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Biomedical subjects

J B Reitsma

Publications and source records attributed to J B Reitsma.

26 records · Page 2Linked to original sources
PubMed2001

Impact of stroke type on survival and functional health.

In a cohort 760 consecutive stroke patients (23 hospitals in the Netherlands), we studied prognosis in relation to stroke type and focused on (a) short-term and long-term mortality, and (b) long-term functional health. Based on clinical and CT data, we distinguished infratentorial strokes from supratentorial strokes (lacunar infarctions, (sub)cortical infarctions and intracerebral hemorrhages). Cumulative mortality for all stroke patients was 34% at 6 months, 51% at 3 years, and 62% at 5 years. Short-term mortality could be explained by stroke type, whereas long-term mortality could not. Of all survivors, 55% were in poor functional health at 6 months, 49% at 3 years and 42% at 5 years. Long-term functional health outcomes were associated with stroke type. We conclude that the impact of stroke type on mortality is limited to the first 6 months, whereas the type of stroke influences the long-term functional health.

Aged↗
PubMed1999

Cardiovascular disease in the Netherlands, 1975 to 1995: decline in mortality, but increasing numbers of patients with chronic conditions.

OBJECTIVE: To examine the relation between trends over time in mortality and hospital morbidity caused by various cardiovascular diseases in the Netherlands. DESIGN: Trend analysis by Poisson regression of national data on mortality and hospital admissions from 1975 to 1995. SUBJECTS: The Dutch population. RESULTS: All cardiovascular diseases combined were responsible for 39% of all deaths and 16% of all hospital admissions in 1995. From 1975 to 1995, age adjusted cardiovascular mortality declined by an annual change of -2.0% (95% confidence intervals (CI) -2.1% to -1.9%), while in the same period age adjusted discharge rates increased annually by 1. 3% (95% CI 1.1% to 1.5%). Around 60% of the gain in life expectancy in this period was related to lower cardiovascular mortality. For mortality, major reductions were seen in coronary heart disease (annual change -2.9%) and in stroke (-2.1%), whereas the increase in hospital admissions was mainly caused by chronic manifestations of coronary heart disease (5.1%), heart failure (2.1%), and diseases of the arteries (1.8%). In recent years, the gap between men and women at risk of dying from coronary heart disease became smaller for those aged </= 65 years. CONCLUSIONS: Our findings of a decrease in cardiovascular mortality and an increase in admission rates for chronic conditions such as heart failure, chronic coronary syndromes, and diseases of the arteries, support the hypothesis that the longer survival of many patients with heart diseases is leading to a growing pool of patients at increased risk for subsequent cardiovascular complications in Western countries.

Adolescent↗
PubMed1998

Epidemiology of stroke in The Netherlands from 1972 to 1994: the end of the decline in stroke mortality.

In 1994, stroke was responsible for the death of 4,994 men and 7,601 women in the Netherlands, corresponding to 7.5% of all deaths in men and 11.4% in women. Age-adjusted stroke mortality declined by 39% for men and by 45% for women between 1972 and 1994. However, the decline in mortality levelled off after 1987. In contrast to mortality, age-adjusted discharge rates increased by 47% for men and by 28% for women during the study period. The decline in mortality was equally distributed over the age groups, while the increase in the number of hospital admissions was more pronounced in the older age groups. The analyses by diagnostic subgroups of stroke showed the importance of increasing diagnostic capabilities in the hospital setting. The use of diagnostic subgroups in national mortality data was of limited value, illustrated by the fact that 70% of all stroke deaths in 1994 belonged to the ill-defined type of stroke.

Age Distribution↗
PubMed1996

Increasing incidence of aneurysms of the abdominal aorta in The Netherlands.

OBJECTIVES: To study the trend in incidence of aneurysms of the abdominal aorta in The Netherlands during the past two decades. SETTING: The Dutch population from 1972 to 1992. DESIGN: Analysis of all hospital admissions and deaths due to aneurysms of the abdominal aorta. OUTCOME MEASURES: Age adjusted and age specific mortality and discharge rates. In-hospital mortality after surgery upon aneurysms of the abdominal aorta. RESULTS: From 1972 to 1992 age adjusted mortality from aneurysms of the abdominal aorta rose from 3.1 to 8.1 per 100,000 in men, and from 1.4 to 2.2 in women. Age adjusted discharge rates (alive and dead) for non-ruptured abdominal aortic aneurysms increased from 3.7 to 37.6 per 100,000 in men and from 1.2 to 5.5 in women. For ruptured aneurysms, the age adjusted discharge rates increased from 2.4 to 10.3 per 100,000 in men and from 0.7 to 1.7 in women. Age adjusted in-hospital mortality after surgery upon non-ruptured aneurysms was halved from 13% in 1972 to 7% in 1992, mortality after acute repair upon ruptured aneurysms also decreased from 52% in 1972 to 36% in 1992. CONCLUSIONS: There was an impressive increase in the hospital based incidence for aneurysms of the abdominal aorta during the past two decades in The Netherlands. An improved detection rate through ultrasound is probably a major contributor to this increase, but gender differences and the rise in the number of ruptured aneurysms suggest that a real increase in incidence may exist, especially in men. Surgical outcome for both ruptured and non-ruptured aneurysms of the abdominal aorta improved.

Age Distribution↗
PubMed1996

Increase in hospital admission rates for heart failure in The Netherlands, 1980-1993.

OBJECTIVE: To study the trend in hospital admission rates for heart failure in the Netherlands from 1980 to 1993. DESIGN: All hospital admissions in the Netherlands with a principal discharge diagnosis of heart failure were analysed. In addition, individual records of heart failure patients from a subset of 7 hospitals were analysed to estimate the frequency and timing of readmissions. RESULTS: The total number of discharges for men increased from 7377 in 1980 to 13 022 in 1993, and for women from 7064 to 12 944. From 1980 through 1993 age adjusted discharge rates rose 48% for men and 40% for women. Age adjusted in-hospital mortality for heart failure decreased from 19% in 1980 to 15% in 1993. For all age groups in-hospital mortality for men was higher than for women. The mean length of hospital admissions in 1993 was 14.0 days for men and 16.4 days for women. A review of individual patient records from a 6.3% sample of all hospital admissions in the Netherlands indicated that within a 2 year period 18% of the heart failure patients were admitted more than once and 5% more than twice. CONCLUSIONS: For both men and women a pronounced increase in age adjusted discharge rates for heart failure was observed in the Netherlands from 1980 to 1993. Readmissions were a prominent feature among heart failure patients. Higher survival rates after acute myocardial infarction and the longer survival of patients with heart disease, including heart failure may have contributed to the observed increase. The importance of advances in diagnostic tools and of possible changes in admission policy remain uncertain.

Age Distribution↗
PubMed1994

[Increase in the number of admissions due to heart failure in Dutch hospitals in the period 1980-1992].

OBJECTIVE: Determination of the trend in the occurrence of hospital admissions because of heart failure in the Netherlands. DESIGN: Descriptive investigation. SETTING: Dutch general and university hospitals. METHOD: Data on hospital admissions because of heart failure from 1980 to 1992, obtained from the National Medical Register, were analysed. Three ICD-9 CM diagnoses were combined (congestive heart failure 428.x, diseases of the heart due to hypertension 402.x and myocardial degeneration 429.I). RESULTS: From 1980 through 1992 the annual number of hospital admissions for heart failure increased by 69%, for both men and women, from 14,441 to 24,368. Age-adjusted admission rates increased by 43% for men, and by 30% for women. The admission rates were strongly age-related, with higher rates in the older age groups. Among men 89% of the patients in 1992 were older than 60 years, and 63% older than 70 years. Among women these figures were 94% and 79%, respectively. During the study period the age-specific admission rates rose in all relevant age groups. The rise was higher in the older age groups. In 1992 the average duration of stay in hospital was 14 days for men and 17 for women. CONCLUSION: Probable causes of the rise in the number of hospital admissions for heart failure were the increasing median age of the population, higher survival rates after acute myocardial infarction and longer survival of persons with heart disease. Demographic changes and medical progress will probably lead to a further rise in morbidity and mortality and of costs of heart failure.

Academic Medical Centers↗
PubMed1994

Relationship between improved postprandial lipemia and low-density lipoprotein metabolism during treatment with tetrahydrolipstatin, a pancreatic lipase inhibitor.

The effect of tetrahydrolipstatin (THL), a recently developed pancreatic lipase inhibitor, on fasting plasma lipid levels and postprandial lipoprotein and retinyl palmitate (RP) metabolism was studied in 17 hyperlipidemic subjects, using an oral RP fat load (8 hours, 50 g fat/m2). During therapy with THL, fasting plasma cholesterol, low-density lipoprotein (LDL) cholesterol, and apolipoprotein (apo) B concentrations decreased by 8% (P = .006), 9% (P = .002), and 10% (P = .002), respectively. The postprandial plasma triglyceridemia, which was expressed as the area under the 8-hour triglyceride (TG) curve, improved by 27% during THL therapy (P = .04) without changes in fasting plasma TG or high-density lipoprotein (HDL) cholesterol levels. The improved postprandial triglyceridemia was accompanied by a 19% reduction in circulating levels of chylomicrons and chylomicron remnants, determined by the decreased areas under the 8-hour RP curves. The most likely mechanisms involved are decreased formation of chylomicrons by a decrease of intestinal TG absorption as a consequence of THL treatment, as well as reduced delivery of dietary lipid and fatty acids to the liver and subsequent upregulation of hepatic LDL receptors. In agreement with the latter mechanism, the decrease in postprandial lipemia expressed as delta area under the TG curve was significantly related to the decrease (delta) in LDL cholesterol level during THL treatment (r = .81, P = .0001). The present data indicated that pancreatic lipase inhibition improved postprandial lipoprotein metabolism, which in turn resulted in lower plasma total and LDL cholesterol concentrations.

Administration, Oral↗