Abstract 11: Persistent Risk Of Venous Thromboembolism After Discharge Among Stroke Survivors - A Seven-Years Longitudinal Study

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Yogesh Moradiya ◽  
Devanshi Dharaiya ◽  
Santosh Murthy ◽  
Christa San Luis ◽  
Sneha Modi
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Metastatic Cancer ◽  
International Classification Of Diseases ◽  
Incidence Rates ◽  
Stroke Survivors ◽  
Post Discharge ◽  
Classification Of Diseases ◽  
Comorbidity Index ◽  
Discharge From Hospital

Background and Purpose: Risk of venous thromboembolism (VTE) in stroke patients persists after discharge from hospital due to residual deficits. Quantification of VTE risk at various post-discharge intervals may have implications for surveillance and/or prophylactic strategies for high-risk individuals. We therefore, studied incidence rates and risk factors of deep venous thrombosis (DVT) and pulmonary embolism (PE) among stroke survivors after discharge from the hospital. Methods: Adults with principle diagnosis of ischemic stroke discharged alive from acute care hospitals in California State between January 2005 and December 2010 were followed up until December 2011 using state inpatient and emergency department databases for development of DVT and/or PE. Case ascertainment was done using International Classification of Diseases -9 codes. We calculated incidence rates of DVT and PE during first 30 days, 31-90 days, 91-365 days and >1-year after the discharge. We calculated independent risk factors for VTE within 90 days after discharge by using logistic regression controlling for baseline demographics, comorbidities, inpatient complications and procedures. Results: A total of 168,194 stroke survivors were followed up for a mean duration of 3.6+/-1.9 (SD) years after discharge. Among these, 6,179 (3.7%) developed DVT and 2,487 (1.5%) developed PE resulting in incidence rate of 1.02 and 0.41 per 100 person year for DVT and PE respectively. The incidence rates of DVT during first 30 days, 31-90 days, 91-365 days and >1-year post-discharge were 6.53, 2.91, 1.24 and 0.66 per 100 person year respectively. Similarly, the incidence of PE was 3.04, 1.13, 0.46 and 0.26 during first 30 days, 31-90 days, 91-365 days and >1-year after discharge respectively. Factors independently associated with VTE within 90 days were age>65 years, African-American race, higher Charlson comorbidity index, metastatic cancer, anemia, obesity, acute myocardial infarction, pneumonia, sepsis, hemodialysis, gastrostomy and mechanical ventilation during index admission. Conclusions: VTE risk remains high among stroke survivors even after discharge from the hospital. The risk is highest during first 30 days and remains high as long as 1 year after discharge.

scholarly journals Risk factors for death within 90 days of Clostridium difficile infection

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M K Koziol ◽  
M Z Z.urek
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Metastatic Cancer ◽  
International Classification Of Diseases ◽  
The European Union ◽  
Policy Makers ◽  
Healthcare Data ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
The Impact

Abstract Background The conducted analysis emphasizes increasing problem of Clostridium difficile infections (CDI) in Poland. There are no other publications based on Polish healthcare data that would more precisely indicate the impact of risk factors for death after the infection. The purpose of the analysis was to present the incidence of CDI in the overall population of Poland in the years 2009-2018 and to evaluate the risk factors for death within 90 days after CDI infection. Methods In order to detect the incidence of CDI the data of the National Health Fund from years 2009-2018 were used. Code A04.7 from International Classification of Diseases (ICD-10) allowed to identify CDI. Risk factor analysis was based on 14 212 patients' hospitalizations in the year 2017. The risk factors were related to patient's medical history and demographic profile. Logistic regression was applied to estimate the impact of the defined variables on the death within 90 days after CDI infection. Results CDI incidence increased from 952 hospitalizations in 2009 to 14 582 hospitalizations in 2018. Morbidity of CDI infections (48,3/10 000 patient days in 2017) indicated Poland as the country with the highest prevalence in the European Union (average 2,38/10 000 patient days in 2016). 37,1% of the patients died within first 90 days after CDI infection in 2017. The most important factors that increases the chance of death are: age (>85 OR = 25,8, 65-84 OR = 10,5, 50-64 OR = 4,7 in comparison to age <50), AIDS/HIV (OR = 4,6), metastatic cancer (OR = 4,6), weight loss (OR = 2,6) and alcohol abuse (OR = 2,1). Conclusions The results indicated increasing problem of CDI in Poland. It is important to take precautions and use more effective treatment methods particularly in case of the most exposed populations. Furthermore, policy makers should pay attention to compliance with the principles of restricted sanitary procedures and increase awareness of CDI epidemiology among doctors. Key messages CDI is an increasing problem, unmentioned in health policy. Restricted sanitary procedures should be implemented in case of hospitalizations of older patients with comorbidities.

Four-Corner Arthrodesis versus Proximal Row Carpectomy: Risk Factors and Complications Associated with Prolonged Postoperative Opioid Use

2020 ◽  
Author(s):  
Neill Y. Li ◽  
Alexander S. Kuczmarski ◽  
Andrew M. Hresko ◽  
Avi D. Goodman ◽  
Joseph A. Gil ◽  
...  
Keyword(s):  
Risk Factors ◽  
International Classification Of Diseases ◽  
Opioid Use ◽  
Proximal Row Carpectomy ◽  
Use Patterns ◽  
Patient Demographics ◽  
Implant Complications ◽  
Increased Risk ◽  
Classification Of Diseases

Abstract Introduction This article compares opioid use patterns following four-corner arthrodesis (FCA) and proximal row carpectomy (PRC) and identifies risk factors and complications associated with prolonged opioid consumption. Materials and Methods The PearlDiver Research Program was used to identify patients undergoing primary FCA (Current Procedural Terminology [CPT] codes 25820, 25825) or PRC (CPT 25215) from 2007 to 2017. Patient demographics, comorbidities, perioperative opioid use, and postoperative complications were assessed. Opioids were identified through generic drug codes while complications were defined by International Classification of Diseases, Ninth and Tenth Revisions, Clinical Modification codes. Multivariable logistic regressions were performed with p < 0.05 considered statistically significant. Results A total of 888 patients underwent FCA and 835 underwent PRC. Three months postoperatively, more FCA patients (18.0%) continued to use opioids than PRC patients (14.7%) (p = 0.033). Preoperative opioid use was the strongest risk factor for prolonged opioid use for both FCA (odds ratio [OR]: 4.91; p < 0.001) and PRC (OR: 6.33; p < 0.001). Prolonged opioid use was associated with an increased risk of implant complications (OR: 4.96; p < 0.001) and conversion to total wrist arthrodesis (OR: 3.55; p < 0.001) following FCA. Conclusion Prolonged postoperative opioid use is more frequent in patients undergoing FCA than PRC. Understanding the prevalence, risk factors, and complications associated with prolonged postoperative opioid use after these procedures may help physicians counsel patients and implement opioid minimization strategies preoperatively.

scholarly journals Risk and predictors of heart failure in sarcoidosis in a population-based cohort study from Sweden

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319129
Author(s):  
Marios Rossides ◽  
Susanna Kullberg ◽  
Johan Grunewald ◽  
Anders Eklund ◽  
Daniela Di Giuseppe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
General Population ◽  
Strong Predictor ◽  
Strong Association ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Clinical Predictors ◽  
Cox Models ◽  
Classification Of Diseases

ObjectivesPrevious studies showed a strong association between sarcoidosis and heart failure (HF) but did not consider risk stratification or risk factors to identify useful aetiological insights. We estimated overall and stratified HRs and identified risk factors for HF in sarcoidosis.MethodsSarcoidosis cases were identified from the Swedish National Patient Register (NPR; ≥2 International Classification of Diseases-coded visits, 2003–2013) and matched to general population comparators. They were followed for HF in the NPR. Treated were cases who were dispensed ≥1 immunosuppressant ±3 months from the first sarcoidosis visit (2006–2013). Using Cox models, we estimated HRs adjusted for demographics and comorbidity and identified independent risk factors of HF together with their attributable fractions (AFs).ResultsDuring follow-up, 204 of 8574 sarcoidosis cases and 721 of 84 192 comparators were diagnosed with HF (rate 2.2 vs 0.7/1000 person-years, respectively). The HR associated with sarcoidosis was 2.43 (95% CI 2.06 to 2.86) and did not vary by age, sex or treatment status. It was higher during the first 2 years after diagnosis (HR 3.7 vs 1.9) and in individuals without a history of ischaemic heart disease (IHD; HR 2.7 vs 1.7). Diabetes, atrial fibrillation and other arrhythmias were the strongest independent clinical predictors of HF (HR 2.5 each, 2-year AF 20%, 16% and 12%, respectively).ConclusionsAlthough low, the HF rate was more than twofold increased in sarcoidosis compared with the general population, particularly right after diagnosis. IHD history cannot solely explain these risks, whereas ventricular arrhythmias indicating cardiac sarcoidosis appear to be a strong predictor of HF in sarcoidosis.

Prevalence and risk factors for chalazion in an older veteran population

2021 ◽  
pp. bjophthalmol-2020-318420
Author(s):  
Sneh Patel ◽  
Natalia Tohme ◽  
Emmanuel Gorrin ◽  
Naresh Kumar ◽  
Brian Goldhagen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tear Film ◽  
International Classification Of Diseases ◽  
Retrospective Case ◽  
Eyelid Margin ◽  
Factors Associated ◽  
Classification Of Diseases ◽  
Health Database ◽  
Irritable Bowel ◽  
The Impact

BackgroundChalazia are common inflammatory eyelid lesions, but their epidemiology remains understudied. This retrospective case–control study examined the prevalence, risk factors and geographic distribution of chalazia in a large veteran population.MethodsData on all individuals seen at a Veterans Affairs (VA) clinic between October 2010 and October 2015 were extracted from the VA health database. Subjects were grouped based on International Classification of Diseases, Ninth Revision (ICD-9) code for chalazion. Univariable logistic regression modelling was used to identify clinical and demographic factors associated with chalazion presence, followed by multivariable modelling to examine which factors predicted risk concomitantly. All cases were mapped across the continental US using geographic information systems modelling to examine how prevalence rates varied geographically.ResultsOverall, 208 720 of 3 453 944 (6.04%) subjects were diagnosed with chalazion during the study period. Prevalence was highest in coastal regions. The mean age of the population was 69.32±13.9 years and most patients were male (93.47%), white (77.13%) and non-Hispanic (93.72%). Factors associated with chalazion risk included smoking (OR=1.12, p<0.0005), conditions of the tear film (blepharitis (OR=4.84, p<0.0005), conjunctivitis (OR=2.78, p<0.0005), dry eye (OR=3.0, p<0.0005)), conditions affecting periocular skin (eyelid dermatitis (OR=2.95, p<0.0005), rosacea (OR=2.50, p<0.0005)), allergic conditions (history of allergies (OR=1.56, p<0.0005)) and systemic disorders (gastritis (OR=1.54, p<0.0005), irritable bowel syndrome (OR=1.45, p<0.0005), depression (OR=1.35, p<0.0005), anxiety (OR=1.31, p<0.0005)). These factors remained associated with chalazion risk when examined concomitantly.ConclusionPeriocular skin, eyelid margin and tear film abnormalities were most strongly associated with risk for chalazion. The impact of environmental conditions on risk for chalazion represents an area in need of further study.

scholarly journals Patient Outcomes following Subarachnoid Hemorrhage between the Medical Center and Regional Hospital: Whether All Patients Should Be Transferred to Medical Centers

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Tsung-Ying Lin ◽  
Chieh Hsin Wu ◽  
Wei-Che Lee ◽  
Chao-Wen Chen ◽  
Liang-Chi Kuo ◽  
...  
Keyword(s):  
Health Insurance ◽  
Subarachnoid Hemorrhage ◽  
Hospital Volume ◽  
Medical Center ◽  
International Classification Of Diseases ◽  
Research Database ◽  
Medical Centers ◽  
Classification Of Diseases ◽  
Comorbidity Index

Subarachnoid hemorrhage (SAH) is a critical illness that may result in patient mortality or morbidity. In this study, we investigated the outcomes of patients treated in medical center and nonmedical center hospitals and the relationship between such outcomes and hospital and surgeon volume. Patient data were abstracted from the National Health Insurance Research Database of Taiwan in the Longitudinal Health Insurance Database 2000, which contains all claims data of 1 million beneficiaries randomly selected in 2000. The International Classification of Diseases, Ninth Revision, subarachnoid hemorrhage (430) was used for the inclusion criteria. We identified 355 patients between 11 and 87 years of age who had subarachnoid hemorrhage. Among them, 32.4% (115/355) were men. The median Charlson comorbidity index (CCI) score was 1.3 (SD ± 0.6). Unadjusted logistic regression analysis demonstrated that low mortality was associated with high hospital volume (OR = 3.21; 95% CI: 1.18–8.77). In this study, we found no statistical significances of mortality, LOS, and total charges between medical centers and nonmedical center hospitals. Patient mortality was associated with hospital volume. Nonmedical center hospitals could achieve resource use and outcomes similar to those of medical centers with sufficient volume.

A nationwide study on delirium in psychiatric patients from 1995 to 2011

2013 ◽  
Vol 26 (4) ◽  
pp. 234-239 ◽  
Author(s):  
Anne Sofie Lundberg ◽  
Niels Okkels ◽  
Lea Nørgreen Gustafsson ◽  
Janne Tidselbak Larsen ◽  
Lisbeth Uhrskov Sørensen ◽  
...  
Keyword(s):  
Psychiatric Patients ◽  
Age Distribution ◽  
Psychiatric Hospitals ◽  
International Classification Of Diseases ◽  
Incidence Rates ◽  
Mental Illnesses ◽  
Central Research ◽  
Total Incidence ◽  
Classification Of Diseases ◽  
First Time

ObjectivesDelirium shares symptoms with some mental illnesses. This may lead to misdiagnosis of delirium in psychiatric patients and a risk of inadequate management. Moreover, literature on delirium in psychiatric patients is sparse. The aim was to analyse possible changes in the diagnostic incidence of delirium in psychiatric patients from 1995 to 2011, and to investigate the patients with regard to sex, age, and type of patient.MethodsAll first time ever diagnoses of delirium among psychiatric patients were identified in the nationwide Danish Psychiatric Central Research Register (DPCRR) from 1995 to 2011. The delirium diagnoses include (1) delirium unspecified, (2) delirium with dementia, and (3) drug-related delirium, all in accordance with International Classification of Diseases-10. The incidence rates were age standardised.ResultsA total of 15 680 persons diagnosed with delirium for the first time were identified in the DPCRR between 1995 and 2011. The total incidence rate of delirium has decreased, reaching 8.4/1000 person-years in 2011. In 2011, 2.6% of the demented patients were diagnosed with delirium with dementia. Diagnosis of delirium is significantly more common in men, and the three groups of delirium showed a characteristic age distribution.ConclusionOur incidences were markedly lower when compared with previous studies. This suggests a possible underdiagnosis of delirium in psychiatric hospitals and should be investigated further, as delirium is a serious state and identifying the syndrome is important for sufficient treatment.

Hospitalization of paediatric patients for methicillin-resistant Staphylococcus aureus skin and soft-tissue infection, 1998–2006

2009 ◽  
Vol 138 (5) ◽  
pp. 677-682 ◽  
Author(s):  
K. D. SIRCAR ◽  
E. BANCROFT ◽  
D. M. NGUYEN ◽  
L. MASCOLA
Keyword(s):  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Los Angeles ◽  
Soft Tissue Infection ◽  
International Classification Of Diseases ◽  
Incidence Rates ◽  
Tissue Infection ◽  
Predictive Values ◽  
Methicillin Resistant ◽  
Classification Of Diseases

SUMMARYHospital discharge reports have provided data for studies of methicillin-resistant Staphylococcus aureus (MRSA) skin and soft-tissue infection (SSTI) studies. This analysis determined the sensitivity and positive predictive value of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code combinations to calculate hospitalization incidence rates, representativeness of a set of three ICD-9-CM codes to define MRSA SSTI, and hospitalization incidence rate trends for paediatric MRSA SSTIs in Los Angeles County (LAC). Using 133 cases from 31 hospitals, we found that the set of three ICD-9-CM codes used to define laboratory-confirmed cases had one of the highest positive predictive values (49%). There was no difference in age and race between those categorized using three codes vs. other code combinations. A dramatic increase in paediatric MRSA SSTI cases occurred in LAC during 1998–2006. We conclude that this combination of codes may be used to determine the rise of MRSA SSTIs in paediatric populations.

Anatomically Associated Venous Thromboembolism in Patients With Peripherally Inserted Central Catheters

2017 ◽  
Vol 22 (4) ◽  
pp. 182-187
Author(s):  
Travis Kimple ◽  
Niaman Nazir ◽  
Chad M. Cannon
Keyword(s):  
Venous Thromboembolism ◽  
International Classification Of Diseases ◽  
Tertiary Hospital ◽  
Peripherally Inserted Central Catheters ◽  
Vein Thrombosis ◽  
Icd9 Code ◽  
Classification Of Diseases ◽  
Clinically Significant ◽  
Deep Vein ◽  
Central Catheters

Abstract Background: Peripherally inserted central catheters (PICCs) are ubiquitous in modern hospitals, but are associated with venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and/or pulmonary embolism (PE). We retrospectively examined this association in hospitalized patients, highlighting anatomically associated VTEs (those with DVT in the PICC extremity). Methods: Charts with an International Classification of Diseases, Ninth Revision (ICD9) code for VTE were collected from a discharge database of PICC-managed patients at a tertiary hospital. A sample (52.3%) of the VTE charts was manually reviewed to verify PICC-associated VTE (unverified charts were excluded), and determine such data as the extremity in which each DVT was diagnosed (using ultrasound reports). VTE rates were calculated using an uncorrected method (from charts with VTE ICD9 code) and a corrected method (from charts with manually verified PICC-associated VTE). Results: Our uncorrected VTE rate was 3.9% (P &lt; .0001), whereas the corrected rate was 1.5%. Among 125 charts with manually verified PICC-associated VTE, 69 (60.5%) out of 114 patients with a DVT had their DVT occur in the PICC extremity, yielding an anatomically associated VTE rate of 0.84%. The most common reason for a chart being excluded (60.2%) was a VTE occurring before PICC placement. Conclusions: We found clinically significant rates of PICC-associated VTE. The majority of patients' DVT occurred in the same extremity as their PICC, lending further evidence that PICCs are an independent risk factor for VTE and require judicious use. There was also a discrepancy in VTE rate derived from ICD codes alone vs. manual chart review.

scholarly journals Identifying Risk Factors for Morbidity and Mortality in Patients with Primary Head and Neck Cancers in a Nigerian Population

2018 ◽  
Vol 12 ◽  
pp. 117955491878398
Author(s):  
Adeyi A Adoga ◽  
John P Yaro ◽  
Joyce G Mugu ◽  
Chukwunonso J Mgbachi
Keyword(s):  
Risk Factors ◽  
Head And Neck ◽  
Tumor Stage ◽  
International Classification Of Diseases ◽  
Head And Neck Cancers ◽  
Advanced Tumor Stage ◽  
Female Ratio ◽  
Advanced Tumor ◽  
Classification Of Diseases ◽  
Nigerian Population

Background: The risk factors for head and neck cancers (HNC) vary in different parts of the world. Objectives: To identify the risk factors for HNC and the correlation between these factors and the involved anatomical sites. Methods: We retrieved and analyzed health records of patients that met the inclusion criteria for HNC managed at our facility in a 10-year period using the International Classification of Diseases (ICD) version 10. Results: We studied 122 patients with a male to female ratio of 2.1:1 aged 13 years to 85 years (mean = 51 years). Alcohol ( P = .02), cigarette smoking ( P = .01), and cooking wood smoke ( P = .01) were associated with advanced tumor stage. Conclusions: The strongest risk factors for HNC are alcohol, tobacco, HIV, agricultural chemicals, and cooking wood fumes in both sexes in their sixth and seventh decades.

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