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Article ; Online: Hospital mortality and length of stay differences in emergency medical admissions related to 'on-call' specialty.

Conway, Richard P / Byrne, Declan G / O'Riordan, Deirdre M R / Silke, Bernard

2022 Volume 192, Issue 3, Page(s) 1427–1433

Abstract: ... 85.9% vs. 81.3%; p < 0.001), Charlson Index (> group 0; 61.5% vs. 54.6%; p < 0.001), and Comorbidity ... Score (40.7% vs. 36.7%; p < 0.001). Over time, there was a small (+ 8%) but significant increase in 30 ...

Abstract	Background: The outcomes of acute medical admissions have been shown to be influenced by a variety of factors including system, patient, societal, and physician-specific differences. Aim: To evaluate the influence of on-call specialty on outcomes in acute medical admissions. Methods: All acute medical admissions to our institution from 2015 to 2020 were evaluated. Admissions were grouped based on admitting specialty. Thirty-day in-hospital mortality and length of stay (LOS) were evaluated. Data was analysed using multivariable logistic regression and truncated Poisson regression modelling. Results: There were 50,347 admissions in 30,228 patients. The majority of admissions were under Acute Medicine (47.0%), and major medical subspecialties (36.1%); Elderly Care admitted 12.1%. Acute Medicine admissions were older at 72.9 years (IQR 57.0, 82.9) vs. 67.2 years (IQR 50.1, 80.2), had higher Acute Illness Severity (grades 4-6: 85.9% vs. 81.3%; p < 0.001), Charlson Index (> group 0; 61.5% vs. 54.6%; p < 0.001), and Comorbidity Score (40.7% vs. 36.7%; p < 0.001). Over time, there was a small (+ 8%) but significant increase in 30-day in-hospital mortality. Mortality rates for Acute Medicine, major medical specialties, and Elderly Care were not different at 5.1% (95% CI: 4.7, 5.5), 4.7% (95% CI: 4.3, 5.1), and 4.7% (95% CI: 3.9, 5.4), respectively. Elderly Care admissions had shorter LOS (7.8 days (95% CI: 7.6, 8.0)) compared with either Acute Medicine (8.7 days (95% CI: 8.6, 8.8)) or major medical specialties (8.7 days (95% CI: 8.6, 8.9)). Conclusion: No difference in mortality and minor differences in LOS were observed. The prior pattern of improved outcomes year on year for emergency medical admissions appears ended.
MeSH term(s)	Humans ; Length of Stay ; Hospital Mortality ; Emergency Service, Hospital ; Hospitalization ; Medicine ; Retrospective Studies
Language	English
Publishing date	2022-07-08
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	390895-1
ISSN	1863-4362 ; 0021-1265
ISSN (online)	1863-4362
ISSN	0021-1265
DOI	10.1007/s11845-022-03084-w
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Article ; Online: Emergency medical admissions and COVID-19: impact on 30-day mortality and hospital length of stay.

Conway, Richard P / Byrne, Declan G / O'Riordan, Deirdre M R / Kent, Brian D / Kennedy, Barry M J / Cheallaigh, Clíona M Ní / O'Connell, Brian P / Akasheh, Nadim B / Browne, Joseph G / Silke, Bernard M

Irish journal of medical science

2021 Volume 191, Issue 4, Page(s) 1905–1911

Abstract: Background: The COVID-19 pandemic has put considerable strain on healthcare systems.: Aim: To investigate the effect of the COVID-19 pandemic on 30-day in-hospital mortality, length of stay (LOS) and resource utilization in acute medical care.: ... ...

Abstract	Background: The COVID-19 pandemic has put considerable strain on healthcare systems. Aim: To investigate the effect of the COVID-19 pandemic on 30-day in-hospital mortality, length of stay (LOS) and resource utilization in acute medical care. Methods: We compared emergency medical admissions to a single secondary care centre during 2020 to the preceding 18 years (2002-2019). We investigated 30-day in-hospital mortality with a multiple variable logistic regression model. Utilization of procedures/services was related to LOS with zero truncated Poisson regression. Results: There were 132,715 admissions in 67,185 patients over the 19-year study. There was a linear reduction in 30-day in-hospital mortality over time; over the most recent 5 years (2016-2020), there was a relative risk reduction of 36%, from 7.9 to 4.3% with a number needed to treat of 27.7. Emergency medical admissions increased 18.8% to 10,452 in 2020 with COVID-19 admissions representing 3.5%. 18.6% of COVID-19 cases required ICU admission with a median stay of 10.1 days (IQR 3.8, 16.0). COVID-19 was a significant univariate predictor of 30-day in-hospital mortality, 18.5% (95%CI: 13.9, 23.1) vs. 3.0% (95%CI: 2.7, 3.4)-OR 7.3 (95%CI: 5.3, 10.1). ICU admission was the dominant outcome predictor-OR 12.4 (95%CI: 7.7, 20.1). COVID-19 mortality in the last third of 2020 improved-OR 0.64 (95%CI: 0.47, 0.86). Hospital LOS and resource utilization were increased. Conclusion: A diagnosis of COVID-19 was associated with significantly increased mortality and LOS but represented only 3.5% of admissions and did not attenuate the established temporal decline in overall in-hospital mortality.
MeSH term(s)	COVID-19/therapy ; Hospital Mortality ; Hospitals ; Humans ; Length of Stay ; Pandemics ; Patient Admission ; Retrospective Studies
Language	English
Publishing date	2021-08-30
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	390895-1
ISSN	1863-4362 ; 0021-1265
ISSN (online)	1863-4362
ISSN	0021-1265
DOI	10.1007/s11845-021-02752-7
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Article ; Online: Lung function and outcomes in emergency medical admissions.

Akasheh, Nadim / Byrne, Declan / Coss, Peter / Conway, Richard / Cournane, Seán / O'Riordan, Deirdre / Silke, Bernard

European journal of internal medicine

2018 Volume 59, Page(s) 34–38

Abstract: ... 2.9: p = 0.08).: Conclusion: The 30-day mortality outcome was clearly related to the pre ...

Abstract	Background: We examine the ability of pre-existing measures of Forced Expiratory Volume in 1 s (FEV1), and Diffusion Capacity for Carbon Monoxide (DLCO) to determine the subsequent 30-day mortality outcome following unselected acute medical admission. Methods: Between 2002 and 2017, we studied all emergency medical admissions (106,586 episodes in 54,928 patients) of whom 8071 were classified as respiratory. We employed logisitic multiple variable regression models to evaluate the ability of FEV1 or DLCO to predict the 30-day hospital mortality outcome. Results: The 30-day hospital episode mortality outcome demonstrated curvilinear relationships to the underlying FEV1 or DLCO values; adjusted for major outcome predictors, a higher FEV1 - OR 0.85 (95% CI: 0.82, 0.89) or DLCO OR 0.76 (95% CI: 0.73, 0.79) values predicted survival. The range of predicted mortalities was from 3.3% (95% CI: 2.5, 4.0) to 23.5% (95% CI: 20.8, 26.2); the FEV1 (Model1) and DLCO (Model2) outcome prediction was essentially equivalent (Chi2 = 2.9: p = 0.08). Conclusion: The 30-day mortality outcome was clearly related to the pre-admission FEV1 and DLCO value. The outcome relationship was curvilinear. Either parameter appears a useful tool to explore hospital outcomes. Previously suggested cut-points are likely an artefact and not supported by these data.
MeSH term(s)	Adult ; Aged ; Carbon Monoxide/blood ; Emergency Service, Hospital/statistics & numerical data ; Female ; Forced Expiratory Volume ; Hospital Mortality ; Humans ; Ireland/epidemiology ; Logistic Models ; Lung/physiopathology ; Male ; Middle Aged ; Prognosis ; Severity of Illness Index
Chemical Substances	Carbon Monoxide (7U1EE4V452)
Language	English
Publishing date	2018-09-20
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1038679-8
ISSN	1879-0828 ; 0953-6205
ISSN (online)	1879-0828
ISSN	0953-6205
DOI	10.1016/j.ejim.2018.09.010
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Article: Extending the Grazing Period for Bulls, Prior to Finishing on a Concentrate Ration: Composition, Collagen Structure and Organoleptic Characteristics of Beef.

Mezgebo, Gebrehawerya B / Monahan, Frank J / McGee, Mark / O'Riordan, Edward G / Marren, Declan / Listrat, Anne / Picard, Brigitte / Richardson, R Ian / Moloney, Aidan P

Foods (Basel, Switzerland)

2019 Volume 8, Issue 7

Abstract: The biochemical and organoleptic characteristics of the longissimus thoracis muscle from suckler bulls ( ...

Abstract	The biochemical and organoleptic characteristics of the longissimus thoracis muscle from suckler bulls (
Language	English
Publishing date	2019-07-23
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2704223-6
ISSN	2304-8158
ISSN	2304-8158
DOI	10.3390/foods8070278
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Article ; Online: Outcomes in acute medicine - Evidence from extended observations on readmissions, hospital length of stay and mortality outcomes.

Conway, Richard / Byrne, Declan / O'Riordan, Deirdre / Silke, Bernard

European journal of internal medicine

2019 Volume 66, Page(s) 69–74

Abstract: ... p = .001). Calculated per admission the 30-day in-hospital mortality was 4.5% (95%CI 4.4% to 4.6 ...

Abstract	Background: The Acute Medical Admission Unit (AMAU) model of care has been widely deployed, we examine changes in hospital readmission rates, length of stay (LOS) and 30-day in-hospital mortality over 16 years. Methods: All emergency medical admissions between 2002 and 2017 were examined. We assessed 30-day in-hospital mortality, readmission rates, and LOS using logistic regression and margins statistics modelled outcomes against predictor variables. Results: There were 106,586 admissions in 54,928 patients over 16 years. Calculated per patient the 30-day in-hospital mortality was 8.9% (95%CI 8.6% to 9.2%) and showed a relative risk reduction (RRR) of 61.1% from 12.4% to 4.8% over the 16 years (p = .001). Calculated per admission the 30-day in-hospital mortality was 4.5% (95%CI 4.4% to 4.6%) with a RRR of 31.9% from 2002 to 2017. Over this extended period 48.7% of patients were readmitted at least once, 9.3% >5 times and 20 patients >50 times each. The median LOS was 5.9 days (IQR 2.4, 12.9) with no trend of change over time. Total readmissions increased as a time dependent function; early readmissions (<4 weeks) fluctuated without time trend at 10.5% (95%CI 9.6 to 11.3). A logistic regression model described the hospital LOS as a linear function both of comorbidity and the utilisation of inpatient procedures and services. Conclusion: 30-day in-hospital mortality showed a linear trend to reduce over time at unaltered LOS and readmission rates. LOS showed linear dependency on clinical complexity; interventions aimed at reducing LOS may not be appropriate beyond a certain point.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Comorbidity ; Emergency Service, Hospital/statistics & numerical data ; Female ; Hospital Mortality/trends ; Humans ; Ireland ; Length of Stay/statistics & numerical data ; Logistic Models ; Male ; Middle Aged ; Patient Readmission/statistics & numerical data ; Patient Readmission/trends ; Severity of Illness Index ; Time Factors
Language	English
Publishing date	2019-06-10
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1038679-8
ISSN	1879-0828 ; 0953-6205
ISSN (online)	1879-0828
ISSN	0953-6205
DOI	10.1016/j.ejim.2019.06.001
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Article: Extending the Grazing Period for Bulls, Prior to Finishing on a Concentrate Ration: Composition, Collagen Structure and Organoleptic Characteristics of Beef

Mezgebo, Gebrehawerya B / Monahan, Frank J / McGee, Mark / O’Riordan, Edward G / Marren, Declan / Listrat, Anne / Picard, Brigitte / Richardson, R. Ian / Moloney, Aidan P

Foods. 2019 July 23, v. 8, no. 7

2019

Abstract: ... bulls (n = 56) finished on a concentrate-based system (C) or raised in a pasture-based system (P ... Intramuscular fat concentration was lower (p < 0.001) for P99 than for C, P162 and P231 bulls, which did not differ ... Soluble collagen proportion was lower (p < 0.01) for P162 and P231 than for P99 and C bulls. Collagen ...

Abstract	The biochemical and organoleptic characteristics of the longissimus thoracis muscle from suckler bulls (n = 56) finished on a concentrate-based system (C) or raised in a pasture-based system (P) incorporating 99 (P99), 162 (P162) or 231 days (P231) of grazing prior to indoor finishing on the concentrate-based diet were investigated. Age at slaughter increased with increasing period at pasture. Intramuscular fat concentration was lower (p < 0.001) for P99 than for C, P162 and P231 bulls, which did not differ. Soluble collagen proportion was lower (p < 0.01) for P162 and P231 than for P99 and C bulls. Collagen cross-link content was higher (p < 0.05) for P231 than for P99 and C bulls and for P162 than for C bulls. The proportion of type I muscle fibres was higher (p < 0.01) for P231 and P162 than for P99 and C bulls. Sensory tenderness was higher (p < 0.001) for C and P162 than for P99 and P231 bulls and overall liking was higher (p < 0.01) for C than for P99 and P231 bulls but similar to P162 bulls. Extending the grazing period to 162 days did not negatively influence the sensory qualities of beef compared to the intensive concentrate-based system.
Keywords	age at slaughter ; beef ; bulls ; collagen ; diet ; finishing ; grazing ; intramuscular fat ; longissimus muscle ; muscle fibers ; pastures ; sensory properties
Language	English
Dates of publication	2019-0723
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2704223-6
ISSN	2304-8158
ISSN	2304-8158
DOI	10.3390/foods8070278
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Fifteen-year outcomes of an acute medical admission unit.

Conway, Richard / Byrne, Declan / Cournane, Seán / O'Riordan, Deirdre / Silke, Bernard

Irish journal of medical science

2018 Volume 187, Issue 4, Page(s) 1097–1105

Abstract: ... 2002 and 2016, from 7.0 to 4.6% (p = 0.001), number need to treat (NNT) 41.9. By unique patient the 30 ... and 2016, from 15.1 to 5.8% (p = 0.001), NNT 10.7. The median LOS was 5.0 days (IQR 2.1, 9.8) and was ...

Abstract	Background: The Acute Medical Admission Unit (AMAU) model of care has been associated with improved short- and medium-term outcomes; whether these improvements are sustained remains unclear. We report on the 15-year outcomes of an AMAU in our institution. Methods: All emergency medical admissions between 2002 and 2016 were examined and 30-day in-hospital mortality, admission rates, readmission rates and length of stay (LOS) assessed. We used logistic and Poisson regression and margin statistics to evaluate outcomes. Results: There were 96,305 admissions in 50,612 patients. By admission, the 30-day in-hospital mortality averaged 5.6% (95% CI 5.4 to 5.7%); there was a relative risk reduction (RRR) of 33.9% between 2002 and 2016, from 7.0 to 4.6% (p = 0.001), number need to treat (NNT) 41.9. By unique patient the 30-day in-hospital mortality averaged 10.5% (95% CI 10.3 to10.8%); there was a RRR of 61.7% between 2002 and 2016, from 15.1 to 5.8% (p = 0.001), NNT 10.7. The median LOS was 5.0 days (IQR 2.1, 9.8) and was unaltered over time. Deprivation status strongly influenced the admission rate/1000 population increasing from Q1 7.7 (95% CI 7.6 to 7.8) to Q5 37.8 (95% CI 37.6 to 38.0); this showed a slight trend to increase over time. Total readmissions increased as a function of time; early readmissions (< 4 weeks) remained constant 10.5% (95% CI 9.6 to 11.3). Conclusion: The 30-day in-hospital mortality showed a linear trend to reduce over the 15 years following the institution of an AMAU; other key parameters were unaltered.
MeSH term(s)	Adult ; Aged ; Emergency Service, Hospital/statistics & numerical data ; Female ; Follow-Up Studies ; Hospital Mortality ; Hospitalization/statistics & numerical data ; Humans ; Ireland/epidemiology ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Patient Admission/statistics & numerical data ; Time Factors
Language	English
Publishing date	2018-03-17
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	390895-1
ISSN	1863-4362 ; 0021-1265
ISSN (online)	1863-4362
ISSN	0021-1265
DOI	10.1007/s11845-018-1789-y
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Article ; Online: Hyponatraemia during an emergency medical admission as a marker of illness severity & case complexity.

McCarthy, Kevin / Conway, Richard / Byrne, Declan / Cournane, Seán / O'Riordan, Deirdre / Silke, Bernard

European journal of internal medicine

2018 Volume 59, Page(s) 60–64

Abstract: ... They had a higher 30-day in-hospital mortality at 6.4% vs 4.4% (p < 0.001). Admission sodium predicted ...

Abstract	Background: Altered sodium balance at time of an emergency medical admission adversely impacts on outcome; whether hyponatraemia is independently associated with outcomes or a surrogate of acute illness severity has been debated. Methods: All emergency medical admissions between 2002 and 2017 were studied and a risk score calculated. We compared univarate deciles of admission sodium using a multivariable model, adjusting for risk score. Results: There were 106,586 admissions in 54,928 patients. Patients with lower sodium at admission were older at 66.7 years (IQR 46.7-79.5) compared with 63.3 years (IQR 42.9-78.2) with a longer length of stay (LOS) of 6.8 days (IQR 3.0-14.7) versus 4.9 days (IQR 1.8-10.9). They had a higher 30-day in-hospital mortality at 6.4% vs 4.4% (p < 0.001). Admission sodium predicted survival - OR 0.89 (95%CI 0.88-0.90). We adjusted the model with a Risk Score that is predictive and exponentially related to 30-day in-hospital mortality. When adjusted for Risk Score, the admission sodium value was less predictive - OR 0.95 (95%CI 0.92-0.97). The cumulative percentages within the lowest five deciles fell from 63.3% between 2002 and 2009 to 48.1% from 2010 to 2017. The slope of the prediction line relating admission sodium to mortality did not change over time but a lower mortality rate was predicted at any given sodium level. Conclusion: Hyponatraemia at the time of an emergency medical admission is predictive and probably a marker of Acuity Illness Severity and Case Complexity. Both the frequency of abnormality in admission sodium and mortality have fallen over time.
MeSH term(s)	Adult ; Aged ; Biomarkers/blood ; Databases, Factual ; Emergency Service, Hospital/statistics & numerical data ; Female ; Hospital Mortality/trends ; Humans ; Hyponatremia/blood ; Hyponatremia/mortality ; Iceland/epidemiology ; Length of Stay/statistics & numerical data ; Logistic Models ; Male ; Middle Aged ; Predictive Value of Tests ; Risk Factors ; Severity of Illness Index ; Sodium/blood
Chemical Substances	Biomarkers ; Sodium (9NEZ333N27)
Language	English
Publishing date	2018-08-07
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1038679-8
ISSN	1879-0828 ; 0953-6205
ISSN (online)	1879-0828
ISSN	0953-6205
DOI	10.1016/j.ejim.2018.08.002
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Article ; Online: Phthalate-associated hypertension in premature infants: a prospective mechanistic cohort study.

Jenkins, Randall / Tackitt, Shane / Gievers, Ladawna / Iragorri, Sandra / Sage, Kylie / Cornwall, Tonya / O'Riordan, Declan / Merchant, Jennifer / Rozansky, David

Pediatric nephrology (Berlin, Germany)

2019 Volume 34, Issue 8, Page(s) 1413–1424

Abstract: ... of urinary DEHP metabolites was associated with prior IV and respiratory tubing DEHP exposures (p < 0.05 ... Both IV and respiratory DEHP exposures were greater in hypertensive infants (p < 0.05). SBP index was ... related to DEHP exposure from IV fluid (p = 0.018), but not respiratory DEHP. Urinary cortisol/cortisone ...

Abstract	Background: Phthalates are associated with increased blood pressure in children. Large exposures to di-(2-ethylhexyl) phthalate (DEHP) among premature infants have been a cause for concern. Methods: We conducted a prospective observational cohort study to determine if DEHP exposures are related to systolic blood pressure (SBP) in premature infants, and if this exposure is associated with activation of the mineralocorticoid receptor (MR). Infants were monitored longitudinally for 8 months from birth. Those who developed idiopathic hypertension were compared with normotensive infants for DEHP exposures. Appearance of urinary metabolites after exposure was documented. Linear regression evaluated the relationship between DEHP exposures and SBP index and whether urinary cortisol/cortisone ratio (a surrogate marker for 11β-HSD2 activity) mediated those relationships. Urinary exosomes were quantified for sodium transporter/channel expression and interrogated against SBP index. Results: Eighteen patients met the study criteria, nine developed transient idiopathic hypertension at a postmenstrual age of 40.6 ± 3.4 weeks. The presence of urinary DEHP metabolites was associated with prior IV and respiratory tubing DEHP exposures (p < 0.05). Both IV and respiratory DEHP exposures were greater in hypertensive infants (p < 0.05). SBP index was related to DEHP exposure from IV fluid (p = 0.018), but not respiratory DEHP. Urinary cortisol/cortisone ratio was related to IV DEHP and SBP index (p < 0.05). Sodium transporter/channel expression was also related to SBP index (p < 0.05). Conclusions: Increased blood pressure and hypertension in premature infants are associated with postnatal DEHP exposure. The mechanism of action appears to be activation of the MR through inhibition of 11β-HSD2.
MeSH term(s)	11-beta-Hydroxysteroid Dehydrogenases/metabolism ; Administration, Intravenous/adverse effects ; Administration, Intravenous/instrumentation ; Airway Management/adverse effects ; Airway Management/instrumentation ; Blood Pressure/drug effects ; Diethylhexyl Phthalate/toxicity ; Female ; Humans ; Hypertension/chemically induced ; Hypertension/diagnosis ; Hypertension/epidemiology ; Hypertension/metabolism ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases/chemically induced ; Infant, Premature, Diseases/diagnosis ; Infant, Premature, Diseases/epidemiology ; Male ; Plasticizers/toxicity ; Prospective Studies ; Receptors, Mineralocorticoid/metabolism ; Signal Transduction/drug effects
Chemical Substances	NR3C2 protein, human ; Plasticizers ; Receptors, Mineralocorticoid ; Diethylhexyl Phthalate (C42K0PH13C) ; 11-beta-Hydroxysteroid Dehydrogenases (EC 1.1.1.146)
Language	English
Publishing date	2019-04-26
Publishing country	Germany
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	631932-4
ISSN	1432-198X ; 0931-041X
ISSN (online)	1432-198X
ISSN	0931-041X
DOI	10.1007/s00467-019-04244-4
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Article ; Online: Effect of social deprivation on the admission rate and outcomes of adult respiratory emergency admissions.

Cournane, Seán / Byrne, Declan / Conway, Richard / O'Riordan, Deirdre / Coveney, Seamus / Silke, Bernard

Respiratory medicine

2017 Volume 125, Page(s) 94–101

Abstract: ... quintile was increased (p < 0.01), Q5 1.31 (95% CI: 1.07, 1.61). Particulate matter (PM: Conclusion ...

Abstract	Background: Patients with respiratory disorders constitute a major source of activity for Acute Medicine. We have examined the impact of Socio-Economic Status (SES) and weather factors on the outcomes (30-day in-hospital mortality) of emergency hospitalisations with a respiratory presentation. Methods: All emergency respiratory admissions to St. James Hospital, Dublin, from 2002 to 2014 were evaluated. Patients were categorized by quintile of Deprivation Index, and evaluated against hospital admission rate (/1000 population) and 30-day in-hospital mortality. Univariate and multivariable risk estimates (Odds Ratios (OR) or Incidence Rate Ratios (IRR)) were calculated, using logistic or zero truncated Poisson regression as appropriate. Results: There were 32,538 episodes in 14,093 patients, representing 39.5% of medical emergency episodes over the 13-yr period. Deprivation Quintile independently predicted the admission rate, with incidence rate ratios (IRR) of Q3 2.02 (95% CI: 1.27, 3.23), Q4 2.55 (95% CI: 1.35, 4.83) and Q5 5.68 (95% CI: 3.56, 9.06). The 30-day in-hospital mortality for the highest quintile was increased (p < 0.01), Q5 1.31 (95% CI: 1.07, 1.61). Particulate matter (PM Conclusion: Socio-Economic Status influences the admission rate incidence and hospital mortality of respiratory emergency admissions; local environmental conditions (air pollution and temperature) appear only relevant to the mortality outcomes.
Language	English
Publishing date	2017-04
Publishing country	England
Document type	Journal Article
ZDB-ID	1003348-8
ISSN	1532-3064 ; 0954-6111
ISSN (online)	1532-3064
ISSN	0954-6111
DOI	10.1016/j.rmed.2017.01.003
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In stock of ZB MED Cologne/Königswinter

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