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10.1001/jamainternmed.2020.6466 http://scihub22266oqcxt.onion/10.1001/jamainternmed.2020.6466 33165560!7653540!33165560     free     free     free Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\33165560.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117       JAMA+Intern+Med 2021 ; 181 (2): 229-236 Nephropedia Template TP {{tp|p=33165560|t=2021. Association Between Nursing Home Crowding and COVID-19 Infection and Mortality in Ontario, Canada |pdf=|usr=}}{{33165560}} gab.com Text Association Between Nursing Home Crowding and COVID-19 Infection and Mortality in Ontario, Canada JO: JAMA Intern Med http://www.kidney.de/pget.php?&tw=1&pmid=33165560 #FOAvip IMPORTANCE: Nursing home residents have been disproportionately affected by coronavirus disease 2019 (COVID-19). Prevention recommendations emphasize frequent testing of health care personnel and residents, but additional strategies are needed. OBJECTIVE: To develop a reproducible index of nursing home crowding and determine whether crowding was associated with COVID-19 cases and mortality in the first months of the COVID-19 epidemic. DESIGN, SETTING, AND PARTICIPANTS: This population-based retrospective cohort study included more than 78?000 residents across more than 600 nursing homes in Ontario, Canada, and was conducted from March 29 to May 20, 2020. EXPOSURES: The nursing home crowding index equaled the mean number of residents per bedroom and bathroom. MAIN OUTCOMES AND MEASURES: The cumulative incidence of COVID-19 cases confirmed by a validated nucleic acid amplification assay and mortality per 100 residents; the introduction of COVID-19 into a home (>/=1 resident case) was a negative tracer. RESULTS: Of 623 homes in Ontario, we obtained complete information on 618 homes (99%) housing 78?607 residents (women, 54?160 [68.9%]; age >/=85 years, 42?919 [54.6%]). A total of 5218 residents (6.6%) developed COVID-19 infection, and 1452 (1.8%) died of COVID-19 infection as of May 20, 2020. COVID-19 infection was distributed unevenly across nursing homes; 4496 infections (86%) occurred in 63 homes (10%). The crowding index ranged across homes from 1.3 (mainly single-occupancy rooms) to 4.0 (exclusively quadruple occupancy rooms); 308 homes (50%) had a high crowding index (>/=2). Incidence in high crowding index homes was 9.7% vs 4.5% in low crowding index homes (P < .001), while COVID-19 mortality was 2.7% vs 1.3%, respectively (P < .001). The likelihood of COVID-19 introduction did not differ (high = 31.3% vs low = 30.2%; P = .79). After adjustment for regional, nursing home, and resident covariates, the crowding index remained associated with an increased incidence of infection (relative risk [RR] = 1.73, 95% CI, 1.10-2.72) and mortality (RR, 1.69; 95% CI, 0.99-2.87). A propensity score analysis yielded similar conclusions for infection (RR, 2.09; 95% CI, 1.30-3.38) and mortality (RR, 1.83; 95% CI, 1.09-3.08). Simulations suggested that converting all 4-bed rooms to 2-bed rooms would have averted 998 COVID-19 cases (19.1%) and 263 deaths (18.1%). CONCLUSIONS AND RELEVANCE: In this cohort of Canadian nursing homes, crowding was common and crowded homes were more likely to experience larger and deadlier COVID-19 outbreaks. Twit Text FOAVip Association Between Nursing Home Crowding and COVID-19 Infection and Mortality in Ontario, Canada ????JAMA Intern Med http://www.kidney.de/pget.php?&tw=1&pmid=33165560 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=33165560 #FOAvip English Wikipedia <ref>{{Cite pmid|33165560}}</ref> Association Between Nursing Home Crowding and COVID-19 Infection and Mortality in Ontario, Canada #MMPMID33165560 Brown KA; Jones A; Daneman N; Chan AK; Schwartz KL; Garber GE; Costa AP; Stall NM JAMA Intern Med 2021[Feb]; 181 (2): 229-236 PMID33165560show ga IMPORTANCE: Nursing home residents have been disproportionately affected by coronavirus disease 2019 (COVID-19). Prevention recommendations emphasize frequent testing of health care personnel and residents, but additional strategies are needed. OBJECTIVE: To develop a reproducible index of nursing home crowding and determine whether crowding was associated with COVID-19 cases and mortality in the first months of the COVID-19 epidemic. DESIGN, SETTING, AND PARTICIPANTS: This population-based retrospective cohort study included more than 78?000 residents across more than 600 nursing homes in Ontario, Canada, and was conducted from March 29 to May 20, 2020. EXPOSURES: The nursing home crowding index equaled the mean number of residents per bedroom and bathroom. MAIN OUTCOMES AND MEASURES: The cumulative incidence of COVID-19 cases confirmed by a validated nucleic acid amplification assay and mortality per 100 residents; the introduction of COVID-19 into a home (>/=1 resident case) was a negative tracer. RESULTS: Of 623 homes in Ontario, we obtained complete information on 618 homes (99%) housing 78?607 residents (women, 54?160 [68.9%]; age >/=85 years, 42?919 [54.6%]). A total of 5218 residents (6.6%) developed COVID-19 infection, and 1452 (1.8%) died of COVID-19 infection as of May 20, 2020. COVID-19 infection was distributed unevenly across nursing homes; 4496 infections (86%) occurred in 63 homes (10%). The crowding index ranged across homes from 1.3 (mainly single-occupancy rooms) to 4.0 (exclusively quadruple occupancy rooms); 308 homes (50%) had a high crowding index (>/=2). Incidence in high crowding index homes was 9.7% vs 4.5% in low crowding index homes (P < .001), while COVID-19 mortality was 2.7% vs 1.3%, respectively (P < .001). The likelihood of COVID-19 introduction did not differ (high = 31.3% vs low = 30.2%; P = .79). After adjustment for regional, nursing home, and resident covariates, the crowding index remained associated with an increased incidence of infection (relative risk [RR] = 1.73, 95% CI, 1.10-2.72) and mortality (RR, 1.69; 95% CI, 0.99-2.87). A propensity score analysis yielded similar conclusions for infection (RR, 2.09; 95% CI, 1.30-3.38) and mortality (RR, 1.83; 95% CI, 1.09-3.08). Simulations suggested that converting all 4-bed rooms to 2-bed rooms would have averted 998 COVID-19 cases (19.1%) and 263 deaths (18.1%). CONCLUSIONS AND RELEVANCE: In this cohort of Canadian nursing homes, crowding was common and crowded homes were more likely to experience larger and deadlier COVID-19 outbreaks. |*Crowding[MESH] |*Nursing Homes[MESH] |Aged, 80 and over[MESH] |COVID-19/*mortality[MESH] |Disease Outbreaks[MESH] |Female[MESH] |Humans[MESH] |Incidence[MESH] |Male[MESH] |Ontario/epidemiology[MESH] |Retrospective Studies[MESH] |Risk Factors[MESH]Association Between Nursing Home Crowding and COVID-19 Infection and M(epmc).pdf DeepDyve Pubget Overpricing