scholarly journals Hospital Admission Trends for Bronchiolitis in Scotland, 2001–2016: A National Retrospective Observational Study

2020 ◽  
Vol 222 (Supplement_7) ◽  
pp. S592-S598 ◽  
Author(s):  
Alexandria Chung ◽  
Rachel M Reeves ◽  
Harish Nair ◽  
Harry Campbell ◽  
Rachel M Reeves ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Temporal Trends ◽  
Epidemiological Data ◽  
Patient Characteristics ◽  
Policy Makers ◽  
Admission Rates ◽  
International Classification Of Disease ◽  
Syncytial Virus ◽  
National Trends ◽  
Preventative Interventions

Abstract Background Bronchiolitis is the commonest cause of respiratory related hospital admissions in young children. This study aimed to describe temporal trends in bronchiolitis admissions for children under 2 years of age in Scotland by patient characteristics, socioeconomic deprivation, and duration of admission. Methods The national hospital admissions database for Scotland was used to extract data on all bronchiolitis admissions (International Classification of Disease, Tenth Revision, code J21) in children <2 years of age from 2001 to 2016. Deprivation quintiles were classified using the 2011 Scottish Index of Multiple Deprivation. Results Over the 15-year study period, admission rates for children under 2 years old increased 2.20-fold (95% confidence interval [CI], 1.4–3.6-fold) from 17.2 (15.9–18.5) to 37.7 (37.4–38.1) admissions per 1000 children per year. Admissions peaked in infants aged 1 month, and in those born in the 3 months preceding the peak bronchiolitis month—September, October, and November. Admissions from the most-deprived quintile had the highest overall rate of admission, at 40.5 per 1000 children per year (95% CI, 39.5–41.5) compared with the least-deprived quintile, at 23.0 admissions per 1000 children per year (22.1–23.9). The most-deprived quintile had the greatest increase in admissions over time, whereas the least-deprived quintile had the lowest increase. Zero-day admissions, defined as admission and discharge within the same calendar date, increased 5.3-fold (5.1–5.5) over the study period, with the highest increase in patients in the most-deprived quintile. Conclusions This study provides baseline epidemiological data to aid policy makers in the strategic planning of preventative interventions. With the majority of bronchiolitis caused by respiratory syncytial virus (RSV), and several RSV vaccines and monoclonal antibodies currently in clinical trials, understanding national trends in bronchiolitis admissions is an important proxy for determining potential RSV vaccination strategies.

scholarly journals Hospital admissions for respiratory tract infections in children aged 0-5 years for 2017/2023

2021 ◽  
Author(s):  
Fredrik Methi ◽  
Ketil Størdal ◽  
Kjetil Elias Telle ◽  
Vilde Bergstad Larsen ◽  
Karin Magnusson
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Hospital Admissions ◽  
Respiratory Support ◽  
Pediatric Hospital ◽  
Policy Makers ◽  
Syncytial Virus ◽  
Tract Infections ◽  
Business As Usual ◽  
Hospital Wards

Background: To compare hospital admissions across common respiratory tract infections (RTI) in 2017-21, and project possible hospital admissions for the RTIs among children aged 0-12 months and 1-5 years in 2022 and 2023. Methods: In 644 885 children aged 0-12 months and 1-5 years, we plotted the observed monthly number of RTI admissions (upper- and lower RTI, influenza, respiratory syncytial virus (RSV), and COVID-19) from January 1st, 2017 until October 31st, 2021. We also plotted the number of RTI admissions with a need for respiratory support. We used the observed data to project four different scenarios of RTI admissions in 2022 and 2023, with different impacts on hospital wards: 1) ″Business as usual″, 2) ″Continuous lockdown″, 3) ″Children′s immunity debt″, and 4) ″Maternal and child immunity debt″. Results: By October 31st, 2021, the number of simultaneous RTI admissions had exceeded the numbers usually observed at the typical season peak in January, i.e. ~900. Based on our observed data and assuming that children and their mothers (who transfer antibodies to the very youngest) have not been exposed to RTI over the last one and a half years, our scenarios suggest that hospitals should be prepared to handle two to three times as many RTI admissions, and two to three times as many RTI admissions requiring respiratory support among 0-5-year-olds as normal, from November 2021 to April 2022. Conclusion: Scenarios with immunity debt suggest that pediatric hospital wards and policy makers should plan for extended capacity.

scholarly journals Interactions of viral pathogens on hospital admissions for pneumonia, croup and chronic obstructive pulmonary diseases: results of a multivariate time-series analysis

2006 ◽  
Vol 134 (6) ◽  
pp. 1174-1178 ◽  
Author(s):  
R. E. G. UPSHUR ◽  
R. MOINEDDIN ◽  
E. J. CRIGHTON ◽  
M. MAMDANI
Keyword(s):  
Time Series ◽  
Granger Causality ◽  
Hospital Admissions ◽  
Multivariate Time Series ◽  
Chronic Obstructive Lung Disease ◽  
Epidemiological Data ◽  
Chronic Obstructive ◽  
Causality Test ◽  
Syncytial Virus ◽  
The Impact

Co-circulation of respiratory syncytial virus (RSV) and influenza has made the partitioning of morbidity and mortality from each virus difficult. Given the interaction between chronic obstructive lung disease (COPD) and pneumonia, often one can be mistaken for the other. Multivariate time-series methodology was applied to examine the impact of RSV and influenza on hospital admissions for bronchiolitis, pneumonia, and COPD. The Granger Causality Test, used to determine the causal relationship among series, showed that COPD and pneumonia are not influenced by RSV (P=0·2999 and 0·7725), but RSV does influence bronchiolitis (P=0·0001). Influenza was found to influence COPD, pneumonia, and bronchiolitis (P<0·0001). The use of multivariate time series and Granger causality applied to epidemiological data clearly illustrates the significant contribution of influenza and RSV to morbidity in the population.

scholarly journals Respiratory Syncytial Virus-Associated Hospital Admissions in Children Younger Than 5 Years in 7 European Countries Using Routinely Collected Datasets

2020 ◽  
Vol 222 (Supplement_7) ◽  
pp. S599-S605
Author(s):  
Rachel M Reeves ◽  
Maarten van Wijhe ◽  
Sabine Tong ◽  
Toni Lehtonen ◽  
Luca Stona ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Hospital Admissions ◽  
European Countries ◽  
Hospital Data ◽  
Admission Rates ◽  
Time Series Modelling ◽  
Modelling Methodology ◽  
Syncytial Virus ◽  
Future Work ◽  
The Impact

Abstract Background Respiratory syncytial virus (RSV) is a leading cause of respiratory tract infection (RTI) in young children. Registries provide opportunities to explore RSV epidemiology and burden. Methods We explored routinely collected hospital data on RSV in children aged &lt; 5 years in 7 European countries. We compare RSV-associated admission rates, age, seasonality, and time trends between countries. Results We found similar age distributions of RSV-associated hospital admissions in each country, with the highest burden in children &lt; 1 years old and peak at age 1 month. Average annual rates of RTI admission were 41.3–112.0 per 1000 children aged &lt; 1 year and 8.6–22.3 per 1000 children aged &lt; 1 year. In children aged &lt; 5 years, 57%–72% of RTI admissions with specified causal pathogen were coded as RSV, with 62%–87% of pathogen-coded admissions in children &lt; 1 year coded as RSV. Conclusions Our results demonstrate the benefits and limitations of using linked routinely collected data to explore epidemiology and burden of RSV. Our future work will use these data to generate estimates of RSV burden using time-series modelling methodology, to inform policymaking and regulatory decisions regarding RSV immunization strategy and monitor the impact of future vaccines.

scholarly journals Hospitalization Trends for Acute Appendicitis in Spain, 1998 to 2017

2021 ◽  
Vol 18 (23) ◽  
pp. 12718
Author(s):  
Concepción Carratalá-Munuera ◽  
Jessica del Rocio Pilco ◽  
Domingo Orozco-Beltrán ◽  
Antonio Compañ ◽  
Jose A. Quesada ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Regression Models ◽  
Hospital Admissions ◽  
Length Of Hospital Stay ◽  
Epidemiological Data ◽  
Age Group ◽  
Joinpoint Regression ◽  
Annual Percent Change ◽  
Admission Rates ◽  
Gender And Age

The incidence of acute appendicitis decreased in Western countries from 1930 to at least the early 1990s, when epidemiological data started becoming scarcer. This study aimed to assess the trend in annual hospitalizations for acute appendicitis in all people Spain for a 20-year period between 1998 and 2017. This observational study analyzing direct age-standardized hospital admission rates by gender and age group (0–14 years, 15–34 years, 35–44 years, 45–64 years, and ≥65 years). Joinpoint regression models were fitted to evaluate changes in trends. There were 789,533 emergency hospital admissions for acute appendicitis between 1998 and 2017: 58.9% in boys and men and 41.1% in girls and women. Overall, there was a significant increase in admissions for this cause from 1998 to 2009, with an annual percent change (APC) of 0.6%. Following the peak in 2009, admission rates decreased by around 1.0% annually until 2017. The length of hospital stay gradually decreased from 4.5 days in 1998 to 3.4 days in 2017. The trends in hospital admissions for acute appendicitis in Spain changed over the study period, decreasing from 2009, especially in people younger than 35 years.

scholarly journals Epidemiology of Bronchiolitis in Hospitalized Infants at Tawam Hospital, Al Ain, United Arab Emirates

2021 ◽  
Vol 15 (1) ◽  
pp. 7-13
Author(s):  
Amar Al Shibli ◽  
Muhammad B. Nouredin ◽  
Abdulla Al Amri ◽  
Durdana Iram ◽  
Hassib Narchi
Keyword(s):  
United Arab Emirates ◽  
Hospital Admissions ◽  
Epidemiological Data ◽  
Significant Morbidity ◽  
Male Predominance ◽  
Al Ain ◽  
Chest X Ray ◽  
Hospital Resources ◽  
The Mean ◽  
Syncytial Virus

Background: Bronchiolitis is the commonest lower respiratory tract infection, found worldwide in children < 2 years of age. Over sixty percent of cases are caused by Respiratory Syncytial Virus (RSV). The disease is known to have significant morbidity, mortality and health care costs. Its seasonal variability, manifestations and complications vary between countries. The aim of this study was to determine the epidemiological and clinical characteristics of infants hospitalized with bronchiolitis in Al Ain City, United Arab Emirates. Methods: Retrospective observational chart review was made of an unselected cohort of infants ≤ 2 years admitted to the pediatric department of Tawam hospital over a 3-year period and discharged with the diagnosis of bronchiolitis. Epidemiological data and risk factors were analyzed. Results: RSV was the commonest pathogen (51%). Hospitalizations occurred year-round but increased significantly in December and January. The patients’ median age was 5.8 months with a male predominance (male:female ratio of 1.5:1.0). The mean age at admission was 6.6 months and presentation occurred, on average, 2.9 days after the onset of the symptoms. The majority (94%) had respiratory distress on presentation. Chest x-ray was performed in 80% of the patients. Most children received bronchodilator therapy and oxygen therapy was administered to 42%. The mean duration of hospital stay was 3 days. Conclusion: Bronchiolitis remains a common reason for hospital admission and carries significant morbidity. RSV is the primarily responsible virus for hospital admissions and morbidity. A better understanding of the burden of bronchiolitis in our setting would enable better planning and use of hospital resources to minimize its short and long-term sequelae.

scholarly journals Impact of the 2014 American Academy of Pediatrics Immunoprophylaxis Policy on the Rate, Severity, and Cost of Respiratory Syncytial Virus Hospitalizations among Preterm Infants

2019 ◽  
Vol 37 (02) ◽  
pp. 174-183 ◽  
Author(s):  
Leonard R. Krilov ◽  
Jaime Fergie ◽  
Mitchell Goldstein ◽  
Lance Brannman
Keyword(s):  
Respiratory Syncytial Virus ◽  
American Academy ◽  
Preterm Infants ◽  
Policy Change ◽  
Temporal Trends ◽  
Patient Characteristics ◽  
Administrative Claims ◽  
Term Infants ◽  
American Academy Of Pediatrics ◽  
Syncytial Virus

Objective This study examined the rate, severity, and cost of respiratory syncytial virus (RSV) hospitalizations among preterm infants 29 to 34 weeks gestational age (wGA) versus term infants before and after a 2014 change in the American Academy of Pediatrics policy for RSV immunoprophylaxis. Study Design Preterm (29–34 wGA) and term infants born from July 2011 to March 2017 and aged < 6 months were identified in a U.S. commercial administrative claims database. RSV hospitalization (RSVH) rate ratios, severity, and costs were evaluated for the 2011 to 2014 and 2014 to 2017 RSV seasons. Postpolicy changes in RSVH risks for preterm versus term infants were assessed with difference-in-difference (DID) modeling to control for patient characteristics and temporal trends. Results In the DID analysis, prematurity-associated RSVH risk was 55% greater in 2014 to 2017 versus 2011 to 2014 (relative risk = 1.55, 95% confidence interval: 1.10–2.17, p = 0.011). RSVH severity increased among preterm infants after 2014 and was highest among those aged < 3 months. Differences in mean RSVH costs for preterm infants in 2014 to 2017 versus 2011 to 2014 were not statistically significant. Conclusion RSVH risk for preterm versus term infants increased after the policy change, confirming previous national analyses. RSVHs after the policy change were more severe, particularly among younger preterm infants.

scholarly journals Trends in Hospitalization of Patients with Potentially Serious Diseases Evaluated at a Quick Diagnosis Clinic

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 585
Author(s):  
Xavier Bosch ◽  
Andrea Ladino ◽  
Pedro Moreno-Lozano ◽  
Anna Jordán ◽  
Alfonso López-Soto
Keyword(s):  
Temporal Trends ◽  
Final Analysis ◽  
Cost Effective ◽  
Patient Characteristics ◽  
Admission Rates ◽  
Clinical Complications ◽  
Evaluation Protocol ◽  
Significant Downward Trend ◽  
Patients At Risk ◽  
Cost Effective Alternative

Although quick diagnosis units (QDU) have become a cost-effective alternative to inpatient admission for diagnosis of potentially serious diseases, the rate of return hospitalizations among evaluated patients is unknown. This study examined the temporal trends in admissions of QDU patients through 15 years. Adult patients referred to QDU from 2004 to 2019 who were hospitalized between the first and last visit in the unit were eligible. Decisions about admissions were mainly based on the Appropriateness Evaluation Protocol and required independent validation by experienced clinicians using a customized tool. The final analysis included 825 patients. Patient characteristics and major reasons for admission were compared each year and linear trends were analyzed. Admission rates decreased from 7.2% in 2004–2005 to 4.3% in 2018–2019 (p < 0.0001). While a significant increasing trend was observed in the rate of admissions due to cancer-related complications (from 39.5% in 2004–2005 to 61.7% in 2018–2019; p < 0.0001), those due to anemia-related complications and scheduled invasive procedures experienced a significant downward trend. A likely explanation for these declining trends was the relocation of the unit to a new daycare center in 2013–2014 with recovery rooms and armchairs for IV treatments. The facts of this study could help in the provision of anticipatory guidance for the optimal management of patients at risk of clinical complications.

scholarly journals Hospital Admissions for Respiratory Tract Infections in Children Aged 0–5 Years for 2017/2023

2022 ◽  
Vol 9 ◽  
Author(s):  
Fredrik Methi ◽  
Ketil Størdal ◽  
Kjetil Telle ◽  
Vilde Bergstad Larsen ◽  
Karin Magnusson
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Hospital Admissions ◽  
Respiratory Support ◽  
Pediatric Hospital ◽  
Policy Makers ◽  
Syncytial Virus ◽  
Tract Infections ◽  
Business As Usual ◽  
Hospital Wards

Aim: To compare hospital admissions across common respiratory tract infections (RTI) in 2017-21, and project possible hospital admissions for the RTIs among children aged 0–12 months and 1-5 years in 2022 and 2023.Methods: In 644 885 children aged 0–12 months and 1–5 years, we plotted the observed monthly number of RTI admissions [upper- and lower RTI, influenza, respiratory syncytial virus (RSV), and COVID-19] from January 1st, 2017 until October 31st, 2021. We also plotted the number of RTI admissions with a need for respiratory support. We used the observed data to project four different scenarios of RTI admissions for the rest of 2021 until 2023, with different impacts on hospital wards: (1) “Business as usual,” (2) “Continuous lockdown,” (3) “Children's immunity debt,” and (4) “Maternal and child immunity debt.”Results: By October 31st, 2021, the number of simultaneous RTI admissions had exceeded the numbers usually observed at the typical season peak in January, i.e., ~900. Based on our observed data and assuming that children and their mothers (who transfer antibodies to the very youngest) have not been exposed to RTI over the last one and a half years, our scenarios suggest that hospitals should be prepared to handle two to three times as many RTI admissions, and two to three times as many RTI admissions requiring respiratory support among 0–5-year-olds as normal, from November 2021 to April 2022.Conclusion: Scenarios with immunity debt suggest that pediatric hospital wards and policy makers should plan for extended capacity.

scholarly journals Temporal Changes in Clinical Practice with COVID-19 Hospitalized Patients: Potential Explanations for Better In-Hospital Outcomes

2020 ◽  
Author(s):  
Kevin E Kip ◽  
Graham Snyder ◽  
Donald M Yealy ◽  
John W Mellors ◽  
Tami Minnier ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Clinical Practice ◽  
Propensity Score ◽  
Hospital Admissions ◽  
Medical Center ◽  
Temporal Trends ◽  
Patient Characteristics ◽  
Temporal Changes ◽  
Hospitalized Patients ◽  
Hospital Outcomes

Background/Aims: We reviewed demographic and clinical profiles, along with measures of hospital-based clinical practice to identify temporal changes in clinical practice that may have affected in-hospital outcomes of patients with COVID-19. Methods: Data consisted of sociodemographic and clinical data captured in University of Pittsburgh Medical Center (UPMC) electronic medical record (EMR) systems, linked by common variables (deidentified). The analysis population included hospitalized patients (across 21 hospitals) with a primary diagnosis of COVID-19 infection during the period March 14-August 31, 2020. The primary outcome was a composite of in-hospital mechanical ventilation/mortality. We compared temporal trends in patient characteristics, clinical practice, and hospital outcomes using 4 time-defined epochs for calendar year 2020: March 14-March 31 (epoch 1); April 1-May 15, (epoch 2), May 16-June 28 (epoch 3); and June 29-August 31 (epoch 4). We report unadjusted survival estimates, followed by propensity score analyses to adjust for differences in patient characteristics, to compare in-hospital outcomes of epoch 4 patients (recently treated) to epoch 1-3 patients (earlier treated). Results: Mean number of hospital admissions was 9.9 per day during epoch 4, which was ~2- to 3-fold higher than the earlier epochs. Presenting characteristics of the 1,076 COVID-19 hospitalized patients were similar across the 4 epochs, including mean age. The crude rate of mechanical ventilation/mortality was lower in epoch 4 patients (17%) than in epoch 1-3 patients (23% to 35%). When censoring for incomplete patient follow-up, the rate of mechanical ventilation/mortality was lower in epoch 4 patients (p<0.0001), as was the individual component of mechanical ventilation (p=0.0002) and mortality (p=0.02). In propensity score adjusted analyses, the in-hospital relative risk (RR) of mechanical ventilation/mortality was lower in epoch 4 patients (RR=0.67, 95% CI: 0.48, 0.93). For the outcome being discharged alive within 3, 5, or 7 days of admission, adjusted odds ranged from 1.6- to 1.7-fold higher among epoch 4 patients compared to earlier treated patients. The better outcomes in epoch 4 patients were principally observed in patients under the age of 75 years. Patient level dexamethasone use was 55.6% in epoch 4 compared to 15% or less of patients in the earlier epochs. Most patients across epochs received anticoagulation drugs (principally heparin). Overall steroid (81.7% vs. 54.3%, p<0.0001) and anticoagulation use (90.4% vs. 80.7%, p=0.0001) was more frequent on the day or day after hospitalization in epoch 4 patients compared to earlier treated patients. Conclusions: In our large system, recently treated hospitalized COVID-19 patients had lower rates of in-hospital mechanical ventilation/mortality and shorter length of hospital stay. Alongside of this was a change to early initiation of glucocorticoid therapy and anticoagulation. The extent to which the improvement in patient outcomes was related to changes in clinical practice remains to be established.

Trends in Acute Pulmonary Embolism Admission Rates and Mortality Outcomes in Australia, 2002–2003 to 2017–2018: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Scott Hoskin ◽  
David Brieger ◽  
Vincent Chow ◽  
Leonard Kritharides ◽  
Austin Chin Chwan Ng
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Temporal Trends ◽  
Admission Rate ◽  
Epidemiological Data ◽  
Linkage Study ◽  
Study Cohort ◽  
Medium Term ◽  
Admission Rates ◽  
Acute Pe

Abstract Background Contemporary Australian epidemiological data on acute pulmonary embolism (PE) are lacking. Objectives To determine the admission rates of acute PE in Australia, and to assess the temporal trends in short- and medium-term mortality following acute PE. Methods Retrospective population-linkage study of all New South Wales residents admitted with a primary diagnosis of PE between January 1, 2002 and December 31, 2018 using data from the Centre for Health Record Linkage databases. Main outcome measures included temporal trends in total PE admissions and all-cause mortality at prespecified time points up to 1 year, stratified by gender. Results There were 61,607 total PE admissions between 2002 and 2018 (mean ± standard deviation: 3,624 ± 429 admissions per annum; 50.42 ± 3.70 admissions per 100,000 persons per annum). The mean admission rate per annum was higher for females than for males (54.85 ± 3.65 vs. 44.91 ± 4.34 admissions per 100,000 persons per annum, respectively) and remained relatively stable for both genders throughout the study period. The main study cohort, limited to index PE admission only, comprised 46,382 persons (mean age: 64.6 ± 17.3 years; 44.4% males). The cumulative in-hospital, 30-day, 3-month, and 1-year mortality rates were 3.7, 5.6, 9.6, and 16.8%, respectively. When compared with 2002 as the reference year, there was a significant reduction in in-hospital (odds ratio [OR] = 0.34; 95% confidence interval [CI] = 0.25–0.46), 30-day (OR = 0.58, 95% CI = 0.46–0.73), and 1-year (hazard ratio = 0.74, 95% CI = 0.66–0.84) (all p < 0.001) mortality risk by 2017 after adjusting for age, gender, and relevant confounders. The survival improvements were seen in both genders and were greater for females than for males. Conclusion Mortality following PE has improved with reductions observed in both short- and medium-term follow-ups between 2002 and 2018 with greater reductions in females despite their higher admission rates over time.

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