Abstract 3596: National Estimates of Down Syndrome Prevalence in Patients with Moyamoya Disease

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Daraspreet S Kainth ◽  
Saqib A Chaudhry ◽  
Hunar Kainth ◽  
M. Fareed K Suri ◽  
Adnan I Qureshi
Keyword(s):  
Down Syndrome ◽  
Moyamoya Disease ◽  
Average Length ◽  
Hospital Costs ◽  
Length Of Hospital Stay ◽  
International Classification Of Diseases ◽  
Nursing Facilities ◽  
Patient Identification ◽  
Classification Of Diseases ◽  
National Estimates

Background: An association between Moyamoya disease and Down syndrome appears to exist based on reported anectdotal cases in the literature. Objective: We performed this study to determine the prevalence of Down syndrome associated with Moyamoya disease in inpatients and to identify the clinical features of Moyamoya disease that may be unique when associated with Down syndrome. Methods: We analyzed data from patients entered in the Nationwide Inpatient Sample between 2002 and 2009, using International Classification of Diseases codes for Moyamoya disease and Down syndrome for patient identification. Data including patient age, gender, ethnicity, secondary diagnosis, medical complications, hospital costs, and patient outcomes was obtained. Results: From 2002 to 2009, an estimated 518 patients (mean age [±SD] 16.2 [± 1.68] years) with co-existing Moyamoya disease and Down syndrome were admitted as inpatients. The estimated prevalence was 3.76% (3760 per 100,000) among patients admitted with Moyamoya disease and 10.6% (10,600 per 100,000) among patients aged under 15 years. Patients admitted with Moyamoya disease and Down syndrome were most frequently Caucasian and Hispanic (p=0.015). They were more likely to present with symptoms of ischemic stroke and less commonly with hemorrhagic stroke, 15.3% and 2.7%(p < 0.05), respectively. The average length of hospital stay was 8.7 days (3.0 - 14.4). The majority were discharged home, 6.9% to nursing facilities, and 1.8% died in the hospital. Conclusion: This is the first study to estimate the prevalence of Down syndrome in patients with Moyamoya disease. The 300 fold greater prevalence of Down syndrome in patients with Moyamoya disease compared with prevalence among live births (12 per 100,000) highlight the need for better understanding of common pathophysiology of both conditions .

scholarly journals Retrospective Analysis of Injuries and Hospitalizations of Patients Following the 2009 Earthquake of L’Aquila City

2019 ◽  
Vol 16 (10) ◽  
pp. 1675 ◽  
Author(s):  
Jacopo Del Papa ◽  
Pierpaolo Vittorini ◽  
Francesco D’Aloisio ◽  
Mario Muselli ◽  
Anna Rita Giuliani ◽  
...  
Keyword(s):  
Bone Fractures ◽  
Average Length ◽  
Central Italy ◽  
International Classification Of Diseases ◽  
Discharge Data ◽  
Discharge Disposition ◽  
Average Length Of Stay ◽  
Multiple Injured ◽  
Classification Of Diseases ◽  
The Impact

The aim of this study was to investigate the injury patterns and the hospitalizations of patients who were admitted to hospital following the 2009 earthquake in the city of L’Aquila, Central Italy. To the best of our knowledge, this is the first study to analyze the patterns of earthquake-related injuries in Italy. We reviewed the hospital discharge data of 171 patients admitted to hospital within the following 96 h from the mainshock. This is an observational and descriptive study: We controlled for variables such as patient demographics, primary and secondary ICD-9-CM (International Classification of Diseases) diagnosis codes in order to identify the multiple injured patients, main type of injury that resulted in the hospital admission, discharge disposition, and average length of stay (LOS). Seventy-three percent of the 171 patients were admitted to hospital on the first day. Multiple injuries accounted for 52% of all trauma admissions, with a female to male ratio of 63% versus 37%. The most common type of injuries involved bone fractures (46.8%), while lower extremities were the most frequently affected sites (38.75%). The average LOS was 12.11 days. This study allows the evaluation of the impact of earthquake-related injuries in relation both to the health needs of the victims and to the use of the health care resources and assistance.

scholarly journals Fingertip Injuries in Children: Epidemiology, Financial Burden, and Implications for Prevention

Hand ◽  
2016 ◽  
Vol 12 (4) ◽  
pp. 342-347 ◽  
Author(s):  
Rachel R. Yorlets ◽  
Kathleen Busa ◽  
Kyle R. Eberlin ◽  
Mohammad Ali Raisolsadat ◽  
Donald S. Bae ◽  
...  
Keyword(s):  
Average Length ◽  
Medical Center ◽  
Pediatric Population ◽  
Financial Burden ◽  
International Classification Of Diseases ◽  
Hospital Charges ◽  
Average Length Of Stay ◽  
Significant Burden ◽  
Classification Of Diseases

Background: Although fingertip injuries are common, there is limited literature on the epidemiology and hospital charges for fingertip injuries in children. This descriptive study reports the clinical features of and hospital charges for fingertip injuries in a large pediatric population treated at a tertiary medical center. Methods: Our hospital database was queried using International Classification of Diseases, Revision 9 (ICD-9) codes, and medical records were reviewed. Frequency statistics were generated for 1807 patients with fingertip injuries who presented to the emergency department (ED) at Boston Children’s Hospital (BCH) between 2005 and 2011. Billing records were analyzed for financial data. Results: A total of 1807 patients were identified for this study; 59% were male, and the mean age at time of injury was 8 years. Most commonly, injuries occurred when a finger was crushed (n = 831, 46%) in a door or window. Average length of stay in the ED was 3 hours 45 minutes, 25% of cases needed surgery, and, on average, patients had more than 1 follow-up appointment. About one-third of patients were referred from outside institutions. The average ED charge for fingertip injuries was $1195 in 2014, which would amount to about $320 430 each year (in 2014 dollars) for fingertip injuries presenting to BCH. Conclusion: Fingertip injuries in children are common and result in significant burden, yet are mostly preventable. Most injuries occur at home in a door or window. Although these patients generally heal well, fingertip injuries pose a health, time, and financial burden. Increased awareness and education may help to avoid these injuries.

Impact of a telemedicine eICU cart on sepsis management in a community hospital emergency department

2017 ◽  
Vol 24 (3) ◽  
pp. 202-208 ◽  
Author(s):  
Shana M Machado ◽  
Erika H Wilson ◽  
John O Elliott ◽  
Kim Jordan
Keyword(s):  
Emergency Department ◽  
Hospital Costs ◽  
International Classification Of Diseases ◽  
Surviving Sepsis Campaign ◽  
Sepsis Management ◽  
Institutional Review ◽  
Classification Of Diseases ◽  
Ninth Edition ◽  
Complications And Mortality

Introduction Intensivist involvement for patients with sepsis is associated with decreased complications and mortality, and lower hospital resource utilization, but few studies have evaluated outcomes for patients exposed to electronic intensive care unit (eICU) telemedicine sepsis management in the emergency department (ED). In this study, we assess whether eICU cart exposure in the ED improved compliance with components of the 2010 Surviving Sepsis Campaign bundles, length of stay (LOS), disposition and hospital costs. Methods An institutional review board-approved, retrospective cohort study was completed on patients with confirmed sepsis who presented to our ED from July 2010 through February 2013. Results Of 711 patient ED encounters, 314 cases met criteria for analysis (95 exposed and 219 non-exposed). Patient cohorts had similar demographics and comorbid International Classification of Diseases, Ninth Edition (ICD-9) diagnoses. The exposed cohort received antibiotics more quickly (122.3 minutes ±83.3 versus 163.4 minutes ±204.4, p = 0.043) and were more likely to have lactic acid levels drawn within six hours (98.9% vs. 90%, p = 0.019). The exposed cohort had a shortened ED LOS (in days) 0.08 ± 0.28 versus 0.16 ± 0.37, p = 0.036. Hospital LOS, disposition and death were similar in both cohorts. Total hospital costs for the exposed cohort were lower and less variable (US$19,713 ± 16,550 vs. US$24,364 ± 25068), but this was not significant ( p = 0.274). Discussion Our findings suggest that in individuals with confirmed sepsis, ED exposure to a telemedicine-based eICU cart impacted adherence to aspects of the Surviving Sepsis Campaign recommended bundle, but did not impact overall survival and medical costs.

The Medico-economic Impacts of Marijuana Use on the Outcomes and In-hospital Mortality in Patients with Atrial Fibrillation – Nationwide Database study

2021 ◽  
Vol 4 (11) ◽  
pp. 01-05
Author(s):  
Hammam Shereef
Keyword(s):  
Atrial Fibrillation ◽  
Hospital Mortality ◽  
Length Of Hospital Stay ◽  
Marijuana Use ◽  
International Classification Of Diseases ◽  
Atrial Arrhythmias ◽  
National Inpatient Sample ◽  
Hospitalization Costs ◽  
Classification Of Diseases ◽  
Medico Economic

Introduction Cannabinoid users are at high risk of developing atrial arrhythmias. We sought to investigate the outcomes and the economic impact of marijuana use on patients with atrial fibrillation utilizing the National Inpatient Sample. Materials and Methods Patients with atrial fibrillation were identified in the National Inpatient Sample (NIS) database between 2012 and 2014 using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), who subsequently were divided into two groups, those with and without marijuana smoking. The primary outcome was all-cause in-hospital mortality in the two groups. Secondary outcomes were in-hospital morbidities, required procedures and complications. We also evaluated the length of hospital stay and the cost of hospitalization. Logistic regression model was performed to address potential confounding factors. Results: The marijuana-users group had no significant increase of in-hospital mortality (OR: 1.24; 95% CI: 0.51 - 3.01, p = 0.632). However, marijuana users were predominantly younger males and less likely to undergo cardiac surgery (OR: 0.54, 95% CI 0.37 - 0.78, p = 0.001). Moreover, marijuana users are more likely to have a lower cost of hospitalization when compared to non-users ($28,916 vs $32,303, p = 0.001). Conclusion: Cannabinoid use was not associated with an increase in mortality among patients admitted with atrial fibrillation. However, marijuana users were younger, had fewer comorbidities, and cardiac surgeries with associated lower hospitalization costs. Admittedly, given the growing popularity of these products, further large prospective studies are needed to investigate the safety and evaluate different integral associations of cannabis use with worse cardiac outcomes in atrial arrhythmias patients, particularly those with atrial fibrillation.

Abstract 242: Incidence, Predictors, Causes, and Costs for 30-day Readmission After In-Hospital Cardiopulmonary Resuscitation Discharge in United States

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Yusuke Morita ◽  
Tetsuya Haruna ◽  
Yoshisumi Haruna ◽  
Eisaku Nakane ◽  
Yuhei Yamaji ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiopulmonary Resuscitation ◽  
International Classification Of Diseases ◽  
Care Utilization ◽  
Hospital Discharges ◽  
Episode Of Care ◽  
Common Causes ◽  
Classification Of Diseases ◽  
Risk Patients ◽  
National Estimates

Background: Readmissions after in-hospital cardiopulmonary resuscitation (ICPR) are common and contribute to increased health care utilization and costs. This is the first study to estimate the burden and patterns of 30-day readmission after ICPR from Nationwide Readmission Database (NRD). Methods and Results: Patients undergoing ICPR (International Classification of Diseases-Ninth Revision-Clinical Modification codes 99.60 and 99.63) between January and November 2014 from NRD were included. Incidence, predictors, causes, and costs of 30-day readmission were analyzed using discharge weights to obtain national estimates. Among estimated 27278 index admissions survived to hospital discharges after ICPR, 5439 (20.0%) were readmitted within 30 days. Length of stay (LOS) ≧15 days during index hospitalization (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.16-1.42), Medicare or Medicaid insurance (HR, 1.34; 95% CI, 1.19-1.51), heart failure (HR, 1.2; 95% CI, 1.1-1.32), and discharge of metropolitan teaching hospital (HR, 1.19; 95% CI, 1.07-1.33) were independent predictors of 30-day readmission. Among 5439 readmissions, Sepsis (13.7%), heart failure (10.8%), respiratory failure (6.4%), and cardiac dysrhythmias (5.2%) were the most common causes. Estimated total costs of readmission were $102 million and mean of $19122 ±30201, which is accounted for 25.7% of total episode of care (index+readmission). The mean LOS was 8.0 ±10.5 days. The patients with readmission revealed high mortality rate of 10.1%. Conclusions: Thirty-day readmissions after ICPR are frequent and are related to baseline comorbidities and hospital characteristics. Awareness of these predictors can help identify and target high-risk patients for interventions, to reduce readmissions and costs.

A retrospective audit of joint mother–baby admissions to the Werribee Mercy mother and baby unit (MBU) and of the severity of maternal depression over the course of admission

2019 ◽  
Vol 28 (2) ◽  
pp. 220-225
Author(s):  
Imogen Wang ◽  
Carolyn Breadon
Keyword(s):  
Depressive Symptoms ◽  
Average Length ◽  
International Classification Of Diseases ◽  
Maternal Depressive Symptoms ◽  
Average Length Of Stay ◽  
Retrospective Audit ◽  
Mother And Baby Unit ◽  
Classification Of Diseases ◽  
Study Population

Objectives: This study examined (i) the demographic and illness profiles of mothers admitted to Werribee Mercy MBU in Victoria, Australia and (ii) the severity of maternal depressive symptoms over the course of admission. Method: A retrospective audit was conducted on consecutively admitted mother–baby dyads between January 2011 and June 2015. Routinely collected maternal Beck Depression Inventory, second edition (BDI-II) scores were analysed for severity and change. Results: A total of 307 mother–baby dyads were admitted during the study period. The majority of mothers was partnered and educated young adults. The average length of stay was 4.4 weeks. The mean age of babies was 3.3 months. One-third of mothers met International Classification of Diseases, 10th edition criteria for two or more psychiatric diagnoses. Unipolar major depression was the commonest diagnosis. Of the 307 mothers, 125 mothers completed BDI-II on admission and on discharge, which showed a mean reduction of 16 points ( p < 0.001) on discharge. Conclusions: This study notes the similarities between the clinical profiles of the study population with mother–baby admissions to MBUs worldwide. Maternal depressive symptoms improved by 16 points on the BDI-II over the course of MBU admission, which shows the utility of MBU admission on maternal depressive symptoms.

scholarly journals An Assessment of Frequency of Dermatologic Diseases in Patients Admitted to Shiraz Referral Dermatology Ward, Southern Iran 2008-2011

2015 ◽  
Vol 4 (1) ◽  
pp. 50-52
Author(s):  
Ladan Dastgheib ◽  
Nasrin Saki ◽  
Sina Kardeh ◽  
Zakaria Rezaei
Keyword(s):  
Skin Diseases ◽  
Average Length ◽  
Demographic Data ◽  
International Classification Of Diseases ◽  
Occurrence Rate ◽  
Fars Province ◽  
Duration Of Treatment ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Drug Rash

Background: As the early and accurate diagnosis of all diseases, including skin disorders directly influences the duration of treatment and its costs, which may be a significant burden, it is very important for physicians to be familiar with all types of diseases, especially those with a higher incidence in population. Considering that disease patterns vary from region to region and there is no demographic data on patterns of skin diseases in Fars Province, we aimed to assess the frequency of skin diseases in admitted patients to Dermatology Ward of Shahid Faghihi Hospital. Materials and Methods: The medical records of 1450 patients, who completed a questionnaire during the years 2008 to 2011, were evaluated in this retrospective study. Demographic data and diagnoses of skin diseases were analyzed by SPSS software and classified according to the International Classification of Diseases (ICD-10).Results: Pemphigus (12.5%), drug rash (11.7%) and eczema (10.5%) were the most common cause of referral to dermatology ward. The mean age of patients was 41.89±20.79 and the average length of hospitalization in this study was 9.34 days.Conclusion: The high occurrence rate of Pemphigus and drug rash indicates that further study is required to root out the underlying causes. Proper health policies should be implemented to manage these diseases.

Abstract 15301: Skilled Nursing Facilities and 30-day Hospital Readmissions in Heart Failure

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Sheila M Manemann ◽  
Alanna M Chamberlain ◽  
Jennifer St. Sauver ◽  
Susan A Weston ◽  
Ruoxiang Jiang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Readmissions ◽  
Skilled Nursing Facility ◽  
International Classification Of Diseases ◽  
Revolving Door ◽  
Nursing Facilities ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Classification Of Diseases ◽  
The Impact

Background: Referral to a skilled nursing facility (SNF) should contribute to reducing hospital readmissions; however, a “revolving door” phenomenon after admission to SNF has been hypothesized to drive readmissions. The urgent need to study the impact of SNF on readmissions in heart failure (HF) was recently emphasized, yet this has never been studied in the community. Objectives: To evaluate the association between discharge to SNF and 30-day readmissions in a community cohort of hospitalized incident HF patients. Methods: Olmsted County, MN residents hospitalized with first ever (incident) HF (International Classification of Diseases-9 th Revision code 428) from 1995 through 2010 were identified. HF was validated by Framingham criteria. Patients residing in a SNF prior to hospitalization were excluded from the analysis. Logistic regression was used to examine the association between discharge to SNF and 30-day readmissions. Results: Among 1360 HF patients (mean age 74±14, 47% male), 241(18%) were referred to a SNF. Overall, 296 (22%) patients were readmitted within 30-days after index hospitalization. The proportion of 30-day readmissions was greater among patients discharged to a SNF compared to patients discharged home (27% vs 21%, p=0.031). After adjustment for age and sex, patients discharged to a SNF had a 40% increase in the odds of having a hospital readmission within 30 days post HF compared to those discharged home (OR: 1.42, 95% CI 1.01-1.99). Further adjustment for year of HF diagnosis, ejection fraction, anemia, renal function, dementia and cancer did not alter the strength of the association (OR: 1.43, 95% CI: 0.99-2.09). Conclusion: Among community patients with HF, 30-day readmissions remain frequent and are more likely to occur among patients discharged to a SNF compared to those discharged home. These data provide new insight into the drivers of HF readmissions and suggest that interventions targeted to HF patients in SNFs may be warranted.

Outcomes of Right and Left Colectomy at Academic Centers

2007 ◽  
Vol 73 (10) ◽  
pp. 945-948 ◽  
Author(s):  
Marcelo W. Hinojosa ◽  
Viken R. Konyalian ◽  
Zuri A. Murrell ◽  
J. Esteban Varela ◽  
Michael J. Stamos ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Malignant Disease ◽  
Lower Cost ◽  
Length Of Hospital Stay ◽  
International Classification Of Diseases ◽  
Administrative Database ◽  
Wound Infections ◽  
Left Colectomy ◽  
Classification Of Diseases ◽  
Mean Cost

Few studies have compared outcomes of right colectomy (RC) and left colectomy (LC) with respect to both benign and malignant disease. The objective of this study was to compare outcomes of RC versus LC for benign and malignant disease using a national administrative database of academic medical centers. Using International Classification of Diseases, 9th Revision diagnosis and procedure codes, data was obtained from the University HealthSystem Consortium Clinical Data Base for patients that underwent RC and LC for benign and malignant disease between 2002 and 2006. The main outcomes compared were demographics, length of hospital stay, observed to expected in-hospital mortality, complications, 30-day readmission, and mean cost. There were a total of 27,483 patients; 12,971 patients (47.2%) underwent RC. Compared with LC for benign disease, RC was associated with a shorter length of stay, lower overall complications, lower wound infections, lower 30-day readmissions, and lower cost. Compared with LC for malignant disease, RC was associated with lower overall complications, lower wound infections, and lower cost. In this analysis of academic centers, RC was associated with a lower length of stay, lower morbidity, and lower cost when compared with LC for benign and malignant disease.

scholarly journals Hospital Costs of Injection Drug Use in Florida

2020 ◽  
Author(s):  
Austin E Coye ◽  
Kasha J Bornstein ◽  
Tyler S Bartholomew ◽  
Hua Li ◽  
Stanley Wong ◽  
...  
Keyword(s):  
Drug Use ◽  
Healthcare System ◽  
Injection Drug Use ◽  
People Who Inject Drugs ◽  
Hospital Costs ◽  
International Classification Of Diseases ◽  
System Cost ◽  
Costs Of Care ◽  
Classification Of Diseases

Abstract People who inject drugs (PWID) experience significant injection-related infections (IRIs) at significant healthcare system cost. This study used and validated an algorithm based on the International Classification of Diseases, Tenth Revision, to estimate hospitalized PWID populations, assess the total statewide morbidity for IRIs among PWID, and calculate associated costs of care.

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