Incidence and characteristics of falls leading to hospital treatment: a one-year population surveillance study of the Danish population aged 45 years and over

ObjectivesTo estimate the incidence, characteristics and outcomes of 10-fold or greater or a tenth or less medication errors in children aged <16 years in Wales.DesignPopulation-based surveillance study July 2017 to June 2019. Cases were identified by paediatricians and hospital pharmacists using monthly electronic Welsh Paediatric Surveillance Unit (WPSU) reporting system.Patients‘Definite’ incident occurred when children received all or any of the incorrect dose of medication. ‘Near miss’ was where the prescribed, prepared or dispensed medication was not administered to the child.Main outcome measuresIncidence, patient characteristics, setting, drug characteristics, outcome, harm and enabling or preventive factors.ResultsIn total, 50 10-fold errors were reported; 20 definite and 30 near miss cases. This yields a minimum annual incidence of 1 per 3797 admissions, or 4.6/100 000 children. Of these, 43 were overdoses and 7 underdoses. 33 incidents occurred in children <5 years of age. Overall, 37 different medications were involved with the majority, 31 cases, being administered enterally. Of these 31 enteral medication errors, all definite cases (10) had received liquid preparations. Temporary harm occurred in 5/20 (25%) definite cases with one requiring intensive care; all fully recovered.ConclusionsIn this first ever population surveillance study in a high-resource healthcare system, 10-fold errors in children were rare, sometimes prevented and uncommonly caused harm. We recommend country-wide improvements be made to reduce iatrogenic harm. Understanding the enabling and preventive factors may help national improvement strategies to reduce these errors.

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Diagnoses and mortality in a population without acute myocardial infarction, but with elevated highsensitive troponin I – a retrospective register-based single center study

Acute Medicine Journal ◽

10.52964/amja.0838 ◽

2021 ◽

Vol 20 (1) ◽

pp. 18-24

Author(s):

Rasmus Søgaard Hansen ◽

◽

Jesper Revsholm ◽

Daniel Pilsgaard Henriksen ◽

Lars Christian Lund Lund ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Troponin I ◽

Inclusion Criteria ◽

Danish Population ◽

Medical Observation ◽

Single Center Study ◽

One Year ◽

High Sensitive Troponin ◽

Center Study

Aim: To explore, which differential diagnoses to consider in individuals with elevated troponins without acute myocardial infarction (AMI), and the mortality for those individuals. Methods: Retrospective, register-based study on a representative sample of the Danish population with the following inclusion criteria: High-sensitive troponin I (hs-TnI) ≥25 ng/L, age ≥18 years, and exclusion of AMI. Results: 3067 individuals without AMI but increased hs-TnI were included. Most frequent discharge diagnoses: Pneumonia (12.8%), Aortic valve disorder (11.3%), Medical observation (10.9%) and Heart failure (8.9%). The 30-days and one-year mortality was 15.8% and 32.0%, respectively. Conclusions: A selected number of alternative diagnoses must be considered in individuals with increased hs-TnI. Due to high mortality it is crucial to carefully evaluate these individuals despite the absence of AMI.

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Testing Denmark: A Danish nationwide surveillance study of COVID-19

10.1101/2021.08.10.21261777 ◽

2021 ◽

Author(s):

Kamille Fogh ◽

Jarl E Strange ◽

Bibi FSS Scharff ◽

Alexandra RR Eriksen ◽

Rasmus B Hasselbalch ◽

...

Keyword(s):

Large Scale ◽

Point Of Care ◽

Rapid Test ◽

Physical Contact ◽

Surveillance Study ◽

Epidemiological Surveillance ◽

Danish Population ◽

Positive Polymerase Chain Reaction ◽

Geographic Population ◽

Associated Risk Factors

Background National data on the spread of SARS-CoV-2 infection and knowledge on associated risk factors are important for understanding the course of the pandemic. Testing Denmark is a national large-scale epidemiological surveillance study of SARS-CoV-2 in the Danish population. Methods Between September and October 2020, approximately 1.3 million of 5.8 million Danish citizens (age > 15 years) were randomly invited to fill in an electronic questionnaire covering COVID-19 exposures and symptoms. The prevalence of SARS-CoV-2 antibodies was determined by Point-of Care rapid Test (POCT) distributed to participants home addresses. Findings In total 318,552 participants (24.5% invitees) completed the questionnaire and provided the result of the POCT. Of these, 2,519 (0.79%) were seropositive (median age 55 years) and women were more often seropositive than men, interquartile range (IQR) 42-64, 40.2% males. Of participants with a prior positive Polymerase Chain Reaction (PCR) test (n=1,828), 29.1% were seropositive in the POCT. Seropositivity increased with age irrespective of sex. Elderly participants (>61 years) reported less symptoms and had less frequently been tested for SARS-CoV-2 compared to younger participants. Seropositivity was associated with physical contact with SARS-CoV-2 infected individuals (Risk ratio (RR) 7.43, 95% CI: 6.57-8.41) and in particular household members (RR 17.70, 95% CI: 15.60-20.10). Home care workers had a higher risk of seropositivity (RR 2.09 (95% CI: 1.58-2.78) as compared to office workers. Geographic population density was not associated to seropositivity. A high degree of compliance with national preventive recommendations was reported (e.g., > 80% use of face masks), but no difference was found between seropositive and seronegative participants. Interpretation This study provides insight into the immunity of the Danish population seven to eight months after the first COVID-19 case in Denmark. The seroprevalence was lower than expected probably due to a low sensitivity of the POCT used or due to challenges relating to the reading of test results. Occupation or exposure in local communities were major routes of infection. As elderly participants were more often seropositive despite fewer symptoms and less PCR tests performed, more emphasis should be placed on testing this age group.

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P3614Impact of renal dysfunction in patients with acute myocardial infarction on early management and outcome: a first observational French study

European Heart Journal ◽

10.1093/eurheartj/ehz745.0473 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

V Bernard ◽

C El Khoury ◽

L Fraticelli

Keyword(s):

Myocardial Infarction ◽

Cardiovascular Risk ◽

Hospital Mortality ◽

Real Life ◽

Patient Characteristics ◽

Hospital Treatment ◽

Kidney Dysfunction ◽

Early Management ◽

St Segment Elevation ◽

One Year

Abstract Background Kidney dysfunction (KD) is largely associated to cardiovascular mortality. Purpose Analyse early management and outcome in real life of ST segment elevation myocardial infarction (STEMI) patients with KD compared to STEMI patients with normal renal function. Methods Using 10 years' data from OSCAR regional registry, we investigated the early management and outcome of all patients with STEMI. Kidney dysfunction (KD) has been defined by creatinine clearance (CrCl) <90mL/min and was assessed using Cockcroft-Gault (CG) equation. Among them, two groups were identified: patients with normal kidney function (NKF) (CrCl ≥90mL/min) and patients with KD (CrCl <90mL/min). KD patients were stratified into 3 groups: patients with mild KD (CrCl 60–90mL/min), patients with moderate KD (CrCl 30–60mL/min) and patients with severe KD (CrCl <30mL/min). The comparison of the groups concerned patient characteristics, therapeutic strategy and follow-up at 1, 6 and 12 months. Results Our study included 8 003 STEMI patients from 2009 to 2018, 4 234 (52.9%) of them with KD. Among these, 2441 (57.6%) patients had mild KD, 1494 (35.3%) moderate KD and 299 (7.1%) severe KD. NKF patients were younger than KD group (54 [48–61] vs 72 [63–81]). KD patients had more cardiovascular risk factors such as diabetes, hypertension and personal history of coronary disease (p<0.001), but were less smokers (p<0,001). KD patients presented less often chest pain, and more dyspnea or cardiac arrest (p<0,001). There was no difference in symptom-first medical contact delay (p=0.30). More than 14% of patients with KD presented with Killip≥2. In the KD group location of infarction was more often anterior and lateral. In-hospital treatment differed among the groups: KD patients received less prasugrel (11% vs 20%), ticagrelor (44% vs 49%), enoxaparin (70% vs 80%), morphine (29% vs 39%) or other analgesic (30% vs 35%), but more clopidogrel (33% vs 23%), diuretics (3% vs 0,7%) and catecholamines (5% vs 2%) (p<0.001). In-hospital mortality was higher in the KD group (9% vs 1%, p<0.001). One-year mortality was 14% in the KD group compared to 2% for patients with NKF (p<0.001). Also, in-hospital mortality was increasing exponentially with KD severity (2%, 8% and 24% for mild, moderate and severe KD) (p<0,001) as well as 1-year mortality (respectively 1%, 6% and 12% after 1 year) (p<0,001). Conclusion Kidney insufficiency is an independent risk factor for death in patients after myocardial infarction and was associated with poor prognosis at short- and long-term. We observed that mortality increased with KD severity. Despite a high cardiovascular risk, KD patients presenting STEMI are less likely to receive therapy, while having more co-morbidities and extended infarction. To achieve an optimal medical care of KD patients with STEMI, we should introduce evidence-based therapies in the acute phase.

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Discussion on the rates of dyspepsia one year after Helicobacter pylori screening and eradication in a Danish population

Gastroenterology ◽

10.1053/j.gastro.2004.02.045 ◽

2004 ◽

Vol 126 (4) ◽

pp. 1223-1224 ◽

Cited By ~ 1

Author(s):

Hannelore I. Bax ◽

Ernst J. Kuipers ◽

Jan L.C.M. Van Saase

Keyword(s):

Helicobacter Pylori ◽

Danish Population ◽

One Year

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Szívinfarktust túlélt betegek terápiahűsége a másodlagos megelőzés szempontjából fontos gyógyszeres kezelésekhez

Orvosi Hetilap ◽

10.1556/650.2017.30795 ◽

2017 ◽

Vol 158 (27) ◽

pp. 1051-1057 ◽

Cited By ~ 1

Author(s):

András Jánosi ◽

Péter Ofner ◽

Zoltán Kiss ◽

Levente Kiss ◽

Róbert Gábor Kiss ◽

...

Keyword(s):

Myocardial Infarction ◽

Beta Blockers ◽

Platelet Aggregation Inhibitors ◽

Hospital Treatment ◽

Evidence Based ◽

Index Event ◽

Aggregation Inhibitors ◽

Observational Cohort ◽

Long Term Prognosis ◽

One Year

Abstract: Introduction and aim: The aim was to study the patients’ adherence to some evidence-based medication (statins, beta blockers, platelet and RAS inhibitors) after suffering a myocardial infarction, and its impact on the outcome. Method: Retrospective observational cohort study was carried out from the data of the Hungarian Myocardial Infarction Registry between January 1, 2013, and December 31, 2014. 14,843 patients were alive at the end of hospital treatment, from them, those who had no myocardial infarction or death until 180 days were followed for one year. The adherence was defined as the proportion of time from the index event to the endpoint (or censoring) covered with prescription fillings. The endpoint was defined as death or reinfarction. Information on filling prescriptions for statins, platelet aggregation inhibitors, beta blockers and ARB/ACEI-inhibitors were obtained. Multivariate regression was used to model adherence and survival time. Results: Good adherence (\>80%) to clopidogrel, statins, beta blockers, aspirin and ARB/ACEI was found in 64.9%, 54.4%, 36.5%, 31.7% and 64.0%, respectively. Patients treated with PCI during the index hospitalization had higher adherence to all medication (all p<0.01), except for beta-blocker (p = 0.484). Multivariate analysis confirmed that adherence to statins, to clopidogrel and ARB/ACEI-inhibitors was associated with 10.1% (p<0.0001), 10.4% (p = 0.0002) and 15.8% (p<0.0001) lower hazard of endpoint respectively for 25% points increase in adherence, controlling for age, sex, performing of PCI, 5 anamnestic data and date of index event. Adherence to aspirin and beta blockers was not significantly associated with the hazard. Conclusion: Higher adherence to some evidence-based medications was found to be associated with improved long term prognosis of the patients. Orv Hetil. 2017; 158(27): 1051–1057.

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One-year outcomes in unselected patients treated with a thin-strut, platinum-chromium, paclitaxel-eluting stent: primary endpoint results from the TAXUS Element European post-approval surveillance study (TE-PROVE)

EuroIntervention ◽

10.4244/eijy15m01_01 ◽

2015 ◽

Vol 10 (11) ◽

pp. 1261-1266 ◽

Cited By ~ 3

Author(s):

Corrado Tamburino ◽

Davide Capodanno ◽

Andrejs Erglis ◽

Ian B.A. Menown ◽

Iván G. Horváth ◽

...

Keyword(s):

Primary Endpoint ◽

Surveillance Study ◽

One Year

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Abstract 3588: Treatment of Diabetes and Outcome After Myocardial Infarction: A Community Study

Circulation ◽

10.1161/circ.116.suppl_16.ii_812-c ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Richard K Patch ◽

Adelaide M Arruda-Olson ◽

Cynthia L Leibson ◽

Adrian Vella ◽

Susan A Weston ◽

...

Keyword(s):

Myocardial Infarction ◽

Reperfusion Therapy ◽

Population Surveillance ◽

Adverse Impact ◽

Community Studies ◽

Community Based ◽

Risk Of Death ◽

Post Marketing Surveillance ◽

Post Marketing ◽

One Year

BACKGROUND Epidemiological cohorts can assist with post-marketing surveillance as they provide community-based outcomes data. Concern was raised about the adverse impact of sulfonylureas (SU) drugs on the outcome of diabetes after myocardial infarction (MI). We evaluated the outcome of MI according to treatment among diabetic persons compared to non-diabetic counterparts in a community-based cohort. METHODS All MIs that occurred in Olmsted County, MN between 1979 and 2002 were validated by standardized epidemiological including cardiac pain, biomarkers and ECG Minnesota coding. Diabetes mellitus (DM) was defined by the National Diabetes Data Group criteria. RESULTS Among 2732 persons with MI (mean age 70 ± 12 years, 44% men), 486 (18%) had DM. Subjects with DM were treated with second generation SU (SU2) (24%), insulin (47%) or diet alone (22%) Diabetic subjects were more likely to be overweight, hyperlipidemic and to receive reperfusion therapy during hospitalization than non-diabetic subjects. One year after the MI, 518 subjects died. Diabetic subjects taking SU2 experienced better survival than subjects without diabetes, while subjects treated with diet alone or insulin experienced worse survival. (Figure ). After adjusting for age, sex, reperfusion and duration of DM, an excess risk of death was detected among persons with insulin-treated DM, particularly those with long-standing DM. No association was found for DM patients treated with SU2 or diet. CONCLUSION These data do not support the concern for an adverse impact of SU2 on survival and underscore the potential role of community studies for population surveillance.

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