崔翔
北京协和医学院阜外医院 流行病学部
BACKGROUND:Free wall rupture is a fatal and emergency complication of acute myocardial infarction. The factors associated with in-hospital mortality from free wall rupture remain unclear.OBJECTIVES:To investigate the factors associated with in-hospital mortality from free wall rupture.METHODS:We performed a single-center, retrospective study. We enrolled 111 consecutive patients with free wall rupture following acute myocardial infarction who were admitted to Fuwai Hospital from January 2005 to May 2021. The primary endpoint was in-hospital death. Clinical characteristics, laboratory data, and treatment modalities associated with in-hospital mortality were analyzed.RESULTS:Eighty-seven of the 111 study participants died in hospital. Multivariate Cox regression analysis showed that pericardiocentesis (hazard ratio [HR] 0.296, 95% confidence interval [CI] 0.094-0.929, p = 0.037), pericardial effusion at admission (HR 0.083, 95% CI 0.025-0.269, p<0.001), time interval between acute myocardial infarction and free wall rupture (HR 0.670, 95% CI 0.598-0.753, p<0.001), and previous myocardial infarction (HR 0.046, 95% CI 0.010-0.208, p<0.001) were independently associated with in-hospital mortality.CONCLUSIONS:Pericardiocentesis, pericardial effusion at admission, the acute myocardial infarction to free wall rupture time, and previous myocardial infarction are associated with a lower rate of in-hospital mortality from free wall rupture after acute myocardial infarction.
Heart & lung : the journal of critical care 2023
What is already known about this topic?:The impacts of population aging have appeared in China, leading to a marked shift in the major contributors to life expectancy. Longevity improvements are now mainly promoted by reductions in mortality rates of the aged.What is added by this report?:This study systematically evaluates both changes in mortality rates of major chronic diseases among populations aged over 60 years as well as their contributions to life expectancy increases in China, from 2005 to 2020.What are the implications for public health practice?:The results of this study demonstrate that more attention should be paid to health conditions of the elderly, especially for the prevention and control of major chronic diseases.
China CDC weekly 2022
BACKGROUNDS:Cardiovascular disease (CVD) remains the leading cause of deaths nationwide. However, little is understood about its temporal trend and corresponding influence on longevity improvements. We aimed to describe the updated tendency in CVD mortality and to quantify its impact on life expectancy (LE) increase in China.METHODS:All-cause mortality rates were calculated with population sizes from the National Bureau of Statistics and death counts from the National Health Commission. We estimated CVD mortality rates by allocating age- and sex-based mortality envelopes to each CVD subtype based on its proportion derived from the Disease Surveillance Points system. The probability of CVD premature deaths and LE were calculated with life tables and we adopted Arriaga's method to quantitate age- and cause-specific contributions to LE gains.RESULTS:During 2013 to 2018, the age-standardized mortality rate of CVD decreased from 289.69 (95% confidence interval [CI]: 289.03, 290.35)/100,000 to 272.37 (95%CI: 271.81, 272.94)/100,000, along with a decline in probability of CVD premature deaths from 9.05% (95%CI: 9.02%, 9.09%) to 8.13% (95%CI: 8.10%, 8.16%). The gap in CVD mortality across sexes expanded with more remarkable declines in females, especially for those aged 15 to 64 years. Among major subtypes, the probability of premature deaths from hemorrhage stroke declined fastest, while improvements of ischemic stroke and ischemic heart disease were limited, and there was an increase in stroke sequelae. LE in China reached 77.04 (95%CI: 76.96, 77.12) years in 2018 with an increase of 1.38 years from 2013. Of the total LE gains, 21.15% (0.29 years) were attributed to reductions of CVD mortality in the overall population, mostly driven by those aged >65 years.CONCLUSIONS:The general process in reducing CVD mortality has contributed to longevity improvements in China. More attention should be paid to prevention and control of atherosclerotic CVD and stroke sequelae, especially for the elderly. Working-age males also deserve additional attention due to inadequate improvements.
Chinese medical journal 2022
As Twitter emerged as an important data source for pharmacovigilance, heterogeneous data veracity becomes a major concern for extracted adverse drug reactions (ADRs). Our objective is to categorize different levels of data veracity and explore linguistic features of tweets and Twitter variables as they may be used for automatic screening high-veracity tweets that contain ADR-related information. We annotated a published Twitter corpus with linguistic features from existing studies and clinical experts. Multinomial logistic regression models found that first-person pronouns, expressing negative sentiment, ADR and drug name being in the same sentence were significantly associated with higher levels of data veracity (p<0.05), using medical terminology and fewer indications were associated with good data veracity (p<0.05), less drug numbers were marginally associated with good data veracity (p=0.053). These findings suggest opportunities for developing machine learning models for automatic screening of ADR-related tweets using key linguistic features, Twitter variables, and association rules.
Studies in health technology and informatics 2022
OBJECTIVE:To describe the contemporary trends in total, inpatient, and outpatient expenditure on major subtypes of cancer in different classifications of hospitals in mainland China.METHODS:Home page of Inpatient Medical Records (HIMRs) and Hospital Annual Reports (HARs) were used to estimate hospital care expenditure on cancer. Inpatient payments and their share of cancer were calculated with the top-down method. Kriging spatial interpolation methods were used at the county level and summed at the province level. Outpatient expenditure was estimated with inpatient expenditure and the ratios of outpatient to inpatient payments in specialized cancer hospitals, stratified by province. Total expenditure on cancer was the sum of both payments. Log-linear regression was applied to estimate annual percentage change (APC) of expenditure.RESULTS:Total expenses for cancer of Chinese residents reached up to 304.84 billion Chinese Yuan (CNY) in 2017, accounting for 5.8% of the total health expenses (THE). After adjusting for consumer price index (CPI), medical expenses for cancer have increased from 63.30 billion CNY in 2008 to 249.56 billion CNY in 2017 [APC: 15.2%, 95% confidence interval (95% CI): 13.4%-17.0%]. The APC was slightly higher than THE around 2013, while was lower after 2013. During 2008-2017, the ratio of inpatient to outpatient costs for cancer decreased from 4.3:1 to 3.8:1. The inpatient payments for cancer mainly happened in grade 3 general hospitals, East China, and among lung, colorectal, and stomach cancer; while the fastest increase was found in West China, and among thyroid, prostate, and colorectal cancer.CONCLUSIONS:During 2008-2017, the rapid growth trend of medical expenses for cancer has been effectively controlled with the continuous deepening of medical reform and improvements of residents' health care. More attention should be paid to potential increases of medical costs caused by technological progress and demand release. Socialized and multi-channel insurance financing modes should be explored in the future.
Chinese journal of cancer research = Chung-kuo yen cheng yen chiu 2021
