Abstract P053: Increment And Stabilization Of Diabetes Prevalence In The Province Of Quebec, Canada: A Combination Of Lower Mortality And Incidence In Older Adults Only

Introduction: In the last decade, an increase in the prevalence and a reduction in the incidence of diabetes have been observed in many countries including Canada. Yet, some Canadian provinces depicted an elevation in incidence rates among younger age groups. Our objective was to document these trends in the province of Quebec from fiscal years 2001 to 2017. Hypothesis: Prevalence is increasing because of raising incidence in individuals aged <50 years. Methods: Prevalence, incidence and all-cause mortality among cases of diabetes ≥20 years were assessed using the Quebec Integrated Chronic Disease Surveillance System (n=6,551,045 in 2017). Estimations were age-standardized or stratified by 10-year age groups. Results: In 2017, the crude prevalence and incidence of diabetes were 9.9% [99% confidence interval: 9.9-10.0] (n=651,370) and 6.0 per 1,000 inhabitants [5.9-6.0] (n=35,355), respectively. Between 2001 and 2017, the age-standardized prevalence increased by 43% (6.3% [6.3-6.3] to 9.0% [9.0-9.1]), while age-standardized incidence decreased by 29% (8.3 per 1,000 [8.2-8.4] to 5.9 per 1,000 [5.9-6.0]). In every age group, the prevalence increased steadily with progressive stabilization from 2011 and onward, except for the 60-69 years old group who depicted a reduction from 2012 to 2017. Incidence remained stable among <50 years old, while it decreased for ≥50 years (-26%, -33%, -36% for 50-59, 60-69 and ≥70 years old, respectively) (Figure 1). Age-standardized mortality among adults with diabetes decreased by 24% (20.7 per 1,000 [20.1-21.3] to 15.8 per 1,000 [15.4-16.3]). Mortality rates decreased by 27% among the 40-49 years old, with greater reductions in older age groups (-28%, -35%, -34% in the 50-59, 60-69 and ≥70 years, respectively). Conclusions: The rise and stabilization of diabetes prevalence could be due to a reduction in incidence in patients aged ≥50 years and mortality among all age groups. Prevention of diabetes should be a priority among individuals aged <50 years as diabetes incidence is not decreasing.

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Estimates of drug treated diabetes incidence and prevalence using Australian administrative pharmaceutical data

International Journal for Population Data Science ◽

10.23889/ijpds.v6i1.1398 ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Shaun Francis Purkiss ◽

Tessa Keegel ◽

Hassan Vally ◽

Dennis Wollersheim

Keyword(s):

Census Data ◽

Age Groups ◽

National Health Survey ◽

Incidence Rates ◽

Community Survey ◽

Older Age ◽

Diabetes Prevalence ◽

Diabetes Incidence ◽

Prevalence Estimates ◽

Incident Cases

IntroductionThe incidence and prevalence of diabetes within a population are important public health metrics. Pharmaceutical administrative data may offer a resource that can contribute to quantifying these measures using the recorded signals derived from the drugs used to treat people with diabetes. ObjectiveTo estimate the longitudinal incidence and prevalence of drug treated (DT) diabetes in Australia utilising an Australian Pharmaceutical Benefits Scheme (PBS) dataset and compare estimates with community survey data for all diabetes reported in the Australian National Health Survey (NHS). MethodsPersons with DT diabetes were identified within the PBS dataset using assigned Anatomic Therapeutic Chemical codes for `Drugs used in diabetes'. Prevalent persons with DT diabetes were determined by a single annual treatment, and incident cases from the earliest treatment with diabetes medications. Counts were aggregated by age group and utilised Australian national census data as a denominator to calculate diabetes disease frequencies for the period 2004--14. Comparison of PBS prevalence data was made with NHS surveys over equivalent years. ResultsThe age adjusted incidence of DT diabetes was 3.4/1000 in 2006 and increased to 3.8/1000 in 2011 and 5.1/1000 in 2014. Age adjusted prevalence of DT diabetes in Australia also rose from 26.7/1000 in 2006 to 32.1/1000 in 2011 and 42.1/1000 in 2014. DT diabetes prevalence estimates correlated with NHS estimates of self-reported diabetes prevalence across age groups and in 2014 was r = 0.987. However, PBS estimates of DT diabetes prevalence generally underestimated NHS values of self-reported diabetes in older age groups with mean percentage differences of -22% to -3%. In contrast, PBS data captured more younger persons with diabetes in comparison to NHS data. These differences were then used to adjust DT diabetes incidence rates to provide age specific estimates that could potentially reflect diabetes incidence estimates acquired by community survey. ConclusionsPBS data representing dispensed medications prescribed to persons with diabetes offers a perspective for the assessment of diabetes incidence and prevalence. PBS derived DT diabetes prevalence estimates correlate well with community survey estimates of self-reported diabetes, but underestimate NHS data in older age groups. Calibrated DT incidence estimates may potentially reflect community survey derived diabetes incidence estimates and may offer a method for longitudinal monitoring.

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P.065 Alzheimer’s disease (AD) and dementias in Canada: First national surveillance data from the Canadian Chronic Disease Surveillance System (CCDSS)

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2017.149 ◽

2017 ◽

Vol 44 (S2) ◽

pp. S29-S29

Author(s):

C Pelletier ◽

C Robitaille ◽

N Gabora-Roth ◽

J Toews

Keyword(s):

Disease Surveillance ◽

Age Groups ◽

Incidence Rates ◽

Case Definition ◽

Administrative Databases ◽

Fiscal Year ◽

Prevalence Rates ◽

Disease Surveillance System ◽

Icd 10 ◽

Group Sex

Background: With a growing and aging population, the number of individuals with AD and dementias and their associated costs are expected to increase in Canada. Up to now, no national mechanism was in place to monitor the epidemiological burden of AD and dementias. This presentation will showcase the first CCDSS data available on these conditions. Methods: Through the CCDSS, a Federal/Provincial/Territorial partnership, health administrative databases are linked to collect data on chronic conditions. Using selected ICD-9(CM)/ICD-10 codes for AD and dementias, the validated case definition implemented to identify relevant cases aged 65+ is:1+ hospitalizations; or3+ physician claims within 2 years, with a 30-day-gap between each claim; or1+ anti-dementia drug prescriptions.Prevalence and incidence rates will be presented by 5-year age group, sex, province/territory, and fiscal year. Results: Overall, incidence and prevalence rates were higher in women. The prevalence rate approximately doubled between 5-year age groups and sex differences tended to widen with age. While aged-standardised data show increasing prevalence rates over time, incidence rates fluctuated but suggest a decline since 2009/10. Conclusions: CCDSS data can be used to monitor the burden of AD and dementias in Canada. This information is important for the assessment of prevention actions and the planning of health care resources.

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911. Assessment of Representativeness of IPD Surveillance Conducted by the National Microbiology Laboratory of Canada

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1099 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S490-S490

Author(s):

Rajeev M Nepal ◽

Stephane B Dion ◽

Ana Gabriela Grajales ◽

Maria Major ◽

Alejandro Cane ◽

...

Keyword(s):

Disease Surveillance ◽

Age Groups ◽

Incidence Rates ◽

Microbiology Laboratory ◽

Disease Surveillance System ◽

Time Period ◽

Case Count ◽

Surveillance Programs ◽

The Difference ◽

Insight Into

Abstract Background Understanding the evolving epidemiology of Streptococcus pneumoniae serotypes is important for assessing the current and potential future immunization programs. In Canada, Invasive pneumococcal disease (IPD) is mandatory reportable to provincial/territorial public health. Provinces and territories voluntarily submit annual IPD data to the Canadian Notifiable Disease Surveillance System (CNDSS), which publishes information on IPD cases and incidence rates, however serotype data are not available. Provinces/territories also voluntarily submit IPD isolates to the National Microbiology laboratory (NML) for serotyping; provinces that conduct their own serotyping submit this information. The NML produces comprehensive IPD surveillance reports including serotype distribution; due to lack of population denominator, no incidence rates are available. The two surveillance programs are not linked. The objective of the study is to assess the representativeness of the NML surveillance as compared to the CNDSS and provincial reportable diseases databases. Methods Over the study time period (2010-2017), we compared annual IPD case counts between the NML and CNDSS reports. Due to the difference in age grouping between CNDSS and NML, comparison was limited to these groups: all age, < 5, 5-14 and > 15 years. In addition, the IPD counts from NML were compared to data from four largest provinces. Results For < 5 group, NML reported 91% of CNDSS case count whereas for 5-14 and > 15 years of age, it was 81% and 79%, respectively. Compared to the corresponding provincial databases, NML reported 91%, 97%, and 93% case counts for Ontario, British Columbia, and Alberta, respectively, while it was only 47% for Quebec. Further analysis revealed that the discrepancy in Quebec is the result of under-representation of >5 populations. Figure 1: Comparison of age stratified IPD case counts between CNDSS and NML Figure 2. Comparison of all age IPD case counts between NML and provincial databases Conclusion IPD surveillance conducted by NML has been instrumental to gain insight into the evolving epidemiology of S. pneumoniae serotypes in Canada. Comparisons of IPD counts from NML surveillance reports with reportable disease databases revealed different levels of concordance across provinces and age groups. The limitations of NML surveillance including incomplete or inconsistent reporting should be taken into consideration when interpreting the data. Disclosures Rajeev M. Nepal, PhD, Pfizer (Employee) Stephane B. Dion, PhD, Pfizer (Employee) Ana Gabriela Grajales, MD, Pfizer (Employee) Maria Major, B.Sc., MPH, Pfizer (Employee) Alejandro Cane, MD, Pfizer (Employee) Jelena Vojicic, MD, Pfizer (Employee)

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Tularemia transmission to humans: a multifaceted surveillance approach

Epidemiology and Infection ◽

10.1017/s0950268818002492 ◽

2018 ◽

Vol 146 (16) ◽

pp. 2139-2145 ◽

Cited By ~ 4

Author(s):

N. Akhvlediani ◽

I. Burjanadze ◽

D. Baliashvili ◽

T. Tushishvili ◽

M. Broladze ◽

...

Keyword(s):

Risk Factors ◽

Disease Surveillance ◽

Incidence Rates ◽

Clinical Factors ◽

Notifiable Disease ◽

Surveillance Studies ◽

Disease Surveillance System ◽

Acute Infections ◽

System 2 ◽

Incident Cases

AbstractTularemia has sustained seroprevalence in Eurasia, with estimates as high as 15% in endemic regions. The purpose of this report is to characterise the current epidemiology of Francisella tularensis subspecies holarctica in Georgia. Three surveillance activities are summarised: (1) acute infections captured in Georgia's notifiable disease surveillance system, (2) infectious disease seroprevalence study of military volunteers, and (3) a study of seroprevalence and risk factors in endemic regions. Descriptive analyses of demographic, exposure and clinical factors were conducted for the surveillance studies; bivariate analyses were computed to identify risk factors of seropositivity using likelihood ratio χ2 tests or Fisher's exact tests. Of the 19 incident cases reported between 2014 and August 2017, 10 were confirmed and nine met the presumptive definition; the estimated annual incidence was 0.12/100 000. The first cases of tularemia in Western Georgia were reported. Seroprevalences of antibodies for F. tularensis were 2.0% for military volunteers and 5.0% for residents in endemic regions. Exposures correlated with seropositivity included work with hay and contact with multiple types of animals. Seroprevalence studies conducted periodically may enhance our understanding of tularemia in countries with dramatically underestimated incidence rates.

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Higher Incidence of Chronic Myeloid Leukemia (CML) Among Blacks Compared to Whites in the Post-Imatinib Period (2002–2009) Corresponds with Worse Survival Observed within the Surveillance, Epidemiology and End Results 18 Registries

Blood ◽

10.1182/blood.v120.21.3773.3773 ◽

2012 ◽

Vol 120 (21) ◽

pp. 3773-3773

Author(s):

Adam Mendizabal ◽

Paul H Levine

Keyword(s):

Tyrosine Kinase ◽

Incidence Rate ◽

Kinase Inhibitors ◽

Age Groups ◽

Incidence Rates ◽

Age At Diagnosis ◽

Age Group ◽

Risk Of Death ◽

Younger Age ◽

Adjusted Incidence

Abstract Abstract 3773 Background: Age at diagnosis of CML varies by race in the United States with median occurring around ages 54 and 63 among Black and White patients, respectively. The treatment paradigm shifted when Imatinib was approved in 2001 for treatment of CML. More recently, second generation tyrosine kinase inhibitors (TKI) have also been used for treatment of CML. Differences in outcomes by race have been previously reported prior to the TKI treatment period. We aimed to assess whether the earlier age at diagnosis resulted in differential trends in age-adjusted incidence rates and survival outcomes by race in the post-Imatinib treatment period. Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) 18 Registries were extracted for diagnoses between 2002 and 2009 based on the assumption that cases diagnosed after 2002 would be treated with TKI's. CML was defined according to the International Classification of Diseases for Oncology 3rd edition code 9863 (CML-NOS) and 9875 (CML-Philadelphia Chromosome Positive). Cases diagnosed by autopsy or death certificate only were excluded. Incidence rates are expressed per 100,000 person-years and age-adjusted to the 2000 US Standard Population. Black/White incidence rate ratios (IRRBW) are shown with corresponding 95% confidence intervals (CI). Kaplan-Meier estimates of CML-specific survival (CPS) and overall survival (OS) were estimated at 5-years post-diagnosis with the event being time to CML-specific death or any death, respectively. Stratified Cox proportional hazards models were constructed to assess the impact of age and race on the risk of death expressed as a hazard ratio (HR). Results: Since 2002, 6,632 patients diagnosed with CML were reported to the SEER 18 registries including 5,829 White patients (87.9%) and 803 Black patients (12.1%) with 57% being male. The age-adjusted incidence rate for Blacks was 1.18 (95% CI, 1.10–1.27) per 100,000 and 1.12 (95% CI, 1.09–1.27) per 100,000 for Whites. The corresponding IRRBW was 1.06 (95% CI, 0.98– 1.14). When considering 20-year age-groups, Blacks had higher incidence rates in the 20–39 and 40–59 age groups; IRRBW of 1.26 (95% CI, 1.06–1.49; p=0.0073) and 1.23 (95% CI, 1.09–1.39; p=0.0007), respectively. No statistically significant differences in IRRBW were seen within the 0–19, 60–79 and 80+ age-groupings although Whites have higher non-significant incidence rates in the latter 2 age-groups. Differences in IRRBW prompted an assessment of survival to determine if the excess incidence observed in the younger age groups corresponded with a worse survival. CPS at 5-years was 85.5% (95% CI, 84.3–86.6). In univariate analysis, age was an important predictor of outcome (p<0.0001) with patients diagnosed after age 80 having the worse outcomes (OS: 58.3%), followed by patients diagnosed between 60 and 79 years (OS 84.7%), 0–19 years (OS: 87.1%), 40–59 years (OS: 90.2%), and 20–39 years (OS: 92.6%). When considering all age-groups, race was not a significant predictor of death (HR 0.91; 95% CI, 0.72–1.15). However, in a stratified analysis with 20-year age groups, Blacks had an increased risk of death as compared to Whites (Figure 1) in the 20–39 age group (HR: 2.94; 95% CI, 1.72–5.26; p<0.0001) and the 40–59 age group (HR: 1.67; 95% CI, 1.22–2.27; p=0.0069) while no differences were seen within the 0–19, 60–79 and 80+ age groups. Conclusions from OS models were similar to that of the CPS models. Conclusions: Through this analysis of population-based cancer registry data collected in the US between 2002 and 2009, we show that Blacks have a younger age at diagnosis with higher incidence rates observed in the 20–39 and 40–59 age-groups as compared to Whites. Both CPS and OS outcomes differed by race and age. Similar to the differences observed with the incidence rates, survival was worse in Blacks diagnosed within the 20–39 and 40–59 age-groups as compared to Whites. Although outcomes have globally improved in patients with CML since the advent of tyrosine kinase inhibitors, the persistence of incidence heterogeneity and poorer survival among Blacks warrants further attention. Access to care may be a possible reason for the differences observed but further studies are warranted to rule out biological differences which may be causing an earlier age at onset and poorer survival. Disclosures: No relevant conflicts of interest to declare.

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Kaposi Sarcoma Rates Among Persons Living With Human Immunodeficiency Virus in the United States: 2008—2016

Clinical Infectious Diseases ◽

10.1093/cid/ciaa999 ◽

2020 ◽

Author(s):

Qianlai Luo ◽

Anna Satcher Johnson ◽

H Irene Hall ◽

Elizabeth K Cahoon ◽

Meredith Shiels

Keyword(s):

Human Immunodeficiency Virus ◽

Age Groups ◽

Kaposi Sarcoma ◽

Cancer Registries ◽

The United States ◽

Geographic Region ◽

Incidence Rates ◽

Younger Age ◽

Immunodeficiency Virus ◽

Racial Ethnic

Abstract Background Recent studies have suggested that Kaposi sarcoma (KS) rates might be increasing in some racial/ethnic groups, age groups, and US regions. We estimated recent US trends in KS incidence among people living with human immunodeficiency virus (HIV; PLWH). Methods Incident KS patients aged 20–59 years were obtained from 36 cancer registries and assumed to be living with HIV. The number of PLWH was obtained from national HIV surveillance data from 2008 to 2016. Age-standardized KS rates and annual percent changes (APCs) in rates were estimated by age, sex, race/ethnicity, state, and region. Results Between 2008 and 2016, the age-adjusted KS rate among PLWH was 116/100 000. Rates were higher among males, in younger age groups, and among white PLWH. Washington, Maine, and California had the highest KS rates among PLWH. KS rates among PLWH decreased significantly (average APC = −3.2% per year, P < .001) from 136/100 000 to 97/100 000 between 2008 and 2016. There were no statistically significant increases in KS rates in any age, sex, or racial/ethnic group or in any geographic region or state. However, there were nondecreasing trends in some states and in younger age groups, primarily among black PLWH. Conclusions KS incidence rates among PLWH have decreased nationally between 2008 and 2016. Though there were no statistically significant increases in KS rates in any demographic or geographic group, nondecreasing/stagnant KS trends in some states and among younger and black PLWH highlight the need for early diagnosis and treatment of HIV infection.

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Factors associated with increasing campylobacteriosis incidence in Michigan, 2004–2013

Epidemiology and Infection ◽

10.1017/s095026881600159x ◽

2016 ◽

Vol 144 (15) ◽

pp. 3316-3325 ◽

Cited By ~ 8

Author(s):

W. CHA ◽

T. HENDERSON ◽

J. COLLINS ◽

S. D. MANNING

Keyword(s):

Risk Factors ◽

Disease Surveillance ◽

Age Groups ◽

Spatial Analyses ◽

Factors Associated ◽

Disease Surveillance System ◽

Animal Density ◽

Increased Risk ◽

Increasing Trend ◽

Case Data

SUMMARYThis study was conducted to examine the incidence trend of campylobacteriosis in Michigan over a 10-year period and to investigate risk factors and clinical outcomes associated with infection. Campylobacter case data from 2004 to 2013 was obtained from the Michigan Disease Surveillance System. We conducted statistical and spatial analyses to examine trends and identify factors linked to campylobacteriosis as well as ecological associations using animal density data from the National Agricultural Statistics Service. An increasing trend of Campylobacter incidence and hospitalization was observed, which was linked to specific age groups and rural residence. Cases reporting ruminant contact and well water as the primary drinking source had a higher risk of campylobacteriosis, while higher cattle density was associated with an increased risk at the county level. Additional studies are needed to identify age-specific risk factors and examine prevalence and transmission dynamics in ruminants and the environment to aid in the development of more effective preventive strategies.

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Carbapenem Resistant Enterobacteriaceae infections in Houston, Texas: An outline

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v9i1.7677 ◽

2017 ◽

Vol 9 (1) ◽

Author(s):

Hafeez Rehman ◽

Imran Shaikh ◽

Kasimu Muhetaer ◽

Salma Khuwaja

Keyword(s):

Health Care ◽

Disease Surveillance ◽

Age Groups ◽

Acute Care Hospital ◽

Resistant Bacteria ◽

Care Hospital ◽

Term Care ◽

Health Care Settings ◽

Disease Surveillance System ◽

Enterobacteriaceae Infections

ObjectiveTo examine demographic as well as clinical characteristics of theCarbapenam Resistant Enteriobacteriacae (CRE) Organisms cases inHouston, Texas, 2015-2016IntroductionAccording to CDC, CRE is used to describe bacteria that are non-susceptible to one or more carbapenems; doripenem, meropenemor imipenem and resistant to third generation cephalosporins likeceftriaxone, cefotaxime and ceftazidime. These organisms causeinfections that are associated with high mortality rates and they havethe potential to spread widely. Antibiotic resistant bacteria causemore than 2 million illnesses and at least 23,000 deaths each year inUnited States. CREs are found in many health care settings like acutecare hospitals, long term care facilities, nursing homes, rehabilitationfacilities and other health care settings. Although CREs includes anumber of species, reporting in State of Texas is limited to CRE-Klebsiellaspecies and CRE-E.coli.MethodsPopulation-based surveillance data was generated from Houston’selectronic disease surveillance system reported to Houston HealthDepartment (HHD) from October 2015 to July 2016. Descriptiveanalysis was performed to examine demographic and clinicalcharacteristics across different age groups, gender and race/ethnicity.HHD has received a total of 463 CRE cases during the time period,out of which 72 were non-reportable and did not meet the casecriteria, 187 were out of jurisdiction. The remaining 204 cases wereincluded in this study.ResultsOut of a total of 204 cases, males and females were representedequally (50% each). The mean age of the cases was 67 years(age ranges from 22-98). Majority of the cases were in the older agegroup, 70 years and above 53 (26%), followed by 48 (24%) in agegroup 80 and above years. Among the different race/ethnic groups,African-Americans comprised of 82 (40%), followed by Whites67 (33%) and Hispanics 33 (16%). Out of 204 cases, 156 (76%)were hospitalized, which included acute care hospital, long-termacute care or nursing home. Out of 156 hospitalized cases, 71 (34%)were in Intensive Care Unit (ICU) and 136 (67%) had an invasiveor indwelling device. Of all the cases, 80% had CREKlebsiellapneumoniae, followed by 11% who had CRE- E coli. The cases weredistributed evenly across the city when plotted on ArcGIS with theirresidential addresses.ConclusionsCRE cases are found to be more common among older age groups,African American population and in hospitalized patients. CRE canbe a ground for increasing infectious diseases in the community andone of the reason may be unnecessary use of antimicrobial agents.This study provides a glimpse into the number of CRE cases reportedin Houston since CREs are classified a separate disease in Texas.Further studies are needed to explore the occurrence of anti-microbialdrug resistance among the specific population groups and how thecase investigation efforts can be targeted to enhance prevention.

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LESSONS FROM THE COVID-19 THIRD WAVE IN CANADA: THE IMPACT OF VARIANTS OF CONCERN AND SHIFTING DEMOGRAPHICS

10.1101/2021.08.27.21261857 ◽

2021 ◽

Author(s):

Finlay A McAlister ◽

Majid Nabipoor ◽

Anna Chu ◽

Douglas Lee ◽

Lynora Saxinger ◽

...

Keyword(s):

Age Groups ◽

Vaccine Hesitancy ◽

First Year ◽

Third Wave ◽

Wild Type ◽

Lengths Of Stay ◽

Younger Age ◽

Canadian Provinces ◽

Event Rates ◽

The Impact

Importance: With the emergence of more transmissible SARSCoV2 variants of concern (VOC), there is an urgent need for evidence about disease severity and the health care impacts of VOC in North America, particularly since a substantial proportion of the population have declined vaccination thus far. Objective: To examine 30day outcomes in Canadians infected with SARSCoV2 in the first year of the pandemic and to compare event rates in those with VOC versus wild type infection. Design: Retrospective cohort study using linked healthcare administrative datasets. Setting: Alberta and Ontario, the two Canadian provinces that experienced the largest third wave in the spring of 2021. Participants: All individuals with a positive SARSCoV2 reverse transcriptase polymerase chain reaction swab from March 1, 2020 until March 31, 2021, with genomic confirmation of VOC screen positive tests during February and March 2021 (wave 3). Exposure of Interest: VOC versus wild type SARSCoV2 Main Outcomes and Measures: All-cause hospitalizations or death within 30 days after a positive SARSCoV2 swab. Results: Compared to the 372,741 individuals with SARSCoV2 infection between March 2020 and January 2021 (waves 1 and 2 in Canada), there was a shift in transmission towards younger patients in the 104,232 COVID19 cases identified in wave 3. As a result, although third wave patients were more likely to be hospitalized (aOR 1.34 [1.29 to 1.39] in Ontario and aOR 1.53 [95%CI 1.41 to 1.65] in Alberta), they had shorter lengths of stay (median 5 vs. 7 days, p<0.001) and were less likely to die within 30 days (aOR 0.66 [0.60 to 0.71] in Ontario and aOR 0.74 [0.62 to 0.89] in Alberta). However, within the third wave, patients infected with VOC (91% Alpha) exhibited higher risks of death (aOR 1.52 [1.27 to 1.81] in Ontario and aOR 1.67 [1.13 to 2.48] in Alberta) and hospitalization (aOR 1.57 [1.47 to 1.69] in Ontario and aOR 1.88 [1.74 to 2.02] in Alberta) than those with wild-type SARSCoV2 infections during the same timeframe. Conclusions and Relevance: On a population basis, the shift towards younger age groups as the COVID19 pandemic has evolved translates into more hospitalizations but shorter lengths of stay and lower mortality risk than seen in the first 10 months of the pandemic in Canada. However, on an individual basis, infection with a VOC is associated with a higher risk of hospitalization or death than the original wild type SARSCoV2; this is important information to address vaccine hesitancy given the increasing frequency of VOC infections now.

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Changes in Hysterectomy Route and Adnexal Removal for Benign Disease in Australia 2001–2015: A National Population-Based Study

Minimally Invasive Surgery ◽

10.1155/2018/5828071 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Natalie De Cure ◽

Stephen J. Robson

Keyword(s):

Age Groups ◽

Laparoscopic Hysterectomy ◽

Abdominal Hysterectomy ◽

Population Based ◽

Incidence Rates ◽

Older Age ◽

Age Group ◽

Female Population ◽

Younger Women ◽

Younger Age

Objective. Hysterectomy rates have fallen over recent years and there remains debate whether salpingectomy should be performed to reduce the lifetime risk of ovarian cancer. We examined trends in adnexal removal and route of hysterectomy in Australia between 2001 and 2015. Methods. Data were obtained from the national procedural dataset for hysterectomy approach (vaginal, VH; abdominal, AH; and, laparoscopic, LH) and rates of adnexal removal, as well as endometrial ablation. The total female population in two age groups (“younger age group,” 35 to 54 years, and “older age group,” 55 to 74 years) was obtained from the Australian Bureau of Statistics. Results. The rate of hysterectomy fell in both younger (61.7 versus 45.2/10000/year, p<0.005) and older (38.8 versus 33.2/10000/year, p<0.005) age groups. In both age groups there were significant decreases in the incidence rates for VH (by 53% in the younger age group and 29% in the older age group) and AH (by 53% and 55%, respectively). The rates of LH increased by 153% in the younger age group and 307% in the older age group. Overall, the proportion of hysterectomies involving adnexal removal increased (31% versus 65% in the younger age group, p<0.005; 44% versus 58% in the older age group, p<0.005). The increase occurred almost entirely after 2011. Conclusion. Hysterectomy is becoming less common, and both vaginal and abdominal hysterectomy are being replaced by laparoscopic hysterectomy. Removal of the adnexae is now more common in younger women.

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