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While some studies have previously estimated lives saved by COVID-19 vaccination, we estimate how many deaths could have been averted by vaccination in the US but were not because of a failure to vaccinate. We used a simple method based on a nationally representative dataset to estimate the preventable deaths among unvaccinated individuals in the US from May 30, 2021 to September 3, 2022 adjusted for the effects of age and time. We estimated that at least 232,000 deaths could have been prevented among unvaccinated adults during the 15 months had they been vaccinated with at least a primary series. While uncertainties exist regarding the exact number of preventable deaths and more granular data are needed on other factors causing differences in death rates between the vaccinated and unvaccinated groups to inform these estimates, this method is a rapid assessment on vaccine-preventable deaths due to SARS-CoV-2 that has crucial public health implications. The same rapid method can be used for future public health emergencies.

Tremendous progress has been made in cancer research over the years, and, as a result, immunotherapy has emerged as an important therapy for the treatment of cancer, either as a stand-alone treatment or in conjunction with other cancer therapies. Immunotherapy has demonstrated encouraging outcomes and offers a viable strategy for not only enhancing the quality of life but also dramatically boosting the overall survival rate of cancer patients. The objective of this systematic review was to assess the efficacy of immunotherapy in the treatment of cancer. Databases such as PubMed and Science Direct were searched from their inception until September 2021, using the following keywords: cancer immunotherapy, cancer recurrence, cancer treatment options, and cancer therapies. The systematic review was conducted in accordance with the PRISMA protocol. There were a total of 599 articles; however, after applying the inclusion and exclusion criteria, the final review ended up with 34 publications. In conclusion, the studies have demonstrated that immunotherapy is a viable alternative treatment option for patients with recurrent or metastatic cancer, since the overall survival rate and progression-free survival rate were shown to be successful.

BackgroundThe number of preventable inpatient deaths in the USA is commonly estimated as between 44,000 and 98,000 deaths annually. Because many inpatient deaths are believed to be preventable, mortality rates are used for quality measures and reimbursement. We aimed to estimate the proportion of inpatient deaths that are preventable.MethodsA systematic literature search of Medline, Embase, Web of Science, and the Cochrane Library through April 8, 2019, was conducted. We included case series of adult patients who died in the hospital and were reviewed by physicians to determine if the death was preventable. Two reviewers independently performed data extraction and study quality assessment. The proportion of preventable deaths from individual studies was pooled using a random-effects model.ResultsSixteen studies met inclusion criteria. Eight studies of consecutive or randomly selected cohorts including 12,503 deaths were pooled. The pooled rate of preventable mortality was 3.1% (95% CI 2.2–4.1%). Two studies also reported rates of preventable mortality limited to patients expected to live longer than 3 months, ranging from 0.5 to 1.0%. In the USA, these estimates correspond to approximately 22,165 preventable deaths annually and 7150 deaths for patients with greater than 3-month life expectancy.DiscussionThe number of deaths due to medical error is lower than previously reported and the majority occur in patients with less than 3-month life expectancy. The vast majority of hospital deaths are due to underlying disease. Our results have implications for the use of hospital mortality rates for quality reporting and reimbursement.Study RegistrationPROSPERO registration number CRD42018095140.

Background Fatal trauma is one of the leading causes of death in Western industrialized countries. The aim of the present study was to determine the preventability of traumatic deaths, analyze the medical measures related to preventable deaths, detect management failures, and reveal specific injury patterns in order to avoid traumatic deaths in Berlin. Materials and methods In this prospective observational study all autopsied, direct trauma fatalities in Berlin in 2010 were included with systematic data acquisition, including police files, medical records, death certificates, and autopsy records. An interdisciplinary expert board judged the preventability of traumatic death according to the classification of non-preventable (NP), potentially preventable (PP), and definitively preventable (DP) fatalities. Results Of the fatalities recorded, 84.9 % ( n  = 224) were classified as NP, 9.8 % ( n  = 26) as PP, and 5.3 % ( n  = 14) as DP. The incidence of severe traumatic brain injury (sTBI) was significantly lower in PP/DP than in NP, and the incidence of fatal exsanguinations was significantly higher. Most PP and NP deaths occurred in the prehospital setting. Notably, no PP or DP was recorded for fatalities treated by a HEMS crew. Causes of DP deaths consisted of tension pneumothorax, unrecognized trauma, exsanguinations, asphyxia, and occult bleeding with a false negative computed tomography scan. Conclusions The trauma mortality in Berlin, compared to worldwide published data, is low. Nevertheless, 15.2 % ( n  = 40) of traumatic deaths were classified as preventable. Compulsory training in trauma management might further reduce trauma-related mortality. The main focus should remain on prevention programs, as the majority of the fatalities occurred as a result of non-survivable injuries.

Health inequity, that is socially determined, and preventable disparities in health, hinders the advancement of life expectancy. In Russia, which has witnessed the collapse of a social system rooted in the principles of social equality in a remarkably brief historical period, both the topic itself and the search for methods to investigate it are of utmost importance. The purpose of the study is to evaluate the manifestations of health inequity through the lens of their social dependence and preventability in terms of avoidable mortality.Material and methods. The calculation of avoidable mortality is based on the cause classification in ages under 65, proposed by Walter W. Holland in 1993. The analysis was conducted using data for the period between 2000 and 2019.The subsequent period is marked by turbulence. The study used official data provided by Rosstat as its information base. Standardized mortality rates for preventable death causes were calculated using the direct method (European standard population).Results. The disparity in life expectancy between urban and rural populations, as well as its regional variations, is largely attributable to avoidable mortality. The example of a substantial reduction in the rural-urban gap in avoidable mortality over the first two decades of the 21st century, including a convergence in treatable deaths, suggests that significant progress has been made in addressing health disparities between urban and rural populations within a remarkably short timeframe.In terms of regional disparities, progress is minimal. The economically prosperous regions of the country have much greater potential for improving the life expectancy of their populations by reducing preventable deaths, compared to poorer regions. In both cases, priority should be given to prevention interventions aimed at lifestyle modification, as the social component of avoidable mortality dominates, and interventions aimed at reducing it are the most cost-effective strategy.

Introduction Preventable deaths following trauma are high and unchanged over the last two decades. The objective of this study was to describe the location of death in patients with penetrating trauma, stratified by anatomic location of injury, in order to better tailor our approach to reducing preventable deaths from trauma. Methods This retrospective analysis of a prospectively maintained trauma registry included consecutive adult trauma activations with penetrating trauma at a level 1 trauma center between 07/2012 and 03/2018. Injuries were categorized as extremity, junctional, and torso. Head and neck injuries were excluded. Patients injured in >1 defined location were categorized as “multiple.” Location of death was defined as on-scene, emergency department (ED), or hospital. Two-sided χ2 tests were used to compare groups. Multivariate analysis was performed using logistic regression. Results A total of 1024 patients were included with an overall case fatality rate (CFR) of 7.8%. The CFR following extremity injury (3.0%) was significantly lower than all other injury sites (P = .02).There were no significant differences in CFR for junctional (10.4%), torso (8.3%), or multiple injuries (9.6%). Forty percent of fatalities following junctional injury occurred on-scene and an additional 20% occurred in the ED. Discussion To our knowledge, this is the first study to describe location of death stratified by anatomic location of injury. There was no difference in the CFRs of junctional and torso injuries, and a large proportion of deaths occurred prior to reaching the hospital or in the trauma bay. These findings support reevaluating the classical algorithms and care pathways for patients with proximal penetrating trauma.

This study aims to investigate the trends of avoidable mortality and regional inequality from 1995 to 2019 and to provide evidence for policy effectiveness to address regional health disparities in Korea. Mortality and population data were obtained from the Statistics Korea database. Age-standardized all-cause, avoidable, preventable, and treatable mortality was calculated for each year by sex and region. Changes in mortality trends between metropolitan and non-metropolitan areas were compared with absolute and relative differences. Avoidable mortality decreased by 65.7% (350.5 to 120.2/100,000 persons) in Korea, 64.5% in metropolitan areas, and 65.8% in non-metropolitan areas. The reduction in avoidable mortality was greater in males than in females in both areas. The main causes of death that contribute to the reduction of avoidable mortality are cardiovascular diseases, cancer, and injuries. In preventable mortality, the decrease in non-metropolitan areas (−192.4/100,000 persons) was greater than that in metropolitan areas (−142.7/100,000 persons). However, in treatable mortality, there was no significant difference between the two areas. While inequalities in preventable mortality improved, inequalities in treatable mortality worsened, especially in females. Our findings suggest that regional health disparities can be resolved through a balanced regional development strategy with an ultimate goal of reducing health disparities.

BackgroundCardiac tamponade is a life-threatening and challenging condition involving fluid accumulation in the pericardium. Coroners in the United Kingdom must write publicly available preventing future deaths (PFD) reports if they identify contributing factors that could prevent recurrence of mortality. We sought to analyze these reports for cardiac tamponade.MethodsWe formulated new software to download and extract PFD reports’ text data using Pdfminer and Pytesseract for 4650 reports from 01/08/2013 to 07/10/2024. We processed and indexed the data to make it searchable with Tantivy, and searched for ‘cardiac tamponade’ and ‘tamponade’.ResultsWe identified 13 PFD reports accounting for 15 total deaths mentioning cardiac tamponade. Of these 15 deaths, cardiac tamponade was the cause of death in 11, and incidental in the remaining 4. Where directly attributable, 6 (55%) of cardiac tamponade deaths were at the management level, secondary to iatrogenic injury judged to be avoidable. Four of these were among neonates during central line insertion for umbilical venous catheterization. The other two were during insertion of a pacemaker and pacing wires for percutaneous coronary intervention. Four cases were at the diagnosis level: two premature discharges resulted in out-of-hospital sudden death secondary to tamponade from a missed aortic root aneurysm and dissection, another was due to missed heart failure from sepsis leading to tamponade, while the fourth was a missed ventricular fibrillation secondary to aortic dissection and resulting tamponade. The final preventable death was at the public health level, where the improper layout of a road junction led to a motor vehicle collision causing a traumatic tamponade.ConclusionIatrogenic injury and missed diagnoses were common themes of preventable deaths related to cardiac tamponade. Targeted quality improvement interventions involving education on clinical recognition, procedural up-skilling, and appropriate safety-netting may reduce mortality secondary to tamponade.

Trauma is the leading cause of death in the Western world. Trauma systems have been paramount in opposing this problem. Commonly, Level 1 Trauma Centers are staffed by in-house (IH) attending trauma surgeons available 24/7, whereas other institutions function on an on-call (OC) basis with defined response times. There is on-going debate about the value of an IH attending trauma surgeon compared to OC trauma surgeons regarding clinical outcome. This study was performed at a tertiary care facility complying with all requirements to be a designated Level 1 Trauma Center as defined by the American College of Surgeons Committee on Trauma (ACSCOT). Inclusion occurred from January 1, 2012 through December 31, 2013. Patients were assigned an identifier for IH trauma surgeon attendance versus OC attendance. The primary outcome variable studied was overall mortality in relation to IH or OC attending trauma surgeons. Additionally, time to operating theater, hospital length-of-stay (HLOS), and intensive care unit (ICU) admittance were investigated. A total of 1,287 unique trauma cases in 1,285 patients were presented to the trauma team. Of all cases, 712 (55.3%) occurred between 1700h and 0800h. These 712 cases were treated by an IH attending in 66.3% (n = 472) and an OC attending in 33.7% (n = 240). In the group of patients treated by an IH attending trauma surgeon, the overall mortality rate was 5.5% (n = 26); in the group treated by an OC attending, the overall mortality rate was 4.6% (n = 11; P = .599). Cause of death was traumatic brain injury (TBI) in 57.6%. No significant difference was found in the time between initial presentation at the trauma room and arrival in the operating theater. In terms of trauma-related mortality during non-office hours, no benefit was demonstrated through IH trauma surgeons compared to OC trauma surgeons.

The breathing rate monitoring is an important measure in medical applications and daily physical activities. The contact sensors have shown their effectiveness for breathing monitoring and have been mostly used as a standard reference, but with some disadvantages for example in burns patients with vulnerable skins. Contactless monitoring systems are then gaining attention for respiratory frequency detection. We propose a new non-contact technique to estimate the breathing rate based on the motion video magnification method by means of the Hermite transform and an Artificial Hydrocarbon Network (AHN). The chest movements are tracked by the system without the use of an ROI in the image video. The machine learning system classifies the frames as inhalation or exhalation using a Bayesian-optimized AHN. The method was compared using an optimized Convolutional Neural Network (CNN). This proposal has been tested on a Data-Set containing ten healthy subjects in four positions. The percentage error and the Bland–Altman analysis is used to compare the performance of the strategies estimating the breathing rate. Besides, the Bland–Altman analysis is used to search for the agreement of the estimation to the reference.The percentage error for the AHN method is 2.19±2.1 with and agreement with respect of the reference of ≈99%.