scholarly journals SUN-620 Gender Difference in the Outcome of Patients with Diabetes Admitted for Hyperosmolar Hyperglycemia. from the National Inpatient Sample

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Fatima Ahmed ◽  
Ashraf Abugroun ◽  
Manar Elhassan ◽  
Berhane Seyoum
Keyword(s):  
Mechanical Ventilation ◽  
Length Of Stay ◽  
Lower Risk ◽  
Female Gender ◽  
Secondary Outcome ◽  
National Inpatient Sample ◽  
Patients With Diabetes ◽  
Hyperosmolar Hyperglycemic State ◽  
The Mean ◽  
The Impact

Abstract Objective: There is paucity of literature on the impact of gender on outcomes of hyperosmolar hyperglycemic state (HHS) among adult patients with diabetes. The aim of this study was to evaluate the effect of gender on the outcome of these patients. Methodology: The National Inpatient Sample (NIS) was queried for all patients who were admitted with a diagnosis of hyperosmolar hyperglycemic state (HHS) during the years 2005-2014. The primary outcomes of the study were all-cause mortality, acute myocardial infarction (MI), and acute stroke. The secondary outcomes were acute kidney injury (AKI), rhabdomyolysis, acute respiratory failure (ARF), need for mechanical ventilation (MV), length of stay (LOS), and total cost of stay. Results: Overall, 188,725 patients were admitted for HHS. Mean age of males was 53.7, standard error of the mean (SEM: 0.13), and of females was 58.5 (SEM: 0.15), p<0.001. Females were (43.9%), Caucasians were 37.4% while African Americans were 35.2%. Total mortality was 1.1%, MI was 1.3% and stroke was 1.1%. Most common secondary outcome was AKI seen in 31.3% followed by ARF seen in 2.9% of total. The mean cost was 7887 $ (SEM: 84.6) and mean LOS was 4.1 days (SEM: 0.03). Both males and females had equivalent rates of mortality, stroke, ARF and need for mechanical ventilation. Compared to males, females had significantly higher risk for MI 1.6% vs 1.1%, p<0.001, lower risk for AKI 29.3% vs 32.9%, p<0.001, lower risk for rhabdomyolysis 1.1% vs 2%, p<0.001 and higher LOS 4.3 vs 3.9 days, p<0..01 and higher total costs 8165.6 $ vs 7669.3 $, p < 0.001. On multivariable analysis, female gender was independently predictive for higher risk for MI with adjusted odds ratio (aOR) 1.34 [95%CI: 1.08-1.67] p=0.01 and lower risk for rhabdomyolysis with aOR 0.52 [95%CI: 0.42-0.63] p<0.001 and lower risk for AKI with aOR 0.74 [95%CI: 0.7-0.78] p<0.001. In addition, female gender correlated with higher cost and length of stay. Conclusion: Females with hyperosmolar hyperglycemic state are at higher risk for MI and lower risk for AKI and rhabdomyolysis.

scholarly journals SUN-611 Impact of Existing Heart Failure on Outcomes of Hospitalization of Hyperosmolar Hyperglycemic State. From the National Inpatient Sample

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Fatima Ahmed ◽  
Ashraf Abugroun ◽  
Manar Elhassan ◽  
Berhane Seyoum
Keyword(s):  
Heart Failure ◽  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Length Of Stay ◽  
Secondary Outcome ◽  
Diabetic Patients ◽  
National Inpatient Sample ◽  
Patients With Heart Failure ◽  
Hyperosmolar Hyperglycemic State ◽  
The Impact

Abstract Introduction: Patients with underlying heart failure (HF) are at increased risk for hyperosmolar hyperglycemic state (HHS). However, no studies have investigated whether the presence of existing HF would impact the outcomes of HHS. Objective: we aimed to study the impact of heart HF on outcomes of HHS among adult patients hospitalized for HHS. Methodology: The National Inpatient Sample (NIS) was queried for all patients who were admitted with a diagnosis of hyperosmolar hyperglycemic state during the years 2005-2014. The primary outcomes of the study were all-cause mortality, acute myocardial infarction (MI), acute stroke. The secondary outcomes were acute kidney injury (AKI), rhabdomyolysis, acute respiratory failure (ARF), need for mechanical ventilation (MV), length of stay (LOS), and total cost of stay. Results: Overall, 188,725 patients were admitted for hyperosmolar hyperglycemic state. Mean age was 55.9 (SEM: 0.1). Females were (43.9%), Caucasians were 37.4% while African American were 35.2%. Total mortality was 1.1%, MI was 1.3% and stroke was 1.1%. Most common secondary outcome was AKI seen in 31.3% followed by ARF seen in 2.9% of total. The mean cost was 7887 $ (SEM: 84.6) and mean LOS was 4.1 days (SEM: 0.03). Patients with heart failure had higher rates for mortality 2% vs 0.9%, p<0.001, MI 3.1% vs 1.1 % p<0.001 and stroke 1.6% vs 1%, p<0.001. In addition, they had higher rates for AKI, ARF, need for mechanical ventilation, length of stay and cost. No significant difference on risk for rhabdomyolysis. On multivariable analysis, patients with heart failure had higher odds for mortality adjusted odd’s ratio (a OR) 1.58 [95%CI: 1.15-2.17] p<0.01 and higher risk for stroke a OR 1.43 [95%CI:1.04-1.95] p=0.03. In addition, presence of heart failure significantly correlated with ARF, need for mechanical ventilation, higher cost and longer LOS. No significant association was demonstrated between heart failure and risk for Rhabdomyolysis, MI and AKI. Conclusion: Diabetic patients with heart failure who develop hyperosmolar hyperglycemic state are at higher risk for stroke and mortality and respiratory failure. Particular attention on fluid balance as well as early recognition for signs of stroke is warranted.

Incidence and Outcomes of Ventilator-Associated Pneumonia in Japanese Intensive Care Units: The Japanese Nosocomial Infection Surveillance System

2007 ◽  
Vol 28 (3) ◽  
pp. 307-313 ◽  
Author(s):  
Machi Suka ◽  
Katsumi Yoshida ◽  
Hideo Uno ◽  
Jun Takezawa
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Length Of Stay ◽  
Nosocomial Infection ◽  
Patient Outcomes ◽  
Ventilator Associated Pneumonia ◽  
Drug Resistant ◽  
Icu Patients ◽  
The Mean ◽  
The Impact

Objectives.To determine the incidence of ventilator-associated pneumonia (VAP) among intensive care unit (ICU) patients in Japan and to assess the impact of VAP on patient outcomes, including mortality, length of stay, and duration of mechanical ventilation.Design.Multicenter cohort study.Setting.Twenty-eight ICUs in multidisciplinary Japanese hospitals with more than 200 beds.Patients.A total of 21,909 patients 16 years or older who were admitted to an ICU between June 2002 and June 2004, stayed in the ICU for 24 to 1,000 hours, and were not transferred to another ICU.Results.The overall infection rates for nosocomial pneumonia and VAP were 6.5 cases per 1,000 patient-days and 12.6 cases per 1,000 ventilator-days, respectively. The standardized mortality rates for the patients with VAP was 1.3 (95% confidence interval [CI], 1.1-1.6): 1.1 (95% CI, 0.9-1.4) for the cases due to drug-susceptible pathogens and 1.5 (95% CI, 1.1-1.9) for the cases due to drug-resistant pathogens. After adjusting for Acute Physiology and Chronic Health Evaluation II score, the mean length of stay for the patients with VAP caused by drug-susceptible pathogens (15.2 days [95% CI, 14.6-15.8]) and by drug-resistant pathogens (17.8 days [95% CI, 17.0-18.6]) was significantly longer than that in the patients without nosocomial infection (6.8 days [95% CI, 6.7-6.9]). The mean duration of mechanical ventilation in the patients with VAP caused by drug-susceptible pathogens (12.0 days [95% CI, 11.5-12.5]) and drug-resistant pathogens (14.1 days [95% CI, 13.5-14.8]) was significantly longer than that in the patients without nosocomial infection (4.7 days [95% CI, 4.6-4:8]).Conclusion.The incidence of VAP is substantial among ICU patients in Japan. The potential impact of VAP on patient outcomes emphasizes the importance of preventive measures against VAP, especially for VAP caused by drug-resistant pathogens.

scholarly journals SUN-625 The Impact of Age on Outcomes of Hyperosmolar Hyperglycemia Among Adult Patients with Diabetes. from the National Inpatient Sample

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Fatima Ahmed ◽  
Ashraf Abugroun ◽  
Manar Elhassan ◽  
Berhane Seyoum
Keyword(s):  
Middle Age ◽  
Age Groups ◽  
Adverse Outcomes ◽  
Older Age ◽  
National Inpatient Sample ◽  
Total Cost ◽  
Patients With Diabetes ◽  
The Mean ◽  
Secondary Outcomes ◽  
The Impact

Abstract Objective: There is paucity of literature on the impact of age on outcomes hyperosmolar hyperglycemic state (HHS) among adult patients with diabetes. The aim of the study was to evaluate the effect of age on the outcome of patients admitted for the management of HHS. Methodology: The National Inpatient Sample (NIS) was queried for all patients who were admitted with a diagnosis of HHS during the years 2005-2014. The primary outcomes of the study were all-cause mortality, acute myocardial infarction (MI), and acute stroke. The secondary outcomes were acute kidney injury (AKI), rhabdomyolysis, acute respiratory failure (ARF), need for mechanical ventilation (MV) length of stay (LOS), and total cost of stay. Results: Overall, 188,725 patients were admitted for HHS. Mean age was 55.9, standard error of the mean (SEM): 0.1. Majority were of middle age. Females were (43.9%), Caucasians were 37.4% while African Americans were 35.2%. Total mortality was 1.1%, MI was 1.3% and stroke was 1.1%. Most common secondary outcome was AKI seen in 31.3% followed by ARF seen in 2.9% of total. The mean cost was 7887 $ (SEM: 84.6) and mean LOS was 4.1 days (SEM: 0.03). Young age was defined as age ≤ 35 years, middle age was > 35 and ≤ 65 years, old age was > 65 years. Mortality was 0.3 %, 0.6%, 2.5% in young, middle and older aged groups respectively. Similarly, higher age correlated with increased risk for MI, stroke and all secondary outcomes. On multivariable analysis, age was an independent predictor for all adverse outcomes. Compared to young patients, middle and older age groups had higher odds for mortality with adjusted odds ratio (aOR) 2.23 [95%CI:1.10-4.52], p=0.03 and aOR 7.35 [95%CI: 3.27-16.53], p<0.001 respectively, higher risk for stroke with aOR 9.32 [95%CI: 2.92-29.7], p<0.001 and aOR 17.46 [95%CI:5.23-58.3], p<0.001 and higher risk for MI aOR 5.18 [95%CI:2.15-12.51], p<0.00 and aOR 5.80 [95%CI:2.27-14.80], p<0.00 for middle and older age groups respectively. In addition, compared to the younge age group, the risk for rhabdomyolysis, AKI, ARF, MV, total cost and LOS was significantly higher among middle and older age groups respectively. Conclusion: Age is an important determinant for adverse outcomes among patients with hyperosmolar hyperglycemic sate.

Impact of Antibiotic-Resistant Pathogens Colonizing the Respiratory Secretions of Patients in an Extended-Care Area of the Emergency Department

2003 ◽  
Vol 24 (5) ◽  
pp. 351-355 ◽  
Author(s):  
Sônia R. P. E. Dantas ◽  
M. Luiza Moretti-Branchini
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Mechanical Ventilation ◽  
Length Of Stay ◽  
Univariate Analysis ◽  
Antibiotic Resistant ◽  
Prolonged Stay ◽  
Nasogastric Intubation ◽  
Extended Care ◽  
The Mean

AbstractObjective:To determine the incidence of acquired infection, and the incidence, risk factors, and molecular typing of multidrug-resistant bacterial organisms (MROs) colonizing respiratory secretions or the oropharynx of patients in an extended-care area of the emergency department (ED) in a tertiary-care university hospital.Methods:A case-control study was conducted regarding risk factors for colonization with MROs in ED patients from July 1996 to August 1998. The most prevalent MRO strains were determined using plasmid and genomic analysis with PFGE.Results:MROs colonized 59 (25.4%) of 232 ED patients and 173 controls. The mean ED length of stay for the 59 cases was 13.9 days versus 9.8 days for the 173 controls. The mean length of stay prior to the first isolation of MROs was 9.9 days. MRO species included Acinetobacter baumannii, Staphylococcus aureus, and Pseudomonas aeruginosa. The rate of hospital-acquired infection was 32.7 per 1,000 ED patient-days. The case fatality rate was significantly higher for cases. Univariate analysis identified mechanical ventilation, nebulization, nasogastric intubation, urinary catheterization, antibiotic therapy, and number of antibiotics as risk factors for MRO colonization. Multivariate regression analysis found that mechanical ventilation and nasogastric intubation independently predicted MRO colonization. Endemic clones were identified by PFGE in ED patients and were also found in patients in other parts of the hospital.Conclusions:Prolonged stay in the ED posed a risk for colonization with MROs and for contracting nosocomial infections, both of which were associated with increased mortality. Patients colonized with antibiotic-resistant A. baumannii may serve as a reservoir for spread in this hospital.

65Utilization of percutaneous left atrial appendage closure in patients with atrial fibrillation in the United States: analysis from national inpatient sample 2016

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Wu ◽  
K Ho
Keyword(s):  
Length Of Stay ◽  
Left Atrial Appendage ◽  
National Inpatient Sample ◽  
Left Atrial Appendage Closure ◽  
Total Cost ◽  
The Us ◽  
Comorbidity Index ◽  
The Mean ◽  
Mean Time ◽  
Related Mortality

Abstract Introduction/Background In recent years, the percutaneous left atrial appendage closure (LAAC) has been gaining its popularity in the US. However its use in the US in recent years has not been well described. Purpose To provide an updated cross-sectional survey of performance of percutaneous LAAC in the US at national database level. Methods We use ICD-10 disease and procedure code to identify all the percutaneous LAAC performed in 2016 in US from national inpatient sample database. The demographic feature, comorbidity, mean time to procedure, mortality, complication rate, length of stay, total cost were described. Procedure related complication Including any vascular, cardiac, respiratory, neurologic and renal complications defined by AHRQ as patient safety indicators. Results There is approximately a total of 7550 percutaneous LAAC performed in the US in 2016. The majority of the patients were elderly (mean age 66.83±0.34), white (80.41%) male (59.04%). The mean Charlson Comorbidity Index score is 1.74, with hypertension (76.75%), diabetes (29.23%) being the most common comorbidity. The mean time to procedure is 1.98±0.11 days. The procedure related mortality is 2.06%, whereas the complication rate is 19.6%. The average length of stay is 10.77 day, with an average total cost of 239.67 thousand dollars. Baseline characterlistisc and outcomes Total percutaneous LAAC (estimated from sample) 7550 Age, years 66.83±0.34 Male, % 59.04 White, % 80.41 Mean Charlson Comorbidity Index 1.74±0.31 Hypertension, % 76.75 Diabetes, % 29.23 CKD, % 21.42 Mean Time to procedure, days 1.98±0.11 Mortality, % 2.06 Length of Stay, days 10.77±0.25 Any Complication, % 19.6 Total Cost, thousand dollars 239.67±10.01 Values are reported as mean ± SD. Categorical variables are represented as frequency. Conclusion A total of 7550 percutaneous LAAC was performed in US in 2016. The procedure related mortality is 2.06%, with an average time to procedure of 1.98 days and a length of stay of 10.77 days.

scholarly journals P139: The impact of a pancreatitis admission algorithm on emergency department length of stay in a tertiary care academic hospital

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S114-S115
Author(s):  
A. Albina ◽  
F. Kegel ◽  
F. Dankoff ◽  
G. Clark
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Tertiary Care ◽  
Physician Satisfaction ◽  
Academic Hospital ◽  
Before And After ◽  
Potential Applicability ◽  
The Mean ◽  
Algorithm Implementation ◽  
The Impact

Background: Emergency department (ED) overcrowding is associated with a broad spectrum of poor medical outcomes, including medical errors, mortality, higher rates of leaving without being seen, and reduced patient and physician satisfaction. The largest contributor to overcrowding is access block – the inability of admitted patients to access in-patient beds from the ED. One component to addressing access block involves streamlining the decision process to rapidly determine which hospital service will admit the patient. Aim Statement: As of Sep 2011, admission algorithms at our institution were supported and formalised. The pancreatitis algorithm clarified whether general surgery or internal medicine would admit ED patients with pancreatitis. We hypothesize that this prior uncertainty delayed the admission decision and prolonged ED length of stay (LOS) for patients with pancreatitis. Our project evaluates whether implementing a pancreatitis admission algorithm at our institution reduced ED time to disposition (TTD) and LOS. Measures & Design: A retrospective review was conducted in a tertiary care academic hospital in Montreal for all adult ED patients diagnosed with pancreatitis from Apr 2010 to Mar 2014. The data was used to plot separate run charts for ED TTD and LOS. Serial measurements of each outcome were used to monitor change and evaluate for special cause variation. The mean ED LOS and TTD before and after algorithm implementation were also compared using the Student's t test. Evaluation/Results: Over four years, a total of 365 ED patients were diagnosed with pancreatitis and 287 (79%) were admitted. The mean ED LOS for patients with pancreatitis decreased following the implementation of an admission algorithm (1616 vs. 1418 mins, p = 0.05). The mean ED TTD was also reduced (1171 vs. 899 mins, p = 0.0006). A non-random signal of change was suggested by a shift above the median prior to algorithm implementation and one below the median following. Discussion/Impact: This project demonstrates that in a busy tertiary care academic hospital, an admission algorithm helped reduce ED TTD and LOS for patients with pancreatitis. This proves especially valuable when considering the potential applicability of such algorithms to other disease processes, such as gastrointestinal bleeding and congestive heart failure, among others. Future studies demonstrating this external applicability, and the impact of such decision algorithms on physician decision fatigue and within non-academic institutions, proves warranted.

Comparison of Fixed-Dose Inhaled Epoprostenol and Inhaled Nitric Oxide for Acute Respiratory Distress Syndrome in Critically Ill Adults

2020 ◽  
pp. 088506662090680 ◽  
Author(s):  
Mitchell S. Buckley ◽  
Sumit K. Agarwal ◽  
Roxanne Garcia-Orr ◽  
Rajeev Saggar ◽  
Robert MacLaren
Keyword(s):  
Nitric Oxide ◽  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Length Of Stay ◽  
Respiratory Distress Syndrome ◽  
Clinical Outcomes ◽  
Distress Syndrome ◽  
Cost Savings ◽  
Fixed Dose ◽  
The Mean

Purpose: Several reports have demonstrated similar effects on oxygenation between inhaled epoprostenol (iEPO) compared to inhaled nitric oxide (iNO) for acute respiratory distress syndrome (ARDS). Previous studies directly comparing oxygenation and clinical outcomes between iEPO and iNO exclusively in an adult ARDS patient population utilized a weight-based dosing strategy. The purpose of this study was to compare the clinical and economic impact between iNO and fixed-dosed iEPO for ARDS in adult intensive care unit (ICU) patients. Methods: This retrospective cohort study was conducted at a major academic medical center between January 1, 2014, and October 31, 2018. Patients ≥18 years of age with moderate-to-severe ARDS were included. The primary end point was to compare the mean change in partial arterial oxygen pressure to fraction of inspired oxygen (Pao 2: Fio 2) at 4 hours from baseline between iEPO and iNO. Other secondary aims were total acquisition drug costs, in-hospital mortality, ICU and hospital length of stay, and duration of mechanical ventilation. Results: A total of 239 patients were included with 139 (58.2%) and 100 (41.8%) in the iEPO and iNO groups, respectively. The mean change in Pao 2: Fio 2 at 4 hours from baseline in the iEPO and iNO groups were 31.4 ± 54.6 and 32.4 ± 42.7 mm Hg, respectively ( P = .88). The responder rate at 4 hours was similar between iEPO and iNO groups (64.7% and 66.0%, respectively, P = .84). Clinical outcomes including mortality, overall hospital and ICU length of stay, and mechanical ventilation duration were similar between iEPO and iNO groups. Estimated annual cost-savings realized with iEPO was USD1 074 433. Conclusion: Fixed-dose iEPO was comparable to iNO in patients with moderate-to-severe ARDS for oxygenation and ventilation parameters as well as clinical outcomes. Significant cost-savings were realized with iEPO use.

scholarly journals Impact of a specialist service in the Emergency Department on admission, length of stay and readmission of patients presenting with falls, syncope and dizziness

QJM ◽  
2020 ◽  
Author(s):  
K Jusmanova ◽  
C Rice ◽  
R Bourke ◽  
A Lavan ◽  
C G McMahon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Admission Rate ◽  
Readmission Rates ◽  
Specialist Service ◽  
Admission Rates ◽  
Potential Benefits ◽  
Bed Days ◽  
The Mean ◽  
The Impact

Summary Background Up to half of patients presenting with falls, syncope or dizziness are admitted to hospital. Many are discharged without a clear diagnosis for their index episode, however, and therefore a relatively high risk of readmission. Aim To examine the impact of ED-FASS (Emergency Department Falls and Syncope Service) a dedicated specialist service embedded within an ED, seeing patients of all ages with falls, syncope and dizziness. Design Pre- and post-cohort study. Methods Admission rates, length of stay (LOS) and readmission at 3 months were examined for all patients presenting with a fall, syncope or dizziness from April to July 2018 (pre-ED-FASS) inclusive and compared to April to July 2019 inclusive (post-ED-FASS). Results There was a significantly lower admission rate for patients presenting in 2019 compared to 2018 [27% (453/1676) vs. 34% (548/1620); X2 = 18.0; P < 0.001], with a 20% reduction in admissions. The mean LOS for patients admitted in 2018 was 20.7 [95% confidence interval (CI) 17.4–24.0] days compared to 18.2 (95% CI 14.6–21.9) days in 2019 (t = 0.98; P = 0.3294). This accounts for 11 344 bed days in the 2018 study period, and 8299 bed days used after ED-FASS. There was also a significant reduction in readmission rates within 3 months of index presentation, from 21% (109/1620) to 16% (68/1676) (X2 = 4.68; P = 0.030). Conclusion This study highlights the significant potential benefits of embedding dedicated multidisciplinary services at the hospital front door in terms of early specialist assessment and directing appropriate patients to effective ambulatory care pathways.

The impact of time to tracheostomy on mechanical ventilation duration, length of stay, and mortality in intensive care unit patients

2009 ◽  
Vol 24 (3) ◽  
pp. 435-440 ◽  
Author(s):  
Yaseen M. Arabi ◽  
Jamal A. Alhashemi ◽  
Hani M. Tamim ◽  
Andres Esteban ◽  
Samir H. Haddad ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Length Of Stay ◽  
Ventilation Duration ◽  
Mechanical Ventilation Duration ◽  
The Impact

The Epidemiology and Clinical Associations of Stroke in Patients with Acute Myeloid Leukemia: A Review of 10,972 Admissions from the 2012 National Inpatient Sample

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 1314-1314
Author(s):  
Taeha Kim ◽  
Joseph Shatzel ◽  
Harley Friedman ◽  
Frederick Lansigan
Keyword(s):  
Mechanical Ventilation ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Length Of Stay ◽  
Myeloid Leukemia ◽  
Hospitalized Patients ◽  
National Database ◽  
National Inpatient Sample ◽  
Inpatient Mortality ◽  
Clinical Associations

Abstract Background: Patients withacute myeloid leukemia (AML) are at increased risk for both hemorrhage and thrombosis, including in the central nervous system. There is limited data on the incidence, clinical association and mortality associated with cerebrovascular accident (CVA) in hospitalized patients with active AML. The aim of this study is to evaluate the epidemiology and mortality of hospitalized patients with AML who suffered concurrent stroke from a large national database. Methods: Using the 2012 National Inpatient Sample (NIS), admissions with an International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes for AML without remission and AML in relapse (205.00 and 205.02, respectively) were extracted, and correlated with age, gender, length of stay and mortality. All CVA (ICD-9-CM 434.91) data were extracted as well for comparison of mortality, length of stay (LOS). Results: Of the 7,296,968 unweighted admissions in the 2012 NIS, 9384 involved AML patients who had not yet achieved remission, and 1600 involved relapsed AML (Prevalence of 0.12% and 0.021% respectively). Of the combined group of admitted patients with active AML (N=10,984), 65 patients (0.59%) had a concomitant CVA (either hemorrhagic or ischemic, of whom 56 (0.51%) had active disease and 9 (0.08%) had relapsed disease). Compared to all other active AML patients, those who developed stroke were older (Mean age 66 y/o vs 58 y/o P=0.003), had longer LOS (20 days vs 12 days P= 0.53), were predominantly female (55% vs 45%; p=0.078) and had significantly higher inpatient mortality rates (36.9% vs 10.5%; OR 3.5; 95%CI 2.2, 5.5; P<0.0001). AML patients with CVA had significantly higher inpatient mortality then all admitted patients with stroke (36.9% vs 6.7%; OR 5.5; 95%CI 3.5, 8.8; P<0.0001). Multivariate logistic regression attempting to find significant clinical associations in AML patients who develop stroke, after controlling for confounding variables, found that acute renal failure with tubular necrosis(OR 4.47; 95%CI 1.8, 11.2; P=0.0013), hypernatremia (OR 3.85; 95%CI 1.6, 9.1; P=0.002), urinary tract infection (OR 3.28; CI95% 1.8, 6.1; P=0.0002) and secondary thrombocytopenia (OR 2.92; 95%CI 1.5, 5.7; P=0.0018) were all significantly predictive, as were mechanical ventilation >96 hours (OR 4.92; CI95% 1.02, 23.6; P=0.047) and continuous positive airway pressure ventilation (OR 3.03; CI95% 1.11, 8.26; P=0.031). Disseminated intravascular coagulation (DIC) and leukocytosis were more prevalent in AML patients with CVA compare to all AML patients, but the difference did not reach statistical significance. Conclusions: CVA in patients with active AML was strongly associated with older age and higher mortality, and appeared to be a relatively rare event, occurring in only 0.59% of patients. There was no statistically significant difference in LOS or gender distribution between those who developed CVA and those who did not amont active AML patients. As compared to all CVA patients, active AML patients with CVA had 5-fold higher risk of mortality. Significant acute renal failure, hypernatremia and thrombocytopenia appear to portend a higher risk of stroke in patients with active AML. It is unclear if UTI, and the need for mechanical ventilation is a predictor of stroke, as much as they may be a ramification of it. While more common in AML patients with CVA vs AML patients without CVA, we did not find DIC or hyperleukocytosis to be significantly predictive. Disclosures No relevant conflicts of interest to declare.

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