Characteristics and factors affecting mortality of patients admitted for chemotherapy in the United States during the year 2017.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19025-e19025
Author(s):  
Arya Mariam Roy ◽  
Manojna Konda ◽  
Akshay Goel ◽  
Rashmi Verma
Keyword(s):  
Average Length ◽  
Private Insurance ◽  
Progression Free Survival ◽  
The United States ◽  
Factors Affecting ◽  
Beneficial Effects ◽  
Average Length Of Stay ◽  
Icd 10 ◽  
Life Threatening

e19025 Background: Over the past two decades, there has been a tremendous increase in the chemotherapy options available to cancer patients. In terms of overall, progression-free survival, and temporary suppression of cancer-related symptoms, chemotherapy has shown beneficial effects. However, the side effects of chemotherapy are sometimes life threatening which affects an individual’s physical health, emotional state and quality of life. There is a considerable increase in the prevention, early identification and timely management of toxicities associated with chemotherapy; however, chemotherapy-related deaths still occur. Methods: We conducted a retrospective analysis of the National Inpatient Sample Database for the year 2017. Patients who were admitted for the administration of chemotherapy are identified using ICD- 10 codes. The epidemiology, the role of insurance providers in the treatment outcome were studied. Results: A total of 29,018 hospitalizations for the administration of chemotherapy were there in 2017. The median age of patients who received chemotherapy was 48. The overall mortality related to chemotherapy admissions was 0.80% (n = 233). The mortality of females who were admitted for chemotherapy did not vary much when compared to males admitted for chemotherapy (0.89% vs 0.73%, p = 0.132). It was found that admissions for chemotherapy during weekend had 85 % higher odds of dying as compared to admission during weekdays (1.6% vs 0.76%, OR = 1.85, p = 0.001, CI = 1.16 – 2.95). Patients who were admitted electively for chemotherapy were 74% less likely to die in hospital when compared to those who were admitted emergently for chemotherapy (1.4 % vs 0.49% OR = 0.36, p = 0.001, CI = 0.266 – 0.49). Interestingly, patients who had Medicare and Medicaid had higher mortality than those who had private insurance and self-pay when admitted for chemotherapy (2.08 % vs 0.58% vs 0.36%, p = 0.00). Those who had private insurance were 60% less likely to die in hospital while admitted for chemotherapy. The average length of stay for chemotherapy admissions were 5.92 ± 7.9%. Conclusions: Medicare and Medicaid patients, weekend admissions and emergent admissions were more likely to die in hospital while admitted for chemotherapy. Further studies are needed to reveal the disparities in the mortality of chemotherapy admissions, based on the socioeconomic status and the insurance payers.

scholarly journals 839. Examining the Effects of HIV Infection on Severity of Outcomes in Those with COVID-19

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S511-S511
Author(s):  
Melissa Parkinson ◽  
Rebecca Gerrity ◽  
Rachel Strength ◽  
Christian J Fuchs ◽  
Christopher Jackson ◽  
...  
Keyword(s):  
Viral Load ◽  
Charlson Comorbidity Index ◽  
Average Length ◽  
Cd4 Count ◽  
Large Hospital ◽  
Factors Affecting ◽  
Average Length Of Stay ◽  
Chi Squared ◽  
Icd 10 ◽  
Comorbidity Index

Abstract Background Throughout the SARS-CoV-2 pandemic, there have been many questions about how COVID-19 affects patients living with HIV (PLWH). We examined the clinical courses of 45 PLWH who required hospitalization with SARS-CoV-2 infection. Methods This is a retrospective cohort study in which ICD-10 codes were used to identify PLWH who were admitted to three large hospital systems in Memphis, TN with COVID-19. We included all patients ≥ 18 years of age with HIV and a documented positive SARS-CoV-2 PCR test. After manual abstraction from the electronic health records, chi-squared and T-tests were performed to evaluate associations between patient-level factors and outcomes. Results A total of 45 patients with HIV who tested positive for SARS-CoV-2 were admitted to Memphis, TN area hospitals between March 2020 and October 2020. 18 (40%) were female, 43 (95.6%) were Black, and the average age was 50.3 years (SD 12.6). The average BMI was 30.2 (SD 8.6). 40 (88.9%) patients admitted had at least one comorbidity with the most common being hypertension (28 patients, 62.2%) and diabetes (14 patients, 31.1%). 24 (46.7%) patients had a Charlson Comorbidity Index > 3. 15/43 (48.4%) patients had a CD4 count < 200, and 35 (77.8%) were on ART. 30 (66.7%) patients met SIRS criteria within 24 hours of admission, and 27 (60%) required some form of oxygen supplementation during hospitalization, including 4 (8.9%) who required intubation. The average length of stay was 10.4 days (SD 12.5). 9 (20%) patients required an ICU stay, and 3 (6.7%) died. BMI > 30, CD4 count < 200, and viral load > 1000 were not associated with worse outcomes. Both a Charlson Comorbidity Index > 3 and the absence of ART were associated with need for ICU-level care. Conclusion Viral load, CD4 count, and BMI were not correlated with differences in mortality or oxygen use in our study. Patients with higher Charlson Comorbidity Indices and patients who were not on ART at presentation were significantly more likely to require the ICU. Further study is needed to definitively determine factors affecting the outcomes of PLWH with SARS-CoV-2 infection. Disclosures All Authors: No reported disclosures

scholarly journals Factors Affecting the Length of Stay in the Intensive Care Unit: Our Clinical Experience

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Mehmet Toptas ◽  
Nilay Sengul Samanci ◽  
İbrahim Akkoc ◽  
Esma Yucetas ◽  
Egemen Cebeci ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Average Length ◽  
Cerebrovascular Diseases ◽  
Factors Affecting ◽  
Average Length Of Stay ◽  
Lengths Of Stay ◽  
Life Threatening ◽  
Hospital Days

Background and Aim. Long hospital days in intensive care unit (ICU) due to life-threatening diseases are increasing in the world. The primary goal in ICU is to decrease length of stay in order to improve the quality of medical care and reduce cost. The aim of our study is to identify and categorize the factors associated with prolonged stays in ICU.Materials and Method. We retrospectively analyzed 3925 patients. We obtained the patients’ demographic, clinical, diagnostic, and physiologic variables; mortality; lengths of stay by examining the intensive care unit database records.Results. The mean age of the study was 61.6 ± 18.9 years. The average length of stay in intensive care unit was 10.2 ± 25.2 days. The most common cause of hospitalization was because of multiple diseases (19.5%). The length of stay was positively correlated with urea, creatinine, and sodium. It was negatively correlated with uric acid and hematocrit levels. Length of stay was significantly higher in patients not operated on than in patients operated on (p<0.001).Conclusion. Our study showed a significantly increased length of stay in patients with cardiovascular system diseases, multiple diseases, nervous system diseases, and cerebrovascular diseases. Moreover we showed that when urea, creatinine, and sodium values increase, in parallel the length of stay increases.

scholarly journals THU0442 GOUT AND HEART FAILURE IN THE US: A NATIONAL PERSPECTIVE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 458.2-458
Author(s):  
G. Singh ◽  
M. Sehgal ◽  
A. Mithal
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Confidence Intervals ◽  
Burden Of Illness ◽  
Average Length ◽  
Private Insurance ◽  
Significant Risk ◽  
Case Fatality ◽  
The United States ◽  
The Us

Background:Heart failure (HF) is the eighth leading cause of death in the US, with a 38% increase in the number of deaths due to HF from 2011 to 2017 (1). Gout and hyperuricemia have previously been recognized as significant risk factors for heart failure (2), but there is little nationwide data on the clinical and economic consequences of these comorbidities.Objectives:To study heart failure hospitalizations in patients with gout in the United States (US) and estimate their clinical and economic impact.Methods:The Nationwide Inpatient Sample (NIS) is a stratified random sample of all US community hospitals. It is the only US national hospital database with information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured. We examined all inpatient hospitalizations in the NIS in 2017, the most recent year of available data, with a primary or secondary diagnosis of gout and heart failure. Over 69,800 ICD 10 diagnoses were collapsed into a smaller number of clinically meaningful categories, consistent with the CDC Clinical Classification Software.Results:There were 35.8 million all-cause hospitalizations in patients in the US in 2017. Of these, 351,735 hospitalizations occurred for acute and/or chronic heart failure in patients with gout. These patients had a mean age of 73.3 years (95% confidence intervals 73.1 – 73.5 years) and were more likely to be male (63.4%). The average length of hospitalization was 6.1 days (95% confidence intervals 6.0 to 6.2 days) with a case fatality rate of 3.5% (95% confidence intervals 3.4% – 3.7%). The average cost of each hospitalization was $63,992 (95% confidence intervals $61,908 - $66,075), with a total annual national cost estimate of $22.8 billion (95% confidence intervals $21.7 billion - $24.0 billion).Conclusion:While gout and hyperuricemia have long been recognized as potential risk factors for heart failure, the aging of the US population is projected to significantly increase the burden of illness and costs of care of these comorbidities (1). This calls for an increased awareness and management of serious co-morbid conditions in patients with gout.References:[1]Sidney, S., Go, A. S., Jaffe, M. G., Solomon, M. D., Ambrosy, A. P., & Rana, J. S. (2019). Association Between Aging of the US Population and Heart Disease Mortality From 2011 to 2017. JAMA Cardiology. doi:10.1001/jamacardio.2019.4187[2]Krishnan E. Gout and the risk for incident heart failure and systolic dysfunction. BMJ Open 2012;2:e000282.doi:10.1136/bmjopen-2011-000282Disclosure of Interests: :Gurkirpal Singh Grant/research support from: Horizon Therapeutics, Maanek Sehgal: None declared, Alka Mithal: None declared

Factors affecting in vitro and in vivo antioxidant effects. Experimental conditions and nature of oxidants determine antioxidant efficacy

2021 ◽  
pp. 1-9
Author(s):  
Etsuo Niki
Keyword(s):  
Biological Molecules ◽  
Experimental Conditions ◽  
Factors Affecting ◽  
Beneficial Effects ◽  
Multiple Oxidants ◽  
Antioxidant Effects

Reactive oxygen and nitrogen species have been implicated in the onset and progression of various diseases and the role of antioxidants in the maintenance of health and prevention of diseases has received much attention. The action and effect of antioxidants have been studied extensively under different reaction conditions in multiple media. The antioxidant effects are determined by many factors. This review aims to discuss several important issues that should be considered for determination of experimental conditions and interpretation of experimental results in order to understand the beneficial effects and limit of antioxidants against detrimental oxidation of biological molecules. Emphasis was laid on cell culture experiments and effects of diversity of multiple oxidants on antioxidant efficacy.

Airway Management of Epiglottitis: A National Perspective

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P62-P62
Author(s):  
Jason L Acevedo ◽  
Lina Lander ◽  
Sukgi S Choi ◽  
Rahul K Shah
Keyword(s):  
Average Length ◽  
Private Insurance ◽  
Teaching Hospitals ◽  
Airway Intervention ◽  
Average Length Of Stay ◽  
Care Facilities ◽  
The Mean ◽  
National Perspective ◽  
And Training ◽  
Total Charges

Objective To describe demographics and utilization in the treatment of epiglottitis. Methods The Kids’ Inpatient Database (KID) was used to extract data for patients 7 years old and younger with a diagnosis of epiglottitis; children undergoing airway intervention (intubation or tracheostomy) were studied. Results 33 patients were identified that were either intubated (n=31) or had a tracheotomy (n=3); 1 patient that had a tracheotomy was intubated prior. The mean age of patients was 1.7 years old; 58% being 2 years older or less. 52% were male, and 42% were Caucasian. Average length of stay was 17.7 days (range=0–199). January and October were the most common months for admission (n=5, each). Of admissions - Texas and Massachusetts handled the most (n=4, each). Average total charges were $83860. Private insurance was the primary payor in 55% of cases; 18% patients were discharged to shortterm care facilities. 73% of cases were managed at teaching hospitals; all tracheotomies were at teaching hospitals. There were no mortalities. Conclusions In the post-HiB era, epiglottitis has become a rare entity. Of children under 7 years of age, only 33 required airway intervention in the 36 states sampled in 2003. More than half of affected children were, on average, 2 years old and younger. Airway intervention for epiglottitis is associated with high total charges and prolonged hospitalization. Epiglottitis is a rare, expensive, and protracted disease to treat in the HiB vaccine era. The infrequency of this disease has significant implications for resident education and training.

scholarly journals Deaths from necrotizing fasciitis in the United States, 2003–2013

2015 ◽  
Vol 144 (6) ◽  
pp. 1338-1344 ◽  
Author(s):  
N. ARIF ◽  
S. YOUSFI ◽  
C. VINNARD
Keyword(s):  
United States ◽  
Necrotizing Fasciitis ◽  
Incidence Rate ◽  
Racial Differences ◽  
Cause Of Death ◽  
The United States ◽  
Crude Mortality Rate ◽  
Crude Mortality ◽  
Icd 10 ◽  
Life Threatening

SUMMARYNecrotizing fasciitis (NF) is a life-threatening infection requiring urgent surgical and medical therapy. Our objective was to estimate the mortality burden of NF in the United States, and to identify time trends in the incidence rate of NF-related mortality. We obtained data from the National Center for Health Statistics, which receives information from death certificates from all states, including demographic information and cause of death. The U.S. Multiple Cause of Death Files were searched from 2003 to 2013 for a listing of NF (ICD-10 code M72.6) as either the underlying or contributing cause of death. We identified a total of 9871 NF-related deaths in the United States between 2003 and 2013, corresponding to a crude mortality rate of 4·8 deaths/1 000 000 person-years, without a significant time trend. Compared to white individuals, the incidence rate of NF-associated death was greater in black, Hispanic, and American Indian individuals, and lower in Asian individuals. Streptococcal infection was most commonly identified in cases where a pathogen was reported. Diabetes mellitus and obesity were more commonly observed in NF-related deaths compared to deaths due to other causes. Racial differences in the incidence of NF-related deaths merits further investigation.

scholarly journals Risk conditions in children hospitalized with influenza in Norway, 2017-2019

2020 ◽  
Author(s):  
Siri Helene Hauge ◽  
Inger Johanne Bakken ◽  
Birgitte Freiesleben de Blasio ◽  
Siri Eldevik Håberg
Keyword(s):  
Odds Ratio ◽  
Influenza Season ◽  
Average Length ◽  
Patient Registry ◽  
Average Length Of Stay ◽  
Hospitalization Rates ◽  
Severe Influenza ◽  
Primary Health ◽  
Icd 10 ◽  
Norwegian Patient

Abstract BackgroundNorwegian children are more frequently hospitalized with influenza than adults. Little is known about the characteristics of these children. Our aim was to investigate the presence of pre-existing risk conditions and to determine the duration of influenza hospitalizations in children during two influenza seasons.MethodsThe Norwegian Patient Registry holds data on all hospitalized patients in Norway. We included all patients younger than 18 years hospitalized with a diagnosis of influenza during the influenza seasons 2017-18 and 2018-19. Pre-existing risk conditions for influenza were identified by ICD-10 diagnoses in the Norwegian Patient Registry. In addition, information on asthma diagnoses were also retrieved from the Norwegian Registry for Primary Health Care. To estimate the prevalence of risk conditions in the child population, we obtained diagnoses on all Norwegian children in a two-year period prior to each influenza season. We calculated age-specific rates for hospitalization and risk for being hospitalized with influenza in children with risk conditions.ResultsIn total, 1013 children were hospitalized with influenza during the two influenza seasons. Children younger than 6 months had the highest rate of hospitalization, accounting for 13.5% of all admissions (137 children). Hospitalization rates decreased with increasing age. Among children hospitalized with influenza, 25% had one or more pre-existing risk conditions for severe influenza, compared to 5% in the general population under 18 years. Having one or more risk conditions significantly increased the risk of hospitalization, (Odds Ratio (OR) 6.1, 95% confidence interval (CI) 5.0-7.4 in the 2017-18 season, and OR 6.8, 95% CI 5.4-8.4 in the 2018-19 season). Immunocompromised children and children with epilepsy had the highest risk of hospitalization with influenza, followed by children with heart disease and lung disease. The average length of stay in hospital were 4.6 days, and this did not differ with age.ConclusionChildren with pre-existing risk conditions for influenza had a higher risk of hospitalization for influenza. However, most children (75%) admitted to hospital with influenza in Norway during 2017-2019 did not have pre-existing risk conditions. Influenza vaccination should be promoted in particular for children with risk conditions and pregnant women to protect new-borns.

Intercapitalist Maneuvers and the ICD-10 Transition: The Instrumental Role of the State in the Corporate Governance of U.S. Health Care

2019 ◽  
Vol 49 (3) ◽  
pp. 457-475 ◽  
Author(s):  
Mary Bugbee
Keyword(s):  
Health Care ◽  
Corporate Governance ◽  
Financial Burden ◽  
Health Sector ◽  
The United States ◽  
The State ◽  
Coding System ◽  
Role Of The State ◽  
Icd 10

In 2015, the United States transitioned to the ICD-10-CM/PCS, a comprehensive updated coding system for medical reimbursement. This transition was part of a larger move toward value-based reimbursement in U.S. health care and required nearly 2 decades of planning. As an unfunded mandate from Congress, it created a substantial financial burden for many groups within the health sector. This article traces the ICD-10 transition using the concept of the corporate governance of health care, attending to the role the state plays in mediating intercapitalist maneuvers. The ICD-10 was not a simple top-down declaration originating in a neutral state. Rather, it was produced and modified through lobbying efforts on the part of various stakeholders who, along with their competitors, would be affected by the transition in differential ways. The health information technology industry, in particular, stood to gain the most from this transition, at the expense of other capitalist players. An examination of the intercapitalist maneuevers behind the ICD-10 transition demonstrates that even when corporate powers govern U.S. health care, the role of the state should not be written off as inconsequential but rather interrogated and analyzed in relation to the corporate interests with which it is entangled.

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