scholarly journals Association of Indoor Smoke-Free Air Laws with Hospital Admissions for Acute Myocardial Infarction and Stroke in Three States

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Brett R. Loomis ◽  
Harlan R. Juster
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
New York ◽  
Hospital Admissions ◽  
Local Level ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Admission Rates ◽  
Policy Tool ◽  
Free Air

Objective. To examine whether comprehensive smoke-free air laws enacted in Florida, New York, and Oregon are associated with reductions in hospital admissions for acute myocardial infarction (AMI) and stroke.Methods. Analyzed trends in county-level, age-adjusted, hospital admission rates for AMI and stroke from 1990 to 2006 (quarterly) for Florida, 1995 to 2006 (monthly) for New York, and 1998 to 2006 (monthly) for Oregon to identify any association between admission rates and passage of comprehensive smoke-free air laws. Interrupted time series analysis was used to adjust for the effects of preexisting moderate local-level laws, seasonal variation in hospital admissions, differences across counties, and a secular time trend.Results. More than 3 years after passage of statewide comprehensive smoke-free air laws, rates of hospitalization for AMI were reduced by 18.4% (95% CI: 8.8–28.0%) in Florida and 15.5% (95% CI: 11.0–20.1%) in New York. Rates of hospitalization for stroke were reduced by 18.1% (95% CI: 9.3–30.0%) in Florida. The few local comprehensive laws in Oregon were not associated with reductions in AMI or stroke statewide.Conclusion. Comprehensive smoke-free air laws are an effective policy tool for reducing the burden of AMI and stroke.

The impact of smoke-free air laws and conventional cigarette taxes on cardiovascular hospitalizations

2021 ◽  
Author(s):  
Jon F Oliver
Keyword(s):  
Myocardial Infarction ◽  
Older Adults ◽  
Acute Myocardial Infarction ◽  
Cerebrovascular Disease ◽  
Local Level ◽  
National Level ◽  
State Level ◽  
Cigarette Taxes ◽  
Free Air ◽  
Working Age

Abstract Introduction Smoke-free air legislation and conventional cigarette taxes have long been used to reduce smoking initiation, prevalence, and conventional cigarette consumption. However, the extent to which these policies affect population health across a range of diagnoses and age groups remains less well understood. Methods Analyses use 2005-2014 hospital inpatient discharge data from up to 40 US states to estimate the effects of smoke-free air laws and conventional cigarette taxes on cardiovascular hospitalizations among working age and older adults. Results An increase in the percent of a county’s population covered by smoke-free air laws yielded a significant decline of 2.4% (RR: 0.976, 95%CI: 0.954, 0.997) in acute cerebrovascular disease hospitalizations among older adults. Moreover, significant declines of 2.0% (RR: 0.980, 95%CI: 0.967, 0.994) and 2.8% (RR: 0.972, 95%CI:0.949, 0.996) in acute cerebrovascular disease were observed among older adults in the first year and subsequent years after smoke-free air legislation was implemented, respectively. Conventional cigarette taxes did not yield a significant change in acute cerebrovascular disease hospitalizations, nor did either tobacco control policy lead to a significant decline in acute myocardial infarction hospitalizations. Conclusions Smoke-free air laws play an important role in reducing adult cardiovascular hospitalizations. These findings confirm existing research on acute cerebrovascular disease outcomes, as well as the modest effects on acute myocardial infarction hospitalizations observed in state- and national-level analyses. Implications Current research at the local level finds smoke-free air laws yield 40% declines in acute myocardial infarction hospitalizations and 29% declines in acute cerebrovascular disease.State- and national-level analyses find smaller effects of smoke-free air laws, and largely omits analyses of working age adults. Existing research likely suffers from omitted variable bias, including state-level tobacco control funding and local-level conventional cigarette taxes. Using adult hospitalization data from up to 40 states, this study confirms existing evidence at the national and state level, and provides new evidence that smoke-free air laws significantly reduce acute cerebrovascular disease hospitalizations among older adults.

scholarly journals Declines in Hospital Admissions for Acute Myocardial Infarction in New York State After Implementation of a Comprehensive Smoking Ban

2007 ◽  
Vol 97 (11) ◽  
pp. 2035-2039 ◽  
Author(s):  
Harlan R. Juster ◽  
Brett R. Loomis ◽  
Theresa M. Hinman ◽  
Matthew C. Farrelly ◽  
Andrew Hyland ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
New York ◽  
Hospital Admissions ◽  
New York State ◽  
Smoking Ban ◽  
York State

scholarly journals Impact of the national home safety equipment scheme ‘Safe At Home’ on hospital admissions for unintentional injury in children under 5: a controlled interrupted time series analysis

2021 ◽  
pp. jech-2021-216613
Author(s):  
Trevor Hill ◽  
Carol Coupland ◽  
Denise Kendrick ◽  
Matthew Jones ◽  
Ashley Akbari ◽  
...  
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Hospital Admissions ◽  
Unintentional Injury ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Home Safety ◽  
Safety Equipment ◽  
Admission Rates ◽  
Children Under 5

BackgroundUnintentional home injuries are a leading cause of preventable death in young children. Safety education and equipment provision improve home safety practices, but their impact on injuries is less clear. Between 2009 and 2011, a national home safety equipment scheme was implemented in England (Safe At Home), targeting high-injury-rate areas and socioeconomically disadvantaged families with children under 5. This provided a ‘natural experiment’ for evaluating the scheme’s impact on hospital admissions for unintentional injuries.MethodsControlled interrupted time series analysis of unintentional injury hospital admission rates in small areas (Lower Layer Super Output Areas (LSOAs)) in England where the scheme was implemented (intervention areas, n=9466) and matched with LSOAs in England and Wales where it was not implemented (control areas, n=9466), with subgroup analyses by density of equipment provision.Results57 656 homes receiving safety equipment were included in the analysis. In the 2 years after the scheme ended, monthly admission rates declined in intervention areas (−0.33% (−0.47% to −0.18%)) but did not decline in control areas (0.04% (−0.11%–0.19%), p value for difference in trend=0.001). Greater reductions in admission rates were seen as equipment provision density increased. Effects were not maintained beyond 2 years after the scheme ended.ConclusionsA national home safety equipment scheme was associated with a reduction in injury-related hospital admissions in children under 5 in the 2 years after the scheme ended. Providing a higher number of items of safety equipment appears to be more effective in reducing injury rates than providing fewer items.

scholarly journals Impact of medicaid expansion on disparities in revascularization in patients hospitalized with acute myocardial infarction

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243385
Author(s):  
Laurent G. Glance ◽  
Caroline P. Thirukumaran ◽  
Ernie Shippey ◽  
Stewart J. Lustik ◽  
Andrew W. Dick
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Interrupted Time Series ◽  
Myocardial Infarctions ◽  
Medicaid Expansion ◽  
Interrupted Time Series Analysis ◽  
St Segment Elevation ◽  
Percentage Point Increase ◽  
St Segment ◽  
Black Patients

Introduction Blacks are more likely to live in poverty and be uninsured, and are less likely to undergo revascularization after am acute myocardial infarction compared to whites. The objective of this study was to determine whether Medicaid expansion was associated with a reduction in revascularization disparities in patients admitted with an acute myocardial infarction. Methods Retrospective analysis study using data (2010–2018) from hospitals participating in the University Health Systems Consortium, now renamed the Vizient Clinical Database. Comparative interrupted time series analysis was used to compare changes in the use of revascularization therapies (PCI and CABG) in white versus non-Hispanic black patients hospitalized with either ST-segment elevation (STEMI) or non-ST-segment elevation acute myocardial infarctions (NSTEMI) after Medicaid expansion. Results The analytic cohort included 68,610 STEMI and 127,378 NSTEMI patients. The percentage point decrease in the uninsured rate for STEMIs and NSTEMIs was greater for blacks in expansion states compared to whites in expansion states. For patients with STEMIs, differences in black versus white revascularization rates decreased by 2.09 percentage points per year (95% CI, 0.29–3.88, P = 0.023) in expansion versus non-expansion states after adjusting for patient and hospital characteristics. Black patients hospitalized with STEMI in non-expansion states experienced a 7.24 percentage point increase in revascularization rate in 2014 (95% CI, 2.83–11.7, P < 0.001) but did not experience significant annual percentage point increases in the rate of revascularization in subsequent years (1.52; 95% CI, -0.51–3.55, P = 0.14) compared to whites in non-expansion states. Medicaid expansion was not associated with changes in the revascularization rate for either blacks or whites hospitalized with NSTEMIs. Conclusion Medicaid expansion was associated with greater reductions in the number of uninsured blacks compared to uninsured whites. Medicaid expansion was not associated, however, with a reduction in revascularization disparities between black and white patients admitted with acute myocardial infarctions.

scholarly journals Daylight saving time does not seem to be associated with number of percutaneous coronary interventions for acute myocardial infarction in the Netherlands

2021 ◽  
Author(s):  
L. Derks ◽  
◽  
S. Houterman ◽  
G. S. C. Geuzebroek ◽  
P. van der Harst ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
The Netherlands ◽  
Incidence Rate ◽  
Hospital Admissions ◽  
Control Period ◽  
Daylight Saving Time ◽  
Daylight Saving ◽  
Percutaneous Coronary ◽  
Acute Mi

Abstract Background In multiple studies, the potential relationship between daylight saving time (DST) and the occurrence of acute myocardial infarction (MI) has been investigated, with mixed results. Using the Dutch Percutaneous Coronary Intervention (PCI) registry facilitated by the Netherlands Heart Registration, we investigated whether the transitions to and from DST interact with the incidence rate of PCI for acute MI. Methods We assessed changes in hospital admissions for patients with ST-elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI) undergoing PCI between 1 January 2015 and 31 December 2018. We compared the incidence rate of PCI procedures during the first 3 or 7 days after the transition with that during a control period (2 weeks before transition plus second week after transition). Incidence rate ratio (IRR) was calculated using Poisson regression. Potential gender differences were also investigated. Results A total of 80,970 PCI procedures for STEMI or NSTEMI were performed. No difference in incidence rate a week after the transition to DST in spring was observed for STEMI (IRR 0.95, 95% confidence interval (CI) 0.87–1.03) or NSTEMI (IRR 1.04, 95% CI 0.96–1.12). After the transition from DST in autumn, the IRR was also comparable with the control period (STEMI: 1.03, 95% CI 0.95–1.12, and NSTEMI: 0.98, 95% CI 0.91–1.06). Observing the first 3 days after each transition yielded similar results. Gender-specific results were comparable. Conclusion Based on data from a large, nationwide registry, there was no correlation between the transition to or from DST and a change in the incidence rate of PCI for acute MI.

Management of non-traumatic epistaxis in adults in the emergency department

2021 ◽  
pp. 1-6
Author(s):  
Ashley Reed ◽  
Martyn Barnes ◽  
Caroline Howard
Keyword(s):  
Emergency Department ◽  
Hospital Admissions ◽  
Interrupted Time Series ◽  
University Teaching ◽  
Attendance Rate ◽  
Interrupted Time Series Analysis ◽  
Current Management ◽  
Emergency Ambulance ◽  
Bed Days ◽  
The Impact

Background/aims Despite epistaxis being a common presentation to emergency departments there is a lack of guidelines, both nationally and internationally, for its management. The authors reviewed the current management of epistaxis and then introduced a new pathway for management to see if care could be improved. The aims were to evaluate the impact of the pathway on reduction of emergency department breaches, emergency ambulance transfers and hospital admissions. Methods The study was an interrupted time series analysis over 29 months and included 903 participants. A pathway for the management of adults with non-traumatic epistaxis was designed and implemented in a university teaching hospital with an emergency department annual attendance rate of 105 495 in 2019–20. Results The pathway led to a 14-minute longer stay in the emergency department, a 5% increase in emergency department breaches, an 8.2% reduction in admissions, a 3.6% reduction in emergency ambulance transfers, a 14.1% increase in nasal cautery and a 3.2% reduction in nasal packing. Conclusions The authors calculate that these results equate to roughly 56 hospital bed days saved, providing better care closer to home for patients, in addition to beneficial knock-on effects for other emergency department and admitted patients.

Predictors of 30-Day Mortality in Patients With Refractory Cardiogenic Shock Following Acute Myocardial Infarction Despite a Patent Infarct Artery

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Jason Katz
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
New York ◽  
Cardiogenic Shock ◽  
Martin Luther ◽  
Refractory Cardiogenic Shock

Abstract 503 Jason N Katz, Duke Univ Medical Ctr & Duke Clinical Res Inst, Durham, NC; Amanda L Stebbins, Duke Clinical Res Inst, Durham, NC; John H Alexander, Duke Univ Medical Ctr & Duke Clinical Res Inst, Durham, NC; Harmony R Reynolds, New York Univ, New York, NY; Karen S Pieper, Duke Clinical Res Inst, Durham, NC; Witold Ruzyllo, Natl Inst of Cardiology, Warsaw, Poland; Karl Werdan, Martin-Luther-Univ Halle-Wittenberg, Halle-Wittenberg, Germany; Alexander Geppert, Wilhelminen hospital Vienna, Vienna, Austria; Vladimir Dzavik, Univ of Toronto, Toronto, ON, Canada; Frans Van de Werf, Univ Hosp of Gasthuisberg, Leuven, Belgium; Judith S Hochman, New York Univ, New York, NY; TRIUMPH Investigators Jason Katz, 2008 Finalist and Presenting Author

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