scholarly journals Pediatric intensive care unit admissions for COVID-19: insights using state level data

2020 ◽  
Author(s):  
Rohit S. Loomba ◽  
Enrique G. Villarreal ◽  
Juan S. Farias ◽  
Ronald A. Bronicki ◽  
Saul Flores
Keyword(s):  
Intensive Care ◽  
Population Density ◽  
Pediatric Intensive Care ◽  
State Level ◽  
The United States ◽  
Pulmonary Complications ◽  
Level Data ◽  
Beta Coefficient ◽  
Using Data

Introduction Intensive care has played a pivotal role during the COVID-19 pandemic as many patients developed severe pulmonary complications. The availability of information in pediatric intensive care (PICUs) remains limited. The purpose of this study is to characterize COVID-19 positive admissions (CPAs) in the United States and to determine factors that may impact those admissions. Materials and Methods This is a retrospective cohort study using data from the COVID-19 dashboard virtual pediatric system containing information regarding respiratory support and comorbidities for all CPAs between March and April 2020. The state level data contained 13 different factors from population density, comorbid conditions and social distancing score. The absolute CPAs count was converted to frequency using the state's population. Univariate and multivariate regression analyses were performed to assess the association between CPAs frequency and endpoints. Results A total of 205 CPAs were reported by 167 PICUs across 48 states. The estimated CPAs frequency was 2.8 per million children. A total of 3,235 tests were conducted with 6.3% positive tests. Children above 11 years of age comprised 69.7% of the total cohort and 35.1% had moderated or severe comorbidities. The median duration of a CPA was 4.9 days [1.25-12.00 days]. Out of the 1,132 total CPA days, 592 [52.2%] were for mechanical ventilation. The inpatient mortalities were 3 [1.4%]. Multivariate analyses demonstrated an association between CPA's with greater population density [beta-coefficient 0.01, p<0.01] and increased percent of children receiving the influenza vaccination [beta-coefficient 0.17, p=0.01]. Conclusions Inpatient mortality during PICU CPAs is relatively low at 1.4%. CPA frequency seems to be impacted by population density while characteristics of illness severity appear to be associated with ultraviolet index, temperature, and comorbidities such as Type 1 diabetes. These factors should be included in future studies using patient-level data.

scholarly journals Pediatric Intensive Care Unit Admissions for COVID-19: Insights Using State-Level Data

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Rohit S. Loomba ◽  
Enrique G. Villarreal ◽  
Juan S. Farias ◽  
Ronald A. Bronicki ◽  
Saul Flores
Keyword(s):  
Intensive Care ◽  
Population Density ◽  
Multivariate Analyses ◽  
Pediatric Intensive Care ◽  
State Level ◽  
The United States ◽  
Respiratory Support ◽  
Level Data ◽  
Beta Coefficient

Introduction. Intensive care has played a pivotal role during the COVID-19 pandemic as many patients developed severe pulmonary complications. The availability of information in pediatric intensive care units (PICUs) remains limited. The purpose of this study is to characterize COVID-19 positive admissions (CPAs) in the United States and to determine factors that may impact those admissions. Materials and Methods. This is a retrospective cohort study using data from the COVID-19 Virtual Pediatric System (VPS) dashboard containing information regarding respiratory support and comorbidities for all CPAs between March and April 2020. The state-level data contained 13 different factors from population density, comorbid conditions, and social distancing score. The absolute CPA count was converted to frequency using the state’s population. Univariate and multivariate regression analyses were performed to assess the association between CPA frequency and admission endpoints. Results. A total of 205 CPAs were reported by 167 PICUs across 48 states. The estimated CPA frequency was 2.8 per million children in a one-month period. A total of 3,235 tests were conducted of which 6.3% were positive. Children above 11 years of age comprised 69.7% of the total cohort and 35.1% had moderated or severe comorbidities. The median duration of a CPA was 4.9 days (1.25–12.00 days). Out of the 1,132 total CPA days, 592 (52.2%) involved mechanical ventilation. The inpatient mortalities were 3 (1.4%). Multivariate analyses demonstrated an association between CPAs with greater population density (beta coefficient 0.01, p < 0.01 ). Multivariate analyses also demonstrated an association between pediatric type 1 diabetes mellitus with increased CPA duration requiring advanced respiratory support (beta coefficient 5.1, p < 0.01 ) and intubation (beta coefficient 4.6, p < 0.01 ). Conclusions. Inpatient mortality during PICU CPAs is relatively low at 1.4%. CPA frequency seems to be impacted by population density. Type 1 DM appears to be associated with increased duration of HFNC and intubation. These factors should be included in future studies using patient-level data.

scholarly journals Disparities in Case Frequency and Mortality of Coronavirus Disease 2019 (COVID-19) Among Various States in the United States

2020 ◽  
Author(s):  
Rohit S. Loomba ◽  
Gaurav Aggarwal ◽  
Saurabh Aggarwal ◽  
Saul Flores ◽  
Enrique G. Villarreal ◽  
...  
Keyword(s):  
Population Density ◽  
State Level ◽  
The United States ◽  
Testing Frequency ◽  
Level Data ◽  
The Us ◽  
Mortality Case ◽  
Percent Mortality ◽  
Beta Coefficient ◽  
Reported Data

Objective: To utilize publicly reported, state-level data to identify factors associated with the frequency of cases, tests, and mortality in the US. Materials & Methods: Retrospective study using publicly reported data collected included the number of COVID-19 cases, tests, and mortality from March 14th through April 30th, 2020. Publicly available state-level data was collected which included: demographics comorbidities, state characteristics and environmental factors. Univariate and multivariate regression analyses were performed to identify the significantly associated factors with percent mortality, case and testing frequency. All analyses were state-level analyses and not patient-level analyses. Results: A total of 1,090,500 COVID-19 cases were reported during the study period. The calculated case and testing frequency were 3,332 and 19,193 per 1,000,000 patients. There were 63,642 deaths during this period which resulted in a mortality of 5.8%. Factors including to but not limited to population density (beta coefficient 7.5, p< 0.01), transportation volume (beta coefficient 0.1, p< 0.01), tourism index (beta coefficient -0.1, p=0.02) and older age (beta coefficient 0.2, p=0.01) are associated with case frequency and percent mortality. Conclusions: There were wide variations in testing and case frequencies of COVID-19 among different states in the US. States with higher population density had a higher case and testing rate. States with larger population of elderly and higher tourism had a higher mortality.

scholarly journals The prevalence and characteristics of rapid response systems in hospitals with pediatric intensive care units in Japan and barriers to their use

2020 ◽  
Vol 32 (5) ◽  
pp. 325-331
Author(s):  
Taiki Haga ◽  
Hiroshi Kurosawa ◽  
Junji Maruyama ◽  
Katsuko Sakamoto ◽  
Ryo Ikebe ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
The United States ◽  
Rapid Response ◽  
Full Time ◽  
Pediatric Intensive Care Units ◽  
Rapid Response Systems ◽  
Significant Difference ◽  
Response Systems

Abstract Objective The use of pediatric rapid response systems (RRSs) to improve the safety of hospitalized children has spread in various western countries including the United States and the United Kingdom. We aimed to determine the prevalence and characteristics of pediatric RRSs and barriers to use in Japan, where epidemiological information is limited. Design A cross-sectional online survey. Setting All 34 hospitals in Japan with pediatric intensive care units (PICUs) in 2019. Participants One PICU physician per hospital responded to the questionnaire as a delegate. Main outcome measures Prevalence of pediatric RRSs in Japan and barriers to their use. Results The survey response rate was 100%. Pediatric RRSs had been introduced in 14 (41.2%) institutions, and response teams comprised a median of 6 core members. Most response teams employed no full-time members and largely comprised members from multiple disciplines and departments who served in addition to their main duties. Of 20 institutions without pediatric RRSs, 11 (55%) hoped to introduce them, 14 (70%) had insufficient knowledge concerning them and 11 (55%) considered that their introduction might be difficult. The main barrier to adopting RRSs was a perceived personnel and/or funding shortage. There was no significant difference in hospital beds (mean, 472 vs. 524, P = 0.86) and PICU beds (mean, 10 vs. 8, P = 0.34) between institutions with/without pediatric RRSs. Conclusions Fewer than half of Japanese institutions with PICUs had pediatric RRSs. Operating methods for and obstructions to RRSs were diverse. Our findings may help to popularize pediatric RRSs.

Prevalence of adverse events in pediatric intensive care units in the United States*

2010 ◽  
Vol 11 (5) ◽  
pp. 568-578 ◽  
Author(s):  
Swati Agarwal ◽  
David Classen ◽  
Gitte Larsen ◽  
Nancy M. Tofil ◽  
Leslie W. Hayes ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Adverse Events ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
The United States ◽  
Pediatric Intensive Care Units

Distribution and capacity utilization in the United States: evidence from state-level data

2020 ◽  
Vol 8 (2) ◽  
pp. 240-267
Author(s):  
Luke Petach
Keyword(s):  
United States ◽  
Distribution System ◽  
Capacity Utilization ◽  
State Level ◽  
The United States ◽  
Coordination Failure ◽  
Wage Policy ◽  
Us States ◽  
Level Data ◽  
Strategy I

Applying previously unused regional data to the problem of wage- versus profit-led growth, this paper estimates a demand-and-distribution system for a panel of US states for the years 1974 to 2014. Using variation in minimum-wage policy across states as an instrument for the labor share, I find that – at a regional level – the United States is strongly wage-led. In the absence of a satisfactory econometric identification strategy, I estimate the distributive curve non-parametrically. The results suggest the presence of significant non-linearities, with US states exhibiting profit-squeeze dynamics at low levels of capacity utilization and wage-squeeze dynamics at high levels. These results suggest difficulties for wage-led policy akin to a coordination failure.

scholarly journals The Partisan Mask: Political Orientation, Collectivism, and Religiosity Predict Mask Use During COVID-19

2021 ◽  
Author(s):  
Hohjin Im ◽  
Peiyi Wang ◽  
Chuansheng Chen
Keyword(s):  
State Level ◽  
The United States ◽  
Political Orientation ◽  
Third Party ◽  
The Us ◽  
Political Conservatism ◽  
Strong Correlate ◽  
Using Data ◽  
The Individual ◽  
Socioeconomic And Demographic Factors

In the United States, the COVID-19 pandemic became an unconventional vehicle to advance partisan rhetoric and antagonism. Using data available at the individual- (Study 1; N = 4,220), county- (Study 2; n = 3,046), and state-level (n = 49), we found that partisanship and political orientation was a robust and strong correlate of mask use. Political conservatism and Republican partisanship were related to downplaying the severity of COVID-19 and perceiving masks as being ineffective that, in turn, were related to lower mask use. In contrast, we found that counties with majority Democrat partisanship reported greater mask use, controlling for various socioeconomic and demographic factors. Lastly, states with strong cultural collectivism reported greater mask use while those with strong religiosity reported the opposite. States with greater Democrat partisanship and strong cultural collectivism subsequently reported lower COVID-19 deaths, mediated by greater mask use and lower COVID-19 cases, in the five months following the second wave of COVID-19 in the US during the Summer of 2020. Nonetheless, more than the majority for Democrats (91.58%), Republicans (77.52%), and third-party members (82.48%) reported using masks. Implications for findings are discussed.

scholarly journals Racial Residential Segregation and Colorectal Cancer Mortality in the Mississippi Delta Region

2020 ◽  
Author(s):  
Aaron J Kruse-Diehr ◽  
Justin T McDaniel ◽  
Marquita W Lewis-Thames ◽  
Aimee James ◽  
Musa Yahaya
Keyword(s):  
Colorectal Cancer ◽  
Residential Segregation ◽  
Mississippi Delta ◽  
State Level ◽  
The United States ◽  
Census Bureau ◽  
Delta Region ◽  
Community Factors ◽  
Black And White ◽  
Using Data

Abstract Background Few studies have examined the effects of segregation on colorectal cancer (CRC) outcomes, and none has determined if rurality moderates the effect of segregation on CRC mortality. We examined whether the effect of segregation on CRC mortality was moderated by rurality in the Mississippi Delta Region, an economically distressed and historically segregated region of the United States. Methods Using data from the US Census Bureau and the Surveillance, Epidemiology, and End Results (SEER) program, we estimated linear mixed-effects models with state-level random effects in which Black and White CRC mortality rates in Delta Region counties (N = 252) were regressed on county rurality, White-Black residential segregation indices, an interaction term for these two variables, and a vector of socioeconomic control variables. Missing data were replaced with values generated via random forest imputation. Results Segregation was a risk factor for Black CRC mortality in urban Delta counties but was associated with lower Black CRC mortality in rural counties (B = − 23.30 [95% CI = − 38.51, − 7.92]). For Whites, living in a rural area did not moderate the relationship between segregation and CRC mortality, though White CRC mortality was inversely associated with White population proportion (B = − 7.12 [95% CI = − 10.66, − 3.43]). Conclusions Health outcomes related to segregation vary by racial, contextual and community factors. We give possible explanations for our findings and provide implications for practice and recommendations for further research to better understand the CRC mortality burden in segregated communities.

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