Morbidity and mortality of infective endocarditis in a hospital system in New York City serving a diverse urban population

Infective endocarditis (IE) is a severe illness associated with significant morbidity and mortality. The primary purpose of this study was to evaluate morbidity and mortality of IE in a hospital serving the most diverse area in New York City. An analysis of 209 patients admitted to the hospital from 2000 to 2012 who were found to have IE based on modified Duke criteria. Among the 209 patients with IE, 188 (88.8%) had native heart valves and 21 (11.2%) had prosthetic valves. Of the patients with native heart valves, 3.7% had coronary artery bypass graft, 4.3% were active drug users, 6.3% had permanent pacemakers, 12.2% had a history of IE, 25.7% were diabetic, 17% had end-stage renal disease (ESRD), 9% had congestive heart failure, 8% had abnormal heart valves, and 13.8% had an unknown etiology. Mortality rates of the patients with prosthetic heart valves were 27.7% compared to 8.11% in patients with native heart valves (OR 3, p<0.0001). Since we identified diabetes mellitus and ESRD to be significant risk factors in our population, we isolated and compared characteristics of patients with and without IE. IE among patients with diabetes mellitus was 23% compared with 13.8% in the control group (p=0.016). Cases of IE in patients with ESRD were 15.3%, compared with 4% in the control group (p<0.0001). We identified an overall mortality rate of 20.1% in patients with IE, a readmission rate within 30 days of discharge of 21.5%, and an average age of 59 years. Among 209 patients, 107 were males and 102 females. The most common organisms identified were Staphylococcus aureus (43.7%), viridans streptococci (17%) followed by Enterococcus (14.7%). Despite appropriate treatment, high rates of morbidity and mortality remained, with a higher impact in patients greater than 50 years of age. Such discoveries raise the importance of controlling and monitoring risk factors for IE.

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ID: 99: PREVELNACE, MORBIDTY AND MORTALITY OF INFECTIVE ENDOCARDITIS IN THE MOST DIVESE AREA OF USA IN NEW YORK CITY

Journal of Investigative Medicine ◽

10.1136/jim-2016-000120.83 ◽

2016 ◽

Vol 64 (4) ◽

pp. 952.2-952

Author(s):

H Alkhawam ◽

R Sogomonian ◽

F Zaiem ◽

N Vyas ◽

J Jolly ◽

...

Keyword(s):

Risk Factors ◽

New York ◽

Infective Endocarditis ◽

Mortality Rate ◽

Readmission Rate ◽

Heart Valves ◽

Age Groups ◽

Morbidity And Mortality ◽

Causative Organism ◽

Group D

BackgroundInfective endocarditis (IE) is a serious illness associated with significant morbidity and mortality. The primary purpose of this study was to evaluate the mortality and morbidity of IE in a community public hospital of the most diverse area in New York.MethodsAn analysis of 209 patients that were admitted to hospital from 2000 to 2012, found to have IE based on Duke's criteria.ResultsThe incidence rate of IE is trending down since 2000 (figure 1A).Among our study population, the overall mortality rate of IE was 20.1% (95% CI: 9.84–19.56%), readmission rate within 30 days after discharge was 21.5% (95% CI: 16.22–27.58%) with an average age of 59 years (95% CI: 57.63–60.37%). The most common causative organisms were staphylococcus aureus (43.7%), followed by streptococcus viridians (17%) and Group D enterococcus (14.7%). We divided the patients into two groups; male (n=107) versus female (n=102). And the same aspects were identified and studied in each gender group.The incidence of IE has a slight female predominance, except two age groups with male significant predominance; 40–49 and 50–59 years. (figure 1-B).The mortality rate in males was 17% vs 23% in females (p=0.09) and Readmission rate within 30 days after discharge from the hospital was 20% in males vs 22% in females (p=0.1).Of the 209 patients, 188 patients were with native hearts and 21 patients had non-native heart valves. Of the 188 native heart valves, 114 had risk factors such as: CABG surgeries, were active drugs users, had pacemakers, valves disease or CHF. Mortality rate in non-native hearts and/or patients with risk factors were 27.7% compared to patients with native heart without risk factors of 8.11%(OR:3, P<0.0001).The causative organism of IE was evaluated in our study and we found that S. aureus is the most common cause in males and females among all age groups. The only exception to that is a slightly higher prevalence of S. viridians in males between the ages of 30–39 (figure1-C). Similarly, the prevalence of group D enterococcus appeared higher in females aged 70–79 years. (figure 1-D).Approximately 71% of males' patient with S. aureus IE between ages 50–49 had DM. Also, 80% of female patients with IE between ages 60–69 had DM which could explain the high prevalence of IE with S. aureus in this age groups as DM may complicated with skin infections which is mostly Staphylococcus infection that led to IE.The highest incidences of IE in our study were in Hispanic ethnicity group (38%) follow by white (29%). However, the lowest incidences were observed in South Asia population (5%).ConclusionDespite appropriate prophylaxis and treatment of IE patients, high rates of incidences, morbidity and mortality remained especially in population >50 years. Risk factors for developing IE such as Diabetes Mellitus which might complicated with skin infection and lead to IE, raising the importance of controlling and monitoring risk factors for IE in patients older than 50 years of age.Abstract ID: 99 Figure 1

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A risk index for COVID-19 severity is associated with COVID-19 mortality in New York City

BMC Public Health ◽

10.1186/s12889-021-11498-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wil Lieberman-Cribbin ◽

Naomi Alpert ◽

Raja Flores ◽

Emanuela Taioli

Keyword(s):

Risk Factors ◽

New York ◽

New York City ◽

York City ◽

Underserved Populations ◽

Risk Index ◽

Data Repository ◽

Severe Illness ◽

Mortality Data ◽

Cross Sectional

Abstract Background New York City (NYC) was the epicenter of the COVID-19 pandemic, and is home to underserved populations with higher prevalence of chronic conditions that put them in danger of more serious infection. Little is known about how the presence of chronic risk factors correlates with mortality at the population level. Here we determine the relationship between these factors and COVD-19 mortality in NYC. Methods A cross-sectional study of mortality data obtained from the NYC Coronavirus data repository (03/02/2020–07/06/2020) and the prevalence of neighborhood-level risk factors for COVID-19 severity was performed. A risk index was created based on the CDC criteria for risk of severe illness and complications from COVID-19, and stepwise linear regression was implemented to predict the COVID-19 mortality rate across NYC zip code tabulation areas (ZCTAs) utilizing the risk index, median age, socioeconomic status index, and the racial and Hispanic composition at the ZCTA-level as predictors. Results The COVID-19 death rate per 100,000 persons significantly decreased with the increasing proportion of white residents (βadj = − 0.91, SE = 0.31, p = 0.0037), while the increasing proportion of Hispanic residents (βadj = 0.90, SE = 0.38, p = 0.0200), median age (βadj = 3.45, SE = 1.74, p = 0.0489), and COVID-19 severity risk index (βadj = 5.84, SE = 0.82, p < 0.001) were statistically significantly positively associated with death rates. Conclusions Disparities in COVID-19 mortality exist across NYC and these vulnerable areas require increased attention, including repeated and widespread testing, to minimize the threat of serious illness and mortality.

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Clinical and Demographic Risk Factors for COVID-19 during Delivery Hospitalizations in New York City

American Journal of Perinatology ◽

10.1055/s-0041-1727168 ◽

2021 ◽

Author(s):

Desmond Sutton ◽

Timothy Wen ◽

Anna P. Staniczenko ◽

Yongmei Huang ◽

Maria Andrikopoulou ◽

...

Keyword(s):

Risk Factors ◽

New York ◽

New York City ◽

Logistic Regression ◽

York City ◽

Demographic Data ◽

Outcome Data ◽

Demographic Risk ◽

Demographic Risk Factors ◽

Zip Code

Objective This study was aimed to review 4 weeks of universal novel coronavirus disease 2019 (COVID-19) screening among delivery hospitalizations, at two hospitals in March and April 2020 in New York City, to compare outcomes between patients based on COVID-19 status and to determine whether demographic risk factors and symptoms predicted screening positive for COVID-19. Study Design This retrospective cohort study evaluated all patients admitted for delivery from March 22 to April 18, 2020, at two New York City hospitals. Obstetrical and neonatal outcomes were collected. The relationship between COVID-19 and demographic, clinical, and maternal and neonatal outcome data was evaluated. Demographic data included the number of COVID-19 cases ascertained by ZIP code of residence. Adjusted logistic regression models were performed to determine predictability of demographic risk factors for COVID-19. Results Of 454 women delivered, 79 (17%) had COVID-19. Of those, 27.9% (n = 22) had symptoms such as cough (13.9%), fever (10.1%), chest pain (5.1%), and myalgia (5.1%). While women with COVID-19 were more likely to live in the ZIP codes quartile with the most cases (47 vs. 41%) and less likely to live in the ZIP code quartile with the fewest cases (6 vs. 14%), these comparisons were not statistically significant (p = 0.18). Women with COVID-19 were less likely to have a vaginal delivery (55.2 vs. 51.9%, p = 0.04) and had a significantly longer postpartum length of stay with cesarean (2.00 vs. 2.67days, p < 0.01). COVID-19 was associated with higher risk for diagnoses of chorioamnionitis and pneumonia and fevers without a focal diagnosis. In adjusted analyses, including demographic factors, logistic regression demonstrated a c-statistic of 0.71 (95% confidence interval [CI]: 0.69, 0.80). Conclusion COVID-19 symptoms were present in a minority of COVID-19-positive women admitted for delivery. Significant differences in obstetrical outcomes were found. While demographic risk factors demonstrated acceptable discrimination, risk prediction does not capture a significant portion of COVID-19-positive patients. Key Points

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Estimation of HIV Prevalence, Risk Factors, and Testing Frequency among Sexually Active Men Who Have Sex with Men, Aged 18–64 Years—New York City, 2002

Journal of Urban Health ◽

10.1007/s11524-006-9135-5 ◽

2007 ◽

Vol 84 (2) ◽

pp. 212-225 ◽

Cited By ~ 30

Author(s):

Susan E. Manning ◽

Lorna E. Thorpe ◽

Chitra Ramaswamy ◽

Anjum Hajat ◽

Melissa A. Marx ◽

...

Keyword(s):

Risk Factors ◽

New York ◽

New York City ◽

York City ◽

Hiv Prevalence ◽

Sexually Active ◽

Testing Frequency ◽

Sex With Men

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Cardiovascular Disease Risk Factors Among Immigrant and US-Born Adults in New York City

Public Health Reports ◽

10.1177/00333549211007519 ◽

2021 ◽

pp. 003335492110075

Author(s):

Claudia Chernov ◽

Lisa Wang ◽

Lorna E. Thorpe ◽

Nadia Islam ◽

Amy Freeman ◽

...

Keyword(s):

United States ◽

Risk Factors ◽

Cardiovascular Disease ◽

New York ◽

New York City ◽

Health Insurance ◽

York City ◽

The United States ◽

Nutrition Examination Survey ◽

Health And Nutrition

Objectives Immigrant adults tend to have better health than native-born adults despite lower incomes, but the health advantage decreases with length of residence. To determine whether immigrant adults have a health advantage over US-born adults in New York City, we compared cardiovascular disease (CVD) risk factors among both groups. Methods Using data from the New York City Health and Nutrition Examination Survey 2013-2014, we assessed health insurance coverage, health behaviors, and health conditions, comparing adults ages ≥20 born in the 50 states or the District of Columbia (US-born) with adults born in a US territory or outside the United States (immigrants, following the National Health and Nutrition Examination Survey) and comparing US-born adults with (1) adults who immigrated recently (≤10 years) and (2) adults who immigrated earlier (>10 years). Results For immigrant adults, the mean time since arrival in the United States was 21.8 years. Immigrant adults were significantly more likely than US-born adults to lack health insurance (22% vs 12%), report fair or poor health (26% vs 17%), have hypertension (30% vs 23%), and have diabetes (20% vs 11%) but significantly less likely to smoke (18% vs 27%) (all P < .05). Comparable proportions of immigrant adults and US-born adults were overweight or obese (67% vs 63%) and reported CVD (both 7%). Immigrant adults who arrived recently were less likely than immigrant adults who arrived earlier to have diabetes or high cholesterol but did not differ overall from US-born adults. Conclusions Our findings may help guide prevention programs and policy efforts to ensure that immigrant adults remain healthy.

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Risk Factors for New Neurological Diagnoses in Hospitalized COVID-19 Patients: A Case-Control Study in New York City

SSRN Electronic Journal ◽

10.2139/ssrn.3991082 ◽

2021 ◽

Author(s):

Kiran Thakur ◽

Victoria T. Chu ◽

Christine Hughes ◽

Carla Y. Kim ◽

Shannon Fleck-Dardarian ◽

...

Keyword(s):

Risk Factors ◽

New York ◽

New York City ◽

York City ◽

Case Control Study ◽

Case Control ◽

Control Study

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Cardiovascular disease risk factors among older Chinese Americans living in New York City

The FASEB Journal ◽

10.1096/fasebj.24.1_supplement.lb304 ◽

2010 ◽

Vol 24 (S1) ◽

Author(s):

Sally S Wong ◽

Beth Dixon ◽

Juidth A Gilbride ◽

Warren W Chin

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

New York ◽

New York City ◽

York City ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Chinese Americans ◽

Older Chinese ◽

Older Chinese Americans

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Sex-related differences in the clinical presentation and risk factors for mortality in patients hospitalized with Coronavirus Disease 2019 in New York City

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab370 ◽

2021 ◽

Author(s):

Jyoti S Mathad ◽

Myung Hee Lee ◽

Andrea Chalem ◽

Melissa K Frey ◽

Eloise Chapman-Davis ◽

...

Keyword(s):

Risk Factors ◽

New York ◽

New York City ◽

Viral Load ◽

York City ◽

Clinical Presentation ◽

Independent Predictor

Abstract We evaluated sex-related differences in symptoms and risk factors for mortality in 4798 patients hospitalized with Covid-19 in New York City. When adjusted for age and comorbidities, being male was an independent predictor of death with mortality significantly higher than females, even with low SARS-CoV-2 viral load at admission.

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