scholarly journals 765. Pyomyositis in the United States: Trends and Associations From the Healthcare Utilization Project Nationwide Inpatient Sample Database

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S340-S341
Author(s):  
Rheanne K Maravelas ◽  
Thomas Melgar ◽  
Sapna Sadarangani ◽  
Neiberg Lima ◽  
Zachary Rich ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Risk Factors ◽  
Healthcare Utilization ◽  
Nationwide Inpatient Sample ◽  
Myositis Ossificans ◽  
Organ Transplant ◽  
The United States ◽  
Nationwide Inpatient Sample Database ◽  
Duration Of Hospitalization

Abstract Background Pyomyositis is a spontaneous infection of skeletal muscle that can lead to abscess formation and sepsis. The purpose of our study was to better describe the characteristics, risk factors, and trends of primary pyomyositis in the United States. Methods This study is a retrospective review of data from the Healthcare Utilization Project Nationwide Inpatient Sample Database from 2002 to 2014. We systematically searched ICD-9 codes and included diagnoses of infective myositis and/or tropical pyomyositis and excluded progressive myositis ossificans and/or traumatic myositis ossificans. We compiled lists of codes for co-occurring infections, candidate risk factors, and microbiological data. Each group of related ICD-9 codes was combined into a single composite indicator. SAS studio was utilized for analysis. Results The database included a total of 100,790,900 discharges accounting for 482,872,274 weighted discharges with 13,011 pyomyositis cases accounting for 62,657 weighted cases. The patients with pyomyositis were significantly more likely to be younger, male, and have a longer duration of hospitalization. The proportion of discharges with pyomyositis has steadily risen more than 3-fold from 0.0054% to 0.0209%. Of the cases of pyomyositis, a minority had co-occurring deep tissue infections: 16.9% had osteomyelitis and 8.8% had septic arthritis. We found significantly higher rates of co-occurrence with HIV, diabetes mellitus, organ transplant, alcohol abuse, and chronic kidney disease compared with the general hospitalized population, suggesting these as relevant risk factors. When microorganisms were diagnosed, Staphylococus aureus was most common, followed by Streptococcus spp. Conclusion Our study identified a rapid increase in pyomyositis cases in the United States over our 12-year study period. Our results substantiate risk factors for pyomyositis related to immunosuppression and suggest that diabetes mellitus may be an important risk factor in the United States. Identifying causative organisms is helpful for empiric treatment. It is important that clinicians be aware of this emerging diagnosis relevant in both temperate and tropical areas of the globe. Disclosures All authors: No reported disclosures.

Abstract 237: Prevalence of Cardiovascular Risk Factors and Cardiovascular Disease in Transgender Persons in The United States

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Aditi Malhotra ◽  
Hal A Skopicki ◽  
Smadar Kort ◽  
Noelle Mann ◽  
Puja Parikh
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Kidney Disease ◽  
The United States ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Transgender Persons

Background: There is a paucity of data regarding prevalence of cardiovascular disease (CVD) and corresponding cardiovascular (CV) risk factors in transgender individuals. We sought to assess the prevalence of CV risk factors and CVD in transgender persons in the United States. Methods: The 2018 Centers for Disease Control’s Behavioral Risk Factor Surveillance Survey was utilized to identify a cohort of 1,038 transgender individuals in the United States. Presence of CVD was noted with a single affirmative response to the following questions: “Has a health care professional ever told you that you had any of the following:” (1) a heart attack or myocardial infarction, (2) angina or coronary heart disease, (3) a stroke? Results: Among the 1,038 transgender individuals studied, a total of 145 (14.0%) had CVD while 893 (86.0%) did not. No differences in prevalence of CVD was noted in transgender individuals who transitioned from male-to-female (n=387), female-to-male (n=400), and gender nonconforming status (n=251) (15.0% vs 13.8% vs 12.7%, p=0.72). Transgender individuals with CVD were older, had lower annual income, higher rates of smoking (28.4% vs 18.1%, p=0.004), and higher rates of multiple co-morbidities including asthma (26.6% vs 17.4%, p = 0.009), skin cancer (21.8% vs 5.0%, p <0.001), non-skin cancers (16.8% vs 6.8%, p <0.001), chronic obstructive pulmonary disease (27.5% vs 7.0%, p <0.001), arthritis (65.3% vs 28.7%, p<0.001), depressive disorder (42.7% vs 31.0%, p= 0.006), chronic kidney disease (16.2% vs 3.3%, p< 0.001), and diabetes mellitus (42.0% vs 12.7%, p <0.001). No significant differences in race, health insurance status, or body mass index was noted between transgender individuals with CVD versus those without. In multivariable analysis, independent predictors of CVD in transgender individuals included older age, diabetes mellitus [odds ratio (OR) 2.82, 95% confidence interval (CI) 1.73 - 4.58], chronic kidney disease (OR 3.69, 95% CI 1.80 - 7.57), chronic obstructive pulmonary disease (OR 2.18, 95% CI 1.19 - 3.99), and depressive disorder (OR 1.82, 95% CI 1.09 - 3.03). Conclusions: In this observational contemporary study, CVD was prevalent in 14% of transgender individuals in the United States. Predictors of CVD in the transgender population exist and transgender persons should be appropriately screened for CV risk factors so as to minimize their risk of CVD.

scholarly journals Laparoscopic Appendectomy Trends and Outcomes in the United States: Data from the Nationwide Inpatient Sample (NIS), 2004–2011

2014 ◽  
Vol 80 (10) ◽  
pp. 1074-1077 ◽  
Author(s):  
Hossein Masoomi ◽  
Ninh T. Nguyen ◽  
Matthew O. Dolich ◽  
Steven Mills ◽  
Joseph C. Carmichael ◽  
...  
Keyword(s):  
United States ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Conversion Rate ◽  
Nationwide Inpatient Sample ◽  
Open Appendectomy ◽  
Perforated Appendicitis ◽  
The United States ◽  
Hospital Charges ◽  
Nationwide Inpatient Sample Database

Laparoscopic appendectomy (LA) is becoming the standard procedure of choice for appendicitis. We aimed to evaluate the frequency and trends of LA for acute appendicitis in the United States and to compare outcomes of LA with open appendectomy (OA). Using the Nationwide Inpatient Sample database, we examined patients who underwent appendectomy for acute appendicitis from 2004 to 2011. A total of 2,593,786 patients underwent appendectomy during this period. Overall, the rate of LA was 60.5 per cent (children: 58.1%; adults: 63%; elderly: 48.7%). LA rate significantly increased from 43.3 per cent in 2004 to 75 per cent in 2011. LA use increased 66 per cent in nonperforated appendicitis versus 100 per cent increase in LA use for perforated appendicitis. The LA rate increased in all age groups. The increased LA use was more significant in male patients (84%) compared with female patients (62%). The overall conversion rate of LA to OA was 6.3 per cent. Compared with OA, LA had a significantly lower complication rate, a lower mortality rate, a shorter mean hospital stay, and lower mean total hospital charges in both nonperforated and perforated appendices. LA has become an established procedure for appendectomy in nonperforated and perforated appendicitis in all rates exceeding OA. Conversion rate is relatively low (6.3%).

Incidence of and Risk Factors for Nosocomial Bloodstream Infections in Adults in the United States, 2003

2009 ◽  
Vol 30 (11) ◽  
pp. 1036-1044 ◽  
Author(s):  
Omar M. AL-Rawajfah ◽  
Frank Stetzer ◽  
Jeanne Beauchamp Hewitt
Keyword(s):  
United States ◽  
Risk Factors ◽  
Case Fatality Rate ◽  
Nationwide Inpatient Sample ◽  
Hospital Admissions ◽  
Case Fatality ◽  
The United States ◽  
Fatality Rate ◽  
The Us ◽  
National Estimates

Background.Although many studies have examined nosocomial bloodstream infection (BSI), US national estimates of incidence and case-fatality rates have seldom been reported.Objective.The purposes of this study were to generate US national estimates of the incidence and severity of nosocomial BSI and to identify risk factors for nosocomial BSI among adults hospitalized in the United States on the basis of a national probability sample.Methods.This cross-sectional study used the US Nationwide Inpatient Sample for the year 2003 to estimate the incidence and case-fatality rate associated with nosocomial BSI in the total US population. Cases of nosocomial BSI were defined by using 1 or more International Classification of Diseases, 9th Revision, Clinical Modification codes in the secondary field(s) that corresponded to BSIs that occurred at least 48 hours after admission. The comparison group consisted of all patients without BSI codes in their NIS records. Weighted data were used to generate US national estimates of nosocomial BSIs. Logistic regression was used to identify independent risk factors for nosocomial BSI.Results.The US national estimated incidence of nosocomial BSI was 21.6 cases per 1,000 admissions, while the estimated case-fatality rate was 20.6%. Seven of the 10 leading causes of hospital admissions associated with nosocomial BSI were infection related. We estimate that 541,081 patients would have acquired a nosocomial BSI in 2003, and of these, 111,427 would have died. The final multivariate model consisted of the following risk factors: central venous catheter use (odds ratio [OR], 4.76), other infections (OR, 4.61), receipt of mechanical ventilation (OR, 4.97), trauma (OR, 1.98), hemodialysis (OR, 4.83), and malnutrition (OR, 2.50). The total maximum rescaled R2 was 0.22.Conclusions.The Nationwide Inpatient Sample was useful for estimating national incidence and case-fatality rates, as well as examining independent predictors of nosocomial BSI.

scholarly journals Incidence of and Risk Factors for Skin Cancer in Organ Transplant Recipients in the United States

2017 ◽  
Vol 153 (3) ◽  
pp. 296 ◽  
Author(s):  
Giorgia L. Garrett ◽  
Paul D. Blanc ◽  
John Boscardin ◽  
Amanda Abramson Lloyd ◽  
Rehana L. Ahmed ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Skin Cancer ◽  
Organ Transplant ◽  
The United States ◽  
Transplant Recipients ◽  
Organ Transplant Recipients

scholarly journals Investigating the Design and Manufacture of PneuNet Actuators As a Prosthetic Tongue for Mimicking Human Deglutition

2020 ◽  
Author(s):  
Francis Darmont Araya ◽  
Pradeep Radhakrishnan
Keyword(s):  
United States ◽  
Nationwide Inpatient Sample ◽  
Deposition Process ◽  
The United States ◽  
Decision Matrix ◽  
Kinematic Data ◽  
Prosthetic Devices ◽  
Nationwide Inpatient Sample Database ◽  
Increasing Trend ◽  
Design And Manufacture

Abstract The number of Total Glossectomy cases in the United States is seeing an increasing trend as per the Nationwide Inpatient Sample Database. Patients, who have undergone such aggressive surgical procedures, have extensive limitations performing basic oral functions such as swallowing (deglutition), eating and speaking. Current rehabilitation prostheses do little in restoring the functionality of the original tongue. This is true especially in deglutition, which is necessary to transfer a bolus to the esophagus. Such patients need advanced prosthetic devices and through this research, investigations into potential solutions for prosthetic tongues to aid in deglutition were carried out. Different designs were considered and based on a decision matrix, PneuNets (pneumatic networks) were adopted as the foundational basis for generating prosthetic tongue designs. Several prototypes were fabricated that used the Fused Filament Deposition process for producing the mold and silicone Eco-flex 00-30 for producing the mechanism. The resulting mechanism was powered using a pneumatic input and kinematic data was collected. Details from literature review, design iterations, simulations, validation processes, manufacturing challenges and conclusions will be discussed in depth in this paper.

Abstract 2157: Racial Differences in Hospitalizations for Atrial Fibrillation in the United States

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Paul B Tabereaux ◽  
Todd M Brown ◽  
Jose Osorio ◽  
G. N Kay ◽  
Dawn M Bravada
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
The United States ◽  
Principal Diagnosis ◽  
Common Risk Factors

Introduction: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in the United States; however a paucity of population-based data about nonwhite individuals exist. The objectives of this study were to compare hospitalizations among Whites and African Americans (AA) and to determine whether race is an independent predictor of hospitalization for AF in the United States. Methods: Data was obtained from the National Hospital Discharge Survey (years 1996 –2005) and included hospitalizations with a principal diagnosis of AF for patients aged ≥18 yrs and race designated as either White or AA. Codes from the International Classification of Diseases -9th revision were used to define AF (427.31), hypertension (401– 405), ischemic heart disease (410 – 414), diabetes mellitus (250), heart failure (425,428) and valvular heart disease (424). Multivariable analysis with logistic regression was used to identify factors that were independently associated with AF hospitalizations Results: Among 297,962,043 hospitalizations between 1996 –2005, 3,676,787 (1.2%) had a principal diagnosis of AF. Among the hospitalizations for AF, white race was more common than AA race (2,393,659/186,904,962 of whites (1.3% of white’s hospitalized) and 209,788/33,972,665 of African Americans (0.6% of AA’s hospitalized), p<0.0001). After adjusting for the most common risk factors for AF (age, sex, hypertension, ischemic heart disease, diabetes mellitus, heart failure and valvular heart disease) AA race was independently associated with a decreased odds of hospitalizations for AF (Table 1 : adjusted OR=0.49, 95%CI 0.46 – 0.51). Conclusions: After adjusting for the most common risk factors for AF, the odds of hospitalization for AF in AA’s remained half that of whites. Race may be a novel and unaccounted risk factor for atrial fibrillation.

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