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Increased mortality in women: sex differences in burn outcomes

Burns & Trauma 2017年第2期5卷 113-120页

作者： karen karimi Iris Faraklas Giavonni Lewis Daniel Ha Bridget Walker Yan Zhai Gareth Graves Sharmila Dissanaike Department of Surgery Texas Tech University Health Sciences Center 36014th Street MS 8312 Lubbock TX 79430 USA Department of Surgery University of Utah Health Sciences Center 30 N 1900 East Salt Lake City UT 84132 USA

Background: There is increasing evidence that sex differences may influence responses after thermal injury and affect clinical outcomes. The objective of this study was to evaluate the relationships between sex, thermal injury,body size, and inpatient mortality in burn ***: Medical records of adults with >20% total body surface area (TBSA) burn injury admitted to two American Burn Association (ABA)-verified burn centers between 2008 and 2014 were retrospectively *** details and baseline characteristics, including body size as estimated by body surface area (BSA) and body mass index (BMI) were recorded, along with details of the hospital course. The primary outcome of inpatient mortality was compared between ***: Out of 334 subjects, 60 were women (18%). Median TBSA was 33% (IQR 25-49) in this cohort, with 19% full thickness burns and 30% inhalation injury. Despite no significant difference in age, presence of inhalation injury, TBSA,or depth of burn, women had significantly higher rates of inpatient mortality (45 vs. 29%, P = 0.01). BSA was significantly lower in women vs. men (P < 0.001), but this difference was not more pronounced among *** was no difference in BMI between men and women non-survivors. Although not significant (P = 0.28), women succumbed to their injuries sooner than men (day 4 vs. 10 post-injury).Conclusions: Women are less likely to survive burn injuries and die sooner than men with similar injuries. Body size does not appear to modulate this effect. Burn centers should be aware of the higher mortality risk in women with large burns.

关键词： Mortality Sex Gender Burn Survival Outcome

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High levels of psychosocial distress among Australian frontline healthcare workers during the COVID-19 pandemic: a cross- sectional survey

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General Psychiatry 2021年第5期34卷 31-41,I0006-I0025页

作者： Natasha Smallwood Leila karimi Marie Bismark Mark Putland Douglas Johnson Shyamali Chandrika Dharmage Elizabeth Barson Nicola Atkin Claire Long Irene Ng Anne Holland Jane E Munro Irani Thevarajan Cara Moore Anthony McGillion Debra Sandford karen Willis Department of Respiratory Medicine Alfred HospitalPrahranVictoriaAustralia Department of Allergy Immunology and Respiratory MedicineCentral Clinical SchoolAlfred HospitalMonash UniversityMelbourneVictoriaAustralia School of Psychology and Public Health La Trobe UniversityMelbourneVictoriaAustralia School of Medicine and Healthcare Management Caucasus UniversityTbilisiGeorgia Department of Psychiatry The Royal Melbourne HospitalParkvilleVictoriaAustralia Department of Public Health Law Melbourne School of Population and Global HealthThe University of MelbourneParkvilleVictoriaAustralia Department of Emergency Services The Royal Melbourne HospitalParkvilleVictoriaAustralia Department of Critical Care Faculty of MedicineDentistry and Health SciencesThe University of MelbourneMelbourneVictoriaAustralia Departments of General Medicine and Infectious Diseases The Royal Melbourne HospitalParkvilleVictoriaAustralia Department of Medicine The Royal Melbourne HospitalThe University of MelbourneParkvilleVictoriaAustralia Allergy and Lung Health Unit School of Population and Global HealthThe University of MelbourneParkvilleVictoriaAustralia Department of Allied Health The Royal Melbourne HospitalParkvilleVictoriaAustralia Parkville Integrated Palliative Care Service The Royal Melbourne HospitalParkvilleVictoriaAustralia Sir Peter MacCallum Department of Oncology The University of MelbourneParkvilleVictoriaAustralia Department of Geriatric Medicine Western HealthFootscrayVictoriaAustralia Department of Anaesthesia and Pain Management The Royal Melbourne HospitalParkvilleVictoriaAustralia Centre for Integrated Critical Care Melbourne Medical SchoolThe University of MelbourneParkvilleVictoriaAustralia Department of Physiotherapy Alfred HealthMelbourneVictoriaAustralia Rheumatology Unit Royal Children's HospitalParkvilleVictoriaAustralia Arthritis and Rheumatology Murdoch Children's Research InstituteParkvilleVictoriaAustralia Department of Infectious Diseases T

Background The coronavirus disease 2019(COVID-19)pandemic has had a profound and prolonged impact on healthcare services and healthcare *** The Australian COVID-19 Frontline Healthcare Workers Study aimed to investigate the severity and prevalence of mental health issues,as well as the social,workplace and financial disruptions experienced by Australian healthcare workers during the COVID-19 *** A nationwide,voluntary,anonymous,single timepoint,online survey was conducted between 27 August and 23 October *** self-identifying as frontline healthcare workers in secondary or primary care were invited to *** were recruited through health organisations,professional associations or colleges,universities,government contacts and national ***,home and work situation,health and psychological well-being data were *** A total of 9518 survey responses were received;of the 9518 participants,7846(82.4%)participants reported complete *** regard to age,4110(52.4%)participants were younger than 40 years;6344(80.9%)participants were *** were nurses(n=3088,39.4%),doctors(n=2436,31.1%),allied health staff(n=1314,16.7%)or in other roles(n=523,6.7%).In addition,1250(15.9%)participants worked in primary *** measured mental health symptoms were common:mild to severe anxiety(n=4694,59.8%),moderate to severe burnout(n=5458,70.9%)and mild to severe depression(n=4495,57.3%).Participants were highly resilient(mean(SD)=3.2(0.66)).Predictors for worse outcomes on all scales included female gender;younger age;pre-existing psychiatric condition;experiencing relationship problems;nursing,allied health or other roles;frontline area;being worried about being blamed by colleagues and working with patients with *** The COVID-19 pandemic is associated with significant mental health symptoms in frontline healthcare *** preparedness together with policies and pra

关键词： distress nurse workers

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