scholarly journals Variations in case fatality and fatality risk factors of meningococcal disease in Western Norway, 1985–2002

2005 ◽  
Vol 134 (1) ◽  
pp. 103-110 ◽  
Author(s):  
I. SMITH ◽  
A. T. BJØRNEVIK ◽  
I. M. B. AUGLAND ◽  
A. BERSTAD ◽  
T. WENTZEL-LARSEN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Skin Rash ◽  
Meningococcal Disease ◽  
Case Fatality Rate ◽  
Multivariate Analyses ◽  
Case Fatality ◽  
Fatality Rate ◽  
The Public ◽  
Admission Time ◽  
Meningococcal Septicaemia

SUMMARYIn a retrospective epidemiological study, 293 meningococcal disease patients hospitalized during 1985–2002, were examined for fatality and risk factors related to death. The overall case fatality rate (CFR) was 8·2%, but increased from 4% during 1985–1993 to 17% during 1994–2002. The latter 9-year period was characterized by more serogroup C infections and more patients with thrombocytopenia on admission to hospital. All patients categorized as meningitis on admission survived. Of the 24 patients who died, 21 had meningococcal skin rash on admission, 23 had an onset to admission time of ⩽24 h, and 16 had severe septicaemia with hypotension and/or ecchymoses without meningitis on admission. By multivariate analyses, a short onset to admission time, >50 petechiae, thrombocytopenia and severe septicaemia on admission were associated with fatality. More lives could be saved through earlier admission to hospital. This can be achieved through more information to the public about the early signs of meningococcal septicaemia, with the recommendation to look for skin rash in patients with acute fever during the first day and night.

Morbidity, mortality and spatial distribution of meningococcal disease, 1974–2007

2009 ◽  
Vol 137 (11) ◽  
pp. 1631-1640 ◽  
Author(s):  
M. HOWITZ ◽  
L. LAMBERTSEN ◽  
J. B. SIMONSEN ◽  
J. J. CHRISTENSEN ◽  
K. MØLBAK
Keyword(s):  
Risk Factors ◽  
Spatial Distribution ◽  
Meningococcal Disease ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Incidence Rates ◽  
Fatality Rate ◽  
Risk Of Death ◽  
Increased Risk ◽  
High Age

SUMMARYTo identify determinants for mortality and sequelae and to analyse the spatial distribution of meningococcal disease, we linked four national Danish registries. In the period 1974–2007, 5924 cases of meningococcal disease were registered. Our analysis confirms known risk factors for a fatal meningococcal disease outcome, i.e. septicaemia and high age (>50 years). The overall case-fatality rate was 7·6%; two phenotypes were found to be associated with increased risk of death; C:2a:P1.2,5 and B:15:P1.7,16. B:15:P1.7,16 was also associated with excess risk of perceptive hearing loss. The incidence rates of meningococcal disease were comparable between densely and less densely populated areas, but patients living further from a hospital were at significantly higher risk of dying from the infection. To improve control of meningococcal disease, it is important to understand the epidemiology and pathogenicity of virulent ‘successful clones’, such as C:2a:P1.2,5 and B:15:P1.7,16, and, eventually, to develop vaccines against serogroup B.

scholarly journals Clinical Characteristics and Outcomes of COVID-19–Infected Cancer Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Hua Zhang ◽  
Han Han ◽  
Tianhui He ◽  
Kristen E Labbe ◽  
Adrian V Hernandez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Case Fatality Rate ◽  
Meta Analysis ◽  
Univariate Analysis ◽  
Case Fatality ◽  
The United States ◽  
Fatality Rate ◽  
Patients With Cancer ◽  
Increased Risk

Abstract Background Previous studies have indicated coronavirus disease 2019 (COVID-19) patients with cancer have a high fatality rate. Methods We conducted a systematic review of studies that reported fatalities in COVID-19 patients with cancer. A comprehensive meta-analysis that assessed the overall case fatality rate and associated risk factors was performed. Using individual patient data, univariate and multivariable logistic regression analyses were used to estimate odds ratios (OR) for each variable with outcomes. Results We included 15 studies with 3019 patients, of which 1628 were men; 41.0% were from the United Kingdom and Europe, followed by the United States and Canada (35.7%), and Asia (China, 23.3%). The overall case fatality rate of COVID-19 patients with cancer measured 22.4% (95% confidence interval [CI] = 17.3% to 28.0%). Univariate analysis revealed age (OR = 3.57, 95% CI = 1.80 to 7.06), male sex (OR = 2.10, 95% CI = 1.07 to 4.13), and comorbidity (OR = 2.00, 95% CI = 1.04 to 3.85) were associated with increased risk of severe events (defined as the individuals being admitted to the intensive care unit, or requiring invasive ventilation, or death). In multivariable analysis, only age greater than 65 years (OR = 3.16, 95% CI = 1.45 to 6.88) and being male (OR = 2.29, 95% CI = 1.07 to 4.87) were associated with increased risk of severe events. Conclusions Our analysis demonstrated that COVID-19 patients with cancer have a higher fatality rate compared with that of COVID-19 patients without cancer. Age and sex appear to be risk factors associated with a poorer prognosis.

scholarly journals Risk factors for incidence and case-fatality rates of healthcare-associated infections: a 20-year follow-up of a hospital-based cohort

2015 ◽  
Vol 144 (1) ◽  
pp. 198-206 ◽  
Author(s):  
R.-F. WANG ◽  
S.-H. SHEN ◽  
A. M.-F. YEN ◽  
T.-L. WANG ◽  
T.-N. JANG ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Incidence Rate ◽  
Case Fatality Rate ◽  
Tertiary Care ◽  
Case Fatality ◽  
Healthcare Associated Infections ◽  
Fatality Rate ◽  
Infection Site ◽  
Healthcare Associated

SUMMARYInformation is lacking on the integrated evaluation of mortality rates in healthcare-associated infections (HAIs). Our aim was to differentiate the risk factors responsible for the incidence from those for the case-fatality rates in association with HAIs. We therefore examined the time trends of both incidence and case-fatality rates over a 20-year period at a tertiary-care teaching medical centre in Taiwan and the mortality rate was expressed as the product of the incidence rate and the case-fatality rate. During the study period the overall mortality rate fell from 0·46 to 0·32 deaths/1000 patient-days and the incidence rate fell from 3·41 to 2·31/1000 patient-days, but the case-fatality rate increased marginally from 13·5% to 14·0%. The independent risk factors associated with incidence of HAIs were age, gender, infection site, admission type, and department of hospitalization. Significant prognostic factors for HAI case-fatality were age, infection site, intensive care, and clinical department. We conclude that the decreasing trend for the HAI mortality rate was accompanied by a significant decline in the incidence rate and this was offset by a slightly increasing trend in the case-fatality rate. This deconstruction approach could provide further insights into the underlying complex causes of mortality for HAIs.

scholarly journals Invasive meningococcal disease associated with a very high case fatality rate in the North-West of Poland

2006 ◽  
Vol 46 (2) ◽  
pp. 230-235 ◽  
Author(s):  
Anna SkoczyÅ„ska ◽  
Marcin KadÅ‚ubowski ◽  
Józef Knap ◽  
Maria Szulc ◽  
Marzena Janusz-Jurczyk ◽  
...  
Keyword(s):  
Meningococcal Disease ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Invasive Meningococcal Disease ◽  
Fatality Rate ◽  
High Case Fatality Rate ◽  
North West ◽  
The North ◽  
Very High

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 Internações por bronquiolite aguda na rede pública da Região Metropolitana de Porto Alegre – RS de 2012 a 2014

2021 ◽  
Vol 7 (2) ◽  
pp. 196-202
Author(s):  
Morgana Thaís Carollo Fernandes ◽  
Luciana Medeiros Paungartner ◽  
Roger Dos Santos Rosa
Keyword(s):  
Length Of Stay ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Metropolitan Region ◽  
Fatality Rate ◽  
Acute Bronchiolitis ◽  
Porto Alegre ◽  
Public Network ◽  
The Public ◽  
La Red

Resumo A bronquiolite aguda é uma doença caracterizada por inflamação aguda dos bronquíolos e aumento da produção e da secreção de muco que pode estar associada a broncoespasmo. Acomete principalmente os lactentes, sendo a causa mais comum de hospitalizações pediátricas no primeiro ano de vida. O objetivo deste trabalho foi descrever as características das hospitalizações e os gastos na rede pública por bronquiolite aguda de residentes de 0 a 2 anos da Região Metropolitana de Porto Alegre (RMPA), no sul do Brasil, no período 2012 a 2014. As hospitalizações com diagnóstico principal CID-10 J21.0 e J21.8 foram analisadas a partir de dados do Sistema de Informações Hospitalares, disponíveis publicamente. Foram calculados indicadores por sexo, faixas etárias, permanência, letalidade e gastos por internação. Ocorreram 7.091 internações (2.364/ano), na rede pública, por bronquiolite aguda de residentes da RMPA de 2012 a 2014 (153,6/10 mil habitantes/ano). O sexo masculino predominou (4.246 ou 59,9%) e as internações de pacientes de até um ano representaram 99,2%. Bronquiolite por vírus sincicial respiratório respondeu por 2.226 (31,4%) das internações, sendo que o tempo médio de permanência foi de 5,3 dias e a letalidade 0,2% tendo 12 pacientes falecidos. O gasto médio anual foi de R$ 946,2 mil e o valor médio por internação de R$ 400,29. Concluiu-se que as hospitalizações por bronquiolite aguda caracterizaram-se por elevada incidência, curta duração e baixa letalidade na rede pública da Região Metropolitana de Porto Alegre. Palavras-chave: Bronquiolite; hospitalização; Sistema Único de Saúde; criança; doenças respiratórias.     Abstract Hospitalizations for Acute Bronchiolitis in the public network of the Metropolitan Region of Porto Alegre– RS: a cross-sectional study from 2012 to 2014 The acute bronchiolitis is a disease characterized by acute inflammation of the bronchioles and increased mucus production and secretion that can be associated with bronchospasm. It mainly affects infants, being the most common cause of pediatric hospitalizations in the first year of life. The objective of this work was to describe the characteristics of hospitalizations and spent in the public network for acute bronchiolitis of residents aged 0 to 2 years in the Metropolitan Region of Porto Alegre (MRPA), in southern Brazil, from 2012 to 2014. Analysis of hospitalizations with the main diagnosis CID-10 J21.0 and J21.8was performed from the Hospital Information System, publicly available. Calculations of indicators by sex, age groups, length of stay, lethality and spent of hospitalization were also performed. A total of 7,091 hospitalizations occurred (2,364/year) in the public network for acute bronchiolitis of residents of the MRPA from 2012 to 2014 (153.6/10 thousand inhabitants/year). The male gender predominated (4,246 or 59.9%) and hospitalizations of patients up to one year accounted for 99.2%. Bronchiolitis due to respiratory syncytial virus accounted for 2,226 (31.4%) hospitalizations and the average length of stay was 5.3 days and the case fatality rate was 0.2% (12 patients deceased). The average annual expenditure was R $ 946.2 thousand and the average amount per hospitalization was R $ 400.29. It was concluded that hospitalizations for acute bronchiolitis were characterized by high incidence, short duration and low case fatality rate in the public network of the Metropolitan Region of Porto Alegre. Keywords: Bronchiolitis; hospitalization; Health Unic System; child; respiratory diseases.     Resumen Hospitalizaciones por Bronquiolitis Aguda em la Red Pública de la Región Metropolitana de Porto Alegre – RS: un estudio transversal de 2012 a 2014 La bronquiolitis aguda es una enfermedad caracterizada por la inflamación aguda de los bronquiolos y aumento de la producción y secreción de moco que puede asociarse a broncoespasmo. Afecta principalmente los lactantes, siendo la causa más común de hospitalizaciones pediátricas en el primer año de vida. El objetivo de este trabajo fue describir las características de las hospitalizaciones y costos en la red pública por bronquiolitis aguda de residentes de 0 a 2 años de edad de la Región Metropolitana de Porto Alegre, en el sur de Brasil, en el período 2012 a 2014. Las hospitalizaciones con diagnóstico principal CID-10 J21.0 y J21.8fueron analizadas a partir del Sistema de Información Hospitalaria, disponible publicamente. Fueron calculados indicadores por sexo, grupos de edad, permanencia, letalidad y costos por hospitalización. Hubo 7.091 hospitalizaciones (2.364/año) em la red pública por bronquiolitis aguda de residentes de la Región Metropolitana de Porto Alegre de 2012 a 2014 (153,6/10 mil habitantes/año). Predominó el género masculino (4.246 o 59,9%) y las hospitalizaciones de pacientes hasta un año representaron 99,2%. La bronquiolitis por virus respiratorio sincitial representó 2.226 (31,4%) de las hospitalizaciones y el promedio de permanencia fue de 5,3 días y la letalidad 0,2%, teniéndose 12 pacientes fallecidos. El costo pro medio anual fue de R$ 946,2 mil y el monto promedio por hospitalización fue de R$ 400,29. Se concluye que las hospitalizaciones por bronquiolitis aguda se caracterizaron por alta incidencia, corta duración y baja letalidad em la red pública de la Región Metropolitana de Porto Alegre. Palabras clave: Bronquiolitis; hospitalización; Sistema Único de Salud; niño; enfermidades respiratorias.

scholarly journals Fetomaternal outcomes in patients with Uterine Rupture managed at Bugando Medical Centre, Tanzania: 5-year review of cases

2019 ◽  
Author(s):  
Simon Mrema ◽  
Anthony Massinde ◽  
Dismas Matovelo ◽  
Albert Kihunrwa ◽  
Richard Rumanyika ◽  
...  
Keyword(s):  
Risk Factors ◽  
Uterine Rupture ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Maternal Outcomes ◽  
Fatality Rate ◽  
Obstructed Labor ◽  
Apgar Scores ◽  
Bugando Medical ◽  
Bugando Medical Centre

Abstract Background Uterine rupture is one of the major obstetric complications, associated with adverse fetal and maternal outcomes including hemorrhage, genital urinary injury, low Apgar scores, fetomaternal deaths. There is a paucity of data regarding uterine rupture and its consequences among pregnant women in Mwanza, Tanzania. As a result, it is difficult to know the magnitude of the problem and formulate appropriate measures to reduce its incidence. This study was thus conducted to determine the cumulative incidence, risk factors, fetal and maternal outcomes among women with uterine rupture managed at Bugando Medical Centre (BMC), Mwanza-Tanzania.Methods This was a 5-year (2013 to 2017) retrospective descriptive study of cases of uterine rupture at BMC. The case files were collected from medical records department and maternal demographic information, clinical presentation, risk factors, interventions and feto-maternal outcomes were extracted using a checklist. Data were analyzed using STATA software version 13.Results There were 37,763 deliveries within five years. Caesarean section accounted for a quarter (n=9,136) of these deliveries. During this period 81 cases of ruptured uterus were identified, making a cumulative incidence of 2.2 cases per 1,000 deliveries. Common risk factors for uterine rupture were history of previous caesarean section 54% (n=36), obstructed labor 37% (n=25), grandmultiparity 19.4% (n=13) and use of oxytocin 21% (n=14). Maternal case fatality rate in this study was 1.5% (n=1). More than half of cases had hysterectomy while about a third (n=25) had uterine repair without bilateral tubal ligation (BTL). Over 80% (n=55) of cases required blood transfusion. Sepsis developed in 21% (n=14) of cases and vesicovaginal fistula (VVF) in 12% (n=8). Perinatal case fatality rate was 72% (n=48). Out of the 24 babies who were born alive, 37.5% (n=9) had low Apgar scores and 20.8% (n=5) died before discharge.Conclusion The leading risk factor for uterine rupture seen was previous caesarean scar and obstructed labor associated with high perinatal case fatality rate. Improvement in monitoring of patients in labor is necessary to detect early features of uterine rupture, obstructed labour and fetal compromise. This will contribute to reduced incidence of uterine rupture and improve fetomaternal outcomes.

scholarly journals Is there room for improving case management for contacts of meningococcal disease in the European Union?

2008 ◽  
Vol 13 (10) ◽  
pp. 1-2 ◽  
Author(s):  
P L Lopalco
Keyword(s):  
European Union ◽  
Meningococcal Disease ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Severe Illness ◽  
Fatality Rate ◽  
The European Union ◽  
High Case Fatality Rate ◽  
Children And Young Adults ◽  
Loss Of Limbs

Invasive meningococcal disease (IMD) is a severe illness primarily affecting children and young adults. It has a high case fatality rate (10%-14%) and 11%-19% of patients who recover experience permanent hearing loss, mental retardation, loss of limbs or other serious sequelae.

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