Risultati per: GPG: Versione 5.7.5 (Novembre 2021)

Circulation, Volume 150, Issue Suppl_1, Page A4147096-A4147096, November 12, 2024. Introduction:Increased prevalence and incidence of heart failure have resulted in a significant rise in the number of patients progressing to advanced heart failure (AHF). Heart transplantation (HT) has been the gold standard treatment for AHF. However, there is limited long-term data on trends in HT procedures and associated costs.Aim:This study aims to perform a comprehensive analysis to ascertain the trends in the number of HTs and the corresponding costs incurred.Methods:Utilizing the National Readmission Database 2010 to 2021, the study population was identified as new recipients of HT, and their median index admission charges were evaluated. We excluded patients aged < 18 with HT and LVAD during the index hospitalization.Results:We identified 36,379 weighted index hospital admissions from January to December 2010 - 2021. The annual HTs increased from 2,905 to 4,046, and the HT numbers increased by 39.28% (Figure 1). From 2010 to 2017, the HT numbers increased by approximately 11.46%; from 2018 to 2021, the increase was about 19.81%. Concurrently, median index admission costs increased from $146,817 in 2010 to $243,079 in 2021 (Figure 2), with a 65.57% cost increase. Considering patient demographics, 47% had private insurance, and Medicare covered 34%. Most patients were discharged home (48%) or to home with health care services (42%).Conclusion:Over the past 12 years, the total number of HT procedures rose by 39.28%. However, associated costs have surged disproportionately by 65.57% since 2010. A significant increase in OHT procedures from 2018 may be linked to policy changes by the United Network for Organ Sharing(Maitra, Dugger et al., 2023). Escalating costs warrant in-depth evaluation and potential policy revisions to curb healthcare expenses for managing advanced end-stage heart failure.

Circulation, Volume 150, Issue Suppl_1, Page A4146053-A4146053, November 12, 2024. Introduction:Cardiomyopathy (CM) and myocarditis rank as the fifth leading cause of death and disability in G20 countries amongst all cardiovascular disease related (CVD) deaths. Despite their escalating burden, there is a notable lack of consistent data across these nations. This study is the first to estimate the burden of these cardiac conditions over the last three decades, including the initial two years of the COVID-19 pandemic, highlighting the urgent need for improved surveillance and specific healthcare strategies to manage these critical health issues.Method:We estimated incidence, prevalence, deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs) due to CM and myocarditis by age, sex, year and location across the G20 countries from 1990-2021 using global burden of disease 2021 methodology.Results:From 1990 to 2021, the total percentage change (TPC) in prevalence counts increased by 64% (95% Uncertainty Interval: 53% to 75%), incidence by 57% (47% to 68%), and deaths by 37% (26% to 49%). Japan had the highest age-standardized incidence rate (ASIR) at 19.84 (16.38-24.21) cases per 100,000, closely followed by Sweden at 19.74 cases per 100,000. The highest mortality rate (ASMR) was observed in Latvia at 27.95 (23.89-31.99) cases per 100,000, with Russia following at 26.3 cases per 100,000 in 2021. Poland recorded the highest YLD rate (ASYLDR) at 16.13 (11.05-22.86), with Sweden next at 15.67 per 100,000 in 2021. The highest incidence occurred in the 70-74 age group with 76,173 cases (46,415-113,840), with the most deaths in the 80-84 age group at 31,289 (27,390-33,741), and the highest DALYs in the 55-59 age group at 750,723 (680,540-814,890) in 2021. Regarding gender, the TPC in incidence for males was 55% compared to 61% for females, in deaths 57% for males versus 16% for females, and in YLDs 67% for males versus 54% for females from 1990 to 2021.Conclusion:Deaths due to CM and myocarditis accounted for 2.04% of all CVD deaths in G20 countries in 2021. The increasing burden highlights the need of proactive initiatives, including tailored health education and advanced screening programs. It should be prioritized to address the needs of the most affected demographics and regions. Integrating technology and cross-border healthcare collaborations could play a pivotal role in mitigating the impact of this condition and enhancing overall public health resilience.

Circulation, Volume 150, Issue Suppl_1, Page A4146172-A4146172, November 12, 2024. Background:Transcatheter Aortic Valve Implantation (TAVI) is increasingly used to treat severe aortic stenosis in patients who are at high risk for conventional surgery. Patients with leukemia represent a unique subset, often presenting with additional comorbidities and a higher susceptibility to complications. Gender differences in clinical outcomes following TAVI in leukemia patients remain under-explored. Understanding these differences is crucial for optimizing patient care and improving procedural outcomes in this vulnerable population.Methods:A retrospective analysis using the National Inpatient Sample (NIS) data from 2016 to 2021 compared male and female leukemia patients undergoing TAVI. Multivariate logistic regression was utilized to analyze variables such as in-hospital mortality, transfusion requirements, bleeding, and other complications. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and statistical significance was determined by P-values.Results:The study included 2,175 male and 1,055 female leukemia patients undergoing TAVI. The majority of patients were White, with 91.92% of males and 92.12% of females. Black patients constituted 2.14% of the male and 2.46% of the female groups.The mean age of male patients was 79.25 years, while female patients were slightly older, with a mean age of 80.66 years. Total charges were comparable between genders, with males incurring $217,554.6 and females $224,248.3. The length of stay was also similar, with males staying an average of 3.48 days and females 3.82 days. Mortality was significantly higher in females compared to males, with an odds ratio (OR) of 8.824 (95% CI: 1.415-55.017, P=0.02). Females also had higher odds of requiring transfusions (OR=2.049, 95% CI: 1.052-3.989, P=0.035) and experiencing bleeding complications (OR=2.039, 95% CI: 1.17-3.555, P=0.012). Other complications, such as vascular injury, permanent pacemaker (PPM) insertion, arrhythmias, and respiratory failure, did not show significant gender differences.Conclusion:Female leukemia patients undergoing TAVI are at a significantly higher risk of mortality, requiring more transfusions, and experiencing increased bleeding compared to their male counterparts. These findings underscore the urgent need for gender-specific management strategies and further research to enhance outcomes for this high-risk population.

Circulation, Volume 150, Issue Suppl_1, Page A4140684-A4140684, November 12, 2024. Introduction:The success of cardiac surgical techniques and progress of interventional therapies prolonged the life expectancy patients with congenital heart anomalies (CHA). Reduction of mortality and extension of lifespan exacerbated the burden of non-fatal comorbidities. Developmental intellectual disability (DID) is the most substantial non-fatal comorbidities of pediatric patients with CHA. However, no epidemiological study describe the global burden of DID attributable to CHA (DID-CHA).Research Question:What was the global burden, regional inequality, and age specific discrepancy of DID-CHA?Goal:The aim of this study is to address the gap of lacking epidemiological data of global burden, regional inequality, and age discrepancy of DID-CHA.Methods:This was a secondary analysis study by utilizing impairment data of GBD study 2021. Data was collected from the website of Institute for Health Metrics and Evaluation (IHME, query tool:https://ghdx.healthdata.org/gbd-2021). The prevalence, disability adjusted life years (DALYs), and their calculayted annual percentage changes (EAPC) across global, both sexes, seven regions, five SDI regions, and 204 countries and territories from 1990 to 2021 were investigated.Results:In 2021, the global number of DID-CHA cases was 1.05 million (95% UI: 0.83 to 1.24 million) with an age-standardized prevalence rates of 15.71 per 100,000 (95% UI: 12.36 to 18.58). From 1990 to 2021, the EAPC of prevalence was -0.15 (95% CI: -0.16 to -0.13). Regional inequality of disease burden of DID-CHA remained prevalent worldwide. Pediatric population, especially neonates and infants, had a more substatial disease burden of DID-CHA compared to adults aged over 20 years.Conclusions:This is the first study that thoroughly describe the global prevalence, regional inequality, and age discrepancy of the burden on DID-CHA, by utilizing the public data of GBD 2021. DID-CHD is believed to be a progressive issues for the whole-life management of CHD. Future efforts on resource allocation for neurodevelopmental disability in population with CHD should be comparable with the expenditure in reducing CHD mortality. Persistent regional socioeconomic disparities will definitely move to impact the discrepant burden of DID-CHA. Increasing socioeconomic resources aimed at improving DID-CHA outcomes should prioritize in neonate and infants with CHA, as they represent the most critically affected age groups.

Circulation, Volume 150, Issue Suppl_1, Page A4146077-A4146077, November 12, 2024. Introduction:Ischemic Heart Disease (IHD) is the primary cause of morbidity and mortality across Southeast Asia, East Asia, and Oceania. Although there has been a lack of comprehensive studies on the burden of IHD attributable to air pollution, this study is the first to estimate its impact over the last three decades, including the initial two years of the COVID-19 pandemic.Method:Using global burden of disease tool, we estimated deaths, disability adjusted life years (DALYs), years lived with disability (YLDs), years of life lost (YLLs) due to IHD attributable to Air pollution by age, sex, year across the SEA, EA, and Oceania from 1990-2021.Results:From 1990 to 2021, the annual percentage change (APC) in total deaths due to ambient particulate matter pollution increased by 112% (95% UI: 79-151%), with DALYs rising by 77% (51-108%) and YLDs by 106% (91-120%). The age-standardized mortality rate (ASMR) increased by 124%, and DALYs rate by 102%. Timor-Leste observed the highest APC in ASMR at 329%, followed by China at 147%, while the highest DALYs rate was also in Timor-Leste at 321%, followed by the Solomon Islands at 141%. The highest number of deaths was recorded in the 80–84-year-old age group with 148,592, and DALYs were highest in the 70-74 age group at 2.2 million due to IHD attributable to AP in 2021. Males experienced a higher burden compared to females over the last three decades, with a total percentage change in deaths at 168% vs. 130%, YLDs at 128% vs. 153%, and YLLs at 112% vs. 73%.Conclusion:Urgent action is crucial to combat the escalating burden IHD due to AP in Southeast Asia, East Asia, and Oceania. Public stakeholders and policy makers must implement robust strategies to slash particulate matter pollution and protect public health.

Background
Management of postoperative pain leads to positive patient progress and shortens the duration of hospital stay. There is a lack of information on nurse’s postoperative pain management practice and its associated factors.

Objective
To assess postoperative pain management practice and associated factors among nurses working in public hospitals of West Shoa Zone, Oromia, Ethiopia, 2021.

Design
An institutional-based cross-sectional study was employed.

Setting
Study was conducted among eight public hospitals (two tertiary hospitals and six secondary hospitals), which were located in West Shoa Zone in Oromia, Ethiopia.

Participants
Totally 377 participants were selected by using simple random sampling. From this, 277 were men and 100 participants were women. All nurses who were worked in surgical ward, medical wards, minor operation room and major operation room, recovery rooms, emergency, obstetrics and gynaecology wards were included.

Methods
Data were collected by distributing structured self-administered questionnaires that adapted from different literatures and were entered into Epi data V.3.1 and exported to SPSS V.22 for analysis. Variables with significant association in the bivariate analyses were entered into a multivariable regression analysis to identify the independent factors associated with nurses’ postoperative pain management practice. Significant factors were declared at p

This study uses public US Food and Drug Administration lists to identify new drugs approved from 2015 through 2021 to examine recent estimates of compliance with and timing of pediatric testing requirements after passage of the Pediatric Research Equity Act.

In III Rapporto salute di Cittadinanzattiva più luci che ombre

Stroke, Ahead of Print. BACKGROUND:This study aims to perform a comprehensive analysis of stroke burden from the Global Burden of Disease 2021.METHODS:We conducted a comprehensive analysis of the burden, including prevalence, incidence, mortality, and disability-adjusted life year rates, for stroke across 204 countries and regions from 1990 to 2021 using data from the Global Burden of Disease 2021. We calculated the estimated annual percentage change (EAPC) and performed a joinpoint regression analysis to identify the trends. We also explored the association between the stroke burden and sociodemographic index.RESULTS:The age-standardized prevalence, incidence, mortality, and disability-adjusted life year rates for stroke were 1099.310, 141.553, 87.454, and 1886.196 per 100 000 persons in 2021, respectively. The general stroke burden trends declined in EAPC analysis (age-standardized prevalence: EAPC, −0.37; age-standardized incidence: EAPC, −0.99; age-standardized mortality: EAPC, −1.81; and disability-adjusted life year: EAPC, −1.76). However, we found an increasing burden of stroke in East Asia and Southern Sub-Saharan Africa (EAPC >0). The global burdens of intracerebral hemorrhage, subarachnoid hemorrhage, and ischemic stroke showed a similar trend. The stroke, intracerebral hemorrhage, and ischemic stroke burdens were heavier in men than in women, except for that of subarachnoid hemorrhage in women. Our joinpoint regression analysis revealed that the age-standardized burden rates of stroke decreased from 1990 to 2021 (average annual percent change 0). The burden of stroke was inversely proportional to the sociodemographic index (P

This Medical News article is an interview with emergency management and medical experts from Oregon and Washington who experienced the record-breaking heat wave in June of 2021.

Objectives
To assess the seroprevalence of infection-acquired SARS-CoV-2 and the mental health of school/daycare staff in the months after reopening of schools in Montreal, Quebec (Canada) in the Fall of 2020 and whether these varied by school and participant characteristics.

Design
A cross-sectional design based on a convenience sample of schools/daycares and staff was used as the originally planned longitudinal design was no longer feasible due to obstacles in recruitment, for example, teacher’s strike.

Setting
Forty-nine schools/daycares in four Montreal neighbourhoods from March to October 2021.

Participants
Three-hundred and sixty-two participants completed both questionnaires and serology tests.

Primary and secondary outcome measures
SARS-CoV-2 seroprevalence and prevalence of anxiety, depression, resilience and burnout/emotional exhaustion.

Results
The seroprevalence estimate made representative to the Quebec population of educators was 8.6% (95% CI 5.2 to 13.0). The adjusted seroprevalence in high school was 20% that of elementary school (aRR=0.20, 95% CI 0.07 to 0.58). Thirty per cent of seropositive staff were exposed to a household member with confirmed COVID-19. Prevalence of high emotional exhaustion/burnout was 35%, 44% and 53% in daycare, elementary school and high school staff, respectively. However, moderate/severe anxiety and depression and low resilience did not exceed 18%. After adjusting for confounders, being very afraid of catching COVID-19 at school was associated with moderate–severe anxiety, moderate–severe depression and high emotional exhaustion (aRR=4.4, 95% CI 2.2 to 8.9; aRR=2.8, 95% CI 1.5 to 5.4; aRR=2.2, 95% CI 1.6 to 3.0, respectively).

Conclusion
The seroprevalence, anxiety and depression among school/daycare staff were comparable to the reported levels in the adult population of Quebec. The prevalence of emotional exhaustion/burnout was high across all school levels and exceeding the average across all occupations in the USA and in teachers in Germany.

This cross-sectional study uses data from the Youth Risk Behavior surveys to assess the association of state-level recreational marijuana laws and youth marijuana use.

This cross-sectional study estimates the number of children who lost a parent to drug overdose in the US from 2011 to 2021.

Circulation, Volume 150, Issue 5, Page e105-e105, July 30, 2024.

This population-based retrospective study uses data from the National Vital Statistics System to evaluate trends in risk factors for preeclampsia in the US between 2010 and 2021.