-
Association Between Body Mass Index and Morbidity and Mortality During Hospitalization After Trauma.Journal of Trauma Nursing : the...Literature suggests that unhealthy body mass index is a risk factor for adverse clinical outcomes.
BACKGROUND
Literature suggests that unhealthy body mass index is a risk factor for adverse clinical outcomes.
OBJECTIVES
To study the association between unhealthy body mass index and morbidity and mortality after trauma using the 2016 American College of Surgeons Trauma Quality Improvement Program database.
METHODS
A retrospective review was conducted comparing the normal weight control group to the underweight, overweight, obese, severely obese, and morbidly obese groups for differences in demographic factors, injury severity score, comorbidities, length of stay, and complications.
RESULTS
Underweight, overweight, obese, severely obese, and morbidly obese body mass indexes, in comparison to normal weight body mass index, were associated with a higher probability of developing at least one complication after trauma. Additionally, we observed a J-shaped curve when analyzing body mass index and mortality, suggesting that both high and low body mass indexes are positively associated with mortality. In fact, morbidly obese patients had the highest mortality rate, followed by underweight patients (p < .001). Interestingly, however, multivariate logistic regression demonstrated that, compared with normal weight body mass index, overweight and obese body mass indexes were independently associated with 9.6% and 10.5% lower odds of mortality, respectively (p < .001 and p = .001).
CONCLUSION
Irrespective of preexisting comorbidities, injury severity score, and mechanism of injury, underweight, overweight, obese, severely obese, and morbidly obese body mass indexes were independently associated with higher risks of morbidity, whereas overweight and obese body mass indexes were associated with lower mortality risks. These findings emphasize the complex relationship between body mass index and clinical outcomes for trauma patients.
Topics: Body Mass Index; Hospitalization; Humans; Morbidity; Obesity, Morbid; Thinness
PubMed: 35275109
DOI: 10.1097/JTN.0000000000000639 -
Indian Heart Journal 2020The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) study was published recently demonstrating that over a period... (Review)
Review
The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) study was published recently demonstrating that over a period of 3.3 years a routine invasive approach along with optimised medical therapy (OMT) was not superior to OMT alone in patients with stable coronary artery disease and at least moderate to severe ischemia. Considerable interest and discussion have emerged over the applicability of the trial to real-world settings and the limitations of the trial. Given the fact that no clinical trial will ever be designed that will be perfect, it is important to prise out the pearls that the findings reveal and not interpret the findings as either positive or negative towards one approach or the other.
Topics: Global Health; Humans; Morbidity; Myocardial Ischemia; Myocardial Revascularization
PubMed: 33357658
DOI: 10.1016/j.ihj.2020.11.001 -
The Surgical Clinics of North America Apr 2021The prevalence of noncommunicable diseases has increased dramatically in North America and throughout the world and is expected to continue increasing in coming years.... (Review)
Review
The prevalence of noncommunicable diseases has increased dramatically in North America and throughout the world and is expected to continue increasing in coming years. Obesity has been linked to several types of cancers and is associated with increased morbidity and mortality following cancer diagnosis. Bariatric surgery has emerged as the prominent model to evaluate the effects of intentional weight loss on cancer incidence and outcomes. Current literature, comprising prospective cohort investigations, indicates site-specific reductions in cancer risk with select bariatric procedures. Future research is required to establish evidence-based indications for bariatric surgery in the context of cancer prevention.
Topics: Bariatric Surgery; Global Health; Humans; Morbidity; Neoplasms; Obesity, Morbid; Weight Loss
PubMed: 33743967
DOI: 10.1016/j.suc.2020.12.003 -
American Journal of Perinatology Oct 2022Survival of preterm infants differs dramatically depending on birthplace. No previous studies have compared outcomes of preterm infants between low middle-income and...
OBJECTIVE
Survival of preterm infants differs dramatically depending on birthplace. No previous studies have compared outcomes of preterm infants between low middle-income and high-income countries such as India and the United States. The purpose of this study is to evaluate differences in care practices, resources, mortality, and morbidities in preterm infants with birth weight 700 to 1,500 g between two major neonatal centers in these countries.
STUDY DESIGN
This is a retrospective cohort study with de-identified data from Fernandez Hospital (FH) in Hyderabad, India, and Texas Children's Hospital (TCH) in Houston, TX, for infants born January 2016 to December 2018, and weighing 700 to 1,500 g at birth. The primary outcome was death before hospital discharge.
RESULTS
Of 1,195 infants, 736 were admitted to FH and 459 were admitted to TCH. After controlling for differences in gestational age, small for gestational age, and antenatal corticosteroid use, TCH patients had lower mortality before hospital discharge (adjusted odds ratio [aOR] = 0.28, 95% confidence interval [CI]: 0.16-0.48, < 0.001) and more bronchopulmonary dysplasia (BPD; aOR = 2.2, 95% CI: 1.51-3.21, < 0.001). The composite outcome of death or BPD and death or any major morbidity (BPD or intraventricular hemorrhage grade II or more or periventricular leukomalacia grade II or more or retinopathy of prematurity requiring treatment) were not different.
CONCLUSION
In this study, TCH infants had decreased odds of death before hospital discharge compared with FH but higher odds of BPD, which may be related to increased survival and differences in care practices.
KEY POINTS
· Few studies compared outcomes of premature infants between different high-income countries.. · There are no studies comparing preterm infants between low middle-income and high-income countries such as India and the United States.. · This study evaluated detailed comparison of care practices and infrastructure of NICUs in India and United states..
Topics: Adrenal Cortex Hormones; Bronchopulmonary Dysplasia; Child; Female; Gestational Age; Humans; Infant; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Infant, Premature, Diseases; Morbidity; Pregnancy; Retrospective Studies
PubMed: 33486747
DOI: 10.1055/s-0040-1722654 -
International Review of Psychiatry... May 2021Chronic diseases commonly entail disability and are highly comorbid with mental health problems, particularly depression. Prevalence of depression across different... (Review)
Review
Chronic diseases commonly entail disability and are highly comorbid with mental health problems, particularly depression. Prevalence of depression across different disabling conditions affecting adult patients, as well as risk factors for depression in these patient groups are reviewed in the current work, with a particular focus on the literature published in the past 5 years. The prevalence of depression in disabling conditions is higher than in the general population and is associated with different factors. Examples of disease-specific factors include neurological implications of stoke, diabetic related conditions (e.g. amputation), limitations imposed by vision loss caused by age-related eye diseases, fatigue in rheumatoid arthritis, and pain in cancer. Common factors identified across different conditions include pre-morbid depression, history of mental health problems, poor social support, disease-related disability, multi-morbidity, and less adaptive coping strategies. We also reviewed studies suggesting a potential bidirectional relationship between depression and chronic disease, particularly for stroke, cardiovascular disease, diabetes, and potential factors mediating that relationship. Current findings suggested that long-term depression might be associated with an increased risk of subsequent physical health problems, although the nature of that relationship and its underlying mechanisms are still unclear.
Topics: Adaptation, Psychological; Chronic Disease; Depression; Humans; Prevalence; Risk Factors
PubMed: 33823727
DOI: 10.1080/09540261.2021.1887823 -
Pediatrics and Neonatology Jan 2023There is growing recognition of the role of platelets in inflammation and immune responses, and platelets have been associated with various cardiovascular diseases. It...
BACKGROUND
There is growing recognition of the role of platelets in inflammation and immune responses, and platelets have been associated with various cardiovascular diseases. It is also known that neonatal morbidities are related to overall platelet activity, and platelet parameters may have the potential to predict morbidities and mortality in preterm infants. This study aimed to assess the initial platelet parameters and the association with major morbidities and mortality in preterm neonates.
METHODS
We retrospectively reviewed data from very preterm neonates with a gestational age (GA) <32 weeks who were admitted between June 2020 and May 2021 for platelet parameters (counts, mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (platelet counts x MPV/10000(%)) at birth. Major morbidities included early- onset sepsis (EOS) ≤3 days after birth, severe intraventricular hemorrhage (IVH) grade ≥3, and early or overall mortality.
RESULTS
A total of 197 very preterm neonates were studied. Their mean (±SD) GA was 28.0 ± 2.4 weeks, birth weight was 990 ± 293 g, platelet counts were 245 ± 81 x1000/μL, MPV was 10.0 ± 0.7 fl, PDW was 11.0 ± 1.6 fl, and plateletcrit was 0.24 ± 0.08%. MPV had a weak negative correlation with both GA (r = -0.234, p = 0.001) and BW (r = -0.343, p <0.001). A lower plateletcrit was associated with EOS (0.14 (0.04-0.22) % vs. 0.23 (0.19-0.30) %, p = 0.027), severe IVH ≤7 days after birth (0.18 (0.14-0.27) % vs. 0.23 (0.20-0.30) %, p = 0.022), and early and overall mortality (0.15 (0.20-0.30) % vs. 0.23 (0.20-0.30) %, p = 0.049; 0.20 ± 0.09 % vs. 0.25 ± 0.07 %, p = 0.008).
CONCLUSION
A lower plateletcrit within 24 hours of birth was associated with EOS, severe IVH ≤7 days after birth, and first-week and overall mortality in very preterm neonates.
Topics: Infant; Infant, Newborn; Humans; Infant, Premature; Retrospective Studies; Blood Platelets; Mean Platelet Volume; Morbidity; Sepsis
PubMed: 36207265
DOI: 10.1016/j.pedneo.2022.06.009 -
Annals of Surgery Sep 2020
Review
Topics: COVID-19; Delivery of Health Care; Global Health; Health Personnel; Humans; Morbidity; Pandemics
PubMed: 32452951
DOI: 10.1097/SLA.0000000000004108 -
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 -
Future Oncology (London, England) Dec 2023Cancer is one of the leading causes of morbidity and mortality in India. Despite recent medical and technological advances, the cancer burden in India remains high and... (Review)
Review
Cancer is one of the leading causes of morbidity and mortality in India. Despite recent medical and technological advances, the cancer burden in India remains high and continues to rise. Moreover, substantial regional disparities in cancer incidence and access to essential medical resources exist throughout the country. While innovative and effective cancer therapies hold promise for improving patient outcomes, several barriers hinder their development and utilization in India. Here we provide an overview of these barriers, including challenges related to patient awareness, inadequate infrastructure, scarcity of trained oncology professionals, and the high cost of cancer care. Furthermore, we discuss the limited availability of cancer clinical trials in the country, along with an examination of potential avenues to enhance cancer care in India. By confronting these hurdles head-on and implementing innovative, pragmatic solutions, we take an indispensable step toward a future where every cancer patient in the country can access quality care.
Topics: Humans; Morbidity; Incidence; India; Neoplasms
PubMed: 37675499
DOI: 10.2217/fon-2023-0047 -
Reproduction in Domestic Animals =... Sep 2023The neonatal period may be defined as the first month of the calf's life; it may be considered part of the fourth trimester. It is the most hazardous due to the... (Review)
Review
The neonatal period may be defined as the first month of the calf's life; it may be considered part of the fourth trimester. It is the most hazardous due to the immaturity of the neonate's immune system and the environmental challenge from infections, the main causes of both bovine neonatal morbidity and mortality. The five most common morbidities causing mortality in neonatal calves are, in descending order, gastrointestinal infections, respiratory infections, abomasal disorders, umbilical infections and developmental abnormalities. This review describes the aetiology, incidence, risk factors and sequelae of these common morbidities and highlights current preventive strategies both at farm and national levels.
Topics: Animals; Cattle; Incidence; Cattle Diseases; Risk Factors; Animals, Newborn
PubMed: 37128970
DOI: 10.1111/rda.14369