Publications by authors named "Haris Imsirovic"
Background: The COVID-19 pandemic disproportionately affected frail individuals, especially those living in long-term care (LTC) homes. This study examined the role of linguistic factors on COVID-19 related outcomes in LTC homes.
Methods: We performed a population-based, retrospective cohort study of residents living in LTC homes in Ontario, Canada who were diagnosed with COVID-19 between March 31, 2020 and March 31, 2021.
Objective: The Infant Toddler Checklist (ITC) may be promising as a single tool at the 18-month visit to detect a range of developmental concerns. We examined the predictive validity of the ITC; and the association between positive ITC screening and health care utilization (HCU).
Methods: Prospective cohort study of children at average-risk for developmental delay attending their 18-month visit in primary care in Toronto, Canada.
Background: As individuals approach death, they experience declines in their cognitive, physical, motor, sensory, physiologic, and psychosocial functions. In this exploratory study we examined individuals' physiologic changes in the last year of life by examining laboratory tests commonly used in clinical practice.
Methods: Using health administrative datasets, we conducted an observational matched cohort study to assess laboratory test use and values over a decedent's last 12 months and a matched observation window for non-decedents.
Resistance-associated substitutions (RASs) are mutations within the hepatitis C (HCV) genome that may influence the likelihood of achieving a sustained virological response (SVR) with direct acting antiviral (DAA) treatment. Clinicians conduct RAS testing to adapt treatment regimens with the intent of improving the likelihood of cure. The Canadian Network Undertaking against Hepatitis C (CANUHC) prospective cohort consists of chronic HCV patients enrolled between 2015 and 2023 across 17 Canadian sites.
View Article and Find Full Text PDFHematologic cancers, notably leukemias and lymphomas, pose significant challenges to healthcare systems globally, due to rising incidence rates and increasing costs. This study aimed to estimate the phase and lifetime health system total costs (not net costs) of care for patients diagnosed with leukemia and lymphoma in Ontario, Canada. We conducted a population-based study of patients diagnosed between 2005 and 2019, using data from the Ontario Cancer Registry linked with health administrative databases.
View Article and Find Full Text PDFPhysician Follow-Up of Pediatric and Young Adult Emergency Department Visits for Substance Use in Ontario, Canada.
J Adolesc Health
November 2024
Purpose: To study the proportion and predictors of outpatient physician follow-up within 60 days of substance-related emergency department (ED) visits for Ontario youth.
Methods: We examined administrative data on substance-related ED visits before and during the COVID-19 pandemic among youths aged 10-24 years in Ontario, Canada. Substance-related visits were identified using International Classification of Diseases-10-CA codes.
The prevalence of mixed hepatitis C virus (HCV) genotype infection in a representative Canadian HCV cohort is reported and virological response with direct acting antiviral (DAA) treatment was evaluated. 3272 HCV-positive participants were enrolled, of which 2945 (90.0%) initiated DAA therapy.
View Article and Find Full Text PDFPopulation-wide eGFR percentiles in younger adults and clinical outcomes.
Nephrol Dial Transplant
February 2025
Article Synopsis
- The study aims to identify significant reductions in estimated glomerular filtration rate (eGFR) among younger adults (<65 years) to help guide prevention strategies for kidney and cardiovascular diseases.
- A retrospective analysis of 8.7 million adults in Ontario, Canada, revealed that lower eGFR percentiles (especially ≤10th) are linked to worse health outcomes, including increased risk of kidney failure and all-cause mortality, particularly in younger individuals.
- Findings suggest that a population-based understanding of eGFR percentiles can enhance the recognition and management of at-risk younger adults, as those with lower eGFR values are often not referred for further evaluation.
Importance: Bronchiolitis is the most common and most cumulatively expensive condition in pediatric hospital care. Few population-based studies have examined health inequalities in bronchiolitis outcomes over time.
Objective: To examine trends in bronchiolitis-related emergency department (ED) visit and hospitalization rates by sociodemographic factors in a universally funded health care system.
Dying in nonpalliative acute care is generally considered inappropriate and avoidable. Place of death, a commonly reported big-dot indicator of end-of-life care quality, is often used as a proxy for place of care despite no empirical evidence for their correlations. Thus, we examined the correlations between place of death and place of care in the last month of life.
View Article and Find Full Text PDFImpaired Renal Function and Major Cardiovascular Events in Young Adults.
J Am Coll Cardiol
September 2023
Background: Cardiovascular (CV) disease in young adults (aged 18-39 years) is on the rise. Whether subclinical reductions in kidney function (ie, estimated glomerular filtration rate [eGFR] above the current threshold for chronic kidney disease but below age-expected values) are associated with elevated CV risk is unknown.
Objectives: The goal of this study was to examine age-specific associations of subclinical eGFR reductions in young adults with major adverse cardiovascular events (MACEs) and MACE plus heart failure (MACE+).
Article Synopsis
- The study examines the outcomes of critically ill patients without COVID-19 admitted to ICUs during the pandemic compared to the previous year, highlighting a gap in understanding the pandemic's broader impact on non-COVID patients.
- It revealed that all-cause in-hospital mortality increased during the pandemic (13.5% vs. 12.5%) along with higher rates of mortality in specific groups like patients with COPD exacerbations and recent immigrants.
- The study utilized health data from Ontario and involved over 32,000 patients during the pandemic period, showing similarities in patient demographics but variations in health outcomes.*
Background: Hypertension plus obstructive sleep apnea (OSA) is recommended in some guidelines as an indication to screen for primary aldosteronism (PA), yet prior data has brought the validity of this recommendation into question. Given this context, it remains unknown whether this screening recommendation is being implemented into clinical practice.
Methods: We conducted a population-based retrospective cohort study of all adult Ontario (Canada) residents with hypertension plus OSA from 2009 to 2020 with follow-up through 2021 utilizing provincial health administrative data.
This cohort study analyzes the patterns of emergency department use, hospitalization, revisit, and mortality rates associated with bronchiolitis in children younger than 2 years.
View Article and Find Full Text PDFThis cross-sectional study assesses age and sex differences in risk of 1-year mortality in patients with emergency department visits due to alcohol compared with the general population in Ontario, Canada.
View Article and Find Full Text PDFImportance: Over the last 2 decades, bronchiolitis guidelines and improvement efforts focused on supportive care and reducing unnecessary tests, treatments, and hospitalization. There have been limited population-based studies examining hospitalization outcomes over time.
Objective: To describe rates and trends in bronchiolitis hospitalization, intensive care unit (ICU) use, mortality, and costs.
Article Synopsis
- Healthcare expenditures in ICUs are high, and this study focuses on high-cost users who make up a significant portion of these costs, assessing their health outcomes and spending patterns.
- A retrospective study of ICU patients in Ontario identified 37,006 high-cost users, characterized by older age, higher comorbidities, and significantly longer ICU stays (22.4 days vs. 5.56 days for non-high-cost users).
- Despite having lower in-hospital mortality rates, high-cost users had total healthcare costs that were five times greater than their non-high-cost counterparts, highlighting the need for further research to understand and potentially mitigate these expenses.
Primary aldosteronism is a common, yet highly underdiagnosed, cause of hypertension that leads to disproportionately high rates of cardiovascular disease. Hypertension plus hypokalemia is a guideline-recommended indication to screen for primary aldosteronism, yet the uptake of this recommendation at the population level remains unknown. We performed a population-based retrospective cohort study of adults ≥18 years old in Ontario, Canada, with hypertension plus hypokalemia (potassium <3.
View Article and Find Full Text PDFBackground: Research considering the impact of language on health care utilization is limited. We conducted a population-based study to: (1) investigate the association between residents' preferred language and hospital-based health care utilization; and (2) determine whether this association is modified by dementia, a condition which can exacerbate communication barriers.
Methods: We used administrative databases to establish a retrospective cohort study of home care recipients (2015-2017) in Ontario, Canada, where the predominant language is English.
Objective: While the overall health system burden of alcohol is large and increasing in Canada, little is known about how this burden differs by sociodemographic factors. The objectives of this study were to assess sociodemographic patterns and temporal trends in emergency department (ED) visits due to alcohol to identify emerging and at-risk subgroups.
Methods: We conducted a retrospective population-level cohort study of all individuals aged 10 to 105 living in Ontario, Canada.