Determinants of low birthweight: a comparative study

1993 ◽  
Vol 25 (1) ◽  
pp. 87-100 ◽  
Author(s):  
Barthelemy Kuate Defo ◽  
Melissa Partin
Keyword(s):  
Risk Factors ◽  
Low Birthweight ◽  
Preterm Births ◽  
The United States ◽  
Multiple Births ◽  
Previous Pregnancy ◽  
Behavioural Determinants ◽  
The Us ◽  
Unmarried Motherhood ◽  
Cross National

SummaryThe study compares biological, socioeconomic and behavioural determinants of low birthweight in Cameroon and the United States. Some factors in low birthweight are found to be cross-national, but others are specific to the setting. Positive risk factors of low birthweight in both countries include unmarried motherhood, female sex, multiple births, and preterm births. Outcome of the previous pregnancy is a positive risk factor in the US, but not in Cameroon. Significant negative risk factors include prenatal care visits (in both countries), mother's education (in the US only), births to mothers aged 20–34 and birth orders of 2 or more (in Cameroon only). Separate analyses of all births and the subsamples of singleton births reveal that estimates for the two groups differ only marginally.

scholarly journals THU0442 GOUT AND HEART FAILURE IN THE US: A NATIONAL PERSPECTIVE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 458.2-458
Author(s):  
G. Singh ◽  
M. Sehgal ◽  
A. Mithal
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Confidence Intervals ◽  
Burden Of Illness ◽  
Average Length ◽  
Private Insurance ◽  
Significant Risk ◽  
Case Fatality ◽  
The United States ◽  
The Us

Background:Heart failure (HF) is the eighth leading cause of death in the US, with a 38% increase in the number of deaths due to HF from 2011 to 2017 (1). Gout and hyperuricemia have previously been recognized as significant risk factors for heart failure (2), but there is little nationwide data on the clinical and economic consequences of these comorbidities.Objectives:To study heart failure hospitalizations in patients with gout in the United States (US) and estimate their clinical and economic impact.Methods:The Nationwide Inpatient Sample (NIS) is a stratified random sample of all US community hospitals. It is the only US national hospital database with information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured. We examined all inpatient hospitalizations in the NIS in 2017, the most recent year of available data, with a primary or secondary diagnosis of gout and heart failure. Over 69,800 ICD 10 diagnoses were collapsed into a smaller number of clinically meaningful categories, consistent with the CDC Clinical Classification Software.Results:There were 35.8 million all-cause hospitalizations in patients in the US in 2017. Of these, 351,735 hospitalizations occurred for acute and/or chronic heart failure in patients with gout. These patients had a mean age of 73.3 years (95% confidence intervals 73.1 – 73.5 years) and were more likely to be male (63.4%). The average length of hospitalization was 6.1 days (95% confidence intervals 6.0 to 6.2 days) with a case fatality rate of 3.5% (95% confidence intervals 3.4% – 3.7%). The average cost of each hospitalization was $63,992 (95% confidence intervals $61,908 - $66,075), with a total annual national cost estimate of $22.8 billion (95% confidence intervals $21.7 billion - $24.0 billion).Conclusion:While gout and hyperuricemia have long been recognized as potential risk factors for heart failure, the aging of the US population is projected to significantly increase the burden of illness and costs of care of these comorbidities (1). This calls for an increased awareness and management of serious co-morbid conditions in patients with gout.References:[1]Sidney, S., Go, A. S., Jaffe, M. G., Solomon, M. D., Ambrosy, A. P., & Rana, J. S. (2019). Association Between Aging of the US Population and Heart Disease Mortality From 2011 to 2017. JAMA Cardiology. doi:10.1001/jamacardio.2019.4187[2]Krishnan E. Gout and the risk for incident heart failure and systolic dysfunction. BMJ Open 2012;2:e000282.doi:10.1136/bmjopen-2011-000282Disclosure of Interests: :Gurkirpal Singh Grant/research support from: Horizon Therapeutics, Maanek Sehgal: None declared, Alka Mithal: None declared

Abstract WMP60: Temporal Trends in Incidence, Prevalence and Epidemiological Characteristics of Cerebral Venous Thrombosis in the United States

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Fadar Otite ◽  
Smit Patel ◽  
Richa Sharma ◽  
Pushti Khandwala ◽  
Devashish Desai ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Cerebral Venous Thrombosis ◽  
The United States ◽  
P Value ◽  
Joinpoint Regression ◽  
The Us ◽  
Epidemiological Characteristics ◽  
Over Time ◽  
Age And Sex

Background: The primary aim of this study is to describe current trends in racial-, age- and sex-specific incidence, clinical characteristics and burden of cerebral venous thrombosis (CVT) in the United States (US). Methods: Validated International Classification of Disease codes were used to identify all adult new cases of CVT (n=5,567) in the State Inpatients Database of New York and Florida (2006-2016) and all cases of CVT in the entire US from the National Inpatient Sample 2005-2016 (weighted n=57,315). Incident CVT counts were combined with annual US Census data to compute age and sex-specific incidence of CVT. Joinpoint regression was used to evaluate trends in incidence over time. Results: From 2005-2016, 0.47%-0.80% of all strokes in the US were CVTs but this proportion increased by 70.4% over time. Of all CVTs over this period, 66.7% were in females but this proportion declined over time (p<0.001). Pregnancy/puerperium (27.4%) and cancer (11.8%) were the most common risk factors in women, while cancer (19.5%) and central nervous trauma (11.3) were the most common in men. Whereas the prevalence of pregnancy/puerperium declined significantly over time in women, that of cancer, inflammatory conditions and trauma increased over time in both sexes. Annual age and sex-standardized incidence of CVT in cases/million population ranged from 13.9-20.2, but incidence varied significantly by sex (women: 20.3-26.9; men 6.8-16.8) and by age/sex (women 18-44yo: 24.0-32.6%; men: 18-44yo: 5.3-12.8). Age and sex-standardized incidence also differed by race (Blacks:18.6-27.2; whites: 14.3-18.5; Asians: 5.1-13.8). On joinpoint regression, incidence increased across 2006-2016 but most of this increase was driven by increase in all age groups of men (combined annualized percentage change (APC) 9.2%, p-value <0.001), women 45-64 yo (APC 7.8%, p-value <0.001) and women ≥65 yo (APC 7.4%, p-value <0.001). Incidence in women 18-44 yo remained unchanged over time . Conclusion: The epidemiological characteristics of CVT patients in the US is changing. Incidence increased significantly over the last decade. Further studies are needed to determine whether this increase represents a true increase from changing risk factors or artefactual increase from improved detection.

A Cross-National Comparison of Risk Factors for Teen Dating Violence in Mexico and the United States

2017 ◽  
Vol 47 (3) ◽  
pp. 547-559 ◽  
Author(s):  
Samantha Ludin ◽  
Jessika H. Bottiani ◽  
Katrina Debnam ◽  
Mercedes Gabriela Orozco Solis ◽  
Catherine P. Bradshaw
Keyword(s):  
United States ◽  
Risk Factors ◽  
Dating Violence ◽  
Teen Dating Violence ◽  
The United States ◽  
National Comparison ◽  
Teen Dating ◽  
Cross National

Incidence of and Risk Factors for Nosocomial Bloodstream Infections in Adults in the United States, 2003

2009 ◽  
Vol 30 (11) ◽  
pp. 1036-1044 ◽  
Author(s):  
Omar M. AL-Rawajfah ◽  
Frank Stetzer ◽  
Jeanne Beauchamp Hewitt
Keyword(s):  
United States ◽  
Risk Factors ◽  
Case Fatality Rate ◽  
Nationwide Inpatient Sample ◽  
Hospital Admissions ◽  
Case Fatality ◽  
The United States ◽  
Fatality Rate ◽  
The Us ◽  
National Estimates

Background.Although many studies have examined nosocomial bloodstream infection (BSI), US national estimates of incidence and case-fatality rates have seldom been reported.Objective.The purposes of this study were to generate US national estimates of the incidence and severity of nosocomial BSI and to identify risk factors for nosocomial BSI among adults hospitalized in the United States on the basis of a national probability sample.Methods.This cross-sectional study used the US Nationwide Inpatient Sample for the year 2003 to estimate the incidence and case-fatality rate associated with nosocomial BSI in the total US population. Cases of nosocomial BSI were defined by using 1 or more International Classification of Diseases, 9th Revision, Clinical Modification codes in the secondary field(s) that corresponded to BSIs that occurred at least 48 hours after admission. The comparison group consisted of all patients without BSI codes in their NIS records. Weighted data were used to generate US national estimates of nosocomial BSIs. Logistic regression was used to identify independent risk factors for nosocomial BSI.Results.The US national estimated incidence of nosocomial BSI was 21.6 cases per 1,000 admissions, while the estimated case-fatality rate was 20.6%. Seven of the 10 leading causes of hospital admissions associated with nosocomial BSI were infection related. We estimate that 541,081 patients would have acquired a nosocomial BSI in 2003, and of these, 111,427 would have died. The final multivariate model consisted of the following risk factors: central venous catheter use (odds ratio [OR], 4.76), other infections (OR, 4.61), receipt of mechanical ventilation (OR, 4.97), trauma (OR, 1.98), hemodialysis (OR, 4.83), and malnutrition (OR, 2.50). The total maximum rescaled R2 was 0.22.Conclusions.The Nationwide Inpatient Sample was useful for estimating national incidence and case-fatality rates, as well as examining independent predictors of nosocomial BSI.

scholarly journals Risk factors for cardiovascular disease among Mexican-American adults in the United States and Mexico: a comparative study

2014 ◽  
Vol 56 (2) ◽  
pp. 197 ◽  
Author(s):  
Leo S Morales ◽  
Yvonne N Flores ◽  
Mei Leng ◽  
Noémie Sportiche ◽  
Katia Gallegos-Carrillo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Mexican American ◽  
Hdl Cholesterol ◽  
The United States ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Men And Women ◽  
The Us ◽  
Low Hdl

 Objective. To compare cardiovascular disease (CVD) risk factors in a cohort of Mexican health workers with repre­sentative samples of US-born and Mexico-born Mexican-Americans living in the US. Materials and methods. Data were obtained from the Mexican Health Worker Cohort Study (MHWCS) in Mexico and the National Health and Nutrition Examination Survey (NHANES) IV 1999-2006 in the US. Regression analyses were used to investigate CVD risk factors. Results. In adjusted analyses, NHANES participants were more likely than MHWCS participants to have hypertension, high total cholesterol, diabetes, obesity, and abdominal obesity, and were less likely to have low HDL cholesterol and smoke. Less-educated men and women were more likely to have low HDL cholesterol, obesity, and ab­dominal obesity. Conclusions. In this binational study, men and women enrolled in the MHWCS appear to have fewer CVD risk factors than US-born and Mexico-born Mexican-American men and women living in the US.

scholarly journals The Cross-national Applicability of Lean Implementation Measures and Hospital Performance Measures: A Case Study of Finland and the United States

2021 ◽  
Author(s):  
Elina Reponen ◽  
Thomas G Rundall ◽  
Stephen M Shortell ◽  
Janet C Blodgett ◽  
Ritva Jokela ◽  
...  
Keyword(s):  
United States ◽  
Healthcare System ◽  
Performance Measures ◽  
Service Provision ◽  
The United States ◽  
Hospital Performance ◽  
Lean Implementation ◽  
The Us ◽  
Cross National

Abstract Background Healthcare organizations around the world are striving to achieve transformational performance improvement, often through adopting process improvement methodologies such as Lean management. Indeed, Lean management has been implemented in hospitals in many countries. But despite a shared methodology and the potential benefit of benchmarking lean implementation and its effects on hospital performance, cross-national Lean benchmarking is rare. Healthcare organisations in different countries operate in very different contexts, including different healthcare system models, and these differences may be perceived as limiting the ability of improvers to benchmark Lean implementation and related organisational performance. However, there is no empirical research available on the international relevance and applicability of Lean implementation and hospital performance measures. To begin to understand the opportunities and limitations related to cross-national benchmarking of Lean in hospitals, we conducted a cross-national case study of the relevance and applicability of measures of Lean implementation in hospitals and hospital performance. Methods We report an exploratory case study of the relevance of Lean implementation measures and the applicability of hospital performance measures using quantitative comparisons of data from Hospital District of XX XX University Hospital in Finland and a sample of 75 large academic hospitals in the United States. Results The relevance of Lean-related measures was high across the two countries: almost 90% of the items developed for a US survey were relevant and available from XX. A majority of the US-based measures for financial performance (66.7%), service provision/utilisation (100.0%), and service provision/care processes (60.0%) were available from XX. Differences in patient satisfaction measures prevented comparisons between XX and the US. Of 18 clinical outcome measures, only four (22%) were not comparable. Clinical outcome measures were less affected by the differences in healthcare system models than measures related to service provision and financial performance. Conclusions Lean implementation measures are highly relevant in healthcare organisations operating in the United States and Finland, as is the applicability of a variety of performance improvement measures. Cross-national benchmarking in Lean healthcare is feasible, but a careful assessment of contextual factors, including the healthcare system model, and their impact on the applicability and relevance of chosen benchmarking measures is necessary. The differences between the US and Finnish healthcare system models is most clearly reflected in financial performance measures and care process measures.

scholarly journals Trends and Risk Factors for Leishmaniasis among Reproductive Aged Women in the United States

2021 ◽  
Vol 10 (2) ◽  
pp. 166-173
Author(s):  
Chioma Ikedionwu ◽  
Deepa Dongarwar ◽  
Courtney Williams ◽  
Evelyn Odeh ◽  
Maylis Nkeng Peh ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Global Health ◽  
Protective Factor ◽  
Private Insurance ◽  
The United States ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
The Us ◽  
Clinical Awareness

Background and Objective: Leishmaniasis, a neglected tropical disease, is endemic in several regions globally, but commonly regarded as a disease of travelers in the United States (US). The literature on leishmaniasis among hospitalized women in the US is very limited. The aim of this study was to explore trends and risk factors for leishmaniasis among hospitalized women of reproductive age within the US. Methods: We analyzed hospital admissions data from the 2002-2017 Nationwide Inpatient Sample among women aged 15-49 years. We conducted descriptive statistics and bivariate analyses for factors associated with leishmaniasis. Utilizing logistic regression, we assessed the association between sociodemographic and hospital characteristics with leishmaniasis disease among hospitalized women of reproductive age in the US. Joinpoint regression was used to examine trends over time. Results: We analyzed 131,529,239 hospitalizations; among these, 207 cases of leishmaniasis hospitalizations were identified, equivalent to an overall prevalence of 1.57 cases per million during the study period. The prevalence of leishmaniasis was greatest among older women of reproductive age (35-49 years), Hispanics, those with Medicare, and inpatient stay in large teaching hospitals in the Northeast of the US. Hispanic women experienced a statistically significant increased odds of leishmaniasis diagnosis (OR, 1.80; 95% CI, 1.19-4.06), compared to Non-Hispanic (NH) White women. Medicaid and Private Insurance appeared to serve as a protective factor in both unadjusted and adjusted models. We did not observe a statistically significant change in leishmaniasis rates over the study period. Conclusion and Global Health Implications: Although the prevalence of leishmaniasis among women of reproductive age appears to be low in the US, some risk remains. Thus, appropriate educational, public health and policy initiatives are needed to increase clinical awareness and timely diagnosis/treatment of the disease.   Copyright © 2021 Ikedionwu, et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

scholarly journals Exploring Innovations in Human Milk Analysis in the Neonatal Intensive Care Unit: A Survey of the United States

2021 ◽  
Vol 8 ◽  
Author(s):  
Stacey R. Ramey ◽  
Stephanie Merlino Barr ◽  
Katie A. Moore ◽  
Sharon Groh-Wargo
Keyword(s):  
United States ◽  
Intensive Care ◽  
Human Milk ◽  
Clinical Setting ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
The United States ◽  
Future Research ◽  
Milk Analysis ◽  
The Us

Introduction: Human milk (HM) is the ideal enteral feeding for nearly all infants and offers unique benefits to the very low birthweight (VLBW) infant population. It is a challenge to meet the high nutrient requirements of VLBW infants due to the known variability of HM composition. Human milk analysis (HMA) assesses the composition of HM and allows for individualized fortification. Due to recent U.S. Food and Drug Administration (FDA) approval, it has relatively recent availability for clinical use in the US.Aim: To identify current practices of HMA and individualized fortification in neonatal intensive care units (NICUs) across the United States (US) and to inform future translational research efforts implementing this nutrition management method.Methods: An institutional review board (IRB) approved survey was created and collected data on the following subjects such as NICU demographics, feeding practices, HM usage, HM fortification practices, and HMA practices. It was distributed from 10/30–12/21/2020 via online pediatric nutrition groups and listservs selected to reach the intended audience of NICU dietitians and other clinical staff. Each response was assessed prior to inclusion, and descriptive analysis was performed.Results: About 225 survey responses were recorded during the survey period with 119 entries included in the analysis. This represented 36 states and Washington D.C., primarily from level III and IV NICUs. HMA was reported in 11.8% of responding NICUs. The most commonly owned technology for HMA is the Creamatocrit Plus TM (EKF Diagnostics), followed by the HM Analyzer by Miris (Uppsala, Sweden). In NICUs practicing HMA, 84.6% are doing so clinically.Discussion: Feeding guidelines and fortification of HM remain standard of care, and interest in HMA was common in this survey. Despite the interest, very few NICUs are performing HMA and individualized fortification. Barriers identified include determining who should receive individualized fortification and how often, collecting a representative sample, and the cost and personnel required.Conclusions: Human milk analysis and individualized fortification are emerging practices within NICUs in the US. Few are using it in the clinical setting with large variation in execution among respondents and many logistical concerns regarding implementation. Future research may be beneficial to evaluate how practices change as HMA and individualized fortification gain popularity and become more commonly used in the clinical setting.

Disproportionate impact of COVID-19 disease among racial and ethnic minorities in the U.S. cancer population as seen in CancerLinQ Discovery data.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 84-84
Author(s):  
Danielle Potter ◽  
Mark Riffon ◽  
Sirisha Kakamada ◽  
Robert S. Miller ◽  
George Anthony Komatsoulis
Keyword(s):  
Risk Factors ◽  
African Americans ◽  
Geographical Location ◽  
Malignant Neoplasm ◽  
The United States ◽  
Elevated Risk ◽  
Rt Pcr ◽  
Patients With Cancer ◽  
The Us ◽  
Icd 10

84 Background: Patients with cancer may face difficult care decisions during the COVID-19 outbreak in the US. Understanding COVID-19 risk factors may help patients and oncologists identify high-risk patients and plan for the best cancer treatment in a timely fashion. This analysis provides an assessment of racial and ethnic risk factors for COVID-19 disease within the CancerLinQ (CLQ) Discovery database. Methods: CLQ is a health technology platform developed by ASCO, which collects and aggregates longitudinal electronic health record (EHR) data from oncology practices throughout the United States. Patients with a diagnosis of a malignant neoplasm and at least two encounters in the past year at a reporting CLQ practice were defined as the underlying cancer patient population at risk for SARS-CoV-2 infection. COVID-19 cases were identified via a positive RT-PCR test for SARS-CoV-2 RNA and/or an ICD-10 code for coronavirus (e.g., B97.29, U07.1, or U07.2). Relative risks and 95% CI were calculated using SAS. Results: We identified 232,428 patients with cancer. From 1/1/2020-4/30/2020, we identified 223 COVID-19 cases in patients with cancer. Of these, 203 had a positive RT-PCR, 26 had an ICD-10 diagnosis code for SARS-CoV-2, and 6 had both. SARS-CoV-2 cases were identified from 19 of the 35 CLQ practices (52.8%) reporting data during the study period. Compared to white patients, African Americans were approximately 2 times more likely to have COVID-19 disease (RR = 1.95; 95% CI = 1.40-2.71), and Hispanics were more than 4 times more likely (RR = 4.65; 95% CI = 3.36-6.43). Patients with hematologic cancers were 1.5 times as likely to be diagnosed with COVID-19 (RR = 1.53; 95% CI = 1.09-2.16) compared to patients with solid tumors. At the time of this abstract, 10 patients (4.5%) died. Conclusions: These results are based on data from a sample of CLQ practices and represent an initial analysis of COVID-19 in the CLQ population. The elevated risk for COVID-19 among African Americans and Hispanics with cancer is noteworthy, particularly since these patients often suffer poorer cancer outcomes. The elevated risk among patients with hematologic cancers is also worth noting because these patients often have compromised immune systems and are already susceptible to many other types of infection. Because the US is in the midst of an active outbreak, we are continuing to analyze new cases and additional risk factors, such as geographical location, anti-cancer treatments, and other cancer variables (e.g. stage).

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