scholarly journals Seasonality of urinary tract infections in the United Kingdom in different age groups: longitudinal analysis of The Health Improvement Network (THIN)

2017 ◽  
Vol 146 (1) ◽  
pp. 37-45 ◽  
Author(s):  
A. ROSELLO ◽  
K. B. POUWELS ◽  
M. DOMENECH DE CELLÈS ◽  
E. VAN KLEEF ◽  
A. C. HAYWARD ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Negative Binomial ◽  
Seasonal Pattern ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Health Improvement ◽  
Electronic Patient Records ◽  
The Health Improvement Network ◽  
The Uk ◽  
Tract Infections

SUMMARYEvidence regarding the seasonality of urinary tract infection (UTI) consultations in primary care is conflicting and methodologically poor. To our knowledge, this is the first study to determine whether this seasonality exists in the UK, identify the peak months and describe seasonality by age. The monthly number of UTI consultations (N = 992 803) and nitrofurantoin and trimethoprim prescriptions (N = 1 719 416) during 2008–2015 was extracted from The Health Improvement Network (THIN), a large nationally representative UK dataset of electronic patient records. Negative binomial regression models were fitted to these data to investigate seasonal fluctuations by age group (14–17, 18–24, 25–45, 46–69, 70–84, 85+) and by sex, accounting for a change in the rate of UTI over the study period. A September to November peak in UTI consultation incidence was observed for ages 14–69. This seasonality progressively faded in older age groups and no seasonality was found in individuals aged 85+, in whom UTIs were most common. UTIs were rare in males but followed a similar seasonal pattern than in females. We show strong evidence of an autumnal seasonality for UTIs in individuals under 70 years of age and a lack of seasonality in the very old. These findings should provide helpful information when interpreting surveillance reports and the results of interventions against UTI.

scholarly journals Catheter-Associated Symptomatic Urinary Tract Infections in Nursing Homes—National Healthcare Safety Network, 2013–2018

2020 ◽  
Vol 41 (S1) ◽  
pp. s153-s154
Author(s):  
Elisabeth Mungai ◽  
Jonathan Edwards ◽  
Taniece Eure ◽  
Angela Anttila ◽  
Theresa Rowe ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Nursing Homes ◽  
Urinary Tract Infections ◽  
Negative Binomial ◽  
Care Facility ◽  
Negative Binomial Regression ◽  
Incidence Rates ◽  
Term Care ◽  
Long Term Care Facility ◽  
Tract Infections

Background: Catheter-associated symptomatic urinary tract infections (CA-SUTIs) are a common adverse healthcare event in nursing homes and have been the focus of multiple prevention strategies.1 In 2012, the CDC launched the NHSN Long-Term Care Facility (LTCF) Component, which nursing homes, the CDC, and prevention collaborators can use to monitor nursing home CA-SUTI incidence and prevention progress.2 The objective of this analysis was to compare CA-SUTI rates and reporting patterns of nursing homes between 2013–2015 and 2016–2018. Methods: We analyzed CA-SUTI data from nursing homes reporting to the NHSN during 2013–2018. Consistent reporters submitted ≥6 months of complete data in any calendar year during the period. To potentially confirm patterns in CA-SUTI rates, we defined “consecutive” reporters, as nursing homes that submitted data for ≥6 months each year during 2013–2018. CA-SUTI incidence rates were calculated as the number of CA-SUTI events divided by the number of catheter days multiplied by 1,000. Likelihood ratio tests using negative binomial regression were used to compare CA-SUTI rates from 2016–2018 and 2013–2015 among both consistent and consecutive reporters. Results: During 2013–2018, the number of nursing homes submitting at least 1 month of CA-SUTI data to NHSN increased from 60 to 120 (Fig. 1). Among these nursing homes, 194 (88%) were consistent reporters. The pooled CA-SUTI rate of 1.77 per 1,000 catheter days in 2016–2018 was significantly lower than the pooled CA-SUTI rate of 2.45 per 1,000 catheter days in 2013–2015 among consistent reporters by ~24% (Table 1). Also, 50 consecutive reporters submitted CA-SUTI data during 2013–2018. Among these consecutive reporters, the pooled CA-SUTI rate of 2.11 per 1,000 catheter days in 2016–2018 was significantly lower than the rate of 2.53 per 1,000 catheter days in 2013–2015 by ~21% (Table 1). Conclusions: This analysis suggests that nursing homes using NHSN for CA-SUTI surveillance have made progress in prevention efforts. During 2013–2018, evidence showed that CA-SUTI incidence rates declined among consistent reporters between the 2 reporting periods. This decrease was verified among consecutive reporters. Additional study is needed to determine which factors account for varying reporting patterns and differential CA-SUTI incidence.Funding: NoneDisclosures: None

scholarly journals Environmental factors, winter respiratory infections and the seasonal variation in heart failure admissions

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Doron Aronson
Keyword(s):  
Heart Failure ◽  
Seasonal Variation ◽  
Environmental Factors ◽  
Negative Binomial ◽  
Respiratory Infections ◽  
Seasonal Pattern ◽  
Negative Binomial Regression ◽  
Inverse Association ◽  
Rate Ratios ◽  
Tract Infections

AbstractSeasonal cycles of AHF are causally attributed to the seasonal pattern of respiratory tract infections. However, this assumption has never been formally validated. We aimed to determine whether the increase in winter admissions for acute heart failure (AHF) can be explained by seasonal infectious diseases. We studied 12,147 patients admitted for AHF over a period of 11 years (2005–2015). Detailed virology and bacteriology data were collected on each patient. Meteorological information including daily temperature and relative humidity was obtained for the same period. The peak-to-low ratio, indicating the intensity of seasonality, was calculated using negative binomial regression-derived incidence rate ratios (IRR). AHF admissions occurred with a striking annual periodicity, peaking in winter (December-February) and were lowest in summer (June–August), with a seasonal amplitude (January vs. August) of 2.00 ([95% CI 1.79–2.24]. Occurrence of confirmed influenza infections was low (1.59%). Clinical diagnoses of respiratory infections, confirmed influenza infections, and influenza-like infections also followed a strong seasonal pattern (P < 0.0001; Peak/low ratio 2.42 [95% CI 1.394–3.03]). However, after exclusion of all respiratory infections, the seasonal variation in AHF remained robust (Peak/low ratio January vs. August, 1.81 [95% CI 1.60–2.05]; P < 0.0001). There was a strong inverse association between AHF admissions and average monthly temperature (IRR 0.95 per 1℃ increase; 95% CI 0.94 to 0.96). In conclusion, these is a dominant seasonal modulation of AHF admissions which is only partly explained by the incidence of winter respiratory infections. Environmental factors modify the susceptibility of heart failure patients to decompensation.

scholarly journals Sickness absence and disability pension after carpal tunnel syndrome diagnosis: A register-based study of patients and matched references in Sweden

2021 ◽  
pp. 140349482110027
Author(s):  
Tea Lallukka ◽  
Rahman Shiri ◽  
Kristina Alexanderson ◽  
Jenni Ervasti ◽  
Ellenor Mittendorfer-Rutz ◽  
...  
Keyword(s):  
Health Care ◽  
Carpal Tunnel Syndrome ◽  
Sickness Absence ◽  
Carpal Tunnel ◽  
Disability Pension ◽  
Negative Binomial ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Sociodemographic Factors ◽  
Tunnel Syndrome

Aims: The aim of this study was to examine sickness absence and disability pension (SA/DP) during working lifespan among individuals diagnosed with carpal tunnel syndrome (CTS) and their matched references, accounting for sociodemographic factors. Methods: We used a register cohort of 78,040 individuals aged 19–60 years when diagnosed with CTS in secondary health care (hospitals and outpatient specialist health care) and their 390,199 matched references from the general population in 2001–2010. Sociodemographic factors and SA/DP net days during a three-year follow-up were included. Negative binomial regression was used. Results: For those not on DP at inclusion, the average number of SA/DP days per person-year was 58 days (95% confidence interval (CI) 56–60 days) among individuals with CTS and 20 days (95% CI 19–21 days) among the matched references. Among both groups, these numbers increased with age and were higher among women than among men. The rate ratio (RR) of SA/DP days was threefold higher among people with CTS than among the matched references (adjusted RR=3.00, 95% CI 2.91–3.10) Moreover, compared to the matched references, the RR for SA/DP was higher among men with CTS (RR=3.86, 95% CI 3.61–4.13) than among women with CTS (RR=2.69, 95% CI 2.59–2.78). The association between CTS and the number of SA/DP days was smaller among older age groups. Sociodemographic factors were similarly associated with SA/DP among people with and without CTS. Conclusions: Numbers of SA/DP days were higher among people with CTS than their matched references in all age groups, particularly among individuals in their early work careers, highlighting public-health relevance of the findings.

scholarly journals Association between Androgen Deprivation Therapy and Risk of Dementia in Men with Prostate Cancer

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3861
Author(s):  
Jui-Ming Liu ◽  
Chin-Yao Shen ◽  
Wallis C. Y. Lau ◽  
Shih-Chieh Shao ◽  
Kenneth K. C. Man ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Incidence Rates ◽  
Androgen Deprivation ◽  
Health Improvement ◽  
The United Kingdom ◽  
Incident Dementia ◽  
The Health Improvement Network ◽  
The Uk ◽  
Incidence Of Dementia

The risk of dementia after androgen deprivation therapy (ADT) in patients with advanced prostate cancer (PCa) remains controversial. This study aimed to evaluate the association between ADT and the incidence of dementia in patients with PCa. We identified patients newly diagnosed with PCa in the National Health Insurance Database of Taiwan from 1 January 2002 to 30 June 2016 and in The Health Improvement Network of the United Kingdom (UK) from 1 January 1998 to 31 March 2018. We classified patients with PCa into ADT and ADT-naïve groups. Propensity score (PS) methods were used to minimize the differences in characteristics between the groups. We performed a Cox proportional hazard model to obtain the adjusted hazard ratio (HR) to compare the incidence of dementia between the groups. Our ADT group comprised 8743 and 73,816 patients in Taiwan and the UK, respectively, which were matched 1:1 to ADT-naïve patients by PS. The incidence rates of dementia in the ADT group were 2.74 versus 3.03 per 1000 person-years in the ADT naïve groups in Taiwan, and 2.81 versus 2.79 per 1000 person-years in the UK. There was no statistical difference between ADT and ADT-naïve groups (adjusted HR: 1.12; 95% confidence interval (CI): 0.87–1.43 in Taiwan and adjusted HR: 1.02; 95% CI: 0.85–1.23 in the UK). We found no association between the incidence of dementia and ADT in patients with advanced PCa in either database. Further studies are warranted to evaluate other possible triggers of incident dementia in patients receiving ADT for advanced PCa.

scholarly journals THE US MIDLIFE MORTALITY CRISIS CONTINUES: INCREASED DEATH RATES FROM CAUSES OTHER THAN COVID-19 DURING 2020

2021 ◽  
Author(s):  
Dana A Glei
Keyword(s):  
Indirect Effect ◽  
Causes Of Death ◽  
Excess Mortality ◽  
Negative Binomial ◽  
National Level ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Negative Binomial Regression Model ◽  
Age Group ◽  
External Causes

COVID-19 has prematurely ended many lives, particularly among the oldest Americans, but the pandemic has also had an indirect effect on health and non-COVID mortality among the working-age population, who have suffered the brunt of the economic consequences. This analysis quantifies the changes in mortality for selected causes of death during the COVID 19 pandemic up to December 31, 2020, and investigates whether the levels of excess mortality varied by age group. The data comprise national-level monthly death counts by age group and selected causes of death from January 1999 to December 2020 combined with annual mid-year population estimates over the same period. A negative binomial regression model was used to estimate monthly cause-specific excess mortality during 2020 controlling for the pre-pandemic mortality patterns by age, calendar year, and season. To determine whether excess mortality varied by age, we tested interactions between broad age groups and dichotomous indicators for the pre-pandemic (January-February) and the pandemic (March-December) portions of 2020. In relative terms, excess all cause mortality (including COVID-19) peaked in December at ages 25-44 (RR=1.58 relative to 2019, 95% CI=1.50-1.68). Excluding COVID-19, all of the excess mortality occurred between ages 15 and 64, peaking in July among those aged 25-44 (RR=1.45, 95% CI 1.37-1.53). We find notable excess mortality during March-December 2020 for many causes (i.e., influenza/pneumonia, other respiratory diseases, diabetes, heart disease, cerebrovascular disease, kidney disease, and external causes), but almost exclusively among young and midlife (aged 25-74) Americans. For those aged 75 and older, there was little excess mortality from causes other than COVID-19 except from Alzheimer's disease. Excess non-COVID mortality may have resulted, at least partly, from incorrectly classified COVID-19 deaths, but neither misclassification nor an atypical flu season that disproportionately affected younger people is likely to explain the increase in mortality from external causes, which was evident even during January-February 2020. Exploratory analyses suggest that drug-related mortality may be driving the early rise in external mortality. The growth in drug overdoses well before there was any hint of a pandemic suggests it is probably not solely an indirect effect of COVID-19, although the pandemic may have exacerbated the problem.

scholarly journals Smoke-free legislation and paediatric hospitalisations for acute respiratory tract infections: national quasi-experimental study with unexpected findings and important methodological implications

2017 ◽  
Vol 27 (e2) ◽  
pp. e160-e166 ◽  
Author(s):  
Jasper V Been ◽  
Daniel F Mackay ◽  
Christopher Millett ◽  
Ireneous Soyiri ◽  
Constant P van Schayck ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Negative Binomial ◽  
Temporal Trends ◽  
Pneumococcal Vaccination ◽  
Negative Binomial Regression ◽  
Break Point ◽  
Negative Binomial Regression Model ◽  
Published Evidence ◽  
Tract Infections

ObjectivesWe investigated whether Scottish implementation of smoke-free legislation was associated with a reduction in unplanned hospitalisations or deaths (‘events’) due to respiratory tract infections (RTIs) among children.DesignInterrupted time series (ITS).Setting/participantsChildren aged 0–12 years living in Scotland during 1996–2012.InterventionNational comprehensive smoke-free legislation (March 2006).Main outcome measureAcute RTI events in the Scottish Morbidity Record-01 and/or National Records of Scotland Death Records.Results135 134 RTI events were observed over 155 million patient-months. In our prespecified negative binomial regression model accounting for underlying temporal trends, seasonality, sex, age group, region, urbanisation level, socioeconomic status and seven-valent pneumococcal vaccination status, smoke-free legislation was associated with an immediate rise in RTI events (incidence rate ratio (IRR)=1.24, 95% CI 1.20 to 1.28) and an additional gradual increase (IRR=1.05/year, 95% CI 1.05 to 1.06). Given this unanticipated finding, we conducted a number of post hoc exploratory analyses. Among these, automatic break point detection indicated that the rise in RTI events actually preceded the smoke-free law by 16 months. When accounting for this break point, smoke-free legislation was associated with a gradual decrease in acute RTI events: IRR=0.91/year, 95% CI 0.87 to 0.96.ConclusionsOur prespecified ITS approach suggested that implementation of smoke-free legislation in Scotland was associated with an increase in paediatric RTI events. We were concerned that this result, which contradicted published evidence, was spurious. The association was indeed reversed when accounting for an unanticipated antecedent break point in the temporal trend, suggesting that the legislation may in fact be protective. ITS analyses should be subjected to comprehensive robustness checks to assess consistency.

scholarly journals Differences in drinking patterns between men and women in Brazil

2011 ◽  
Vol 33 (4) ◽  
pp. 367-373 ◽  
Author(s):  
Cynthia C Wolle ◽  
Marcos Sanches ◽  
Monica L Zilberman ◽  
Raul Caetano ◽  
Marcos Zaleski ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Binge Drinking ◽  
Negative Binomial ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Treatment Programs ◽  
Drinking Patterns ◽  
Age And Gender ◽  
Men And Women ◽  
And Gender

OBJECTIVE: To examine sex differences in alcohol consumption according to age groups, and to assess gender and age effects on several aspects of alcohol consumption patterns. METHOD: Based on a Brazilian nationwide representative sample (n = 3,007), we analysed the differences in drinking patterns between genders. We also assessed the effects of gender, age, and gender by age interaction for alcohol consumption dimensions (frequent drinking, usual intake, binge drinking, and frequent binge drinking), using logistic and negative binomial regression models. RESULTS: Gender, age, and gender by age interaction had significant effects on the predictive models for all studied drinking patterns, except for the 'usual' dosage. The effect of gender on drinking patterns varies with age. While gender has a greater effect in older age groups, the difference between men and women decreased in the younger age groups. CONCLUSIONS: Gender convergence regarding alcohol use is a trend that might be influenced by environmental factors and should be addressed in prevention and treatment programs, as well as in public health policies.

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