727: Temporal trends of risks among planned home births in the US 2006-2012

Introduction: Growing clinical experience and innovative implantation techniques have allowed individual pediatric centers to push the boundaries of VAD use. However, data describing the global trends in VAD utilization are lacking. We sought to assess temporal trends in the use of VADS as a bridge to transplant in children across the US. Methods: Children <18 years listed for heart transplant 1/2006-6/2014 who were bridged with a VAD were identified in the UNOS database. Patients were stratified by era (Early: 2006-2010, Current: 2011-2014). Descriptive statistics were used to assess trends. Results: Of 3986 patients listed, 589 (15%) received a VAD as bridge to transplant during the study period. The percentage of patients bridged with a VAD increased in the current era (12% vs. 18%, p<0.001), while both durable cfVAD use and waitlist times increased (Table). Children < 25 kg continue to be bridged to transplant almost exclusively with pulsatile devices while 95% of patients ≥ 25 kg were bridged with a cfVAD in 2014 (Figure). Conclusions: The current era has seen a 1.5-fold increase in the percentage of children bridged to transplant with a VAD as well as a 3-fold increase in the percentage of patients bridged with a durable cfVAD in patients > 25 kg. The emergence of cfVAD technology in an era of increasing waitlist times, raises the prospect of a dramatic increase in the number of children discharged from the hospital while supported with a cfVAD. This underscores the need to rapidly define pediatric specific best care practices in outpatient VAD management.

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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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Abstract 60: National Temporal Patterns in Recurrent Stroke by Demographic Characteristics and Geographic Regions: 2001-2016

Stroke ◽

10.1161/str.52.suppl_1.60 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Judith H Lichtman ◽

Erica C Leifheit ◽

Yun Wang ◽

Larry B Goldstein

Keyword(s):

Proportional Hazards Model ◽

Recurrent Stroke ◽

Temporal Trends ◽

Healthcare Delivery ◽

Temporal Patterns ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Fee For Service ◽

The Us ◽

Over Time

Background: There have been important advances in secondary stroke prevention and a focus on healthcare delivery in the US over the past two decades. Yet, little is known about temporal patterns of recurrent stroke in the US. We examined temporal trends in recurrent stroke by sociodemographic characteristics and geographic areas using national Medicare data. Methods: We included fee-for-service Medicare beneficiaries aged ≥65y with a primary discharge diagnosis of ischemic stroke from 2001 to 2016. We fit a Cox proportional hazards model that censored for change in Medicare enrollment and accounted for death to evaluate the temporal trend in 1-year recurrent stroke, adjusting for demographic and clinical factors. Models were repeated for subgroups defined by age, sex, race, and state. We mapped smoothed rates of 1-year recurrent stroke by county to assess geographic variation over time. Results: There were 3,485,618 unique beneficiaries discharged with stroke during the study period. Demographic and clinical characteristics remained relatively stable over time, but the proportions discharged with home health services and inpatient rehabilitation increased. The observed 1-year recurrent stroke rate decreased from 11.2% in 2001-2004 to 9.3% in 2013-2016, with an adjusted annual reduction in recurrence from 2001-2016 of 1.49% (95% CI 1.40%-1.58%). There were significant reductions for all age, sex, and race groups (A). Geographic areas with persistently high rates were identified over time (B). In state-stratified analysis, the annual percentage reduction in recurrence ranged from -1.2% to 2.5% and was significant for all but 12 states. Conclusions: Recurrent strokes decreased over time overall and by sociodemographic subgroups; however, we identified geographic areas with persistently high recurrence rates. Such findings can target secondary prevention intervention opportunities for high-risk populations and communities.

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Temporal and spatial variations in freeze warnings in the conterminous United States: 2005–2018

Theoretical and Applied Climatology ◽

10.1007/s00704-019-03056-8 ◽

2019 ◽

Vol 139 (3-4) ◽

pp. 1379-1384

Author(s):

Brandon Lawhorn ◽

Robert C. Balling

Keyword(s):

United States ◽

Temporal Trends ◽

The United States ◽

Temporal Variations ◽

Atmospheric Composition ◽

Southeastern Us ◽

The Us ◽

Temporal And Spatial ◽

Frost Free Period ◽

Spatial And Temporal Trends

AbstractIt is well-documented that the United States (US), along with other mid-latitude land locations, has experienced warming in recent decades in response to changes in atmospheric composition. Among other changes, Easterling (2002) reported that the frost-free period is now longer across much of the US with the first frost in fall occurring later and the last freeze in spring occurring earlier. In this investigation, we explore spatial and temporal variations in all freeze warnings issued by the US National Weather Service. Freeze warning counts are highest in the southeastern US peaking overall in the spring and fall months. Freeze warnings tend to occur more toward summer moving northward and westward into more northerly states. Consistent with the warming in recent decades, we find statistically significant northward movements in freeze warning centroids in some months (December, February) across the study period (2005–2018). Detection of spatial and temporal trends in freeze warnings may be of interest to any number of scientists with applied climatological interests.

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An analecta of visualizations for foodborne illness trends and seasonality

Scientific Data ◽

10.1038/s41597-020-00677-x ◽

2020 ◽

Vol 7 (1) ◽

Author(s):

Ryan B. Simpson ◽

Bingjie Zhou ◽

Tania M. Alarcon Falconi ◽

Elena N. Naumova

Keyword(s):

Visual Analytics ◽

Disease Surveillance ◽

Temporal Trends ◽

Disease Outbreaks ◽

Data Interpretation ◽

Population Based ◽

Annual Reports ◽

Surveillance Systems ◽

The Us ◽

Annual Time Series

Abstract Disease surveillance systems worldwide face increasing pressure to maintain and distribute data in usable formats supplemented with effective visualizations to enable actionable policy and programming responses. Annual reports and interactive portals provide access to surveillance data and visualizations depicting temporal trends and seasonal patterns of diseases. Analyses and visuals are typically limited to reporting the annual time series and the month with the highest number of cases per year. Yet, detecting potential disease outbreaks and supporting public health interventions requires detailed spatiotemporal comparisons to characterize spatiotemporal patterns of illness across diseases and locations. The Centers for Disease Control and Prevention’s (CDC) FoodNet Fast provides population-based foodborne-disease surveillance records and visualizations for select counties across the US. We offer suggestions on how current FoodNet Fast data organization and visual analytics can be improved to facilitate data interpretation, decision-making, and communication of features related to trend and seasonality. The resulting compilation, or analecta, of 436 visualizations of records and codes are openly available online.

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Liver Transplantation for Nonalcoholic Steatohepatitis in the US: Temporal Trends and Outcomes

Digestive Diseases and Sciences ◽

10.1007/s10620-017-4684-x ◽

2017 ◽

Vol 62 (10) ◽

pp. 2915-2922 ◽

Cited By ~ 98

Author(s):

George Cholankeril ◽

Robert J. Wong ◽

Menghan Hu ◽

Ryan B. Perumpail ◽

Eric R. Yoo ◽

...

Keyword(s):

Liver Transplantation ◽

Nonalcoholic Steatohepatitis ◽

Temporal Trends ◽

The Us

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Childhood nephroblastoma in Southern and Eastern Europe and the US: Incidence variations and temporal trends by human development index

Cancer Epidemiology ◽

10.1016/j.canep.2018.03.012 ◽

2018 ◽

Vol 54 ◽

pp. 75-81 ◽

Cited By ~ 4

Author(s):

Dimitrios Doganis ◽

Paraskevi Panagopoulou ◽

Athanasios Tragiannidis ◽

Marios K. Georgakis ◽

Maria Moschovi ◽

...

Keyword(s):

Eastern Europe ◽

Human Development ◽

Human Development Index ◽

Temporal Trends ◽

Development Index ◽

The Us

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A Large-Scale Observational Study on the Temporal Trends and Risk Factors of Opioid Overdose: Real-World Evidence for Better Opioids

10.1101/2020.10.08.20208678 ◽

2020 ◽

Author(s):

Jianyuan Deng ◽

Wei Hou ◽

Xinyu Dong ◽

Janos Hajagos ◽

Mary Saltz ◽

...

Keyword(s):

Risk Factors ◽

Large Scale ◽

Care Setting ◽

Temporal Trends ◽

Prescription Opioid ◽

Opioid Overdose ◽

Prescription Opioids ◽

Health Records ◽

The Us ◽

Increasing Trends

AbstractBackgroundThe United States is in the midst of an opioid overdose epidemic. We evaluated the temporal trends and risk factors of inpatient opioid overdose. Based on the opioid overdose patterns, we further examined the innate properties underlying less overdose events.MethodsWe conducted a retrospective cross-sectional study based a large-scale inpatient electronic health records database, Cerner Health Facts®. We included patients admitted between January 1, 2009 and December 31, 2017. Opioid overdose prevalence by year, demographics and prescription opioid exposures.ResultsA total of 4,720,041 patients with 7,339,480 inpatient encounters were retrieved from Cerner Health Facts®. Among them, 30.2% patients were aged 65+, 57.0% female, 70.1% Caucasian, 42.3% single, 32.0% from South and 80.8% in urban area. From 2009 to 2017, annual opioid overdose prevalence per 1,000 patients significantly increased from 3.7 to 11.9 with an adjusted odds ratio (aOR): 1.16, 95% confidence interval (CI): [1.15-1.16]. Comparing to the major demographic counterparts above, being in 1) age group: 41-50 (overall aOR 1.36, 95% CI: [1.31-1.40]) or 51-64 (overall aOR 1.35, 95% CI: [1.32-1.39]), marital status: divorced (overall aOR 1.19, 95% CI: [1.15-1.23]), 3) census region: West (overall aOR 1.32, 95% CI: [1.28-1.36]), were significantly associated with higher odds of opioid overdose. Prescription opioid exposures were also associated with increased odds of opioid overdose, such as meperidine (overall aOR 1.09, 95% CI: [1.06-1.13]) and tramadol (overall aOR 2.20. 95% CI: [2.14-2.27]). Examination on the relationships between opioid agonists’ properties and their association strengths, aORs, in opioid overdose showed that lower aORs values were significantly associated with 1) high molecular weight, 2) negative interaction with multi-drug resistance protein 1 (MDR1) or positive interaction with cytochrome P450 3A4 (CYP3A4) and 3) negative interaction with delta opioid receptor (DOR) or kappa opioid receptor (KOR).ConclusionsThe significant increasing trends of opioid overdose at the inpatient care setting from 2009 to 2017 indicated an ongoing need of efforts to combat the opioid overdose epidemic in the US. Risk factors associated with opioid overdose included patient demographics and prescription opioid exposures. Different prescription opioids were associated with opioid overdose to different extents, indicating a necessity to better differentiate them during prescribing practice. Moreover, there are physicochemical, pharmacokinetic and pharmacodynamic properties underlying less overdose events, which can be utilized to develop better opioids.Key PointsThere were significant increasing trends of opioid overdose at the US inpatient care setting from 2009 to 2017, showing an ongoing need for opioid overdose prevention.Different prescription opioids were associated with opioid overdose to different extents, indicating a necessity to differentiate prescription opioids during prescribing.The optimal properties underlying less overdose events mined from the large-scale, real-world electronic health records hold high potential to guide the development of better opioids with reduced overdose effects.

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They’re Dying in the Suburbs: COVID-19 Cases and Deaths by Geography in Louisiana (USA)

10.1101/2020.10.28.20221341 ◽

2020 ◽

Author(s):

Alina Schnake-Mahl ◽

Usama Bilal

Keyword(s):

New Orleans ◽

Rural Areas ◽

Urban Areas ◽

Temporal Trends ◽

Data Availability ◽

Suburban Areas ◽

Incidence And Mortality ◽

The Us ◽

Urban And Rural Areas ◽

Second Peak

AbstractThe national COVID-19 conversation in the US has mostly focused on urban areas, without sufficient examination of another geography with large vulnerable populations: the suburbs. While suburbs are often thought of as areas of uniform affluence and racial homogeneity, over the past 20 years, poverty and diversity have increased substantially in the suburbs. In this study, we compare geographic and temporal trends in COVID-19 cases and deaths in Louisiana, one of the few states with high rates of COVID-19 during both the spring and summer. We find that incidence and mortality rates were initially highest in New Orleans. By the second peak, trends reversed: suburban areas experienced higher rates than New Orleans and similar rates to other urban and rural areas. We also find that increased social vulnerability was associated with increased positivity and incidence during the first peak. During the second peak, these associations reversed in New Orleans while persisting in other urban, suburban, and rural areas. The work draws attention to the high rates of COVID-19 cases and deaths in suburban areas and the importance of metropolitan-wide actions to address COVID-19.RegistrationN/AFunding sourceNIH (DP5OD26429) and RWJF (77644)Code and data availabilityCode for replication along with data is available here: https://github.com/alinasmahl1/COVID_Louisiana_Suburban/.

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