scholarly journals Ten-year trends in stroke admissions and outcomes in Canada

2015 ◽  
Vol 42 (3) ◽  
pp. 168-175 ◽  
Author(s):  
Noreen Kamal ◽  
M. Patrice Lindsay ◽  
Robert Côté ◽  
Jiming Fang ◽  
Moira K. Kapral ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Hospital Admissions ◽  
Age Groups ◽  
Population Based ◽  
Stroke Patients ◽  
Discharge Abstract Database ◽  
Absolute Increase ◽  
Admission Rates ◽  
Administrative Dataset ◽  
Hospital Administrative

AbstractBackgroundWe analyzed a 10-year stroke administrative dataset to examine trends in admissions, mortality, and discharge destination in Canada.MethodsWe conducted an analysis of hospital administrative data from April 1st 2003 to March 31st 2013 from the Canadian Institute of Health Information’s Discharge Abstract Database. Ten-year trends for population-based age- and sex-standardized admission rates were calculated. We reviewed 10-year trends in absolute stroke admissions for differences between provinces and age groups. Stroke 30-day in-hospital mortality rates were calculated and adjusted for sex, age, stroke type and comorbidities. We documented changes in discharge location for ischemic and hemorrhagic stroke patients discharged from acute care.ResultsThe rate of hospital admissions has declined from 140.2 to 117.5 (per 100,000 people). The number of absolute stroke admissions within provinces increased in Alberta and British Columbia (21.7% and 16.2% respectively). The proportion of stroke patients aged 40-69 years old increased by 4.8% (p<0.0001) over the 10 years, whereas the proportion aged over 70 decreased by 4.9% (p<0.0001). Risk-adjusted 30-day in-hospital mortality decreased from: 18.5% to 14.9% for all strokes; 15.2% to 12.1% for ischemic strokes; 35.6% to 29.7% for intracerebral hemorrhage; and 25.1% to 18.0% for subarachnoid hemorrhage. The absolute increase in patients requiring inpatient and outpatient support increased by 4% (p<0.0001).ConclusionThe rate of admissions for stroke is decreasing but there is an increase in stroke admissions for younger patients. In-hospital mortality is decreasing; fewer patients are going directly home without services and more are requiring support services.

scholarly journals Fourteen-Year Study of Hospital Admissions for Diverticular Disease in Ontario

2007 ◽  
Vol 21 (2) ◽  
pp. 97-99 ◽  
Author(s):  
Eiran Warner ◽  
Eric J Crighton ◽  
Rahim Moineddin ◽  
Muhammad Mamdani ◽  
Ross Upshur
Keyword(s):  
Cohort Study ◽  
Diverticular Disease ◽  
Hospital Admissions ◽  
Age Groups ◽  
Population Based ◽  
Future Studies ◽  
Admission Rates ◽  
Gastrointestinal Conditions ◽  
Canadian Population ◽  
Age And Sex

BACKGROUND: Diverticular disease is one of the most common gastrointestinal conditions affecting the Canadian population, yet very little is known about its epidemiology.OBJECTIVE: The aim of the present study was to measure the rate of hospital admission for diverticular disease by age and sex over a 14-year period in the population of Ontario.PATIENTS AND METHODS: The present study was a retrospective, population-based cohort study of all hospital admissions for diverticular disease from 1988 to 2002.RESULTS: There were 133,875 hospital admissions during the period. Admission rates increased with age, and women were admitted at higher rates than men across all age groups.CONCLUSION: Diverticular disease is an important cause of gastrointestinal morbidity. As the population ages, a rise in the incidence of diverticular disease can be anticipated. Future studies to explain sex difference in admissions are required.

scholarly journals The risk of severe COVID-19: hospital and ICU admission rates in Norway

2020 ◽  
Author(s):  
Morten Munkvik ◽  
Ingvild Vatten Alsnes ◽  
Lars Vatten
Keyword(s):  
Hospital Admissions ◽  
Age Groups ◽  
Admission Rate ◽  
Epidemiological Studies ◽  
Population Based ◽  
Western Region ◽  
Eastern Region ◽  
Detailed Data ◽  
Admission Rates ◽  
Restrictive Measures

Background: Epidemiological studies of COVID-19 with population based information may add to the knowledge needed to prioritise resources and advice on how restrictive measures should be targeted. This study provides admission rates to hospitals and intensive care units (ICU) in Norway, aiming to better understand the risk of severe COVID-19 infection. Methods: Data from official reports from The Norwegian Institute of Public Health (NIPH) and the Norwegian Directorate of Health were used to calculate admission rates to hospitals and to ICU per 100 000 inhabitants. We compared rates of hospitalisation between the four health regions and provide separate rates for Oslo. We also assessed national admissions to ICU stratified by age. Results: The admission rate in the south-eastern region was 3.1 per 100 000, and the rate for Oslo was 5.8. Compared to the western region (reference), the Oslo rate was 4.0 times (confidence interval (CI) 3.0-5.5) higher. In Norway as a whole, the rate of ICU admissions was 3.9 per 100 000, and in the age groups 60-69 and 70-79, ICU rates were 10.3 and 11.5, respectively. These rates were 9.5 (CI 6.3-14.3) and 10.6 (CI 6.9-16.2) times higher compared to people younger than 50 years. Conclusion: Hospital admissions due to Covid-19 are much higher in Oslo than anywhere else in Norway, and in the country as a whole, ICU admissions are highest among people 60-79 years of age. These results and more detailed data could provide better advice on how restrictions can be safely lessened.

scholarly journals Vascular injury-related in-hospital mortality in Ontario between 1991 and 2009

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098772
Author(s):  
Abdulmajeed Altoijry ◽  
Thomas F. Lindsay ◽  
K. Wayne Johnston ◽  
Muhammad Mamdani ◽  
Mohammed Al-Omran
Keyword(s):  
Hospital Mortality ◽  
Vascular Injury ◽  
Hospital Admissions ◽  
Temporal Trends ◽  
Population Based ◽  
Cross Sectional Study ◽  
Body Region ◽  
Multivariable Logistic Regression Analysis ◽  
Discharge Abstract Database ◽  
Cross Sectional

Objective Trauma-related vascular injuries are major contributors to morbidity and mortality worldwide. We conducted a retrospective, population-based, cross-sectional study to examine temporal trends and factors associated with traumatic vascular injury-related in-hospital mortality in Ontario, Canada from 1991 to 2009. Methods We obtained data on Ontario hospital admissions for traumatic vascular injury, including injury mechanism and body region; and patient age, sex, socioeconomic status, and residence from the Canadian Institute for Health Information Discharge Abstract Database and Registered Persons Database from fiscal years 1991 to 2009. We performed time series analysis of vascular injury-related in-hospital mortality rates and multivariable logistic regression analysis to identify significant mortality-associated factors. Results The overall in-hospital mortality rate for trauma-related vascular injury was 5.5%. A slight but non-significant decline in mortality occurred over time. The likelihood of vascular injury-related in-hospital mortality was significantly higher for patients involved in transport-related accidents (odds ratio [OR[=2.21, 95% confidence interval [CI], 1.76–2.76), age ≥65 years (OR = 4.34, 95% CI, 2.25–8.38), or with thoracic (OR = 2.24, 95% CI, 1.56–3.20) or abdominal (OR = 2.45, 95% CI, 1.75–3.42) injuries. Conclusions In-hospital mortality from traumatic vascular injury in Ontario was low and stable from 1991 to 2009.

scholarly journals Challenges of using asthma admission rates as a measure of primary care quality in children: An international comparison

2021 ◽  
pp. 135581962110127
Author(s):  
Irina Lut ◽  
Kate Lewis ◽  
Linda Wijlaars ◽  
Ruth Gilbert ◽  
Tiffany Fitzpatrick ◽  
...  
Keyword(s):  
Primary Care ◽  
Hospital Admission ◽  
Hospital Admissions ◽  
Underlying Disease ◽  
Primary Diagnosis ◽  
Care Quality ◽  
Attendance Rates ◽  
Admission Rates ◽  
Primary Care Quality ◽  
Hospital Administrative

Objectives To demonstrate the challenges of interpreting cross-country comparisons of paediatric asthma hospital admission rates as an indicator of primary care quality. Methods We used hospital administrative data from >10 million children aged 6–15 years, resident in Austria, England, Finland, Iceland, Ontario (Canada), Sweden or Victoria (Australia) between 2008 and 2015. Asthma hospital admission and emergency department (ED) attendance rates were compared between countries using Poisson regression models, adjusted for age and sex. Results Hospital admission rates for asthma per 1000 child-years varied eight-fold across jurisdictions. Admission rates were 3.5 times higher when admissions with asthma recorded as any diagnosis were considered, compared with admissions with asthma as the primary diagnosis. Iceland had the lowest asthma admission rates; however, when ED attendance rates were considered, Sweden had the lowest rate of asthma hospital contacts. Conclusions The large variations in childhood hospital admission rates for asthma based on the whole child population reflect differing definitions, admission thresholds and underlying disease prevalence rather than primary care quality. Asthma hospital admissions among children diagnosed with asthma is a more meaningful indicator for inter-country comparisons of primary care quality.

Falling Rates of Hospital Admissions for Alcoholic Liver Disease in Northeast Italy: A Retrospective Study on a Large Database

2019 ◽  
Vol 54 (6) ◽  
pp. 662-666
Author(s):  
Diego Caroli ◽  
Erik Rosa-Rizzotto ◽  
Claudio Pilerci ◽  
Salvatore Lobello ◽  
Franca De Lazzari ◽  
...  
Keyword(s):  
Liver Disease ◽  
Alcoholic Liver Disease ◽  
Alcoholic Hepatitis ◽  
Hospital Admissions ◽  
Age Groups ◽  
Veneto Region ◽  
Admission Rates ◽  
Hospitalization Rates ◽  
Acute Alcoholic Hepatitis ◽  
Regional Population

Abstract Aim To describe recent trends in hospital admission rates for alcoholic liver disease (ALD) in the Veneto region of Italy. Methods This retrospective cohort study is based on anonymous hospital discharge records (HDRs) for 2000–2017 from all public and accredited private hospitals operating within the context of the Regional (Veneto) Health Services that are conserved in National/Regional database. It examined the HDR’s of all the hospitalizations of the residents of the Veneto region that were registered under an ALD diagnosis. These were classified under three subheadings: acute alcoholic hepatitis Alcoholic liver cirrhosis and ‘other ALD’. Results During 2000–2017, 30,089 hospital admissions (out of a total regional population of 4,900,000) were registered for ALD. Hospitalization stratified by age showed that the percentage attributable to acute alcoholic hepatitis is higher in younger age groups: 42% in 15–24-year-old (odds ratios (ORs): 14.74; CI95%: 7–30.86; P &lt; 0.000) and 15% in the 25–44-year-old (OR: 3.51; CI95%: 3.12–3.94; P &lt; 0.000). A longitudinal analysis of hospitalization patterns showed a 7% increase in average age in both sexes (from 58.8 ± 9.2 to 62.4 ± 9.7) and a substantial decrease (63.5%) in standardized hospitalization rates (HRs, χ2 trend: 4099.827; P &lt; 0.000) and a smaller decrease (47%) in standardized mortality rates (χ2 trend: 89.563; P &lt; 0.000). Conclusions The fall in the overall ALD-related HR in the Veneto region can be explained by a decrease in population alcohol consumption. Increase in the HRs for acute alcoholic hepatitis in the age group 15–44 suggests an ongoing need for strategies to prevent alcohol abuse by young people.

scholarly journals Evaluation of community coalition training effects on youth hospital-admitted injury incidence in Victoria, Australia: 2001–2017

2019 ◽  
Vol 26 (5) ◽  
pp. 463-470 ◽  
Author(s):  
Janneke Berecki-Gisolf ◽  
Bosco Rowland ◽  
Nicola Reavley ◽  
Barbara Minuzzo ◽  
John Toumbourou
Keyword(s):  
Risk Factors ◽  
Injury Risk ◽  
Negative Binomial ◽  
Hospital Admissions ◽  
Intervention Strategy ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Injury Incidence ◽  
The Impact

BackgroundInjuries are one of the three leading causes of morbidity and mortality for young people internationally. Although community risk factors are modifiable causes of youth injury, there has been limited evaluation of community interventions. Communities That Care (CTC) offers a coalition training process to increase evidence-based practices that reduce youth injury risk factors.MethodUsing a non-experimental design, this study made use of population-based hospital admissions data to evaluate the impact on injuries for 15 communities that implemented CTC between 2001 and 2017 in Victoria, Australia. Negative binomial regression models evaluated trends in injury admissions (all, unintentional and transport), comparing CTC and non-CTC communities across different age groups.ResultsStatistically significant relative reductions in all hospital injury admissions in 0–4 year olds were associated with communities completing the CTC process and in 0–19 year olds when communities began their second cycle of CTC. When analysed by subgroup, a similar pattern was observed with unintentional injuries but not with transport injuries.ConclusionThe findings support CTC coalition training as an intervention strategy for preventing youth hospital injury admissions. However, future studies should consider stronger research designs, confirm findings in different community contexts, use other data sources and evaluate intervention mechanisms.

scholarly journals Analysis of in-hospital mortality among people with and without Diabetes in Australian Public Hospitals (2014-2017)

2021 ◽  
Author(s):  
Tina Gao ◽  
Kingsley E Agho ◽  
Milan K Piya ◽  
David Simmons ◽  
Uchechukwu L Osuagwu
Keyword(s):  
Mortality Rate ◽  
Hospital Mortality ◽  
Age Groups ◽  
Public Health Problem ◽  
Binary Logistic Regression ◽  
Population Based ◽  
Public Hospitals ◽  
Major Public Health Problem ◽  
Factors Associated ◽  
Cardiovascular Comorbidities

Abstract Background Diabetes is a major public health problem affecting about 1.4 million Australians, especially in South Western Sydney, a hotspot of diabetes with higher than average rates for hospitalisations. The current understanding of the international burden of diabetes and related complications is poor and there is paucity of data on hospital outcomes and/or what common factors influence mortality rate in people with diabetes in Australia. This study determined in-hospital mortality rate and the factors associated among people with and without diabetes. Methods Retrospective data for 554,421 adult inpatients was extracted from the population-based New South Wales (NSW) Admitted Patient Data over 3 financial years (from 2014-15 to 2016-17). The in-hospital mortality per 1000 admitted persons, standardised mortality ratios (SMR) were calculated. Binary logistic regression was performed, adjusting for potential covariates and co-morbidities for people with and without diabetes over three years. Results Over three years 8.7% (48,038 people) of admissions involved those with diabetes. This increased from 8.4% in 2014-15 to 8.9% in 2016-17 (p = 0.007). Across all age groups, in-hospital mortality rate was significantly greater in people with diabetes (20.6, 95% Confidence intervals CI 19.3–21.9 per 1000 persons) than those without diabetes (11.8, 95%CI 11.5–12.1) and more in men than women (23.1, 95%CI 21.2–25.0 vs 17.9, 95%CI 16.2–19.8) with diabetes. The SMR for those with and without diabetes were 3.13 (95%CI 1.78–4.48) and 1.79 (95%CI 0.77–2.82), respectively. There were similarities in the factors associated with in hospital mortality in both groups including: aged > 54years, men, the widowed, those who stayed longer than 4 days or received intensive care in admission and had respiratory and cardiovascular comorbidities. Conclusions The study found that in-patients with diabetes continue to have higher mortality rates than those without diabetes and the Australian population. Overall, similar factors influenced mortality rate in people with and without diabetes in this region indicating that continued improved management of all inpatients is needed in order to minimise the persistent poor outcomes.

Epidemiology and survival of neuroendocrine tumors in Ontario: A 15-year population-based study.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 184-184 ◽  
Author(s):  
Moises Cukier ◽  
Calvin Law ◽  
Ning Liu ◽  
Refik Saskin ◽  
Simron Singh
Keyword(s):  
Overall Survival ◽  
Metastatic Disease ◽  
The United States ◽  
Population Based ◽  
Incidence Rates ◽  
Anatomical Site ◽  
Discharge Abstract Database ◽  
Population Based Study ◽  
Absolute Increase ◽  
The Impact

184 Background: A recent study of the SEER database in the United States showed a 5-fold increase in neuroendocrine tumours (NETs) over the last 30 years. An increasing incidence has also been reported in Norway, Sweden, England, Holland, Italy and Japan, but interestingly not in Denmark and Switzerland. The objective of our study is to describe the incidence, anatomical distribution and survival of NETs in Ontario. Methods: A population based study was initiated using the Ontario Cancer Registry, cross-linked with the Registered Persons Database and the Canadian Institute of Health Information Discharge Abstract Database. All cases of NETs were identified in Ontario (> 13 million persons) from 1994 to 2009. Baseline demographic, clinical and outcomes data were abstracted to allow for an analysis of annual incidence rates, and overall survival. Results: A total of N = 5619 cases were identified. The incidence rate increased from 2.46/ 100,000 (95% CI, 2.13-2.83) in 1994 to 5.86/ 100,000 (95% CI, 5.40 – 6.35) in 2009. The median age was 62 with 50.5% female cases. When divided by site, bronchopulmonary NETs where the most common (22%), then jejunum/ileum (17%) and rectal (16%) NETs, while pancreatic NETs (pNETs) and gastric NETs were 10% and 5% respectively. The absolute increase in the study period was most pronounced for pNETs (6-fold), rectal (5-fold) and gastric (5-fold) NETs. Metastatic disease was documented in 45% of the cases; 20% at diagnosis and 25% during follow-up. The 5-and 10-year overall survival (OS) was 61% and 46% respectively, for the entire population. Site specific 5-year OS were: rectal (87.0%), small bowel (73.4%), gastric (67.4%), colon (64.3%) and pancreas (48.8%). 5-year OS was compared for patients with and without metastatic disease after diagnosis (69.0% vs 40.1%, p<0.0001). Conclusions: There appears to be a significant increase of reported cases of NETs in Ontario, Canada, particularly pNETs, rectum NETs and gastric NETs. This supports much of the population-based reports worldwide. Survival appears to vary significantly according to anatomical site and extent of disease. Further research is required to understand the impact of this cancer previously perceived to be rare but clearly increasing.

MO364ASSOCIATION OF AKI-EVENT DEFINED BY DIFFERENT DEFINITIONS WITH IN-HOSPITAL MORTALITY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Fateme Nateghi ◽  
Konstantinos Makris ◽  
Pierre Delanaye ◽  
Hans Pottel
Keyword(s):  
Logistic Regression ◽  
Hospital Mortality ◽  
Hospital Admissions ◽  
Kidney Injury ◽  
Relative Increase ◽  
Local Health ◽  
Absolute Increase ◽  
Severe Stage ◽  
Stage 1 ◽  
The Impact

Abstract Background and Aims Studies have shown that millions of hospitalized patients suffer from Acute Kidney Injury (AKI) per year which increases mortality risk for these patients. Different definitions for AKI have been proposed during the past years such as RIFLE (2002) and AKIN (2004). In 2012, KDIGO published a clinical practice guideline harmonizing AKIN and RIFLE into one general guideline which classifies AKI into 3 stages, where stage 1 is defined as an absolute increase of SCr ≥ 0.3 mg/dl over 48 hours or a relative increase in SCr ≥ 50% from baseline within the previous 7 days. A recent study [Sparrow et al., 2019] evaluated the impact of further categorizing AKI stage 1 into 2 stages based on SCr criteria. The study separates KDIGO AKI stage 1 and AKIN stage 1 into 2 stages (KDIGO-4 and AKIN-4) based on the different SCr criteria. Having different AKI definitions makes it challenging to analyze AKI incidence and associated outcomes among studies. The present study aimed to investigate the incidence of AKI events defined by 4 different definitions (standard AKIN and KDIGO, and modified AKIN-4 and KDIGO-4) and its association with in-hospital mortality. Method Retrospective clinical data available for all adult (≥18 years old) hospital admissions to a local health district in Athens, Greece between October 1999 and March 2019 was used in the analysis. We excluded patients whose time between admission and discharge was less than 7 days. Also, patients with less than 5 Scr measurements were omitted from the analysis resulting in the final cohort of 7242 admissions. We used the AKIN, KDIGO, AKIN-4, and KDIGO-4 definitions to check the incidence of AKI. As our second goal, we assessed associations of AKI-events with in-hospital mortality, adjusted for characteristics (age, sex, AKI staging) using multivariable logistic regression. Results The incidence of in-hospital AKI using the modified KDIGO-4 was 6.72% for stage 1a, 15.71% for stage 1b, 8.06% for stage 2, and 2.97% for stage 3; however, these percentages for AKIN-4 were 11.5%, 5.83%,1.75%, and 0.33% for stage 1a, stage 1b, stage 2, and stage 3, respectively. Using the standard KDIGO and AKIN definition, 19.08 and 14.05 % developed stage 1, respectively. To find the association between AKI stages and in-hospital mortality, we considered the most severe stage of AKI reached by a patient. Results of logistic regression models show that in-hospital mortality increased as the stage of AKI events increased for both KDIGO-4 and AKIN-4 (Table 1). Table 2 shows the same results using the original KDIGO and AKIN definitions. Conclusion The results of both definitions (AKIN-4 and KDIGO-4) show a significant association with mortality, but KDIGO-4 has a larger odds ratio meaning that AKI classification based on KDIGO-4 has a stronger association with mortality than AKI classification based on AKIN-4. However, based on our results, splitting stage 1 to stage 1a and stage 1b does not seem to make a difference; hence, using KDIGO-4 as a replacement for KDIGO would not have a significant impact on capturing AKI events.

scholarly journals Outcomes in Hospitalized Ischemic Stroke Patients with Dementia on Admission: A Population-Based Cohort Study

2018 ◽  
Vol 45 (3) ◽  
pp. 290-294 ◽  
Author(s):  
Charlotte Zerna ◽  
Mary P. Lindsay ◽  
Jiming Fang ◽  
Richard H. Swartz ◽  
Eric E. Smith
Keyword(s):  
Ischemic Stroke ◽  
Negative Binomial ◽  
Population Based ◽  
Stroke Patients ◽  
Discharge Abstract Database ◽  
Adjusted Risk ◽  
Dementia Prevalence ◽  
People With Dementia ◽  
Administrative Data Source ◽  
Diagnosis Of Dementia

AbstractBackgroundDementia prevalence is rising, and it will double in the next 20 years. This study sought to understand the prevalence of dementia in hospitalized patients with ischemic stroke, and its impact on outcomes.MethodsUsing the Canadian Institute of Health Information’s (CIHI) Discharge Abstract Database (DAD), all acute ischemic stroke admissions from April 2003 to March 2015 in Canada (excluding Quebec) were analyzed. Concurrent dementia at the time of admission was assessed based on hospital diagnostic codes. Characteristics and in-hospital outcomes were compared in patients with and without dementia using χ2 and negative binomial, as well as Poisson regression analysis.ResultsDuring the observed period, 313,138 people were admitted to a hospital in Canada for an ischemic stroke. Of those, 21,788 (7.0%) had a concurrent diagnosis of dementia. People with dementia had older median age (84 vs. 76 years; p<0.0001), were more often female (59.6% vs. 48.4%; p<0.0001) and more often had Charlson-Deyo Comorbidity Index ≥2 (64.5% vs. 43.5%; p<0.0001). Patients with dementia were less likely to be discharged to a rehabilitation facility (adjusted risk ratio [RR] 3.089, 95% confidence interval [CI] 2.992-3.188, p<0.0001) or home independently (adjusted RR 0.756, 95% CI 0.737-0.776, p<0.0001).InterpretationApproximately 1 in 13 hospitalized ischemic stroke patients has coded dementia. Patients with ischemic stroke and concurrent dementia have higher mortality, face significantly more dependence after stroke and utilize greater healthcare resources than stroke patients without dementia. Causative conclusions are limited by the administrative data source. Early care planning and coordination could potentially optimize outcomes.

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