scholarly journals Association of asthma severity and educational attainment at age 6–7 years in a birth cohort: population-based record-linkage study

Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-215422
Author(s):  
Annette Evans ◽  
Daniel Farewell ◽  
Joanne Demmler ◽  
Amrita Bandyopadhyay ◽  
Colin Victor Eric Powell ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Educational Attainment ◽  
Hospital Admission ◽  
Birth Cohort ◽  
Hospital Admissions ◽  
Respiratory Infections ◽  
Acute Asthma ◽  
Population Based ◽  
Multilevel Logistic Regression ◽  
Inpatient Hospital

BackgroundThere is conflicting research about the association between asthma and poor educational attainment that may be due to asthma definitions. Our study creates seven categories of current chronic and acute asthma to investigate if there is an association for poorer educational attainment at age 6–7 years, and the role of respiratory infections and school absence.MethodsThis study used a population-based electronic cross-sectional birth cohort 1998–2005, in Wales, UK, using health and education administrative datasets. Current asthma or wheeze categories were developed using clinical management guidelines in general practice (GP) data, acute asthma was inpatient hospital admissions and respiratory infections were the count of GP visits, from birth to age 6–7 years. We used multilevel logistic regression grouped by schools to ascertain if asthma or wheeze was associated with not attaining the expected level in teacher assessment at Key Stage 1 (KS1) adjusting for sociodemographics, perinatal, other respiratory illness and school characteristics. We tested if absence from school was a mediator in this relationship using the difference method.ResultsThere were 85 906 children in this population representative cohort with 7-year follow-up. In adjusted multilevel logistic regression, only asthma inpatient hospital admission was associated with increased risk for not attaining the expected level at KS1 (adjusted OR 1.14 95% CI (1.02 to 1.27)). Lower respiratory tract infection (LRTI) GP contacts remained an independent predictor for not attaining the expected level of education. Absence from school was a potential mediator of the association between hospital admission and educational attainment.ConclusionsClinicians and educators need to be aware that children who have inpatient hospital admissions for asthma or wheeze, or repeated LRTI, may require additional educational support for their educational outcomes.

scholarly journals Indirect effects of the covid-19 pandemic on childhood infection in England: population based observational study

BMJ ◽  
2022 ◽  
pp. e067519 ◽  
Author(s):  
Seilesh Kadambari ◽  
Raphael Goldacre ◽  
Eva Morris ◽  
Michael J Goldacre ◽  
Andrew J Pollard
Keyword(s):  
Confidence Interval ◽  
Hospital Admission ◽  
Hospital Admissions ◽  
Respiratory Infections ◽  
Population Based ◽  
Day Case ◽  
Admission Rates ◽  
Before And After ◽  
Invasive Infections ◽  
Childhood Infection

AbstractObjectiveTo assess the impact of the covid-19 pandemic on hospital admission rates and mortality outcomes for childhood respiratory infections, severe invasive infections, and vaccine preventable disease in England.DesignPopulation based observational study of 19 common childhood respiratory, severe invasive, and vaccine preventable infections, comparing hospital admission rates and mortality outcomes before and after the onset of the pandemic in England.SettingHospital admission data from every NHS hospital in England from 1 March 2017 to 30 June 2021 with record linkage to national mortality data.PopulationChildren aged 0-14 years admitted to an NHS hospital with a selected childhood infection from 1 March 2017 to 30 June 2021.Main outcome measuresFor each infection, numbers of hospital admissions every month from 1 March 2017 to 30 June 2021, percentage changes in the number of hospital admissions before and after 1 March 2020, and adjusted odds ratios to compare 60 day case fatality outcomes before and after 1 March 2020.ResultsAfter 1 March 2020, substantial and sustained reductions in hospital admissions were found for all but one of the 19 infective conditions studied. Among the respiratory infections, the greatest percentage reductions were for influenza (mean annual number admitted between 1 March 2017 and 29 February 2020 was 5379 and number of children admitted from 1 March 2020 to 28 February 2021 was 304, 94% reduction, 95% confidence interval 89% to 97%), and bronchiolitis (from 51 655 to 9423, 82% reduction, 95% confidence interval 79% to 84%). Among the severe invasive infections, the greatest reduction was for meningitis (50% reduction, 47% to 52%). For the vaccine preventable infections, reductions ranged from 53% (32% to 68%) for mumps to 90% (80% to 95%) for measles. Reductions were seen across all demographic subgroups and in children with underlying comorbidities. Corresponding decreases were also found for the absolute numbers of 60 day case fatalities, although the proportion of children admitted for pneumonia who died within 60 days increased (age-sex adjusted odds ratio 1.71, 95% confidence interval 1.43 to 2.05). More recent data indicate that some respiratory infections increased to higher levels than usual after May 2021.ConclusionsDuring the covid-19 pandemic, a range of behavioural changes (adoption of non-pharmacological interventions) and societal strategies (school closures, lockdowns, and restricted travel) were used to reduce transmission of SARS-CoV-2, which also reduced admissions for common and severe childhood infections. Continued monitoring of these infections is required as social restrictions evolve.

scholarly journals Risk Factors for Hospital Admission with RSV Bronchiolitis in England: A Population-Based Birth Cohort Study

PLoS ONE ◽  
2014 ◽  
Vol 9 (2) ◽  
pp. e89186 ◽  
Author(s):  
Joanna Murray ◽  
Alex Bottle ◽  
Mike Sharland ◽  
Neena Modi ◽  
Paul Aylin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Hospital Admission ◽  
Birth Cohort ◽  
Population Based ◽  
Birth Cohort Study

scholarly journals Physiological respiratory parameters in pre-hospital patients with suspected COVID-19: A prospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257018
Author(s):  
Johan Mälberg ◽  
Nermin Hadziosmanovic ◽  
David Smekal
Keyword(s):  
Logistic Regression ◽  
Hospital Admission ◽  
Tidal Volume ◽  
Respiratory Rate ◽  
Dead Space ◽  
Hospital Admissions ◽  
Rapid Shallow Breathing Index ◽  
Respiratory Parameters ◽  
Hospital Patients ◽  
Adjusted Logistic Regression

Background The COVID-19 pandemic has presented emergency medical services (EMS) worldwide with the difficult task of identifying patients with COVID-19 and predicting the severity of their illness. The aim of this study was to investigate whether physiological respiratory parameters in pre-hospital patients with COVID-19 differed from those without COVID-19 and if they could be used to aid EMS personnel in the prediction of illness severity. Methods Patients with suspected COVID-19 were included by EMS personnel in Uppsala, Sweden. A portable respiratory monitor based on pneumotachography was used to sample the included patient’s physiological respiratory parameters. A questionnaire with information about present symptoms and background data was completed. COVID-19 diagnoses and hospital admissions were gathered from the electronic medical record system. The physiological respiratory parameters of patients with and without COVID-19 were then analyzed using descriptive statistical analysis and logistic regression. Results Between May 2020 and January 2021, 95 patients were included, and their physiological respiratory parameters analyzed. Of these patients, 53 had COVID-19. Using adjusted logistic regression, the odds of having COVID-19 increased with respiratory rate (95% CI 1.000–1.118), tidal volume (95% CI 0.996–0.999) and negative inspiratory pressure (95% CI 1.017–1.152). Patients admitted to hospital had higher respiratory rates (p<0.001) and lower tidal volume (p = 0.010) compared to the patients who were not admitted. Using adjusted logistic regression, the odds of hospital admission increased with respiratory rate (95% CI 1.081–1.324), rapid shallow breathing index (95% CI 1.006–1.040) and dead space percentage of tidal volume (95% CI 1.027–1.159). Conclusion Patients taking smaller, faster breaths with less pressure had higher odds of having COVID-19 in this study. Smaller, faster breaths and higher dead space percentage also increased the odds of hospital admission. Physiological respiratory parameters could be a useful tool in detecting COVID-19 and predicting hospital admissions, although more research is needed.

scholarly journals Risk factors for unplanned hospital admission in a specialist homeless general practice population: case–control study to investigate the relationship with tri-morbidity

2020 ◽  
Vol 70 (695) ◽  
pp. e406-e411
Author(s):  
Catherine Himsworth ◽  
Priyamvada Paudyal ◽  
Christopher Sargeant
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Risk Factor ◽  
Hospital Admission ◽  
Case Control Study ◽  
Hospital Admissions ◽  
Case Control ◽  
Homeless Population ◽  
Unplanned Hospital Admissions ◽  
Control Study

Background‘Tri-morbidity’ describes the complex comorbidity of chronic physical illness, mental illness, and alcohol and/or drug misuse within the homeless population. Poor health outcomes of homeless people are reflected by the higher rate of unplanned hospital admissions compared with the non-homeless population.AimTo identify whether tri-morbidity is a risk factor for unplanned hospital admissions in the homeless population.Design and settingA case–control study of patients who were registered with a specialist homeless GP surgery in Brighton (72 cases and 72 controls).MethodCases were defined as those who had ≥1 overnight hospital admission within a 12-month period. Controls were matched for demographics but with no hospital admission. The primary care record was analysed, and tri-morbidity entered into binomial logistic regression with admission as the dichotomous dependent variable.ResultsThe logistic regression analysis demonstrated that other enduring mental health disorders and/or personality disorder (odds ratio [OR] 3.84, 95% confidence interval [CI] = 1.56 to 9.44), alcohol use (OR 2.92, 95% CI = 1.42 to 5.98), and gastrointestinal disorder (OR 2.90, 95% CI = 1.06 to 7.98) were independent risk factors for admission. Tri-morbidity increased odds of admission by more than four-fold (OR 4.19, 95% CI = 1.90 to 9.27).ConclusionThis study shows that tri-morbidity is an important risk factor for unplanned hospital admissions among the homeless population, and provides an interesting starting point for the development of a risk stratification tool to identify those at risk of unplanned admission in this population.

Preschool respiratory hospital admissions following infant bronchiolitis: a birth cohort study

2019 ◽  
Vol 104 (7) ◽  
pp. 658-663 ◽  
Author(s):  
Helen Skirrow ◽  
Thomas Wincott ◽  
Elizabeth Cecil ◽  
Alex Bottle ◽  
Ceire Costelloe ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hospital Admission ◽  
Birth Cohort ◽  
Hospital Admissions ◽  
Public Hospitals ◽  
Birth Cohort Study ◽  
Comorbid Condition ◽  
Upper Respiratory Tract ◽  
Tract Infections ◽  
Children Under 5

BackgroundBronchiolitis causes significant infant morbidity worldwide from hospital admissions. However, studies quantifying the subsequent respiratory burden in children under 5 years are lacking.ObjectiveTo estimate the risk of subsequent respiratory hospital admissions in children under 5 years in England following bronchiolitis admission in infancy.DesignRetrospective population-based birth cohort study.SettingPublic hospitals in England.PatientsWe constructed a birth cohort of 613 377 infants born between 1 April 2007 and 31 March 2008, followed up until aged 5 years by linking Hospital Episode Statistics admissions data.MethodsWe compared the risk of respiratory hospital admission due to asthma, wheezing and lower and upper respiratory tract infections (LRTI and URTI) in infants who had been admitted for bronchiolitis with those who had not, using Cox proportional hazard regression. We adjusted hazard ratios (HR) for known respiratory illness risk factors including living in deprived households, being born preterm or with a comorbid condition.ResultsWe identified 16 288/613 377 infants (2.7%) with at least one admission for bronchiolitis. Of these, 21.7% had a further respiratory hospital admission by age 5 years compared with 8% without a previous bronchiolitis admission (HR (adjusted) 2.82, 95% CI 2.72 to 2.92). The association was greatest for asthma (HR (adjusted) 4.35, 95% CI 4.00 to 4.73) and wheezing admissions (HR (adjusted) 5.02, 95% CI 4.64 to 5.44), but were also significant for URTI and LRTI admissions.ConclusionsHospital admission for bronchiolitis in infancy is associated with a threefold to fivefold risk of subsequent respiratory hospital admissions from asthma, wheezing and respiratory infections. One in five infants with bronchiolitis hospital admissions will have a subsequent respiratory hospital admission by age 5 years.

scholarly journals Effect of multiple risk behaviours in adolescence on educational attainment at age 16 years: a UK birth cohort study

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e020182 ◽  
Author(s):  
Caroline Wright ◽  
Ruth Kipping ◽  
Matthew Hickman ◽  
Rona Campbell ◽  
Jon Heron
Keyword(s):  
Cohort Study ◽  
Educational Attainment ◽  
Birth Cohort ◽  
Outcome Measures ◽  
Population Based ◽  
Birth Cohort Study ◽  
Risk Behaviours ◽  
Additional Risk ◽  
Parents And Children ◽  
Multiple Risk

ObjectivesTo explore the association between adolescent multiple risk behaviours (MRBs) and educational attainment.DesignProspective population-based UK birth cohort study.SettingAvon Longitudinal Study of Parents and Children (ALSPAC), a UK birth cohort of children born in 1991–1992.ParticipantsData on some or all MRB measures were available for 5401 ALSPAC participants who attended a clinic at age 15 years and/or completed a detailed questionnaire at age 16 years. Multiple imputation was used to account for missing data.Primary outcome measuresCapped General Certificate of Secondary Education (GCSE) score and odds of attaining five or more GCSE examinations at grades A*–C. Both outcome measures come from the National Pupil Database and were linked to the ALSPAC data.ResultsEngagement in MRB was strongly associated with poorer educational attainment. Each additional risk equated to −6.31 (95% CI −7.03 to −5.58, p<0.001) in capped GCSE score, equivalent to a one grade reduction or reduced odds of attaining five or more A*–C grades of 23% (OR 0.77, 95% CI 0.74 to 0.81, p<0.001). The average cohort member engaged in 3.24 MRB and therefore have an associated reduction in GCSE score equivalent to three and a half grades in one examination, or reduced odds of attaining five or more A*–C grades of 75%.ConclusionEngagement in adolescent MRB is strongly associated with poorer educational attainment at 16 years. Preventing MRB could improve educational attainment and thereby directly and indirectly improve longer-term health.

scholarly journals Emergency department use and hospital admission in children following ambulatory surgery: a retrospective population-based cohort study

2021 ◽  
Vol 5 (1) ◽  
pp. e001188
Author(s):  
Monakshi Sawhney ◽  
Elizabeth G VanDenKerkhof ◽  
David H Goldstein ◽  
Xuejiao Wei ◽  
Genevieve Pare ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Hospital Admission ◽  
Hospital Admissions ◽  
Ambulatory Surgery ◽  
Day Surgery ◽  
Population Based ◽  
Administrative Database ◽  
Same Day Discharge ◽  
Ed Visits

IntroductionPaediatric ambulatory surgery (same day surgery and planned same day discharge) is more frequently being performed more in Canada and around the world; however, after surgery children may return to hospital, either through the emergency department (ED) or through a hospital admission (HA). The aim of this study was to determine the patient characteristics associated with ED visits and HA in the 3 days following paediatric ambulatory surgery.MethodsThis population-based retrospective cohort study used de-identified health administrative database housed at ICES and included residents of Ontario, younger than 18 years of age, who underwent ambulatory surgery between 2014 and 2018. Patients were not involved in the design of this study. The proportion of ED visit and HA were calculated for the total cohort, and the type of surgery. The ORs and 95% CIs were calculated for each outcome using logistic regression.Results83 468 children underwent select ambulatory surgeries. 2588 (3.1%) had an ED visit and 608 (0.7%) had a HA in the 3 days following surgery. The most common reasons for ED visits included pain (17.2%) and haemorrhage (10.5%). Reasons for HA included haemorrhage (24.8%), dehydration (21.9%), and pain (9.1%).ConclusionsOur findings suggest that pain, bleeding and dehydration symptoms are associated with a return visit to the hospital. Implementing approaches to prevent, identify and manage these symptoms may be helpful in reducing ED visits or hospital admissions.

RCVS: Symptoms, Incidence, and Resource Utilization in a Population-Based US Cohort

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012223
Author(s):  
Jessica Magid-Bernstein ◽  
Setareh Salehi Omran ◽  
Neal S. Parikh ◽  
Alexander E. Merkler ◽  
Babak Navi ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Administrative Data ◽  
Census Data ◽  
Hospital Admissions ◽  
Population Based ◽  
Cerebrovascular Diseases ◽  
Cerebral Vasoconstriction ◽  
Icd 10 ◽  
Incidence Of Hospitalization ◽  
Age And Sex

Objective:To estimate the incidence of hospitalization for reversible cerebral vasoconstriction syndrome (RCVS), we identified RCVS-related hospital admissions across 11 U.S. states in 2016.Methods:We tested the validity of ICD-10 code I67.841 in 79 patients with hospital admissions for RCVS or other cerebrovascular diseases at one academic and one community hospital. After determining that this code had a sensitivity of 100% (95% CI, 82-100%) and a specificity of 90% (95% CI, 79-96%), we applied it to administrative data from the Healthcare Cost and Utilization Project on all ED visits and hospital admissions. Age- and sex-standardized RCVS incidence was calculated using census data. Descriptive statistics were used to analyze associated diagnoses.Results:Across 5,067,250 hospital admissions in our administrative data, we identified 222 patients with a discharge diagnosis of RCVS in 2016. The estimated annual age- and sex-standardized incidence of RCVS hospitalization was 2.7 (95% CI, 2.4-3.1) cases per million adults. Many patients had concomitant neurologic diagnoses, including subarachnoid hemorrhage (37%), ischemic stroke (16%), and intracerebral hemorrhage (10%). In the 90 days before the index admission, 97 patients had an ED visit and 34 patients a hospital admission, most commonly for neurologic, psychiatric, and pregnancy-related diagnoses. Following discharge from the RCVS hospital admission, 58 patients had an ED visit and 31 had a hospital admission, most commonly for neurologic diagnoses.Conclusions:Using population-wide data, we estimated the age- and sex-standardized incidence of hospitalization for RCVS in U.S. adults as approximately 3 per million per year.

scholarly journals Gestational age and hospital admissions during childhood: population based, record linkage study in England (TIGAR study)

BMJ ◽  
2020 ◽  
pp. m4075
Author(s):  
Victoria Coathup ◽  
Elaine Boyle ◽  
Claire Carson ◽  
Samantha Johnson ◽  
Jennifer J Kurinzcuk ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Gestational Age ◽  
Record Linkage ◽  
Hospital Admissions ◽  
Population Based ◽  
Admission Rates ◽  
Adjusted Rate ◽  
Gestational Age At Birth ◽  
Adjusted Rate Ratio ◽  
Age At Birth

AbstractObjectiveTo examine the association between gestational age at birth and hospital admissions to age 10 years and how admission rates change throughout childhood.DesignPopulation based, record linkage, cohort study in England.SettingNHS hospitals in England, United Kingdom.Participants1 018 136 live, singleton births in NHS hospitals in England between January 2005 and December 2006.Main outcome measuresPrimary outcome was all inpatient hospital admissions from birth to age 10, death, or study end (March 2015); secondary outcome was the main cause of admission, which was defined as the World Health Organization’s first international classification of diseases, version 10 (ICD-10) code within each hospital admission record.Results1 315 338 admissions occurred between 1 January 2005 and 31 March 2015, and 831 729 (63%) were emergency admissions. 525 039 (52%) of 1 018 136 children were admitted to hospital at least once during the study period. Hospital admissions during childhood were strongly associated with gestational age at birth (<28, 28-29, 30-31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, and 42 weeks). In comparison with children born at full term (40 weeks’ gestation), those born extremely preterm (<28 weeks) had the highest rate of hospital admission throughout childhood (adjusted rate ratio 4.92, 95% confidence interval 4.58 to 5.30). Even children born at 38 weeks had a higher rate of hospital admission throughout childhood (1.19, 1.16 to 1.22). The association between gestational age and hospital admission decreased with increasing age (interaction P<0.001). Children born earlier than 28 weeks had an adjusted rate ratio of 6.34 (95% confidence interval 5.80 to 6.85) at age less than 1 year, declining to 3.28 (2.82 to 3.82) at ages 7-10, in comparison with those born full term; whereas in children born at 38 weeks, the adjusted rate ratios were 1.29 (1.27 to 1.31) and 1.16 (1.13 to 1.19), during infancy and ages 7-10, respectively. Infection was the main cause of excess hospital admissions at all ages, but particularly during infancy. Respiratory and gastrointestinal conditions also accounted for a large proportion of admissions during the first two years of life.ConclusionsThe association between gestational age and hospital admission rates decreased with age, but an excess risk remained throughout childhood, even among children born at 38 and 39 weeks of gestation. Strategies aimed at the prevention and management of childhood infections should target children born preterm and those born a few weeks early.

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