Changes in the prevalence of hospitalization and comorbidity in US adults with stroke: A three decade cross-sectional and birth cohort analysis

2016 ◽  
Vol 11 (9) ◽  
pp. 987-998 ◽  
Author(s):  
Longjian Liu ◽  
Xuan Yang ◽  
Yong Long ◽  
Arshpreet Kaur Mallhi ◽  
Kathan Mehta ◽  
...  
Keyword(s):  
Cohort Analysis ◽  
Age Groups ◽  
Hospitalization Rate ◽  
Birth Cohorts ◽  
Clinical Practices ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Old Adults ◽  
Hospitalization Rates

Background and purpose Little attention was paid to the transition of care for stroke that may partially explain the long-term trend of stroke rates. We aimed to test the trend of hospitalization attributable to stroke in US adults. Methods Data from National Hospital Discharge Surveys 1980–2010 in patients aged ≥18 (n = 6,527,304) were analyzed to examine the trend of patients with first-list diagnoses of stroke. Stroke comorbidities were classified in stroke patients with second- to seven-listed diagnoses of coronary heart disease, hypertension, diabetes, arrhythmias, or hyperlipidemia. Stroke trends by survey years and birth cohorts were analyzed using univariate, multivariate, and birth cohorts methods. Results Of the total study sample, the prevalence of hospitalization due to stroke was 22.99%, 30.00%, and 27.03% in years of 1980–1989, 1990–1999, and 2000–2010 in males, and 17.30%, 22.04%, and 19.34% in females, respectively. Overall, hospitalization rates in stroke patients significantly increased among adults aged <65, and decreased in adults aged ≥65. There was an increase in stroke hospitalization rate in the old adults aged ≥65 in recent birth cohorts. Significant increased trends of comorbid hypertension, diabetes, arrhythmias, and hyperlipidemia were observed from 1980 to 2010. Conclusion A significant increase in stroke hospitalization rate was observed in adults aged <65 in the past three decades, and in old adults in recent years. Increases in stroke comorbidity rates were observed in all age groups. Findings from the study highlight that both public health and clinical practices face a serious challenge in controlling this unwelcome increased stroke trend.

Cohort Analysis of Ontario Suicide Rates, 1877–1976

1986 ◽  
Vol 31 (3) ◽  
pp. 208-213 ◽  
Author(s):  
Rosemary A. Barnes ◽  
Jon Ennis ◽  
Renate Schober
Keyword(s):  
Birth Cohort ◽  
Cohort Analysis ◽  
Age Groups ◽  
The United States ◽  
Suicidal Risk ◽  
Transient Effects ◽  
Birth Cohorts ◽  
Cross Sectional ◽  
Weak Support ◽  
Suicide Rates

Birth cohort studies of suicide rates in Alberta, the United States and Australia indicate that within each generation, suicide rates increase with age. Such studies argue that cohort-specific suicidal risk, together with present high suicide rates among young people predict even higher rates as these generations grow older. Ontario data from a 100-year period demonstrate that within birth cohorts suicide rates consistently increase with age, peak between ages 50 and 70, then decline. Gradual increases in mean suicide rates result in every birth cohort having higher suicide rates than the preceding cohort at almost every age level. These trends combine to produce a regular birth cohort effect and a steady shift in cross-sectional data to higher rates of suicide among younger age groups. Abrupt increases in suicide rates occurring during the Great Depression had only transient effects on birth cohort and cross-sectional curves. Results provide weak support for the hypothesis of cohort-specific suicidal risk and clarify the factors which produce birth cohort effects.

scholarly journals Age, Period and Cohort Analysis of Smoking Prevalence in Iranian Population over a 25-Year Period

2021 ◽  
Vol 24 (1) ◽  
pp. 7-14
Author(s):  
Parisa Ghelichkhani ◽  
Masoud Baikpour ◽  
Kazem Mohammad ◽  
Fattah Hama Rahim Fattah ◽  
Nazila Rezaei ◽  
...  
Keyword(s):  
Health Surveys ◽  
Smoking Prevalence ◽  
Cohort Analysis ◽  
Age Groups ◽  
Daily Smoking ◽  
Birth Cohorts ◽  
Cross Sectional ◽  
Cross Sectional Studies ◽  
The Impact ◽  
National Health Surveys

Background: Current and daily smoking prevalence rates have been have investigated in several cross-sectional studies. However, analyses in terms of age-period-cohort (APC) have not been carried out. We assessed daily smoking dynamics over a 25-year period using the APC model. Methods: In our analyses, we used data from 214,652 people aged 15 to 64 years, collected by national health surveys conducted in 1990-1991, 1999, 2005, 2007, 2011 and 2016. The Intrinsic Estimator model was used to analyze the impact of APC on daily smoking prevalence. Results: Males were found to exhibit a higher prevalence of smoking compared to females (26.0% against 2.7%). Prevalence of smoking increased by age, peaking at the age groups of 40-44 in men and 45-49 in women, followed by a decreasing trend. The 1990 period had the highest prevalence in both genders, and the 2016 period had the lowest. The coefficients of birth cohort effects showed different patter19s of fluctuations in the two genders with the maximum and minimum coefficients for men calculated in the 1966-1970 and 1991-95 birth cohorts, and for females the 1931-1935 and 1971-1975 birth cohorts, respectively. Conclusion: We showed the impact of APC on daily tobacco smoking prevalence, and these factors should be considered when dealing with smoking.

Lymphopenia and risk for long-term mortality among patients undergoing coronary angiography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B Zafrir ◽  
R Jaffe ◽  
H Sliman ◽  
O Barnett-Griness ◽  
W Saliba
Keyword(s):  
Coronary Angiography ◽  
Mortality Risk ◽  
Predictive Accuracy ◽  
Cohort Analysis ◽  
Cox Proportional Hazards ◽  
Cross Sectional ◽  
Distribution Width ◽  
Increased Risk ◽  
Long Term Mortality

Abstract Background Lymphopenia has been shown to be associated with adverse prognosis in chronic disease states that are related to immune dysregulation. Purpose We aimed to determine the association between lymphopenia and all-cause mortality in patients presenting to coronary angiography with or without acute coronary syndromes (ACS). We also investigated whether elevated red blood cell distribution width (RDW), an established cardiovascular prognostic marker, further refines risk stratification and improves predictive accuracy beyond lymphocytes count. Methods Retrospective cohort analysis of patients undergoing coronary angiography for evaluation or treatment of coronary artery disease between 2003 and 2018. Long-term mortality risk associated with relative (1000–1500 /μL) or severe (&lt;1000 /μL) lymphopenia was analyzed using Cox proportional hazards regression models, adjusting for comorbidities, ACS and RDW. Results Overall, 15179 patients underwent coronary angiography, at a mean age of 65±12 years. On cross-sectional analysis, lymphopenia was associated with kidney disease, cancer, heart failure and presentation with ACS, but lower rates of smoking and obesity. During a median follow-up of 7 (IQR 3.5–11.5) years, 4253 patients died. Compared to normal lymphocytes count (1500–5000 /μL), the multivariable adjusted hazard ratio (HR) (95% confidence interval) for mortality was 1.31 (1.21–1.41) and 1.97 (1.75–2.22) for relative and severe lymphopenia, respectively. The increase in mortality associated with severe lymphopenia was significant in patients presenting with non-ACS [HR 2.18 (1.74–2.73)], ST-segment elevation myocardial infarction (STEMI) [HR 1.59 (1.15–2.21)], or unstable angina/non-STEMI [HR 2.00 (1.70–2.34)]; p-for-interaction 0.626. The association of lymphopenia with mortality remained significant after additional adjustment to RDW. High RDW (&gt;14.5%) was associated with increased mortality risk in each of the lymphocytes count groups, and improved the predictive accuracy with AUC increase from 0.609 (0.601–0.616) to 0.646 (0.639–0.654) (p&lt;0.001). Conclusions Lymphopenia is associated with increased risk for long-term mortality in patients undergoing coronary angiography, regardless of coronary presentation. High RDW may enhance the predictive ability of lymphopenia. Lymphocyte count and mortality risk Funding Acknowledgement Type of funding source: None

scholarly journals FREQUENCY OF FUNCTIONAL DISABILITY AND COGNITIVE IMPAIRMENTS IN SUB-ACUTE STROKE PATIENTS

2021 ◽  
Vol 10 (2) ◽  
pp. 69-74
Author(s):  
Aisha Sarfaraz ◽  
Dr Abdul Azeem ◽  
Mehwish Butt ◽  
Muhammad Umar
Keyword(s):  
Acute Stroke ◽  
Functional Disability ◽  
Cognitive Impairments ◽  
Age Groups ◽  
Female Gender ◽  
Primary Objective ◽  
P Value ◽  
Stroke Patients ◽  
Cross Sectional Survey ◽  
Cross Sectional

BACKGROUND & OBJECTIVE Stroke is a very common neurological condition affects various aspects of health. The primary objective of this study was to find out the frequency of functional disability and cognitive impairments in Sub-acute Stroke patients. MATERIAL AND METHODS A cross-sectional survey was conducted on 112 Sub-acute Stroke patients in Karachi, Pakistan. Using Barthel Index (BI) and Mini-Mental State Examination (MMSE) test was used to find out the frequency of functional disability and cognitive impairments of Sub-acute Stroke patients. RESULTS The correlation of BI scores with MMSE scores for the Male gender was 0.576 whilst the correlation of BI scores with MMSE scores for the Female gender was 0.440. The severity of functional disability concerning age groups assessed P-value was 0.026 using Chi-Square Test. The severity of functional disability (BI severity) concerning gender, P-value was found 0.097 using the same test. CONCLUSION Functional Disability is directly linked with age. However, there was no linkage established between Cognitive Impairment and age as well as gender. On close inspection, there was a trend between Functional disability and gender but not statistically significant.

scholarly journals Cohort analysis of colorectal cancer mortality in the Republic of Serbia over the period 1971-1996

2002 ◽  
Vol 130 (5-6) ◽  
pp. 173-177 ◽  
Author(s):  
Olga Gajic-Veljanoski ◽  
Mirjana Jarebinski ◽  
Ana Jovicevic-Bekic ◽  
Tatjana Pekmezovic
Keyword(s):  
Colorectal Cancer ◽  
Mortality Risk ◽  
Cancer Mortality ◽  
Cohort Analysis ◽  
Age Groups ◽  
Birth Cohorts ◽  
Mortality Trends ◽  
Death Rates ◽  
The Republic ◽  
Colorectal Cancer Mortality

Colorectal cancer is one of the most frequent malignant neoplasms in both sexes within developed countries. In the Republic of Serbia(Serbia) colorectal cancer mortality in 1971 ranged 5 in females, and 4 in males; it became the second leading malignancy in 1982 in females (after breast cancer), and in 1992 in males (after lung cancer). The objective of this descriptive-epidemiological study was to examine colorectal cancer mortality in Serbian population, particularly the effect of cohort variations on death rates in defined age groups over the period 1971-1996. Mortality rates were calculated from unpublished national vital statistics data of the Institute of Statistics of the Republic of Serbia. To estimate the age effect on colorectal cancer mortality, specific death rates were computed for cohorts born between 1892-96 and 1972-76, and died at subsequent time periods. The mortality rates were adjusted by direct method, using the world standard population. Confidence intervals (CI) for death rates were assessed with 95% level of probability. In time trend analysis of mortality, Fisher's test was used as a significance test for linear regression coefficient. In the study period (1971-1996), a share of all digestive tumors in cancer mortality has decreased from 42.0% to 32.3%. However, the mortality risk of colorectal cancer and its share in cancer mortality have increased. For example, in men, the share of colorectal cancer in digestive cancer mortality increased from 20.7% (1971) to 32.8% (1996) and in overall cancer mortality from 7.5% to 10.5%. In women, the share of colorectal cancer in digestive cancer mortality increased from 23.0%(1971) to 35.6%(1996), and in overall cancer mortality from 8.5% to 11.6%. The average colorectal cancer age-adjusted death rates (1971-1996) were 11.2 per 100,000 men (95% CI: 10.1-12.3), and 8.3 per 100,000 women (95% CI: 7.7-8.9). The secular linear mortality trends showed significant increase both in males (y = 11.2 + 0.2x; ? = 0.000), and females (y = 8.3 + 0.1 ?; ? = 0.000). The highest rise in age-specific death rates, according to linear mortality trends, was observed in males over 65 years (7.8% annually), and females between 60 and 69 years (5.9% annually). In cohort analysis of age-specific rates in males, younger birth cohorts were compared with older ones. The increasing colorectal cancer mortality risk has been observed for ages over 40, with statistical significance in age groups over 45. In ages between 45 and 59, and over 60, the youngest birth cohorts were at 2 and 2.5-fold higher cancer mortality risk than birth cohorts of the oldest generations. For example, the age specific colorectal cancer death rates in a 70-74 year group were 2.5-fold higher in men born between 1922 and 1926 (139.3/100,000) than in cohorts born 25 years earlier (58.7/100,000). In cohort analysis of age-specific rates in females, changes in the age under 50 were not so expressive. In all age groups over 50, women of younger generations were at 2-fold higher cancer mortality risk than the oldest ones. The age specific colorectal cancer death rates in a 65-69 year group were doubled in women born between 1927 and 1931 (61.0/100 000), than in cohorts born 25 years earlier (30.5/100 000). According to the present mortality trends, the further increase in colorectal cancer death rates especially in the ages over 40, should be expected in future generations. Consistent increase in mortality risk in all younger birth cohorts of older ages, as well as in successive five-year age groups of the observed generations, could reflect the continuous increase in colorectal cancer incidence attributed to predominantly environmental exposures.

scholarly journals Side Effects Following Administration of the First Dose of Oxford-AstraZeneca’s Covishield Vaccine in Bangladesh: A Cross-Sectional Study

2021 ◽  
Vol 13 (4) ◽  
pp. 888-901
Author(s):  
Nishat Jahan ◽  
Fahad Imtiaz Rahman ◽  
Poushali Saha ◽  
Sadia Afruz Ether ◽  
ASM Roknuzzaman ◽  
...  
Keyword(s):  
Side Effects ◽  
Rapid Development ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Post Vaccination ◽  
Long Term Follow Up ◽  
Larger Sample

In response to the raging COVID-19 pandemic, Bangladesh started its vaccine administration in early 2021; however, due to the rapid development and launch of the vaccines in the market, many people had concerns regarding the safety of these vaccines. The purpose of this study was to evaluate the side effects that were experienced by the Bangladeshi residents after receiving the first dose of the Oxford-AstraZeneca’s Covishield vaccine (ChAdOx1nCoV-19). The study was conducted using both online and printed questionnaires and the data were analysed using SPSS. The results included the responses of 474 vaccine recipients from March–April 2021. Pain at the site of injection, fever, myalgia, fatigue and headache were the most commonly reported symptoms, and the overall side effects were found to be significantly more prevalent in the younger population (p ≤ 0.05). These findings were consistent with the results indicated by the clinical trial of ChAdOx1nCoV-19. Logistic regression analysis further revealed that compared to people aged 70 years or above, the incidence of reported side effects was significantly higher in people aged 18–30 years (odds ratio (OR) = 8.56), 31–40 years, (OR = 5.05), 41–50 years (OR = 4.08), 51–60 years (OR = 3.77) and 61–70 years (OR = 3.67). In addition, a significantly higher percentage of female participants suffered from post-vaccination side effects compared to males (OR = 1.51). It was concluded that the Covishield vaccine was well-tolerated among people of different age groups. Nevertheless, further long-term follow-up study with a larger sample size is warranted to establish the long-term safety of the COVID-19 vaccine.

scholarly journals Lipid profile in school children: study from a District of Uttar Pradesh, India

2017 ◽  
Vol 4 (3) ◽  
pp. 719
Author(s):  
Utkarsh Bansal ◽  
Ekansh Rathoria ◽  
Abhishek Gupta ◽  
Nyay Bhai Gupta ◽  
Shwinka Agarwal ◽  
...  
Keyword(s):  
Lipid Profile ◽  
Age Groups ◽  
Uttar Pradesh ◽  
Cross Sectional Study ◽  
Lipid Levels ◽  
Cross Sectional ◽  
Number Of Children ◽  
Prevention Of Atherosclerosis ◽  
Pro Forma

Background:Lipid imbalance when diagnosed in childhood, can forecast the development of atherosclerosis in adulthood and its complications. Therefore, early detection of dyslipidemia should begin in childhood and it should lead to long-term prevention of atherosclerosis by controlling the risk factors. The Objectives of the study were to study lipid profile of children in the age group of 10-19 years and the prevalence of dyslipidemia among them.Methods: This is a cross-sectional study, which was conducted in 300 children aged 10 to 19 years, of either sex, from schools of Barabanki. After getting consent from school authorities, children and their parents, a detailed history was taken with a pre-designed pro forma and fasting blood samples were analyzed for lipid profile.Results:Mean total cholesterol (TC) for boys and girls were 161.06±33.14 mg/dl and 164.68±33.53 mg/dl, LDL-C 99.35±27.41 mg/dl and 101.71±26.44 mg/dl, HDL-C 42.76±5.78 mg/dl and 43.93±5.68 mg/dl, VLDL-C 18.94±4.47 mg/dl and 19.04±4.97 mg/dl and triglycerides (TG) 94.69±22.34 mg/dl and 95.20±24.83 mg/dl respectively. Serum TC, TG, LDL-C, VLDL-C and HDL-C levels were higher in girls than in boys for all age groups. 26.55% boys and 25.20% girls had TC levels above 190 mg/dl. The overall results revealed that 26.0% of children had hypercholesterolemia.Conclusions:The study presents age- and sex-related findings about the dynamics of changes in serum lipid levels in children. Significant number of children had hypercholesterolemia.

DSRIP’s innovation and collaboration in population health management: A cross-sectional segmented time series model

2019 ◽  
Vol 33 (1) ◽  
pp. 2-12
Author(s):  
Amrita Gopinath Shenoy
Keyword(s):  
Time Series ◽  
Population Health ◽  
Development Program ◽  
Hospitalization Rate ◽  
Health Improvement ◽  
Infrastructure Development ◽  
Cross Sectional ◽  
Preventable Hospitalization ◽  
Hospitalization Rates ◽  
The Impact

Texas Medicaid Section 1115 waiver approved Delivery System Reform Incentive Payment (DSRIP) program has four categories, namely infrastructure development, program innovation and redesign, reporting of quality improvement outcomes, and population health improvement. A metric of the fourth category, preventable hospitalization rate, was analyzed for a set of eight diagnostic conditions to assess the impact of DSRIP on participating- and non-participating hospitals over two time periods, pre-DSRIP and post-DSRIP, with the help of a cross-sectional segmented time series regression model. Texas Healthcare Information Collection database was leveraged to obtain preventable hospitalization rate data. The dependent variables were preventable hospitalization rates of eight program-specified conditions and the independent variables were time, intervention, and post-implementation intervention. The overall combined preventable hospitalization rate for DSRIP hospitals was observed to decrease by 25.73%, whereas the overall combined preventable hospitalization rate for non-DSRIP hospitals was observed to increase by 37.57%. DSRIP hospitals had invested in coordinating healthcare projects and were subsequently reimbursed by the state for healthcare improvements. The implementation of DSRIP may have had the capacity to decrease preventable hospitalization rates in regions wherein its adoption may have improved the health of the population.

scholarly journals Analysis of measles-related hospitalizations in Tuscany from 2000 to 2014

2016 ◽  
Vol 144 (12) ◽  
pp. 2605-2612 ◽  
Author(s):  
E. BERTI ◽  
S. SOLLAI ◽  
E. ORLANDINI ◽  
L. GALLI ◽  
M. DE MARTINO ◽  
...  
Keyword(s):  
Young Adults ◽  
Age Groups ◽  
Public Health Problem ◽  
Hospitalization Rate ◽  
Measles Elimination ◽  
Hospitalization Rates ◽  
Significant Difference ◽  
Measles Outbreaks ◽  
Measles Incidence ◽  
Discharge Database

SUMMARYTo evaluate measles incidence and its relevant changes over a 14-year period (2000–2014), we analysed data from the regional hospital discharge database on children and adults hospitalized in Tuscany, Italy. A total of 181 paediatric and 413 adult cases were identified. Despite all the efforts towards regional measles elimination, we observed that the overall measles hospitalization rates for children and adults living in Tuscany globally increased from 0·45 to 0·85/100 000 during the study period (P = 0·001) showing fluctuations due to periodic measles outbreaks. Data stratified by age group showed that the hospitalization rate significantly increased in young adults over the study period, confirming an increase in susceptibility to measles in this subpopulation. Conversely, no statistically significant difference was observed in the hospitalization rate in the other age groups. However, children aged <1 year still exhibit the highest hospitalization rate. Pneumonia represented the most common complication in both the adult and children subsets. No death was reported. Measles still represents a public health problem, and national strategies should be implemented, focusing on emergent susceptible subsets, such as infants and young adults.

Relationship between Age and Activities of Daily Living using Modified Shah Barthel Index on Stroke Patient in Chronic Phase

2020 ◽  
Vol 70 (6) ◽  
pp. 115-120
Author(s):  
Malika Sabrina Yunifananda ◽  
Widjajalaksmi Kusumaningsih
Keyword(s):  
Barthel Index ◽  
Chronic Phase ◽  
Chronic Stroke ◽  
Daily Activities ◽  
Bivariate Analysis ◽  
Age Group ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Cross Sectional Design

Background: Stroke is the chief cause of long-term disability in the world. Predominantly, the disease is known as a degenerative disease on geriatrics age group, yet several studies have proven that incidence on productive ages are also increasing.  Objective: The study aimed to know whether there are any difference in Modified Shah Barthel Index (MSBI) score in different age group, geriatric and productive age group and to know independence score in daily activities based on age. Method: The study utilized the cross-sectional design and analytical observational method. Twenty five samples of chronic stroke patients was recruited and grouped into two groups productive and geriatric age group. MSBI score was calculated and compared between two groups.   Result: Bivariate analysis proves that there is a significant association between MSBI score and age of stroke patients on chronic phase (p=0.017). Discussion.  There is a significant association between age and MSBI score on stroke patients in chronic phase. Conclusion: There was a significance difference between productive and geriatric age with daily activities using MSBI in chronic stroke patients. The productive age group has a higher Modified Shah Barthel Index score than the geriatric age group.

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