Trends In Hospital Admissions Research Articles

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.

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.

A follow up report validating long term predictions of the COVID-19 epidemic in the UK using a dynamic causal model.

This paper asks whether Dynamic Causal modelling (DCM) can predict the long-term clinical impact of the COVID-19 epidemic. DCMs are designed to continually assimilate data and modify model parameters, such as transmissibility of the virus, changes in social distancing and vaccine coverage-to accommodate changes in population dynamics and virus behavior. But as a novel way to model epidemics do they produce valid predictions? We presented DCM predictions 12 months ago, which suggested an increase in viral transmission was accompanied by a reduction in pathogenicity. These changes provided plausible reasons why the model underestimated deaths, hospital admissions and acute-post COVID-19 syndrome by 20%. A further 12-month validation exercise could help to assess how useful such predictions are. we compared DCM predictions-made in October 2022-with actual outcomes over the 12-months to October 2023. The model was then used to identify changes in COVID-19 transmissibility and the sociobehavioral responses that may explain discrepancies between predictions and outcomes over this period. The model was then used to predict future trends in infections, long-COVID, hospital admissions and deaths over 12-months to October 2024, as a prelude to future tests of predictive validity. Unlike the previous predictions-which were an underestimate-the predictions made in October 2022 overestimated incidence, death and admission rates. This overestimation appears to have been caused by reduced infectivity of new variants, less movement of people and a higher persistence of immunity following natural infection and vaccination. despite an expressive (generative) model, with time-dependent epidemiological and sociobehavioral parameters, the model overestimated morbidity and mortality. Effectively, the model failed to accommodate the "law of declining virulence" over a timescale of years. This speaks to a fundamental issue in long-term forecasting: how to model decreases in virulence over a timescale of years? A potential answer may be available in a year when the predictions for 2024-under a model with slowly accumulating T-cell like immunity-can be assessed against actual outcomes.

Hospital Admissions for Eating Disorders in Children and Adolescents in Spain: A Population-Based Study.

Limited evidence exists regarding the impact of the COVID-19 pandemic on the onset and trajectory of eating disorders (EDs) among young in Spain. This study aims to analyze the characteristics and recent trends in hospital admissions for EDs within the pediatric population. A retrospective analysis was conducted on hospital admissions for EDs among patients aged 10-19 years between 2016 and 2022. The main outcomes examined included hospital rates (overall, stratified by ED type and age group), psychiatric comorbidities, and length of stay. A total of 8275 hospitalizations due to EDs were identified, constituting 1 in 6 hospital admissions for mental illness and behavioral disorders. Predominant characteristics of this population included female sex (93%), aged 15-19 years (58.3%), admission primarily for anorexia nervosa (71.6%), and psychiatric comorbidity (35.6%). Hospital admissions for EDs in the pediatric population showed an increasing trend, with an annual average increase of 11.1% (95% CI: 2.6, 22.6). This rise was led by children aged 10-14 years, with a yearly increase in EDs hospitalization rates of 28.4% (95% CI: 13.5, 56.3) since 2019. Each discharge related to EDs was associated with a median stay of 24 days (IQR: 10, 40). Efforts in community healthcare should prioritize early detection and intervention for symptoms indicative of EDs in the pediatric population, aiming to mitigate the severity of cases requiring hospitalization. These findings underscore the necessity for targeted health planning policies to address the growing burden of EDs among Spanish youth.

Trends in Hospital Admissions for Patients with Amyotrophic Lateral Sclerosis: Insights from a Retrospective Cohort Study in a Province in Northern Italy.

ALS is characterized by a highly heterogeneous course, ranging from slow and uncomplicated to rapid progression with severe extra-motor manifestations. This study investigated ALS-related hospitalizations and their connection to clinical aspects, comorbidities, and prognosis. We performed a retrospective cohort study including patients residing in Modena, Italy, newly diagnosed between 2007 and 2017 and followed up until 31 December 2022. Data were obtained from the Emilia Romagna ALS registry, regional hospitals, and medical records. Among the 249 patients, there were 492 hospital admissions, excluding those for diagnostic purposes; 63% of the patients had at least one hospitalization post-diagnosis, with an average stay of 19.90 ± 23.68 days. Younger patients were more likely to be hospitalized multiple times and experienced longer stays (44.23 ± 51.71 days if <65 years; 26.46 ± 36.02 days if older, p < 0.001). Patients who were hospitalized at least once more frequently underwent gastrostomy (64.97%) or non-invasive (66.24%) and invasive (46.50%) ventilation compared to those never hospitalized (21.74%, 31.52%, 13.04%, respectively, p < 0.001 for all). Emergency procedures led to longer hospitalizations (62.84 ± 48.91 days for non-invasive ventilation in emergencies vs. 39.88 ± 46.46 days electively, p = 0.012). Tracheostomy-free survival was not affected by hospitalizations. In conclusion, younger ALS patients undergo frequent and prolonged hospitalizations, especially after emergency interventions, although these do not correlate with reduced survival.

Eye and adnexa hospitalization in Australia: An ecological study.

To investigate the trends of hospital admissions concerning diseases of the eye and adnexa in Australia in the past 2 decades. This is a descriptive ecological study on the population level that examined hospitalization data for the duration between 1998 and 2021 in Australia. Hospitalization data were extracted from the National Hospital Morbidity Database. The chi-squared test was utilized to assess the difference in admission rates between the years 1998 and 2021. Hospital admission rate for diseases of the eye and adnexa increased by 1.20-fold (from 852.32 [95% confidence interval [CI] 848.16-856.47] in 1998 to 1873.72 [95% CI 1868.48-1878.96] in 2021 per 100,000 persons, P < .01). The most common cause of hospitalization for diseases of the eye and adnexa was disorders of the lens (65.7%), followed by disorders of the choroid and retina (15.6%), followed by disorders of the eyelid, lacrimal system, and orbit (7.7%). Hospital admission rate among males increased by 1.25-fold (from 737.67 [95% CI 732.18-743.16] in 1998 to 1657.19 [95% CI 1650.19-1664.20] in 2021 per 100,000 persons). Hospital admission rate among females increased less sharply by 1.03-fold (from 965.37 [95% CI 959.14-971.59] in 1998 to 1964.35 [95% CI 1956.80-1971.90] in 2021 per 100,000 persons). There are clear gender and age roles in the epidemiology of hospital admissions related to eye and adnexa disorders. Lens disorders were the most common cause of hospital admission. The admission rate increase during the past decades could be due to increases in life expectancy, lifestyle changes, and improvements in screening protocols.

The Burden of Herpes Zoster on Hospital Admissions: A Retrospective Analysis in the Years of 2015-2021 from the Abruzzo Region, Italy.

(1) Background: Herpes zoster (HZ) is a disease caused by the reactivation of the Varicella Zoster Virus (VZV). Clinical reactivation, herpes zoster, takes place in 10-20% of subjects who contracted the primary infection, with a higher risk of developing zoster increasing proportionally with age, especially after 50 years of age. HZ is a common clinical problem, particularly among patients aged over 50 years and immunocompromised patients. Immunocompromised patients and adults could present an atypical and more severe course. In addition, they are at greater risk of complications. For this reason, it is important to understand the real burden of the disease and to identify the subjects who are at higher risk of HZ and its complications, also to direct preventive strategies at the right targets. The aim of the present study is to analyze HZ-related hospitalization trends in Abruzzo in the period of 2015-2021. (2) Methods: Data related to hospital admissions were extracted from the hospital discharge records (HDRs) of the whole region, considering all admissions during the years of 2015-2021. The trends in hospital admissions and length of stay were evaluated and analyzed. (3) Results: A total of 768 hospital discharges with a diagnosis of herpes zoster were registered in Abruzzo during the 7-year study period. During the study period, an increasing trend was observed from the year 2015 to the year 2017, ranging from 8.19 cases/100,000 to 11.5 cases/100,000 (APC (Annual percentage change) +20.8%; 95%CI -2.3; 47.6). After the year 2017, a significantly decreasing trend was observed, reaching 5.46 cases/100,000 in the year 2021 (APC -18.4%; 95%CI -31.5; -12.0). Across the entire study period, an average annual percentage change (AAPC) of -7.0% (95%CI -13.0; -1.3) was observed. (4) Conclusions: Despite the trend of a reduction in hospitalizations, this study highlights that HZ continues to have a great impact on public health. So, it is important to update recommendations for the use of the already available HZ vaccine and to implement new strategies to increase awareness of the prevention of the disease.

Trends in hospital admissions and prescribing due to diseases of the digestive system in England and Wales between 1999 and 2019: An ecological study.

This study aimed to investigate the trends in diseases of the digestive system hospital admissions (DDSHA) in England and Wales between (1999-2019). Secondary objectives were to investigate the type of admission and medication prescribing related to the digestive system in England. This is an ecological study using data from the Hospital Episode Statistics (HES) database and the Patient Episode Database between April 1999 and March 2019. The rate of hospital admissions with 95% confidence intervals (CIs) was calculated by dividing the number of DDSHA by the mid-year population. The trend in hospital admissions was assessed using a Poisson model. Overall, the rate of DDSHA rose by 84.2% (from 2231.27 [95% CI 2227.26-2235.28] in 1999 to 4109.33 [95% CI 4104.29-4114.38] in 2019 per 100,000 persons, trend test, P < .001). The most remarkable rise in hospital admission was seen in liver diseases, followed by other diseases of intestines with 1.85-fold, and 1.59-fold, respectively. Between 2004 and 2019, the overall prescribing rate for medications related to the gastrointestinal system increased by 74.6%, and stoma care related medications prescribing rate increased by 2.25-fold, followed by drugs affecting intestinal secretions and antisecretory drugs and mucosal protectants. There was an increase in hospital admission rate due to GI diseases in the United Kingdom (UK) by 84.2% from 1999 to 2019. The most remarkable rise in the rate of hospital admissions was seen in diseases of the liver and intestine.

Hospital admissions to Phillip Island Wildlife Clinic, Victoria, Australia, over a 10-year period, 2012-2021.

Wildlife hospitals play a critical role in safeguarding diverse animal species, but their admissions data are also valuable for investigating threats and challenges impacting local wildlife. This study examines 10 years of admissions data from the Phillip Island Wildlife Clinic in Victoria, Australia, to identify species, primary causes, outcomes, and temporal trends of hospital admissions. Avian species constitute the majority of admissions (64.5%), with sea and water birds being the most frequently admitted group. Motor vehicle accidents (MVAs), injuries of unknown cause, and orphaning are the dominant causes of admission for birds and mammals. Car strikes are the leading cause of admission for land birds, land mammals, macropods, and turtles. Orphaning exhibits a seasonal pattern, with a higher number of cases in spring. Overall, 70.3% of admissions resulted in mortality, with causes related to trauma showing significantly higher mortality risks than others. The findings emphasize the impact of tourism on wildlife populations and the urgent need for targeted conservation strategies on Phillip Island.

Hospitalizations and Mortality From Myasthenia Gravis: Trends From 2 US National Datasets

Myasthenia gravis (MG) is a rare neuromuscular disorder where IgG antibodies damage the communication between nerves and muscles, leading to muscle weakness that can be severe and have a significant impact on patients' lives. MG exacerbations include myasthenic crisis with respiratory failure, the most serious manifestation of MG. Recent studies have found MG prevalence increasing, especially in older patients. This study examined trends in hospital admissions and in-hospital mortality for adult patients with MG and readmissions and postdischarge mortality in older (65 years or older) adults with MG. Data from the Nationwide Inpatient Sample (NIS), an all-payer national database of hospital discharges, were used to characterize trends in hospitalizations and in-hospital mortality related to MG exacerbations and MG crisis among adult patients aged 18 years or older. The Medicare Limited Data Set, a deidentified, longitudinal research database with demographic, enrollment, and claims data was used to assess hospitalizations, length of stay (LOS), readmissions, and 30-day postdischarge mortality among fee-for-service Medicare beneficiaries aged 65 years or older. The study period was 2010-2019. Multinomial logit models and Poisson regression were used to test for significance of trends. Hospitalization rates for 19,715 unique adult patients and 56,822 admissions increased from 2010 to 2019 at an average annualized rate of 4.9% (MG noncrisis: 4.4%; MG crisis: 6.8%; all p < 0.001). Readmission rates were approximately 20% in each study year for both crisis and noncrisis hospitalizations; the in-hospital mortality rate averaged 1.8%. Among patients aged 65 years or older, annualized increases in hospitalizations were estimated at 5.2%, 4.2%, and 7.7% for all, noncrisis, and crisis hospitalizations, respectively (all p < 0.001). The average LOS was stable over the study period, ranging from 11.3 to 13.1 days, but was consistently longer for MG crisis admissions. Mortality among patients aged 65 years or older was higher compared with that in all patients, averaging 5.0% across each of the study years. Increasing hospitalization rates suggest a growing burden associated with MG, especially among older adults. While readmission and mortality rates have remained stable, the increasing hospitalization rates indicate that the raw numbers of readmissions-and deaths-are also increasing. Mortality rates are considerably higher in older patients hospitalized with MG.

Incidence of Rotavirus-Related Hospitalizations in an Italian Southern Region from 2015 to 2021.

(1) Background: Rotavirus is one of the leading causes of severe diarrhea and dehydration in infants and young children worldwide. The economic and social burden of rotavirus-related hospitalizations, particularly among children, remains a pressing concern for healthcare systems across the globe. Healthcare infrastructure and access to medical care can vary significantly within the region. Differences in the availability of healthcare facilities and the quality of care may influence the management and outcomes of rotavirus cases. (2) Methods: This was a retrospective study performed in the Abruzzo region, Italy. The study considered all hospitalization due to rotavirus gastroenteritis that occurred in the Abruzzo region from the year 2015 to 2021. Data were extracted from the hospital discharge records. The trend in hospital admissions, hospitalization costs and length of stay were evaluated and analyzed. (3) Results: A total of 664 admissions were reported during the study period. The incident rate grew till year 2019 with an annual percentage change of +13.9% (95%CI 12.6-15.2, p < 0.001). During the pandemic years, the incident rate showed a significant decrease with an annual percentage change of 12.5% (95%CI 15.5-9.3, p = 0.004). The length of stay of admissions was significantly higher among patients aged less than 1 year. (4) Conclusions: Rotavirus admission represents a heavy burden even in a high-income country such as Italy. These findings have the potential to inform targeted public health interventions, including vaccination strategies, and improve the overall well-being of children.

The COVID-19 pandemic and the incidence of acute coronary syndromes at General Hospital of Veroia

Background: Although deaths from Acute Coronary Syndromes (ACS) are the most prevalent globally, during the outbreak of the new SARS-CoV-2 coronavirus pandemic, there was a declining trend in hospital admissions for ACS patients. Inevitably a reduction of invasive procedures in cardiac catheterization laboratories was observed. Moreover, an increase in sudden out-of-hospital cardiac deaths was recorded. On the other hand, patients that eventually treated in the hospital had a much worse outcome in terms of cardiac function. Inadequate treatment of acute myocardial infarction resulted in a further increase in mortality due to coronary artery disease. The aim of our study was the comparison of admissions of the patients with ACS before and during the COVID-19 pandemic. Methods: A retrospective single center study was conducted. We recorded all admissions with ACS underwent invasive interventions during the period of lockdown due to COVID-19 pandemic, in Greece, from 16 March 2020 to 1 May 2020 (study period A), as well as in the period of gradual withdraw of restrictions from 2 May 2020 to 1 June 2020 (study period B),. The data were compared with those of the periods of 2019 (control period A and B). Results: One hundred thirty eight patients were the group of study period and 158 were the group of the control period. The reduction rate was 12.7% in study period. The largest decrease in admissions concerned with elderly patients over 75 years old, as well as females (by 52% - 53% respectively). The severity of the restrictions but also the fear of the spread of the coronavirus may be relevant to the insufficient seek of help for these groups of patients. Conclusion: Our study showed that during the pandemic period, the invasive interventions were fewer than those of 2019. However, the expected reduction of catheterizations during this two and a half months period was mitigated by the increase of inter-hospital transfers of patients with ACS from neighboring hospitals, without a catheterization laboratory.

Impact of SARS-CoV-2 Vaccine Rollout on Hispanic and Non-Hispanic Admission and Mortality Trends: An Interrupted Time Series Analysis

Challenges with SARS-CoV-2 vaccine prioritization, access, and hesitancy have influenced vaccination uptake. Was the impact of SARS-CoV-2 vaccine rollout on COVID-19 monthly admission and mortality trends different between Hispanic and non-Hispanic populations? We used interrupted time series analysis to conduct an ancillary study of the Viral Infection and Respiratory Illness Universal Study registry supplemented by electronic health record data from five participating Mayo Clinic sites in Florida, Arizona, Minnesota, and Wisconsin. We included hospitalized patients with COVID-19 admitted between April 2020 and December 2021. Our primary outcome was the impact of vaccine rollout on admission trends. Our secondary outcome was the impact of vaccine rollout on mortality trends. This interrupted time series analysis includes 6,442 patients. Vaccine rollout was associated with improved monthly hospital admission trends among both Hispanic and non-Hispanic patients. Among Hispanic patients, pre-vaccine rollout, monthly admissions increased by 12.9%(95%CI, 8.1%-17.9%). Immediately after vaccine rollout, patient admissions declined by-66.3%(95%CI,-75.6%to-53.9%). Post-vaccine rollout, monthly admissions increased by 3.7%(95%CI, 0.2%-7.3%). Among non-Hispanic patients, pre-vaccine rollout, monthly admissions increased by 35.8%(95%CI, 33.4%-38.1%). Immediately after vaccine rollout, patient admissions declined by-75.2%(95%CI,-77.6%to-72.7%). Post-vaccine rollout, monthly admissions increased by 5.6%(95%CI, 4.5%-6.7%). These pre-vaccine rollout admission trends were significantly different (P< .001). Post-vaccine rollout, the change in admission trend was significantly different (P< .001). The associated beneficial impact from vaccine rollout on monthly hospital admission trends among Hispanic patients was significantly lower. The trend in monthly mortality rate was fourfold greater (worse) among Hispanic patients (8.3%; 95%CI, 3.6%-13.4%) vsnon-Hispanic patients (2.2%; 95%CI, 0.6%-3.8%), but this was not shown to be related to vaccine rollout. SARS-CoV-2 vaccine rollout was associated with improved COVID-19 admission trends among non-Hispanic vsHispanic patients. Vaccine rollout was not shown to influence mortality trends in either group, which were four times higher among Hispanic patients. Improved vaccine rollout may have reduced disparities in admission trends for Hispanic patients, but other factors influenced their mortality trends.

Trends by Acuity for Emergency Department Visits and Hospital Admissions in California, 2012 to 2022

This cohort study investigates trends in emergency department (ED) visits and hospital admissions from EDs in California by visit acuity from 2012 to 2022.

Analyzing the Interactions between Environmental Parameters and Cardiovascular Diseases Using Random Forest and SHAP Algorithms.

Cardiovascular diseases (CVD) remain the predominant global cause of mortality, with both low and high temperatures increasing CVD-related mortalities. Climate change impacts human health directly through temperature fluctuations and indirectly via factors like disease vectors. Elevated and reduced temperatures have been linked to increases in CVD-related hospitalizations and mortality, with various studies worldwide confirming the significant health implications of temperature variations and air pollution on cardiovascular outcomes. A database of daily Emergency Room admissions at the Giovanni XIII Polyclinic in Bari (Southern Italy) was developed, spanning from 2013 to 2019, including weather and air quality data. A Random Forest (RF) supervised machine learning model was used to simulate the trend of hospital admissions for CVD. The Seasonal and Trend decomposition using Loess (STL) decomposition model separated the trend component, while cross-validation techniques were employed to prevent overfitting. Model performance was assessed using specific metrics and error analysis. Additionally, the SHapley Additive exPlanations (SHAP) method, a feature importance technique within the eXplainable Artificial Intelligence (XAI) framework, was used to identify the feature importance. An of 0.97 and a Mean Absolute Error of 0.36 admissions were achieved by the model. Atmospheric pressure, minimum temperature, and carbon monoxide were found to collectively contribute about 74% to the model's predictive power, with atmospheric pressure being the dominant factor at 37%. This research underscores the significant influence of weather-climate variables on cardiovascular diseases. The identified key climate factors provide a practical framework for policymakers and healthcare professionals to mitigate the adverse effects of climate change on CVD and devise preventive strategies.

Social-geographic disparities in suicidal ideations among methamphetamine users in the USA

Methamphetamine use is a growing public health concern nationwide. Suicide is the second leading cause of death in 2019 for US citizens aged 10-14 years and 25-34 years and is also a significant public health concern. Understanding the intersection of methamphetamine use and suicidal ideation (SI) is necessary to develop public health and policy solutions that mitigate these ongoing severe public health issues. Our objective was to examine SI in methamphetamine users to allow us to determine prevalence and trends by age, sex, race, and geographical region. Using data collected between 2008 and 2019 from the National Inpatient Sample (NIS) database, we identified hospital admissions (HA) of patients ≥18 years of age with a primary or secondary diagnosis of SI who were also diagnosed as methamphetamine users. Those who used other substances with methamphetamine were excluded from the analysis. To determine the trend and prevalence of hospital admissions due to SI and SI among methamphetamine users, we used trend weights to calculate the national estimates and performed design-based analysis to account for complex survey design and sampling weights on data collected between 2008 and 2019 in the US. The prevalence ratio (PR) of hospitalizations with concurrent SI and methamphetamine use increased 16-fold from 2008 to 2019. The most significant increase occurred between 2015 and 2016; the PR doubled from 6.07 to 12.14. The PR of hospitalizations with concurrent SI and methamphetamine use was highest in patients aged 26-40 (49.08%) and 41-64 (28.49%). Patients aged 41-64 showed the most significant increase from 2008 to 2019 (15.8-fold). While non-Hispanic White patients comprised most of these hospitalizations (77.02%), non-Hispanic Black patients showed the highest proportional increase (39.1-fold). The Southern and Western regions in the US showed the highest PR for these hospitalizations (34.86% and 34.31%, respectively). Our findings indicate that SI in methamphetamine users has been increasing for some time and is likely to grow. In addition, our results suggest that these patients are demographically different. Both conditions are associated with a lesser likelihood of seeking and receiving care. Therefore, when addressing increased SI or methamphetamine use, learning more about patients who share both conditions is necessary to ensure proper care.

387 Age-Related Trends in Laboratory Testing, Radiologic Imaging, Empiric Antibiotics, Intravenous Fluids, and Hospital Admission Among Adult Patients Presenting With Diarrhea to United States Emergency Departments (2016-2020)

387 Age-Related Trends in Laboratory Testing, Radiologic Imaging, Empiric Antibiotics, Intravenous Fluids, and Hospital Admission Among Adult Patients Presenting With Diarrhea to United States Emergency Departments (2016-2020)

Trends in hospital admissions for chronic obstructive pulmonary disease over 16 years in Canada.

Chronic obstructive pulmonary disease (COPD) is an ambulatory care-sensitive condition, and the rate of hospital admissions for COPD is an indicator of the quality of outpatient care. We sought to determine long-term trends in hospital admissions for COPD in Canada. Using a comprehensive national database of hospital admissions in Canada, we identified those with a main discharge diagnosis of COPD for patients aged 40 years and older between 2002 and 2017. We calculated sex-specific, age-standardized trends in annual rates of hospital admissions for COPD separately for younger (40-64 yr) and older adults (≥ 65 yr). We used spline regression to examine changes in the admissions trends for each sex and age group. Over 16 years, 1 134 359 hospital admissions were for COPD. Between 2002 and 2017, the total number of admissions increased by 68.8%, from 52 937 to 89 384. The overall crude admission rate increased by 30.0%, from 368 to 479 per 100 000 population, and the sex-and age-standardized admission rate increased by 9.6%, from 437 to 479 per 100 000 population. Age-standardized rates increased by 12.2% among younger females, by 24.4% among younger males and by 29.8% among older females, but decreased by 9.0% among older males. Over the same period, the all-cause sex-and age-standardized admission rate declined by 23.0%. Hospital admissions for COPD have increased since 2010, even after adjusting for population growth and aging, and despite declining rates of all-cause hospital admissions. The secular increase in COPD admissions indicates that the burden of COPD on Canadian health care systems is increasing.

The burden of hospital admissions for skeletal dysplasias in Sri Lanka: a population-based study

BackgroundSkeletal dysplasias are a diverse group of rare disorders in the chondro-osseous tissue that can have a significant impact on patient’s functionality. The worldwide prevalence of skeletal dysplasias at birth is approximately 1:5000 births. To date, disease burden and trends of skeletal dysplasias in the Sri Lankan population have not been described in any epidemiological study. Our aim was to evaluate the burden and the current trends in hospital admissions for skeletal dysplasias in the Sri Lankan population. A retrospective evaluation of hospital admissions for skeletal dysplasia during 2017–2020 was performed using population-based data from the eIMMR database which covers government hospitals in the entire country. The trends in hospital admissions for skeletal dysplasias by calendar year, age, and types of skeletal dysplasia were described using appropriate summary statistics.ResultsRespective crude admission rates of skeletal dysplasias in the years 2017, 2018, 2019 and 2020 were 5.2, 8.1, 8.0, and 6.5 per million population. A female predominance (1.4:1) was noted during the studied period. Of all reported cases the majority (n = 268; 44.2%) were children less than 4 years. Each year, 0–4 years age group represented 40–47% of the total hospital admissions. More than half of the cases were reported from Colombo (28.1%) and Kandy (25.4%) districts combined. 60% of cases were diagnosed as osteogenesis imperfecta (OI). Rising trends were observed in the hospital admissions for osteogenesis imperfecta, achondroplasia and osteopetrosis, while other skeletal dysplasia types collectively showed a relatively stable trend.ConclusionThis preliminary study revealed a female predominance of skeletal dysplasias and a relatively high admission rate of osteogenesis imperfecta in the Sri Lankan population. A distinct trend was not visible in the studied years probably due to the impact on hospital services due to COVID- Pandemic. Future research on the healthcare burden on families affected by skeletal dysplasia is required to better understand the overall cost of care and identify therapies that reduce admission rates. This study highlights the value of analysing population-based data on rare diseases to improve healthcare in low-resource countries.

Hospitalizations of children and adolescents with complex chronic conditions in Brazil: a temporal analysis from 2009 to 2020.

Access to advanced and sophisticated health technologies made it possible to increase the survival of children with complex chronic conditions. Thus, the profile of pediatric patients admitted to hospitals has changed in recent decades. In Brazil, there are few epidemiological studies on this subject. This study aims to evaluate the main characteristics and temporal trend of hospital admissions of children and adolescents with complex chronic conditions in Brazil, 2009-2020. This is a cross-sectional study with data on hospitalizations of children and adolescents with complex chronic conditions, extracted from the Hospital Information System of the Unified Health System, 2009-2020, in the 26 Brazilian states and the Federal District. The analysis included descriptive statistics and a generalized linear model. From 2009 to 2020, there were 1,337,120 hospitalizations of children and adolescents with complex chronic conditions, and of these, 735,820 (55.0%) were male. The percentage of hospital deaths during the analyzed period was 4.0%. The most recurrent diagnostic category was malignancy (41.0%), with an annual incidence increase of 2.61 (95% CI: 1.16-4.05). Between 2009 and 2019, the increase in hospitalizations for complex chronic conditions was 27.4% for boys and 25.2% for girls, and the reductions in the number of hospitalizations for other causes were 15.4% and 11.9% for boys and girls, respectively. Conclusions: Hospitalizations for complex chronic conditions in pediatrics are increasing in Brazil. This increase is a new challenge for the Brazilian public health system. What is Known: •The profile of pediatric patients admitted to hospitals has changed in recent decades, with a reduction in the total number of hospitalizations, but with an increase in the complexity and costs of these hospitalizations. •The world's scientific production on CCC is concentrated in the United States health care system. Epidemiological studies on the topic in universal health care systems are scarce. What is New: •This is the first study that evaluated the temporal trend of hospitalizations of children and adolescents with CCC in Brazil. •Hospitalizations for CCC in pediatrics are increasing in Brazil, with emphasis on the condition of malignancy, higher incidence in males and in children under one year of age. Furthermore, our study found a decrease in hospitalizations for other pediatric causes.