scholarly journals COVID-19: Spatial Analysis of Hospital Case-Fatality Rate in France

2020 ◽  
Author(s):  
Marc SOURIS ◽  
Jean-Paul Gonzalez
Keyword(s):  
International Organizations ◽  
Rate Ratio ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Healthcare Systems ◽  
Fatality Rate ◽  
Average Case ◽  
Hospital Case ◽  
Reporting Systems ◽  
Overall Efficiency

When the population risk factors and reporting systems are similar, the assessment of the case-fatality (or lethality) rate (ratio of cases to deaths) represents a perfect tool for analyzing, understanding and improving the overall efficiency of the health system. The objective of this article is to estimate the influence of the hospital care system on lethality in metropolitan France during the inception of the COVID-19 epidemic, by analyzing the spatial variability of the hospital case-fatality rate between French districts (i.e. French departements). The results show that the higher case-fatality rates observed by districts are mostly related to the level of morbidity, therefore to the overwhelming of the healthcare systems during the acute phases of the epidemic. However, the magnitude of this increase of case-fatality rate represents less than 10 per cent of the average case-fatality rate and cannot explain the magnitude of the variations in case-fatality rate reported per country by international organizations or information sites. These differences can only be explained by the systems for reporting cases and deaths, which, indeed, vary greatly from country to country, and not attributed to the care or treatment of patients, even during hospital stress due to epidemic peaks.

scholarly journals COVID-19: Spatial analysis of hospital case-fatality rate in France

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243606
Author(s):  
Marc Souris ◽  
Jean-Paul Gonzalez
Keyword(s):  
Healthcare System ◽  
Case Fatality Rate ◽  
Healthcare Access ◽  
Case Fatality ◽  
Fatality Rate ◽  
System Quality ◽  
Hospital Data ◽  
Average Case ◽  
Hospital Case ◽  
Age Related

When the population risk factors and reporting systems are similar, the assessment of the case-fatality (or lethality) rate (ratio of cases to deaths) represents a perfect tool for analyzing, understanding and improving the overall efficiency of the health system. The objective of this article is to estimate the influence of the hospital care system on lethality in metropolitan France during the inception of the COVID-19 epidemic, by analyzing the spatial variability of the hospital case-fatality rate (CFR) between French districts. In theory, the hospital age-standardized CFR should not display significant differences between districts, since hospital lethality depends on the virulence of the pathogen (the SARS-CoV-2 virus), the vulnerability of the population (mainly age-related), the healthcare system quality, and cases and deaths definition and the recording accuracy. We analyzed hospital data on COVID-19 hospitalizations, severity (admission to intensive care units for reanimation or endotracheal intubation) and mortality, from March 19 to May 8 corresponding to the first French lockdown. All rates were age-standardized to eliminate differences in districts age structure. The results show that the higher case-fatality rates observed by districts are mostly related to the level of morbidity. Time analysis shows that the case-fatality rate has decreased over time, globally and in almost all districts, showing an improvement in the management of severe patients during the epidemic. In conclusion, it appears that during the first critical phase of COVID-19 ramping epidemic in metropolitan France, the higher case-fatality rates were generally related to the higher level of hospitalization, then potentially related to the overload of healthcare system. Also, low hospitalization with high case-fatality rates were mostly found in districts with low population density, and could due to some limitation of the local healthcare access. However, the magnitude of this increase of case-fatality rate represents less than 10 per cent of the average case-fatality rate, and this variation is small compared to much greater variation across countries reported in the literature.

scholarly journals Declining Trend in the In-Hospital Case-Fatality Rate From Acute Myocardial Infarction in Miyagi Prefecture From 1980 to 1999

2001 ◽  
Vol 65 (11) ◽  
pp. 941-946 ◽  
Author(s):  
Jun Watanabe ◽  
Kaoru Iwabuchi ◽  
Yoshito Koseki ◽  
Mitsumasa Fukuchi ◽  
Tsuyoshi Shinozaki ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Fatality Rate ◽  
Hospital Case ◽  
Miyagi Prefecture

Impact of Vena Cava Filters on In-hospital Case Fatality Rate from Pulmonary Embolism

2012 ◽  
Vol 125 (5) ◽  
pp. 478-484 ◽  
Author(s):  
Paul D. Stein ◽  
Fadi Matta ◽  
Daniel C. Keyes ◽  
Gary L. Willyerd
Keyword(s):  
Pulmonary Embolism ◽  
Case Fatality Rate ◽  
Vena Cava ◽  
Case Fatality ◽  
Fatality Rate ◽  
Hospital Case ◽  
Vena Cava Filters

scholarly journals The Uncertainties Underlying Herd Immunity against COVID-19

2020 ◽  
Author(s):  
Farid Rahimi ◽  
Amin Talebi Bezmin Abadi
Keyword(s):  
Antiviral Therapy ◽  
Case Fatality Rate ◽  
Herd Immunity ◽  
Case Fatality ◽  
Healthcare Systems ◽  
Fatality Rate ◽  
Economic Implications ◽  
Rate Transmission ◽  
The Social ◽  
And Control

Herd immunity happens when a relatively large proportion of a population becomes infected by an agent, subsequently recovers, and attains immunity against the same agent. That proportion thus indirectly protects the naïve population by preventing the spread of the infection. Herd immunity has been suggested to interrupt and control the COVID-19 pandemic. However, relying on establishing herd immunity can be catastrophic considering the virulence and lethality of SARS-CoV-2. Meanwhile our understanding of the pathogenesis, case-fatality rate, transmission routes, and antiviral therapy for COVID-19 remains limited now. Interrupting or slowing the COVID-19 transmission seems more opportune than vaccination, antiviral therapy, or herd immunity, all of which will take some time to yield. Thus, social distancing, face-masking, and hygiene are the most appropriate immediate countermeasures. Because the social fabrics, economic implications, and local demands of various nations are unique, early relaxation of restrictions may seem hasty particularly when fatality rates are high, or when the healthcare systems could be inadequate or become inundated. Conclusively, avoiding any overwhelmingly risky approach in fighting the pandemic is prudent.

Time trends and case fatality rate of in-hospital treated pulmonary embolism during 11 years of observation in Northwestern Italy

2016 ◽  
Vol 115 (02) ◽  
pp. 399-405 ◽  
Author(s):  
Walter Ageno ◽  
Fulvio Pomero ◽  
Luigi Fenoglio ◽  
Alessandro Squizzato ◽  
Matteo Bonzini ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Incidence Rate ◽  
Time Trends ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Population Based ◽  
Fatality Rate ◽  
Entire Study ◽  
Mortality And Morbidity ◽  
Hospital Case

SummaryPulmonary embolism (PE) is a common disorder with high mortality and morbidity rates. However, population-based information on its incidence and prognosis remains limited. We conducted a large epidemiology study collecting data on hospitalisation for PE (from 2002 to 2012) in a population of about 13 million people in Northwestern Italy. Patients were identified using the ICD-9-CM codes: 415.11, 415.19; gender and age specific incidence rate of PE during the study period were estimated using the resident population for each year of the study. Furthermore, time trends in the in-hospital PE-related mortality and case fatality rate were calculated. Results were adjusted for possible confounders. A total of 60,853 patients (mean age 72.8 years, ± 14.1, 59.6 % females) with PE were included; the overall crude incidence rate for the entire study period was 55.4 and 40.6 events per year per 100,000 inhabitants for women and men, respectively (p < 0.001). However, this difference was completely lost after standardisation for age. The incidence of PE significantly increased in both genders during the study period. In-hospital case fatality rate significantly decreased throughout the study period (p < 0.001) in women (from 15.6 % to 10.2 %) and in men (from 17.6 % to 10.1 %). The observed decrease of the in-hospital case-fatality throughout the study period remained significant also after adjustment for possible confounders. In conclusion, time trends over an 11-year period show an increasing incidence of PE, but a significant reduction in mortality during hospitalisation. Reduction in the case fatality rate remained significant after adjustment for these possible confounders.Supplementary Material to this article is available online at www.thrombosis-online.com.

scholarly journals The unavoidable costs of frailty: a geriatric perspective in the time of COVID-19

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Maria Cristina Polidori ◽  
Stefania Maggi ◽  
Francesco Mattace-Raso ◽  
Alberto Pilotto
Keyword(s):  
Older Persons ◽  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Healthcare Systems ◽  
World Population ◽  
Fatality Rate ◽  
Human Beings ◽  
The World ◽  
Older Subjects

The world is facing speechless one of the most feared, greatest catastrophes for human beings. Despite better healthcare systems, despite warnings through similar situations and even documented threats, as the COVID-19 pandemic hit, it found us largely unprepared. It offered to us on a silver tray the fragility of mankind. And once again, but this time in a particularly overwhelming way, the most vulnerable part of the world population is mowed down: older persons. Indeed, recent data from the Italian Istituto Superiore di Sanità showed that COVID-19 is more lethal in older subjects: in Italy, at the date of March 17, 2020, the overall case-fatality rate was 7.2% and 96.4% of died patients had more than 60 years. When data were stratified by age groups, individuals aged 70 years or older represent 35.5% of cases, while subjects aged ≥80 years were 52.3%. These data confirm once again that the older generation payed the highest price in time of crisis...

scholarly journals Vena Cava Filters and In-Hospital Case Fatality Among Patients With Pulmonary Embolism: Results From a Large Population-Based Study

2019 ◽  
Vol 25 ◽  
pp. 107602961988802 ◽  
Author(s):  
Fulvio Pomero ◽  
Walter Ageno ◽  
Francesco Dentali ◽  
Luigi Fenoglio ◽  
Alessandro Squizzato ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Case Fatality Rate ◽  
Large Population ◽  
Vena Cava ◽  
Case Fatality ◽  
First Episode ◽  
Fatality Rate ◽  
Hospital Case ◽  
Vena Cava Filters ◽  
Acute Pe

In patients with venous thromboembolism (VTE), vena cava filters (VCFs) are currently only recommended when anticoagulant treatment is contraindicated or if VTE has recurred despite adequate anticoagulation. However, evidence on the efficacy of filter in patients with VTE is not compelling. We evaluated potential efficacy of VCF in reducing in-hospital mortality in a large population of patients presenting with a first episode of pulmonary embolism (PE). Patients were collected using regional hospital-discharge databases covering a population of more than 13 million of inhabitants in Northern Italy. For each year of observation, we calculated the proportion of cases with VCF among all PE incident cases. The temporal trend of VCF application during the study period was also derived. The effect of VCF use on in-hospital case-fatality rate was evaluated with a multivariate regression model and with the use of propensity score matching. During the study period (2002-2012), 60 813 patients were hospitalized for a first episode of acute PE. In-hospital case-fatality rate for PE was 13.3%. Vena cava filters were used in 745 (1.22%) patients. The annual use of VCF remained stable from 2002 to 2008, while it progressively decreased afterward. After adjustment for available confounders, case-fatality rate remained significantly lower in patients who received VCF compared to the one registered in patients who did not (odds ratio [OR] 0.46; 95% confidence interval [CI]: 0.34-0.62). Propensity score matching gave similar results (OR: 0.42; 95% CI: 0.30-0.61). Vena cava filters were infrequently used in patients with acute PE. Insertion of VCF appeared to sensibly reduce all-cause in-hospital mortality in this subgroup of patients.

We Have the Solution: Now What's the Problem?

PEDIATRICS ◽  
1992 ◽  
Vol 90 (1) ◽  
pp. 113-115 ◽  
Author(s):  
RONALD E. KLEINMAN
Keyword(s):  
Replacement Therapy ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Western Hemisphere ◽  
Watery Diarrhea ◽  
Fatality Rate ◽  
Years Of Experience ◽  
Average Case ◽  
Electrolyte Replacement

The largest outbreak of the current cholera pandemic and the first to strike the Western hemisphere in this century began in Peru in January of 1991. Two hundred seventy-four thousand, seven hundred sixty-eight cases were reported as of August 7, 1991, with an average case-fatality rate of just over 1%.1 For more than 30 years cholera has served as the paradigm for watery diarrhea, fully treatable by fluid and electrolyte replacement therapy. More than 20 years of experience, including this most recent epidemic in our own hemisphere, has proven the effectiveness of this therapy when given by mouth. It is hard to imagine a more impressive benefit from a cheap and simple therapy.

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