Trends In Admissions Research Articles

Comparison of Outcomes for Emergency Medical Services-Transported Infants With Suspected Brief Resolved Unexplained Events Before and After the Coronavirus Disease 2019 Pandemic.

This study compares care-seeking behavior, care delivery, and outcomes for infants with suspected brief resolved unexplained events (BRUEs) who were treated by emergency medical services (EMS) and emergency department clinicians before and after the onset of the coronavirus disease 2019 (COVID-19) pandemic and stay-at-home mandates. This multicenter, retrospective observational study uses prehospital and hospital data on EMS-treated infants (age ≤12 months) with a primary paramedic impression of BRUE. We evaluated interventions, management, and outcomes, including transports and admissions, before (April 2019 to February 2020) and after (April 2020 to February 2021) the start of the pandemic and stay-at-home mandates in March 2020. We also characterized longitudinal trends in transports and hospital admissions for BRUE infants between July 2017 and February 2021. Data were analyzed using descriptive statistics and interrupted time series modeling. There were no significant differences in demographic characteristics or infant presentations before and after the beginning of the pandemic and stay-at-home mandates. We noted an increase in transports during the before period, but transports plateaued in the after period. There was no significant difference in admissions between the before and after periods. For EMS-treated infants with paramedic-suspected BRUE, presentations and hospital admissions were similar before and after the beginning of the COVID-19 pandemic and stay-at-home mandates. There was a longitudinal increase in EMS transports for infants with suspected BRUE before the COVID-19 pandemic and stay-at-home mandates, which then leveled off in the after period.

Admission to acute medical wards for mental health concerns among children and young people in England from 2012 to 2022: a cohort study.

There are challenges in providing high quality care for children and young people who are admitted to acute medical wards for mental health concerns. Although there is concern that these admissions are increasing, national data describing these patterns are scarce. We aimed to describe trends in these admissions in England over a 10-year period, and to identify factors associated with repeat admission and length of stay. In this cohort study we used data on all admissions to medical wards in England among children and young people aged 5-18 years from April 1, 2012, to March 31, 2022. We classified admissions for mental health concerns using the Global Burden of Disease Study cause hierarchy. We described national trends in admissions for mental health concerns over time by sex, age, ethnicity, and index of multiple deprivation quintile. We examined associations between sociodemographic and clinical factors and odds of the admission lasting more than 1 week, as well as hazard ratios of repeat admissions, using mixed-effects models. We identified 342 511 admissions for any cause in children and young people aged 5-18 years in 2021-22 in England, of which 39 925 (11·7%) were for mental health concerns. 21 337 (53·4%) admissions for mental health concerns were due to self-harm. Between 2012-13 and 2021-22, annual admissions for mental health concerns increased from 24 198 to 39 925 (65·0% increase), whereas all-cause admissions increased from 311 067 to 342 511 (10·1% increase). Increases were particularly steep in females aged 11-15 years, rising from 9091 to 19 349 (112·8% increase), and for eating disorders, rising from 478 to 2938 (514·6% increase). In 2021-22, 3130 (7·8%) admissions for mental health concerns lasted longer than 1 week, compared with 12 044 (3·5%) all-cause admissions. Of 239 541 children and young people who were admitted for mental health concerns between 2012-13 and 2021-22, 32 107 (13·4%) had a repeat admission within 6 months. The odds of long-stay admission and hazard ratios for being readmitted were significantly higher for children and young people aged 11-15 years, those who were female, those from less deprived areas, and those with eating disorders than among other groups. We found large increases in the number of children and young people admitted to acute medical wards for mental health concerns over a 10-year period. Further work is needed to understand factors driving these trends and how to improve care for children and young people with mental health concerns admitted to medical wards. National Institute for Health and Care Research.

Admission trends, associated factors and the outcomes for children hospitalised to paediatric intensive care unit for asthma – A population based longitudinal study

Admission trends, associated factors and the outcomes for children hospitalised to paediatric intensive care unit for asthma – A population based longitudinal study

P-486. Current Trends in Hospitalization Among People Living with HIV at an Inner City Hospital in Newark, N.J

Abstract Background As HIV disease is becoming a chronic outpatient condition, we were interested in understanding what is driving high-cost hospitalization in people living with HIV (PLWH) at our inner city hospital in Newark, New Jersey. We sought to examine the trends in admissions over the last two years.Table 1compares the causes of hospitalization between 2022 and 2023 [n = 110] Methods A retrospective study was performed on electronic medical records of PLWH >18 years old admitted for at least 24 hours to the medical, intensive care, or psychiatry unit of Saint Michael's Medical Center from 2022-2023. The reason for hospitalization was determined to be the main diagnosis related to the symptoms on admission upon chart review. We calculated the standardized mortality ratios using observed deaths and expected deaths compared to mortality in the general inpatient population. We used R software to compare the causes of hospitalization between the two years using the Welch two-sample t-test.Figure 1demonstrates the breakdown of causes by infectious diseases over the 2 years Results We identified 110 HIV-positive adults admitted to the hospital. The mean age was 55.8 +/- 12.7 in 2022 and 53.6 +/- 16.3 in 2023. The causes of hospitalization are illustrated in Table 1, p=0.2438. Infections were the top cause of admissions with the most common infections from the respiratory system over two years as demonstrated in Figure 1. AIDS-defining infections were only 4.5% with a decreasing trend during the study period. Overall inpatient mortality in PLWH was 10% in 2022 and 7.14% in 2023. The mortality rate decreased from 4.06 (95% CI 2.20 - 6.91) in 2022 to 1.91 (95% CI 0.89 - 4.06) in 2023. The length of stay (LOS) among PLWH was 26% shorter than the LOS of the general inpatient population in 2022 (n = 4.475) and the same in 2023 (n = 5.34). The mean LOS in PLWH increased by 19.32% over the two years. Conclusion Infections are the most common cause of hospitalization in PLWH with stable trends over the last two years. Average mortality rates and length of stay were lower in PLWH compared to the general hospital admissions. Disclosures Jihad Slim, MD, FACP, AbbVie: Grant/Research Support|AbbVie: Honoraria|AbbVie: Speaker Bureau|Gilead Sciences, Inc.: Grant/Research Support|Gilead Sciences, Inc.: Honoraria|Gilead Sciences, Inc.: Speaker Bureau|Merck: Grant/Research Support|Merck: Honoraria|Merck: Speaker Bureau|Theratechnologies: Advisor/Consultant|Theratechnologies: Honoraria|ViiV Healthcare: Advisor/Consultant|ViiV Healthcare: Grant/Research Support|ViiV Healthcare: Speaker Bureau

P1215 Hospital utilisation for ulcerative colitis in Australia, 1993–2022: a review of observational separation data

Abstract Background The prevalence of ulcerative colitis (UC) is compounding in Western nations, including in the Australasia region1. Mortality has fallen over the last 7 decades since the introduction of intravenous corticosteroids, but despite newer therapies, colectomy rates have not improved2, 3. UC is a chronic, relapsing and remitting condition, and flares lead to hospitalisations and significant costs4. In the era of advanced IBD therapies, understanding trends in admissions will guide cost management strategies. We aimed to assess hospital utilisation trends for UC in Australia between 1993-94 and 2021-22. Methods We obtained resident population figures from the Australian Bureau of Statistics and hospital data for the financial years 1993-94 and 2021-22 from the Australian Institute of Health and Welfare’s National Hospital Morbidity Database. We calculated the rate of hospital separations due to UC (ICD-10 code K51) per 100,000 residents, mean length of stay, and bed utilisation rate for UC admissions. The advent of biologics between 1993-94 and 2021-22 led to an increase in hospital separations and bed days, as each visit to an infusion unit is treated as a separate same-day hospital separation with a uniform length of stay of 1 day. Therefore, we also assessed the separation rate, mean length of stay, and bed utilisation rate for non-same-day separations (i.e., overnight or multi-day stays) to better reflect trends in acute UC flares requiring emergency treatment. Results Total hospital separations for UC grew by 841.1%, from 5,148 in 1993-94, to 48,447 in 2021-22; total patient days increased by 286.1%, from 18,396 to 71,034. Same-day admissions rose 1160.7%, from 3,499 to 44,111. Non-same-day hospitalisations grew by 163.0%, from 1,649 to 4,336, and total days in hospital for these multi-day stays grew by 80.7%, from 14,897 to 26,923. The rate of non-same-day hospitalisation increased by 80.0%, from 9.3 to 16.7 per 100,000 people. Mean length of stay for non-same-day admissions decreased by 31.2%, from 9.0 days to 6.2 days per stay. The bed utilisation rate for UC non-same-day admissions per 100,000 increased by 23.7% from 83.7 to 103.5 per 100,000 people. Conclusion Infusion unit visits for new biologics have driven a massive rise in same-day hospital separations with a primary diagnosis of UC. Despite treatment advances, the rate of non-same-day hospitalisations for UC has also grown, though more modestly, and although mean length of stay has shortened, overall bed utilisation rates due to non-same-day UC admissions have increased. These trends appear to reflect the increasing prevalence of UC in Australia, and healthcare cost modelling must factor this in going forward.

P0855 Rise in admissions for Acute Severe Ulcerative Colitis at an Australian tertiary IBD centre with a culturally and linguistically diverse population: Implications for health resource planning

Abstract Background Epidemiological data suggests greater risk of inflammatory bowel disease in first- and second-generation migrants from a low to high prevalence country, with risk of ulcerative colitis (UC) preceding Crohn’s disease. Little is known about the effect of this on hospitalisations for UC, including acute severe ulcerative colitis (ASUC). This study evaluated demographic trends of ASUC admissions in a metropolitan healthcare setting with an expanding culturally and linguistically diverse (CALD) population, with admission outcomes compared. Methods Demographic and disease characteristics of patients admitted with ASUC at a single tertiary metropolitan centre from January 2016 to October 2024 were recorded. Trends in presentation and outcomes in ASUC patients of European Caucasian and non-European background were compared. Results During this 9-year period, 210 patients (88 [41.9%] female, median age 34.5 [16-90] years) had a total of 261 admissions. The ethnicity of patients for UC admissions was 50.9% European Caucasian, 16.2% South Asian, and 13.8% Middle Eastern; ethnicity information was not available for 11% of patients. Of index admissions, 150 (71.4%) met Truelove and Witts criteria for ASUC (62 [41.3%] female, median age 33.5 [16-87] years); 51.3% European Caucasian, 16% South Asian, and 12% Middle Eastern; ethnicity information was not available for 12% of patients. For patients with recorded ethnicity, when comparing all UC admissions in 2016-2019 to 2020-2024, there was a significant increase in the proportion of non-European background patients, increasing from 32.1% to 47.3% (p=0.05), and an increasing trend in ASUC admissions from 29.0% to 46.8% (p=0.08). Median length of stay was 6 days (IQR 5-11) in European Caucasian patients and 6 days (IQR 4-7) in non-European background patients (p=0.11). 12-month steroid dosage was similar in both European Caucasian (median 1685mg) and non-European (median 1612.5mg) patients (p=0.45). 12-month readmission rate was significantly less in the non-European background ASUC population (10.0%) when compared with the European Caucasian population (30.1%), p = 0.02. 7.1% patients of European Caucasian background required inpatient colectomy, compared with 7.5% of non- European background (p=0.94). Conclusion There was an increase in proportion of patients of non-European background hospitalised with UC, including ASUC. In ASUC patients, 12 month-steroid usage, colectomy rates, and length of stay of index admission were similar across ethnicities, but patients of non-European background had lower readmission rates. Further studies are required for improved planning of healthcare resources and assessment of ASUC in CALD populations.

Understanding the growing burden of Malignant Pleural Effusion - epidemiology, health care utilization and cost, a Canadian perspective.

Malignant Pleural Effusion (MPE) is common in advanced malignancy. Data are needed on health care utilization and costs. This population-based retrospective cohort study included patients aged ≥18 years with an MPE diagnosed between January 1, 2004 and December 31, 2018. We described the incidence and prevalence of MPE from 2004 to 2018, and trends in hospital admissions, emergency department (ED) visits, and pleural-based procedures. In patients diagnosed with MPE from 2006 to 2016 we estimated 2-year health care costs (2018 US dollars) from the public payer perspective. The annual incidence and prevalence of MPE increased from 5,090 and 14,579 in 2004 to 6,977 and 23,204 in 2018, respectively. Annual mortality among prevalent patients decreased from 32% to 28%. In 2004, 57% of patients were hospitalized, decreasing to 50% in 2018. ED visits increased (59% to 61%). From 2004 to 2018, the number of patients who had insertions of thoracostomy tube (2,211 to 3,664) and tunnelled pleural catheter (383 to 1,164) increased. The number of patients receiving pleurodesis declined (565 to 284). No change occurred in the number of patients receiving video-assisted thoracoscopy (range 140 - 208/year). Between 2004 and 2016, 76,190 patients were diagnosed with MPE (mean age 71.2; 52% female). The median (interquartile range) health care cost during follow-up was $45,641 ($23,237-$86,700), with $19,753 ($9,590-$38,746) for inpatient hospitalization. Hospitalization and temporizing MPE procedures are associated with high costs. This population-based study may guide clinicians and policy makers to improve MPE management and reduce health care costs.

Inpatient Cost of Trauma Care Versus Repair of Elective Open Inguinal Hernias: Nationwide Trends Over Nearly a Decade.

Purpose: Concerns exist regarding increased trauma activation fees at the expense of vulnerable patients. In contrast, elective open inguinal hernia repair (E-OIHR) has remained relatively fixed in terms of technique. This study aimed to examine health care costs for E-OIHR and trauma patients, hypothesizing trauma cost would increase from 2010 to 2018, while E-OIHR cost would remain unchanged. Methods: The Nationwide Inpatient Sample database was queried (2010-2018) for admitted patients undergoing unilateral E-OIHR or trauma-related admission. Health care costs per admission, total annual costs, and trends of E-OIHR and trauma admissions were also examined. Multiple linear regression was used to estimate the association of individual- and hospital-level variables with total costs. Results: Unilateral E-OIHR admission cost more than doubled per case in 2018. Trauma cost per admission also increased, however, only by 34%. Total costs for all E-OIHR admissions increased 26%, whereas trauma admission costs increased 32%. Both trauma admissions and unilateral E-OIHR admissions decreased; however, E-OIHR admissions decreased more. Multiple linear regression demonstrated compared to the cost of E-OIHR, trauma care decreased when adjusting for year, age, severity, hospital type, and length of stay (P < .001). Conclusion: The rate of increase in cost per unilateral E-OIHR admission exceeded that of trauma. However, the total economic burden for trauma care increased by billions of dollars due to a steady increase in per incidence cost and only slightly lower rates of trauma admissions. Increased focus on high-value care to curtail increasing costs of E-OIHR and especially trauma appears warranted.

National trends in heart failure admissions in Peru: Insights on regional and demographic disparities from 2018 to 2023.

Heart failure (HF) represents a significant public health challenge, particularly in low- and middle-income countries, where demographic shifts and healthcare disparities influence disease patterns. This study aimed to analyze trends in HF admissions across Peru from 2018 to 2023. We conducted a secondary data analysis of emergency department morbidity records of patients aged ≥20 years registered in the National Superintendence of Health (SUSALUD) database. HF admissions were identified using ICD-10 codes. Age-adjusted standardized HF admission rates per 100,000 persons were estimated using the direct method. Annual percentage changes with their 95% confidence intervals (CI) were estimated using Poisson regression models. In total, 38,931 HF admissions were recorded, with the majority occurring in patients aged ≥60 years (69.2%), and 51.2% of cases were men. HF admissions showed an overall annual growth rate of 2.78% (95% CI 0.95% - 4.65%), 2.92% (95% CI 1.13% - 4.74%) for men, and 2.57% (95% CI 0.45% - 4.73%) for women. Regional disparities were evident, with the highest rates observed in the Amazon region. HF admissions declined during 2020, followed by a rebound in subsequent years. HF admissions in Peru increased from 2018 to 2023, with notable disparities by sex and region. These findings underscore the need for targeted interventions to address regional and demographic variations in HF burden.

Examining the impact of implementing routine rotavirus vaccination on the number of paediatric admissions due to diarrhoea and dehydration in Kenyan hospitals: A study using interrupted time series analysis.

Dehydration secondary to diarrhoea is a major cause of hospitalization and mortality in children aged less than five years. Most diarrhoea cases in childhood are caused by rotavirus, and routine introduction of rotavirus vaccine is expected to reduce the incidence and severity of dehydration secondary to diarrhoea in vaccinated infants. Previously, studies have examined changes in admissions with stools positive for rotavirus but this study reports on all admissions with dehydration secondary to diarrhoea regardless of stool rotavirus results. We aimed to assess the changes in all-cause severe diarrhoea and dehydration (DAD) admissions following the vaccine's introduction. We examined changes in admissions of all clinical cases of DAD before and after introduction of routine vaccination with rotavirus vaccine in July 2014 in Kenya. We use data from 13 public hospitals currently involved in a clinical network, the Clinical Information Network (CIN). Routinely collected data for children aged 2-36 months were examined. We used a segmented mixed effects model to assess changes in the burden of diarrhoea and dehydration after introduction of rotavirus vaccine. For sensitivity analysis, we examined trends for non-febrile admissions (surgical or burns). There were 17,708 patients classified as having both diarrhoea and dehydration. Average monthly admissions due to DAD for each hospital before vaccine introduction (July 2014) was 35 (standard deviation: ±22) and 17 (standard deviation: ±12) after vaccine introduction. Segmented mixed effects regression model showed there was a 33% (95% CI, 30% to 38%) decrease in DAD admissions immediately after the vaccine was introduced to the Kenya immunization program in July 2014. There was no change in admissions due to non-febrile admissions pre-and post-vaccine introduction. The rotavirus vaccine, after introduction into the Kenya routine immunization program resulted in reduction of all-cause admissions of diarrhoea and dehydration in children to public hospitals.

Trends in Cardiovascular Diseases and Costs Among Type 2 Diabetes Mellitus (T2DM) Patients in Malaysia: A Cohort Study of 240,611 Public Hospital Inpatients.

Identifying trends of hospital admissions and costs for cardiovascular disease events (CVDEs) is crucial for public health intervention and the economic burden for future clinical improvements andbetter outcomes. This study aims to define the admission trends and cost of CVDE among type 2 diabetes mellitus (T2DM) patients in Malaysia between 2014 and 2020. Methodology: An ecological study was conducted using hospital admission data taken from the Casemix database in public hospitals in Malaysia. Hospital admission data for CVDE among T2DM patients were extracted for the period between 2014 and 2020. The cost data were retrieved from the Malaysian Disease Related Group (MalaysianDRG) costing section, and the median and total costs were calculated per CVDE per year. Descriptive statistical analysis and multiple logistic regression models were used to analyze trends and factors associated. A total of 240,611 T2DM admissions, representing 35.1% of 684,809 CVDE admissions, were included in this study. Among these, 32.9% were treated for myocardial infarction (MI), 20.1% for cerebrovascular accident (CVA), 19.4% for heart failure, 12.8% for ischemic heart disease (IHD), 8.2% for hypertensive heart disease (HHD), 5.6% for cardiomyopathy, and 1.0% for atherosclerosis and peripheral vascular disease (PVD). CVDE admissions were prevalent among males (59.2%) and associated with higher cost of admission (β = 1.13, P < 0.001), patients aged 40-49 years old had 24% high odd for high cost (β = 1.24, P < 0.001) compared to those aged 19-29 years. Compared to Malay, Chinese and other ethnicities were significantly associated with high cost (β = 1.13, P < 0.001). Patients with severity level III were 10 times more likely to have higher costs as compared to severity level I (β = 10.39, P < 0.001), 72.6% were admitted in less than five days, and 23.1% were less likely to incur high cost as compared to patients admitted more than five days (β = 0.769, P < 0.001). The trend of admissions is increasing each year, with the median total hospital expenditure higher in IHD patients with T2DM, which increased by 55.5% from 2014 to 2020 (from RM 4,187.98 to RM 6,510.43). This was followed by MI, which saw an 8% increase (from RM 3,881.80 to RM 4,211.18). The findings of this research indicated cardiovascular disease (CVD) admission trends and costs increased substantially over the years and higher costs in dual noncommunicable diseases (NCDs). These findings underscore the urgent need for enhanced preventive strategies targeting high-risk populations, such as males, individuals with severe disease levels, and specific ethnic groups. Policies should emphasize lifestyle modification programs, early diagnosis of cardiovascular risks among T2DM patients, and cost-effective treatments to mitigate the growing financial burden. Furthermore, resource allocation must be adjusted to address the increasing demand for care, particularly for conditions like IHD and MI, ensuring equitable access to quality care while containing healthcare costs.

Trend Analysis of Admission, Enrolment and Completion Rates in Primary Education in Bongo District, Ghana (2012-2021)

The purpose of this study was to investigate trends in primary education admission, enrolment and completion rates in the Bongo District from 2012 to 2021. The study was grounded on the Theory of Justice developed by John Rawl in 1971. A descriptive exploratory design was used. This study used secondary data from the Ghana Education Office of the Bongo District in the Upper East region of Ghana to analyse trends in access to and participation in primary education within the district during the period studied. Data were analysed using appropriate formulae to calculating ratios for the educational indicators. Findings revealed that a significant number of children enrolled in primary education were not in the appropriate grade for their age; the majority were either below or above the age range of 6 to 11 years for primary education in Ghana. Additionally, the percentage of the out-of-school population within the appropriate age range for primary education (NER) increased by 1.1 percentage points, from 15.4% in 2012 to 16.5% in 2021. The study concluded that despite recognisable efforts by the country and district to widen access to education through free education policy, the education system has not yet absorbed all school-age children in the district due to several barriers. This study therefore recommends community outreach programmes by the district education office to address sociocultural factors affecting pupils’ participation in primary education.

Trend Analysis of Admission, Enrolment, Completion, and Transition Rates in Primary Education in Ghana

The purpose of this study was to investigate trends in primary education admission, enrolment, completion rates, and transition rates to junior high school in the Bongo District from 2012 to 2021. A descriptive exploratory design was used. This study used secondary data from the Ghana Education Office of the Bongo District in the Upper East region of Ghana to analyse trends in access to and participation in primary education within the district during the period studied. Findings revealed that a significant number of children enrolled in primary education were not in the appropriate grade for their age; the majority were either below or above the age range of 6 to 11 years for primary education in Ghana. Additionally, the percentage of the out-of-school population within the appropriate age range for primary education (NER) increased by 1.1 percentage points, from 15.4% in 2012 to 16.5% in 2021. This study recommends community outreach programmes by the district education office to address sociocultural factors affecting pupils’ participation in primary education. Received: 28 August 2024 / Accepted: 11 November 2024 / Published: 20 November 2024

Trends in syncope testing and admissions in the USA from 2006 through 2019.

Syncope is common, with bimodal distribution through life, peaking in adolescence and in the elderly, and overall increases in incidence with age among both men and women. In this context, syncope-related visits to emergency departments (ED), hospitalizations, and testing are a significant healthcare cost burden. Ultimately, understanding the volume of testing types and settings of syncope encounters may aid in more effective healthcare utilization and high value care for this patient population. Data for this study were collected from the Truven Health Analytics MarketScan Database from 2006 to 2019. This database contains both commercially insured patients and those with Medicare coverage. Patients with the diagnosis of syncope were identified using International Classification of Diseases (ICD)-9 and -10 codes. We assessed the incidence of various tests for syncope evaluation and ED disposition for the study period. The incidence of syncope among the study cohort rose from nine per 1000 patients to 13 per 1000 patients during the study period. The incidence of testing for syncope among multiple domains (neurologic, cardiac, blood testing) decreased in some categories, but routine testing remained prevalent. Women had a significantly lower incidence of testing in most testing domains. Discharge rate from the ED for patients presenting with syncope remained stable during the study period. However, admission rate to the hospital for those aged > 65 years increased during the study time. Testing and admissions for syncope remain prevalent and are drivers of healthcare-associated costs. There is a clear need for further work in developing a focused approach in the evaluation of syncope patients in order to mitigate healthcare costs and improve outcomes.

Time trends in work-related MSK injury admissions in Victoria: Effects of the COVID-19 pandemic

BackgroundWork-related musculoskeletal (MSK) injuries pose significant challenges to workers' health, productivity, and healthcare systems. Increased working from home since the onset of the COVID-19 pandemic may have affected the incidence and prevalence of work-related MSK injuries. Despite workers' compensation systems providing valuable data, underreporting remains a concern, necessitating additional data sources such as hospital admissions to better understand the burden of MSK injuries. ObjectiveTo determine time trends in the rates of hospitalization due to work-related MSK injuries in Victoria, Australia, before and during the COVID-19 pandemic. MethodsRetrospective administrative data analysis was conducted using data from the Victorian Admitted Episodes Dataset (VAED). Adults (aged 15+ years) hospital admissions between July 2012 and June 2022 were included. Interrupted time series analysis was employed to evaluate changes in monthly incidence rates of hospital admissions for work-related MSK injuries before and during the pandemic. ResultsA total of 67,689 index hospital admissions for work-related MSK injuries were recorded in the study period, with an average of 6,769 annually. Acute injuries were predominant during the pandemic, accounting for 63.6 % of cases compared to 60.1 % before the pandemic. Over ten years, the average annual incidence rate of acute MSK injuries was 13.20 cases per 10,000 workers, while cumulative injuries showed a rate of 8.62 cases per 10,000 workers. Comparing pre-pandemic and pandemic periods, the average annual incidence rate of acute MSK injuries increased, while cumulative injuries decreased. ConclusionThe study observed a gradual decrease in the overall incidence rate of hospital admissions for cumulative work-related MSK injuries over the last decade. Despite expectations of disruptions, no significant deviations in MSK injury trends were observed following the onset of the COVID-19 pandemic in Victoria, Australia.

Exploring Risk Factors Associated With Intensive Care Unit Admission in a Retrospective Cohort of 631 Children With Bronchiolitis.

Examine the trends and epidemiological features of acute hospitalized bronchiolitis cases among children aged 28 days to 2 years, both before and after the COVID-19 pandemic. Furthermore, evaluate their need for intensive care unit (ICU) admission and identify primary risk factors associated with severe bronchiolitis. A retrospective analysis was conducted on the medical records of paediatric patients admitted to Meyer Children's Hospital in Florence (Italy) from September 2019 to March 2023, with the diagnosis of bronchiolitis. Between 2019 and 2023, bronchiolitis hospitalizations grew by 76%, going from 131 to 230 cases, after the historical minimum of 14 cases in the 2020-2021 season. Respiratory syncytial virus (RSV) infection emerged as the predominant etiological agent, contributing to 76% of hospitalizations in both 2021-2022 and 2022-2023 seasons. Coinfection cases increased fivefold from 2019 to 2023, accounting for 23% of hospitalizations in 2022-2023. In addition, the ICU admission rate increased from 13% in 2019-2020 to 31% of bronchiolitis hospitalizations in 2022-2023. Univariate and multivariate analysis data show that infants below 2 months of age, preterm births, comorbidities and RSV infections were correlated with a higher risk for ICU admission. The growing trend in ICU admissions for acute bronchiolitis in hospitalized children represents a substantial health challenge. Addressing the bronchiolitis epidemic necessitates a strategic focus on RSV prevention through interventions such as vaccines and monoclonal antibodies. Urgent implementation of preventive initiatives, together with continuous surveillance and the establishment of national databases, is imperative and cannot be further deferred.

Association of Respiratory Morbidities with Particulate Air Pollution in Delhi, India- A Prospective Study

Abstract Background: Elevated levels of air pollution and long-term exposure can lead to detrimental health conditions, mainly affecting cardiorespiratory systems. Materials and Methods: A prospective observational study was conducted in five sampled hospitals in Delhi. A pre-designed, pre-tested, semi-structured questionnaire was filled out for each patient with data from hospital records. The admission rates were recorded daily over the study period along with the air quality with reference to particulate matter (PM). The trends of the hospital admissions for respiratory morbidity were corroborated with PM 2.5. Descriptive statistics and correlation amongst emergency admissions and air pollutants were analysed using Microsoft Excel. The impact of air quality on the rate of hospitalisation due to respiratory conditions was projected by mathematical modelling. Results: The rate of hospitalisation due to bronchial asthma, chronic obstructive pulmonary disease, bronchitis and lower respiratory tract infections was found to be directly proportional to an increase in PM2.5. Conclusion: The healthcare system is increasingly strained and thus, the additional burden due to rising air pollution needs to be prevented by making people aware about the methods of reducing air pollution.

Characteristics of adolescents with acute alcohol intoxication accessing emergency care in The Netherlands

Abstract Background Prevent alcohol consumption amongst minors is a major concern for national governments. Collecting comprehensive data on adolescent drinking patterns is crucial for developing effective prevention strategies. Therefore, the aim of this study is to give an overview of demographic and clinical characteristics of adolescents with an acute alcohol intoxication in the Netherlands. Methods This study was conducted using a cohort of adolescents aged 14-17 years presenting with acute alcohol intoxication symptoms at the emergency department from 2015-2023. Data were collected at the Reinier de Graaf Gasthuis in Delft in order to monitor trends in admissions for acute alcohol intoxication. Data on patients age, blood alcohol concentration, sex, combined drug use and reason of admission were collected. Results A total of 505 patients who presented themselves with symptoms of acute alcohol intoxication at the Reinier de Graaf Gasthuis were included. The mean age of patients was 15.7 years old. The mean blood alcohol concentration was 2.0‰. During the COVID-lockdown period there were statistically significant less admissions with alcohol intoxication. The distribution of sex was nearly equal with 50.3% females and 49.7% males. Combined drug use was present in 13.4% of all cases, with cannabis as the most frequent type of drugs found. The most common known reason for admission was ‘reduced consciousness’ (35.9%). Conclusions These findings are relevant for both the central government’s ongoing prevention initiatives and treatment strategies within hospitals. In the future, more countries should evaluate data on adolescent drinking patterns.

Trends in Pediatric Hospital Admissions Caused or Contributed by SARS-CoV-2 Infection in England

To investigate the changing characteristics of SARS-CoV-2-related pediatric hospital admissions overtime. This was a national, observational cohort study from July 1, 2020, to August 31, 2023, using English population-linked electronic health records. We identified 45 203 children younger than 18years old in whom SARS-CoV-2 either caused or contributed to hospitalization, excluding those admitted with "incidental" infection. Studied outcomes were types of hospitalization and severe hospitalizations involving either critical care or pediatric inflammatory multisystem syndrome-temporally associated with SARS-CoV-2 (PIMS-TS). There were 45 920 SARS-CoV-2-related hospitalizations in children: 34 870 (75.9%) attributable to COVID-19; 1845 (4.0%) attributable to PIMS-TS; 8330 (18.1%) with SARS-CoV-2 as contributor to admission; and 875 (1.9%) acquired nosocomial SARS-CoV-2 infection. The most notable changes between the first 3 waves (March 2020 through November 2021) and the Omicron era (December 2021 onwards) were a decrease in PIMS-TS from 1575 of 14 020 (11.2%) to 270 of 31 905 (0.8%); a reduction in critical care use from 1175 of 14 020 (8.4%) to 1390 of 31 905 (4.4%); a decreased in mortality rate amongthose hospitalized from 521 per 100 000 to 249 per 100 000; and a decrease in the median age of hospitalized children from 4.7 (IQR 0.6,12.3) to 1.1 (IQR 0.3,6.4) years. Of children hospitalized, infants, 10.2% of whom had a recorded underlying health condition, comprised 4225 of 14 020 (30.1%) admissions 2020 through 2021 and 15 555 of 31 900 (48.8%) since 2022. (P<.001 for all comparisons). Infants are now the pediatric age group most affected by SARS-CoV-2, at least partially because they have the least immunity to the virus, and are most vulnerable to respiratory illnesses.

An epidemiological and spatiotemporal analysis of visceral leishmaniasis in West Pokot, Kenya, between 2018 and 2022

BackgroundVisceral leishmaniasis (VL) remains a significant public health concern in West Pokot County, Kenya, where a large outbreak between 2020 and 2022 emphasised the need for improved VL control strategies. However, these measures are partially hampered by limited insight into the geographical distribution of cases and localised outbreaks of the disease. This study aimed to describe the epidemiology and spatiotemporal patterns of VL in West Pokot between 2018 and 2022, in order to map the spread of VL transmission and identify regions that should be prioritised for control interventions.MethodsVL patient demographics and village of residence were retrieved from admission records of Kacheliba Sub-County Hospital in West Pokot, Kenya. The temporal trend in VL admissions between 2018 and 2022 was analysed using seasonal decomposition analysis. To describe the spatial distribution of VL cases, geographic coordinates of villages of residence were collected from pre-established databases, and VL incidence was mapped at the sub-location level. Hotspot analysis was performed per study year to identify villages with high VL incidence, and scan statistics were applied to detect spatiotemporal clusters of VL cases during the study period.ResultsA total of 1948 VL patients were reported between 2018 and 2022. The annual number of cases increased from 245 in 2019 to 598 in 2022, and VL admissions were generally higher at the start of the wet seasons. 70% of the VL cases could be georeferenced, and mapping of VL incidence revealed high case rates in the east of West Pokot during the complete study period. The eastern villages Lotongot and Chepaywat were marked as VL hotspots at a 99% confidence level in all study years. In addition, five significant spatiotemporal clusters were detected in the east and north, suggestive of local VL outbreaks in these regions.ConclusionsThe increase in VL hospital admissions during the study period stresses the need for enhanced VL control and outbreak mitigation in West Pokot. These control measures should be focused on the hotspot regions in the east of the county.