Adverse drug events among patients receiving postsurgical opioids in a large health system: Risk factors and outcomes

2014 ◽  
Vol 71 (18) ◽  
pp. 1556-1565 ◽  
Author(s):  
Harold S. Minkowitz ◽  
Stephen K. Gruschkus ◽  
Manan Shah ◽  
Aditya Raju
2002 ◽  
Vol 22 (6) ◽  
pp. 385-392 ◽  
Author(s):  
J. Doucet ◽  
A. Jego ◽  
D. Noel ◽  
C.E. Geffroy ◽  
C. Capet ◽  
...  

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Abbey C Sidebottom ◽  
Arthur Sillah ◽  
David M Vock ◽  
Michael M Miedema ◽  
Raquel Pereira ◽  
...  

Background: Despite a highly recognized priority for public health and healthcare to implement population-level strategies to reduce the burden of cardiovascular disease (CVD), limited evidence exists on the most effective strategies. Data collection and evaluation of large scale, community based-prevention programs can be challenging and costly to achieve. The Heart of New Ulm (HONU) Project, begun in 2009, is a population-based initiative with healthcare, community, and workplace interventions addressing multiple levels of the social-ecological model designed to reduce modifiable CVD risk factors in rural New Ulm, MN. The community is served by one health system, enabling the use of electronic health record (EHR) data for surveillance. Objective: To assess trends for CVD risk factors, events, and healthcare utilization for New Ulm residents compared to a matched control population. Methods: We matched New Ulm residents (n = 4,077) with controls (n = 4,077) from a regional community served by the same health system using refined covariate balance techniques to match on baseline demographics, CVD risk factors, and health care utilization. Mixed effects longitudinal models with adjustment for age and gender, and an interaction for time by community, were run. Model based estimates were constructed for the entire cohort at each time period. Results: Over the first 6 years of the HONU Project,blood pressure, LDL, total cholesterol, and triglycerides were managed better in New Ulm than the matched comparison community. The proportion of New Ulm residents with controlled blood pressure increased by 6.2 percentage points while the control group increased by 2 points. 10-year ASCVD risk scores showed less decline for New Ulm residents than controls (16 vs. 18.4). The intervention and control groups did not differ with regard to inpatient stays, CVD events, smoking, or glucose. Conclusions: Compared to a matched control population, we found improved control of CVD risk factors in the New Ulm Population exposed to the HONU Project.


2001 ◽  
Vol 161 (13) ◽  
pp. 1629 ◽  
Author(s):  
Terry S. Field ◽  
Jerry H. Gurwitz ◽  
Jerry Avorn ◽  
Danny McCormick ◽  
Shailavi Jain ◽  
...  

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S375-S376
Author(s):  
Kartik Gupta ◽  
Lea Monday ◽  
Milan Kaushik ◽  
George J Alangaden ◽  
Indira Brar

Abstract Background Remdesivir (RDV), an antiviral agent, is approved by Food and Drug Administration (FDA) for the treatment of patients (pts) admitted with SARS-COV-2 infection (COVID-19). Earlier RDV studies (such as ACCT-1) prior to widespread use of corticosteroids (CS), showed a 30-day mortality of 11%. Advanced age, obesity, and certain comorbidities are known risk factors for death in COVID-19, but whether these risks vary in pts treated with RDV and CS is unknown. As of March 20, 2020 CS were routinely used for the treatment of pts admitted with COVID19 in our health care system. The objective of this study was to identify risk factors associated with 30 -Day mortality in a cohort of pts admitted with COVID-19 and who received RDV and CS. Methods This retrospective cohort study evaluated pts admitted to a health system in South East Michigan with COVID-19 between March and November 2020 who received ≥1 dose RDV. Demographics, comorbidities, and characteristics including quick sequential organ failure assessment (qSOFA) score were collected and compared between patients who died versus survived. Primary outcome was 30 day mortality. Secondary outcomes were risk factors for death using logistic regression and time-to-event analysis. Results A total of 1,591 pts received RDV and were included in the study; median age 67 years, 56% male and 18% Black. RDV use increased after emergency use authorization and FDA approval (Fig 1). Death within 30 days occurred in 15.3%. Patients who died were older males with higher rates of hypertension, kidney disease, diabetes, and were more likely to have qSOFA ≥2 on arrival (Table 1). In a multivariable logistic model, advanced age, male gender, pulmonary disease, CKD, obesity, and qSOFA≥2 were independent predictors of death (Figure 2). Among these, age and qSOFA≥2 were the most important risk factors (Figure 2). Patients receiving remdesivir (red) were included in the study. Routine use of corticosteroids was adopted on all patients in our health system beginning March 20, 2020. System-wide use of remdesivir increased following Food and Drug Administration approval in fall 2020. On both logistic regression and time-to-event analysis, advanced age and qSOFA ≥ 2 had the highest predictive value for mortality. Others comorbidities were similar and comparable in importance. Conclusion The population in our Real-world study was older with more comorbidities as compared to ACCT-1, and the 30 day mortality was 15%. Despite the use of CS and RDV advanced age and qSOFA were the most important drivers of mortality. Future, therapeutic strategies need to focus on this group which is at the highest risk of dying from COVID-19 infection. Disclosures All Authors: No reported disclosures


Author(s):  
Shoshana J. Herzig ◽  
Timothy S. Anderson ◽  
Yoojin Jung ◽  
Long H. Ngo ◽  
Ellen P. McCarthy

2020 ◽  
Vol 8 (01) ◽  
pp. 025-028
Author(s):  
Gunjan Y. Trivedi ◽  
Banshi Saboo

AbstractHealthy immune system helps in enhancing the quality of life and reduces the risk of infectious disease. Chronic disease increases the risk of immune system impairment. The article reviews the evidence on risk factors causing immune system imbalance and articulates the complex nature of the relationships between immune system risk factors, chronic disease, and infectious disease to highlight the importance of lifestyle choices. Finally, some evidence is presented on mind–body interventions and lifestyle choices for enhancing the immune system function.


Sign in / Sign up

Export Citation Format

Share Document