Abstract TMP90: Trends in Tracheostomy after Stroke: Analysis of the 1993-2013 Nationwide Inpatient Sample

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Abhinaba Chatterjee ◽  
Gino Gialdini ◽  
Santosh Murthy ◽  
Hooman Kamel ◽  
Alexander E Merkler
Keyword(s):  
Nationwide Inpatient Sample ◽  
Secondary Analysis ◽  
Descriptive Statistics ◽  
Multivariate Logistic Regression ◽  
Severe Stroke ◽  
The Past ◽  
Exact Confidence Intervals ◽  
The Mean ◽  
Stroke Type ◽  
Procedure Codes

Background: Tracheostomy is a potentially life-sustaining procedure for patients with severe stroke, yet trends in its use are not well known. Methods: Patients presenting with ischemic stroke (IS), intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH) were identified from the 1993 to 2013 Nationwide Inpatient Sample using previously validated ICD-9-CM codes. Our outcome was tracheostomy, also defined using previously validated procedure codes. Survey weights and descriptive statistics with exact confidence intervals [CI] were used to report rates of tracheostomy, stratified by stroke type. In a secondary analysis, we used multivariate logistic regression to assess rates of tracheostomy stratified by age, race, and sex. Results: From 1993-2013, 13,729,365 patients (95% CI, 13,103,569-14,355,160) were hospitalized in the U.S. with IS, ICH, or SAH. Among these patients, 230,555 (1.7%; 95% CI, 1.6-1.8%) received a tracheostomy. The mean age of patients undergoing tracheostomy was 58.9 (±19.8) years. Rates of tracheostomy use were 1.1% (95% CI, 1.0-1.5%) after IS, 3.8% (95% CI, 3.6-4.0%) after ICH, and 6.2% (95% CI, 5.8-6.6%) after SAH. Tracheostomy was more common in men (OR, 1.32; 95% CI, 1.30-1.35), non-whites (OR, 2.04; 95% CI, 2.00-2.09), and those ≤60 years of age (OR, 2.33; 95% CI, 2.30-2.37). The overall rate of tracheostomy use after any type of stroke increased from 1.2% in 1993 to 2.0% in 2013 (p <0.001). This trend was more pronounced in patients with ICH and SAH than in patients with IS (Figure 1). Tracheostomy use increased annually by 0.9% (p <0.001) among patients ≤60 years of age versus 1.7% (p <0.001) among patients >60 years of age, and by 2.7% (p <0.001) among men versus 0.02% (p <0.05) among women. Conclusion: Over the past two decades, the use of tracheostomy appears to be increasing among patients admitted with stroke.

scholarly journals AUDIT OF EVOLVING ROLES OF LAPAROSCOPY IN THE CURRENT SURGICAL PRACTICE AT CHRIS HANI BARAGWANATH ACADEMIC HOSPITAL: A 5 YEAR REVIEW

2021 ◽  
Vol 8 (5) ◽  
pp. 16-24
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Standard Of Care ◽  
Descriptive Statistics ◽  
Academic Hospital ◽  
Surgical Practice ◽  
The Past ◽  
Wide Range ◽  
Accepted Standard ◽  
The Mean

Background: Laparoscopic surgery (LS) is gaining momentum and has revolutionised the practice of surgery. Over the past thirty years, LS has been used to manage a wide range of surgical pathologies and has become a recognised and generally accepted standard of care. Aim: The aim of this study is to describe the evolution of LS in selected procedures.. Methods: Data were collected from theatre registries. Statistical analysis was performed using the software IMB SPSS. The data were analysed using descriptive statistics of mean and standard deviation for age, and percentage and frequencies for categories of variables . Results: Of the 3745 patients involved in the study, 59.1% were males and 40.9% were females. The mean age of the patients was 35.17±17.30 years. Laparoscopic surgery was represented in 43.2% of the procedures, with laparoscopic appendicectomy (46.73%) and laparoscopic cholecystectomy (32.69%) being the most commonly performed procedures.. Twenty-five adrenalectomies were performed over the study period, and of those 12 (52%) were performed laparoscopically. All the thymectomies (12) were performed thoracoscopically, with one conversion. Conclusion: The findings of this study suggest that there has been an increase in the overall incidence of laparoscopic surgery in selected procedures at CHBAH.

scholarly journals Sex Workers’ Access to Police Assistance in Safety Emergencies and Means of Escape from Situations of Violence and Confinement under an “End Demand” Criminalization Model: A Five City Study in Canada

2021 ◽  
Vol 10 (1) ◽  
pp. 13
Author(s):  
Anna-Louise Crago ◽  
Chris Bruckert ◽  
Melissa Braschel ◽  
Kate Shannon
Keyword(s):  
Logistic Regression ◽  
Confidence Interval ◽  
Sex Workers ◽  
Racial Profiling ◽  
Descriptive Statistics ◽  
Multivariate Logistic Regression ◽  
Lower Odds ◽  
The Past ◽  
Police Harassment ◽  
Police Protection

There is limited available evidence on sex workers (SW) ability to access police protection or means of escaping situations of violence and confinement under an “end demand” criminalization model. Of 200 SW in five cities in Canada, 62 (31.0%) reported being unable to call 911 if they or another SW were in a safety emergency due to fear of police detection (of themselves, their colleagues or their management). In multivariate logistic regression, police harassment–linked to social and racial profiling in the past 12 months (being carded or asked for ID documents, followed by police or detained without arrest) (Adjusted Odd Ratio (AOR): 5.225, 95% Confidence Interval (CI): 2.199–12.417), being Indigenous (AOR: 2.078, 95% CI: 0.849–5.084) or being in Ottawa (AOR: 2.317, 95% CI: 0.865–6.209) were associated with higher odds of being unable to call 911, while older age was associated with lower odds (AOR: 0.941 per year older, 95% CI: 0.901–0.982). In descriptive statistics, of 115 SW who had experienced violence or confinement at work in the past 12 months, 19 (16.52%) reported the incident to police. Other sex workers with shared expenses were the most commonly reported group to have assisted sex workers to escape situations of violence or confinement in the past 12 months (n = 13, 35.14%). One of the least commonly reported groups to have assisted sex workers to escape situations of violence or confinement in the past 12 months were police (n = 2, 5.41%). The findings of this study illustrate how the current “end demand” criminalization framework compromises sex workers’ access to assistance in safety emergencies.

scholarly journals Geographic Disparities in the Surgical Management of Hemifacial Spasm in Canada

2018 ◽  
Vol 46 (1) ◽  
pp. 83-86
Author(s):  
Mohamed Somji ◽  
Anthony M. Kaufmann
Keyword(s):  
Length Of Stay ◽  
Health Information ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Descriptive Statistics ◽  
Geographic Disparities ◽  
Canadian Institute ◽  
The Mean ◽  
Procedure Codes ◽  
The Impact

AbstractBackgroundWe aimed to interrogate the Canadian Institute for Health Information (CIHI) database in order to determine the geographic distribution and outcomes of microvascular decompression (MVD) for the treatment of hemifacial spasm (HFS).MethodsThe CIHI database was searched from 2004 to 2017 for relevant diagnostic and procedure codes. A new database was populated with the following categories: year, institution, province, number of interventions per year, and mean length of stay. Descriptive statistics were generated. Provincial utilization rates of MVD for HFS were calculated.ResultsDuring the period 2004-17, we identified 671 MVDs performed for HFS at 20 centers across Canada. During the study period, 286 MVDs (42.6%) were performed at one center in Manitoba. Another 131 (19.5%) and 72 (10.7%) were performed at one center in British Columbia and Ontario, respectively. The remaining 182 (27.1%) MVDs for HFS were performed at 17 centers across the rest of Canada where the mean number of cases performed per year was 1.1 (SD=0.9, range 0.2-2.9). When out-of-province cases were re-allocated to place of residence, the adjusted provincial utilization of MVD for HFS ranged between 0.5 and 6.1 patients per million per year.ConclusionsMicrovascular decompression for HFS is performed relatively rarely and there is a tremendous geographic variation in utilization across Canada. Although most of these surgeries are performed by a few surgeons, more than half of Canadian centers perform an average of less than 1 case per year. Further examination of the impact of these discrepancies appears warranted.

Severe Maternal Morbidity and Hospital Cost among Hospitalized Deliveries in the United States

2018 ◽  
Vol 35 (13) ◽  
pp. 1287-1296 ◽  
Author(s):  
Suneet Chauhan ◽  
Sean Blackwell ◽  
Han-Yang Chen
Keyword(s):  
United States ◽  
Hospital Cost ◽  
Maternal Morbidity ◽  
Nationwide Inpatient Sample ◽  
Hospital Costs ◽  
The United States ◽  
Severe Maternal Morbidity ◽  
The Mean ◽  
Procedure Codes ◽  
Mean Cost

Objective The objective of this study was to estimate the contemporary national rate of severe maternal morbidity (SMM) and its associated hospital cost during delivery hospitalization. Study Design We conducted a retrospective study identifying all delivery hospitalizations in the United States between 2011 and 2012. We used data from the National (Nationwide) Inpatient sample of the Healthcare Cost and Utilization Project. The delivery hospitalizations with SMM were identified by having at least one of the 25 previously established list of diagnosis and procedure codes. Aggregate and mean hospital costs were estimated. A generalized linear regression model was used to examine the association between SMM and hospital costs. Results Of 7,438,946 delivery hospitalizations identified, the rate of SMM was 154 per 10,000 delivery hospitalizations. Without any SMM, the mean hospital cost was $4,300 and with any SMM, the mean hospital cost was $11,000. After adjustment, comparing to those without any SMM, the mean cost of delivery hospitalizations with any SMM was 2.1 (95% confidence interval: 2.1–2.2) times higher, and this ratio increases from 1.7-fold in those with only one SMM to 10.3-fold in those with five or more concurrent SMM. Conclusion The hospital cost with any SMM was 2.1 times higher than those without any SMM. Our findings highlight the need to identify interventions and guide research efforts to mitigate the rate of SMM and its economic burden.

GAMBARAN BEBAN KERJA MENTAL PADA DOSEN FAKULTAS X UNIVERSITAS X

2019 ◽  
Vol 2 (3) ◽  
Author(s):  
Kartiani Dewi ◽  
Suryani S ◽  
Ahmad Yamin
Keyword(s):  
Community Service ◽  
Mental Workload ◽  
Sampling Technique ◽  
Mean Value ◽  
Descriptive Statistics ◽  
Large Contribution ◽  
Mean Dimension ◽  
The Mean ◽  
Quantitative Descriptive ◽  
University Lecturers

Lecturers are responsible for implementing the three main responsibilities in university (Tridharma Perguruan Tinggi) with 12 credits to 16 credits each semester. However, many lecturers feel that the workload is very excessive. The purpose of this study was to describe the mental workload of lecturers at the Faculty of X Padjadjaran University. The method of this research was quantitative descriptive by using a total sampling technique involving 43 lecturers. Data collection used NASA-TLX instruments. Data were analysed using descriptive statistics. The results of the study showed that overall the mental workload of the Faculty of X Padjadjaran University lecturers was included in the high category both in education and teaching assignments (74.4%), research assignments (76.7%), and community service assignments (74.4%). ) Effort dimensions have the highest mean value that is equal to 51.8, while the dimensions that have the lowest mean are Perfomance dimension, namely 9.4, where the greater the mean dimension shows the large contribution in the mental workload felt by the lecturer. The conclusions, this study show that most lecturers have a high mental workload. It is suggested that the lecturers need to have balance numbers of tasks according to their abilities, balance the time working with recreation, and meet the needs of rest. The results of this study need to be followed up by examining methods or efforts that can reduce the lecturers' mental workload.

Scrub typhus (Orientia tsutsugamushi), A rapidly spreading epidemic in Chennai - A standalone lab experience

2016 ◽  
Vol 5 (09) ◽  
pp. 4896
Author(s):  
Sripriya C.S.* ◽  
Shanthi B. ◽  
Arockia Doss S. ◽  
Antonie Raj I. ◽  
Mohana Priya
Keyword(s):  
Scrub Typhus ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Orientia Tsutsugamushi ◽  
The Past ◽  
Igm Elisa ◽  
The Mean ◽  
Specific Symptoms ◽  
Symptoms And Signs

Scrub typhus (Orientia tsutsugamushi), is a strict intracellular bacterium which is reported to be a recent threat to parts of southern India. There is re-emergence of scrub typhus during the past few years in Chennai. Scrub typhus is an acute febrile illness which generally causes non-specific symptoms and signs. The clinical manifestations of this disease range from sub-clinical disease to organ failure to fatal disease. This study documents our laboratory experience in diagnosis of scrub typhus in patients with fever and suspected clinical symptoms of scrub typhus infection for a period of two years from April 2014 to April 2016 using immunochromatography and IgM ELISA methods. The study was conducted on 648 patients out of whom 188 patients were found to be positive for scrub typhus. Results also showed that pediatric (0 -12 years) and young adults (20 – 39 years) were more exposed to scrub typhus infection and female patients were more infected compared to male. The study also showed that the rate of infection was higher between September to February which also suggested that the infection rate is proportional to the climatic condition. Statistical analysis showed that the mean age of the patients in this study was 37.6, standard deviation was 18.97, CV % was 50.45. 

Descriptive statistics

2017 ◽  
Author(s):  
Andrew Gelman ◽  
Deborah Nolan
Keyword(s):  
Descriptive Statistics ◽  
Metabolic Rates ◽  
World Record ◽  
Linear Combinations ◽  
Record Times ◽  
Starting Point ◽  
Statistics Course ◽  
Scatter Plots ◽  
Economic Indexes ◽  
The Mean

Descriptive statistics is the typical starting point for a statistics course, and it can be tricky to teach because the material is more difficult than it first appears. The activities in this chapter focus more on the topics of data displays and transformations, rather than the mean, median, and standard deviation, which are covered easily in a textbook and on homework assignments. Specific topics include: distributions and handedness scores; extrapolation of time series and world record times for the mile run; linear combinations and economic indexes; scatter plots and exam scores; and logarithmic transformations and metabolic rates.

scholarly journals 797. Management of Patients with Multiple Clostridioides difficile Infection Recurrences using a Tapered-Pulsed Fidaxomicin Strategy

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S441-S442
Author(s):  
Xing Tan ◽  
Andrew M Skinner ◽  
Benjamin Sirbu ◽  
Larry H Danziger ◽  
Dale N Gerding ◽  
...  
Keyword(s):  
First Episode ◽  
Initial Symptom ◽  
Once Daily ◽  
The Past ◽  
Clostridioides Difficile ◽  
Time To Recurrence ◽  
Clostridioides Difficile Infection ◽  
The Mean ◽  
Systemic Antibiotics

Abstract Background There is a paucity of data assessing outcomes of alternate fidaxomicin strategies in patients with recurrent Clostridioides difficile infection (rCDI). The objective of our study is to evaluate a tapered-pulsed (T-P) fidaxomicin regimen that was administered immediately following a course of CDI treatment with initial symptom resolution in patients with multiple rCDI. Methods We reviewed the characteristics and outcomes of 46 consecutive patients who received T-P fidaxomicin between January 1, 2014-June 30, 2019 in a specialty CDI clinic. The first episode in which fidaxomicin T-P was administered was analyzed. Failure was defined as the persistence of diarrhea and/or the need for additional CDI treatment at any time on T-P fidaxomicin. Sustained clinical cure (SCC) was defined as resolution of diarrhea without recurrence. Recurrence was defined as the return of diarrhea requiring retreatment with CDI therapy after completion of T-P fidaxomicin. Both SCC and recurrence were evaluated at 30 and 90 days after completion of T-P fidaxomicin. Results The mean±SD age of the 46 patients was 63.2±19.9 years, 71.7% were female, and the mean±SD CDI episodes within the past year was 3±1.4 . Most patients (73.9%) had previously failed a vancomycin tapered and/or pulsed regimen. Prior to administering T-P fidaxomicin, a treatment regimen was given to ensure resolution of symptoms. The CDI treatment most commonly used (58.7%) was vancomycin. The T-P fidaxomicin regimen used consisted of 200 mg given once daily for 7 days followed by 200 mg every other day for a median (min-max) duration of 33 (6-120) days. Two patients (4%) failed to respond to T-P fidaxomicin; 34 (74%) and 28 (61%) achieved SCC at 30 and 90 days, respectively. Among the 44 patients that successfully completed the T-P fidaxomicin regimen, recurrence developed in 10 (22.7%) and 16 (36.4%) of patients at 30 and 90 days, respectively, with a median (min-max) time to recurrence of 20 (3-87) days (Figure 1). Four patients with recurrence had received subsequent systemic antibiotics. Figure 1. Course of CDI therapy and follow-up Conclusion A tapered-pulsed fidaxomicin strategy may be effective in patients with multiply rCDI who are refractory to other treatments, including a vancomycin tapered and pulsed regimen. Disclosures Larry H. Danziger, PharmD, Merck (Speaker’s Bureau)

Evaluating psychiatrists’ attitudes and expectations about pharmacists’ role in psychiatry in Jordan

2021 ◽  
Author(s):  
Derar H Abdel-Qader ◽  
Esraa E Al Jomaa ◽  
Jennifer Silverthorne ◽  
Walid Shnaigat ◽  
Salim Hamadi ◽  
...  
Keyword(s):  
Mental Illness ◽  
Logistic Regression ◽  
Response Rate ◽  
Psychotropic Medications ◽  
Descriptive Statistics ◽  
Multivariate Logistic Regression ◽  
Current Role ◽  
Electronic Survey ◽  
Survey Response Rate

Abstract Objectives Evaluating Jordanian pharmacists’ roles in psychiatry from psychiatrists perspective. Methods An electronic survey was sent to 100 psychiatrists registered in the Jordanian Psychiatrists Association. Statistical analysis included descriptive statistics and multivariate logistic regression. Key findings A total of 80 psychiatrists completed the survey (response rate 80%). Most psychiatrists thought that pharmacists are unable to give individuals with mental illness enough time to discuss their medications (62/80, 77.6%) and to monitor psychotropic medications (PM) efficacy (50/80, 62.6%). Around half of respondents thought that, in the future, pharmacists would not be able to suggest PM for patients (42/80, 52.6%), nor changes in PM dosages (37/80, 46.3%). Most psychiatrists emphasized the importance of psychiatric courses to improve pharmacists’ role. Conclusion Although psychiatrists were generally not satisfied with the current role of pharmacists, they had positive expectations about pharmacists’ competency to do certain activities and to assist them in designing drug therapy plans.

Increasing author counts in neurosurgical journals from 1980 to 2020

2021 ◽  
pp. 1-5
Author(s):  
Tyler S. Cole ◽  
Mark A. Pacult ◽  
Michael T. Lawton
Keyword(s):  
Scientific Productivity ◽  
Academic Journals ◽  
Publication Type ◽  
Medical Specialties ◽  
The Past ◽  
The Mean ◽  
Scopus Database ◽  
Publication Volume ◽  
Over Time ◽  
Number Of Authors

OBJECTIVE Scientific productivity, as assessed by publication volume, is a common metric by which the academic neurosurgical field assesses its members. The number of authors per peer-reviewed article has been observed to increase over time across a broad range of medical specialties. This study provides an update to this trend in the neurosurgical literature. METHODS All publications from January 1, 1980, to April 30, 2020, were queried from four neurosurgical journals: Neurosurgery, Journal of Neurosurgery (JNS), JNS: Pediatrics, and JNS: Spine. Publication information was acquired from the National Center for Biotechnology Information Entrez database and reconciled with the Scopus database. Publication type was limited to articles and excluded editorials, letters, and reviews. The number of authors and affiliation counts were determined based on structured abstract fields provided in the two databases. RESULTS Between January 1, 1980, and April 30, 2020, the overall increase in author count for the four neurosurgical journals was 0.12 to 0.18 authors per year (p < 0.001). For Neurosurgery, the mean (SD) author count increased from 2.81 (1.4) in 1980–1985 to 7.97 (4.92) in 2016–2020 (p < 0.001). For the JNS, the mean (SD) author count increased from 2.82 (1.04) in 1980–1985 to 7.6 (3.65) in 2016–2020 (p < 0.001). The percentage of articles with more than 10 authors increased from 0.2% to 22.3% in Neurosurgery and from 1.9% to 17.5% in JNS. Only 28% of the author count variation was explained by an increasing number of institutional or departmental affiliations. CONCLUSIONS Author counts for peer-reviewed articles in neurosurgical academic journals have increased significantly during the past 4 decades, with large increases in the numbers of articles with more than 10 authors in the past 5 years. A total of 28% of the variation in this increase can be explained by an increase in multiinstitutional or multidepartmental studies.

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