Class of 2012 Abstract / Specific Aims: The objectives of this study were to determine the financial impact and mortality of CLL and Richter’s transformation in CLL in the inpatient setting in the payer’s perspective, the common diagnoses at discharge for patients with CLL, and to compare demographics, hospital characteristics, and co-morbidities for CLL cases versus Richter’s only cases. Methods: This study was a retrospective cohort of inpatient hospital charges and mortality of CLL patients and CLL patients with Richter’s transformation in the United States in the perspective of the payer. Using weighted statistical methods, results of this investigation yielded nationally-representative findings. The hospital charges were analyzed with a gamma regression with log link, and mortality was analyzed with a generalized linear regression. Main Results: There were total of 391,287 cases and 7% (27,259) were Richter’s cases. The overall hospital charges for CLL and CLL patients with Richter’s transformation from 2005 to 2009 were $38,735 (±58859) per case and $53,118 (±77993) per case, respectively. The mortality was 6.3% (24,520 deaths) overall and 9.1% mortality (2,485 deaths) for Richter’s transformation patients. The significant predictors (p < 0.05) that were associated with an increase the hospital charges for Richter’s patients was sepsis while sepsis and weight loss were associated with an increase in mortality. Conclusions This study adds to the few studies published to show the impact of CLL and Richter’s. However, due to the limitation on pharmacotherapies, it was not possible to determine therapeutic cost drivers for these cases. Future studies are warranted to determine the cost of therapies associated to the different stages of CLL.

The aim of this thesis was to analyse detailed data on the development of infant mortality for different countries and their comparison. The countries were selected from several parts of Europe to provide high quality data for analysis. Different components of infant mortality with respect to data availability were examined as well as infant mortality by gender. Comparisons among selected countries were made based on different variability measures. Largely, the thesis deals with infant mortality depending on the level of development of the countries. Using regression and correlation analysis, infant mortality dependence was determined on various determinants with prerequisites to explain part of the infant mortality variability. The selected determinants include, for example, GDP per capita, unemployment rate or life expectancy.

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Introduction.: The evaluation and improvement of the quality of health care services begins with the knowledge about the trends and causes of diseases. Purpose: To describe the morbidity and mortality patterns for the under-5 year old children who were admitted in 11 district hospitals in Eastern Cape Province from 2000 to 2004. Methods: Descriptive study where a multi-stage sampling technique was used to select 11 district hospitals. There were 25,122 causes of paediatric ward admissions (2000 to 2004) among under-5 children from ward register were reviewed and ICD-10 coded. Findings: Pre-transitional causes were the leading causes of morbidity (68.4%) and mortality (74.2%) especially diarrhoeal lower respiratory tract infections and protein-energy malnutrition. There was particularly among male high infant morbidity and mortality rates observed from 2000 to 2004. Non-communicable diseases (8% morbidity and 4.2% mortality) and injuries (10% morbidity and 4.4% mortality) appeared to be of less public health concern among the under-5 children. Majority of under-5 mortality (43.4%) occurred within 24 hours of admissions (23.7% died on arrival). Influential variables for morbidity and mortality were region (Eastern), age (infants), year admitted and broad classification of the diseases (group I causes). There was a constant increase in morbidity and mortality which was observed during studied period. Conclusion: Pre-transitional causes (especially diarrhoeal, lower respiratory tract infections and protein energy malnutrition) were of public health concern among the under-5 children and their magnitude has increased over the years studied. Copyright / Dissertation (MSc)--University of Pretoria, 2010. / Clinical Epidemiology / unrestricted

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Background Previous measurements of preventable death in hospital do not account for the uncertainty of preventability ratings. Objective To determine the proportion of deaths in hospital that a have high probability of being prevented with high quality care. Methods We created summaries for every death at a tertiary care hospital over 4-months. Four reviewers assigned preventability ratings to each death and latent class analysis was used to classify deaths into high and low preventability categories. Results There were 480 decedents with mean age of 73.9. Inter-rater reliability was poor with an intra-class correlation of 0.14. The best latent class model found that 6.2% (95% CI 0.00 – 15.2%) of deaths had a 31.0% probability of being rated more likely preventable than not by each reviewer. In contrast, 93.8% (95% CI 84.8 - 100.0%) of deaths had a 0.8% probability of being rated more likely preventable than not by each reviewer. The incidence of truly preventable deaths is less than the 6.2% that are deemed possibly preventable. xi Conclusion Very few deaths in hospital are preventable. The low incidence of preventable deaths and low inter-rater reliability means that peer review methodology is only sensitive to large differences in preventable death rate.

The objective of this thesis is to find patterns trends and assumptions for mortality vs. age prediction. Based on the analysis of trends in the already extinct cohorts, the most suitable models for estimating the future development of mortality among surviving cohorts are selected. This thesis compares real data extinct cohorts with balanced data Gompertz-Makehamovy function. The research and analysis is focused on the specifics of cohort mortality from the age of 90. The last part of this thesis illustrates comparison between real data of extinct cohorts with DeRaS model outputs. The selection of Kannisto and Thatcher as the optimal model is presented in the form of graphical outputs indicating the cohort life expectancy of men and women aged 90 years.

The survival data for two hundred patients who underwent coronary bypass surgery are subjected to quantitative analysis. The questions of interest are: (i) the long-term survival rates of these patients, (ii) the prognostic factors influencing survival, and (iii) the importance of types of grafting in long-term survival. Statistical methods used to ascertain the important prognostic variables include contingency table analysis and discriminant analysis. It is found that left ventricular function, age, risk classification, and extent of occlusion of the diseased artery are the most influential variables. The relationship of these variables to survival is analysed in detail using the proportional hazards model discussed by Cox (1972). / Science, Faculty of / Statistics, Department of / Graduate

In recent years, mortalities of unknown aetiology have occurred in Pacific oyster aquaculture in Baynes Sound, BC during the summer. Field studies were conducted to examine environmental, reproductive and microbial factors that could be contributing to these mortalities. In 2017, oysters were observed at three sites from July 5 to September 15. Each intertidal site had three modules containing seven stacked trays with 80 oysters per tray. Final mortalities ranged from 9.3 ± 1.9 to 38.8 ± 4.9% per module. The mortality per module correlated significantly with gonad length and the proportion of oysters that were female in a multiple linear regression model (R2=0.824, p=0.002). Vibrio aestuarianus, a well-documented pathogen of farmed Pacific oysters in France, was well represented in bacterial cultures from intertidal oysters in 2017 based on recA gene sequencing of 158 bacterial isolates. In 2018, juvenile Pacific oysters were monitored to characterize the onset of a summer mortality event in suspended culture. From May 11 to September 17, data on shell size, reproductive development, environmental conditions, and the microbial community of gill tissue was tracked at culture densities of 150, 300, 450, and 600 oysters tray-1. The onset of mortality was associated with a period of rapid growth, reproductive development, and elevated temperatures. Cumulative mortality per tray ranged from 34 to 75%, with the highest density trays having significantly lower mortality (p=0.023), smaller shell width (p=0.001), smaller shell length (p=0.002) and smaller gonad length (p=0.049) than the lowest density trays in a linear mixed-effects regression. Histology of oysters from August 12, during the mortality event, showed a mixed microbial infection in peripheral gill tissue. High-throughput sequencing of the 16S rRNA gene and qPCR of V. aestuarianus using species-specific recA primers suggest V. aestuarianus is temporally associated with summer mortality. Mortalities observed in 2017 and 2018 occurred in different age classes and with different oyster culture techniques, but all were associated with elevated water temperature, increased reproductive effort, and the presence of V. aestuarianus. / Graduate / 2021-08-06

Purpose of the study - Identify predictors of mortality and develop a related care plan for patients who are on antiretroviral therapy (ART) in Gondar, Ethiopia. Design - A quantitative, retrospective cohort study was conducted analysing medical records of HIV patients who presented to Gondar University Hospital (GUH), Gondar, and started ART between 1 January 2007 and 30 June 2010. Results - In defining the predictors of mortality, the findings in bivariate analysis revealed: female sex, CD4 cell count ≤ 50/μl, CD4 cell count 51-199/μl, a haemoglobin concentration ≤8g/dl, a history of oral candidiasis, tuberculosis and Cryptococcus meningitis were all statistically significant. A female sex, CD4 cell count ≤ 50/μl and CD4 cell count 51-199/μl maintain their significance level in the multivariate analysis. Conclusions - The study therefore recommends that clinicians and case managers be vigilant of these predictors of mortality while managing HIV patients who are on ART. Key Concepts- ART, AIDS, HIV, predictors of mortality / Health Studies / (M.A. (Public Health))