Temporal Trends and Predictors of Drug Utilization and Outcomes in First-Ever Stroke Patients: A Population-Based Study Using the Singapore Stroke Registry

(1) Background: It is not well known whether there is an association between COPD and hemorrhagic stroke (HS). We aim to analyze the incidence, clinical characteristics, procedures, and outcomes of HS in patients with and without COPD and to assess sex differences. Secondly, to identify factors associated with in-hospital mortality (IHM). (2) Methods: Patients aged ≥40 years hospitalized with HS included in the Spanish National Hospital Discharge Database (2016–2018) were analyzed. Propensity score matching (PSM) was used to compare patients according to sex and COPD status. (3) Results: We included 55,615 patients (44.29% women). Among men with COPD the HS adjusted incidence was higher (IRR 1.31; 95% CI 1.24–1.57) than among non-COPD men. COPD men had higher adjusted incidence of HS than COPD women (IRR 1.87; 95% CI 1.85–1.89). After matching, COPD men had a higher IHM (29.96% vs. 27.46%; p = 0.032) than non-COPD men. Decompressive craniectomy was more frequently conducted among COPD men than COPD women (6.74% vs. 4.54%; p = 0.014). IHM increased with age and atrial fibrillation, while decompressive craniectomy reduced IHM. (4) Conclusions: COPD men had higher incidence and IHM of HS than men without COPD. COPD men had higher incidence of HS than COPD women. Decompressive craniectomy was more frequently conducted in COPD men than COPD women and this procedure was associated to better survival.

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Disparities in the Use of Intravenous t-PA among Ischemic Stroke Patients: Population-based Recent Temporal Trends

Journal of Stroke and Cerebrovascular Diseases ◽

10.1016/j.jstrokecerebrovasdis.2019.01.013 ◽

2019 ◽

Vol 28 (5) ◽

pp. 1243-1251 ◽

Cited By ~ 1

Author(s):

Mohammad A. Faysel ◽

Jonathan Singer ◽

Caroline Cummings ◽

Dimitre G. Stefanov ◽

Steven R. Levine

Keyword(s):

Ischemic Stroke ◽

Temporal Trends ◽

Population Based ◽

Stroke Patients

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Drug utilization in patients with OA: a population-based study

Rheumatology ◽

10.1093/rheumatology/keu403 ◽

2014 ◽

Vol 54 (5) ◽

pp. 860-867 ◽

Cited By ~ 28

Author(s):

Nicholas Wilson ◽

Lidia Sanchez-Riera ◽

Rosa Morros ◽

Adolfo Diez-Perez ◽

M. Kassim Javaid ◽

...

Keyword(s):

Drug Utilization ◽

Population Based ◽

Population Based Study

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Temporal Trends in Incidence and Severity of Acute Pancreatitis in Lüneburg County, Germany: A Population-Based Study

Pancreatology ◽

10.1159/000209217 ◽

2009 ◽

Vol 9 (4) ◽

pp. 420-426 ◽

Cited By ~ 24

Author(s):

Paul Georg Lankisch ◽

Mirwais Karimi ◽

Anja Bruns ◽

Patrick Maisonneuve ◽

Albert B. Lowenfels

Keyword(s):

Acute Pancreatitis ◽

Temporal Trends ◽

Population Based ◽

Population Based Study

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Temporal trends in the risk of second primary cancers among survivors of adult-onset cancers, 1980 through 2013: An Australian population-based study

Cancer ◽

10.1002/cncr.31247 ◽

2018 ◽

Vol 124 (8) ◽

pp. 1808-1818 ◽

Cited By ~ 2

Author(s):

Yuanzi Ye ◽

Petr Otahal ◽

Karen E. Wills ◽

Amanda L. Neil ◽

Alison J. Venn

Keyword(s):

Temporal Trends ◽

Population Based ◽

Second Primary ◽

Adult Onset ◽

Australian Population ◽

Population Based Study ◽

Second Primary Cancers

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Abstract WP292: Temporal Trends in the Use of Ems Service as a Mode of Arrival by Acute Ischemic Stroke Patients

Stroke ◽

10.1161/str.51.suppl_1.wp292 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Syed F Ali ◽

Lee H Schwamm ◽

Sanjeeva Onteddu ◽

Krishna Nalleballe ◽

Kelly-Ann Patrice ◽

...

Keyword(s):

African Americans ◽

Univariate Analysis ◽

Temporal Trends ◽

Stroke Patients ◽

Altered Level ◽

Stroke Registry ◽

Stroke Risk Factors ◽

The Us ◽

Ems Education ◽

Iv Tpa

Intro: Utilization of emergency medical services (EMS) can increase the likelihood of appropriate therapy with IV tPA or endovascular intervention. We investigate the use of EMS services in three large states across the US during the past decade. Methods: Using GWTG stroke registry data from three large comprehensive stroke centers in the Northeast, South and West, we analyzed 9,251 stroke admissions from 01/2010 - 12/2018. Overall rates of EMS use and temporal trends were computed. Factors associated with EMS use were evaluated with univariate analysis. Results: Of the 9,251 patients, 29.2 % (2,697/9,251) presented via EMS service. Overtime use of EMS service increased from 29% in 2010-11 to 34% in 2018. Use of EMS increased among severe stroke patients but decreased among mild stroke patients. Patients presenting via EMS were older, more often females while less often African Americans. They had more stroke risk factors, including hypertension, diabetes, atrial fibrillation and previous stroke/TIA. Smokers less often use EMS services. Median NIHSS was higher among patients presenting via EMS, and those with altered level of consciousness used EMS more often. In-hospital intervention rates (IV tPA/endovascular) were higher among patients presenting via EMS. Conclusion: Our results showed that after extensive EMS education in most parts of the study states, stroke presentation has increased via EMS overtime. Disparity in the use of EMS still exists with African Americans using the service less often. Patients should be encouraged to use EMS services and decrease delay in presentation which can results in higher rates of intervention.

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Temporal trends in neonatal mortality and morbidity following spontaneous and clinician-initiated preterm birth in Washington State, USA: a population-based study

BMJ Open ◽

10.1136/bmjopen-2018-023004 ◽

2019 ◽

Vol 9 (1) ◽

pp. e023004 ◽

Cited By ~ 4

Author(s):

Lindsay L Richter ◽

Joseph Ting ◽

Giulia M Muraca ◽

Anne Synnes ◽

Kenneth I Lim ◽

...

Keyword(s):

Neonatal Mortality ◽

Preterm Infants ◽

Temporal Trends ◽

Population Based ◽

Washington State ◽

Late Preterm ◽

Population Based Study ◽

Mortality And Morbidity ◽

Late Preterm Infants ◽

Spontaneous Labour

ObjectiveAfter a decade of increase, the preterm birth (PTB) rate has declined in the USA since 2006, with the largest decline at late preterm (34–36 weeks). We described concomitant changes in gestational age-specific rates of neonatal mortality and morbidity following spontaneous and clinician-initiated PTB among singleton infants.Design, setting and participantsThis retrospective population-based study included 754 763 singleton births in Washington State, USA, 2004–2013, using data from birth certificates and hospitalisation records. PTB subtypes included preterm premature rupture of membranes (PPROM), spontaneous onset of labour and clinician-initiated delivery.Outcome measuresThe primary outcomes were neonatal mortality and a composite outcome including death or severe neonatal morbidity. Temporal trends in the outcomes and individual morbidities were assessed by PTB subtype. Logistic regression yielded adjusted odds ratios (AOR) per 1 year change in outcome and 95% CI.ResultsThe rate of PTB following PPROM and spontaneous labour declined, while clinician-initiated PTB increased (all p<0.01). Overall neonatal mortality remained unchanged (1.3%; AOR 0.99, CI 0.95 to 1.02), though gestational age-specific mortality following clinician-initiated PTB declined at 32–33 weeks (AOR 0.85, CI 0.74 to 0.97) and increased at 34–36 weeks (AOR 1.10, CI 1.01 to 1.20). The overall rate of the composite outcome increased (from 7.9% to 11.9%; AOR 1.06, CI 1.05 to 1.08). Among late preterm infants, combined mortality or severe morbidity increased following PPROM (AOR 1.13, CI 1.08 to 1.18), spontaneous labour (AOR 1.09, CI 1.06 to 1.13) and clinician-initiated delivery (AOR 1.10, CI 1.07 to 1.13). Neonatal sepsis rates increased among all preterm infants (AOR 1.09, CI 1.08 to 1.11).ConclusionsTiming of obstetric interventions is associated with infant health outcomes at preterm. The temporal decline in late PTB among singleton infants was associated with increased mortality among late preterm infants born following clinician-initiated delivery and increased combined mortality or severe morbidity among all late preterm infants, mainly due to increased rate of sepsis.

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