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Background We aimed to build a basic daily mortality curve in Israel based on 20-year data accounting for long-term and annual trends, influenza-like illness (ILI) and climate factors among others, and to use the basic curve to estimate excess mortality during 65 weeks of the COVID-19 pandemic in 2020–2021 stratified by age groups. Methods Using daily mortality counts for the period 1 January 2000 to 31 December 2019, weekly ILI counts, daily climate and yearly population sizes, we fitted a quasi-Poisson model that included other temporal covariates (a smooth yearly trend, season, day of week) to define a basic mortality curve. Excess mortality was calculated as the difference between the observed and expected deaths on a weekly and periodic level. Analyses were stratified by age group. Results Between 23 March 2020 and 28 March 2021, a total of 51 361 deaths were reported in Israel, which was 12% higher than the expected number for the same period (expected 45 756 deaths; 95% prediction interval, 45 325–46 188; excess deaths, 5605). In the same period, the number of COVID-19 deaths was 6135 (12% of all observed deaths), 9.5% larger than the estimated excess mortality. Stratification by age group yielded a heterogeneous age-dependent pattern. Whereas in ages 90+ years (11% excess), 100% of excess mortality was attributed to COVID-19, in ages 70–79 years there was a greater excess (21%) with only 82% attributed to COVID-19. In ages 60–69 and 20–59 years, excess mortality was 14% and 10%, respectively, and the number of COVID-19 deaths was higher than the excess mortality. In ages 0–19 years, we found 19% fewer deaths than expected. Conclusion The findings of an age-dependent pattern of excess mortality may be related to indirect pathways in mortality risk, specifically in ages

BackgroundCoronavirus disease 2019 was first diagnosed in Israel at the end of February 2020. By the end of June 2021, there were 842 536 confirmed cases and 6428 deaths. Our aim in this multicenter, retrospective, cohort study is to describe the demographic and clinical characteristics of hospitalized patients and compare the pandemic waves before immunization.MethodsOf 22 302 patients hospitalized in general medical centers, we randomly selected 6329 for the study. Of these, 3582 and 1106 were eligible for the study in the first period (first and second waves) and in the second period (third wave), respectively.ResultsThirty-day mortality was higher in the second period than in the first period, 25.20% vs 13.68% (P ConclusionsInvasive ventilation, use of ECMO, and mortality rate were 1.5 to 2 times higher in the second period than in the first period. In the second period, patients had a more severe presentation and higher mortality than those in the first period.

The diagnosis and management of acute myocardial infarction (AMI) has undergone major changes during the last decade. These changes reflect the results of numerous controlled clinical trials that established the basis for evidence-based guidelines.The aims of this study were to examine the trends in the characteristics, management and outcome of patients with AMI, hospitalized in all 25 Intensive Care Units (ICCU) operating in Israel during the last decade (1994-2004).Data were derived from the biannual two-month national AMI/Acute Coronary Syndrome Israeli Surveys (ACSIS) performed in Israel. During the last decade, there was a continuous increase in the number of AMI patients admitted to the ICCU's operating in Israel - 999 AMI patients in 1994 and 1,534 in 2004. This increase was possibly due to shortening of hospital stay of AMI patients.The mean age of patients (64 years) did not change significantly in the last decade. The ICCU population has been characterized by an increasing number of octogenarians (7% in 1994 and 13% in 2004) and higher numbers of patients with past history of PCI, CABG, CVA and other comorbidities. There have been increases in the use of evidence-based medications during hospital stays and at discharge, reflecting greater adherence to guidelines. The "primary reperfusion" rate increased in the last decade from 60% in 1998 to 64% in 2004. The mode of reperfusion has changed in favor of primary PCI in 2004. In 1998, 88% of STEMI patients who underwent primary reperfusion were treated with thrombolysis and 12% by primary PCI while in 2004, 33% were treated with thrombolysis and 67% by primary PCI. The hospital course of patients with AMI in the last decade is characterized by better outcomes with reductions in rates of reischemia and reinfarction, cardiogenic shock, atrial fibrillation, VT/VF, and AV Block 2 degrees - 3 degrees. The most striking change in the last decade is the significant reduction in short- and long-term mortality with 45% reduction in 7-day mortality and 33% reduction in one-year mortality.This trend of better clinical outcomes and lower mortality in the last decade most probably relates to the use of evidence-based treatment and to better adherence to guidelines in the operating ICCUs in Israel.

The infant mortality rate is a health status indicator.To analyze the differences in infant mortality rates between Jews and Arabs in Israel between 1975 and 2000.Data were used from the Central Bureau of Statistics and the Department of Mother, Child and Adolescent Health in the Ministry of Health.The IMR in 2000 was 8.6 per 1,000 live births in the Israeli Arab population as compared to 4.0 in the Jewish population. Between 1970 and 2000 the IMR decreased by 78% among Moslems, 82% among Druze, and 88% among Christians, as compared to 79% in the Jewish population. In 2000, in the Arab population, 40% of all infant deaths were caused by congenital malformations and 29% by prematurity, compared to 23% and 53%, respectively, in the Jewish population. Between 1970 and 2000 the rate of congenital malformations declined in both the Arab and Jewish populations. In the 1970s the rate was 1.4 times higher in the Arab community than in the Jewish community, and in 2000 it was 3.7 times higher.As in the Jewish population, the IMR in the Arab community has decreased over the years, although it is still much higher than that in the Jewish community. Much remains to be done to reduce the incidence of congenital malformations among Arabs, since this is the main cause of the high IMR in this population.

Little information is available on the clinical practice and implementation of guidelines for treating acute myocardial infarction patients in Israel.To assess patient characteristics, hospital course, management, and 30 day clinical outcome of all AMI patients hospitalized in Israel during a 2 month period in 2000.We conducted a prospective 2 month survey of consecutive AMI patients admitted to 82 of 96 internal medicine departments and all 26 cardiac departments operating in Israel in 2000. Data were collected uniformly by means of a hospital and 30 day follow-up form.During the survey 1,683 consecutive patients with a discharge diagnosis of AMI were included. Their mean age was 66 years; 73% were male. The electrocardiographic pattern on admission revealed ST elevation, non-ST elevation and an undetermined ECG in 63%, 34% and 4% of patients respectively. Aspirin and heparin were given to 95% of patients. Beta-blockers and angiotensin-converting enzyme inhibitors were given to 76% and 65% of patients respectively. Among hospital survivors, 45% received lipid-lowering drugs. Thrombolytic therapy was administered in 28% of patients, coronary angiography was used in 45%, and 7% of patients underwent primary percutaneous coronary intervention. The 7 and 30 day mortality rates were 7% and 11% respectively.This nationwide survey shows that one-third of the AMI patients in Israel are elderly (or = 75 years). The survey suggests that clinical guidelines for the management of patients with AMI are partially implemented in the community. Data from large surveys representing the "real world" practice are of utmost importance for the evaluation of clinical guidelines, research and educational purposes.