Factors associated with hospitalization for aortic stenosis in Portugal from 2015 to 2017

Abstract Background Severe aortic stenosis prevalence has been growing worldwide and constitutes a public health challenge. The gold-standard treatment is Surgical Aortic Valve Replacement (SAVR) however Transcatheter Aortic Valve Implantation (TAVI) has been increasing, especially in high-risk surgical patients. This study aims identifying the factors associated to the implementation of TAVI to minimize possible disparities in access to health services. Methods This study used data on inpatient discharges from the Portuguese NHS, from 2015 to 2017. SAVR and TAVI, were classified according to the International Classification of Diseases (ICD). Chi-square test and independent T-tests with 1% significance level in the SPSS® were performed to identify the factors associated with both interventions. Results A total of 8398 hospitalizations were analysed, 88.5% SAVR and 11.5% TAVI. The mean (SD) age for SAVR was 70 (±11) years old and 81 (±7) years old for TAVI (p < 0.001), 56.9% were male among SAVR and 44.6% among TAVI (p < 0.001). Year (p < 0.001), type of admission (p < 0.001), geographic location (p < 0.001), severity (p < 0.001) and Charlson Comorbidity Index (CCI) (p < 0.001) were associated with the type of intervention. Conclusions TAVI was performed in more severe patients and there was an increase in TAVI over the years, which is consistent with the growing use of the technology among other patients, e.g., the high-risk surgical patients. We also found a geographic pattern in the use of SAVR and TAVI. This might reveal the existence of geographic disparities regarding availability and access to health services. Key messages • In Portugal, there is an increase in the performance of TAVI, with geographical concentration that reflects on access. • TAVI is more often performed in more severe patients as an alternative to SAVR with similar discharge outcomes.


Background:
Considering the current pandemic situation, the growing problem of antibiotic resistance and the increase in healthcare costs, attention to daily disinfection is becoming increasingly important. This study aimed to evaluate the bactericidal efficacy of a modern and stylish UV-C device designed for the home environment.

Methods:
The experimental study was conducted between July-August 2020 on four bacterial strains: Staphylococcus aureus, Salmonella typhymurium, Klebsiella pneumoniae and Escherichia coli. The UV-C device consist of a protective dome with a reflective coating, a UV-C lamp (placed in the device base) and three reflective holders. Different positions and exposure times were tested using two different carriers holder for the bacterial inoculum (plastic and stainless steel) to estimate the germicidal efficency related to UV-C lamp exposure, with direct and reflected (from the dome coating) light.

Results:
The experiment showed that the higher bacterial inactivation effect (3.5 to 7 log10) was achieved for all four strains at 3 minutes, but even at 1 minute, there is a marked reduction in the bacterial load with the only exception of Klebsiella pneumoniae. After 45 and 30 seconds, steel carriers contaminated by Escherichia coli and Staphylococcus aureus on the opposite side of the UV-C source showed significant reductions in the range between 99 and 99,9%.

Conclusions:
The device has proven to be effective for the disinfection of various everyday objects placed into the lamp and introduces beauty to the household environment. Key messages: In this study, UV-C device proved to be a valuable tool for disinfecting household items and enhancing safety for everyday health.
UV-C device proved to be a valuable tool for disinfecting household items and enhancing safety for everyday health.

Background:
Severe aortic stenosis prevalence has been growing worldwide and constitutes a public health challenge. The gold-standard treatment is Surgical Aortic Valve Replacement (SAVR) however Transcatheter Aortic Valve Implantation (TAVI) has been increasing, especially in high-risk surgical patients. This study aims identifying the factors associated to the implementation of TAVI to minimize possible disparities in access to health services.

Methods:
This study used data on inpatient discharges from the Portuguese NHS, from 2015 to 2017. SAVR and TAVI, were classified according to the International Classification of Diseases (ICD). Chi-square test and independent T-tests with 1% significance level in the SPSS Õ were performed to identify the factors associated with both interventions.

Conclusions:
TAVI was performed in more severe patients and there was an increase in TAVI over the years, which is consistent with the growing use of the technology among other patients, e.g., the high-risk surgical patients. We also found a geographic pattern in the use of SAVR and TAVI. This might reveal the existence of geographic disparities regarding availability and access to health services. Key messages: In Portugal, there is an increase in the performance of TAVI, with geographical concentration that reflects on access. TAVI is more often performed in more severe patients as an alternative to SAVR with similar discharge outcomes.