scholarly journals The Impact of COPD in Trends of Urinary Tract Infection Hospitalizations in Spain, 2001–2018: A Population-Based Study Using Administrative Data

2020 ◽  
Vol 9 (12) ◽  
pp. 3979
Author(s):  
Javier de Miguel-Diez ◽  
Romana Albaladejo-Vicente ◽  
Domingo Palacios-Ceña ◽  
David Carabantes-Alarcon ◽  
José Javier Zamorano-Leon ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Protective Factor ◽  
Multivariable Analysis ◽  
Population Based ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Men And Women ◽  
Tract Infections ◽  
The Impact ◽  
Over Time

(1) Background: To examine trends in incidence and outcomes of urinary tract infections (UTIs) among men and women with or without chronic obstructive pulmonary disease (COPD), and to identify the predictors for in-hospital mortality (IHM). (2) Methods: We included patients (aged ≥40 years) who were hospitalized with UTIs between 2001 and 2018. Data were collected from the Spanish National Hospital Discharge Database. (3) Results: We identified 748,458 UTI hospitalizations, 6.53% with COPD. The UTIs incidence increased over time. It was 1.55 times higher among men COPD patients than among non-COPD men (incidence rate ratio (IRR) 1.55; 95% CI 1.53–1.56). The opposite happened in women with COPD compared to non-COPD women (IRR 0.30; 95% CI 0.28–0.32). IHM was higher in men with COPD than non-COPD men (5.58% vs. 4.47%; p < 0.001) and the same happened in women (5.62% vs. 4.92%; p < 0.001). The risk of dying increased with age and comorbidity, but the urinary catheter was a protective factor among men (OR 0.75; 95% CI 0.64–0.89). Multivariable analysis showed a significant reduction in the IHM over time for men and women with COPD. Suffering from COPD only increased the risk of IHM among men (OR 1.07; 95% CI 1.01–1.13). (4) Conclusions: The incidence of UTIs increased over time. Suffering COPD increased the risk of IHM among men, but not among women.

Antibiotic Prescribing Patterns in Italian Hospital Inpatients with Pneumonia, Chronic Obstructive Pulmonary Disease, and Urinary Tract Infections

1993 ◽  
Vol 27 (1) ◽  
pp. 18-22 ◽  
Author(s):  
Luigi Guglielmo ◽  
Roberto Leone ◽  
Ugo Moretti ◽  
Anita Conforti ◽  
Alvise Spolaor ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Prescribing Patterns ◽  
Chronic Obstructive ◽  
Antibiotic Prescribing ◽  
Obstructive Pulmonary Disease ◽  
Tract Infections ◽  
Hospital Inpatients

OBJECTIVE: The primary objective of this study was to describe the antibiotic prescribing patterns in hospital inpatients with pneumonia (PN), exacerbations of chronic obstructive pulmonary disease (COPD), and urinary tract infections (UTIs). A second objective was to verify if some selected variables (i.e., risk factors, patient age, size of hospitals) were affecting the therapeutic choice. DESIGN: Survey was performed on 1609 patients. The data were collected by physicians using a special form, covering a six-month period. SETTING: Twenty-six medical wards and 8 geriatric wards in 24 acute-care hospitals in the Veneto Region in Northern Italy. PATIENTS: A consecutive sample of PN, COPD, and UTI patients treated with antibiotics. MAIN OUTCOME MEASURES: The following information was collected: patient and hospital demographics, risk factors, diagnoses, and antibiotic regimens. RESULTS: Sixty-three antimicrobial agents used, with 2115 administrations, 1227 of which were single-drug therapy. The most frequently used drugs were third-generation cephalosporins (24.6 percent), fluoroquinolones (15.4 percent), aminopenicillins (15.0 percent), and ureidopenicillins (9.7 percent). There is great variability of therapeutic regimens in the various hospitals for the same disease. However, this variability is not explained by the different types of hospitals or by the patients' characteristics (e.g., age, risk factors). CONCLUSIONS: Our results show that the use of broad-spectrum antibiotics probably is excessive. Moreover, the treatment seems to be based more on the opinion of the treating physician and the local habits rather than objective criteria. These factors may have negative repercussions not only in economic terms, but also in terms of alteration of the bacterial ecology.

scholarly journals Trends of Healthcare-associated Infections in a Tuinisian University Hospital and Impact of COVID-19 Pandemic

2021 ◽  
Vol 58 ◽  
pp. 004695802110679
Author(s):  
Hela Ghali ◽  
Asma Ben Cheikh ◽  
Sana Bhiri ◽  
Selwa Khefacha ◽  
Houyem Said Latiri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Protective Factor ◽  
Bloodstream Infections ◽  
Point Prevalence ◽  
University Hospital ◽  
Healthcare Associated Infection ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Background Although efforts to manage coronavirus disease 2019 (COVID-19) pandemic have understandably taken immediate priority, the impacts on traditional healthcare-associated infection (HAI) surveillance and prevention efforts remain concerning. Aim To describe trends in HAIs in a Tunisian university hospital through repeated point prevalence surveys over 9 years, assess the impact of measures implemented for COVID-19 pandemic, and to identify associated factors of HAI. Methods The current study focused on data collected from annual point prevalence surveys conducted from 2012 to 2020. All types of HAIs as defined by the Centers for Disease Control and Prevention (CDC) were included. Data collection was carried out using NosoTun plug. Univariate and multivariate logistic analysis were used to identify HAI risk factors. Results Overall, 2729 patients were observed in the 9 surveys; the mean age was 48.3 ± 23.3 years and 57.5% were male. We identified 267 infected patients (9.8%) and 296 HAIs (10.8%). Pneumonia/lower respiratory tract infections were the most frequent HAI (24%), followed by urinary tract infection (20.9%).The prevalence of infected patients increased from 10.6% in 2012 to 14.9% in 2020. However, this increase was not statistically significant. The prevalence of HAIs increased significantly from 12.3% to 15.5% ( P =.003). The only decrease involved is bloodstream infections (from 2% to 1%). Independent risk factors significantly associated with HAI were undergoing surgical intervention (aOR = 1.7), the use of antibiotic treatment in previous 6 months (aOR = 1.8), peripheral line (aOR=2), parenteral nutrition (aOR=2.4), urinary tract within 7 days (aOR=2.4), central line (aOR = 6.3), and prosthesis (aOR = 12.8), length of stay (aOR = 3), and the year of the survey. Young age was found as protective factor (aOR = .98). Conclusion Contrary to what was expected, we noticed an increase in the HAIs rates despite the preventive measures put in place to control the COVID-19 pandemic. This was partly explained by the vulnerability of hospitalized patients during this period.

scholarly journals When people do not ‘Zol’: Reduced emergency centre attendance of patients with chronic obstructive pulmonary disease during coronavirus disease 2019 lockdown with the accompanying tobacco sales ban in South Africa

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Piero Saieva ◽  
Louis S. Jenkins
Keyword(s):  
South Africa ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Prevalence Rate ◽  
Chronic Obstructive ◽  
Western Cape ◽  
Western Cape Province ◽  
Obstructive Pulmonary Disease ◽  
Tract Infections ◽  
The Impact

The coronavirus disease 2019 (COVID-19) pandemic has spread throughout the world, with devastating effects of the virus as well as the repercussions of the resulting ‘lockdowns’. South Africa went into a national lockdown in March 2020 to mitigate the impact of the virus. This included a ban on the sales of tobacco and electronic cigarette products. The ban has been a highly contentious issue in South Africa, discussed worldwide, which has drawn many criticisms. The prevalence rate of smoking in South Africa was around 21.5%, with the Western Cape province having a prevalence rate of 39%. We compared the number of chronic obstructive pulmonary disease (COPD) presentations at a large regional referral hospital in the Western Cape province from January to August 2019 with the same period in 2020. Electronic emergency centre data showed a reduction of 69.28% in COPD presentations. To control for some confounders for the same period, we also reviewed patients presenting with urinary tract infections, which showed only a 30.60% reduction. This notable reduction in COPD presentations reduced service pressure of emergency centre and most likely benefitted patients’ health. Further research and policies are needed to ensure ongoing reduction in the prevalence of smoking.

scholarly journals The Risk Factors and the Impact of Hernia Development on Technique Survival in Peritoneal Dialysis Patients: A Population-Based Cohort Study

2015 ◽  
Vol 35 (3) ◽  
pp. 351-359 ◽  
Author(s):  
Shang-Feng Yang ◽  
Chia-Jen Liu ◽  
Wu-Chang Yang ◽  
Chao-Fu Chang ◽  
Chih-Yu Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Protective Factor ◽  
Female Gender ◽  
Population Based ◽  
Chronic Obstructive ◽  
Research Database ◽  
Hernia Formation ◽  
History Of ◽  
The Impact

ObjectivesThere is a lack of consensus on the risk factors for hernia formation, and the impact on peritoneal dialysis (PD) survival has seldom been studied.MethodsThis was a population-based study and all collected data were retrieved from the National Health Insurance Research Database of Taiwan. Patients who commenced PD between January 1998 and December 2006 were screened for inclusion. Multiple logistic regression and Cox proportional hazards models were applied to estimate the predictors for hernia formation and determine the predictors of PD withdrawal.ResultsA total of 6,928 PD patients were enrolled and followed until December 2009, with 631 hernia events and 391 hernioplasties being registered in 530 patients (7.7%). The incidence rate was 0.04 hernias/patient/year. Longer PD duration (per 1 month increase, hazard ratio (HR) 1.019) and history of mitral valve prolapse (MVP) (HR 1.584) were independent risk factors for hernia formation during PD, and female gender (HR 0.617) was a protective factor. On the other hand, there were 4,468 PD withdrawals, with cumulative incidence rates of 41% at 1 year, 66% at 3 years, and 82% at 5 years. Independent determinants for cumulative PD withdrawal included hernia formation during PD (HR 1.154), age (per 1 year increase, HR 1.014), larger dialysate volume (per 1 liter increase, HR 0.496), female gender (HR 0.763), heart failure (HR 1.092), hypertension (HR 1.207), myocardial infarction (HR 1.292), chronic obstructive pulmonary disease (COPD) (HR 1.227), cerebrovascular accident (CVA) (HR 1.364), and history of MVP (HR 0.712)ConclusionsProlonged PD duration was a risk factor for hernia formation, and female gender was protective. Hernia formation during PD therapy may increase the risk of PD withdrawal.

scholarly journals Ischemic Etiology and Prognosis in Men and Women with Acute Heart Failure

2021 ◽  
Vol 10 (8) ◽  
pp. 1713
Author(s):  
Lourdes Vicent ◽  
Jose Guerra ◽  
Rafael Vazquez-García ◽  
José R. Gonzalez-Juanatey ◽  
Luis Martínez Dolz ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Heart Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
P Value ◽  
Obstructive Pulmonary Disease ◽  
Men And Women ◽  
The Impact ◽  
Multicenter Registry

Coronary heart disease is common in heart failure (HF). Our aim was to determine the impact of ischemic etiology on prognosis among men and women with HF. This study is a prospective national multicenter registry. The primary endpoint was 12-month mortality. Patients with HF and ischemic heart disease were stratified according to sex. A total of 1830 patients were enrolled of which 756 (41.3%) were women. Ischemic etiology was more common in men (446 (41.6%)) than in women (167 (22.2%)). Among patients with ischemic HF, diabetes was more frequent in women than in men. Ischemic etiology was not associated with higher mortality risk, and this was true for women (Hazard Ratio [HR] 1.51, 95% Confidence Interval [CI] 0.98–2.32; p = 0.61) and men (HR 1.14, 95% CI 0.81–1.61; p = 0.46), p-value for interaction: 0.067. Mortality/readmission risk in ischemic HF increased in men with previous readmissions (HR 1.15, 95% CI 1.02–1.29; p = 0.022), chronic obstructive pulmonary disease (HR1.20, 95% CI 1.02–1.41; p = 0.026) and in women with diabetes (HR 2.23, 95% CI 1.05–4.47; p = 0.035). Ischemic etiology was not associated with mortality in HF patients. In ischemic HF, the variables associated with a poor prognosis were diabetes in women and previous readmissions and chronic obstructive pulmonary disease in men.

scholarly journals Rates and Patterns of Chronic Obstructive Pulmonary Disease Exacerbations

2004 ◽  
Vol 11 (8) ◽  
pp. 559-564 ◽  
Author(s):  
Magda Nunes de Melo ◽  
Pierre Ernst ◽  
Samy Suissa
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Average Rate ◽  
Large Population ◽  
Population Based ◽  
Administrative Databases ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Men And Women ◽  
Acute Exacerbations

BACKGROUND:Acute exacerbations of chronic obstructive pulmonary disease (COPD) are believed to be a common occurrence in patients with COPD and are known to be associated with considerable morbidity.OBJECTIVE:To describe the frequency of treated COPD exacerbations in a large population-based cohort.SUBJECTS AND METHODS:A cohort of newly treated patients with COPD was formed from the administrative databases of Saskatchewan Health. The outcome was the occurrence of all moderate or severe exacerbations from 1990 to 1999. Exacerbations were defined in three ways: dispensing of a prescription for a systemic antibiotic; dispensing of both a prescription for an antibiotic and a prescription for an oral corticosteroid on the same day; and requiring a hospitalization with a primary discharge diagnosis of COPD.RESULTS:There were 5645 patients who entered the COPD cohort between 1990 and 1997, of whom 4453 experienced at least one exacerbation requiring treatment during follow-up. The overall rate of acute exacerbations was 1.12/person-year. It was constant across all age groups, and was similar in both men and women (1.13/person-year versus 1.11/person-year, respectively). The rate of exacerbations was highest in the first trimester of therapy for the disease (1.39/person-year) and stabilized thereafter at 1.04 exacerbations/person-year.CONCLUSIONS:The results indicate that in a population-based cohort of patients with COPD, the average rate of exacerbations was 1.12/person-year. Men and women had similar rates of exacerbations.

scholarly journals Value of an Aggregate Index in Describing The Impact of Trends in Antimicrobial Resistance forEscherichia coli

2015 ◽  
Vol 26 (1) ◽  
pp. 33-38 ◽  
Author(s):  
David M Patrick ◽  
Catharine Chambers ◽  
Dale Purych ◽  
Mei Chong ◽  
Diana George ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Urinary Tract Infections ◽  
Age Group ◽  
Cumulative Impact ◽  
Adaptive Use ◽  
Aggregate Index ◽  
Tract Infections ◽  
The Impact ◽  
Over Time

BACKGROUND: Drug resistance indexes (DRIs) quantify the cumulative impact of antimicrobial resistance on the likelihood that a given pathogen will be susceptible to antimicrobial therapy.OBJECTIVE: To derive a DRI for community urinary tract infections caused byEscherichia coliin British Columbia for the years 2007 to 2010, and to examine trends over time and across patient characteristics.METHODS: Indication-specific utilization data were obtained from BC PharmaNet for outpatient antimicrobial prescriptions linked to diagnostic information from physician payment files. Resistance data forE coliurinary isolates were obtained from BC Biomedical Laboratories (now part of LifeLabs Medical Laboratory Services). DRIs were derived by multiplying the rate of resistance to a specific antimicrobial by the proportional rate of utilization for that drug class and aggregating across drug classes. Higher index values indicate more resistance.RESULTS: Adaptive-use DRIs remained stable over time at approximately 18% (95% CI 17% to 18%) among adults ≥15 years of age and approximately 28% (95% CI 26% to 31%) among children <15 years of age. Similar results were observed when proportional drug use was restricted to the baseline year (ie, a static-use model). Trends according to age group suggest a U-shaped distribution, with the highest DRIs occurring among children <10 years of age and adults ≥65 years of age. Males had consistently higher DRIs than females for all age groups.CONCLUSIONS: The stable trend in adaptive-use DRIs over time suggests that clinicians are adapting their prescribing practices for urinary tract infections to local resistance patterns. Results according to age group reveal a higher probability of resistance to initial therapy among young children and elderly individuals.

scholarly journals The impact of comorbidities on mortality among men and women with COPD: report from the OLIN COPD study

2019 ◽  
Vol 13 ◽  
pp. 175346661986005 ◽  
Author(s):  
Sami Sawalha ◽  
Linnea Hedman ◽  
Helena Backman ◽  
Nikolai Stenfors ◽  
Eva Rönmark ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Normal Lung ◽  
Mortality Data ◽  
Chronic Obstructive ◽  
Prognostic Impact ◽  
Men And Women ◽  
Risk Of Death ◽  
The Impact

Background: Comorbidities probably contribute to the increased mortality observed among subjects with chronic obstructive pulmonary disease (COPD), but sex differences in the prognostic impact of comorbidities have rarely been evaluated in population-based studies. The aim of this study was to evaluate the impact of common comorbidities, cardiovascular disease (CVD), diabetes mellitus (DM), and anxiety/depression (A/D), on mortality among men and women with and without airway obstruction in a population-based study. Methods: All subjects with airway obstruction [forced expiratory volume in 1 second (FEV1)/(forced) vital capacity ((F)VC) <0.70, n = 993] were, together with age- and sex-matched referents, identified after examinations of population-based cohorts in 2002–2004. Spirometric groups: normal lung function (NLF) and COPD (post-bronchodilator FEV1/(F)VC <0.70) and additionally, LLN-COPD (FEV1/(F)VC <lower limit of normal). Mortality data was collected until December 2015. Results: In COPD, the prevalence of CVD and DM was higher in men, whereas the prevalence of A/D was higher in women. The cumulative mortality was significantly higher in COPD than NLF, and higher in men than women in both groups. Among women with COPD, CVD and A/D but not DM increased the risk of death independent of age, body mass index, smoking habits, and disease severity, whereas among men DM and A/D but not CVD increased the risk for death. When the LLN criterion was applied, the pattern was similar. Conclusion: There were sex-dependent differences regarding the impact of comorbidities on prognosis in COPD. Even though the prevalence of CVD was higher in men, the impact of CVD on mortality was higher in women, and despite higher prevalence of A/D in women, the impact on mortality was similar in both sexes. The reviews of this paper are available via the supplemental material section.

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