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It is commonly known that irresponsible alcohol use can have adverse effects. For some people, it results in health problems, for others in productivity loss, and some experience the worst possible outcome of alcohol misuse - death. This paper estimates the effect of reduced alcohol sales hours on alcohol-attributable mortality (AAM) in Estonia. Using novel mortality data from 1997 to 2015, this paper analyzes the effect of alcohol sales policies at both the county level and the country level. By applying the difference-in-differences method and the ARIMA model, this paper finds that the alcohol sales policy reduced AAM to between 1.710 and 2.401 deaths per 100,000 per month, which equals a reduction of 31% to 40% in AAM deaths. These findings suggest that individuals who are the most at risk of dying from alcohol-attributable causes of death benefit remarkably from reduced alcohol availability.
Frailty assessment is recommended before elective transcatheter aortic valve implantation (TAVI) to determine post-interventional prognosis. Several studies have investigated frailty in TAVI-patients using numerous assessments; however, it remains unclear which is the most appropriate tool for clinical practice. Therefore, we evaluate which frailty assessment is mainly used and meaningful for ≤30-day and ≥1-year prognosis in TAVI patients. Randomized controlled or observational studies (prospective/retrospective) investigating all-cause mortality in older (≥70 years) TAVI patients were identified (PubMed; May 2020). In total, 79 studies investigating frailty with 49 different assessments were included. As single markers of frailty, mostly gait speed (23 studies) and serum albumin (16 studies) were used. Higher risk of 1-year mortality was predicted by slower gait speed (highest Hazard Ratios (HR): 14.71; 95% confidence interval (CI) 6.50–33.30) and lower serum albumin level (highest HR: 3.12; 95% CI 1.80–5.42). Composite indices (five items; seven studies) were associated with 30-day (highest Odds Ratio (OR): 15.30; 95% CI 2.71–86.10) and 1-year mortality (highest OR: 2.75; 95% CI 1.55–4.87). In conclusion, single markers of frailty, in particular gait speed, were widely used to predict 1-year mortality. Composite indices were appropriate, as well as a comprehensive assessment of frailty. View Full-Text