Pub Date : 1900-01-01DOI: 10.30918/irjmms.104.22.029
Ban A. Majeed, Christos Hatzigeorgiou, Mishma Farsi, Matthew Heiken, D. Ayyala, David W. Walsh
The objective of this study is to determine hospitalization and case-fatality rates in adult patients diagnosed with COVID-19 at a large academic medical center in the United States of America which predominately serves rural and underrepresented populations. EMR data abstraction of a cohort of lab-confirmed COVID-19, outpatient and inpatient, adult patients, who tested positive at Augusta University Medical Center (AUMC) in 2020 (N = 18,403) was conducted. Eligible patients were identified using the data mining tool, i2b2. COVID-19 hospitalization and case fatality rates were calculated. Logistic and Poisson regression models were constructed to identify characteristics associated with hospitalization, death, and hospital stay. The hospitalization rate was 3.97%. Patients aged 45-64 and 65+ had significantly higher hospitalization rates. Compared to White, hospitalization rates were higher in Black (AOR 2.35, 95% CI, 1.99-2.77, p 0.001) and Hispanic patients (AOR 1.92, 95% CI, 1.92-3.01, p 0.01). Overall COVID-19 case fatality rate was 0.62% and, in hospitalized patients, was 14.25%. Patients 65+ had higher odds of death (AOR 7.57, 95% CI, 3.25-22.13, p 0.001). Case fatality rates did not vary by race. In conclusion, in a primarily rural and underserved population prior to known effective therapy, overall and hospitalized case fatality rates were similar to studies from large urban areas. Keywords: COVID-19, case fatality, hospitalization rate, rural health.
本研究的目的是确定在美国一家主要服务于农村和代表性不足人口的大型学术医疗中心诊断为COVID-19的成年患者的住院率和病死率。对奥古斯塔大学医学中心(AUMC) 2020年实验室确诊的新冠肺炎(COVID-19)门诊和住院成年患者(N = 18403)进行EMR数据提取。使用数据挖掘工具i2b2确定符合条件的患者。计算COVID-19住院率和病死率。构建Logistic和泊松回归模型以确定与住院、死亡和住院时间相关的特征。住院率为3.97%。45-64岁和65岁以上患者的住院率明显高于65岁。与白人患者相比，黑人患者(AOR 2.35, 95% CI, 1.99-2.77, p 0.001)和西班牙裔患者(AOR 1.92, 95% CI, 1.92-3.01, p 0.01)的住院率更高。COVID-19总病死率为0.62%，住院患者病死率为14.25%。65岁以上患者的死亡几率更高(AOR为7.57,95% CI为3.25-22.13,p 0.001)。病死率没有因种族而异。总之，在已知有效治疗之前，主要是农村和服务不足的人口中，总体和住院病例死亡率与来自大城市地区的研究相似。关键词:新型冠状病毒病死率住院率农村卫生
{"title":"Hospitalization and case fatality rates of adult patients diagnosed with COVID-19 at a tertiary academic medical center in 2020","authors":"Ban A. Majeed, Christos Hatzigeorgiou, Mishma Farsi, Matthew Heiken, D. Ayyala, David W. Walsh","doi":"10.30918/irjmms.104.22.029","DOIUrl":"https://doi.org/10.30918/irjmms.104.22.029","url":null,"abstract":"The objective of this study is to determine hospitalization and case-fatality rates in adult patients diagnosed with COVID-19 at a large academic medical center in the United States of America which predominately serves rural and underrepresented populations. EMR data abstraction of a cohort of lab-confirmed COVID-19, outpatient and inpatient, adult patients, who tested positive at Augusta University Medical Center (AUMC) in 2020 (N = 18,403) was conducted. Eligible patients were identified using the data mining tool, i2b2. COVID-19 hospitalization and case fatality rates were calculated. Logistic and Poisson regression models were constructed to identify characteristics associated with hospitalization, death, and hospital stay. The hospitalization rate was 3.97%. Patients aged 45-64 and 65+ had significantly higher hospitalization rates. Compared to White, hospitalization rates were higher in Black (AOR 2.35, 95% CI, 1.99-2.77, p 0.001) and Hispanic patients (AOR 1.92, 95% CI, 1.92-3.01, p 0.01). Overall COVID-19 case fatality rate was 0.62% and, in hospitalized patients, was 14.25%. Patients 65+ had higher odds of death (AOR 7.57, 95% CI, 3.25-22.13, p 0.001). Case fatality rates did not vary by race. In conclusion, in a primarily rural and underserved population prior to known effective therapy, overall and hospitalized case fatality rates were similar to studies from large urban areas. Keywords: COVID-19, case fatality, hospitalization rate, rural health.","PeriodicalId":170316,"journal":{"name":"International Research Journal of Medicine and Medical Sciences","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128263571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.30918/irjmms.103.22.019
Valerie Maboulou, Aicha Ngoutane, J. Molu, M. Mansour, C. Kountchou, Ibrahima Djoulde, Vehlima Adamou, G. Wanda, Roger Ahouga, M. Amougou, Livo Esemo, A. Bouba, Marcelle Eyong, Milaine Toukap, L. Akwah, Mbakop Calixte, Nkengazong Lucia, Marie Chantal Ngonde Essome
Sickle cell disease is the most common autosomal recessive disease in sub-Saharan Africa. Our study aimed to determine the sickle cell trait, to assess knowledge, attitudes, practices and perceptions regarding sickle cell disease of people living in Yaoundé. We carried out a cross-sectional and descriptive study at the Institute of Medical Research and Medicinal Plants studies in Yaoundé. We included a total of 191 participants of mixed sex and ages ranging from 10 to 70 years old, able to complete a questionnaire and having accepted a blood sample for the hemoglobin electrophoresis test. Data was collected using a questionnaire. We used the Chi-square test to assess the relationships between variables with p-value ˂ 0.05 for meaningful relationships. More than half of the participants were women (59.16%), and the representative age group was 20-29 years old (47.12%). The highest level of education was university level (71.73%). Most of the participants had heard of sickle cell disease (93.72%) and the most talked-about information channel was television (41.90%). The proportions in relation to knowledge about sickle cell disease were as follows: in the transmission mode, 71.73% had mentioned that it is an inherited disease; in prevention mode, 88.08% had mentioned the hemoglobin electrophoresis test. For the follow-up of the disease, 85.86% noted the hospital as the location. Compared to marriage with a sickle cell disease patient, 68.59% answered negatively. There is a significant relationship (p˂0.05) between the level of education and knowledge of sickle cell disease transmission. The results of our study showed that the university population of Yaoundé had a good knowledge of sickle cell disease. Young people are called upon to be tested for sickle cell disease before marriage. Studies on larger samples should be conducted to have a better appreciation of the sickle cell trait in the population of Yaoundé. Keywords: Sickle cell trait, knowledge, attitudes, practices, sickle cell disease, Center Region, Yaoundé Cameroon.
{"title":"Sickle cell trait, knowledge, attitudes, practices and perceptions regarding sickle cell disease among people living in Yaoundé, Cameroon","authors":"Valerie Maboulou, Aicha Ngoutane, J. Molu, M. Mansour, C. Kountchou, Ibrahima Djoulde, Vehlima Adamou, G. Wanda, Roger Ahouga, M. Amougou, Livo Esemo, A. Bouba, Marcelle Eyong, Milaine Toukap, L. Akwah, Mbakop Calixte, Nkengazong Lucia, Marie Chantal Ngonde Essome","doi":"10.30918/irjmms.103.22.019","DOIUrl":"https://doi.org/10.30918/irjmms.103.22.019","url":null,"abstract":"Sickle cell disease is the most common autosomal recessive disease in sub-Saharan Africa. Our study aimed to determine the sickle cell trait, to assess knowledge, attitudes, practices and perceptions regarding sickle cell disease of people living in Yaoundé. We carried out a cross-sectional and descriptive study at the Institute of Medical Research and Medicinal Plants studies in Yaoundé. We included a total of 191 participants of mixed sex and ages ranging from 10 to 70 years old, able to complete a questionnaire and having accepted a blood sample for the hemoglobin electrophoresis test. Data was collected using a questionnaire. We used the Chi-square test to assess the relationships between variables with p-value ˂ 0.05 for meaningful relationships. More than half of the participants were women (59.16%), and the representative age group was 20-29 years old (47.12%). The highest level of education was university level (71.73%). Most of the participants had heard of sickle cell disease (93.72%) and the most talked-about information channel was television (41.90%). The proportions in relation to knowledge about sickle cell disease were as follows: in the transmission mode, 71.73% had mentioned that it is an inherited disease; in prevention mode, 88.08% had mentioned the hemoglobin electrophoresis test. For the follow-up of the disease, 85.86% noted the hospital as the location. Compared to marriage with a sickle cell disease patient, 68.59% answered negatively. There is a significant relationship (p˂0.05) between the level of education and knowledge of sickle cell disease transmission. The results of our study showed that the university population of Yaoundé had a good knowledge of sickle cell disease. Young people are called upon to be tested for sickle cell disease before marriage. Studies on larger samples should be conducted to have a better appreciation of the sickle cell trait in the population of Yaoundé. Keywords: Sickle cell trait, knowledge, attitudes, practices, sickle cell disease, Center Region, Yaoundé Cameroon.","PeriodicalId":170316,"journal":{"name":"International Research Journal of Medicine and Medical Sciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131023656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.30918/irjmms.103.22.021
Omkar Mayur, Jack D Owens, D. Linder, Varghese George, J. Franklin, R. MacArthur
In early 2020, Albany Georgia, located in a predominately rural part of Georgia, had the 4th highest per capita rate of COVID-19 infection in the United States. Many of these patients developed secondary infections or presented with concomitant infections, which were noted anecdotally to be associated with a worse outcome compared to those who did not develop secondary infections. We conducted a retrospective chart review of all patients admitted to Phoebe Putney Memorial Hospital in the calendar year 2020. We were primarily interested in the effect of respiratory and bloodstream culture positivity on the outcome. We recorded data for other variables potentially contributing to a bad outcome, including Charlson Comorbidity Index (CCI), Body Mass Index (BMI), age, sex, and race. Variables initially identified as significantly associated with bad outcomes (defined as either need for mechanical ventilation or death) were then analyzed by multinomial regression. During a 10-month period (March to December), 1,431 patients were admitted. Of these, 155 (10.8%) had a positive blood culture and 142 (9.9%) had a positive respiratory culture at any time during admission. Odds ratios (OR) for death or mechanical ventilation without death were 43.0 and 86.1, respectively, for a positive respiratory culture and 4.5 and 3.3, respectively, for a positive blood culture. Age > 70 and CCI also were associated with an increased risk of death, with OR of 2.0 and 1.3, respectively. In conclusion, in our large, single-center study of patients admitted with COVID-19 in the calendar year 2020, positive respiratory culture or a positive blood culture had the highest OR associated with the bad outcome of all the variables considered. Keywords: COVID-19, risk factors, inpatients.
{"title":"The association of a positive respiratory or bloodstream culture on outcome in a large, single-center study of predominately rural Georgia patients admitted with COVID-19 in 2020","authors":"Omkar Mayur, Jack D Owens, D. Linder, Varghese George, J. Franklin, R. MacArthur","doi":"10.30918/irjmms.103.22.021","DOIUrl":"https://doi.org/10.30918/irjmms.103.22.021","url":null,"abstract":"In early 2020, Albany Georgia, located in a predominately rural part of Georgia, had the 4th highest per capita rate of COVID-19 infection in the United States. Many of these patients developed secondary infections or presented with concomitant infections, which were noted anecdotally to be associated with a worse outcome compared to those who did not develop secondary infections. We conducted a retrospective chart review of all patients admitted to Phoebe Putney Memorial Hospital in the calendar year 2020. We were primarily interested in the effect of respiratory and bloodstream culture positivity on the outcome. We recorded data for other variables potentially contributing to a bad outcome, including Charlson Comorbidity Index (CCI), Body Mass Index (BMI), age, sex, and race. Variables initially identified as significantly associated with bad outcomes (defined as either need for mechanical ventilation or death) were then analyzed by multinomial regression. During a 10-month period (March to December), 1,431 patients were admitted. Of these, 155 (10.8%) had a positive blood culture and 142 (9.9%) had a positive respiratory culture at any time during admission. Odds ratios (OR) for death or mechanical ventilation without death were 43.0 and 86.1, respectively, for a positive respiratory culture and 4.5 and 3.3, respectively, for a positive blood culture. Age > 70 and CCI also were associated with an increased risk of death, with OR of 2.0 and 1.3, respectively. In conclusion, in our large, single-center study of patients admitted with COVID-19 in the calendar year 2020, positive respiratory culture or a positive blood culture had the highest OR associated with the bad outcome of all the variables considered. Keywords: COVID-19, risk factors, inpatients.","PeriodicalId":170316,"journal":{"name":"International Research Journal of Medicine and Medical Sciences","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115008540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.30918/irjmms.102.22.016
I. Tsai, Hsin-Yueh Hu, Chen-Chun Kuo, K. Cheng, Ying-Hao Lu
Meperidine was often used for postoperative pain relief, but it has addictive and neurotoxic side effects. In order to reduce the use of Meperidine and meet the needs of clinical use, the hospital started using Nalbuphine in August 2018, and the effectiveness for about three years was analyzed with the expectations of reducing the risk of Meperidine use and improving the safety of analgesic treatment. The clinical departments in the hospital advocated that Nalbuphine can replace Meperidine, and the notification of short message service for those with large usages was enhanced. Finally, the data on the changes in the usage of Meperidine and Nalbuphine from August 2018 to December 2021 were collected. Overall, the usage of Nalbuphine increased month by month after it was introduced; in contrast, the average monthly usage of Meperidine decreased from 545 in 2018 to 47 in 2021. It was found that a key point of the golden cross appeared for the use of the two drugs one year after Nalbuphine was introduced. In conclusion, Nalbuphine can indeed replace Meperidine to meet the clinical needs for pain relief when it is used in hospitals. In addition, the annual drug purchase cost of Meperidine can be significantly saved to improve the effectiveness of hospital operations, so the non-controlled drug Nalbuphine has the added benefit of drug profit. Finally, it is hoped that other medical institutions can learn and apply these research findings to the management of controlled drugs in the hospital. Keywords: Meperidine, Nalbuphine, patient safety, hospital management.
{"title":"Medication use evaluation: The impact of introducing Nalbuphine on hospital management of Meperidine","authors":"I. Tsai, Hsin-Yueh Hu, Chen-Chun Kuo, K. Cheng, Ying-Hao Lu","doi":"10.30918/irjmms.102.22.016","DOIUrl":"https://doi.org/10.30918/irjmms.102.22.016","url":null,"abstract":"Meperidine was often used for postoperative pain relief, but it has addictive and neurotoxic side effects. In order to reduce the use of Meperidine and meet the needs of clinical use, the hospital started using Nalbuphine in August 2018, and the effectiveness for about three years was analyzed with the expectations of reducing the risk of Meperidine use and improving the safety of analgesic treatment. The clinical departments in the hospital advocated that Nalbuphine can replace Meperidine, and the notification of short message service for those with large usages was enhanced. Finally, the data on the changes in the usage of Meperidine and Nalbuphine from August 2018 to December 2021 were collected. Overall, the usage of Nalbuphine increased month by month after it was introduced; in contrast, the average monthly usage of Meperidine decreased from 545 in 2018 to 47 in 2021. It was found that a key point of the golden cross appeared for the use of the two drugs one year after Nalbuphine was introduced. In conclusion, Nalbuphine can indeed replace Meperidine to meet the clinical needs for pain relief when it is used in hospitals. In addition, the annual drug purchase cost of Meperidine can be significantly saved to improve the effectiveness of hospital operations, so the non-controlled drug Nalbuphine has the added benefit of drug profit. Finally, it is hoped that other medical institutions can learn and apply these research findings to the management of controlled drugs in the hospital. Keywords: Meperidine, Nalbuphine, patient safety, hospital management.","PeriodicalId":170316,"journal":{"name":"International Research Journal of Medicine and Medical Sciences","volume":"369 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134018229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.30918/irjmms.102.22.014
A. Khalid, Rubina Rafique, M. Arshad, M. Hamdani, Maria Pirzada, Shaukat Ali, Shoukat Hussain
The objective of this study is to determine the prevalence of end-organ damage in hypertensive patients in a tertiary care hospital in Azad Kashmir. The study was conducted in a public sector teaching hospital of AJK-Medical College between March 2019 and Feb 2020. Adult hypertensive patients above the age of 27 years were included in the study from out-patient and in-patient departments. A standard Performa was used to collect and document the demographic information, medical history and physical examination of patients. The age, sex, residential area, marital status, education, profession, presenting complaints, smoking, addictions, functional status, and physical activity were recorded. The measurement of Blood Pressure (BP) was performed with a mercury sphygmomanometer and end-organs damage (Retinopathy, Nephropathy, Cardiovascular and cerebrovascular disease) was assessed by clinical evaluation and relevant investigations. A total of 100, hypertensive patients were enrolled in the study between the ages of 27 to 96 years. The mean age of the participants was 57 years (Std. deviation 17.8). 55% of patients were male while 45% of patients were female. 23% had good control of hypertension while 77% had poor control. 7% of participants were monitoring their BP on daily basis, 32% weekly, 39% once a month while 22% never had any schedule of monitoring their Blood Pressure. A family history of hypertension was present in 61%. Overall, 91% of the participants had retinopathy, 48% had nephropathy, 48% had cardiovascular disease and 19% had evidence of stroke. In conclusion, there is a high prevalence of End-Organ damage in middle age and elderly hypertensive patients. Keywords: Hypertension, hypertensive end-organ damage.
{"title":"Duration of hypertension and prevalence of end-organ damage in hypertensive patients","authors":"A. Khalid, Rubina Rafique, M. Arshad, M. Hamdani, Maria Pirzada, Shaukat Ali, Shoukat Hussain","doi":"10.30918/irjmms.102.22.014","DOIUrl":"https://doi.org/10.30918/irjmms.102.22.014","url":null,"abstract":"The objective of this study is to determine the prevalence of end-organ damage in hypertensive patients in a tertiary care hospital in Azad Kashmir. The study was conducted in a public sector teaching hospital of AJK-Medical College between March 2019 and Feb 2020. Adult hypertensive patients above the age of 27 years were included in the study from out-patient and in-patient departments. A standard Performa was used to collect and document the demographic information, medical history and physical examination of patients. The age, sex, residential area, marital status, education, profession, presenting complaints, smoking, addictions, functional status, and physical activity were recorded. The measurement of Blood Pressure (BP) was performed with a mercury sphygmomanometer and end-organs damage (Retinopathy, Nephropathy, Cardiovascular and cerebrovascular disease) was assessed by clinical evaluation and relevant investigations. A total of 100, hypertensive patients were enrolled in the study between the ages of 27 to 96 years. The mean age of the participants was 57 years (Std. deviation 17.8). 55% of patients were male while 45% of patients were female. 23% had good control of hypertension while 77% had poor control. 7% of participants were monitoring their BP on daily basis, 32% weekly, 39% once a month while 22% never had any schedule of monitoring their Blood Pressure. A family history of hypertension was present in 61%. Overall, 91% of the participants had retinopathy, 48% had nephropathy, 48% had cardiovascular disease and 19% had evidence of stroke. In conclusion, there is a high prevalence of End-Organ damage in middle age and elderly hypertensive patients. Keywords: Hypertension, hypertensive end-organ damage.","PeriodicalId":170316,"journal":{"name":"International Research Journal of Medicine and Medical Sciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121373765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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