The 2015 and 2016 terrorist attacks in France: was there a short-term impact on hospitalizations for cardiovascular disease?

Edouard Chatignoux, Amélie Gabet, Elodie Moutengou, Philippe Pirard, Yvon Motreff, Christophe Bonaldi, Valérie Olié Non-Communicable Diseases and Trauma Direction, The French Public Health Agency, Saint-Maurice, France Background: The terrorist attacks in Paris and Nice in 2015 and 2016 generated widespread emotional stress in France. Given that acute emotional stress is a well-known trigger for cardiovascular disease, we investigated whether these attacks had any short-term impact on hospitalizations for acute cardiovascular disease in France. Methods: Annual hospital discharge data from 2009 to 2016 were extracted from the French Hospital Discharge Database. All hospitalizations with a primary diagnosis of acute coronary syndrome, heart failure, or stroke were selected. Generalized additive Poisson models were used to differentiate “unusual” variations in daily hospitalization numbers in the 15 days following the attacks from the expected background hospitalization rate. Results: The average daily number of hospitalizations was 396.4 for acute coronary syndrome, 598.6 for heart failure, and 334.6 for stroke. The daily mean number of hospitalizations for heart failure and stroke was higher in the 15 days following each attack compared with the reference periods. However, multivariate analysis showed no significant variation in the risk of hospitalization in the days following the attacks. Interpretation: Watching events unfold on television, no matter how dramatic, was not a sufficiently potent trigger for cardiovascular disease, although it may have led to an increase in hospitalizations for stress or anxiety. The 2015 and 2016 terrorist attacks do not seem to have had any measurable short-term impact on hospitalizations for cardiovascular disease either in the Paris and Nice regions or in the rest of France. Keywords: hospitalization, terrorist attacks, cardiovascular diseas

Identification des maladies neurodégénératives dans les bases de données médicoadministratives en France : revue systématique de la littérature

National audienceBackground - Given the health, social and economic burden of neurodegenerative diseases (ND), the development of epidemiologic studies is required. Administrative databases, such as the French national health insurance database (SNIIRAM) could represent an opportunity for researchers. ND could be presumed from drug reimbursement data, hospital stays or registration of a chronic condition. The aim of this study was to describe, in French administrative databases, algorithms used to identify Alzheimer's disease and associated disorders (ADAD), Parkinson's disease and associated disorders (PDAD), multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS). Methods - A systematic literature review was performed in Medline and gray literature through December 31th, 2015. French studies focusing on ADAD, PDAD, MS or ALS as a primary health outcome, conducted among one of the SNIIRAM data sources (outpatient reimbursements, chronic condition registration, hospital discharge) were included. Results - Thirty-four studies were included (ADAD, n=18, PDAD, n=9, MS, n=4, ALS, n=3), leading to 36 algorithms. For each studied ND, there was an important variability in the algorithms, concerning (i) the type of criteria used (administrative database versus multi-source systems); (ii) the number of criteria used; (iii) the definition used for each criteria. The extent and level of drug exposure highly varied. Identification through hospitalizations showed variations in terms of type of stay (short stay, long-term stay, psychiatric ward…), extent of diagnosis codes used, diagnosis type (principal, related, associated diagnosis) and period used. A validation study was conducted for 2 out of 36 algorithms (PDAD), and criteria completeness was estimated for 3 algorithms (MS, ALS). Conclusion - Despite the increase in ND identification among French administrative databases, few algorithms have been validated. Validation studies should be encouraged

Road Safety Data, Collection, Transfer and Analysis DaCoTa. Factsheet Traffic safety basic facts 2010 : cyclists.

This fact sheet explores the characteristics of pedal cyclist fatalities. These make up a relatively small proportion of the fatality total, but cyclists? high level of vulnerability means that it is important to understand well the characteristics of this road user group. A good insight into the problem provides an opportunity to improve the safety of this cheap, convenient and environmentally safe mode of transport. Fatality refers to any road user who was killed outright or who died within 30 days as a result of the accident. This fact sheet addresses fatalities among cyclists and all references to fatalities thus refer to a fatal injury of a cyclist. The terms “bicycles” and “cycles” refer only to two-wheel push bikes. Where data availability allows, the most recent year or period has been analysed, and a note is made of exceptions. (Author/publisher