Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 449
Filtrar
2.
Medicine (Baltimore) ; 99(51): e23779, 2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33371147

RESUMO

ABSTRACT: Pneumothorax is a life-threatening complication during acute asthma attack. However, long-term risk of pneumothorax in asthmatic children remains unknown.In this retrospective cohort study, 333,657 children were defined as asthma cohort and a 1:1 matched non-asthma cohort were generated from 2000 to 2011. At the end of 2012, the incidence of pneumothorax in asthma and non-asthma cohorts and asthma to non-asthma hazard ratios (HRs) with confidence intervals (CIs) of pneumothorax were analyzed.The incidence of pneumothorax was 1.35-fold higher in the asthma cohort than that in the non-asthma cohort. The asthma to non-asthma HRs of pneumothorax were higher in children younger than 6 years (1.76, 95% CI: 1.21-2.57) and in girls (2.27; 95% CI: 1.23-4.16). The HRs of pneumothorax were higher in asthmatic children with more asthma-related out-patient clinic visits/per year (>5 visits; HR: 2.81; 95% CI: 1.79-4.42), more emergency department visits/per year (>4 visits; HR: 1.68; 95% CI: 1.02-2.78), and longer hospitalization days due to asthma (>4 days; HR: 3.42; 95% CI: 1.52-6.94) (P < .0001, the trend test).Asthmatic children had greater risk for pneumothorax, particularly in young children and in those with severe and uncontrolled asthma.


Assuntos
Asma/complicações , Pneumotórax/etiologia , Medição de Risco/métodos , Urbanização , Adolescente , Asma/epidemiologia , Asma/fisiopatologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Masculino , Pneumotórax/epidemiologia , Pneumotórax/fisiopatologia , Estudos Retrospectivos , Medição de Risco/tendências , Fatores de Risco
3.
Diabetes Metab Syndr ; 14(6): 2103-2109, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33161221

RESUMO

BACKGROUND AND AIMS: The ongoing COVID-19 pandemic is disproportionately affecting patients with comorbidities. Therefore, thorough comorbidities assessment can help establish risk stratification of patients with COVID-19, upon hospital admission. Charlson Comorbidity Index (CCI) is a validated, simple, and readily applicable method of estimating the risk of death from comorbid disease and has been widely used as a predictor of long-term prognosis and survival. METHODS: We performed a systematic review and meta-analysis of CCI score and a composite of poor outcomes through several databases. RESULTS: Compared to a CCI score of 0, a CCI score of 1-2 and CCI score of ≥3 was prognostically associated with mortality and associated with a composite of poor outcomes. Per point increase of CCI score also increased mortality risk by 16%. Moreover, a higher mean CCI score also significantly associated with mortality and disease severity. CONCLUSION: CCI score should be utilized for risk stratifications of hospitalized COVID-19 patients.


Assuntos
/mortalidade , Hospitalização/tendências , /diagnóstico , Comorbidade/tendências , Humanos , Estudos Prospectivos , Estudos Retrospectivos , Medição de Risco/tendências
4.
Risk Anal ; 40(S1): 2272-2299, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33145799

RESUMO

One-fifth of the way through the 21st century, a commonality of factors with those of the last 50 years may offer the opportunity to address unfinished business and current challenges. The recommendations include: (1) Resisting the tendency to oversimplify scientific assessments by reliance on single disciplines in lieu of clear weight-of-evidence expressions, and on single quantitative point estimates of health protective values for policy decisions; (2) Improving the separation of science and judgment in risk assessment through the use of clear expressions of the range of judgments that bracket protective quantitative levels for public health protection; (3) Use of comparative risk to achieve the greatest gains in health and the environment; and (4) Where applicable, reversal of the risk assessment and risk management steps to facilitate timely and substantive improvements in public health and the environment. Lessons learned and improvements in the risk assessment process are applied to the unprecedented challenges of the 21st century such as, pandemics and climate change. The beneficial application of the risk assessment and risk management paradigm to ensure timely research with consistency and transparency of assessments is presented. Institutions with mandated stability and leadership roles at the national and international levels are essential to ensure timely interdisciplinary scientific assessment at the interface with public policy as a basis for organized policy decisions, to meet time sensitive goals, and to inform the public.


Assuntos
Saúde Pública , Medição de Risco , Gestão de Riscos , /prevenção & controle , Mudança Climática/história , Saúde Ambiental , Medicina Baseada em Evidências , História do Século XX , História do Século XXI , Humanos , Pandemias/prevenção & controle , Formulação de Políticas , Saúde Pública/história , Saúde Pública/tendências , Política Pública/história , Política Pública/tendências , Medição de Risco/história , Medição de Risco/tendências , Gestão de Riscos/história , Gestão de Riscos/tendências , Estados Unidos , United States Government Agencies
6.
Vaccine ; 38(42): 6500-6507, 2020 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-32863069

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) was declared a pandemic in March 2020. Several prophylactic vaccines against COVID-19 are currently in development, yet little is known about people's acceptability of a COVID-19 vaccine. METHODS: We conducted an online survey of adults ages 18 and older in the United States (n = 2,006) in May 2020. Multivariable relative risk regression identified correlates of participants' willingness to get a COVID-19 vaccine (i.e., vaccine acceptability). RESULTS: Overall, 69% of participants were willing to get a COVID-19 vaccine. Participants were more likely to be willing to get vaccinated if they thought their healthcare provider would recommend vaccination (RR = 1.73, 95% CI: 1.49-2.02) or if they were moderate (RR = 1.09, 95% CI: 1.02-1.16) or liberal (RR = 1.14, 95% CI: 1.07-1.22) in their political leaning. Participants were also more likely to be willing to get vaccinated if they reported higher levels of perceived likelihood getting a COVID-19 infection in the future (RR = 1.05, 95% CI: 1.01-1.09), perceived severity of COVID-19 infection (RR = 1.08, 95% CI: 1.04-1.11), or perceived effectiveness of a COVID-19 vaccine (RR = 1.46, 95% CI: 1.40-1.52). Participants were less likely to be willing to get vaccinated if they were non-Latinx black (RR = 0.81, 95% CI: 0.74-0.90) or reported a higher level of perceived potential vaccine harms (RR = 0.95, 95% CI: 0.92-0.98). CONCLUSIONS: Many adults are willing to get a COVID-19 vaccine, though acceptability should be monitored as vaccine development continues. Our findings can help guide future efforts to increase COVID-19 vaccine acceptability (and uptake if a vaccine becomes available).


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Vacinação/psicologia , Adolescente , Adulto , Betacoronavirus/efeitos dos fármacos , Betacoronavirus/imunologia , Betacoronavirus/patogenicidade , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/virologia , Estudos Transversais , Humanos , Imunogenicidade da Vacina , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente/psicologia , Cooperação do Paciente/estatística & dados numéricos , Segurança do Paciente , Pneumonia Viral/imunologia , Pneumonia Viral/virologia , Medição de Risco/tendências , Recusa do Paciente ao Tratamento/psicologia , Recusa do Paciente ao Tratamento/estatística & dados numéricos , Estados Unidos/epidemiologia , Vacinas Virais/administração & dosagem
8.
Intern Emerg Med ; 15(8): 1435-1443, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32812204

RESUMO

Among patients with Coronavirus disease (COVID-19), the ability to identify patients at risk for deterioration during their hospital stay is essential for effective patient allocation and management. To predict patient risk for critical COVID-19 based on status at admission using machine-learning models. Retrospective study based on a database of tertiary medical center with designated departments for patients with COVID-19. Patients with severe COVID-19 at admission, based on low oxygen saturation, low partial arterial oxygen pressure, were excluded. The primary outcome was risk for critical disease, defined as mechanical ventilation, multi-organ failure, admission to the ICU, and/or death. Three different machine-learning models were used to predict patient deterioration and compared to currently suggested predictors and to the APACHEII risk-prediction score. Among 6995 patients evaluated, 162 were hospitalized with non-severe COVID-19, of them, 25 (15.4%) patients deteriorated to critical COVID-19. Machine-learning models outperformed the all other parameters, including the APACHE II score (ROC AUC of 0.92 vs. 0.79, respectively), reaching 88.0% sensitivity, 92.7% specificity and 92.0% accuracy in predicting critical COVID-19. The most contributory variables to the models were APACHE II score, white blood cell count, time from symptoms to admission, oxygen saturation and blood lymphocytes count. Machine-learning models demonstrated high efficacy in predicting critical COVID-19 compared to the most efficacious tools available. Hence, artificial intelligence may be applied for accurate risk prediction of patients with COVID-19, to optimize patients triage and in-hospital allocation, better prioritization of medical resources and improved overall management of the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/complicações , Aprendizado de Máquina/tendências , Pneumonia Viral/complicações , Medição de Risco/métodos , APACHE , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Estado Terminal/mortalidade , Estado Terminal/terapia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Curva ROC , Estudos Retrospectivos , Medição de Risco/tendências
9.
Aust J Gen Pract ; 49(8): 471-473, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32738857

RESUMO

BACKGROUND: Primary prevention of cardiovascular disease (CVD) has been traditionally guided by individual risk factors such hypertension and hypercholesterolaemia. An absolute risk-based approach is more effective. OBJECTIVE: The aim of this article is to outline the superiority of an absolute risk-based approach when compared with individual risk factor management for the primary prevention of CVD, and to elaborate on the derivation and use of the Australian absolute CVD risk calculator. DISCUSSION: An absolute risk-based approach is superior to the traditional individual risk factor approach when identifying which patients would benefit most from the prescription of blood pressure-lowering and lipid-lowering medications.


Assuntos
Doenças Cardiovasculares/classificação , Medição de Risco/normas , Idoso , Austrália/epidemiologia , Doenças Cardiovasculares/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco/métodos , Medição de Risco/tendências , Fatores de Risco
11.
Eur J Endocrinol ; 182(5): D1-D16, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32197235

RESUMO

Each year, the proportion of thyroid cancer patients presenting with low-risk disease is increasing. The shift in the landscape of thyroid cancer presentation is forcing clinicians to re-evaluate not only management but also surveillance paradigms. During the follow-up, patients are stratified considering their response to treatment and classified into one of the following response categories: excellent, biochemical incomplete, structural incomplete, or indeterminate. These categories reflect a real-time prognosis and thereby substantially influence and personalise disease management. Although at present, no guideline recommends stopping differentiated thyroid carcinoma (DTC) surveillance at any particular time point, the relatively low prevalence of treatment failures in low-risk patients may prompt early discontinuation of surveillance in this subgroup. Therefore, this debate will present an overview of the controversies surrounding the surveillance of low-risk patients with DTC.


Assuntos
Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/terapia , Intervalo Livre de Doença , Seguimentos , Humanos , Indução de Remissão/métodos , Medição de Risco/métodos , Medição de Risco/tendências , Neoplasias da Glândula Tireoide/epidemiologia , Fatores de Tempo
12.
Comput Inform Nurs ; 38(8): 415-423, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32205474

RESUMO

The incidence rate of pressure injury is a critical nursing quality indicator in clinic care; consequently, factors causing pressure injury are diverse and complex. The early prevention of pressure injury and monitoring of these complex high-risk factors are critical to reduce the patients' pain, prevent further surgical treatment, avoid prolonged hospital stay, decrease the risk of wound infection, and lower associated medical costs and expenses. Although a number of risk assessment scales of pressure injury have been adopted in various countries, their criteria are set for specific populations, which may not be suitable for the medical care systems of other countries. This study constructs three prediction models of inpatient pressure injury using machine learning techniques, including decision tree, logistic regression, and random forest. A total of 11 838 inpatient records were collected, and 30 sets of training samples were adopted for data analysis in the experiment. The experimental results and evaluations of the models suggest that the prediction model built using random forest had most favorable classification performance of 0.845. The critical risk factors for pressure injury identified in this study were skin integrity, systolic blood pressure, expression ability, capillary refill time, and level of consciousness.


Assuntos
Previsões/métodos , Aprendizado de Máquina/tendências , Lesão por Pressão/prevenção & controle , Distribuição de Qui-Quadrado , Humanos , Modelos Lineares , Lesão por Pressão/fisiopatologia , Medição de Risco/métodos , Medição de Risco/normas , Medição de Risco/tendências
13.
Mil Med ; 185(Suppl 1): 334-341, 2020 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-32074327

RESUMO

INTRODUCTION: Despite efforts in prevention, suicide rates in the US military remain unchanged. This article describes the development of a tool for leaders to identify and mitigate suicide risk factors. METHODS: A seven-item measure, the Leader Suicide Risk Assessment Tool (LSRAT), was constructed to allow leaders to assess and mitigate suicide drivers. During a 6-mo pilot, unit leaders completed the LSRAT for 161 at-risk soldiers. The LSRAT data were compared to clinical data from a subset of these soldiers. RESULTS: The LSRAT showed good test-retest reliability. The LSRAT scores showed significant correlations with both clinical and screening measures of suicidality. Command actions mitigated or partially mitigated 89% of risk factors identified on the LSRAT. CONCLUSIONS: This study provides initial psychometric data on a tool that prescribes concrete responses to mitigate risk. The LSRAT may be a valid and feasible tool to assist front-line commanders in identifying potential area's risk mitigation. Synchronization efforts between commanders, clinicians, and support services are crucial to ensure effective intervention to prevent suicide behavior.


Assuntos
Liderança , Psicometria/normas , Medição de Risco/métodos , Suicídio/psicologia , Adulto , Feminino , Humanos , Masculino , Projetos Piloto , Psicometria/instrumentação , Psicometria/métodos , Pesquisa Qualitativa , Reprodutibilidade dos Testes , Medição de Risco/tendências , Fatores de Risco , Suicídio/estatística & dados numéricos , Inquéritos e Questionários
14.
Artigo em Inglês | MEDLINE | ID: mdl-31878182

RESUMO

The article presents an assessment of the long-term variability of storm activity in the aspect of potential threats to aircraft. The analysis of data from the period 1970-2018 was conducted for selected airports in Poland: Gdansk Lech Walesa Airport, IATA code: GDN, ICAO code: EPGD (54°22'39″N 18°27'59″E, altitude above sea level 149 m above sea level); Solidarity Szczecin- Goleniow Airport, IATA code: SZZ, ICAO code: EPSC (53°35'05″ N 14°54'08″ E, altitude above sea level 47 m above sea level); Poznan-Lawica Henryk Wieniawski Airport, IATA code: POZ, ICAO code: EPPO (52°25'16″ N 16°49'35″ E, altitude above sea level 94 m above sea level); Warsaw Chopin Airport, IATA code: WAW, ICAO code: EPWA (52°09'57″ N 20°58'02″ E, altitude above sea level 110 m above sea level); Copernicus Airport Wroclaw, IATA code: WRO, ICAO code: EPWR (51°06'10″ N 16°53'10″ E, altitude above sea level 123 m above sea level); John Paul II International Airport Kraków-Balice, IATA code: KRK, ICAO code: EPKK (50°04'40″ N 19°47'06″ E, altitude above sea level 241 m above sea level). The purpose of this paper is to assess the long-term variability of storm activity in the aspect of potential threats to air operations in Poland with the examples of six selected airports. In order to achieve the goal, an analysis of the frequency of storm phenomena in Poland was carried out both in annual and long- term terms. The analysis will allow the assessment of the geographical diversity of the distribution of storm phenomena and their variability in the years 1970-2018. The next stage of the work will be to determine the climatic conditions that exert the greatest impact on the formation of storms. The important factors include atmospheric circulation, which, over the Polish territory, is shaped by the influence of air masses from the Atlantic Ocean, the Baltic Sea and in addition, from the vast continental area. All these air masses clash over the area of Poland causing large variability in the frequency of occurrence of hazardous atmospheric phenomena. For this reason, the Polish climate is defined as a moderate warm climate with transitory features. The important factors affecting regional diversity are local conditions, such as terrain, nature of the land, and distance from water reservoirs. The thermal, humidity and aerodynamic properties of the substrate, which are components of radiation processes, determine the exchange of energy at the interface between the atmosphere and the earth, and largely determine the intensity of selected hazardous atmospheric phenomena. Each occurrence of a storm is a potentially dangerous meteorological event that threatens the environment and human activities, including all types of transport. The studied phenomenon of storms is particularly dangerous for air transport. Literature shows that storm phenomena in Poland are characterized by a large regional diversity, both during the year and over many years. The greatest threat of storm phenomena occurs in the warm period of the year-spring and summer.


Assuntos
Aeronaves/estatística & dados numéricos , Aeroportos/estatística & dados numéricos , Aeroportos/tendências , Tempestades Ciclônicas/estatística & dados numéricos , Medição de Risco/estatística & dados numéricos , Medição de Risco/tendências , Estações do Ano , Previsões , Meteorologia , Polônia
16.
PLoS Biol ; 17(8): e3000372, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31465433

RESUMO

The 2016 Frank Lautenberg Chemical Safety for the 21st Century Act (Lautenberg TSCA) amended the 1976 Toxic Substances Control Act (TSCA) to mandate protection of susceptible and highly exposed populations. Program implementation entails a myriad of choices that can lead to different degrees of public health protections. Well-documented exposures to multiple industrial chemicals occur from air, soil, water, food, and products in our workplaces, schools, and homes. Many hazardous chemicals are associated with or known to cause health risks; for other industrial chemicals, no data exist to confirm their safety because of flaws in 1976 TSCA. Under the 2016 Lautenberg amendments, the United States Environmental Protection Agency (EPA) must evaluate chemicals against risk-based safety standards under enforceable deadlines, with an explicit mandate to identify and assess risks to susceptible and highly exposed populations. Effective public health protection requires EPA to implement the Lautenberg TSCA requirements by incorporating intrinsic and extrinsic factors that affect susceptibility, adequately assessing exposure among vulnerable groups, and accurately identifying highly exposed groups. We recommend key scientific and risk assessment principles to inform health-protective chemical policy such as consideration of aggregate exposures from all pathways and, when data are lacking, the use of health-protective defaults.


Assuntos
Segurança Química/legislação & jurisprudência , Conservação dos Recursos Naturais/legislação & jurisprudência , Conservação dos Recursos Naturais/métodos , Substâncias Perigosas/toxicidade , Humanos , Saúde Pública/legislação & jurisprudência , Medição de Risco/tendências , Estados Unidos , United States Environmental Protection Agency/legislação & jurisprudência
17.
Pediatrics ; 144(2)2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31278210

RESUMO

BACKGROUND AND OBJECTIVES: An early-onset sepsis (EOS) risk calculator tool to guide evaluation and treatment of infants at risk for sepsis has reduced antibiotic use without increased adverse outcomes. We performed an electronic health record (EHR)-driven quality improvement intervention to increase calculator use for infants admitted to a newborn nursery and reduce antibiotic treatment of infants at low risk for sepsis. METHODS: This 2-phase intervention included programming (1) an EHR form containing calculator fields that were external to the infant's admission note, with nonautomatic access to the calculator, education for end-users, and reviewing risk scores in structured bedside rounds and (2) discrete data entry elements into the EHR admission form with a hyperlink to the calculator Web site. We used statistical process control to assess weekly entry of risk scores and antibiotic orders and interrupted time series to assess trend of antibiotic orders. RESULTS: During phase 1 (duration, 14 months), a mean 59% of infants had EOS calculator scores entered. There was wide variability around the mean, with frequent crossing of weekly means beyond the 3σ control lines, indicating special-cause variation. During phase 2 (duration, 2 years), mean frequency of EOS calculator use increased to 85% of infants, and variability around the mean was within the 3σ control lines. The frequency of antibiotic orders decreased from preintervention (7%) to the final 6 months of phase 2 (1%, P < .001). CONCLUSIONS: An EHR-driven quality improvement intervention increased EOS calculator use and reduced antibiotic orders, with no increase in adverse events.


Assuntos
Antibacterianos/uso terapêutico , Registros Eletrônicos de Saúde/tendências , Sepse Neonatal/diagnóstico , Sepse Neonatal/tratamento farmacológico , Diagnóstico Precoce , Registros Eletrônicos de Saúde/normas , Feminino , Humanos , Recém-Nascido , Masculino , Sepse Neonatal/sangue , Medição de Risco/normas , Medição de Risco/tendências
18.
Transgenic Res ; 28(Suppl 2): 111-117, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31321693

RESUMO

Foundational activities at the international level underlie current risk and safety assessment approaches for genetically engineered/modified organisms (GEOs/GMOs). Early risk assessment considerations beginning with the OECD 'Blue Book' established risk/safety assessment as the characterization of the organism and its environmental release; establishment and persistence in the environment; and human and ecological effects, analyzed in principle through existing methods. Important in this context was recognition that GEOs/GMOs as a class did not represent new risks relative to products of traditional plant breeding and that any incremental risk would need to be established on a stepwise case-by-case comparative basis with existing crops and derived-foods as the baseline. Accordingly, concepts of familiarity and substantial equivalence were advanced by OECD and WHO as ways to establish a risk analysis baseline for determining whether and to what extent risk/safety assessment was needed. Regulatory implementations of this paradigm have skewed to increasingly complex portfolios of studies rather than adhering to analysis which is formulated to fit the risk/safety questions relevant to a given case. Plants produced through genome editing technology will benefit from risk analysis that implements sound problem formulation to guide the need for and nature of risk/safety assessments.


Assuntos
Produtos Agrícolas/genética , Inocuidade dos Alimentos , Alimentos Geneticamente Modificados , Plantas Geneticamente Modificadas/genética , Ecologia , Edição de Genes , Humanos , Medição de Risco/tendências
19.
J Wound Ostomy Continence Nurs ; 46(4): 291-297, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31274856

RESUMO

PURPOSE: The purpose of this study was to develop and compare 3 predictive models for pressure injury (PI) occurrence in surgical patients. DESIGN: Retrospective case-control study. SUBJECTS AND SETTING: Data on PI risk assessment and preanesthesia evaluation records from 400 patients (80 patients who developed PIs after surgery and 320 patients who did not) in a South Korean acute care setting who underwent surgery between January 2015 and May 2016 were extracted from the electronic health record. METHODS: Three models were developed with items from the Braden Scale (model 1), the Scott Triggers tool (model 2), and the Scott Triggers tool in addition to type of anesthesia, laboratory test results, and comorbid conditions (model 3) using logistic regression to analyze items (factors) in each model. Predictive performance indices, which included sensitivity, specificity, positive predictive value, negative predictive value, area under the receiver operating characteristics curve, and Akaike information criterion, were compared among the 3 models. RESULTS: Findings showed there were no significant factors in model 1, the estimated surgery time and serum albumin level were significant in model 2, and the estimated surgery time, serum albumin level, and brain disease were significant in model 3. The model performance evaluation revealed that model 2 was the best fitting model, demonstrating the highest sensitivity (84.4%), highest negative predictive value (94.6%), and lowest Akaike information criterion (302.03). CONCLUSIONS: The Scott Triggers tool in model 2, which consists of simple items that are easy to extract from preanesthesia evaluation records, was the best fitting model. We recommend the Scott Triggers tool be used to predict the development of PIs in surgical patients in acute care settings.


Assuntos
Lesão por Pressão/etiologia , Medição de Risco/métodos , Medição de Risco/normas , Atividades Cotidianas/classificação , Adulto , Estudos de Casos e Controles , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Percepção , Complicações Pós-Operatórias/epidemiologia , Lesão por Pressão/epidemiologia , Curva ROC , República da Coreia/epidemiologia , Estudos Retrospectivos , Medição de Risco/tendências , Fatores de Risco , Sensibilidade e Especificidade , Estatísticas não Paramétricas
20.
Arch Osteoporos ; 14(1): 66, 2019 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-31227921

RESUMO

The usage of FRAX® tool in Thailand and other countries was explored using Google Analytics data. Over the period 2010-2018, Thailand ranked 35th in the world for FRAX usage (the US is ranked first). Incorporation of FRAX into a national osteoporosis guideline in Thailand appears to have increased its usage. PURPOSE: To document access to the web-based FRAX® tool and specifically its access in Thailand between 2010 and 2018. METHODS: A descriptive retrospective study using data from Google Analytics that provides numerical and geographical information on internet access to the FRAX tool website worldwide. RESULT: In Thailand, Bangkok is the highest ranked site for FRAX access with more than 20,000 usage sessions since 2010 (3.6 usage session per 1000 population) followed by Khon Kaen and Chiang Mai. It has been accessed from within 76 out of 77 provinces (98.7%). There was a steady increase in access to FRAX from within Thailand of approximately 1000 usage sessions per year between 2010 and 2016. After the FRAX fracture risk calculation was included in the national guideline for osteoporosis management published in late 2016, the rate of increase in access was four-fold higher compared with the previous period. In world ranking, the USA is the country with the most frequent access to the FRAX tool, whereas Thailand was ranked 35th in the world. There were weak but significant correlations between the absolute number of FRAX sessions and population size (r = 0.165, p = 0.011) and land area (r = 0.375, p < 0.001). CONCLUSION: Access to the FRAX tool website is increasing in Thailand. The incorporation of FRAX into national guidelines, in parallel to the adoption of osteoporosis fracture prevention into national policy, has had a rapid and significant impact on its use.


Assuntos
Osteoporose/complicações , Fraturas por Osteoporose , Humanos , Estudos Retrospectivos , Medição de Risco/normas , Medição de Risco/estatística & dados numéricos , Medição de Risco/tendências , Fatores de Risco , Tailândia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA