scholarly journals COVID-19 In-Hospital Mortality in People with Diabetes Is Driven by Comorbidities and Age—Propensity Score-Matched Analysis of Austrian National Public Health Institute Data

Viruses ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2401
Author(s):  
Faisal Aziz ◽  
Felix Aberer ◽  
Alexander Bräuer ◽  
Christian Ciardi ◽  
Martin Clodi ◽  
...  
Keyword(s):  
Public Health ◽  
Logistic Regression ◽  
Propensity Score ◽  
Hospital Mortality ◽  
Odds Ratio ◽  
National Public Health Institute ◽  
Data Platform ◽  
National Public Health ◽  
The Impact ◽  
Public Health Institute

Background: It is a matter of debate whether diabetes alone or its associated comorbidities are responsible for severe COVID-19 outcomes. This study assessed the impact of diabetes on intensive care unit (ICU) admission and in-hospital mortality in hospitalized COVID-19 patients. Methods: A retrospective analysis was performed on a countrywide cohort of 40,632 COVID-19 patients hospitalized between March 2020 and March 2021. Data were provided by the Austrian data platform. The association of diabetes with outcomes was assessed using unmatched and propensity-score matched (PSM) logistic regression. Results: 12.2% of patients had diabetes, 14.5% were admitted to the ICU, and 16.2% died in the hospital. Unmatched logistic regression analysis showed a significant association of diabetes (odds ratio [OR]: 1.24, 95% confidence interval [CI]: 1.15–1.34, p < 0.001) with in-hospital mortality, whereas PSM analysis showed no significant association of diabetes with in-hospital mortality (OR: 1.08, 95%CI: 0.97–1.19, p = 0.146). Diabetes was associated with higher odds of ICU admissions in both unmatched (OR: 1.36, 95%CI: 1.25–1.47, p < 0.001) and PSM analysis (OR: 1.15, 95%CI: 1.04–1.28, p = 0.009). Conclusions: People with diabetes were more likely to be admitted to ICU compared to those without diabetes. However, advanced age and comorbidities rather than diabetes itself were associated with increased in-hospital mortality in COVID-19 patients.

scholarly journals National Public Health Institute Legal Framework: A Tool to Build Public Health Capacity

2020 ◽  
Vol 18 (S1) ◽  
pp. S-43-S-52 ◽  
Author(s):  
Emily L. Rosenfeld ◽  
Sue Binder ◽  
C. Adam Brush ◽  
Ellen A. Spotts Whitney ◽  
Dennis Jarvis ◽  
...  
Keyword(s):  
Public Health ◽  
Legal Framework ◽  
National Public Health Institute ◽  
Health Institute ◽  
National Public Health ◽  
Public Health Institute

scholarly journals Disease modeling for public health: added value, challenges, and institutional constraints

2019 ◽  
Vol 41 (1) ◽  
pp. 39-51 ◽  
Author(s):  
Mirjam Kretzschmar
Keyword(s):  
Public Health ◽  
Mathematical Modeling ◽  
Disease Modeling ◽  
Scientific Evidence ◽  
Policy Support ◽  
Added Value ◽  
National Public Health Institute ◽  
Health Institute ◽  
National Public Health ◽  
Public Health Institute

AbstractPublic health policymakers face increasingly complex questions and decisions and need to deal with an increasing quantity of data and information. For policy advisors to make use of scientific evidence and to assess available intervention options effectively and therefore indirectly for those deciding on and implementing public health policies, mathematical modeling has proven to be a useful tool. In some areas, the use of mathematical modeling for public health policy support has become standard practice at various levels of decision-making. To make use of this tool effectively within public health organizations, it is necessary to provide good infrastructure and ensure close collaboration between modelers and policymakers. Based on experience from a national public health institute, we discuss the strategic requirements for good modeling practice for public health. For modeling to be of maximal value for a public health institute, the organization and budgeting of mathematical modeling should be transparent, and a long-term strategy for how to position and develop mathematical modeling should be in place.

scholarly journals Hour-1 Bundle Adherence Was Associated With Reduction of In-Hospital Mortality Among Patients With Sepsis In Japan

2021 ◽  
Author(s):  
Yutaka Umemura ◽  
Toshikazu Abe ◽  
Hiroshi Ogura ◽  
Seitato Fujishima ◽  
Shigeki Kushimoto ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Hospital Mortality ◽  
Broad Spectrum ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Blood Cultures ◽  
Care Bundle ◽  
Study Cohort ◽  
Broad Spectrum Antibiotics ◽  
The Impact

Abstract Background: The updated Surviving Sepsis Campaign guidelines recommend a 1-hour window for completion of a sepsis care bundle, however, the effectiveness of the hour-1 bundle has not been fully evaluated. The present study aimed to evaluate the impact of hour-1 bundle completion on clinical outcomes in sepsis patients.Methods: This is a multicenter, prospective, observational study conducted in 17 intensive care units in tertiary hospitals in Japan. We included all adult patients who were diagnosed as having sepsis by Sepsis-3 and admitted to the ICUs from July 2019 to August 2020. Impacts of hour-1 bundle adherence and delay of adherence on risk-adjusted in-hospital mortality were estimated by multivariable logistic regression analyses.Results: The final study cohort included 178 patients with sepsis. Among them, 89 received bundle-adherent care. Completion rates of each component (measure lactate level; obtain blood cultures; administer broad-spectrum antibiotics; administer crystalloid, apply vasopressors) within 1 hour were 98.9%, 86.2%, 51.1%, 94.9%, and 69.1%, respectively. Completion rate of all components within 1 hour was 50.3%. In-hospital mortality was 18.0% in patients with and 30.3% in patients without bundle-adherent care (p=0.054) Adjusted odds ratio of non-bundle-adherent versus bundle-adherent care for in-hospital mortality was 2.32 (95% CI 1.09–4.95) using propensity score. Non-adherence to obtaining blood cultures and administering broad-spectrum antibiotics within 1 hour were related to in-hospital mortality (2.65 [95% CI 1.25–5.62] and 4.81 [95% CI 1.38–16.72], respectively). Adjusted odds ratio for 1-hour delay in achieving hour-1 bundle components for in-hospital mortality was 1.28 (95% CI 1.04–1.57) by logistic regression analysis.Conclusion: Completion of the hour-1 bundle was associated with lower in-hospital mortality. Obtaining blood cultures and administering antibiotics within 1 hour may have been the components most contributing to decreased in-hospital mortality.

Traditional Chinese Medicine Decoctions Significantly Reduce the Mortality in Severe and Critically Ill Patients with COVID-19: A Retrospective Cohort Study

2021 ◽  
pp. 1-30
Author(s):  
Qin-Guo Sun ◽  
Xue-Dong An ◽  
Ping Xie ◽  
Bo Jiang ◽  
Jia-Xing Tian ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cohort Study ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Propensity Score ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Hospital Death ◽  
The Impact

Coronavirus disease (COVID-19) is a new infectious disease associated with high mortality, and traditional Chinese medicine decoctions (TCMDs) have been widely used for the treatment of patients with COVID-19 in China; however, the impact of these decoctions on severe and critical COVID-19-related mortality has not been evaluated. Therefore, we aimed to address this gap. In this retrospective cohort study, we included inpatients diagnosed with severe/critical COVID-19 at the Tongren Hospital of Wuhan University and grouped them depending on the recipience of TCMDs (TCMD and non-TCMD groups). We conducted a propensity score-matched analysis to adjust the imbalanced variables and treatments and used logistic regression methods to explore the risk factors associated with in-hospital death. Among 282 patients with COVID-19 who were discharged or died, 186 patients (66.0%) received TCMD treatment (TCMD cohort) and 96 (34.0%) did not (non-TCMD cohort). After propensity score matching at a 1:1 ratio, 94 TCMD users were matched to 94 non-users, and there were no significant differences in baseline clinical variables between the two groups of patients. The all-cause mortality was significantly lower in the TCMD group than in the non-TCMD group, and this trend remained valid even after matching (21.3% [20/94] vs. 39.4% [37/94]). Multivariable logistic regression model showed that disease severity (odds ratio: 0.010; 95% CI: 0.003, 0.037; [Formula: see text] < 0.001) was associated with increased odds of death and that TCMD treatment significantly decreased the odds of in-hospital death (odds ratio: 0.115; 95% CI: 0.035, 0.383; [Formula: see text] < 0.001), which was related to the duration of TCMD treatment. Our findings show that TCMD treatment may reduce the mortality in patients with severe/critical COVID-19.

scholarly journals Is mild hypernatremia an independent predictor of poor clinical outcome in neurocritically ill patients?

2020 ◽  
Author(s):  
Yun Im Lee ◽  
Joonghyun Ahn ◽  
Jeong-Am Ryu
Keyword(s):  
Propensity Score ◽  
Hospital Mortality ◽  
Odds Ratio ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Independent Predictor ◽  
Multivariable Analysis ◽  
Poor Clinical Outcome ◽  
Neurosurgical Patients ◽  
The Impact

Abstract We investigated the impact of hypernatremia on mortality of neurocritically ill patients. Among neurosurgical patients admitted to the intensive care unit (ICU) from January 2013 to December 2019, the patients who were hospitalized in the ICU for more than 5 days included. Hypernatremia was defined as the highest serum sodium level exceeding 150 mEq/L observed. Among 1,146 patients, 353 patients (30.8%) showed hypernatremia. Based on propensity score matching, 290 pairs were analyzed. Hypernatremia group had higher rates of in-hospital mortality compared with non-hypernatremia group in overall and matched population (p < 0.001 and p = 0.001, respectively). In multivariable analysis of propensity score-matched population, moderate and severe hypernatremia were significantly associated with in-hospital mortality (adjusted odds ratio [OR]: 4.58, 95% confidence interval [CI]: 2.15 – 9.75 and adjusted OR: 6.93, 95% CI: 3.46 – 13.90, respectively) compared with the absence of hypernatremia. However, in-hospital mortality was not significantly different between non-hypernatremia and mild hypernatremia groups (p = 0.720). Interestingly, mild hypernatremia group of matched population showed the best survival rate. Eventually, moderate and severe hypernatremia were associated with poor clinical outcomes in neurocritically ill patients. However, prognosis of the patients with mild hypernatremia was similar with those without hypernatremia.

scholarly journals SARS: the situation in France - 3 April

2003 ◽  
Vol 7 (14) ◽  
Author(s):  
Keyword(s):  
Public Health ◽  
Hong Kong ◽  
Severe Acute Respiratory Syndrome ◽  
Respiratory Infection ◽  
National Public Health Institute ◽  
Health Institute ◽  
National Public Health ◽  
Epidemiological Evaluation ◽  
Public Health Institute

Since an epidemic alert was released in France on 13 March (1), 216 people with symptoms of respiratory infection returning from Vietnam, China, Hong Kong, or Singapore were notified to the national Public Health Institute (Institut de veille sanitaire, InVS) (2). Of these, 201 were excluded after clinical, radiological, biological, and epidemiological evaluation of their compatibility with Severe Acute Respiratory Syndrome (SARS).

Project Plan for Studies on Suicide, Attempted Suicide, and Suicide Prevention1The editors of Crisis invited Jouko Lönnqvist and his group to inform the journal's readers about their research plans for the future.

Crisis ◽  
1995 ◽  
Vol 16 (4) ◽  
pp. 162-175 ◽  
Author(s):  
Jouko Lönnqvist ◽  
H. Aro ◽  
M. Heikkinen ◽  
H. Heilä ◽  
M. Henriksson ◽  
...  
Keyword(s):  
Public Health ◽  
Suicide Prevention ◽  
Attempted Suicide ◽  
Suicide Mortality ◽  
The European Union ◽  
National Public Health Institute ◽  
Health Institute ◽  
National Public Health ◽  
Suicide Attempted ◽  
Public Health Institute

Completed and attempted suicide are major public health problems in most western countries. The importance of suicidal behavior as a health problem, particularly among adolescents and young adults, has been emphasized by the European Union, the WHO (Europe), as well as the Finnish authorities. Due to the exceptionally high suicide mortality, suicide prevention has been one of the main targets of Finnish health policy since the late 1980s. However, to develop feasible strategies for suicide prevention, better knowledge of the phenomenon of self-destruction is necessary. The Department of Mental Health of the National Public Health Institute has been actively involved in suicide research and the development of suicide strategies both in Finland and western Europe since 1986. The success is based on a long tradition of suicide research in Finland, the representative and reliable suicide data, a highly motivated research group, and also the necessary economic support by both the National Public Health Institute and the Finnish Academy. This article outlines our groups research plan for the next few years.

scholarly journals Green Deal as a Climate Changes Dam on the Road to Health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Jevtic ◽  
C Bouland
Keyword(s):  
Public Health ◽  
Climate Change ◽  
Circular Economy ◽  
Clinical Medicine ◽  
Health Sector ◽  
The Public ◽  
The Road ◽  
National Public Health ◽  
On The Road ◽  
The Impact

Abstract Public health professionals (PHP) have a dual task in climate change. They should persuade their colleagues in clinical medicine of the importance of all the issues covered by the GD. The fact that the health sector contributes to the overall emissions of 4.4% speaks to the lack of awareness within the health sector itself. The issue of providing adequate infrastructure for the health sector is essential. Strengthening the opportunities and development of the circular economy within healthcare is more than just a current issue. The second task of PHP is targeting the broader population. The public health mission is being implemented, inter alia, through numerous activities related to environmental monitoring and assessment of the impact on health. GD should be a roadmap for priorities and actions in public health, bearing in mind: an ambitious goal of climate neutrality, an insistence on clean, affordable and safe energy, a strategy for a clean and circular economy. GD provides a framework for the development of sustainable and smart transport, the development of green agriculture and policies from field to table. It also insists on biodiversity conservation and protection actions. The pursuit of zero pollution and an environment free of toxic chemicals, as well as incorporating sustainability into all policies, is also an indispensable part of GD. GD represents a leadership step in the global framework towards a healthier future and comprises all the non-EU members as well. The public health sector should consider the GD as an argument for achieving goals at national levels, and align national public health policies with the goals of this document. There is a need for stronger advocacy of health and public-health interests along with incorporating sustainability into all policies. Achieving goals requires the education process for healthcare professionals covering all of topics of climate change, energy and air pollution to a much greater extent than before.

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