Abstract 12259: Epidemiology of Valvular Heart Diseases: A 30-Year Retrospective of Hospitalizations and In-Hospital Mortality in New York State

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Phyllis G Supino ◽  
Ofek Y Hai ◽  
Nasimullah Khan ◽  
Jeffrey S Borer
Keyword(s):  
New York ◽  
Heart Diseases ◽  
New York State ◽  
Temporal Trends ◽  
Case Fatality ◽  
Female Gender ◽  
York State ◽  
Death Risk ◽  
Valvular Heart Diseases ◽  
Rate Of Increase

Background: Valvular heart disease (VHD) is among the most predictable causes of heart failure (HF) and an important cause of sudden death. Temporal trends of clinically significant VHD during the past three decades have not been defined. Methods: To obtain information for our region, we conducted a longitudinal analysis of all inpatient hospital records (79,689,879) obtained from the New York State (NYS) Statewide Planning and Research Cooperative System (SPARCS) database for years 1983 (first year reliable data were consistently available) through 2012 (last year data were complete). VHD cases (2,720,313) were identified from principal or secondary ICD-9 codes for aortic, mitral, tricuspid or pulmonic VHD. Linear regression was used to evaluate trends over time for VHD hospitalizations, valve surgery (VS) and in-hospital deaths. Logistic regression was used to predict mortality risk factors. Results: From 1983-2012, total hospitalizations decreased by ~500,000 cases; simultaneously, VHD hospitalizations increased markedly (34,395 in 1983 to 125,139 in 2012). Rate of increase was linear across all VHD categories = 4,248 new cases (12.4%)/yr, r 2 = 0.99, p<.0001) through 2006 (peak= 132,323 cases), and then flattened through 2012. A parallel trend was found for VS, though no appreciable flattening occurred (2,582 cases in 1983 to 7,787 in 2012, linearized increase rate=207 VS [8.0%]/yr, r 2 =0.97, p<.001). Both numbers of hospitalizations and performance of VS rose with patient age (p<.001). Over the study interval, 123,787 patients with VHD died in the hospital, including 9,272 who died after VS; avg case fatality rates were 4.6% (all VHD) and 6.4% (VS). Deaths were independently associated with advancing age, nonelective admission and presence of associated HF (p<.0001, all). Male gender predicted increased death risk among the general VHD population; female gender predicted death risk among those undergoing VS. Conclusions: The incidence of VHD hospitalization and VS in NYS has risen substantially since the early 1980s and can be expected to rise further as the population ages. Thus, intensive planning is needed to deal with public health implications of these trends as we attempt to meet the growing needs of this patient population.

scholarly journals A large-scale retrospective study of opioid poisoning in New York State with implications for targeted interventions

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xin Chen ◽  
Wei Hou ◽  
Sina Rashidian ◽  
Yu Wang ◽  
Xia Zhao ◽  
...  
Keyword(s):  
New York ◽  
Race And Ethnicity ◽  
Large Scale ◽  
New York State ◽  
Temporal Trends ◽  
Opioid Overdose ◽  
York State ◽  
Targeted Interventions ◽  
Level Data ◽  
Zip Code

AbstractOpioid overdose related deaths have increased dramatically in recent years. Combating the opioid epidemic requires better understanding of the epidemiology of opioid poisoning (OP). To discover trends and patterns of opioid poisoning and the demographic and regional disparities, we analyzed large scale patient visits data in New York State (NYS). Demographic, spatial, temporal and correlation analyses were performed for all OP patients extracted from the claims data in the New York Statewide Planning and Research Cooperative System (SPARCS) from 2010 to 2016, along with Decennial US Census and American Community Survey zip code level data. 58,481 patients with at least one OP diagnosis and a valid NYS zip code address were included. Main outcome and measures include OP patient counts and rates per 100,000 population, patient level factors (gender, age, race and ethnicity, residential zip code), and zip code level social demographic factors. The results showed that the OP rate increased by 364.6%, and by 741.5% for the age group > 65 years. There were wide disparities among groups by race and ethnicity on rates and age distributions of OP. Heroin and non-heroin based OP rates demonstrated distinct temporal trends as well as major geospatial variation. The findings highlighted strong demographic disparity of OP patients, evolving patterns and substantial geospatial variation.

scholarly journals A Seasonal Shift in the Frequency of Extreme Hydrological Events in Southern New York State

2013 ◽  
Vol 26 (23) ◽  
pp. 9577-9593 ◽  
Author(s):  
Adão H Matonse ◽  
Allan Frei
Keyword(s):  
New York ◽  
Extreme Precipitation ◽  
New York State ◽  
Warm Season ◽  
Hurricane Sandy ◽  
Study Region ◽  
York State ◽  
Extreme Precipitation Events ◽  
Rate Of Increase ◽  
Extreme Hydrological Events

The recent sequence of extreme hydrological events across the eastern United States (e.g., Hurricane Irene in August 2011, Tropical Storm Lee in September 2011, and Hurricane Sandy in October 2012), which led to unprecedented flooding including in various parts in the study region, the Catskill Mountains, and Hudson River Valley in southern New York State, have raised the question of whether the frequency of extreme events across the region is changing. In this study variations in the frequency of extreme precipitation and streamflow events available from historical records are analyzed. This study finds that there has been a marked increase in the frequency of warm season (June–October) extreme hydrologic events during the last two decades, with an accelerated rate of increase since the mid-1990s. The most recent decade has the highest frequency of extreme warm season events in the last 100 years across the study region. No such trend is observed between November and May; in fact the frequency of 4-day extreme precipitation events during the cold period has declined during the last two decades.

scholarly journals Marked reduction in mortality in patients with severe traumatic brain injury

2013 ◽  
Vol 119 (6) ◽  
pp. 1583-1590 ◽  
Author(s):  
Linda M. Gerber ◽  
Ya-Lin Chiu ◽  
Nancy Carney ◽  
Roger Härtl ◽  
Jamshid Ghajar
Keyword(s):  
Traumatic Brain Injury ◽  
New York ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
New York State ◽  
Case Fatality ◽  
York State ◽  
Brain Trauma Foundation ◽  
Guidelines Adherence ◽  
Generalized Linear Mixed Effects

Object In spite of evidence that use of the Brain Trauma Foundation Guidelines for the Management of Severe Traumatic Brain Injury (Guidelines) would dramatically reduce morbidity and mortality, adherence to these Guidelines remains variable across trauma centers. The authors analyzed 2-week mortality due to severe traumatic brain injury (TBI) from 2001 through 2009 in New York State and examined the trends in adherence to the Guidelines. Methods The authors calculated trends in adherence to the Guidelines and age-adjusted 2-week mortality rates between January 1, 2001, and December 31, 2009. Univariate and multivariate logistic regression analyses were performed to evaluate the effect of time period on case-fatality. Intracranial pressure (ICP) monitor insertion was modeled in a 2-level hierarchical model using generalized linear mixed effects to allow for clustering by different centers. Results From 2001 to 2009, the case-fatality rate decreased from 22% to 13% (p < 0.0001), a change that remained significant after adjusting for factors that independently predict mortality (adjusted OR 0.52, 95% CI 0.39–0.70; p < 0.0001). Guidelines adherence increased, with the percentage of patients with ICP monitoring increasing from 56% to 75% (p < 0.0001). Adherence to cerebral perfusion pressure treatment thresholds increased from 15% to 48% (p < 0.0001). The proportion of patients having an ICP elevation greater than 25 mm Hg dropped from 42% to 29% (p = 0.0001). Conclusions There was a significant reduction in TBI mortality between 2001 and 2009 in New York State. Increase in Guidelines adherence occurred at the same time as the pronounced decrease in 2-week mortality and decreased rate of intracranial hypertension, suggesting a causal relationship between Guidelines adherence and improved outcomes. Our findings warrant future investigation to identify methods for increasing and sustaining adherence to evidence-based Guidelines recommendations.

scholarly journals Estimation of case-fatality rate in COVID-19 patients with hypertension and diabetes mellitus in the New York State

2020 ◽  
Author(s):  
Yang Ge ◽  
Shengzhi Sun ◽  
Ye Shen
Keyword(s):  
Diabetes Mellitus ◽  
New York ◽  
Case Fatality Rate ◽  
Elderly Population ◽  
New York State ◽  
Case Fatality ◽  
The Elderly ◽  
Fatality Rate ◽  
York State

We estimated the case-fatality rate (CFR) and ratios (RR) in adult COVID-19 cases with hypertension and diabetes mellitus in the New York State. We found that the elderly population had a higher CFR, but the elevated CFR ratios associated with comorbidities are more pronounced for the younger population.

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