scholarly journals Hospitalisation for COPD in Puglia: the role of hospital discharge database to estimate prevalence and incidence

2016 ◽  
Vol 70 (3) ◽  
Author(s):  
P. Trerotoli ◽  
N. Bartolomeo ◽  
A.M. Moretti
Keyword(s):  
Disease Management ◽  
Hospital Discharge ◽  
Respiratory Diseases ◽  
Hospital Admissions ◽  
Diagnostic Procedures ◽  
Chronic Respiratory Disease ◽  
Chronic Obstructive ◽  
Chronic Respiratory Diseases ◽  
Hospital Discharge Database ◽  
Discharge Database

Background and aim. Chronic Obstructive Pulmonary Disease (COPD), although largely preventable, is a great health burden in all the countries worldwide. Statistics of morbidity and mortality of COPD show the need for correct management of the disease. Chronic Obstructive Respiratory Diseases (DRG 88) are in 9th place for discharge in in-patient hospital admission. It is necessary to establish specific indicators which are efficacious and relevant for the patient, the doctor and the health manager. This study will analyse the information in respect of hospital admissions (Hospital discharge database) in Puglia for the period 2000-2005. Methods. The analysis was carried out utilising the Puglia Region hospital patient discharge database, selecting those patients with admission for chronic respiratory disease as principal or secondary diagnosis. Results. Chronic respiratory diseases are more frequent in males and in people over 45 years old with frequency increasing with age. Geographical distribution shows that there are greater rates of hospitalisation in big cities and in the neighbourhood of industrial areas. Although the trend over time is slight. A higher percentage of re-admission has been found for patients with COPD, and the interval between the two admissions occurs within one or two months; the diagnosis at the second admission is the same as for the first. 10.6% of discharge forms report one diagnosis, especially in patients older than 65 years of age. Little could be said about diagnostic procedures because these are not reported on the discharge form. Conclusion. Hospitalisation data confirms expectations regarding age and sex of patients. The high hospitalisation rates indicate that in-patients care still remains the only viable treatment for COPD and other chronic respiratory diseases. The high number of exacerbations reflect the absence of out-patients service or community care, and the same diagnosis in more than one episode shows the lack of efficiency of health services and disease management. This data is necessary to understand disease distribution and the modification of disease management in order to reduce health care costs, to increase efficacy in disease control and to limit repeated exacerbation and so to obtain the maximum benefit for the patients.

Abstract O.02: Validation of Kawasaki Disease Incidence Assessment as Derived from Health System Administrative Databases vs. Active Retrospective Surveillance in Ontario, Canada

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Cedric Manlhiot ◽  
Sunita O’Shea ◽  
Bailey Bernknopf ◽  
Michael Labelle ◽  
Mathew Mathew ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Hospital Discharge ◽  
Hospital Admissions ◽  
Disease Incidence ◽  
Administrative Databases ◽  
Canadian Hospital ◽  
Hospital Discharge Database ◽  
Incident Cases ◽  
Discharge Database

Introduction: Historically, 2 methods have been used to determine the incidence of Kawasaki disease (KD): active or passive surveillance, or the use of administrative databases. Given the increasing regulatory requirements, mainly around patient privacy, periodic retrospective surveillances have become increasingly challenging. Administrative databases are not curated datasets and doubts have been cast on their accuracy. Methods: The Hospital for Sick Children has been conducting retrospective triennial surveillances of KD since 1995 by contacting all hospitals in Ontario and manually reviewing all cases through chart review, reconciling inter-hospital transfers and multiple readmissions. We queried the Canadian hospital discharge database (Canadian Institute for Health Information) for hospitalizations associated with a diagnosis of KD between 2004-9. The administrative dataset was manually reviewed; patient national health number, institution and dates of admission/discharge were used to identify inter-hospital transfers, readmission and follow-up episodes. Results: The Canadian hospital discharge database reported 1,685 admissions during the study period (281±44 per year) for Ontario. Manual review of the dataset identified 219 (13%) as inter-hospital transfers (56, 26%), readmissions (122, 56%), admissions for follow-up of coronary artery aneurysms (14, 6%) or hospital admissions not related to KD (27, 12%). When these admissions were removed, the total number of incident cases for the study period was 1,466 (244±45 per year). The retrospective triennial surveillance identified 1,373 KD cases during the same period (229±33 per year). The Canadian hospital discharge database overestimated the number of cases in all 6 years by an average of 6.7±5.9%. The overestimation likely comes from patients who were originally diagnosed with KD but in whom the diagnosis of KD was subsequently excluded (historically ~5-6%). Conclusions: Reliance on administrative data to determine incidence of KD is possible and accurate; data should be manually reviewed to remove non-incident cases and estimates should be adjusted to reflect the expected proportion of patients in whom the diagnosis of KD will be subsequently excluded.

scholarly journals The ABCs of Rhinoviruses, Wheezing, and Asthma

2010 ◽  
Vol 84 (15) ◽  
pp. 7418-7426 ◽  
Author(s):  
James E. Gern
Keyword(s):  
Respiratory Diseases ◽  
Chronic Obstructive Lung Disease ◽  
Allergic Diseases ◽  
Chronic Respiratory Disease ◽  
Chronic Obstructive ◽  
Respiratory Illnesses ◽  
Chronic Respiratory Diseases ◽  
Acute Exacerbations ◽  
Close Relationship ◽  
Viral Diagnostics

ABSTRACT Human rhinoviruses (HRVs) were discovered as common cold pathogens over 50 years ago. Recent advances in molecular viral diagnostics have led to an appreciation of their role in more-significant respiratory illnesses, including bronchiolitis in infancy, childhood pneumonia, and acute exacerbations of chronic respiratory diseases such as asthma, chronic obstructive lung disease, and cystic fibrosis. Until a few years ago, only two groups of HRVs (A and B) had been recognized. However, full and partial sequencing of HRVs led to the discovery of a third species of HRV (HRV-C) that has distinct structural and biologic features. Risk factors and pathogenic mechanisms for more-severe HRV infections are being defined, and yet fundamental questions persist about mechanisms relating this common pathogen to allergic diseases and asthma. The close relationship between HRV infections and asthma suggests that antiviral treatments could have a major impact on the morbidity associated with this chronic respiratory disease.

Incidence of Thrombosis in Children with Tunneled Central Venous Access Devices Versus Peripherally Inserted Central Catheters (PICC lines)

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1146-1146
Author(s):  
Maralee Kanin ◽  
Guy Young
Keyword(s):  
Hospital Discharge ◽  
Pediatric Patients ◽  
Hospital Admissions ◽  
Conflicts Of Interest ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Hospital Discharge Database ◽  
The Mean ◽  
Discharge Database ◽  
Central Catheters

Abstract Abstract 1146 Background: The recent proliferation in deep vein thrombosis (DVT) in pediatric patients has been attributed to the improved care of children with serious and life-threatening disorders as well as the prolonged survival of children with chronic disease. Often such treatment involves the insertion of central venous catheters. Yet the incidence of DVT associated with peripherally-inserted central catheters (PICC) and tunneled Lines (TL) has not been investigated in depth. Thus we report a retrospective database study to determine the incidence of DVT in pediatric patients with PICC and TL lines. Methods: Children <18 years of age who were admitted to Children's Hospital Los Angeles from January 1, 2003- December 31, 2009 were eligible for inclusion. Data were extracted from the CHLA hospital discharge database which includes data on all procedures and up to 20 diagnoses per admission. Diagnoses and procedures were identified by International Classification of Disease, Ninth Revision (ICD-9) coding in the hospital discharge database. PICC codes used were: 365.69 and TL codes used were: 365.57, 365.58, 365.60, 365.61, 365.63, 365.65, 365.66. DVT codes were: 415.11, 415.12, 415.19, 452, 453.0, 453.1, 453.3, 453.41, 453.42, 453.8, 453.9. Patient diagnoses other than DVT were grouped according to ICD. 9 coding into categories termed Complex Chronic Conditions (CCC) as previously described. To ensure that the DVT event was related to the individual line insertion, patients were excluded if their lines were placed after three days of hospital admissions and if they received more than one line or more than one type of line. A limitation of the data is the lack of information regarding the length of time the catheters remained in place. Results: Over the 6 year period of this study, 1449 eligible subjects were identified of whom 29 had DVTs (2%). There were 947 PICC insertions and 502 TL insertions. The mean age of PICC patients was 12±4 years and 56% were male. The mean age of TL patients was 8±6 years and 54% were male. There were 9 (0.95%) DVTs in PICC patients, and 20 (3.9%) DVTs in TL patients. The odds ratio for developing a DVT with a TL was 3.6 (p-value.002; confidence interval 1.6–8.1) which remained significant at 3.8 (p=.001; confidence value 1.7–8.55) when controlling for the presence of CCCs. Conclusions: Despite the proliferation in the utilization of PICC in recent years, it appears that they are not associated with a higher risk for DVT than TL, and in fact, the data from this study suggests that TL were associated with more DVT than PICC. Although it is possible that the results could be explained by the fact that TL in general remain in place for a longer period of time than PICC, this study nonetheless provides important reassurance that PICC appear to have relatively low thrombotic potential when compared to TL. Disclosures: No relevant conflicts of interest to declare.

scholarly journals The Effects of Air Quality on Hospital Admissions for Chronic Respiratory Diseases in Petaling Jaya, Malaysia, 2013–2015

Atmosphere ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 1060
Author(s):  
Karyn Morrissey ◽  
Ivy Chung ◽  
Andrew Morse ◽  
Suhanya Parthasarath ◽  
Margaret M. Roebuck ◽  
...  
Keyword(s):  
Air Pollution ◽  
Air Quality ◽  
Respiratory Diseases ◽  
Hospital Admissions ◽  
Cumulative Effect ◽  
Chronic Obstructive ◽  
Kuala Lumpur ◽  
Short Term ◽  
Chronic Respiratory Diseases ◽  
The Impact

This study assesses the impact of a decrease in air quality and the risk of hospital admissions to a public hospital for chronic respiratory diseases for residents of Petaling Jaya, a city in the Greater Kuala Lumpur area in Malaysia. Data on hospital admissions for asthma, bronchitis, emphysema and other chronic obstructive pulmonary disease, weather conditions and the Malaysian Air Pollution Index, a composite indicator of air quality, were collated. An unconstrained distributed lag model to obtain risk of hospitalization for a 10 μg/m3 increase in the API. The lag cumulative effect for a 10 μg/m3 increase in the API was calculated to test for harvesting in the short term. Findings indicate that after an initial decrease in admissions (days 3 and 4), admissions increased again at day 7 and 8 and this relationship was significant. We therefore conclude that a 10 μg/m3 increase has a greater effect on admissions for respiratory health in the short term than a harvesting effect alone would suggest. These results suggest that while air quality is improving in the Greater Kuala Lumpur area, no level of air pollution can be deemed safe.

scholarly journals Association of diurnal temperature range with daily hospitalization for exacerbation of chronic respiratory diseases in 21 cities, China

2020 ◽  
Author(s):  
Zihui Wang ◽  
Yumin Zhou ◽  
Ming Luo ◽  
Huajing Yang ◽  
Shan Xiao ◽  
...  
Keyword(s):  
Diurnal Temperature Range ◽  
Respiratory Diseases ◽  
Hospital Admissions ◽  
Cold Season ◽  
Population Characteristics ◽  
Chronic Obstructive ◽  
Chronic Respiratory Diseases ◽  
Diurnal Temperature ◽  
Temperature Range ◽  
Daily Hospitalization

Abstract Background The association between diurnal temperature range (DTR) and hospitalization for exacerbation of chronic respiratory diseases (CRD) was rarely reported. Objectives To examine the association between DTR and daily hospital admission for exacerbations of CRD and find out the potential effect of modifications on this association. Method: Data on daily hospitalization for exacerbation of chronic obstructive pulmonary disease (COPD), asthma and bronchiectasis and meteorology measures from 2013 through 2017 were obtained from 21 cities in South China. After controlling the effects of daily mean temperature, relative humidity (RH), particulate matter < 2.5 µm diameter (PM2.5) and other confounding factors, a standard generalized additive model (GAM) with a quasi-Poisson distribution was performed to evaluate the relationships between DTR and daily hospital admissions of CRD in a two-stage strategy. Subgroup analysis was performed to find potential modifications, including seasonality and population characteristics. Result Elevated risk of hospitalization for exacerbation of CRD (RR = 1.09 [95%CI: 1.08 to 1.11]) was associated with interquartile range (IQR) increase in DTR. The effects of DTR on hospital admissions for CRD were strong at low DTR in the hot season and high DTR in the cold season. The relative risk (RR) of hospitalization was 1.11 (95%CI: 1.08 to 1.12) for exacerbations of COPD and 1.09 (95%CI: 1.05 to 1.13) for asthma per IQR increase in DTR. The adverse effect of DTR on hospitalization for bronchiectasis was only observed in female patients (RR = 1.06 [95%CI: 1.03 to 1.10]). Conclusion Our study provided additional evidences for the association between DTR and daily hospitalization for exacerbation of CRD, especially in COPD patients and the cold season.

CRISPR/Cas9 Genome Editing Tool: A Promising Tool for Therapeutic Applications on Respiratory Diseases

2020 ◽  
Vol 20 (5) ◽  
pp. 333-346
Author(s):  
Sadiya Bi Shaikh ◽  
Yashodhar Prabhakar Bhandary
Keyword(s):  
Respiratory Diseases ◽  
Gene Editing ◽  
Epithelial Mesenchymal Transition ◽  
Respiratory Health ◽  
Chronic Obstructive ◽  
Therapeutic Tool ◽  
Obstructive Pulmonary Disease ◽  
Mesenchymal Transition ◽  
Chronic Respiratory Diseases ◽  
Promising Tool

Respiratory diseases are one of the prime topics of concern in the current era due to improper diagnostics tools. Gene-editing therapy, like Clustered regularly interspaced palindromic repeats- associated nuclease 9 (CRISPR/Cas9), is gaining popularity in pulmonary research, opening up doors to invaluable insights on underlying mechanisms. CRISPR/Cas9 can be considered as a potential gene-editing tool with a scientific community that is helping in the advancement of knowledge in respiratory health and therapy. As an appealing therapeutic tool, we hereby explore the advanced research on the application of CRISPR/Cas9 tools in chronic respiratory diseases such as lung cancer, Acute respiratory distress syndrome (ARDS) and cystic fibrosis (CF). We also address the urgent need to establish this gene-editing tool in various other lung diseases such as asthma, Chronic obstructive pulmonary disease (COPD) and Idiopathic pulmonary fibrosis (IPF). The present review introduces CRISPR/Cas9 as a worthy application in targeting epithelial-mesenchymal transition and fibrinolytic system via editing specific genes. Thereby, based on the efficiency of CRISPR/Cas9, it can be considered as a promising therapeutic tool in respiratory health research.

Interleukin-17A: A Potential Therapeutic Target in Chronic Lung Diseases

2019 ◽  
Vol 19 (7) ◽  
pp. 921-928 ◽  
Author(s):  
Sadiya Bi Shaikh ◽  
Ashwini Prabhu ◽  
Yashodhar Prabhakar Bhandary
Keyword(s):  
Respiratory Diseases ◽  
Inflammatory Cytokine ◽  
Inflammatory Responses ◽  
Chronic Obstructive ◽  
Interleukin 17 ◽  
Potential Therapeutic Target ◽  
Chronic Respiratory Diseases ◽  
Chronic Lung Diseases ◽  
Interleukin 17A ◽  
Insight Into

Background: Interleukin-17A (IL-17A) is a pro-inflammatory cytokine that has gained a lot of attention because of its involvement in respiratory diseases. Interleukin-17 cytokine family includes six members, out of which, IL-17A participates towards the immune responses in allergy and inflammation. It also modulates the progression of respiratory disorders. Objective: The present review is an insight into the involvement and contributions of the proinflammatory cytokine IL-17A in chronic respiratory diseases like Idiopathic Pulmonary Fibrosis (IPF), Chronic Obstructive Pulmonary Distress (COPD), asthma, pneumonia, obliterative bronchiolitis, lung cancer and many others. Conclusion: IL-17A is a major regulator of inflammatory responses. In all the mentioned diseases, IL- 17A plays a prime role in inducing the diseases, whereas the lack of this pro-inflammatory cytokine reduces the severity of respective respiratory diseases. Thereby, this review suggests IL-17A as an instrumental target in chronic respiratory diseases.

scholarly journals Reduction in hospitalisation following pulmonary rehabilitation in patients with COPD

2008 ◽  
Vol 32 (3) ◽  
pp. 415 ◽  
Author(s):  
Nola Cecins ◽  
Elizabeth Geelhoed ◽  
Sue C Jenkins
Keyword(s):  
Exercise Capacity ◽  
Pulmonary Rehabilitation ◽  
Hospital Admissions ◽  
Chronic Respiratory Disease ◽  
Health Care Utilisation ◽  
Chronic Obstructive ◽  
Copd Exacerbation ◽  
Chronic Respiratory Disease Questionnaire ◽  
Number Of Patients ◽  
Bed Days

Objectives: Pulmonary rehabilitation (PR) improves exercise capacity and health-related quality of life (HRQoL), and reduces health care utilisation. This study quantified outcomes of a PR program over a 6-year period and determined the effects of PR on hospitalisation. Methods: Patients with chronic obstructive pulmonary disesae (COPD) who entered an 8-week outpatient PR program from 1998 to 2003 were included. Functional exercise capacity (6-minute walk distance [6MWD]) and HRQoL (Chronic Respiratory Disease Questionnaire) were measured before and following PR. The number of hospital admissions and total bed-days due to a COPD exacerbation in the 12 months before and following PR were recorded. Setting: Physiotherapy Department, Sir Charles Gairdner Hospital, Western Australia. Results: 187 (73%) of the 256 patients who entered PR completed the program. Improvements in 6MWD (404.2 �114.6 m to 439.6 �115.0m, P < 0.001) and HRQoL (4.1 �0.9 points per item to 4.9 �0.9 points per item, P < 0.001) occurred following PR. There was a 46% reduction in the number of patients admitted to hospital (71 to 38) with a COPD exacerbation and a 62% reduction in total bed-days (1131 to 432) following PR. Conclusion: Pulmonary rehabilitation provided in an Australian teaching hospital was associated with a reduction in COPD hospitalisation, and the resultant savings outweighed the costs of providing the program.

scholarly journals Chronic respiratory diseases at primary health care level in Georgia: the results of the pilot study

2016 ◽  
Vol 71 (4) ◽  
Author(s):  
I. Chkhaidze ◽  
T. Maglakelidze ◽  
N. Khaltaev
Keyword(s):  
Allergic Rhinitis ◽  
Respiratory Diseases ◽  
Chronic Obstructive ◽  
Official Statistics ◽  
Global Alliance ◽  
Care Level ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Chronic Morbidity ◽  
Official Data

Background and aim. Millions of people suffer from chronic respiratory diseases (CRD). To address this serious global health problem WHO formed the Global Alliance against Chronic Respiratory Diseases (GARD). Chronic obstructive pulmonary disease (COPD) is a major priority of GARD due to high chronic morbidity and mortality; however, there is still little prevalence data available. The prevalence of COPD in Georgia, as well as other CRD, is suspected to be high. Methods. GARD Pilot Survey (GAPS) in Georgia had been carried out by the Georgian Respiratory Association. The survey was conducted in the Sagarejo and Mtskheta districts with total population of about 70.000. All subjects provided information on asthma, bronchitis, respiratory symptoms, smoking, allergic conditions, CRD comorbidity and lifestyle via an interviewer-administered questionnaire. A total of 3,646 questionnaires were analysed. Results. It was discovered that official data concerning allergic rhinitis, TB and asthma are almost equal, but readings in relation to CRD are about five times lower according to official data of the Ministry of Health of Georgia. The data results: for allergic rhinitis - 218 in GAPS vs. 177 in the official statistics (for 100.000 population); for TB -105 in GAPS vs. 147 in the official statistics; for asthma -250 in GAPS vs. 374 in the official statistics; the data about CRD according to our survey is almost five times higher - 365 in GAPS vs. 84 in the official statistics (for 100.000 population). Conclusions. It is necessary to expand the survey to the entire country population. Country results are likely to be useful and interesting for local doctors and managers, as well as for officials.

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