), erectile dysfunction (ED) (20% vs 12%, P = .02), diabetes (6% vs 3%, P = .07), or anxiety/depression (15% vs 10%, P = 0.06) compared to TCS with normal levels, and also to have peripheral neuropathy (PN) (31% vs 23%, P = .04). HG status did not correlate with oto- or renal toxicity. Conclusions: Over a third of TCS have HG at a relatively young age. HG was associated with increased cardiovascular disease risk factors, ED, and PN. SHBG polymorphisms appear important in TCS, but our study was underpowered to confirm an association. Providers should screen TCS for HG and treat those who are symptomatic.

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