Profile of hospital admissions for adults with cerebral palsy: a retrospective cohort study

2020 ◽  
Vol 62 (8) ◽  
pp. 939-945 ◽  
Author(s):  
Prue Morgan ◽  
Joanne Enticott ◽  
Rujuta Nikam ◽  
Jane Tracy
Keyword(s):  
Cerebral Palsy ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hospital Admissions

scholarly journals Hospital-based acute care in the last 30 days of life among patients with chronic disease that received early, late or no specialist palliative care: a retrospective cohort study of eight chronic disease groups

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044196
Author(s):  
Madalene Earp ◽  
Pin Cai ◽  
Andrew Fong ◽  
Kelly Blacklaws ◽  
Truong-Minh Pham ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cohort Study ◽  
Heart Disease ◽  
Chronic Disease ◽  
Acute Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hospital Admissions ◽  
Specialist Palliative Care ◽  
Icu Admission

ObjectiveFor eight chronic diseases, evaluate the association of specialist palliative care (PC) exposure and timing with hospital-based acute care in the last 30 days of life.DesignRetrospective cohort study using administrative data.SettingAlberta, Canada between 2007 and 2016.Participants47 169 adults deceased from: (1) cancer, (2) heart disease, (3) dementia, (4) stroke, (5) chronic lower respiratory disease (chronic obstructive pulmonary disease (COPD)), (6) liver disease, (7) neurodegenerative disease and (8) renovascular disease.Main outcome measuresThe proportion of decedents who experienced high hospital-based acute care in the last 30 days of life, indicated by ≥two emergency department (ED) visit, ≥two hospital admissions,≥14 days of hospitalisation, any intensive care unit (ICU) admission, or death in hospital. Relative risk (RR) and risk difference (RD) of hospital-based acute care given early specialist PC exposure (≥90 days before death), adjusted for patient characteristics.ResultsIn an analysis of all decedents, early specialist PC exposure was associated with a 32% reduction in risk of any hospital-based acute care as compared with those with no PC exposure (RR 0.69, 95% CI 0.66 to 0.71; RD 0.16, 95% CI 0.15 to 0.17). The association was strongest in cancer-specific analyses (RR 0.53, 95% CI 0.50 to 0.55; RD 0.31, 95% CI 0.29 to 0.33) and renal disease-specific analyses (RR 0.60, 95% CI 0.43 to 0.84; RD 0.22, 95% CI 0.11 to 0.34), but a~25% risk reduction was observed for each of heart disease, COPD, neurodegenerative diseases and stroke. Early specialist PC exposure was associated with reducing risk of four out of five individual indicators of high hospital-based acute care in the last 30 days of life, including ≥two ED visit,≥two hospital admission, any ICU admission and death in hospital.ConclusionsEarly specialist PC exposure reduced the risk of hospital-based acute care in the last 30 days of life for all chronic disease groups except dementia.

Diabetes, Drug Treatment and Mortality in COVID-19: A Multinational Retrospective Cohort Study

2021 ◽  
Author(s):  
Jennifer E. Nyland ◽  
Nazia T. Raja-Khan ◽  
Kerstin Bettermann ◽  
Philippe A. Haouzi ◽  
Douglas L. Leslie ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Randomized Clinical Trials ◽  
Hospital Admissions ◽  
Inflammatory Responses ◽  
Research Network ◽  
Respiratory Complications ◽  
Dipeptidyl Peptidase 4 ◽  
Increased Risk

Patients with type 2 diabetes mellitus (T2DM) are at increased risk of severe COVID-19 outcomes possibly due to dysregulated inflammatory responses. Glucose-regulating medications such as glucagon-like peptide-1 receptor (GLP-1R) agonists, dipeptidyl peptidase-4 (DPP-4) inhibitors, and pioglitazone are known to have anti-inflammatory effects that may improve outcomes in patients with SARS-CoV-2 infection. In a multinational retrospective cohort study, we used the TriNetX COVID-19 Research Network of 56 large healthcare organizations to examine these medications in relation to the incidence of hospital admissions, respiratory complications, and mortality within 28 days following a COVID-19 diagnosis. After matching for age, sex, race, ethnicity, body mass index, and significant comorbidities, use of GLP-1R agonists and/or pioglitazone was associated with significant reductions in hospital admissions (GLP-1R: 15.7% vs 23.5%; RR, 0.67 [95% CI, 0.57-0.79]; <i>P</i> <.001; pioglitazone: 20.0% vs 28.2%; RR, 0.71 [95% CI, 0.54-0.93]; <i>P</i> =.01). Use of GLP-1R agonists was also associated with reductions in respiratory complications (15.3% vs 24.9%; RR, 0.62 [95% CI, 0.52-0.73]; <i>P</i> <.001) and incidence of mortality (1.9% vs 3.3%; RR, 0.58 [95% CI, 0.35-0.97]; <i>P</i> =.04). Use of DPP-4 inhibitors was associated with a reduction in respiratory complications (24.0% vs 29.2%; RR, 0.82 [95% CI, 0.74-0.90]; <i>P</i> <.001), and continued use of DPP-4 inhibitors after hospitalization was associated with a decrease in mortality compared with those who discontinued use (9% vs 19%; RR, 0.45 [95% CI, 0.28-0.72]; <i>P</i> <.001). In conclusion, use of glucose-regulating medications such as GLP-1R agonists, DPP-4 inhibitors, or pioglitazone may improve outcomes for COVID-19 patients with T2DM; randomized clinical trials are needed to further investigate this possibility.

scholarly journals Cardiovascular and non-cardiovascular hospital admissions associated with atrial fibrillation: a Danish nationwide, retrospective cohort study

BMJ Open ◽  
2013 ◽  
Vol 3 (1) ◽  
pp. e001800 ◽  
Author(s):  
Christine Benn Christiansen ◽  
Jonas Bjerring Olesen ◽  
Gunnar Gislason ◽  
Morten Lock-Hansen ◽  
Christian Torp-Pedersen
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hospital Admissions

scholarly journals Accuracy of administrative claims data for cerebral palsy diagnosis: a retrospective cohort study

CMAJ Open ◽  
2017 ◽  
Vol 5 (3) ◽  
pp. E570-E575 ◽  
Author(s):  
Maryam Oskoui ◽  
Pamela Ng ◽  
Marc Dorais ◽  
Nicole Pigeon ◽  
Louise Koclas ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Claims Data ◽  
Administrative Claims ◽  
Administrative Claims Data

scholarly journals Effect of Bariatric Surgery on Survival and Hospitalizations in Patients with Severe Obesity. A Retrospective Cohort Study

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3150
Author(s):  
Enrica Migliore ◽  
Amelia Brunani ◽  
Giovannino Ciccone ◽  
Eva Pagano ◽  
Simone Arolfo ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Proportional Hazards ◽  
Severe Obesity ◽  
Hospital Admissions ◽  
Cox Proportional Hazards ◽  
Hazard Ratios

Bariatric surgery (BS) confers a survival benefit in specific subsets of patients with severe obesity; otherwise, effects on hospital admissions are still uncertain. We assessed the long-term effect on mortality and on hospitalization of BS in patients with severe obesity. This was a retrospective cohort study, including all patients residing in Piedmont (age 18–60 years, BMI ≥ 40 kg/m2) admitted during 2002–2018 to the Istituto Auxologico Italiano. Adjusted hazard ratios (HR) for BS were estimated for mortality and hospitalization, considering surgery as a time-varying variable. Out of 2285 patients, 331 (14.5%) underwent BS; 64.4% received sleeve gastrectomy (SG), 18.7% Roux-en-Y gastric bypass (RYGB), and 16.9% adjustable gastric banding (AGB). After 10-year follow-up, 10 (3%) and 233 (12%) patients from BS and non-BS groups died, respectively (HR = 0.52; 95% CI 0.27–0.98, by a multivariable Cox proportional-hazards regression model). In patients undergoing SG or RYGB, the hospitalization probability decreased significantly in the after-BS group (HR = 0.77; 0.68–0.88 and HR = 0.78; 0.63–0.98, respectively) compared to non-BS group. When comparing hospitalization risk in the BS group only, a marked reduction after surgery was found for all BS types. In conclusion, BS significantly reduced the risk of all-cause mortality and hospitalization after 10-year follow-up.

scholarly journals Indirect impact of the COVID-19 pandemic on emergency department presentations and hospital admissions for urgent early pregnancy conditions: a population-based retrospective cohort study

2021 ◽  
Author(s):  
Lisa Hui ◽  
Wanyu Chu ◽  
Elizabeth McCarthy ◽  
Mary McCarthy ◽  
Paddy Moore ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Early Pregnancy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Linear Prediction ◽  
Hospital Admissions ◽  
Population Based ◽  
Termination Of Pregnancy ◽  
The Impact

Objective: To compare emergency department (ED) presentations and hospital admissions for urgent early pregnancy conditions in Victoria before and after the onset of COVID-19 lockdown on 31 March 2020. Design: Population-based retrospective cohort study Setting: Australian state of Victoria Population: Pregnant women presenting to emergency departments or admitted to hospital Methods: We obtained state-wide hospital separation data from the Victorian Emergency Minimum Dataset and the Victorian Admitted Episodes Dataset from January 1, 2018, to October 31, 2020. A linear prediction model based on the pre-COVID period was used to identify the impact of COVID restrictions. Main outcome measures: Monthly ED presentations for miscarriage and ectopic pregnancy, hospital admissions for termination of pregnancy, with subgroup analysis by region, socioeconomic status, disease acuity, hospital type. Results: There was an overall decline in monthly ED presentations and hospital admissions for early pregnancy conditions in metropolitan areas where lockdown restrictions were most stringent. Monthly ED presentations for miscarriage during the COVID period were consistently below predicted, with the nadir in April 2020 (790 observed vs 985 predicted, 95% CI 835-1135). Monthly admissions for termination of pregnancy were also below predicted throughout lockdown, with the nadir in August 2020 (893 observed vs 1116 predicted, 95% CI 905-1326). There was no increase in ED presentations for complications following abortion, ectopic or molar pregnancy during the COVID period. Conclusions: Fewer women in metropolitan Victoria utilized hospital-based care for early pregnancy conditions during the first seven months of the pandemic, without any observable increase in maternal morbidity.

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