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Article ; Online: Short-term forecasts of expected deaths.

Rizzi, Silvia / Vaupel, James W

Proceedings of the National Academy of Sciences of the United States of America

2021 Volume 118, Issue 15

Abstract: ... Sweden did not. We make forecasts by age and sex to predict expected deaths if COVID-19 had not struck ... We introduce a method for making short-term mortality forecasts of a few months, illustrating ... Subtracting these forecasts from observed deaths gives the excess death count. Excess deaths were lower ...

Abstract	We introduce a method for making short-term mortality forecasts of a few months, illustrating it by estimating how many deaths might have happened if some major shock had not occurred. We apply the method to assess excess mortality from March to June 2020 in Denmark and Sweden as a result of the first wave of the coronavirus pandemic; associated policy interventions; and behavioral, healthcare, social, and economic changes. We chose to compare Denmark and Sweden because reliable data were available and because the two countries are similar but chose different responses to COVID-19: Denmark imposed a rather severe lockdown; Sweden did not. We make forecasts by age and sex to predict expected deaths if COVID-19 had not struck. Subtracting these forecasts from observed deaths gives the excess death count. Excess deaths were lower in Denmark than Sweden during the first wave of the pandemic. The later/earlier ratio we propose for shortcasting is easy to understand, requires less data than more elaborate approaches, and may be useful in many countries in making both predictions about the future and the past to study the impact on mortality of coronavirus and other epidemics. In the application to Denmark and Sweden, prediction intervals are narrower and bias is less than when forecasts are based on averages of the last 5 y, as is often done. More generally, later/earlier ratios may prove useful in short-term forecasting of illnesses and births as well as economic and other activity that varies seasonally or periodically.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; COVID-19/mortality ; Child ; Child, Preschool ; Denmark/epidemiology ; Female ; Forecasting ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Pandemics ; SARS-CoV-2/isolation & purification ; Sweden/epidemiology ; Young Adult
Language	English
Publishing date	2021-05-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	209104-5
ISSN	1091-6490 ; 0027-8424
ISSN (online)	1091-6490
ISSN	0027-8424
DOI	10.1073/pnas.2025324118
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Article ; Online: Poor short-term outcomes for prognostic high-risk patients with chronic limb-threatening ischemia undergoing endovascular therapy.

Takei, Tatsuro / Kajiya, Takashi / Ohura, Norihiko / Tomimura, Natsuko / Kamiyama, Takuro / Ninomiya, Toshiko / Takaoka, Junichiro / Atsuchi, Nobuhiko

CVIR endovascular

2024 Volume 7, Issue 1, Page(s) 31

Abstract: ... to evaluate short-term prognosis and wound healing rates using the prognostic predictors (PPs) indicated above ... with an expected life expectancy of 2 or more years, which significantly influences treatment decisions. However, death ... p = 0.086).: Conclusions: The assessment of short-term prognosis and wound healing rates using ...

Abstract	Background: The prognosis of chronic limb-threatening ischemia (CLTI) is poor, with an expected life expectancy of 2 or more years, which significantly influences treatment decisions. However, death may occur at the early stages of treatment for wound healing, and aggressive treatment may limit the quality of life of such patients. In patients with CLTI undergoing endovascular therapy (EVT), the Wound, Ischemia, and foot Infection (WIfI) clinical stage, male sex, older age, non-ambulatory status, low body mass index, and dialysis have been reported as predictors of mortality risk. However, most studies have not fully investigated the WIFI clinical stage as a prognostic predictor of CLTI. This study aimed to evaluate short-term prognosis and wound healing rates using the prognostic predictors (PPs) indicated above in risk-stratified patients with CLTI who underwent EVT. Methods: This retrospective single-center observational study included 61 CLTI patients undergoing EVT from April 2020 to October 2022. The patients were divided into a high-risk group (PPs ≥ 4, n = 20) and low-risk group (PPs ≤ 3, n = 41) according to the number of PPs. Survival and wound healing rates within one year were compared between these two groups. Results: The mean age of the patients was 74.7 ± 1.6 years, and 42 (68.9%) were male. Among these patients, the high-risk group compared with the low-risk group had a significantly worse survival rate within one year (46.4% vs. 84.7%, log-rank p < 0.001). Fifteen patients died within one year. Of these, seven deaths were cardiovascular deaths and six were deaths from infectious diseases. Cox proportional hazards analysis showed that WIfI clinical stage 4 (p = 0.043, hazard ratio [HR] = 4.85) and the male sex (p = 0.037, HR = 6.34) influenced the prognosis of this population. The high-risk group tended to have a worse wound healing rate within one year than that had by the low-risk group (55.4% vs. 83.0%, log-rank p = 0.086). Conclusions: The assessment of short-term prognosis and wound healing rates using PPs may be useful. Discussing the results of short-term clinical outcome assessments with patients should be considered when determining their individualized treatment plans.
Language	English
Publishing date	2024-03-19
Publishing country	Switzerland
Document type	Journal Article
ISSN	2520-8934
ISSN (online)	2520-8934
DOI	10.1186/s42155-024-00443-9
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Article ; Online: Comparing the current short-term cancer incidence prediction models in Brazil with state-of-the-art time-series models.

Bouzon Nagem Assad, Daniel / Gomes Ferreira da Costa, Patricia / Spiegel, Thaís / Cara, Javier / Ortega-Mier, Miguel / Monteiro Scaff, Alfredo

Scientific reports

2024 Volume 14, Issue 1, Page(s) 4566

Abstract: ... this can guide oncological research towards more accurate estimates that align with the expected demand ... The World Health Organization has highlighted that cancer was the second-highest cause of death ... in 2019. This research aims to present the current forecasting techniques found in the literature, applied ...

Abstract	The World Health Organization has highlighted that cancer was the second-highest cause of death in 2019. This research aims to present the current forecasting techniques found in the literature, applied to predict time-series cancer incidence and then, compare these results with the current methodology adopted by the Instituto Nacional do Câncer (INCA) in Brazil. A set of univariate time-series approaches is proposed to aid decision-makers in monitoring and organizing cancer prevention and control actions. Additionally, this can guide oncological research towards more accurate estimates that align with the expected demand. Forecasting techniques were applied to real data from seven types of cancer in a Brazilian district. Each method was evaluated by comparing its fit with real data using the root mean square error, and we also assessed the quality of noise to identify biased models. Notably, three methods proposed in this research have never been applied to cancer prediction before. The data were collected from the INCA website, and the forecast methods were implemented using the R language. Conducting a literature review, it was possible to draw comparisons previous works worldwide to illustrate that cancer prediction is often focused on breast and lung cancers, typically utilizing a limited number of time-series models to find the best fit for each case. Additionally, in comparison to the current method applied in Brazil, it has been shown that employing more generalized forecast techniques can provide more reliable predictions. By evaluating the noise in the current method, this research shown that the existing prediction model is biased toward two of the studied cancers Comparing error results between the mentioned approaches and the current technique, it has been shown that the current method applied by INCA underperforms in six out of seven types of cancer tested. Moreover, this research identified that the current method can produce a biased prediction for two of the seven cancers evaluated. Therefore, it is suggested that the methods evaluated in this work should be integrated into the INCA cancer forecast methodology to provide reliable predictions for Brazilian healthcare professionals, decision-makers, and oncological researchers.
MeSH term(s)	Humans ; Brazil/epidemiology ; Incidence ; Breast ; Forecasting ; Neoplasms/epidemiology
Language	English
Publishing date	2024-02-25
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-55230-2
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Article ; Online: Optimal timing for the Modified Early Warning Score for prediction of short-term critical illness in the acute care chain: a prospective observational study.

Veldhuis, Lars Ingmar / Kuit, Merijn / Karim, Liza / Ridderikhof, Milan L / Nanayakkara, Prabath Wb / Ludikhuize, Jeroen

Emergency medicine journal : EMJ

2024

Abstract: ... consciousness, as these values were expected not to deviate. Critical illness was defined as requiring ... intensive care unit admission, myocardial infarction or death within 72 hours after ED presentation. Accuracy ... chain MEWS has the highest accuracy in predicting critical illness.: Methods: Adult patients brought ...

Abstract	Introduction: The Modified Early Warning Score (MEWS) is an effective tool to identify patients in the acute care chain who are likely to deteriorate. Although it is increasingly being implemented in the ED, the optimal moment to use the MEWS is unknown. This study aimed to determine at what moment in the acute care chain MEWS has the highest accuracy in predicting critical illness. Methods: Adult patients brought by ambulance to the ED at both locations of the Amsterdam UMC, a level 1 trauma centre, were prospectively included between 11 March and 28 October 2021. MEWS was calculated using vital parameters measured prehospital, at ED presentation, 1 hour and 3 hours thereafter, imputing for missing temperature and/or consciousness, as these values were expected not to deviate. Critical illness was defined as requiring intensive care unit admission, myocardial infarction or death within 72 hours after ED presentation. Accuracy in predicting critical illness was assessed using the area under the receiver operating characteristics curve (AUROC). Results: Of the 790 included patients, critical illness occurred in 90 (11.4%). MEWS based on vital parameters at ED presentation had the highest performance in predicting critical illness with an AUROC of 0.73 (95% CI 0.67 to 0.79) but did not significantly differ compared with other moments. Patients with an increasing MEWS over time are significantly more likely to become critical ill compared with patients with an improving MEWS. Conclusion: The performance of MEWS is moderate in predicting critical illness using vital parameters measured surrounding ED admission. However, an increase of MEWS during ED admission is correlated with the development of critical illness. Therefore, early recognition of deteriorating patients at the ED may be achieved by frequent MEWS calculation. Further studies should investigate the effect of continuous monitoring of these patients at the ED.
Language	English
Publishing date	2024-05-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2040124-3
ISSN	1472-0213 ; 1472-0205
ISSN (online)	1472-0213
ISSN	1472-0205
DOI	10.1136/emermed-2022-212733
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Article ; Online: Impact of Short-Term Exposure to Extreme Temperatures on Mortality

Claire Demoury / Raf Aerts / Bram Vandeninden / Bert Van Schaeybroeck / Eva M. De Clercq

International Journal of Environmental Research and Public Health, Vol 19, Iss 3763, p

A Multi-City Study in Belgium

2022 Volume 3763

Abstract: ... natural deaths, the mortality risk associated to low temperature was 1.32 (95% CI: 1.21–1.44) and 1.21 (95 ... In light of climate change, health risks are expected to be exacerbated by more frequent high ... for current and future public health interventions and prevention strategies. ...

Abstract	In light of climate change, health risks are expected to be exacerbated by more frequent high temperatures and reduced by less frequent cold extremes. To assess the impact of different climate change scenarios, it is necessary to describe the current effects of temperature on health. A time-stratified case-crossover design fitted with conditional quasi-Poisson regressions and distributed lag non-linear models was applied to estimate specific temperature-mortality associations in nine urban agglomerations in Belgium, and a random-effect meta-analysis was conducted to pool the estimates. Based on 307,859 all-cause natural deaths, the mortality risk associated to low temperature was 1.32 (95% CI: 1.21–1.44) and 1.21 (95% CI: 1.08–1.36) for high temperature relative to the minimum mortality temperature (23.1 °C). Both cold and heat were associated with an increased risk of cardiovascular and respiratory mortality. We observed differences in risk by age category, and women were more vulnerable to heat than men. People living in the most built-up municipalities were at higher risk for heat. Air pollutants did not have a confounding effect. Evidence from this study helps to identify specific populations at risk and is important for current and future public health interventions and prevention strategies.
Keywords	climate change ; temperature ; cause-specific mortality ; case-crossover ; DLNM ; vulnerability ; Medicine ; R
Subject code	310
Language	English
Publishing date	2022-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A modelling assessment of short- and medium-term risks of programme interruptions for gambiense human African trypanosomiasis in the DRC.

Huang, Ching-I / Crump, Ronald E / Crowley, Emily H / Hope, Andrew / Bessell, Paul R / Shampa, Chansy / Mwamba Miaka, Erick / Rock, Kat S

PLoS neglected tropical diseases

2023 Volume 17, Issue 4, Page(s) e0011299

Abstract: Gambiense human African trypanosomiasis (gHAT) is a deadly vector-borne, neglected tropical disease ... as in 2019, we expect a marginal negative impact on transmission, however this depends on the strength ... predicted to be delayed by more than one additional year compared to the length of the interruption ...

Abstract	Gambiense human African trypanosomiasis (gHAT) is a deadly vector-borne, neglected tropical disease found in West and Central Africa targeted for elimination of transmission (EoT) by 2030. The recent pandemic has illustrated how it can be important to quantify the impact that unplanned disruption to programme activities may have in achieving EoT. We used a previously developed model of gHAT fitted to data from the Democratic Republic of the Congo, the country with the highest global case burden, to explore how interruptions to intervention activities, due to e.g. COVID-19, Ebola or political instability, could impact progress towards EoT and gHAT burden. We simulated transmission and reporting dynamics in 38 regions within Kwilu, Mai Ndombe and Kwango provinces under six interruption scenarios lasting for nine or twenty-one months. Included in the interruption scenarios are the cessation of active screening in all scenarios and a reduction in passive detection rates and a delay or suspension of vector control deployments in some scenarios. Our results indicate that, even under the most extreme 21-month interruption scenario, EoT is not predicted to be delayed by more than one additional year compared to the length of the interruption. If existing vector control deployments continue, we predict no delay in achieving EoT even when both active and passive screening activities are interrupted. If passive screening remains as functional as in 2019, we expect a marginal negative impact on transmission, however this depends on the strength of passive screening in each health zone. We predict a pronounced increase in additional gHAT disease burden (morbidity and mortality) in many health zones if both active and passive screening were interrupted compared to the interruption of active screening alone. The ability to continue existing vector control during medical activity interruption is also predicted to avert a moderate proportion of disease burden.
MeSH term(s)	Animals ; Humans ; Trypanosomiasis, African/epidemiology ; Trypanosomiasis, African/prevention & control ; Trypanosomiasis, African/diagnosis ; Trypanosoma brucei gambiense ; Democratic Republic of the Congo/epidemiology ; COVID-19
Language	English
Publishing date	2023-04-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2735
ISSN (online)	1935-2735
ISSN	1935-2735
DOI	10.1371/journal.pntd.0011299
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Article ; Online: A multi-institutional study of short-term mortality in COVID-positive patients undergoing hip fracture surgery: is survival better than expected?

Foster, Jeffrey A / Landy, David C / Pectol, Richard W / Annamalai, Ramkumar T / Aneja, Arun

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie

2023 Volume 34, Issue 1, Page(s) 285–291

Abstract: ... a statistically significant predictor of 30-day mortality (p = 0.01), with all deaths occurring in patients over ... term mortality, the clinical situation may not be as dire as initially described, which may reflect ... may be better than initially reported. While COVID-positive patients with hip fractures have high short ...

Abstract	Purpose: Early reports of 30-day mortality in COVID-positive patients with hip fracture were often over 30% and were higher than historical rates of 10% in pre-COVID studies. We conducted a multi-institutional retrospective cohort study to determine whether the incidence of 30-day mortality and complications in COVID-positive patients undergoing hip fracture surgery is as high as initially reported. Methods: A retrospective chart review was performed at 11 level I trauma centers from January 1, 2020 to May 1, 2022. Patients 50 years or older undergoing hip fracture surgery with a positive COVID test at the time of surgery were included. The primary outcome measurements were the incidence of 30-day mortality and complications. Post-operative outcomes were reported using proportions with 95% confidence interval (C.I.). Results: Forty patients with a median age of 71.5 years (interquartile range, 50-87 years) met the criteria. Within 30-days, four patients (10%; 95% C.I. 3-24%) died, four developed pneumonia, three developed thromboembolism, and three remained intubated post-operatively. Increased age was a statistically significant predictor of 30-day mortality (p = 0.01), with all deaths occurring in patients over 80 years. Conclusion: In this multi-institutional analysis of COVID-positive patients undergoing hip fracture surgery, 30-day mortality was 10%. The 95% C.I. did not include 30%, suggesting that survival may be better than initially reported. While COVID-positive patients with hip fractures have high short-term mortality, the clinical situation may not be as dire as initially described, which may reflect initial publication bias, selection bias introduced by testing, or other issues. Levels of evidence: Therapeutic Level III.
MeSH term(s)	Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Retrospective Studies ; COVID-19/complications ; Postoperative Complications/etiology ; Hip Fractures/complications ; Hip Fractures/surgery ; Hip Fractures/epidemiology ; Hospital Mortality
Language	English
Publishing date	2023-07-18
Publishing country	France
Document type	Multicenter Study ; Journal Article
ZDB-ID	1231084-0
ISSN	1432-1068 ; 1633-8065 ; 0948-4817 ; 0940-3264
ISSN (online)	1432-1068
ISSN	1633-8065 ; 0948-4817 ; 0940-3264
DOI	10.1007/s00590-023-03620-z
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Article: Predicting Prognosis in Internal Medicine: A Short and Long-Term Mortality Comparison Analysis.

Guerreiro, Renato / Henriques, Célia / Trevas, Sara / Gouveia, Cláudio / Roldão, Marta / Egídio de Sousa, Inês / Faria, Catarina / Pimenta, Gonçalo / Araújo, Inês / Fonseca, Candida

Cureus

2022 Volume 14, Issue 1, Page(s) e21734

Abstract: ... mortality, and adequate care. We aimed to study short and long-term mortality and predictors of all-cause ... were independent predictors of short-term (p<0.001, p=0.001, p<0.001, respectively) and long-term (p<0 ... of the population died in the follow-up period (51.5%). Deaths were significantly higher in the first six months ...

Abstract	Introduction The marked increase in life expectancy seen in Portugal in the last five decades led to a change in the profile of patients being most commonly admitted in internal medicine wards. In deciding the best care for these patients, prognostication models are needed in order to reduce readmissions, mortality, and adequate care. We aimed to study short and long-term mortality and predictors of all-cause mortality, independently of cause admission, of patients admitted in an internal medicine ward. Methods This two-part, single-center study enrolled patients from October 2013 to October 2014 with a follow-up of 60 months. Results A total of 681 patients were included; the mean age was 75.86 years with 60.4% females. The most frequent comorbidities were anemia, hypertension, and renal impairment. More than half of the population died in the follow-up period (51.5%). Deaths were significantly higher in the first six months after discharge (53% of all deaths) and then decreased abruptly to 11.6% in the second half-year after discharge. Based on the multivariate logistic regression model, with age over 80 years, anemia and neoplasm were independent predictors of short-term (p<0.001, p=0.001, p<0.001, respectively) and long-term (p<0.001 for the three conditions) mortality. Heart failure (p=0.018) and diabetes (p=0.025) were also predictors of long-term mortality. Conclusion High mortality, mainly in the first six months after discharge, elicits strategies targeting transition of care and close follow-up in the first months, which can be the key to improving outcomes. Identification of patients at higher risk may help design realistic models aiming to improve care for this frail population and decrease morbimortality.
Language	English
Publishing date	2022-01-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.21734
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Article ; Online: What is the best fitness measure in wild populations? A case study on the power of short-term fitness proxies to predict reproductive value.

Alif, Živa / Dunning, Jamie / Chik, Heung Ying Janet / Burke, Terry / Schroeder, Julia

PloS one

2022 Volume 17, Issue 4, Page(s) e0260905

Abstract: ... from birth to death is often impossible. Wild study systems therefore use short-term fitness metrics ... values and lineage survival to the end of the study period. The three short-term fitness proxies predict ... with the reproductive values. The commonly used short-term fitness proxies best predict long-term fitness when measured ...

Abstract	Fitness is at the core of evolutionary theory, but it is difficult to measure accurately. One way to measure long-term fitness is by calculating the individual's reproductive value, which represents the expected number of allele copies an individual passes on to distant future generations. However, this metric of fitness is scarcely used because the estimation of individual's reproductive value requires long-term pedigree data, which is rarely available in wild populations where following individuals from birth to death is often impossible. Wild study systems therefore use short-term fitness metrics as proxies, such as the number of offspring produced. This study compared two frequently used short-term metrics for fitness obtained at different offspring life stages (eggs, hatchlings, fledglings and recruits), and compared their ability to predict reproductive values derived from the genetic pedigree of a wild passerine bird population. We used twenty years of precise field observations and a near-complete genetic pedigree to calculate reproductive success, individual growth rate and de-lifed fitness as lifetime fitness measures, and as annual de-lifed fitness. We compared the power of these metrics to predict reproductive values and lineage survival to the end of the study period. The three short-term fitness proxies predict the reproductive values and lineage survival only when measured at the recruit stage. There were no significant differences between the different fitness proxies at the same offspring stages in predicting the reproductive values and lineage survival. Annual fitness at one year old predicted reproductive values equally well as lifetime de-lifed fitness. However, none of the short-term fitness proxies were strongly associated with the reproductive values. The commonly used short-term fitness proxies best predict long-term fitness when measured at recruitment stage. Thus, because lifetime fitness measured at recruit stage and annual fitness in the first year of life were the best proxies of long-term fitness in short-lived birds, we encourage their future use.
MeSH term(s)	Animals ; Animals, Wild/genetics ; Biological Evolution ; Genetic Fitness ; Passeriformes/genetics ; Pedigree ; Reproduction/genetics
Language	English
Publishing date	2022-04-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0260905
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Article ; Online: Impact of Short-Term Exposure to Extreme Temperatures on Mortality: A Multi-City Study in Belgium.

Demoury, Claire / Aerts, Raf / Vandeninden, Bram / Van Schaeybroeck, Bert / De Clercq, Eva M

International journal of environmental research and public health

2022 Volume 19, Issue 7

Abstract: ... natural deaths, the mortality risk associated to low temperature was 1.32 (95% CI: 1.21-1.44) and 1.21 (95 ... In light of climate change, health risks are expected to be exacerbated by more frequent high ... for current and future public health interventions and prevention strategies. ...

Abstract	In light of climate change, health risks are expected to be exacerbated by more frequent high temperatures and reduced by less frequent cold extremes. To assess the impact of different climate change scenarios, it is necessary to describe the current effects of temperature on health. A time-stratified case-crossover design fitted with conditional quasi-Poisson regressions and distributed lag non-linear models was applied to estimate specific temperature-mortality associations in nine urban agglomerations in Belgium, and a random-effect meta-analysis was conducted to pool the estimates. Based on 307,859 all-cause natural deaths, the mortality risk associated to low temperature was 1.32 (95% CI: 1.21-1.44) and 1.21 (95% CI: 1.08-1.36) for high temperature relative to the minimum mortality temperature (23.1 °C). Both cold and heat were associated with an increased risk of cardiovascular and respiratory mortality. We observed differences in risk by age category, and women were more vulnerable to heat than men. People living in the most built-up municipalities were at higher risk for heat. Air pollutants did not have a confounding effect. Evidence from this study helps to identify specific populations at risk and is important for current and future public health interventions and prevention strategies.
MeSH term(s)	Air Pollutants/analysis ; Belgium/epidemiology ; Cities/epidemiology ; Cold Temperature ; Female ; Hot Temperature ; Humans ; Male ; Mortality ; Temperature
Chemical Substances	Air Pollutants
Language	English
Publishing date	2022-03-22
Publishing country	Switzerland
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph19073763
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