The epidemiology of falls in Portugal: An analysis of hospital admission data

Background Falls are a common cause of injury and pose an increased risk of morbidity, mortality, and lifelong disability. Falls encompass a troublesome definition and can pose challenges in epidemiological studies. Data on fall-related hospital admissions in Portugal remain unpublished. This study aimed to examine the epidemiology of fall-related hospital admissions in the Portuguese population between 2010 and 2018. It also aimed to examine annual rates of fall-related hospital admissions using three methodological approaches. Methods The Portuguese Hospital Morbidity Database was used to identify all cases resulting in one or more inpatient admission in public hospitals related to falls from 2010 to 2018. Fall-related hospital admissions were described by age groups, sex, geographical area of residence, and type of fall. Annual rates were computed using three approaches: i) based on the number of inpatient admissions with an ICD code of fall, ii) based on the number of patients admitted to inpatient care with an ICD code of fall, and iii) based on the number of inpatient admissions with a principal diagnosis of injury. Results Between 2010 and 2018, 383,016 fall-related admissions occurred in 344,728 patients, corresponding to 2.1% of the total number of hospitalizations during the same period. Higher rates were seen among the younger (20–25) and the oldest age groups (+85), males until the age of 60, females from the age of 60, and areas of residence with a higher aging index. An overall rate of falls per 100,000 population was estimated at 414 (based on number of admissions), 373 (based on number of patients) and 353 (based on number of admissions with a principal diagnosis of injury). Conclusions This study provides an overall picture of the landscape of falls in a scarcely explored setting. The results aim to contribute to identifying appropriate preventive interventions and policies for these populations.

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Designing Epidemiology Studies to Determine the Incidence and Prevalence of Encapsulating Peritoneal Sclerosis (EPS)

Peritoneal Dialysis International ◽

10.3747/pdi.2015.00186 ◽

2015 ◽

Vol 35 (7) ◽

pp. 678-682 ◽

Cited By ~ 3

Author(s):

Dorothea Nitsch ◽

Andrew Davenport

Keyword(s):

Significant Risk ◽

Significant Risk Factor ◽

Epidemiological Studies ◽

Length Of Treatment ◽

Current Test ◽

Number Of Patients ◽

Increased Risk ◽

Different Types ◽

Epidemiology Studies

The reported incidence and prevalence of encapsulating peritoneal sclerosis (EPS) varies markedly between North America, Europe, Japan, and Australia. Although this could reflect differences in clinical practice patterns and access to transplantation as there is no current test for early detection, and some patients may present many years after discontinuation of peritoneal dialysis (PD), there are concerns about under-reporting, particularly for those with milder forms. Currently, only PD vintage has been identified as a significant risk factor for developing EPS, although some patients can develop EPS within months of starting PD. As such, there is a need for epidemiological studies to determine the incidence and prevalence of EPS to allow for patient education and counselling in terms of dialysis modality choice and length of treatment. In addition, carefully designed epidemiological studies could potentially allow for the identification of risk factors and bio-markers that could then be used to identify patients at increased risk of developing EPS in the future. Typically, studies to date have been underpowered with inadequate longitudinal follow-up. We review the different types of epidemiological studies and provide information as to the number of patients to be recruited and the duration of follow-up required to determine the incidence and prevalence of EPS.

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Clinical management and mortality risk in those with eating disorders and self-harm: e-cohort study using the SAIL databank

BJPsych Open ◽

10.1192/bjo.2021.23 ◽

2021 ◽

Vol 7 (2) ◽

Author(s):

Ann John ◽

Amanda Marchant ◽

Joanne Demmler ◽

Jacinta Tan ◽

Marcos DelPozo-Banos

Keyword(s):

Eating Disorders ◽

Cohort Study ◽

Mortality Risk ◽

Hospital Admissions ◽

Age Groups ◽

Healthcare Utilisation ◽

Years Of Life Lost ◽

Service Utilisation ◽

Increased Risk ◽

Self Harm

Background Individuals with eating disorders who self-harm are a vulnerable group characterised by greater pathology and poorer outcomes. Aims To explore healthcare utilisation and mortality in those with a record of: self-harm only; eating disorders only; and both co-occurring. Method We conducted a retrospective whole population e-cohort study of individuals aged 10–64 years from 2003 to 2016. Individuals were divided into: record of self-harm only; eating disorders only; both self-harm and eating disorders; and no record of self-harm or eating disorders. We used linked routinely collected healthcare data across primary care, emergency departments, hospital admissions and out-patient appointments to examine healthcare contacts and mortality. Results We identified 82 627 individuals: n = 75 165 with self-harm only; n = 5786 with eating disorders only; n = 1676 with both combined. Across all groups and settings significantly more individuals attended with significantly more contacts than the rest of the population. The combined group had the highest number of contacts per person (general practitioner, incident rate ratio IRR = 3.3, 95% CI 3.1–3.5; emergency department, IRR = 5.2, 95% CI 4.7–5.8; hospital admission, IRR = 5.2, 95% CI 4.5–6.0; out-patients, IRR = 3.9, 95% CI 3.5–4.4). Standardised mortality ratios showed the highest excess mortality overall in the self-harm only group (SMR = 3.2, 95% CI 3.1–3.3), particularly for unnatural causes of death (SMR = 17.1, 95% CI 16.3–17.9). SMRs and years of life lost showed an increased risk of mortality in younger age groups in the combined group. Adjusted hazard ratios showed increased mortality across all groups (self-harm only, HR = 5.3, 95% CI 5.2–5.5; eating disorders only, HR = 4.1, 95% CI 3.4–4.9; combined group, HR = 6.8, 95% CI 5.4–8.6). Conclusions Individuals in all groups had higher healthcare service utilisation than the general population. The increased mortality risk in young people with a record of both eating disorders and self-harm highlights the need for early specialist intervention and enhanced support.

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Hospitalization of children under five years of age due to avoidable causes

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692012000100018 ◽

2012 ◽

Vol 20 (1) ◽

pp. 135-142 ◽

Cited By ~ 7

Author(s):

Rosana Rosseto de Oliveira ◽

Josane Rosenilda da Costa ◽

Thais Aidar de Freitas Mathias

Keyword(s):

Health Care ◽

Primary Health Care ◽

Child Health ◽

Hospital Admissions ◽

Age Groups ◽

Perinatal Period ◽

Parasitic Diseases ◽

Main Diagnosis ◽

Primary Health ◽

Hospital Morbidity

This study characterizes the profile of hospital morbidity according to the main diagnosis upon admission, in individuals younger than five years old, residents of three cities (Maringá, Sarandi and Paiçandu) in the Paraná state, Brazil. Information contained in hospital admission forms from 1998 to 2009 was used. The hospitalizations of 41,220 individuals younger than five years old were analyzed. The results indicate a decline of 16.1% in hospital admissions of patients younger than five years old in relation to the total number of admissions in all age groups. As for the main diagnoses, there were diseases of the respiratory system (55.6%), infectious and parasitic diseases (14.8%) and diseases originating in the perinatal period (12.9%). Such conditions can be avoided by implementing primary health care measures, which shows the need to intensify the actions recommended by the programs directed to child health.

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Association between Ambient Temperature and Severe Diarrhoea in the National Capital Region, Philippines

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158191 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8191

Author(s):

Paul L. C. Chua ◽

Chris Fook Sheng Ng ◽

Adovich S. Rivera ◽

Eumelia P. Salva ◽

Miguel Antonio Salazar ◽

...

Keyword(s):

Ambient Temperature ◽

Hospital Admissions ◽

Healthcare Services ◽

Epidemiological Studies ◽

National Capital Region ◽

Severe Diarrhoea ◽

Capital Region ◽

Relative Risks ◽

Increased Risk ◽

National Capital

Epidemiological studies have quantified the association between ambient temperature and diarrhoea. However, to our knowledge, no study has quantified the temperature association for severe diarrhoea cases. In this study, we quantified the association between mean temperature and two severe diarrhoea outcomes, which were mortality and hospital admissions accompanied with dehydration and/or co-morbidities. Using a 12-year dataset of three urban districts of the National Capital Region, Philippines, we modelled the non-linear association between weekly temperatures and weekly severe diarrhoea cases using a two-stage time series analysis. We computed the relative risks at the 95th (30.4 °C) and 5th percentiles (25.8 °C) of temperatures using minimum risk temperatures (MRTs) as the reference to quantify the association with high- and low-temperatures, respectively. The shapes of the cumulative associations were generally J-shaped with greater associations towards high temperatures. Mortality risks were found to increase by 53.3% [95% confidence interval (CI): 29.4%; 81.7%)] at 95th percentile of weekly mean temperatures compared with the MRT (28.2 °C). Similarly, the risk of hospitalised severe diarrhoea increased by 27.1% (95% CI: 0.7%; 60.4%) at 95th percentile in mean weekly temperatures compared with the MRT (28.6 °C). With the increased risk of severe diarrhoea cases under high ambient temperature, there may be a need to strengthen primary healthcare services and sustain the improvements made in water, sanitation, and hygiene, particularly in poor communities.

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The risk of severe COVID-19: hospital and ICU admission rates in Norway

10.1101/2020.07.16.20155358 ◽

2020 ◽

Cited By ~ 1

Author(s):

Morten Munkvik ◽

Ingvild Vatten Alsnes ◽

Lars Vatten

Keyword(s):

Hospital Admissions ◽

Age Groups ◽

Admission Rate ◽

Epidemiological Studies ◽

Population Based ◽

Western Region ◽

Eastern Region ◽

Detailed Data ◽

Admission Rates ◽

Restrictive Measures

Background: Epidemiological studies of COVID-19 with population based information may add to the knowledge needed to prioritise resources and advice on how restrictive measures should be targeted. This study provides admission rates to hospitals and intensive care units (ICU) in Norway, aiming to better understand the risk of severe COVID-19 infection. Methods: Data from official reports from The Norwegian Institute of Public Health (NIPH) and the Norwegian Directorate of Health were used to calculate admission rates to hospitals and to ICU per 100 000 inhabitants. We compared rates of hospitalisation between the four health regions and provide separate rates for Oslo. We also assessed national admissions to ICU stratified by age. Results: The admission rate in the south-eastern region was 3.1 per 100 000, and the rate for Oslo was 5.8. Compared to the western region (reference), the Oslo rate was 4.0 times (confidence interval (CI) 3.0-5.5) higher. In Norway as a whole, the rate of ICU admissions was 3.9 per 100 000, and in the age groups 60-69 and 70-79, ICU rates were 10.3 and 11.5, respectively. These rates were 9.5 (CI 6.3-14.3) and 10.6 (CI 6.9-16.2) times higher compared to people younger than 50 years. Conclusion: Hospital admissions due to Covid-19 are much higher in Oslo than anywhere else in Norway, and in the country as a whole, ICU admissions are highest among people 60-79 years of age. These results and more detailed data could provide better advice on how restrictions can be safely lessened.

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Factors Affecting Return Visits to the Emergency Department within 30 Days

10.22514/sv.2020.16.0080 ◽

2020 ◽

Keyword(s):

Hospital Admissions ◽

Demographic Data ◽

Age Groups ◽

Delayed Diagnosis ◽

University Hospital ◽

Renal Diseases ◽

Return Visit ◽

Triage Category ◽

Increased Risk ◽

Return Visits

Background and Objectives: The goal of this study is to determine the factors associated with the admission to hospital on a return visit to the ED. The reasons of return visits to the ED are complex and involve such causes as disease progression, medical errors, delayed diagnosis, or misdiagnosis. Materials and methods: A retrospective study was conducted in Vilnius University Hospital Santaros Klinikos. All the emergency visits from 1 January 2018 through 20 May 2019 were included. The patients were divided into two groups: the patients who visited the ED only once within a month were attributed to group 1, while those who paid two or more visits to the ED within 30 days belonged to group 2. The demographic data, the triage category, the number of laboratory and radiology tests, specialist consultations, diagnoses and the time spent in the ED were evaluated. The statistical analysis was performed using R statistical software package, non-parametric statistical methods were used. Results: 32,215 patients were included in the analysis, 3,243 patients (10.05%of all the initial visits) returned to the ED within 30 days. The number of laboratory tests had a statistically significant impact on admission to the ward both the first and the return visits. The triage category was associated with the admission on the return visit to the ED. Age, gender, number of consultations and radiology tests had no medium or large impact. Among the diagnoses, cardiovascular, gastrointestinal and renal diseases were related to the admission on return visit. Conclusions: Patients with cardiovascular, gastrointestinal and renal system diseases in all age groups, patients with medical conditions and advanced investigation (the increased number of laboratory testing and the time spent in the ED) have an increased risk for a return visit over a 30-day time frame and an increased rate of hospital admissions.

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Rectal bleeding

10.1093/med/9780199568741.003.0030 ◽

2018 ◽

Author(s):

Satish Keshav ◽

Alexandra Kent

Keyword(s):

Colorectal Cancer ◽

Diverticular Disease ◽

Rectal Bleeding ◽

Hospital Admissions ◽

Age Groups ◽

Epidemiological Studies ◽

Common Symptom ◽

Mortality And Morbidity ◽

Common Causes

Rectal bleeding is a common symptom, affecting all age groups, with the highest incidence in the sixth and seventh decades and associated with a higher mortality and morbidity with increasing age. Epidemiological studies have shown rectal bleeding to occur in nearly 1% of hospital admissions. Bleeding stops spontaneously in 80% of cases, although rebleeding occurs in 25%. Common causes are haemorrhoids, diverticular disease, and colorectal cancer or polyps.

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Heat, heatwaves and cardiorespiratory hospital admissions in Helsinki, Finland

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.140 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

H Sohail ◽

P Tiittanen ◽

V Kollanus ◽

T Lanki

Keyword(s):

Hospital Admissions ◽

Age Groups ◽

Health Sector ◽

Northern Europe ◽

Finnish Meteorological Institute ◽

The Public ◽

Weather Information ◽

National Hospital Discharge Register ◽

Increased Risk ◽

Summer Time

Abstract Background There is a lack of knowledge concerning the effects of heat on morbidity in Northern Europe. Therefore, this study aimed to evaluate the relationships of daily summer-time temperature and heatwaves with cardiorespiratory hospital admissions in Helsinki, Finland. Methods Time-series models adjusted for potential confounders such as air pollution were used to investigate the associations of daily temperature and heatwaves with cause-specific cardiorespiratory hospital admissions, during the summer months of 2000-2017. Daily number of hospitalizations was obtained from the national hospital discharge register, weather information from the Finnish meteorological institute. Results Heatwave-days were associated with an increased risk of pneumonia (RR: 1.17, 95%CI: 1.04-1.31), any respiratory disease in some age groups, and myocardial infarction (RR: 1.54, 95% CI: 1.12-2.12) among person 65-74 years of age. In addition, high effect estimates were observed for many types of cardiorespiratory diseases in association with heatwaves in some age-groups. In contrast, risk of arrhythmia was decreased during heatwaves (RR: 0.81, 95% CI: 0.70-0.93). Conclusions We found no associations and even protective associations between daily mean temperature and cardiorespiratory hospital admissions. However, our results suggest that heatwaves are a serious health threat affecting the morbidity even in the Northern climate Key messages Heatwaves are associated with increased risk of cardio-respiratory hospital admissions. There is a need to adapt to climate change in the public health sector also in Northern Europe to protect vulnerable population groups.

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Hospitalisation in Children with Adrenal Insufficiency and Hypopituitarism: Is There a Differential Burden between Boys and Girls and between Age Groups?

Hormone Research in Paediatrics ◽

10.1159/000479370 ◽

2017 ◽

Vol 88 (5) ◽

pp. 339-346 ◽

Cited By ~ 8

Author(s):

R. Louise Rushworth ◽

Georgina L. Chrisp ◽

Benjamin Dean ◽

Henrik Falhammar ◽

David J. Torpy

Keyword(s):

Adrenal Insufficiency ◽

Hospital Admissions ◽

Age Groups ◽

Admission Rate ◽

Adrenal Crisis ◽

Age Group ◽

Adrenal Hyperplasia ◽

Prevention Strategies ◽

Principal Diagnosis ◽

Admission Rates

Background/Aims: To determine the burden of hospitalisation in children with adrenal insufficiency (AI)/hypopituitarism in Australia. Methods: A retrospective study of Australian hospitalisation data. All admissions between 2001 and 2014 for patients aged 0–19 years with a principal diagnosis of AI/hypopituitarism were included. Denominator populations were extracted from national statistics datasets. Results: There were 3,779 admissions for treatment of AI/hypopituitarism in patients aged 0–19 years, corresponding to an average admission rate of 48.7 admissions/million/year. There were 470 (12.4%) admissions for an adrenal crisis (AC). Overall, admission for AI/hypopituitarism was comparable between the sexes. Admission rates for all AI, hypopituitarism, congenital adrenal hyperplasia (CAH), and “other and unspecified causes” of AI were highest among infants and decreased with age. Admissions for primary AI increased with age in both sexes. Males had significantly higher rates of admission for hypopituitarism. AC rates differed by both sex and age group. Conclusion: This nationwide study of the epidemiology of hospital admissions for a principal diagnosis of AI/hypopituitarism shows that admissions generally decreased with age; males had higher rates of admission for hypopituitarism; females had higher rates of admission for CAH and “other and unspecified causes” of AI; and AC incidence varied by age and sex. Increased awareness of AI and AC prevention strategies may reduce some of these admissions.

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Age, Comorbidities, and Mortality Correlation in COVID-19 Patients: A Review

Journal of Respiratory Infections ◽

10.18297/jri/vol4/iss1/69 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Vidyulata Salunkhe ◽

Keyword(s):

Age Groups ◽

Economic Policies ◽

The Novel ◽

Risk Of Death ◽

Grand Total ◽

Risk Of Mortality ◽

Number Of Patients ◽

Increased Risk ◽

Novel Virus ◽

Underlying Diseases

Background: The risk of death due to COVID-19 among hospitalized patients is known to be higher in older adults and those with underlying health conditions. Understanding the percentage of patients who are at increased risk of death due COVID-19 and how this varies between age groups will inform the healthcare community how to evaluate the risk of COVID-19, and better design healthcare and economic policies. Methods: We conducted a literature search for studies published between December 2019 until May 16, 2020 in PubMed, Embase, and Cochrane (CENTRAL). Descriptive statistics were performed. Results: We reviewed 14 studies of which 13 were retrospective and one was prospective. Eleven studies were conducted in Wuhan, China. A grand total of 11,938 COVID-19 confirmed patients were reviewed. Among these patients, 7637 (64%) were males. Our review reported hypertension (41%), diabetes (21%), cardiac diseases (14%), COPD (8%), chronic kidney disease (4%) and cerebrovascular disease (10%) as the most common underlying diseases among patients who died during hospitalization due to COVID-19. The total number of patients died in the hospital was 1744 (15%). Among patients who died in the hospital, 1% patients were 30-39 years, 16% patients were 40-59 years and 83% patients were more than 60 years of age. Conclusions: Older patients with underlying diseases appear to be at higher risk of mortality from COVID-19. Comorbidities are significant predictors of mortality in COVID-19 patients. There is an urgent need to know the epidemiology of the novel virus and characterize its potential impact.

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