Ten-Year Study of Pediatric Drownings and Near-Drownings in King County, Washington: Lessons in Injury Prevention

PEDIATRICS ◽  
1989 ◽  
Vol 83 (6) ◽  
pp. 1035-1040
Author(s):  
Linda Quan ◽  
Edmond J. Gore ◽  
Kim Wentz ◽  
Jill Allen ◽  
Alvin H. Novack
Keyword(s):  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
King County ◽  
Fatality Rate ◽  
Swimming Pools ◽  
Older Children ◽  
History Of ◽  
Water Sports ◽  
Preschool Aged Children

The factors associated with submersion events among <20-year-old persons that occurred in King County from 1974 to 1983 were studied to focus prevention efforts. Near-drowning (n = 103) and drowning (n = 96) victims were identified from medical examiners' reports, paramedics' reports, and hospital discharge registers. Annual incidence was 5.5; the mortality rate was 2.6 per 100,000 children. Although preschool-aged children had the largest incidence (12.8), followed by older adolescents (4.9), adolescents had the largest case fatality rate, 77%. Lake and river victims had the largest incidence, mortality, and case fatality rate; swimming pools, the smallest case fatality rate (25%). A total of 89% of all victims had absent or no supervision; victims supervised by lifeguards had a 42% case fatality rate. Prior seizures were part of the history of 7.5% of all victims; 25% of fatal submersions by adolescents were associated with alcohol. Bathtub submersions were associated with child abuse in three of 16 preschool-aged children and epilepsy in four of five older children. Certain age groups and sites combined had the greatest incidence: preschool-aged children in swimming pools, infants in bathtubs, teenagers in lakes and rivers. Incidence decreased in public and semipublic pools coincident with fencing regulations. These findings suggest prevention strategies: extending fencing requirements to private pools, discouraging alcohol consumption during water sports, changing bathing practices of epileptics, and improving lifeguard efficacy.

scholarly journals Disease Profile and Death Pattern among the Children Admitted in Rajshahi Medical College Hospital

2021 ◽  
Vol 34 (1) ◽  
pp. 55-62
Author(s):  
Be Nazir Ahmmad ◽  
Fazlur Rahman ◽  
Naznin Parvin ◽  
Md Shamsul Alam ◽  
Shitangshu Banerjee ◽  
...  
Keyword(s):  
Health Care ◽  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Medical College Hospital ◽  
Watery Diarrhea ◽  
Fatality Rate ◽  
College Hospital ◽  
Under Five ◽  
Medical College

Background: Rajshahi medical college hospital is a tertiary care teaching and referral center in the North-West part of Bangladesh. To assess the epidemiological trend in hospital admission, including morbidity and mortality pattern of illness in the pediatric population, it needs to develop effective health care planning, appropriate resource allocation, and integration of existing health care service facilities. Objective: To evaluate the diseases and deaths of children admitted in the department of pediatrics, Rajshahi medical college hospital, Rajshahi. Materials and methods: This is a retrospective study. The collected case records of all patients admitted in the department of pediatrics from 1st January 2017 to 31st December 2019 (3 years) were analyzed.  Result: A total of 62000 children were admitted during the mentioned study period. All the patients were distributed into three age groups infant, under five, and more than five, contributing 22%, 27.5%, and 19%, respectively. Acute watery diarrhea (21%), hereditary hemolytic anemia (18%), bronchopneumonia (10.4%), acute gastritis (9.4%), and acute bronchiolitis and wheezy child (7.17%) were the top five diseases in each of the three years of admission. Among the total admitted patients, 1003 (1.61%) patients died. Infant, under five, and more than five age groups constitute 61.3%, 28.1%, and 15.1%, respectively. Encephalitis and fulminant hepatic failure found the top two diseases causing death with a case fatality rate was 61% and 43%, respectively. The next highest case fatality rate was found in acute leukemia (15%). Other common causes of death include meningitis, cerebral palsy with complications (7.5%), bronchopneumonia with complications (3.8%). Conclusion: An admission-related comprehensive evaluation of this study will help to understand the diseases and death patterns of a hospital, leading to the development of more effective planning and case management strategies. TAJ 2021; 34: No-1: 55-62

CASE FATALITY IN INFANTS AND CHILDREN WITH PERTUSSIS, 1942-1946

PEDIATRICS ◽  
1950 ◽  
Vol 5 (5) ◽  
pp. 840-852
Author(s):  
JEROME L. KOHN ◽  
ALFRED E. FISCHER ◽  
HERBERT H. MARKS
Keyword(s):  
United States ◽  
Case Fatality Rate ◽  
Communicable Disease ◽  
Case Fatality ◽  
The United States ◽  
Fatality Rate ◽  
Older Children ◽  
Severity Of The Disease ◽  
One Year ◽  
In Infants And Children

Analysis of data on patients with pertussis during 1942-1946 obtained by means of a questionnaire from communicable disease hospitals and from health officers in a number of cities in the United States and Canada showed these results: Case fatality rates of patients admitted to hospitals for treatment have declined substantially in the period under review. This decline is general, both among infants under one year of age and among older children. In 1946, the case fatality rate of the infants hospitalized for the disease was 5.0% in those cities for which data for at least four years were available. This may be compared with the rate of 7.8% in 1942 and 11.1% in 1943. At ages one year and over, the rate was only 1.3% in 1946, as compared with 1.7% in 1942 and 3.7% in 1943. The rates in the hospitals with larger experiences were generally more favorable than in hospitals with smaller experiences. Despite the incomplete reporting of pertussis, which results in exaggerating the case fatality rate for the general population, the level of these rates in the community as a whole was lower than for hospitalized cases. This reflects the higher proportion of the severer cases in the hospitalized group. Indications are that in many places hospitalization is limited more and more to severe cases. Progress in the management of pertussis, especially of the severer cases admitted to hospitals, is believed to be the chief factor in the decline in case fatality of pertussis. A request contained in the questionnaire for an opinion on the severity of pertussis during the period studied elicited few replies, and these replies showed a division of opinion on the matter. It appears unlikely that there has been much of any change in the severity of the disease.

Phylogenetic group and serotype of E. coli isolates are important risk factors affecting intensity of colibacillosis in broilers

2018 ◽  
Author(s):  
S. Kumar ◽  
R. Gupta ◽  
N. Jindal and Y.C. Bangar
Keyword(s):  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Phylogenetic Group ◽  
Fatality Rate ◽  
Phylogenetic Groups ◽  
Factors Affecting ◽  
E Coli ◽  
Significant Difference ◽  
Class 1

The study was conducted on 106 E. coli isolates to determine the phylogenetic group, serotype and carriage of Class 1 integrons in isolates and ascertain their association along with other parameters with vital disease measures in broiler flocks affected with colibacillosis. Out of 32 isolates of which “O” antigen was characterized, serogroup O2 comprising of 12 (37.5%) isolates was most prevalent in the present study. Most of the isolates (85/106; 80.19%) belonged to phylogenetic group B2. Mean apparent morbidity, mortality and case fatality rate (CFR) were 3.77%, 2.32% and 61.49%, respectively. There was significant difference in number of outbreaks reported in different age groups (p less than 0.0001). Also, there was significant association between phylogenetic group and age of outbreak due to E. coli (p=0.024). Comparatively, no significant association was observed between age of outbreaks and serotypes (p=0.980). There was significant association between various disease measures and E. coli isolates affiliated to various phylogenetic groups and serotypes. All the measures (apparent morbidity, mortality and CFR) of disease were highest in outbreaks due to isolates of phylogenetic group B2 and serogroup O20. However, the measures were not significantly affected by the presence of integrons in the E. coli.

scholarly journals Chagas Disease-Related Mortality in Spain, 1997 to 2018

2021 ◽  
Vol 9 (9) ◽  
pp. 1991
Author(s):  
Jose-Manuel Ramos-Rincon ◽  
Jara Llenas-García ◽  
Hector Pinargote-Celorio ◽  
Veronica Sánchez-García ◽  
Philip Wikman-Jorgensen ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Chagas Disease ◽  
Case Fatality Rate ◽  
Hospital Admissions ◽  
Multivariable Analysis ◽  
Age Groups ◽  
Case Fatality ◽  
Fatality Rate ◽  
Infected People ◽  
Male Sex

Background. Chagas disease (CD) is associated with excess mortality in infected people in endemic countries, but little information is available in non-endemic countries. The aim of the study was to analyze mortality in patients admitted to the hospital with CD in Spain. Methods. A retrospective, observational study using the Spanish National Hospital Discharge Database. We used the CD diagnostic codes of the 9th and 10th International Classification of Diseases to retrieve CD cases from the national public registry from 1997 to 2018. Results. Of the 5022 hospital admissions in people with CD, there were 56 deaths (case fatality rate (CFR) 1.1%, 95% confidence interval (CI) 0.8%, 1.4%), 20 (35.7%) of which were considered directly related to CD. The median age was higher in those who died (54.5 vs. 38 years; p < 0.001). The CFR increased with age, peaking in the 70–79-year (7.9%, odds ratio (OR) 6.27, 95% CI 1.27, 30.90) and 80–89-year (16.7%, OR 14.7, 95% CI 2.70, 79.90) age groups. Men comprised a higher proportion of those who died compared to survivors (50% vs. 22.6%; p < 0.001). Non-survivors were more likely to have neoplasms (19.6% vs. 3.4%; p < 0.001), heart failure (17.9% vs. 7.2%; p = 0.002), diabetes (12.5% vs. 3.7%; p = 0.001), chronic kidney failure (8.9% vs. 1.6%; p < 0.001), and HIV (8.9% vs. 0.8%; p < 0.001). In the multivariable analysis, the variables associated with mortality were age (adjusted OR (aOR) 1.05; 95% CI: 1.03, 1.07), male sex (aOR 1.79, 95% CI 1.03, 3.14), cancer (aOR: 4.84, 95% CI 2.13, 11.22), and HIV infection (aOR 14.10 95% CI 4.88, 40.73). Conclusions. The case fatality rate of CD hospitalization was about 1%. The mortality risk increased with age, male sex, cancer, and HIV infection.

scholarly journals Morbidity, mortality and case fatality rate from chronic hepatitis B with and without a delta agent in Kyrgyzstan for the period 2010–2017

2020 ◽  
Vol 1 (10) ◽  
pp. 39-44
Author(s):  
K. A. Nogoibaeva ◽  
S. T. Tobokalova ◽  
K. T. Kasymbekova ◽  
S. I. Umarova
Keyword(s):  
Hepatitis B ◽  
Viral Hepatitis ◽  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Chronic Viral Hepatitis ◽  
Fatality Rate ◽  
Significant Difference ◽  
Viral Hepatitis B ◽  
Microsoft Office

The purpose of the study is to research the morbidity, mortality and case fatality rate y of chronic viral hepatitis B without and with a delta agent from 2010–2017. in Kyrgyzstan.Materials and methods: analyzed state reporting forms No. 12 “Report on morbidity and preventive work (family medicine center, dispensary)” and “C51 — Distribution of deaths by sex, age groups and causes of death” from 2010–2017. Data processed by Microsoft Office Excel.Results: In the country from 2010–2017 3292 cases of chronic viral hepatitis B were detected, 1738 patients of them verified an independent course (СhHBV), and 1,554 patients combined with a delta agent (СhHDV), while the incidence did not have a statistically significant difference (3.80/0000, 95% CI 2.4–4.0 and 3.40/0000, 95% CI 2.2–3.4, СhHBV and СhHDV, respectively) were 20 times lower compared to the HBV Carrier (60 40/0000). There was no statistically significant difference between the cumulative morbidity, mortality, case fatality rate and the proportion of deaths in СhHBV and СhHDV. The death rate СhHBV increased by 4.7 times (0.090/0000 and 0.410/0000), case fatality rate — by 11.8 times (1355.00/0000 and 16025.60/0000) amid a decrease the incidence is 2.5 times (6.40/0000 and 2.50/0000) from 2014 to 2017, respectively. At СhHDV, the mortality rate was also increased by 4.7 times (0.030/0000 and 0.160/0000), case fatality rate — by 32.3 times (793.70/0000 and 25641.80/0000) against the background of a decrease in incidence by 6.9 times (4.40/0000 and 0.60/0000) from 2014 to 2017, respectively.Conclusion: In Kyrgyzstan from 2010–2017, relatively low detectability of chronic forms of HBV infection with and without delta agent was found, compared with the “HBV carrier”. There has been an increase in mortality and case fatality rate over the past 4 years, with a sharp rise in 2017 against the background of a downward trend in the incidence of СhHBV and СhHDV.

"Epidemiology of Diphtheria in Yemen, 2017-2018: Surveillance Data Analysis" (Preprint)

2021 ◽  
Author(s):  
Mohammed Alamad ◽  
Yousef S. Khader, Khader
Keyword(s):  
Surveillance System ◽  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Warning System ◽  
Daily Basis ◽  
Vaccination Status ◽  
Age Group ◽  
Fatality Rate ◽  
Probable Case

BACKGROUND As a consequence of war and collapse of health system in Yemen, diphtheria fatal epidemic occurred at the end of 2017 OBJECTIVE This study aims to describe epidemiology of diphtheria in Yemen, determine its incidence and case fatality rate METHODS Data of patients with diphtheria was obtained from the Diphtheria program in a form of line list which were collected on daily basis by electronic Diseases Early Warning System (eDEWS). Probable case was defined as any person suffered from laryngitis or pharyngitis or tonsillitis and adherent membrane of the tonsils, pharynx and/or nose. Confirmed case was defined as probable case that is laboratory-confirmed or linked epidemiologically to laboratory-confirmed case RESULTS A total of 2,243 cases were reported during the period between July 2017 and August 2018. About 49% of cases were males and 51% of cases were females. About 44% of cases were 5 -15 years old. Respiratory tract infection was the predominant symptoms (91%) followed by psedumembrane (81%). Based on the vaccination status, the percentage of partial vaccinated patients, vaccinated, unvaccinated, and unknown were 7%, 31%, 48% and 14%, respectively. The overall incidence of diphtheria was 8 per 100,000 of population. The highest incidence was among age group <15 years (11 per 100,000) and the lowest incidence was among age group of ≥ 15 years (5 per 100,000). The overall case fatality rate (CFR) among all age groups was 5%, being higher (10%) in the age group < 5 years. . Five of difficult to access governorates had double CFR (22%) which were Raymah, Abyan , Sa'ada, Lahj, Al Jawf. CONCLUSIONS : Diphtheria in Yemen in 2017-2018 affected a significant number of people. The majority of patients were partially or not vaccinated. Children ≤ 15 years were more affected with higher fatality among children < five years. Five of difficult to access governorates had double CFR of WHO estimate. To control diphthereia epidemic in Yemn, it is recommended to increase vaccination coverage through campaigns and boosters, increase public health awareness toward diphtheria and strengthen the surveillance system for early detection and immediate response and provide antitoxin for management of severe cases.

scholarly journals Patient and strain characteristics in relation to the outcome of meningococcal disease: a multivariate analysis

1994 ◽  
Vol 112 (1) ◽  
pp. 115-124 ◽  
Author(s):  
R. J. P. M. Scholten ◽  
H. A. Bijlmer ◽  
H. A. Valkenburg ◽  
J. Dankert
Keyword(s):  
The Netherlands ◽  
Meningococcal Disease ◽  
Case Fatality Rate ◽  
Fatal Outcome ◽  
Age Groups ◽  
Case Fatality ◽  
Surface Characteristics ◽  
Fatality Rate ◽  
Increased Risk ◽  
Meningococcal Strain

SummaryTo investigate the joint association of patient and strain characteristics with the outcome of meningococcal disease (MD), data were collected on 563 consecutive cases of MD reported between 1989 and 1990 in The Netherlands. The meningococcal isolates were characterized with regard to their surface characteristics. Sequelae occurred in 8.5% of the patients, and were only associated with the presence of bacteraemia. The case-fatality rate was 7.7%. Infants aged ≤ 5 months and patients in the age-groups of 10–19 years and ≥ 50 years had an increased risk for a fatal outcome compared with children from 6 months to 9 years old (Odds Ratios [ORs]: 5.1, 3.4 and 9.8, respectively). The OR for females versus males was 2.3. The ORs for patients with bacteraemia, or a combination of bacteraemia and meningitis, compared with meningitic patients, were 2.3 and 3.1. Meningococcal strain characteristics did not influence the case-fatality rate substantially. In conclusion, host factors were found to be determinants for a fatal outcome of MD in The Netherlands from 1989 to 1990.

scholarly journals The unavoidable costs of frailty: a geriatric perspective in the time of COVID-19

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Maria Cristina Polidori ◽  
Stefania Maggi ◽  
Francesco Mattace-Raso ◽  
Alberto Pilotto
Keyword(s):  
Older Persons ◽  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Healthcare Systems ◽  
World Population ◽  
Fatality Rate ◽  
Human Beings ◽  
The World ◽  
Older Subjects

The world is facing speechless one of the most feared, greatest catastrophes for human beings. Despite better healthcare systems, despite warnings through similar situations and even documented threats, as the COVID-19 pandemic hit, it found us largely unprepared. It offered to us on a silver tray the fragility of mankind. And once again, but this time in a particularly overwhelming way, the most vulnerable part of the world population is mowed down: older persons. Indeed, recent data from the Italian Istituto Superiore di Sanità showed that COVID-19 is more lethal in older subjects: in Italy, at the date of March 17, 2020, the overall case-fatality rate was 7.2% and 96.4% of died patients had more than 60 years. When data were stratified by age groups, individuals aged 70 years or older represent 35.5% of cases, while subjects aged ≥80 years were 52.3%. These data confirm once again that the older generation payed the highest price in time of crisis...

scholarly journals The Clinical Profile of Severe Pediatric Malaria in an Area Targeted for Routine RTS,S/AS01 Malaria Vaccination in Western Kenya

2019 ◽  
Vol 71 (2) ◽  
pp. 372-380 ◽  
Author(s):  
Samuel Akech ◽  
Mercy Chepkirui ◽  
Morris Ogero ◽  
Ambrose Agweyu ◽  
Grace Irimu ◽  
...  
Keyword(s):  
Severe Malaria ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Malaria Prevalence ◽  
Interquartile Range ◽  
Clinical Profile ◽  
Fatality Rate ◽  
Older Children ◽  
Severe Respiratory Distress ◽  
Western Kenya

Abstract Background The malaria prevalence has declined in western Kenya, resulting in the risk of neurological phenotypes in older children. This study investigates the clinical profile of pediatric malaria admissions ahead of the introduction of the RTS,S/AS01 vaccine. Methods Malaria admissions in children aged 1 month to 15 years were identified from routine, standardized, inpatient clinical surveillance data collected between 2015 and 2018 from 4 hospitals in western Kenya. Malaria phenotypes were defined based on available data. Results There were 5766 malaria admissions documented. The median age was 36 months (interquartile range, 18–60): 15% were aged between 1–11 months of age, 33% were aged 1–23 months of age, and 70% were aged 1 month to 5 years. At admission, 2340 (40.6%) children had severe malaria: 421/2208 (19.1%) had impaired consciousness, 665/2240 (29.7%) had an inability to drink or breastfeed, 317/2340 (13.6%) had experienced 2 or more convulsions, 1057/2340 (45.2%) had severe anemia, and 441/2239 (19.7%) had severe respiratory distress. Overall, 211 (3.7%) children admitted with malaria died; 163/211 (77% deaths, case fatality rate 7.0%) and 48/211 (23% deaths, case fatality rate 1.4%) met the criteria for severe malaria and nonsevere malaria at admission, respectively. The median age for fatal cases was 33 months (interquartile range, 12–72) and the case fatality rate was highest in those unconscious (44.4%). Conclusions Severe malaria in western Kenya is still predominantly seen among the younger pediatric age group and current interventions targeted for those &lt;5 years are appropriate. However, there are increasing numbers of children older than 5 years admitted with malaria, and ongoing hospital surveillance would identify when interventions should target older children.

scholarly journals Clinical factors adversely affecting early outcome after brain infarction

1994 ◽  
Vol 52 (2) ◽  
pp. 153-160 ◽  
Author(s):  
Charles André ◽  
Sérgio A. P. Novis
Keyword(s):  
Case Fatality Rate ◽  
Brain Infarction ◽  
Univariate Analysis ◽  
Disease Onset ◽  
Case Fatality ◽  
Large Artery ◽  
Fatality Rate ◽  
Babinski Sign ◽  
Death Risk ◽  
History Of

PURPOSE AND METHODS: One-hundred-and-nine consecutive patients admitted during the acute phase of a CT-confirmed brain infarction (BI) were studied. Putative adverse influence of demographic and stroke risk factors, previous medical history, clinical presentation, initial and follow-up neurological examination, initial general evaluation, laboratory findings, chest X-ray and electrocardiographic findings, treatment, and topography and etiology of the ischemic insult was analysed. The end-point for assessment was early death (within 30 days). Statistical analysis was performed with univariate analysis and multiple regression. RESULTS: The main adverse factors related to an increased death risk during the first 30 days were, in decreasing order of importance: coma 48-72 hours after admission; stroke occuring in already hospitalized patients; Babinski sign on admission; minor degrees of impairment of consciousness 48-72 hours after admission; stroke related to large artery atherothrombosis and to embolism; a history of early impairment of consciousness; cardiac failure on admission. In 53 lucid patients on admission, only a history of congestive heart failure (CHF) was associated with a reduced survival rate. In 56 patients with impaired consciousness, the presence of a Babinski sign increased death risk, but the main factor predicting a high case-fatality rate was the persistence of consciousness disturbances after48-72 hours. CONCLUSIONS: The presence of impairment of consciousness, especially coma, 2-3 days after disease onset, and a history of CHF greatly increase the early case fatality rate in patients with acute BI presenting with or without consciousness disturbances at admission, respectively. The use of a prognostic algorythm considering these few variables seems to predict the approximate 30-day fatality rates.

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