Clinical Epidemiology and Global Health最新文献

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Factors associated with tuberculosis among PLHIV: An observational study in a Government Medical College in West Bengal, India PLHIV 中与结核病相关的因素:印度西孟加拉邦一所公立医学院的观察研究。
IF 2.3
Clinical Epidemiology and Global Health Pub Date : 2024-07-21 DOI: 10.1016/j.cegh.2024.101729
{"title":"Factors associated with tuberculosis among PLHIV: An observational study in a Government Medical College in West Bengal, India","authors":"","doi":"10.1016/j.cegh.2024.101729","DOIUrl":"10.1016/j.cegh.2024.101729","url":null,"abstract":"<div><h3>Background</h3><p>Tuberculosis (TB) is one of the leading causes of significant morbidity and mortality among the People Living with Human Immune-deficiency Virus (PLHIV) in India. Reducing TB burden among PLHIV is a priority area under the National TB Elimination Program (NTEP).</p></div><div><h3>Methodology</h3><p>We analyzed the routinely collected data from an Anti-Retro-viral Treatment Centre (ARTC) of Malda Medical College, West Bengal with an aim of identifying the factors associated with TB prevalence among the PLHIV. All 739 PLHIV who attended the ARTC during 2020–2022, were included in this study.</p></div><div><h3>Results</h3><p>Mean age of the study participants was 34 years (SD:13). 47.9 % PLHIV received Co-trimoxazole Prophylaxis Treatment (CPT) whereas 67.7 % PLHIV received TB preventive treatment (TPT). Transgender [2.9 (1.4–6)], Males [3.7 (1.8–7.9)], Widow/Separated [2.5 (1.2–5.4)], Living with 2–4 Family members [1.6 (1–2.7)], CD4 count less than 200 [1.9 (1.1–3.2)], those who received CPT [17 (7.1–40.8)] and those who didn't receive TPT [1.6 (1–2.6)] were independently associated with increased risk of developing TB. There was no significant association of Age with TB diagnosis among the PLHIV.</p></div><div><h3>Conclusions</h3><p>It is evident from this study, that introduction of TPT and improving CD4 count by Anti-retroviral Treatment is the key intervention to reduce TB burden among PLHIV. The study found significant association of CPT with TB. Further study may be conducted to determine the actual reason for such association.</p></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213398424002252/pdfft?md5=f38a501f28727864059c5bfb749323bc&pid=1-s2.0-S2213398424002252-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimising Indian healthcare delivery with standard treatment workflows 利用标准治疗工作流程优化印度医疗服务
IF 2.3
Clinical Epidemiology and Global Health Pub Date : 2024-07-21 DOI: 10.1016/j.cegh.2024.101732
{"title":"Optimising Indian healthcare delivery with standard treatment workflows","authors":"","doi":"10.1016/j.cegh.2024.101732","DOIUrl":"10.1016/j.cegh.2024.101732","url":null,"abstract":"<div><h3>Background</h3><p>Standard treatment workflows (STWs) indeed play a crucial role in enhancing healthcare delivery by providing structured guidelines for managing prevalent diseases. These guidelines are particularly beneficial in primary and secondary healthcare settings, where they help standardize treatment protocols, streamline referrals, and ultimately improve healthcare efficiency.</p></div><div><h3>Methods</h3><p>Indian Council of Medical Research, in collaboration with the National Health Authority and the World Health Organisation India country office developed the STWs. The broad medical specialities were identified and speciality expert groups each of 5–12 experienced members led by an eminent chairperson were constituted. Priority disease conditions were identified and the speciality experts deliberated on the evidence available for various recommendations and developed the content for the STW. These were then converted to a one-pager infographic. The draft STWs were reviewed by relevant experts for internal and external validation of content.</p></div><div><h3>Results</h3><p>125 STWs in 23 specialties have been developed.</p></div><div><h3>Conclusion</h3><p>STWs are one-page summaries of clinical guidelines designed to improve healthcare delivery in India. Training healthcare profesionals and collaboration with medical bodies are crucial for successful implementation. This can ensure standardized, evidence-based care throughout India's healthcare system.</p></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213398424002288/pdfft?md5=a91ce8ca2b355d6d4d8060f2298306dc&pid=1-s2.0-S2213398424002288-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Increased socioeconomic vulnerability in breast cancer diagnosis during the COVID-19 pandemic in Brazil 在巴西 COVID-19 大流行期间,乳腺癌诊断中的社会经济脆弱性增加
IF 2.3
Clinical Epidemiology and Global Health Pub Date : 2024-07-21 DOI: 10.1016/j.cegh.2024.101735
{"title":"Increased socioeconomic vulnerability in breast cancer diagnosis during the COVID-19 pandemic in Brazil","authors":"","doi":"10.1016/j.cegh.2024.101735","DOIUrl":"10.1016/j.cegh.2024.101735","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the impact of the coronavirus disease (COVID-19) pandemic on the time of breast cancer diagnosis in Brazil and associated socioeconomic factors.</p></div><div><h3>Methods</h3><p>This population-based retrospective study examined breast cancer diagnoses in women between 2019 and 2020 (n = 12,597). Two periods were evaluated: the pre-pandemic (March–December 2019) and pandemic periods (March–December 2020). Logistic regression was performed to calculate odds ratios and 95 % confidence intervals (CIs).</p></div><div><h3>Results</h3><p>There was a 50.2 % reduction (<em>p</em> &lt; 0.01) in the number of diagnoses, and the average time from the first consultation to diagnosis increased from 28 to 36 days during the first six months of the COVID-19 pandemic (<em>p</em> = 0.006). Before the pandemic, the regression model indicated an increased possibility of delay in breast cancer diagnosis in women with lower education levels (OR = 1.30; 95 % CI:1.14–1.48); who were residents in the north, northeast, or midwest regions (OR = 1.56; 95 % CI:1.35–1.81); and who presented staging I or II (OR = 1.96; 95 % CI:1.71–2.24). During the pandemic, there was an increase in the odds ratios for all variables: education, an increase of 10.8 %; region of residence, 20.5 %; and staging, 9.2 %.</p></div><div><h3>Conclusion</h3><p>The COVID-19 pandemic exacerbated pre-existing socioeconomic disparities during the early detection of breast cancer. It is important that, at critical moments in health, interventions be carried out for patients in vulnerable circumstances, thus minimizing the effects of possible delays in diagnosis.</p></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213398424002318/pdfft?md5=20f21b0cdcc149d477e1897f2f8afa8f&pid=1-s2.0-S2213398424002318-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141841457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnostic accuracy of Xpert MTB/RIF and Xpert ultra tests in pulmonary and extrapulmonary tuberculosis compared to Löwenstein-Jensen culture Xpert MTB/RIF 和 Xpert ultra 检测与 Löwenstein-Jensen 培养法相比,在肺结核和肺外结核病中的诊断准确性
IF 2.3
Clinical Epidemiology and Global Health Pub Date : 2024-07-20 DOI: 10.1016/j.cegh.2024.101730
{"title":"Diagnostic accuracy of Xpert MTB/RIF and Xpert ultra tests in pulmonary and extrapulmonary tuberculosis compared to Löwenstein-Jensen culture","authors":"","doi":"10.1016/j.cegh.2024.101730","DOIUrl":"10.1016/j.cegh.2024.101730","url":null,"abstract":"<div><h3>Background</h3><p>Tuberculosis (TB) is one of the leading causes of death worldwide. However, an accurate diagnosis contributes to timely treatment, reducing its adverse consequences. The aim of this research was to determine the diagnostic accuracy of the molecular test Xpert MTB/RIF and Xpert MTB/RIF Ultra (Xpert Ultra) for the diagnosis of pulmonary and extrapulmonary TB compared to Löwenstein-Jensen culture.</p></div><div><h3>Methods</h3><p>We conducted a cross-sectional study of diagnostic accuracy. We included samples from patients who attended a Peruvian laboratory between 2011 and 2022. The index test was the Xpert MTB/RIF and Xpert Ultra and the reference standard was Löwenstein-Jensen solid culture for <em>Mycobacterium tuberculosis</em>. We calculated sensitivity, specificity, and positive and negative likelihood ratios.</p></div><div><h3>Results</h3><p>We evaluated 1023 samples, of which 737 were pulmonary samples, 197 tested positive for the Xpert MTB/RIF and Xpert Ultra tests; and 151 tested positive for culture. The Xpert (MTB/RIF and Ultra) showed a joint sensitivity and specificity of: 97 % (95%CI: 93–99) and 93 % (95%CI: 91–95) in pulmonary samples, 100 % (95%CI: 29.2–100) and 98.3 % (95%CI: 94.1–99.8) in cerebrospinal fluid, 66.7 % (95%CI: 22.3–95.7) and 96.8 % (95%CI: 91–99.3) in pleural fluid, 100 % (95%CI: 15.8–100) and 94.3 % (95%CI: 80.8–99.3) in urine. For the detection of pulmonary TB, the Xpert MTB/RIF had a sensitivity and specificity of 97.1 % (95%CI: 89.9–99.6) and 95.6 % (95%CI: 92.9–97.5) and the Xpert Ultra of 97 % (95%CI: 88.5–99.6) 89.5 % (95%CI: 84.9–93.1) respectively.</p></div><div><h3>Conclusion</h3><p>Our results suggest that the Xpert MTB/RIF and the Xpert Ultra are tests with high diagnostic performance for the detection of pulmonary TB and adequate specificity in pulmonary, cerebrospinal fluid, pleural, and urine samples. However, the results for other samples were imprecise.</p></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213398424002264/pdfft?md5=a30709977ef40c2bbab41f653e67a270&pid=1-s2.0-S2213398424002264-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141960170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Breast cancer screening in Lebanon: Understanding knowledge, attitudes and barriers 黎巴嫩的乳腺癌筛查:了解知识、态度和障碍
IF 2.3
Clinical Epidemiology and Global Health Pub Date : 2024-07-20 DOI: 10.1016/j.cegh.2024.101733
{"title":"Breast cancer screening in Lebanon: Understanding knowledge, attitudes and barriers","authors":"","doi":"10.1016/j.cegh.2024.101733","DOIUrl":"10.1016/j.cegh.2024.101733","url":null,"abstract":"<div><h3>Background</h3><p>Breast cancer (BC) has been increasing in both prevalence and incidence in Lebanon. Knowing the positive impact mammographic screening has on reducing mortality rates, we sought to investigate the knowledge, attitudes and barriers towards BC screening amongst Lebanese women across all districts.</p></div><div><h3>Methods</h3><p>We conducted a cross-sectional study with 400 Lebanese women aged 35–75, with no prior or current diagnosis of BC, employing an online questionnaire filled face-to-face with participants to gather sociodemographic data and assess BC history and screening practices. We utilized the Breast Cancer Screening Beliefs Questionnaire (BCSBQ) and Champion Health Belief Model Scale (CHBMS) to evaluate knowledge, attitudes, and barriers.</p></div><div><h3>Results</h3><p>Findings revealed inadequate attitudes towards general health check-ups (77.5 %) and insufficient BC screening knowledge (56.4 %). Furthermore, 38.5 % encountered obstacles to mammography screening. Education significantly affected BC knowledge. Interestingly, increased knowledge of BC reduced barriers to mammographic screening. Participants with healthcare connections or background exhibited better attitudes towards health check-ups and encountered fewer screening obstacles.</p></div><div><h3>Conclusion</h3><p>This is the first study that endeavors to comprehensively investigate Lebanese women's knowledge, attitudes, and barriers concerning BC screening, encompassing all demographics and regions using validated scales (BCSBQ and CHBMS). Our data highlight the crucial role of education in advocating for early BC screening and the necessity to reevaluate national campaigns, particularly in communication methods, to ensure equitable access to screening across Lebanon.</p></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221339842400229X/pdfft?md5=7de630de6cd922c738b900740dbc9724&pid=1-s2.0-S221339842400229X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141960144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Financial impact of needle stick injury on a tertiary care teaching hospital 针刺伤对一家三级教学医院的财务影响。
IF 2.3
Clinical Epidemiology and Global Health Pub Date : 2024-07-19 DOI: 10.1016/j.cegh.2024.101726
{"title":"Financial impact of needle stick injury on a tertiary care teaching hospital","authors":"","doi":"10.1016/j.cegh.2024.101726","DOIUrl":"10.1016/j.cegh.2024.101726","url":null,"abstract":"<div><h3>Background</h3><p>Accidental needle stick injuries (NSIs) are an occupational hazard for healthcare workers (HCWs). Despite the implementation of preventive measures, NSIs still continue to occur in health care settings. The cost incurred by an institute for the management of occupational exposure to blood borne pathogen is a significant economic burden.This retrospective study was aimed to estimate the prevalence, factors associated with NSIs and cost burden on hospital due to NSIs.</p></div><div><h3>Material and methods</h3><p>Retrospective data of all reported NSIs among HCWs between January 2019 and December 2021 in a tertiary care hospital was collected and analyzed. CDC definition was used to calculate direct &amp; indirect cost.</p></div><div><h3>Results</h3><p>&amp; Discussion- A total 205 NSIs were reported between January 2019 and December 2021. Nurses were the most affected category of HCWs. The maximum number of NSI cases (18.54 %) occurred during handling of biomedical waste. Both the source and the affected HCWs were tested and it was found that the source was seropositive in 30(14.63 %), seronegative in 128 (62.44 %) cases and in 47(22.93 %) cases there was an unknown source resulting in NSI. A total of 13, 21,206 INR, which included both direct and indirect cost, spent by hospital in the management of NSI's, over a period of 3yrs.</p></div><div><h3>Conclusion</h3><p>Surveillance and analysis of NSI is very crucial for the planning of both preventive measures and training modules. Managing NSI generates significant cost. Hepatitis B vaccination for all healthcare workers plays major role in reducing cost of managing NSIs.</p></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213398424002227/pdfft?md5=e36a32c0b8e829563a7ae29d7c559103&pid=1-s2.0-S2213398424002227-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141850488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Unraveling patient satisfaction, associated factors, and dissatisfaction reasons in the provision of health care services for rural communities in Bangladesh: A cross-sectional investigation 解读孟加拉国农村社区医疗服务中的患者满意度、相关因素和不满意原因:一项横断面调查
IF 2.3
Clinical Epidemiology and Global Health Pub Date : 2024-07-19 DOI: 10.1016/j.cegh.2024.101724
{"title":"Unraveling patient satisfaction, associated factors, and dissatisfaction reasons in the provision of health care services for rural communities in Bangladesh: A cross-sectional investigation","authors":"","doi":"10.1016/j.cegh.2024.101724","DOIUrl":"10.1016/j.cegh.2024.101724","url":null,"abstract":"<div><h3>Background</h3><p>Access to high-quality healthcare is a fundamental right, but rural communities in Bangladesh face challenges in accessing such services. Patient satisfaction plays a crucial role in healthcare outcomes. Identifying factors influencing satisfaction is vital for targeted interventions.</p></div><div><h3>Methods</h3><p>A cross-sectional investigation was conducted in rural areas of Sirajganj, Rajshahi, Bangladesh, from April to June 2023. Convenient sampling was employed, and face-to-face interviews were conducted using a semi-structured questionnaire. A total of 411 participants were included in the final analysis. Descriptive statistics, as well as bivariate and multivariable logistic regression analyses, were carried out using SPSS software.</p></div><div><h3>Results</h3><p>Most unmarried participants (mean age: 41.93 ± 14.54 years; age range: 18–88 years) had primary education and a family income below 15,000 BDT. Among them, 80.3 % reported dissatisfaction with treatment. Significant factors linked to dissatisfaction included low education, being a businessman, living in nuclear families, daily physical exercise, difficulty accessing healthcare, average doctor-patient communication, high treatment costs, long waiting times, government hospital services, proximity to healthcare centers, lack of follow-up services, and absence of Telemedicine or M-health services.</p></div><div><h3>Conclusion</h3><p>This study identifies key factors affecting patient satisfaction in rural Bangladesh. Interventions should focus on improving doctor-patient communication, reducing treatment costs and waiting times, enhancing access to healthcare and follow-up services, and incorporating Telemedicine or M-health services. Special attention is needed for businessmen, nuclear family residents, those who exercise daily, and patients using government hospitals or living near healthcare centers, as these groups report higher dissatisfaction.</p></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213398424002203/pdfft?md5=429c52f1d16bc20a08d78701f9a6a410&pid=1-s2.0-S2213398424002203-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identification and resolution of drug-related problems among neonates in neonatal intensive care unit (NICU): A prospective longitudinal observational study "新生儿重症监护室(NICU)新生儿药物相关问题的识别与解决:一项前瞻性纵向观察研究"
IF 2.3
Clinical Epidemiology and Global Health Pub Date : 2024-07-19 DOI: 10.1016/j.cegh.2024.101728
{"title":"Identification and resolution of drug-related problems among neonates in neonatal intensive care unit (NICU): A prospective longitudinal observational study","authors":"","doi":"10.1016/j.cegh.2024.101728","DOIUrl":"10.1016/j.cegh.2024.101728","url":null,"abstract":"<div><h3>Background</h3><p>Drug related problems (DRPs) can interfere with the desired therapeutic outcomes. Neonates are susceptible for DRP occurrence due to clinical heterogeneity, inappropriate formulations, complexity of drug regimens and polypharmacy. Thus, the objective of this study was to characterize the DRP, their resolutions and associated risk factors among neonates in the Neonatal Intensive Care Unit (NICU).</p></div><div><h3>Methods</h3><p>A cross-sectional study was carried out in NICU ward at tertiary care teaching hospital for 18 months. Clinical pharmacists participated on daily basis to collect patient information and assess their medication therapy for DRPs. DRPs were classified into problems and their causes according to Pharmaceutical Care Network Europe (PCNE) Version 9.1. Clinical pharmacist implicated evidence-based interventions to resolve DRPs. SPSS V.25 was used for the statistical analysis. Univariate logistic regression analysis was used for the determination of risk factors for DRPs, with a p-value &lt;0.05 for associations that were statistically significant.</p></div><div><h3>Results</h3><p>A total of 426 neonates were enrolled with a mean gestational age of 35.2 ± 7.5 weeks and a mean birth weight of 2316 ± 1814 g. A total of 486 DRPs were found among 55.6 % neonates. Among them, majority of DRPs were belongs to treatment effectiveness [n = 427 (87.8 %)]. In total, 559 interventions were made, resulting in the resolution of 87.4 % of the DRPs. Furthermore, neonates staying in hospital for more than 5 days identified as most significant risk factor of DRPs.</p></div><div><h3>Conclusion</h3><p>DRPs are common in neonates admitted to NICU. Clinical Pharmacist can play significant roles in identifying, preventing and resolving DRPs among neonates.</p></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213398424002240/pdfft?md5=a49c2d9d804bfdc71ec2f6650f1024db&pid=1-s2.0-S2213398424002240-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
All-cause 30-day mortality associated with hysterectomy in Sweden from 2015 to 2021 using data from the Swedish perioperative register 利用瑞典围手术期登记册的数据,分析 2015-2021 年瑞典子宫切除术相关的全因 30 天死亡率
IF 2.3
Clinical Epidemiology and Global Health Pub Date : 2024-07-18 DOI: 10.1016/j.cegh.2024.101727
{"title":"All-cause 30-day mortality associated with hysterectomy in Sweden from 2015 to 2021 using data from the Swedish perioperative register","authors":"","doi":"10.1016/j.cegh.2024.101727","DOIUrl":"10.1016/j.cegh.2024.101727","url":null,"abstract":"<div><h3>Objective</h3><p>Hysterectomy is one of the most common gynaecological procedures. All-cause mortality within 30 days is an important indicator of care quality.</p><p>The primary objectives of this quality project were to study all-cause 30-day mortality following hysterectomy in Sweden and the impact of age, ASA class, and malignant indication on outcomes.</p></div><div><h3>Population and methods</h3><p>All hysterectomy procedures documented in the Swedish Perioperative Register (SPOR) were included from 2015 to 01-01 until 2021-12-31. Patient demographics and perioperative observations were collected and analysed.</p></div><div><h3>Main outcome measure</h3><p>All-cause 30-day mortality.</p></div><div><h3>Results</h3><p>The study cohort consisted of 25,391 patients with a mean age of 55.0 ± 13.8, and 54 % of patients were ASA I-II. All-cause 30-day mortality was low: only 1 patient died within the first 24 h, and 23 deaths were noted within 30 days among 25,391 procedures studied; equal to a perioperative mortality rate (POMR) 0.09 %. Higher age, higher ASA class, malignant indication, and combined general and neuraxial anaesthesia increased numerical POMR. Elderly (&gt;65-years) and ASA III-IV were associated with significant increased un- and adjusted Odds Ratio for death within 30-days at 4.3 (95%CI 1.3–14.3, p = 0.02) and 15.3 (95%CI 4.8–84.4, p = 0.001) respectively.</p></div><div><h3>Conclusions</h3><p>All-cause 30-day mortality associated with hysterectomy in Sweden during recent years is low with a POMR of 0.09 %. Higher age and more pronounced higher ASA class increased the odds ratio for all-cause 30-day mortality. Further efforts to optimise the perioperative care of elderly and frail patients are important.</p></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213398424002239/pdfft?md5=b15b9556ea2d073835b0df892399bea5&pid=1-s2.0-S2213398424002239-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
ENDS and global health: India's stand matters ENDS 与全球健康:印度的立场很重要
IF 2.3
Clinical Epidemiology and Global Health Pub Date : 2024-07-16 DOI: 10.1016/j.cegh.2024.101725
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