A National Registry-Based Epidemiological Study to Evaluate 395 646 Patients Hospitalized Due to Eye Diseases in Poland in 2019.

BACKGROUND The Nationwide General Hospital Morbidity Study Registry collects demographic, health, and medical data on patients hospitalized throughout Poland, and acts as a registry for epidemiological, public health, and hospital administrative studies. This epidemiological national registry-based study aimed to evaluate the characteristics of 395 646 patients hospitalized due to eye diseases in Poland in 2019. MATERIAL AND METHODS This study is a retrospective nationwide registry-based analysis. Data on all patients hospitalized due to eye diseases in 2019 were obtained from the Nationwide General Hospital Morbidity Study Registry. Demographic characteristics of patients hospitalized due to eye diseases as well as the hospitalization course were analyzed using descriptive epidemiology tools. RESULTS Disorders of the lens accounted for 68.6% of all hospital admissions, and disorders of the choroid and retina were the second most common (13.9%) cause of hospital admission due to eye diseases in 2019. Over three-quarters of hospital admissions (77.4%) lasted less than 24 h, and 86.8% were scheduled admissions. Most of the patients hospitalized due to eye diseases were females (59.9%) and over 70% lived in urban areas. There were regional differences in the hospital admissions rate per 100 000 inhabitants. According to the data presented in the registry, less than one-third of patients had comorbidities. CONCLUSIONS Hospital ophthalmological care in Poland is based mainly on planned hospitalizations lasting less than 24 h and related to ophthalmological surgery. Data on the comorbidity of ophthalmologic patients suggest that ophthalmologists do not pay enough attention to identifying and recording the patient's health status.

Trends in Hospitalization Duration for Rare Diseases: A Retrospective Analysis of Sarcoidosis, Still's Disease, and Systemic Sclerosis in Poland (2009-2018).

BACKGROUND A rare disease is a health condition that rarely occurs in the population. It is estimated that up to 400 million people around the world suffer from a rare disease. This retrospective study aimed to investigate factors associated with length of hospitalization in 78 626 patients with sarcoidosis, 3294 patients with adults-onset Still's disease, and 35 549 patients with systemic sclerosis between 2009 and 2018 using data from the National Institute of Public Health in Poland. MATERIAL AND METHODS In this population-based study, we analyzed hospital discharge records of first-time and subsequent hospitalizations. To perform the statistical analyses, R software was used. RESULTS The average length of hospitalization over the selected period in the diseases was 5.39 days for sarcoidosis, 6.22 days for scleroderma, and 7.44 days for Still's disease, and was shorter for each of the diseases analyzed compared with the length of hospitalization for second and subsequent stays. There were no substantial differences in length of hospitalization between males and females. The average length of hospitalization increased with each additional comorbidity. CONCLUSIONS The study showed that hospitalizations for selected rare diseases do not cause a significant burden on the healthcare system. The results also showed that advanced age and comorbidities are important factors determining the length of hospitalization. The average length of hospital stay for selected rare diseases in Poland is not longer than the European Union (EU) average, so it can be assumed that the process of inpatient treatment in Poland is optimal.

Ukrainian migrants' and war refugees' admissions to hospital: evidence from the Polish Nationwide General Hospital Morbidity Study, 2014-2022.

BACKGROUND: Considering the rapid influx of Ukrainian migrants and war refugees into Poland, the knowledge of their health condition is becoming increasingly important for health system policy and planning. The aim of the study was to assess war-related changes in the frequency and structure of hospitalizations among Ukrainian migrants and refugees in Poland. METHODS: The study is based on the analysis of hospital admission records of Ukrainian patients, which were collected in the Nationwide General Hospital Morbidity Study from 01.01.2014 to 31.12.2022. RESULTS: In the study period, 13,024 Ukrainians were hospitalized in Poland, 51.7% of whom had been admitted to hospital after February 24, 2022. After the war broke out, the average daily hospital admissions augmented from 2.1 to 21.6 person/day. A noticeable increase in the share of women (from 50% to 62%) and children (from 14% to 51%) was also observed. The average age of patients fell from 33.6 ± 0.2 years to 24.6 ± 0.3 years. The most frequently reported hospital events among the migrants until 23.02.2022 were injuries (S00-T98) - 26.1%, pregnancy, childbirth and the puerperium (O00-O99) - 18.4%, and factors influencing health status and contact with health services (Z00-Z99) - 8.4%. After the war started, the incidence of health problems among migrants and war refugees changed, with pregnancy, childbirth and the puerperium (O00-O99) being the most common - 14.9%, followed by abnormal clinical and lab findings (R00-R99) - 11.9%, and infectious and parasitic diseases (A00-B99) - 11.0%. CONCLUSIONS: Our findings may support health policy planning and delivering adequate healthcare in refugee-hosting countries.

Clinical Characteristics and Factors Associated with In-Hospital Mortality in 66 755 Patients Hospitalized Due to Diabetes in Poland, January to December 2019.

BACKGROUND The global burden of diabetes mellitus is increasing, and diabetes poses a serious problem for the healthcare system. We aimed to characterize patients hospitalized due to diabetes in Poland in 2019 and identify factors associated with the risk of in-hospital death and prolonged hospitalization. MATERIAL AND METHODS Data on all patients hospitalized due to diabetes in Poland in 2019 were taken from hospital discharge records collected by the National Institute of Public Health, Warsaw, Poland. The presence of comorbidities, in-hospital mortality rate, and duration of hospitalization were analyzed separately for type 1 and type 2 diabetes. RESULTS In 2019, a total of 28 617 patients were admitted to the hospital due to type 1 diabetes and 38 138 patients due to type 2 diabetes. The prevalence of comorbidities was 55.2% among patients with type 1 diabetes and 78.9% among those with type 2 diabetes. The in-hospital mortality rates were 2.1% and 3.3%, respectively. For emergency admissions, the in-hospital mortality rate was 4.0% and 4.5%, respectively. Over 30% of patients were hospitalized for more than 7 days. Older age and respiratory diseases were the most critical factors associated with higher risk of in-hospital death in patients with type 1 or type 2 diabetes (P<0.001). Male sex, age, and presence of at least 1 comorbidity were associated (P<0.001) with a higher risk of prolonged hospitalization. CONCLUSIONS Effective management of respiratory diseases in patients hospitalized due to diabetes, especially those admitted in an emergency, seems crucial to reduce the risk of in-hospital death.

Analysis of diabetic patients hospitalizations in Poland by gender, age and place of residence.

Background: There are few updated data on rates of hospital mortality of diabetic patients and length of their hospital stay on a country level. To determine such rates we provided analysis using claims data from a Nationwide General Hospital Morbidity Study carried out by the National Institute of Public Health - National Institute of Hygiene (NIPHNIH) in Warsaw from 2010 to 2018. Objective: The aim of the study was to analyze the nine years changes of in-hospital morbidity and mortality in diabetic patients and length of hospital stay using a comparative approach by gender, age and place of residence. Material and methods: The data on all patients from general hospitals in Poland treated because of diabetes were taken from a nationwide database, kept since 1979 by the Department for Monitoring and Analyses of Population Health of NIPH-NIH. This database contains information gathered under the Statistical Research Program of Public Statistics. Hospitalization rates were used to evaluate the 'hospitalized' incidence of diabetes (number of hospitalization cases due to diabetes per year by the analyzed unit of population). In-hospital mortality was calculated as the percentage of deceased patients out of all patients hospitalized due to diabetes. Results: The number of cases and hospitalization rates of diabetic patients was rapidly declining by 18.8% for type 2 (E11) and 23.7% for type 1 (E10) diabetes. The downward tendency in the scope of hospitalization affected mainly older women and rural residents. Hospital mortality due to diabetes rose up dangerously to 3.77% exceeding the rates recorded eight years earlier. Conclusions: The recent reduction in hospitalization rates of people with diabetes in Poland may be associated with an unexpected increase in hospital mortality.

Cost-effectiveness of public health interventions against human influenza pandemics in France: a methodological contribution from the FLURESP European Commission project.

BACKGROUND: The FLURESP project is a public health project funded by the European Commission with the objective to design a methodological approach in order to compare the cost-effectiveness of existing public health measures against human influenza pandemics in four target countries: France, Italy, Poland and Romania. This article presents the results relevant to the French health system using a data set specifically collected for this purpose. METHODS: Eighteen public health interventions against human influenza pandemics were selected. Additionally, two public-health criteria were considered: 'achieving mortality reduction ≥40%' and 'achieving morbidity reduction ≥30%'. Costs and effectiveness data sources include existing reports, publications and expert opinions. Cost distributions were taken into account using a uniform distribution, according to the French health system. RESULTS: Using reduction of mortality as an effectiveness criterion, the most cost-effective options was 'implementation of new equipment of Extracorporeal membrane oxygenation (ECMO) equipment'. Targeting vaccination to health professionals appeared more cost-effective than vaccination programs targeting at risk populations. Concerning antiviral distribution programs, curative programs appeared more cost-effective than preventive programs. Using reduction of morbidity as effectiveness criterion, the most cost-effective option was 'implementation of new equipment ECMO'. Vaccination programs targeting the general population appeared more cost-effective than both vaccination programs of health professionals or at-risk populations. Curative antiviral programs appeared more cost-effective than preventive distribution programs, whatever the pandemic scenario. CONCLUSION: Intervention strategies against human influenza pandemics impose a substantial economic burden, suggesting a need to develop public-health cost-effectiveness assessments across countries.

Epidemiology of Pulmonary Aspergillosis in Hospitalized Patients in Poland During 2009-2016.

Aspergillus is one of the most prevalent airborne fungal pathogens in the developed countries that may cause fatal invasive pulmonary aspergillosis in immunocompromised patients. The epidemiological information on aspergillosis in Poland is scarce. This retrospective, population-based study evaluated the incidence of pulmonary and other forms of aspergillosis, and also gender distribution and territorial differences in the occurrence of aspergillosis in hospitalized patients in Poland during 2009-2016. The incidence of aspergillosis was estimated on the basis of a dataset provided by hospital morbidity study carried out by the National Institute of Public Health. The data consisted of 4206 hospitalization records of 2338 patients, with some patients being hospitalized more than one time due to disease remissions. Significant gender differences were observed (1484 females vs. 2722 males, p < 0.001). No statistical differences were found for the place of residence. The average annual incidence rates for all forms of aspergillosis, invasive pulmonary aspergillosis, and other pulmonary aspergillosis were 13.8 per million (95% CI: 11.3-16.3), 4.0 per million (95% CI: 3.0-5.0), and 4.4 (CI: 3.5-5.2) per million, respectively. Over time, a significant increase in the rate of hospitalization were observed for all forms of aspergillosis (10.7 per million in 2009 vs. 15.7 per million in 2016, p for trend <0.005), invasive pulmonary aspergillosis (2.3 per million in 2009 vs. 5.0 per million in 2016, p for trend <0.001), and other pulmonary aspergillosis (3.6 per million in 2009 vs. 4.9 per million in 2016, P for trend <0.02). During the period analyzed 283 patients (12.0%) died while hospitalized and 224 of them (9.6% of all patients) died during the first-time hospitalization. We conclude that the incidence of aspergillosis is on the rise in hospitalized patients in Poland.

Nationwide General Hospital Morbidity Study as a source of data about Polish population health

The objective of this article is description of the important source of data on hospitalised morbidity collected in Poland within the frameworks of public statistics, and also underlying the significance of the quality of data collected at the hospital level for the purpose of the practical application of them. The Nationwide General Hospital Morbidity Study has been conducted by the Department of Population Health Monitoring and Analysis of the NIPH-NIH for more than 40 years within the frameworks of the Programme of Statistical Surveys of Official Statistics. Since the year 2000, it has had a complete character, collecting individual data for all cases of hospitalisation in Poland within the scope compliant with the MZ/Szp-11 form, among others, sex, age, place of residence of a patient, data on hospital, information about the course of treatment (length of stay in hospital, principal diagnosis and comorbidity, applied medical procedures, the mode of admission and discharge). The collected data are anonymous. In the recent years, annually, more than 8 million of the cases of hospitalisation have been documented. Almost all obliged hospitals (96%) participate in the study. Some weak point is the completeness of submitted data, in particular, regarding information about the external causes of injuries and poisonings (in the year 2017, 27% of the required data were missing). Interestingly, a high level of missing data is generated by a comparatively small number of hospitals. Significant differences are observed in the quality of data depending on the voivodship of hospital location. The collected data render it possible to, among others, determine the frequency of hospitalisations due to particular causes taking under consideration the localisation of a hospital, and also the sex, age and the place of residence of patients, the analysis of the duration of hospital stay or in-hospital fatality. The aggregated results are reported to international databases (WHO, OECD, Eurostat), and support the administrative authorities of various levels. They are also a basis for numerous published scientific papers. The most important results of routine analyses are presented of the web page of the Study (http://www.statystyka1.medstat.waw.pl/).

Variations in experience of social support and physical health among adult residents of Poland in urban versus rural areas

Background: A study reveals ­ against to common beliefs ­less support between rural area residents in comparison to town-dwellers and significantly higher support for healthy, not for poor health research participants. Objectives: The aim of our paper was comparing support from spouse/partner, relatives, friends and strangers among people with good and ill physical health. A next purpose was to find differences of social support and experience of social undermining in urban and rural residential settings. Material and methods: The study "Epidemiology of Mental Disorders and Access to Mental Health Care, EZOP ­ Poland" was carried out on random sample of 24 000 of Poland residents and a 50,4% response rate, 10 081 computerassisted personal interviews. Of those respondents, 4 000 constituted a sub-sample asked to complete the social networks and support section of the questionnaire. Data were analyzed by age, gender, residential setting and marital status for statistically significant differences in the percentage of functional and structural social support being reported, using the chi-squared test with a significance level of 0.05 used to reject the null hypothesis (H0 = lack of relationship between variables). Results: A majority of respondents maintain that in difficult life situations, family and a close network of friends and acquaintances make it possible to openly discuss problems and obtain help. However, respondents who rate their health as "poor" or "very poor" significantly less often than healthy individuals experience support coming from their relatives, friends, or strangers. In comparison to urban areas, the extent of social support in rural areas is significantly limited. The rural setting offers less support and even less opportunities for interaction with relatives, friends, acquaintances and strangers. Negative social factors­ low levels of trust, isolation from friends and family, lack of a social life, lack of a helpful neighborhood ­ are conditions significantly more often found in the countryside than in urban areas. Conclusions: Results obtained from the EZOP study shows that amount of social support received is higher in urban areas and among those who enjoy better physical health.

Epidemiology of Granulomatosis with Polyangiitis in Poland, 2011-2015.

Granulomatosis with polyangiitis (GPA) is a form of vasculitis that affects small- and medium-sized vessels in many organs. The aim of the study was to describe the epidemiology of GPA in Poland in 2011-2015, including the incidence and prevalence rates. The authors conducted a retrospective, population-based study, using hospital discharge records with GPA diagnosis. GPA incidence was estimated on the basis of the data from the Polish hospital morbidity study carried out by the National Institute of Public Health. The final study group consisted of 1491 patients (749 females, 742 males) who were first time hospitalized with the diagnosis of GPA. The average annual incidence of GPA in Poland was 7.7/1,000,000 (95% CI, 4.1-11.4), and the point prevalence at the end of 2015 was 36/1,000,000. A statistically significant decrease in the GPA incidence was noticed in this study. A 1-year survival rate for GPA was 94%. In conclusion, the incidence and prevalence rates of GPA in Poland are similar to that reported in other European countries. The study provides recent epidemiological data on GPA in Poland, which may be useful for comparisons with other geographical regions.

ICU mortality and variables associated with ICU survival in Poland: A nationwide database study.

BACKGROUND: Recently published international comparison data across European countries revealed high mortality rates in Polish ICUs. OBJECTIVES: Estimation of the rate of ICU mortality and identification of variables associated with ICU survival in Poland. DESIGN: Retrospective analyses of a database reporting ICU stays in Poland. SETTINGS AND PATIENTS: The study included data from all adult patients admitted to an ICU in Poland from 1 January 2012 to 31 December 2012. MAIN OUTCOME MEASURES: ICU mortality and variables associated with ICU survival. RESULTS: A total of 48 282 patients were treated in 347 ICUs (mean age 63.1 ±â€Š16.8 years, 59% men) with 20 278 deaths (42.0%). Variables associated with ICU survival were: tertiary level of hospital care [relative risk (RR) 0.86, 95% confidence interval (CI) 0.80 to 0.92, P < 0.001]; high annual patient volume in the ICU (RR 0.9995 patient year, 95% CI 0.9994 to 0.9996, P < 0.001); younger patient age (RR 1.025 year, 95% CI 1.024 to 1.026, P < 0.001); female sex (RR 0.92, 95% CI 0.88 to 0.96; P < 0.001); and lower number of comorbidities (RR 1.33, 95% CI 1.31 to 1.35, P < 0.001). CONCLUSION: ICU mortality was high in Poland. Structural variables, such as the level of hospital care and annual patient volume, may be associated with ICU survival.

Hospital Morbidity Database for Epidemiological Studies on Churg-Strauss Syndrome.

Churg-Strauss syndrome or more accurately eosinophilic granulomatosis with polyangiitis (EGPA) is a small-vessel necrotizing vasculitis with a characteristic late-onset allergic rhinitis and asthma. The use of hospital morbidity database is an important element of the epidemiological analysis of this rare disease. The present study was undertaken to assess the incidence of EGPA and factors related to its epidemiology in Poland; the first analysis of the kind in Poland, enabling a comparison in the European context. This is a retrospective, population-based study using hospital discharge records with EGPA diagnosis, collected for a National Institute of Public Health survey covering the period from 2008 to 2013. The group consisted of 344 patients (206 females and 138 males) with the first-time hospitalization for EGPA. The major findings are that the annual incidence of EGPA in Poland was 1.5 per million (95% confidence intervals: 1.2-1.8), with the point prevalence of 8.8 per million at the end of 2013. A greater incidence of EGPA was observed in the regions with urban predominance. We conclude that discharge records may be a useful element of epidemiological studies on EGPA.

Trends in Hospitalization of Children with Bacterial Pneumonia in Poland.

AIM: The aim of the study was to evaluate the hospitalization trends in children aged 0-6 suffering from bacterial pneumonia in the years 2007-2011 in Poland. METHODS: The data pertained to the hospitalized patients diagnosed with the diseases registered as J13-J15 according to ICD-10. RESULTS: In the years 2007-2011, the hospitalization rate increased from 16.3/10,000 to 44.1/10,000 for boys and from 13.8/10,000 to 33.0/10,000 for girls. The most frequently hospitalized children were between 1 and 2 years of age (90.6/10,000 for boys and 58.0/10,000 for girls in 2011). The average length of stay (LOS) of the investigated children fell from 10.1 days in 2007 to 8.2 days in 2011. The longest stays were recorded for the youngest children, under 2 years of age (from almost 11 days in 2007 to around 9 days in 2011). CONCLUSION: Bacterial pneumonia is a serious problem of public health and especially babies are at high risk of this disease. Given the effects of vaccinations against Streptococcus pneumoniae conducted all over the world and to a limited extend in Poland as well, further steps towards vaccinating children against pneumococci should be taken in Poland.

The burden of Herpes Zoster and its complications in Poland in according to the age.

BACKGROUND: Incidence of shingles in different regions of the world ranged from 300 to 500/100,000 persons, and in the population older than 80 years of age reaches more than 1000/100,000. In the age group 50+ the incidence is enough high to be a serious medical and economic burden. Lack of details about the incidence and frequency of complications in Polish population let us too made an attempt to assess the scale of the problem, among others to the purpose of the evaluation of the legitimacy of implementing vaccination in the 50+ population. METHODS: First, based on coming data from the Swietokrzyskie Province Division of the National Health Fund we judged the incidence of shingles in this province in 2013 in individual ancient groups and depending on detailed diagnoses and with the division into the basic health, clinic and hospital care. Second, based on gathered data through NIZP-PZH, we judged hospital morbidity connected with shingles in Poland in 2008-2012 years, in individual ancient groups. RESULTS: Extrapolating the data from the Swietokrzyskie province we assess the incidence of shingles on average 338.8/100,000. She is tallest in the age group 50+ (614.3/100,000) and in this group also the most complications are being observed. Hospital morbidity in entire Poland showed in 2008-2012 years the frequency on average 4.93-5.42/100,000, in the group of 0-19 years; 0.10-1.50/100,000, in the group of 20-49 years; 4.9-5.42/100,000 and in the 50+ group--9.99-13.37/100,000. CONCLUSIONS: (1) Shingles, especially in the 50+ age group, constitutes a serious health problem in Poland, being a cause of numerous advices in basic health care and at clinics in Poland, as well of numerous hospitalizations and dangerous complications. (2) It seems, that active immunization against shingles, especially of 50+ persons, would be a favourable solution from the individual, as well as public perspective.

Hospitalizations of patients with sarcoidosis before and during the COVID-19 pandemic in Poland.

INTRODUCTION: Sarcoidosis is a multisystemic granulomatous disease that mostly affects the lungs and lymphatic system. Due to its rarity and variable clinical course, analyses of factors related to sarcoidosis should be based on large databases and long observation periods. OBJECTIVES: The aim of this study was to determine the characteristics of patients with sarcoidosis hospitalized in Poland over a long period (2016-2021). PATIENTS AND METHODS: We conducted a retrospective study using hospital discharge records compiled by the National Institute of Public Health NIH - National Research Institute. We analyzed the records of patients with sarcoidosis from the entire Polish population at their first hospitalization. RESULTS: We identified a total of 15 548 first-time hospitalizations for sarcoidosis. The mean annual disease incidence was 6.8 cases per 100 000. The mean (SD) age of the patients was 45.8 (13.6) years, and it was lower in men than in women (42.9 [12.5] vs 49.8 [14.2] years; P <0.001). There were significantly more hospitalizations among city dwellers (62.3% vs 37.3% for rural residents; P <0.001). At the beginning of the COVID­19 pandemic in Poland there was a decrease in the number of hospitalizations for sarcoidosis, followed by an increase in the subsequent year. The all­cause in­hospital death rate was significantly higher during the COVID­19 pandemic, as compared with the period before the pandemic (7.2 vs 2.3 per 1000; P <0.001). CONCLUSIONS: Health care changes related to the outbreak of the COVID­19 pandemic may have increased the health debt for inpatient sarcoidosis treatment. The occurrence of sarcoidosis in Poland may be related to demographic and territorial factors.

Newborn Hospitalizations Before and During COVID-19 Pandemic in Poland: A Comparative Study Based on a National Hospital Registry.

Objectives: There are limited data on the impact of the COVID-19 outbreak in Poland on newborn health. The aim of the study is to show recent information on hospitalizations of newborns in Poland in the pre-pandemic and COVID-19 pandemic era. Methods: A retrospective, population-based study was conducted using data from hospital discharge records of patients hospitalized in 2017-2021. Results: The data on which the study was based consisted of a substantial number of 104,450 hospitalization records. Annual hospitalization rate was estimated to be 50.3-51.9 per 1,000 in 2017-2019, 56 per 1,000 in 2020 and it rose to 77.7 per 1,000 in 2021. In comparison to the pre-pandemic period, in the COVID-19 era, we observed significantly more hospitalization cases of newborns affected by maternal renal and urinary tract diseases (p < 0.001), syndrome of infant of mother with gestational diabetes (p < 0.001), maternal complications of pregnancy (p < 0.001). In the COVID-19 era, the prevalence of COVID-19 among newborns was 4.5 cases per 1,000 newborn hospitalizations. Conclusion: The COVID-19 pandemic outbreak could significantly contribute to qualitative and quantitative changes in hospitalizations among newborns.

Hospitalizations of patients with herpes zoster in Poland during 2012-2021: A population-based study.

INTRODUCTION: The varicella-zoster virus (VZV) is an infectious agent that causes both chickenpox and herpes zoster/shingles (HZ). This infection can take various clinical forms, result in permanent complications, and be a marker of immunosuppression, e.g. in the course of a neoplastic disease. The aim of this study is to analyze epidemiological trends in hospitalization and hospital mortality rate among HZ patients in Poland (2012-2021). METHODS: Our study is a population-based, retrospective analysis of hospital discharge records of patients with HZ. Data were obtained from the National Institute of Public Health in Poland, and they covered the period from 2012 to 2021. All hospitalization records with primary or secondary ICD-10 B02 code diagnosis were included in the study. RESULTS: We analyzed the total number of 23,432 hospital discharge records of HZ patients in 2012-2021. The study group consisted of 22,169 (94.6 %) hospitalization records of first-time diagnosis of HZ in hospitalized patients: 9,309 males (42 %) and 12,860 females (58 %). In this group, 70.3 % were patients over 60 years old. The mean and median age was 64 and 69 years, respectively. The mean annual first-time hospitalization rate for HZ was estimated to be 5.8 per 100,000 person-years (95 % CI: 4.8-6.7 per 100,000 person-years). The hospitalization rate for HZ was similar during 2012-2019. There was a significant decrease in hospitalizations in 2020-2021 in comparison with the previous years (R2 = 0.42, p < 0.05). Women showed a higher hospitalization rate than men (p < 0.001). Urban residents had a higher hospitalization rate than rural residents (p < 0.001). In the analyzed period, 246 deaths were recorded (1.1 % of all hospitalized HZ patients) -119 males and 127 females. CONCLUSIONS: The HZ-related number of hospitalizations and mortality in Poland are relatively low, but HZ is still a significant health problem. Risk factors include female gender, older age and residence in urban areas.

Time Trend Analysis of Comorbidities in Ankylosing Spondylitis: A Population-Based Study from 53,142 Hospitalizations in Poland.

BACKGROUND: (1) Influence of comorbidities on life expectancy and treatment outcomes is one of the main concerns of modern rheumatology, due to their rising prevalence and increasing impact on mortality and disability. The main objective of our study was to analyze the time trends and shifts in the comorbidity profile and mortality over 10 years in the Polish population with ankylosing spondylitis (AS). (2) Data from 2011-2020 years were acquired from the General Hospital Morbidity Study in the National Institute of Public Health-National Institute of Hygiene (NIH-PIB) as ICD-10 codes. Based on ICD10 codes, we calculated the percentage shares for comorbidities, with the relative risk ratios and odds ratios. We analyzed the hospitalization rates and mortality from the overlapping conditions. Also, we analyzed age and sex related differences in the clinical manifestations of AS patients. (3) Results: From 53,142 hospitalizations of patients with AS, we found that the male population presented higher rates of cardiovascular (2.7% vs. 1.3% p < 0.001) and pulmonary conditions (1.2% vs. 0.8% p < 0.025). Inflammatory bowel diseases were more common in the female population than in males (2.3% vs. 1.7%, p < 0.001). In the years 2011-2020, we observed a decline in the number of hospitalized patients due to cardiovascular (p < 0.001) and respiratory system conditions (p < 0.001), yet the relative risk and odd ratios remained high. In the years 2011-2020, 4056 patients received biological treatment (7%). The number of initiated biological therapies correlated negatively with the number of reported hospitalizations due to ischemic heart diseases (IHD) (p < 0.031, r = -0.8). Furthermore, in the logistic regression model, we found strong collinearity between cardiovascular and pulmonary comorbidities (VIF = 14; tolerance = 0.1); also, the number of reported IHD's correlated positively with the number of pulmonary infections (p < 0.031, r = 0.7) (4). CONCLUSIONS: Cardiopulmonary comorbidities are a main factor associated with increased mortality in patients with AS, especially in hospitalized patients. The mortality rates among patients with AS admitted to hospital due to other conditions other than movement disorders exceed the populational risk. The number of biologically treated patients correlated negatively with hospital admissions due to IHD.

Effect of the PCV 10 vaccination on community-acquired pneumonia hospitalisations after four years of its introduction into the Polish National Immunisation Programme: Follow-up study.

BACKGROUND: Vaccination against pneumococci is currently the most effective method of protection against pneumococcal infections. The aim of the study was to analyse changes in hospitalisations and in-hospital deaths due to pneumonia before (2009-2016) and after (2017-2020) the introduction of PCV 10 vaccinations in the National Immunisation Programme in Poland. METHODS: Data on hospitalisations related to community acquired pneumonia (CAP) in the years 2009-2020 were obtained from the Nationwide General Hospital Morbidity Study. Analyses were made in the age groups: <2, 2-3, 4-5, 6-19, 20-59, 60+ years in 2009-2016 and 2017-2020. RESULTS: Overall, there were 1,503,105 CAP-related hospitalisations in 2009-2020, 0.7% of which were caused by Streptococcus pneumoniae infections. Children <2 years of age were the most frequently hospitalised for CAP per 100,000 population, followed by patients aged 2-3, 4-5 and 60+ years. In the years 2009-2016, the percentage of CAP hospital admissions increased significantly, and after the year 2017, it decreased significantly in each of the age groups (p<0.001). In the years 2009-2016, a significant increase in hospitalisations for Streptococcus pneumoniae infections was observed in the age groups <2, 2-3 and 4-5 years (p<0.05). A significant reduction in hospitalisations was observed in the age groups <2, 20-59 and 60+ in 2017-2020 (p<0.05). In the years 2009-2020, there were 84,367 in-hospital deaths due to CAP, 423 (0.5%) of which due to Streptococcus pneumoniae, with patients mainly aged 60+. CONCLUSIONS: Implementation of the PCV vaccination programme has effectively decreased the incidence of CAP hospitalisations, including children <2 years of age. The group that is most at risk of death are persons aged 60+. The results of our study can be useful in evaluating the vaccine efficacy and benefits, and they can be an essential part of public health policy. Effective prevention strategies for CAP should be implemented in different age groups.

Fall related hospital admissions among seniors in Poland in 2010.

BACKGROUND: Falls among elderly people causing hospitalization are considered one of the most important public health problems. Our objective was to analyse fall related hospital admissions among seniors (> or = 65 years old) in Poland in 2010. The analyses were conducted with regard to gender, place of residence and age. Additionally, the health consequences of falls among elderly people were studied. Injuries and other consequences of external causes, were expressed in the form of three-character ICD-10 codes representing the underlying disease (S00-T98). METHODS: Data on hospital admissions resulting from falls among seniors were obtained from the database held at the Department - Centre for Monitoring and Analyses of Population Health Status and Health Care System by the National Institute of Public Health - National Institute of Hygiene. RESULTS: Analysis has shown that the hospitalization ratio due to falls is much higher for women than for men. On average, 1 024 per 100 000 women are hospitalized due to a fall, while the number for men is 649. For every analysed age group women are at a higher risk of hospitalization due to a fall than men. In 2010 nearly 70% of hospital admissions of elderly people due to a fall were caused by a fall on the same level as a result of tripping or slipping (31 712 hospitalizations). No differences in relation to gender were observed. Risk of hospitalization due to a fall increases with age. For people over 80 years of age it is 2.5 times higher than for people in the 65-69 age group (1 459 and 570 per 100 000 respectively). It was observed that the length of hospital stay increases with age. There were no significant differences between the number of hospitalizations depending on the place of residence. The analysis showed that differences in the length of stay for women and men are statistically significant. However, there was no statistically significant difference between the lengths of stay depending on a place of residence. Almost one-third of hospitalizations (31.4%) resulted from femur fracture (14 356 hospitalizations). Women are more likely to suffer from a femur fracture. CONCLUSIONS: A comparison of results of research conducted, among other countries, in the United States, The Netherlands, and Denmark, as well as Polish demographic prognosis, has shown that an increase of fall related hospital admissions among senior citizens is to be expected in Poland in oncoming years.