scholarly journals Length of Stay and Total Hospital Charges of Clipping Versus Coiling for Ruptured and Unruptured Adult Cerebral Aneurysms in the Nationwide Inpatient Sample Database 2002 to 2006

Stroke ◽  
2010 ◽  
Vol 41 (2) ◽  
pp. 337-342 ◽  
Author(s):  
Brian L. Hoh ◽  
Yueh-Yun Chi ◽  
Matthew F. Lawson ◽  
J. Mocco ◽  
Fred G. Barker
Keyword(s):  
Length Of Stay ◽  
Nationwide Inpatient Sample ◽  
Cerebral Aneurysms ◽  
Hospital Charges ◽  
Total Hospital ◽  
Nationwide Inpatient Sample Database

scholarly journals Incidence of Seizures or Epilepsy After Clipping or Coiling of Ruptured and Unruptured Cerebral Aneurysms in the Nationwide Inpatient Sample Database: 2002-2007

Neurosurgery ◽  
2011 ◽  
Vol 69 (3) ◽  
pp. 644-650 ◽  
Author(s):  
Brian L Hoh ◽  
Sunina Nathoo ◽  
Yueh-Yun Chi ◽  
J Mocco ◽  
Fred G Barker
Keyword(s):  
Odds Ratio ◽  
Nationwide Inpatient Sample ◽  
Cerebral Aneurysms ◽  
Unruptured Aneurysm ◽  
Hospital Charges ◽  
Patient Specific ◽  
Unruptured Aneurysms ◽  
Unruptured Cerebral Aneurysm ◽  
Nationwide Inpatient Sample Database ◽  
Specific Factors

Abstract BACKGROUND: It is not clear whether treatment modality (clipping or coiling) affects the risk of seizures after treatment for cerebral aneurysms. OBJECTIVE: To determine whether there is an increased risk of seizures after clipping vs coiling. METHODS: Hospitalizations for clipping or coiling of ruptured and unruptured aneurysms were identified in the Nationwide Inpatient Sample Database for 2002 to 2007 by International Classification of Diseases 9th Revision codes for subarachnoid hemorrhage or unruptured cerebral aneurysm and codes for clipping or coiling. Clipping and coiling were compared for the combined primary endpoint of seizures or epilepsy. The analysis was adjusted for patient-specific and hospital-specific factors using generalized linear models with generalized estimated equations. RESULTS: There were 10 899 hospitalizations for ruptured aneurysms (6593 clipping, 4306 coiling), and 9686 hospitalizations for unruptured aneurysms (4483 clipping, 5203 coiling). For ruptured aneurysm patients, clipping had a similar incidence of seizures or epilepsy compared with coiling (10.7% vs 11.1%, respectively, adjusted odds ratio: 0.596; 95% confidence interval: 0.158-2.248; P = .445 after adjustment for patient-specific and hospital-specific factors). For unruptured aneurysm patients, clipping was associated with a significantly higher risk of seizures or epilepsy (9.2%) compared with coiling (6.2%) (adjusted odds ratio: 1.362; 95% confidence interval: 0.155-1.606; P < .001 after adjustment for patient-specific and hospital-specific factors). Seizures or epilepsy were significantly associated with longer hospitalizations (P < .01) and higher hospital charges (P < .0001), except in coiled unruptured aneurysm patients, in which seizures or epilepsy were not significantly associated with hospital charges (P = .31). CONCLUSION: In unruptured cerebral aneurysm patients, clipping is associated with a higher risk of seizures or epilepsy.

Abstract 15333: Choosing Where to Live or Die: Regional Variation in Outcomes Following Out-of-hospital Cardiac Arrest (OHCA) in the United States

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Aiham Albaeni ◽  
May A. Beydoun ◽  
Shaker M. Eid ◽  
Bolanle Akinyele ◽  
Lekshminarayan RaghavaKurup ◽  
...  
Keyword(s):  
United States ◽  
Care Delivery ◽  
The United States ◽  
Hospital Charges ◽  
Trauma Patients ◽  
The South ◽  
The West ◽  
Total Hospital ◽  
North East ◽  
Nationwide Inpatient Sample Database

Background: Regional Differences in health outcomes following OHCA has been poorly studied, and was the focus of this investigation. Methods: We used the 2002 to 2012 Nationwide Inpatient Sample database to identify adults ≥ 18 years old, with an ICD-9 code principal diagnosis of cardio respiratory arrest (427.5) or ventricular fibrillation (427.1). Trauma patients were excluded. In 4 predefined federal geographic regions: North East, Midwest, South and West, means and proportions of total hospital charges (adjusted to the 2012 consumer price index,) and mortality rate were calculated. Multiple linear and logistic regression models, were adjusted for patient demographics, hospital characteristics and Charlson Comorbidity Index. Trends in binary outcome were examined with YearхRegion interaction terms. Results: From 2002 to 2012, of 155,592 OHCA patients who survived to hospital admission , 26,007 (16.7%) were in the Northeast, 39,921 (25.7% ) in the Midwest, 56,263 (36.2%) in the South, and 33,401 (21.5% ) in the West. Total hospital charges (THC) rose significantly over the years across all regions of the United States ( P trend <0.0001), and were higher in the West Vs the North East (THC>$109,000/admission, AOR 1.85; 95% CI 1.53-2.24, p<0.0001), and not different in other regions. Compared to the Northeast, mortality was lower in the Midwest ( AOR 0.86, 95% CI 0.77-0.97 p=0.01), marginally lower in the South ( AOR 0.91, 95% CI 0.82-1.01 p=0.07), with no difference detected between the West and the Northeast ( AOR 1.02, 95% CI 0.90-1.16 P=0.78). Increased expenditure was not rewarded by an increase in survival, as trends in Mortality did not differ significantly between regions (YearхRegion effects P>0.05, P trend =0.29). Conclusions: Nationwide, there is a considerable variability in survival and charges associated with caring for the post arrest patient. Higher charges did not yield better outcomes. Further investigation is needed to optimize health care delivery.

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%).

Palliative Care in Ruptured Aortic Aneurysm in the United States: A Retrospective Analysis of Nationwide Inpatient Sample Database

Angiology ◽  
2020 ◽  
Vol 71 (7) ◽  
pp. 633-640
Author(s):  
Tomo Ando ◽  
Oluwole Adegbala ◽  
Takeshi Uemura ◽  
Said Ashraf ◽  
Emmanuel Akintoye ◽  
...  
Keyword(s):  
Palliative Care ◽  
Aortic Aneurysm ◽  
Length Of Stay ◽  
Nationwide Inpatient Sample ◽  
The United States ◽  
Hospitalization Cost ◽  
Ruptured Aortic Aneurysm ◽  
Nationwide Inpatient Sample Database ◽  
The Cost ◽  
Repair Group

We assessed the trend of palliative care (PC) referrals and its effect on hospitalization cost and length of stay (LOS) in ruptured aortic aneurysm (rAA). The Nationwide Inpatient Sample from 2005 to 2014 was used to identify admissions with age ≥50 and rAA. A total of 54 134 rAA admissions were identified and 5019 (9.3%) had PC referrals. During the study period, PC referral rate increased from 0.97% to 15.3% ( P trend < .0001). Length of stay (1.7 vs 2.8 days, adjusted mean ratio [aMR] = 0.62, 95% confidence interval [CI]: 0.58-0.66), and cost (US$7778 vs US$13 575, aMR = 0.57, 95% CI: 0.52-0.63) were significantly lower in rAA admissions that did not undergo interventions. In the percutaneous repair group, LOS was similar but the cost was higher (US$61 759 vs US$52 260, aMR = 1.18, 95% CI: 1.05-1.30), whereas in surgical repair group, LOS was shorter (4.6 vs 5.9 days, aMR = 0.77, 95% CI: 0.73-0.82) but the cost was higher (US$59 755 vs US$52 523, aMR = 1.14, 95% CI: 1.02-1.28). Palliative care could shorten LOS and save hospitalization cost in rAA admissions not a candidate for repair. Further studies are required to investigate the variable effects of PC on rAA.

Impact of tuberculosis on mortality and healthcare resource utilization in cancer patients: A nationwide inpatient sample analysis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13625-e13625
Author(s):  
Ishaan Vohra ◽  
Prasanth Lingamaneni ◽  
Vatsala Katiyar ◽  
Krishna Rekha Moturi ◽  
Sindhu Janarthanam Malapati ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Resource Utilization ◽  
Nationwide Inpatient Sample ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Health Concern ◽  
Hospital Charges ◽  
Solid Organ ◽  
Nationwide Inpatient Sample Database ◽  
Increased Risk

e13625 Background: Tuberculosis (TB) is a major public health concern. Patients with malignancy are at increased risk of developing TB as a result of depressed cellular immunity. The aim of the study is to analyze the prevalence, mortality and healthcare resource utilization of cancer patients with TB. Methods: Adult patients with malignancy and TB (cases) were identified using ICD10 code from Nationwide Inpatient Sample database 2017 and their data was compared to cancer patients without TB (controls). Univariate and multivariable logistic and Poisson regression models were used to analyze mortality and healthcare resource utilization. Results: Among 2,099,294 adult cancer patients admitted in 2017, 1115 were found to have TB. Majority (84%) had pulmonary TB. Mean age of patients was 60.3 years with 65% males and white predominance (33%). Overall prevalence of TB in cancer population was 51.3/100,000 patients, with highest being in Hodgkin lymphoma (182.6/100,000) followed by and MDS/ MPN patients (113.2/100,000) (p < 0.01). Among solid organ malignancies, lung cancer had the highest prevalence of TB (92.1/100,000). After adjusting for the demographic and patient related variables, TB was found to be an independent risk factor for mortality in cancer patients (adjusted HR 1.7, 95% CI 1.13-2.66, p = 0.017). The mortality of cases during inpatient stay was 10.2% compared to 6.2% in controls. The mean length of stay for cases was 12.4 days vs 6.3 days in controls (adjusted coef +6.12, 95% CI 3.64-8.59, P < 0.001) and mean hospital charges in cases was $136,026 vs $67,381 in controls (adjusted coef 68,680, 95% CI 39,053.5-98,306.9, p < 0.001). On multivariate analysis, predictors of mortality in cancer patients with TB were older age, malnutrition, uninsured status, higher Charlson comorbidity score ( = > 3), ICU care, venous thrombo-embolism and Acute renal failure requiring dialysis. Conclusions: TB significantly increases the morbidity and mortality in cancer patients. Widespread TB screening, prompt recognition of infection and treatment can considerably reduce health care costs. [Table: see text]

scholarly journals Severe Vision Impairment and Blindness in Hospitalized Patients: A Nationwide Study

2020 ◽  
Author(s):  
Che Harris ◽  
Scott M Wright
Keyword(s):  
Length Of Stay ◽  
Visual Impairment ◽  
Hospitalized Patients ◽  
Mean Difference ◽  
Vision Impairment ◽  
Hospital Charges ◽  
Total Hospital ◽  
Obesity Epidemic ◽  
Charlson Comorbidity Score ◽  
Attention To Detail

Abstract Background: Outcomes among hospitalized patients with severe vision impairment or blindness have not been extensively explored. This study sought to determine clinical and resource utilization outcomes in patients with severe vision impairment/blindness (SVI/B). Because the obesity epidemic is also on the rise and underrecognized in hospital settings, we also sought to understand its impact among patients with SVI/B.Methods: We conducted a retrospective study using the National Inpatient Sample for the year 2017; hospitalized adults with and without SVI/B were compared. In addition, for all patients with SVI/B, we compared those with and without obesity. Multiple logistic regression and linear analysis were used to evaluate mortality, disposition, length of stay, and hospital charges. We adjusted for age, sex, race, comorbidities, insurance, and income.Results: 30,420,907 adults were hospitalized, of whom 37,200 had SVI/B. Patients with SVI/B were older (mean age ± SEM: 66.4±0.24 vs. 57.9±0.09 years, p <0.01), less likely to be female (50% vs 57.7%, p <0.01), more frequently insured by Medicare (75.7% vs 49.2%, p <0.01), and had more comorbidities (Charlson comorbidity score ≥ 3: 53.2% vs 27.8%, p <0.01). Patients with SVI/B had a higher in-hospital mortality rate (3.9% vs 2.2%; p<0.01), and they were less likely discharged home (adjusted Odds Ratio {aOR} =0.54, [Confidence Interval (CI) 0.51-0.58]; p <0.01) compared to those without visual impairment. Hospital charges were not significantly different (adjusted Mean Difference {aMD} = $247 CI [-$2,474-2,929]; p=0.85) but length of stay was longer (aMD= 0.5 days CI [0.3-0.7]; p<0.01) for those with SVI/B. Visually impaired patients who were also obese had higher total hospital charges compared to those without obesity (mean difference: $9,821 [CI $1,375-$18,268]; p =0.02).Conclusion: Patients admitted to American hospitals in 2017 who had severe vision impairment or blindness had worse clinical outcomes and greater resources utilization. Hospital-based healthcare professionals should recognize that because those with visual impairment are at risk for worse outcomes, extra attention to detail may be warranted to minimize the propagation of such disparity.

scholarly journals 394. Impact of Day of Admission and Time to Diagnostic Arthrocentesis on Mortality and Other Outcomes in Solid-Organ Transplant Recipients with Septic Arthritis: A Nationwide Analysis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S202-S202
Author(s):  
Gustavo Contreras Anez ◽  
Ana B Arevalo ◽  
Shane E Murray ◽  
Christian Olivo Freites
Keyword(s):  
Length Of Stay ◽  
Septic Arthritis ◽  
Organ Transplant ◽  
Mortality Rates ◽  
Solid Organ Transplant ◽  
Hospital Charges ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Total Hospital ◽  
Solid Organ Transplant Recipients

Abstract Background Multiple cases have been reported assessing the outcomes for solid-organ transplant recipients (SOTR) admitted to the hospital with septic arthritis of a native joint (SANJ); however, there are no data evaluating the outcome of these patients when they are admitted on the weekend compared with the rest of the week. Methods The NIS database of the year 2016 was utilized to identify all SOTR with SANJ using ICD-10 codes. SOTR status was defined as those adults with a history of a transplanted organ including heart, lungs, a combined heart and lung, liver, kidney, intestine or pancreas. Admissions between midnight Friday and midnight Sunday were classified as weekend admissions. Early arthrocentesis was defined as percutaneous arthrocentesis performed within 24 hours of admission. Odds ratios (OR) were calculated for primary and secondary outcomes including in-hospital mortality rate, rates of diagnostic arthrocentesis and early arthrocentesis, length o¬f stay and total hospital charges. These results were compared after univariable and multivariable logistic regression adjusted for age, gender, race, day of admission, Charlson comorbidity index and median household yearly income in the patient’s zip code. We used STATA-15 for statistical analysis. Results We identified 319 SOTR with SANJ. Compared with SOTR admitted with SANJ on weekdays, those admitted on weekends had increased in-hospital mortality rates (odds ratio[OR] 11; 95% [CI] 1.2–97.9, P < 0.05), but similar, length of stay (P > 0.05) and hospital charges (P > 0.05). However, regardless of the day of admission those who received an early arthrocentesis had a lower length of stay (P < 0.05), and lower total hospital charges (P < 0.05). Conclusion Our study showed that compared with SOTR admitted with SANJ on weekdays, those admitted on weekends had increased mortality rates but similar length of stays and total hospital charges. However, patients who received an early arthrocentesis had a significantly lower length of stay and hospital charges regardless of the day of admission. These results add weight to the hypothesis of negative outcomes in weekend admissions. Moreover, we believe that our findings require further investigation to establish the role of early arthrocentesis in the management of septic arthritis. Disclosures All authors: No reported disclosures.

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