Temporal Trends in the Microbiological Characteristics of Sepsis in the United States: A Population Based Study

Background Epidemiologic studies are needed for monitoring population-level trends in sepsis. This study examines sepsis-causing microorganisms from 2006 to 2014 in the United States using data from the Nationwide Inpatient Sample database. Methods 7 860 686 adults hospitalized with sepsis were identified using a validated ICD-9 coding approach. Associated microorganisms were identified by ICD-9 code and classified by major groups (Gram-positive, Gram-negative, fungi, anaerobes) and specific species for analysis of their incidence and mortality. Results The rate of sepsis incidence has increased for all four major categories of pathogens, while the mortality rate decreased. In 2014, Gram-negative pathogens had a higher incidence than Gram-positives. Anaerobes increased the fastest with an average annual increase of 20.17% (p < 0.001). Fungi had the highest mortality (19.28%) and the slowest annual decrease of mortality (−2.31%, p = 0.006) in 2013, while anaerobic sepsis had the highest hazard of mortality (adjusted HR 1.60, 95% CI 1.53-1.66). Conclusions Gram-negative pathogens have replaced Gram-positives as the leading cause of sepsis in the United States in 2014 during the study period (2006-2014). The incidence of anaerobic sepsis has an annual increase of 20%, while the mortality of fungal sepsis has not decreased at the same rate as other microorganisms. These findings should inform the diagnosis and management of septic patients, as well as the implementation of public health programs.

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Temporal trends of pancreatic ductal adenocarcinoma in young adults in the United States: A Population-Based Study

Clinics and Research in Hepatology and Gastroenterology ◽

10.1016/j.clinre.2019.07.001 ◽

2020 ◽

Vol 44 (2) ◽

pp. 204-210

Author(s):

Mohamed M. Gad ◽

Anas M. Saad ◽

Muneer J. Al-Husseini ◽

Youssef M. Abdel-Gawad ◽

Obai M. Alsalhani ◽

...

Keyword(s):

United States ◽

Young Adults ◽

Pancreatic Ductal Adenocarcinoma ◽

Temporal Trends ◽

The United States ◽

Population Based ◽

Ductal Adenocarcinoma ◽

Population Based Study

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Temporal trends in liver-directed therapy of patients with intrahepatic cholangiocarcinoma in the United States: A population-based analysis

Journal of Surgical Oncology ◽

10.1002/jso.23605 ◽

2014 ◽

Vol 110 (2) ◽

pp. 163-170 ◽

Cited By ~ 37

Author(s):

Neda Amini ◽

Aslam Ejaz ◽

Gaya Spolverato ◽

Yuhree Kim ◽

Joseph M. Herman ◽

...

Keyword(s):

United States ◽

Intrahepatic Cholangiocarcinoma ◽

Temporal Trends ◽

The United States ◽

Population Based

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A Population-Based Study of Pyogenic Liver Abscesses in the United States: Incidence, Mortality, and Temporal Trends

The American Journal of Gastroenterology ◽

10.1038/ajg.2009.614 ◽

2010 ◽

Vol 105 (1) ◽

pp. 117-124 ◽

Cited By ~ 139

Author(s):

Liisa Meddings ◽

Robert P Myers ◽

James Hubbard ◽

Abdel Aziz Shaheen ◽

Kevin B Laupland ◽

...

Keyword(s):

United States ◽

Temporal Trends ◽

The United States ◽

Population Based ◽

Population Based Study ◽

Liver Abscesses

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Temporal Trends in Incidence and Outcomes of Peripartum Cardiomyopathy in the United States: A Nationwide Population‐Based Study

Journal of the American Heart Association ◽

10.1161/jaha.114.001056 ◽

2014 ◽

Vol 3 (3) ◽

Cited By ~ 103

Author(s):

Dhaval Kolte ◽

Sahil Khera ◽

Wilbert S. Aronow ◽

Chandrasekar Palaniswamy ◽

Marjan Mujib ◽

...

Keyword(s):

United States ◽

Temporal Trends ◽

The United States ◽

Population Based ◽

Peripartum Cardiomyopathy ◽

Population Based Study

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Relative Survival of Patients with Nodal Marginal Zone Lymphoma in the United States: A Population-Based Analysis

Blood ◽

10.1182/blood-2020-137178 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 5-6

Author(s):

John L Vaughn ◽

Laura C Pinheiro ◽

Narendranath Epperla

Keyword(s):

United States ◽

Excess Mortality ◽

Marginal Zone ◽

Advanced Disease ◽

Relative Survival ◽

Population Level ◽

The United States ◽

Population Based ◽

Stage At Diagnosis ◽

Nodal Marginal Zone Lymphoma

Introduction: Nodal marginal zone lymphoma (NMZL) is an indolent B-cell non-Hodgkin lymphoma (iNHL) that usually presents in elderly patients with painless lymphadenopathy. Patients often have advanced disease at diagnosis, and bone marrow involvement is common. Treatment of NZML involves radiation therapy for localized disease, and systemic therapy for advanced disease including single-agent rituximab, rituximab and chemotherapy (such as bendamustine, chlorambucil), or novel agents (especially in the relapsed setting such as ibrutinib, lenalidomide and PI3K inhibitors). The objective of this study was to determine whether advances in treatment and supportive care over the past decade have translated to improved relative survival at the population level in patients with NMZL in the United States. Method: We used the population-based Surveillance, Epidemiology, and End Results (SEER)-18 database. We included adult patients with NMZL diagnosed between 2000-2017 who were 18-84 years old at the time of diagnosis. We excluded patients with a history of malignancy prior to NMZL, those with missing survival times and those with central nervous system involvement. Patients were divided into two cohorts based on period of diagnosis (era-1: 2000-2008, and era-2: 2009-2017). Relative survival (RS) was estimated using the Pohar-Perme method, and the difference between RS distributions was tested using a log-rank-type test. Relative survival was modeled using Poisson regression where the effect of follow-up time was included as restricted cubic spline with 5 knots. All tests of differences were performed at a two-sided alpha of 0.05. Results: We included 5,355 patients with NMZL. Table 1 shows the baseline characteristics. The median age at diagnosis was 66 years (IQR = 56-74 years). Most patients were non-Hispanic White (73%) with advanced stage at diagnosis (stage III-IV, 63%). The 5-year RS (unadjusted) was 84% (95% CI = 82% - 86%) for patients diagnosed in era-1 and 86% (95% CI = 84% - 89%) for patients diagnosed in era-2 (log-rank-type p = 0.07). Figure 1A shows cumulative RS, and Figure 1B shows the trend in 5-year RS over the study period (including model-based and empirical estimates). In our multivariable Poisson regression model for RS, the period of diagnosis, age, sex, median household income, and stage at diagnosis were significant predictors of excess mortality (Table 2). Patients in era-2 had significantly lower excess mortality [excess hazard ratio (EHR) = 0.76, 95% CI=0.62-0.93], while excess mortality significantly increased with age over 65 years [EHR = 2.09, 95% CI=1.70-2.56], male sex [EHR = 1.38, 95% CI=1.13-1.68], and advanced stage at diagnosis [EHR = 1.96, 95% CI=1.47-2.63]. Conclusion: There has been a significant improvement in RS in the most recent era for patients with NMZL in the United States after adjusting for differences in age, sex, race/ethnicity, income, and stage at diagnosis. This improvement at the population level is likely reflective of the improvement in supportive care and advances in the NMZL treatment including identification of better tolerable chemotherapy regimens and novel agents. Disclosures Epperla: Verastem Oncology: Speakers Bureau; Pharmacyclics: Honoraria.

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Secular Trends in Gram-Negative Resistance among Urinary Tract Infection Hospitalizations in the United States, 2000–2009

Infection Control and Hospital Epidemiology ◽

10.1086/671740 ◽

2013 ◽

Vol 34 (9) ◽

pp. 940-946 ◽

Cited By ~ 61

Author(s):

Marya D. Zilberberg ◽

Andrew F. Shorr

Keyword(s):

United States ◽

Urinary Tract ◽

The United States ◽

Secular Trends ◽

Hospitalized Patients ◽

Resistance Pattern ◽

Surveillance Network ◽

Gram Negative ◽

Nationwide Inpatient Sample Database ◽

Tract Infections

Objective.Urinary tract infections (UTIs) are common among hospitalized patients. Selection of an appropriate antibiotic for this infection requires knowledge of both its general microbiology and the epidemiology of drug-resistant organisms. We sought to determine secular trends in UTI hospitalizations that involve gram-negative (GN) multidrug-resistant Pseudomonas aeruginosa (MDR-PA), extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (EC) and Klebsiella pneumoniae(KP), and carbapenem-resistant Enterobacteriaceae (CRE).Design.Survey.Patients.Patients with UTI in US hospitals between 2000 and 2009.Methods.We first derived the total number of UTI hospitalizations in the United States from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database years 2000–2009. Based on a literature review, we then determined what proportion of all UTIs arise due to each of the organisms of interest, irrespective of resistance pattern. Finally, we assessed the prevalence of resistance within each pathogen based on the Eurofins Surveillance Network database 2000–2009. Susceptibility patterns served as phenotypic surrogates for resistance.Results.Between 2000 and 2009, the frequency of UTI hospitalizations increased by approximately 50%, from 53 to 77 cases per 1,000 hospitalizations. Infections due to all GN bacteria followed a similar trajectory, whereas those caused by resistant GN pathogens increased by approximately 50% (MDR-PA) to approximately 300% (ESBL). CRE emerged and reached 0.5 cases per 1,000 hospitalizations in this 10-year period.Conclusions.The epidemiology and microbiology of GN UTI hospitalizations has shifted over the past decade. The proportion of all hospitalizations involving this infection has climbed. Resistant GN bacteria are becoming more prevalent and are implicated in an increasing proportion of UTIs among hospitalized patients.

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Temporal trends in stillbirth in the United States, 1992-2004: a population-based cohort study

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/1471-0528.12883 ◽

2014 ◽

Vol 121 (10) ◽

pp. 1229-1236 ◽

Cited By ~ 6

Author(s):

X Zhang ◽

MS Kramer

Keyword(s):

United States ◽

Cohort Study ◽

Temporal Trends ◽

The United States ◽

Population Based

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Temporal trends in population-based death rates associated with chronic liver disease and liver cancer in the United States over the last 30 years

Cancer ◽

10.1002/cncr.28843 ◽

2014 ◽

Vol 120 (19) ◽

pp. 3058-3065 ◽

Cited By ~ 35

Author(s):

Yuhree Kim ◽

Aslam Ejaz ◽

Amit Tayal ◽

Gaya Spolverato ◽

John F. P. Bridges ◽

...

Keyword(s):

United States ◽

Liver Disease ◽

Liver Cancer ◽

Chronic Liver Disease ◽

Temporal Trends ◽

The United States ◽

Population Based ◽

Chronic Liver ◽

Death Rates

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BSCI-06. FREQUENCY OF BRAIN METASTASIS FROM BREAST AND LUNG CANCER IN THE UNITED STATES -- A POPULATION-BASED ASSESSMENT

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz014.005 ◽

2019 ◽

Vol 1 (Supplement_1) ◽

pp. i2-i2

Author(s):

Quinn Ostrom ◽

Mustafa Ascha ◽

Carol Kruchko ◽

Jill Barnholtz-Sloan

Keyword(s):

United States ◽

Lung Cancer ◽

Linked Data ◽

Triple Negative ◽

Population Level ◽

The United States ◽

Population Based ◽

Small Cell ◽

Cancer Site ◽

Central Nervous System Tumor

Abstract BACKGROUND: Brain metastases (BM) are the most common central nervous system tumor in the United States and occur with increasingly frequency due to improved screening and therapeutics leading to improved survival. Current estimates of frequency of BM vary significantly by cancer site and are typically not population-based. Population-based estimates of incidence have recently become possible due to collection of data on BM identified at diagnosis (“synchronous” BM, SBM). BM may occur at any point after cancer diagnosis. We report our recent population-based estimates of SBM and period incidence of BM (PBM) from breast (BC) and lung cancer (LC). METHODS: Data from Surveillance, Epidemiology, and End Results (SEER, 2010–2016 diagnoses) were used to estimate SBM and linked data from SEER-Medicare (2008–2012 diagnoses for individuals 65+, with 2007–2014 claims) were used to estimate PBM, for BC and LC overall and by BC and LC subtypes. RESULTS: Within the SEER data, 10.9% of LC cases presented with SBM (15.5% in small cell LC [SCLC], and 10.8% in non-small cell LC [NSCLC]); 0.4% of BC cases presented with SBM, 0.7% in triple negative (TNBC), 0.8% for HER2+, and 0.2% for ER+\PR+\HER2-. Within the SEER-Medicare data, 13.5% of LC overall had LBM with 23.1% for SCLC and 15.3% for NSCLC; 1.8% of BC overall had LBM with 4.2% in triple negative (TNBC), 3.1% for HER2+, and 1.1% for ER+\PR+\HER2. CONCLUSION: Frequency of synchronous and period BM varies by originating site as well as subtype. The new SBM variable in SEER allows for estimation of this important statistic, while the SEER-Medicare linked data allows for estimation of PBM, both on a population-level for the US population. These estimates are useful to clinical practice and critical for estimating morbidity and mortality due to BM.

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