scholarly journals Trends in Hospital Admissions and Death Causes in Patients with Systemic Lupus Erythematosus: Spanish National Registry

2021 ◽  
Vol 10 (24) ◽  
pp. 5749
Author(s):  
Víctor Moreno-Torres ◽  
Carlos Tarín ◽  
Guillermo Ruiz-Irastorza ◽  
Raquel Castejón ◽  
Ángela Gutiérrez-Rojas ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Causes Of Death ◽  
Hospital Admissions ◽  
Absolute Number ◽  
National Registry ◽  
National Hospital ◽  
The Past ◽  
Venous Thromboembolic ◽  
Discharge Database ◽  
Death Causes

Background: the admission and death causes of SLE patients might have changed over the last years. Methods: Analysis of the Spanish National Hospital Discharge database. All individuals admitted with SLE, according to ICD-9, were selected. The following five admission categories were considered: SLE, cardiovascular disease (CVD), neoplasm, infection, and venous-thromboembolic disease (VTED), along four periods of time (1997–2000, 2001–2005, 2006–2010, and 2011–2015). Results: The admissions (99,859) from 43.432 patients with SLE were included. The absolute number of admissions increased from 15,807 in 1997–2000 to 31,977 in 2011–2015. SLE decreased as a cause of admission (from 47.1% to 20.8%, p < 0.001), while other categories increased over the time, as follows: 5% to 8.6% for CVD, 8.2% to 13% for infection, and 1.4% to 5.5% for neoplasm (p < 0.001 for all). The admission mortality rate rose from 2.22% to 3.06% (p < 0.001) and the causes of death evolved in parallel with the admission categories. A significant trend to older age was observed over time in the overall population and deceased patients (p < 0.001). Conclusions: Better control of SLE over the past two decades has led to a decrease in early admissions, and disease chronification. As a counterpart, CVD, infections, and neoplasm have become the main causes of admissions and mortality.

Death causes and pathogens analysis of systemic lupus erythematosus during the past 26 years

2013 ◽  
Vol 33 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Yunyun Fei ◽  
Xiaochun Shi ◽  
Fengying Gan ◽  
Xuemei Li ◽  
Wen Zhang ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
The Past ◽  
Death Causes

scholarly journals Analysis of trends and causes of death in SLE patients over a 40-years period in a cohort of patients in the United Kingdom

Lupus ◽  
2021 ◽  
pp. 096120332098860
Author(s):  
Ana Lorenzo-Vizcaya ◽  
David Isenberg
Keyword(s):  
Lupus Erythematosus ◽  
Causes Of Death ◽  
Premature Mortality ◽  
Real World Data ◽  
The Past ◽  
Autoimmune Rheumatic Disease ◽  
Life Threatening ◽  
University College London ◽  
Duration Of Disease ◽  
The University

Background Systemic Lupus Erythematosus (SLE) an autoimmune rheumatic disease with a complex pathogenesis, remains potentially life-threatening. SLE patients have increased morbidity and premature mortality compared to non-SLE patients. The five-year survival rate has improved from <50% in the 1950s to >90% in the 1980s. Lupus patients still have a mortality risk three times that of the general population. Objectives To provide a detailed analysis of the causes of death, main characteristics and trends in the management of the deceased SLE patients from the lupus clinic at the University College London Hospital (UCLH); during the past four decades. Methods This was a non-interventional, retrospective study based on historical real-world data from paper and electronic records of patients followed up at UCLH. The analysis focused on data collected between 1st January 1978 and 31th December 2018. We collected the: causes of death, duration of disease, key laboratory and clinical parameters and the treatment received. We compared the results from the four decades to ascertain trends in the causes of mortality. All statistical analyses were performed using the Statistical Package for Social Sciences (SPSS), version 22.0. The 95% confidence intervals for the means of data were calculated. Results 111 SLE patients (15%), died during follow-up. Their median age was 51 years (interquartile range (IQR) = 38–63 years) and the median duration of disease, 15 years (IQR = 8.5–24 years). The main causes of death in the past 40 years were infection (31.7%), cancer (26.7%) and cardiovascular disease (CVD) (21.8%). 93.6% of these patients were immunosupressed. During the 40-year period, there were several therapeutic developments notably the introduction of mycophenolate mofetil (MMF) and rituximab; the latter initially only given to patients when more conventional inmunosupressants had failed, but more recently offered to patients at diagnosis. There was a statistically significant increase in the use of hydroxycloroquine (HCQ), MMF and rituximab. In contrast, the use of Azathioprine (AZA) and steroids, hardly changed over time. Conclusions This retrospective review shows how epidemiological factors, causes of death and treatment of SLE patients have changed during the last 40 years in the UCLH cohort.

Causes of Death

2018 ◽  
Author(s):  
Michael Anderson ◽  
Corinne Roughley
Keyword(s):  
Heart Disease ◽  
Pulmonary Tuberculosis ◽  
Western Europe ◽  
Causes Of Death ◽  
Whooping Cough ◽  
The Elderly ◽  
World War Two ◽  
World War ◽  
The Past ◽  
Disease Mortality

The principal reported causes of death have changed dramatically since the 1860s, though changes in categorization of causes and improved diagnosis make it difficult to be precise about timings. Diseases particularly affecting children such as measles and whooping cough largely disappeared as killers by the 1950s. Deaths particularly linked to unclean environments and poor sanitary infrastructure also declined, though some can kill babies and the elderly even today. Pulmonary tuberculosis and bronchitis were eventually largely controlled. Reported cancer, stroke, and heart disease mortality showed upward trends well into the second half of the twentieth century, though some of this was linked to diagnostic improvement. Both fell in the last decades of our period, but Scotland still had among the highest rates in Western Europe. Deaths from accidents and drowning saw significant falls since World War Two but, especially in the past 25 years, suicide, and alcohol and drug-related deaths rose.

scholarly journals One Year of the COVID-19 Pandemic in Galicia: A Global View of Age-Group Statistics during Three Waves

2021 ◽  
Vol 18 (10) ◽  
pp. 5104
Author(s):  
Iván Area ◽  
Henrique Lorenzo ◽  
Pedro J. Marcos ◽  
Juan J. Nieto
Keyword(s):  
Intensive Care Unit ◽  
Hospital Admissions ◽  
Age Groups ◽  
Age Group ◽  
Nw Spain ◽  
The Past ◽  
Global View ◽  
Time Period ◽  
Key Variables ◽  
One Year

In this work we look at the past in order to analyze four key variables after one year of the COVID-19 pandemic in Galicia (NW Spain): new infected, hospital admissions, intensive care unit admissions and deceased. The analysis is presented by age group, comparing at each stage the percentage of the corresponding group with its representation in the society. The time period analyzed covers 1 March 2020 to 1 April 2021, and includes the influence of the B.1.1.7 lineage of COVID-19 which in April 2021 was behind 90% of new cases in Galicia. It is numerically shown how the pandemic affects the age groups 80+, 70+ and 60+, and therefore we give information about how the vaccination process could be scheduled and hints at why the pandemic had different effects in different territories.

scholarly journals Levels of Evidence in Rhinology and Skull Base Surgery Research

2021 ◽  
pp. 019459982098713
Author(s):  
Jennifer A. Silver ◽  
Marco Mascarella ◽  
George Tali ◽  
Rickul Varshney ◽  
Marc A. Tewfik ◽  
...  
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Absolute Number ◽  
High Quality ◽  
Level Of Evidence ◽  
Levels Of Evidence ◽  
The Past ◽  
Significant Difference ◽  
Surgery Research ◽  
Based Medicine

Objective The purpose of this study was to evaluate the quality of evidence of rhinology and rhinologic skull base surgery (RSBS) research and its evolution over the past decade. Study Design Review article. Setting We reviewed articles from 2007 to 2019 in 4 leading peer-reviewed otolaryngology journals and 3 rhinology-specific journals. Methods The articles were reviewed and levels of evidence were assigned using the Oxford Centre for Evidence-Based Medicine 2011 guidelines. High quality was defined as level of evidence 1 or 2. Results In total, 1835 articles were reviewed in this study spanning a 13-year period. Overall, the absolute number of RSBS publications increased significantly 22.6% per year, from 108 articles in 2007 to 481 in 2019 ( P < .001; 95% CI, 7.9-37.2). In 2007, only 13 articles, or 15%, were high quality, and this grew to 146 articles, or 39%, in 2019. A 14.0% per year exponential increase in the number of high-quality publications was found to be statistically significant ( P < .001; 95% CI, 7.2, 20.7). Overall, high-quality publications represented just 25.8% of RSBS articles overall. There was no significant difference in quality between rhinology-specific journals and general otolaryngology journals (χ2 = 3.1, P = .077). Conclusion The number of overall publications and of high-quality RSBS publications has significantly increased over the past decade. However, the proportion of high-quality studies continues to represent a minority of total RSBS research.

scholarly journals O21 The incidence of COVID-19 among children with rheumatic diseases receiving biological agents

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Nadezhda Tsurikova ◽  
Elena Ligostaeva ◽  
Vadim Avdeenko ◽  
Nataliya Kobzeva ◽  
Irina Tsiganok ◽  
...  
Keyword(s):  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Biological Agents ◽  
Tnf Receptor ◽  
The Past ◽  
Different Types ◽  
Mediterranean Fever ◽  
Positive Results ◽  
Single Center Observational Study

Abstract Background/Aims  During the COVID-19 pandemic, analysis of the incidence of COVID-19 among patients suffering from rheumatic diseases and receiving therapy with biological agents remains relevant. Methods  This single-center observational study included 118 children suffering from various rheumatic diseases and receiving therapy with anti-rheumatic drugs and biological agents. In this research, we analyzed the incidence of CIVID-19 and the frequency of documented contact with SARS-CoV-2 in the period from 01.03.2020 to 11.10.2020 (32 weeks). The results were analyzed using descriptive statistics. Results  Among 118 children, there were 28 (24%) boys and 90 (76%) girls, average age 10.3±4.2. 104 (88.2%) patients had different types of juvenile idiopathic arthritis (JIA), 2 (1.6%) children had systemic lupus erythematosus (SLE), 2 (1.6%) patients had juvenile dermatomyositis (JDM), 1 (1%) child had ANCA-associated vasculitis, 6 (5%) patients had familial Mediterranean fever (FMF), 2 (1.6%) children had deficiency of adenosine deaminase 2 (DADA2), 1 (1%) child had TNF receptor-associated periodic syndrome (TRAPS). In this group of patients 94 (79%) patients were treated with methotrexate, 1 (1%) - azathioprine, 3 (2%) patients received hydroxychloroquine, 6(5%) - mycophenolate mofetil, 4 (3%) - sulfasalazine, 14(11%) children received prednisone, 6(5%) - cyclosporine A. All children included in this study received biological agents for more than 1 year, the distribution of biological agents among patients was as follows: 41(34%) - etanercept, 33(28%) - adalimumab, 24 (20%) - tocilizumab, 7 (6%) - canakinumab, 3 (2%) - abatacept, 4 (3%) - golimumab, 6 (5%) - rituximab. Out of 118 children, 4 (3%) patients had flu-like symptoms and positive results of PCR tests for COVID-19 (1 patient was treated with etanercept, 1 - adalimumab, 1 - tocilizumab, 1 - rituximab), none of the patients had signs of SARS-CoV-2 pneumonia. 10 (8%) patients had documented contact with COVID-19: among this patients 2 children had flu-like symptoms, positive results of PCR tests and absence of COVID-19 pneumonia (one of this patient was treated with adalimumab, another one - with rituximab), one more patient was treated with tocilizumab and had positive PCR test without any symptoms of COVID-19; other 7 children had negative PCR tests and didn’t have any signs of COVID-19. Conclusion  Among our patients with various rheumatic diseases treated with biological agents there were no registered severe cases of COVID-19. Over the past period (32 weeks of follow-up) 3% of children with COVID-19 were identified and 8% patients had documented contact with COVID-19, but we suppose it is too early to make conclusions about the degree and severity of COVID-19 among children suffering from rheumatic diseases and receiving various biological agents. Further follow-up is needed to better understand the risk and impact of COVID-19 among children with rheumatic diseases and receiving therapy with biological agents. Disclosure  N. Tsurikova: None. E. Ligostaeva: None. V. Avdeenko: None. N. Kobzeva: None. I. Tsiganok: None. K. Skorobogatova: None. A. Motkina: None.

scholarly journals Effect of COPD on the Hospital Outcomes and Mortality among Hemorrhagic Stroke Patients. Sex Differences in a Population-Based Study

2021 ◽  
Vol 10 (11) ◽  
pp. 2491
Author(s):  
Javier de Miguel-Diez ◽  
Marta Lopez-Herranz ◽  
Rodrigo Jiménez-García ◽  
Valentín Hernández-Barrera ◽  
Isabel Jimenez-Trujillo ◽  
...  
Keyword(s):  
Sex Differences ◽  
Decompressive Craniectomy ◽  
Hemorrhagic Stroke ◽  
Population Based ◽  
Stroke Patients ◽  
National Hospital ◽  
Population Based Study ◽  
Factors Associated ◽  
Adjusted Incidence ◽  
Discharge Database

(1) Background: It is not well known whether there is an association between COPD and hemorrhagic stroke (HS). We aim to analyze the incidence, clinical characteristics, procedures, and outcomes of HS in patients with and without COPD and to assess sex differences. Secondly, to identify factors associated with in-hospital mortality (IHM). (2) Methods: Patients aged ≥40 years hospitalized with HS included in the Spanish National Hospital Discharge Database (2016–2018) were analyzed. Propensity score matching (PSM) was used to compare patients according to sex and COPD status. (3) Results: We included 55,615 patients (44.29% women). Among men with COPD the HS adjusted incidence was higher (IRR 1.31; 95% CI 1.24–1.57) than among non-COPD men. COPD men had higher adjusted incidence of HS than COPD women (IRR 1.87; 95% CI 1.85–1.89). After matching, COPD men had a higher IHM (29.96% vs. 27.46%; p = 0.032) than non-COPD men. Decompressive craniectomy was more frequently conducted among COPD men than COPD women (6.74% vs. 4.54%; p = 0.014). IHM increased with age and atrial fibrillation, while decompressive craniectomy reduced IHM. (4) Conclusions: COPD men had higher incidence and IHM of HS than men without COPD. COPD men had higher incidence of HS than COPD women. Decompressive craniectomy was more frequently conducted in COPD men than COPD women and this procedure was associated to better survival.

Stem cell transplantation: progress in Asia

Lupus ◽  
2010 ◽  
Vol 19 (12) ◽  
pp. 1468-1473 ◽  
Author(s):  
L. Sun
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Stem Cell ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Hematopoietic Stem ◽  
The Past ◽  
Complex Autoimmune Disease ◽  
Significant Mortality

Systemic lupus erythematosus (SLE) is a complex autoimmune disease with multiorgan involvement and high mortality, which was reduced because of the most widely and classically used immunosuppressive therapies. However, some patients continue to have significant mortality. So a shift in the approach to the treatment of SLE is needed. In the past decade, most transplants have been performed in the treatment of SLE with allogeneic or autologous hematopoietic stem cells and currently emerging mesenchymal stem cells. There are some important differences between the two procedures.

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