scholarly journals What Caused Dire Clusters ? ~Analysis of Nosocomial COVID-19 Outbreaks in Kyoto City, Japan From the 1st Wave Through 3rd Wave in 2020/21

2021 ◽  
Author(s):  
Miki Nagao ◽  
Takeshi Ikeda ◽  
Yasufumi Matsumura ◽  
Masaki Yamamoto ◽  
Taro Noguchi ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Infection Control ◽  
Hospital Mortality ◽  
Healthcare Workers ◽  
First Year ◽  
Full Time ◽  
City Area ◽  
Kyoto City ◽  
Hospital Patients ◽  
Index Cases

Abstract Fifteen COVID-19 nosocomial clusters occurred in the first year of the pandemic in Kyoto City, involving 232 in-hospital patients and 157 healthcare workers (HCWs). Among them, 40 percent of index cases were HCWs. The in-hospital mortality rate among patients was 18.1%, whereas the mortality rate in the Kyoto City area during the study period was 1.79%. The time needed to contain outbreaks was shorter in hospitals with full-time infection control personnel assigned.

scholarly journals Labour Market Attachment, Workplace Infection Control Procedures and Mental Health: A Cross-Sectional Survey of Canadian Non-healthcare Workers during the COVID-19 Pandemic

2020 ◽  
Author(s):  
Peter M Smith ◽  
John Oudyk ◽  
Guy Potter ◽  
Cameron Mustard
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Infection Control ◽  
Labour Market ◽  
Healthcare Workers ◽  
Internet Survey ◽  
Anxiety And Depression ◽  
Full Time ◽  
Increased Risk ◽  
Different Types

Abstract Background The COVID-19 pandemic has led to large proportions of the labour market moving to remote work, while others have become unemployed. Those still at their physical workplace likely face increased risk of infection, compared to other workers. The objective of this paper is to understand the relationship between working arrangements, infection control programs (ICP), and symptoms of anxiety and depression among Canadian workers, not specifically working in healthcare. Methods A convenience-based internet survey of Canadian non-healthcare workers was facilitated through various labour organizations between April 26 and June 6, 2020. A total of 5180 respondents started the survey, of which 3779 were assessed as employed in a full-time or part-time capacity on 2 March 2020 (prior to large-scale COVID-19 pandemic responses in Canada). Of this sample, 3305 (87.5%) had complete information on main exposures and outcomes. Anxiety symptoms were measured using the Generalised Anxiety Disorder screener (GAD-2), and depressive symptoms using the Patient Health Questionnaire screener (PHQ-2). For workers at their physical workplace (site-based workers) we asked questions about the adequacy and implementation of 11 different types of ICP, and the adequacy and supply of eight different types of personal protective equipment (PPE). Respondents were classified as either: working remotely; site-based workers with 100% of their ICP/PPE needs met; site-based workers with 50–99% of ICP/PPE needs met; site-based workers with 1–49% of ICP/PPE needs met; site-based workers with none of ICP/PPE needs met; or no longer employed. Regression analyses examined the association between working arrangements and ICP/PPE adequacy and having GAD-2 and PHQ-2 scores of three and higher (a common screening point in both scales). Models were adjusted for a range of demographic, occupation, workplace, and COVID-19-specific factors. Results A total of 42.3% (95% CI: 40.6–44.0%) of the sample had GAD-2 scores of 3 and higher, and 34.6% (95% CI: 32.–36.2%) had PHQ-2 scores of 3 and higher. In initial analyses, symptoms of anxiety and depression were lowest among those working remotely (35.4 and 27.5%), compared to site-based workers (43.5 and 34.7%) and those who had lost their jobs (44.1 and 35.9%). When adequacy of ICP and PPE was taken into account, the lowest prevalence of anxiety and depressive symptoms was observed among site-based workers with all of their ICP needs being met (29.8% prevalence for GAD-2 scores of 3 and higher, and 23.0% prevalence for PHQ-2 scores of 3 and higher), while the highest prevalence was observed among site-based workers with none of their ICP needs being met (52.3% for GAD-2 scores of 3 and higher, and 45.8% for PHQ-2 scores of 3 and higher). Conclusion Our results suggest that the adequate design and implementation of employer-based ICP have implications for the mental health of site-based workers. As economies re-open the ongoing assessment of ICP and associated mental health outcomes among the workforce is warranted.

scholarly journals Incidence, Risk Factors and Outcomes of Sepsis in Post-Craniotomy Critical Ill Patients

2021 ◽  
Author(s):  
Jianfang Zhou ◽  
Xu-Ying Luo ◽  
Guang-Qiang Chen ◽  
Hong-Liang Li ◽  
Linlin Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Hospital Costs ◽  
Primary Diagnosis ◽  
Apache Ii Score ◽  
Critical Ill Patients ◽  
Hospital Patients ◽  
Incidence Risk ◽  
Critical Ill

Abstract Background: Data about the epidemiology of sepsis in post-craniotomy critical ill patients are scarce. This study aims to assess the incidence, risk factors, and outcomes of sepsis in this population.Methods: We conducted a prospective cohort study between January 1, 2017, and December 31, 2018, in the intensive care unit (ICU) of Beijing Tiantan Hospital. Patients admitted to ICU after intracranial operations and meeting the inclusion criteria were screened daily for the presence of infection and sepsis. We also collected demographics, primary diagnosis, chronic comorbidities, information about surgery, infection, and patients’ outcomes. Results: Of the 900 included patients, 509 (56.6%) were with infection, and 300 developed sepsis. The cumulative incidence of sepsis was 33.3% [95% CI, 30.2%-36.4%]. Male sex, older in age, supratentorial surgery, the sellar region tumors, postoperative hydrocephalus, higher Acute Physiology and Chronic Health Evaluation (APACHE) II score, higher Sequential Organ Failure Assessment (SOFA) score, and lower Glasgow Coma Scale (GCS) were independent risk factors of sepsis. Sepsis was associated with a higher hospital mortality rate (13.7% vs. 8.3%, p =0.012), lower Glasgow Outcome Scale (GOS) at discharge (3 vs. 4, p<0.001), longer ICU length of stay (LOS) (14 vs. 4 days, p<0.001), longer hospital LOS (31 vs. 19 days, p<0.001), and higher total medical costs (RMB 138,394 vs 75,918 Yuan, p<0.001). Conclusions: Sepsis is a frequent complication in post-craniotomy critical ill patients, and is associated with increased hospital mortality rate, increased hospital costs, prolonged ICU LOS, and hospital LOS.Trial registration: Clinicaltrials.gov number: NCT03803813

Darmkrebs-OP: Auf die Erfahrung kommt es an

2020 ◽  
Vol 52 (04) ◽  
pp. 162-164
Author(s):  
Frank Lichert
Keyword(s):  
Rectal Cancer ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Hospital Volume ◽  
Rectum Resection

Diers J et al. Nationwide in-hospital mortality rate following rectum resection for rectal cancer according to annual hospital volume in Germany. BJS Open 2020; doi:10.1002/bjs5.50254

Knowledge of COVID-19 infection control among healthcare workers in radiology departments in Saudi Arabia

2020 ◽  
pp. 1-10
Author(s):  
Rowa Aljondi ◽  
Salem Saeed Alghamdi ◽  
Ikhlas Abdelaziz ◽  
Lubna Bushara ◽  
Somayah Alghamdi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Infection Control ◽  
Healthcare Workers

scholarly journals Evaluation of a home-based 7-day infection control strategy for healthcare workers following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2): A cohort study

2020 ◽  
pp. 1-4
Author(s):  
Carla Benea ◽  
Laura Rendon ◽  
Jesse Papenburg ◽  
Charles Frenette ◽  
Ahmed Imacoudene ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Control Strategy ◽  
Healthcare Workers ◽  
Control Strategies ◽  
Risk Exposure ◽  
Nasopharyngeal Swab ◽  
Home Based ◽  
Respiratory Coronavirus ◽  
Second Wave

Abstract Objective: Evidence-based infection control strategies are needed for healthcare workers (HCWs) following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2). In this study, we evaluated the negative predictive value (NPV) of a home-based 7-day infection control strategy. Methods: HCWs advised by their infection control or occupational health officer to self-isolate due to a high-risk SARS-CoV-2 exposure were enrolled between May and October 2020. The strategy consisted of symptom-triggered nasopharyngeal SARS-CoV-2 RNA testing from day 0 to day 7 after exposure and standardized home-based nasopharyngeal swab and saliva testing on day 7. The NPV of this strategy was calculated for (1) clinical coronavirus disease 2019 (COVID-19) diagnosis from day 8–14 after exposure, and for (2) asymptomatic SARS-CoV-2 detected by standardized nasopharyngeal swab and saliva specimens collected at days 9, 10, and 14 after exposure. Interim results are reported in the context of a second wave threatening this essential workforce. Results: Among 30 HCWs enrolled, the mean age was 31 years (SD, ±9), and 24 (80%) were female. Moreover, 3 were diagnosed with COVID-19 by day 14 after exposure (secondary attack rate, 10.0%), and all cases were detected using the 7-day infection control strategy: the NPV for subsequent clinical COVID-19 or asymptomatic SARS-CoV-2 detection by day 14 was 100.0% (95% CI, 93.1%–100.0%). Conclusions: Among HCWs with high-risk exposure to SARS-CoV-2, a home-based 7-day infection control strategy may have a high NPV for subsequent COVID-19 and asymptomatic SARS-CoV-2 detection. Ongoing data collection and data sharing are needed to improve the precision of the estimated NPV, and here we report interim results to inform infection control strategies in light of a second wave threatening this essential workforce.

scholarly journals All-cause mortality and location of death in patients with established cardiovascular disease before, during, and after the COVID-19 lockdown: a Danish Nationwide Cohort Study

2021 ◽  
Author(s):  
Jawad H Butt ◽  
Emil L Fosbøl ◽  
Thomas A Gerds ◽  
Charlotte Andersson ◽  
Kristian Kragholm ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Location Of Death ◽  
All Cause Mortality ◽  
History Of ◽  
Adjusted Incidence Rate ◽  
Artery Disease ◽  
Adjusted Incidence ◽  
Overall Mortality

Abstract Background On 13 March 2020, the Danish authorities imposed extensive nationwide lockdown measures to prevent the spread of the coronavirus disease 2019 (COVID-19) and reallocated limited healthcare resources. We investigated mortality rates, overall and according to location, in patients with established cardiovascular disease before, during, and after these lockdown measures. Methods and results Using Danish nationwide registries, we identified a dynamic cohort comprising all Danish citizens with cardiovascular disease (i.e. a history of ischaemic heart disease, ischaemic stroke, heart failure, atrial fibrillation, or peripheral artery disease) alive on 2 January 2019 and 2020. The cohort was followed from 2 January 2019/2020 until death or 16/15 October 2019/2020. The cohort comprised 340 392 and 347 136 patients with cardiovascular disease in 2019 and 2020, respectively. The overall, in-hospital, and out-of-hospital mortality rate in 2020 before lockdown was significantly lower compared with the same period in 2019 [adjusted incidence rate ratio (IRR) 0.91, 95% confidence interval (CI) CI 0.87–0.95; IRR 0.95, 95% CI 0.89–1.02; and IRR 0.87, 95% CI 0.83–0.93, respectively]. The overall mortality rate during and after lockdown was not significantly different compared with the same period in 2019 (IRR 0.99, 95% CI 0.97–1.02). However, the in-hospital mortality rate was lower and out-of-hospital mortality rate higher during and after lockdown compared with the same period in 2019 (in-hospital, IRR 0.92, 95% CI 0.88–0.96; out-of-hospital, IRR 1.04, 95% CI1.01–1.08). These trends were consistent irrespective of sex and age. Conclusions Among patients with established cardiovascular disease, the in-hospital mortality rate was lower and out-of-hospital mortality rate higher during lockdown compared with the same period in the preceding year, irrespective of age and sex.

scholarly journals Total numbers and in-hospital mortality of patients with myocardial infarction in Germany during the FIFA soccer world cup 2014

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Karsten Keller ◽  
Lukas Hobohm ◽  
Volker H. Schmitt ◽  
Martin Engelhardt ◽  
Philip Wenzel ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Environmental Stress ◽  
Nationwide Inpatient Sample ◽  
Hospital Admissions ◽  
Patient Characteristics ◽  
World Cup ◽  
National Team ◽  
Comparison Period

AbstractEnvironmental stress like important soccer events can induce excitation, stress and anger. We aimed to investigate (i) whether the FIFA soccer world cup (WC) 2014 and (ii) whether the soccer games of the German national team had an impact on total numbers and in-hospital mortality of patients with myocardial infarction (MI) in Germany. We analyzed data of MI inpatients of the German nationwide inpatient sample (2013–2015). Patients admitted due to MI during FIFA WC 2014 (12th June–13th July2014) were compared to those during the same period 2013 and 2015 (12th June–13th July). Total number of MI patients was higher during WC 2014 than in the comparison-period 2013 (18,479 vs.18,089, P < 0.001) and 2015 (18,479 vs.17,794, P < 0.001). WC was independently associated with higher MI numbers (2014 vs. 2013: OR 1.04 [95% CI 1.01–1.07]; 2014 vs. 2015: OR 1.07 [95% CI 1.04–1.10], P < 0.001). Patient characteristics and in-hospital mortality rate (8.3% vs. 8.3% vs. 8.4%) were similar during periods. In-hospital mortality rate was not affected by games of the German national team (8.9% vs. 8.1%, P = 0.110). However, we observed an increase regarding in-hospital mortality from 7.9 to 9.3% before to 12.0% at final-match-day. Number of hospital admissions due to MI in Germany was 3.7% higher during WC 2014 than during the same 31-day period 2015. While in-hospital mortality was not affected by the WC, the in-hospital mortality was highest at WC final.

Trends in hospitalization and in-hospital mortality of patients with heart failure in Spain. A population-based study (2003–2015)

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.L Bonilla Palomas ◽  
M.P Anguita-Sanchez ◽  
F.J Elola ◽  
J.L Bernal ◽  
C Fernandez-Perez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
National Health System ◽  
Admission Rate ◽  
Population Data ◽  
Principal Diagnosis ◽  
Data Set ◽  
Discharge Rates ◽  
Mortality Ratio

Abstract Background Heart failure (HF) is one of the most pressing current public health concerns. However, in Spain there is a lack of population data. Purpose To investigate trends in HF hospitalization and in-hospital mortality rates. Methods We conducted a retrospective observational study of patients discharged with the principal diagnosis of HF from The National Health System' acute hospitals during 2003–2015. The source of the data was the Minimum Basic Data Set of the Ministry of Health, Consumer and Social Welfare. We analyzed trends in hospital discharge rates for HF (discharge rates were weighted by age and gender) an in-hospital mortality. The risk-standardized in-hospital mortality ratio (RSMR) was defined as the ratio between predicted mortality (which individually considers the performance of the hospital where the patient is attended) and expected mortality (which considers a standard performance according to the average of all hospitals) multiplied by the crude rate of mortality. RSMR was calculated using a risk adjustment multilevel logistic regression models developed by the Medicare and Medicaid Services. Temporal trend during the observed period was modelled using Poisson regression analysis with year as the only independent variable. In this model, the incidence rate ratio (IRR) and their 95% confidence intervals (95% CI) was calculated. Results A total of 1 254 830 episodes of HF were selected. Throughout 2003–2015 the number of hospital discharges with principal diagnosis of HF increased by 61% (IRR: 1.04; CI: 1.03–1.04; p&lt;0.001), meanwhile the crude mortality rate and the mean length of stay (LOS) diminished significantly (IRR: 0.99; CI: 0.98–1; and IRR: 1.04; CI: 0.99–0.99; p&lt;0.001, for both). Discharge rates weighted by age and sex showed a statistically significant increase during the period (IRR: 1.03; CI: 1.03–1.03; p&lt;0.001); however, whereas discharge rates increased significantly in older groups of age (≥75 years old) (IRR: 1–1.02; p&lt;0.001) they diminished in younger groups of age (45–74 years old) (IRR: 0.99; p&lt;0.001 and there was not a significant trend in the discharge rates for the group of 35–44 years old (Figure). The risk-standardized in-hospital mortality ratio did not significantly change throughout 2003–2015 (IRR: 0.997; CI: 0.992–1; p=0.32), however the risk-standardized LOS ratio diminished from 1.07 in 2003 to 0.97 in 2015 (IRR: 0.98: IC: 0.98–0.99; p&lt;0.001). Conclusions From 2003 to 2015, HF admission rate increased significantly in Spain as a consequence of the sustained increase of hospitalization in the population over 75. The crude in-hospital mortality rate diminished significantly for the same period, but the risk-standardized in-hospital mortality ratio did not significantly change. Figure 1 Funding Acknowledgement Type of funding source: None

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