Patient characteristics and incidence of childhood hospitalisation due to hypertrophic cardiomyopathy in the United States of America 2001–2014

2019 ◽  
Vol 29 (3) ◽  
pp. 344-354 ◽  
Author(s):  
Rie Sakai-Bizmark ◽  
Eliza J. Webber ◽  
Emily H. Marr ◽  
Laurie A. Mena ◽  
Ruey-Kang R. Chang
Keyword(s):  
United States ◽  
Emergency Department ◽  
Hypertrophic Cardiomyopathy ◽  
Odds Ratio ◽  
Age Groups ◽  
Patient Characteristics ◽  
The United States ◽  
Age Group ◽  
White Children ◽  
Nationally Representative

AbstractThis study investigated patient characteristics in paediatric hospitalisations for hypertrophic cardiomyopathy. We used Nationwide Inpatient Sample, which is the largest all-payer inpatient database in the United States, yielding nationally representative estimates, from 2001 to 2014. ICD-9-CM diagnostic codes identified hospitalisations for patients with hypertrophic cardiomyopathy and <18 years. Outcomes included yearly rate of hospitalisation, death, admission via emergency department, and need for surgery. Predictors of interest were age groups (<1, 1–9, and ⩾10 y/o), sex, and race/ethnicity. Logistic regression modelled associations, adjusted by patient- and hospital-level variables. With 2302 weighted hospitalisations, hospitalisation rates were 0.22 per 100,000 children/year, with higher rates for <1 y/o (0.42) and ⩾10 y/o (0.31). Male-to-female ratios were more prominent in the oldest age group; 2.7:1 in ⩾10 y/o versus less than 1.7:1 for <10 y/o. In-hospital mortality was 1.5%, with highest mortality rates among the <1 y/o (6.3%). Children ⩾10 y/o had 5.59 times higher risk of admission from the emergency department than 1–9 y/o age group. Both ⩾10 and <1 y/o age groups had lower risk of surgical intervention compared to the 1–9 y/o group with odds ratio 0.56 and 0.26, respectively. Black children had higher risk of admission from the emergency department than White children with odds ratio 2.78. A relation between age group and sex was observed, with sex-based differences in prevalence and treatment of hypertrophic cardiomyopathy becoming more pronounced with age. Further studies are needed to clarify mechanisms behind age and racial disparity in hospitalisation, especially admission source.

Impact of age on outcomes in patients with hypertrophic cardiomyopathy: a nationwide inpatient database study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V Jain ◽  
M.G Gupta ◽  
A.B Bansal ◽  
B.G Griffin ◽  
B.X Xu
Keyword(s):  
United States ◽  
Hypertrophic Cardiomyopathy ◽  
Elderly Patients ◽  
Odds Ratio ◽  
Age Groups ◽  
Pacemaker Implantation ◽  
The United States ◽  
Age Group ◽  
Alcohol Septal Ablation ◽  
Septal Myectomy

Abstract Background Hypertrophic cardiomyopathy (HCM) is an inherited cardiovascular condition, associated with increased risk of premature adverse events. Once considered a disease of the young, it is increasingly being recognized in septuagenarians and octogenarians, with a few small-scale studies indicating that the risk of adverse cardiovascular outcomes may be lower in the older population. Purpose There are limited data regarding the outcomes of elderly patients with HCM. We therefore investigated a nationwide cohort in the United States to evaluate the pattern of disease presentation and outcomes of HCM patients, with a focus on the geriatric population. Methods The Nationwide Inpatient Sample (NIS) was queried to identify patients who were admitted for any cause with a concomitant diagnosis of HCM between 2011 and 2014 using ICD-9 (International Classification of Diseases-9th Edition-Clinical Modification) diagnosis code 425.1. All patients were further sub-categorized based on their age into those less than 65 years of age (representative of younger population), 66–75 years, 76–85 years and more than or equal to 86 years. We performed the Chi-squared tests for categorical variables and Mann–Whitney U tests for continuous variables. Multiple logistic regression was performed to assess the predictors of mortality. A two-tailed p-value of &lt;0.05 was considered to be significant. Results We identified 120,805 patients who were admitted with a diagnosis of HCM, of whom 46.4% were in the &lt;65 age group, 21.5% were in the 66–75 age group, 20.5% were in the 76–85 age group, and 11.5% were in the &gt;86 age group. The proportion of patients with ventricular fibrillation was lower (1.8% vs 1.0% vs 0.5% vs 0.1%, p&lt;0.01), whereas the proportion of patients undergoing permanent pacemaker placement was higher (1.2% vs 2.3% vs 3.7% vs 3.6%, p&lt;0.01) in successive age groups. The proportion of people undergoing operative procedures including septal myectomy (SM) (5.4% vs 4.5% vs 1.8% vs 0.2%, p-intervention &lt;0.01) and alcohol septal ablation (ASA) (3.2% vs 3.3% vs 1.9% vs 1.0%, p-intervention &lt;0.01) were lower in the advanced age groups when compared to the younger age groups. Pacemaker implantation (odds ratio (OR): 0.32, 95% confidence intervals (CIs): 0.20–0.50, p&lt;0.01) and implantable cardioverter defibrillator (ICD) placement (OR: 0.059, 95% CI: 0.024–0.144, p&lt;0.01) were found to be associated with decreased odds of in-hospital mortality across all age groups. Conclusion In a large nationwide cohort of HCM patients in the United States, a significant proportion of patients were septuagenarians and octogenarians. Fewer elderly patients with HCM underwent septal myectomy and alcohol septal ablation, while elderly patients underwent more pacemaker implants. A combination of reduced ventricular conduction abnormalities coupled with increased pacemaker implantation may be contributing to increased longevity in older HCM patients. Odds-ratio for predictors of mortality Funding Acknowledgement Type of funding source: None

scholarly journals Real-World Utilization of Oral Anticancer Agents Costs in Older Adults with Metastatic Renal Cell Carcinoma in the United States

Kidney Cancer ◽  
2021 ◽  
pp. 1-13
Author(s):  
Lauren E. Wilson ◽  
Lisa Spees ◽  
Jessica Pritchard ◽  
Melissa A. Greiner ◽  
Charles D. Scales ◽  
...  
Keyword(s):  
United States ◽  
Anticancer Agents ◽  
Patient Characteristics ◽  
The United States ◽  
Socioeconomic Indicators ◽  
Economic Implications ◽  
Southern Us ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Oral Anticancer Agents

Background: Substantial racial and socioeconomic disparities in metastatic RCC (mRCC) have persisted following the introduction of targeted oral anticancer agents (OAAs). The relationship between patient characteristics and OAA access and costs that may underlie persistent disparities in mRCC outcomes have not been examined in a nationally representative patient population. Methods: Retrospective SEER-Medicare analysis of patients diagnosed with mRCC between 2007–2015 over age 65 with Medicare part D prescription drug coverage. Associations between patient characteristics, OAA receipt, and associated costs were analyzed in the 12 months following mRCC diagnosis and adjusted to 2015 dollars. Results: 2,792 patients met inclusion criteria, of which 32.4%received an OAA. Most patients received sunitinib (57%) or pazopanib (28%) as their first oral therapy. Receipt of OAA did not differ by race/ethnicity or socioeconomic indicators. Patients of advanced age (>  80 years), unmarried patients, and patients residing in the Southern US were less likely to receive OAAs. The mean inflation-adjusted 30-day cost to Medicare of a patient’s first OAA prescription nearly doubled from $3864 in 2007 to $7482 in 2015, while patient out-of-pocket cost decreased from $2409 to $1477. Conclusion: Race, ethnicity, and socioeconomic status were not associated with decreased OAA receipt in patients with mRCC; however, residing in the Southern United States was, as was marital status. Surprisingly, the cost to Medicare of an initial OAA prescription nearly doubled from 2007 to 2015, while patient out-of-pocket costs decreased substantially. Shifts in OAA costs may have significant economic implications in the era of personalized medicine.

Emergency Department Visits due to Scabies in the United States: A Retrospective Analysis of a Nationally Representative Emergency Department Sample

2019 ◽  
Author(s):  
Raghav Tripathi ◽  
Konrad D Knusel ◽  
Harib H Ezaldein ◽  
Jeremy S Bordeaux ◽  
Jeffrey F Scott
Keyword(s):  
United States ◽  
Emergency Department ◽  
Retrospective Analysis ◽  
The United States ◽  
Cost Of Care ◽  
Emergency Department Visits ◽  
Limited Information ◽  
Targeted Interventions ◽  
Ed Visits ◽  
Nationally Representative

Abstract Background Limited information exists regarding the burden of emergency department (ED) visits due to scabies in the United States. The goal of this study was to provide population-level estimates regarding scabies visits to American EDs. Methods This study was a retrospective analysis of the nationally representative National Emergency Department Sample from 2013 to 2015. Outcomes included adjusted odds for scabies ED visits, adjusted odds for inpatient admission due to scabies in the ED scabies population, predictors for cost of care, and seasonal/regional variation in cost and prevalence of scabies ED visits. Results Our patient population included 416 017 218 ED visits from 2013 to 2015, of which 356 267 were due to scabies (prevalence = 85.7 per 100 000 ED visits). The average annual expenditure for scabies ED visits was $67 125 780.36. The average cost of care for a scabies ED visit was $750.91 (±17.41). Patients visiting the ED for scabies were most likely to be male children from lower income quartiles and were most likely to present to the ED on weekdays in the fall, controlling for all other factors. Scabies ED patients that were male, older, insured by Medicare, from the highest income quartile, and from the Midwest/West were most likely to be admitted as inpatients. Older, higher income, Medicare patients in large Northeastern metropolitan cities had the greatest cost of care. Conclusion This study provides comprehensive nationally representative estimates of the burden of scabies ED visits on the American healthcare system. These findings are important for developing targeted interventions to decrease the incidence and burden of scabies in American EDs.

scholarly journals Contact surveys reveal heterogeneities in age-group contributions to SARS-CoV-2 dynamics in the United States

2021 ◽  
Author(s):  
Taylor Chin ◽  
Dennis M. Feehan ◽  
Caroline O. Buckee ◽  
Ayesha S. Mahmud
Keyword(s):  
United States ◽  
Age Groups ◽  
The United States ◽  
Contact Rate ◽  
Age Group ◽  
Contact Rates ◽  
Contact Patterns ◽  
Age Structured ◽  
The Impact ◽  
Over Time

SARS-CoV-2 is spread primarily through person-to-person contacts. Quantifying population contact rates is important for understanding the impact of physical distancing policies and for modeling COVID-19, but contact patterns have changed substantially over time due to shifting policies and behaviors. There are surprisingly few empirical estimates of age-structured contact rates in the United States both before and throughout the COVID-19 pandemic that capture these changes. Here, we use data from six waves of the Berkeley Interpersonal Contact Survey (BICS), which collected detailed contact data between March 22, 2020 and February 15, 2021 across six metropolitan designated market areas (DMA) in the United States. Contact rates were low across all six DMAs at the start of the pandemic. We find steady increases in the mean and median number of contacts across these localities over time, as well as a greater proportion of respondents reporting a high number of contacts. We also find that young adults between ages 18 and 34 reported more contacts on average compared to other age groups. The 65 and older age group consistently reported low levels of contact throughout the study period. To understand the impact of these changing contact patterns, we simulate COVID-19 dynamics in each DMA using an age-structured mechanistic model. We compare results from models that use BICS contact rate estimates versus commonly used alternative contact rate sources. We find that simulations parameterized with BICS estimates give insight into time-varying changes in relative incidence by age group that are not captured in the absence of these frequently updated estimates. We also find that simulation results based on BICS estimates closely match observed data on the age distribution of cases, and changes in these distributions over time. Together these findings highlight the role of different age groups in driving and sustaining SARS-CoV-2 transmission in the U.S. We also show the utility of repeated contact surveys in revealing heterogeneities in the epidemiology of COVID-19 across localities in the United States.

scholarly journals Monitoring Sexual Violence Trends in Emergency Department Visits Using Syndromic Data From the National Syndromic Surveillance Program—United States, January 2017–December 2019

2021 ◽  
Vol 111 (3) ◽  
pp. 485-493
Author(s):  
Ashley Schappell D'Inverno ◽  
Nimi Idaikkadar ◽  
Debra Houry
Keyword(s):  
United States ◽  
Emergency Department ◽  
Sexual Violence ◽  
Syndromic Surveillance ◽  
Age Groups ◽  
The United States ◽  
Emergency Department Visits ◽  
Surveillance Program ◽  
Time Period ◽  
Ed Visits

Objectives. To report trends in sexual violence (SV) emergency department (ED) visits in the United States. Methods. We analyzed monthly changes in SV rates (per 100 000 ED visits) from January 2017 to December 2019 using Centers for Disease Control and Prevention’s National Syndromic Surveillance Program data. We stratified the data by sex and age groups. Results. There were 196 948 SV-related ED visits from January 2017 to December 2019. Females had higher rates of SV-related ED visits than males. Across the entire time period, females aged 50 to 59 years showed the highest increase (57.33%) in SV-related ED visits, when stratified by sex and age group. In all strata examined, SV-related ED visits displayed positive trends from January 2017 to December 2019; 10 out of the 24 observed positive trends were statistically significant increases. We also observed seasonal trends with spikes in SV-related ED visits during warmer months and declines during colder months, particularly in ages 0 to 9 years and 10 to 19 years. Conclusions. We identified several significant increases in SV-related ED visits from January 2017 to December 2019. Syndromic surveillance offers near-real-time surveillance of ED visits and can aid in the prevention of SV.

scholarly journals Prevalence of Cervical Artery Dissection among Hospitalized Patients with Stroke by Age in a Nationally Representative Sample from the United States

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011420
Author(s):  
Yahya B. Atalay ◽  
Pirouz Piran ◽  
Abhinaba Chatterjee ◽  
Santosh Murthy ◽  
Babak B. Navi ◽  
...  
Keyword(s):  
United States ◽  
Ischemic Stroke ◽  
Representative Sample ◽  
Age Groups ◽  
Vertebral Artery Dissection ◽  
The United States ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Cervical Artery ◽  
Nationally Representative

Objective:To test the hypothesis that the prevalence of cervical artery dissection remains constant across age groups, we evaluated the relationship between age and cervical artery dissection in patients with stroke using a Nationally Representative Sample from the United States.Methods:We used inpatient claims data included in the 2012-2015 releases of the National Inpatient Sample (NIS). We used validated ICD-9-CM codes to identify adults hospitalized with ischemic stroke and a concomitant diagnosis of carotid- or vertebral-artery dissection. Survey weights provided by the NIS and population estimates from the U.S. census were used to calculate nationally representative estimates. The chi-square test for trend was used to compare the prevalence of concomitant dissection among stroke hospitalizations across patient subgroups defined by age. Poisson regression and the Wald test for trend were used to evaluate whether the prevalence of hospitalizations for stroke and concomitant dissection per million person-years varied by age groups.Results:There were 17,320 (95% confidence interval [CI], 15,614-19,026) hospitalizations involving ischemic stroke and a concomitant dissection. The prevalence of dissection among stroke hospitalizations decreased across 10-year age groups from 7.2% (95% CI, 6.2%-8.1%) among persons younger than age 30 years to 0.2% (95% CI, 0.1%-0.2%) among persons older than age 80 years (P value for trend <0.001). However, the prevalence of hospitalizations for stroke and concomitant dissection increased from 5.4 (95% CI, 4.6-6.2) hospitalizations per million person-years among adults younger than age 30 to 24.4 (95% CI, 21.0-27.9) hospitalizations per million person-years among adults older than age 80 (P value for trend <0.01).Conclusions:In a nationally representative sample, the prevalence of hospitalizations for dissection-related stroke increased with age.

scholarly journals Decreasing Incidence of Estrogen Receptor-Negative Breast Cancer in the United States: Trends by Race and Region

2021 ◽  
Author(s):  
Brittny C Davis Lynn ◽  
Pavel Chernyavskiy ◽  
Gretchen L Gierach ◽  
Philip S Rosenberg
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Estrogen Receptor ◽  
African American Women ◽  
Breast Cancer Incidence ◽  
Age Groups ◽  
The United States ◽  
Age Group ◽  
Annual Percent Change ◽  
Hispanic White

Abstract Background Incidence of estrogen receptor (ER)-negative breast cancer, an aggressive subtype, is highest in United States (US) African American women and in southern residents but has decreased overall since 1992. We assessed whether ER-negative breast cancer is decreasing in all age groups and cancer registries among non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic White (HW) women. Methods We analyzed 17 Surveillance, Epidemiology, and End-Results Program registries (twelve for 1992-2016; five for 2000-2016) to assess NHW, NHB, and HW trends by ER status and age group (30-39, 40-49, 50-69, 70-84 years). We used hierarchical age-period-cohort models that account for sparse data, which improve estimates to quantify between-registry heterogeneity in mean incidence rates and age-adjusted trends versus SEER overall. Results Overall, ER-negative incidence was highest in NHB, then NHW and HW women, and decreased from 1992-2016 in each age group and racial/ethnic group. The greatest decrease was for HW women ages 40-49 years with an annual percent change of –3.5%/year (95% credible interval = −4.4%, −2.7%), averaged over registries. The trend heterogeneity was statistically significant in every race/ethnic and age group. Furthermore, the incidence relative risks by race/ethnicity compared to the race-specific SEER average were also statistically significantly heterogeneous across the majority of registries and age groups (62 of 68 strata). The greatest heterogeneity was seen in HW women, followed by NHB women, and the least in NHW women. Conclusion Decreasing ER-negative breast cancer incidence differs meaningfully by US region and age among NHB and HW women. Analytical studies including minority women from higher and lower incidence areas may provide insights into breast cancer racial disparities.

Abstract 3898: Predictors Of Admissions In Patients Presenting To Emergency Department With Transient Ischemic Attacks In United States- A National Survey

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Nauman Tariq ◽  
Saqib A Chaudhry ◽  
Ashter Rizvi ◽  
M Fareed K Suri ◽  
Gustavo J Rodriguez ◽  
...  
Keyword(s):  
United States ◽  
Emergency Department ◽  
Hospital Admission ◽  
Hospital Admissions ◽  
Multivariate Logistic Regression Analysis ◽  
The United States ◽  
Primary Diagnosis ◽  
Transient Ischemic Attacks ◽  
Hospital Type ◽  
Nationally Representative

Background: The estimates of patients who present with transient ischemic attacks (TIA) in the emergency departments (ED) of United states and their disposition including factors that determine hospital admission are not well understood. Objective: We used a nationally representative database to determine the rate and predictors of admission in TIA patients presenting to the ED. Methods: We analyzed the data from National Emergency Department Sample (NEDS 2006-2007) for all patients presenting with primary diagnosis of TIAs in the United States. Samples were weighted to provide national estimates of TIA hospitalizations and identify factors that increase the odds of hospital admission including age, sex, type of insurance, hospital type (urban teaching, urban nonteaching and non urban). Multivariate logistic regression analysis was used to identify predictors of hospital admission. Results: Of the total of 631750 patients presenting with TIA to the EDs in a period of two years in US, 41, 9447 (66.4%) were admitted to the hospital. In the multivariate analysis, independent factors associated with hospital admissions were women (odds ratio[OR] 1.042, 95% confidence interval [CI] 1.014-1.071, p =0.003) , Medicare insurance type (OR 0.82, 95% CI 0.88-0.93, p<0.0001), and urban non-teaching hospital ED (OR 0.825, 95% CI 0.778-0.875, p<0.0001). Conclusion: Approximately 70% of all patients presenting with TIAs to the EDs within United States are admitted. Factors unrelated to patients condition such as insurance status and ED affiliated hospital type play an important role in the decision to admit TIA patients to the hospitals.

Prevalence and Demographic Differences in Work as a Calling in the United States: Results From a Nationally Representative Sample

2021 ◽  
pp. 106907272199569
Author(s):  
Micah J. White ◽  
Dylan R. Marsh ◽  
Bryan J. Dik ◽  
Cheryl L. Beseler
Keyword(s):  
United States ◽  
Panel Study ◽  
Social Science Research ◽  
Age Groups ◽  
Science Research ◽  
The United States ◽  
Demographic Differences ◽  
Life Study ◽  
Nationally Representative ◽  
The U.S

Within the last two decades, social science research on work as a calling has rapidly grown. To date, knowledge regarding prevalence and demographic differences of calling in the United States derives from data collected mainly from regionally limited and/or occupationally homogenous samples. The present study used data from the Portraits of American Life Study, a nationally stratified panel study of religion in the United States (U.S.), to estimate calling’s prevalence in the U.S. Our findings represent the first known population estimates of seeking, perceiving, and living a calling in the U.S. Results revealed that calling is a relevant concept for many U.S. adults, with 43% endorsing “mostly true” or “totally true” to the statement “I have a calling to a particular kind of work.” Small differences for presence of and search for a calling emerged across age groups, employment statuses, and levels of importance of God or spirituality. For living a calling, significant differences were identified only for importance of God or spirituality, contrasting with previous findings that suggested that living a calling varies as a function of income and social status. Implications for research and practice are explored.

Sign in / Sign up

Export Citation Format

Share Document