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MeSH: Ohio

7 záznamů v Medvik Filtry

Článek online

Excess Mortality Associated With COVID-19 by Demographic Group: Evidence From Florida and Ohio

Quast, Troy
Autor Quast, Troy College of Public Health, University of South Florida, Tampa, FL, USA
Andel, Ross
Autor Andel, Ross College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA Department of Neurology, Charles University and Motol University Hospital, Prague, Czech Republic International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic

Public health reports. 2021 ; 136 (6) : 782-790. [pub] 20210826

Public Health Rep
ISSN 1468-2877
Medvik
Zdroj

OBJECTIVE: COVID-19 mortality varies across demographic groups at the national level, but little is known about potential differences in COVID-19 mortality across states. The objective of this study was to estimate the number of all-cause excess deaths associated with COVID-19 in Florida and Ohio overall and by sex, age, and race. METHODS: We calculated the number of weekly and cumulative excess deaths among adults aged ≥20 from March 15 through December 5, 2020, in Florida and Ohio as the observed number of deaths less the expected number of deaths, adjusted for population, secular trends, and seasonality. We based our estimates on death certificate data from the previous 10 years. RESULTS: The results were based on ratios of observed-to-expected deaths. The ratios were 1.17 (95% prediction interval, 1.14-1.21) in Florida and 1.15 (95% prediction interval, 1.11-1.19) in Ohio. Although the largest number of excess deaths occurred in the oldest age groups, in both states the ratios of observed-to-expected deaths were highest among adults aged 20-49 (1.21; 95% prediction interval, 1.11-1.32). The ratio of observed-to-expected deaths for the Black population was especially elevated in Florida. CONCLUSIONS: Although excess deaths were largely concentrated among older cohorts, the high ratios of observed-to-expected deaths among younger age groups indicate widespread effects of COVID-19. The high levels of observed-to-expected deaths among Black adults may reflect in part disparities in infection rates, preexisting conditions, and access to care. The finding of high excess deaths among Black adults deserves further attention.

Článek

Donor facial composite allograft recovery operation: Cleveland and Boston experiences

Plastic and reconstructive surgery. 2012 ; 129 (3) : 461e-467e.

Plast Reconstr Surg
ISSN 1529-4242
Medvik
Zdroj

BACKGROUND: Complexity of logistic issues related to facial transplantation includes donor tissue recovery, recipient preparation, and operative execution. Limited information is available on the intricate process associated with facial allograft procurement in the United States. METHODS: The face transplant teams at the Cleveland Clinic and Brigham and Women's Hospital have combined their experiences regarding collaboration with organ procurement organizations and institutional review boards, and outlined technical and logistic challenges encountered during the process of facial allograft procurement and compared them with those of solid organ procurement. RESULTS: In a collaborative effort, both programs have created comprehensive guidelines for all aspects involved in donor facial allograft procurement. CONCLUSIONS: The authors suggest that every face transplant team should develop a thorough understanding of the local and regional legislative issues related to organ and tissue donation and ethical concerns surrounding this procedure. The recovery plan has to be communicated extensively among all members of the team. The Cleveland and Boston teams hope their experiences may help other teams in the process of building new face transplant programs. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

Článek

Riziko srdečního selhání u nekardiálních operací
[Outcomes of patients with stable heart failure undergoing elective noncardiac surgery]

YO, Xu-Cai
Autor YO, Xu-Cai

Clinical Cardiology Alert. 2008 ; 2 (4) : 26.

ISSN 1213-2586
Medvik
Zdroj

To evaluate modern surgical outcomes in patients with stable heart failure undergoing elective major noncardiac surgery and to compare the experience of patients with heart failure who have reduced vs preserved left ventricular ejection fraction (EF). PATIENTS AND METHODS: We retrospectively studied 557 consecutive patients with heart failure (192 EF less than or equal to 40% and 365 EF greater than 40%) and 10,583 controls who underwent systematic evaluation by hospitalists in a preoperative clinic before having major elective noncardiac surgery between January 1, 2003, and March 31, 2006. We examined outcomes in the entire cohort and in propensity-matched case-control groups. RESULTS: Unadjusted 1-month postoperative mortality in patients with both types of heart failure vs controls was 1.3% vs 0.4% (P equals .009), but this difference was not significant in propensity-matched groups (P equals .09). Unadjusted differences in mean hospital length of stay among heart failure patients vs controls (5.7 vs 4.3 days; P less than .001) and 1-month readmission (17.8% vs 8.5%; P less than .001) were also markedly attenuated in propensity-matched groups. Crude 1-year hazard ratios for mortality were 1.71 (95% confidence interval [CI], 1.5-2.0) for both types of heart failure, 2.1 (95% CI, 1.7-2.6) in patients with heart failure who had EF less than or equal to 40%, and 1.4 (95% CI, 1.2-1.8) in those who had EF greater than 40% (P less than .01 for all 3 comparisons); however, the differences were not significant in propensity-matched groups (P equals .43). CONCLUSION: Patients with clinically stable heart failure did not have high perioperative mortality rates in association with elective major noncardiac surgery, but they were more likely than patients without heart failure to have longer hospital stays, were more likely to require hospital readmission, and had a substantial long-term mortality rate.