scholarly journals Mortality among people hospitalised with covid-19 in Switzerland: a nationwide population-based analysis

2021 ◽  
Author(s):  
Nanina Anderegg ◽  
Radoslaw Panczak ◽  
Matthias Egger ◽  
Nicola Low ◽  
Julien Riou
Keyword(s):  
Older People ◽  
Complete Information ◽  
Population Based ◽  
Survival Models ◽  
Comorbid Condition ◽  
Wave Age ◽  
Comorbid Conditions ◽  
Risk Of Death ◽  
Epidemic Wave ◽  
Over Time

Objectives: To investigate mortality among people hospitalised with covid-19 in Switzerland according to epidemic wave, age, sex, comorbid conditions and intensive care unit (ICU) occupancy. Design: Population-based, national study.Setting: Mandatory surveillance reports from all hospitals in Switzerland. Participants: All 22,648 people who tested positive for SARS-CoV-2 infection and were hospitalised between February 24, 2020 and March 01, 2021 in Switzerland with complete information about age, sex, and comorbidities. Main outcome measures: Survival after positive SARS-CoV-2 test among people hospitalised with covid-19 by epidemic wave, age, sex, comorbid conditions and ICU occupancy, expressed as adjusted hazard ratios (aHR) of death and probability of survival over time and at 40 days, all with 95% credible intervals (CrI). Results: Of 22,648 people hospitalised with covid-19, 4,785 (21.1%) died. Bayesian survival models adjusted for age, sex, and the presence of comorbidity showed that survival was lower during the first epidemic wave than the second (standardised predicted survival probability at 40 days 76.1% versus 80.5%; aHR of death 1.38, 95% CrI 1.28 to 1.48). During the second epidemic wave, occupancy among all available ICU beds (certified beds and add-on beds) in Switzerland varied between 51.7% and 78.8%. Modelling the association between survival and ICU occupancy with restricted cubic splines indicated stable survival when ICU occupancy was below 70%, but worse survival when ICU occupancy exceeded 70%. This threshold of 70% occupancy among total available ICU beds corresponded to around 85% occupancy among certified beds. Survival was decreased for men, older people, and patients with comorbid conditions. Comorbid conditions reduced survival more in younger people than in older people. As single comorbid condition, hypertension was not associated with poorer survival, but appeared to increase the risk of death in combination with a cardiovascular disease. Conclusion: Survival after hospitalisation with covid-19 has improved over time, consistent with improved management of severe covid-19. The decreased survival starting at approximately 70% ICU occupancy in Switzerland supports the need to introduce measures for prevention and control of SARS-CoV-2 transmission in the population far before ICUs are full.

Apolipoprotein E ϵ4 allele and neuropsychiatric symptoms among older adults in Central Africa (EPIDEMCA study)

2021 ◽  
Vol 33 (3) ◽  
pp. 295-306 ◽  
Author(s):  
Inès Yoro-Zohoun ◽  
Dismand Houinato ◽  
Philippe Nubukpo ◽  
Pascal Mbelesso ◽  
Bébène Ndamba-Bandzouzi ◽  
...  
Keyword(s):  
Older People ◽  
Apolipoprotein E ◽  
Urban Areas ◽  
Neuropsychiatric Symptoms ◽  
Central Africa ◽  
Complete Information ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Two Phase ◽  
Community Screening

AbstractObjectives:To evaluate the association between neuropsychiatric symptoms and apolipoprotein E (APOE) ϵ4 allele among older people in Central African Republic (CAR) and the Republic of Congo (ROC).Design:Multicenter population-based study following a two-phase design.Setting:From 2011 to 2012, rural and urban areas of CAR and ROC.Participants:People aged 65 and over.Measurements:Following screening using the Community Screening Interview for Dementia, participants with low cognitive scores (CSI-D ≤ 24.5) underwent clinical assessment. Dementia diagnosis followed the DSM-IV criteria and Peterson’s criteria were considered for Mild Cognitive Impairment (MCI). Neuropsychiatric symptoms were evaluated through the brief version of the Neuropsychiatric Inventory (NPI-Q). Blood samples were taken from all consenting participants before APOE genotyping was performed by polymerase chain reaction (PCR). Logistic regression models were used to evaluate the association between the APOE ϵ4 allele and neuropsychiatric symptoms.Results:Overall, 322 participants had complete information on both neuropsychiatric symptoms and APOE status. Median age was 75.0 years and 81.1% were female. Neuropsychiatric symptoms were reported by 192 participants (59.8%) and at least 1 APOE ϵ4 allele was present in 135 (41.9%). APOE ϵ4 allele was not significantly associated with neuropsychiatric symptoms but showed a trend toward a protective effect in some models.Conclusion:This study is the first one investigating the association between APOE ϵ4 and neuropsychiatric symptoms among older people in sub-Saharan Africa (SSA). Preliminary findings indicate that the APOE ϵ4 allele was not associated with neuropsychiatric symptoms. Further research seems, however, needed to investigate the protective trend found in this study.

scholarly journals Influence of Mortality on Estimating the Risk of Kidney Failure in People with Stage 4 CKD

2019 ◽  
Vol 30 (11) ◽  
pp. 2219-2227 ◽  
Author(s):  
Pietro Ravani ◽  
Marta Fiocco ◽  
Ping Liu ◽  
Robert R. Quinn ◽  
Brenda Hemmelgarn ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Kidney Failure ◽  
Absolute Risk ◽  
Population Based ◽  
Comparison Standard ◽  
Risk Of Death ◽  
Failure Risk ◽  
Stage 4 ◽  
Standard Risk ◽  
Over Time

BackgroundMost kidney failure risk calculators are based on methods that censor for death. Because mortality is high in people with severe, nondialysis-dependent CKD, censoring for death may overestimate their risk of kidney failure.MethodsUsing 2002–2014 population-based laboratory and administrative data for adults with stage 4 CKD in Alberta, Canada, we analyzed the time to the earliest of kidney failure, death, or censoring, using methods that censor for death and methods that treat death as a competing event factoring in age, sex, diabetes, cardiovascular disease, eGFR, and albuminuria. Stage 4 CKD was defined as a sustained eGFR of 15–30 ml/min per 1.73 m2.ResultsOf the 30,801 participants (106,447 patient-years at risk; mean age 77 years), 18% developed kidney failure and 53% died. The observed risk of the combined end point of death or kidney failure was 64% at 5 years and 87% at 10 years. By comparison, standard risk calculators that censored for death estimated these risks to be 76% at 5 years and >100% at 7.5 years. Censoring for death increasingly overestimated the risk of kidney failure over time from 7% at 5 years to 19% at 10 years, especially in people at higher risk of death. For example, the overestimation of 5-year absolute risk ranged from 1% in a woman without diabetes, cardiovascular disease, or albuminuria and with an eGFR of 25 ml/min per 1.73 m2 (9% versus 8%), to 27% in a man with diabetes, cardiovascular disease, albuminuria >300 mg/d, and an eGFR of 20 ml/min per 1.73 m2 (78% versus 51%).ConclusionsKidney failure risk calculators should account for death as a competing risk to increase their accuracy and utility for patients and providers.

scholarly journals Trends in Overall Survival and Treatment Patterns in Two Large Population-Based Cohorts of Patients with Breast and Colorectal Cancer

Cancers ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1239 ◽  
Author(s):  
Abbema ◽  
Vissers ◽  
Vos-Geelen ◽  
Lemmens ◽  
Janssen-Heijnen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Survival Rates ◽  
Relative Survival ◽  
Population Based ◽  
Treatment Patterns ◽  
Entire Study ◽  
Younger Patients ◽  
Risk Of Death ◽  
Over Time

Previous studies showed substantial improvement of survival rates in patients with cancer in the last two decades. However, lower survival rates have been reported for older patients compared to younger patients. In this population-based study, we analyzed treatment patterns and the survival of patients with breast cancer (BC) and colorectal cancer (CRC). Patients with stages I–III BC and CRC and diagnosed between 2003 and 2012 were selected from the Netherlands Cancer Registry (NCR). Trends in treatment modalities were evaluated with the Cochran-Armitage trend test. Trends in five-year overall survival were calculated with the Cox hazard regression model. The Ederer II method was used to calculate the five-year relative survival. The relative excess risk of death (RER) was estimated using a multivariate generalized linear model. During the study period, 98% of BC patients aged <75 years underwent surgery, whereas for patients ≥75 years, rates were 79.3% in 2003 and 66.7% in 2012 (p < 0.001). Most CRC patients underwent surgery irrespective of age or time period, although patients with rectal cancer aged ≥75 years received less surgery or radiotherapy over the entire study period than younger patients. The administration of adjuvant chemotherapy increased over time for CRC and BC patients, except for BC patients aged ≥75 years. The five-year relative survival improved only in younger BC patients (adjusted RER 0.95–0.96 per year), and was lower for older BC patients (adjusted RER 1.00, 95% Confidence Interval (CI) 0.98–1.02, and RER 1.00; 95% CI 0.98–1.01 per year for 65–74 years and ≥75 years, respectively). For CRC patients, the five-year relative survival improved over time for all ages (adjusted RER on average was 0.95 per year). In conclusion, the observed survival trends in BC and CRC patients suggest advances in cancer treatment, but with striking differences in survival between older and younger patients, particularly for BC patients.

Is the naturalistic course of depression in older people related to received support over time? Results from a longitudinal population-based study

2016 ◽  
Vol 32 (6) ◽  
pp. 657-663 ◽  
Author(s):  
Wim Houtjes ◽  
Dorly Deeg ◽  
Peter M. van de Ven ◽  
Berno van Meijel ◽  
Theo van Tilburg ◽  
...  
Keyword(s):  
Older People ◽  
Population Based ◽  
Population Based Study ◽  
Over Time ◽  
Course Of Depression

scholarly journals Assessment of clinical profile and factors affecting outcome of COVID-19 patient in Chhattisgarh state

2021 ◽  
Vol 8 (8) ◽  
pp. 3989
Author(s):  
Nirmal Verma ◽  
Alok Shukla ◽  
Neha Shrivastava ◽  
Swapnil Shinkar
Keyword(s):  
Data Collection ◽  
Treatment Strategies ◽  
Clinical Profile ◽  
Local Context ◽  
Comorbid Condition ◽  
Comorbid Conditions ◽  
Factors Affecting ◽  
Risk Of Death ◽  
Patient Will ◽  
Male Preponderance

Background: India is in the grab of COVID pandemic, understanding the clinical profile, comorbid condition, vaccine status of COVID patient, will help in better prevention, treatment strategies, especially in local context, therefore present study is designed to describe, the clinical profile, comorbid conditions and factors determining the death and recovery of patient both in home and hospital setting.Methods: It is a retrospective record based study of COVID-19 patient from September 2020 to May 2021 who underwent treatment either home or at hospital. Results: Majority 90% patient were hospitalised, with male preponderance, 96.4% patient were non vaccinated at the time of data collection, risk of death about 83% were more >45years age, with associated breathlessness and comorbidity.Conclusions: Higher age, comorbidity, non -vaccinated status was associated with risk of death among COVID-19 patient. 

Risk of Death Related to Psychotropic Drug Use in Older People During the European 2003 Heatwave: A Population-Based Case–Control Study

2009 ◽  
Vol 17 (12) ◽  
pp. 1059-1067 ◽  
Author(s):  
Clementine Nordon ◽  
Karin Martin-Latry ◽  
Laurence de Roquefeuil ◽  
Philippe Latry ◽  
Bernard Bégaud ◽  
...  
Keyword(s):  
Drug Use ◽  
Older People ◽  
Psychotropic Drug ◽  
Case Control Study ◽  
Population Based ◽  
Case Control ◽  
Risk Of Death ◽  
Psychotropic Drug Use ◽  
Control Study

Improved Survival for Patients with CLL in the Era of Combination Chemoimmunotherapy - a Danish Population Based Study

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 1740-1740 ◽  
Author(s):  
Caspar da Cunha-Bang ◽  
Jacob Simonsen ◽  
Klaus Rostgaard ◽  
Christian H Geisler ◽  
Henrik Hjalgrim ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Probability ◽  
Population Based ◽  
Danish Population ◽  
Younger Patients ◽  
Risk Of Death ◽  
Improvement In Survival ◽  
The Impact ◽  
First Time ◽  
Over Time

Abstract Background The treatment of chronic lymphocytic leukemia (CLL) is in rapid transition. As single agents, Fludarabine (F) was shown to be superior to chlorambucil (Rai, NEJM, 2000). Soon after F with Cyclophosphamide (C), showed superiority to F alone (Eichhorst, Blood, 2006; Flinn, JCO, 2007, Catovsky, Lancet, 2007). Subsequently, the addition of CD20 antibody rituximab (R) to FC for the first time showed a survival benefit for fit patients in a clinical trial (Hallek, Lancet, 2010). Likewise, in unfit patients the addition of CD20 antibodies to chlorambucil led to increased overall survival (Goede, NEJM, 2014). Eventually, BCR-targeted treatment for patients harboring TP53 aberrations demonstrated promising results (Farooqui, Lancet Onc, 2015). Here we assess the impact of these successive changes of therapy on the survival of patients with CLL in a Danish population-based cohort. Methods We studied the survival of a population-based cohort of CLL patients reported to the Danish Cancer Registry 1978-2013. Patients were categorized according to year of diagnosis from 1978-1994, 1995-2000, 2001-2005 and 2006-2013. For each CLL patient, we randomly selected 50 controls from the general population matched on age, gender and municipality. Kaplan MeierÕs survival curves and Hazard ratios (HR) and 95% confidence interval (95%CI) for death since time of diagnosis /matching date for controls were calculated. Change in survival probability relative to the controls with stratification on gender, age and calendar period of diagnosis was assessed. Results In total, 10500 patients were diagnosed with CLL in Denmark from 1978 to 2013 as follows: 1978-1994: 4651, 1995-2000: 1622, 2001-2005: 1664 and 2006-2013: 2563. Thus, the reported incidence of CLL increased slightly after year 2000. Overall, we observed a continuously decreasing risk of death for patients with CLL compared to matched controls, with HRs from 3.47 (3.37 - 3.58) to 2.09 (1.96 - 2.24) for patients diagnosed 1978-1994 and 2005-2013, respectively. In inter group analyses, a significant stepwise reduction in risk of death was observed for each period (Figure 1). In all age groups and calendar periods, male patients had an inferior survival compared to female patients and younger patients survived longer than older patients (p<0.0001). Discussion A significant improvement in survival probability for patients with CLL over time was found. This coincides with the introduction of FCR as standard therapy for younger patients with CLL (approval by EMA in 2009, affecting the cohort diagnosed 2006-2013). Significant survival improvement was also observed in the 2001-2005 cohort, possibly due to a shift to combination chemotherapy. Also for elderly patients, otherwise expected to get less intensive treatment in part due to co-morbidities, the survival improved over time. This may be accounted for by the introduction of semi-intensive chemotherapy like bendamustine, reduced intensity FC(R) and more recently chlorambucil combined with CD20-targeting antibodies. For the first time, we here present population-based data showing significant improvement in survival for patients with CLL in parallel with the introduction of new chemo-immunotherapeutic regimens into clinical practice. These data substantiate the reported increased survival for patients treated with chemo-immunotherapy in clinical studies. Further investigation and cross-reference with treatment databases are warranted in order to assess the impact of new targeted treatment options for CLL. Figure 1. Overall survival for patients (70-79 and 50-59 years), lower four curves; upper four curves represent matched controls. Figure 1. Overall survival for patients (70-79 and 50-59 years), lower four curves; upper four curves represent matched controls. Disclosures Geisler: GlaxoSmithKline: Consultancy; Novartis: Consultancy; Janssen: Consultancy; Celgene: Consultancy; Gilead: Consultancy; Roche: Consultancy. Niemann:Novartis: Other: Travel grant; Janssen: Consultancy; Roche: Consultancy; Gilead: Consultancy.

scholarly journals Patient-reported comorbidity and survival in older adults with cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10033-10033
Author(s):  
Grant Richard Williams ◽  
Allison Mary Deal ◽  
Jennifer Leigh Lund ◽  
YunKyung Chang ◽  
Hyman B. Muss ◽  
...  
Keyword(s):  
Older Adults ◽  
Clinical Trials ◽  
Functional Limitation ◽  
Mortality Data ◽  
Comorbid Condition ◽  
Cancer Type ◽  
Comorbid Conditions ◽  
Risk Of Death ◽  
The North ◽  
Patient Reported

10033 Background: Our ability to optimize the care of older adults with cancer and comorbid illnesses is insufficient as most clinical trials lack systematic measurement of comorbidities. The primary purpose of this study was to evaluate the prevalence and impact of patient-reported comorbidity on survival using various comorbidity scoring algorithms. Methods: We utilized a unique linkage of the Carolina Senior Registry, an institutional registry (NCT01137825) that contains geriatric assessment data, with the North Carolina Central Cancer Registry to obtain mortality data. Comorbidity was assessed using a patient-reported version of the Older Americans Resources and Services Questionnaire (OARS) Physical Health subscale that includes information regarding 13 specific comorbid conditions and the degree to which each impairs function (“not at all” to “a great deal”). Multivariable Cox proportional hazard regression models were used to evaluate the association between comorbidities and all-cause mortality. Results: 539 patients were successfully linked to mortality data. Median age 72, 72% female, 85% Caucasian, 47% breast cancer, and 12% lung cancer. 92% of participants reported at least one comorbid condition, mean of 2.7 conditions (range 0-10), with arthritis and hypertension the most common (52 and 50%, respectively). 62% of patients with a comorbid illness reported a functional limitation related to comorbidity. Both the presence of 3 or more total comorbidities (hazard ratio (HR) 1.44, CI 1.08-1.92) and 2 or more comorbidities impacting function (HR 1.46, CI 1.09-1.95) increased mortality. After adjusting for age, cancer type, and stage, the risk of death increased 12% for each comorbid condition impacting function (HR 1.12, CI 1.02-1.24), but did not significantly increase for the number of comorbid conditions alone (HR 1.07, CI 0.99-1.15). Conclusions: Comorbid conditions in older adults with cancer are highly prevalent, frequently impair function, and impact survival. Comorbid conditions that impair function have a greater impact on survival than the presence of comorbidity alone. Comorbidity assessment should be incorporated in clinical trials and can be measured via a simple one-page patient-reported questionnaire.

scholarly journals Associations between stuttering, comorbid conditions and executive function in children: a population-based study

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Ai Leen Choo ◽  
Sara Ashley Smith ◽  
Hongli Li
Keyword(s):  
Executive Function ◽  
Self Regulation ◽  
Parent Report ◽  
Population Based ◽  
Comorbid Condition ◽  
Comorbid Conditions ◽  
Population Based Study ◽  
Socioemotional Competence ◽  
Interview Survey ◽  
The Relationship

Abstract Background The aim of this study was to investigate the relationship between executive function (EF), stuttering, and comorbidity by examining children who stutter (CWS) and children who do not stutter (CWNS) with and without comorbid conditions. Data from the National Health Interview Survey were used to examine behavioral manifestations of EF, such as inattention and self-regulation, in CWS and CWNS. Methods The sample included 2258 CWS (girls = 638, boys = 1620), and 117,725 CWNS (girls = 57,512; boys = 60,213). EF, and the presence of stuttering and comorbid conditions were based on parent report. Descriptive statistics were used to describe the distribution of stuttering and comorbidity across group and sex. Regression analyses were to determine the effects of stuttering and comorbidity on EF, and the relationship between EF and socioemotional competence. Results Results point to weaker EF in CWS compared to CWNS. Also, having comorbid conditions was also associated with weaker EF. CWS with comorbidity showed the weakest EF compared to CWNS with and without comorbidity, and CWS without comorbidity. Children with stronger EF showed higher socioemotional competence. A majority (60.32%) of CWS had at least one other comorbid condition in addition to stuttering. Boys who stutter were more likely to have comorbid conditions compared to girls who stutter. Conclusion Present findings suggest that comorbidity is a common feature in CWS. Stuttering and comorbid conditions negatively impact EF.

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