Differences in Spontaneous Intracerebral Hemorrhage Cases between Urban and Rural Regions of Taiwan: Big Data Analytics of Government Open Data

Ting, Hsien-Wei; Chien, Ting-Ying; Lai, K. Robert; Pan, Ren-Hao; Wu, Kuan-Hsien; Chen, Junmin; Chan, Chien-Lung

doi:10.3390/ijerph14121548

Cited by 13 publications

(12 citation statements)

References 19 publications

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“…In this study, the surgical treatment rate of sICH inpatients was 30.84%, which was lower than that observed in northwest China (61.55%) [ 16 ] as well as in the United Kingdom (51.08%). [ 36 ] Our results indicated that the average hospital stay of sICH patients was 16 days, which was shorter than the 17.9 days observed in Taiwan [ 37 ] and longer than that observed in Canada (8 days). [ 38 ] In this study, the median cost of hospitalization was $3,608, which was lower than the $5,456 observed in Germany.…”

Section: Discussionmentioning

confidence: 59%

Epidemiological characteristics of 561 cases of intracerebral hemorrhage in Chengdu, China

Yu¹,

Zhu

He³

et al. 2021

Medicine

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To explore the epidemiology of patients with spontaneous intracerebral hemorrhage (sICH) in Chengdu, China, we retrieved the data of patients with spontaneous cerebral hemorrhage admitted to the First Affiliated Hospital of Chengdu Medical College from January 2017 to December 2019. We performed a comprehensive analysis of the location of hemorrhage, demographics, factors of hemorrhage, condition of body, severity of disturbance of consciousness, treatment, length of stay (days), inpatient costs, prognosis, and mortality rate in patients with sICH. In total, data of 561 in patients with sICH were included. The hemorrhage site was primarily located in the basal ganglia and thalamus (64.71%). The mean patient age was 63.2 ± 12.4 years (64.17% men, 35.83% women). Male patients (mean age 62.3 ± 12.5 year) were younger than female patients (mean age 64.9 ± 12.1 year). The age of sICH onset in our sample was between 40 and 79 years; this occurred in 87.70% of the included cases. There were more males than females, which may be related to more daily smoking, longer drinking years, and overweight in males than in females. Cases occurred most frequently during the winter and spring months, and the relationship between sICH visits and hospitalizations appeared as a U-shape. The median time from illness onset to hospital admission was 3.0 hours. According to the Glasgow Coma Scale (GCS) score at admission, 20.50% of sICH cases were of mild intensity, 39.93% were moderate, and 39.57% were severe. Moderate disorder is the most common sICH severity. Factors influencing the disturbance of consciousness were blood glucose level at the time of admission as well as the number of years with hypertension. The lower the degree of disturbance of consciousness and the more they smoked per day indicated they had a higher likelihood of receiving surgical treatment while in hospital. The median hospital stay was 13.0 days, while the median inpatient cost was USD 3609. The 30-day mortality rate was 18.36%. sICH is an important public health problem in Chengdu, China. A governmental initiative is urgently needed to establish a sICH monitoring system that covers the Chengdu region to develop more effective and targeted measures for sICH prevention, treatment, and rehabilitation.

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Section: Discussionmentioning

confidence: 59%

Epidemiological characteristics of 561 cases of intracerebral hemorrhage in Chengdu, China

Yu¹,

Zhu

He³

et al. 2021

Medicine

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“…Clinical decision support systems (CDSSs), which integrate electronic health records (EHRs) and expert knowledge, have improved the decision-making of physicians and medical caregivers [8][9][10][11]. Many methods have been developed for CDSSs, including linear/logistic regression, support vector machines (SVMs), decision trees, random forest (RF), rough sets, and trajectory methods [12][13][14][15][16][17][18]. Glycated hemoglobin (HbA1c) is extensively studied in these approaches because it is a good indicator of DM control.…”

Section: Introductionmentioning

confidence: 99%

A Clinical Decision Support System for Diabetes Patients with Deep Learning: Experience of a Taiwan Medical Center

Chien¹,

Ting²,

Chen³

et al. 2021

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Background: Diabetes mellitus (DM) is a major public health problem worldwide. It involves dysfunction of blood sugar regulation resulting from insulin resistance, inadequate insulin secretion, or excessive glucagon secretion.Methods: This study collated 971,401 drug usage records of 51,009 DM patients. These data included patient identification code, age, gender, outpatient visit dates, visit codes, medication features (including items, doses, and frequencies of drugs), HbA1c results, and time of testing. We applied a random forest (RF) model for feature selection and implemented a regression model with a bidirectional long short-term memory (Bi-LSTM) deep learning architecture. Finally, we used the root mean square error (RMSE) as the evaluation index for the prediction model.Results: After data cleaning, the data included 8,729 male and 9,115 female cases. Metformin was suggested to be the most important feature by the RF model, followed by glimepiride, acarbose, pioglitazone, glibenclamide, gliclazide, repaglinide, nateglinide, sitagliptin, and vildagliptin. The model performed better when using the past two seasons in the training data than with additional seasons. Further, the Bi-LSTM model performed better than the support vector machine (SVM) model.Conclusion: This study found that the Bi-LSTM model is a well processing architecture in a clinical decision support system (CDSS), which assists physicians in decision-making, and increasing the number of seasons had a negative impact on the model performance. In addition, this study showed that the most important drug was metformin, which is recommended as the first-line oral hypoglycemic agent (OHA) in DM patients.

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“…15 16 17 18 Excellent scientific works have been published separately on the epidemiology, management, and clinical outcome of traumatic and nontraumatic ICH before. 5 11 13 19 20 21 22 23 24 25 26 However, the comparison of these populations based on data retrieved by different patient cohorts being treated at separate centers and disparate times is susceptible to a large amount of selection and treatment bias. To minimize the potential treatment bias, we directly compared patients with traumatic and nontraumatic ICH in a single cohort diagnosed and treated simultaneously in the same surgical department.…”

Section: Introductionmentioning

confidence: 99%

Distinct Behavior of Traumatic versus Nontraumatic Intracerebral Hematomas: Different Biology or Impact of Age?

Gousias

Pleger

Markou

et al. 2021

J Neurol Surg A Cent Eur Neurosurg

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Background and Study Aims Patients with large intracerebral hematomas (ICH) may demonstrate different demographics and underlying brain and systemic diseases, as well as different radiologic courses and distinct outcomes. It remains unclear whether their different behavior attributes to a different biology of the ICH or to the asymmetric characteristics of the two populations. To analyze and adjust for potential sources of selection and treatment bias, our study compared age-matched patients with traumatic and nontraumatic ICH in a single cohort diagnosed and treated in the same surgical department. Material and Methods We analyzed 135 consecutive patients with traumatic (n = 90) or spontaneous ICH (n = 45) undergoing treatment at a surgical intensive care unit of an urban university hospital. We documented their differences before and after adjustment for age in terms of demographics, the therapies applied, their radiologic (i.e., volume and rate of ICH expansion [HE]) and clinical (patients' outcome at 30 days) course, the length of hospital and ICU stay, as well as the hospital costs. Results Patients with traumatic ICH demonstrated more favorable clinical and radiologic characteristics at admission, that is, higher Glasgow Coma Scale score (p < 0.001), less frequently dilated pupil (p = 0.028), lower Charlson Comorbidity Index (p < 0.001), smaller ICH volume (p < 0.001), noneloquent (p < 0.001) or nonintraventricular (p = 0.003) ICH locations, as well as underwent fewer neurosurgical interventions (p < 0.001) and showed a better outcome (p = 0.041), defined as Glasgow Outcome Scale 4 and 5. After adjustment for age, no different outcomes were observed. Of note, elderly patients on novel oral anticoagulants (NOACs) were more likely to develop an HE compared with those on vitamin K antagonists (VKAs, p = 0.05) after traumatic brain injury (TBI) but not after spontaneous ICH. Conclusion Our data reveal a significant heterogeneity within the traumatic series. Whereas younger patients show an excellent outcome, the elderly population of the traumatic cases demonstrates a poor outcome similar to that of the nontraumatic cohort. HE under NOACs rather than under VKAs is more likely in the elderly after TBI. Larger prospective trials are warranted to elucidate the potential individual underlying molecular mechanisms for the development of an ICH and HE in these diseases.

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Differences in Spontaneous Intracerebral Hemorrhage Cases between Urban and Rural Regions of Taiwan: Big Data Analytics of Government Open Data

Cited by 13 publications

References 19 publications

Epidemiological characteristics of 561 cases of intracerebral hemorrhage in Chengdu, China

Epidemiological characteristics of 561 cases of intracerebral hemorrhage in Chengdu, China

A Clinical Decision Support System for Diabetes Patients with Deep Learning: Experience of a Taiwan Medical Center

Distinct Behavior of Traumatic versus Nontraumatic Intracerebral Hematomas: Different Biology or Impact of Age?

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