Estimating Asthma, Myocardial Infarction, and Heart Failure Hospitalizations and Emergency Room Visits in New York City from PM2.5 Exposure Using a Bayesian Modeling Approach

2018 ◽  
Vol 2018 (1) ◽  
Author(s):  
Eric Steven Hall
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
New York ◽  
New York City ◽  
Emergency Room ◽  
York City ◽  
Bayesian Modeling ◽  
Emergency Room Visits ◽  
Modeling Approach ◽  
Pm2.5 Exposure

scholarly journals Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study

BMJ ◽  
2020 ◽  
pp. m1966 ◽  
Author(s):  
Christopher M Petrilli ◽  
Simon A Jones ◽  
Jie Yang ◽  
Harish Rajagopalan ◽  
Luke O’Donnell ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Mechanical Ventilation ◽  
New York City ◽  
Cohort Study ◽  
Critical Illness ◽  
Hospital Admission ◽  
York City ◽  
Hospice Care ◽  
Male Sex

AbstractObjectiveTo describe outcomes of people admitted to hospital with coronavirus disease 2019 (covid-19) in the United States, and the clinical and laboratory characteristics associated with severity of illness.DesignProspective cohort study.SettingSingle academic medical center in New York City and Long Island.Participants5279 patients with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection between 1 March 2020 and 8 April 2020. The final date of follow up was 5 May 2020.Main outcome measuresOutcomes were admission to hospital, critical illness (intensive care, mechanical ventilation, discharge to hospice care, or death), and discharge to hospice care or death. Predictors included patient characteristics, medical history, vital signs, and laboratory results. Multivariable logistic regression was conducted to identify risk factors for adverse outcomes, and competing risk survival analysis for mortality.ResultsOf 11 544 people tested for SARS-Cov-2, 5566 (48.2%) were positive. After exclusions, 5279 were included. 2741 of these 5279 (51.9%) were admitted to hospital, of whom 1904 (69.5%) were discharged alive without hospice care and 665 (24.3%) were discharged to hospice care or died. Of 647 (23.6%) patients requiring mechanical ventilation, 391 (60.4%) died and 170 (26.2%) were extubated or discharged. The strongest risk for hospital admission was associated with age, with an odds ratio of >2 for all age groups older than 44 years and 37.9 (95% confidence interval 26.1 to 56.0) for ages 75 years and older. Other risks were heart failure (4.4, 2.6 to 8.0), male sex (2.8, 2.4 to 3.2), chronic kidney disease (2.6, 1.9 to 3.6), and any increase in body mass index (BMI) (eg, for BMI >40: 2.5, 1.8 to 3.4). The strongest risks for critical illness besides age were associated with heart failure (1.9, 1.4 to 2.5), BMI >40 (1.5, 1.0 to 2.2), and male sex (1.5, 1.3 to 1.8). Admission oxygen saturation of <88% (3.7, 2.8 to 4.8), troponin level >1 (4.8, 2.1 to 10.9), C reactive protein level >200 (5.1, 2.8 to 9.2), and D-dimer level >2500 (3.9, 2.6 to 6.0) were, however, more strongly associated with critical illness than age or comorbidities. Risk of critical illness decreased significantly over the study period. Similar associations were found for mortality alone.ConclusionsAge and comorbidities were found to be strong predictors of hospital admission and to a lesser extent of critical illness and mortality in people with covid-19; however, impairment of oxygen on admission and markers of inflammation were most strongly associated with critical illness and mortality. Outcomes seem to be improving over time, potentially suggesting improvements in care.

Asthma, Allergy, and Air Pollution

2002 ◽  
Author(s):  
Inge F. Goldstein ◽  
Martin Goldstein
Keyword(s):  
United States ◽  
New York ◽  
Air Pollution ◽  
New York City ◽  
Emergency Room ◽  
York City ◽  
The United States ◽  
York City Department ◽  
Diesel Trucks ◽  
The City

One night in early October 1997, Felipe G., a nine-year-old child of Dominican immigrants to New York City living in East Harlem, woke up struggling for breath. Felipe had had asthma attacks before, and his parents knew, or thought they knew, what to do: they called for an ambulance, which rushed him to the emergency room of Harlem Hospital nearby. But this time he stopped breathing on the way to the hospital, and could not be revived there. His younger sister Ana also has asthma, but so far has never had to go to the emergency room. The tenement building in which Felipe’s family lives is three blocks from the Harlem River Drive, a highway on which thousands of cars travel each workday, emitting, in spite of their catalytic converters, large quantities of oxides of nitrogen, carbon monoxide, and incompletely combusted gasoline. Several blocks north is a parking garage for the diesel trucks of the New York City Department of Sanitation. The drivers of the trucks that use the lot often keep their motors idling, so that great quantities of diesel exhaust particles are emitted to the surrounding area. The Harlem district of New York City, inhabited mainly by African-Americans and Hispanics, is shielded to a large extent from the prevailing west winds by higher areas on the west side of Manhattan. Hence, air pollution produced within Harlem—for example, by cars, diesel trucks, and buses, and by an electric power generating plant located there—tends to remain longer than in other areas of the city. The New York City Department of Environmental Protection operated a network of air monitoring stations from the 1940s to the 1970s, during which time Harlem was consistently found to be the most polluted area in the city. It had then, and still has, one of the highest rates of hospitalization for asthma in the city. In most countries, asthma is more common among children of higher social class. In the United States this pattern is reversed: people living in the inner cities of the United States, mostly low-income minorities, have higher rates of asthma than other Americans.

scholarly journals ‘Walking the line between saint and sinner’

2016 ◽  
Vol 11 (2) ◽  
pp. 151-163 ◽  
Author(s):  
Kristyn Gorton
Keyword(s):  
New York ◽  
New York City ◽  
Emergency Room ◽  
York City ◽  
City Hospital ◽  
Contemporary Society ◽  
American Television ◽  
Moral Boundaries ◽  
Moral Ethics ◽  
Care Practices

This article considers how the notion of care, whether as an act of kindness or as a moral ethics, is reflected and worked through in the contemporary American television series, Nurse Jackie (2009–2015). Nurse Jackie, a comedy drama set in a fictional Catholic New York City Hospital, explores the ‘line between saint and sinner’, in the life of an emergency room (ER) nurse. This article considers how Jackie’s character negotiates moral boundaries in a way that allows for a reconsideration of both the complexity of care practices in contemporary society and the gendered nature of these practices.

scholarly journals 429. Ocular gonorrhea infections in New York City, 2006–2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S214-S215 ◽  
Author(s):  
Maroun M Sfeir ◽  
Kimberly Johnson ◽  
Ellen Klingler ◽  
Julia Schillinger
Keyword(s):  
New York ◽  
New York City ◽  
Emergency Room ◽  
Hospital Discharge ◽  
York City ◽  
New York State ◽  
Surveillance Data ◽  
York State ◽  
Hospital Discharge Database ◽  
Discharge Database

Abstract Background Ocular gonorrhea infections (OGI) have been rarely reported in United States adults. Unlike other bacterial eye infections which may be treated with topical antibiotics, OGI is typically characterized by purulent conjunctivitis with profuse exudate and requires treatment with systemic antibiotics. Genital gonorrhea infections are increasing nationally and in New York City (NYC). New York State mandates prophylactic antibiotic treatment of newborns to prevent purulent conjunctivitis. We describe the number and characteristics of OGI case-patients diagnosed among NYC residents over a 12-year period. Methods We examined data from two different sources: (1) the NYC Health Department sexually transmitted infections (STI) surveillance registry (January 2006-October 2017) in which OGI cases were defined as laboratory-confirmed infection of the eye or eye appendages; and (2) a hospital discharge database (inpatient and emergency room) for NYC residents admitted to any New York State hospital (inpatient or emergency room discharges, January 2006–December 2016) in which cases of OGI were identified using diagnostic codes corresponding to OGI. We characterized de-duplicated OGI cases identified across these data sources for 2006–2017 and calculated the OGI rate/100,000 reported gonorrhea cases. Results Thirty-six OGI cases were identified in STI surveillance data and 55 additional cases in the hospital discharge database. Out of the total of 91 OGI cases, 20 (22%) were ≤1 year (11 males, 9 females), 3 (3.3%) were 2–14 years (all males), and 68 (74.7%) were ≥15 years old. Among the 68 adolescent/adult case-patients, the mean age was 29.04 ± 13.4 years. The majority were males (69.1%, 47/68,) and African American (42.6%, 29/68). The OGI rate in adolescents/adults was 39.95/100,000 gonorrhea cases (females, 35.76; males, 42.31); the rate remained almost constant since 2006 despite the increases in gonorrhea over the past decade. Conjunctivitis was the most common presentation (90.1% of all cases; 82/91), followed by eye appendage infections (2.2%; 2/91). The STI surveillance data revealed the diagnosis of OGI was made mainly by ocular culture (86.1%; 31/36), followed by nucleic acid amplification test (NAAT) (8.3%), or both culture and NAAT (5.6%). Conclusion OGI appear to be a rare disease in NYC. The majority of infections occurred among adolescents and adults, likely due to mandated newborn prophylaxis. Disclosures All authors: No reported disclosures.

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