Stroke mortality in a teaching hospital in South Western Nigeria

2007 ◽  
Vol 37 (3) ◽  
pp. 186-188 ◽  
Author(s):  
M A Komolafe ◽  
O Ogunlade ◽  
E O Komolafe
Keyword(s):  
Risk Factors ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Uncontrolled Hypertension ◽  
Fatality Rate ◽  
Stroke Mortality ◽  
Community Based ◽  
High Risk Factors ◽  
Treatment Of Hypertension ◽  
The Mean

Stroke, a major cause of morbidity and mortality, is on the increase and with increasing mortality. Our retrospective review of all stroke admissions from 1990-2000 show that cerebrovascular disease accounted for 3.6% (293/8144) of all medical admissions; it has a case fatality rate of 45% with the majority (61%) occurring in the first week; the mean age of stroke deaths was 62 years (standard deviation-13); and severe as well as uncontrolled hypertension is the most important risk factor. Community-based programmes aimed at early detection and treatment of hypertension, in addition to screening for those with high risk factors, should be put in place.

scholarly journals Identification of Inpatients with Coronavirus Disease 2019 (COVID-19) at Risk of Clinical Deterioration: A Multicenter, Retrospective Cohort Study

2020 ◽  
Author(s):  
Yi Zhang ◽  
Xiaojing Wu ◽  
Lan Ni ◽  
Lei Chen ◽  
Changzhi Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Fatality Rate ◽  
Early Stage ◽  
Case Fatality ◽  
Clinical Deterioration ◽  
Ordinal Scale ◽  
Ground Glass ◽  
Fatality Rate ◽  
Neutrophil Lymphocyte Ratio ◽  
High Risk Factors

Abstract Background: Current information is not enough to recognize the risk factors of clinical deterioration and to make medical decisions in COVID-19 patients. Methods: A retrospective study was performed, with collecting data from medical records of COVID-19 patients in three designated hospitals from January 8, 2020 to May 6, 2020. Clinical data were analyzed between the deteriorated and the non-deteriorated patients, which was defined as either a increase of 2 categories on the modified 6-category ordinal scale, or a decline of PaO2-to-FIO2 ratio more than 100mmHg. Results: Total 238 patients with COVID-19 were selected, where 31 were deteriorated and 207 were non-deteriorated. In the deterioration group, the case fatality rate was up to 41.9%. Compared with non-deteriorated patients, the deteriorated were older (65.8[IQR 54.3-72.3] vs 54.4[41.0-66.1], p=0.004) and were more likely to have chronic medical illnesses (17[54.8%]) vs 92[44.4%]). Multivariable regression showed that three variables, neutrophil-lymphocyte ratio (NLR)≥3.66 (OR, 9.85; 95% CI, 1.68-57.57), hyponatremia (OR, 8.35; 95% CI, 1.74-40.16), and presence of ground-glass opacities with consolidation (OR, 5.84; 95% CI, 1.24-27.49) were associated with increased odds of clinical deterioration. The variable that inspiring air or traditional oxygen therapy only within 72 hours after admission, indicated a decreased odd of illness progression (OR, 0.075; 95% CI, 0.012–0.465).Conclusions: COVID-19 patients with clinical deterioration had more common extra-pulmonary organ impair in early stage and high case fatality rate. Three factors, NLR ≥3.66, hyponatremia and presence of ground-glass opacities with consolidation were determined as high risk factors in deterioration.

scholarly journals Variations in case fatality and fatality risk factors of meningococcal disease in Western Norway, 1985–2002

2005 ◽  
Vol 134 (1) ◽  
pp. 103-110 ◽  
Author(s):  
I. SMITH ◽  
A. T. BJØRNEVIK ◽  
I. M. B. AUGLAND ◽  
A. BERSTAD ◽  
T. WENTZEL-LARSEN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Skin Rash ◽  
Meningococcal Disease ◽  
Case Fatality Rate ◽  
Multivariate Analyses ◽  
Case Fatality ◽  
Fatality Rate ◽  
The Public ◽  
Admission Time ◽  
Meningococcal Septicaemia

SUMMARYIn a retrospective epidemiological study, 293 meningococcal disease patients hospitalized during 1985–2002, were examined for fatality and risk factors related to death. The overall case fatality rate (CFR) was 8·2%, but increased from 4% during 1985–1993 to 17% during 1994–2002. The latter 9-year period was characterized by more serogroup C infections and more patients with thrombocytopenia on admission to hospital. All patients categorized as meningitis on admission survived. Of the 24 patients who died, 21 had meningococcal skin rash on admission, 23 had an onset to admission time of ⩽24 h, and 16 had severe septicaemia with hypotension and/or ecchymoses without meningitis on admission. By multivariate analyses, a short onset to admission time, >50 petechiae, thrombocytopenia and severe septicaemia on admission were associated with fatality. More lives could be saved through earlier admission to hospital. This can be achieved through more information to the public about the early signs of meningococcal septicaemia, with the recommendation to look for skin rash in patients with acute fever during the first day and night.

scholarly journals Clinical Characteristics and Outcomes of COVID-19–Infected Cancer Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Hua Zhang ◽  
Han Han ◽  
Tianhui He ◽  
Kristen E Labbe ◽  
Adrian V Hernandez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Case Fatality Rate ◽  
Meta Analysis ◽  
Univariate Analysis ◽  
Case Fatality ◽  
The United States ◽  
Fatality Rate ◽  
Patients With Cancer ◽  
Increased Risk

Abstract Background Previous studies have indicated coronavirus disease 2019 (COVID-19) patients with cancer have a high fatality rate. Methods We conducted a systematic review of studies that reported fatalities in COVID-19 patients with cancer. A comprehensive meta-analysis that assessed the overall case fatality rate and associated risk factors was performed. Using individual patient data, univariate and multivariable logistic regression analyses were used to estimate odds ratios (OR) for each variable with outcomes. Results We included 15 studies with 3019 patients, of which 1628 were men; 41.0% were from the United Kingdom and Europe, followed by the United States and Canada (35.7%), and Asia (China, 23.3%). The overall case fatality rate of COVID-19 patients with cancer measured 22.4% (95% confidence interval [CI] = 17.3% to 28.0%). Univariate analysis revealed age (OR = 3.57, 95% CI = 1.80 to 7.06), male sex (OR = 2.10, 95% CI = 1.07 to 4.13), and comorbidity (OR = 2.00, 95% CI = 1.04 to 3.85) were associated with increased risk of severe events (defined as the individuals being admitted to the intensive care unit, or requiring invasive ventilation, or death). In multivariable analysis, only age greater than 65 years (OR = 3.16, 95% CI = 1.45 to 6.88) and being male (OR = 2.29, 95% CI = 1.07 to 4.87) were associated with increased risk of severe events. Conclusions Our analysis demonstrated that COVID-19 patients with cancer have a higher fatality rate compared with that of COVID-19 patients without cancer. Age and sex appear to be risk factors associated with a poorer prognosis.

scholarly journals Risk factors for incidence and case-fatality rates of healthcare-associated infections: a 20-year follow-up of a hospital-based cohort

2015 ◽  
Vol 144 (1) ◽  
pp. 198-206 ◽  
Author(s):  
R.-F. WANG ◽  
S.-H. SHEN ◽  
A. M.-F. YEN ◽  
T.-L. WANG ◽  
T.-N. JANG ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Incidence Rate ◽  
Case Fatality Rate ◽  
Tertiary Care ◽  
Case Fatality ◽  
Healthcare Associated Infections ◽  
Fatality Rate ◽  
Infection Site ◽  
Healthcare Associated

SUMMARYInformation is lacking on the integrated evaluation of mortality rates in healthcare-associated infections (HAIs). Our aim was to differentiate the risk factors responsible for the incidence from those for the case-fatality rates in association with HAIs. We therefore examined the time trends of both incidence and case-fatality rates over a 20-year period at a tertiary-care teaching medical centre in Taiwan and the mortality rate was expressed as the product of the incidence rate and the case-fatality rate. During the study period the overall mortality rate fell from 0·46 to 0·32 deaths/1000 patient-days and the incidence rate fell from 3·41 to 2·31/1000 patient-days, but the case-fatality rate increased marginally from 13·5% to 14·0%. The independent risk factors associated with incidence of HAIs were age, gender, infection site, admission type, and department of hospitalization. Significant prognostic factors for HAI case-fatality were age, infection site, intensive care, and clinical department. We conclude that the decreasing trend for the HAI mortality rate was accompanied by a significant decline in the incidence rate and this was offset by a slightly increasing trend in the case-fatality rate. This deconstruction approach could provide further insights into the underlying complex causes of mortality for HAIs.

Incidence, 30-day case-fatality rate, and prognosis of stroke in Iquique, Chile: a 2-year community-based prospective study (PISCIS project)

The Lancet ◽  
2005 ◽  
Vol 365 (9478) ◽  
pp. 2206-2215 ◽  
Author(s):  
Pablo M Lavados ◽  
Claudio Sacks ◽  
Liliana Prina ◽  
Arturo Escobar ◽  
Claudia Tossi ◽  
...  
Keyword(s):  
Prospective Study ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Fatality Rate ◽  
Day Case ◽  
Community Based

Incidence of and Risk Factors for Nosocomial Bloodstream Infections in Adults in the United States, 2003

2009 ◽  
Vol 30 (11) ◽  
pp. 1036-1044 ◽  
Author(s):  
Omar M. AL-Rawajfah ◽  
Frank Stetzer ◽  
Jeanne Beauchamp Hewitt
Keyword(s):  
United States ◽  
Risk Factors ◽  
Case Fatality Rate ◽  
Nationwide Inpatient Sample ◽  
Hospital Admissions ◽  
Case Fatality ◽  
The United States ◽  
Fatality Rate ◽  
The Us ◽  
National Estimates

Background.Although many studies have examined nosocomial bloodstream infection (BSI), US national estimates of incidence and case-fatality rates have seldom been reported.Objective.The purposes of this study were to generate US national estimates of the incidence and severity of nosocomial BSI and to identify risk factors for nosocomial BSI among adults hospitalized in the United States on the basis of a national probability sample.Methods.This cross-sectional study used the US Nationwide Inpatient Sample for the year 2003 to estimate the incidence and case-fatality rate associated with nosocomial BSI in the total US population. Cases of nosocomial BSI were defined by using 1 or more International Classification of Diseases, 9th Revision, Clinical Modification codes in the secondary field(s) that corresponded to BSIs that occurred at least 48 hours after admission. The comparison group consisted of all patients without BSI codes in their NIS records. Weighted data were used to generate US national estimates of nosocomial BSIs. Logistic regression was used to identify independent risk factors for nosocomial BSI.Results.The US national estimated incidence of nosocomial BSI was 21.6 cases per 1,000 admissions, while the estimated case-fatality rate was 20.6%. Seven of the 10 leading causes of hospital admissions associated with nosocomial BSI were infection related. We estimate that 541,081 patients would have acquired a nosocomial BSI in 2003, and of these, 111,427 would have died. The final multivariate model consisted of the following risk factors: central venous catheter use (odds ratio [OR], 4.76), other infections (OR, 4.61), receipt of mechanical ventilation (OR, 4.97), trauma (OR, 1.98), hemodialysis (OR, 4.83), and malnutrition (OR, 2.50). The total maximum rescaled R2 was 0.22.Conclusions.The Nationwide Inpatient Sample was useful for estimating national incidence and case-fatality rates, as well as examining independent predictors of nosocomial BSI.

scholarly journals Characteristics of COVID-19 fatality cases in East Kalimantan, Indonesia

2020 ◽  
Author(s):  
Swandari Paramita ◽  
Ronny Isnuwardana ◽  
Krispinus Duma ◽  
Rahmat Bakhtiar ◽  
Muhammad Khairul Nuryanto ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Information System ◽  
Cerebrovascular Disease ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Fatality Rate ◽  
Rt Pcr ◽  
East Kalimantan ◽  
The Mean ◽  
Underlying Diseases

Introduction. Coronavirus Disease (COVID-19) is caused by SARS-CoV-2 infection. On March 2, 2020, Indonesia announced the first confirmed cases of COVID-19 infection. East Kalimantan will play an important role as the new capital of Indonesia. There is attention to the preparedness of East Kalimantan to respond to COVID-19. We report the characteristics of COVID-19 fatality cases in here. Methods. We retrospectively analyzed the fatality cases of COVID-19 patients from the East Kalimantan Health Office information system. All patients were confirmed COVID-19 by RT-PCR examination. Results. By July 31, 2020, 31 fatality cases of patients had been identified as having confirmed COVID-19 in East Kalimantan. The mean age of the patients was 55.1 + 9.2 years. Most of the patients were men (22 [71.0%]) with age more than 60 years old (14 [45.2%]). Balikpapan has the highest number of COVID-19 fatality cases from all regencies. Hypertension was the most comorbidities in the fatality cases of COVID-19 patients in East Kalimantan. Discussion. Older age and comorbidities still contributed to the fatality cases of COVID-19 patients in East Kalimantan, Indonesia. Hypertension, diabetes, cardiovascular disease, and cerebrovascular disease were underlying conditions for increasing the risk of COVID-19 getting into a serious condition. Conclusion. Active surveillance for people older than 60 years old and having underlying diseases is needed for reducing the case fatality rate of COVID-19 in East Kalimantan. Keywords. Comorbidity, fatality cases, COVID-19, Indonesia.

scholarly journals Fetomaternal outcomes in patients with Uterine Rupture managed at Bugando Medical Centre, Tanzania: 5-year review of cases

2019 ◽  
Author(s):  
Simon Mrema ◽  
Anthony Massinde ◽  
Dismas Matovelo ◽  
Albert Kihunrwa ◽  
Richard Rumanyika ◽  
...  
Keyword(s):  
Risk Factors ◽  
Uterine Rupture ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Maternal Outcomes ◽  
Fatality Rate ◽  
Obstructed Labor ◽  
Apgar Scores ◽  
Bugando Medical ◽  
Bugando Medical Centre

Abstract Background Uterine rupture is one of the major obstetric complications, associated with adverse fetal and maternal outcomes including hemorrhage, genital urinary injury, low Apgar scores, fetomaternal deaths. There is a paucity of data regarding uterine rupture and its consequences among pregnant women in Mwanza, Tanzania. As a result, it is difficult to know the magnitude of the problem and formulate appropriate measures to reduce its incidence. This study was thus conducted to determine the cumulative incidence, risk factors, fetal and maternal outcomes among women with uterine rupture managed at Bugando Medical Centre (BMC), Mwanza-Tanzania.Methods This was a 5-year (2013 to 2017) retrospective descriptive study of cases of uterine rupture at BMC. The case files were collected from medical records department and maternal demographic information, clinical presentation, risk factors, interventions and feto-maternal outcomes were extracted using a checklist. Data were analyzed using STATA software version 13.Results There were 37,763 deliveries within five years. Caesarean section accounted for a quarter (n=9,136) of these deliveries. During this period 81 cases of ruptured uterus were identified, making a cumulative incidence of 2.2 cases per 1,000 deliveries. Common risk factors for uterine rupture were history of previous caesarean section 54% (n=36), obstructed labor 37% (n=25), grandmultiparity 19.4% (n=13) and use of oxytocin 21% (n=14). Maternal case fatality rate in this study was 1.5% (n=1). More than half of cases had hysterectomy while about a third (n=25) had uterine repair without bilateral tubal ligation (BTL). Over 80% (n=55) of cases required blood transfusion. Sepsis developed in 21% (n=14) of cases and vesicovaginal fistula (VVF) in 12% (n=8). Perinatal case fatality rate was 72% (n=48). Out of the 24 babies who were born alive, 37.5% (n=9) had low Apgar scores and 20.8% (n=5) died before discharge.Conclusion The leading risk factor for uterine rupture seen was previous caesarean scar and obstructed labor associated with high perinatal case fatality rate. Improvement in monitoring of patients in labor is necessary to detect early features of uterine rupture, obstructed labour and fetal compromise. This will contribute to reduced incidence of uterine rupture and improve fetomaternal outcomes.

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