Browsing by Subject "incidence"

Now showing 1 - 6 of 6
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    Incidence and Outcomes Associated With Infections Caused by Vancomycin-Resistant Enterococci in the United States: Systematic Literature Review and Meta-Analysis
    (Cambridge, 2017-02) Chiang, Hsiu-Yin; Perencevich, Eli N.; Nair, Rajeshwari; Nelson, Richard E.; Samore, Matthew; Khader, Karim; Chorazy, Margaret L.; Herwaldt, Loreen A.; Blevins, Amy E.; Ward, Melissa A.; Schweizer, Marin L.; Department of Medicine, School of Medicine
    Information about the health and economic impact of infections caused by vancomycin-resistant enterococci (VRE) can inform investments in infection prevention and development of novel therapeutics. To systematically review the incidence of VRE infection in the United States and the clinical and economic outcomes. We searched various databases for US studies published from January 1, 2000, through June 8, 2015, that evaluated incidence, mortality, length of stay, discharge to a long-term care facility, readmission, recurrence, or costs attributable to VRE infections. We included multicenter studies that evaluated incidence and single-center and multicenter studies that evaluated outcomes. We kept studies that did not have a denominator or uninfected controls only if they assessed postinfection length of stay, costs, or recurrence. We performed meta-analysis to pool the mortality data. Five studies provided incidence data and 13 studies evaluated outcomes or costs. The incidence of VRE infections increased in Atlanta and Detroit but did not increase in national samples. Compared with uninfected controls, VRE infection was associated with increased mortality (pooled odds ratio, 2.55), longer length of stay (3-4.6 days longer or 1.4 times longer), increased risk of discharge to a long-term care facility (2.8- to 6.5-fold) or readmission (2.9-fold), and higher costs ($9,949 higher or 1.6-fold more). VRE infection is associated with large attributable burdens, including excess mortality, prolonged in-hospital stay, and increased treatment costs. Multicenter studies that use suitable controls and adjust for time at risk or confounders are needed to estimate the burden of VRE infections.
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    Incidence of Dementia and Alzheimer Disease Over Time: A Meta-Analysis
    (Wiley, 2019-06-20) Gao, Sujuan; Burney, Heather N.; Callahan, Chris M.; Purnell, Christianna E.; Hendrie, Hugh C.; Biostatistics, School of Public Health
    Background/Objectives: Population-based incidence estimates of dementia and Alzheimer’s disease (AD) provide important information for public health policy and resource allocation. We conducted a meta-analysis of published studies that reported age-specific incidence rates of dementia and AD to determine whether dementia and AD incidence rates are changing over time. Design: PubMed and MEDLINE were searched for publications through June 30, 2017 using keywords dementia, Alzheimer, and incidence. Inclusion criteria for the meta-analysis are: (1) population-based studies using personal interviews and direct examinations of the study subjects, (2) Standardized clinical diagnosis criteria, (3) Reporting age-specific incidence rates, (4) Published in English, and (5) Sample size greater or equal to 500 and length of follow-up greater or equal than two years. Mixed effects models were used to determine the association between birth year and incidence rates. Measurements: Age-specific dementia/AD incidence rates and their standard errors reported in each study. Results: Thirty-eight articles with 53 cohorts on dementia incidence and 31 articles with 35 cohorts on AD incidence met the inclusion criteria. There were significant associations between later birth years and decreased dementia incidence rates in all three age groups (65-74, 75-84 and 85+). There were no significant associations between birth year and AD incident rates in any of the three age groups. In particular, AD incidence rates reported from Western countries stayed steady in all age groups while studies in non-Western countries showed significantly increased AD incidence rates for the 65-74 age group (OR=2.78, p=0.04), but non-significant association for the 75-84 or 85+ groups. Conclusion: Dementia incidence declined over the last four decades, but AD incidence did not decline. Further research, especially from non-Western countries, is needed to elucidate the mechanism underlying the trends in dementia and AD incidence over time.
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    Predicting spatial and temporal responses to non-pharmaceutical interventions on COVID-19 growth rates across 58 counties in New York State: A prospective event-based modeling study on county-level sociological predictors
    (JMIR, 2020) Xiao, Yunyu; School of Social Work
    Background: Non-pharmaceutical interventions (NPIs) have been implemented in the New York State since the COVID-19 outbreak on March 1, 2020 to control the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Projecting the growth rate of incidence as a response to key NPIs is crucial to guide future policy making. Few studies, however, considered spatial variations of incidence growth rate across different time points of NPIs. Objective: This study quantifies county-level predictors of the time evolution of COVID-19 incidence growth rate following key NPIs in New York State. Methods: County-level COVID-19 incidence data were retrieved from the Coronavirus Case Data from Social Explorer Website between March and June 2020. 5-day moving average growth rates of COVID-19 were calculated for 16 selected time points on the dates of eight NPIs and their respective 14-day-lag-behind time points. A total of 36 county-level predictors were extracted from multiple public datasets. Geospatial mapping was used to display the spatial heterogeneity of county-level COVID-19 outbreak. Generalized mixed effect least absolute shrinkage and selection operator (LASSO) regression was employed to identify significant county-level predictors related to the change of county-level COVID-19 growth rate over time. Results: Since March 1, the growth rate of COVID-19 infection increased and peaked by the end of March, followed by a decrease. Over time, the region with the highest growth rates shifted from New York metropolitan area towards Western and Northern areas. Proportions of population aged 45 years and above (β=3.25 [0.17–6.32]), living alone at residential houses (β=3.31 [0.39–-6.22]), and proportion of crowd residential houses (β=6.15 [2.15–10.14]) were positively associated with the growth rate of COVID-19 infection. In contrast, living alone at rental houses (β=-2.47 [-4.83–-0.12]) and rate of mental health providers (β=-1.11 [-1.95–-0.28]) were negatively associated with COVID-19 growth rate across all 16 time points. Conclusions: Tailored interventions and policies are required to effectively control the epidemic for different counties. Attention towards economic, racial/ethnic, and healthcare resource disparities are needed to narrow the unequal health impact on vulnerable populations.
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    Prevalence of Advanced, Precancerous Colorectal Neoplasms in Black and White Populations: A Systematic Review and Meta-analysis
    (AGA, 2018) Imperiale, Thomas F.; Abhyankar, Priya R.; Stump, Timothy E.; Emmett, Thomas W.; Medicine, School of Medicine
    Background & Aims Colorectal cancer (CRC) incidence and mortality are higher in black vs white populations. The reasons for these disparities are not clear, yet some guidelines recommend screening black persons for CRC starting at ages 40–45 years. We performed a systematic review and meta-analysis to compare the prevalence of advanced adenomas (AAs) and advanced, precancerous colorectal neoplasms (ACNs) between asymptomatic black and white screen-eligible adults. Methods We searched Ovid MEDLINE, PubMed, Embase, and the Cochrane Library to identify articles (published from 1946 through June 2017) that reported prevalence values of AA or ACN in average-risk black and white individuals undergoing screening colonoscopy. Two authors independently assessed study quality and risk for bias using a modified validated quality assessment instrument. Following the PRISMA guidelines, 2 authors independently abstracted descriptive and quantitative data from each study. We performed a random effects meta-analysis to determine risk differences and odds ratios (ORs). Results From 1653 articles, we identified 9 studies for analysis, comprising 302,128 individuals. Six of the 9 studies were of high methodological quality, had a low risk for bias, and were included in the meta-analysis. In these 9 studies, the overall prevalence values for AA and ACN did not differ significantly between back (6.57%) and white screened individuals (6.20%; OR, 1.03; 95% CI, 0.81–1.30). Among a subgroup of 5 studies, the prevalence of proximal AA and ACN was significantly higher in black (3.30%) than in white screened individuals (2.42%; OR, 1.20; 95% CI, 1.12–1.30). Excluding the largest study did not affect overall prevalence (OR, 0.99; CI, 0.73–1.34) but eliminated the difference in prevalence of proximal AA or ACN (OR, 1.48; 95% CI, 0.87–2.52). Conclusions In a meta-analysis, we found the overall prevalence of AA and ACN did not differ significantly between average-risk black and white persons, indicating that the age at which to begin CRC screening need not differ based on race.
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    Stent-Only Versus Adjunctive Balloon Angioplasty Approach for Saphenous Vein Graft Percutaneous Coronary Intervention
    (American Heart Association, 2020-02-05) Latif, Faisal; Uyeda, Lauren; Edson, Robert; Bhatt, Deepak L.; Goldman, Steven; Holmes, David R.; Rao, Sunil V.; Shunk, Kendrick; Aggarwal, Kul; Uretsky, Barry; Bolad, Islam; Ziada, Khaled; McFalls, Edward; Irimpen, Anand; Truong, Huu Tam; Kinlay, Scott; Papademetriou, Vasilios; Velagaleti, Raghava S.; Rangan, Bavana V.; Mavromatis, Kreton; Shih, Mei-Chiung; Banerjee, Subhash; Brilakis, Emmanouil S.; Medicine, School of Medicine
    BACKGROUND: Direct stenting without pre-dilation or post-dilation has been advocated for saphenous vein graft percutaneous coronary intervention to decrease the incidence of distal embolization, periprocedural myocardial infarction, and target lesion revascularization. METHODS: We performed a post hoc analysis of patients enrolled in the DIVA (Drug-Eluting Stents Versus Bare Metal Stents in Saphenous Vein Graft Angioplasty; ) prospective, double-blind, randomized controlled trial. Patients were stratified into stent-only and balloon-stent groups. Primary end point was 12-month incidence of target vessel failure (defined as the composite of cardiac death, target vessel myocardial infarction, or target vessel revascularization). Secondary end points included all-cause death, stent thrombosis, myocardial infarction, and target lesion revascularization during follow-up. RESULTS: Of the 575 patients included in this substudy, 185 (32%) patients underwent stent-only percutaneous coronary intervention. Patients in the stent-only versus balloon-stent group had similar baseline characteristics and similar incidence of target vessel failure at 12-months (15% versus 19%; hazard ratio, 1.34 [95% CI, 0.86–2.08]; P=0.19). During long-term follow-up (median of 2.7 years), the incidence of definite stent thrombosis (1% versus 5%; hazard ratio, 9.20 [95% CI, 1.23–68.92]; P=0.0085), the composite of definite or probable stent thrombosis (5% versus 11%; hazard ratio, 2.52 [95% CI, 1.23–5.18]; P=0.009), and target vessel myocardial infarction (8% versus 14%; hazard ratio, 1.92 [95% CI, 1.08–3.40]; P=0.023) was lower in the stent-only group. Multivariable analysis showed that a higher number of years since coronary artery bypass grafting and >1 target saphenous vein graft lesions were associated with increased target vessel failure during entire follow-up, while preintervention Thrombolysis in Myocardial Infarction-3 flow was protective. CONCLUSIONS: In patients undergoing percutaneous coronary intervention of de novo saphenous vein graft lesions, there was no difference in target vessel failure at 12 months and long-term follow-up in the stent-only versus the balloon-stent group; however, the incidence of stent thrombosis was lower in the stent-only group, as was target vessel myocardial infarction.
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    Temporal Trends of Sex Differences in Transient Ischemic Attack Incidence Within a Population
    (Elsevier, 2019-07-01) Madsen, Tracy E.; Khoury, Jane C.; Alwell, Kathleen; Moomaw, Charles J.; Rademacher, Eric; Flaherty, Matthew L.; Woo, Daniel; De Los Rios La Rosa, Felipe; Mackey, Jason; Martini, Sharyl; Ferioli, Simona; Adeoye, Opeolu; Khatri, Pooja; Broderick, Joseph P.; Kissela, Brett M.; Kleindorfer, Dawn; Neurology, School of Medicine
    Objective: Previously we reported that ischemic stroke incidence is declining over time for men but not women. We sought to describe temporal trends of sex differences in incidence of transient ischemic attack (TIA) within the same large, biracial population. Methods: Among the population of 1.3 million in the Greater Cincinnati Northern Kentucky Stroke Study (GCNKSS) region, TIAs among area residents (≥20 years old) were identified at all local hospitals. Out of hospital cases were ascertained using a sampling scheme. First-ever cases and first within each study period for a patient were included in incidence rates. All cases were physician-adjudicated. Incidence rates (during 7/93-6/94 and calendar years 1999, 2005, and 2010) were calculated using the age-, race-, and sex-specific number of TIAs divided by the GCNKSS population in that group; rates were standardized to the 2010 U.S. population. T-tests with Bonferroni correction were used to compare rates over time. Results: There were a total of 4746 TIA events; 53% were female, and 12% were black. In males, incidence decreased from 153 (95%CI 139-167) per 100,000 in 1993/4 to 117 (95%CI 107-128) in 2010 (p<0.05 for trend test) but was similar over time among females (107 (95%CI 97-116) to 102 (95%CI 94-111), p>0.05). Conclusions: Within the GCNKSS population, TIA incidence decreased significantly over time in males but not females, data which parallels trends in ischemic stroke in the GCNKSS over the same time period. Future research is needed to determine if these sex differences in incidence over time continue past 2010.