SENTINEL1: Two-Season Study of Respiratory Syncytial Virus Hospitalizations among U.S. Infants Born at 29 to 35 Weeks' Gestational Age Not Receiving Immunoprophylaxis.
Humans; Male; Female; Infant; Infant Newborn; Odds Ratio; Multivariate Analysis; Antiviral Agents/therapeutic use; United States/epidemiology; Intensive Care Units Pediatric; Community-Acquired Infections/epidemiology; Respiration Artificial; Hospitalization/statistics & numerical data; Infant Premature; Respiratory Syncytial Virus Human; Infant Premature Diseases/epidemiology/prevention & control/therapy; Palivizumab/therapeutic use; Respiratory Syncytial Virus Infections/epidemiology/prevention & control/therapy
OBJECTIVE: The SENTINEL1 observational study characterized confirmed respiratory syncytial virus hospitalizations (RSVH) among U.S. preterm infants born at 29 to 35 weeks' gestational age (wGA) not receiving respiratory syncytial virus (RSV) immunoprophylaxis (IP) during the 2014 to 2015 and 2015 to 2016 RSV seasons. STUDY DESIGN: All laboratory-confirmed RSVH at participating sites during the 2014 to 2015 and 2015 to 2016 RSV seasons (October 1-April 30) lasting ≥24 hours among preterm infants 29 to 35 wGA and aged <12 months who did not receive RSV IP within 35 days before onset of symptoms were identified and characterized. RESULTS: Results were similar across the two seasons. Among infants with community-acquired RSVH (N = 1,378), 45% were admitted to the intensive care unit (ICU) and 19% required invasive mechanical ventilation (IMV). There were two deaths. Infants aged <6 months accounted for 78% of RSVH observed, 84% of ICU admissions, and 91% requiring IMV. Among infants who were discharged from their birth hospitalization during the RSV season, 82% of RSVH occurred within 60 days of birth hospitalization discharge. CONCLUSION: Among U.S. preterm infants 29 to 35 wGA not receiving RSV IP, RSVH are often severe with almost one-half requiring ICU admission and about one in five needing IMV.
Anderson EJ; DeVincenzo JP; Simões EAF; Krilov LR; Forbes ML; Pannaraj PS; Espinosa CM; Welliver RC; Wolkoff LI; Yogev R; Checchia PA; Domachowske JB; Halasa N; McBride SJ; Kumar VR; McLaurin KK; Rizzo CP; Ambrose CS
American Journal of Perinatology
2020
2020-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1055/s-0039-1681014" target="_blank" rel="noreferrer noopener">10.1055/s-0039-1681014</a>
Relation of concomitant heart failure to outcomes in patients hospitalized with influenza.
Female; Humans; Male; Aged; Middle Aged; Retrospective Studies; United States/epidemiology; Incidence; Comorbidity; Follow-Up Studies; Survival Rate/trends; Hospitalization/statistics & numerical data; Inpatients; Length of Stay/trends; Heart Failure/epidemiology; Hospital Mortality/trends; Influenza Human/epidemiology
Influenza is a major public health challenge. Patients hospitalized with influenza who also have heart failure (HF) may be at risk for worse outcomes compared with patients without HF. There is a lack of large studies examining this issue. We queried the 2013 to 2014 National Inpatient Sample for all adult patients (aged ≥ 18 years) admitted with influenza with and without concomitant HF. Using propensity score matching, patients were matched across demographics, discharge weights, and comorbidities. Outcomes included in-hospital mortality, complications, length of stay, and average hospital costs. Of 218,540 influenza hospitalizations, 45,460 (20.8%) had concomitant HF. Patients with HF had higher in-hospital mortality (6.1% vs 3.8%, adjusted odds ratio [aOR] 1.66 [95% confidence interval [CI] 1.44 to 1.91]; p <0.001), acute kidney injury (29.5% vs 22.2%, aOR 1.47 [95% CI 1.37 to 1.57]; p <0.001), acute kidney injury requiring dialysis (2.0% vs 1.0%, aOR 2.08 [1.62 to 2.67], acute respiratory failure (36.2% vs 23.5%, aOR 1.85 [1.73 to 1.97]; p <0.001), and acute respiratory failure requiring mechanical ventilation (17.1% vs 9.3%, OR 2.01 [1.84 to 2.21]; p <0.001), longer length of stay (5.70 ± 0.02 days vs 4.60 ± 0.01 days, p <0.001) and higher average hospital costs ($11,609 ± $52 vs $9,003 ± $38, p <0.001). In conclusion, in patients hospitalized with influenza, HF is associated with increased risk of in-hospital mortality and complications. Our results highlight a need for early recognition and aggressive treatment of HF in these patients to try to improve outcomes.
Panhwar MS; Kalra A; Gupta T; Kolte D; Khera S; Bhatt DL; Ginwalla M
The American journal of cardiology
2019
2019-05-01
Copyright © 2019 Elsevier Inc. All rights reserved.
journalArticle
<a href="http://doi.org/10.1016/j.amjcard.2019.01.046" target="_blank" rel="noreferrer noopener">10.1016/j.amjcard.2019.01.046</a>
PMID: 30819433
Screening for adolescent depression in a pediatric emergency department.
*Adolescent Behavior; Adolescent; Adult; Age Distribution; Comorbidity; Cross-Sectional Studies; Depression/classification/*diagnosis/*epidemiology; Emergency Service; Female; Hospital/*statistics & numerical data; Hospitalization/statistics & numerical data; Humans; Logistic Models; Male; Mass Screening/*instrumentation/*statistics & numerical data; Ohio/epidemiology; Patient Participation/statistics & numerical data; Pediatrics/*statistics & numerical data; Prevalence; Psychiatric Status Rating Scales; Transportation of Patients/statistics & numerical data; Wounds and Injuries/epidemiology
OBJECTIVES: To describe the prevalence of depressive symptoms in adolescents presenting to the emergency department (ED) and to describe their demographics and outcomes compared with adolescents endorsing low levels of depressive symptoms. METHODS: The Beck Depression Inventory-2nd edition (BDI-II) was used to screen all patients 13-19 years of age who presented to the ED during the period of study. The BDI-II is a 21-item self-report instrument used to measure the presence and severity of depressive symptoms in adolescents and adults. Demographics and clinical outcomes of screening-program participants were abstracted by chart review. Patients were categorized into one of four severity categories (minimal, mild, moderate, or severe) and one of three presenting complaint categories (medical, trauma, mental health). RESULTS: Four hundred eighty-seven patients were approached, and 351(72%) completed the screening protocol. Participants endorsed minimal (n = 192, 55%), mild (n = 52, 15%), moderate (n = 41, 11%), or severe depressive symptoms (n = 66, 19%). Those with moderate or severe depressive symptoms were more likely to be hospitalized. Of patients completing the BDI-II, 72% with psychiatric, 12% with traumatic, and 19% with medical chief complaints endorsed either moderate or severe depressive symptoms. CONCLUSIONS: Depressive symptoms are prevalent in this screening sample, regardless of presenting complaint. A substantial proportion of patients with nonpsychiatric chief complaints endorsed moderate or severe depressive symptoms. A screening program might allow earlier identification and referral of patients at risk for depression.
Scott Emily Gale; Luxmore Brett; Alexander Heather; Fenn Robin L; Christopher Norman C
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
2006
2006-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1197/j.aem.2005.11.085" target="_blank" rel="noreferrer noopener">10.1197/j.aem.2005.11.085</a>
Inhaled corticosteroid use in asthmatic children receiving Ohio Medicaid: trend analysis, 1997-2001.
Administration; Adolescent; Adrenal Cortex Hormones/administration & dosage/*therapeutic use; African Americans/statistics & numerical data; Ambulatory Care/statistics & numerical data; Asthma/diagnosis/*drug therapy/ethnology; Child; Cross-Sectional Studies; Drug Utilization/statistics & numerical data/trends; Emergency Service; European Continental Ancestry Group/statistics & numerical data; Female; Hospital/statistics & numerical data; Hospitalization/statistics & numerical data; Humans; Infant; Inhalation; Male; Medicaid/*statistics & numerical data; Newborn; Ohio; Preschool; Regression Analysis; Retrospective Studies; Sex Factors; United States
BACKGROUND: In 1997, national guidelines emphasized that inhaled corticosteroids (ICSs) are key therapy for individuals with all classes of persistent asthma, including children. OBJECTIVE: To examine the effect of these guidelines via time-trend analysis of ICS dispensation among children with asthma and Ohio Medicaid insurance. METHODS: A retrospective cross-sectional analysis by yearly cohorts was performed. From January 1, 1997, to December 31, 2001, all children from birth to the age of 18 years with 6 months of Ohio Medicaid enrollment or more, 1 or more asthma diagnoses associated with a provider claim, and 1 or more prescription claims for an asthma medication in a given calendar year were identified using claims data. The daily beclomethasone equivalent (BME) dose, the daily albuterol equivalent dose, and asthma-related health care use were calculated for each child within each yearly cohort. A time-trend regression analysis of subjects enrolled in all 5 years examined factors associated with BME. RESULTS: A total of 77,557 children met the study criteria. Among the 1,475 children enrolled during all 5 years, year of enrollment was a positive independent predictor of BME after adjustment for age, race, sex, systemic steroid bursts, albuterol equivalent dose, and health care use (P \textless .001). CONCLUSIONS: The daily BME dose significantly increased for children with asthma insured by Ohio Medicaid from 1997 to 2001. However, the percentages of children receiving both ICS and a therapeutic BME dose were alarmingly low. The mean BME dose was particularly low among children with 1 or more emergency department visits, no hospitalizations, and 3 or fewer physician visits for asthma per year, suggesting that broader efforts to target this group are needed.
Stevenson Michelle D; Heaton Pamela C; Moomaw Charles J; Bean Judy A; Ruddy Richard M
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
2008
2008-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/S1081-1206(10)60049-X" target="_blank" rel="noreferrer noopener">10.1016/S1081-1206(10)60049-X</a>
Similarities Between Large Animal-Related and Motor Vehicle Crash-Related Injuries.
*Equidae; *Injury Severity Score; *Ruminants; Accidents; Adult; animal; Animals; Blood Alcohol Content; Female; Hospitalization/statistics & numerical data; Humans; injury; Male; Middle Aged; Retrospective Studies; rural; Traffic/*statistics & numerical data; trauma; United States; vehicle; Wounds and Injuries/classification/*epidemiology/etiology
OBJECTIVE: Many Americans sustain large animal-related injuries (LARIs) from blunt trauma. We compare the injuries and management of LARI in our region of the United States with those of motor vehicle crashes (MVCs). METHODS: A 15-year retrospective study of trauma patients with LARI matched to MVC controls by Injury Severity Score (ISS), age, and sex was conducted. Values were statistically compared, and differences were considered statistically significant at P \textless .05. RESULTS: There were 156 LARI cases, of which 87% were related to horses, 8% to bulls, and the remainder to deer, mules, bison, cows, and rams. In the LARI group, the age was 42+/-18 years (mean+/-SD), ISS was 7+/-4, and 61% were females. The MVC group had a significantly longer length of hospital stay (5+/-5 vs 4+/-3 days) and blood alcohol concentration (35+/-84 vs 3+/-20 g/L). There were no significant differences in injury patterns between LARI and MVC; however, additional radiological studies (RS) were performed on MVC (9+/-6 vs 7+/-5). LARI patients were more often transferred from rural locations (39% vs 25%) and traveled further to our trauma center (40+/-32 vs 24+/-29 km) than did MVC patients. CONCLUSIONS: LARI has a similar pattern of injury to MVC, but fewer RS. LARI typically occurred further away, requiring transfer from rural areas to our institution. We recommend a similar approach for the evaluation of LARI and MVC.
Tremelling Abigail M; Marley Robert A; Marley Mackenzie B; Woofter Christina M; Docherty Courtney; Salvator Ann E; Muakkassa Farid F
Wilderness & environmental medicine
2017
2017-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.wem.2017.05.004" target="_blank" rel="noreferrer noopener">10.1016/j.wem.2017.05.004</a>