Abstract P585: Age- and Sex-Specific Temporal Trends in the Incidence of Pediatric Stroke in New York State From 2006-2016

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Husitha R Vanguru ◽  
Nnabuchi Anikpezie ◽  
Karen C Albright ◽  
Julius G Latorre ◽  
Fadar O Otite
Keyword(s):  
New York ◽  
Census Data ◽  
Systems Of Care ◽  
New York State ◽  
Temporal Trends ◽  
Pediatric Stroke ◽  
Total N ◽  
Stroke Incidence ◽  
Over Time ◽  
Age And Sex

Objectives: 1. To estimate sex- and race-specific incidence of pediatric stroke by age group 2. To describe trends in pediatric stroke incidence in New York(NY) from 2006 to 2016 Methods: International Classification of Disease codes were used to retrospectively to identify all acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), and cerebral venous thrombosis (CVT) admissions in pediatric patients (0-19 years old [yo]) in the 2006-2016 NY State Inpatients Database (SID; total N=4,083). Incident counts were combined with annual US Census data to compute age- and sex-specific incidence. Joinpoint regression was used to evaluate trends in incidence over time. Results: Across the study period, 52% of all pediatric strokes were AIS, 23% ICH, 11% SAH, and 14% CVT. Total stroke incidence/100,000 population was 47.8 and the age-standardized incidence in >=1yo was 4.8. Incidence differed by age (1-4yo: 4.4, 5-9yo: 3.6, 10-14yo: 4.5, and 15-19yo: 6.7), but not by sex. Age-standardized incidence of strokes in >=1yo also differed by race (Blacks 5.9, Whites 4.0, Hispanics 3.3, Asians/Pacific Islanders 3.1). While there was no change in overall stroke, AIS, or SAH incidence, ICH (annualized percentage change [APC] 4.3%, 95%CI 1.7-6.9) and CVT (APC 4.1, 95%CI 1.22-6.25%) increased over time. When stratified by age, overall stroke incidence increased over time in 15-19 yo (APC 1.3%, 95%CI 0.27-2.35, p=0.019), but not in other age groups. Conclusion: We observed increasing incidence in pediatric ICH, CVT, and overall stroke in 15-19 yo in the state of NY. Pediatric stroke incidence in NY is disproportionately higher in blacks compared to other races. Further investigation is warranted to determine the association of these changes with risk factors, lifestyle and systems of care.

scholarly journals Trends in incidence and epidemiologic characteristics of cerebral venous thrombosis in the United States

Neurology ◽  
2020 ◽  
Vol 95 (16) ◽  
pp. e2200-e2213 ◽  
Author(s):  
Fadar Oliver Otite ◽  
Smit Patel ◽  
Richa Sharma ◽  
Pushti Khandwala ◽  
Devashish Desai ◽  
...  
Keyword(s):  
United States ◽  
New York ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Census Data ◽  
Age Groups ◽  
The United States ◽  
Joinpoint Regression ◽  
Over Time ◽  
Age And Sex

ObjectiveTo test the hypothesis that race-, age-, and sex-specific incidence of cerebral venous thrombosis (CVT) has increased in the United States over the last decade.MethodsIn this retrospective cohort study, validated ICD codes were used to identify all new cases of CVT (n = 5,567) in the State Inpatients Databases (SIDs) of New York and Florida (2006–2016). A new CVT case was defined as first hospitalization for CVT in the SID without prior CVT hospitalization. CVT counts were combined with annual Census data to compute incidence. Joinpoint regression was used to evaluate trends in incidence over time.ResultsFrom 2006 to 2016, annual age- and sex-standardized incidence of CVT in cases per 1 million population ranged from 13.9 to 20.2, but incidence varied significantly by sex (women 20.3–26.9, men 6.8–16.8) and by age/sex (women 18–44 years of age 24.0–32.6, men 18–44 years of age 5.3–12.8). Incidence also differed by race (Blacks: 18.6–27.2; Whites: 14.3–18.5; Asians: 5.1–13.8). On joinpoint regression, incidence increased across 2006 to 2016, but most of this increase was driven by an increase in all age groups of men (combined annualized percentage change [APC] 9.2%, p < 0.001), women 45 to 64 years of age (APC 7.8%, p < 0.001), and women ≥65 years of age (APC 7.4%, p < 0.001). Incidence in women 18 to 44 years of age remained unchanged over time.ConclusionCVT incidence is disproportionately higher in Blacks compared to other races. New CVT hospitalizations increased significantly over the last decade mainly in men and older women. Further studies are needed to determine whether this increase represents a true increase from changing risk factors or an artifactual increase from improved detection.

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.

Abstract 20: Patterns of Stroke Center Certification and the Impact on Stroke Mortality in Counties of New York State

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Emily Chapman ◽  
Kurt A Yaeger ◽  
J D Mocco
Keyword(s):  
New York ◽  
Socioeconomic Status ◽  
Household Income ◽  
New York State ◽  
Stroke Care ◽  
Stroke Mortality ◽  
Median Household Income ◽  
Stroke Incidence ◽  
York State ◽  
The Relationship

Introduction: To establish a statewide stroke system in March 2019, New York State (NYS) created the Stroke Designation Program. Stroke centers (SCs) must be certified by a state-approved certifying organization (CO), which is tasked with initial designation and ongoing re-certification. Previous research has found an association at the national level between socioeconomic status and access to higher levels of acute stroke care. Objective: This study characterizes the relationship between socioeconomic status of NYS populations and stroke care level access by comparing median household income and wealth in counties with and without certified SCs. Methods: Population and median household income from the U.S. Census (2010), stroke epidemiological data from the Center for Disease Control, and Area Deprivation Index (ADI) data (ranked within NYS) from the Neighborhood Atlas, a project that quantifies disadvantage by census tract, were collected and averaged for each county. Income has been used to assess local wealth and ADI to analyze community health risks. Certification data were mined from quality check databases for The Joint Commission and Det Norske Veritas, the most commonly used COs. Student’s t-tests compared income and ADI in counties with at least one certified SC to those without. Linear regression characterized the relationship between income and ADI with number of certified SCs, stroke incidence and stroke mortality. Results: All 62 counties in NYS were investigated to yield 40 certified SCs. Counties with at least one certified SC had a significantly higher income ($68,183.63 vs. $57,155.12; p=0.03) and lower ADI (5.90 vs. 7.37; p=0.004) compared to counties with no certified SC. Higher income (p<0.001) and lower ADI (p<0.001) were also associated with more certified SCs. Counties with fewer certified SCs had significantly higher stroke mortality (p<0.001) despite having similar stroke incidence. Conclusion: Socioeconomic heterogeneity in NYS counties is correlated to differential access to certified SCs and quality stroke care, as fewer centers are found in lower-income and disadvantaged communities. Although populations with less access experience stroke at similar rates, this study finds higher death rates in these counties.

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 Temporal Trends in Stroke Incidence Over Time by Sex and Age in the GCNKSS

Stroke ◽  
2020 ◽  
Vol 51 (4) ◽  
pp. 1070-1076 ◽  
Author(s):  
Tracy E. Madsen ◽  
Jane C. Khoury ◽  
Michelle Leppert ◽  
Kathleen Alwell ◽  
Charles J. Moomaw ◽  
...  
Keyword(s):  
Temporal Trends ◽  
Stroke Incidence ◽  
Over Time

scholarly journals Three months of informational trends in COVID-19 across New York City

2020 ◽  
Vol 42 (3) ◽  
pp. 448-450
Author(s):  
Wil Lieberman-Cribbin ◽  
Naomi Alpert ◽  
Adam Gonzalez ◽  
Rebecca M Schwartz ◽  
Emanuela Taioli
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Information Seeking ◽  
New York State ◽  
Search Term ◽  
Multiple Sources ◽  
The Usa ◽  
Trend Data ◽  
Over Time

Abstract In the midst of widespread community transmission of coronavirus disease 2019 (COVID-19) in New York, residents have sought information about COVID-19. We analyzed trends in New York State (NYS) and New York City (NYC) data to quantify the extent of COVID-19-related queries. Data on the number of 311 calls in NYC, Google Trend data on the search term ‘Coronavirus’ and information about trends in COVID-19 cases in NYS and the USA were compiled from multiple sources. There were 1228 994 total calls to 311 between 22 January 2020 and 22 April 2020, with 50 845 calls specific to COVID-19 in the study period. The proportion of 311 calls related to COVID-19 increased over time, while the ‘interest over time’ of the search term ‘Coronavirus’ has exponentially increased since the end of February 2020. It is vital that public health officials provide clear and up-to-date information about protective measures and crucial communications to respond to information-seeking behavior across NYC.

scholarly journals Temporal Trends in COVID-19 associated AKI from March to December 2020 in New York City

2021 ◽  
Author(s):  
Sergio Dellepiane ◽  
Akhil Vaid ◽  
Suraj K Jaladanki ◽  
Ishan Paranjpe ◽  
Steven Coca ◽  
...  
Keyword(s):  
United States ◽  
New York ◽  
Acute Kidney Injury ◽  
New York City ◽  
Renal Replacement Therapy ◽  
York City ◽  
Temporal Trends ◽  
Kidney Injury ◽  
Clinical Approach ◽  
Over Time

AbstractAcute Kidney Injury (AKI) is among the most common complications of Coronavirus Disease 2019 (COVID-19). Throughout 2020 pandemic, the clinical approach to COVID-19 has progressively improved, but it is unknown how these changes have affected AKI incidence and severity. In this retrospective analysis, we report the trend over time of COVID-19 associated AKI and need of renal replacement therapy in a large health system in New York City, the first COVID-19 epicenter in United States.

Abstract 4: Variation and Temporal Trends in the Characteristics of US Hospitals Treating Acute Ischemic Stroke Patients with IV-tPA: Findings from GWTG-Stroke

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Lee H Schwamm ◽  
Syed F Ali ◽  
Mathew J Reeves ◽  
Eric E Smith ◽  
Jeffrey L Saver ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Systems Of Care ◽  
Team Building ◽  
Temporal Trends ◽  
High Volume ◽  
Wilcoxon Test ◽  
Chi Square ◽  
Over Time ◽  
Iv Tpa

Introduction: Utilization of IV tPA is challenging for many hospitals. Using data from the national Get With The Guidelines-Stroke program, we analyzed changes over time in the characteristics of the hospitals that treated patients with tPA. Methods: We analyzed patient-level data from 2003-2011 at 1600 GWTG hospitals that joined the program at any time during the study period and admitted any acute ischemic stroke (AIS) patients arriving ≤ 2 hr of onset and eligible for tPA. Descriptive trends by time were analyzed by chi-square or Wilcoxon test for continuous data. Results: IV tPA was given within 3 hr at 1394 sites to 50,798/ 75,115 (67.6%) eligible AIS patients arriving ≤ 2 hr; 206 (14.8%) sites had a least one eligible patients but no tPA use. IV tPA treatment rates varied substantially across hospitals (median 61.2%, range 0-100%), with > 200 hospitals providing tPA < 10% of the time (Figure). Over time, more patients and a larger proportion of patients were treated at smaller (median bed size 407 vs. 372, p< 0.001), non-academic, Southern hospitals, and those with lower annualized average ischemic stroke volumes (252.4 vs. 235.2, p< 0.001) (Table). While more than half of all tPA patients were treated at Primary Stroke Centers, this proportion did not change over time. The proportion of patients treated at high volume tPA treatment sites (average > 20/year) increased over time (31.9 vs. 34.5, p< 0.007). Conclusion: Over the past decade, while primary stroke centers still account for more than half of all treatments, tPA has been increasingly delivered in smaller, non-academic hospitals. These data support the continued emphasis on stroke team building and systems of care at US hospitals.

Abstract P372: Coronary Angiography Use, Results and Revascularization Trends in Olmsted County, Minnesota, 2000 to 2015

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Yariv L Gerber ◽  
Susan Weston ◽  
Jill Killian ◽  
Matteo Fabbri ◽  
Sheila Manemann ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Regression Models ◽  
Direct Method ◽  
Coronary Revascularization ◽  
Temporal Trends ◽  
Olmsted County ◽  
Left Main ◽  
Logistic Regression Models ◽  
Over Time ◽  
Age And Sex

Background: A decline in all forms of coronary revascularization has been previously reported. Whether the decline has continued after the turn of the century is unknown as well as whether it is influenced by trends in the use and results of coronary angiography. Methods: All diagnostic and therapeutic coronary procedures performed among Olmsted County, MN residents from 2000-2015 were analyzed. Standardized rates (per 100,000 population) were calculated applying the direct method and temporal trends compared using Poisson regression models. Trends in disease severity, defined as 3-vessel and/or left main coronary artery disease (CAD), were assessed using logistic regression models. Results: Between 2000 and 2015, 11,691 coronary angiographies were performed (63% men; 54% ≥ 65 years of age). The age- and sex-standardized rates of angiography decreased over time (p trend < 0.001; Figure). Overall, 30% of the subjects had 3-vessel and/or left main CAD, and this proportion decreased over time (age- and sex-adjusted odds ratios (95% CI) for severe CAD: 0.68 (0.62-0.76) in 2005-2009 and 0.69 (0.63-0.77) in 2010-2015 compared with 2000-2004). Among 5,222 coronary revascularization procedures performed, 78% were PCI and 22% CABG. The age- and sex-standardized rates of any revascularization declined during the study period, reflecting temporal decreases in both PCI and CABG (all p trend < 0.001; Figure). The declines in angiography rates, CAD severity, and revascularization utilization were consistently greater in women than men (all P for interactions < 0.01). Conclusions: Declines in all forms of coronary revascularization, which were greater in women than men, have occurred in Olmsted County, MN, from 2000-2015. The declines occurred in the context of fewer angiograms performed in the population and reduced severity of anatomic CAD.

Community stroke education practices in New York State designated stroke centres

2019 ◽  
Vol 78 (8) ◽  
pp. 1012-1019
Author(s):  
Olajide Williams ◽  
Ellyn Leighton-Herrmann Quinn ◽  
Anna Colello ◽  
Crismely Perdomo ◽  
Ji Chong ◽  
...  
Keyword(s):  
New York ◽  
Best Practice ◽  
Systems Of Care ◽  
New York State ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
York State ◽  
Stroke Education ◽  
Stroke Systems Of Care

Objective: Community stroke education is a regulated, integral component of stroke systems of care. However, little is known about the types of activities conducted by hospitals. This study was designed to examine the annual requirement for community stroke education among New York State’s 119 designated Primary Stroke Centres and identify areas for improvement that may have an implication on stroke outcomes. Design: Cross-sectional survey design Setting: All 119 New York State designated Primary Stroke Centres were invited to participate. Methods: Participating hospitals completed a 29-item online questionnaire assessing multiple domains related to community stroke education including hospital characteristics, allocated resources, implementation barriers, current community stroke education practices and willingness to adopt best practice guidelines. Data were analysed using univariate descriptive and chi-square statistics. Results: Eighty-eight percent of hospitals completed the survey (105/119). Respondents were mostly stroke coordinators and stroke directors. Stroke outreach education was conducted two to four times per year in 58% of the hospitals ( n = 69). Community stroke education included behavioural risk factor modification, the detection of stroke risk through screening and stroke preparedness education at health fairs. Although 95% of hospitals ( n = 98) reported using at least one best practice approach for these activities, evaluation was generally poor, with only about 23% ( n = 24) implementing outcome-specific assessments. Major barriers to stroke outreach were inadequate staffing, time constraints and lack of funding. Conclusion: Hospital-driven community stroke education efforts occur infrequently and are poorly evaluated. This component of stroke systems of care would benefit from guidelines from regulatory agencies, which currently do not exist.

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