-
Paediatric and Perinatal Epidemiology Mar 2022Measuring infant health at birth is key for surveillance and research in obstetrics and neonatology, but there is no international consensus on morbidity indicators. The...
BACKGROUND
Measuring infant health at birth is key for surveillance and research in obstetrics and neonatology, but there is no international consensus on morbidity indicators. The Neonatal Adverse Outcome Indicator (NAOI) is a composite indicator, developed in Australia, which measures the burden of severe neonatal morbidity using hospital discharge data.
OBJECTIVE
To evaluate the applicability of the NAOI in France for surveillance and research.
METHODS
We constituted a cohort of live births ≥24 weeks' gestational age in Metropolitan France from 2014 to 2015 using hospital discharge, insurance claims and cause of death data. Outlier hospitals were identified using funnel plots of standardised morbidity ratios (SMR), and their coding patterns were assessed. We compared the NAOI and its component codes with published Australian and English data and estimated unadjusted and adjusted risk ratios for known risk factors for neonatal morbidity.
RESULTS
We included 1,459,123 births (511 hospitals). Twenty-eight hospitals had SMR above funnel plot control limits. Newborns with NAOI morbidities in these hospitals had lower mortality and shorter stays than in other hospitals. Amongst within-limit hospitals, NAOI prevalence was 4.8%, comparable to Australia (4.6%) and England (5.4%). Most individual components had a similar prevalence, with the exception of respiratory support, intravenous fluid procedures and infection. NAOI was lowest at 39 weeks (2.2%) with higher risks for maternal age ≥40 (relative risk [RR] 1.47, 95% confidence interval [CI] 1.42, 1.51), state medical insurance (RR 1.60, 95% CI 1.52, 1.68), male sex (RR 1.21, 95% CI 1.19, 1.23) and birthweight <3 percentile (RR 4.60, 95% CI 4.51, 4.69).
CONCLUSIONS
The NAOI provides valuable information on population prevalence of severe neonatal morbidity and its risk factors. Whilst the prevalence was similar in high-income countries with comparable neonatal mortality levels, ensuring valid comparisons between countries and hospitals will require further work to harmonize coding procedures, especially for infection and respiratory morbidity.
Topics: Australia; Female; Hospitals; Humans; Infant; Infant Mortality; Infant, Newborn; Male; Morbidity; Patient Discharge; Pregnancy
PubMed: 34797588
DOI: 10.1111/ppe.12816 -
Cardiology Clinics Feb 2017Infective endocarditis (IE) is a rare, life-threatening disease with a mortality rate of 25% and significant debilitating morbidities. Although much has been reported on... (Review)
Review
Infective endocarditis (IE) is a rare, life-threatening disease with a mortality rate of 25% and significant debilitating morbidities. Although much has been reported on contemporary IE in high-income countries, conclusions on the state of IE in low- and middle-income countries (LMICs) are based on studies conducted before the year 2000. Furthermore, unique challenges in the diagnosis and management of IE persist in LMICs. This article reviews IE studies conducted in LMICs documenting clinical experiences from the year 2000 to 2016. Presented are the causes of IE, management of patients with IE, and prevailing challenges in diagnosis and treatment of IE in LMICs.
Topics: Developing Countries; Endocarditis; Humans; Morbidity; Poverty; Socioeconomic Factors
PubMed: 27886786
DOI: 10.1016/j.ccl.2016.08.011 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2022The aim: To determine national trends in morbidity and mortality from diseases of the circulatory system, cerebrovascular diseases and strokes.
OBJECTIVE
The aim: To determine national trends in morbidity and mortality from diseases of the circulatory system, cerebrovascular diseases and strokes.
PATIENTS AND METHODS
Materials and methods: Data from official sources of statistical information of Ukraine were used and systematic analysis and generalization of the obtained data was performed and trends in morbidity and mortality from diseases of the circulatory system, cerebrovascular diseases and strokes in Ukraine were calculated.
RESULTS
Results: Were found tendencies to decrease of national levels of prevalence and primary morbidity in Ukraine for DCS (-16.3 % and -28.0 %), CVD (-22.8 % and 24.1 %) and strokes (-12.2 %) with significant trends (+83.9 %) of increase in primary incidence of strokes in 2010-2017 with fairly high and threatening levels for 2017 (respectively 22199563, 2521601 and 96978 - prevalence and 1725137, 290557 and 96978 - primary incidence). National levels of reduction of deaths from DCS in Ukraine from 440369 (2013) to 389348 (2019) with a trend of -11.6 % and a decrease in mortality due to CVD from 94267 (2013) to 76232 (2019) with a trend -19.1 % were found.
CONCLUSION
Conclusions: The trends to reduce of national prevalence, primary morbidity and mortality rates in Ukraine for DCS, CVD and stroke are fully consistent with other global trends of reduction of these levels among world countries.
Topics: Cardiovascular System; Cerebrovascular Disorders; Humans; Morbidity; Mortality; Prevalence; Stroke
PubMed: 35758494
DOI: 10.36740/WLek202205118 -
PloS One 2023Maternal morbidities especially life-threatening pregnancy complications are major health concerns in developing countries. The main aim is to investigate the prevalence...
BACKGROUND
Maternal morbidities especially life-threatening pregnancy complications are major health concerns in developing countries. The main aim is to investigate the prevalence of maternal morbidity during pregnancy and its determinants among women from urban areas of Bangladesh.
METHODS
The secondary data were used and extracted from the latest Bangladesh Urban Health Survey (BUHS) 2013. Several statistical models: Poisson, negative binomial (NB) and mixed Poisson were adapted and compared to explore the best model for investigating potential determinants of maternal morbidity. Pearson chi-square statistic was used for the detection of overdispersion in the data. Results Overall 13.5% of the urban women in Bangladesh suffered from at least two pregnancy complications. The study detected the overdispersion existing in the maternal morbidity count data and found the NB regression as the best choice for analyzing the data because of its smallest Akaike information criterion. Administrative division (Rangpur: p = 0.003, incidence rate ratio, IRR = 1.34, 95% confidence interval, CI: 1.11 to 1.63; Sylhet: p = 0.006, incidence rate ratio, IRR = 1.42, 95% CI: 1.11 to 1.82), unwanted pregnancy (p<0.001, IRR = 1.25, 95% CI: 1.11 to 1.40), place of delivery (p<0.001, IRR = 1.68, 95% CI: 1.53 to 1.86) and wealth index (Poor: p<0.001, IRR = 1.34, 95% CI: 1.19 to 1.50; Middle: p = 0.003, IRR = 1.21, 95% CI: 1.08 to 1.36) were found to be statistically significant determinants for maternal morbidity during pregnancy among the urban women in Bangladesh.
CONCLUSIONS
Urban women in Bangladesh with an unwanted pregnancy, from the poor/middle-income group; and living in Rangpur and Sylhet divisional cities have a higher risk of maternal morbidity during pregnancy. Study findings may help the government and relevant authorities to take necessary steps for reducing maternal morbidity and mortality due to pregnancy-related complications.
Topics: Pregnancy; Humans; Female; Bangladesh; Pregnancy Complications; Health Surveys; Morbidity; Urban Population
PubMed: 36827352
DOI: 10.1371/journal.pone.0268487 -
The Journal of Maternal-fetal &... Dec 2022Rates of severe maternal morbidity (SMM) are significantly higher among Black women and some data suggests further worsening of these rates among hospitals with the...
OBJECTIVE
Rates of severe maternal morbidity (SMM) are significantly higher among Black women and some data suggests further worsening of these rates among hospitals with the highest proportion of Black deliveries. In this study, we sought to examine whether Black women have higher SMM in Washington State and whether this varied by hospital.
METHODS
We conducted a retrospective cohort study using linked birth-hospital discharge data from Washington State. We compared Non-Hispanic Black women with Non-Hispanic white women and excluded observations with missing hospital information. SMM was defined using an already published algorithm. We ranked hospitals into low-, medium- and high Black-serving hospitals by using proportions of deliveries to Black women among all deliveries. Multivariable logistic regression models were used to examine the association of Black women with SMM adjusted for demographics, co-morbidities and clustering within hospital.
RESULTS
In the cohort of 407,808 women, 4556 (1.12%) had SMM. High Black-serving hospitals had the highest rate of SMM (1.94%) as compared to medium Black-serving hospitals (1.16%) and low Black-serving hospitals (1.06%) ( < .01). Odds of SMM was higher in Black women (OR = 1.58, 95% CI: 1.39-1.78) and remained elevated after adjusting for demographics and the level of Black-serving hospital (aOR= 1.29, 95% CI: 1.11-1.49).
CONCLUSION
We found that the risk of SMM was higher among Black women. Hospital level performance and health outcomes stratified by maternal race and ethnicity in hospitals and hospital systems should be addressed to further reduce disparities and optimize outcomes.
Topics: Female; Pregnancy; Humans; White People; Black or African American; Retrospective Studies; Washington; Black People; Morbidity
PubMed: 33775201
DOI: 10.1080/14767058.2021.1903423 -
International Journal of Environmental... Jan 2019Previous studies have shown there are no consistent and robust associations between socioeconomic status and morbidity rates. This study focuses on the relationship...
Previous studies have shown there are no consistent and robust associations between socioeconomic status and morbidity rates. This study focuses on the relationship between the socioeconomic status and the morbidity rates in China, which helps to add new evidence for the fragmentary relationship between socioeconomic status and morbidity rates. The (NHSS) and (CHARLS) data are used to examine whether the association holds in both all-age cohorts and in older only cohorts. Three morbidity outcomes (two-week incidence rate, the prevalence of chronic diseases, and the number of sick days per thousand people) and two socioeconomic status indicators (income and education) are mainly examined. The results indicate that there are quadratic relationships between income per capita and morbidities. This non-linear correlation is similar to the patterns in European countries. Meanwhile, there is no association between education years and the morbidity in China, i.e., either two-week incidence rate or prevalence rate of chronic diseases has no statistically significant relationship with the education level in China.
Topics: China; Chronic Disease; Female; Humans; Incidence; Longitudinal Studies; Male; Morbidity; National Health Programs; Prevalence; Retirement; Socioeconomic Factors; Surveys and Questionnaires
PubMed: 30646540
DOI: 10.3390/ijerph16020215 -
European Journal of Cardiovascular... Oct 2022Postoperative morbidity places considerable burden on health and resources. Thus, strategies to identify, predict, and reduce postoperative morbidity are needed.
BACKGROUND
Postoperative morbidity places considerable burden on health and resources. Thus, strategies to identify, predict, and reduce postoperative morbidity are needed.
AIMS
To identify and explore existing preoperative risk assessment tools for morbidity after cardiac surgery.
METHODS
Electronic databases (including MEDLINE, CINAHL, and Embase) were searched to December 2020 for preoperative risk assessment models for morbidity after adult cardiac surgery. Models exploring one isolated postoperative morbidity and those in patients having heart transplantation or congenital surgery were excluded. Data extraction and quality assessments were undertaken by two authors.
RESULTS
From 2251 identified papers, 22 models were found. The majority (54.5%) were developed in the USA or Canada, defined morbidity outcome within the in-hospital period (90.9%), and focused on major morbidity. Considerable variation in morbidity definition was identified, with morbidity incidence between 4.3% and 52%. The majority (45.5%) defined morbidity and mortality separately but combined them to develop one model, while seven studies (33.3%) constructed a morbidity-specific model. Models contained between 5 and 50 variables. Commonly included variables were age, emergency surgery, left ventricular dysfunction, and reoperation/previous cardiac surgery, although definition differences across studies were observed. All models demonstrated at least reasonable discriminatory power [area under the receiver operating curve (0.61-0.82)].
CONCLUSION
Despite the methodological heterogeneity across models, all demonstrated at least reasonable discriminatory power and could be implemented depending on local preferences. Future strategies to identify, predict, and reduce morbidity after cardiac surgery should consider the ageing population and those with minor and/or multiple complex morbidities.
Topics: Adult; Cardiac Surgical Procedures; Humans; Morbidity; Postoperative Complications; Postoperative Period; Reoperation; Risk Assessment
PubMed: 35171231
DOI: 10.1093/eurjcn/zvac003 -
Frontiers in Endocrinology 2023Diabetes is a chronic disease associated with numerous complications including diabetic foot disorders, which are associated with significant morbidity and mortality as... (Review)
Review
Diabetes is a chronic disease associated with numerous complications including diabetic foot disorders, which are associated with significant morbidity and mortality as well as high costs. The costs associated with diabetic foot disorders comprise those linked to care (direct) and loss of productivity and poor quality of life (indirect). Due to the constant increase in diabetes prevalence, it is expected that diabetic foot disorder will require more resources, both in terms of caregivers and economically. We reviewed findings on management, morbidity, mortality, and costs related to diabetic foot disorder.
Topics: Humans; Diabetic Foot; Quality of Life; Cost of Illness; Morbidity; Prevalence; Diabetes Mellitus
PubMed: 38298183
DOI: 10.3389/fendo.2023.1323315 -
West African Journal of Medicine Nov 2022
Topics: Humans; Comorbidity; Stroke; Morbidity
PubMed: 36450106
DOI: No ID Found -
American Journal of Kidney Diseases :... Sep 2021Optimal glycemic control in kidney transplant recipients with diabetes is associated with improved morbidity and better patient and allograft survival. Transplant... (Review)
Review
Optimal glycemic control in kidney transplant recipients with diabetes is associated with improved morbidity and better patient and allograft survival. Transplant options for patients with diabetes requiring insulin therapy and chronic kidney disease who are suitable candidates for kidney transplantation should include consideration of β-cell replacement therapy: pancreas or islet transplantation. International variation related to national regulatory policies exists in offering one or both options to suitable candidates and is further affected by pancreas/islet allocation policies and transplant waiting list dynamics. The selection of appropriate candidates depends on patient age, coexistent morbidities, the timing of referral to the transplant center (predialysis versus on dialysis) and availability of living kidney donors. Therefore, early referral (estimated glomerular filtration rate < 30 mL/min/1.73 m) is of the utmost importance to ensure adequate time for informed decision making and thorough pretransplant evaluation. Obesity, cardiovascular disease, peripheral vascular disease, smoking, and frailty are some of the conditions that need to be addressed before acceptance on the transplant list, and ideally before dialysis becoming imminent. This review offers insights into selection of pancreas/islet transplant candidates by transplant centers and an update on posttransplant outcomes, which may have practice implications for referring nephrologists.
Topics: Diabetes Mellitus, Type 1; Global Health; Graft Survival; Humans; Kidney Diseases; Kidney Transplantation; Living Donors; Morbidity; Postoperative Complications; Transplantation, Homologous
PubMed: 33992729
DOI: 10.1053/j.ajkd.2021.02.339