Background
Abdominal obesity as a predominant comorbidity has played a key role in the incidence and worsening of heart failure with preserved ejection fraction (HFpEF), and waist-to-height ratio (WHtR) behaves better than waist circumference or body mass index in evaluating abdominal obesity. While the association between WHtR and all-cause death in Chinese patients with HFpEF remains unclear.
Methods
Patients with stable HFpEF (N = 2041) who presented to our hospital from January 2008 to July 2019 were divided into low-WHtR (< 0.5, N = 378) and high-WHtR (≥ 0.5, N = 1663). Multivariable Cox proportional-hazard models were used to examine the association of WHtR with all-cause death.
Results
The average age was 76.63 ± 11.44 years, and the mean follow-up was 4.53 years. During follow-up, 185 patients (9.06%) reached the primary outcome of all-cause death. As for the secondary outcome, 79 patients (3.87%) experienced cardiovascular death, 106 (5.19%) had non-cardiovascular death, and 94 (4.61%) had heart failure rehospitalization. After multivariable adjustment, a higher WHtR was significantly associated with the increased risks of all-cause death [adjusted hazard ratios (HR) 1.91, 95% confidence interval (CI) 1.06–3.45, p = 0.032], cardiovascular death (adjusted HR 2.58; 95% CI 1.01–6.67, p = 0.048), and HF rehospitalization (adjusted HR 3.04; 95% CI 1.26–7.31, p = 0.013).
Conclusions
Higher WHtR is an independent risk factor for all-cause death in Chinese patients with HFpEF.
Objective
To investigate the burden for Health Care Workers (HCWs) who suffer from Occupational-Related Adverse Events (ORAEs) while working in contaminated areas in a specialized hospital for Novel Coronavirus Pneumonia, to explore related risk factors, and to evaluate the effectiveness of Bundled interventions. In addition, to provide scientific evidence regarding the reduction of risks concerning ORAEs and occupational exposure events.
Methods
The study was completed on a special team of 138 HCWs assembled for a specialized hospital for Novel Coronavirus Pneumonia in Wuhan, dated from February 16th to March 26th, 2020. The incidence of occupational exposure was determined by data reported from the hospital, whilst the prevalence of ORAEs was derived from questionnaire results. The relation coefficients of ORAEs and the variable potential risk factors are analyzed by logistic regression. After the risk factors are identified, targeted organized intervention was implemented and Chi-square tests were performed to compare the incidence of occupational exposure and the prevalence of ORAEs in contaminated areas before and after the interventions.
Results
Ninety one out of 138 (65.94%) had reported ORAEs with 300 (27.96%) cases of ORAEs being recorded in a total of 1073 entries into contaminated areas. The prevalence of different ORAEs include 205 tenderness (24.73%), 182 headache/dizziness (21.95%), 138 dyspnoea (16.65%), 130 blurred vision (15.68%) and 95 nausea/vomiting (11.46%). Personal Protective Equipment (PPE) is significantly associated with ORAEs in contaminated areas (P<0.05). Among non-PPE-related factors, insomnia is associated with the majority of ORAEs in contaminated areas. Significant differences were achieved after organized interventions in the incidence of occupational exposure of HCW (χ2=39.07, P<0.001) and the prevalence of ORAEs in contaminated areas (χ2=22.95, P<0.001).
Conclusion
During the epidemic period of novel severe respiratory infectious disease, the burden of the ORAEs in contaminated areas and the risk of occupational exposure of HCWs are relatively high. In-time, comprehensive and multi-level bundled interventions may help to decrease the risk of both ORAEs and occupational exposure.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.