scholarly journals Epidemiology and Trends of Sepsis in Young Adults Aged 20–44 Years: A Nationwide Population-Based Study

2019 ◽  
Vol 9 (1) ◽  
pp. 77
Author(s):  
Carmen Bouza ◽  
Teresa López-Cuadrado
Keyword(s):  
Young Adults ◽  
Hospital Mortality ◽  
Organ Dysfunction ◽  
Case Fatality ◽  
Population Based ◽  
Incidence Rates ◽  
Mortality Trends ◽  
Crude Incidence ◽  
Source Of Infection ◽  
Primary Endpoints

Background: While sepsis may have especially marked impacts in young adults, there is limited population-based information on its epidemiology and trends. Methods: Population-based longitudinal study on sepsis in adults aged 20–44 years using the 2006–2015 Spanish national hospital discharge database. Cases are identified by an ICD-9-CM coding strategy. Primary endpoints are incidence and in-hospital mortality. Trends are assessed for annual percentage change (AAPC) in rates using Joinpoint regression models. Results: 28,351 cases are identified, representing 3.06‰ of all-cause hospitalisations and a crude incidence of 16.4 cases/100,000 population aged 20–44. The mean age is 36 years, 58% of cases are men, and around 60% have associated comorbidities. Seen in one third of cases, the source of infection is respiratory. Single organ dysfunction is recorded in 45% of cases. In-hospital mortality is 24% and associated with age, comorbidity and extent of organ dysfunction. Incidence rates increase over time in women (AAPC: 3.8% (95% CI: 2.1, 5.5)), whereas case-fatality decline with an overall AAPC of −5.9% (95% CI −6.6, −5.2). Our results indicate that sepsis is common in young adults and associated with high in-hospital mortality, though it shows a decreasing trend. The substantial increase in incidence rates in women needs further research.

scholarly journals Incidence, Risk Factors, and Outcomes of Preterm and Early Term Births: A Population-Based Register Study

2021 ◽  
Vol 18 (11) ◽  
pp. 5865
Author(s):  
Salma Younes ◽  
Muthanna Samara ◽  
Rana Al-Jurf ◽  
Gheyath Nasrallah ◽  
Sawsan Al-Obaidly ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Population Based ◽  
Incidence Rates ◽  
Large For Gestational Age ◽  
Mortality And Morbidity ◽  
Early Term ◽  
Incidence Risk

Preterm birth (PTB) and early term birth (ETB) are associated with high risks of perinatal mortality and morbidity. While extreme to very PTBs have been extensively studied, studies on infants born at later stages of pregnancy, particularly late PTBs and ETBs, are lacking. In this study, we aimed to assess the incidence, risk factors, and feto-maternal outcomes of PTB and ETB births in Qatar. We examined 15,865 singleton live births using 12-month retrospective registry data from the PEARL-Peristat Study. PTB and ETB incidence rates were 8.8% and 33.7%, respectively. PTB and ETB in-hospital mortality rates were 16.9% and 0.2%, respectively. Advanced maternal age, pre-gestational diabetes mellitus (PGDM), assisted pregnancies, and preterm history independently predicted both PTB and ETB, whereas chromosomal and congenital abnormalities were found to be independent predictors of PTB but not ETB. All groups of PTB and ETB were significantly associated with low birth weight (LBW), large for gestational age (LGA) births, caesarean delivery, and neonatal intensive care unit (NICU)/or death of neonate in labor room (LR)/operation theatre (OT). On the other hand, all or some groups of PTB were significantly associated with small for gestational age (SGA) births, Apgar <7 at 1 and 5 minutes and in-hospital mortality. The findings of this study may serve as a basis for taking better clinical decisions with accurate assessment of risk factors, complications, and predictions of PTB and ETB.

Abstract P625: Rate of Hemorrhagic Transformation After Ischemic Stroke and Associated Risk Factors: The Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS)

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Robert J Stanton ◽  
Eleni Antzoulatos ◽  
Elisheva R Coleman ◽  
Felipe De Los Rios La Rosa ◽  
Stacie L Demel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Case Fatality ◽  
Population Based ◽  
Hemorrhagic Transformation ◽  
Incidence Rates ◽  
Icd 10 ◽  
Potential Risk Factors ◽  
Adjusted Rate ◽  
Associated Risk Factors

Background: Hemorrhagic transformation (HT) of ischemic stroke can have devastating consequences, leading to longer hospitalizations, increased morbidity and mortality. We sought to identify the rate of HT in stroke patients not treated with tPA within a large, biracial population. Methods: The GCNKSS is a population-based stroke epidemiology study from five counties in the Greater Cincinnati region. During 2015, we captured all hospitalized strokes by screening ICD-9 codes 430-436 and ICD-10 codes I60-I68, and G45-46. Study nurses abstracted all potential cases and physicians adjudicated cases, including classifying the degree of HT. Patients treated with thrombolytics were excluded. Incidence rates per 100,000 and associated 95% confidence intervals (CI) were estimated for HT cases, age and sex adjusted to the 2000 US population. Multiple logistic regression was used to examine risk factors associated with HT. Results: In 2015, there were 2301 ischemic strokes included in the analysis. Of these 104 (4.5%) had HT; 23 (22.1%) symptomatic, 55 (52.9%) asymptomatic and 26 (25%) unknown. Documented reasons for not receiving tPA in these patients were: time (71, 68.3%), anticoagulant use (1, 1.0%), other (18,17.3%) and unknown (14, 13.5%), which were not significantly different compared to those without HT. Only 29/104 (18.3%) had HT classified as PH-1 or PH-2. The age, sex and race-adjusted rate of HT was 9.8 (7.9, 11.6) per 100,000. The table shows rates of potential risk factors and the adjusted odds of developing HT. 90 day all-cause case fatality for patients with HT was significantly higher, 27.9% vs. 15.7%, p<0.0001. Conclusion: We found that 4.5% of non-tPA treated IS patients had HT. These patients had more severe strokes, were more likely to have abnormal coagulation tests or anticoagulant use, and were more likely to die within 90 days. We also report the first population-based incidence rate of HT in non-tPA treated of 9.8/100,000, a rate similar to the incidence of SAH.

scholarly journals Recent trends in hospitalization and in-hospital mortality associated with traumatic brain injury in Canada: a nationwide, population-based study

2015 ◽  
Vol 42 (S1) ◽  
pp. S21-S21
Author(s):  
T Fu ◽  
R Jing ◽  
S McFaull ◽  
M Cusimano
Keyword(s):  
Traumatic Brain Injury ◽  
Young Adults ◽  
Brain Injury ◽  
Hospital Mortality ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Population Based ◽  
Hospital Length Of Stay ◽  
Elderly Adults ◽  
Hospitalization Rates

Background: Traumatic brain injury (TBI) is the leading cause of traumatic death and disability worldwide. We examined nationwide trends in TBI-related hospitalizations and in-hospital mortality between April 2006 and March 2010 using a population-based database that is mandatory for all hospitals in Canada. Methods: Trends in hospitalization rates were analyzed using linear regression. Independent predictors of in-hospital mortality were evaluated using logistic regression. Results: Hospitalization rates remained stable for children and young adults, but increased considerably among elderly adults (ages 65 and older). Falls and motor vehicle collisions (MVCs) were the most common causes of TBI hospitalizations. TBIs caused by falls increased by 24% (p=0.01), while MVC-related hospitalization rates decreased by 18% (p=0.03). Elderly adults were most vulnerable to falls, and experienced the greatest increase (29%) in fall-related hospitalization rates. Young adults (ages 15-24) were most at risk for MVCs, but experienced the greatest decline (28%) in MVC-related admissions. There were significant trends towards increasing age, injury severity, comorbidity, hospital length of stay, and in-hospital mortality. However, multivariate regression showed that the odds of death decreased over time after controlling for relevant factors. Conclusions: Hospitalizations for TBI are increasing in severity and involve older populations with more complex comorbidities.

Prostate cancer incidence and predictions: Observational Study (Monastir, Tunisia: 2002-2030)

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Bannour ◽  
I Zemni ◽  
C Ben Nasrallah ◽  
N Aroua ◽  
M Kacem ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Incidence ◽  
Cancer Registries ◽  
Population Based ◽  
Incidence Rates ◽  
Cancer Site ◽  
International Agency ◽  
Crude Incidence ◽  
The Future ◽  
Spss Software

Abstract Introduction Cancer is an eminent public health issue in the developing countries. The risk factors incriminated in cancer higher incidence are multiple such as the growing population rates, increasing tobacco consumption, the changes of diet and lifestyle. In Tunisia, there are three population-based cancer registries at the present time providing data on cancer incidence and survival. According to the data published by WHO International Agency for Research on Cancer (IACR) (GLOBOCAN 2018), prostate cancer in Tunisia ranks fifth among cancers with almost 819 new cases per year. The aim of this study was to we report trends in the cancer incidence during the span of time between 2002 and 2013 from the population-based cancer registry of the centre of Tunisia, and to predict the future number of cancer cases by 2030. Methods The cancer incidence data were collected from the Center cancer registries from 2003 to 2012.The data were stratified by cancer site, sex and age. We used SPSS software in order to calculate the crude incidence rates and age-standardized incidence rates. SPSS software was used in order to estimate the future number of cancer cases by 2030. Results A total of 725 cases of prostate cancer were enregistrated. The mean age of patients was 71.6 ±10.61years. The crude incidence rates were estimated 23.537. The standardized incidence rate was 33.92. A significant positive trend was noted with a b = 0133 and p &lt; 10-3. 1033 new cases are predicted by 2030 Conclusions The data of the cancer register of the center shows that the incidence of cancer is rising, and it is consistent with the National cancer intelligence, but some cancer incidence showed slightly higher, such as thyroid cancer and prostate cancer. In order to face this alarming situation, many preventive steps should be done such as strengthening early screening and diagnosis of cancer, improving clinical research in order to better control the risks factors. Key messages Prediction of the future number of cancer cases is of great interest to society. Prostate cancer in Tunisia ranks fifth among cancers.

Secular Trends of Stroke Epidemiology in Örebro, Sweden, 2017 Compared to the Trends in 1999: A Population-Based Study

2019 ◽  
Vol 48 (3-6) ◽  
pp. 149-156 ◽  
Author(s):  
Peter Appelros
Keyword(s):  
Length Of Stay ◽  
Incidence Study ◽  
Large Population ◽  
Case Fatality ◽  
Population Based ◽  
Incidence Rates ◽  
European Population ◽  
Stroke Severity ◽  
Stroke Incidence ◽  
Preventive Medication

Background and Purpose: A stroke incidence study in ­Örebro, situated in Southern Sweden, that was carried out in 1999 showed high incidence rates. Since then, in many Western countries, declining incidence rates have been observed. The main purpose of this study is to examine whether there have been any changes in stroke incidence in the city of ­Örebro between 1999 and 2017. Secondary purposes are to show trends in stroke severity, length of stay and case fatality (CF). Methods: The criterion of an “ideal” stroke incidence study was used in both the 1999 and the present investigation. These criteria include uniform diagnostics, case ascertainment including strokes managed outside the hospital, and the use of several overlapping sources, prospective design, well-defined denominator, and a large population. Results: The overall stroke incidence rate of first ever stroke (adjusted to the 2013 European population) dropped from 346/100,000 (95% CI 314–380) to 168/100,000 (95% CI 148–190). Stroke severity declined from a median of 6 to 4 points on the National Institute of Health Stroke scale. CF within 28 days also declined from 19 to 16% (n.s.). Median length-of-stay in hospital was 16 days in 1999, and 10 days in 2017. Twenty-one per cent of all kinds of stroke were recurrent (not included in the above results). Conclusions: During the years between 1999 and 2017, there have been reductions in stroke incidence, severity and mortality. The explanation is most likely to be found in the prevalence of risk factors and how they are treated. The use of antihypertensives and statins has increased, corresponding to lower levels of blood pressure and cholesterol in the population. The use of anticoagulants in patients with atrial fibrillation has increased. Cigarette smoking has decreased. These are encouraging results that show that preventive medication and public health measures work in practice.

Abstract 6082: Sex Differences in Mortality after Acute Myocardial Infarction: Changes from 1994 to 2006

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Viola Vaccarino ◽  
Lori Parsons ◽  
Eric D Peterson ◽  
William J Rogers ◽  
Catarina Kiefe ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Hospital Mortality ◽  
Excess Mortality ◽  
Age Groups ◽  
Case Fatality ◽  
Patient Characteristics ◽  
National Registry ◽  
Mortality Trends ◽  
Younger Women ◽  
Study Population

Introduction. In the past 10 years, several studies have shown that younger, but not older, women have a higher hospital mortality than age-matched men. We examined whether such mortality differences have declined in recent years. Methods. We investigated temporal tends in the case fatality of MI according to sex and age (in 5 age groups) during a12-year period, 1994 to 2006. The study population included 916,380 MI patients from the National Registry of Myocardial Infarction (NRMI) who had a confirmed diagnosis of MI. Results. Hospital mortality declined markedly between 1994 and 2006 in all patients, but more so in women than in men in virtually every age group. The mortality reduction in 2006 relative to 1994 was largest in women <55 years old (53%) and lowest in men <55 years old (33%). In patients <55 years, the absolute decline in mortality was 3 times larger in women than in men (2.7% vs 0.9%). The sex difference in mortality decline became progressively lower in older patients (p=0.002 for the interaction between sex, age and year). As a result, the excess mortality in younger women compared with men was less pronounced in 2004 – 06 than in 1994 –95 (Figure ). Changes in patient characteristics and treatments over time accounted in part for these mortality trends. Conclusion. In recent years, women, particularly younger women, experienced larger improvements in hospital mortality after MI than men. As a result, the higher mortality of younger MI women compared with men has narrowed.

Incidence Rates and Case-Fatality Rates of Cerebral Vein Thrombosis: A Population-Based Study

Stroke ◽  
2021 ◽  
Author(s):  
Emanuele Rezoagli ◽  
Aldo Bonaventura ◽  
Jonathan M. Coutinho ◽  
Alessandra Vecchié ◽  
Vera Gessi ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Epidemiological Study ◽  
Charlson Comorbidity Index ◽  
Odds Ratio ◽  
Case Fatality ◽  
Population Based ◽  
Cerebral Vein ◽  
Cerebral Vein Thrombosis ◽  
Vein Thrombosis ◽  
Comorbidity Index

Background and Purpose: Cerebral vein thrombosis (CVT) incidence is estimated to be >10 per 1 000 000 per year. Few population-based studies investigating case-fatality rates (CFRs) and pyogenic/nonpyogenic CVT incidence are available. We assessed trends in CVT incidence between 2002 and 2012, as well as adjusted in-hospital CFRs and incidence of hospital admissions for pyogenic/nonpyogenic CVT in a large Northwestern Italian epidemiological study. Methods: Primary and secondary discharge diagnoses of pyogenic/nonpyogenic CVT were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes 325, 671.5, and 437.6. Age, sex, vital status at discharge, length of hospital stay, and up to 5 secondary discharge diagnoses were collected. Concomitant presence of intracerebral hemorrhage (ICH) was registered, and comorbidities were assessed through the Charlson comorbidity index. Results: A total of 1718 patients were hospitalized for CVT (1147 females—66.8%; 810 pyogenic and 908 nonpyogenic CVT, 47.1% and 52.9%, respectively), with 134 patients (7.8%) experiencing a concomitant ICH. The overall incidence rate for CVT was 11.6 per 1 000 000 inhabitants with a sex-specific rate of 15.1 and 7.8 per 1 000 000 in females and males, respectively. CVT incidence significantly increased in women during time of observation ( P =0.007), with the highest incidence being at 40 to 44 years (27.0 cases per 1 000 000). In-hospital CFR was 3%, with no difference between pyogenic/nonpyogenic CVT. Patients with concomitant ICH had a higher in-hospital CFR compared with patients without ICH (7.5% versus 2.7%; odds ratio, 2.96 [95% CI, 1.45–6.04]). In-hospital CFR progressively increased with increasing Charlson comorbidity index ( P =0.003). Age (odds ratio, 1.03 [95% CI, 1.02–1.05]), Charlson comorbidity index ≥4 (odds ratio, 4.33 [95% CI, 1.29–14.52]), and ICH (odds ratio, 3.05 [95% CI, 1.40–6.62]) were independent predictors of in-hospital mortality. Conclusions: In a large epidemiological study, CVT incidence was found to be comparable to the one registered in population-based studies reported after the year 2000. CVT incidence increased among women over time. In-hospital CFR was low, but not negligible, in patients with concomitant ICH. Age, ICH, and a high number of comorbidities were independent predictors of in-hospital mortality. Pyogenic CVT was not a predictor of in-hospital CFR, although its high proportion was not confirmed by internal validation.

Hypersensitivity reactions with allopurinol and febuxostat: a study using the Medicare claims data

2020 ◽  
Vol 79 (4) ◽  
pp. 529-535 ◽  
Author(s):  
Jasvinder A. Singh ◽  
John D. Cleveland
Keyword(s):  
Cox Regression ◽  
Medicare Beneficiary ◽  
Population Based ◽  
Outpatient Setting ◽  
Incidence Rates ◽  
Hypersensitivity Reactions ◽  
Population Based Study ◽  
Crude Incidence ◽  
Female Sex ◽  
Starting Dose

ObjectiveTo assess the risk of hypersensitivity reactions (HSRs) with allopurinol and febuxostat in a population-based study.MethodsWe used the 5% Medicare beneficiary sample (≥65 years) from 2006 to 2012 to identify people with a newly filled prescription for allopurinol, febuxostat or colchicine. We used multivariable-adjusted Cox regression analyses to compare the hazard ratio (HR) of incident HSRs with allopurinol or febuxostat use versus colchicine use; separate analyses were done in people exposed to allopurinol. Propensity-matched analyses (5:1) compared hazards with allopurinol versus febuxostat.ResultsCrude incidence rates of HSRs were as follows: allopurinol, 23.7; febuxostat, 30.7; and colchicine, 25.6 per 1000 person-years. Compared with colchicine, allopurinol, febuxostat and febuxostat+colchicine were associated with significantly higher HRs of HSRs, 1.32 (95% CI: 1.10 to 1.60) and 1.54 (95% CI: 1.12 to 2.12) and 2.17 (95% CI: 1.18 to 3.99), respectively. In propensity-matched analyses, febuxostat did not significantly differ from allopurinol; HR for HSRs was 1.25 (95% CI: 0.93 to 1.67). Compared with allopurinol start dose <200 mg/day, allopurinol start dose ≥300 mg/day, diabetes and female sex were associated with significantly higher hazard of HSRs, 1.27 (95% CI: 1.12 to 1.44), 1.21 (95% CI: 1.00 to 1.45) and 1.32 (95% CI: 1.17 to 1.48), respectively. The majority (69%) of HSRs occurred in the outpatient setting.ConclusionsCompared with colchicine, allopurinol and febuxostat similarly increased the risk of HSRs. Allopurinol and febuxostat did not differ from each other. In allopurinol users, starting dose, female sex and diabetes increased this risk, findings that need further study.

Clostridioides difficile infection and antibiotic prescription rates in the community: Explaining the gender gap

2020 ◽  
pp. 1-3
Author(s):  
Mariam Younas ◽  
Julie Royer ◽  
Sharon B. Weissman ◽  
Hana R. Winders ◽  
Sangita Dash ◽  
...  
Keyword(s):  
South Carolina ◽  
Gender Gap ◽  
Antibiotic Prescription ◽  
Population Based ◽  
Incidence Rates ◽  
Cross Sectional ◽  
Crude Incidence ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Prescription Rates

Abstract In this cross-sectional population-based study, women had significantly higher crude incidence rates of both community-associated Clostridioides difficile infection (CA-CDI) and ambulatory antibiotic prescriptions compared to men in South Carolina in 2015. After adjustments for antibiotic prescription rates, there was no difference in the incidence rates of CA-CDI between the genders.

scholarly journals Estimated and Observed Cancer Incidence in Italy: A Validation Study

2007 ◽  
Vol 93 (4) ◽  
pp. 387-391 ◽  
Author(s):  
Riccardo Capocaccia ◽  
Carlotta Buzzoni ◽  
Enrico Grande ◽  
Riccardo Inghelmann ◽  
Francesco Bellù ◽  
...  
Keyword(s):  
Cancer Registries ◽  
Population Based ◽  
Incidence Rates ◽  
Italian Population ◽  
Sudden Increase ◽  
Crude Incidence ◽  
Incidence Data ◽  
Incidence Trends ◽  
Model Based ◽  
Italian Regions

Aims and background The study aimed to validate model-based incidence estimates by means of observed incidence rates provided by Italian cancer registries, for five major cancer sites (stomach, colon and rectum, lung, breast and prostate cancers) and for all cancers together. Methods Recent incidence rates observed by Italian population-based cancer registries were extracted from the data base of the Italian Association of Cancer Registries. Regional estimates of incidence rates for the same cancers were obtained by the MIAMOD method. Observed and estimated crude incidence rates and incidence trends were compared for the period of diagnosis 1985-2000. Eight Italian cancer registries and seven regions were selected for the analysis since they had incidence data available during the entire selected period. Results and conclusions An excellent agreement between estimated and observed crude incidence rates was found for all single cancer sites, regarding absolute incidence levels and time trends. A partial exception was breast, where empirical data showed a sudden increase in the last three years of observation, perhaps due to organized screenings in some Italian regions, and not captured by statistical models. Substantial underestimation of model-based incidence rates was found for all cancers combined, where the difference tended to increase with calendar year, up to a maximum of 20% in recent years. The greatest part of the discrepancy can be attributed to multiple cancers, which were included in cancer registries statistics but were not accounted for in MIAMOD estimates.

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