scholarly journals Analysis of in-hospital mortality among people with and without diabetes in South Western Sydney public hospitals (2014–2017)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tina Gao ◽  
Kingsley E. Agho ◽  
Milan K. Piya ◽  
David Simmons ◽  
Uchechukwu L. Osuagwu
Keyword(s):  
Mortality Rate ◽  
Hospital Mortality ◽  
Age Groups ◽  
Public Health Problem ◽  
Binary Logistic Regression ◽  
Population Based ◽  
Public Hospitals ◽  
Major Public Health Problem ◽  
Factors Associated ◽  
Patients With Diabetes

Abstract Background Diabetes is a major public health problem affecting about 1.4 million Australians, especially in South Western Sydney, a hotspot of diabetes with higher than average rates for hospitalisations. The current understanding of the international burden of diabetes and related complications is poor and data on hospital outcomes and/or what common factors influence mortality rate in people with and without diabetes in Australia using a representative sample is lacking. This study determined in-hospital mortality rate and the factors associated among people with and without diabetes. Methods Retrospective data for 554,421 adult inpatients was extracted from the population-based New South Wales (NSW) Admitted Patient Data over 3 financial years (from 1 July 2014–30 June 2015 to 1 July 2016–30 June 2017). The in-hospital mortality per 1000 admitted persons, standardised mortality ratios (SMR) were calculated. Binary logistic regression was performed, adjusting for potential covariates and co-morbidities for people with and without diabetes over three years. Results Over three years, 8.7% (48,038 people) of admissions involved people with diabetes. This increased from 8.4% in 2014–15 to 8.9% in 2016–17 (p = 0.007). Across all age groups, in-hospital mortality rate was significantly greater in people with diabetes (20.6, 95% Confidence intervals CI 19.3–21.9 per 1000 persons) than those without diabetes (11.8, 95%CI 11.5–12.1) and more in men than women (23.1, 95%CI 21.2–25.0 vs 17.9, 95%CI 16.2–19.8) with diabetes. The SMR for those with and without diabetes were 3.13 (95%CI 1.78–4.48) and 1.79 (95%CI 0.77–2.82), respectively. There were similarities in the factors associated with in hospital mortality in both groups including: older age (> 54 years), male sex, marital status (divorced/widowed), length of stay in hospital (staying longer than 4 days), receiving intensive care in admission and being admitted due to primary respiratory and cardiovascular diagnoses. The odds of death in admission was increased in polymorbid patients without diabetes (28.68, 95%CI 23.49–35.02) but not in those with diabetes. Conclusions In-patients with diabetes continue to have higher mortality rates than those without diabetes and the Australian population. Overall, similar factors influenced mortality rate in people with and without diabetes, but significantly more people with diabetes had two or more co-morbidities, suggesting that hospital mortality may be driven by those with pre-existing health/comorbidities. Urgent measures in primary care to prevent admissions among people with multiple co-morbidities are needed.

scholarly journals Analysis of in-hospital mortality among people with and without Diabetes in Australian Public Hospitals (2014-2017)

2021 ◽  
Author(s):  
Tina Gao ◽  
Kingsley E Agho ◽  
Milan K Piya ◽  
David Simmons ◽  
Uchechukwu L Osuagwu
Keyword(s):  
Mortality Rate ◽  
Hospital Mortality ◽  
Age Groups ◽  
Public Health Problem ◽  
Binary Logistic Regression ◽  
Population Based ◽  
Public Hospitals ◽  
Major Public Health Problem ◽  
Factors Associated ◽  
Cardiovascular Comorbidities

Abstract Background Diabetes is a major public health problem affecting about 1.4 million Australians, especially in South Western Sydney, a hotspot of diabetes with higher than average rates for hospitalisations. The current understanding of the international burden of diabetes and related complications is poor and there is paucity of data on hospital outcomes and/or what common factors influence mortality rate in people with diabetes in Australia. This study determined in-hospital mortality rate and the factors associated among people with and without diabetes. Methods Retrospective data for 554,421 adult inpatients was extracted from the population-based New South Wales (NSW) Admitted Patient Data over 3 financial years (from 2014-15 to 2016-17). The in-hospital mortality per 1000 admitted persons, standardised mortality ratios (SMR) were calculated. Binary logistic regression was performed, adjusting for potential covariates and co-morbidities for people with and without diabetes over three years. Results Over three years 8.7% (48,038 people) of admissions involved those with diabetes. This increased from 8.4% in 2014-15 to 8.9% in 2016-17 (p = 0.007). Across all age groups, in-hospital mortality rate was significantly greater in people with diabetes (20.6, 95% Confidence intervals CI 19.3–21.9 per 1000 persons) than those without diabetes (11.8, 95%CI 11.5–12.1) and more in men than women (23.1, 95%CI 21.2–25.0 vs 17.9, 95%CI 16.2–19.8) with diabetes. The SMR for those with and without diabetes were 3.13 (95%CI 1.78–4.48) and 1.79 (95%CI 0.77–2.82), respectively. There were similarities in the factors associated with in hospital mortality in both groups including: aged > 54years, men, the widowed, those who stayed longer than 4 days or received intensive care in admission and had respiratory and cardiovascular comorbidities. Conclusions The study found that in-patients with diabetes continue to have higher mortality rates than those without diabetes and the Australian population. Overall, similar factors influenced mortality rate in people with and without diabetes in this region indicating that continued improved management of all inpatients is needed in order to minimise the persistent poor outcomes.

scholarly journals Factors associated to the type of childbirth in public and private hospitals in Brazil

2017 ◽  
Vol 17 (3) ◽  
pp. 571-580 ◽  
Author(s):  
Raphael Mendonça Guimarães ◽  
Rafael Leiróz Pereira Duarte Silva ◽  
Viviane Gomes Parreira Dutra ◽  
Pedro Gomes Andrade ◽  
Ana Camila Ribeiro Pereira ◽  
...  
Keyword(s):  
Age Groups ◽  
National Health System ◽  
Binary Logistic Regression ◽  
Positive Association ◽  
Public Hospitals ◽  
Cesarean Sections ◽  
Public And Private ◽  
Factors Associated ◽  
Public And Private Hospitals ◽  
Pregnancy And Birth

Abstract Objectives: to estimate the prevalence of cesarean sections and factors associated to the type of childbirth in Brazil. Methods: data on childbirths were collected in Brazil in 2014. Demographic characteristics, related to pregnancy and birth hospital regime (public or private) were evaluation. For each hypothesis raised, the variables were modeled by the binary logistic regression, which the outcome was considered in the type of childbirth. Results: the prevalence of the cesarean sections in Brazil in 2014 was 52.8%; that is 38.1% at public hospitals and 92.8% at private ones. The association between cesarean section and the legal regime at the hospital was highlighted in the logistic model which presented a positive association and interaction between age groups (OR = 23.26; 95% CI= 13.39 - 41.79 for women between 20 and 24 years old and OR = 51.04; 95% CI 31.06 - 84.23 for women aged 35 and over). Conclusions: the performance of childbirth in Brazil meets the routines and recommendations regarding women's health and humanized childbirth established by the Brazilian National Health System policies.

Investigate the Effect of Diabetes on Hypertension based on Bangladesh Demography and Health Survey, 2017-18

2021 ◽  
Author(s):  
Md. Merajul Islam ◽  
Md. Jahanur Rahman ◽  
Most. Tawabunnahar ◽  
Md. Menhazul Abedin ◽  
Md. Maniruzzaman
Keyword(s):  
Logistic Regression ◽  
Health Survey ◽  
Age Groups ◽  
Public Health Problem ◽  
Binary Logistic Regression ◽  
Bivariate Analysis ◽  
P Value ◽  
Diabetic Patients ◽  
Major Public Health Problem ◽  
Chi Square

Abstract Background and objectives: Hypertension is a major public health problem with raising its prevalence and effect among adults overtime worldwide, especially in Bangladesh. The aim is to investigate the effect of diabetes on hypertension.Materials and methods: The dataset used in this study was extracted from Bangladesh Demographic Health Survey, 2017-18 having a total of 6,965 (male: 3,376 and female: 3,589) adults whose ages were B35 years. Bivariate analysis along with Pearson’s chi-square test was executed to observe the association between different selected factors and hypertension. Additionally, binary logistic regression was employed to investigate the effect of diabetes on hypertension based on adjusted odds ratio (AOR) along with p-value in Bangladesh.Results: The results of the study revealed that average age of the participants was 51.04a12.731 and a total of 34.7 percent participants were identified as hypertension. Logistic regression analysis demonstrated that diabetic patients were 1.280 times (95% CI of AOR: 1.107-1.479; p-value=0.001) higher risk of hypertension compared to non-diabetic. Furthermore, our finding’s also showed that diabetic patient who was 35–49 years age, 1.462 times (95% CI of AOR: 1.182-1.807; p-value=0.000) higher risk of hypertension compared to age groups ≥50 years.Conclusions: Based on the results, this study claimed that people with diabetes was significantly associated with hypertension. This study suggested greater attention of government and policymakers to make appropriate strategies to reduce hypertension as well as associated risk in Bangladesh.

scholarly journals Trends and seasonality in cause-specific mortality among children under 15 years in Guangzhou, China, 2008-2018

2020 ◽  
Author(s):  
Xiao-Han Xu ◽  
Hang Dong ◽  
Li Li ◽  
Wen-Hui Liu ◽  
Guo-Zhen Lin ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Policy Development ◽  
Causes Of Death ◽  
Neurological Diseases ◽  
Age Groups ◽  
Reduction Rate ◽  
Public Health Problem ◽  
Temporal Variations ◽  
Population Based ◽  
Risk Of Death

Abstract Background: This study analyzed the trends and seasonality in mortality among children aged 0-14 years in Guangzhou, China during 2008-2018. Understanding the epidemiology of this public health problem can guide policy development for children mortality prevention.Methods: A population-based epidemiological retrospective study was conducted. 7,265 individual data of children mortality were obtained from the Guangzhou Centre for Disease Control and Prevention. The Poisson regression was used to quantify the annual average reduction rate and the difference in mortality rate between gender and age groups. Incidence ratios with 95% confidence intervals (CI) were calculated to determine the ratio of the observed number of deaths to the expected deaths (i.e. the average assuming no variations) by month, season, school term, weeks and holidays deaths.Results: Between 2008 and 2018, the children mortality rate in Guangzhou decreased from 54.0 to 34.3 per 100,000 children, with an annual reduction rate of 4.6% (95%CI: 1.1%-8.1%), especially the under-5 mortality rate decreased by 8.3% (95%CI: 4.8%-11.6%) per year. The decline trend varied by causes of death, even with an upward trend for the mortality of asphyxia and neurological diseases. The risk of death among male children was 1.78 times (95%CI: 1.61-1.98) that of females. The distribution of causes of death differed by age groups. Maternal and perinatal, congenital and pneumonia were the top three causes of death in infants and cancer accounted for 17% of deaths in children aged 1-14 years. Moreover, the injury-related mortality showed significant temporal variations with higher risk during the weekend. And there was a summer peak for drowning and a winter peak for asphyxia. Conclusions: Guangzhou has made considerable progress in reducing mortality over the last decade. The findings of characteristics of children mortality would provide important information for the development and implementation of integrated interventions targeted specific age groups and causes of death.

scholarly journals Trends and seasonality in cause-specific mortality among children under 15 years in Guangzhou, China, 2008-2018

2020 ◽  
Author(s):  
Xiao-Han Xu ◽  
Hang Dong ◽  
Li Li ◽  
Wen-Hui Liu ◽  
Guo-Zhen Lin ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Policy Development ◽  
Causes Of Death ◽  
Neurological Diseases ◽  
Age Groups ◽  
Reduction Rate ◽  
Public Health Problem ◽  
Temporal Variations ◽  
Population Based ◽  
Risk Of Death

Abstract Background: This study analyzed the trends and seasonality in mortality among children aged 0-14 years in Guangzhou, China during 2008-2018. Understanding the epidemiology of this public health problem can guide policy development for children mortality prevention. Methods: A population-based epidemiological retrospective study was conducted. 7,265 individual data of children mortality were obtained from the Guangzhou Center for Disease Control and Prevention. The Poisson regression was used to quantify the annual average reduction rate and the difference in mortality rate between sex and age groups. Incidence ratio with 95% confidence interval (CI) was estimated to determine the temperaol variations in mortality by month, season, school term, day of the week and between holidays and other days. Results: Between 2008 and 2018, the children mortality rate in Guangzhou decreased from 54.0 to 34.3 per 100,000 children, with an annual reduction rate of 4.6% (95% CI: 1.1%-8.1%), especially the under-5 mortality rate decreased by 8.3% (95% CI: 4.8%-11.6%) per year. Decline trends varied by causes of death, even with an upward trend for the mortality of asphyxia and neurological diseases. The risk of death among males children was 1.33 times (95% CI: 1.20-1.47) of that of females. The distribution of causes of death differed by age group. Maternal and perinatal, congenital and pneumonia were the top three causes of death in infants and cancer accounted for 17% of deaths in children aged 1-14 years. Moreover, the injury-related mortality showed significant temporal variations with higher risk during the weekend. And there was a summer peak for drowning and a winter peak for asphyxia. Conclusions: Guangzhou has made considerable progress in reducing mortality over the last decade. The findings of characteristics of children mortality would provide important information for the development and implementation of integrated interventions targeted specific age groups and causes of death.

The Prevalence of Vitamin D Deficiency in Iran: A Literature Review

2020 ◽  
Vol 16 (7) ◽  
pp. 1015-1027
Author(s):  
Mohammad Bagherniya ◽  
Zahra Khorasanchi ◽  
Mina S. Bidokhti ◽  
Gordon A. Ferns ◽  
Mitra Rezaei ◽  
...  
Keyword(s):  
Vitamin D ◽  
Literature Review ◽  
Vitamin D Deficiency ◽  
Medical Condition ◽  
Scientific Information ◽  
Age Groups ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Vitamin D Levels ◽  
High Prevalence

Background: Vitamin D deficiency is a common medical condition worldwide. In Iran, it has been reported that between 30-90% of people have vitamin D deficiency. However, its distribution in different parts of the country and among different age and regional groups is unclear. Therefore, the aim of this study was to review the recent literature on vitamin D deficiency in Iran. Methods: The literature review was performed using Web of Science, PubMed-Medline, Scopus and Scientific Information Database (SID) with a cut-off date of November 2016 to identify articles on vitamin D status in Iran published in the last 10 years. Studies in English and Persian that reported vitamin D levels in male and female subjects of all age groups and in healthy populations were included. Results: From 325 studies that were initially retrieved, 82 articles met the inclusion criteria. A high prevalence of vitamin D deficiency was reported, and in some regions, this was reported as >90% and was found in all age groups and in all regions of Iran. Conclusion: This review highlights the very high prevalence of vitamin D deficiency in Iran. It will be important to recognize the importance of vitamin D deficiency as a major public health problem in Iran.

scholarly journals Mortality in Escherichia coli bloodstream infections: a multinational population-based cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melissa C. MacKinnon ◽  
Scott A. McEwen ◽  
David L. Pearl ◽  
Outi Lyytikäinen ◽  
Gunnar Jacobsson ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Mortality Rate ◽  
Case Fatality ◽  
Population Based ◽  
Day Case ◽  
Fatality Risk ◽  
E Coli ◽  
Factors Associated ◽  
Case Fatality Risk ◽  
Age And Sex

Abstract Background Escherichia coli is the most common cause of bloodstream infections (BSIs) and mortality is an important aspect of burden of disease. Using a multinational population-based cohort of E. coli BSIs, our objectives were to evaluate 30-day case fatality risk and mortality rate, and determine factors associated with each. Methods During 2014–2018, we identified 30-day deaths from all incident E. coli BSIs from surveillance nationally in Finland, and regionally in Sweden (Skaraborg) and Canada (Calgary, Sherbrooke, western interior). We used a multivariable logistic regression model to estimate factors associated with 30-day case fatality risk. The explanatory variables considered for inclusion were year (2014–2018), region (five areas), age (< 70-years-old, ≥70-years-old), sex (female, male), third-generation cephalosporin (3GC) resistance (susceptible, resistant), and location of onset (community-onset, hospital-onset). The European Union 28-country 2018 population was used to directly age and sex standardize mortality rates. We used a multivariable Poisson model to estimate factors associated with mortality rate, and year, region, age and sex were considered for inclusion. Results From 38.7 million person-years of surveillance, we identified 2961 30-day deaths in 30,923 incident E. coli BSIs. The overall 30-day case fatality risk was 9.6% (2961/30923). Calgary, Skaraborg, and western interior had significantly increased odds of 30-day mortality compared to Finland. Hospital-onset and 3GC-resistant E. coli BSIs had significantly increased odds of mortality compared to community-onset and 3GC-susceptible. The significant association between age and odds of mortality varied with sex, and contrasts were used to interpret this interaction relationship. The overall standardized 30-day mortality rate was 8.5 deaths/100,000 person-years. Sherbrooke had a significantly lower 30-day mortality rate compared to Finland. Patients that were either ≥70-years-old or male both experienced significantly higher mortality rates than those < 70-years-old or female. Conclusions In our study populations, region, age, and sex were significantly associated with both 30-day case fatality risk and mortality rate. Additionally, 3GC resistance and location of onset were significantly associated with 30-day case fatality risk. Escherichia coli BSIs caused a considerable burden of disease from 30-day mortality. When analyzing population-based mortality data, it is important to explore mortality through two lenses, mortality rate and case fatality risk.

Age differences in mortality in patients undergoing surgery for infective endocarditis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Ostergaard ◽  
M.H Smerup ◽  
K Iversen ◽  
A.D Jensen ◽  
A Dahl ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Hospital Mortality ◽  
Hazard Analysis ◽  
Age Groups ◽  
Prosthetic Heart Valve ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Factors Associated ◽  
Increased Risk

Abstract Background Infective endocarditis (IE) is associated with high mortality. Surgery may improve survival, but the intercept between benefit and harm is hard to balance and may be closely related to age. Purpose To examine the in-hospital and 90-day mortality in patients undergoing surgery for IE and to identify differences between age groups and type of valvular intervention. Methods By crosslinking nationwide Danish registries we identified patients with first-time IE undergoing surgical treatment in the period from 2000 to 2017. The study population was grouped in patients &lt;60 years, 60–75 years, and ≥75 years of age. High-risk subgroups by age and surgical valve intervention (mitral vs aortic vs mitral+aortic) during IE admission were examined. Kaplan Meier estimates was used to identify 90-day mortality by age groups and multivariable adjusted Cox proportional hazard analysis was used to examine factors associated with 90-day mortality. Results We included 1,767 patients with IE undergoing surgery, 735 patients &lt;60 years (24.1% female), 766 patients 60–75 years (25.8% female), and 266 patients &gt;75 years (36.1% female). The proportion of patients with IE undergoing surgery was 35.3%, 26.9%, and 9.1% for patients &lt;60 years, 60–75 years, and &gt;75 years, respectively. For patients with IE undergoing surgery, the in-hospital mortality was 6.4%, 13.6%, and 20.3% for patients &lt;60 years, 60–75 years, and ≥75 years of age, respectively and mortality at 90 days were 7.5%, 13.9%, and 22.3%, respectively. Factors associated with an increased risk 90-day mortality were: mitral valve surgery and a combination of mitral and aortic valve surgery as compared with isolated aortic valve surgery, patients 60–75 years and &gt;75 years as compared with patients aged &lt;60 years, prosthetic heart valve prior to IE admission, and diabetes, Figure. Patients &gt;75 years undergoing a combination of mitral and aortic valve surgery had an in-hospital mortality of 36.3%. Conclusion In patients undergoing surgery for IE, a stepwise increase in 90-day mortality was seen for age groups, highest among patients &gt;75 years with a 90-day mortality of more than 20%. Patients undergoing mitral and combined mitral and aortic valve surgery as compared to isolated aortic valve surgery were associated with a higher mortality. These findings may be of importance for the management strategy of patients with IE. Mortality risk Funding Acknowledgement Type of funding source: None

scholarly journals Fragility Fractures and Imminent Fracture Risk in the Spanish Population: A Retrospective Observational Cohort Study

2021 ◽  
Vol 10 (5) ◽  
pp. 1082
Author(s):  
Maria-José Montoya-García ◽  
Mercè Giner ◽  
Rodrigo Marcos ◽  
David García-Romero ◽  
Francisco-Jesús Olmo-Montes ◽  
...  
Keyword(s):  
Cohort Study ◽  
Incidence Rate ◽  
Public Health Problem ◽  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
Population Based ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Skeletal Site ◽  
Mortality Incidence

Fragility fractures constitute a major public health problem worldwide, causing important high morbidity and mortality rates. The aim was to present the epidemiology of fragility fractures and to assess the imminent risk of a subsequent fracture and mortality. This is a retrospective population-based cohort study (n = 1369) with a fragility fracture. We estimated the incidence rate of index fragility fractures and obtained information on the subsequent fractures and death during a follow-up of up to three years. We assessed the effect of age, sex, and skeletal site of index fracture as independent risk factors of further fractures and mortality. Incidence rate of index fragility fractures was 86.9/10,000 person-years, with highest rates for hip fractures in women aged ≥80 years. The risk of fracture was higher in subjects with a recent fracture (Relative Risk(RR), 1.80; p < 0.01). Higher age was an independent risk factor for further fracture events. Significant excess mortality was found in subjects aged ≥80 years and with a previous hip fracture (hazard ratio, 3.43 and 2.48, respectively). It is the first study in Spain to evaluate the incidence of major osteoporotic fractures, not only of the hip, and the rate of imminent fracture. Our results provide further evidence highlighting the need for early treatment.

scholarly journals Healthcare use prior to suicide in the Stockholm County population 2011-2016

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Narusyte ◽  
K Kosidou ◽  
C Dalman
Keyword(s):  
Age Groups ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Healthcare Use ◽  
Stockholm County ◽  
Suicide Death ◽  
Death Registry ◽  
County Population ◽  
Study Population ◽  
One Year

Abstract Background Suicide is a major public health problem. A detailed description of healthcare use prior to suicide can serve to improve prevention strategies. The aim of the study was to describe the patterns of primary, specialized outpatient, and inpatient healthcare use from two weeks and up to one year prior to suicide in Stockholm County. Methods The study population included all 15 year or older suicide victims who died in Stockholm County 2011-2016 (n = 1950) identified through National Cause of Death Registry. Data on number of visits and contacts with healthcare among suicide victims were obtained from VAL healthcare use registry in Stockholm County. Healthcare use was depicted from one year to up to two weeks prior to suicide death. Results Preliminary results showed that there were 65% and 57% of women and men, respectively, who had at least one contact with healthcare during the last two weeks before suicide death. Measured one year prior to suicide, there were 93% of women and 85% of men who had at least one contact with healthcare. Among those who had at least one contact with healthcare two weeks prior to suicide, there were 16% of women and 12% of men who were hospitalized, 55% of women and 47% of men who had a contact with specialized outpatient care, and 32% of women and 27% of men who had a contact with primary healthcare. The proportion of those who did not have any contact with healthcare during the six months prior to suicide decreased gradually with increasing age among men (23% at ages of 15-24 years old and 7% at ages of 65 and older). There were on average 7% of women in all age groups who did not have any contact with healthcare during the six months prior to suicide. Conclusions The majority of the suicide victims had a contact with healthcare during the last year prior to suicide death. The findings suggest that suicide prevention efforts may target improved tools for clinically-based risk assessment. Key messages The majority of the suicide victims had at least one contact with healthcare during the last year prior to suicide death. Those who did not have any contact with healthcare during six months prior to suicide were more likely to be young men.

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