The Impact of Obesity on Outcomes in Geriatric Blunt Trauma

2019 ◽  
Vol 85 (2) ◽  
pp. 188-195 ◽  
Author(s):  
Rahman Barry ◽  
Milad Modarresi ◽  
Rafael Duran ◽  
David Denning ◽  
Stephen Wilson ◽  
...  

Blunt trauma is poorly tolerated in the elderly, and the degree to which obesity, a known risk factor for suboptimal outcomes in trauma affects this population remains to be determined. The incidence, prevalence, and mortality rates of blunt trauma by demographics, year, and geography were found using datasets from both the Global Burden of Disease database, and a Regional Level II trauma registry. Global Burden of Disease data were extracted from 284 country-year and 976 subnational-year combinations from 27 countries for the period 1990 to 2015. The regional trauma registry was interrogated for patients ≥70 years admitted with blunt trauma between 2014 and 2016. The incidence of elderly blunt trauma from falls increased at a global, national (United States), and state (WV) level from 1990 to 2015 by 78.3 per cent, 54.7 per cent, and 42.7 per cent, respectively with concomitant increases in mortality rates of 5.7 per cent, 102.6 per cent, and 89.3 per cent (P < 0.05). The regional cohort had a statistically similar mortality (obese, n = 320 vs nonobese, n = 926 of 4.8% vs 4.4%, respectively, P > 0.05). The hospital length-of-stay, Glasgow Coma Scale score, and systolic blood pressure on presentation were similar (P > 0.05) as was the Injury Severity Score. Major medical comorbidities were identified in 280 (87.5%) and 783 (84.6%) patients in the obese and nonobese groups, respectively. Blunt trauma, secondary to falls, has increased in elderly patients at a global, national, and state level with a concomitant increase in mortality rates. Although a similar increase in the incidence of blunt trauma in the elderly was noted at a regional center, its mortality has not been increased by obesity, possibly because of similar comorbidity rates.

Processes ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1719
Author(s):  
Meghnath Dhimal ◽  
Francesco Chirico ◽  
Bihungum Bista ◽  
Sitasma Sharma ◽  
Binaya Chalise ◽  
...  

Air pollution consisting of ambient air pollution and household air pollution (HAP) threatens health globally. Air pollution aggravates the health of vulnerable people such as infants, children, women, and the elderly as well as people with chronic diseases such as cardiorespiratory illnesses, little social support, and poor access to medical services. This study is aimed to estimate the impact of air pollution on global burden of disease (GBD). We extracted data about mortality and disability adjusted life years (DALYs) attributable to air pollution from 1990 to 2019. The extracted data were then organized and edited into a usable format using STATA version 15. Furthermore, we also estimated the impacts for three categories based on their socio-demographic index (SDI) as calculated by GBD study. The impacts of air pollution on overall burden of disease by SDI, gender, type of pollution, and type of disease is estimated and their trends over the period of 1990 to 2019 are presented. The attributable burden of ambient air pollution is increasing over the years while attributable burden of HAP is declining over the years, globally. The findings of this study will be useful for evidence-based planning for prevention and control of air pollution and reduction of burden of disease from air pollution at global, regional, and national levels.


2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Periklis Charalampous ◽  
Elena Pallari ◽  
Stefanos Tyrovolas ◽  
Nicos Middleton ◽  
Mary Economou ◽  
...  

Abstract Background Non-communicable diseases (NCDs) accounted for over 90% of all deaths in the Cypriot population, in 2018. However, a detailed and comprehensive overview of the impact of NCDs on population health of Cyprus over the period of 1990 to 2017, expressed in disability-adjusted life years (DALYs), is currently not available. Knowledge about the drivers of changes in NCD DALYs over time is paramount to identify priorities for the prevention of NCDs in Cyprus and guide evidence-based decision making. The objectives of this paper were to: 1) assess the burden of NCDs in terms of years of life lost (YLLs), years lived with disability (YLDs), and DALYs in Cyprus in 2017, and 2) identify changes in the burden of NCDs in Cyprus over the 28-year period and assess the main drivers of these changes. Methods We performed a secondary database descriptive study using the Global Burden of Disease (GBD) 2017 results on NCDs for Cyprus from 1990 to 2017. We calculated the percentage change of age-standardized DALY rates between 1990 and 2017 and decomposed these time trends to assess the causes of death and disability that were the main drivers of change. Results In Cyprus in 2017, 83% (15,129 DALYs per 100,000; 12,809 to 17,707 95%UI) of total DALYs were due to NCDs. The major contributors to NCD DALYs were cardiovascular diseases (16.5%), neoplasms (16.3%), and musculoskeletal disorders (15.6%). Between 1990 and 2017, age-standardized NCD DALY rates decreased by 23%. For both males and females, the largest decreases in DALY rates were observed in ischemic heart disease and stroke. For Cypriot males, the largest increases in DALY rates were observed for pancreatic cancer, drug use disorders, and acne vulgaris, whereas for Cypriot females these were for acne vulgaris, psoriasis and eating disorders. Conclusion Despite a decrease in the burden of NCDs over the period from 1990 to 2017, NCDs are still a major public health challenge. Implementation of interventions and early detection screening programmes of modifiable NCD risk factors are needed to reduce occurrence and exacerbation of leading causes of NCDs in the Cypriot population.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Van Den Hazel

Abstract The Global Burden of Disease is the most comprehensive effort to date to measure epidemiological levels and trends worldwide. It is the product of a global research collaborative and quantifies the impact of hundreds of diseases, injuries, and risk factors in countries around the world. The publication published in The Lancet on September 12, 2017, namely the study, “Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016,” is the starting point to discuss the health-related SDG indicators as develop by the Institute for Health Metrics and Evaluation (IHME) and Global Burden of Disease collaborators. The projected increases in mortality are steep for chronic obstructive pulmonary disease and other chronic diseases. Non-communicable diseases are increasingly recognized as major causes of death and disability worldwide. The question is whether the targets in the SDGs are sufficiently addressing these increases. Or are demographic changes underlying the projected increases? Health related SDGs have been addressed in a tool made by the Institute for Health Metrics and Evaluation (IHME). Results on air pollution, smoking, unsafe water, sanitation and hygiene are presented by current and projected data in an interactive tool.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Machado ◽  
L Guedes ◽  
M Felisbino-Mendes

Abstract High-sodium diet leads to significant health problems such as high blood pressure, chronic kidney disease, ventricular hypertrophy and stroke. In Brazil, 2008 survey data have shown an average intake of 4.7 g/day of sodium, equivalent to 12 g/day of salt. In 2014, the average ofsalt intake estimated was 9.3 g/day. In both surveys, the numbers are higher than the international recommendation of 5g/day of salt. Considering this excessive consumption and the invisibility of the major consequences of such lifestyle, the aim of this study was to estimate the burden of diseases due to a high-sodium diet in Brazil. We used the high-sodium diet attributable disability-adjusted life-years (DALYs) and deaths estimates of the Global Burden of Disease study in 2017 among Brazilian. The burden of high-sodium diet was assessed using a comparative risk assessment approach, which allows the calculation of the population attributable fraction of each disease that has an established relation with this behavior. Input data from Brazil to reach such estimates have included surveys that report the dietary sodium. Data on disease occurrence and mortality were obtained from health information systems and health surveys. In 2017, high-sodium diet contributed with a significant number of deaths (51,434, 95% U.I.: 9,266-105,118) and DALYs (988,258, 95% U.I.: 139,943-2,149,179) in Brazil. The states of Northern Region presented lower mortality rates (Roraima: 11.1/100,000; 95% U.I.: 1.5-24.0 and Amapa: 10.6/100,000; 1.5-23.5), while those in the Southeast have higher mortality rates (Rio de Janeiro: 33.2/100,000; 95% U.I.: 5.4-68.1 and São Paulo: 32.0/100,000; 95% U.I.: 3.5-49.6). The same pattern by states was observed for DALYs. These findings are significant and support the urgent necessity of strategies to reinforce the promotion of a healthy diet, restricted in ultra-processed foods high in sodium, among the Brazilian population in order to prevent early morbidity and mortality. Key messages Salt consumption in Brazil is high and contributes to a significant number of deaths and DALYs. It is necessary to increase and reinforce actions that promote the Brazilian traditional food, such as the Brazilian Food Guide, and also the sodium reduction agreements with industries.


Epidemiology ◽  
2020 ◽  
Vol 32 (1) ◽  
pp. 1-5
Author(s):  
Kate Causey ◽  
Katrin Burkart ◽  
Gwen Collman ◽  
Howard Hu ◽  
Michael Brauer ◽  
...  

2014 ◽  
Vol 19 (8) ◽  
pp. 884-893 ◽  
Author(s):  
Thomas Clasen ◽  
Annette Pruss‐Ustun ◽  
Colin D. Mathers ◽  
Oliver Cumming ◽  
Sandy Cairncross ◽  
...  

2020 ◽  
Vol 18 (S1) ◽  
Author(s):  
Mariana Santos Felisbino-Mendes ◽  
Ewerton Cousin ◽  
Deborah Carvalho Malta ◽  
Ísis Eloah Machado ◽  
Antonio Luiz Pinho Ribeiro ◽  
...  

Abstract Background The prevalence and burden of disease resulting from obesity have increased worldwide. In Brazil, more than half of the population is now overweight. However, the impact of this growing risk factor on disease burden remains inexact. Using the 2017 Global Burden of Disease (GBD) results, this study sought to estimate mortality and disability-adjusted life years (DALYs) lost to non-communicable diseases caused by high body mass index (BMI) in both sexes and across age categories. This study also aimed to describe the prevalence of overweight and obesity throughout the states of Brazil. Methods Age-standardized prevalence of overweight and obesity were estimated between 1990 and 2017. A comparative risk assessment was applied to estimate DALYs and deaths for non-communicable diseases and for all causes linked to high BMI. Results The prevalence of overweight and obesity increased during the period of analysis. Overall, age-standardized prevalence of obesity in Brazil was higher in females (29.8%) than in males (24.6%) in 2017; however, since 1990, males have presented greater rise in obesity (244.1%) than females (165.7%). Increases in prevalence burden were greatest in states from the North and Northeast regions of Brazil. Overall, burden due to high BMI also increased from 1990 to 2017. In 2017, high BMI was responsible for 12.3% (8.8–16.1%) of all deaths and 8.4% (6.3–10.7%) of total DALYs lost to non-communicable diseases, up from 7.2% (4.1–10.8%), and 4.6% (2.4-6.0%) in 1990, respectively. Change due to risk exposure is the leading contributor to the growth of BMI burden in Brazil. In 2017, high BMI was responsible for 165,954 deaths and 5,095,125 DALYs. Cardiovascular disease and diabetes have proven to be the most prevalent causes of deaths, along with DALYs caused by high BMI, regardless of sex or state. Conclusions This study demonstrates increasing age-standardized prevalence of obesity in all Brazilian states. High BMI plays an important role in disease burdens in terms of cardiovascular diseases, diabetes, and all causes of mortality. Assessing levels and trends in exposures to high BMI and the resulting disease burden highlights the current priority for primary prevention and public health action initiatives focused on obesity.


2019 ◽  
Vol 85 (12) ◽  
pp. 1354-1362
Author(s):  
Rahman Barry ◽  
Milad Modarresi ◽  
Rodrigo Aguilar ◽  
Jacqueline Sanabria ◽  
Thao Wolbert ◽  
...  

Traumatic injuries account for 10% of all mortalities in the United States. Globally, it is estimated that by the year 2030, 2.2 billion people will be overweight (BMI ≥ 25) and 1.1 billion people will be obese (BMI ≥ 30). Obesity is a known risk factor for suboptimal outcomes in trauma; however, the extent of this impact after blunt trauma remains to be determined. The incidence, prevalence, and mortality rates from blunt trauma by age, gender, cause, BMI, year, and geography were abstracted using datasets from 1) the Global Burden of Disease group 2) the United States Nationwide Inpatient Sample databank 3) two regional Level II trauma centers. Statistical analyses, correlations, and comparisons were made on a global, national, and state level using these databases to determine the impact of BMI on blunt trauma. The incidence of blunt trauma secondary to falls increased at global, national, and state levels during our study period from 1990 to 2015, with a corresponding increase in BMI at all levels ( P < 0.05). Mortality due to fall injuries was higher in obese patients at all levels ( P < 0.05). Analysis from Nationwide Inpatient Sample database demonstrated higher mortality rates for obese patients nationally, both after motor vehicle collisions and mechanical falls ( P < 0.05). In obese and nonobese patients, regional data demonstrated a higher blunt trauma mortality rate of 2.4% versus 1.2%, respectively ( P < 0.05) and a longer hospital length of stay of 4.13 versus 3.26 days, respectively ( P = 0.018). The obesity rate and incidence of blunt trauma secondary to falls are increasing, with a higher mortality rate and longer length of stay in obese blunt trauma patients.


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