scholarly journals Prioritizing Elective Surgery During the COVID-19 Pandemic Has Caused Age-Related Inequality: a Multicenter Study

2022 ◽  
Vol 4 (1) ◽  
Author(s):  
Mikko Uimonen ◽  
Ilari Kuitunen ◽  
Ville Ponkilainen ◽  
Ville M. Mattila

AbstractThe concern has been that this prioritization has resulted in age-related inequality between patients, with the older population suffering the most. The aim of this multicenter study was to examine the differences in incidence and waiting times of elective surgeries by age during the SARS-CoV-2 coronavirus disease (COVID-19) pandemic in Finland. Data on elective surgery (88 716 operations) were gathered from three Finnish public hospitals for the years 2017–2020. Surgery incidence and waiting times stratified by age groups (younger than 18, 18 to 49, 50 to 69, and 70 or older) were examined, and the year 2020 was compared to the reference years 2017–2019. The mean annual, monthly, and weekly waiting times were calculated with 95% confidence intervals (CI). The first COVID-19 wave decreased surgery incidence most prominently in patients younger than 18 (incidence rate ratio [IRR] 0.64, CI 0.60–0.68) and 70 or older (IRR 0.68, CI 0.66–0.70). After the first wave, the incidence increased in patients aged 50 to 69 and 70 or older by 22% and 29%, respectively. Among patients younger than 18, the incidence in 2020 was 15% lower. In patients younger than 18, waiting times were at mean of 43% longer in June to December compared to the reference years. In patients aged 18 to 49, 50 to 69, and 70 or older, waiting times increased in May but recovered to normal level during fall 2020. COVID-19 decreased the incidence of surgery and led to increased waiting times. Clearing of the treatment backlog started with older patients which resulted in prolonged waiting times among pediatric patients.

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0253875
Author(s):  
Mikko Uimonen ◽  
Ilari Kuitunen ◽  
Juha Paloneva ◽  
Antti P. Launonen ◽  
Ville Ponkilainen ◽  
...  

Background A concern has been that health care reorganizations during the first COVID-19 wave have led to delays in elective surgeries, resulting in increased complications and even mortality. This multicenter study examined the changes in waiting times of elective surgeries during the COVID-19 pandemic in Finland. Methods Data on elective surgery were gathered from three Finnish public hospitals for years 2017–2020. Surgery incidence and waiting times were examined and the year 2020 was compared to the reference years 2017–2019. The mean annual, monthly, and weekly waiting times were calculated with 95% confidence intervals (CI). The most common diagnosis groups were examined separately. Findings A total of 88 693 surgeries were included during the study period. The mean waiting time in 2020 was 92.6 (CI 91.5–93.8) days, whereas the mean waiting time in the reference years was 85.8 (CI 85.1–86.5) days, resulting in an average 8% increase in waiting times in 2020. Elective procedure incidence decreased rapidly in the onset of the first COVID-19 wave in March 2020 but recovered in May and June, after which the surgery incidence was 22% higher than in the reference years and remained at this level until the end of the year. In May 2020 and thereafter until November, waiting times were longer with monthly increases varying between 7% and 34%. In gastrointestinal and genitourinary diseases and neoplasms, waiting times were longer in 2020. In cardiovascular and musculoskeletal diseases, waiting times were shorter in 2020. Conclusion The health care reorganizations due to the pandemic have increased elective surgery waiting times by as much as one-third, even though the elective surgery rate increased by one-fifth after the lockdown.


1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77


Author(s):  
Alison Smiley ◽  
Carolyn MacGregor ◽  
Mary Chipman ◽  
Kathy Kawaja ◽  
Leo Tasca

Studies of age-related collision risk have not considered how collision risk varies by season. In 1994, the Ministry of Transportation of Ontario conducted an exposure survey which gathered year-round data to ensure that seasonal variations in collision risk could be measured and analyzed. Three-day trip logs were mailed to a stratified random sample of 11,250 Ontario drivers. The logs were mailed out at the rate of 938 per month. The survey was conducted from December 1993 to November 1994. The mean daily kilometrage for six age groups was estimated, and seasonal collision rates per 1 million km driven were calculated. Drivers aged 80 to 89 show the most dramatic fluctuations in collision risk. The winter collision rate of 22.4 is over three times higher than the rate observed in the fall (6.7). The collision rate in spring (13.4) is twice that observed in the summer and fall. When the youngest and oldest age groups are compared, it is evident that the collision risk of 80- to 89-year-old drivers is 2.0 times higher in winter and about 1.5 times in spring. The youngest drivers, however, have a collision risk that is substantially higher than the oldest drivers in summer and fall.


1980 ◽  
Vol 3 (1) ◽  
pp. 1-17 ◽  
Author(s):  
Willy Lens ◽  
Antoine Gailly

Age related differences in extension of future time perspective in motivational goals are studied at three socio-economic levels in a representative sample of the French speaking adult population in Belgium. The hypothesis of an inverted U-shaped relationship between age and extension of future time perspective is tested statistically. It cannot be maintained when using two indices of future extension that are borrowed from earlier studies in this field: (a) the proportion of number of references to the near future to the number of references to the distant future, and (b) the mean future extension score in number of years. The proportion of the mean future extension score to the statistically calculated expected life time is proposed as a new and better index of future extension for comparing different age groups. With this new index the hypothesis is confirmed at the three socioeconomic levels. The limits of the cross-sectional method that is used and the relative value of the new index of extension of future time perspective are discussed.


2020 ◽  
Vol 15 (2) ◽  
pp. 61-67
Author(s):  
Fatema Johora ◽  
Abu Sadat Mohammad Nurunnabi ◽  
Dilruba Siddiqua ◽  
Hasna Hena ◽  
Shamim Ara

Background: Changes in the size of the kidney are evident in humans, as age progresses. Objective: To see the age-related changes in the morphological dimensions of the kidney in a sample of the Bangladeshi population. Methods: This crosssectional study was done in the Department of Anatomy, Dhaka Medical College, Dhaka, from July 2008 to June 2009, based on a collection of 140 postmortem human kidneys collected from 70 unclaimed dead bodies from the morgue of the same institution. All the samples of kidney were divided into three age groups, including A (10-19 years), B (20-39 years) and C (40-59 years). The length, breadth and thickness of all the kidneys were measured by using a slide calipers and recorded. Data were expressed as mean±SD. For statistical analysis, independent sample t test and one way ANOVA was used. Results: The length of the right and left kidneys found were 8.72±0.25 cm and 9.28±0.12 cm; 9.73±0.35 cm and 10.31±0.41 cm; 9.68±0.21 cm and 10.24±0.06 cm in group A, B and C respectively. The breadth of the right and left kidneys found were 4.32±0.09 cm and 4.22±0.11 cm; 4.74±0.29 cm and 4.55±0.28 cm; 4.61±0.21 cm and 4.44±0.21 cm in group A, B and C respectively. The thickness of the right and left kidneys found were 2.84±0.10 cm and 2.64±0.05 cm; 3.31±0.16 cm and 3.11±0.10 cm; 3.17±0.07 cm and 3.11±0.10 cm in group A, B and C respectively. The mean length of the left kidneys was found significantly greater than that of the right , whereas the mean breadth and the thickness of the right kidneys were found greater than that of the left kidney in all age groups. Moreover, age related changes were significant in all dimensions (length, breadth and thickness) of the kidney when compared between group A & B and A & C. Conclusion: This study results concluded that the length of the left kidney was greater than that of the right, but the breadth and the thickness of the right kidney were greater than that of the left one in all age groups. In addition, age related changes in all dimensions (i.e. length, breadth and thickness) of the kidneys were evident in middle age versus young adult and older adult versus young adult. J Bangladesh Soc Physiol. 2020, December; 15(2): 61-67


Author(s):  
K.C. Ogbanya ◽  
C.A. Eze ◽  
J.I. Ihedioha

The objective of the study was to establish reference values for radiographic soft tissue indices of the hooves of apparently healthy Nigerian horses and to identify sex and age-related variations if any. Lateromedial radiographic examinations of the forelimb hooves of 52 apparently healthy Nigerian horses of both sexes aged young (1 – 5years), adult (6 – 10years) and old (11years and above) were carried out in the cross-sectional survey design. Radiographic soft tissue indices such as hoof wall distal phalanx distance (HWDPD), hoof wall proximal phalanx distance (HWPPD), coronary extensor distance (CED), sole depth (SD), hoof cup (HC), palmarocortical length (PCL) of the third phalanx, hoof wall angle (HWA), angle of third phalanx (AP3) and angle of rotation (AR) were measured and compared between sexes and among age groups. There was no significant sex variations in the indices investigated. However, the mean SD and HC showed age-related significant variation. The mean SD was only significantly (P less than 0.05) lower in old horses compared to young and adult horses. The mean values of HC were significantly (P less than 0.05) lower in adult and old horses compared to young horses. Radiographic morphometric indices assessed in this study may differ with those reported from other breeds, so they can be used in the future as reference values for diagnosis of laminitis in front feet of Nigerian horses.


2018 ◽  
Vol 4 (2) ◽  
pp. 137-140
Author(s):  
Hasna Hena ◽  
Shamim Ara ◽  
Rubina Qasim ◽  
Dilruba Siddiqua ◽  
Fatema Johora ◽  
...  

Background: The fallopian tubes act as conduit for spermatozoa to reach the oocyte and to convey the fertilized (egg) to enter the uterine cavity following fertilization. Problems with the fallopian tubes can lead to infertility. Detailed morphological and histological knowledge is essential for the diagnosis and management of fallopian tube disease.Objective: The purpose of the present study was to identify the inner diameter of ampulla of the fallopian tube and its changes with advancing age.Methodology: This descriptive cross-sectional study was conducted in the Department of Anatomy at Dhaka Medical College, Dhaka, Bangladesh from July 2008 to June 2009 for a period of one (01) year. This present study was performed on post mortem fallopian tubes of Bangladeshi female. Among them lowest age was 12 years and highest age was 50 years. Samples were divided into three differential age groups named asgroup A (10 to 13 years), group B (14 to 45 years), and group C (46 to 50 years). All samples were studied morphologically and histologically.Results: The mean inner diameter of the ampulla of the right and left fallopian tubes ranged from 1.99±0.08 to 3.24±0.27 mm. The difference between all the groups were statistically significant (p < 0.001).Conclusion: The mean difference of the inner diameter of the ampulla of the right and left fallopian tubesbetween groupA and groupB and groupB and groupC were statistically significant; however, there was no significant difference between right and left fallopian tube.Journal of National Institute of Neurosciences Bangladesh, 2018;4(2): 137-140


Parasitology ◽  
1992 ◽  
Vol 104 (2) ◽  
pp. 247-252 ◽  
Author(s):  
A. J. Trees ◽  
G. Wahl ◽  
S. Kläger ◽  
A. Renz

SUMMARYOnchocerca ochengi is a common parasite of cattle in savanna areas of West Africa and its adult stages inhabit intradermal nodules. We have exploited the accessibility of the macrofilariae to examine quantitative and qualitative differences in both the macro- and microfilariae (mff) in relation to age in naturally infected cattle. Autochthonous cattle at a site on the Adamawa plateau, North Cameroon, situated near a perennial Simulium damnosum s.l. breeding site, were examined in three age groups (1·5–2·5, n = 34; 3–5, n = 39 and ≥ 8 years old, n = 21). Skin mff densities were assessed from ventral skin biopsies, total body counts of nodules were done by palpation and 1–4 nodules were excised from positive animals, collagenase digested and the numbers and condition of macrofilariae determined. Embryogenesis profiles (embryograms) were done on a representative number of female worms in each age group. The overall prevalence of infection in the study population was 71% for mff and 85% for nodules. Nodule prevalence increased significantly from the 1·5–2·5 to 3–5 years old groups, but no other inter-age prevalences were significantly different. While the mean number of nodules per animal increased with age, geometric means (gm) 3·7, 15·5 and 23·1, the skin mff density maximized in the middle age group and decreased significantly in the old animals (gm 15·8, 44·7 and 11·4 mff/g, difference between latter two parameters significant, P < 0·05). Moreover, there was a significant correlation (P < 0·01) between individual nodule counts and skin mff densities in the mid-aged group but not in the oldest group. Examination of nodules showed that nodule counts equated to numbers of female worms, since almost all of 133 nodules examined contained only 1 live female worm. Although the proportion of old female (and male) worms increased with the age groups – 2 (0), 30 (28) and 54 (32)% – the proportion of gravid females (52·8, 48·8 and 58·0%) and the mean number of viable embryos in these females (82·5 × 103, 76·0 × 103 and 102·1 × 103) did not change with age. Thus, due to the higher nodule counts, a calculated productivity index reflecting the potential mff production per animal was 8 times higher in the ≥ 8-year-old animals than in the youngest and 3 times higher than in the middle group, which sharply contrasts with the decline in skin mff density. Although further research is required, these findings may indicate acquired immunity directed against microfilariae. They demonstrate the potential of O. ochengi infections in cattle to investigate a number of aspects of the host–parasite relationship which may have relevance to human onchocerciasis.


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