scholarly journals COVID-19 – exploring the implications of long-term condition type and extent of multimorbidity on years of life lost: a modelling study

2020 ◽  
Vol 5 ◽  
pp. 75 ◽  
Author(s):  
Peter Hanlon ◽  
Fergus Chadwick ◽  
Anoop Shah ◽  
Rachael Wood ◽  
Jon Minton ◽  
...  
Keyword(s):  
Policy Making ◽  
Life Tables ◽  
Years Of Life Lost ◽  
Long Term Conditions ◽  
Healthcare Data ◽  
Estimate Life Expectancy ◽  
Before And After ◽  
Wide Variability ◽  
The Mean

Background: The COVID-19 pandemic is responsible for increasing deaths globally. Most estimates have focused on numbers of deaths, with little direct quantification of years of life lost (YLL) through COVID-19.  As most people dying with COVID-19 are older with underlying long-term conditions (LTCs), some have speculated that YLL are low. We aim to estimate YLL attributable to COVID-19, before and after adjustment for number/type of LTCs. Methods: We first estimated YLL from COVID-19 using standard WHO life tables, based on published age/sex data from COVID-19 deaths in Italy. We then used aggregate data on number/type of LTCs to model likely combinations of LTCs among people dying with COVID-19. From these, we used routine UK healthcare data to estimate life expectancy based on age/sex/different combinations of LTCs. We then calculated YLL based on age, sex and type of LTCs and multimorbidity count. Results: Using the standard WHO life tables, YLL per COVID-19 death was 14 for men and 12 for women. After adjustment for number and type of LTCs, the mean YLL was slightly lower, but remained high (13 and 11 years for men and women, respectively). The number and type of LTCs led to wide variability in the estimated YLL at a given age (e.g. at ≥80 years, YLL was >10 years for people with 0 LTCs, and <3 years for people with ≥6). Conclusions: Deaths from COVID-19 represent a substantial burden in terms of per-person YLL, more than a decade, even after adjusting for the typical number and type of LTCs found in people dying of COVID-19. The extent of multimorbidity heavily influences the estimated YLL at a given age. More comprehensive and standardised collection of data on LTCs is needed to better understand and quantify the global burden of COVID-19 and to guide policy-making and interventions.

scholarly journals COVID-19 – exploring the implications of long-term condition type and extent of multimorbidity on years of life lost: a modelling study

2021 ◽  
Vol 5 ◽  
pp. 75
Author(s):  
Peter Hanlon ◽  
Fergus Chadwick ◽  
Anoop Shah ◽  
Rachael Wood ◽  
Jon Minton ◽  
...  
Keyword(s):  
Life Tables ◽  
Years Of Life Lost ◽  
Long Term Conditions ◽  
Healthcare Data ◽  
Estimate Life Expectancy ◽  
Sex Type ◽  
Before And After ◽  
Wide Variability ◽  
The Mean

Background: COVID-19 is responsible for increasing deaths globally. Estimates focused on numbers of deaths, do not quantify potential years of life lost (YLL) through COVID-19.  As most people dying with COVID-19 are older with underlying long-term conditions (LTCs), some speculate that YLL are low. We aim to estimate YLL attributable to COVID-19, before and after adjustment for number/type of LTCs. Methods: We first estimated YLL from COVID-19 using WHO life tables, based on published age/sex data from COVID-19 deaths in Italy. We then used aggregate data on number/type of LTCs inform a Bayesian model for likely combinations of LTCs among people dying with COVID-19. From these, we used routine UK healthcare data from Scotland and Wales to estimate life expectancy based on age/sex/ combinations of LTCs using Gompertz models. We then calculated YLL based on age, sex, type of LTCs and multimorbidity count. Results: Using the standard WHO life tables, YLL per COVID-19 death was 14 for men and 12 for women. After adjustment for number and type of LTCs, the mean YLL was slightly lower, but remained high (11.6 and 9.4 years for man and women, respectively). The number and type of LTCs led to wide variability in the estimated YLL at a given age (e.g. at ≥80 years, YLL was >10 years for people with 0 LTCs, and <3 years for people with ≥6). Conclusions: Deaths from COVID-19 represent a substantial burden in terms of per-person YLL, more than a decade, even after adjusting for the typical number and type of LTCs found in people dying of COVID-19. The extent of multimorbidity heavily influences the estimated YLL at a given age. More comprehensive and standardised collection of data on LTCs is needed to better understand and quantify the global burden of COVID-19 and to guide policy-making and interventions.

scholarly journals COVID-19 – exploring the implications of long-term condition type and extent of multimorbidity on years of life lost: a modelling study

2021 ◽  
Vol 5 ◽  
pp. 75
Author(s):  
Peter Hanlon ◽  
Fergus Chadwick ◽  
Anoop Shah ◽  
Rachael Wood ◽  
Jon Minton ◽  
...  
Keyword(s):  
Care Home ◽  
Life Tables ◽  
Years Of Life Lost ◽  
Limited Data ◽  
Long Term Conditions ◽  
Healthcare Data ◽  
Estimate Life Expectancy ◽  
Before And After ◽  
Wide Variability

Background: COVID-19 is responsible for increasing deaths globally. As most people dying with COVID-19 are older with underlying long-term conditions (LTCs), some speculate that YLL are low. We aim to estimate YLL attributable to COVID-19, before and after adjustment for number/type of LTCs, using the limited data available early in the pandemic. Methods: We first estimated YLL from COVID-19 using WHO life tables, based on published age/sex data from COVID-19 deaths in Italy. We then used aggregate data on number/type of LTCs in a Bayesian model to estimate likely combinations of LTCs among people dying with COVID-19. We used routine UK healthcare data from Scotland and Wales to estimate life expectancy based on age/sex/these combinations of LTCs using Gompertz models from which we then estimate YLL. Results: Using the standard WHO life tables, YLL per COVID-19 death was 14 for men and 12 for women. After adjustment for number and type of LTCs, the mean YLL was slightly lower, but remained high (11.6 and 9.4 years for men and women, respectively). The number and type of LTCs led to wide variability in the estimated YLL at a given age (e.g. at ≥80 years, YLL was >10 years for people with 0 LTCs, and <3 years for people with ≥6). Conclusions: Deaths from COVID-19 represent a substantial burden in terms of per-person YLL, more than a decade, even after adjusting for the typical number and type of LTCs found in people dying of COVID-19. The extent of multimorbidity heavily influences the estimated YLL at a given age. More comprehensive and standardised collection of data (including LTC type, severity, and potential confounders such as socioeconomic-deprivation and care-home status) is needed to optimise YLL estimates for specific populations, and to understand the global burden of COVID-19, and guide policy-making and interventions.

scholarly journals Different approaches to quantify years of life lost from COVID-19

2021 ◽  
Author(s):  
Tamás Ferenci
Keyword(s):  
Years Of Life Lost ◽  
Expected Number ◽  
Long Term Conditions ◽  
Developed Country ◽  
Individual Patient Level ◽  
Level Data ◽  
Parametric Survival Model ◽  
Epidemiologic Risk ◽  
Parametric Survival

AbstractThe burden of an epidemic is often characterized by death counts, but this can be misleading as it fails to acknowledge the age of the deceased patients. Years of life lost is therefore widely used as a more relevant metric, however, such calculations in the context of COVID-19 are all biased upwards: patients dying from COVID-19 are typically multimorbid, having far worse life expectation than the general population. These questions are quantitatively investigated using a unique Hungarian dataset that contains individual patient level data on comorbidities for all COVID-19 deaths in the country. To account for the comorbidities of the patients, a parametric survival model using 11 important long-term conditions was used to estimate a more realistic years of life lost. As of 12 May, 2021, Hungary reported a total of 27,837 deaths from COVID-19 in patients above 50 years of age. The usual calculation indicates 10.5 years of life lost for each death, which decreases to 9.2 years per death after adjusting for 11 comorbidities. The expected number of years lost implied by the life table, reflecting the mortality of a developed country just before the pandemic is 11.1 years. The years of life lost due to COVID-19 in Hungary is therefore 12% or 1.3 years per death lower when accounting for the comorbidities and is below its expected value, but how this should be interpreted is still a matter of debate. Further research is warranted on how to optimally integrate this information into epidemiologic risk assessments during a pandemic.

Extending the Comfort Zone: Building Resilience in Older People With Long-Term Conditions

2017 ◽  
Vol 38 (6) ◽  
pp. 825-848 ◽  
Author(s):  
Mark Robinson ◽  
Esmée Hanna ◽  
Gary Raine ◽  
Steve Robertson
Keyword(s):  
Older People ◽  
Peer Support ◽  
Social Engagement ◽  
Well Being ◽  
Significant Drop ◽  
Long Term Conditions ◽  
Before And After ◽  
And Gender ◽  
Ongoing Support

This article examines how a 6-week mental health resilience course for people with long-term conditions (LTCs; diabetes, heart disease, and arthritis) increased perceived resilience of older participants. This article examines how peer support assisted participants to develop resilience, considers gender issues, examines the importance of course activities, and explores how resilience enhances quality of life. A mixed methods approach was used. A before-and-after questionnaire was administered 3 times, including 3-month follow-up. Interviews were held with 24 program participants, aged 45 to 80 years. Diaries were kept by participants over 3 months. Survey findings showed significant gains in perceived resilience, at the end of the course, with no significant drop-off after 3 months. Interview and diary narratives highlighted positive experiences around well-being, condition management, and social engagement. Peer support was key to effective processes. Challenges concern ongoing support in communities, and considering age and gender variables when researching what improved resilience means to older people with LTCs.

scholarly journals Management of Gastric Varices Unsuccessfully Treated by Balloon-Occluded Retrograde Transvenous Obliteration: Long-Term Follow-Up and Outcomes

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Fumio Uchiyama ◽  
Satoru Murata ◽  
Shiro Onozawa ◽  
Ken Nakazawa ◽  
Fumie Sugihara ◽  
...  
Keyword(s):  
Hepatic Function ◽  
Gastric Varices ◽  
Gastroesophageal Varices ◽  
Before And After ◽  
Complete Obliteration ◽  
Long Term Follow Up ◽  
The Mean ◽  
Serum Ammonia

Our aim was to evaluate the long-term efficacy and safety of percutaneous transhepatic obliteration (PTO) alone and combined with balloon-occluded retrograde transvenous obliteration (BRTO) for gastroesophageal varices refractory to BRTO alone. Between July 1999 and December 2010, 13 patients with gastroesophageal varices refractory to BRTO were treated with PTO (n= 6) or a combination of PTO and BRTO (n= 7). We retrospectively investigated the rates of survival, recurrence, or worsening of the varices; hepatic function before and after the procedure; and complications. The procedure achieved complete obliteration or significant reduction of the varices in all 13 patients without major complications. During follow-up, the varices had recurred in 2 patients, of which one had hepatocellular carcinoma, and the other died suddenly from variceal rebleeding 7 years after PTO. The remaining 11 patients did not experience worsening of the varices and showed significant improvements in the serum ammonia levels and prothrombin time. The mean follow-up period was 90 months, and the cumulative survival rate at 1, 3, and 5 years was 92.9%, 85.7%, and 85.7%, respectively. Both PTO and combined PTO and BRTO seem as safe and effective procedures for the treatment of gastroesophageal varices refractory to BRTO alone.

scholarly journals Long-term follow-up of neodymium:YAG laser anterior capsulotomy for the treatment of anterior capsular phimosis

2018 ◽  
Vol 46 (9) ◽  
pp. 3692-3697 ◽  
Author(s):  
Hehua Ye ◽  
Jiming Zhang ◽  
Yiyong Qian
Keyword(s):  
Nd:Yag Laser ◽  
Case Series ◽  
Anterior Capsule ◽  
Long Term Study ◽  
Before And After ◽  
Long Term Follow Up ◽  
The Mean ◽  
Anterior Capsulotomy

Objective To investigate the long-term safety and efficacy of Nd:YAG laser anterior capsulotomy for the treatment of anterior capsular phimosis. Methods We retrospectively analyzed a consecutive case series of Nd:YAG laser anterior capsulotomy in patients with anterior capsular phimosis, who were treated between November 2012 and April 2014. Data collected included risk factors, interval between surgery and capsulotomy, best-corrected visual acuity (BCVA), and diameter of anterior capsule opening before and after Nd:YAG laser anterior capsulotomy. Results Eleven eyes of 11 patients were included in the study. The mean follow-up time was 30.1 ± 4.5 months (range: 26–42 months). At the last follow-up, the mean diameter of the anterior capsule opening was 5.1 ± 0.2 mm, which was significantly greater than the diameter before laser capsulotomy (2.2 ± 0.8 mm). BCVA remained stable or improved in nine eyes (81.8%) following capsulotomy. No patients experienced recurrence of phimosis. Conclusions In a long-term study of >2 years, we found that Nd:YAG laser anterior capsulotomy is safe and effective for the treatment of anterior capsule phimosis.

scholarly journals Importance of multidisciplinary trauma prevention program for youth

2014 ◽  
Vol 41 (4) ◽  
pp. 245-250 ◽  
Author(s):  
Alcir Escocia Dorigatti ◽  
Laísa Simakawa Jimenez ◽  
Barbara Ribeiro Redondano ◽  
Rodrigo Barros de Carvalho ◽  
Thiago Rodrigues Araujo Calderan ◽  
...  
Keyword(s):  
High School ◽  
High School Students ◽  
Prevention Program ◽  
Drunk Driving ◽  
School Students ◽  
Before And After ◽  
Huge Impact ◽  
The Mean ◽  
Alcohol Effects

OBJECTIVE: present the experience of the P.A.R.T.Y. program in Campinas, thereby changing the habits of young people.METHODS: The organizers visited the participating schools talking to the students, who are aged between 14-18 years. These students spent an afternoon at the Clinics Hospital of Unicamp, where, for four hours, they attended lectures of the organizers, partners and municipal sectors, and also visited the hospital, talking with trauma victims. Questionnaires were evaluated between2010-2012, being applied before and after the project.RESULTS:2,450 high school students attended the program. The mean age is 16 ± 0,99 years and 37.6% were male. 3.6% of males already drive while drunk versus 0.8% of women. Before the project 116 (11.3%) thought that drunk driving wasn't a risk, and only 37 (3.6%) knew the alcohol effects. After the project, 441 (43%) began to consider drunk driving a risk and 193 (18.8%) know the alcohol effects when driving. 956 (93.3%) considered that prevention projects have a huge impact on their formation.CONCLUSION: It's expected that the attendees will act as multipliers of information, conveying the message of prevention to their entire social circles resulting in reduction in the number of trauma events involving the young, in the long term.

scholarly journals Long-term outcomes of prediction error after combined phacoemulsification and trabeculectomy in glaucoma patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yeon Soo Kang ◽  
Mi Sun Sung ◽  
Hwan Heo ◽  
Yong Sok Ji ◽  
Sang Woo Park
Keyword(s):  
Risk Factors ◽  
Prediction Error ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Absolute Error ◽  
Long Term Outcomes ◽  
Corrected Visual Acuity ◽  
Before And After ◽  
The Mean

Abstract Background To investigate long-term outcomes of prediction error after phacotrabeculectomy and to determine risk factors that may cause unstable prediction error after phacotrabeculectomy in glaucoma patients. Methods A total 120 eyes of 120 patients who had underwent uncomplicated phacotrabeculectomy (combined group) or phacoemulsification (phaco-only group) were included. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) were measured before and after surgery, and anterior segment parameters including anterior chamber depth (ACD), lens vault (LV), and anterior vault (AV) measured using anterior-segment optical coherence tomography were compared between the two groups. The mean absolute error (MAE) at 3, 6, 12, and 24 months postoperatively were compared. Risk factors associated with unstable prediction error (MAE ≥ 0.5) were investigated in the combined group. Results In both groups, BCVA was improved and IOP was decreased significantly. MAE at 3, 6, 12, 24 months postoperatively were not significantly different between two groups. The risk factors for unstable prediction error after 12 months of phacotrabeculectomy were old age and LV. Whereas, the only factor predicting unstable prediction error after 24 months of phacotrabeculectomy was LV. The cut-off value of LV for predicting unstable refractive error analyzed by the ROC curve was 0.855 mm. Conclusions Phacotrabeculectomy may be an effective treatment with stable long-term outcomes of prediction error similar to phacoemulsification in patients with glaucoma. However, elderly patients or patients with large LV may be predisposed to unstable prediction error after phacotrabeculectomy.

scholarly journals Effect of vitamin D supplementation on fetal growth and development in pregnant women

Biomedicine ◽  
2021 ◽  
Vol 41 (4) ◽  
pp. 821-824
Author(s):  
Srilekha V. ◽  
B. Vijayalakshmi ◽  
I. Yogananda Reddy ◽  
Nayiema Fathima
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Vitamin D Supplementation ◽  
Mean Difference ◽  
Post Intervention ◽  
Biparietal Diameter ◽  
Before And After ◽  
The Mean

Introduction and Aim:  Fetal growth is a dynamic process that must be monitored in pregnant women to reduce the long-term consequences of fetal anomalies and post-natal effects on their life. The current study was aimed to find out the effectiveness and association of vitamin D on fetal growth during the prenatal period.   Materials and Methods: It was a randomized control trial undertaken in 100 pregnant women who were allocated randomly into two groups based on calcemic state. After giving 6000 IU of vitamin D intervention the fetal growth was measured at the end of 3 months and the variables were obtained before and after the intervention.   Results: The mean difference of fetal weight between groups was 77g was significantly increased to 277g (p<0.01) after 3 months. The mean difference of femur length before intervention was 0.95mm (p-0.18) significantly increased to 3.03mm (p<0.01). Further, the mean biparietal diameter difference was 0.13mm (p-0.92) was substantially increased to 4.77mm(p<0.01).   Conclusion: The current study suggests that the fetal growth variables were significantly increased in post-intervention phases which can be attributed to vitamin D. It has an immense effect on fetal growth which can be supplemented during different trimesters to enhance fetal development.

scholarly journals Long-Term Refractive Outcomes After Combined Phacoemulsification and Trabeculectomy in Glaucoma Patients

2020 ◽  
Author(s):  
Yeon Soo Kang ◽  
Mi Sun Sung ◽  
Hwan Heo ◽  
Yong Sok Ji ◽  
Sang Woo Park
Keyword(s):  
Risk Factors ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Absolute Error ◽  
Refractive Outcome ◽  
Refractive Outcomes ◽  
Corrected Visual Acuity ◽  
Before And After ◽  
The Mean

Abstract Background: To investigate long-term refractive outcomes after phacotrabeculectomy and to determine risk factors that may cause unstable refractive outcomes after phacotrabeculectomy in glaucoma patients.Methods: A total 120 eyes of 120 patients who had underwent uncomplicated phacotrabeculectomy (combined group) or phacoemulsification (phaco-only group) were included. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) were measured before and after surgery, and anterior segment parameters including anterior chamber depth (ACD), lens vault (LV), and anterior vault (AV) measured using anterior-segment optical coherence tomography were compared between the two groups. The mean absolute error (MAE) at 3, 6, 12, and 24 months postoperatively were compared. Risk factors associated with unstable refractive outcomes (MAE ≥ 0.5) were investigated in the combined group.Results: In both groups, BCVA was improved and IOP was decreased significantly. MAE at 3, 6, 12, 24 months postoperatively were not significantly different between two groups. The risk factors for unstable refractive outcomes after 12 months of phacotrabeculectomy were old age and LV. Whereas, the only factor predicting unstable refractive outcome after 24 months of phacotrabeculectomy was LV. The cut-off value of LV for predicting unstable refractive outcome analyzed by the ROC curve was 0.855 mm.Conclusions: Phacotrabeculectomy may be an effective treatment with predictable long-term refractive outcomes similar to phacoemulsification in patients with glaucoma. However, elderly patients or patients with large LV may be predisposed to unpredictable postoperative refractive outcomes after phacotrabeculectomy.

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