Abstract 15132: Inpatient Outcome of Infective Pericarditis in the United States: An Analysis From National Inpatient Sample 2016-2017

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Bolun Liu ◽  
Bing Chen ◽  
Omid Behnamfar ◽  
Trisha Gomez ◽  
Ajoe Kattoor
Keyword(s):  
Cardiac Tamponade ◽  
Hemodynamic Instability ◽  
The United States ◽  
Primary Diagnosis ◽  
National Inpatient Sample ◽  
All Cause Mortality ◽  
Icd 10 ◽  
The Mean ◽  
Baseline Characteristics ◽  
Basic Characteristics

Introduction: Infective pericarditis is a relatively uncommon condition in the modern antibiotic era, has a high mortality rate (20-30%) and is associated with immunosuppression, alcohol use, illicit drug use, thoracic surgery. Outcomes data in the current era is unknown. We aim to analyze the baseline characteristics and outcomes of patients admitted in the hospital with infective pericarditis. Methods: We conducted a retrospective study using National Inpatient Sample (NIS) database from 2016 to 2017. Hospital visits with a primary diagnosis of infective pericarditis (ICD10, I30.1) during which a pericardial procedure was performed were identified using ICD-10-CM and ICD-10-PCS Codes. Our primary outcome was basic characteristics and in-hospital all-cause mortality. Multivariate regression model was used to adjust for the pericardial procedure approach, age, and cardiac tamponade. R (Version 3.6.1) was utilized for the analysis. Results: A total of 1010 weighted hospitalizations in adult patients with infective pericarditis were identified. The mean age was 56.7±1.1 years (woman - 41.4%). The baseline characteristics and comorbidities are described in table 1 and table 2. 60.5% of the patients underwent percutaneous pericardial drainage, 36.4% had open surgery, and 3.2% had VATs. The mean time from admission to a pericardial procedure is 1.7±0.2 days. In-hospital all-cause mortality was 2.27%. The mean length of stay was 7.59±0.43 days. The mean total cost was 22530±1193 US dollars. Among all hospitalizations, 61.8% of them were complicated by hemodynamic instability and 56.8% had cardiac tamponade. Compared to pericardiocentesis, patients who underwent pericardiotomy had a higher mortality (5% vs 0.8%, adjusted OR 8.03, P = 0.043). Conclusions: Our study demonstrates relatively low inpatient mortality with infective pericarditis compared to older studies. Around half of the patients had cardiac tamponade.

Abstract 14314: Men Admitted With Takotsubo Syndrome (TTS) Have Increased In-Hospital Morbidity and Mortality: Perspectives From the National Inpatient Sample Database

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Louis T Vincent ◽  
Jelani Grant ◽  
Bertrand Ebner ◽  
Jennifer Maning ◽  
Paul Montana ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Skilled Nursing Facility ◽  
Hemodynamic Instability ◽  
Primary Diagnosis ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Takotsubo Syndrome ◽  
National Inpatient Sample ◽  
Increased Risk ◽  
All Cause Mortality

Introduction: Takotsubo Syndrome (TTS), also known as Stress Induced Cardiomyopathy, is characterized by reversible left ventricular dysfunction without obstructive coronary disease, and largely affects post-menopausal women. However, limited data suggest increased mortality risk in men. We sought to compare national in-hospital outcomes between men and women admitted with TTS. Methods: All patients above 18 years who were admitted with primary diagnosis of TTS between 2012-2017 were identified by International Classification of Diseases (ICD)-9 and ICD-10 diagnostic codes in the National Inpatient Sample (NIS) Database. The primary endpoint was in-hospital all-cause mortality. Secondary endpoints included in-hospital complications, total cost, and duration of hospitalization. Results: A total of 8732 patients (90.8% female) were admitted with primary diagnosis of TTS. Women with TTS were older compared to men (66.9±12.4 vs. 63.1±15.7 years, p<0.001). However, men had increased tobacco use (48.8% vs 37.2%), alcohol use (11.6% vs 3.1%), and coronary artery disease (47.0% vs 39.7%, p<0.001 for all). Prevalence of diabetes, hypertension, atrial fibrillation, anemia, and heart failure was similar between groups. Men more frequently developed cardiogenic shock (7.1% vs 4.4%, p<0.001) requiring mechanical circulatory support (2.9% vs 1.7%, p=0.01), and had greater all-cause mortality compared to women (2.5% vs 1.4%, p=0.01). Using a multivariate regression model to adjust for age, race, substance use, and comorbidities, male gender (OR 2.12, 95% CI [1.69-2.68], p<0.001) and cardiogenic shock (OR 15.1, 95% CI [12.6-18.0], p<0.001) were associated with increased all-cause mortality. Lastly, men experienced greater length and cost of stay (4.0±4.2 vs. 3.6±3.6 days, and $56,428 vs. $46,908), fewer routine discharges (74.3% vs. 77.6%), and greater need for skilled nursing facility (11.6% vs. 9.2%, p<0.001 for all). Conclusion: TTS occurs predominantly in women but carries increased risk of in-hospital mortality in men, especially when complicated by cardiogenic shock. Perhaps improved risk stratification and early identification of patients with signs of shock or hemodynamic instability may help to improve outcomes.

Anemia Is Associated With Poor Clinical Outcomes in Hospitalized Patients With Takotsubo Cardiomyopathy

Angiology ◽  
2021 ◽  
pp. 000331972199949
Author(s):  
Xiaojia Lu ◽  
Pengyang Li ◽  
Catherine Teng ◽  
Peng Cai ◽  
Bin Wang
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Kidney Injury ◽  
Length Of Hospital Stay ◽  
International Classification Of Diseases ◽  
The United States ◽  
Primary Diagnosis ◽  
National Inpatient Sample ◽  
Classification Of Diseases ◽  
Icd 10

The association between anemia and Takotsubo cardiomyopathy (TCM) has not been well studied. To assess the effect of anemia on patients hospitalized with TCM, we identified 4733 patients with a primary diagnosis of TCM from the 2016 to 2018 National Inpatient Sample (NIS) database (the United States) using the International Classification of Diseases, 10th edition, Clinical Modification ( ICD-10-CM) code. Of these, 603 (12.7%) patients had a comorbidity of anemia and 4130 did not. After propensity score matching, we compared the in-hospital outcomes between the 2 groups (anemia vs nonanemia, n = 594 vs 1137). Patients with TCM with anemia had significantly higher rates of in-hospital complications, including cardiogenic shock (11.4% vs 4.0%, P < .001), ventricular arrhythmia (6.6% vs 3.6%, P = .008), acute kidney injury (22.7% vs 13.1%, P < .001), acute respiratory failure (22.6% vs 13.1%, P < .001), longer length of hospital stay (5.6 ± 5.8 days vs 3.6 ± 3.6 days, P < .001), and higher total charges (US$79 586 ± 10 2436 vs US$50 711 ± 42 639, P < .001). In conclusion, patients with anemia who were admitted for TCM were associated with a higher incidence of in-hospital complications compared with those without anemia.

Abstract 16255: Acute Pericarditis Related Hospitalization and Readmission in the United States

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Prakash Acharya ◽  
Farhad Sami ◽  
Omar Al-Taweel ◽  
Sagar Ranka ◽  
Brianna Stack ◽  
...  
Keyword(s):  
Cox Regression ◽  
Secondary Analysis ◽  
The United States ◽  
Primary Diagnosis ◽  
Emergency Department Visits ◽  
Index Admission ◽  
Acute Pericarditis ◽  
Increased Risk ◽  
Multiple Variables ◽  
The Mean

Introduction: Acute pericarditis accounts for one in every twenty emergency department visits for chest pain and a majority of these patients get admitted to a hospital. However, apart from small studies, there is a lack of data regarding the incidence and predictors of readmissions in these patients. Methodology: A secondary analysis of the Nationwide Readmission Database for years 2016-2017 was performed. Patients who were admitted with a primary diagnosis of acute pericarditis in the first six months of each year were identified based on International Classification of Diseases (ICD-10), Clinical Modification codes, and were followed for 180 days. A multivariate cox-regression model was utilized to delineate the predictors of pericarditis related readmissions. Results: A total of 21,115 patients were admitted with a primary diagnosis of acute pericarditis. The mean age was 53.3+19 years and 60.83% were males. About 23% of patients had pericardial effusion or tamponade and 19.4% of patients presenting with pericarditis required pericardiocentesis. The mortality rate during index admission was 3.21% and the mean length of stay was 6.4+9 days. The rate of all-cause readmission was 30.8% within 180 days, of which 23.8% were pericarditis related. The mean time to readmission for pericarditis was 37.7+41 days. Females were at higher risk of readmission for pericarditis [OR 1.66, CI (1.38-1.99), p<0.001] after adjustment for multiple variables (including connective tissue disease, congestive heart failure and malignancy). Presence of comorbidities like diabetes mellitus [HR 1.21, CI(1.01-1.45), p=0.04], obesity [HR 1.27, CI(1.05-1.54), p=0.01], and chronic lung disease [HR 1.32, CI(1.12-1.57), p=0.001] also increased risk of pericarditis related readmissions. Moreover, the length of index hospitalization was significantly higher in patients with pericarditis related readmissions [5.4+6 vs1.6+5 days, p<0.001]. Conclusion: Even though the mortality during index admission in patients admitted with pericarditis is low, about 1 in every 3 patients will be readmitted within 180 days. While females account for a minority of initial admissions for pericarditis, their risk of readmission is significantly higher.

In-hospital mortality in acute promyelocytic leukemia patients: A study of national inpatient sample.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18521-e18521
Author(s):  
Dipesh Uprety ◽  
Yazhini Vallatharasu ◽  
Amir Bista ◽  
Mamatha Gaddam ◽  
Andrew J Borgert ◽  
...  
Keyword(s):  
United States ◽  
Hospital Volume ◽  
Early Death ◽  
The United States ◽  
Promyelocytic Leukemia ◽  
Early Mortality ◽  
Matched Cohort ◽  
National Inpatient Sample ◽  
Inpatient Mortality ◽  
Icd 10

e18521 Background: Acute Promyelocytic Leukemia (APL), a subtype of acute myeloid leukemia, has excellent outcomes, but continues to show high rates of early mortality. An epidemiologic study utilizing SEER between 1992 & 2007 showed an early death rate of 17.3%. There is limited data on the incidence of inpatient mortality in APL patients in the United States and the factors that contribute to early death. Methods: National Inpatient Sample was utilized to identify adult patients (≥18 years) diagnosed with APL using International Classification of Diseases, 10th edition (ICD-10-CM) code C92.40. Since the United States transitioned from using ICD-9-CM to ICD-10-CM on October 2015, we included APL patients diagnosed between 2015 & 2016. Clinical, sociodemographic and hospital characteristic data were examined; hospital volume was divided into quartiles. The association between overall inpatient survival & receipt of chemotherapy was examined in a propensity score matched cohort of patients not discharged to another acute care facility. Statistical analyses were conducted utilizing SAS version 9.4. Results: In total, 433 APL patients were identified (median age 52 years, 52% males, 65% whites). The inpatient mortality rate was 9.93%. 59.5% (n = 258) of patients did not receive chemotherapy. On univariate-analysis, patients with younger age, black-race, transfer in from other hospital, elective admissions, private insurance, large bed size hospital & large hospital volume were more likely to receive chemo. In the matched-cohort, receipt of chemo was associated with decreased mortality (Hazard Ratio 0.27, 95% CI: 0.12-0.60). We ran additional mortality analysis landmarked at 3 days and 7 days: 75% of chemo patients receiving treatment within 3 days had survival advantage with chemo (HR: 0.35 [0.15-0.82]). 90% of chemo patients receiving treatment within 7 days didn’t show any difference in survival (HR: 0.49 [0.18-1.32]) but the sample size was small. Conclusions: Our study showed an early survival benefit when patient with APL received chemotherapy within 3 days of admission. Early recognition & prompt treatment initiation will help reduce the rate of early mortality in patients with APL.

Abstract 13349: An Investigation Into the Association Between Inflammatory Bowel Disease and Cardiac Arrhythmias an Examination of the United States National Inpatient Sample Database

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mahmood Mubasher ◽  
Tausif Syed ◽  
Amir Hanafi ◽  
Zhao Yu ◽  
Ibrahim Yusuf ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
General Population ◽  
Bowel Disease ◽  
Cardiac Arrhythmias ◽  
The United States ◽  
National Inpatient Sample ◽  
Inflammatory Bowel ◽  
Baseline Characteristics ◽  
Exact Relationship

Introduction: A growing evidence depicted the role of systemic inflammation in the pathogenesis of cardiac Arrhythmias (CA). However, uncertainty remains as to the exact relationship between Inflammatory Bowel Disease (IBD) and CA. So far, most of the studies had centered on the implication of inflammatory mechanisms in the development of atrial fibrillation (AF) in IBD. The association between IBD and other arrhythmias is not well elucidated. Hypothesis: We hypothesized that IBD might be associated with a higher burden of CA. Methods: We queried the national inpatient sample (NIS) from 2012 to 2014. Discharges associated with IBD (Chron's or ulcerative colitis), cardiac arrhythmias including AF, Atrial flutter, SVT, VT, VF were identified using ICD-9-CM codes 555.xx, 556.xx, 427.3, 427.32, 427.0, 427.1, 427.41, respectively. We divided patients into two groups, IBD Vs. Non-IBD. Outcomes are the prevalence of CA (AF, A.flutter, SVT, VT, V.fib) amongst both groups, as well as the correlation between CA and demographic of patient cohorts. Multivariable logistic regression (MLR) was utilized to adjust for differences in baseline characteristics. Results: We identified 847,235 weighted hospitalizations among patients with IBD and 84,757,349 hospitalizations among the general population, ≥18 years of age. Overall, IBD patients were less likely to be admitted with cardiac arrhythmias than the non-IBD population (9.7% versus 14.2%, P, <0.001). On MLR, IBD Group had lower odds of CA during hospitalization (OR, 0.87; 95% CI 0.85-0.88), AF (OR, 086; 95%CI 0.85-0.88) A.flutter (OR,0.78; 95% CI 0.74-0.83), VF (OR, 0.69; 95% CI 0.59-0.79). While the prevalence of SVT and VT was not different between the two groups. Male sex, age of more than 60 years, and white Race were risk factors for Arrhythmias. Conclusions: In conclusion NIS analysis revealed lower rates of hospitalization-associated arrhythmias in the IBD population compared to the general population.

scholarly journals National Trends for Primary and Revision Lumbar Disc Arthroplasty Throughout the United States

2017 ◽  
Vol 8 (2) ◽  
pp. 172-177 ◽  
Author(s):  
Comron Saifi ◽  
Alejandro Cazzulino ◽  
Caroline Park ◽  
Joseph Laratta ◽  
Philip K. Louie ◽  
...  
Keyword(s):  
United States ◽  
Length Of Stay ◽  
Lumbar Disc ◽  
The United States ◽  
Care Utilization ◽  
National Inpatient Sample ◽  
Disc Arthroplasty ◽  
Total Cost ◽  
Lumbar Disc Arthroplasty ◽  
The Mean

Study Design: Retrospective database study. Objectives: Analysis of economic and demographic data concerning lumbar disc arthroplasty (LDA) throughout the United States to improve value-based care and health care utilization. Methods: The National Inpatient Sample database was queried for patients who underwent primary or revision LDA between 2005 and 2013. Demographic and economic data included total surgeries, costs, length of stay, and frequency of routine discharge. The National Inpatient Sample database represents a 20% sample of discharges from US hospitals weighted to provide national estimates. Results: Primary LDA decreased 86% from 3059 to 420 from 2005 to 2013. The mean total cost of LDA increased 33% from $17 747 to $23 804. The mean length of stay decreased from 2.8 to 2.4 days. The mean routine discharge (home discharge without visiting nursing care) remained constant at 91%. Revision procedures (removal, supplemental fixation, or reoperation at the treated level) declined 30% from 194 to 135 cases over the study period. The mean revision burden, defined as the ratio of revision procedures to the sum of primary and revision procedures, was 12% (range 6% to 24%). The mean total cost of revisions ranged from $12 752 to $22 282. Conclusions: From 2005 to 2013, primary LDA significantly declined in the United States by 86% despite several studies pointing to improved efficacy and cost-efficiency. This disparity may be related to a lack of surgeon reimbursement from insurance companies. Congruently, the number of revision LDA cases has declined 30%, while revision burden has risen from 6% to 24%.

scholarly journals 1488. Effects of Clostridium difficile Infection in Hospitalized Patients with Inflammatory Bowel Disease, National Inpatient Sample Study 2016

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S542-S542
Author(s):  
Bing Chen ◽  
Omar Mahmoud ◽  
Bolun Liu
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clostridium Difficile ◽  
Hospital Length ◽  
Hospitalized Patients ◽  
Hospital Length Of Stay ◽  
National Inpatient Sample ◽  
Total Cost ◽  
All Cause Mortality ◽  
Inflammatory Bowel ◽  
The Mean

Abstract Background Patients with inflammatory bowel disease (IBD) including ulcerative colitis (UC) and Crohn’s disease (CD) have been shown to have increased Clostridium difficile infection (CDI) rates. In this study, we aimed to determine the effects of concurrent CDI in the outcomes of hospitalized patients with IBD. Methods In this retrospective cohort study, we analyzed the 2016 National Inpatient Sample (NIS) database of hospitalized patients with a first or secondary diagnosis of IBD and CDI using their respective ICD-10 codes. Primary outcomes of interest were all-cause mortality, hospital length of stay, total cost for hospital stay, and rate of colectomy. Multivariate regression was used to adjust for age, gender, race, hospital bed size, and Charlson comorbidity index. We used STATA 14 for analysis. Results There were a total of 3,306 patients admitted with IBD and CDI, of which 1,864 had a diagnosis of UC and 1,460 had a diagnosis of CD. 58.02% of the cases were female and the mean age was 52.5 years old. The mean age of patients in the CD group (48.97 [47.79–50.15]) was lower than the UC group (55.16 [54.01–56.31]). The results of in-hospital outcomes are shown in Tables 1 and 2. Conclusion We observed a significant increase in all-cause mortality, hospital length of stay, and total cost for hospital stay in IBD patients with concurrent CDI. There was no statistical difference in the rate of colectomy. In the subgroup analysis, there was a statistically non-significant increase in all-cause mortality in the CD group and a statistically significant increase in all-cause mortality in the UC group. Thus, in our study, IBD patients, especially UC patients, with concurrent CDI had a worse prognosis but they did not have more colectomies. Disclosures All authors: No reported disclosures.

scholarly journals In-Hospital Complications and Outcomes of Autologous Stem Cell Transplantation in Multiple Myeloma Patients Older Than 65-Years Old in the United States: National Inpatient Sample Analysis, 2011-2015

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4764-4764
Author(s):  
Veli Bakalov ◽  
Amy Tang ◽  
Hira G. Shaikh ◽  
Shrunjal Shah ◽  
Zena Chahine ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Hospital Mortality ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
The United States ◽  
Primary Diagnosis ◽  
P Value ◽  
Baseline Characteristics

Background. Use of Autologous Stem Cell Transplantation (ASCT) continues to increase in elderly patients with multiple myeloma. The main goal of our study was to describe in-hospital complications and outcomes after ASCT in patients younger and older than 65-years old utilizing the Nationwide Inpatient Sample (NIS) database. Methods. Cohort selection. The NIS database for the years 2011 to 2015 was queried for the analysis. We used International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) in order to identify patients with MM as a primary diagnosis for the hospitalization, and ASCT as a primary diagnosis of the hospitalization. In order to determine comorbidities in selected population we used Clinical Classifications Software (CCS) in conjunction with ICD-9-CM codes. Statistical Analysis.Complex weights were used throughout all calculations, enabling appropriate national projections. Chi-squared and independent t-tests were used for univariate analysis where appropriate. In our study p-value <0.05 was considered statistically significant. Data were analyzed using SAS v9.4 (SAS Institute, Cary, NC). Results.A total of 3,664 patients with MM receiving ASCT were identified in our cohort. Males represented 57.1% of the population, majority of the patients were white, with private insurance, located at the urban teaching hospitals (Table 1). Main insurance in patients older than 65 years old was Medicare. Main comorbidities during hospitalization were anemia, hypertension, electrolyte abnormalities, acute kidney injury, cardiac dysrhythmias, sepsis and pneumonia (Table 2). Overall in-hospital mortality was low, 0.7%, and was significantly higher in patients older than 65 years old (1.3% vs 0.4%, p-value 0.002), however when adjusted for the baseline characteristics with multivariate logistic regression analysis in-hospital mortality was no longer statistically significant (Table 3). Conclusions. We found that patients older than 65 years with MM receiving ASCT are more susceptible to in-hospital complications. However we found that in-hospital outcomes are not statistically significant when adjusted to baseline characteristics, suggesting that the procedure is safe even in the elderly population. Findings of our study can be used to design future randomized controlled trials. Disclosures No relevant conflicts of interest to declare.

Abstract WP47: Combined Treatment of Rt-PA With Mechanical Thrombectomy is Associated With Better Outcome Than Mechanical Thrombectomy Alone and Possibly Underutilized - A National Inpatient Sample Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Nandakumar Nagaraja ◽  
Paul Kubilis ◽  
Brian L Hoh ◽  
Adam G Kelly
Keyword(s):  
Mechanical Thrombectomy ◽  
Combined Treatment ◽  
Severity Of Illness ◽  
Pairwise Comparison ◽  
Primary Diagnosis ◽  
National Inpatient Sample ◽  
Inpatient Mortality ◽  
Percent Reduction ◽  
Discharge Disposition ◽  
Icd 10

Background and Purpose: 2015 AHA/ASA guidelines recommend mechanical thrombectomy (MT) with rt-PA for eligible patients within 6 hours of acute ischemic stroke (AIS). We evaluated the real world impact of the guidelines by analyzing trends and outcomes of stroke patients discharged from 2012 to 2016 in National Inpatient Sample database. Methods: Patients discharged with primary diagnosis of AIS were identified with ICD-9 codes for 2012 to third quarter of 2015 and ICD-10 codes for 2016 and last quarter of 2015. Patients who received only rt-PA, only MT, rt-PA+MT or no treatment were analyzed for discharge outcomes including length of stay (LOS), inpatient mortality and discharge status to home. Survey procedures were used for analysis. Multivariable regression analysis with pairwise comparison of treatment groups with no treatment group was performed to evaluate outcomes controlling for risk factors and all patient refined DRG severity of illness and risk of mortality scores. Results: A total of 2,290,520 adult AIS patients were in the study with mean age 70.4 years (SE 0.03) and 51.1% (SE 0.08) women. There was a significant increase in treatment with rt-PA (5.86% in 2012 to 7.67% in 2016, OR=1.07, 95% CI 1.05-1.08); and MT (0.55% in 2012 to 1.75% in 2016, OR=1.38, 95%CI 1.31-1.45); but not combination rt-PA+MT (0.54% in 2012 to 0.57% in 2016, OR=1.04, 95% CI 0.99 - 1.08). LOS was significantly reduced for rt-PA (mean 6.07 days in 2012 to 4.91 days in 2016, p<0.0001, 1.7 percent reduction/year), and rt-PA+MT (mean 9.19 days in 2012 to 7.10 days in 2016, p=0.0067, 2.9 percent reduction/year) but not for MT alone (9.61 days in 2012 to 8.51 days in 2016, p=0.50). The odds of patients discharged home was significantly higher by 8%, 9% and 15% among patients who received rt-PA (p<0.0001), MT (p=0.0095) and rt-PA+MT group (p=0.0004), respectively, compared to those who did not receive treatment. There was no significant change in inpatient mortality between the groups. Conclusion: The utilization of MT increased but that of rt-PA+MT remained unchanged from 2012 to 2016. Patients with AIS have better LOS and discharge disposition to home when treated with rt-PA+MT than MT alone. Combined treatment of rt-PA with MT may be underutilized in clinical practice.

scholarly journals Epilepsy Mortality in Wales: 2005-2017

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Helen Daniels ◽  
Arron Lacey ◽  
Ashley Akbari ◽  
Rob Powell ◽  
Owen Pickrell
Keyword(s):  
Death Certificate ◽  
Premature Death ◽  
Health Concern ◽  
Age At Death ◽  
Premature Deaths ◽  
Significant Public Health Concern ◽  
All Cause Mortality ◽  
Significant Public Health ◽  
Icd 10 ◽  
The Mean

BackgroundEpilepsy is a common, chronic neurological condition that affects 50 million people worldwide. The risk of premature death in people with epilepsy is up to three times higher than for the general population making this disease a significant public health concern. In England, there are around 3,100 deaths associated with epilepsy each year; 49 per cent of these deaths are premature. The mortality of epilepsy in Wales in recent years is currently unknown. Main Aim To ascertain mortality figures for deaths associated with epilepsy in Wales. MethodWe anonymously linked the Annual District Death Extract and the Welsh Demographics Service datasets within the Secure Anonymised Information Linkage Databank. Using ICD-10 codes for epilepsy, we identified all people who died with a mention of epilepsy on their death certificate, date of their death, and age at death between 2005 and 2017. Number of deaths per year were summed for each year. We also calculated the proportion of premature deaths and mean age at death for each year. All-cause mortality figures were collated as comparators. ResultsDuring the study period, there were around 173 deaths associated with epilepsy in Wales each year. The proportion of epilepsy-associated deaths compared with all-cause deaths increased almost two-fold during this time. 54% of all deaths associated with epilepsy occurred under the age of 75 years, compared with 33 per cent of all-cause deaths. The mean age at death for people with epilepsy is 67 years; 11 years younger than all-cause deaths (78 years). ConclusionThe number of deaths associated with epilepsy is increasing every year in Wales. These figures also show that having epilepsy reduces life expectancy. More research is needed into the causes of epilepsy-associated deaths to inform policy and improve outcomes for this patient group.

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