mahnaz yadollahi; Zahra Moradi; Kazem Jamali; Maryam Fadaie Dashti
Volume 26, Issue 1 , 2024
Abstract
Background: The current study aimed to successively assess the applicability of trauma scoring systems.Objectives: To evaluate the outcomes, prognosis, and mortality in trauma patients.Methods: The present study was conducted on all 221 injured patients referred to Shahid Rajaee Hospital from January ...
Read More
Background: The current study aimed to successively assess the applicability of trauma scoring systems.Objectives: To evaluate the outcomes, prognosis, and mortality in trauma patients.Methods: The present study was conducted on all 221 injured patients referred to Shahid Rajaee Hospital from January 2014 toDecember 2020 with International Classification of Diseases-10th Revision (ICD-10) injury mechanism codes of W32.0-34.09, indicating afirearm injury. Univariate analysis and Chi-square test were employed to discover the individual relationship between each variable andthe injury outcome. Logistic regression analysis was performed to control the confounder. Finally, the area under the Receiver OperatingCharacteristic (ROC) curve was used to compare the predictive efficiency of the injury severity scales.Results: The mortality rate of the gunshot was 15 (6.78%). The cause of the gunshot was related to assaults in 73.68% of the survivingpatients. Meanwhile, suicide attempt was the second cause of death in gunshot patients (16.67%). Most of the injuries that occurredamong 20-24-year-old patients resulted from assaults. The odds of mortality in gunshot victims increased by 4.25 times (95% CI [1.99,9.10]) for each additional unit AIS. In the random forest model, the Trauma Injury Severity Score (TRISS) was the most importantmortality predictor. The TRISS was the highest area under the ROC curve for death prediction among firearms gunshot patients.Conclusion: Injury Severity Score (ISS) had the least, and TRISS had the most area under the curve. Therefore, TRISS was found to be thebest predictor in determining the death or survival of firearms gunshot patients.
Mostafa Ghanei; Seyed Hassan Saadat; Alireza Najimi-Varzaneh; Mohammad Gholami Fesharaki
Volume 26, Issue 1 , 2024
Abstract
Context: The prevalence of in-hospital death due to COVID-19 hospital is one of the qualitative indexes, which can be used to assess the quality of care, as well as the mortality patterns in COVID-19 pandemic.Objectives: Therefore, this study has been done with the goal of estimating overall prevalence ...
Read More
Context: The prevalence of in-hospital death due to COVID-19 hospital is one of the qualitative indexes, which can be used to assess the quality of care, as well as the mortality patterns in COVID-19 pandemic.Objectives: Therefore, this study has been done with the goal of estimating overall prevalence in-hospital death due to COVID-19 disease in iranian patients.Evidence Acquisition: Articles were identified through iranian searching databases including Health.barakatkns, IranDoc, SID, Civilica and MagIran and international searching databases including Scopus, Web of Science, PubMed and Elsevier . Additional search was also done by Google Scholar search engine. We reviewed systematically all studies reporting the prevalence of in-hospital death due to COVID-19 disease. In this study meta-analysis method with random effect model has been used to estimate the pooled in-hospital death.Results: 118 records were identified by the electronic search, of which 43 studies were identified as relevant documents that were meta-analyzed for the pooled in-hospital death due to COVID-19 prevalence. Overall, prevalence of death were 12.16% (95% CI: 10.72%-13.61%). The highest and lowest death prevalence has been reported in Northern Provinces (Gilan, 27.27% (95% CI: 8.66%-45.88%) and Mazandaran, 21.27% (95% CI: 18.14%-24.40%)) and Turkish-speaking provinces (Azerbaijan, East, 3.29% (95% CI: 2.11%-4.47%) and Zanjan, 3.42% (95% CI: 1.82%-5.02%)) respectively.Conclusions: Considering the death rate obtained in this study and its comparison with other countries, it can be said that the performance of the Iranian medical system in COVID-19 pandemic is acceptable.
Elham Hosseinalizadeh; Robab Mehdizadeh Esfanjani; Haniyeh Ebrahimi Bakhtavar; Farzad Rahmani
Volume 25, Issue 10 , 2023
Abstract
Background: It is of prime importance to manage trauma patients in the early hours and use easy trauma severity scoring systems to make decisions and evaluate patient prognosis.Objectives: The present study aimed to design a predictive model of the mortality of multi-trauma patients due to traffic accidents.Methods: ...
Read More
Background: It is of prime importance to manage trauma patients in the early hours and use easy trauma severity scoring systems to make decisions and evaluate patient prognosis.Objectives: The present study aimed to design a predictive model of the mortality of multi-trauma patients due to traffic accidents.Methods: This cross-sectional analytical study was performed on 600 patients who suffered from multi-trauma caused by traffic accidents from December 2019 to September 2021. Collected data included age, sex, vital signs, trauma mechanism, involved vehicle in the accident, accident location, and hospital outcome.Results: In this study, 600 multi-trauma cases caused by traffic accidents were evaluated. Among the significant variables included in the regression model, age, Mean Arterial Pressure (MAP), Glasgow Coma Scale (GCS), AVPU (Alert, Verbal response, Pain response, Unresponsive), and vehicle versus fixed objects (in Vehicle 2) in the presence of other variables in the model, significantly predicted patient outcomes. Therefore, with the other variables being constant, one unit increase in the age variable increases the probability of death by 1.04 times, one unit increase in the score of the two variables of MAP and GCS, and also the transfer of trauma mechanism from the fixed object to the vehicle reduces death by 0.92, 0.62, and 0.10 times, respectively. In the AVPU variable, the transition from Alert to Verbal, the transition from Verbal to Pain, and the transition from Pain to Unresponsive increases the probability of death by 32, 104, and 567, respectively.Conclusion: In this study, AVPU, age, MAP, primary GCS, and trauma mechanism due to hitting a vehicle with a fixed object had significantly the highest predictive power of hospital mortality in patients with multiple trauma due to traffic accidents, respectively. It is suggested that further studies be performed to replace the AVPU variable with GCS in the newly designed formulas for calculating the severity of trauma to simplify these scores.
Zhiqiang Long; Qinghao Liu; Jian Li
Volume 24, Issue 9 , 2022
Abstract
Background: Esophageal cancer is one of the most prevalent types of cancer and causes of death worldwide. As the mainstream treatment, surgical resection is technically demanding and time-consuming. Therefore, the scope of its application is limited in the clinical setting. A new surgical approach is ...
Read More
Background: Esophageal cancer is one of the most prevalent types of cancer and causes of death worldwide. As the mainstream treatment, surgical resection is technically demanding and time-consuming. Therefore, the scope of its application is limited in the clinical setting. A new surgical approach is thus needed for an improved surgical effect and the prognosis of esophageal cancer.
Objectives: This study aimed to investigate the effect of a modified thoracoscopic en-bloc esophagectomy on the removal of patients esophageal cancers and its outcomes.
Methods: In this study, a modified en-bloc esophagectomy was developed to remove esophageal cancer. Patients who underwent the modified en-bloc esophagectomy by right thoracoscopic approach or thoracoscope-assisted small incisional approach to have their esophageal cancers removed in Peking University First Hospital (Beijing, China) between January 2014 and January 2017, were screened and retrospectively studied. Cancer recurrence, overall survival, mortality, as well as intraoperative and postoperative outcomes, were reported.
Results: A total of 31 patients (22 male and 9 female, mean age: 62.9 years) were included in the study. Out of 30 patients with R0 resection, eight patients had cancer recurrences in the neck, lung, liver, and bone; however, none of the recurrences was identified in the mediastinum. Six patients died during the follow-up period. By the end of December 2020, the five-year survival rate of all patients was 58.3%. The median survival time of N0 patients was 52 months, which was significantly longer than that in N1+2 patients (23 months). Additionally, there was no statistically significant difference between the median survival time of N1 and N2 patients. Moreover, perioperative complications included pneumonia, arrhythmia, hoarseness, and chylous ascites, which were consistent with those reported previously.
Conclusion: The modified en-bloc esophagectomy to remove esophageal cancer by right thoracoscopic approach or thoracoscope-assisted small incisional approach was found safe and reliable due to decreased cancer recurrence, increased overall survival rate, and prolonged survival time.
Fatih Dal; U?ur Topal; Erdogan Mutevelli Sozuer; Muhammet Akyuz; Tutkun Talih; Hizir Yakup Akyildiz
Volume 24, Issue 2 , 2022
Abstract
Objective: In this five-year study, we aimed at investigating the factors related to strangulation and mortality in patients who underwent urgent surgery to treat incarcerated abdominal wall hernias.Methods: Patients presenting to the emergency department with an incarcerated abdominal wall hernia (incisional, ...
Read More
Objective: In this five-year study, we aimed at investigating the factors related to strangulation and mortality in patients who underwent urgent surgery to treat incarcerated abdominal wall hernias.Methods: Patients presenting to the emergency department with an incarcerated abdominal wall hernia (incisional, umbilical, femoral, or inguinal) between October 2015and October 2019 were included in the study. The presence of intraoperative ischemia and necrosis was defined as "strangulation." Depending on the presence or absence of strangulation in the incarcerated segment, patients were divided into two groups: Group 1 (nonstrangulated) and Group 2 (strangulated). Between the groups, length of time between incarceration and hospital admission, demographic and clinical data, and physical examination findings, Risk factors for strangulation and mortality were determined with univariate and multivariate analyses.Results: A total of 161 patients were enrolled in the study. Group 1 consisted of 119 patients and Group 2 consisted of 42 patients. In multivariate analysis, the prominent risk factors for strangulation were: high ASA score (p=0.008), acute abdomen findings with distension and elevated body temperature (p<0.001), delayed hospital admission (p<0.001), procalcitonin >0.5 ng/ml (p<0.001), D-Dimer > 500 µg/L (p<0.001), lactate > 2 mmol/L (p<0.001),and creatinine levels > 2 mg/dl (p<0.001). For mortality, the presence of strangulation (p<0.001), lactate levels > 2 mg/dl (p=0.004), and ASA scores > 3 (p =0.035) were the leading risk factors.Conclusion: The most significant risk factors for strangulation were delay of more than 48 hours, high procalcitonin, creatinine, lactate and D-Dimer levels while for mortality, strangulation, high lactate and ASA levels were significantly effective. Mortality rates may be lowered with an earlier diagnosis, more specifically, one made before the development of metabolic and radiologic impairment.
Alireza Molaei; Mohammad Gholami Fesharaki
Volume 23, Issue 11 , 2021
Abstract
Background: COVID-19 has raised a worldwide trajectory since it emerged in Wuhan, China in December 2019. The direct and indirect mortalities in the world and as well as in Iran have increased significantly after the occurrence of this pandemic.
Objectives: In this study, Excess Mortality Rate (EMR) ...
Read More
Background: COVID-19 has raised a worldwide trajectory since it emerged in Wuhan, China in December 2019. The direct and indirect mortalities in the world and as well as in Iran have increased significantly after the occurrence of this pandemic.
Objectives: In this study, Excess Mortality Rate (EMR) was estimated by multilevel poison regression method and then this estimation was compared to the historical trends to obtain total deaths related to COVID-19. Additionally, the geographic distribution of EMR has also been presented for Iran.
Methods: All-cause mortality rates of each province of Iran from March 21, 2013 to September 22, 2021 was downloaded from National Organization for Civil Registration (NOCR). The data of COVID-19 pandemic period (spring 1399 SH (Mar 20, 2020) to summer 1400 SH (Sep 22, 2021)) was removed from the data and then the multilevel poison model was applied to estimate all-cause mortality in this period. Then, EMR= (real deaths-expected death)/(real deaths) ratio was calculated.
Results: The results of this study showed that Irans EMR in COVID-19 pandemic was 36% (Male=35%, Female=36%, P-value=0.798). Our findings also revealed four category of EMR including low (EMR?30%, n=9), moderate (30 %< EMR?35%, n=8), high (35 %< EMR?40%, n=10) and very high (40 %< EMR, n=4) in different provinces.
Conclusion: Due to the diverse EMR in different provinces of Iran, the type of disease management of provinces with low and moderate EMR can be used as an appropriate model to control EMR in provinces with high and very high EMR.
Mevlut Harun A?ca; U?ur Topal; Cem Kaan Parsak; ismail Cem Eray; Mehmet Onur Gul; ?shak Ayd?n
Volume 23, Issue 10 , 2021
Abstract
Background: Esophageal cancer is the eighth most common cancer and the sixth most common cause of death from cancer. Esophagectomy is still the essential treatment for esophageal cancer despite its high morbidity rate. The prediction of complications that are likely to appear after surgery can be the ...
Read More
Background: Esophageal cancer is the eighth most common cancer and the sixth most common cause of death from cancer. Esophagectomy is still the essential treatment for esophageal cancer despite its high morbidity rate. The prediction of complications that are likely to appear after surgery can be the most critical factor in reducing morbidity.
Objectives: The present study aimed to examine the postoperative complications and causes of mortality in patients undergoing esophagectomy for esophageal cancer.
Methods: Data from 34 patients with esophageal adenocarcinoma or squamous cell carcinoma undergoing esophagectomy in the general surgery clinic of Çukurova University Medical School Hospital were collected and analyzed retrospectively between January 1, 2011, and January 1, 2020. Postoperative complications were identified according to the Clavien-Dindo classification (CD). "The patients were assigned into two groups (Group 1 and Group 2). Group 1 and Group 2 included patients with CD grade <3 and CD grade >3, respectively."
Results: The mean±SD age of patients (n=34) undergoing resection for esophageal cancer was obtained at 56.38±11.00 years. The ratio of female to male patients was equal. The most common accompanying disease was diabetes mellitus. The number of patients with the American Society of Anesthesiologists score 3 was higher in Group 2 (P=0.034). The tumor was most frequently located in the lower thoracic esophagus of patients in Group 1 and Group 2, and the rate of cervical anastomosis was higher in Group 2. The rate of manual anastomosis was higher in both groups. Respiratory complications were the most frequent complication in both groups; however, a higher rate of respiratory complications was observed in Group 2 (P=0.038). The postoperative 30-days mortality and the reoperation rate were higher in Group 2.
Conclusion: Radical surgery for esophageal cancer results in a high rate of complications and death due to the location of the tumor and diagnosis at the advanced stage. Complications and mortality may result from patient-related factors and the surgical technique. The diagnosis and treatment of the correctable causes before surgery can enhance the chance of survival and the quality of life in patients.
Alireza Ahmadi; Soroush Ardeshiri; Vahid Rajab Nezhadi; Aida Pajoohesh; Touba Narimani Moghadam; Mohamad Sabaghan; Jaffar Fatahi Asl; Javad Zarei; Kambiz Ahmadi Angali
Volume 23, Issue 9 , 2021
Abstract
Background: Coronavirus disease 2019 (COVID-19) has become a global health challenge with high transmission and mortality rates.
Objectives: This study aimed to identify the risk factors for mortality in hospitalized patients with COVID-19 in Behbahan, Southwestern of Iran.
Methods: In this cross-sectional ...
Read More
Background: Coronavirus disease 2019 (COVID-19) has become a global health challenge with high transmission and mortality rates.
Objectives: This study aimed to identify the risk factors for mortality in hospitalized patients with COVID-19 in Behbahan, Southwestern of Iran.
Methods: In this cross-sectional study, information of 800 patients with COVID-19 admitted to Shahidzadeh Hospital in Behbahan, Southwest of Iran, were investigated from March 20, 2020, to January 20, 2021. Subsequently, the demographic characteristics, clinical symptoms, vital signs, pharmacotherapy, laboratory findings, and the patients' underlying diseases were extracted from their medical records. Multivariable Cox regression with proportional hazard assumption was used to investigate the risk factors of death.
Results: The present study included 800 patients with COVID-19 with a mean age of 57.51±16.83 years at the time of diagnosis. Overall, 447 (55.8%) male and 353 (44.1%) female patients were included in this study, respectively. Among the total patients, 116 (14.5%) and 684 (85.5%) cases died and recovered, respectively. Based on the multivariable Cox regression analysis, age (HR=1.04; 95% CI: 1.03-1.05; P<0.001), cardiovascular diseases (HR=2.46; 95% CI: 1.63- 3.70; P<0.001), and renal failure (HR=2.77; 95% CI: 1.43- 534; P<0.001) were found to be associated with the death hazard in patients with COVID-19.
Conclusion: According to the findings of this study, the patient's age at the time of diagnosis, cardiovascular diseases, and renal failure were indicated to be the risk factors of high mortality rate in patients with COVID-19. Identification of these risk factors can be helpful in the timely intervention of patients at high risk of death for health care providers.
Taghi Riahi; Sima Shokri; Seyed Hamid Reza Faiz; Karim Hemati; Seyed Hamzeh Mousavie; Amir Baghestani; Ali Khazaeian; Babak Hassanlouei
Volume 23, Issue 5 , 2021
Abstract
Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a variety of symptoms and laboratory and radiologic features whose identification can help diagnose and manage patients with COVID-19 more effectively.
Objectives: This ...
Read More
Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a variety of symptoms and laboratory and radiologic features whose identification can help diagnose and manage patients with COVID-19 more effectively.
Objectives: This study aimed to describe the epidemiological, clinical, and laboratory features of patients with COVID-19, compare clinical features of patients in the intensive care unit (ICU) with those of non-ICU admitted patients, and define mortality risk factors for this disease.
Methods: This cross-sectional study was carried out on 781 COVID-19 patients hospitalized in Rasool Akram Medical Complex, Tehran, Iran, from February to May 2020. Patients epidemiological, demographic, clinical, laboratory findings were collected. Routine blood tests included complete blood count, coagulation profile, and serum biochemical tests. Confirmed infection was defined as positive reverse transcription-polymerase chain reaction (RT-PCR) to SARS-CoV-2 in their nasopharyngeal specimens or typical clinical, laboratory, and imaging findings of COVID-19 infection altogether. All data were analyzed using SPSS software (version 21).
Results: In this study, the majority of patients were male (n=470, 60.2%) and the remainder were female. The median age of the patients was 64 years. Hypertension (31.8%) and tuberculosis (1.4%) were the most common and the least common underlying condition among the patients, respectively. Moreover, cough and seizure were the most common (75.7%) and the least common (2.4%) symptoms in patients. The history of diabetes mellitus, the presence of dyspnea, loss of taste, and the occurrence of seizure were associated with a higher risk of ICU admission. On the other hand, advanced age, positive PCR, presence of dyspnea, myalgia, loss of taste, and elevated liver enzymes, and lactate dehydrogenase (LDH) were associated with a higher risk of mortality. Based on the results, smoking had a preventive effect on mortality (OR=0.292, P=0.048); however, it had no significant effect on ICU admission.
Conclusion: According to the obtained results, positive PCR and initial symptoms of dyspnea and myalgia were associated with increased odds of mortality by two times. In addition, elevated alanine aminotransferase and lactate dehydrogenase were associated with a higher rate of mortality. ICU admission was the main variable to increase the odds of mortality. Eventually, smoking might play a protective role against COVID-19 mortality.
Maolu Tian; Yan Zha; Qian Li; Jing Yuan
Volume 21, Issue 11 , 2019, Pages 1-7
Abstract
Background: Muscle strength assessment is a convenient clinical test that has shown to correlate with the nutritional status of dialysis patients. Articles written in English to investigate the association between Handgrip Strength (HGS) and mortality in Main- tenance Hemodialysis (MHD) patients are ...
Read More
Background: Muscle strength assessment is a convenient clinical test that has shown to correlate with the nutritional status of dialysis patients. Articles written in English to investigate the association between Handgrip Strength (HGS) and mortality in Main- tenance Hemodialysis (MHD) patients are mainly from Brazil and several other non-Asian countries.Objectives: This study aimed to examine the association of HGS with all-cause mortality in Chinese MHD patients.Methods: The current multicenter observational longitudinal study enrolled MHD patients from June 2015 to June 2016. The study setting was seven dialysis centers of tertiary general hospitals in Guizhou province, China. Patients were followed up until June 2018. The ROC curves were plotted to seek the best cutoffs for HGS to predict mortality in men and women. Survival analysis was done using the Kaplan-Meier survival curve and the Cox proportional hazard model.Results: We enrolled 857 MHD patients and followed up for 24.9 ± 10.2 months. During the follow-up, 204 (23.8%) patients died, 39 (4.6%) received renal transplantation, 18 (2.1%) switched to peritoneal dialysis, and 118 (11.7%) were transferred to nonparticipating dialysis units. The cutoff value of HGS to predict all-cause mortality was 12.4 kg for women and 25 kg for men. Utilizing the cutoffs to fit the survival curve of Kaplan-Meier, the correlation of HGS with mortality was verified for both genders. After adjustment for demographic and biochemical variables, HGS remained an independent predictor of all-cause mortality.Conclusions: Handgrip strength was strongly associated with all-cause mortality in patients receiving MHD. The cutoff values to predict all-cause mortality were 12.4 kg for women and 25 kg for men. Handgrip strength may be incorporated into clinical practice for assessing functional status and predicting prognosis in MHD patients.
Abbas Ostadtaghizadeh; Hamidreza Aghababaeian; Mona Khaleghy Rad; Ladan Araghi Ahvazi; Maryam Kiarsi
Volume 21, Issue 9 , 2019, Pages 1-5
Abstract
Background: In Spring 2018, due to intense rainfalls in Iran, plenty of mushrooms had grown, some of which were poisonous and their consumption had induced poisoning in people of different provinces; 1151 mushroom poisoning cases were reported within 25 days from 12 May to 9 July 2018.Objectives: This ...
Read More
Background: In Spring 2018, due to intense rainfalls in Iran, plenty of mushrooms had grown, some of which were poisonous and their consumption had induced poisoning in people of different provinces; 1151 mushroom poisoning cases were reported within 25 days from 12 May to 9 July 2018.Objectives: This study aimed to address this issue from the public health perspective. The study further aimed at reporting the mortality and morbidity associated with mushroom poisoning and ascertaining the reasons behind the increase in the numbers of the affected persons.Methods: This report was based on the review of official reports and a field assessment in the areas affected by mushroom poisoning in the western part of Iran.Results: There were 1151 mushroom poisoning cases, out of which 1133 (98.4%) were hospitalized, and unfortunately, 18 (1.56%) died. Kermanshah province had the highest rate of mushroom poisoning casualties, out which seven people died. A total of 12 provinces were affected.Conclusions: Lack of knowledge of local people about the types of mushroom and their inability to differentiate between the toxic and non-toxic mushrooms, as well as lack of a swift and convenient immediate warning system has caused this incident of massive mushroom poisoning. However, planning and proper management can help to resolve these problems.
Ling Sun; Lu-Xi Zou; Yan Lu; Na Deng; Hui-Xin Wang
Volume 21, Issue 3 , 2019, Pages 1-7
Abstract
Background: Hepcidin is a key regulator of iron homeostasis, while the clinical utility of hepcidin remains uncertain in hemodial- ysis (HD) patients.Objectives: Our study aimed to evaluate the predictive effect of serum hepcidin-25 on mortality in HD patients.Methods: A prospective observational cohort ...
Read More
Background: Hepcidin is a key regulator of iron homeostasis, while the clinical utility of hepcidin remains uncertain in hemodial- ysis (HD) patients.Objectives: Our study aimed to evaluate the predictive effect of serum hepcidin-25 on mortality in HD patients.Methods: A prospective observational cohort study of chronic HD patients were conducted at Xuzhou Central Hospital, Jiangsu, China, during years 2015 - 2017. The data on demographic factors, dialysis vintage, comorbidities, and laboratory measures were collected. Kaplan-Meier survival analysis was used to compare the effect of serum hepcidin-25 levels on mortality. Logistic regression models and multivariate Cox proportional hazard models were performed to identify the predictors of all-cause mortality in HD patients.Results: A total of 159 patients were included in this cohort, who were stratified into three groups by tertiles of hepcidin-25 values, and their 2-year overall mortality rate was 11.94%. The Kaplan-Meier analysis showed that patients with the highest tertile of serum hepcidin-25 had significantly higher all-cause mortality than in the two lower tertiles (P < 0.001). Serum hepcidin-25 was an inde- pendent risk factor for all-cause mortality after multivariate adjustments using logistic regression models and Cox proportional hazard models.Conclusions: A higher level of serum hepcidin-25 in chronic HD patients could be associated with increased mortality. Further studies are needed in a larger size of HD patients with a longer term of follow up.
Mahnaz Yadollahi; Asieh Mahmoudi; Mohammadhadi Niakan; Maryam Fadaei Dashti
Volume 20, Issue 5 , 2018, Pages 1-7
Abstract
Background: Trauma is the main cause of death in all age groups, as well as the 7th leading cause of fatality among the elderly. Compared to the youth, the risk of mortality and length of hospital stay are higher in elderly patients experiencing similar trauma and injury severity. Objectives: The present ...
Read More
Background: Trauma is the main cause of death in all age groups, as well as the 7th leading cause of fatality among the elderly. Compared to the youth, the risk of mortality and length of hospital stay are higher in elderly patients experiencing similar trauma and injury severity. Objectives: The present study aimed to identify the risk factors for mortality in the elderly. Methods: This was a cross-sectional study conducted on 65304 trauma patients who were referred to Shahid Rajaee (Emtiaz) Hos- pital trauma referral center, Shiraz, Iran 2011 - 2016. Information such as age, gender, injured body region, length of hospital stay, injury severity score (ISS), injury mechanism, nosocomial infection, and mortality was recorded. Injury severity scores and injured body regions were determined based on a conversion of international classification of diseases, the 10th revision (ICD-10) injury codes to Abbreviated Injury Scale (AIS-98) severity codes using a domestically developed electronic algorithm. The binary logistic regression was used to determine the partial effects of independent risk factors. Results: Patients over 60 had a mean age of 70.79 ± 8.83. Mortality rates were 4.7% (330) and 1.05% (614) among patients over and under 60, respectively. The most important risk factors for geriatric mortality included age over 75 [OR = 1.91, 95% CI (1.28 - 2.85)], nosocomial infection [OR = 10.56, 95% CI (6.52 - 17.10)], ISS (16 - 24) [OR = 12.51, 95% CI (7.28 - 21.490)], head injury [OR = 13.17, 95% CI (5.83 - 29.77)], and pedestrian accidents [OR = 1.47, 95% CI (1.47 - 1.95)]. Aging led to increased mortality due to nosocomial infection. Among the elderly patients, males had a higher mean injury severity score compared to females. Conclusions: According to our results, mortality rates increased by age in geriatric trauma patients. With similar severity of in- juries, there was a greater risk of mortality for trauma patients with very old age compared to old patients. Aging, gender (males), nosocomial infection, ISS, and head injury were the most significant predictors of mortality in the elderly.
Maryam Salari; Anoshirvan Kazemnejad; Farid Zayeri
Volume 19, Issue 8 , August 2017, , Pages 1-10
Abstract
Background: Liver cancer is considered as the 6th common cancer from which people are suffering all around the world. Poor prognosis is the main challenge regarding this disease.Objectives: The aim of this study was to compare the changing trends in the liver cancer death rate in Asian countries from ...
Read More
Background: Liver cancer is considered as the 6th common cancer from which people are suffering all around the world. Poor prognosis is the main challenge regarding this disease.Objectives: The aim of this study was to compare the changing trends in the liver cancer death rate in Asian countries from 1990 to 2015.Methods: This ecological longitudinal study was performed to compare the death rate resulting from liver cancer. The data were gathered from all Asian countries provided by the global burden of disease’s (GBD) online database in the global health research center at the University of Washington published in October 2016. The classification was done based on the death rate using the growth mixed model (GMM).Results: The rate of liver cancer death in men was higher than women, there were 2 optimal classes. Both classes had an increasing trend. The first class had a steeper slope by a higher intercept. Taiwan, Thailand, Mongolia, North Korea, South Korea, China, and Japan were countries classified in this class. The mean of the intercept was estimated as 21.1 deaths per 100,000 people and the mean of the slope was 2.4. The other class had an increasing rate with a lower slope.Conclusions: In general, our statistical analyses showed that most Asian countries had an increasing trend in the rate of their liver cancer mortality. Therefore, it is highly recommended that officials in the health policy-making identify the reasons for the increase in the mortality rate and take due actions such as interventional programs of countries which have succeeded in taking under control the ramifications of liver cancer
Gohar Mohammadi; Mohammad Esmaeil Akbari; Yadollah Mehrabi; Ali Ghanbari Motlagh; Mohammad Heidari; Shahla Ghanbari
Volume 19, Issue 3 , March 2017, , Pages 1-8
Abstract
Background: It is important to be able to predict cancer incidence and mortality rates for planning and managing the risk factors.Objectives: The present study investigated the changes in the incidence and mortality rates of five most common cancers in Iran.Methods: The cancer incidence and mortality ...
Read More
Background: It is important to be able to predict cancer incidence and mortality rates for planning and managing the risk factors.Objectives: The present study investigated the changes in the incidence and mortality rates of five most common cancers in Iran.Methods: The cancer incidence and mortality data were obtained from the national cancer and mortality registries. Five most common cancers in both men and women were selected. Changes in the incidence and mortality rates of the selected cancers in both sexes were estimated by age group, annual percent change (APC), and average APC (AAPC) and then graphically displayed.Results: The most common cancers (except skin cancer) were breast, colorectal, stomach, esophageal, and thyroid cancers in women and stomach, prostate, bladder, colorectal, and esophageal cancers in men, respectively. The AAPCs of all cancer incidence rates had increased by 11.9% in men and 11.6% in women from 2002 to 2010. Also, the mortality rates had enhanced by 0.4% and 0.1% per year in men and women from 2006 to 2011, respectively. The greatest APC was reported in prostate cancer. The rate had increased by 41.9% from 2002 to 2004, by 13.4% from 2004 to 2008, andslowly augmented by 3.9% from 2008 to 2010. In women, the greatest APC was observed in colorectal cancer; the rate had enhanced by 13.4% per year from 2002 to 2010. The greatest increase for age-standardized mortality and incidence in 2011 was attributed to gastric cancer (12.5% and 17.1% per 100,000 men, respectively). In women, the highest age-standardized mortality rate was related to gastric cancer at 6.9% per 100,000 women. The incidence and mortality patterns of colorectal and esophageal cancers in men and women were similar, although they were slightly higher in menthan women.Conclusions: Overall, cancer incidence rates had increased in both sexes. Many factors were responsible, such as changes in lifestyle, environmental factors, increased life expectancy, improvements in the registration systems, and declining mortality rates due to early detection and treatment. The results of this study provided useful information for the prediction of changes in the incidence and mortality of cancer and subsequent design of cancer control programs in Iran.
