16 results found
Kontis V, Bennett JE, Rashid T, et al., 2020, Magnitude, demographics and dynamics of the effect of the first wave of the COVID-19 pandemic on all-cause mortality in 21 industrialized countries, Nature Medicine, Vol: 26, Pages: 1919-1928, ISSN: 1078-8956
The Coronavirus Disease 2019 (COVID-19) pandemic has changed many social, economic, environmental and healthcare determinants of health. We applied an ensemble of 16 Bayesian models to vital statistics data to estimate the all-cause mortality effect of the pandemic for 21 industrialized countries. From mid-February through May 2020, 206,000 (95% credible interval, 178,100–231,000) more people died in these countries than would have had the pandemic not occurred. The number of excess deaths, excess deaths per 100,000 people and relative increase in deaths were similar between men and women in most countries. England and Wales and Spain experienced the largest effect: ~100 excess deaths per 100,000 people, equivalent to a 37% (30–44%) relative increase in England and Wales and 38% (31–45%) in Spain. Bulgaria, New Zealand, Slovakia, Australia, Czechia, Hungary, Poland, Norway, Denmark and Finland experienced mortality changes that ranged from possible small declines to increases of 5% or less in either sex. The heterogeneous mortality effects of the COVID-19 pandemic reflect differences in how well countries have managed the pandemic and the resilience and preparedness of the health and social care system.
Moledina S, Shanmuganathan M, Baston V, et al., 2020, UTILITY OF CARDIAC MRI IN PREDICTION OF ACUTE RIGHT VENTRICULAR FAILURE AFTER LVAD IMPLANTATION, Conference of American-College-of-Cardiology (ACC) / World Congress of Cardiology (WCC), Publisher: ELSEVIER SCIENCE INC, Pages: 1826-1826, ISSN: 0735-1097
Sarri G, Halim K, McCurry M, et al., 2019, Cardiac magnetic resonance imaging in lung transplant assessment: the clinical significance of right ventricular-pulmonary arterial coupling and right ventricular trabecular complexity, Congress of the European-Society-of-Cardiology (ESC) / World Congress of Cardiology, Publisher: OXFORD UNIV PRESS, Pages: 205-205, ISSN: 0195-668X
Asaria P, Elliott P, Douglass M, et al., 2017, Acute myocardial infarction hospital admissions and deaths in England: a national follow-back and follow-forward record-linkage study, Lancet Public Health, Vol: 2, Pages: e191-e201, ISSN: 2468-2667
Background Little information is available on how primary and comorbid acute myocardial infarction contribute to the mortality burden of acute myocardial infarction, the share of these deaths that occur during or after a hospital admission, and the reasons for hospital admission of those who died from acute myocardial infarction. Our aim was to fill in these gaps in the knowledge about deaths and hospital admissions due to acute myocardial infarction. Methods We used individually linked national hospital admission and mortality data for England from 2006 to 2010 to identify all primary and comorbid diagnoses of acute myocardial infarction during hospital stay and their associated fatality rates (during or within 28 days of being in hospital). Data were obtained from the UK Small Area Health Statistics Unit and supplied by the Health and Social Care Information Centre (now NHS Digital) and the Office of National Statistics. We calculated event rates (reported as per 100 000 population for relevant age and sex groups) and case-fatality rate for primary acute myocardial infarction diagnosed during the first physician encounter or during subsequent encounters, and acute myocardial infarction diagnosed only as a comorbidity. We also calculated what proportion of deaths from acute myocardial infarction occurred in people who had been in hospital on or within the 28 days preceding death, and whether acute myocardial infarction was one of the recorded diagnoses in such admissions. Findings Acute myocardial infarction was diagnosed in the first physician encounter in 307 496 (69%) of 446 744 admissions with a diagnosis of acute myocardial infarction, in the second or later physician encounter in 52 374 (12%) admissions, and recorded only as a comorbidity in 86 874 (19%) admissions. Patients with comorbid diagnoses of acute myocardial infarction had two to three times the case-fatality rate of patients in whom acute myocardial infarction was a primary diagnosis. 135 950 death
Grey C, Jackson R, Schmidt M, et al., 2017, One in four major ischaemic heart disease events are fatal and 60% are pre-hospital deaths: a national data-linkage study (ANZACS-QI 8), EUROPEAN HEART JOURNAL, Vol: 38, Pages: 172-180, ISSN: 0195-668X
Fontana M, Asaria P, Moraldo M, et al., 2014, Patient-accessible tool for shared decision making in cardiovascular primary prevention balancing longevity benefits against medication disutility, Circulation, Vol: 129, Pages: 2539-2546, ISSN: 0009-7322
Background—Primary prevention guidelines focus on risk, often assuming negligible aversion to medication, yet most patients discontinue primary prevention statins within 3 years. We quantify real-world distribution of medication disutility and separately calculate the average utilities for a range of risk strata.Method and Results—We randomly sampled 360 members of the general public in London. Medication aversion was quantified as the gain in lifespan required by each individual to offset the inconvenience (disutility) of taking an idealized daily preventative tablet. In parallel, we constructed tables of expected gain in lifespan (utility) from initiating statin therapy for each age group, sex, and cardiovascular risk profile in the population. This allowed comparison of the widths of the distributions of medication disutility and of group-average expectation of longevity gain. Observed medication disutility ranged from 1 day to >10 years of life being required by subjects (median, 6 months; interquartile range, 1–36 months) to make daily preventative therapy worthwhile. Average expected longevity benefit from statins at ages ≥50 years ranges from 3.6 months (low-risk women) to 24.3 months (high-risk men).Conclusion—We can no longer assume that medication disutility is almost zero. Over one-quarter of subjects had disutility exceeding the group-average longevity gain from statins expected even for the highest-risk (ie, highest-gain) group. Future primary prevention studies might explore medication disutility in larger populations. Patients may differ more in disutility than in prospectively definable utility (which provides only group-average estimates). Consultations could be enriched by assessing disutility and exploring its reasons.
Nowbar AN, Howard JP, Finegold JA, et al., 2014, 2014 Global geographic analysis of mortality from ischaemic heart disease by country, age and income: Statistics from World Health Organisation and United Nations, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 174, Pages: 293-298, ISSN: 0167-5273
Cook C, Cole G, Asaria P, et al., 2014, The annual global economic burden of heart failure, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 171, Pages: 368-376, ISSN: 0167-5273
Finegold JA, Asaria P, Francis DP, 2013, Mortality from ischaemic heart disease by country, region, and age: Statistics from World Health Organisation and United Nations, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 168, Pages: 934-945, ISSN: 0167-5273
Di Cesare M, Khang Y-H, Asaria P, et al., 2013, Inequalities in non-communicable diseases and effective responses, LANCET, Vol: 381, Pages: 585-597, ISSN: 0140-6736
Asaria P, Fortunato L, Fecht D, et al., 2012, Trends and inequalities in cardiovascular disease mortality across 7932 English electoral wards, 1982-2006: Bayesian spatial analysis, International Journal of Epidemiology, Vol: 41, Pages: 1737-1749, ISSN: 1464-3685
Background Cardiovascular disease (CVD) mortality has more than halved in England since the 1980s, but there are few data on small-area trends. We estimated CVD mortality by ward in 5-year intervals between 1982 and 2006, and examined trends in relation to starting mortality, region and community deprivation.Methods We analysed CVD death rates using a Bayesian spatial technique for all 7932 English electoral wards in consecutive 5-year intervals between 1982 and 2006, separately for men and women aged 30–64 years and ≥65 years.Results Age-standardized CVD mortality declined in the majority of wards, but increased in 186 wards for women aged ≥65 years. The decline was larger where starting mortality had been higher. When grouped by deprivation quintile, absolute inequality between most- and least-deprived wards narrowed over time in those aged 30–64 years, but increased in older adults; relative inequalities worsened in all four age–sex groups. Wards with high CVD mortality in 2002–06 fell into two groups: those in and around large metropolitan cities in northern England that started with high mortality in 1982–86 and could not ‘catch up’, despite impressive declines, and those that started with average or low mortality in the 1980s but ‘fell behind’ because of small mortality reductions.Conclusions Improving population health and reducing health inequalities should be treated as related policy and measurement goals. Ongoing analysis of mortality by small area is essential to monitor local effects on health and health inequalities of the public health and healthcare systems.
Beaglehole R, Bonita R, Horton R, et al., 2011, Priority actions for the non-communicable disease crisis, LANCET, Vol: 377, Pages: 1438-1447, ISSN: 0140-6736
Asaria P, Francis DP, 2011, Heart Forecast for cardiovascular risk assessment, HEART, Vol: 97, Pages: 173-174, ISSN: 1355-6037
Ferenczi EA, Asaria P, Hughes AD, et al., 2010, Can a Statin Neutralize the Cardiovascular Risk of Unhealthy Dietary Choices?, AMERICAN JOURNAL OF CARDIOLOGY, Vol: 106, Pages: 587-592, ISSN: 0002-9149
Asaria P, Beaglehole R, Chisholm D, et al., 2010, Chronic disease prevention: the importance of calls to action., Int J Epidemiol, Vol: 39, Pages: 309-310
Asaria P, Chisholm D, Mathers C, et al., 2007, Chronic diseases 3 - Chronic disease prevention: health effects and financial costs of strategies to reduce salt intake and control tobacco use, LANCET, Vol: 370, Pages: 2044-2053, ISSN: 0140-6736
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