National Trends in Surgical Resection of Vestibular Schwannomas

2020 ◽  
Vol 163 (6) ◽  
pp. 1244-1249
Author(s):  
Yin Ren ◽  
Rosh K. V. Sethi ◽  
Konstantina M. Stankovic
Keyword(s):  
Surgical Resection ◽  
The United States ◽  
Population Based ◽  
Hospital Charges ◽  
Future Research ◽  
Seer Database ◽  
Surgical Volume ◽  
National Inpatient Sample ◽  
Discharge Patterns ◽  
National Trends

Objective To characterize the national trend for surgical resection of vestibular schwannoma (VS) and to assess changes in demographics, length of stay (LOS), discharge patterns, and hospital charges. Study Design Population-based inpatient registry analysis. Setting National Inpatient Sample and SEER database (Surveillance, Epidemiology, and End Results). Patients and Methods Retrospective review of the US National Inpatient Sample and the SEER database from 2001 to 2014 of all patients who underwent resection of VS. Results A total of 24,380 VS resections were performed. While the annual incidence of VS remained stable at 1.38 per 100,000, surgical volume declined by 36.1%, from 2807 in 2001 to 1795 in 2014 ( R2 = 0.58). Total hospital charges more than doubled, from $52,475 in 2001 to $115,164 in 2014 ($4478 per year, R2 = 0.96). While most procedures were performed at large-sized hospitals, this decreased from 89% in 2002 to 75.8% in 2014. Average LOS remained stable at 5.2 days during the study period. The number of discharges to a nursing facility increased from 113 (5.5%) in 2002 to 245 (13.6%) in 2014 ( P = .0002). Conclusion VS resection has evolved in the United States. While the incidence remained stable, surgical volume decreased by 36%, and hospital charges more than doubled. More cases are being performed at smaller hospitals. Although LOS did not vary significantly, there is an increase in nonroutine discharges. These data may guide future research in resource utilization in neurotology.

scholarly journals Caring for Older Patients With Cancer: Estimates of the Prevalence, Burden, and Unmet Needs of Caregivers in the United States

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 690-690
Author(s):  
Erin Kent
Keyword(s):  
Family Caregivers ◽  
Older Patients ◽  
Unmet Needs ◽  
The United States ◽  
Population Based ◽  
Data Sources ◽  
Behavioral Risk ◽  
Ripple Effect ◽  
The Us ◽  
National Trends

Abstract In 2020, ~1.8 million Americans are expected to be newly diagnosed with cancer, with approximately 70% of cases diagnosed over the age of 65. Cancer can have a ripple effect, impacting not just patients themselves, but their family caregivers. This presentation will provide an overview of the estimates of the number of family caregivers caring for individuals with cancer in the US, focusing on older patients, from several population-based data sources: Caregiving in the US 2020, the Health Information National Trends Survey (HINTS, 2017-2019), the Behavioral Risk Factors Surveillance System (BRFSS, 2015-2019), and the National Health and Aging Trends (NHATS) Survey. The presentation will compare features of the data sources to give a comprehensive picture of the state of cancer caregiving. In addition, the presentation will highlight what is known about the experiences of cancer caregivers, including caregiving characteristics, burden, unmet needs, and ideas for improving support for family caregivers.

A population-based study of acute panmyelosis with myelofibrosis in the United States: 2004 to 2015.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e19003-e19003
Author(s):  
Nicole McLaughlin ◽  
Gordon Ruan ◽  
Courtney N. Day ◽  
William S. Harmsen ◽  
Caleb J. Smith ◽  
...  
Keyword(s):  
United States ◽  
Multivariable Analysis ◽  
The United States ◽  
Population Based ◽  
Cox Proportional Hazards Model ◽  
Seer Database ◽  
Univariable Analysis ◽  
Adjusted Analysis ◽  
Male Sex

e19003 Background: Acute panmyelosis with myelofibrosis (APMF) is a rare subtype of acute myeloid leukemia characterized by acute panmyeloid proliferation with increased blasts, cytopenias with bone marrow fibrosis, and absence of splenomegaly. There is a paucity of population-based studies of APMF. Methods: We queried the United States Surveillance, Epidemiology, and End Results (SEER) database and National Cancer Database (NCDB) using the ICD-O-3 code 9931/3. The SEER 17 registries (2004-2015) were used to find data on incidence. For NCDB data, comorbid disease burden was calculated using the Charlson-Deyo Score (CDS). Hazard ratios (HR) with confidence intervals (CI) were calculated using a Cox proportional hazards model. Overall survival (OS) was estimated with the Kaplan-Meier method. Variables significant in univariable analysis were included in a multivariable analysis. Results: We identified 260 APMF patients using the SEER database. Incidence was 0.3 cases/million individuals and did not change significantly from 2004-2015. With a median follow up of 6.9 years (95% CI 6.1-7.8), the median OS was 2.3 years (95% CI 1.7-2.8). We identified 530 APMF patients using the NCDB. The median age at diagnosis was 67 years (range 22-90) and 311 (59%) were male. With a median follow up of 5.0 years (95% CI 3.0-7.6), the median OS was 2.3 years (95% CI: 0.8-6.5). OS was 69%, 31%, and 18% at 1-, 5-, and 10- years, respectively. Patients diagnosed in 2012-2015 had a significantly improved OS compared to those diagnosed in 2004-2007 (HR 0.65, 95% CI 0.49-0.85; p=0.002). 271 patients (53%) patients received chemotherapy. The OS for those that received chemotherapy was 70% at 1 year and 30% at 5 years versus 70% and 32% at 1- and 5- years for those who did not ( p=0.99). The median time to chemotherapy from time of diagnosis was 25 days (range 0-532 days). 52 patients (10%) underwent transplantation and the OS of those patients was 90% at 1 year and 45% at 5 years versus 67% and 29% at 1- and 5- years for those who did not (HR: 1.7 (95% CI: 1.2-2.6), p=0.006). In univariable analysis, factors predicting inferior OS were age ≥ 65 years old at diagnosis (HR 1.8, 95% CI 1.5-2.3; p<0.001), male sex (HR 1.5, 95% CI 1.2-1.8; p<0.001), CDS ≥ 1 (HR: 1.5 (95% CI: 1.2-2.0), p<0.001), government insurance (HR 1.8, 95% CI 1.4-2.3; p<0.001), diagnosis at a non-academic facility (HR 1.6, 95% CI 1.2-2.0, p<0.001), and not receiving a hematologic transplant (HR 1.7, 95% CI 1.2-2.6; p=0.006). Multivariable-adjusted analysis is shown in the Table. Conclusions: The overall incidence of APMF has not changed between 2004 and 2015, but OS for 2012-2015 was improved compared to 2004-2007. Age ≥ 65 years old, male sex, CDS ≥ 1, and diagnosis at a nonacademic facility predicted inferior OS. Multivariable-adjusted analysis.[Table: see text]

Afterword

2017 ◽  
Author(s):  
Frances R. Aparicio
Keyword(s):  
United States ◽  
The United States ◽  
Population Based ◽  
National Identities ◽  
Future Research ◽  
Research Project ◽  
Gender And Race

This chapter addresses the dearth of scholarship on, and academic attention to Latina/os of mixed national heritages as a sector of our population. Based on twenty interviews with Intralatina/os in Chicago, the chapter argues that they perform and embody Latinidad in their everyday family lives, negotiate between their two or more national identities, and experience relational racializations within both of their national communities. Their national negotiations reveal the complicated and shifting meanings of their multiple nationalities. In reclaiming their presence and legitimacy as hybrid Latino/as within their families and communities, Intralatino/as both engage the fluidity of national imaginaries as well as reify them in daily performances of culture, class, gender, and race. This research project aims to foster future research interventions that analyze Intralatina/o lives in the United States.

The role of surgical resection for hepatocellular carcinoma in octogenarians: A population-based analysis.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 202-202
Author(s):  
Takintope Akinbiyi ◽  
Atuhani S. Burnett ◽  
Philip Ernst ◽  
Marisa Cevasco ◽  
Donald A. McCain ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Surgical Resection ◽  
Survival Benefit ◽  
The Elderly ◽  
Population Based ◽  
Seer Database ◽  
Significant Difference ◽  
Disease Stages ◽  
The Impact

202 Background: Hepatocellular carcinoma (HCC) is a significant source of morbidity and mortality amongst the elderly population. In appropriately selected patients, surgery is known to confer a survival advantage. Octagenarians, however, given their remaining life expectancy may receive limited benefit from surgery. Nevertheless, insufficient information is available in the literature on the survival benefit of surgery in octagenarians with HCC. Methods: Octogenarians with HCC were selected from the Surveillance, Epidemiology, and End Results (SEER) database between 1998 and 2009. We evaluated patients who underwent surgical resection and those that declined to assess the impact surgery has on overall survival in this population. Results: A total of 8,614 with HCC were identified in the SEER database, of which surgery was recommended for 3,529 (41%). A total of 1,002 patients (28%) underwent surgery and 2,497 (71%) declined. Although there was a trend towards improved survival in the surgery group (7.91 months) vs the non-surgical group (7.03 months), there was no statistically significant difference in survival between the two groups (p = 0.09). Conclusions: Our study demonstrates that octagenarians as a whole do not experience a survival benefit from surgical resection for HCC. Subgroup analysis, however, may ultimately identify benefit in specific disease stages or patients with fewer comorbidities.

Incidence, Epidemiology, and Outcomes of Pediatric Tracheostomy in the United States from 2000 to 2012

2018 ◽  
Vol 160 (2) ◽  
pp. 332-338 ◽  
Author(s):  
R. Grant Muller ◽  
Madhu P. Mamidala ◽  
Samuel H. Smith ◽  
Aaron Smith ◽  
Anthony Sheyn
Keyword(s):  
United States ◽  
Cohort Analysis ◽  
Secondary Analysis ◽  
The United States ◽  
Population Based ◽  
Geographic Region ◽  
Hospital Charges ◽  
National Database ◽  
Discharge Data ◽  
Procedure Codes

Objectives To investigate national and regional variations in pediatric tracheostomy rates, epidemiology, and outcomes from 2000 to 2012. Study Design Retrospective cohort analysis. Setting Previous research with the 1997 edition of the Kids’ Inpatient Database (KID), a national database of pediatric hospital discharge data, demonstrated that rates and outcomes of pediatric tracheostomy vary among US geographic regions. The KID has since been released an additional 5 times, increasing in size with successive editions. Subjects and Methods Patients ≤18 years old with procedure codes for permanent or temporary tracheostomy from 2000 to 2012 were included. Primary outcome was a weighted population-based rate of tracheostomy stratified by year. Secondary analysis included epidemiologic characteristics and outcomes stratified by year and geographic region. Results A weighted total of 24,354 cases was analyzed. Population-based tracheostomy rates decreased from 6.8 ± 0.2 (mean ± SD) tracheostomies per 100,000 child-years in 2000 to 6.0 ± 0.2 in 2012. Minorities increased from 53.3% in 2000 to 56.4% in 2012. Patients experienced increased procedures, diagnoses, length of stay, and hospital charges with time. From 2000 to 2012, rates and outcomes varied by US geographic region. Mortality during hospitalization (8%) did not vary by year, patient age, region, or sex. Conclusions Pediatric tracheostomy is associated with variation in incidence, epidemiology, and hospitalization outcomes in the United States from 2000 to 2012. While rates of pediatric tracheostomy decreased, patients became increasingly medically complicated and ethnically diverse with outcomes varying according to geographic region.

scholarly journals Inverse National Trends in Decompressive Craniectomy Versus Endovascular Thrombectomy for Stroke

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Nicolas K Khattar ◽  
Beatrice Ugiliweneza ◽  
Mayur Sharma ◽  
Enzo Fortuny ◽  
Shawn William Adams ◽  
...  
Keyword(s):  
Decompressive Craniectomy ◽  
Recent Decade ◽  
The United States ◽  
Hospital Charges ◽  
Utilization Rate ◽  
Study Cohort ◽  
Vessel Occlusion ◽  
Endovascular Thrombectomy ◽  
Stroke Treatment ◽  
National Trends

Abstract INTRODUCTION Endovascular thrombectomy (ET) for acute large vessel occlusion reduces infarct size, and it should hypothetically decrease the incidence of major ischemic strokes requiring decompressive craniectomy (DC). The aim of this retrospective cohort study is to determine trends in the utilization of ET versus DC for stroke in the United States over a 10-yr span. METHODS We extracted data from the Nationwide Inpatient Sample (NIS) using ICD-9/10 codes for the time period 2006 to 2016. Patients with a primary diagnosis of stroke and a concurrent procedure code for ET or DC were included. Baseline demographics, outcomes and hospital charges were analyzed. RESULTS The study cohort comprised 187 355 patients diagnosed with stroke who underwent either ET or DC. The number of ET- or DC-treated stroke patients increased by 266% from 2006 to 2016. During the study period, the ET utilization rate increased (2.7% in 2006 to 68.6% in 2016, P < .0001) and the DC utilization rate decreased (97.3% in 2006 to 31.4% in 2016, P < .0001). In 2015, the utilization rate of ET (50.2%) exceeded that of DC (49.8%). ET-treated patients had shorter durations of hospital stay (mean 8.8 vs 16.8 days, P < .0001), decreased mortality (16.2% vs 19.3%), higher likelihood of discharge home (27.1% vs 24.1%, P < .0001), and lower hospital charges (mean $189,724 vs $261,314, P < .0001) CONCLUSION We identified an inverse relationship between national trends in increasing ET and diminishing DC utilization for stroke treatment over a recent decade. Although direct causation cannot be inferred, our findings suggest that ET curtails the necessity for DC.

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