scholarly journals Population-level COVID-19 mortality risk for non-elderly individuals overall and for non-elderly individuals without underlying diseases in pandemic epicenters

2020 ◽  
Vol 188 ◽  
pp. 109890 ◽  
Author(s):  
John P.A. Ioannidis ◽  
Cathrine Axfors ◽  
Despina G. Contopoulos-Ioannidis
Keyword(s):  
Mortality Risk ◽  
Population Level ◽  
Elderly Individuals ◽  
Underlying Diseases

scholarly journals Population-level COVID-19 mortality risk for non-elderly individuals overall and for non-elderly individuals without underlying diseases in pandemic epicenters

2020 ◽  
Author(s):  
John P.A. Ioannidis ◽  
Cathrine Axfors ◽  
Despina G. Contopoulos-Ioannidis
Keyword(s):  
New York ◽  
New York City ◽  
Absolute Risk ◽  
Population Level ◽  
European Countries ◽  
Elderly Individuals ◽  
Death Risk ◽  
The Absolute ◽  
The Uk ◽  
Underlying Diseases

AbstractOBJECTIVETo provide estimates of the relative risk of COVID-19 death in people <65 years old versus older individuals in the general population, the absolute risk of COVID-19 death at the population level during the first epidemic wave, and the proportion of COVID-19 deaths in non-elderly people without underlying diseases in epicenters of the pandemic.ELIGIBLE DATACountries and US states with at least 800 COVID-19 deaths as of April 24, 2020 and with information on the number of deaths in people with age <65. Data were available for 11 European countries (Belgium, France, Germany, Ireland, Italy, Netherlands, Portugal, Spain, Sweden, Switzerland, UK), Canada, and 12 US states (California, Connecticut, Florida, Georgia, Illinois, Indiana, Louisiana, Maryland, Massachusetts, Michigan, New Jersey and New York) We also examined available data on COVID-19 deaths in people with age <65 and no underlying diseases.MAIN OUTCOME MEASURESProportion of COVID-19 deaths in people <65 years old; relative risk of COVID-19 death in people <65 versus ≥65 years old; absolute risk of COVID-19 death in people <65 and in those ≥80 years old in the general population as of May 1, 2020; absolute COVID-19 death risk expressed as equivalent of death risk from driving a motor vehicle.RESULTSIndividuals with age <65 account for 4.8-9.3% of all COVID-19 deaths in 10 European countries and Canada, 13.0% in the UK, and 7.8-23.9% in the US locations. People <65 years old had 36- to 84-fold lower risk of COVID-19 death than those ≥65 years old in 10 European countries and Canada and 14- to 56-fold lower risk in UK and US locations. The absolute risk of COVID-19 death as of May 1, 2020 for people <65 years old ranged from 6 (Canada) to 249 per million (New York City). The absolute risk of COVID-19 death for people ≥80 years old ranged from 0.3 (Florida) to 10.6 per thousand (New York). The COVID-19 death risk in people <65 years old during the period of fatalities from the epidemic was equivalent to the death risk from driving between 13 and 101 miles per day for 11 countries and 6 states, and was higher (equivalent to the death risk from driving 143-668 miles per day) for 6 other states and the UK. People <65 years old without underlying predisposing conditions accounted for only 0.7-2.6% of all COVID-19 deaths (data available from France, Italy, Netherlands, Sweden, Georgia, and New York City).CONCLUSIONSPeople <65 years old have very small risks of COVID-19 death even in pandemic epicenters and deaths for people <65 years without underlying predisposing conditions are remarkably uncommon. Strategies focusing specifically on protecting high-risk elderly individuals should be considered in managing the pandemic.

scholarly journals Polypharmacy, hospitalization, and mortality risk: a nationwide cohort study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Tae Ik Chang ◽  
Haeyong Park ◽  
Dong Wook Kim ◽  
Eun Kyung Jeon ◽  
Connie M. Rhee ◽  
...  
Keyword(s):  
Public Health ◽  
Cohort Study ◽  
Prescription Drugs ◽  
Mortality Risk ◽  
Residential Area ◽  
Public Health Issue ◽  
Geriatric Population ◽  
Major Public Health Issue ◽  
Elderly Individuals

Abstract Polypharmacy is a growing and major public health issue, particularly in the geriatric population. This study aimed to examine the association between polypharmacy and the risk of hospitalization and mortality. We included 3,007,620 elderly individuals aged ≥ 65 years who had at least one routinely-prescribed medication but had no prior hospitalization within a year. The primary exposures of interest were number of daily prescribed medications (1–2, 3–4, 5–6, 7–8, 9–10, and ≥ 11) and presence of polypharmacy (≥ 5 prescription drugs per day). The corresponding comparators were the lowest number of medications (1–2) and absence of polypharmacy. The study outcomes were hospitalization and all-cause death. The median age of participants was 72 years and 39.5% were men. Approximately, 46.6% of participants experienced polypharmacy. Over a median follow-up of 5.0 years, 2,028,062 (67.4%) hospitalizations and 459,076 (15.3%) all-cause deaths were observed. An incrementally higher number of daily prescribed medications was found to be associated with increasingly higher risk for hospitalization and mortality. These associations were consistent across subgroups of age, sex, residential area, and comorbidities. Furthermore, polypharmacy was associated with greater risk of hospitalization and death: adjusted HRs (95% CIs) were 1.18 (1.18–1.19) and 1.25 (1.24–1.25) in the overall and 1.16 (1.16–1.17) and 1.25 (1.24–1.25) in the matched cohorts, respectively. Hence, polypharmacy was associated with a higher risk of hospitalization and all-cause death among elderly individuals.

Comparison of Mortality Risk Associated With Bacteremia Due to Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus

2007 ◽  
Vol 28 (3) ◽  
pp. 273-279 ◽  
Author(s):  
Simone Shurland ◽  
Min Zhan ◽  
Douglas D. Bradham ◽  
Mary-Claire Roghmann
Keyword(s):  
Staphylococcus Aureus ◽  
Severe Sepsis ◽  
Relative Risk ◽  
Confidence Interval ◽  
Mortality Risk ◽  
Methicillin Resistance ◽  
Methicillin Resistant ◽  
Mrsa Infection ◽  
Underlying Diseases ◽  
Related Mortality

Objective.To quantify the clinical impact of methicillin-resistance in Staphylococcus aureus causing infection complicated by bacteremia in adult patients, while controlling for the severity of patients' underlying illnesses.Design.Retrospective cohort study from October 1, 1995, through December 31, 2003.Patients and Setting.A total of 438 patients with S. aureus infection complicated by bacteremia from a single Veterans Affairs healthcare system.Results.We found that 193 (44%) of the 438 patients had methicillin-resistant S. aureus (MRSA) infection and 114 (26%) died of causes attributable to S. aureus infection within 90 days after the infection was identified. Patients with MRSA infection had a higher mortality risk, compared with patients with methicillin-susceptible S. aureus (MSSA) infections (relative risk, 1.7 [95% confidence interval, 1.3-2.4]; P < .01), except for patients with pneumonia (relative risk, 0.7 [95% confidence interval, 0.4-1.3]). Patients with MRSA infections were significantly older (P < .01), had more underlying diseases (P = .02), and were more likely to have severe sepsis in response to their infection (P < .01) compared with patients with MSSA bacteremia. Patients who died within 90 days after S. aureus infection was identified were significantly older (P < .01) and more likely to have severe sepsis (P < .01) and pneumonia (P = .01), compared with patients who survived. After adjusting for age as a confounder, comorbidities, and pneumonia as an effect modifier, S. aureus infection-related mortality remained significantly higher in patients with MRSA infection than in those with MSSA infection, among those without pneumonia (hazard ratio, 1.8 [95% confidence interval, 1.2-3.0]); P < .01.Conclusions.The results of this study suggest that patients with MRSA infections other than pneumonia have a higher mortality risk than patients with MSSA infections other than pneumonia, independent of the severity of patients' underlying illnesses.

scholarly journals Estimating the mortality burden of large scale mining projects—Evidence from a prospective mortality surveillance study in Tanzania

2021 ◽  
Vol 1 (10) ◽  
pp. e0000008
Author(s):  
Isaac Lyatuu ◽  
Mirko S. Winkler ◽  
Georg Loss ◽  
Andrea Farnham ◽  
Dominik Dietler ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Large Scale ◽  
Road Traffic ◽  
Population Level ◽  
Risk Difference ◽  
Mining Communities ◽  
Gold Mines ◽  
Mortality Burden ◽  
Mining Projects ◽  
Mortality Surveillance

We set up a mortality surveillance system around two of the largest gold mines in Tanzania between February 2019 and February 2020 to estimate the mortality impact of gold mines. Death circumstances were collected using a standardized verbal autopsy tool, and causes of death were assigned using the InSilicoVA algorithm. We compared cause-specific mortality fractions in mining communities with other subnational data as well as national estimates. Within mining communities, we estimated mortality risks of mining workers relative to other not working at mines. At the population level, mining communities had higher road-traffic injuries (RTI) (risk difference (RD): 3.1%, Confidence Interval (CI): 0.4%, 5.9%) and non-HIV infectious disease mortality (RD: 5.6%, CI: 0.8%, 10.3%), but lower burden of HIV mortality (RD: -5.9%, CI: -10.2%, -1.6%). Relative to non-miners living in the same communities, mining workers had over twice the mortality risk (relative risk (RR): 2.09, CI: 1.57, 2.79), with particularly large increases for death due to RTIs (RR: 14.26, CI: 4.95, 41.10) and other injuries (RR:10.10, CI: 3.40, 30.02). Our results shows that gold mines continue to be associated with a large mortality burden despite major efforts to ensure the safety in mining communities. Given that most of the additional mortality risk appears to be related to injuries programs targeting these specific risks seem most desirable.

Impact of different hypopnea definitions on obstructive sleep apnea severity and cardiovascular mortality risk in women and elderly individuals

2016 ◽  
Vol 27-28 ◽  
pp. 54-58 ◽  
Author(s):  
Francisco Campos-Rodriguez ◽  
Miguel A. Martínez-García ◽  
Nuria Reyes-Nuñez ◽  
Maria J. Selma-Ferrer ◽  
Naresh M. Punjabi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Mortality Risk ◽  
Cardiovascular Mortality ◽  
Elderly Individuals ◽  
Obstructive Sleep Apnea Severity ◽  
Obstructive Sleep ◽  
Cardiovascular Mortality Risk

scholarly journals All-cause mortality risk in elderly individuals with disabilities: a retrospective observational study

BMJ Open ◽  
2016 ◽  
Vol 6 (9) ◽  
pp. e011164 ◽  
Author(s):  
Li-Wei Wu ◽  
Wei-Liang Chen ◽  
Tao-Chun Peng ◽  
Sheng-Ta Chiang ◽  
Hui-Fang Yang ◽  
...  
Keyword(s):  
Observational Study ◽  
Mortality Risk ◽  
Retrospective Observational Study ◽  
Individuals With Disabilities ◽  
Elderly Individuals ◽  
All Cause Mortality

scholarly journals Population-level impact of loss on survivor mortality risk

2015 ◽  
Vol 24 (12) ◽  
pp. 2959-2961 ◽  
Author(s):  
Joseph Allegra ◽  
Amara Ezeamama ◽  
Cherie Simpson ◽  
Toni Miles
Keyword(s):  
Mortality Risk ◽  
Population Level

scholarly journals Relationships between creatinine increase and mortality rates in patients given vancomycin in 76 hospitals: The increasing role of infectious disease pharmacists

2021 ◽  
Author(s):  
Kalvin C Yu ◽  
Cynthia Yamaga ◽  
Latha Vankeepuram ◽  
Ying P Tabak
Keyword(s):  
Renal Function ◽  
Mortality Risk ◽  
Renal Toxicity ◽  
Independent Predictor ◽  
Study Cohort ◽  
Vancomycin Therapy ◽  
Creatinine Concentration ◽  
Baseline Serum ◽  
Underlying Diseases

Abstract Purpose Vancomycin is a commonly used antimicrobial with the potential for renal toxicity. We evaluated vancomycin duration, changes in renal function after vancomycin initiation (“post-vancomycin” renal function changes), and associated mortality risk among hospitalized patients. Methods We analyzed data from 76 hospitals and excluded patients with a baseline serum creatinine concentration (SCr) of &gt;3.35 mg/dL. We estimated mortality risk relative to vancomycin duration and the magnitude of post-vancomycin SCr change, controlling for demographics, baseline SCr, underlying diseases, clinical acuity, and comorbidities. Results Among 128,993 adult inpatients treated with vancomycin, 49.0% did not experience SCr elevation. Among the remaining patients, 26.0%, 11.4%, 8.8% and 4.8% experienced increases in post-vancomycin SCr of 1% to 20%, 21% to 40%, 41% to 100%, and greater than 100%, respectively. Compared to mortality risk among patients with a vancomycin therapy duration between 4 and 5 days (the lowest-mortality group), longer vancomycin therapy duration was not independently associated with higher mortality risk after adjusting for confounders. In contrast, there was a graded relationship between post-vancomycin SCr elevation and mortality. Multivariable adjusted mortality odds ratios ranged from 1.60 to 13.66, corresponding to SCr increases of 10% and greater than 200%, respectively. Conclusion Half of patients given vancomycin did not experience SCr elevation and had the lowest mortality, suggesting that vancomycin can be used safely if renal function is stabilized. In the large study cohort, vancomycin duration itself was not an independent predictor of mortality. Post-vancomycin SCr elevation appeared to be a driver of in-hospital mortality. Even a 10% SCr increase from baseline prior to vancomycin infusion was associated with increased mortality risk. This finding stresses the importance of closely monitoring renal function and may support the value of pharmacokinetic dosing.

scholarly journals AVALIAÇÃO DO EQUILÍBRIO POSTURAL E DOS FATORES AMBIENTAIS RELACIONADOS ÀS QUEDAS EM IDOSOS DE INSTITUIÇÕES DE LONGA PERMANÊNCIA

2009 ◽  
Vol 14 (2) ◽  
Author(s):  
Flávio Cesar Vieira Valentim ◽  
Marisa de Cássia Registro Fonseca ◽  
Manuela Oliveira Santos ◽  
Branca Maria De Oliveira Santos
Keyword(s):  
Personal Characteristics ◽  
The Elderly ◽  
Easy Access ◽  
Elderly Subjects ◽  
Retirement Pension ◽  
Elderly Individuals ◽  
Factors Associated ◽  
Aged People ◽  
Musculoskeletal Equilibrium ◽  
Underlying Diseases

Resumo: O presente artigo busca caracterizar o perfil sócio-econômico de 21 idosos acima de 60 anos de duas instituições de longa permanência da cidade de Franca-SP, avaliar o equilíbrio postural através da escala de equilíbrio de Berg e detectar os possíveis fatores associados às quedas no ambiente físico das instituições. Os resultados apontaram para 61,9% de idosos do sexo feminino, com idades entre 60 e 85 anos ou mais, e maior percentual na faixa etária entre 60 e 70 anos, solteiros, escolaridade funda mental, tempo de instituição entre 10 e 26 anos, com doenças de base relacionadas aos sistemas cardiorrespiratório, músculo-esquelético, somato-sensório e tegumentar, que recebiam proventos da aposentadoria e destinavam cerca de 70% da renda para a instituição. As pontuações obtidas da aplicação da escala possibilitaram a identificação de que quanto mais a tarefa exigia do idoso, menor era a pontuação obtida pelo mesmo. Em três idosos, o número máximo de pontos atingidos predizia um equilíbrio debilitado, com 100% de risco de quedas. As duas instituições possuíam características físicas, ambientais e de pessoal similares e apresentavam alguns atores associados à possibilidade de quedas, como a inexistência de barras de apoio em sanitários e a presença de uma escada de livre acesso aos idosos, além de uma preocupação em relação ao uso adequado de roupas e sapatos pelos idosos. Embora o estudo tenha gerado resultados de caráter mais descritivo do que conclusivo, o con junto de dados possibilitou algumas reflexões acerca da situação dos idosos das instituições, direcionando para a impor tância de realização de pesquisas multidisciplinares que contribuam para um (re)pensar a situação de vida dos mesmos nas instituições de longa permanência. Palavras-chave: Idosos; Instituição de Longa Permanência; Postura; Equilíbrio musculoesquelético. Abstract: The purpose of this descriptive study was to characterize the socioeconomic profile of 21 elderly individuals aged over 60 years living in homes of the aged in the city of Franca, in the state of São Paulo, assess their postural balance through the Berg's Scale of Balance, and find the possible factors associated to falls at the institutions. The results presented that 61.9% of the elderly subjects were women, with ages from 60 to 85 years or more, with most in the age group between 60 and 70 years, single, with primary education level, living in the institution for a period of 10 to 26 years, with underlying diseases related to the cardiopulmonary, muscle-skeletal, somatosensorial and tegumentary systems, and who received retirement pension and spent about 70% of their income with the institution. The scores obtained on the scal allowed for identifying that the more the task demanded from the elderly, the lower the score they obtained. In three individuals, the highest score they achieved predicted impaired balance, with 100% of risk for falls. The institutions had similar physical, environmental, and personal characteristics and presented some factors associated to the possibility of falls, such as the lack of support grab bars in the bathrooms and stairs with easy access for the aged individuals, besides a concern about the using clothes and shoes appropriately. Although the study yielded more descriptive than conclusive results, the data allowed for reflecting on the situation of the elderly individuals from the studied institutions, showing there is a need for performing multidisciplinary research that contribute to (re)thinking about their situation at these homes. Keywords: Aged People; Home for the Aged; Posture; Musculoskeletal Equilibrium.   

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