The COVID-19 pandemic significantly impacted Saskatchewan, resulting in high per capita case counts and COVID-19-related deaths. While vaccination mandates have been a key strategy to control the pandemic, their impact in Saskatchewan remains poorly documented. This study assessed the effect of COVID-19 vaccine mandates on the incidence of COVID-19 cases and deaths in Saskatchewan during the first year following vaccine rollout.

A single-group interrupted time series analysis with multiple intervention points was conducted using aggregated daily COVID-19 incidence and mortality rates as outcome variables. The models accounted for confounding effects of daily total vaccine doses administered and public health countermeasures, including the stringency index and economic support index, from April 1, 2020 to January 20, 2022. Average daily COVID-19 incidence and mortality rates were estimated for the pre-vaccine rollout period (April 1 to December 14, 2020), and the post-rollout period (December 15, 2020 to January 20, 2022). In addition, nine supplementary initiatives were introduced during the implementation phase. All estimated effects reflected cumulative changes in trend relative to the pre-vaccination period.

Cumulatively, COVID-19 incidence increased faster than the pre-vaccination trend, likely driven by successive variant surges from wild-type to Omicron, while COVID-19–related deaths remained stable across the same period. The implementation of vaccine rollout, prioritization of vaccines for high-risk populations, and proof-of-vaccination policy were effective in reducing daily COVID-19 incidence and deaths in Saskatchewan. Economic support and an increased number of daily vaccine doses administered were also associated with an improved provincial COVID-19 response. Conversely, surges in COVID-19 incidence and deaths occurred following the introduction of the centralized virtual booking system and booster doses. These surges may reflect accessibility challenges, increased testing, emergence of immune-escape variants, relaxation of public health measures before achieving herd immunity, and waning immunity over time.

Economic support, policy measures, and vaccination efforts played important roles in managing public health crises, hence the need for an integrated approach to managing public health crises. However, temporary surges following certain interventions underscore the need for accessible, adaptable strategies that account for variant emergence, immunity waning and public adherence.

Understanding how suicide rates vary across age, sex, and geography is essential to designing effective prevention strategies. We examined long-term trends in suicide mortality across European countries over three decades, with a focus on age-specific trajectories.

Using the WHO mortality database, we computed annual sex- and age-specific suicide rates (10–14 to 85+ age groups) from 1990 to 2022, for the most populous European countries, and aggregated rates for the EU-27 and four geographical areas (North, West, South, and Centre-East Europe). We also calculated percentage differences across four time periods (1990–1994, 2000–2004, 2010–2014, and 2020–2022), according to data availability.

Suicide rates increased with age, peaking in older individuals (85+) in most countries (e.g., 82.0/100,000 in France in 2020–2022, 77.1/100,000 in Germany among males, in 2020), except in the UK and Northern Europe, where rates peaked at middle age (∼22/100,000 at 45–49, in 2020). EU-27 suicide rates in 2020 ranged from 5.5/100,000 (age 15–19) to 58.2/100,000 (85+) among males, and from 2.6 (15–19) to 8.6/100,000 (85+) among females. Male suicide rates were 3 to 8 times higher than female rates across all ages. While overall rates declined since 1990 in most countries, youth suicide increased after 2010 in Western (e.g., +12%, girls 15–19), Southern (+24.5%, girls 15–19), and Northern (+44%, girls 15–19 and 20–24) Europe. Rates among young and middle-aged adults recently rose in Spain, the UK, and Northern Europe, while they declined in Eastern Europe after the 1990s.

Despite overall declines, our findings highlight marked heterogeneity in sex- and age-specific trends in suicide mortality across Europe. These patterns call for age-tailored prevention strategies that address evolving psychosocial stressors and structural determinants across the lifespan.

Individuals with first-episode psychosis (FEP) face markedly increased excess mortality, yet the long-term trends and key contributing factors remain insufficiently characterized. This study aimed to examine long-term mortality patterns, standardized mortality ratios (SMRs), and associated factors in a FEP cohort.

This population-based cohort study included 1,389 individuals diagnosed with FEP, followed for up to 25 years. Mortality outcomes were obtained from Hong Kong’s centralized hospital database (CMS) and coroner’s court reports, with SMRs calculated. Baseline sociodemographic and clinical, as well as long-term treatment-related factors of all-cause, natural, and unnatural mortality were analyzed.

Among 1,389 participants, 137 deaths (9.86%) occurred during the follow-up period with the overall SMR of 6.56 (95% CI, 5.50–7.71). The cumulative incidence rate of unnatural mortality increased sharply over the first 10 years and that of the natural cause of death started to increase after the first decade of the illness. Male gender and poorer social functioning were associated with increased all-cause mortality risk, while male gender, lower education, and baseline hospitalization raised unnatural mortality risk. Greater monthly antipsychotic variability during the first 10 years increased all-cause mortality risk in the period after the initial 10 years.

This 25-year follow-up study of FEP highlighted the changes in the long-term mortality pattern of FEP and thus the phase-specific needs of individuals with FEP. Therefore, it is important to integrate physical care into mental health services, as well as stage-specific and individualized care for patients with psychotic disorders to reduce long-term excess mortality.

To evaluate the hospital-level impact of the COVID-19 pandemic on U.S. academic medical centers (AMCs) and assess regional variation in care delivery to inform public health emergency preparedness strategies.

We retrospectively analyzed adult inpatient discharges from 106 AMCs using Vizient® Clinical Data Base from October 2019 to December 2023. The study period was divided into pre-COVID (Oct 2019-Mar 2020), early-COVID (Apr 2020-Dec 2020), late-COVD (Jan 2021-May 2023), and post-COVID (Jun-Dec 2023). Outcomes included hospital encounters, length of stay (LOS), ICU admissions, ICU LOS, mortality, and case mix index (CMI). Mixed models assessed temporal and regional variation.

Among 13.5 million discharges, monthly encounters declined during early COVID and rebounded post-COVID (P < 0.0001). Observed LOS increased from 6.2 to 6.7 days during the pandemic and remained elevated post-COVID (P < 0.0001). ICU LOS rose during early and late COVID (P < 0.0001), while ICU admission rates declined slightly over time (P = 0.0112). Mortality peaked at 3.4% during early COVID and returned to 2.8% post-COVID (P < 0.0001).

The COVID-19 pandemic significantly disrupted inpatient operations at U.S. AMCs, with increased LOS, ICU burden, and case complexity. By segmenting the pandemic into phases, we identified patterns in hospital performance that reflect evolving public health challenges.

To quantify optic nerve hypoplasia/septo-optic-pituitary dysplasia (ONH/SOD) all-cause mortality rate and risk of death in Manitoba, Canada.

A retrospective population-based study with a case–control design was undertaken using the Manitoba Population Research Data Repository. Cases were 124 ONH/SOD patients diagnosed during 1990–2019, matched to 620 unrelated population-based controls on year of birth, sex and area of residence. Both cases and controls were followed until March 31, 2022, or until they moved out of the province or died. Crude mortality rate was estimated. Cox proportional hazards models were used to test for differences in all-cause mortality between cases and controls. Hazard ratios (HR) with 95% confidence intervals (CIs) were estimated.

Six of 124 (4.8%) cases with ONH/SOD and 8 of 620 (1.3%) controls died during the study’s follow-up period. The median (25th–75th percentiles) age of death of ONH/SOD patients was 4.6 (2.7–9.1) years. The median duration of follow-up was 12.0 years for the cases and 11.4 years for the controls. The crude mortality rate (95% CIs) was 3.7 (1.7–8.3) per 1000 person-years in patients with ONH/SOD and 1.0 (0.5–2.1) per 1000 person-years in unrelated matched controls. All-cause mortality was significantly higher in ONH/SOD patients compared to unrelated controls (HR = 3.7, 95% CI = 1.3–10.5).

Patients with ONH/SOD have a higher risk of death compared to unrelated controls. Healthcare professionals should be familiar with the morbidities and comorbidities associated with ONH/SOD and the complications that may lead to their demise, since they can be managed to reduce the mortality risk.

The Syrian Civil War (SCW) began in 2011 and has resulted in numerous cases of war-related civilian injuries. The modified Rapid Emergency Medicine Score (mREMS) is widely used as an effective tool for assessing clinical status and mortality risk, particularly in intensive care units (ICUs) and emergency departments (EDs). However, to date, no study has evaluated the ability of mREMS to predict mortality in patients injured during the SCW.

The primary objective of this study was to evaluate the performance of mREMS in predicting in-hospital mortality among adult trauma patients injured during the SCW. The secondary objective was to analyze the epidemiological characteristics of both adult and pediatric populations affected by the SCW.

This single-center, retrospective observational study included patients who were injured during the SCW and presented to the ED from January 2012 through January 2016. Data from 4,074 adult patients and 1,379 pediatric patients were analyzed. The diagnostic and prognostic performance of the mREMS was specifically assessed in the adult cohort. Additionally, an epidemiological evaluation of the demographic and clinical characteristics of both cohorts was conducted.

Among the 4,074 adult patients included in the study, a total of 3,657 (89.8%) were male and 417 (10.2%) were female. In-hospital mortality occurred in 484 patients (11.9%). Adult patients admitted to the ICU exhibited a mortality rate 7.6-times higher than those who were not admitted (odds ratio [OR] = 7.6; 95% confidence interval [CI], 6.2–9.3). The analysis of the mREMS revealed a median score of eight for survivors and fourteen for non-survivors, demonstrating a statistically significant difference (P < .001).

The present study demonstrated that the majority of civilians injured during the SCW were young males. Furthermore, this study’s findings indicated that the mREMS exhibits excellent performance in predicting in-hospital mortality among trauma patients injured during the SCW.

Patients with stroke or transient ischemic attack (TIA) are at high early risk of mortality and morbidity. Current risk prediction tools focus on patients after hospital discharge but not on those surviving to outpatient follow-up. We examined whether demographic and medical history data could predict 1-year stroke recurrence and mortality, among those discharged alive and event-free for 90 days after stroke and 1 day after TIA.

Data were obtained from the Ontario Stroke Registry (13,848 stroke and 13,059 TIA patients) and linked to administrative databases. Two-thirds of each cohort were used for model derivation and one-third for validation. Multivariable regression models were used to predict stroke recurrence and all-cause mortality.

There were 238 (2.71%) recurrent strokes in the ischemic stroke and 298 (3.44%) in the TIA cohorts at one year. Increasing age and previous stroke/TIA were associated with an increased risk of recurrent stroke in both cohorts. A higher modified Rankin Scale and diabetes were associated with an increased risk of recurrent stroke in the stroke cohort and heart failure, smoking and discharge location in the TIA cohort. Time-dependent areas under the curve were modest, 0.59 (0.54–0.64) and 0.59 (0.55–0.64) for the stroke and TIA validation cohorts, respectively. C-statistics from derivation and validation cohorts for mortality ranged from 0.74–0.78.

The predictive accuracy of the models was quite low after accounting for several risk factors. Additional risk factors associated with stroke recurrence for people seen in outpatient stroke clinics, and innovative approaches to individualized secondary prevention are needed.