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Peter Tanuseputro

Publications and source records attributed to Peter Tanuseputro.

8 recordsLinked to original sources
PubMed2006

Effectiveness and efficiency of different guidelines on statin treatment for preventing deaths from coronary heart disease: modelling study.

OBJECTIVE: To examine the potential effectiveness and efficiency of different guidelines for statin treatment to reduce deaths from coronary heart disease in the Canadian population. DESIGN: Modelled outcomes of screening and treatment recommendations of six national or international guidelines--from Canada, Australia, New Zealand, the United States, joint British societies, and European societies. SETTING: Canada. DATA SOURCES: Details for 6760 men and women aged 20-74 years from the Canadian Heart Health Survey (weighted sample of 12,300,000 people) that included physical measurements including a lipid profile. MAIN OUTCOME MEASURES: The number of people recommended for treatment with statins, the potential number of deaths from coronary heart disease avoided, and the number needed to treat to avoid one coronary heart disease death with five years of statin treatment if the recommendations from each guideline were fully implemented. RESULTS: When applied to the Canadian population, the Australian and British guidelines were the most effective, potentially avoiding the most deaths over five years (> 15,000 deaths). The New Zealand guideline was the most efficient, potentially avoiding almost as many deaths (14,700) while recommending treatment to the fewest number of people (12.9% of people v 17.3% with the Australian and British guidelines). If their "optional" recommendations are included, the US guidelines recommended treating about twice as many people as the New Zealand guidelines (24.5% of the population, an additional 1.4 million people) with almost no increase in the number of deaths avoided. CONCLUSIONS: By focusing recommendations on people with the highest risk of coronary heart disease, the Canadian, US, and European societies guidelines could improve either their effectiveness (in terms of hundreds of avoided deaths) or efficiency (in terms of thousands of fewer people recommended treatment) in the Canadian population.

Adult↗
PubMed2006

Characteristics of 1494 pediatric burn patients in Shanghai.

To analyze the epidemiological characteristics of pediatric burn patients in Shanghai and to determine the targets for a pediatric burn prevention program, a retrospective review of all medical records of acute pediatric burn patients (age</=14 years old) admitted to the Burn Center of the Ruijin Hospital between January 1980 and December 2002 was performed. Patient demographics, etiology of burn, mechanism of injury, extent and anatomical areas burned, number of operations, and length of hospital stay were recorded. A total of 1494 pediatric burn patients were admitted. Six hundred eighty-seven (46%) patients were from the migrant population (non-registered population of temporary workers from rural areas outside of Shanghai). Scalding was the main cause of pediatric burns in the age groups. Children 0-3-year-old were the most common victims of scalding, chemical burns, and contact burns. Domestic burns resulted in 1293 (86.5%) injuries followed by burns occurring while playing in public. The incidence of domestic burns has increased since the beginning of the study period, while the incidence of burns while playing in public has decreased. The median total body surface area was 4% for mild burns, 10% for moderate burns, and 18% for extensive burns. Predominant areas involved were the head, neck, anterior trunk, and right lower limb. Most children received conservative treatment, and their mean hospital stay was 16.1+/-12.2 days. There were 17 (1.1%) deaths, mostly due to sepsis (82.4%). Migrant children are the majority of burn victims since 1996. The education of burn prevention should focus on the migrant population in an industrializing city.

Adolescent↗
PubMed2005

Improving population attributable fraction methods: examining smoking-attributable mortality for 87 geographic regions in Canada.

Smoking-attributable mortality (SAM) is the number of deaths in a population caused by smoking. In this study, the authors examined and empirically quantified the effects of methodological problems in the estimation of SAM through population attributable fraction methods. In addition to exploring common concerns regarding generalizability and residual confounding in relative risks, the authors considered errors in measuring estimates of risk exposure prevalence and mortality in target populations and estimates of relative risks from etiologic studies. They also considered errors resulting from combining these three sources of data. By modifying SAM estimates calculated using smoking prevalence obtained from the 2000-2001 Canadian Community Health Survey, a population-based survey of 131,535 Canadian households, the authors observed the following effects of potential errors on estimated national SAM (and the range of effects on 87 regional SAMs): 1) using a slightly biased, mismatched definition of former smoking: 5.3% (range, 1.8% to 11.6%); 2) using age-collapsed prevalence and relative risks: 6.9% (range, 1.1% to 15.5%) and -15.4% (range, -7.9% to -21.0%), respectively; 3) using relative risks derived from the same cohort but with a shorter follow-up period: 8.7% (range, 4.5% to 11.8%); 4) using relative risks for all diseases with age-collapsed prevalence: 49.7% (range, 24.1% to 82.2%); and 5) using prevalence estimates unadjusted for exposure-outcome lag: -14.5% (range, -20.8% to 42.6%) to -1.4% (range, -0.8% to -2.7%), depending on the method of adjustment. Applications of the SAM estimation method should consider these sources of potential error.

Canada↗
PubMed2003

Burden of cardiovascular disease in Canada.

BACKGROUND: This report updates the death estimates for cardiovascular disease (CVD) in Canada and introduces a population-based perspective on disease prevalence and health-related quality of life (HRQOL) burden. METHODS: The Canadian Mortality Database was used to estimate the mortality of men and women in different age groups for the 139 Canadian health regions from 1950 to 1999. Heart disease prevalence and its impact on HRQOL were estimated using the 2000-2001 Canadian Community Health Survey (CCHS). Life table techniques were used to estimate the impact of heart disease on life and health expectancy. RESULTS: Although CVD remains the leading cause of death in Canada, between 1950 and 1999 the death rates from CVD dropped from 702 per 100,000 to 288 per 100,000 men, and from 562 per 100,000 to 175 per 100,000 women. Results from the CCHS indicated that 5.4% of men and 4.6% of women reported having heart disease as diagnosed by a medical professional. Of these individuals, 14% of men and 21% of women reported difficulty ambulating - about six times more than people without heart disease. In total, 4.5 years of life expectancy and 2.8 years of health expectancy were lost due to CVD. The study also found large differences in the burden of CVD among men and women and across the 139 Canadian health regions. CONCLUSIONS: CVD is a major disease burden in terms of both mortality and HRQOL and is an important source of health inequalities between populations in Canada. Any attempt to improve the health of Canadians or to reduce health inequalities should include interventions to reduce CVD mortality and morbidity. Given the present impact of CVD on HRQOL, reducing or eliminating heart disease may potentially result in an increase in life expectancy that will be larger than the gains in health expectancy.

Activities of Daily Living↗
PubMed2003

Risk factors for cardiovascular disease in Canada.

BACKGROUND: This paper provides an update of the prevalence of important cardiovascular disease (CVD) risk factors in subgroups of the Canadian population. To improve awareness of the impact of CVD risk factor variations on disease burden, smoking-attributable mortality (SAM) has been estimated for the first time for each health region in Canada. METHODS: The 2000/01 Canadian Community Health Survey (CCHS) was used to estimate the prevalence of current smoking, obesity, physical inactivity, low income, diabetes and hypertension. Combining smoking prevalence data from the 2000/01 CCHS, mortality data from the 1995 to 1997 Canadian Mortality Database, and relative risk estimates (relating smoking and smoking-associated deaths) from the American Cancer Society's Cancer Prevention Study II, SAM values were generated using population-attributable risk techniques. RESULTS: Based on self-reported data, the 2000/01 CCHS shows that 26.0% of Canadians currently smoke, 14.9% are obese, 53.5% are physically inactive, 11.3% have low income, 13.0% have hypertension and 4.2% have diabetes. Cardiovascular and all-cause SAM were estimated at 18,209 and 44,271 annual deaths, and contributed to 23% and 22% of total CVD and all-cause mortality in Canada, respectively. There are large variations in the prevalence of CVD risk factors and in SAM estimates between sexes and across age groups and geographic regions. CONCLUSIONS: The high prevalence of potentially modifiable CVD risk factors and the large variation that exists between subgroups of the Canadian population suggest that the burden of CVD could be reduced through risk factor modification. While prevalence data for risk factors in a population give an initial understanding of some of the contributing causes of a disease, the actual burden of disease caused by a risk factor is also modified by the magnitude of the increased risk to mortality and morbidity, and is best represented by its estimated attributable mortality and morbidity.

Adolescent↗