scholarly journals Incidence of intoxication events and patient outcomes in Taiwan: A nationwide population-based observational study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244438
Author(s):  
Chun-Kuei Chen ◽  
Yi-Ling Chan ◽  
Tse-Hsuan Su
Keyword(s):  
Mortality Rate ◽  
Geriatric Patients ◽  
National Level ◽  
Medical Costs ◽  
Mortality Rates ◽  
Hospital Length Of Stay ◽  
Research Database ◽  
Psychiatric Illnesses ◽  
Severe Intoxication ◽  
Over Time

Background Intoxicated patients were frequently managed in the emergency departments (ED) with few studies at national level. The study aimed to reveal the incidence, outcomes of intoxications and trend in Taiwan. Methods Adults admitted to an ED due to an intoxication event between 2006 and 2013 were identified using the Taiwan National Health Insurance Research Database. The rate of intoxication and severe intoxication events, mortality rate, hospital length of stay (LOS), and daily medical costs of these patients were analyzed. Changes over time were analyzed using Joinpoint models. Multivariable generalized regressions with GEE were used to assess the effect of sex, age, and presence of prior psychiatric illness. Results A total of 20,371 ED admissions due to intoxication events were identified during the study period, and the incidence decreased with annual percentage change of 4.7% from 2006 to 2013. The mortality rate, hospital LOS, and daily medical costs were not decreased over time. Males and geriatric patients had more severe intoxication events, greater mortality rates, and greater daily medical costs. Patients with psychiatric illnesses had higher mortality rates and a longer hospital LOS, but lower daily medical expenses. Conclusion From 2006 to 2013, there was a decline in the incidence of ED admission for intoxication events in Taiwan. Males, geriatric patients, and those with psychiatric illnesses had greater risks for severe intoxication and mortality.

scholarly journals Incidence of Intoxication Events and Patient Outcomes in Taiwan: a Nationwide Population-based Observational Study

2020 ◽  
Author(s):  
Chun Kuei Chen ◽  
Yi-Ling Chan ◽  
Tse-Hsuan Su
Keyword(s):  
Mortality Rate ◽  
Geriatric Patients ◽  
National Level ◽  
Medical Costs ◽  
Mortality Rates ◽  
Hospital Length Of Stay ◽  
Research Database ◽  
Psychiatric Illnesses ◽  
Severe Intoxication ◽  
Over Time

Abstract Background Intoxicated patients were frequently managed in the emergency departments (ED) with few studies at national level. The study aimed to reveal the incidence, outcomes of intoxications and trend in Taiwan.Methods Adults admitted to an ED due to an intoxication event between 2006 and 2013 were identified using the Taiwan National Health Insurance Research Database. The rate of intoxication and severe intoxication events, mortality rate, hospital length of stay (LOS), and daily medical costs of these patients were analyzed. Changes over time were analyzed using Joinpoint models. Subgroup analyses were used to assess the effect of sex, age, and presence of a prior psychiatric illness.Results A total of 20,371 ED admissions due to intoxication events were identified during the study period, and the incidence decreased with annual percentage change of 4.7% from 2006 to 2013. The mortality rate, hospital LOS, and daily medical costs were not decreased over time. Males and geriatric patients had more severe intoxication events, greater mortality rates, and greater daily medical costs. Patients with psychiatric illnesses had higher mortality rates and a longer hospital LOS, but lower daily medical expenses.Conclusion From 2006 to 2013, there was a decline in the incidence of ED admission for intoxication events in Taiwan. Males, geriatric patients, and those with psychiatric illnesses had greater risks for severe intoxication and mortality.

scholarly journals Geographical and socioeconomic inequalities in female breast cancer incidence and mortality in Iran: A Bayesian spatial analysis of registry data

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248723
Author(s):  
Shadi Rahimzadeh ◽  
Beata Burczynska ◽  
Alireza Ahmadvand ◽  
Ali Sheidaei ◽  
Sara Khademioureh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Mortality Rate ◽  
Cancer Incidence ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Breast Cancer Incidence ◽  
National Level ◽  
Mortality Rates ◽  
Incidence And Mortality ◽  
Over Time

Background In Iran, trends in breast cancer incidence and mortality have generally been monitored at national level. The purpose of this study is to examine province-level disparities in age-standardised breast cancer incidence versus mortality from 2000 to 2010 and their association with socioeconomic status. Methods In this study, data from Iran’s national cancer and death registry systems, and covariates from census and household expenditure surveys were used. We estimated the age-standardised incidence and mortality rates in women aged more than 30 years for all 31 provinces in the consecutive time intervals 2000–2003, 2004–2007 and 2008–2010 using a Bayesian spatial model. Results Mean age-standardised breast cancer incidence across provinces increased over time from 15.0 per 100,000 people (95% credible interval 12.0,18.3) in 2000–2003 to 39.6 (34.5,45.1) in 2008–2010. The mean breast cancer mortality rate declined from 10.9 (8.3,13.8) to 9.9 (7.5,12.5) deaths per 100,000 people in the same period. When grouped by wealth index quintiles, provinces in the highest quintile had higher levels of incidence and mortality. In the wealthiest quintile, reductions in mortality over time were larger than those observed among provinces in the poorest quintile. Relative breast cancer mortality decreased by 16.7% in the highest quintile compared to 10.8% in the lowest quintile. Conclusions Breast cancer incidence has increased over time, with lower incidence in the poorest provinces likely driven by underdiagnoses or late-stage diagnosis. Although the reported mortality rate is still higher in wealthier provinces, the larger decline over time in these provinces indicates a possible future reversal, with the most deprived provinces having higher mortality rates. Ongoing analysis of incidence and mortality at sub-national level is crucial in addressing inequalities in healthcare systems and public health both in Iran and elsewhere.

scholarly journals The level and trend of road traffic injuries attributable mortality rate in Iran, 1990–2015: a story of successful regulations and a roadmap to design future policies

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mehran Shams ◽  
Farnam Mohebi ◽  
Kimiya Gohari ◽  
Masoud Masinaei ◽  
Bahram Mohajer ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Road Traffic ◽  
National Level ◽  
Mortality Rates ◽  
Road User ◽  
Attributable Mortality ◽  
Older Individuals ◽  
Registration System ◽  
Helmet Use ◽  
Road Traffic Injuries

Abstract Background Road-Traffic-Injuries (RTIs) are predicted to rise up to the fifth leading cause of worldwide death by 2030 and Iran has the third highest RTIs mortality among higher-middle income countries. Although the high mortality of RTI in Iran is a warning, it provides the opportunity to indirectly assess the implemented RTI-related regulations’ effectiveness via high-resolution relevant statistics and, hence, Iran could serve as a guide for countries with similar context. In order to do so, we utilized this study to report the time and spatial trends of RTIs-related mortality in different age and sex groups and road user classes in Iran. Methods Based on the national death-registration-system (DRS), cemeteries data, and the demographic characteristics, and after addressing incompleteness, we estimated mortality rates using spatiotemporal and Gaussian process regression models. We assessed Pearson seatbelt and helmet use and RTIs-attributable Age-Standardized-Morality-Rate (ASMR) associations. We also predicted RTIs-death-numbers, 2012–2020, by fitting a Generalized Additive Model to assess the status of achieving relevant sustainable development goal (SDG), namely reducing the number of RTIs-related deaths by half. Results Overall RTIs-attributable death and ASMR at the national level increased from 12.64 [95% UI, 9.52–16.86] to 29.1 [22.76–37.14] per 100,000 people in the time period of 1990–2015. The trend consisted of an increasing segment in 1990–2003 followed by a decreasing part till 2015. The highest percentage of death belonged to the three-or-more-wheels motorized vehicles. Pedestrian injuries percentage increased significantly and the highest mortality rate occurred in 85 years and older individuals. Low prevalence of seatbelt and helmet use were observed in provinces with higher than the median ASMR due to the relevant cause of each. RTIs-attributable death number is expected to reduce by 15.99% till 2020 which is lower than the established SDG goal. Conclusions Despite the observed substantial moderation in the RTI-ASMR, Iran is till among the leading countries in terms of the highest mortality rates in the world. The enforced regulations including speed limitations (particularly for elder pedestrians) and mandatory use of seatbelt and helmet (for young adult and male drivers) had a considerable effect on ASMR, nevertheless, the RTI burden reduction needs to be sustained and enhanced.

Mortality rates in geriatric patients with spinal cord injuries

2007 ◽  
Vol 7 (3) ◽  
pp. 277-281 ◽  
Author(s):  
Daniel R. Fassett ◽  
James S. Harrop ◽  
Mitchell Maltenfort ◽  
Shiveindra B. Jeyamohan ◽  
John D. Ratliff ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Mortality Rate ◽  
Geriatric Patients ◽  
Spinal Cord Injuries ◽  
Mortality Rates ◽  
Neurological Injury ◽  
Patient Age ◽  
Younger Patients ◽  
Patient Âgé ◽  
Chi Square Analysis

Object The authors undertook this study to evaluate the incidence of spinal cord injury (SCI) in geriatric patients (≥ 70 years of age) and examine the impact of patient age, extent of neurological injury, and spinal level of injury on the mortality rate associated with traumatic SCI. Methods A prospectively maintained SCI database (3481 patients) at a single institution was retrospectively studied for the period from 1978 through 2005. Parameters analyzed included patient age, admission American Spinal Injury Association (ASIA) motor score, level of SCI, mechanism of injury, and mortality data. The data pertaining to the 412 patients 70 years of age and older were compared with those pertaining to the younger cohort using a chi-square analysis. Results Since 1980, the number of SCI-related hospital admissions per year have increased fivefold in geriatric patients and the percentage of geriatric patients within the SCI population has increased from 4.2 to 15.4%. In comparison with younger patients, geriatric patients were found to be less likely to have severe neurological deficits (greater percentage of ASIA Grades C and D injuries), but the mortality rates were higher in the older age group both for the period of hospitalization (27.7% compared with 3.2%, p < 0.001) and during 1-year follow-up. The mortality rates in this older population directly correlate with the severity of neurological injury (1-year mortality rate, ASIA Grade A 66%, Grade D 23%, p < 0.001). The mortality rate in elderly patients with SCI has not changed significantly over the last two decades, and the 1-year mortality rate was greater than 40% in all periods analyzed. Conclusions Spinal cord injuries in older patients are becoming more prevalent. The mortality rate in this patient group is much greater than in younger patients and should be taken into account when aggressive interventions are considered and in counseling families regarding prognosis.

The Impact of BMI on Adult Blunt Trauma Outcomes

2019 ◽  
Vol 85 (12) ◽  
pp. 1354-1362
Author(s):  
Rahman Barry ◽  
Milad Modarresi ◽  
Rodrigo Aguilar ◽  
Jacqueline Sanabria ◽  
Thao Wolbert ◽  
...  
Keyword(s):  
United States ◽  
Mortality Rate ◽  
Length Of Stay ◽  
Blunt Trauma ◽  
Nationwide Inpatient Sample ◽  
The United States ◽  
Mortality Rates ◽  
Hospital Length Of Stay ◽  
Obese Patients ◽  
The Impact

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.

Time Trends in Characteristics and Outcome of Twin Pregnancies

1991 ◽  
Vol 40 (2) ◽  
pp. 181-192 ◽  
Author(s):  
L. Moreault ◽  
S. Marcoux ◽  
J. Fabia ◽  
S. Tennina
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Low Birthweight ◽  
Preterm Births ◽  
Mortality Rates ◽  
Fetal Mortality ◽  
Neonatal Mortality Rate ◽  
Risk Of Death ◽  
Twin Pregnancies ◽  
Over Time

AbstractThis study describes the evolution in fetal and neonatal mortality rates among twin pairs born in 22 hospitals located in the eastern regions of the province of Quebec in 1976-1978 (n = 776 pairs) and 1982-1985 (n = 712 pairs). It also assesses the contribution of maternal factors, obstetrical care and characteristics of twins in the variation of the risk of death over time. The fetal mortality rate did not improve from 1976-1978 (22.6 per 1000) to 1982-1985 (28.1 per 1000). However, the neonatal mortality rate declined from 44.7 to 34.7 per 1000 liveborn first twins and from 56.8 to 36.1 per 1000 liveborn second twins. For first twins as for second twins, birthweight-specific neonatal mortality rates decreased within birth weight categories under 2500 g. In the second period, 96.9% of twin pregnancies were detected before confinement compared to 59.6% in the earlier period. The proportion of twins delivered by obstetricians, the percentage of twin births occurring in ultraspecialized perinatal units and the frequency of caesarean sections increased markedly. The proportion of preterm births increased over time (34.5% vs 43.1%) whereas the percentage of low birthweight twins decreased but not significantly (54.3% 51.6%). In this study, changes in maternal age, parity, educational level, sex of pairs, qualification of the physician, and level of care available at the hospital of birth, did not account for the decrease in neonatal mortality rates among twins. The increase in the frequency of caesarean sections seemed to explain only a small proportion of the decrease in the neonatal mortality rate among second twins. In the second as well as in the first period, the neonatal mortality rate for twins was six times higher than that for singletons.

Assessing the trend of HIV/AIDS mortality rate in Asia and North Africa: an application of latent growth models

2015 ◽  
Vol 144 (3) ◽  
pp. 548-555 ◽  
Author(s):  
F. ZAYERI ◽  
E. TALEBI GHANE ◽  
N. BORUMANDNIA
Keyword(s):  
Mortality Rate ◽  
North Africa ◽  
Growth Models ◽  
Mortality Rates ◽  
Asia Pacific ◽  
Prevention Measures ◽  
Latent Growth ◽  
African Countries ◽  
Over Time ◽  
Hiv Aids

SUMMARYOver the last 30 years, HIV/AIDS has emerged as a major global health challenge. This study evaluates the change of HIV/AIDS mortality rates in Asian and North African countries from 1990 to 2010 using the Global Burden of Disease (GBD) study. HIV/AIDS mortality rates were derived from the GBD database from 1990 to 2010, for 52 countries in Asia and North Africa. First, a Latent Growth Model was employed to assess the change in AIDS mortality rate over time in six different regions of Asia, and also the change in AIDS mortality rate over time for males and females in Asia and North Africa. Finally, Latent Growth Mixture Models (LGMMs) were applied to identify distinct groups in which countries within each group have similar trends over time. Our results showed that increase in mortality rate over time for males is about three times greater than for females. The highest and lowest trend of AIDS mortality rates were observed in South-East Asia and high-income Asia-Pacific regions, respectively. The LGMM allocated most countries in the South and South-East region into two classes with the highest trend of AIDS mortality rates. Although the HIV/AIDS mortality rates are decreasing in some countries and clusters, the general trend in the Asian continent is upwards. Therefore, it is necessary to provide programmes to achieve the goal of access to HIV prevention measures, treatment, care, and support for high-risk groups, especially in countries with a higher trend of AIDS mortality rates.

scholarly journals Effects of Hyperglycemia on Adults Hospitalized With Sepsis

2016 ◽  
Author(s):  
Katie Cardoso
Keyword(s):  
Blood Glucose ◽  
National Level ◽  
Mortality Rates ◽  
Acute Illness ◽  
Hospital Length Of Stay ◽  
Surviving Sepsis Campaign ◽  
Diabetes Group ◽  
Glucose Levels ◽  
Lengths Of Stay ◽  
Blood Glucose Levels

<p>Infectious sepsis (IS) is the result of a complex infection that is difficult to identify, diagnosis and treat. The gold standard for treatment of IS is early identification and intervention. There is a rise in patients with IS along with a concurrent rise of adults with Diabetes Mellitus (DM). Adults with DM are more susceptible to acute illness due to the multiple body systems affected by DM. Acute illness in adults with DM leads to increased blood glucose levels that become difficult to treat. Extreme elevations of blood glucose are linked to longer lengths of stay and higher mortality rates in adults with IS. Surviving Sepsis Campaign recommends blood glucose levels to be controlled below 180mg/dl for all adults with and without diabetes. The purpose of this research study was to identify if a relationship exists between hyperglycemia, hyperlactatemia, hospital length of stay and mortality rates in septic adults with diabetes (Group A) and without diabetes (Group B). Findings of the study did not project what was predicted regarding hyperglycemia, however high lactate levels were associated with longer lengths of stay and higher mortality rates as predicted. This retrospective, two group design study found adults without diabetes had longer lengths of stay and higher mortality rates than adults with diabetes indicating poorly controlled glucose levels in nondiabetic adults with sepsis may impact patient outcomes. APRN’s can be instrumental in implementing change in patient care and hospital policy by providing evidenced based practice by following practice standards established at a national level such as the Surviving Sepsis Campaign.</p>

scholarly journals Secular Trends in the Incidence of and Mortality Due to Alzheimer’s Disease and Other Forms of Dementia in China From 1990 to 2019: An Age-Period-Cohort Study and Joinpoint Analysis

2021 ◽  
Vol 13 ◽  
Author(s):  
Yongliang Gao ◽  
Xiaonan Liu
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Mortality Rate ◽  
National Level ◽  
Mortality Rates ◽  
Birth Cohorts ◽  
Analytical Strategy ◽  
Incident Dementia ◽  
Incidence And Mortality ◽  
Males And Females

BackgroundThe number of individuals with dementia is increasing, which negatively affects families, communities, and health care systems worldwide. The changes in the incidence of and mortality due to Alzheimer’s disease and other forms of dementia at the national level in China have remained unknown over the past three decades.MethodsFollowing the general analytical strategy used in the Global Burden of Disease Study (GBD) 2019, the age- and sex-specific incidence and mortality rates for dementia in China were analyzed. Trends in the incidence of and mortality due to dementia from 1990 to 2019 were assessed by joinpoint regression analysis. The effects of age, period and cohort on the incidence of and mortality due to dementia were estimated by an age-period-cohort model.ResultsThe age-standardized incidence and mortality rates per 100,000 population were 103.83 (95% UI, 87.93–118.87) and 23.32 (95% UI, 5.66–61.31), respectively, for dementia in 2019. From 1990 to 2019, a significant average annual percentage change (AAPC) in the age-standardized incidence rate was observed in both males [0.49% (95% CI, 0.43–0.55%)] and females [0.31% (95% CI, 0.24–0.38%)], and the age-standardized mortality rate significantly increased in males [0.42% (95% CI, 0.31–0.53%)]. The population aged 55–59 years had the highest AAPC in the incidence of dementia [0.87% (95% CI, 0.81–0.93%)]. The age effect showed that the relative risks (RRs) of incident dementia and dementia-associated mortality increased with age among males and females, and individuals aged 60 years and older had significantly higher RRs. The RR of incident dementia increased with time, and the RR started to substantially increase in 2009. The cohort effect showed that the incidence decreased in successive birth cohorts.ConclusionAlzheimer’s disease and other forms of dementia continue to become more common among males and females in China, and the associated mortality rate in males significantly increased from 1990 to 2019. Early interventions should be implemented to reduce the burden of dementia on individuals at high risk in China.

Resection of Obstructive Left-Sided Colon Cancer at a National Level: A Prospective Analysis of Short-Term Outcomes in 1,816 Patients

2015 ◽  
Vol 32 (5) ◽  
pp. 317-324 ◽  
Author(s):  
Pieter J. Tanis ◽  
Nuno R. Paulino Pereira ◽  
Jeanin E. van Hooft ◽  
Esther C.J. Consten ◽  
Willem A. Bemelman ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Mortality Rate ◽  
Clinical Decision Making ◽  
National Level ◽  
Treatment Strategies ◽  
Mortality Rates ◽  
National Registry ◽  
Endoscopic Stenting ◽  
Short Term ◽  
First Choice

Background/Aims: The prematurely closed Stent-In II trial in patients with left-sided obstructive colon cancer may have influenced clinical decision making in The Netherlands. The aim of this study was to evaluate treatment of left-sided malignant colon obstruction at a population level since then. Methods: Short-term outcomes of all patients who underwent resection for left-sided obstructive colon cancer between 2009 and 2012 were assessed based on a prospective national registry. Results: In total, 1,816 evaluable patients were included; acute resection was performed in 1,485 (81.8%), and endoscopic stent or decompressing stoma followed by resection in 196 (10.8%) and 135 (7.4%), respectively. The use of endoscopic stenting significantly decreased from 18% (2009) to 6% (2012). Overall 30-day or in-hospital mortality rate was 6.9, 5.6, and 3.7%, respectively (p = 0.107). Mortality rate after acute resection was 2.9% in patients >70 years, but mortality rates up to 32.2% were observed in high-risk elderly patients. Conclusion: Acute resection as first choice treatment seems justified for patients >70 years of age given a mortality rate of 3%. For the elderly frail patients, mortality rates over 30% after acute resection stress the need for alternative treatment strategies.

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