PUK12 BURDEN OF HOSPITALIZATIONS IN UTERINE FIBROIDS (UF) PATIENTS WITH LOW AND HIGH COMORBIDITY INDEX: A PROPENSITY SCORE MATCHED ANALYSIS OF IN-PATIENT CLAIMS DATABASE

AbstractDespite experimental evidence of beneficial metabolic, antiatherosclerotic and antiinflammatory effects of the 30 kDa adipokine, adiponectin, maintenance hemodialysis (MHD) patients with high adiponectin blood levels have paradoxically high mortality rates. We aimed to examine the direction of the associations between adiponectin and all-cause and cardiovascular mortality as well as with markers of oxidative stress, inflammation and nutrition in MHD patients with varying degrees of comorbidities. A cohort of 261 MHD patients (mean age 68.6 ± 13.6 years, 38.7% women), grouped according to baseline comorbidity index (CI) and serum adiponectin levels, were followed prospectively for six years. High and low concentrations were established according to median CI and adiponectin levels and cross-classified. Across the four CI-adiponectin categories, the group with low comorbidities and high adiponectin exhibited the best outcomes. Conversely, the high comorbidity group with high adiponectin levels had the lowest survival rate in both all-cause mortality (log rankχ2 = 23.74, p < 0.001) and cardiovascular mortality (log rankχ2 = 34.16, p < 0.001). Further data adjustment for case-mix covariates including fat mass index did not substantially affect these results. In conclusion, the direction of adiponectin’s prognostic associations in MHD patients is inverse in those with few comorbidities and direct in those with many comorbidities.

Download Full-text

PND31 Comparison of Burden of Hospitalizations in Epilepsy, Migraine and Sleep Disorders: A Propensity Score Matched Analysis of In-Patient Claims Database

Value in Health ◽

10.1016/j.jval.2021.04.815 ◽

2021 ◽

Vol 24 ◽

pp. S164

Author(s):

S. Aggarwal ◽

A. Bela ◽

S. Kumar ◽

H. Topaloglu

Keyword(s):

Propensity Score ◽

Sleep Disorders ◽

Claims Database

Download Full-text

636 SHORT-TERM OUTCOME FOR HIGH-RISK PATIENTS AFTER ESOPHAGECTOMY

Diseases of the Esophagus ◽

10.1093/dote/doab052.636 ◽

2021 ◽

Vol 34 (Supplement_1) ◽

Author(s):

Victor Plat ◽

Wessel Stam ◽

Boukje Bootsma ◽

Jennifer Straatman ◽

Thomas Klausch ◽

...

Keyword(s):

High Risk ◽

Propensity Score ◽

Propensity Score Matching ◽

Charlson Comorbidity Index ◽

Short Term ◽

Term Outcome ◽

High Risk Patients ◽

Short Term Outcome ◽

Risk Patients ◽

Comorbidity Index

Abstract Transthoracic esophagectomy (TTE) for esophageal cancer facilitates mediastinal dissection, however it has a significant impact on cardiopulmonary status. High-risk patients may therefore be better candidates for transhiatal esophagectomy (THE) in order to prevent serious complications. This study addressed short-term outcome following TTE and THE in patients that are considered to have a higher risk of surgery-related morbidity. Methods This population-based study included patients who underwent a curative esophagectomy between 2011 and 2018, registered in the Dutch Upper GI Cancer Audit. The Charlson comorbidity index was used to assign patients to a low-risk (score ≤ 1) and high-risk group (score ≥ 2). Propensity score matching was applied to produce comparable groups between high-risk patients receiving TTE and THE. Primary endpoint was mortality (in-hospital/30-day mortality), secondary endpoints included morbidity and oncological outcomes. Additionally, a matched subgroup analysis was performed, including only cervical reconstructions. Results Of 5438 patients, 945 and 431 high-risk patients underwent TTE and THE respectively. After propensity score matching, mortality (6.3% vs 3.3%, P = 0.050), overall morbidity, Clavien-Dindo ≥3 complications, pulmonary complications, cardiac complications and re-interventions were significantly more observed after TTE compared to THE. A significantly higher mortality after TTE with a cervical reconstruction was found compared to THE (7.0% vs 2.2%, P = 0.020). Conclusion Patients with a high Charlson comorbidity index predispose for a complicated postoperative course after esophagectomy, this was more outspoken after TTE compared to THE. In daily practice these outcomes should be balanced with the lower lymph node yield, but comparable positive node count and radicality after THE.

Download Full-text

PRO27 HOSPITAL LENGTH OF STAY, COSTS AND COMORBIDITIES IN BETA-THALASSEMIA: A PROPENSITY SCORE MATCHED ANALYSIS OF IN-PATIENT CLAIMS DATABASE

Value in Health ◽

10.1016/j.jval.2020.04.1255 ◽

2020 ◽

Vol 23 ◽

pp. S333

Author(s):

S. Aggarwal ◽

A. Bela ◽

O. Topaloglu

Keyword(s):

Length Of Stay ◽

Propensity Score ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Beta Thalassemia ◽

Claims Database

Download Full-text

A Cost Claims Database Study with Propensity Score Applications in Covariates Selection and Balancing

Value in Health ◽

10.1016/j.jval.2018.07.727 ◽

2018 ◽

Vol 21 ◽

pp. S96

Author(s):

L Zhang ◽

G Li ◽

X Lin ◽

G Wang ◽

J Wang ◽

...

Keyword(s):

Propensity Score ◽

Claims Database ◽

Database Study

Download Full-text

Abstract TP19: Charlson Comorbidity Index Predicts Mortality and Functional Outcome in Acute Ischemic Stroke Patients Treated With Mechanical Thrombectomy

Stroke ◽

10.1161/str.47.suppl_1.tp19 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Daniela Samaniego ◽

Maria Hernandez-Perez ◽

Anna Planas ◽

Lorena Martin ◽

Laura Dorado ◽

...

Keyword(s):

Ischemic Stroke ◽

Functional Outcome ◽

Charlson Comorbidity Index ◽

Mechanical Thrombectomy ◽

Stroke Severity ◽

Stroke Patients ◽

Poor Functional Outcome ◽

Arterial Revascularization ◽

Comorbidity Index ◽

High Comorbidity

Introduction: Despite mechanical thrombectomy has achieved a dramatic improvement on ischemic stroke prognosis, up to 50% of patients treated with this approach do not have good functional outcome. Besides age and baseline infarct core, comorbidity might play a role in stroke prognosis. We aim to study the capacity of Charlson comorbidity index (CCI) in predicting mortality and functional outcome in acute ischemic stroke patients who underwent mechanical thrombectomy. Methods: We studied 228 consecutive patients (59% male, mean age 65y) with acute anterior circulation arterial occlusion treated with stent retrievers between May 2009 and March 2015. Demographical data, stroke severity, ASPECTS score at baseline and medical conditions included in the CCI were collected and CCI score was calculated retrospectively. We considered low comorbidity if CCI score was <2 and high comorbidity if CCI score was ≥2. Complete arterial revascularization was defined as a TICI ≥2b on final angiographic run. Good functional outcome was defined as a modified Rankin score ≤2 at 90 days. Results: The CCI was 0 in 47% of patients, 1 in 23%, 2 in 15%, 3 in 10% and ≥4 in 5%. CCI of 2 or more was associated with poor functional outcome (70.6% vs 50%, p = 0.004) and mortality (33.8% vs. 11.7%, p <0.001) compared to patients with low CCI. In a logistic regression adjusted by stroke severity, age, ASPECTS score at baseline and arterial revascularization, high comorbidity remained as an independent predictor of poor outcome (OR 2.9; 95% CI 1.4-5.8) and mortality (OR 4.6, 95% CI 2.0-10.3). Conclusions: High comorbidity assessed by Charlson Comorbidity Index is associated with poor functional outcome and mortality in acute stroke patients treated with mechanical thrombectomy.

Download Full-text