Background There is a paucity of literature addressing COVID-19 case-fatality ratios (CFR) by zip code (ZC). We aim to analyze trends in COVID-19 CFR, population density, and socioeconomic status (SES) indicators (unemployment, median household income) to identify ZCs heavily burdened by COVID-19. Methods Cross-sectional study to investigate the US prevalence of COVD-19 fatalities by ZC and SES. CFRs were calculated from state/county Departments of Health. Inclusion criteria were counties that reported cases/deaths by ZC and a CFR≥2%. This study was reported in line with the STROCSS criteria. Results 609/1,853 ZCs, spanning 327 counties in 7 states had CFRs ≥2%. A significant positive correlation was found between the CFR and median household income (Pearson correlation:0.107; 95% CI [289.1,1937.9]; p < 0.001). No significant correlations exist between the CFR, and population/mi (Sen-Crowe et al., 2020) [2] or unemployment rate. Significant associations exist between the CFR and young males and elderly females without public insurance. CFR was inversely associated with persons aged <44 and individuals aged ≥65. The percentage of nursing homes (NHs) within cities residing within high CFR ZCs range from 8.7% to 67.6%. Conclusion Significant positive association was found between the CFR and median household income. Population/mi (Sen-Crowe et al., 2020) [2] and unemployment rates, did not correlate to CFR. NHs were heavily distributed in high CFR zip codes. We recommend the targeted vaccination of zip codes with a large proportion of long-term care facilities. Finally, we recommend for improved screening and safety guidelines for vulnerable populations (e.g nursing home residents) and established protocols for when there is evidence of substantial infectious spread.

Background While it is widely held that obesity is a risk factor for stroke, its role in mortality after stroke is less understood. We aim to examine effects of Body Mass Index (BMI) on in-hospital mortality after non-subarachnoid, subarachnoid, and ischemic stroke. Methods Retrospective cohort study. Patients aged ≥18 years, who were hospitalized in Florida hospitals between 2008 and 2012 with a diagnosis of first-time stroke as reported by the Agency for Health Care Administration (AHCA). The main independent variable was BMI category, which was divided into non-overweight/non-obese, obese, and morbidly obese. The primary outcome was the adjusted odds ratio (aOR) for in-hospital mortality for subarachnoid and non-subarachnoid hemorrhagic stroke, and ischemic stroke. Logistic regression modeling was utilized to examine the association between each BMI category and in-hospital mortality, while controlling for several potential confounders. This study was reported in line with the STROCSS criteria. Results Of the 333,367 patients included in the database, 150,153 (45.0%) patients met inclusion criteria. After adjusting for age, gender, ethnicity and other possible confounders, obese patients were 21% less likely to die during their hospitalization following a first ischemic stroke (0.79 aOR, 0.69–0.92, 95% CI, p = 0.002), and 32% less likely following a first non-subarachnoid hemorrhage (0.68 aOR, 0.57–0.82, 95% CI, p = 0.0001) compared to non-overweight/non-obese counterparts. Conclusion Obese patients are less likely to die during hospitalization following first-time non-subarachnoid hemorrhage and ischemic stroke than non-overweight/non-obese patients. These findings support the “obesity paradox” concept, though more research is needed for recurrent stroke patients.

Introduction: Total knee arthroplasty (TKA) is common but complex operation. A paucity of literature exists on differences between Hispanics and non-Hispanics with TKA. Our study aims to investigate the association between Hispanic ethnicity and complications in obese patients undergoing TKA.Methods: This is a retrospective cohort study using the National Surgical Quality Improvement Program database for patients with body mass index $30 kg/m 2 who underwent TKA. Exposure in this study was ethnicity (Hispanic versus non-Hispanic), and the primary outcome was postoperative complications. Associations between ethnicity and baseline characteristics and between covariates and the outcome were assessed via bivariate analysis. Multiple logistic regression was done to determine associations between Hispanic ethnicity and complications while controlling for confounders.Results: Thirty five thousand twenty-seven patients were included in our study, of which 6.3% were Hispanic. Among obese adults, Hispanics had a 1.24 (95% CI 1.11 to 1.39) times greater odds of having a postoperative complication after TKA than non-Hispanics. This increased to 1.36 (95% CI 1.20 to 1.54) after adjusting for confounders. Hispanics were notably more likely to receive transfusion (2.62% vs. 1.59%, P , 0.001) and have prolonged length of stay (13.29% vs. 11.12%, P = 0.002) but were less likely to have wound disruption (0.05% vs. 0.27%, P = 0.042). Conclusion:In a national database, Hispanic ethnicity was associated with greater odds of postoperative complication in obese

Ambient/room temperature settings in burn treatment areas vary greatly due to a lack of evidence-based guidelines to direct care. While it is generally understood that ambient/room temperature impacts patient body temperature and metabolism, the ideal settings for optimizing patient outcomes are unclear. The literature assessing this topic is scarce, with many of the articles having significant limitations. We aim to summarize the current evidence for ambient/room temperature control, to address gaps in current reviews addressing this topic, and to elucidate topics requiring further research. PubMed and Google Scholar databases were queried for studies which evaluated the effect of the ambient/room temperature on burn patient core body temperature, patient metabolism, and outcomes among those treated in trauma bays, burn ICUs, and operating rooms. Although existing literature lacks sufficient patient outcome data regarding specific ambient/room temperatures, we highlight physiological processes that are impacted by changes in room temperatures in an effort to describe strategies that can allow for improved patient core body temperature control and outcomes in burn care settings.