Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MORBIDITY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,531 records · Page 85Linked to original sources
PubMed2001

Injury risks and socioeconomic groups in different settings. Differences in morbidity between men and between women at working ages.

BACKGROUND: It is unclear whether greater injury risk in lower socioeconomic groups at working ages is attributable to differences in work conditions or a reflection of a wider overall pattern of risk. The current study investigates socioeconomic differences in non-fatal injury risks in a variety of settings. METHODS: Data were taken from a community-based injury register built up over one year (November 1989 to October 1990) in a semi-urban Swedish municipality (256,510 inhabitants), and then linked by record to Sweden's National Population Register (based on the census of 1990). Injuries among the age group 20-64 were considered. Age-standardized odds ratios were computed by gender for five injury settings and four socioeconomic groups, using salaried employees as the reference group. RESULTS: Compared with salaried employees, male manual workers and from the unspecified population (long-term unemployed, students, etc.) show an excess risk of injury in all settings except sports. Males from all socioeconomic groups show significantly higher morbidity in production/education areas. Female manual workers show significantly higher morbidity in home settings and in production/education; those from the unspecified population, in home settings, transport areas, and 'other areas'. CONCLUSION: Higher morbidity in lower socioeconomic groups results not only from work-related differences, where 25% of the injuries analysed were incurred, but also from the differential impacts of other living environments, e.g. home and transport areas. Differences between socioeconomic groups in care seeking, injury lethality, injury susceptibility, and risk exposure may influence the social patterning of injury morbidity.

Accidents, Occupational↗
PubMed2002

The association of eating behavior with risk for morbidity in older women.

BACKGROUND: Although an influence of eating behavior on dietary intake and physiology has been documented in several studies, the extent to which eating behavior influences long-term health is uncertain. METHODS: Current dietary restraint, disinhibition, and hunger were assessed using the Eating Inventory in 1252 nonsmoking women aged 55 to 65 years. In addition, subjects reported the presence or absence of 22 specific morbidities, along with general demographic information. Logistic regression was used to examine associations between eating behavior scores and morbidity, adjusting for age, prior smoking status, hormone replacement therapy, education level, and body mass index (BMI). RESULTS: In adjusted models excluding BMI, higher disinhibition scores were associated with small increased risks for hypercholesterolemia (odds ratio [OR] 1.04, p =.045), leg cramps (OR 1.05, p =.044), indigestion (OR 1.06, p =.020), and cataract (OR 1.09, p =.036), and a decreased risk of eczema (OR 0.91, p =.008). In addition, higher hunger scores were associated with increased risk of eczema (OR 1.09, p =.026). However, after adjusting for confounding variables plus BMI, higher disinhibition scores were associated with increased risks for low back pain (OR 1.06, p =.031) and constipation (OR 1.10, p =.004), and associations of disinhibition and hunger with eczema were unchanged (OR 0.90, p =.008 and OR 1.09, p =.024, respectively). Dietary restraint was not associated with morbidity in any model. CONCLUSIONS: Higher disinhibition and hunger scores were associated with small alterations in reported morbidity risk in a large population of nonsmoking older women. Although our cross-sectional study design makes the directionality of these relationships unclear, our results suggest at most a relatively minor independent influence of eating behavior constructs on long-term health.

Aged↗
PubMed1995

Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes.

The dementia caregiving literature is reviewed with the goals of (a) assessing the prevalence and magnitude of psychiatric and physical morbidity effects among caregivers, (b) identifying individual and contextual correlates of reported health effects and their underlying causes, and (c) examining the policy relevance of observed findings. Virtually all studies report elevated levels of depressive symptomatology among caregivers, and those using diagnostic interviews report high rates of clinical depression and anxiety. The evidence is more equivocal and generally weaker for the association between caregiving and physical morbidity, such as self-rated health, number of illnesses, symptomatology, health care utilization, preventive health behaviors, and cardiovascular functioning. Across studies, psychiatric morbidity in caregivers was linked to patient problem behaviors, income, self-rated health, perceived stress, and life satisfaction. Physical morbidity was associated with patient problem behaviors and cognitive impairment, and with caregiver depression, anxiety, and perceived social support. Possible causes of reported effects and policy implications are discussed.

Activities of Daily Living↗
PubMed1994

Community-based hygiene education to reduce diarrhoeal disease in rural Zaire: impact of the intervention on diarrhoeal morbidity.

BACKGROUND: Diarrhoeal disease is a leading cause of morbidity in young children in rural Zaire. Few diarrhoea prevention programmes have been implemented in Bandundu Province, where available data suggest an annual prevalence rate of 10%. The urgent need to reduce diarrhoeal morbidity in Zaire, together with the potential effectiveness and feasibility of hygiene education as a diarrhoea prevention strategy, led to the development of the present research project. METHODS: A randomized, controlled trial of an education intervention to reduce diarrhoea through improved personal and domestic hygiene behaviours was conducted in 18 geographically separate village clusters (sites) in rural Zaire. For 12 weeks baseline information on the diarrhoeal morbidity of 2082 children aged 3-35 months was collected at weekly home visits, and structured observations of hygiene practices related to diarrhoea were made on a subset of 300 families. Intervention messages addressed disposal of animal faeces from the yard, handwashing after defecation and before meal preparation and eating, and disposal of children's faeces. Three months after the start of the intervention and exactly 1 year after the baseline studies, a second diarrhoeal morbidity study and a second observational study were conducted in order to evaluate the intervention. RESULTS: Children in intervention communities experienced an 11% reduction in the risk of reporting diarrhoea during the peak diarrhoeal season, compared to controls (P < 0.025). The largest differences were seen among children aged 24-35 months, with those from intervention communities reporting significantly fewer episodes, shorter mean durations and hence fewer days of diarrhoea. There was some evidence that greater reductions in diarrhoea occurred in sites where the quality of the intervention, a scored measure of volunteer efficacy and community participation, was highest. CONCLUSIONS: The results of this study suggest that hygiene education may be an effective approach to reduce the incidence and duration of diarrhoeal episodes in rural Zaire. Children aged 2 years appear to benefit the most. A Hawthorne effect of the education may contribute to diarrhoeal reductions.

Child, Preschool↗
PubMed1997

The impact of malnutrition in morbidity and mortality in stable haemodialysis patients. Spanish Cooperative Study of Nutrition in Hemodialysis.

BACKGROUND: When assessed by single biochemical measurements, malnutrition in dialysis patients is associated with increased mortality, but there are few data evaluating abnormalities in anthropometry or composite nutritional scores and outcome. The aim of our study was to ascertain the prevalence and severity of malnutrition in 761 stable patients from 20 haemodialysis centres and its influence in morbidity and mortality after one year of follow-up. METHODS: Malnutrition was estimated by scoring four anthropometric indexes; body mass index (BMI), triceps skinfold thickness (TSF), mid-arm circumference (MAC), and mid-arm muscle circumference (MAMC); three biochemical measurements; serum albumin, serum transferrin and total lymphocyte count; and clinical examination. Mortality and hospitalizations were collected prospectively during the year of follow-up. RESULTS: A moderate/severe degree of malnutrition was presented by 51.6% of male and 46.3% of female patients. TSF was moderate-severely decreased in 41% without differences between males and females. MAMC was moderately decreased in 19.8% of males and in 8.1% of females (P < 0.001). Multiple logistic regression analysis showed that the predictors of malnutrition were: age > 65 years (OR = 1.96, CI: 1.22-3.14), male sex (OR = 1.95, CI: 1.24-3.07), comorbidity index (OR = 1.23, CI: 1.03-1.45), time on dialysis (OR = 1.13, CI: 1.08-1.18), duration of dialysis (OR = 0.73, CI: 0.63-0.85) and PCR related to ideal body weight (OR = 0.17, CI: 0.06-0.50). After 1 year of follow-up, data from 442 patients were available. A total of 68 patients died (15.4%) with cardiovascular diseases being the most frequent cause of death (57.3% of the cases). The predictors of mortality were: age (OR = 1.06, CI: 1.03-1.09), cardiovascular disease (OR = 2.13, CI: 1.19-3.83), neurological disease (OR = 2.96, CI: 1.41-6.15), nephroangiosclerosis (OR = 2.34, CI: 1.10-4.98) and total lymphocyte count (OR = 0.93, CI: 0.87-0.98). Hospitalization was needed in 44% of patients. The comorbidity index, serum albumin and age were the predictive factors of hospitalization. CONCLUSIONS: Protein-calorie malnutrition is frequent in haemodialysis patients. Fat depletion predominated in both sexes. Duration of dialysis and protein catabolic rate related to ideal body weight was the only predictor which could be influenced by a nutritional intervention. Morbidity appeared to be influenced by the comorbidity index and age was the strongest predictor of mortality. The only nutritional measurements predictive of morbidity and mortality were serum albumin and total lymphocyte count respectively. Therefore, the influence of malnutrition in morbidity and mortality can not be definitively stated.

Adolescent↗
PubMed2004

Morbidity and mortality among outborn neonates at 10 tertiary care institutions in India during the year 2000.

The National Neonatal Perinatal Database (NNPD) network is a collaborative group of leading neonatal units in India involved in the prospective collection of morbidity and mortality data on uniform protocols. The present article reports the morbidity and mortality profile of outborn neonates in the year 2000. Ten centers provided data on outborn neonates. The data were analysed at the nodal center using Epi-Info statistical software version 6 and Excel 97. A total of 3831 neonates were admitted at the participating institutions. A majority of them (87.2 per cent) were delivered in nursing homes and small hospitals. Most of the admissions (68.7 per cent) were male. Nearly half of them (48.7 per cent) were low birthweight and one-third (32.1 per cent) were preterm. Overall mortality was 16.4 per cent, while 7.5 per cent left hospitals against medical advice. Nearly half of all neonatal deaths occurred within the first 48 h following admission. Common primary causes of deaths (n = 630) included: infections (36.0 per cent), prematurity related conditions (26.5 per cent), perinatal hypoxia (10.0 per cent), and malformations (7.8 per cent). Systemic infections (28.4 per cent), hyperbilirubinemia (27.9 per cent), seizures (11.7 per cent), hypoglycemia (11.5 per cent), hypoxic ischemic encephalopathy (8.3 per cent), anemia (8.9 per cent), and hypocalcemia (8.6 per cent) were common morbidities observed. Of systemic infections, 39.2 per cent were culture positive and 51.4 per cent were early onset (< 72 h). Sick babies were managed with antibiotics (75 per cent), oxygen administration (45.3 per cent), phototherapy (34.9 per cent), and assisted ventilation (16.3 per cent). In conclusion, the present study describes the morbidity and mortality profile of a large multicentric cohort of outborn neonates from a developing country.

Cause of Death↗
PubMed1999

The use of a postoperative morbidity survey to evaluate patients with prolonged hospitalization after routine, moderate-risk, elective surgery.

UNLABELLED: Vital healthcare resources are devoted to caring for patients with prolonged hospitalization after routine, moderate-risk surgery. Despite the significant cost, little is known about the overall incidence and pattern of complications in these patients. Four hundred thirty-eight patients undergoing a diverse group of routine, moderate-risk, elective surgical procedures were enrolled into a prospective, blinded, cohort study. Complications were assessed using a postoperative morbidity survey. The main outcome was postoperative complication, defined as either in-hospital death or prolonged postoperative hospitalization (> 7 days). The mortality rate was 1.6%. Postoperative complications occurred in 118 patients (27% [95% CI 23-31]). Complications frequently observed in these patients included: gastrointestinal 51% (42-60), pulmonary 25% (17-33), renal 21% (14-28), and infectious 13% (7-19). Most complications were not directly related to the type/site of surgery. Indices of tissue trauma (blood loss [P < 0.001], surgical duration [P = 0.001]) and tissue perfusion (arterial base deficit [P = 0.008], gastric pHi [P = 0.02]) were the strongest intraoperative predictors of complications. Despite a low mortality rate, we found that complications after routine, moderate-risk, elective surgery are common and involve multiple organ systems. Our 9-point survey can be used by healthcare providers and payers to characterize post-operative morbidity in their respective settings. IMPLICATIONS: Little is known about the overall incidence and pattern of complications in patients with prolonged hospitalization after routine, elective surgery. We prospectively assessed these complications using a novel postoperative morbidity survey. The postoperative morbidity survey can be used in future clinical outcome trials, as well as in routine hospital-based quality assurance.

Data Collection↗
PubMed2000

Reducing postoperative morbidity after the insertion of gold weights to treat lagophthalmos.

Paralysis of the orbicularis oculi muscle leads to an unopposed action of the levator of the upper eyelid (lagophthalmos) in facial nerve palsy. The resultant exposure of the cornea may lead to keratitis, corneal ulceration, and eventual blindness. Although many surgical options exist in the treatment of lagophthalmos, upper lid loading with a gold weight implant has become one of the preferred methods to reduce the complications that may follow. The problems encountered after gold lid loading and methods to reduce postoperative morbidity are not well documented. The objective of this study was to determine the range of morbidity seen after gold weight insertion and to evaluate the effect of supratarsal fixation on subsequent morbidity. After retrospective reviews by questionnaire and case note analysis, supratarsal fixation was found to noticeably reduce the rate of implant ulceration and extrusion. This study demonstrates upper lid loading to be an effective method for the treatment of lagophthalmos, and it supports fixation of gold weights in reducing surgical morbidity.

Adolescent↗
PubMed2001

Effect of preoperative biliary decompression on pancreaticoduodenectomy-associated morbidity in 300 consecutive patients.

OBJECTIVE: To examine the relationship between preoperative biliary drainage and the morbidity and mortality associated with pancreaticoduodenectomy. SUMMARY BACKGROUND DATA: Recent reports have suggested that preoperative biliary drainage increases the perioperative morbidity and mortality rates of pancreaticoduodenectomy. METHODS: Peri-operative morbidity and mortality were evaluated in 300 consecutive patients who underwent pancreaticoduodenectomy. Univariate and multivariate logistic regression analyses were done to evaluate the relationship between preoperative biliary decompression and the following end points: any complication, any major complication, infectious complications, intraabdominal abscess, pancreaticojejunal anastomotic leak, wound infection, and postoperative death. RESULTS: Preoperative prosthetic biliary drainage was performed in 172 patients (57%) (stent group), 35 patients (12%) underwent surgical biliary bypass performed during prereferral laparotomy, and the remaining 93 patients (31%) (no-stent group) did not undergo any form of preoperative biliary decompression. The overall surgical death rate was 1% (four patients); the number of deaths was too small for multivariate analysis. By multivariate logistic regression, no differences were found between the stent and no-stent groups in the incidence of all complications, major complications, infectious complications, intraabdominal abscess, or pancreaticojejunal anastomotic leak. Wound infections were more common in the stent group than the no-stent group. CONCLUSIONS: Preoperative biliary decompression increases the risk for postoperative wound infections after pancreaticoduodenectomy. However, there was no increase in the risk of major postoperative complications or death associated with preoperative stent placement. Patients with extrahepatic biliary obstruction do not necessarily require immediate laparotomy to undergo pancreaticoduodenectomy with acceptable morbidity and mortality rates; such patients can be treated by endoscopic biliary drainage without concern for increased major complications and death associated with subsequent pancreaticoduodenectomy.

Adolescent↗
PubMed2001

Severe obstetric morbidity.

Obstetric morbidity is an important marker of the quality of obstetric care. This review explores the definition, incidence and significance of obstetric morbidity. Some topical issues related to obstetric morbidity are discussed. In addition, the importance of long-term morbidity and violence against women is highlighted.

Eclampsia↗
PubMed1994

Aerosolized pentamidine as primary prophylaxis for Pneumocystis carinii pneumonia: efficacy, mortality and morbidity.

OBJECTIVE: Primary prophylaxis against Pneumocystis carinii pneumonia (PCP) for patients with HIV infection has been recommended by the Centers for Disease Control and Prevention. We evaluated alternatives to routine primary PCP prophylaxis with aerosolized pentamidine. METHODS: A total of 121 HIV-infected patients with CD4+ cell counts < or = 200 x 10(6)/l or an AIDS diagnosis were enrolled in a controlled study of aerosolized pentamidine as primary PCP prophylaxis. Patients were randomly assigned to treatment (n = 61) with aerosolized pentamidine once every month or to no treatment (n = 60). Patients were evaluated for PCP, mortality, morbidity and progression of HIV disease. Morbidity was estimated from the number of days patients were unable to work due to illness, number of days hospitalized and AIDS events. RESULTS: Baseline characteristics were similar in the treatment and control groups and mean CD4+ cell counts were 116 and 107 x 10(6)/l, respectively. Eight incidents of PCP and 19 deaths were observed in the treatment group during a median follow-up of 16.4 months (range, 2.3-32.4 months). Nineteen incidents of PCP and 13 deaths, of which one was related to an acute episode of PCP, were noted in the control group. Median follow-up of controls was 18.5 months (range, 3.1-32.9 months). Patients in the treatment group were unable to work 19% of the observation time and were hospitalized for 4.3% of that time. Corresponding figures were 20 and 3.0%, respectively, in the control group. CONCLUSIONS: Aerosolized pentamidine had significant prophylactic efficacy, but we could not detect any major effect on mortality and morbidity. The overall mortality and morbidity were not markedly influenced by PCP. Clinical check-ups and treatment of acute PCP could be a justifiable alternative to drug prophylaxis with aerosolized pentamidine in selected patients.

AIDS-Related Opportunistic Infections↗
PubMed1998

Psychological morbidity in caregivers is associated with depression in patients with dementia.

The relationship between psychological morbidity in caregivers and depression in patients with dementia was examined using data collected on 193 patient-caregiver dyads attending a memory disorders clinic. Caregivers had high rates and levels of psychological morbidity which were associated with the severity of dementia (but neither the type nor duration), with the caregiver being a spouse and female and living with the person with dementia. A logistic regression analysis identified clinician-rated patient depression score and demanding problem behaviors as being independently and significantly associated with caregiver psychological morbidity. This new finding of a link between patient depression and caregiver psychological morbidity has implications for more focused treatment programs for both caregivers and patients.

Activities of Daily Living↗
PubMed1994

Reduction of morbidity in interhospital transport by specialized pediatric staff.

OBJECTIVE: We prospectively compared the occurrence of morbidity during high-risk interhospital transport in two types of transport systems: specialized tertiary center-based vs. nonspecialized, referring hospital-based. DESIGN: Concurrent, prospective comparison of morbidity at two pediatric centers that use different types of transport team. SETTING: Two tertiary care pediatric intensive care units (ICU). The specialized team consisted of a pediatric resident, pediatric intensive care nurse, and a pediatric respiratory therapist. Comparison was made with referring institution transports by nonspecialized personnel to a second center. The two centers were similar in size and patient mix, with referral areas of similar population and rural/urban ratio. PATIENTS: One hundred forty-one patients transported to two tertiary pediatric ICUs. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Two types of events were assessed: vital signs and other observable clinical events were described as "physiologic deteriorations." Events such as loss of intravenous access, endotracheal tube mishaps, and exhaustion of oxygen supply were described as "intensive care-related adverse events." Pretransport severity of illness and therapy were described by Pediatric Risk of Mortality (PRISM) and Therapeutic Intervention Scoring System (TISS) scores. Only high-risk patients with PRISM scores of > or = 10 were analyzed. Intensive care-related adverse events occurred in one (2%) of 49 transports by the specialized team and 18 (20%) of 92 transports by nonspecialized personnel. The difference is statistically significant (p < .05). Physiologic deterioration was similar in the two groups occurring in five (11%) of 47 specialized team transports and 11 (12%) of 92 transports by the nonspecialized team. CONCLUSION: We conclude that specialized pediatric teams can reduce transport morbidity. This is the first published study to compare two models of pediatric transport using identical definitions of severity and morbidity.

Age Distribution↗
PubMed1993

Follow-up of psychiatric and educational morbidity among adopted children.

OBJECTIVE: The purpose of this study is to evaluate longitudinally the strength of association between adoptive status and psychiatric and educational morbidity and substance use. METHOD: This study makes use of data from the 1983 Ontario Child Health Study and 1987 follow-up. This community survey of children (4- to 16-years-old in 1983, 8- to 20-years-old in 1987) included a subpopulation of adopted children. The primary outcomes measured were psychiatric disorder, poor school performance, and substance use. RESULTS: Adoption, identified in 1983, in boys was a significant marker for psychiatric disorder in 1987. Adoption was not a significant risk indicator for educational morbidity or substance use in 1987. In the multivariate analyses, adoptive status demonstrated no independent influence on 1987 educational morbidity or substance use. However, adoptive status, in the presence of poor school performance in 1983, was a significant risk indicator for psychiatric disorder in 1987. CONCLUSIONS: Adopted children did not do significantly worse than nonadopted children over time in terms of educational morbidity or substance use, but adopted boys demonstrated a significantly increased risk of psychiatric disorder versus nonadopted boys.

Adolescent↗
PubMed1988

The longitudinal course of posttraumatic morbidity. The range of outcomes and their predictors.

This study examined the longitudinal course, over a 25-month period, of posttraumatic morbidity in a group of 469 firefighters exposed to a bushfire disaster. The patterns of posttraumatic morbidity were defined by the General Health Questionnaire. Contrary to expectation, an acute pattern of morbidity was less common than the delayed-onset or chronic forms. Predisaster variables were found to be as important in the onset and course of the disorder as were the firefighters' losses or extent of exposure to the disaster. These data suggest that exposure to an extreme trauma is necessary but not sufficient to explain the onset and pattern of posttraumatic morbidity.

Adult↗
PubMed1986

Excision and grafting of large burns: operation length not related to increased morbidity.

In order to study the relation between length of operation and postoperative morbidity in patients with burns greater than 30% TBSA a retrospective review was done. Seven categories of morbidity were chosen and points assigned for significant change from the preoperative state. There were no intraoperative or immediate postoperative deaths. The overall morbidity was 19%. The eventual mortality was 19%. There was no correlation between length of operation and postoperative morbidity.

Burns↗
PubMed1987

Colostomy closure after colon injury: a low-morbidity procedure.

One justification for expanding the indications for primary repair of colonic injuries is the high morbidity classically associated with colostomy closure. Our impression that this morbidity is overstated prompted us to review our experience with closure of colostomies constructed for treatment of colon trauma for the 5-year period 1979-1984. During this period 75 colostomies created for treatment of colorectal injuries were closed. Complications were frequent after colostomy creation, but few could be attributed to the colostomy. Following colostomy closure, however, complications were infrequent (5%) and generally minor. If morbidity of colostomy closure is cited as a factor justifying expanded indications for primary repair of colon injuries, current morbidity rates should be borne in mind.

Adult↗
PubMed1990

The morbidity and financial impact of colostomy closure in trauma patients.

During a 10-year period, 87 patients who had undergone elective colostomy closure at Bellevue Hospital were retrospectively reviewed in order to evaluate the morbidity of colostomy closure after traumatic injury and its financial impact. Sixty-two per cent of the colostomies were in the left colon and 38% were right sided. The interval from the original injury to colostomy takedown varied from 20 to 465 days, with a mean of 144 days. The mean postoperative hospital stay for the entire group was 15.13 days at a cost of $13,995. There were no deaths and no anastomotic leaks in the entire series, but a morbidity rate of 25% ensued. Small bowel obstruction was the most frequent significant complication, occurring in ten patients (11.5%) and resulting in a prolongation of hospital stay by 7 days at an additional cost of $6,500 per patient. One additional patient developed a subphrenic abscess which required operative drainage, necessitating an additional 24 days in the hospital at an increased cost of $22,200. Other complications which did not prolong hospital stay included eight superficial wound infections, one transient respiratory failure, and two patients who returned at a later date with incisional hernias at the stoma site. The 25% morbidity encountered in this series suggests that colostomy closure is not a low-morbidity procedure and should be considered as an important factor favoring primary repair. Coupled with the significant financial impact of both colostomy formation and takedown, ample justification exists for greater efforts in avoiding colostomy formation whenever feasible.

Adolescent↗