Prospective survey of implantable defibrillator shock anxiety in Japanese patients: Results from the DEF-Chiba study

Background COVID‐19 was temporally associated with an increase in out‐of‐hospital cardiac arrests, but the underlying mechanisms are unclear. We sought to determine if patients with implantable defibrillators residing in areas with high COVID‐19 activity experienced an increase in defibrillator shocks during the COVID‐19 outbreak. Methods and Results Using the Medtronic (Mounds View, MN) Carelink database from 2019 and 2020, we retrospectively determined the incidence of implantable defibrillator shock episodes among patients residing in New York City, New Orleans, LA, and Boston, MA. A total of 14 665 patients with a Medtronic implantable defibrillator (age, 66±13 years; and 72% men) were included in the analysis. Comparing analysis time periods coinciding with the COVID‐19 outbreak in 2020 with the same periods in 2019, we observed a larger mean rate of defibrillator shock episodes per 1000 patients in New York City (17.8 versus 11.7, respectively), New Orleans (26.4 versus 13.5, respectively), and Boston (30.9 versus 20.6, respectively) during the COVID‐19 surge. Age‐ and sex‐adjusted hurdle model showed that the Poisson distribution rate of defibrillator shocks for patients with ≥1 shock was 3.11 times larger (95% CI, 1.08–8.99; P =0.036) in New York City, 3.74 times larger (95% CI, 0.88–15.89; P =0.074) in New Orleans, and 1.97 times larger (95% CI, 0.69–5.61; P =0.202) in Boston in 2020 versus 2019. However, the binomial odds of any given patient having a shock episode was not different in 2020 versus 2019. Conclusions Defibrillator shock episodes increased during the higher COVID‐19 activity in New York City, New Orleans, and Boston. These observations may provide insights into COVID‐19–related increase in cardiac arrests.

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Amoxicillin/clavulanate allergic reaction, implantable defibrillator shock and Kounis syndrome: Pathophysiologic considerations

Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology ◽

10.5543/tkda.2017.00671 ◽

2017 ◽

Author(s):

Nicholas G Kounis

Keyword(s):

Allergic Reaction ◽

Implantable Defibrillator ◽

Kounis Syndrome ◽

Amoxicillin Clavulanate ◽

Defibrillator Shock

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Attitudes about chemotherapy for Japanese patients with or without cancer: Doctors, nurses, and the general public

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.17062 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 17062-17062

Author(s):

K. Kubota ◽

K. Nagai ◽

Y. Nishiwaki ◽

T. Sugiura ◽

S. Tsuchiya ◽

...

Keyword(s):

Cancer Patients ◽

Cost Benefit ◽

Japanese Patients ◽

Control Group ◽

Intensive Chemotherapy ◽

Prospective Survey ◽

Personal Cost ◽

Patients With Cancer ◽

Study Results ◽

Minimal Benefit

17062 Background: A prospective survey in England demonstrated that patients with cancer were much more likely to accept radical treatment with minimal chance of benefit than people who did not have cancer (Slevin et al. Br Med J 1990; 300: 1458–60). We compared responses of Japanese patients with cancer with those of a control group of physicians, nurses, and patients without cancer in assessing personal cost-benefit of chemotherapy using the same questionnaire with Slevin's study. Methods: Subjects were asked with questionnaires whether of not to accept intensive and mild chemotherapy with a supposed minimum chance of effectiveness. 153 patients with cancer, 265 controls, 213 doctors, 397 nurses, and 51 patients without cancer were subjects of the study. Results: Percentage of subjects who accepted intensive chemotherapy with a supposed minimum chance of effectiveness (1% chance of cure, 3-month prolonging life, 1% relief of symptoms) by subject group were as follows: cancer patients; 62/55/52, doctors; 27/32/4, nurses; 11/12/5, non-cancer patients; 35/40/36, controls; 23/24/15, respectively. Conclusions: More patients with cancer than people without cancer accepted treatments giving the minimal benefit for cure, prolonging life or palliation of symptoms. Interestingly, the results in Japanese survey were similar to the previous study in England. No significant financial relationships to disclose.

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Prospective Survey of Financial Toxicity Measured by the Comprehensive Score for Financial Toxicity in Japanese Patients With Cancer

Journal of Global Oncology ◽

10.1200/jgo.19.00003 ◽

2019 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Kazunori Honda ◽

Bishal Gyawali ◽

Masashi Ando ◽

Ryosuke Kumanishi ◽

Kyoko Kato ◽

...

Keyword(s):

Lower Cost ◽

Japanese Version ◽

Japanese Patients ◽

Household Savings ◽

Financial Toxicity ◽

Prospective Survey ◽

Patients With Cancer ◽

Multivariable Analyses ◽

The Cost ◽

Comprehensive Score

PURPOSE We previously reported on the pilot study assessing the feasibility of using the Japanese translation of the Comprehensive Score for Financial Toxicity (COST) tool to measure financial toxicity (FT) among Japanese patients with cancer. In this study, we report the results of the prospective survey assessing FT in Japanese patients with cancer using the same tool. PATIENTS AND METHODS Eligible patients were receiving chemotherapy for a solid tumor for at least 2 months. In addition to the COST survey, socioeconomic characteristics were collected by using a questionnaire and medical records. RESULTS Of the 191 patients approached, 156 (82%) responded to the questionnaire. Primary tumor sites were colorectal (n = 77; 49%), gastric (n = 39; 25%), esophageal (n = 16; 10%), thyroid (n = 9; 6%), head and neck (n = 4; 3%), and other (n = 11; 7%). Median COST score was 21 (range, 0 to 41; mean ± standard deviation, 12.1 ± 8.45), with lower COST scores indicating more severe FT. On multivariable analyses using linear regression, older age (β, 0.15 per year; 95% CI, 0.02 to 0.28; P = .02) and higher household savings (β, 8.24 per ¥15 million; 95% CI, 4.06 to 12.42; P < .001) were positively associated with COST score; nonregular employment (β, −5.37; 95% CI, −10.16 to −0.57; P = .03), retirement because of cancer (β, −5.42; 95% CI, −8.62 to −1.37; P = .009), and use of strategies to cope with the cost of cancer care (β, −5.09; 95% CI, −7.87 to −2.30; P < .001) were negatively associated with COST score. CONCLUSION Using the Japanese version of the COST tool, we identified various factors associated with FT in Japanese patients with cancer. These findings will have important implications for cancer policy planning in Japan.

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