scholarly journals Case Fatality Rate Related to Microcephaly Congenital Zika Syndrome and Associated Factors: A Nationwide Retrospective Study in Brazil †

Viruses ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 1228
Author(s):  
Maria Conceição N. Costa ◽  
Luciana Lobato Cardim ◽  
Maria Gloria Teixeira ◽  
Mauricio L. Barreto ◽  
Rita de Cassia Oliveira de Carvalho-Sauer ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Very Low Birth Weight ◽  
Clinical Manifestations ◽  
Case Fatality ◽  
Preterm Births ◽  
Population Based ◽  
Fatality Rate ◽  
Maternal Characteristics ◽  
Logistic Regression Models ◽  
Congenital Zika Syndrome

Background: The clinical manifestations of microcephaly/congenital Zika syndrome (microcephaly/CZS) have harmful consequences on the child’s health, increasing vulnerability to childhood morbidity and mortality. This study analyzes the case fatality rate and child–maternal characteristics of cases and deaths related to microcephaly/CZS in Brazil, 2015–2017. Methods: Population-based study developed by linkage of three information systems. We estimate frequencies of cases, deaths, case fatality rate related to microcephaly/CZS according to child and maternal characteristics and causes of death. Multivariate logistic regression models were applied. Results: The microcephaly/CZS case fatality rate was 10% (95% CI 9.2–10.7). Death related to microcephaly/CZS was associated to moderate (OR = 2.15; 95% CI 1.63–2.83), and very low birth weight (OR = 3.77; 95% CI 2.20–6.46); late preterm births (OR = 1.65; 95% CI 1.21–2.23), Apgar < 7 at 1st (OR = 5.98; 95% CI 4.46–8.02) and 5th minutes (OR = 4.13; 95% CI 2.78–6.13), among others. Conclusions: A high microcephaly/CZS case fatality rate and important factors associated with deaths related to this syndrome were observed. These results can alert health teams to these problems and increase awareness about the factors that may be associated with worse outcomes.

scholarly journals The clinical characteristics and outcome of children hospitalized with dengue in Barbados, an English Caribbean country

2015 ◽  
Vol 9 (04) ◽  
pp. 394-401 ◽  
Author(s):  
Alok Kumar ◽  
Marquita Gittens-St. Hilair ◽  
Vincent Jason ◽  
Christian Ugwuagu ◽  
Kandamaran Krishnamurthy
Keyword(s):  
Case Fatality Rate ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Case Fatality ◽  
Population Based ◽  
Warning Signs ◽  
Severe Dengue ◽  
Fatality Rate ◽  
Case Files ◽  
Dengue With Warning Signs

Introduction: Although dengue is endemic in all English-speaking Caribbean countries, there are no published studies on the clinical presentations and outcomes of children hospitalized with dengue from this region. This study aims to assess the clinical charcteristics and the outcome in children hospitalized with dengue. Methods: This was a population-based prospective study of all the children hospitalized with confirmed dengue in 2009 in Barbados. All children suspected to have dengue were routinely screened for dengue infection and underwent routine blood tests. Relevant data was extracted from their case files at the time of their discharge from the hospital. Results: Of the 199 children who were hospitalized with suspected dengue, 115 (58%) were confirmed. The overall incidence rate of  dengue among children that required hospitalization was 2.1/1,000 children. Besides the typical clinical features of dengue, 64 children hospitalized with confirmed dengue also presented with gastrointestinal manifestations (56%), 39 with respiratory manifestations (51%), 11 with hepatic manifestations (10%), 8 with neurologic manifestations (7%), and 7 with cardiovascular manifestations (6%). Twenty (17.4%) children hospitalized with confirmed dengue met the criteria for the diagnosis of severe dengue. The other 82.6% had uncomplicated or non-severe (53.9% had dengue and 28.7% had dengue with warning signs) forms of dengue. The case fatality rate in this series was 1.7%. Conclusions: Less than a third of all the children with confirmed dengue required hospitalization. Atypical clinical manifestations were common, and only a minority of these children had severe dengue. Overall, the case fatality rate for dengue in this select population of children hospitalized with dengue was low.

scholarly journals Pediatric Stroke Rates Over 17 Years: Report From a Population-Based Study

2018 ◽  
Vol 33 (7) ◽  
pp. 463-467 ◽  
Author(s):  
Laura L. Lehman ◽  
Jane C. Khoury ◽  
J. Michael Taylor ◽  
Samrat Yeramaneni ◽  
Heidi Sucharew ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Case Fatality ◽  
Population Based ◽  
Pediatric Stroke ◽  
Stroke Rate ◽  
Fatality Rate ◽  
Population Based Study ◽  
Study Region ◽  
Stroke Study ◽  
Stroke Type

We previously published rates of pediatric stroke using our population-based Greater Cincinnati Northern Kentucky Stroke Study (GCNK) for periods July 1993–June 1994 and 1999. We report population-based rates from 2 additional study periods: 2005 and 2010. We identified all pediatric strokes for residents of the GCNK region that occurred in July 1, 1993–June 30, 1994, and calendar years 1999, 2005, and 2010. Stroke cases were ascertained by screening discharge ICD-9 codes, and verified by a physician. Pediatric stroke was defined as stroke in those <20 years of age. Stroke rates by study period, overall, by age and by race, were calculated. Eleven children died within 30 days, yielding an all-cause case fatality rate of 15.7% (95% confidence interval 1.1%, 26.4%) with 3 (27.3%) ischemic, 6 (54.5%) hemorrhagic, and 2 (18.2%) unknown stroke type. The pediatric stroke rate of 4.4 per 100 000 in the GCNK study region has not changed over 17 years.

scholarly journals Correlation of population mortality of COVID-19 and testing coverage: a comparison among 36 OECD countries and Taiwan

2020 ◽  
Author(s):  
Chen Wei ◽  
Chien-Chang Lee ◽  
Tzu-Chun Hsu ◽  
Wan-Ting Hsu ◽  
Chang-Chuan Chan ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Disease Burden ◽  
Case Fatality ◽  
Correlation Coefficients ◽  
Oecd Countries ◽  
Population Based ◽  
Fatality Rate ◽  
Successful Infection ◽  
Population Mortality ◽  
Testing Coverage

ABSTRACTAlthough testing is widely regarded as critical to fighting the Covid-19 pandemic, what measure and level of testing best reflects successful infection control remains unresolved. Our aim was to compare the sensitivity of two testing metrics-population testing number and testing coverage-to population mortality outcomes and identify a benchmark for testing adequacy with respect to population mortality and capture of potential disease burden. This ecological study aggregated publicly available data through April 12 on testing and outcomes related to COVID-19 across 36 OECD (Organization for Economic Development) countries and Taiwan. All OECD countries and Taiwan were included in this population-based study as a proxy for countries with highly developed economic and healthcare infrastructure. Spearman correlation coefficients were calculated between the aforementioned metrics and following outcome measures: deaths per 1 million people, case fatality rate, and case proportion of critical illness. Fractional polynomials were used to generate scatter plots to model the relationship between the testing metrics and outcomes. Testing coverage, but not population testing number, was highly correlated with population mortality (rs= −0.79, P=5.975e-09 vs rs = − 0.3, P=0.05) and case fatality rate (rs= −0.67, P=9.067e-06 vs rs= −0.21, P=0.20). A testing coverage threshold of 15-45 signified adequate testing: below 15, testing coverage was associated with exponentially increasing population mortality, whereas above 45, increased testing did not yield significant incremental mortality benefit. Testing coverage was better than population testing number in explaining country performance and can be used as an early and sensitive indicator of testing adequacy and disease burden. This may be particularly useful as countries consider re-opening their economies.

scholarly journals Aneurysmal subarachnoid hemorrhage: long-term trends in incidence and survival in Olmsted County, Minnesota

2020 ◽  
pp. 1-6
Author(s):  
Enrico Giordan ◽  
Christopher S. Graffeo ◽  
Alejandro A. Rabinstein ◽  
Robert D. Brown ◽  
Walter A. Rocca ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Incidence Rate ◽  
Case Fatality Rate ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Case Fatality ◽  
Population Based ◽  
Fatality Rate ◽  
Olmsted County ◽  
Day Case ◽  
Incident Cases

OBJECTIVERecent population-based and hospital cohort studies have reported a decreasing incidence of aneurysmal subarachnoid hemorrhage (aSAH) and declining aSAH-associated case-fatality rates. Principal drivers of these trends are debated, but improvements in smoking cessation and hypertension control may be critical factors.METHODSThe population-based medical records linkage system of the Rochester Epidemiological Project was used to document aSAH incidence and 30-day case fatality rates during a 20-year study period (1996–2016) in Olmsted County, Minnesota. Incidence rates in the study period were compared with data from a previous Olmsted County study concerning aSAH incidence from 1965 to 1995 and with regional trends in tobacco use.RESULTSOne hundred nineteen incident cases of aSAH were included. The median age at hemorrhage was 59 years (range 16–94 years), and 74 patients were female (62.2%). The overall average annual aSAH incidence rate was 4.2/100,000 person-years (P-Y). The aSAH incidence rate decreased from 5.7/100,000 in 1996 to 3.5/100,000 P-Y in 2011–2016. The overall aSAH-associated 30-day case-fatality rate was 21.9% and declined by approximately 0.5% annually. An accelerated decline in the fatality rate (0.9%/year) was observed from 2006–2016. Smoking among adult Olmsted County residents decreased from 20.4% in 2000 to 9.1% in 2018.CONCLUSIONSA decline in the incidence of aSAH and 30-day case-fatality rate from 1996 to 2016 was observed, as well as an accelerated decline of the fatality rate from 2006 to 2016. These findings confirm and extend the trends reported by prior studies in the same population. The decrease in aSAH in the years studied paralleled a noticeable reduction in the population smoking rates.

scholarly journals Perinatal Case Fatality Rate Related to Congenital Zika Syndrome in Brazil: a Cross-Sectional Study

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S22-S22
Author(s):  
Igor Thiago Queiroz ◽  
Jessika Thais Da Silva Maia ◽  
Gleysson Rosa ◽  
Tatyana Vidal Mendes ◽  
S Jayne Alves Vidal ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Case Fatality ◽  
Rio Grande ◽  
Cross Sectional Study ◽  
High Rate ◽  
Fatality Rate ◽  
Sectional Study ◽  
Zikv Infection ◽  
Cross Sectional ◽  
Congenital Zika Syndrome

Abstract Background Many studies have demonstrated a causal link between Zika virus (ZIKV) infection, microcephaly (MCP), and other congenital abnormalities (CA). This study aimed to determine perinatal case fatality rate in cases of Congenital Zika Syndrome (CZS) in the Rio Grande do Norte State (RN), a Brazilian Northeast State highly impacted by the Zika virus outbreak. Methods A cross-sectional study was conducted using data obtained through the State Health Department (SHD) for cases of MCP and CA in Rio Grande do Norte from April 2015 to February 5, 2016. Definition of perinatal period: commences at 22 completed weeks (154 days) of gestation and ends seven completed days after birth. Results During the study period, there were 486 cases of MCP and others CA notified in RN, of which 142 were confirmed and 108 remain under investigation. The remaining 236 cases have been ruled out by presenting normal examinations or due to presenting microcephaly by noninfectious causes. Of the total confirmed cases, 26.7% (38/142) died after birth or during pregnancy. 15.78% (06/38) of confirmed deaths had ZIKV infection during pregnancy and 2.63% (01/38) had a positive TORCH blood test. The six cases related to ZIKV were confirmed by RT–PCR and/or IgM/IgG antibodies against ZIKV. The remaining cases of deaths remain either under investigation or have been ruled out. Conclusion This study highlights a high rate of perinatal lethality (15.78%) in cases of CZS. Despite the growing number of CZS cases, the real incidence and prevalence might be higher due to the underreporting and lack of resources for confirmatory diagnostic tests (laboratory and imaging). Due to the high rate of lethality and the ongoing uncontrolled ZIKV outbreak, this study predicts an increase in the infant mortality rate in Brazil and highlights the need for developing public health programs to control the ZIKV outbreak. Disclosures All authors: No reported disclosures.

scholarly journals Perinatal Case Fatality Rate Related to Congenital Zika Syndrome in Brazil: A Cross-Sectional Study

2018 ◽  
Vol 81 ◽  
pp. 47-48 ◽  
Author(s):  
Nilson N. Mendes Neto ◽  
Jessika Thais da Silva Maia ◽  
Marcelo Rodrigues Zacarkim ◽  
Igor Queiroz ◽  
Angelle Desiree Labeaud ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Case Fatality ◽  
Cross Sectional Study ◽  
Fatality Rate ◽  
Sectional Study ◽  
Cross Sectional ◽  
Congenital Zika Syndrome

Temporal trends in stroke incidence and case-fatality rates in Arcadia, Greece: A sequential, prospective, population-based study

2021 ◽  
pp. 174749302199559
Author(s):  
Eleni Karantali ◽  
Konstantinos Vemmos ◽  
Evangelos Tsampalas ◽  
Konstantinos Xynos ◽  
Persefoni Karachalia ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Temporal Trends ◽  
Case Fatality ◽  
Population Based ◽  
Incidence Rates ◽  
European Population ◽  
Fatality Rate ◽  
Population Based Study ◽  
Stroke Incidence ◽  
Southern Greece

Background Stroke incidence and case-fatality are reported to decline in high-income countries during the last decades. Epidemiological studies are important for health services to organize prevention and treatment strategies. Aims The aim of this population-based study was to determine temporal trends of stroke incidence and case-fatality rates of first-ever stroke in Arcadia, a prefecture in southern Greece. Methods All first-ever stroke cases in the Arcadia prefecture were ascertained using the same standard criteria and multiple overlapping sources in three study periods: from November 1993 to October 1995; 2004; and 2015–2016. Crude and age-adjusted to European population incidence rates were compared using Poisson regression. Twenty-eight days case fatality rates were estimated and compared using the same method. Results In total, 1315 patients with first-ever stroke were identified. The age-standardized incidence to the European population was 252 per 100,000 person-years (95% CI 231–239) in 1993/1995, 252 (95% CI 223–286) in 2004, and 211 (192–232) in 2015/2016. The overall age- and sex-adjusted incidence rates fell by 16% (incidence rates ratio 0.84, 95% CI: 0.72–0.97). Similarly, 28-day case-fatality rate decreased by 28% (case fatality rate ratio = 0.72, 95% CI: 0.58–0.90). Conclusions This population-based study reports a significant decline in stroke incidence and mortality rates in southern Greece between 1993 and 2016.

Time trends and case fatality rate of in-hospital treated pulmonary embolism during 11 years of observation in Northwestern Italy

2016 ◽  
Vol 115 (02) ◽  
pp. 399-405 ◽  
Author(s):  
Walter Ageno ◽  
Fulvio Pomero ◽  
Luigi Fenoglio ◽  
Alessandro Squizzato ◽  
Matteo Bonzini ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Incidence Rate ◽  
Time Trends ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Population Based ◽  
Fatality Rate ◽  
Entire Study ◽  
Mortality And Morbidity ◽  
Hospital Case

SummaryPulmonary embolism (PE) is a common disorder with high mortality and morbidity rates. However, population-based information on its incidence and prognosis remains limited. We conducted a large epidemiology study collecting data on hospitalisation for PE (from 2002 to 2012) in a population of about 13 million people in Northwestern Italy. Patients were identified using the ICD-9-CM codes: 415.11, 415.19; gender and age specific incidence rate of PE during the study period were estimated using the resident population for each year of the study. Furthermore, time trends in the in-hospital PE-related mortality and case fatality rate were calculated. Results were adjusted for possible confounders. A total of 60,853 patients (mean age 72.8 years, ± 14.1, 59.6 % females) with PE were included; the overall crude incidence rate for the entire study period was 55.4 and 40.6 events per year per 100,000 inhabitants for women and men, respectively (p < 0.001). However, this difference was completely lost after standardisation for age. The incidence of PE significantly increased in both genders during the study period. In-hospital case fatality rate significantly decreased throughout the study period (p < 0.001) in women (from 15.6 % to 10.2 %) and in men (from 17.6 % to 10.1 %). The observed decrease of the in-hospital case-fatality throughout the study period remained significant also after adjustment for possible confounders. In conclusion, time trends over an 11-year period show an increasing incidence of PE, but a significant reduction in mortality during hospitalisation. Reduction in the case fatality rate remained significant after adjustment for these possible confounders.Supplementary Material to this article is available online at www.thrombosis-online.com.

scholarly journals Survival of hospitalized COVID-19 patients in Northern Italy: a population-based cohort study by the ITA-COVID19 Network

2020 ◽  
Author(s):  
P. Giorgi Rossi ◽  
E. Ferroni ◽  
S. Spila Alegiani ◽  
G. Pitter ◽  
O. Leoni ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Case Fatality ◽  
Population Based ◽  
Northern Italy ◽  
Charlson Index ◽  
Fatality Rate ◽  
Survival Curves ◽  
Younger Patients ◽  
High Fatality Rate

AbstractBackgroundCOVID-19 case fatality rate in hospitalized patients varies across countries and studies, but reliable estimates specific for age, sex, and comorbidities are needed to design trials for COVID-19 interventions. Aim of this study is to provide population-based survival curves of hospitalized COVID-19 patients.MethodsA cohort study was conducted in Lombardy, Veneto, and Reggio Emilia using COVID-19 registries linked to hospital discharge databases containing patient clinical histories. All patients with positive SARS-CoV-2 RT-PCR test on oral/nasopharyngeal swabs hospitalized from 21st February to 21st April 2020 were identified. Kaplan Meier survival estimates were calculated at 14 and 30 days for death in any setting, stratifying by age, sex and Charlson Index.FindingsOverall, 42,926 hospitalized COVID-19 patients were identified. Patients’ median age was 69 years (IQR: 57-79), 62·6% were males, 69·4% had a Charlson Index of 0. In total, 11,205 (26·1%) patients died over a median follow-up of 24 days (IQR: 10-35). Survival curves showed that 22·0% of patients died within 14 days and 27·6% within 30 days of hospitalization. Survival was higher in younger patients and in females. Younger patients with comorbidities had a lower survival than older ones with comorbidities.InterpretationOver 27% of hospitalized COVID-19 patients died within one month in three areas of Northern Italy that were heavily affected by SARS-CoV-2 infection. Such a high fatality rate suggests that trials should focus on survival and have follow-up of at least one month.FundingThe study did not receive any external funding.Research in contextEvidence before this studyTwo recent systematic reviews with meta-analyses report case fatality rates of three to four percent in COVID-19 patients. Most studies on hospitalized cohorts report only slightly higher figures. These figures do not correspond to those derived from routinely collected clinical data in most European countries, reporting a 10% case fatality rate which has been increasing over time since the epidemic started.Robust and precise survival estimates of hospitalized COVID-19 patients which take into account prognostic factors such as age, sex and burden of comorbidities are needed to design appropriate phase II and phase III clinical studies of drugs targeting COVID-19.Added value of this studyIn this study we present the first survival estimates by age, sex and Charlson index for a large population-based cohort of Italian hospitalized COVID-19 patients.Implications of all the available evidenceOver 27% of COVID-19 patients died within one month from hospital admission. Such a high fatality rate suggests that studies should prioritize mortality as primary outcome. Furthermore, we found that the fatality rate reaches a plateau 30 days after hospitalization, suggesting that studies should have at least one month of follow up to observe deaths; shorter follow-up could lead to overestimation of treatment benefits.

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