scholarly journals Fatal recurrent VTE after anticoagulant treatment for unprovoked VTE: a systematic review

2018 ◽  
Vol 27 (150) ◽  
pp. 180094 ◽  
Author(s):  
Sake J. van der Wall ◽  
Liselotte M. van der Pol ◽  
Yvonne M. Ende-Verhaar ◽  
Suzanne C. Cannegieter ◽  
Sam Schulman ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Case Fatality ◽  
Point Estimate ◽  
Fatality Rate ◽  
Duration Of Treatment ◽  
Primary Analysis ◽  
Fatal Bleeding ◽  
Recurrent Vte ◽  
Randomised Controlled

Current guidelines recommend long-term anticoagulant therapy in patients with unprovoked venous thromboembolism (VTE). The risk of fatal recurrent VTE after treatment discontinuation (versus that of fatal bleeding during anticoagulation) is of particular relevance in the decision to continue or stop anticoagulation after the first 3 months. Our primary aim was to provide a point-estimate of the yearly rate of fatal recurrent VTE and VTE case-fatality rate in patients with unprovoked VTE after anticoagulation cessation. Data were extracted from both randomised controlled trials and observational studies published before May 1, 2017. The pooled fatality rates were calculated using a random-effects model. 18 studies with low-to-moderate bias were included in the primary analysis, totalling 6758 patients with a median (range) follow-up duration of 2.2 (1–5) years. After anticoagulation cessation, the weighted pooled rate of VTE recurrence was 6.3 (95% CI 5.4–7.3) per 100 patient-years and the weighted pooled rate of fatal recurrent VTE was 0.17 (95% CI 0.047–0.33) per 100 patient-years, for a case-fatality rate of 2.6% (95% CI 0.86–5.0). These numbers are a solid benchmark for comparison to the risks associated with long-term anticoagulation treatment for the decision on the optimal duration of treatment of patients with unprovoked VTE.

Dynamics of case-fatalilty rates of recurrent thromboembolism and major bleeding in patients treated for venous thromboembolism

2013 ◽  
Vol 110 (10) ◽  
pp. 834-843 ◽  
Author(s):  
Ana Alfonso ◽  
David Jiménez ◽  
Carmen Fernández Capitán ◽  
Paolo Prandoni ◽  
Philip S. Wells ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Major Bleeding ◽  
Case Fatality Rate ◽  
Real Life ◽  
Case Fatality ◽  
Fatality Rate ◽  
Duration Of Therapy ◽  
Fatal Bleeding ◽  
Recurrent Vte ◽  
Over Time

SummaryIn patients with venous thromboembolism (VTE), assessment of the risk of fatal recurrent VTE and fatal bleeding during anticoagulation may help to guide intensity and duration of therapy. We aimed to provide estimates of the case-fatality rate (CFR) of recurrent VTE and major bleeding during anticoagulation in a ‘real life’ population, and to assess these outcomes according to the initial presentation of VTE and its etiology. The study included 41,826 patients with confirmed VTE from the RIETE registry who received different durations of anticoagulation (mean 7.8 ± 0.6 months). During 27,110 patient-years, the CFR was 12.1% (95% CI, 10.2–14.2) for recurrent VTE, and 19.7% (95% CI, 17.4–22.1) for major bleeding. During the first three months of anticoagulant therapy, the CFR of recurrent VTE was 16.1% (95% CI, 13.6–18.9), compared to 2.0% (95% CI, 0–4.2) beyond this period. The CFR of bleeding was 20.2% (95% CI, 17.5–23.1) during the first three months, compared to 18.2% (95% CI, 14.0–23.2) beyond this period. The CFR of recurrent VTE was higher in patients initially presenting with PE (18.5%; 95% CI, 15.3–22.1) than in those with DVT (6.3%; 95% CI, 4.5–8.6), and in patients with provoked VTE (16.3%; 95% CI, 13.6–19.4) than in those with unprovoked VTE (5.5%; 95% CI, 3.5–8.0). In conclusion, the CFR of recurrent VTE decreased over time during anticoagulation, while the CFR of major bleeding remained stable. The CFR of recurrent VTE was higher in patients initially presenting with PE and in those with provoked VTE.

scholarly journals “Association between air pollution in Lima and the high incidence of COVID-19: findings from a post hoc analysis.”

2021 ◽  
Author(s):  
Bertha V. Vasquez-Apestegui ◽  
Enrique Parras-Garrido ◽  
Vilma Tapia ◽  
Valeria M. Paz-Aparicio ◽  
Jhojan P. Rojas ◽  
...  
Keyword(s):  
Air Pollution ◽  
Case Fatality Rate ◽  
Virus Disease ◽  
Case Fatality ◽  
Fatality Rate ◽  
Food Markets ◽  
Early Implementation ◽  
High Incidence ◽  
Post Hoc

Abstract Background Corona virus disease (COVID-19) originated in China in December 2019. Thereafter, a global logarithmic expansion of the cases has occurred. Some countries have a higher rate of infections despite of early implementation of quarantine. Air pollution could be related to the high susceptibility to SARS-CoV-2 and the associated case-fatality rates (deaths/cases*100). Lima, Peru has the second highest incidence of COVID-19 in Latin America, and it is also one of the cities with highest levels of air pollution in the Region. Methods This study investigated the association of the levels of PM2.5 exposure in the previous years (2010–2016) in 24 districts of Lima with the positive-cases, deaths and case-fatality rates of COVID-19. Multiple Linear regression was used to evaluate this association controlled by age, sex, population density and number of food markets per district. The study period was from March 6 to June 12, 2020. Results There were in Lima 128,700 SARS-CoV-2 positive cases, and 2,382 deaths due to COVID-19. The case-fatality rate was 1.93%. Previous exposure to PM2.5 (years 2010—2016) was associated with number of Covid-19 positive-cases (β = 0.07; 95% CI: 0.034–0.107) and deaths (β = 0.0014; 95% CI: 0.0006–0.0.0023), but not with case-fatality rate. Conclusions the higher rates of COVID-19 in Metropolitan Lima is attributable, among others, to the increased PM2.5 exposure in the previous years after adjusting for age, sex and number of food markets. Reduction of air pollution since a long-term perspective, and social distancing are needed to prevent spreads of virus outbreak.

scholarly journals Urban Air Pollution May Enhance COVID-19 Case-Fatality and Mortality Rates in the United States

2020 ◽  
Author(s):  
Donghai Liang ◽  
Liuhua Shi ◽  
Jingxuan Zhao ◽  
Pengfei Liu ◽  
Joel Schwartz ◽  
...  
Keyword(s):  
Air Pollution ◽  
Mortality Rate ◽  
Case Fatality Rate ◽  
Urban Air Pollution ◽  
Case Fatality ◽  
Ambient Air ◽  
County Level ◽  
Fatality Rate ◽  
P Values

AbstractBackgroundThe novel human coronavirus disease 2019 (COVID-19) pandemic has claimed more than 240,000 lives worldwide, causing tremendous public health, social, and economic damages. While the risk factors of COVID-19 are still under investigation, environmental factors, such as urban air pollution, may play an important role in increasing population susceptibility to COVID-19 pathogenesis.MethodsWe conducted a cross-sectional nationwide study using zero-inflated negative binomial models to estimate the association between long-term (2010-2016) county-level exposures to NO2, PM2.5 and O3 and county-level COVID-19 case-fatality and mortality rates in the US. We used both single and multipollutant models and controlled for spatial trends and a comprehensive set of potential confounders, including state-level test positive rate, county-level healthcare capacity, phase-of-epidemic, population mobility, sociodemographic, socioeconomic status, behavior risk factors, and meteorological factors.Results1,027,799 COVID-19 cases and 58,489 deaths were reported in 3,122 US counties from January 22, 2020 to April 29, 2020, with an overall observed case-fatality rate of 5.8%. Spatial variations were observed for both COVID-19 death outcomes and long-term ambient air pollutant levels. County-level average NO2 concentrations were positively associated with both COVID-19 case-fatality rate and mortality rate in single-, bi-, and tri-pollutant models (p-values<0.05). Per inter-quartile range (IQR) increase in NO2 (4.6 ppb), COVID-19 case-fatality rate and mortality rate were associated with an increase of 7.1% (95% CI 1.2% to 13.4%) and 11.2% (95% CI 3.4% to 19.5%), respectively. We did not observe significant associations between long-term exposures to PM2.5 or O3 and COVID-19 death outcomes (p-values>0.05), although per IQR increase in PM2.5 (3.4 ug/m3) was marginally associated with 10.8% (95% CI: −1.1% to 24.1%) increase in COVID-19 mortality rate.Discussions and ConclusionsLong-term exposure to NO2, which largely arises from urban combustion sources such as traffic, may enhance susceptibility to severe COVID-19 outcomes, independent of longterm PM2.5 and O3 exposure. The results support targeted public health actions to protect residents from COVID-19 in heavily polluted regions with historically high NO2 levels. Moreover, continuation of current efforts to lower traffic emissions and ambient air pollution levels may be an important component of reducing population-level risk of COVID-19 deaths.

scholarly journals Facemasks and COVID-19 case fatality rate

2021 ◽  
Author(s):  
Zacharias Fögen
Keyword(s):  
Risk Ratio ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Fatality Rate ◽  
Infection Rates ◽  
Long Term Effects ◽  
Conspiracy Theories ◽  
Course Of Disease ◽  
The Individual

Mask mandates have been a globally used epidemiologic intervention during the ongoing COVID-19 pandemic, above all based on the assumption of reduced infection rates. Although there is now much evidence for the latter, the effect of facemasks on the individual and its course of disease has remained controversial. While there are concepts suggesting a protective effect and a better outcome for the individual, public opinion has placed concepts with opposite outcomes in the vicinity of conspiracy theories. However, here I show that counties with mask mandates in Kansas during the summer of 2020 had significantly higher case fatality rates compared to Kansas counties without mask mandates, with a risk ratio of 1.85 for death with COVID-19. Even after adjusting for the number of ‘protected persons’, i.e. the number of persons who were not infected in the mask-mandated group compared to the no-mask group, the risk ratio remains highly significant at 1.52. Over 95% of this effect can solely be attributed to COVID-19. Why this happens and the possible connection between long-term effects associated with SARS-CoV-2 and facemasks are explained in theory herein by the ‘foegen effect’, which describes the deep reinhalation of pure virions that were caught in the facemasks as droplets.

Long-Term Case-Fatality Rate of Nontuberculous Mycobacterial Disease in People Living with HIV

2021 ◽  
Author(s):  
Jingjing Hu ◽  
Ling Gu ◽  
Yueming Shao ◽  
Renfang Zhang ◽  
Tangkai Qi ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Proportional Hazards ◽  
Case Fatality ◽  
Cox Proportional Hazards ◽  
People Living With Hiv ◽  
Fatality Rate ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
Living With Hiv

Abstract Background Few data are available regarding the long-term case-fatality rate (CFR) among people living with HIV (PLWH) with nontuberculous mycobacteria (NTM) disease. Objectives To analyze the long-term CFR in patients with NTM disease and to identify risk factors for their death. Methods A retrospective cohort study of 379 cases of microbiologically confirmed NTM disease in PLWH was conducted during January 1, 2012 to December 31, 2020 in Shanghai, China. We used Kaplan-Meier survival analysis and log-rank test to compare long-term CFR in patients with disseminated NTM (DNTM) and localized NTM disease. Univariate Cox proportional hazards regression analysis and stepwise Cox proportional hazards regression model were used to estimate the predictors of long-term CFR. Results The cohort was follow-up for a median of 26 months. The total CFR was 15.7% by one year and increased to 22.6% at 5 years after the diagnosis of NTM disease. The 5-year CFR of PLWH with DNTM was significantly higher than that of localized NTM (26.7% vs. 19.6% for DNTM and localized NTM disease, respectively). Older age (hazard ratio [HR] = 1.04, 95% confidence interval [CI]: 1.02-1.06, P < 0.001), comorbidity (HR = 2.05, 95% CI: 1.21-3.49, P < 0.01), DNTM (HR = 2.08, 95% CI: 1.17-3.68, P < 0.05), and HIV viral load (HR = 1.32, 95% CI: 1.12-1.55, P < 0.001) were all independent risk factors of long-term CFR. In the subgroup analysis, time to culture positivity was negatively correlated with CFR in patients with DNTM (HR = 0.90, 95% CI: 0.82-0.98, P < 0.05). Conclusions NTM was associated with significantly high long-term CFR in PLWH. Further approaches to prevent NTM disease in PLWH are urgently needed.

scholarly journals Association between air pollution in Lima and the high incidence of COVID-19: findings from a post hoc analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bertha V. Vasquez-Apestegui ◽  
Enrique Parras-Garrido ◽  
Vilma Tapia ◽  
Valeria M. Paz-Aparicio ◽  
Jhojan P. Rojas ◽  
...  
Keyword(s):  
Air Pollution ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Fatality Rate ◽  
Food Markets ◽  
Republic Of China ◽  
Early Implementation ◽  
High Incidence ◽  
Post Hoc

Abstract Background Coronavirus disease 2019 (COVID-19) originated in the People’s Republic of China in December 2019. Thereafter, a global logarithmic expansion of cases occurred. Some countries have a higher rate of infections despite the early implementation of quarantine. Air pollution might be related to high susceptibility to the virus and associated case fatality rates (deaths/cases*100). Lima, Peru, has the second highest incidence of COVID-19 in Latin America and also has one the highest levels of air pollution in the region. Methods This study investigated the association of levels of PM2.5 exposure in previous years (2010–2016) in 24 districts of Lima with cases, deaths and case fatality rates for COVID-19. Multiple linear regression was used to evaluate this association controlled by age, sex, population density and number of food markets per district. The study period was from March 6 to June 12, 2020. Results There were 128,700 cases in Lima and 2382 deaths due to COVID-19. The case fatality rate was 1.93%. Previous exposure to PM2.5 (2010—2016) was associated with the number of COVID-19- cases (β = 0.07; 95% CI: 0.034–0.107) and deaths (β = 0.0014; 95% CI: 0.0006–0.0.0023) but not with the case fatality rate. Conclusions After adjusting for age, sex and number of food markets, the higher rates of COVID-19 in Metropolitan Lima are attributable to the increased PM2.5 exposure in the previous years, among other reasons. Reduction in air pollution from a long-term perspective and social distancing are needed to prevent the spread of virus outbreaks.

Case Fatality Rates of Recurrent Venous Thromboembolism during and Following Anticoagulation Therapy

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3032-3032
Author(s):  
Marc Carrier ◽  
Gregoire Le Gal ◽  
Philip Wells ◽  
Marc Rodger
Keyword(s):  
Major Bleeding ◽  
Case Fatality Rate ◽  
Oral Anticoagulants ◽  
Anticoagulation Therapy ◽  
Case Fatality ◽  
Fatality Rate ◽  
Weighted Estimates ◽  
Vein Thrombosis ◽  
Anticoagulation Treatment ◽  
Recurrent Vte

Abstract Background: The optimal duration of anticoagulation treatment in patients with unprovoked VTE is unknown. In order to counsel VTE patients on the risks and benefits of discontinuing anticoagulants, clinicians need to balance the long-term risk of recurrent VTE with major bleeding on anticoagulants. For all VTE patients on oral anticoagulant, the case-fatality rate of major bleeding was previously reported to be 13.4% (95% confidence intervals (CI): 9.4% to 17.4%). A major knowledge gap exists regarding the case-fatality rate of recurrent pulmonary embolism (PE) during and following anticoagulation therapy for VTE. Purpose: To summarize the case fatality rate of recurrent VTE during and following anticoagulation therapy. Data Source: A systematic literature search strategy was conducted using MEDLINE, EMBASE, the Cochrane Register of Controlled Trials and all EBM Reviews. Study Outcome: We selected 62 studies that reported the rates of fatal PE in patients with recurrent VTE. Fatal PE was defined as confirmed autopsy report; death preceding with confirmed deep vein thrombosis (DVT) or non-fatal PE; sudden death not explained by a condition other than PE. Measurements: Pooled case fatality rates were generated. Ninety-five percent CI were calculated for each case fatality rate using averaged, inverse variance-weighted estimates from each study. Data Synthesis: 30,885 VTE patients were included (17,650 DVT, 8801 PE and 4434 DVT or PE Limitations: Unable to determine the case fatality rate by etiology of VTE (i.e. provoked, unprovoked). Conclusion: Case fatality rates for recurrent VTE are elevated during and following anticoagulation treatment for VTE but appear lower than the case-fatality rate for major bleeding with oral anticoagulants. This information must be considered by clinicians when counseling patients on whether to continue or discontinue anticoagulant therapy following VTE. Not only must absolute recurrent VTE and major bleeding rates be compared between groups that continue and discontinue anticoagulants but the relative consequences (i.e. case fatality rates) must be also considered with more weight placed on major bleeding episodes. Initial event During anticoagulation Treatment (%, 95% CI) Following anticoagulation Treatment (%, 95% CI) DVT 10.6 (8.3–13.0) 7.3 (5.0–9.7) PE 12.3 (5.9–18.7) 12.5 (6.4–28.7) Any event 10.2 (7.9–12.5) 9.0 (7.3–10.8)

The Long-Term Periodic Patterns of Global Rabies Epidemics Among Animals: A Modeling Analysis

2020 ◽  
Vol 30 (03) ◽  
pp. 2050047
Author(s):  
Salihu Sabiu Musa ◽  
Shi Zhao ◽  
Daihai He ◽  
Chao Liu
Keyword(s):  
Public Health ◽  
Wavelet Analysis ◽  
Case Fatality Rate ◽  
Compartmental Model ◽  
Case Fatality ◽  
Transmission Dynamics ◽  
Fatality Rate ◽  
Periodic Patterns ◽  
Modeling Analysis

Rabies remains a serious threat to public health in Asia, Africa and some parts of Europe with a case fatality rate of 95%. We adopted wavelet analysis to study the long-term recurrence of global rabies outbreaks and found that a 3- to 4-year periodicity has existed since 2005. Furthermore, a simple compartmental model is developed and analyzed to study the transmission dynamics, and to show the existence of the observed periodicity as well as the endemic feature of rabies among animals. Our findings indicate the existence of the oscillation patterns (recurrence), and the epidemic is at its peak since 2018.

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