In-Hospital Mortality in Hospitalized Patients with Congestive Heart Failure in Relation to Serum Potassium Levels in the US: National Inpatient Sample Analysis

2017 ◽  
Vol 23 (8) ◽  
pp. S10-S11
Author(s):  
Sijan Basnet ◽  
Dilli R. Poudel ◽  
Sushil Ghimire ◽  
Biswaraj Tharu ◽  
Rashmi Dhital
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Hospital Mortality ◽  
Serum Potassium ◽  
Hospitalized Patients ◽  
National Inpatient Sample ◽  
Sample Analysis ◽  
The Us

scholarly journals Diabetes-related cardiovascular and economic burden in patients hospitalized for heart failure in the US: a recent temporal trend analysis from the National Inpatient Sample

2020 ◽  
Author(s):  
Menatalla Mekhaimar ◽  
Soha Dargham ◽  
Mohamed El-Shazly ◽  
Jassim Al Suwaidi ◽  
Hani Jneid ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Hospital Mortality ◽  
Economic Burden ◽  
Temporal Trend ◽  
National Inpatient Sample ◽  
Crude Mortality ◽  
The Us ◽  
Trend Data ◽  
Total Charges

Abstract We aimed to study the cardiovascular and economic burden of diabetes mellitus (DM) in patients hospitalized for heart failure (HF) in the US and to assess the recent temporal trend. Data from the National Inpatient Sample were analyzed between 2005 and 2014. The prevalence of DM increased from 40.4 to 46.5% in patients hospitalized for HF. In patients with HF and DM, mean (SD) age slightly decreased from 71 (13) to 70 (13) years, in which 47.5% were males in 2005 as compared with 52% in 2014 (p trend < 0.001 for both). Surprisingly, the presence of DM was associated with lower in-hospital mortality risk, even after adjustment for confounders (adjusted OR = 0.844 (95% CI [0.828–0.860]). Crude mortality gradually decreased from 2.7% in 2005 to 2.4% in 2014 but was still lower than that of non-diabetes patients’ mortality on a yearly comparison basis. Hospitalization for HF also decreased from 211 to 188/100,000 hospitalizations. However, median (IQR) LoS slightly increased from 4 (2–6) to 4 (3–7) days, so did total charges/stay that jumped from 15,704 to 26,858 USD (adjusted for inflation, p trend < 0.001 for both). In total, the prevalence of DM is gradually increasing in HF. However, the temporal trend shows that hospitalization and in-hospital mortality are on a descending slope at a cost of an increasing yearly expenditure and length of stay, even to a larger extent than in patient without DM.

scholarly journals Morbidity, Mortality and Costs Associated with Venous Thromboembolism in Hospitalized Patients with Cancer

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2613-2613
Author(s):  
Gary H. Lyman ◽  
Eva Culakova ◽  
Marek S. Poniewierski ◽  
Nicole M. Kuderer
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Venous Thromboembolism ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Cancer Patients ◽  
Infectious Complications ◽  
Hospitalized Patients ◽  
Patients With Cancer ◽  
Risk Of Mortality

Background: Venous thromboembolism (VTE) occurs commonly in patients with cancer and is associated with considerable morbidity and mortality. While the risk of VTE is greater in hospitalized patients and those undergoing active treatment, less is known about factors associated with increased risk of mortality and costs in this setting. The study presented here evaluates the risk of mortality among hospitalized cancer patients with VTE and the association of patient comorbidities and infectious complications on duration of hospitalization, in-hospital mortality and costs. Methods: Data on hospitalization of adult patients (age≥18) with cancer between 2004 and 2012 from 239 US academic medical centers reporting to the University Health Consortium were analyzed. For patients with multiple hospitalizations, the first admission during the time period studied was utilized. Primary outcomes consisted of length of stay, in-hospital mortality and estimated cost of hospitalization. Stratified analyses were performed based on patient characteristics, year of hospitalization, cancer type, major comorbidities and infectious complications. Costs were adjusted to 2014 dollars. Results: Among more than 3.8 million admissions of adult patients with cancer, 246,653 included a diagnostic code for VTE representing 198,173 individual patients with both cancer and VTE. Overall, 41% of patients with cancer and VTE were hospitalized for 10 days or longer with an in-hospital mortality rate of 11.3% and estimated average costs per hospitalization of $37,039. While length of stay and mortality rates remained relatively stable over the 9 years of observation, 2014-adjusted costs per day hospitalization increased from $2,600 in 2004 to $3,200 in 2012. In-hospital mortality was greatest in patients with lung (15.8%) and gastric (14.1%) cancers and leukemia (14.2%). Medical comorbidities associated with the highest rates of mortality included congestive heart failure (19.8%), cerebrovascular disease (20.4%), and major disorders of the lung (20.6%), liver (20.0%), and kidney (21.4%) with mortality increasing in direct proportion to the number of comorbidities. Likewise, comorbidities associated with the greatest average costs per hospitalization included congestive heart failure ($51,885), cerebrovascular disease ($55,815), and major disorders of the lung ($53,899), liver ($51,332), and kidney ($55,774) with estimated costs increasing from $22,622 with no medical comorbidity to over $70,000 with four or more. Alternatively, infectious complications associated with the highest rates of mortality and greatest average costs were sepsis (38.1%; $90,529) and pneumonia (26.0%; $69,024). Conclusions: Hospitalized patients with cancer and VTE are at considerable risk for prolonged hospitalization and in-patient mortality accompanied by considerable hospital costs. Patients with additional major comorbidities and infectious complications are at even greater risk of in-hospital mortality and substantially greater costs. Additional efforts to identify cancer patients at greater risk for VTE and its complications including prolonged hospitalization and in-hospital mortality are needed as well as better strategies and agents for reducing the risk and consequences of VTE. Disclosures Lyman: Amgen: Research Funding.

scholarly journals Inpatient Hospitalization's Associated Cost and Mortality for Myeloma Patients Undergoing Autologous Stem Cell Transplant: A 13-Year Analysis of the National Inpatient Sample

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3431-3431
Author(s):  
Saqib Abbasi ◽  
Brian McClune ◽  
Leyla Shune ◽  
Suman Kambhampati ◽  
Saqib Abbasi
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Stem Cell Transplant ◽  
Chronic Renal Disease ◽  
Autologous Stem Cell Transplant ◽  
Cell Transplant ◽  
National Inpatient Sample ◽  
Morbid Conditions

Introduction: Autologous stem cell transplant (ASCT) is the standard of care for eligible patients with multiple myeloma (MM). With the considerable advances in supportive care for patients receiving ASCT, many institutions now perform ASCT for MM on a completely outpatient basis. The National Inpatient Sample (NIS) tracks all inpatient hospitalizations in the United States. Hence, using the NIS, hospital admissions for MM patients undergoing ASCT and their mortality over a period of time can be tracked. We interrogated the NIS to analyze characteristics of these patients. Methods: From the years of 2002 to 2014, admissions for ASCT for MM patients were identified using the NIS via procedural ICD 9 codes for autologous bone marrow transplantation and MM. Annual trends in mortality, hospital length of stay, and costs of admission were assessed with a linear regression analysis. Chronic co-morbid conditions were investigated for associations with in-hospital mortality in the years of 2013 and 2014 using univariate logistic regression analysis. Results: A total weighted estimate of inpatient admissions for ASCT among MM patients totaled 47,253 (unweighted N=10,231) between the years of 2002 and 2014. Annual inpatient transplants increased from 1,601 in 2002 to 5,170 in 2014. Publicly available data from the Center for International Blood and Marrow Transplant research indicates that the number of ASCT for MM in the US were approximately 2100 in 2002, compared to 7500 patients in 2014, hence the number of inpatient transplants as a ratio of overall transplants decreased significantly from 76.2% in 2002 to 68.9% in 2014 (p &lt;0.001) The in-hospital mortality decreased non-significantly from 0.018% in 2002 to 0.007% in 2014 (p=0.077). The mean length of stay decreased only slightly from 18.8 days in 2002 to 17.3 days in 2014 (p=0.005), Costs of admission increased from $97,391 in 2002 to $184,002 in 2014 (p &lt;0.001), despite the minimal change in the length of stay. Amongst common co-morbidities, significant associations with in-hospital mortality were seen in congestive heart failure (odds ratio (OR) = 4.60), weight loss (OR=4.15), chronic renal disease (OR=4.99) and valvular heart disease (OR=6.16) (Table 1). Conclusion: The proportion of patients receiving ASCT for MM as an outpatient has increased significantly from 2002 to 2014. Among those patients admitted for ASCT, the average length of stay has changed minimally, but the average cost of hospitalization has almost doubled. The presence of co-morbid conditions including congestive heart failure, previous weight loss, chronic renal disease, and valvular disease are significantly associated with a higher incidence of in-hospital mortality for patients with MM undergoing ASCT and likely drive up the cost for inpatient stays. As institutions continue to shift ASCT for MM from an inpatient to outpatient setting, further analysis of the inpatient drivers of cost is needed, as well as a cautious understanding of risk factors for mortality in this setting. Disclosures No relevant conflicts of interest to declare.

scholarly journals Incidence, Risk Factors and Outcomes of New Onset Supraventricular Arrhythmias in African American Patients with Severe Sepsis

2016 ◽  
Vol 26 (2) ◽  
pp. 205 ◽  
Author(s):  
O'Dene Lewis ◽  
Julius Ngwa ◽  
Richard F. Gillum ◽  
Alicia Thomas ◽  
Wayne Davis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Hospital Mortality ◽  
Supraventricular Arrhythmias ◽  
Incidence Risk ◽  
New Onset

<p><strong>Purpose</strong>: New onset supraventricular arrhythmias (SVA) are commonly reported in mixed intensive care settings. We sought to determine the incidence, risk factors and outcomes of new onset SVA in African American (AA) patients with severe sepsis admitted to medical intensive care unit (MICU).</p><p><strong>Methods:</strong> Patients admitted to MICU between January 2012 through December 2012 were studied. Patients with a previous history of arrhythmia or with new onset of ventricular arrhythmia were excluded. Data on risk factors, critical care interventions and outcomes were obtained.</p><p><strong>Results:</strong> One hundred and thirty-one patients were identified. New onset SVA occurred in 34 (26%) patients. Of those 34, 20 (59%) had atrial fibrillation (AF), 6 (18%) had atrial flutter and 8 (24%) had other forms of SVA. Compared with patients without SVA, patients with new onset SVA were older (69 ± 12 yrs vs 59 ± 13 yrs, P=.003), had congestive heart failure (47% vs 24%, P=.015) and dyslipidemia (41% vs 15%, P=.002). Additionally, they had a higher mean mortality prediction model (MPM II) score (65 ± 25 vs 49 ± 26, P=.001) and an increased incidence of respiratory failure (85% vs 55%, P=.001). Hospital mortality in patients with new onset SVA was 18 (53%) vs 30 (31%); P=.024; however, in a multivariate analysis, new onset SVA was associated with nonsignificantly increased odds (OR 2.58, 95% CI 0.86-8.05) for in-hospital mortality.</p><p><strong>Conclusion:</strong> New onset SVA was prevalent in AA patients with severe sepsis and occurred more frequently with advanced age, increased severity of illness, congestive heart failure, and acute respiratory failure; it was associated with higher unadjusted in hospital mortality. However, after multiple adjustments, new onset SVA did not remain an independent predictor of mortality. <em>Ethn Dis.</em>2016;26(2):205-212; doi:10.18865/ ed.26.2.205</p>

Impact of Underlying Congestive Heart Failure on In-Hospital Outcomes in Patients with Septic Shock

2021 ◽  
pp. 088506662110614
Author(s):  
Mohinder R. Vindhyal ◽  
Liuqiang (Kelsey) Lu ◽  
Sagar Ranka ◽  
Prakash Acharya ◽  
Zubair Shah ◽  
...  
Keyword(s):  
Heart Failure ◽  
Septic Shock ◽  
Congestive Heart Failure ◽  
Hospital Mortality ◽  
Secondary Analysis ◽  
Kidney Injury ◽  
Cross Sectional ◽  
Increased Risk ◽  
Icd 10 ◽  
Nationwide Readmission Database

Purpose: Septic shock (SS) manifests with profound circulatory and cellular metabolism abnormalities and has a high in-hospital mortality (25%-50%). Congestive heart failure (CHF) patients have underlying circulatory dysfunction and compromised cardiac reserve that may place them at increased risk if they develop sepsis. Outcomes in patients with CHF who are admitted with SS have not been well studied. Materials and Method: Retrospective cross sectional secondary analysis of the Nationwide Readmission Database (NRD) for 2016 and 2017. ICD-10 codes were used to identify patients with SS during hospitalization, and then the cohort was dichotomized into those with and without an underlying diagnosis of CHF. Results: Propensity match analyses were performed to evaluate in-hospital mortality and clinical cardiovascular outcomes in the 2 groups. Cardiogenic shock patients were excluded from the study. A total of 578,629 patients with hospitalization for SS were identified, of whom 19.1% had a coexisting diagnosis of CHF. After propensity matching, 81,699 individuals were included in the comparative groups of SS with CHF and SS with no CHF. In-hospital mortality (35.28% vs 32.50%, P < .001), incidence of ischemic stroke (2.71% vs 2.53%, P = .0032), and acute kidney injury (69.9% vs 63.9%, P = .001) were significantly higher in patients with SS and CHF when compared to those with SS and no CHF. Conclusions: This study identified CHF as a strong adverse prognosticator for inpatient mortality and several major adverse clinical outcomes. Study findings suggest the need for further investigation into these findings’ mechanisms to improve outcomes in patients with SS and underlying CHF.

Abstract 16: Racial Disparities in Clinical Outcomes and Resource Utilization in Acute Ischemic Stroke Hospitalizations in the United States: Results from the 2012 National Inpatient Sample

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Nilay Kumar ◽  
Anand Venkatraman ◽  
Neetika Garg
Keyword(s):  
Logistic Regression ◽  
Ischemic Stroke ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Acute Ischemic Stroke ◽  
Racial Minorities ◽  
National Inpatient Sample ◽  
The Us ◽  
To Receive ◽  
Total Charges

Background and objectives: There are limited data on racial differences in clinical and economic outcomes of acute ischemic stroke (AIS) hospitalizations in the US. We sought to ascertain the effect of race on AIS outcomes in a population based retrospective cohort study. Methods: We used the 2012 National Inpatient Sample (NIS), which is the largest database of inpatient stays in the US, to identify cases of AIS using ICD9-CM codes 433.01, 433.11, 433.21, 433.31, 433.81, 433.91, 434.01, 434.11, 434.91 and 437.1 in patients >=18 years of age. Cases with missing data on race were excluded (5% of study sample). Primary outcome was in-hospital mortality. Secondary outcomes included proportion receiving endovascular mechanical thrombectomy (EMT) or thrombolysis, mean inflation adjusted charges and length of stay. Linear and logistic regression was used to test differences in continuous and categorical outcomes respectively. Survey techniques were used for all analyses. Results: There were 452, 330 hospitalizations for AIS in patients >=18 years in 2012. In univariate logistic regression using race as predictor, in-hospital mortality was significantly lower for Blacks (p<0.001), Hispanics (p=0.025) and Native Americans (p=0.047) compared to Whites. However, after adjusting for age, sex, Charlson comorbidity index, EMT and thrombolysis only blacks had a significantly lower mortality compared to whites (OR 0.74, 95% CI 0.66 - 0.82, p<0.001). Black patients were less likely to receive thrombolysis (OR 0.87, 95% CI 0.79 - 0.95; p=0.003) whereas Asian or Pacific Islanders were more likely to receive thrombolysis (OR 1.20, 95% CI 1.01 - 1.44; p=0.043) compared to whites. There was no difference in rates of EMT by race (p=0.18). Total charges and length of stay were significantly higher in racial minorities compared to whites (table). Conclusions: Blacks hospitalized for AIS have significantly lower in-hospital mortality compared to whites but are significantly less likely to receive thrombolysis compared to whites. Total charges and length of stay are significantly higher for racial minorities. Future studies should investigate mechanisms of this apparent protective effect of black race on in-hospital mortality in AIS.

Abstract 12789: Clinical Factors Associated With Mortality Among Patients Hospitalized for Heart Failure in Egypt

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ahmed Hassanin ◽  
Mahmoud M Hassanein ◽  
Madiha F Abdel-maksoud
Keyword(s):  
Heart Failure ◽  
Hospital Mortality ◽  
Univariate Analysis ◽  
Elevated Serum ◽  
The United States ◽  
Clinical Factors ◽  
Clinical Variables ◽  
Factors Associated ◽  
The Us ◽  
One Year

Introduction: Heart failure (HF) is a growing public health burden in many low and middle-income countries (LMIC). However, most HF registries were conducted in high income countries, which often have different ethnic and cultural backgrounds from that of LMIC. Hypothesis: Independent clinical variables associated with mortality in patients hospitalized for HF in Egypt are different from those established in the United States (US). Methods: Between 2011 and 2014, 1,660 patients hospitalized for HF were enrolled from 20 centers across Egypt as part of the European Society of Cardiology HF long-term Registry. Deceased patients were compared to survivors, to identify demographic, clinical and biochemical variables associated with in-hospital and one-year mortality. Variables associated with mortality on univariate analysis, and independent variables identified in the Acute Decompensated Heart Failure National Registry (ADHERE) and in the Seattle Heart Failure Model, both based in the US, were entered into the multivariate logistic regression model. Results: In-hospital mortality was 5%. Only two independent clinical factors associated with in-hospital mortality were identified: elevated serum creatinine (sCr), OR=1.47 [95% CI: 1.23, 1.74] for every point increases above one mg/dl; and low admission systolic blood pressure (SBP), OR=1.54; [95% CI: 1.43, 1.65] for every 10 points decrease in SBP below 140 mmHg. At one-year follow up, mortality was 27%. Independent predictors of one-year mortality were: age, OR=1.47; [95% CI: 1.23,1.75] for every 10-year increase above 40; low discharge SBP, OR=1.30 [95% CI: 1.08, 1.52] for every 10 points decrease below 140 mmHg; low ejection fraction, OR=1.51 [95% CI: 0.59,0.73] for every 5 points decrease from 65%; chronic liver disease, OR=3.0 [95% CI: 1.51,5.88]; history of stroke, OR=3.2 [95% CI: 1.52,6.65]. These variables overlapped with those identified in US registries. Conclusions: Independent clinical variables associated with mortality after HF hospitalization in Egypt are similar to those reported in HF registries in the US.

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