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Acute admissions to medical departments in Denmark: diagnoses and patient characteristics.

https://arctichealth.org/en/permalink/ahliterature262754
Source
Eur J Intern Med. 2014 Sep;25(7):639-45
Publication Type
Article
Date
Sep-2014
Author
Betina Vest-Hansen
Anders Hammerich Riis
Henrik Toft Sørensen
Christian Fynbo Christiansen
Source
Eur J Intern Med. 2014 Sep;25(7):639-45
Date
Sep-2014
Language
English
Publication Type
Article
Keywords
Acute Disease - epidemiology - therapy
Adolescent
Adult
Aged
Aged, 80 and over
Clinical Coding - methods
Denmark - epidemiology
Female
Humans
Incidence
Male
Middle Aged
Patient Admission - statistics & numerical data - trends
Registries
Retrospective Studies
Young Adult
Abstract
Despite extensive research on individual diseases, population-based knowledge about reasons for acute medical admissions remains limited. Our aim was to examine primary diagnoses, Charlson Comorbidity Index (CCI) score, age, and gender among patients admitted acutely to medical departments in Denmark.
In this population-based observational study, 264,265 acute medical patients admitted during 2010 were identified in the Danish National Registry of Patients (DNRP), covering all hospitals in Denmark. Reasons for acute admissions were assessed by primary diagnoses, grouped according to the International Classification of Diseases 10th edition. Additionally, the CCI score, age and gender were presented according to each diagnostic group.
Two-thirds of the patients had one of the four following reasons for admission: cardiovascular diseases (19.3%), non-specific Z-diagnoses ("Factors influencing health status and contact with health services") (16.9%), infectious diseases (15.5%), and non-specific R-diagnoses ("Symptoms and abnormal findings, not elsewhere classified") (11.8%). In total, 45% of the patients had a CCI score of one or more and there was a considerable overlap between the patients' chronic diseases and the reason for admission. The median age of the study population was 64 years (IQR 47-77 years), ranging from 46 years (IQR 27-66) for injury and poisoning to 74 years (IQR 60-83) for hematological diseases. Gender representation varied considerably within the diagnostic groups, for example with male predominance in mental disorders (59.0%) and female predominance in diseases of the musculoskeletal system (57.8%).
Our study identifies that acute medical patients often present with non-specific symptoms or complications related to their chronic diseases.
PubMed ID
24997487 View in PubMed
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[Acute alcoholic intoxication in hospital and drunk cell]

https://arctichealth.org/en/permalink/ahliterature71816
Source
Tidsskr Nor Laegeforen. 2001 Sep 30;121(23):2683-5
Publication Type
Article
Date
Sep-30-2001
Author
W. Aasebø
J. Erikssen
J. Jonsbu
Author Affiliation
Medisinsk avdeling Sentralsykehuset i Akershus 1474 Nordbyhagen. waaseboe@online.no
Source
Tidsskr Nor Laegeforen. 2001 Sep 30;121(23):2683-5
Date
Sep-30-2001
Language
Norwegian
Publication Type
Article
Keywords
Adolescent
Adult
Alcoholic Intoxication - epidemiology - therapy
Comparative Study
English Abstract
Female
Humans
Male
Middle Aged
Norway - epidemiology
Patient Admission - statistics & numerical data - trends
Police
Prisons - legislation & jurisprudence
Abstract
BACKGROUND: There are few epidemiological studies of the care for persons with acute ethanol intoxication. Most of them probable do not get into contact with neither the police nor the health care system. MATERIAL AND METHODS: We have studied the files from Romerike Police District and from the Central Hospital of Akershus for the years 1988, 1993, 1998 and 2000, i.e. over a 12-year period. RESULTS: Over these 12 years, the police took care of the vast majority of cases, 2,259 persons compared to the 293 that were admitted to hospital. From 1988 to 2000, there was a 40% reduction in the use of police custody and a 600% increase in the numbers admitted to hospital. Almost all hospital patients were aged 15 to 60 years. Those taken into custody were a slightly younger group; 45% were below 29. The age distribution remained constant throughout the period. Among those taken into custody, only 8% were women, compared to 37% among those hospitalized. There was a steady increase in hospitalized women from 1988 to 2000, especially in the below-20 age group. INTERPRETATION: A marked reduction in the use of police custody took place over this 12-year period. Hospitalization for ethanol intoxication remained constant in men, while there was a dramatic increase in the numbers of women admitted, especially of young women.
PubMed ID
11699374 View in PubMed
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Acute effects of particulate air pollution on respiratory admissions: results from APHEA 2 project. Air Pollution and Health: a European Approach.

https://arctichealth.org/en/permalink/ahliterature15434
Source
Am J Respir Crit Care Med. 2001 Nov 15;164(10 Pt 1):1860-6
Publication Type
Article
Date
Nov-15-2001
Author
R W Atkinson
H R Anderson
J. Sunyer
J. Ayres
M. Baccini
J M Vonk
A. Boumghar
F. Forastiere
B. Forsberg
G. Touloumi
J. Schwartz
K. Katsouyanni
Author Affiliation
Department of Public Health Sciences, St. George's Hospital Medical School, London, United Kingdom. atkinson@sghms.ac.uk
Source
Am J Respir Crit Care Med. 2001 Nov 15;164(10 Pt 1):1860-6
Date
Nov-15-2001
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Age Distribution
Aged
Air Pollution - adverse effects - analysis
Asthma - epidemiology - etiology
Child
Child, Preschool
Emergencies
England - epidemiology
France - epidemiology
Health status
Health Surveys
Humans
Infant
Infant, Newborn
Italy - epidemiology
Middle Aged
Netherlands - epidemiology
Ozone - adverse effects - analysis
Particle Size
Patient Admission - statistics & numerical data - trends
Population Surveillance
Pulmonary Disease, Chronic Obstructive - epidemiology - etiology
Regression Analysis
Research Support, Non-U.S. Gov't
Seasons
Spain - epidemiology
Sweden - epidemiology
Time Factors
Urban Health - statistics & numerical data - trends
Weather
Abstract
The APHEA 2 project investigated short-term health effects of particles in eight European cities. In each city associations between particles with an aerodynamic diameter of less than 10 microm (PM(10)) and black smoke and daily counts of emergency hospital admissions for asthma (0-14 and 15-64 yr), chronic obstructive pulmonary disease (COPD), and all-respiratory disease (65+ yr) controlling for environmental factors and temporal patterns were investigated. Summary PM(10) effect estimates (percentage change in mean number of daily admissions per 10 microg/m(3) increase) were asthma (0-14 yr) 1.2% (95% CI: 0.2, 2.3), asthma (15-64 yr) 1.1% (0.3, 1.8), and COPD plus asthma and all-respiratory (65+ yr) 1.0% (0.4, 1.5) and 0.9% (0.6, 1.3). The combined estimates for Black Smoke tended to be smaller and less precisely estimated than for PM(10). Variability in the sizes of the PM(10) effect estimates between cities was also investigated. In the 65+ groups PM(10) estimates were positively associated with annual mean concentrations of ozone in the cities. For asthma admissions (0-14 yr) a number of city-specific factors, including smoking prevalence, explained some of their variability. This study confirms that particle concentrations in European cities are positively associated with increased numbers of admissions for respiratory diseases and that some of the variation in PM(10) effect estimates between cities can be explained by city characteristics.
PubMed ID
11734437 View in PubMed
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Admissions to a pediatric intensive care unit for status epilepticus: a 10-year experience.

https://arctichealth.org/en/permalink/ahliterature218214
Source
Crit Care Med. 1994 May;22(5):827-32
Publication Type
Article
Date
May-1994
Author
J. Lacroix
C. Deal
M. Gauthier
E. Rousseau
C A Farrell
Author Affiliation
Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Canada.
Source
Crit Care Med. 1994 May;22(5):827-32
Date
May-1994
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Chi-Square Distribution
Child
Child, Preschool
Hospital Mortality
Hospitals, University - utilization
Humans
Infant
Infant, Newborn
Intensive Care Units, Pediatric - utilization
Neurologic Examination
Outcome Assessment (Health Care)
Patient Admission - statistics & numerical data - trends
Prognosis
Quebec - epidemiology
Retrospective Studies
Risk factors
Status Epilepticus - classification - diagnosis - epidemiology - etiology - therapy
Survival Rate
Abstract
To characterize the etiology, course, and prognosis in children admitted to a pediatric intensive care unit (ICU) for status epilepticus.
Retrospective, descriptive study.
Pediatric ICU in a university hospital.
One hundred forty-seven children admitted with status epilepticus.
None.
Status epilepticus was defined as a prolonged (> 30 mins) or repeated tonic or tonic-clonic seizure with a persistent altered state of consciousness. Over 10 yrs, 147 children 0 to 16 yrs of age (median 1; mean 3.4 +/- 3.9 [SD]) were admitted to a pediatric ICU for, or with, 153 episodes of status epilepticus. Status epilepticus was caused most often by epilepsy (n = 52), atypical febrile convulsions (n = 21), bacterial meningitis (n = 20), encephalitis (n = 20), intoxication (n = 8), or a metabolic disorder (n = 12). Two infants, 1 and 3 months of age, and a patient with intoxication by isoniazid, responded to pyridoxine. Among 114 previously normal children, 34 patients displayed a new neurologic problem on discharge from the ICU, among whom, 68% (23/34) still had some neurologic abnormality 1 yr after the episode of status epilepticus. Nine patients died during their ICU stay, mostly from underlying disease rather than from the status epilepticus itself. A normal neurologic status before status epilepticus and age
PubMed ID
8181292 View in PubMed
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Appendectomy in Sweden 1989-1993 assessed by the Inpatient Registry.

https://arctichealth.org/en/permalink/ahliterature33696
Source
J Clin Epidemiol. 1998 Oct;51(10):859-65
Publication Type
Article
Date
Oct-1998
Author
P. Blomqvist
H. Ljung
O. Nyrén
A. Ekbom
Author Affiliation
Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Source
J Clin Epidemiol. 1998 Oct;51(10):859-65
Date
Oct-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Analysis of Variance
Appendectomy - adverse effects - statistics & numerical data - utilization
Appendicitis - diagnosis - epidemiology - surgery
Child
Child, Preschool
Female
Humans
Incidence
Infant
Infant, Newborn
Inpatients - statistics & numerical data
Length of Stay - trends
Linear Models
Male
Middle Aged
Patient Admission - statistics & numerical data - trends
Population Surveillance
Registries
Seasons
Sweden - epidemiology
Abstract
We analyzed all appendectomies in Sweden 1989-1993 (n = 60,306) recorded in the national Inpatient Registry. Our focus was on diagnostic accuracy, incidence rate of appendicitis, perforative appendicitis, and length of stay by day of admission and hospital category. The incidence rate of appendectomy decreased by 9.8% in women compared to 4.1% in men. Since the number of patients with an end diagnosis of appendicitis remained almost constant, diagnostic accuracy increased each year. This was more pronounced in women than men, seen in all hospital categories, and was higher for those admitted during periods of low capacity (weekends/ holidays). Perforated appendicitis did not increase. Duration of hospital stay decreased continuously, especially among the oldest. We found no indications of an increased frequency of complications, such as increases in the incidence rate of perforations or in the length of stay.
PubMed ID
9762879 View in PubMed
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[Are there alternatives to emergency admissions?]

https://arctichealth.org/en/permalink/ahliterature29489
Source
Tidsskr Nor Laegeforen. 2005 Sep 8;125(17):2355-7
Publication Type
Article
Date
Sep-8-2005
Author
Gunvor Eikeland
Helge Garåsen
Geir Jacobsen
Author Affiliation
Kvinneklinikken, St. Olavs Hospital, 7006 Trondheim. gunvor.eikeland@stolav.no
Source
Tidsskr Nor Laegeforen. 2005 Sep 8;125(17):2355-7
Date
Sep-8-2005
Language
Norwegian
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Emergency Service, Hospital - statistics & numerical data - utilization
Emergency Treatment
English Abstract
Female
Hospitals - utilization
Humans
Male
Middle Aged
Monitoring, Physiologic
Norway
Patient Admission - statistics & numerical data - trends
Patient transfer
Physician's Practice Patterns
Questionnaires
Socioeconomic Factors
Abstract
BACKGROUND: Emergency admissions account for an increasing number of admissions to hospitals, especially to medical departments. Several hospitals in Norway are planning alternatives to emergency admissions, e.g. emergency outpatient departments and observation units. MATERIAL AND METHODS: We registered emergency admissions to internal medicine and surgical, orthopaedic and gynaecological departments to St. Olavs University Hospital during one week in June 2003. Using questionnaires we received the admitting and the treating doctors' evaluation of the reason for admissions and also of the possibilities for alternatives as emergency care, nursing homes, observations units or treatment by general practitioners. RESULTS: 202 out of 262 admissions were included the study. Recently oncoming illness was the most important reason. For the whole group, only 10% of the admissions were caused by social issues, but social issues were often the main cause for admissions for older patients. Only 12% of the patients were admitted by their own general practitioner. An observation unit was the mostly recommended alternative to admission, but there were disagreements between primary care and hospital doctors as to which patients would be suitable. The study suggests that it is difficult to identify patients at the time of admission who could be treated without regular admission.
PubMed ID
16151493 View in PubMed
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Are there seasonal patterns to ruptured aortic aneurysms and dissections of the aorta?

https://arctichealth.org/en/permalink/ahliterature197548
Source
Eur J Vasc Endovasc Surg. 2000 Aug;20(2):173-6
Publication Type
Article
Date
Aug-2000
Author
R E Upshur
M M Mamdani
K. Knight
Author Affiliation
Primary Care Research Unit, Sunnybrook and Women's College Health Sciences Centre, Toronto, Canada.
Source
Eur J Vasc Endovasc Surg. 2000 Aug;20(2):173-6
Date
Aug-2000
Language
English
Publication Type
Article
Keywords
Aneurysm, Dissecting - epidemiology - etiology
Aortic Aneurysm - epidemiology - etiology
Aortic Rupture - epidemiology - etiology
Humans
Incidence
Longitudinal Studies
Models, Statistical
Ontario - epidemiology
Patient Admission - statistics & numerical data - trends
Population Surveillance
Retrospective Studies
Risk factors
Seasons
Time Factors
Abstract
to test the hypothesis that there are seasonal increases in aortic aneurysm ruptures and dissections.
a retrospective, population-based time series analysis of hospital admissions for dissection and rupture of the aortic aneurysm in the Province of Ontario from 1988-1997. Analyses were carried out on weekly and monthly aggregations of hospital admissions.
there is weak statistical evidence of seasonality in the weekly time series (BKS=0.0987, p=0.03) and no evidence of seasonality in the monthly time series. There is no evident seasonality in the time plots. The incidence of dissections increased significantly over the study period while the incidence of ruptures decreased.
this large population-based study, contrary to other published reports, fails to find convincing evidence of seasonality in rupture or dissection of aortic aneurysm though did demonstrate contrasting trends in incidence.
PubMed ID
10942690 View in PubMed
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The association between socioeconomic position, use of revascularization procedures and five-year survival after recovery from acute myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature93691
Source
BMC Public Health. 2008;8:44
Publication Type
Article
Date
2008
Author
Rosvall Maria
Chaix Basile
Lynch John
Lindström Martin
Merlo Juan
Author Affiliation
Social Epidemiology, Department of Clinical Sciences, Malmö University Hospital, Lund University, Malmö, Sweden. maria.rosvall@med.lu.se
Source
BMC Public Health. 2008;8:44
Date
2008
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Data Interpretation, Statistical
Female
Hospital Mortality
Humans
Income
Male
Middle Aged
Myocardial Infarction - economics - mortality - therapy
Myocardial Revascularization - economics - utilization
Outcome Assessment (Health Care)
Patient Admission - statistics & numerical data - trends
Recovery of Function
Sex Factors
Social Class
Survival Rate
Sweden
Abstract
BACKGROUND: Patients living under better socioeconomic circumstances often receive more active treatments after an acute myocardial infarction (AMI) compared to less affluent patients. However, most previous studies were performed in countries with less comprehensive coverage for medical services. In this Swedish nation-wide longitudinal study we wanted to evaluate long-term survival after AMI in relation to socioeconomic position (SEP) and use of revascularization. METHODS: From the Swedish Myocardial Infarction Register we identified all 45 to 84-year-old patients (16,041 women and 30,366 men) alive 28 days after their first AMI during the period 1993 to 1996. We obtained detailed information on the use of revascularization, cumulative household income from the 1975 and 1990 censuses and 5-year survival after the AMI. RESULTS: Patients with the highest cumulative income (adding the values of the quartile categories of income in 1975 and 1990) underwent a revascularization procedure within one month after their first AMI two to three times as often as patients with the lowest cumulative income and had half the risk of death within five years. The socioeconomic differences in the use of revascularization procedures could not be explained by differences in co-morbidity or type of hospital at first admission. Patients who underwent revascularization showed a similar lowered mortality risk in the different income groups, while there were strong socioeconomic differences in long-term mortality among patients who did not undergo revascularization. CONCLUSION: This nationwide Swedish study showed that patients with high income had a better long-term survival after recovery from their AMI compared to patients with low income. Furthermore, even though the use of revascularization procedures is beneficial, low SEP groups receive it less often than high SEP groups.
PubMed ID
18241335 View in PubMed
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The association between survey timing and patient-reported experiences with hospitals: results of a national postal survey.

https://arctichealth.org/en/permalink/ahliterature126978
Source
BMC Med Res Methodol. 2012;12:13
Publication Type
Article
Date
2012
Author
Oyvind A Bjertnaes
Author Affiliation
Department for Quality Measurement and Patient Safety, Norwegian Knowledge Centre for the Health Services, Oslo, Norway. oan@kunnskapssenteret.no
Source
BMC Med Res Methodol. 2012;12:13
Date
2012
Language
English
Publication Type
Article
Keywords
Diagnostic Tests, Routine
Educational Status
Female
Health Care Surveys
Hospital-Patient Relations
Hospitals - standards
Humans
Linear Models
Male
Middle Aged
Multivariate Analysis
Norway
Outcome Assessment (Health Care) - statistics & numerical data
Patient Admission - statistics & numerical data - trends
Patient Discharge - statistics & numerical data - trends
Patient satisfaction
Questionnaires
Socioeconomic Factors
Time Factors
Abstract
Research on the effect of survey timing on patient-reported experiences and patient satisfaction with health services has produced contradictory results. The objective of this study was thus to assess the association between survey timing and patient-reported experiences with hospitals.
Secondary analyses of a national inpatient experience survey including 63 hospitals in the 5 health regions in Norway during the autumn of 2006. 10,912 (45%) patients answered a postal questionnaire after their discharge from hospital. Non-respondents were sent a reminder after 4 weeks. Multilevel linear regression analysis was used to assess the association between survey timing and patient-reported experiences, both bivariate analysis and multivariate analysis controlling for other predictors of patient experiences.
Multivariate multilevel regression analysis revealed that survey time was significantly and negatively related to three of six patient-reported experience scales: doctor services (Beta = -0.424, p
Notes
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PubMed ID
22335801 View in PubMed
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Association of anti-smoking legislation with rates of hospital admission for cardiovascular and respiratory conditions.

https://arctichealth.org/en/permalink/ahliterature144274
Source
CMAJ. 2010 May 18;182(8):761-7
Publication Type
Article
Date
May-18-2010
Author
Alisa Naiman
Richard H Glazier
Rahim Moineddin
Author Affiliation
Department of Family and Community Medicine, University of Toronto, Ont. a.naiman@utoronto.ca
Source
CMAJ. 2010 May 18;182(8):761-7
Date
May-18-2010
Language
English
Publication Type
Article
Keywords
Adult
Cardiovascular Diseases - epidemiology
Female
Humans
Lung Diseases - epidemiology
Male
Ontario - epidemiology
Patient Admission - statistics & numerical data - trends
Smoking - legislation & jurisprudence
Social Control, Formal
Tobacco Smoke Pollution - legislation & jurisprudence - prevention & control
Abstract
Few studies have examined the impact of anti-smoking legislation on respiratory or cardiovascular conditions other than acute myocardial infarction. We studied rates of hospital admission attributable to three cardiovascular conditions (acute myocardial infarction, angina, and stroke) and three respiratory conditions (asthma, chronic obstructive pulmonary disease, and pneumonia or bronchitis) after the implementation of smoking bans.
We calculated crude rates of admission to hospital in Toronto, Ontario, from January 1996 (three years before the first phase of a smoking ban was implemented) to March 2006 (two years after the last phase was implemented. We used an autoregressive integrated moving-average (ARIMA) model to test for a relation between smoking bans and admission rates. We compared our results with similar data from two Ontario municipalities that did not have smoking bans and with conditions (acute cholecystitis, bowel obstruction and appendicitis) that are not known to be related to second-hand smoke.
Crude rates of admission to hospital because of cardiovascular conditions decreased by 39% (95% CI 38%-40%) and admissions because of respiratory conditions decreased by 33% (95% CI 32%-34%) during the ban period affecting restaurant settings. No consistent reductions in these rates were evident after smoking bans affecting other settings. No significant reductions were observed in control cities or for control conditions.
Our results serve to expand the list of health outcomes that may be ameliorated by smoking bans. Further research is needed to establish the types of settings in which smoking bans are most effective. Our results lend legitimacy to efforts to further reduce public exposure to tobacco smoke.
Notes
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Comment In: CMAJ. 2010 May 18;182(8):747-820385733
PubMed ID
20385737 View in PubMed
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49 records – page 1 of 5.