BACKGROUND With an increase in the elderly population,the frequency of hospitalizations in recent years has also risen at a rapid pace.This,in turn,has resulted in poor outcomes and costly treatments.Hospitalization r...BACKGROUND With an increase in the elderly population,the frequency of hospitalizations in recent years has also risen at a rapid pace.This,in turn,has resulted in poor outcomes and costly treatments.Hospitalization rates increase in elderly patients due to a decline in glomerular filtration rate(GFR).AIM To investigate the connection between GFR and comorbidity and reasons for hospitalization in elderly patients.METHODS We analyzed patients aged 75 years and over who were admitted to the internal medicine clinic of a tertiary hospital in Eskisehir.At admission,we calculated GFR values using the Modification of Diet in Renal Disease study formula and classified them into six categories:G1,G2,G3a,G3b,G4,and G5.We analyzed associations with hospitalization diagnoses and comorbidity factors.RESULTS The average age of the patients was 80.8 years(±4.5 years).GFR was 57.287±29.5 mL/kg/1.73 m2 in women and 61.3±31.5 mL/kg/1.73 m2 in men(P=0.106).Most patients were admitted to the hospital at G2 stage(32.8%).The main reasons for hospitalization were anemia(34.4%and 28.6%)and malnutrition(20.9%and 20.8%)in women and men,respectively(P=0.078).The most frequent comor-bidity leading to hospitalization was arterial hypertension(n=168,28%),fo-llowed by diabetes(n=166,27.7%)(P=0.001).CONCLUSION When evaluating geriatric patients,low GFR alone does not provide sufficient information.Patients’comorbid factors should also be taken into account.There is no association between low GFR during hospitalization and hospitalization-Hamarat H.Aging and GFR related diagnoses.Knowing the GFR value before hospitalization will be more informative in such studies.展开更多
Few studies have explored the acute effects of fine particulate matter(PM_(2.5))constituents on respiratory diseases(RDs),particularly across a broad spectrum of RD subtypes.We analyzed the associations between PM_(2....Few studies have explored the acute effects of fine particulate matter(PM_(2.5))constituents on respiratory diseases(RDs),particularly across a broad spectrum of RD subtypes.We analyzed the associations between PM_(2.5) and its five major constituents[organic matter(OM),black carbon(BC),sulfate(SO_(4)^(2−)),nitrate(NO_(3)^(−)),and ammonium(NH_(4)^(+))]and RDs(10 major categories and 35 specific)based on the hospitalization records from 153 hospitals in 20 provincial distractions from 2013 to 2020.We found that short-term exposure(lag 0−1)to PM_(2.5) constituents per interquartile range increase was associated with higher hospitalization risks for acute upper respiratory infections,influenza and pneumonia,other acute lower respiratory infections,chronic lower respiratory diseases,other diseases of the pleura,and other diseases of the respiratory system;the effect estimates were 2.45−2.99%,2.02−2.71%,2.98−3.62%,3.06−3.65%,3.22−4.52%,and 2.23−3.66%,respectively.Among 35 specific RDs,12 were significantly affected by PM_(2.5) and its constituents.Individuals aged>60 years were sensitive to PM_(2.5) constituent exposure.Our individual-level nationwide study provided a more comprehensive perspective on the associations between PM_(2.5) constituents and various major and specific RDs,highlighting the necessity of prioritizing targeted control strategies for key constituents to effectively mitigate the burden of RDs in China.展开更多
BACKGROUND Hepatitis A virus(HAV)infection remains the most common cause of acute viral hepatitis globally.In the United States,recent outbreaks have been attributed primarily to person-to-person transmission,with vul...BACKGROUND Hepatitis A virus(HAV)infection remains the most common cause of acute viral hepatitis globally.In the United States,recent outbreaks have been attributed primarily to person-to-person transmission,with vulnerable populations such as people who use illicit drugs,those experiencing homelessness,and men who have sex with men disproportionately affected.AIM To assess the trends in HAV hospitalizations over the past decade and evaluate the impact of substance use on these hospitalizations.METHODS We conducted a retrospective study using the National Inpatient Sample database from 2011 to 2020.Adults(≥18 years)hospitalized with a primary diagnosis of HAV infection were included.We identified active substance use as a secondary diagnosis.Statistical analysis involved descriptive statistics,trend analysis,and propensity score matching to compare HAV hospitalizations with and without substance use.Outcomes included hospitalization trends,complications,length of stay(LOS),and mortality.RESULTS From 2011 to 2020,there were 56972 hospitalizations for HAV infections.Hospitalizations increased from 3917 in 2011 to 8290 in 2020,peaking at 9800 in 2018.Caucasian males(55%)were the most affected,with a mean age of 49 years.The prevalence of active substance use among HAV hospitalizations was 27%,with these patients being younger(mean age:39 years)and predominantly male(63.1%).HAV hospitalizations associated with substance use increased significantly,rising from 235 cases in 2011 to 3200 in 2020(P<0.001).Compared to HAV hospitalizations without substance use,those with substance use had higher rates of co-infections(hepatitis C virus 45%vs 11%,hepatitis B virus 11%vs 6%)and complications,including sepsis(1.9%vs 1%)and infective endocarditis(1.4%vs 0.15%,P<0.001).Hospitalizations with substance use also had longer LOS(4.34 days vs 3.97 days,P<0.05),but mortality rates were comparable.Predictors of mortality in HAV-substance use hospitalizations included acute liver failure,sepsis,and acute respiratory failure.CONCLUSION HAV hospitalizations in the United States have significantly increased over the past decade,with the rise driven by cases involving substance use.These patients face a higher burden of complications and healthcare utilization.Tailored public health strategies,including targeted vaccination and outreach programs for at-risk populations,are essential to reduce the morbidity,mortality,and economic burden associated with HAV.展开更多
Objective To assess the short-term lag effects of climate and air pollution on hospital admissions for cardiovascular and respiratory diseases,and to develop deep learning-based models for daily hospital admission pre...Objective To assess the short-term lag effects of climate and air pollution on hospital admissions for cardiovascular and respiratory diseases,and to develop deep learning-based models for daily hospital admission prediction.Methods A multi-city study was conducted in Tokyo’s 23 wards,Osaka City,and Nagoya City.Random forest models were employed to assess the synergistic short-term lag effects(lag0,lag3,and lag7)of climate and air pollutants on hospitalization for five cardiovascular diseases(CVDs)and two respiratory diseases(RDs).Furthermore,we developed hybrid deep learning models that integrated an autoencoder(AE)with a Long Short-Term Memory network(AE+LSTM)to predict daily hospital admissions.Results On the day of exposure(lag0),air pollutants,particularly nitrogen oxides(NOx),exhibited the strongest influence on hospital admissions for CVD and RD,with pronounced effects observed for hypertension(I10–I15),ischemic heart disease(I20),arterial and capillary diseases(I70–I79),and lower respiratory infections(J20–J22 and J40–J47).At longer lags(lag3 and lag7),temperature and precipitation were more influential predictors.The AE+LSTM model outperformed the standard LSTM,improving the prediction accuracy by 32.4%for RD in Osaka and 20.94%for CVD in Nagoya.Conclusion Our findings reveal the dynamic,time-varying health risks associated with environmental exposure and demonstrate the utility of deep learnings in predicting short-term hospital admissions.This framework can inform early warning systems,enhance healthcare resource allocation,and support climate-adaptive public health strategies.展开更多
BACKGROUND Chronic liver disease is associated with various neuropsychiatric conditions.There are currently no large studies assessing and comparing the prevalence of psy-chiatric illnesses based on patient profiles a...BACKGROUND Chronic liver disease is associated with various neuropsychiatric conditions.There are currently no large studies assessing and comparing the prevalence of psy-chiatric illnesses based on patient profiles and the etiology of cirrhosis.AIM To examine the trends of hospitalizations among psychiatric conditions in cirrhosis.METHODS We used the National Inpatient Sample database 2016-2019 for the primary diagnosis of liver cirrhosis.The outcomes included the prevalence,trends,and associations of psychiatric diagnoses in these hospitalizations.Chi-square for categorical variables and the Wilcoxon rank test for continuous variables were utilized.RESULTS The prevalence of generalized anxiety disorder(GAD)in liver cirrhosis hospitalizations increased from 0.17%in 2009 to 0.92%in 2019(P<0.001).The prevalence of depression increased from 7%in 2009 to 12%in 2019(P<0.001).Attention deficit hyperactivity disorder(ADHD)prevalence increased from 0.06%to 0.24%.The prevalence of schizophrenia increased from 0.59%to 0.87%(P<0.001).Schizoaffective disorder prevalence increased from 0.10%to 0.35%(P<0.001).Posttraumatic stress disorder(PTSD)prevalence displayed increasing trends from 0.36%in 2009 to 0.93%in 2019(P<0.001).The prevalence of suicidal ideation increased from 0.23%to 0.56%in 2019.Cirrhosis related to alcoholic liver disease[adjusted odds ratios(aOR)1.18,95%CI 1.08-1.29,P<0.001]and non-alcoholic fatty liver disease(NAFLD)(aOR 1.14,95%CI 1.01-1.28,P=0.025)was associated with depression more than other causes.Alcohol-and NAFLD-associated cirrhosis had a stronger link to psychiatric disorders.Females had a higher association with GAD(aOR 2.56,95%CI 2.14-3.06,P<0.001),depression(aOR 1.78,95%CI 1.71-1.84,P<0.001),bipolar disorder(aOR 1.64,95%CI 1.52-1.77,P<0.001]and chronic fatigue(aOR 2.31,95%CI 1.31-4.07,P<0.001)when compared to males.Blacks,Hispanics,and Asian/Native Americans had a significantly lower association with GAD,depression,bipolar disorder,PTSD,and ADHD when compared to the white race.CONCLUSION The prevalence of psychiatric comorbidities in liver cirrhosis hospitalizations has increased over the last decade.Females had a higher association with psychiatric disorders compared to males.Blacks,Hispanics,and Asian/Native Americans had lower associations with psychiatric comorbidities compared to the white race.展开更多
BACKGROUND The impact of the coronavirus on hospitalizations for gastrointestinal(GI)disease,particularly at a population level is understudied.AIM To investigate trends in hospitalizations,inpatient endoscopy resourc...BACKGROUND The impact of the coronavirus on hospitalizations for gastrointestinal(GI)disease,particularly at a population level is understudied.AIM To investigate trends in hospitalizations,inpatient endoscopy resource utilization,and outcomes during the first year of the coronavirus pandemic and subsequent lockdowns.METHODS Using the California State Inpatient Database for 2018-2020,we explored year-toyear and 2020 month-to-month trends in hospitalizations,length of stay,and inpatient mortality(all-cause&viral pneumonia-specific)for common inpatient GI diagnoses including acute pancreatitis,diverticulitis,cholelithiasis,noninfectious gastroenteritis,upper and lower GI bleeding(LGIB),Clostridium difficile,viral gastroenteritis,inflammatory bowel disease,and acute cholangitis.RESULTS Disease-specific hospitalizations decreased for all included conditions except nonvariceal upper GI bleeding(NVUGIB),LGIB,and ulcerative colitis(UC)(ptrend<0.0001).Allcause inpatient mortality was higher in 2020 vs 2019,for acute pancreatitis(P=0.029),diverticulitis(P=0.04),NVUGIB(P=0.003),and Crohn’s disease(P=0.004).In 2020,hospitalization rates were lowest in April,November,and December.There was no significant corresponding increase in inpatient mortality except in UC(ptrend=0.048).Viral pneumonia and viral pneumonia complicated by respiratory failure increased(P<0.001)among GI hospitalizations.Endoscopy utilization within 24 h of admission was unchanged for GI emergencies except NVUGIB(P<0.001).CONCLUSION Our findings suggest that hospitalization rates for common GI conditions significantly declined in California during the COVID pandemic,particularly in April,November and December 2020.Allcause mortality was significantly higher among acute pancreatitis,diverticulitis,NVUGIB,and Crohn’s disease hospitalizations.Emergency endoscopy rates were mostly comparable between 2020 and 2019.展开更多
Background: Multiple hospitalizations for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are associated with considerable morbidity and mortality. Objectives: To identify predictive factors of m...Background: Multiple hospitalizations for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are associated with considerable morbidity and mortality. Objectives: To identify predictive factors of multiples hospitalizations for AECOPD. Methods: This is a retrospective single center study of consecutive patients with COPD hospitalized at the Department of Respiratory Medicine between January 1990 and December 2015. We calculated for each patient the mean number of hospitalizations for AECOPD/year (H/y). We distinguished 2 groups (G) of patients. G1: <2 H/y and G2: ≥2 H/y. Predictors of multiple admissions identified by univariate analysis were included in the multivariate analysis. Results: The study included 1167 COPD patients (mean age 67 ± 10 years, 97% males). Three hundred six (26%) COPD patients had a mean number of hospitalizations per year ≥ 2. Multivariate logistic regression analysis demonstrated that an mMRC ≥ 2 (Odd ratio [OR] 1.8, 95% confidence interval [CI] 1.08 - 2.99, p = 0.022), a low PaO2 (PaO2 OR 0.97, 95% CI 0.95 - 0.99, p = 0.007) and frequent exacerbations (OR 2.95, 95% CI 2.56 - 3.39, p < 0.001) are independent factors associated with multiple admissions for AECOPD. Conclusions: An mMRC ≥ 2, a low PaO2 and frequent exacerbations are independently associated with multiple hospitalizations for AECOPD. The identification of these high risk COPD patients will be helpful in the decision of intervention strategies.展开更多
Background:Climate change profoundly shapes the population health at the global scale.However,there was still insufficient and inconsistent evidence for the association between heat exposure and chronic kidney disease...Background:Climate change profoundly shapes the population health at the global scale.However,there was still insufficient and inconsistent evidence for the association between heat exposure and chronic kidney disease(CKD).Methods:In the present study,we studied the association of heat exposure with hospitalizations for cause-specific CKD using a national inpatient database in China during the study period of hot season from 2015 to 2018.Standard time-series regression models and random-effects Meta-analysis were developed to estimate the city-specific and national averaged associations at a 7 lag-day span,respectively.Results:A total of 768,129 hospitalizations for CKD was recorded during the study period.The results showed that higher temperature was associated with elevated risk of hospitalizations for CKD,especially in sub-tropical cities.With a 1℃ increase in daily mean temperature,the cumulative relative risks(RR)over lag 0-7 d were 1.008[95% confidence interval(CI)1.003-1.012]for nationwide.The attributable fraction of CKD hospitalizations due to high temperatures was 5.50%.Stronger associations were observed among younger patients and those with obstructive nephropathy.Our study also found that exposure to heatwaves was associated with added risk of hospitalizations for CKD compared to non-heatwave days(RR=1.116,95%CI 1.069-1.166)above the effect of daily mean temperature.Conclusions:Short-term heat exposure may increase the risk of hospitalization for CKD.Our findings provide insights into the health effects of climate change and suggest the necessity of guided protection strategies against the adverse effects of high temperatures.展开更多
Summary:Throughout the duration of the New Cooperative Medical Scheme(NCMS),it was found that an increasing number of rural patients were seeking out-of^county medical treatment,which posed a great burden on the NCMS ...Summary:Throughout the duration of the New Cooperative Medical Scheme(NCMS),it was found that an increasing number of rural patients were seeking out-of^county medical treatment,which posed a great burden on the NCMS fund.Our study was conducted to examine the prevalence of out-of^county hospitalizations and its related factors,and to provide a scientific basis for follow?up health insurance policies.A total of 215 counties in central and western China from 2008 to 2016 were selected.The total out-of-county hospitalization rate in nine years was 16.95%,which increased from 12.37%in 2008 to 19.21%in 2016 with an average annual growth rate of 5.66%.Its related expenses and compensations were shown to increase each year,with those in the central region being higher than those in the western region.Stepwise logistic regression reveals that the increase in out-of-county hospitalization rate was associated with region(XI),rural population(X2),per capita per year net income(X3),per capita gross domestic product(GDP)(X4),per capita funding amount of NCMS(X5),compensation ratio of out-of^county hospitalization cost(X6),per time average in-county(X7)and out-of-county hospitalization cost(X8).According to Bayesian network(BN),the marginal probability of high out-of^county hospitalization rate was as high as 81.7%.Out-of^county hospitalizations were directly related to X8,X3,X4 and X6.The probability of high out-of-county hospitalization obtained based on hospitalization expenses factors,economy factors,regional characteristics and NCMS policy factors was 95.7%,91.1%,93.0% and 88.8%,respectively.And how these factors affect out-of-county hospitalization and their interrelationships were found out.Our findings suggest that more attention should be paid to the influence mechanism of these factors on out-of-county hospitalizations,and the increase of hospitalizations outside the county should be reasonably supervised and controlled and our results will be used to help guide the formulation of proper intervention policies.展开更多
Objective: Influenza afflicts approximately 5% - 20% of the US population annually. Although prevalence statistics are useful, they are insufficient to understand completely influenza on a health care system. This stu...Objective: Influenza afflicts approximately 5% - 20% of the US population annually. Although prevalence statistics are useful, they are insufficient to understand completely influenza on a health care system. This study estimated Nebraska’s annual hospitalization and comorbidity rates due to influenza from 2007 to 2011. Methods: Influenza was defined according to ICD-9-CM primary codes beginning with 487 or 488 in hospital discharge records. The comorbidities of patients with influenza were defined according to ICD-9-CM secondary diagnosis codes. Results: The highest yearly age-adjusted hospitalization rates were 30.6 and 31.1 per 100,000 populations for 2008 and 2009, respectively. In 2008, the highest hospitalization rate was among those aged 65 yrs and older;in 2009, the highest rate was among those younger than 5 yrs. Asthma was the most frequent comorbidity overall and among those younger than 50 yrs. Conversely, hypertension and heart failure were the most frequent comorbidities among those aged 50 yrs and older. Conclusion: These findings provide a better understanding of the influenza burden and may contribute to developing more effective influenza prevention strategies.展开更多
BACKGROUND Inflammatory bowel disease(IBD)is associated with complications,frequent hospitalizations,surgery and death.The introduction of biologic drugs into the therapeutic arsenal in the last two decades,combined w...BACKGROUND Inflammatory bowel disease(IBD)is associated with complications,frequent hospitalizations,surgery and death.The introduction of biologic drugs into the therapeutic arsenal in the last two decades,combined with an expansion of immunosuppressant therapy,has changed IBD management and may have altered the profile of hospitalizations and in-hospital mortality(IHM)due to IBD.AIM To describe hospitalizations from 2008 to 2018 and to analyze IHM from 1998 to 2017 for IBD in Brazil.METHODS This observational,retrospective,ecological study used secondary data on hospitalizations for IBD in Brazil for 2008-2018 to describe hospitalizations and for 1998-2017 to analyze IHM.Hospitalization data were obtained from the Hospital Information System of the Brazilian Unified Health System and population data from demographic censuses.The following variables were analyzed:Number of deaths and hospitalizations,length of hospital stay,financial costs of hospitalization,sex,age,ethnicity and type of hospital admission.RESULTS There was a reduction in the number of IBD hospitalizations,from 6975 admissions in 1998 to 4113 in 2017(trend:y=-0.1682x+342.8;R^(2)=0.8197;P<0.0001).The hospitalization rate also decreased,from 3.60/100000 in 2000 to 2.17 in 2010.IHM rates varied during the 20-year period,between 2.06 in 2017 and 3.64 in 2007,and did not follow a linear trend(y=-0.0005049x+2.617;R^(2)=0,00006;P=0.9741).IHM rates also varied between regions,increasing in all but the southeast,which showed a decreasing trend(y=-0.1122x+4.427;R^(2)=0,728;P<0.0001).The Southeast region accounted for 44.29%of all hospitalizations.The Northeast region had the highest IHM rate(2.86 deaths/100 admissions),with an increasing trend(y=0.1105x+1.110;R^(2)=0.6265;P<0.0001),but the lowest hospitalization rate(1.15).The Midwest and South regions had the highest hospitalization rates(3.27 and 3.17,respectively).A higher IHM rate was observed for nonelective admissions(2.88),which accounted for 81%of IBD hospitalizations.The total cost of IBD hospitalizations in 2017 exhibited an increase of 37.5%compared to 2008.CONCLUSION There has been a notable reduction in the number of hospitalizations for IBD in Brazil over 20 years.IHM rates varied and did not follow a linear trend.展开更多
BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),formally known as nonalcoholic fatty liver disease,is the most common chronic liver disease in the United States.Patients with MASLD have been...BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),formally known as nonalcoholic fatty liver disease,is the most common chronic liver disease in the United States.Patients with MASLD have been reported to be at a higher risk of developing severe coronavirus disease 2019(COVID-19)and death.However,most studies are single-center studies,and nationwide data in the AIM To study the influence of MASLD on COVID-19 hospitalizations during the initial phase of the pandemic.METHODS We retrospectively analyzed the 2020 National Inpatient Sample(NIS)database to identify primary COVID-19 hospitalizations based on an underlying diagnosis of MASLD.A matched comparison cohort of COVID-19 hospit-alizations without MASLD was identified from NIS after 1:N propensity score matching based on gender,race,and comorbidities,including hypertension,heart failure,diabetes,and cirrhosis.The primary outcomes included inpatient mortality,length of stay,and hospitalization costs.Secondary outcomes included the prevalence of systemic complications.RESULTS A total of 2210 hospitalizations with MASLD were matched to 2210 hospitalizations without MASLD,with a good comorbidity balance.Overall,there was a higher prevalence of severe disease with more intensive care unit admissions(9.5%vs 7.2%,P=0.007),mechanical ventilation(7.2%vs 5.7%,P=0.03),and septic shock(5.2%vs 2.7%,P<0.001)in the MASLD cohort than in the non-MASLD cohort.However,there was no difference in mortality(8.6%vs 10%,P=0.49),length of stay(5 d vs 5 d,P=0.25),and hospitalization costs(42081.5$vs 38614$,P=0.15)between the MASLD and non-MASLD cohorts.CONCLUSION The presence of MAFLD with or without liver cirrhosis was not associated with increased mortality in COVID-19 hospitalizations;however,there was an increased incidence of severe COVID-19 infection.This data(2020)predates the availability of COVID-19 vaccines,and many MASLD patients have since been vaccinated.It will be interesting to see if these trends are present in the subsequent years of the pandemic.展开更多
Background:The public health response to COVID-19 has shifted to reducing deaths and hospitalizations to prevent overwhelming health systems.The amount of SARS-CoV-2 RNA fragments in wastewater are known to correlate ...Background:The public health response to COVID-19 has shifted to reducing deaths and hospitalizations to prevent overwhelming health systems.The amount of SARS-CoV-2 RNA fragments in wastewater are known to correlate with clinical data including cases and hospital admissions for COVID-19.We developed and tested a predictive model for incident COVID-19 hospital admissions in New York State using wastewater data.Methods:Using county-level COVID-19 hospital admissions and wastewater surveillance covering 13.8 million people across 56 counties,we fit a generalized linear mixed model predicting new hospital admissions from wastewater concentrations of SARS-CoV-2 RNA from April 29,2020 to June 30,2022.We included covariates such as COVID-19 vaccine coverage in the county,comorbidities,demographic variables,and holiday gatherings.Findings:Wastewater concentrations of SARS-CoV-2 RNA correlated with new hospital admissions per 100,000 up to ten days prior to admission.Models that included wastewater had higher predictive power than models that included clinical cases only,increasing the accuracy of the model by 15%.Predicted hospital admissions correlated highly with observed admissions(r¼0.77)with an average difference of 0.013 hospitalizations per 100,000(95%CI¼[0.002,0.025])Interpretation:Using wastewater to predict future hospital admissions from COVID-19 is accurate and effective with superior results to using case data alone.The lead time of ten days could alert the public to take precautions and improve resource allocation for seasonal surges.展开更多
This study examined a case of ventilator-associated pneumonia caused by Ralstonia mannitolilytica in a neonatal department in order to determine the source of infection and mode of transmission.Symptoms of infection b...This study examined a case of ventilator-associated pneumonia caused by Ralstonia mannitolilytica in a neonatal department in order to determine the source of infection and mode of transmission.Symptoms of infection began to appear on day 16 of admission,and both sputum and catheter tip cultures revealed R.mannitolilytica.The infection control department of the hospital later sampled and identified R.mannitolilytica in the ventilator tube that was used by the patient with the exact gene sequence as the infecting strain.These findings indicate that ventilator tubing is a significant contamination source of this pathogen,and hospitals need to enhance their disinfection methods of ventilator-related devices.展开更多
BACKGROUND Preoperative anxiety is a significant concern for patients,as it affects surgical outcomes,satisfaction,and pain perception.Although both anxiety and pain are common in surgical settings,their relationship ...BACKGROUND Preoperative anxiety is a significant concern for patients,as it affects surgical outcomes,satisfaction,and pain perception.Although both anxiety and pain are common in surgical settings,their relationship with personality traits has not been previously investigated in the Lebanese population.AIM To examine the prevalence of preoperative anxiety,pain perception,and personality traits among Lebanese surgical patients,and to assess the associations between these factors.METHODS A descriptive cross-sectional study was conducted between April 2024 and January 2025 across Lebanese hospitals.A total of 392 adult patients were recruited through convenience sampling.Data were collected using a questionnaire that included sociodemographic,clinical,and surgical variables,the Amsterdam Preoperative Anxiety and Information Scale for anxiety,the Visual Analog Scale and Numerical Pain Rating Scale for preoperative pain,and the Ten-Item Personality Inventory for personality traits.Ethical approval was obtained from the Institutional Review Boards of Makassed General Hospital and Hammoud University Medical Center.RESULTS Overall,25%of participants experienced preoperative anxiety,and 34.5%reported moderate pain.Personality assessment showed that the majority of participants had moderate extraversion(84.1%),moderate emotional stability(65.1%),high conscientiousness(61%),high agreeableness(54.1%),and moderate openness(49.2%).High conscientiousness was significantly associated with higher pain perception(P<0.05),while high emotional stability was associated with lower levels of anxiety(P<0.05).No significant association was found between preoperative anxiety and pain(P>0.05).CONCLUSION This study challenges the assumption that preoperative anxiety and pain are directly correlated and highlights the role of personality traits in shaping patient experience.These findings support the potential value of integrating psychological profiling into preoperative care and lay the groundwork for developing personalized interventions to improve patient-centered surgical outcomes.展开更多
The concept of Damage Control Surgery(DCS)emphasizes prioritizing hemorrhage control,preventing hypothermia,correcting coagulopathy,and acidosis in trauma treatment.The application of the DCS concept in trauma treatme...The concept of Damage Control Surgery(DCS)emphasizes prioritizing hemorrhage control,preventing hypothermia,correcting coagulopathy,and acidosis in trauma treatment.The application of the DCS concept in trauma treatment at grassroots hospitals faces numerous challenges such as limited resources,high technical difficulty,and insufficient multidisciplinary collaboration.Therefore,DCS strategies need to be adapted to simplified processes to create conditions for subsequent treatment.This paper retrieves relevant literature to discuss the proposal,promotion,and application of the DCS concept,aiming to provide evidence-based basis for optimizing trauma treatment outcomes at grassroots hospitals.展开更多
Objective To determine whether frailty is a risk factor for hospitalization and mortality in older adults enrolled in the "Chronic Heart Failure Program" at a hospital in Lima, Peru, between 2018–2021.Metho...Objective To determine whether frailty is a risk factor for hospitalization and mortality in older adults enrolled in the "Chronic Heart Failure Program" at a hospital in Lima, Peru, between 2018–2021.Methods This was an ambispective cohort study. A total of 85 older adults participating in the Chronic Heart Failure Program at Guillermo Almenara National Hospital were included. Each had an initial frailty assessment, forming two cohorts: frail and non-frail older adults. Medical records were reviewed, and patients were followed for one year to track events of interest(hospitalization and mortality). Overall survival and risk factors for hospitalization and death were determined.Results During follow-up, 15.3% of the older adults died, and frailty was identified in 58.8% of the patients. Overall survival using the Kaplan-Meier method was 96.5% at 3 months after entering the Chronic Heart Failure Program;92.9% at 6 months;and85.9% at one year. Multivariate analysis using Poisson regression found that frailty was not a risk factor for hospitalization(a RR =0.92;95% CI: 0.42–2.03). Survival analysis using the Cox proportional hazards model showed that frailty was also not a risk factor for mortality after one year of follow-up(a HR = 1.32;95% CI: 0.27–6.53).Conclusions Our research does not confirm frailty as a risk factor for hospitalization or mortality in older adults enrolled in the“Chronic Heart Failure Program” after one year of follow-up.展开更多
Profile of Prof.Ning-Li Wang Academician of the Chinese Academy of Engineering(CAE)Member of the International Academy of Ophthalmology Director,Ophthalmology Center,Beijing Tongren Hospital Dean,School of Ophthalmolo...Profile of Prof.Ning-Li Wang Academician of the Chinese Academy of Engineering(CAE)Member of the International Academy of Ophthalmology Director,Ophthalmology Center,Beijing Tongren Hospital Dean,School of Ophthalmology,Capital Medical University Director,National Engineering Research Center for Ophthalmic Diagnosis and Treatment National Distinguished Physician Member,Academic Advisory Committee.展开更多
Few multicity studies have examined the acute effects of nitrogen dioxide(NO_(2))on respiratory disease(RD),especially its specific causes.This study aimed to investigate the associations between short-term exposure t...Few multicity studies have examined the acute effects of nitrogen dioxide(NO_(2))on respiratory disease(RD),especially its specific causes.This study aimed to investigate the associations between short-term exposure to NO_(2)and hospitalization of full-spectrum RDs in China.Hospitalization of 10 major categories and 40 cause-specific RDs were obtained from 20 provinces over the study period of 2013−2020.A time-stratified case-crossover study was conducted at the individual level to explore the associations between NO_(2)and RDs.NO_(2)was significantly associated with increased hospitalization of eight major RDs(acute upper respiratory infections,influenza and pneumonia,acute lower respiratory infections,upper respiratory tract diseases,chronic lower respiratory diseases,respiratory interstitium diseases,pleura diseases,and other respiratory diseases)and 18 specific causes of RDs,with the largest associations observed on lag 0−1 day.The effect estimates ranged from 0.75 to 4.09%per 10μg/m^(3)of NO_(2)exposure.The associations remained robust after controlling for copollutants.The concentration−response curves were mostly positive and linear.This nationwide study provides comprehensive information on the acute effects of NO_(2)on respiratory morbidity across the full spectrum,highlighting the need for caution with regard to this important traffic-related air pollutant in current pollution control programs.展开更多
Few national studies have systemically examined the effects of criteria air pollutants on cardiovascular morbidity.This study aimed to investigate the associations between all criteria air pollutants and hospitalizati...Few national studies have systemically examined the effects of criteria air pollutants on cardiovascular morbidity.This study aimed to investigate the associations between all criteria air pollutants and hospitalization of causespecific cardiovascular diseases(CVD)in China.We obtained data on CVD hospitalization events of four major categories and 12 specific diseases from 153 hospitals distributed in 20 provincial-level regions from 2013 to 2020.We adopted a time-stratified case-crossover study design using individual cases to capture the effect of short-term exposure to six criteria air pollutants on CVD hospitalizations,using conditional logistic regression models.More than 1.1 million CVD hospitalization events were included.The lag pattern exploration demonstrated the largest effect for six air pollutants on lag 0–1 day.PM_(2.5),PM_(10),NO_(2),and CO were significantly associated with increased hospitalization from ischemic heart diseases,cerebrovascular diseases,other heart diseases,and five specific causes of CVD.The effect estimates of NO_(2)were the most robust when adjusting for copollutants.The concentration-response curves were positive and linear for most pollutant–endpoint pairs(except for O_(3)),and these positive associations remained even below the 24-h levels recommended by WHO Air Quality Guidelines and China Air Quality Standards.This nationwide case-crossover study in China demonstrated that short-term exposure to multiple ambient air pollutants may significantly increase the risk of cause-specific CVD hospitalizations even under the most stringent air quality regulations,striking an alert for potential CVD patients against these environmental risk factors.展开更多
文摘BACKGROUND With an increase in the elderly population,the frequency of hospitalizations in recent years has also risen at a rapid pace.This,in turn,has resulted in poor outcomes and costly treatments.Hospitalization rates increase in elderly patients due to a decline in glomerular filtration rate(GFR).AIM To investigate the connection between GFR and comorbidity and reasons for hospitalization in elderly patients.METHODS We analyzed patients aged 75 years and over who were admitted to the internal medicine clinic of a tertiary hospital in Eskisehir.At admission,we calculated GFR values using the Modification of Diet in Renal Disease study formula and classified them into six categories:G1,G2,G3a,G3b,G4,and G5.We analyzed associations with hospitalization diagnoses and comorbidity factors.RESULTS The average age of the patients was 80.8 years(±4.5 years).GFR was 57.287±29.5 mL/kg/1.73 m2 in women and 61.3±31.5 mL/kg/1.73 m2 in men(P=0.106).Most patients were admitted to the hospital at G2 stage(32.8%).The main reasons for hospitalization were anemia(34.4%and 28.6%)and malnutrition(20.9%and 20.8%)in women and men,respectively(P=0.078).The most frequent comor-bidity leading to hospitalization was arterial hypertension(n=168,28%),fo-llowed by diabetes(n=166,27.7%)(P=0.001).CONCLUSION When evaluating geriatric patients,low GFR alone does not provide sufficient information.Patients’comorbid factors should also be taken into account.There is no association between low GFR during hospitalization and hospitalization-Hamarat H.Aging and GFR related diagnoses.Knowing the GFR value before hospitalization will be more informative in such studies.
基金supported by the National Natural Science Foundation of China(82422065)the National Key Research and Development Program of China(2022YFC2704604)+1 种基金the Shanghai 3-year Public Health Action Plan(GWVI-11.2-YQ32,GWVI-11.1-39,GWVI-11.2-YQ31)the Shanghai B&R Joint Laboratory Project(22230750300).
文摘Few studies have explored the acute effects of fine particulate matter(PM_(2.5))constituents on respiratory diseases(RDs),particularly across a broad spectrum of RD subtypes.We analyzed the associations between PM_(2.5) and its five major constituents[organic matter(OM),black carbon(BC),sulfate(SO_(4)^(2−)),nitrate(NO_(3)^(−)),and ammonium(NH_(4)^(+))]and RDs(10 major categories and 35 specific)based on the hospitalization records from 153 hospitals in 20 provincial distractions from 2013 to 2020.We found that short-term exposure(lag 0−1)to PM_(2.5) constituents per interquartile range increase was associated with higher hospitalization risks for acute upper respiratory infections,influenza and pneumonia,other acute lower respiratory infections,chronic lower respiratory diseases,other diseases of the pleura,and other diseases of the respiratory system;the effect estimates were 2.45−2.99%,2.02−2.71%,2.98−3.62%,3.06−3.65%,3.22−4.52%,and 2.23−3.66%,respectively.Among 35 specific RDs,12 were significantly affected by PM_(2.5) and its constituents.Individuals aged>60 years were sensitive to PM_(2.5) constituent exposure.Our individual-level nationwide study provided a more comprehensive perspective on the associations between PM_(2.5) constituents and various major and specific RDs,highlighting the necessity of prioritizing targeted control strategies for key constituents to effectively mitigate the burden of RDs in China.
文摘BACKGROUND Hepatitis A virus(HAV)infection remains the most common cause of acute viral hepatitis globally.In the United States,recent outbreaks have been attributed primarily to person-to-person transmission,with vulnerable populations such as people who use illicit drugs,those experiencing homelessness,and men who have sex with men disproportionately affected.AIM To assess the trends in HAV hospitalizations over the past decade and evaluate the impact of substance use on these hospitalizations.METHODS We conducted a retrospective study using the National Inpatient Sample database from 2011 to 2020.Adults(≥18 years)hospitalized with a primary diagnosis of HAV infection were included.We identified active substance use as a secondary diagnosis.Statistical analysis involved descriptive statistics,trend analysis,and propensity score matching to compare HAV hospitalizations with and without substance use.Outcomes included hospitalization trends,complications,length of stay(LOS),and mortality.RESULTS From 2011 to 2020,there were 56972 hospitalizations for HAV infections.Hospitalizations increased from 3917 in 2011 to 8290 in 2020,peaking at 9800 in 2018.Caucasian males(55%)were the most affected,with a mean age of 49 years.The prevalence of active substance use among HAV hospitalizations was 27%,with these patients being younger(mean age:39 years)and predominantly male(63.1%).HAV hospitalizations associated with substance use increased significantly,rising from 235 cases in 2011 to 3200 in 2020(P<0.001).Compared to HAV hospitalizations without substance use,those with substance use had higher rates of co-infections(hepatitis C virus 45%vs 11%,hepatitis B virus 11%vs 6%)and complications,including sepsis(1.9%vs 1%)and infective endocarditis(1.4%vs 0.15%,P<0.001).Hospitalizations with substance use also had longer LOS(4.34 days vs 3.97 days,P<0.05),but mortality rates were comparable.Predictors of mortality in HAV-substance use hospitalizations included acute liver failure,sepsis,and acute respiratory failure.CONCLUSION HAV hospitalizations in the United States have significantly increased over the past decade,with the rise driven by cases involving substance use.These patients face a higher burden of complications and healthcare utilization.Tailored public health strategies,including targeted vaccination and outreach programs for at-risk populations,are essential to reduce the morbidity,mortality,and economic burden associated with HAV.
基金supported by the Japan Science and Technology Agency SPRING Program(JST SPRING),Grant Number JPMJSP2108,which was partially funded by the Japan Society for the Promotion of Science(JSPS)Grant Numbers 20H03949,23K22919,23K28289the Environmental Restoration and Conservation Agency of Japan,and the Environment Research and Technology Development Fund(S-24).
文摘Objective To assess the short-term lag effects of climate and air pollution on hospital admissions for cardiovascular and respiratory diseases,and to develop deep learning-based models for daily hospital admission prediction.Methods A multi-city study was conducted in Tokyo’s 23 wards,Osaka City,and Nagoya City.Random forest models were employed to assess the synergistic short-term lag effects(lag0,lag3,and lag7)of climate and air pollutants on hospitalization for five cardiovascular diseases(CVDs)and two respiratory diseases(RDs).Furthermore,we developed hybrid deep learning models that integrated an autoencoder(AE)with a Long Short-Term Memory network(AE+LSTM)to predict daily hospital admissions.Results On the day of exposure(lag0),air pollutants,particularly nitrogen oxides(NOx),exhibited the strongest influence on hospital admissions for CVD and RD,with pronounced effects observed for hypertension(I10–I15),ischemic heart disease(I20),arterial and capillary diseases(I70–I79),and lower respiratory infections(J20–J22 and J40–J47).At longer lags(lag3 and lag7),temperature and precipitation were more influential predictors.The AE+LSTM model outperformed the standard LSTM,improving the prediction accuracy by 32.4%for RD in Osaka and 20.94%for CVD in Nagoya.Conclusion Our findings reveal the dynamic,time-varying health risks associated with environmental exposure and demonstrate the utility of deep learnings in predicting short-term hospital admissions.This framework can inform early warning systems,enhance healthcare resource allocation,and support climate-adaptive public health strategies.
文摘BACKGROUND Chronic liver disease is associated with various neuropsychiatric conditions.There are currently no large studies assessing and comparing the prevalence of psy-chiatric illnesses based on patient profiles and the etiology of cirrhosis.AIM To examine the trends of hospitalizations among psychiatric conditions in cirrhosis.METHODS We used the National Inpatient Sample database 2016-2019 for the primary diagnosis of liver cirrhosis.The outcomes included the prevalence,trends,and associations of psychiatric diagnoses in these hospitalizations.Chi-square for categorical variables and the Wilcoxon rank test for continuous variables were utilized.RESULTS The prevalence of generalized anxiety disorder(GAD)in liver cirrhosis hospitalizations increased from 0.17%in 2009 to 0.92%in 2019(P<0.001).The prevalence of depression increased from 7%in 2009 to 12%in 2019(P<0.001).Attention deficit hyperactivity disorder(ADHD)prevalence increased from 0.06%to 0.24%.The prevalence of schizophrenia increased from 0.59%to 0.87%(P<0.001).Schizoaffective disorder prevalence increased from 0.10%to 0.35%(P<0.001).Posttraumatic stress disorder(PTSD)prevalence displayed increasing trends from 0.36%in 2009 to 0.93%in 2019(P<0.001).The prevalence of suicidal ideation increased from 0.23%to 0.56%in 2019.Cirrhosis related to alcoholic liver disease[adjusted odds ratios(aOR)1.18,95%CI 1.08-1.29,P<0.001]and non-alcoholic fatty liver disease(NAFLD)(aOR 1.14,95%CI 1.01-1.28,P=0.025)was associated with depression more than other causes.Alcohol-and NAFLD-associated cirrhosis had a stronger link to psychiatric disorders.Females had a higher association with GAD(aOR 2.56,95%CI 2.14-3.06,P<0.001),depression(aOR 1.78,95%CI 1.71-1.84,P<0.001),bipolar disorder(aOR 1.64,95%CI 1.52-1.77,P<0.001]and chronic fatigue(aOR 2.31,95%CI 1.31-4.07,P<0.001)when compared to males.Blacks,Hispanics,and Asian/Native Americans had a significantly lower association with GAD,depression,bipolar disorder,PTSD,and ADHD when compared to the white race.CONCLUSION The prevalence of psychiatric comorbidities in liver cirrhosis hospitalizations has increased over the last decade.Females had a higher association with psychiatric disorders compared to males.Blacks,Hispanics,and Asian/Native Americans had lower associations with psychiatric comorbidities compared to the white race.
文摘BACKGROUND The impact of the coronavirus on hospitalizations for gastrointestinal(GI)disease,particularly at a population level is understudied.AIM To investigate trends in hospitalizations,inpatient endoscopy resource utilization,and outcomes during the first year of the coronavirus pandemic and subsequent lockdowns.METHODS Using the California State Inpatient Database for 2018-2020,we explored year-toyear and 2020 month-to-month trends in hospitalizations,length of stay,and inpatient mortality(all-cause&viral pneumonia-specific)for common inpatient GI diagnoses including acute pancreatitis,diverticulitis,cholelithiasis,noninfectious gastroenteritis,upper and lower GI bleeding(LGIB),Clostridium difficile,viral gastroenteritis,inflammatory bowel disease,and acute cholangitis.RESULTS Disease-specific hospitalizations decreased for all included conditions except nonvariceal upper GI bleeding(NVUGIB),LGIB,and ulcerative colitis(UC)(ptrend<0.0001).Allcause inpatient mortality was higher in 2020 vs 2019,for acute pancreatitis(P=0.029),diverticulitis(P=0.04),NVUGIB(P=0.003),and Crohn’s disease(P=0.004).In 2020,hospitalization rates were lowest in April,November,and December.There was no significant corresponding increase in inpatient mortality except in UC(ptrend=0.048).Viral pneumonia and viral pneumonia complicated by respiratory failure increased(P<0.001)among GI hospitalizations.Endoscopy utilization within 24 h of admission was unchanged for GI emergencies except NVUGIB(P<0.001).CONCLUSION Our findings suggest that hospitalization rates for common GI conditions significantly declined in California during the COVID pandemic,particularly in April,November and December 2020.Allcause mortality was significantly higher among acute pancreatitis,diverticulitis,NVUGIB,and Crohn’s disease hospitalizations.Emergency endoscopy rates were mostly comparable between 2020 and 2019.
文摘Background: Multiple hospitalizations for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are associated with considerable morbidity and mortality. Objectives: To identify predictive factors of multiples hospitalizations for AECOPD. Methods: This is a retrospective single center study of consecutive patients with COPD hospitalized at the Department of Respiratory Medicine between January 1990 and December 2015. We calculated for each patient the mean number of hospitalizations for AECOPD/year (H/y). We distinguished 2 groups (G) of patients. G1: <2 H/y and G2: ≥2 H/y. Predictors of multiple admissions identified by univariate analysis were included in the multivariate analysis. Results: The study included 1167 COPD patients (mean age 67 ± 10 years, 97% males). Three hundred six (26%) COPD patients had a mean number of hospitalizations per year ≥ 2. Multivariate logistic regression analysis demonstrated that an mMRC ≥ 2 (Odd ratio [OR] 1.8, 95% confidence interval [CI] 1.08 - 2.99, p = 0.022), a low PaO2 (PaO2 OR 0.97, 95% CI 0.95 - 0.99, p = 0.007) and frequent exacerbations (OR 2.95, 95% CI 2.56 - 3.39, p < 0.001) are independent factors associated with multiple admissions for AECOPD. Conclusions: An mMRC ≥ 2, a low PaO2 and frequent exacerbations are independently associated with multiple hospitalizations for AECOPD. The identification of these high risk COPD patients will be helpful in the decision of intervention strategies.
基金This study was supported by the National Natural Science Foundation of China(82003529,72125009)the National Key Research and Development Program of the Ministry of Science and Technology of China(2019YFC2005000)+4 种基金the Chinese Scientific and Technical Innovation Project 2030(2018AAA0102100)the National High Level Hospital Clinical Research Funding(“Star of Outlook”Scientific Research Project of Peking University First Hospital,2022XW06)the CAMS Innovation Fund for Medical Sciences(2019-I2M-5-046)the Young Elite Scientists Sponsorship Program by CAST(2022QNRC001)the PKU-Baidu Fund(2020BD004,2020BD005 and 2020BD032).
文摘Background:Climate change profoundly shapes the population health at the global scale.However,there was still insufficient and inconsistent evidence for the association between heat exposure and chronic kidney disease(CKD).Methods:In the present study,we studied the association of heat exposure with hospitalizations for cause-specific CKD using a national inpatient database in China during the study period of hot season from 2015 to 2018.Standard time-series regression models and random-effects Meta-analysis were developed to estimate the city-specific and national averaged associations at a 7 lag-day span,respectively.Results:A total of 768,129 hospitalizations for CKD was recorded during the study period.The results showed that higher temperature was associated with elevated risk of hospitalizations for CKD,especially in sub-tropical cities.With a 1℃ increase in daily mean temperature,the cumulative relative risks(RR)over lag 0-7 d were 1.008[95% confidence interval(CI)1.003-1.012]for nationwide.The attributable fraction of CKD hospitalizations due to high temperatures was 5.50%.Stronger associations were observed among younger patients and those with obstructive nephropathy.Our study also found that exposure to heatwaves was associated with added risk of hospitalizations for CKD compared to non-heatwave days(RR=1.116,95%CI 1.069-1.166)above the effect of daily mean temperature.Conclusions:Short-term heat exposure may increase the risk of hospitalization for CKD.Our findings provide insights into the health effects of climate change and suggest the necessity of guided protection strategies against the adverse effects of high temperatures.
基金This work was supported by the National Natural Science Foundation of China(No.71573192 and No.81573262)the Fundamental Research Funds for the Central Universities,HUST(No.2016YXZD042).
文摘Summary:Throughout the duration of the New Cooperative Medical Scheme(NCMS),it was found that an increasing number of rural patients were seeking out-of^county medical treatment,which posed a great burden on the NCMS fund.Our study was conducted to examine the prevalence of out-of^county hospitalizations and its related factors,and to provide a scientific basis for follow?up health insurance policies.A total of 215 counties in central and western China from 2008 to 2016 were selected.The total out-of-county hospitalization rate in nine years was 16.95%,which increased from 12.37%in 2008 to 19.21%in 2016 with an average annual growth rate of 5.66%.Its related expenses and compensations were shown to increase each year,with those in the central region being higher than those in the western region.Stepwise logistic regression reveals that the increase in out-of-county hospitalization rate was associated with region(XI),rural population(X2),per capita per year net income(X3),per capita gross domestic product(GDP)(X4),per capita funding amount of NCMS(X5),compensation ratio of out-of^county hospitalization cost(X6),per time average in-county(X7)and out-of-county hospitalization cost(X8).According to Bayesian network(BN),the marginal probability of high out-of^county hospitalization rate was as high as 81.7%.Out-of^county hospitalizations were directly related to X8,X3,X4 and X6.The probability of high out-of-county hospitalization obtained based on hospitalization expenses factors,economy factors,regional characteristics and NCMS policy factors was 95.7%,91.1%,93.0% and 88.8%,respectively.And how these factors affect out-of-county hospitalization and their interrelationships were found out.Our findings suggest that more attention should be paid to the influence mechanism of these factors on out-of-county hospitalizations,and the increase of hospitalizations outside the county should be reasonably supervised and controlled and our results will be used to help guide the formulation of proper intervention policies.
文摘Objective: Influenza afflicts approximately 5% - 20% of the US population annually. Although prevalence statistics are useful, they are insufficient to understand completely influenza on a health care system. This study estimated Nebraska’s annual hospitalization and comorbidity rates due to influenza from 2007 to 2011. Methods: Influenza was defined according to ICD-9-CM primary codes beginning with 487 or 488 in hospital discharge records. The comorbidities of patients with influenza were defined according to ICD-9-CM secondary diagnosis codes. Results: The highest yearly age-adjusted hospitalization rates were 30.6 and 31.1 per 100,000 populations for 2008 and 2009, respectively. In 2008, the highest hospitalization rate was among those aged 65 yrs and older;in 2009, the highest rate was among those younger than 5 yrs. Asthma was the most frequent comorbidity overall and among those younger than 50 yrs. Conversely, hypertension and heart failure were the most frequent comorbidities among those aged 50 yrs and older. Conclusion: These findings provide a better understanding of the influenza burden and may contribute to developing more effective influenza prevention strategies.
文摘BACKGROUND Inflammatory bowel disease(IBD)is associated with complications,frequent hospitalizations,surgery and death.The introduction of biologic drugs into the therapeutic arsenal in the last two decades,combined with an expansion of immunosuppressant therapy,has changed IBD management and may have altered the profile of hospitalizations and in-hospital mortality(IHM)due to IBD.AIM To describe hospitalizations from 2008 to 2018 and to analyze IHM from 1998 to 2017 for IBD in Brazil.METHODS This observational,retrospective,ecological study used secondary data on hospitalizations for IBD in Brazil for 2008-2018 to describe hospitalizations and for 1998-2017 to analyze IHM.Hospitalization data were obtained from the Hospital Information System of the Brazilian Unified Health System and population data from demographic censuses.The following variables were analyzed:Number of deaths and hospitalizations,length of hospital stay,financial costs of hospitalization,sex,age,ethnicity and type of hospital admission.RESULTS There was a reduction in the number of IBD hospitalizations,from 6975 admissions in 1998 to 4113 in 2017(trend:y=-0.1682x+342.8;R^(2)=0.8197;P<0.0001).The hospitalization rate also decreased,from 3.60/100000 in 2000 to 2.17 in 2010.IHM rates varied during the 20-year period,between 2.06 in 2017 and 3.64 in 2007,and did not follow a linear trend(y=-0.0005049x+2.617;R^(2)=0,00006;P=0.9741).IHM rates also varied between regions,increasing in all but the southeast,which showed a decreasing trend(y=-0.1122x+4.427;R^(2)=0,728;P<0.0001).The Southeast region accounted for 44.29%of all hospitalizations.The Northeast region had the highest IHM rate(2.86 deaths/100 admissions),with an increasing trend(y=0.1105x+1.110;R^(2)=0.6265;P<0.0001),but the lowest hospitalization rate(1.15).The Midwest and South regions had the highest hospitalization rates(3.27 and 3.17,respectively).A higher IHM rate was observed for nonelective admissions(2.88),which accounted for 81%of IBD hospitalizations.The total cost of IBD hospitalizations in 2017 exhibited an increase of 37.5%compared to 2008.CONCLUSION There has been a notable reduction in the number of hospitalizations for IBD in Brazil over 20 years.IHM rates varied and did not follow a linear trend.
文摘BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),formally known as nonalcoholic fatty liver disease,is the most common chronic liver disease in the United States.Patients with MASLD have been reported to be at a higher risk of developing severe coronavirus disease 2019(COVID-19)and death.However,most studies are single-center studies,and nationwide data in the AIM To study the influence of MASLD on COVID-19 hospitalizations during the initial phase of the pandemic.METHODS We retrospectively analyzed the 2020 National Inpatient Sample(NIS)database to identify primary COVID-19 hospitalizations based on an underlying diagnosis of MASLD.A matched comparison cohort of COVID-19 hospit-alizations without MASLD was identified from NIS after 1:N propensity score matching based on gender,race,and comorbidities,including hypertension,heart failure,diabetes,and cirrhosis.The primary outcomes included inpatient mortality,length of stay,and hospitalization costs.Secondary outcomes included the prevalence of systemic complications.RESULTS A total of 2210 hospitalizations with MASLD were matched to 2210 hospitalizations without MASLD,with a good comorbidity balance.Overall,there was a higher prevalence of severe disease with more intensive care unit admissions(9.5%vs 7.2%,P=0.007),mechanical ventilation(7.2%vs 5.7%,P=0.03),and septic shock(5.2%vs 2.7%,P<0.001)in the MASLD cohort than in the non-MASLD cohort.However,there was no difference in mortality(8.6%vs 10%,P=0.49),length of stay(5 d vs 5 d,P=0.25),and hospitalization costs(42081.5$vs 38614$,P=0.15)between the MASLD and non-MASLD cohorts.CONCLUSION The presence of MAFLD with or without liver cirrhosis was not associated with increased mortality in COVID-19 hospitalizations;however,there was an increased incidence of severe COVID-19 infection.This data(2020)predates the availability of COVID-19 vaccines,and many MASLD patients have since been vaccinated.It will be interesting to see if these trends are present in the subsequent years of the pandemic.
基金supported by the CDC’s ELC Program,NYS Unique Federal Award Number NU50CK000516 (NYS Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases).
文摘Background:The public health response to COVID-19 has shifted to reducing deaths and hospitalizations to prevent overwhelming health systems.The amount of SARS-CoV-2 RNA fragments in wastewater are known to correlate with clinical data including cases and hospital admissions for COVID-19.We developed and tested a predictive model for incident COVID-19 hospital admissions in New York State using wastewater data.Methods:Using county-level COVID-19 hospital admissions and wastewater surveillance covering 13.8 million people across 56 counties,we fit a generalized linear mixed model predicting new hospital admissions from wastewater concentrations of SARS-CoV-2 RNA from April 29,2020 to June 30,2022.We included covariates such as COVID-19 vaccine coverage in the county,comorbidities,demographic variables,and holiday gatherings.Findings:Wastewater concentrations of SARS-CoV-2 RNA correlated with new hospital admissions per 100,000 up to ten days prior to admission.Models that included wastewater had higher predictive power than models that included clinical cases only,increasing the accuracy of the model by 15%.Predicted hospital admissions correlated highly with observed admissions(r¼0.77)with an average difference of 0.013 hospitalizations per 100,000(95%CI¼[0.002,0.025])Interpretation:Using wastewater to predict future hospital admissions from COVID-19 is accurate and effective with superior results to using case data alone.The lead time of ten days could alert the public to take precautions and improve resource allocation for seasonal surges.
文摘This study examined a case of ventilator-associated pneumonia caused by Ralstonia mannitolilytica in a neonatal department in order to determine the source of infection and mode of transmission.Symptoms of infection began to appear on day 16 of admission,and both sputum and catheter tip cultures revealed R.mannitolilytica.The infection control department of the hospital later sampled and identified R.mannitolilytica in the ventilator tube that was used by the patient with the exact gene sequence as the infecting strain.These findings indicate that ventilator tubing is a significant contamination source of this pathogen,and hospitals need to enhance their disinfection methods of ventilator-related devices.
文摘BACKGROUND Preoperative anxiety is a significant concern for patients,as it affects surgical outcomes,satisfaction,and pain perception.Although both anxiety and pain are common in surgical settings,their relationship with personality traits has not been previously investigated in the Lebanese population.AIM To examine the prevalence of preoperative anxiety,pain perception,and personality traits among Lebanese surgical patients,and to assess the associations between these factors.METHODS A descriptive cross-sectional study was conducted between April 2024 and January 2025 across Lebanese hospitals.A total of 392 adult patients were recruited through convenience sampling.Data were collected using a questionnaire that included sociodemographic,clinical,and surgical variables,the Amsterdam Preoperative Anxiety and Information Scale for anxiety,the Visual Analog Scale and Numerical Pain Rating Scale for preoperative pain,and the Ten-Item Personality Inventory for personality traits.Ethical approval was obtained from the Institutional Review Boards of Makassed General Hospital and Hammoud University Medical Center.RESULTS Overall,25%of participants experienced preoperative anxiety,and 34.5%reported moderate pain.Personality assessment showed that the majority of participants had moderate extraversion(84.1%),moderate emotional stability(65.1%),high conscientiousness(61%),high agreeableness(54.1%),and moderate openness(49.2%).High conscientiousness was significantly associated with higher pain perception(P<0.05),while high emotional stability was associated with lower levels of anxiety(P<0.05).No significant association was found between preoperative anxiety and pain(P>0.05).CONCLUSION This study challenges the assumption that preoperative anxiety and pain are directly correlated and highlights the role of personality traits in shaping patient experience.These findings support the potential value of integrating psychological profiling into preoperative care and lay the groundwork for developing personalized interventions to improve patient-centered surgical outcomes.
文摘The concept of Damage Control Surgery(DCS)emphasizes prioritizing hemorrhage control,preventing hypothermia,correcting coagulopathy,and acidosis in trauma treatment.The application of the DCS concept in trauma treatment at grassroots hospitals faces numerous challenges such as limited resources,high technical difficulty,and insufficient multidisciplinary collaboration.Therefore,DCS strategies need to be adapted to simplified processes to create conditions for subsequent treatment.This paper retrieves relevant literature to discuss the proposal,promotion,and application of the DCS concept,aiming to provide evidence-based basis for optimizing trauma treatment outcomes at grassroots hospitals.
文摘Objective To determine whether frailty is a risk factor for hospitalization and mortality in older adults enrolled in the "Chronic Heart Failure Program" at a hospital in Lima, Peru, between 2018–2021.Methods This was an ambispective cohort study. A total of 85 older adults participating in the Chronic Heart Failure Program at Guillermo Almenara National Hospital were included. Each had an initial frailty assessment, forming two cohorts: frail and non-frail older adults. Medical records were reviewed, and patients were followed for one year to track events of interest(hospitalization and mortality). Overall survival and risk factors for hospitalization and death were determined.Results During follow-up, 15.3% of the older adults died, and frailty was identified in 58.8% of the patients. Overall survival using the Kaplan-Meier method was 96.5% at 3 months after entering the Chronic Heart Failure Program;92.9% at 6 months;and85.9% at one year. Multivariate analysis using Poisson regression found that frailty was not a risk factor for hospitalization(a RR =0.92;95% CI: 0.42–2.03). Survival analysis using the Cox proportional hazards model showed that frailty was also not a risk factor for mortality after one year of follow-up(a HR = 1.32;95% CI: 0.27–6.53).Conclusions Our research does not confirm frailty as a risk factor for hospitalization or mortality in older adults enrolled in the“Chronic Heart Failure Program” after one year of follow-up.
文摘Profile of Prof.Ning-Li Wang Academician of the Chinese Academy of Engineering(CAE)Member of the International Academy of Ophthalmology Director,Ophthalmology Center,Beijing Tongren Hospital Dean,School of Ophthalmology,Capital Medical University Director,National Engineering Research Center for Ophthalmic Diagnosis and Treatment National Distinguished Physician Member,Academic Advisory Committee.
基金supported by the National Natural Science Foundation of China(Grant Nos.92043301,82103790)the Shanghai International Science and Technology Partnership Project(Grant No.21230780200).
文摘Few multicity studies have examined the acute effects of nitrogen dioxide(NO_(2))on respiratory disease(RD),especially its specific causes.This study aimed to investigate the associations between short-term exposure to NO_(2)and hospitalization of full-spectrum RDs in China.Hospitalization of 10 major categories and 40 cause-specific RDs were obtained from 20 provinces over the study period of 2013−2020.A time-stratified case-crossover study was conducted at the individual level to explore the associations between NO_(2)and RDs.NO_(2)was significantly associated with increased hospitalization of eight major RDs(acute upper respiratory infections,influenza and pneumonia,acute lower respiratory infections,upper respiratory tract diseases,chronic lower respiratory diseases,respiratory interstitium diseases,pleura diseases,and other respiratory diseases)and 18 specific causes of RDs,with the largest associations observed on lag 0−1 day.The effect estimates ranged from 0.75 to 4.09%per 10μg/m^(3)of NO_(2)exposure.The associations remained robust after controlling for copollutants.The concentration−response curves were mostly positive and linear.This nationwide study provides comprehensive information on the acute effects of NO_(2)on respiratory morbidity across the full spectrum,highlighting the need for caution with regard to this important traffic-related air pollutant in current pollution control programs.
基金supported by the National Natural Science Foundation of China(grant numbers 92043301 and 91843302)the Shanghai International Science and Technology Partnership Project(grant number 21230780200).
文摘Few national studies have systemically examined the effects of criteria air pollutants on cardiovascular morbidity.This study aimed to investigate the associations between all criteria air pollutants and hospitalization of causespecific cardiovascular diseases(CVD)in China.We obtained data on CVD hospitalization events of four major categories and 12 specific diseases from 153 hospitals distributed in 20 provincial-level regions from 2013 to 2020.We adopted a time-stratified case-crossover study design using individual cases to capture the effect of short-term exposure to six criteria air pollutants on CVD hospitalizations,using conditional logistic regression models.More than 1.1 million CVD hospitalization events were included.The lag pattern exploration demonstrated the largest effect for six air pollutants on lag 0–1 day.PM_(2.5),PM_(10),NO_(2),and CO were significantly associated with increased hospitalization from ischemic heart diseases,cerebrovascular diseases,other heart diseases,and five specific causes of CVD.The effect estimates of NO_(2)were the most robust when adjusting for copollutants.The concentration-response curves were positive and linear for most pollutant–endpoint pairs(except for O_(3)),and these positive associations remained even below the 24-h levels recommended by WHO Air Quality Guidelines and China Air Quality Standards.This nationwide case-crossover study in China demonstrated that short-term exposure to multiple ambient air pollutants may significantly increase the risk of cause-specific CVD hospitalizations even under the most stringent air quality regulations,striking an alert for potential CVD patients against these environmental risk factors.
