Publications
419 results found
Jani C, Marshall D, Singh H, et al., 2021, Lung cancer mortality in Europe and the United States between 2000 and 2017: an observational analysis, European Respiratory Journal Open Research, Vol: 7, Pages: 1-14, ISSN: 2312-0541
Background The lung is the most common site for cancer and has the highest worldwide cancer-related mortality. Our study reports and compares trends in lung cancer mortality in the United States (US) and 26 European countries.Study design and methods Lung cancer mortality data were extracted for males and females for each of the years 2000–2017 from the World Health Organization (WHO) Mortality and the Centers for Disease Control and Prevention (CDC) WONDER databases. Lung cancer mortality trends were compared using Joinpoint regression analysis, and male-to-female mortality ratios were calculated.Results Down-trending lung cancer mortality rates were observed in males in all countries except Cyprus and Portugal between 2000 and 2017. In females, increasing mortality rates were observed in 22 of the 27 countries analyzed. Latvia had the highest estimated annual percentage change (EAPC) in male mortality (−9.6%) between 2013–2015. In the US, EAPCs were −5.1% for males and −4.2% for females between 2014–2017. All countries had an overall decrease in the ratio of male-to-female lung cancer mortality. The most recent observation of median male-to-female mortality was 2.26 (IQR 1.92–4.05). The countries with the greatest current sex disparity in lung cancer mortality were Lithuania (5.51) and Latvia (5.00).Conclusion Between 2000 and 2017, lung cancer mortality rates were decreasing for males in Europe and the US, whereas increasing lung cancer mortality rates were generally observed in females. There is a persistent but decreasing sex-mortality gap, with men having persistently greater lung cancer mortality but with rates decreasing faster than women.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the result
Hartley A, Shalhoub J, Khamis R, 2021, Trends in mortality from aortic stenosis in Europe: 2000-2017, Frontiers in Cardiovascular Medicine, Vol: 8, Pages: 1-9, ISSN: 2297-055X
BackgroundTrends in mortality from aortic stenosis across European countries are not wellunderstood, especially given the significant growth in transcatheter aortic valveimplantation (TAVI) in the last 10 years.MethodsAge-standardised death rates were extracted from the World Health OrganisationMortality Database, using the International Classification of Diseases 10th editioncode for non-rheumatic aortic stenosis for those aged >45 years between 2000 and2017. The UK and countries from the European Union with at least 1,000,000inhabitants and at least 50% available datapoints over the study period were included:a total of 23 countries. Trends were described using Joinpoint regression analysis.ResultsNo reductions in mortality were demonstrated across all countries 2000-2017. Largeincreases in mortality were found for Croatia, Poland and Slovakia for both sexes(>300% change). Mortality plateaued in Germany from 2008 in females and 2012 inmales, whilst mortality in the Netherlands declined for both sexes from 2007. Mortalitydifferences between the sexes were observed, with greater mortality for males thanfemales across most countries.ConclusionsMortality from aortic stenosis has increased across Europe from 2000 to 2017. Thereare, however, sizable differences in mortality trends between Eastern and WesternEuropean countries. The need for health resource planning strategies to specificallytarget AS, particularly given the expected increase with aging populations, ishighlighted.
Hammond-Haley M, Hartley A, Delago AJ, et al., 2021, Trends in infective endocarditis mortality in the United Kingdom and EU 15+countries between 1990-2019: an analysis of the Global Burden of Diseases database, Publisher: OXFORD UNIV PRESS, Pages: 3165-3165, ISSN: 0195-668X
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Al-Khayatt B, Crawley C, Salciccioli J, et al., 2021, Trends in incidence and mortality from non-rheumatic degenerative mitral valve disease across europe, over the past three decades, Publisher: OXFORD UNIV PRESS, Pages: 1579-1579, ISSN: 0195-668X
Jani C, Patel K, Walker A, et al., 2021, Trends of HIV mortality between 2001 and 2018: an observational analysis, Tropical Medicine and Infectious Disease, Vol: 6, Pages: 1-14, ISSN: 2414-6366
Since the beginning of the epidemic in the early 1980s, HIV-related illness has led to the deaths of over 32.7 million individuals. The objective of this study was to describe current mortality rates for HIV through an observational analysis of HIV mortality data from 2001 to 2018 from the World Health Organization (WHO) Mortality Database. We computed age standardized death rates (ASDRs) per 100,000 population using the World Standard Population. We plotted trends using Locally weighted scatterplot smoothing (LOWESS). Data for females was available for 42 countries. 31/48 (64.60%) and 25/42 (59.52%) countries showed decreases in mortality in males and females, respectively. South Africa had the highest ASDRs for both males (467.7/100,000) and females (391.1/100,000). The lowest mortalities were noted in Egypt for males (0.2/100,000) and in Japan for females (0.01/100,000). Kyrgyzstan had the greatest increase in male (+6998.6%). Estonia had the greatest increase in female (+5877.56%). Disparity between Egypt (lowest) and South Africa (highest) was 3042-fold for males, whereas it was 43,454-fold for females between Japan (lowest) and South Africa (highest). Although there has been a decrease in mortality attributed to HIV among most of the countries studied, a rising trend remains in a number of developing countries.
Khatri A, Machin M, Vijay A, et al., 2021, A Review of current and future antithrombotic strategies in surgical patients–leaving the graduated compression stockings behind?, Journal of Clinical Medicine, Vol: 10, ISSN: 2077-0383
Venous thromboembolism (VTE) remains an important consideration within surgery, with recent evidence looking to refine clinical guidance. This review provides a contemporary update of existing clinical evidence for antithrombotic regimens for surgical patients, providing future directions for prophylaxis regimens and research. For moderate to high VTE risk patients, existing evidence supports the use of heparins for prophylaxis. Direct oral anticoagulants (DOACs) have been validated within orthopaedic surgery, although there remain few completed randomised controlled trials in other surgical specialties. Recent trials have also cast doubt on the efficacy of mechanical prophylaxis, especially when adjuvant to pharmacological prophylaxis. Despite the ongoing uncertainty in higher VTE risk patients, there remains a lack of evidence for mechanical prophylaxis in low VTE risk patients, with a recent systematic search failing to identify high-quality evidence. Future research on rigorously developed and validated risk assessment models will allow the better stratification of patients for clinical and academic use. Mechanical prophylaxis’ role in modern practice remains uncertain, requiring high-quality trials to investigate select populations in which it may hold benefit and to explore whether intermittent pneumatic compression is more effective. The validation of DOACs and aspirin in wider specialties may permit pharmacological thromboprophylactic regimens that are easier to administer.
Goodall R, Salciccioli JD, Davies AH, et al., 2021, Trends in peripheral arterial disease incidence and mortality in EU15+ countries 1990-2017, European Journal of Preventive Cardiology, Vol: 28, Pages: 1201-1213, ISSN: 2047-4873
AIMS: The aim was to assess trends in peripheral arterial disease (PAD) incidence and mortality rates in European Union(15+) countries between 1990 and 2017. METHODS AND RESULTS: This observational study used data obtained from the 2017 Global Burden of Disease study. Age-standardised mortality and incidence rates from PAD were extracted from the Global Health Data Exchange for EU15+ countries for the years 1990-2017. Trends were analysed using Joinpoint regression analysis.Between 1990 and 2017, the incidence of PAD decreased in all 19 EU15+ countries for females, and in 18 of 19 countries for males. Increasing PAD incidence was observed only for males in the United States (+1.4%). In 2017, the highest incidence rates were observed in Denmark and the United States for males (213.6 and 202.3 per 100,000, respectively) and in the United States and Canada for females (194.8 and 171.1 per 100,000, respectively). There was a concomitant overall trend for increasing age-standardised mortality rates in all EU15+ countries for females, and in 16 of 19 EU15+ countries for males between 1990 and 2017. Italy (-25.1%), Portugal (-1.9%) and Sweden (-0.6%) were the only countries with reducing PAD mortality rates in males. The largest increases in mortality rates were observed in the United Kingdom (males +140.4%, females +158.0%) and the United States (males +125.7%, females +131.2%). CONCLUSIONS: We identify shifting burden of PAD in EU15+ countries, with increasing mortality rates despite reducing incidence. Strong evidence supports goal-directed medical therapy in reducing PAD mortality - population-wide strategies to improve compliance to optimal goal-directed medical therapy are warranted.
Goodall R, Hughes W, Salciccioli J, et al., 2021, Trends in Lower Extremity Amputation Incidence in European Union 151 Countries 1990-2017, Publisher: OXFORD UNIV PRESS, ISSN: 0007-1323
COVIDSurg Collaborative, GlobalSurg Collaborative, Shalhoub J, 2021, Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study, Anaesthesia, ISSN: 0003-2409
Salciccioli I, Zhou CD, Okonji EC, et al., 2021, European Trends in Cervical Cancer Mortality in Relation to National Screening Programs, 1985-2014, Cancer Epidemiology: the international journal of cancer epidemiology, detection and prevention, ISSN: 0361-090X
Proctor D, Goodall R, Salciccioli J, et al., 2021, Re "International Variations and Sex Disparities in the Treatment of Peripheral Arterial Occlusive Disease: A Report from VASCUNET and the International Consortium of Vascular Registries", European Journal of Vascular and Endovascular Surgery, Vol: 62, Pages: 320-321, ISSN: 1078-5884
Cardiothoracic Interdisciplinary Research Network and COVIDSurg Collaborative, 2021, Early outcomes and complications following cardiac surgery in patients testing positive for coronavirus disease 2019: An international cohort study., Journal of Thoracic and Cardiovascular Surgery, Vol: 162, Pages: e355-e372, ISSN: 0022-5223
Goodall R, Alazawi A, Hughes W, et al., 2021, Trends in type 2 diabetes mellitus disease burden in European Union countries between 1990 and 2019, Scientific Reports, Vol: 11, ISSN: 2045-2322
This observational study aimed to assess trends in type 2 diabetes mellitus (T2DM) disease burden in European Union countries for the years 1990–2019. Sex specific T2DM age-standardised prevalence (ASPRs), mortality (ASMRs) and disability-adjusted life-year rates (DALYs) per 100,000 population were extracted from the Global Burden of Disease (GBD) Study online results tool for each EU country (inclusive of the United Kingdom), for the years 1990–2019. Trends were analysed using Joinpoint regression analysis. Between 1990 and 2019, increases in T2DM ASPRs were observed for all EU countries. The highest relative increases in ASPRs were observed in Luxembourg (males + 269.1%, females + 219.2%), Ireland (males + 191.9%, females + 165.7%) and the UK (males + 128.6%, females + 114.6%). Mortality trends were less uniform across EU countries, however a general trend towards reducing T2DM mortality was observed, with ASMRs decreasing over the 30-year period studied in 16/28 countries for males and in 24/28 countries for females. The UK observed the highest relative decrease in ASMRs for males (− 46.9%). For females, the largest relative decrease in ASMRs was in Cyprus (− 67.6%). DALYs increased in 25/28 countries for males and in 17/28 countries for females between 1990 and 2019. DALYs were higher in males than females in all EU countries in 2019. T2DM prevalence rates have increased across EU countries over the last 30 years. Mortality from T2DM has generally decreased in EU countries, however trends were more variable than those observed for prevalence. Primary prevention strategies should continue to be a focus for preventing T2DM in at risk groups in EU countries.
Rupal A, Singh H, Jani C, et al., 2021, TRENDS IN PULMONARY TB MORTALITY BETWEEN 1985 AND 2018: AN OBSERVATIONAL STUDY, Chest 2021
Gwilym BL, Ambler GK, Saratzis A, et al., 2021, Groin Wound Infection after Vascular Exposure (GIVE) Risk Prediction Models: Development, Internal Validation, and Comparison with Existing Risk Prediction Models Identified in a Systematic Literature Review, European Journal of Vascular and Endovascular Surgery, ISSN: 1078-5884
COVIDSurg Collaborative Co-authors, 2021, Machine learning risk prediction of mortality for patients undergoing surgery with perioperative SARS-CoV-2: the COVIDSurg mortality score, British Journal of Surgery, Vol: 108, Pages: 1274-1292, ISSN: 0007-1323
Since the beginning of the COVID-19 pandemic tens of millions of operations have been cancelled1 as a result of excessive postoperative pulmonary complications (51.2 per cent) and mortality rates (23.8 per cent) in patients with perioperative SARS-CoV-2 infection2. There is an urgent need to restart surgery safely in order to minimize the impact of untreated non-communicable disease.As rates of SARS-CoV-2 infection in elective surgery patients range from 1–9 per cent3–8, vaccination is expected to take years to implement globally9 and preoperative screening is likely to lead to increasing numbers of SARS-CoV-2-positive patients, perioperative SARS-CoV-2 infection will remain a challenge for the foreseeable future.To inform consent and shared decision-making, a robust, globally applicable score is needed to predict individualized mortality risk for patients with perioperative SARS-CoV-2 infection. The authors aimed to develop and validate a machine learning-based risk score to predict postoperative mortality risk in patients with perioperative SARS-CoV-2 infection.
Goodall RJ, Hughes WRM, Salciccioli JD, et al., 2021, Incongruous trends in peripheral arterial disease and amputation in Australia, Publisher: OXFORD UNIV PRESS, ISSN: 0007-1323
COVIDSurg Collaborative, GlobalSurg Collaborative, 2021, Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study, Anaesthesia, Vol: 76, Pages: 748-758, ISSN: 0003-2409
Peri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre‐operative SARS‐CoV‐2 diagnosis, mortality was increased in patients having surgery within 0–2 weeks, 3–4 weeks and 5–6 weeks of the diagnosis (odds ratio (95%CI) 4.1% (3.3–4.8), 3.9% (2.6–5.1) and 3.6% (2.0–5.2), respectively). Surgery performed ≥ 7 weeks after SARS‐CoV‐2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5% (0.9–2.1%)). After a ≥ 7 week delay in undertaking surgery following SARS‐CoV‐2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2–8.7) vs. 2.4% (95%CI 1.4–3.4) vs. 1.3% (95%CI 0.6–2.0%), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS‐CoV‐2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.
Guni A, Machin M, Onida S, et al., 2021, Acute iliofemoral DVT – what evidence is required to justify catheter-directed thrombolysis?, Phlebology, Vol: 36, Pages: 339-341, ISSN: 0268-3555
DeLago A, Essa M, Ghajar A, et al., 2021, Incidence and mortality trends of atrial fibrillation/atrial flutter in the United States 1990 to 2017, American Journal of Cardiology, Vol: 148, Pages: 78-83, ISSN: 0002-9149
Atrial fibrillation / Atrial fibrillation flutter incidence and mortality rate has increased in the United States. The greatest incidence rates for men in 2017 were clustered in the New England region. An inflection point in year 2001 is notable for increased incidence and mortality rates for both genders across most states.
The Vascular and Endovascular Research Network VERN COVER Study Collaborative, Shalhoub J, 2021, Vascular surgery; a priority specialty or collateral damage in the face of a global pandemic? The persistent challenges faced by vascular surgery services during the UK coronavirus pandemic; a snapshot qualitative survey, Annals of the Royal College of Surgeons of England, ISSN: 0035-8843
Schuster-Bruce J, Jani C, Goodall R, et al., 2021, A comparison of the burden of thyroid cancer amongst European Union 15+countries, 1990-2017: Estimates from the Global Burden of Disease Study., Virtual Annual Meeting of the American-Society-of-Clinical-Oncology (ASCO), Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0732-183X
Yang D, Jani C, Crowley C, et al., 2021, Trends in incidence and mortality of squamous cell carcinoma of the skin: An observational analysis of the Global Burden of Disease database from 1990 to 2017., Virtual Annual Meeting of the American-Society-of-Clinical-Oncology (ASCO), Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0732-183X
Guéroult A, Machin M, Lawton R, et al., 2021, What does the future hold for mechanical thromboprophylaxis?, Phlebology, Vol: 36, Pages: 257-259, ISSN: 0268-3555
Normahani P, Mustafa C, Shalhoub J, et al., 2021, A systematic review and meta-analysis of the diagnostic accuracy of point-of-care tests used to establish the presence of peripheral arterial disease in people with diabetes, Journal of Vascular Surgery, Vol: 73, Pages: 1811-1820, ISSN: 0741-5214
ObjectiveThere is currently no agreement as to which bedside test is the most useful for the diagnosis of PAD in diabetes. The aim of this systematic review and meta-analysis was to evaluate the performance of bedside tests for the detection of PAD in individuals with diabetes.Research design and methodsMEDLINE and EMBASE databases were systematically searched for studies providing data on diagnostic performance of bedside tests used for the detection of PAD in people with diabetes. A meta-analysis was performed to obtain pooled estimates of sensitivity and specificity for the diagnosis of PAD.ResultsA total of 18 studies, reporting on a total of 3016 limbs of diabetic patients, were included in our qualitative review. Of these, eleven studies (1543 limbs) were included in the meta-analysis of diagnostic accuracy: ankle-brachial pressure index (ABPI, 9 studies, 1368 limbs, sensitivity 63.5% [95% CI 51.7-73.9%], specificity 89.3% [95% CI 81.1-94.2%]); toe-brachial pressure index (TBPI, 3 studies, 221 limbs, sensitivity 83.0% [95% CI 59.1-94.3%], specificity 66.3% [95% CI 41.3-84.6%]); and tibial waveform assessment (4 studies, 397 limbs, sensitivity 82.8% [95% CI 73.3-89.4%], specificity 86.8% [95% CI 75.5-93.3%]). Overall, there was a high risk of bias across studies, most frequently relating to patient selection and lack of blinding.ConclusionsTBPI, pulse oximetry and tibial arterial waveform assessment have demonstrated some promise, warranting further investigation.Key wordsDiabetesdiabetic footdiagnosisfoot ulcerperipheral arterial disease
Thapar A, Lawton R, Burgess L, et al., 2021, Compression hosiery to avoid post-thrombotic syndrome (CHAPS) protocol for a randomised controlled trial (ISRCTN73041168), BMJ Open, Vol: 11, ISSN: 2044-6055
Introduction: Up to 50% of patients develop post-thrombotic syndrome (PTS) after an above knee deep vein thrombosis (DVT). The aim of the study was to determine the effect of graduated compression stockings in preventing PTS after DVT.Methods and analysis: Pragmatic, UK multicentre randomised trial in adults with first above knee DVT. The standard of care arm is anticoagulation. The intervention arm will receive anticoagulation plus stockings (European class II, 23–32 mm Hg compression) worn for a median of 18 months. The primary endpoint is PTS using the Villalta score. Analysis of this will be through a time to event approach and cumulative incidence at median 6, 12 and 18 months. An ongoing process evaluation will examine factors contributing to adherence to stockings to understand if and how the behavioural interventions were effective.Ethics and dissemination: UK research ethics committee approval (reference 19/LO/1585). Dissemination though the charity Thrombosis UK, the Imperial College London website, peer-reviewed publications and international conferences.Trial registration number: ISRCTN registration number 73041168.
Gwilym B, Waldron C, Thomas-Jones E, et al., 2021, P90 PERCEIVE: PrEdiction of Risk and Communication of outcome following major lower limb amputation - a collaboratIVE study, BJS Open, Vol: 5
<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Introduction</jats:title> <jats:p>Major Lower Limb Amputation (MLLA) is a life changing event with significant morbidity and mortality. Inaccurate risk prediction can lead to poor decision making, resulting in delay to definitive surgery, or undertaking amputation when not in the patient’s best interest. We aim to answer: In adult patients undergoing MLLA for chronic limb threatening ischaemia or diabetes, how accurately do health care professionals prospectively predict outcomes after MLLA, and how does this compare to existing prediction tools?</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>A multicentre prospective observational cohort study is being delivered through the Vascular and Endovascular Research Network. Dissemination was via an existing network of contacts and social media.</jats:p> <jats:p>Consecutive data will be collected for seven months from site launch date, including demographic data and pre-operative outcome predictions from surgeons, anaesthetists, and allied healthcare professionals. Follow-up data will comprise 30-day (mortality, morbidity, MLLA revision, surgical site infection, and blood transfusion) and 1-year (mortality, MLLA revision and ambulation). The accuracy of surgeons’ predictions will be evaluated and compared to pre-existing risk prediction scoring tools.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>PERCEIVE launched on 01/10/2020 with 23 centres (16 UK, 7 international) registered to collect data. 50 other centres (27 UK, 23 international) have expressed interest/are pursuing local audit/ethical approv
Hammond-Haley M, Hartley A, Essa M, et al., 2021, Trends in ischemic heart disease and cerebrovascular disease mortality in Europe: an observational study 1990-2017, Journal of the American College of Cardiology, Vol: 77, Pages: 1697-1698, ISSN: 0735-1097
Hammond-Haley M, Hartley A, Essa M, et al., 2021, Trends in ischaemic heart disease and cerebrovascular disease mortality in Europe: an observational study from 1990-2017, Journal of the American College of Cardiology, Vol: 77, Pages: 1697-1698, ISSN: 0735-1097
Machin M, Younan H-C, Smith S, et al., 2021, Systematic review on the benefit of graduated compression stockings in the prevention of venous thromboembolism in low-risk surgical patients, Phlebology, Vol: 36, Pages: 184-193, ISSN: 0268-3555
Objectives: The aim of this systematic review is to assess the performance of graduated compression stockings (GCS) in comparison to no venous thromboembolism (VTE) prophylaxis in the prevention of hospital-acquired thrombosis in low-risk surgical patients undergoing short-stay procedures. Methods: Aligning with PRISMA guidelines, online databases MEDLINE and EMBASE, Cochrane Library® and trial registries were searched. Eligible articles reported the VTE rate in low-risk surgical patients either receiving GCS or no VTE prophylaxis. Results: Narrative synthesis was performed on a single eligible article. The included study arm consisted of participants undergoing knee arthroscopy with the use of GCS alone reporting a total of 29 VTE events (4.4%), 16 of which were asymptomatic DVTs (2.4%).Conclusion: There is a complete lack of evidence to support the use of GCS in the prevention of HAT for low-risk surgical patients. An adequately powered trial is required to provide level-IA evidence to support this practice.
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